Antecedentes: El embarazo de gemelos monocoriales tienen un mayor riesgo de mortalidad y morbilidad perinatal, que la gestación única y el embarazo gemelar bicorial. Objetivos: Estudiar la incidencia ...y el manejo de las complicaciones fetales propias de las gestaciones gemelares monocoriales biamnióticas. Métodos: Se realizó un análisis retrospectivo de 94 embarazos gemelares monocoriales biamnióticos, seguidos en las Consultas de Tocología de Alto Riesgo del Hospital Universitario La Paz de Madrid, entre 2008 y 2010. Resultados: Se recogieron 94 gestaciones monocoriales biamnióticas. Aparecieron complicaciones fetales en el 23,4% de las mismas: síndrome de transfusión feto-fetal en el 9,57% de los casos, retraso del crecimiento intrauterino selectivo en el 11,7 %, muerte fetal intrauterina en el 2,1%, y malformaciones fetales en el 7,4%. Conclusiones: Las gestaciones monocoriales biamnióticas son un tipo de embarazo gemelar de alto riesgo, asociado con más complicaciones fetales y muerte perinatal. Se recomienda un estrecho seguimiento ecográfico cada 2 semanas, desde la semana 16, para diagnosticar y tratar precozmente las complicaciones fetales.
La hemorragia posparto es la principal causa de muerte obstétrica. Presentamos el caso de una gestación y parto normales tras la embolización bilateral de ambas arterias uterinas, por hemorragia ...posparto en la gestación anterior. La paciente requirió de una nueva embolización bilateral de arterias uterinas en esta segunda gestación con buen resultado obstétrico. La embolización arterial pélvica en el manejo de la hemorragia posparto refractaria al tratamiento médico, permite en ocasiones evitar el tratamiento quirúrgico, conservando la fertilidad de la paciente.The postpartum hemorrhage is the main cause of obstetric death. We report a case of normal pregnancy and delivery after bilateral embolization of uterine arteries due to postpartum hemorrhage in a previous pregnancy. A new bilateral embolization of uterine arteries was needed in this second pregnancy with good obstetric results. The pelvic arterial embolization in the management of postpartum hemorrhage refractory to medical treatment, avoids the surgical treatment, preserving fertility.
La hemorragia posparto es la principal causa de muerte obstétrica. Presentamos el caso de una gestación y parto normales tras la embolización bilateral de ambas arterias uterinas, por hemorragia ...posparto en la gestación anterior. La paciente requirió de una nueva embolización bilateral de arterias uterinas en esta segunda gestación con buen resultado obstétrico. La embolización arterial pélvica en el manejo de la hemorragia posparto refractaria al tratamiento médico, permite en ocasiones evitar el tratamiento quirúrgico, conservando la fertilidad de la paciente.
Antecedentes: El embarazo de gemelos monocoriales tienen un mayor riesgo de mortalidad y morbilidad perinatal, que la gestación única y el embarazo gemelar bicorial. Objetivos: Estudiar la incidencia ...y el manejo de las complicaciones fetales propias de las gestaciones gemelares monocoriales biamnióticas. Métodos: Se realizó un análisis retrospectivo de 94 embarazos gemelares monocoriales biamnióticos, seguidos en las Consultas de Tocología de Alto Riesgo del Hospital Universitario La Paz de Madrid, entre 2008 y 2010. Resultados: Se recogieron 94 gestaciones monocoriales biamnióticas. Aparecieron complicaciones fetales en el 23,4% de las mismas: síndrome de transfusión feto-fetal en el 9,57% de los casos, retraso del crecimiento intrauterino selectivo en el 11,7 %, muerte fetal intrauterina en el 2,1%, y malformaciones fetales en el 7,4%. Conclusiones: Las gestaciones monocoriales biamnióticas son un tipo de embarazo gemelar de alto riesgo, asociado con más complicaciones fetales y muerte perinatal. Se recomienda un estrecho seguimiento ecográfico cada 2 semanas, desde la semana 16, para diagnosticar y tratar precozmente las complicaciones fetales.Background: The monochorionic twin pregnancy has a higher risk of perinatal mortality and morbidity, than the single gestation and the dichorionic twin gestation. Objectives: To detail the incidence and management of specific fetal complications of monochorionic diamniotic twin pregnancies. Methods: We performed a retrospective analysis of monochorionic diamniotic pregnancies followed in the High Risk Obstetrics Unit of the University Hospital La Paz, Madrid, between 2008-2010. Results: We collected 94 monochorionic diamniotic pregnancies. Fetal complications occurred in 23.4% of them: feto-fetal transfusion syndrome in 9.57% of cases, selective intrauterine growth retardation in 11.7%, stillbirth in 2.1%, and fetal malformations in 7.4%. Conclusions: Monochorionic diamniotic twin pregnancies are a high-risk type of twin pregnancy, associated with an increased risk of death and perinatal complications. Ultrasound monitoring is recommended for uncomplicated monochorionic pregnancies every 2 weeks from week 16, to detect and treat fetal complications.
A panel of experts was convened by the Infectious Diseases Society of America (IDSA) to update the 2004 clinical practice guideline on outpatient parenteral antimicrobial therapy (OPAT) 1. This ...guideline is intended to provide insight for healthcare professionals who prescribe and oversee the provision of OPAT. It considers various patient features, infusion catheter issues, monitoring questions, and antimicrobial stewardship concerns. It does not offer recommendations on the treatment of specific infections. The reader is referred to disease- or organism-specific guidelines for such support.
Background: Curcumin, a natural polyphenol product of the plant Curcuma longa, has been shown to inhibit the growth and progression
of colorectal cancer; however, the anticancer mechanism of curcumin ...remains to be elucidated. Materials and Methods: Colorectal
cancer cells were treated with curcumin and changes in proliferation, protein and mRNA levels were analyzed. Results: Curcumin
inhibited proliferation of colorectal cancer cells. This effect was mediated by inhibition of mammalian target of rapamycin
(mTOR) signaling as evidenced by decreased phosphorylation of downstream effectors of mTOR complex 1 (mTORC1), p70S6K and
4E-BP1. Curcumin decreased total expression of mTOR, Raptor and Rictor protein and mRNA levels. Surprisingly, curcumin induced
phosphorylation of Akt(Ser 473); this effect may be attributed to a decrease in levels of the PHLPP1 phosphatase, an inhibitor
of Akt. Conclusion: Our data suggest that curcumin, a natural compound, may exert its antiproliferative effects by inhibition
of mTOR signaling and thus may represent a novel class of mTOR inhibitor.
A panel of experts was convened by the Infectious Diseases Society of America to update the 2004 clinical practice guideline on outpatient parenteral antimicrobial therapy (OPAT) 1. This guideline is ...intended to provide insight for healthcare professionals who prescribe and oversee the provision of OPAT. It considers various patient features, infusion catheter issues, monitoring questions, and antimicrobial stewardship concerns. It does not offer recommendations on the treatment of specific infections. The reader is referred to disease- or organism-specific guidelines for such support.
Abstract
A panel of experts was convened by the Infectious Diseases Society of America (IDSA) to update the 2004 clinical practice guideline on outpatient parenteral antimicrobial therapy (OPAT) 1. ...This guideline is intended to provide insight for healthcare professionals who prescribe and oversee the provision of OPAT. It considers various patient features, infusion catheter issues, monitoring questions, and antimicrobial stewardship concerns. It does not offer recommendations on the treatment of specific infections. The reader is referred to disease- or organism-specific guidelines for such support.
To assess the real-world performance of MiniMed™ 780G for Australians with type 1 diabetes (T1D) following advanced hybrid closed loop (AHCL) activation and to evaluate the effect of changing from ...MiniMed 670/770G to 780G.
We analyzed deidentified Carelink™ continuous glucose monitoring (CGM) data from Australian users from January 2020 to December 2022, including the proportion attaining three major consensus targets: Glucose management indicator (GMI <7.0%), time in range (TIR 70-180 mg/dL >70%), and time below range (TBR 70 mg/dL <4%).
Comparing 670/770G users (
= 5676) for mean ± standard deviation 364 ± 244 days with 780G users (
= 3566) for 146 ± 145 days, the latter achieved a higher TIR (72.6% ± 10.6% vs. 67.3% ± 11.4%;
< 0.001), lower time above range (TAR) (25.5% ± 10.9% vs. 30.6% ± 11.7%;
< 0.001), and lower GMI (6.9% ± 0.4% vs. 7.2% ± 0.4%;
< 0.001) without compromising TBR (1.9% ± 1.8% vs. 2.0% ± 1.8%;
= 0.0015). Of 1051 670/770G users transitioning to 780G, TIR increased (70.0% ± 10.7% to 74.0% ± 10.2%;
< 0.001), TAR decreased (28.1% ± 10.9% to 24.0% ± 10.7%;
< 0.001), and TBR was unchanged. The percentage of users attaining all three CGM targets was higher in 780G users (50.1% vs. 29.5%;
< 0.001). CGM metrics were stable at 12 months post-transition.
Real-world data from Australia shows that a higher proportion of MiniMed 780G users meet clinical targets for CGM consensus metrics compared to MiniMed 670/770G users and glucose control was sustained over 12 months.
Abstract
A panel of experts was convened by the Infectious Diseases Society of America to update the 2004 clinical practice guideline on outpatient parenteral antimicrobial therapy (OPAT) 1. This ...guideline is intended to provide insight for healthcare professionals who prescribe and oversee the provision of OPAT. It considers various patient features, infusion catheter issues, monitoring questions, and antimicrobial stewardship concerns. It does not offer recommendations on the treatment of specific infections. The reader is referred to disease- or organism-specific guidelines for such support.
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