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Experiencia con el perfil biofísico fetal en nuestro medio
Martínez González,Luis Raúl; Torres García,Wilfredo; Pérez Martínez,Caridad;
Revista Cubana de Obstetricia y Ginecolog?-a , 1997,
Abstract: a fetal welfare study was conducted among 213 pregnant women at risk in the "justo legón padilla" gynecoobstetric teaching hospital from october, 1993, to may, 1994. it was used the fetal biophysical profile according to the quantification criteria of the variables proposed by manning. 90.60 % of the biophysical profile were normal, 2.30 % abnormal, and 6.60 % suspicious. it was demonstrated that when the biophysical profile is abnormal there is a significant increase of cesarotomies due to acute fetal suffering,of the low apgar the 5th minute of life, as well as of the amount of meconium amniotic fluids. it was proved that the corporal fetal movements was the biophysical parameter of highest predictive value (80). through the evaluation of the biophysical profile it was determined its high sensitivity, (88) specificity (94) and elevated discriminating power with a wilks lambds of 0.2836. the corporal movements, the tone, and the amniotic fluid are the only parameters considered in this method.
Carcterísticas topográficas del queratocono en nuestro medio Topographic characteristics of the keratoconus in our environment
Adel Samara Samara,María del C. Benítez,Yamila Díaz Parra,Enrique Machado
Revista Cubana de Oftalmolog?-a , 2003,
Abstract: Objetivos: Conocer los patrones topográficos del queratocono en nuestro medio, valorando los índices topográficos obtenidos a partir de ellos. Métodos: el universo de estudio fue de 100 ojos de pacientes con diagnóstico de esta enfermedad, los cuales fueron sometidos a un estudio de topografía corneal donde se analizaron diferentes variables como: poder dióptrico en el ápex del cono y su eje, poder dióptrico central del ojo y del ojo adelfo, la diferencia entre el poder dióptrico corneal superior e inferior, y el astigmatismo. Resultados: se encontró que el queratocono central asimétrico fue el predominante. Los valores topográficos y la diferencia del ápex del cono entre ambos ojos resultaron más elevados en el queratocono central y periférico, igualmente el astigmatismo resultó elevado en estos patrones; mientras que los valores del ápex del cono y su eje, poder dióptrico central del ojo y del ojo adelfo y la diferencia entre el poder dióptrico corneal superior e inferior resultaron menores en el queratocono central. Con relación al eje se evidenció el predominio a nivel temporal inferior. Conclusiones: En este medio, el queratocono es una patología con escasos estudios, y este trabajo trata de establecer los patrones topográficos predominantes donde se encontraron 3 tipos básicos como son el queratocono central, central asimétrico y el periférico, con valores topográficos significativos. Objectives: To know the topographic patterns of the keratoconus in our environment by assessing the topographic indexes obtained from them. Methods: the universe of study was composed of 100 eyes from patients who had been diagnosed this disease. They underwent a corneal topography study where different variables, such as dioptric power in the apex of the cone and its axis, dioptric central power of the eye and of the adelphos eye, the difference between the upper and lower corneal dioptric power, and astigmatism, were analyzed. Results: it was found that the central asymmetric keratoconus is the predominant.The topographic values and the difference of the apex of the cone between both eyes were higher in the central and peripheral keratoconus. Likewise, astigmatism was elevated in these patterns, whereas the values of the apex of the cone and its axis, the central dioptric power of the eye, of the adelphos eye and the difference between the upper and lower corneal dioptric power were lower in the central keratoconus. As regards the axis, it was evidenced the predominance at the lower temporary level. Conclusions: In this setting, the keratoconus is a poorly studied
Fetal Biophysical Profile Scoring
H.R. HaghighatKhah,M. Sanei Taheri
Iranian Journal of Radiology , 2009,
Abstract: "nFetal biophysical profile scoring is a sonographic-based method of fetal assessment first described by Manning and Platt in 1980. "nThe biophysical profile score was developed as a method to integrate real-time observations of the fetus and his/her intrauterine environment in order to more comprehensively assess the fetal condition. These findings must be evaluated in the context of maternal/fetal history (i.e., chronic hypertension, post-dates, intrauterine growth restriction, etc), fetal structural integrity (presence or absence of congenital anomalies), and the functionality of fetal support structures (placental and umbilical cord). For example, acute asphyxia due to placental abruption may result in an absence of the acute variables of the biophysical profile score (fetal breathing movements, fetal movement, fetal tone, and fetal heart rate reactivity) with a normal amniotic fluid volume. With post maturity the asphyxial event may be intermittent and chronic resulting in a decrease in amniotic fluid volume, but with the acute variables remaining normal. "nWhile the 5 components of the biophysical profile score have remained unchanged since 1980 (Manning, 1980), the definitions of a normal and abnormal parameter have evolved with increasing experience. "nIn 1984 the definition of oligohydramnios was increased from < 1cm pocket of fluid to < 2.0 x 1.0 cm pocket. Oligohydramnios is now defined as a pocket of amniotic fluid < 2.0 x 2.0 cm (Manning, 1995a) "nIf the four ultrasound variables are normal, the accuracy of the biophysical profile score was not found to be significantly improved by adding the non-stress test. As a result, in 1987 the profile score was modified to incorporate the non-stress test only when one of the ultrasound variables was abnormal (Manning 1987). Table 1 outlines the current definitions for quantifying a variable as present or absent. "nEach of the 5 components of the biophysical profile score does not have equal significance. Fetal breathing movements, amniotic fluid volume, and the non-stress test are the most powerful variables. For example, when the biophysical profile score is 2, the perinatal mortality varies between 428/1000 with only fetal movement present to 66/1000 if the non-stress test is reactive and all of the ultrasound parameters are absent (Manning 1990b). Some authors have, therefore, proposed utilization of a modified biophysical profile that incorporates only the non-stress test and amniotic fluid volume (Miller 1996). Although the positive predictive value of these 2 tests is equivalent to a biophysic
Prevención de la infección neonatal por estreptococo del grupo B: Es necesaria en nuestro medio? Prevention of perinatal group B streptococcal infection: is it necessary in our country?
Hernán Cortés
Revista Colombiana de Obstetricia y Ginecología , 2005,
Abstract: El Estreptococo del grupo B (GBS) o Streptococcus agalactie, es un microrganismo saprofito habitual de los tractos genitourinario y gastrointestinal del ser humano. Las embarazadas colonizadas pueden transmitir de manera vertical esta bacteria a sus hijos, favoreciendo el desarrollo de la infección neonatal temprana. La prevalencia de colonización materna es variable, entre 5 y 30% dependiendo del país, la raza, edad y técnica de recolección de la muestra. Se presenta colonización entre el 40 a 70% de los bebes nacidos de madres portadoras y de éstos entre el 1 y 2% desarrollarán la enfermedad invasora (sepsis, meningitis y/o neumonía). En Estados Unidos, la infección por GBS es la principal causa de morbimortalidad neonatal. Afortunadamente la mayoría de las infecciones pueden ser prevenidas con el uso de antibióticos profilácticos durante el trabajo de parto. Sin embargo, en nuestro medio desconocemos el impacto de esta patología y no se han implementado las estrategias de prevención. Corresponde pues a la universidad apropiarse de la investigación y desarrollo de estrategias que permitan implementar dicha profilaxis en nuestro país. Group B Streptococcus or agalactie (GBS) is a habitual saprophytic microorganism of the genitourinary and gastrointestinal tracts of human beings. Vertical transmission from the mother to the fetus, as occurs, favors the development of early onset disease in the neonate. The prevalence of maternal colonization is variable (5-30%) depending on the country, race, age and technique of sampling used for culture. Approximately 40-70% of neonates from mothers who are positive for GBS are colonized and of those, 1 to 2% will develop invasive disease (sepsis, meningitis or pneumonia). Fortunately, most of these infections can be prevented by prophylactic antibiotics during labor and delivery. However, in our environment, the impact of this pathology is unknown, and strategies for prevention have not been implemented. Research in our country is needed to address this issue and implement diagnostic and treatment strategies.
Gastric polyps: analysis of endoscopic and histological features in our center Pólipos gástricos: análisis de características endoscópicas e histológicas en nuestro medio  [cached]
Francisco Javier García-Alonso,Rosa María Martín-Mateos,Juan ángel González-Martín,José Ramón Foruny
Revista Espa?ola de Enfermedades Digestivas , 2011,
Abstract: Background and objective: the prevalence of gastric polyps in esophagogastroduodenoscopies (EGDs) ranges between 0.33 and 6.35%. The relative frequency of histological subspecies varies widely among published series. The objective is to describe the endoscopic and histological characteristics of the polypoid lesions, and to study possible associations. Material and methods: we retrospectively revised the EGDs done in our center in 2009. Demographic, endoscopic and histological data were gathered. We proceeded to a descriptive analysis and studied possible associations. Results: gastric polypoid lesions were found in 269 of the 6,307 (4.2%) reviewed EGDs, 61% were found in women. Mean age was 64.93 years (SD: ±15.23). A single polyp was found in 186 patients (69.1%), over 10 lesions appeared in 31 (11.5%). An estimated size of ≤ 3 mm was found in 108 lesions (37.2%) and greater than 10 mm in 52 cases (17.9%). Most lesions were sessile (90.8%). The location of 34.8% was the gastric antrum, 39.3% were found in the gastric body and 25.9% were in the fundus. Chronic gastritis was confirmed in 53.5% of the patients and 46.5% had received PPIs. Histopathological diagnosis was: hyperplastic polyps 50.9%, fundic gland polyps 7.4%, adenomas 3%, adenocarcinomas 1.9% and normal mucosa 29.7%. We found no significant association between the histopathological type of lesions and the use of proton pump inhibitor. Conclusions: we found polypoid lesions in 4.2% of the EGDs. The most frequent histopathological findings were hyperplastic polyps (50.9%), followed by fundic gland polyps (7.4%), adenomas (3%), and adenocarcinomas (1.9%). Antecedentes y objetivo: la prevalencia de pólipos gástricos en la endoscopia digestiva alta (EDA) oscila entre el 0,33 y el 6,35%. La frecuencia de los subtipos histológicos varía ampliamente entre las series publicadas. El objetivo de nuestro estudio es describir las características endoscópicas e histológicas de los pólipos hallados en las EDA y valorar posibles asociaciones. Material y métodos: revisamos retrospectivamente las EDA realizadas en nuestro centro en 2009. Se recogieron variables demográficas, endoscópicas e histológicas. Se realizó un análisis descriptivo y se estudiaron posibles asociaciones. Resultados: se analizaron 6.307 EDA identificándose lesiones polipoideas en 269 (4,2%), el 61% en mujeres. La edad media fue de 64,93 a os (DE: ±15.23). En 186 pacientes (69,1%) se objetivó un solo pólipo y en 31 (11,5%), más de 10. Se estimó un tama o ≤ 3 mm en 108 lesiones (37,2%), y mayor de 10 mm en 52 casos (17,9%). La mayoría de l
Mastoiditis aguda en la presente década: Evolución y características en nuestro medio Acute mastoiditis in the present decade: Evolution and characteristics in our setting
D. Mata Zubillaga,S. Prieto Espu?es,L. Regueras Santos,E. álvaro Iglesias
Boletín de Pediatría , 2009,
Abstract: La incidencia de la mastoiditis aguda parece haber aumentado desde 1989. El presente estudio analiza las características de los pacientes ingresados por mastoiditis aguda en la última década en nuestro medio. Se trata de un estudio observacional descriptivo que incluyó los ingresos desde enero de 2000 hasta agosto de 2008. Ingresaron un total de 31 pacientes, 16 varones y 15 mujeres. El 71% de los ni os ingresaron en los últimos 4 a os (p<0,01). La incidencia fue mayor en oto o e invierno. La edad media fue 3,49 ± 2,99 a os (mediana 22 meses). Los síntomas más frecuentes fueron dolor mastoideo, inflamación retroauricular, despegamiento, fiebre, otorrea y otalgia. Se realizó una tomografía axial computerizada en 24 pacientes (otitis media aguda e inflamación de las celdillas mastoideas) encontrándose abscesos en 5 casos. Se realizó un cultivo en 15 pacientes (negativo en 6 ocasiones, P. aeruginosa y S. Pneumoniae en 3 ocasiones). La duración media del ingreso fue de 8,90 ± 3,39 días. Todos se trataron con antibiótico intravenoso (cefotaxima y amoxicilina-clavulánico). En 7 casos se a adió antibiótico tópico, en 2 casos se aspiró oído medio y 2 pacientes precisaron intervención quirúrgica. The incidence of mastoiditis has increased since 1989. This study compares the incidence in the beginning of the decade with that of the second half and analyzes its features. Descriptive, observational study. It included revenue from January 2000 until August 2008. A total of 31 entered, 16 men and 15 women. 71% of the children entered on the second half of the decade (p<0.01). The incidence was higher in Autum and Winter. The average age was 2.49 ± 2.99 years (median 22 months). The most frequent symptoms were mastoid pain, retroauricular inflammation, can then, fever, otorrea and earache. Average length of stay was 8.90 ± 2.39 days. TAC was performed in 24 (acute otitis media and inflammation of the mastoid cells). There were 5 abscesses. Cultivation was carried out in 15 (negative in 6 cases, P. aeruginosa and S. pneumoniae in 3 times). All were treated with intravenous antibiotic (amoxicillinclavulanate and cefotaxime). Oral antibiotic was used in 24 (amoxicillin-clavulanate and cefixime). In 7 cases was added topical antibiotic, it was aspired middle ear in two and underwent surgery two.
Medio ambiente fetal Fetal environment
César Bernardo Ospina Arcila
Iatreia , 1996,
Abstract: Con base en el artículo clásico "Monte Everest in utero" se hace un análisis de la situación que afronta el feto con respecto a la disponibilidad de oxígeno; para una mejor comprensión del sufrimiento fetal se revisan los siguientes conceptos: presión barométrica, presión parcial del oxígeno atmosférico, presión parcial del oxígeno inspirado, presión barométrica intranasal, ecuación del gas alveolar y difusión de gases a través de la membrana alvéolo capilar. Based on the classical paper by Eastman "Mount Everest in utero" an analysis is made of the situation faced by the fetus with respect to the availability of oxygen; for a better under. standing of fetal distress the following concepts are reviewed: barometric pressure, partial pressure of atmosferic oxygen, partial pressure of inspired oxygen, barometric intranasal pressure, alveolar gas equation and gas diffusion through alveolo-capilar membrane.
The relationship between fetal biophysical profile and cord blood PH
Valadan M,Moridi M,Davari Tanha F,Rahimi Sher Baf F
Tehran University Medical Journal , 2009,
Abstract: "nBackground: The Biophysical Profile (BPP) is a noninvasive test that predicts the presence or absence of fetal asphyxia and, ultimately, the risk of fetal death in the antenatal period. Intervention on the basis of an abnormal biophysical profile result has been reported to yield a significant reduction in prenatal mortality, and an association exists between biophysical profile scoring and a decreased cerebral palsy rate in a given population. The BPP evaluates five characteristics: fetal movement, tone, breathing, heart reactivity, and amniotic fluid (AF) volume estimation. The purpose of study was to determine whether there are different degree of acidosis at which the biophysical activity (acute marker) are affected. "nMethods: In a prospective study of 140 patients undergoing cesarean section before onset of labor, the fetal biophysical profile was performed 24h before the time of cesarean and was matched with cord arterial PH that was obtained from a cord segment (10-20cm) that was double clamped after delivery of newborn. (using cord arterial PH less than 7.20 for the diagnosis of acidosis). "nResults: The fetal biophysical profile was found to have a significant relationship with umbilical blood PH. The sensitivity, specificity, positive predictive value, negative predictive value of fetal biophysical profile score were: 88.9%, 88.6%, 50%, 98.1%. "nConclusion: The first manifestations of fetal acidosis are nonreactive nonstress testing and fetal breathing loss; in advanced acidemia fetal movements and fetal tone are compromised. A protocol of antepartum fetal evaluation is suggested based upon the individual biophysical components rather than the score alone.
FETAL BIOPHYSICAL PROFILE; AS A TOOL TO PREDICT FETAL OUTCOME
BUSHRA BANO,UZMA HUSSAIN
The Professional Medical Journal , 2010,
Abstract: To evaluate fetal Biophysical Profile as an effective technique for the assessment of fetal condition and to improve fetal outcomeby early detection of fetal hypoxia. Design: Co relational study: Place and Duration of Study: The study was carried out for a period of one yearfrom Oct 2004-Oct 2005 at Obstetrics and Gynecology Department of Fatima memorial hospital Lahore. Patients and Methods: All patientswith history of sluggish fetal movements and clinical suspicion of IUGR, were underwent BPP from 32-42weeks. 100 patients were selected andtheir BPP score was recorded and were followed till delivery. Those who went into spontaneous labor and who were induced monitored duringlabor and at any sign of fetal distress immediate caesarean section performed. APGAR score of newborn was noted at one and five minutes andthose having poor APGAR score were resuscitated and were followed till one week after delivery. APGAR score was compared with BPP score.Results: During this study 100 BPP were performed. 34patients were primigravidas and 66 were multigravidas. Among 100 patients 73had aBPP score of 9-10/10, 21 patients had a score of 7-8/10 and 6 patients had 4-6/10.In 2 patients with 4/10score emergency caesarean section ledto the delivery of neonates with APGAR score of 8 at 5 minutes. Majority of patients with normal BPS of 8-9/10 had good APGAR score of 7-8/10.Only 8 patients having BPP of 9-10/10 had poor APGAR score 6/10 or <6/10. Conclusion: The fetal BPP appears to be an effectivetechnique for assessment of fetal condition.
A PROSPECTIVE TRIAL OF THE FETAL BIOPHYSICAL PROFILE VERSUS MODIFIED BIOPHYSICAL PROFILE IN THE MANAGEMENT OF HIGH RISK PREGNANCIES
A. Jamal,V. Marsoosi,L. Eslamian K. Noori
Acta Medica Iranica , 2007,
Abstract: "nThe original biophysical profile is time consuming and costly. This study was performed to compare diagnostic value of the original fetal biophysical profile to the modified biophysical profile. Patients were selected from high risk pregnancies referred for fetal assessment and were randomly assigned to two groups. The measures of outcomes were perinatal mortality, Cesarean section for abnormal test, meconium-stained amniotic fluid and 5-minute Apgar score < 7. Diagnostic values of tests were assessed in terms of the incidence of abnormal outcome. In addition comparisons between the positive and negative predictive values of each of these tests as well as the sensitivity and specificity of the tests were reviewed. A total of 200 patients were entered into the study; 104 pregnancies were managed by the original biophysical profile and 96 pregnancies by the modified biophysical profile. There were 30 abnormal (31.3%) in modified biophysical profile and 24 (23.1%) abnormal tests in original one. There was significant difference in the incidence of meconium passage between two groups. Cesarean section for abnormal tests was 27 of 30 abnormal test (90%) in modified and 22 of 24 (91.6%) in original profile that was similar in both groups. There was not significant difference in Apgar score < 7 between two groups. We did not find significant difference with comparison of the sensitivity, specificity and negative predictive value of two tests for all measures of outcome except the positive predictive value of meconium passage. Original biophysical profile is more costly and time consuming than modified one.
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