Current medical guidelines consider pregnant women with COVID-19 to be a high-risk group. Since physiological gestation downregulates the immunological response to maintain “maternal-fetal ...tolerance”, SARS-CoV-2 infection may constitute a potentially threatening condition to both the mother and the fetus. To establish the immune profile in pregnant COVID-19+ patients, a cross-sectional study was conducted. Pregnant women with COVID-19 (P-COVID-19+; n = 15) were analyzed and compared with nonpregnant women with COVID-19 (NP-COVID-19+; n = 15) or those with physiological pregnancy (P-COVID-19-; n = 13). Serological cytokine and chemokine concentrations, leucocyte immunophenotypes, and mononuclear leucocyte responses to polyclonal stimuli were analyzed in all groups. Higher concentrations of serological TNF-α, IL-6, MIP1b and IL-4 were observed within the P-COVID-19+ group, while cytokines and chemokines secreted by peripheral leucocytes in response to LPS, IL-6 or PMA-ionomicin were similar among the groups. Immunophenotype analysis showed a lower percentage of HLA-DR+ monocytes in P-COVID-19+ than in P-COVID-19- and a higher percentage of CD39+ monocytes in P-COVID-19+ than in NP-COVID-19+. After whole blood polyclonal stimulation, similar percentages of T cells and TNF+ monocytes between groups were observed. Our results suggest that P-COVID-19+ elicits a strong inflammatory response similar to NP-COVID19+ but also displays an anti-inflammatory response that controls the ATP/adenosine balance and prevents hyperinflammatory damage in COVID-19.
Resumen La hipertensión pulmonar, por tradición, se ha clasificado en dos categorías: primaria o secundaria, con base en las causas o factores de riesgo asociados; sin embargo, a partir del Segundo ...Simposio Mundial en Hipertensión Pulmonar, realizado en Évian-les-Bains, Francia, en 1998, se estableció una clasificación clínica con el objetivo de individualizar las diferentes categorías de hipertensión pulmonar que comparten hallazgos patológicos, características hemodinámicas y tratamiento similar, estableciéndose, a partir de ello, cinco grupos de entidades claramente definidas. Se describe el caso de una paciente obstétrica con hipertensión arterial pulmonar grave a gran altitud, su abordaje y tratamiento, que tuvo evolución favorable. Las pacientes con cardiopatías congénitas pueden tener descompensación de la misma y volverse sintomáticas con un evento estresante que conlleva cambios fisiológicos que ponen a prueba su capacidad funcional, como es el embarazo. Éste es uno de los pocos casos existentes en la bibliografía acerca de cardiopatía congénita acianógena con hipertensión arterial pulmonar a gran altura en una paciente obstétrica.
Acute leukemia is rare during pregnancy, affects about 1 in 75,000 pregnancies, of all leukemias diagnosed only 28% are acute lymphoblastic leukemia, this is a risk factor to develop spontaneous ...tumor lysis syndrome, it's a oncologic complication potentially deadly if the prophylactic treatment its avoided. Cases of acute lymphoblastic leukemia associated with pregnancy has been poorly documented in the literature the association of these two entities to pregnancy is the first report published worldwide, so the information is limited.
The first case of cerebral venous thrombosis, described in the past century, was identified in obstetric patients in 1825. The clinical manifestations represent a real diagnostic challenge due to the ...few recorded cases, the wide variety of possible clinical symptoms, and the diversity of medical conditions that cause it. In the past century, the etiology was mainly associated with septic processes; however, due to the widespread use of antibiotics, this cause has been considerably reduced. In the context of the puerperium, several conditions make this group of patients more vulnerable, such as dehydration, hypercoagulable state, iron deficiency, puerperal sepsis, and preeclampsia, the latter is particularly known for an endothelial lesion with different degrees of associated severity, according to the clinical phenotype present. This review aims to highlight the most relevant aspects of cerebral thrombosis in the context of a puerperal patient. It will also present clinical cases reports treated successfully in this health unit.
Liver rupture secondary to preeclampsia represents a complication that, if is not recognized early, can be fatal. Its presentation is rare, but very complex to treat, having options that are not ...clearly protocolized and usually derive from the experience of the surgeon who faces it. We present a case of liver rupture of a patient from Toluca, State of Mexico who was admitted by emergency air transfer with immediate puerperium complicated by severe preeclampsia, postpartum hemorrhage, liver rupture with hemodynamic instability, it was necessary to intervene surgically for a total of seven occasions to control the hemorrhage, as well as pharmacological, medical measures and multiple transfusions; however, she died on the eighteenth day of his hospitalization for septic shock.
PDF
