Asociación entre la pre-eclampsia y sus complicaciones perinatales en el servicio de ginecología del Centro Médico Naval Cirujano Mayor Santiago Távara en el periodo 2019-2021, Lima, Perú

La Preeclampsia es una enfermedad multisistémica producida durante la gestación humana, causando complicaciones maternas, fetales y neonatales antes, durante y después del parto; así también este estudio engloba diferentes complicaciones y factores de riesgo en gestantes con Preeclampsia en el ámbito hospitalario. Objetivo: Identificar los factores asociados a preeclampsia en gestantes atendidas en el Centro Médico Naval Cirujano Mayor Santiago Távara durante el periodo 2019 al 2021. Material y Métodos: Estudio transversal analítico el cual conto con 1329 gestantes durante dicho periodo de las cuales mediante el cálculo maestral participaron 124 gestantes (62 con preeclampsia y 62 sin preeclampsia), se buscó evaluar qué complicaciones y factores se asocian. La presencia de preeclampsia dependió del registro de historias clínicas. Se evaluó según análisis bivariado y multivariado mediante regresión logística. Resultados: El estudio mostró que las complicaciones en gestantes con preeclampsia fueron principalmente RCIU (p <0.005: RP=1.92), BPN(<2500gr) (p<0.005; RP=1.80) y Parto Prematuro por Capurro (p=0.002; RP=2.22). Así también se encontró que las gestantes con Preeclampsia eran jóvenes comprendidas entre los 14 y 26 años (p=0.027; RP=1.21), mostraban una gestación con preeclampsia previa (p=<0.005; RP=3.55) y la culminación del parto más prevalente fue por vía Cesaría (p=0.026; RP=1.56) El análisis multivariado mantuvo una cercanía a la significancia con RCIU y Preeclampsia en gestación anterior. Conclusión: Entre los factores epidemiológicos, se asociaron el número 6 de controles prenatales y la edad materna. Entre los factores obstétricos se encontró asociación en el tipo el tipo de culminación del parto, Preeclampsia en gestación anterior y prematuridad en edad Gestacional por fecha de última regla. Entre las complicaciones se asociaron APGAR ≤7pts al primer minuto, bajo peso al nacer, parto prematuro por Capurro y RCIU

Multiplicación in vitro de Morinda royoc L. en Sistemas de Inmersión Temporal

Morinda royoc L. is a medicinal plant which has identified numerous secondary metabolites important for medical and pharmaceutical industry. The use of in vitro culture techniques could contribute to the production of these. The aim of this work was to multiply M. royoc using Temporary Immersion System (TIS). It was used TIS of 1000 ml capacity. Each contained 250 ml MS medium with 4.4 μM benzyladenine (BA) and 2.9 μM indole acetic acid (IAA). The SIT were inoculated with 30 individual explants (shoot tips and nodal segments). It was determined the effect of the immersion frequency (two, four and six immersions of two minutes per day) and the type of explants (shoot tips, nodal segments) on the multiplication of shoots and biomass production. It was found that with four and six immersions per day the highest values of multiplication coefficient and shoot length were obtained. The maximum biomass production was achieved with six immersions per day. No hyperhidricity symptoms were observed in shoots. It was noted that the nodal segments produced more shoots per explant, increased multiplication coefficient and biomass than the apex, while the latter resulted in longer shoots.Keywords: micropropagation, shoots multiplicationMorinda royoc L. es una planta medicinal de la cual se han identificado numerosos metabolitos secundarios de importancia para la industria médica y farmacéutica. El empleo de técnicas de cultivo in vitro podría contribuir a la producción de estos. El objetivo de este trabajo fue multiplicar M. royoc con el uso de SIT. Se emplearon Sistemas de Inmersión Temporal (TIS) de 1000 ml de capacidad. Cada SIT contenía 250 ml de medio de cultivo de multiplicación MS con 4.4 μM de benciladenina (BA) y 2.9 μM de ácido indol acético (AIA). Los SIT fueron inoculados con 30 explantes individuales (ápices y segmentos nodales). Se determinó el efecto de la frecuencia de inmersión (dos, cuatro y seis inmersiones de dos minutos por día) y el tipo de explante (ápices, segmentos nodales) sobre la multiplicación de los brotes y la producción de biomasa. Se comprobó que con cuatro y seis inmersiones por día se obtuvieron los mayores valores de coeficiente de multiplicación y de longitud de los brotes. El máximo valor en la producción de biomasa se alcanzó con seis inmersiones por día. No se observaron síntomas de hiperhidricidad en los brotes. Se observó que los segmentos nodales produjeron más brotes por explante, mayor coeficiente de multiplicación y biomasa que los ápices, mientras que estos últimos dieron lugar a brotes de mayor longitud.Palabras clave: micropropagación, multiplicación de brote

Variabilidad fenotípica en campo de plantas de Saccharum spp. híbrido cv. ‘C87-51’ regeneradas vía embriogénesis somática

Sugarcane (Saccharum spp.) is a crop of great economic importance that has been propagated by tissue culture through organogenesis and somatic embryogenesis. The present research had as objective to determine the phenotypic variability in the field of sugar cane cv. 'C87-51' plants obtained by somatic embryogenesis in liquid culture media. Plants regenerated from somatic embryos were planted in the field next to plants propagated via organogenesis and from cuttings that were used as control. The evaluations were carried out seven months after planting in cane plant and first shoot and the variables evaluated were stem height, stem diameter, number of stems per seedlings, number of active leaves per stem and Brix. Besides, morphological characteristics were described. Plants out of type were not found in the evaluated populations. The results demonstrated that the plant regeneration pathway significantly influences the development of plants under field conditions. The propagation of sugarcane plants cv. 'C87-51' by somatic embryogenesis in liquid culture medium only induces phenotypic changes in field associated with in vitro rejuvenation similar to those previously reported for plants obtained by organogenesis. Therefore, it can be used as a method of mass propagation of plants. Keywords: bioreactor, somatic embryos, somaclonal variation, sugarcaneLa caña de azúcar (Saccharum spp.) es un cultivo de gran importancia económica que se ha propagado por cultivo de tejidos mediante organogénesis y embriogénesis somática. La presente investigación tuvo como objetivo determinar la variabilidad fenotípica en campo de plantas de caña de azúcar cv. ‘C87-51’ obtenidas mediante embriogénesis somática en medios de cultivo líquido. Fueron plantadas en campo plantas regeneradas a partir de embriones somáticos junto a plantas propagadas vía organogénesis y de estacas que se utilizaron como control. Las evaluaciones se efectuaron a los siete meses de la plantación en caña planta y primer retoño y las variables evaluadas fueron altura del tallo, diámetro del tallo, número de tallos por plantón, número de hojas activas por tallo y Brix. Además, se describieron características morfológicas. No se encontraron plantas fuera de tipo en las poblaciones evaluadas. Los resultados demostraron que la vía de regeneración de plantas influye significativamente en el desarrollo de las plantas en condiciones de campo. La propagación de plantas de caña de azúcar cv. ‘C87-51’ por embriogénesis somática en medio de cultivo líquido solo induce variaciones fenotípicas en campo asociadas al rejuvenecimiento in vitro similares a las referidas previamente para plantas obtenidas por organogénesis y por tanto puede ser empleada como un método de propagación masiva de plantas. Palabras clave: biorreactor, caña de azúcar, embrión somático, variación somaclona

Diagnóstico sonográfico de tumores de partes blandas en el aparato osteomioarticular

A descriptive cross-sectional, descriptive, observational study was conducted at "Arnaldo Milian Castro" University Provincial Hospital of Villa Clara Province, in the period between February 2009 and May 2011 in order to determine the sonographic behavior in soft tissue tumors of osteomioarticular system in relation to its histology, its vascularization and some epidemiological variables. Patients who attended at Consultation of ecosoma of this center with the presumptive diagnosis of a tumor of soft parts of osteomioarticular system, the sample was composed of those who, after performed the sonographic study, requiring confirmation and diagnosis histological by needle biopsy; and epidemiological data from the physical examination and the ultrasound examination findings were collected and the histological diagnosis was confirmed by statistical records of the Department of Pathology of the hospital. The correlation between ultrasound findings, physical exam, vascularization, some epidemiological variables and the final histologic diagnosis was established. Purposeful sampling with inclusion and exclusion criteria given by experts and the researcher was made. After performing the statistical analysis of the results it was reached to conclusions and recommendations.Se realizó un estudio transversal, descriptivo, observacional en el Hospital Provincial Universitario “Arnaldo Milián Castro”, de la Provincia de Villa Clara, en el período comprendido entre febrero de 2009 y mayo de 2011 con el objetivo de determinar el comportamiento sonográfico de los tumores de partes blandas del sistema osteomioarticular en relación con su histología, su vascularización y algunas variables epidemiológicas. Se realizó una encuesta a los pacientes que acudieron a la Consulta de ecosoma con el diagnóstico presuntivo de un tumor de partes blandas del sistema osteomioarticular, la muestra la conformaron aquellos que, luego de realizado el estudio sonográfico, requirieron de confirmación y diagnóstico histológico mediante biopsia con aguja; se recogieron datos de los exámenes físico y epidemiológico y los hallazgos al examen ecográfico y se confirmó el diagnóstico histológico por los registros estadísticos del Departamento de Anatomía Patológica del hospital. Se estableció la correlación entre los hallazgos ecográficos, el examen físico, la vascularización, algunas variables epidemiológicas y el diagnóstico histológico definitivo. Se realizó un muestreo intencionado con criterios de inclusión y exclusión dados por expertos y el investigador. Después de realizar el análisis estadístico de los resultados se llegó a conclusiones y recomendaciones

Copy Number Variants Are Ovarian Cancer Risk Alleles at Known and Novel Risk Loci

BACKGROUND: Known risk alleles for epithelial ovarian cancer (EOC) account for approximately 40% of the heritability for EOC. Copy number variants (CNVs) have not been investigated as EOC risk alleles in a large population cohort. METHODS: Single nucleotide polymorphism array data from 13 071 EOC cases and 17 306 controls of White European ancestry were used to identify CNVs associated with EOC risk using a rare admixture maximum likelihood test for gene burden and a by-probe ratio test. We performed enrichment analysis of CNVs at known EOC risk loci and functional biofeatures in ovarian cancer-related cell types. RESULTS: We identified statistically significant risk associations with CNVs at known EOC risk genes; BRCA1 (PEOC = 1.60E-21; OREOC = 8.24), RAD51C (Phigh-grade serous ovarian cancer [HGSOC] = 5.5E-4; odds ratio [OR]HGSOC = 5.74 del), and BRCA2 (PHGSOC = 7.0E-4; ORHGSOC = 3.31 deletion). Four suggestive associations (P \u3c .001) were identified for rare CNVs. Risk-associated CNVs were enriched (P \u3c .05) at known EOC risk loci identified by genome-wide association study. Noncoding CNVs were enriched in active promoters and insulators in EOC-related cell types. CONCLUSIONS: CNVs in BRCA1 have been previously reported in smaller studies, but their observed frequency in this large population-based cohort, along with the CNVs observed at BRCA2 and RAD51C gene loci in EOC cases, suggests that these CNVs are potentially pathogenic and may contribute to the spectrum of disease-causing mutations in these genes. CNVs are likely to occur in a wider set of susceptibility regions, with potential implications for clinical genetic testing and disease prevention

Copy Number Variants Are Ovarian Cancer Risk Alleles at Known and Novel Risk Loci

BACKGROUND: Known risk alleles for epithelial ovarian cancer (EOC) account for approximately 40% of the heritability for EOC. Copy number variants (CNVs) have not been investigated as EOC risk alleles in a large population cohort. METHODS: Single nucleotide polymorphism array data from 13 071 EOC cases and 17 306 controls of White European ancestry were used to identify CNVs associated with EOC risk using a rare admixture maximum likelihood test for gene burden and a by-probe ratio test. We performed enrichment analysis of CNVs at known EOC risk loci and functional biofeatures in ovarian cancer-related cell types. RESULTS: We identified statistically significant risk associations with CNVs at known EOC risk genes; BRCA1 (PEOC = 1.60E-21; OREOC = 8.24), RAD51C (Phigh-grade serous ovarian cancer [HGSOC] = 5.5E-4; odds ratio [OR]HGSOC = 5.74 del), and BRCA2 (PHGSOC = 7.0E-4; ORHGSOC = 3.31 deletion). Four suggestive associations (P < .001) were identified for rare CNVs. Risk-associated CNVs were enriched (P < .05) at known EOC risk loci identified by genome-wide association study. Noncoding CNVs were enriched in active promoters and insulators in EOC-related cell types. CONCLUSIONS: CNVs in BRCA1 have been previously reported in smaller studies, but their observed frequency in this large population-based cohort, along with the CNVs observed at BRCA2 and RAD51C gene loci in EOC cases, suggests that these CNVs are potentially pathogenic and may contribute to the spectrum of disease-causing mutations in these genes. CNVs are likely to occur in a wider set of susceptibility regions, with potential implications for clinical genetic testing and disease prevention

Common variants in Alzheimer’s disease and risk stratification by polygenic risk scores

Funder: Funder: Fundación bancaria ‘La Caixa’ Number: LCF/PR/PR16/51110003 Funder: Grifols SA Number: LCF/PR/PR16/51110003 Funder: European Union/EFPIA Innovative Medicines Initiative Joint Number: 115975 Funder: JPco-fuND FP-829-029 Number: 733051061Genetic discoveries of Alzheimer's disease are the drivers of our understanding, and together with polygenetic risk stratification can contribute towards planning of feasible and efficient preventive and curative clinical trials. We first perform a large genetic association study by merging all available case-control datasets and by-proxy study results (discovery n = 409,435 and validation size n = 58,190). Here, we add six variants associated with Alzheimer's disease risk (near APP, CHRNE, PRKD3/NDUFAF7, PLCG2 and two exonic variants in the SHARPIN gene). Assessment of the polygenic risk score and stratifying by APOE reveal a 4 to 5.5 years difference in median age at onset of Alzheimer's disease patients in APOE ɛ4 carriers. Because of this study, the underlying mechanisms of APP can be studied to refine the amyloid cascade and the polygenic risk score provides a tool to select individuals at high risk of Alzheimer's disease

New insights into the genetic etiology of Alzheimer's disease and related dementias

Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication