Hemophagocytic syndrome secondary to tuberculosis at 24-week gestation.

Hemophagocytic syndrome is a life-threatening disease characterized by the uncontrolled activation of macrophages, resulting in hemophagocytosis of blood cells in the bone marrow. A 20-year-old gravida at 23-week and 5-day gestation was admitted to hospital to evaluate fever up to 104°F of unknown origin, moderate cytopenia, and elevated levels of liver enzymes. Bone marrow biopsy confirmed hemophagocytic syndrome, and polymerase chain reaction came back positive for Mycobacterium tuberculosis. Supportive care and tuberculosis treatment resulted in clinical improvement. At 27 weeks and 5 days, premature rupture of the membranes occurred, and because of the high probability of reactivating the hemophagocytic syndrome, a cesarean section was performed at 29-week and 2-day gestation. Hemophagocytic syndrome is an uncommon disease which rarely appears during pregnancy. Early diagnosis and treatment can save both maternal and fetal lives.

[A surveillance system for the study of the circulation of influenza in Madrid during the 1986-1991 quinquennium. The Influenza Surveillance Group of Madrid]. / Sistema de vigilancia para el estudio de la circulación gripal en Madrid durante el quinquenio 1986-1991. Grupo de Vigilancia de Gripe de Madrid.

BACKGROUND: The creation of a surveillance system allowing the study of the evolution of the tendency of influenza and act as an alert system for undertaking control measures is necessary due to the great variability characteristic of the circulation of influenza virus. The Madrid Influenza Surveillance Group was therefore designed. The activity carried out during its first five years of existence is evaluated. METHODS: The field work of the Group is based on the clinical study of patients with influenza, among which some are selected for virologic study with the aim to isolate and characterize the circulating virus. The data obtained by the work group itself are used as the dates of the System of Obligatory Disease Declaration and the System of Microbiologic Information as epidemiologic support to define the outbreaks observed. RESULTS: All the virus isolated were similar to those recommended by the World Health Organization for their inclusion in anti-influenza vaccination, with their circulation being largely reproduced throughout Europe. In three of the five seasons studied the type A virus prevailed leading to earlier outbreaks and a greater number of cases than in the two seasons with type B prevalence. CONCLUSIONS: The circulation of the influenza virus in Madrid coincides with that of the rest of Spain at both the maximum peak and relative incidence as well as the type of prevailing virus. The minor circulation detected by the Madrid Group is in concordance with the data provided by the other autonomic communities.

[Contraception in immigrant women: influence of sociocultural aspects on the choice of contraceptive method]. / Anticoncepción en la mujer inmigrante: influencia de los aspectos socioculturales en la elección del método anticonceptivo.

There are currently 6 million immigrants living in Spain. Half of them are women, the majority of whom are of childbearing age. These women, who suffer high rates of induced abortion, form a special group who require a special approach to their reproductive health. In order to study the use of contraceptive methods in this population, a review was made of 1100 clinical histories from our Sexual Health and Reproduction Clinic. Latin American women were the most prevalent group who came to seek information about contraception, followed by Eastern Europeans and Moroccans. Fewer Asian and Sub-Saharan women sought these services. The contraceptives most frequently used were the intrauterine device (used mostly by Latin American and Eastern European women), and combined oral contraception, most used by Moroccan women. It is important to advise the immigrant women about contraceptive methods, taking into account their preferences, in order to improve adherence to the method.

Anticoncepción en la mujer inmigrante: influencia de los aspectos socioculturales en la elección del método anticonceptivo / Contraception in immigrant women: influence of sociocultural aspects on the choice of contraceptive method

Actualmente residen en nuestro país 6 millones de inmigrantes. La mitad son mujeres, la mayoría en edad fértil. Son un grupo de especial problemática, con altas tasas de interrupción voluntaria de embarazo (IVE) en el que es fundamental abordar su salud reproductiva. Hemos dilucidado cómo es el uso de métodos anticonceptivos por esta población. Para ello revisamos 1.100 historias de nuestra consulta de salud sexual y reproducción. El colectivo más prevalente que acude a nosotros en busca de información son las latinoamericanas, seguidas por europeas del Este y marroquíes, y en menor proporción asiáticas y subsaharianas. Los anticonceptivos más utilizados son el DIU, sobre todo latinoamericanas y europeas del Este, y los anticonceptivos orales combinados, más utilizados entre las marroquíes. Es importante informar a las mujeres inmigrantes sobre anticoncepción, teniendo en cuenta sus preferencias, para aumentar la adherencia al tratamiento y disminuir las altas tasas de IVE (AU)

There are currently 6 million immigrants living in Spain. Half of them are women, the majority of whom are of childbearing age. These women, who suffer high rates of induced abortion, form a special group who require a special approach to their reproductive health. In order to study the use of contraceptive methods in this population, a review was made of 1100 clinical histories from our Sexual Health and Reproduction Clinic. Latin American women were the most prevalent group who came to seek information about contraception, followed by Eastern Europeans and Moroccans. Fewer Asian and Sub-Saharan women sought these services. The contraceptives most frequently used were the intrauterine device (used mostly by Latin American and Eastern European women), and combined oral contraception, most used by Moroccan women. It is important to advise the immigrant women about contraceptive methods, taking into account their preferences, in order to improve adherence to the method (AU)