The perinatal consequences of SARS-CoV-2 infection are still largely unknown. This study aimed to describe the features and outcomes of pregnant women with or without SARS-CoV-2 infection after the ...universal screening was established in a large tertiary care center admitting only obstetric related conditions without severe COVID-19 in Mexico City. This retrospective case-control study integrates data between April 22 and May 25, 2020, during active community transmission in Mexico, with one of the highest COVID-19 test positivity percentages worldwide. Only pregnant women and neonates with a SARS-CoV-2 result by quantitative RT-PCR were included in this study. Among 240 pregnant women, the prevalence of COVID-19 was 29% (95% CI, 24% to 35%); 86% of the patients were asymptomatic (95% CI, 76%-92%), nine women presented mild symptoms, and one patient moderate disease. No pregnancy baseline features or risk factors associated with severity of infection, including maternal age > 35 years, Body Mass Index >30 kg/m2, and pre-existing diseases, differed between positive and negative women. The median gestational age at admission for both groups was 38 weeks. All women were discharged at home without complications, and no maternal death was reported. The proportion of preeclampsia was higher in positive women than negative women (18%, 95% CI, 10%-29% vs. 9%, 95% CI, 5%-14%, P<0.05). No differences were found for other perinatal outcomes. SARS-CoV-2 test result was positive for nine infants of positive mothers detected within 24h of birth. An increased number of infected neonates were admitted to the NICU, compared to negative neonates (44% vs. 22%, P<0.05) and had a longer length of hospitalization (2 2-18 days vs. 2 2-3 days, P<0.001); these are potential proxies for illness severity. This report highlights the importance of COVID-19 detection at delivery in pregnant women living in high transmission areas.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
(1) This study aimed to evaluate characteristics, perinatal outcomes, and placental pathology of pregnant women with or without SARS-CoV-2 infection in the context of maternal PCR cycle threshold ...(CT) values. (2) This was a retrospective case-control study in a third-level health center in Mexico City with universal screening by RT-qPCR. The association of COVID-19 manifestations, preeclampsia, and preterm birth with maternal variables and CT values were assessed by logistic regression models and decision trees. (3) Accordingly, 828 and 298 women had a negative and positive test, respectively. Of those positive, only 2.6% of them presented mild to moderate symptoms. Clinical characteristics between both groups of women were similar. No associations between CT values were found for maternal features, such as pre-gestational BMI, age, and symptomatology. A significantly higher percentage of placental fibrinoid was seen with women with low CTs (<25; p < 0.01). Regarding perinatal outcomes, preeclampsia was found to be significantly associated with symptomatology but not with risk factors or CT values (p < 0.01, aOR = 14.72). Moreover, 88.9% of women diagnosed with COVID-19 at <35 gestational weeks and symptomatic developed preeclampsia. (4) The data support strong guidance for pregnancies with SARS-CoV-2 infection, in particular preeclampsia and placental pathology, which need further investigation.
Tuberculosis intestinal perforada y embarazo Villagrana-Zesati, JR; Cepeda-Silva; Araiza-Illán, MA ...
Ginecologia y obstetricia de Mexico,
2017, Letnik:
85, Številka:
8
Journal Article
Odprti dostop
Resumen ANTECEDENTES: el abdomen representa el sexto lugar más frecuente de manifestación extrapulmonar de la tuberculosis; esta enfermedad puede afectar cualquier parte del tubo gastrointestinal, ...peritoneo y sistema hepatobiliar. OBJETIVO: reportar una variante adicional de tuberculosis intestinal, enfermedad reconocida como “la gran simuladora”, relacionada con el embarazo. CASO CLÍNICO: paciente primigesta de 17 años de edad, sin antecedentes de importancia para el padecimiento actual, asintomática, sin afectación inmunológica, con tuberculosis intestinal y múltiples perforaciones y hallazgos transcesárea. El diagnóstico se estableció luego de efectuar estudios microbiológicos e histopatológicos. La evolución de la madre y el recién nacido fue satisfactoria y ambos continuaron con tratamiento antifímico. CONCLUSIÓN: pese a los grandes avances en medicina, la tuberculosis sigue siendo un grave problema de salud pública con una alta tasa de morbilidad y mortalidad. El hallazgo transcesárea, la fuerte sospecha de tuberculosis y el tratamiento oportuno limitaron la morbilidad y mortalidad de nuestra paciente.
Introducción: La corioamnionitis es común durante el embarazo y se asocia con diversas complicaciones perinatales; entre los problemas neonatales más frecuentes están: parto pretérmino, sepsis ...neonatal, enfermedad pulmonar crónica, lesión cerebral secundaria a infección y trastornos del desarrollo neurológico. Es necesario conocer el riesgo de sepsis neonatal temprana en recién nacidos hijos de madres con corioamnionitis, con la intención de plantear estrategias para su prevención y tratamiento. Objetivos: Determinar el grado de asociación entre la corioamnionitis materna y la aparición de sepsis neonatal temprana. Métodos: Se realizó un estudio de casos y controles donde se incluyeron 148 pacientes divididos en dos grupos: grupo I, los casos, hijos de madres con corioamnionitis (n = 74), y grupo II, control, neonatos sin antecedente de corioamnionitis materna (n = 74). Resultados: El grupo de madres con corioamnionitis tuvo menor control prenatal y sus recién nacidos, a pesar de haber recibido antibiótico profiláctico, tuvieron una mayor frecuencia de sepsis y problemas respiratorios. Conclusiones: Los hijos de madres con corioamnionitis tienen un incremento en el riesgo de presentar sepsis neonatal temprana.
The escalating prevalence of Type 2 Diabetes (T2D) represents a substantial burden on global healthcare systems, especially in regions such as Mexico. Existing diagnostic techniques, although ...effective, often require invasive procedures and labor-intensive efforts. The promise of artificial intelligence and data science for streamlining and enhancing T2D diagnosis is well-recognized; however, these advancements are frequently constrained by the limited availability of comprehensive patient datasets. To mitigate this challenge, the present study investigated the efficacy of Generative Adversarial Networks (GANs) for augmenting existing T2D patient data, with a focus on a Mexican cohort. The researchers utilized a dataset of 1019 Mexican nationals, divided into 499 non-diabetic controls and 520 diabetic cases. GANs were applied to create synthetic patient profiles, which were subsequently used to train a Random Forest (RF) classification model. The study’s findings revealed a notable improvement in the model’s diagnostic accuracy, validating the utility of GAN-based data augmentation in a clinical context. The results bear significant implications for enhancing the robustness and reliability of Machine Learning tools in T2D diagnosis and management, offering a pathway toward more timely and effective patient care.
This work presents a human activity recognition (HAR) model based on audio features. The use of sound as an information source for HAR models represents a challenge because sound wave analyses ...generate very large amounts of data. However, feature selection techniques may reduce the amount of data required to represent an audio signal sample. Some of the audio features that were analyzed include Mel-frequency cepstral coefficients (MFCC). Although MFCC are commonly used in voice and instrument recognition, their utility within HAR models is yet to be confirmed, and this work validates their usefulness. Additionally, statistical features were extracted from the audio samples to generate the proposed HAR model. The size of the information is necessary to conform a HAR model impact directly on the accuracy of the model. This problem also was tackled in the present work; our results indicate that we are capable of recognizing a human activity with an accuracy of 85% using the HAR model proposed. This means that minimum computational costs are needed, thus allowing portable devices to identify human activities using audio as an information source.
Protected areas are of paramount relevance to conserving wildlife and ecosystem contributions to people. Yet, their conservation success is increasingly threatened by human activities including ...habitat loss, climate change, pollution, and species overexploitation. Thus, understanding the underlying and proximate drivers of anthropogenic threats is urgently needed to improve protected areas' effectiveness, especially in the biodiversity-rich tropics. We addressed this issue by analyzing expert-provided data on long-term biodiversity change (last three decades) over 14 biosphere reserves from the Mesoamerican Biodiversity Hotspot. Using multivariate analyses and structural equation modeling, we tested the influence of major socioeconomic drivers (demographic, economic, and political factors), spatial indicators of human activities (agriculture expansion and road extension), and forest landscape modifications (forest loss and isolation) as drivers of biodiversity change. We uncovered a significant proliferation of disturbance-tolerant guilds and the loss or decline of disturbance-sensitive guilds within reserves causing a "winner and loser" species replacement over time. Guild change was directly related to forest spatial changes promoted by the expansion of agriculture and roads within reserves. High human population density and low nonfarming occupation were identified as the main underlying drivers of biodiversity change. Our findings suggest that to mitigate anthropogenic threats to biodiversity within biosphere reserves, fostering human population well-being via sustainable, nonfarming livelihood opportunities around reserves is imperative.
Background Between 5 and 25 April 2009, pandemic (H1N1) 2009 caused a substantial, severe outbreak in Mexico, and subsequently developed into the first global pandemic in 41 years. We determined the ...reproduction number of pandemic (H1N1) 2009 by analyzing the dynamics of the complete case series in Mexico City during this early period.
Methods We analyzed three mutually exclusive datasets from Mexico City Distrito Federal which constituted all suspect cases from 15 March to 25 April: confirmed pandemic (H1N1) 2009 infections, non‐pandemic influenza A infections and patients who tested negative for influenza. We estimated the initial reproduction number from 497 suspect cases identified prior to 20 April, using a novel contact network methodology incorporating dates of symptom onset and hospitalization, variation in contact rates, extrinsic sociological factors, and uncertainties in underreporting and disease progression. We tested the robustness of this estimate using both the subset of laboratory‐confirmed pandemic (H1N1) 2009 infections and an extended case series through 25 April, adjusted for suspected ascertainment bias.
Results The initial reproduction number (95% confidence interval range) for this novel virus is 1·51 (1·32–1·71) based on suspected cases and 1·43 (1·29–1·57) based on confirmed cases before 20 April. The longer time series (through 25 April) yielded a higher estimate of 2·04 (1·84–2·25), which reduced to 1·44 (1·38–1·51) after correction for ascertainment bias.
Conclusions The estimated transmission characteristics of pandemic (H1N1) 2009 suggest that pharmaceutical and non‐pharmaceutical mitigation measures may appreciably limit its spread prior the development of an effective vaccine.
Introducción: el cáncer de mama es la neoplasia maligna más común entre las mujeres y se asocia con altos niveles de morbilidad y mortalidad en países en desarrollo. El autoexamen de mama es un ...método fundamental de diagnóstico precoz del cáncer mamario. El objetivo de este estudio fue determinar la prevalencia y evaluar las barreras asociadas a la realización del autoexamen de mama, en mujeres de 18 a 50 años. Métodos: estudio descriptivo, transversal, en 627 mujeres sanas entre los 18 y 50 años de edad, de Pamplona, Colombia. Las barreras para la práctica del autoexamen (edad, estado civil, religión, antecedentes familiares y asesoría profesional o medios de comunicación), se recogieron mediante encuesta estructurada. Se calcularon prevalencias de cada factor y se establecieron asociaciones mediante la construcción de modelos de regresión. Resultados: en el momento de la encuesta, cerca del 72 % de las mujeres acusaron no haberse practicado el autoexamen de mama en el último mes, y el 45 % en los últimos seis meses. Los modelos de regresión muestran que las mujeres pertenecientes al grupo etáreo de 30 a 39 años, las que no tuvieron asesoría por parte de un profesional de la salud y quienes no presentaron antecedentes familiar de cáncer de mama; se asociaron como barreras para el auto-examen de mama. Conclusión: la realización del autoexamen de mama en la población estudiada fue baja. Estos datos podrían utilizarse para ofrecer programas de intervención educativa acerca de la importancia del diagnóstico temprano del cáncer de mama.
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