Restricción del crecimiento intrauterino como factor de riesgo para malformaciones congénitas

Indexación: ScieloAntecedentes: La restricción del crecimiento intrauterino (RCIU) se estima que está presente en el 5% de los nacimientos y es la manifestación de procesos aberrantes que impiden el desarrollo normal del feto. Objetivos: Estimar la frecuencia de esta patología en la maternidad del Hospital Clínico de la Universidad de Chile. Obtener la tasa prevalencia al nacimiento de malformaciones congénitas (MFC) y comparar la frecuencia en recién nacidos pequeños (PEG) con los adecuados (AEG) y grandes (GEG) para la edad gestacional. Método: Se estudian todos los nacimientos, vivos y mortinatos, ocurridos entre enero de 1997 a diciembre de 2008, contenidos en la base de datos del ECLAMC (Estudio Colaborativo Latino Americano de Malformaciones Congénitas) desde 1969 a la fecha. Se excluyen los recién nacidos con malformaciones como hidrocefalia, anencefalia e hidrops, que por sus características dificultan la posibilidad de clasificación en PEG, AEG o GEG. Resultados: 10,1% de los nacimientos del período eran PEG. Entre los nacidos vivos 10% fueron PEG, mientras que 33,5% de los mortinatos eran PEG (p<0,05). Eran malformados el 12,9% de los PEG, 8,5% de los AEG y 9,3% de los GEG (p<0,05). La tasa global de malformaciones fue de 9,5%; en NV el 9,4% y en mortinatos el 33%. Conclusión: El RCIU es un factor que aumenta el riesgo de mortalidad fetal tardía y de presentar malformaciones congénitas.Background: Fetal growth restriction (FGR) is the result of anomalies that prevent the normal development of the fetus, it is present in about the 5% of births. Objectives: To estímate the frequency of FGR in the Clini-cal Hospital of the University of Chile. To estímate the congenital malformation prevalence rate at birth and compare it among small (SGE), adequate (AGE) and large (LGE) newborns according their gestational age. Methods: All live births and stillbirths included in the ECLAMC (Estudio Colaborativo Latino Americano de Malformaciones Congénitas) registered from January 1997 and December 2008 were considered. Newborns with congenital malformations that modified per se the size of the child, like hydrocephaly anencephaly and hydrops were excluded. Results: 10.1% of newborns were SGE. Among live births 10% were SGE instead of the 33.5% found in stillbirths (p<0.05). Congenital malformation rate at birth was 12.9% in SGE, 8.5% in AGE and 9.3% in LGE newborns (p<0.05). The global congenital malformation prevalence rate at birth was 9.5%; 9.4% in live newborns and 33% in stillbirth. Conclusión: The FGR increase the risk of late fetal mortality and congenital anomalies.http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0717-75262009000600008&nrm=is

PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec

Fetal growth restriction as risk factor for congenital malformations Trabajos originales Restricción del crecimiento intrauterino como factor de riesgo para malformaciones congénitas

Background: Fetal growth restriction (FGR) is the result of anomalies that prevent the normal development of the fetus, it is present in about the 5% of births. Objectives: To estimate the frequency of FGR in the Clinical Hospital of the University of Chile. To estimate the congenital malformation prevalence rate at birth and compare it among small (SGE), adequate (AGE) and large (LGE) newborns according their gestational age. Methods: All live births and stillbirths included in the ECLAMC (Estudio Colaborativo Latino Americano de Malformaciones Congénitas) registered from January 1997 and December 2008 were considered. Newborns with congenital malformations that modified per se the size of the child, like hydrocephaly anencephaly and hydrops were excluded. Results: 10.1% of newborns were SGE. Among live births 10% were SGE instead of the 33.5% found in stillbirths (p&lt;0.05). Congenital malformation rate at birth was 12.9% in SGE, 8.5% in AGE and 9.3% in LGE newborns (p&lt;0.05). The glob

Single nucleotide variants in the IL33 and IL1RL1 (ST2) genes are associated with periodontitis and with Aggregatibacter actinomycetemcomitans in the dental plaque biofilm: A putative role in understanding the host immune response in periodontitis.

The Interleukin (IL)-33 is important in several inflammatory diseases and its cellular receptor is the Interleukin 1 receptor-like 1 (IL1RL1), also called suppression of tumorigenicity 2 ligand (ST2L). This study investigated associations between single nucleotide variants (SNVs) in the IL33 gene and in the IL1RL1 (ST2) gene with periodontitis. Additionally, aimed to determine the role of Aggregatibacter actinomycetemcomitans (Aa) relative amount in the subgingival biofilm in these associations. A cross-sectional study was carried out with 506 individuals that answered a structured questionnaire used to collect their health status, socioeconomic-demographic, and behavioral characteristics. Periodontal examination was performed to determine the presence and severity of periodontitis, and subgingival biofilm samples were collected to quantify the relative amount of Aa by real time polymerase chain reaction. Human genomic DNA was extracted from whole blood cells and SNV genotyping was performed. Logistic regression estimated the association measurements, odds ratio (OR), and 95% confidence interval (95%CI), between the IL33 and ST2 genes with periodontitis, and subgroup analyses assessed the relative amount of Aa in these associations. 23% of individuals had periodontitis. Adjusted measurements showed a statistically significant inverse association between two SNVs of the ST2; rs148548829 (C allele) and rs10206753 (G allele). These two alleles together with a third SNV, the rs11693204 (A allele), were inversely associated with moderate periodontitis. One SNV of the IL33 gene also showed a statistically significant inverse association with moderate periodontitis. Nine SNVs of the ST2 gene were inversely associated with the relative amount of Aa. In the high Aa subgroup, there was a direct association between 11 SNVs of the ST2 gene and moderate periodontitis and two SNVs of the ST2 gene and severe periodontitis, and eight SNVs of the ST2 gene and periodontitis. These exploratory findings of genetic variants in IL-33/ST2 axis support the concept that the different tissue responses among individuals with periodontitis may be modulated by the host's genetics, influencing the physiopathology of the disease

Concurrent crack and powder cocaine users from Sao Paulo: Do they represent a different group?

<p>Abstract</p> <p>Background</p> <p>Cocaine abuse is a serious and socially damaging illegal drug problem. Different routes of administration are associated with a specific progression of use, different degrees of abuse liability, propensity for dependence and treatment response. There have been relatively few studies comparing different cocaine users groups and no studies into the characterization of the group of individuals reporting concurrent use of powder cocaine and crack cocaine.</p> <p>Methods</p> <p>Six hundred and ninety-nine cocaine users were assessed during the period August 1997 to October 1998 in one outpatient and six inpatient clinics located in the São Paulo, Brazil. Patients were interviewed using a structured questionnaire schedule in Portuguese, designed specifically for the Brazilian population. The statistical analyses were performed using either ANOVA or a chi-squared test and focusing on their preferred form of use/route of administration and other variables.</p> <p>Results</p> <p>For 83% of the variables tested in this study, the <it>Dual Users </it>subgroup (using both powder and crack cocaine) demonstrated statistical differences from the single drug user subgroups. Those differences include the initiation of cocaine, the abuse of other illicit drugs, and rates of criminal history.</p> <p>Conclusion</p> <p>These data suggest cocaine-dependent individuals who report use of both powder and crack cocaine are an at least partially, distinct subgroup. However, further studies will be necessary to confirm this and to determine if they also show a different treatment response.</p