COMPLICACIONES MATERNAS EN PACIENTES CON PREECLAMPSIA. HOSPITAL CENTRAL UNIVERSITARIO DR. ANTONIO MARIA PINEDA. LAPSO MAYO - DICIEMBRE 2014

La Preeclampsia se considera un problema de salud p\ufablica y est\ue1 asociada a una alta morbi-mortalidad materna y fetal. Por tal motivo, el objetivo del presente estudio fue describir las complicaciones maternas en pacientes con diagn\uf3stico de Preeclampsia ingresadas en el Departamento de Obstetricia y Ginecolog\ueda del Hospital Central Universitario "Dr. Antonio Mar\ueda Pineda", durante el lapso mayo-diciembre 2014. Para ello, se realiz\uf3 un estudio descriptivo retrospectivo, obteniendo una serie de 152 pacientes, de las cuales 62,50% correspondan al grupo de edad entre 20-34 a\uf1os y 46,05% eran primigestas. Adem\ue1s, 62,50% registraron embarazo pret\ue9rmino, 70,39% estuvieron hospitalizadas entre 2-7 d\uedas y 96,05% reportaron preeclampsia severa; en 75% la v\ueda de terminaci\uf3n fue ces\ue1rea y 84,21% fueron atendidas en sala de parto y las maternidades; sin embargo, 8,55% estuvieron hospitalizadas en el Servicio de Medicina de Agudos y 7,24% en la Unidad de Cuidados Intensivos y Trauma Shock. Entre las Comorbilidades se encuentra hipertensi\uf3n arterial cr\uf3nica (15,79%) y obesidad (3,95%). Asimismo, 32,03% presentaron complicaciones maternas, 28,29% complicaciones tanto maternas como fetales, 11,18% complicaciones fetales y 9,87% muerte materna. A su vez, se registraron como complicaciones maternas m\ue9dicas alteraciones hematol\uf3gicas (83,87%), S\uedndrome de Hellp (62,36%), alteraciones metab\uf3licas (39,78%), alteraciones cardio-respiratorias (20,43%) y alteraciones renales (13,97%); mientras que las complicaciones maternas obst\ue9tricas fueron desprendimiento prematuro de placenta (11,82%) y hemorragia postparto (12,90%). De esta manera, al identificar las principales complicaciones maternas es posible ejecutar una conducta adecuada y realizar una intervenci\uf3n precoz para prevenir la aparici\uf3n de las mismas en su forma m\ue1s grave. PALABRAS CLAVE: Preeclampsia, complicaciones maternas m\ue9dicas y obst\ue9tricas. ABSTRACT Preeclampsia is considered a public health problem and it is associated to high maternal and fetal morbility - mortality. For this reason, the objective of the following research was to describe the maternal complications in patients with a diagnosis of preeclampsia who entered in the Obstetrics and Gynecology Department of the Central University Hospital "Dr. Antonio Mar\ueda Pineda", during the time period of May - December 2014. A Descriptive retrospective study was made, obtaining a series of 152 patients in which 62,50% corresponded to the age grup between 20-30 years old, 46,05% were newly expecting mothers. In addition, 62,50% registered prematury delivery, 70,39% were hospitalized between 2-7 days and 96,05% reported severe preeclampsia; also a 75% of de way of culmination of pregnancy was by caesarean operation and 84,21% were treated in the delivery room, however, 8,55% were hospitalized in the Acute Medical Service and 7,24% in the Shock Trauma Intensive Care Unit. Between the comorbidities chronic arterial hypertension was found (15,79%) and obesity (3,95%). Likewise, 32,03% presented maternal complications, 2829% showed both maternal and fetal complications, 11,18% fetal complications and 9,87% maternal death. At the same time, hematologic alterations were registered as medical maternal complications (83,87%), Hellp syndrome (62,36%) metabolic alterations (39,78%), cardio-respiratory alterations (20,43%) and renal alterations (13,97%); whereas the obstetric alterations were premature release of the placenta (11,82%) and postpartum hemorrhage (12,90%). In the way, it was achieved to obtain the main maternal complications in manner to use the most adequate conduct for this disorder together with the early interventions to be able to decrease the maternal events adverse in the context of its acute form. KEY WORDS: Preeclampsia, Obstetric medical complications.<br

Immunoglobulin, glucocorticoid, or combination therapy for multisystem inflammatory syndrome in children: a propensity-weighted cohort study.

BACKGROUND: Multisystem inflammatory syndrome in children (MIS-C), a hyperinflammatory condition associated with SARS-CoV-2 infection, has emerged as a serious illness in children worldwide. Immunoglobulin or glucocorticoids, or both, are currently recommended treatments. METHODS: The Best Available Treatment Study evaluated immunomodulatory treatments for MIS-C in an international observational cohort. Analysis of the first 614 patients was previously reported. In this propensity-weighted cohort study, clinical and outcome data from children with suspected or proven MIS-C were collected onto a web-based Research Electronic Data Capture database. After excluding neonates and incomplete or duplicate records, inverse probability weighting was used to compare primary treatments with intravenous immunoglobulin, intravenous immunoglobulin plus glucocorticoids, or glucocorticoids alone, using intravenous immunoglobulin as the reference treatment. Primary outcomes were a composite of inotropic or ventilator support from the second day after treatment initiation, or death, and time to improvement on an ordinal clinical severity scale. Secondary outcomes included treatment escalation, clinical deterioration, fever, and coronary artery aneurysm occurrence and resolution. This study is registered with the ISRCTN registry, ISRCTN69546370. FINDINGS: We enrolled 2101 children (aged 0 months to 19 years) with clinically diagnosed MIS-C from 39 countries between June 14, 2020, and April 25, 2022, and, following exclusions, 2009 patients were included for analysis (median age 8·0 years [IQR 4·2-11·4], 1191 [59·3%] male and 818 [40·7%] female, and 825 [41·1%] White). 680 (33·8%) patients received primary treatment with intravenous immunoglobulin, 698 (34·7%) with intravenous immunoglobulin plus glucocorticoids, 487 (24·2%) with glucocorticoids alone; 59 (2·9%) patients received other combinations, including biologicals, and 85 (4·2%) patients received no immunomodulators. There were no significant differences between treatments for primary outcomes for the 1586 patients with complete baseline and outcome data that were considered for primary analysis. Adjusted odds ratios for ventilation, inotropic support, or death were 1·09 (95% CI 0·75-1·58; corrected p value=1·00) for intravenous immunoglobulin plus glucocorticoids and 0·93 (0·58-1·47; corrected p value=1·00) for glucocorticoids alone, versus intravenous immunoglobulin alone. Adjusted average hazard ratios for time to improvement were 1·04 (95% CI 0·91-1·20; corrected p value=1·00) for intravenous immunoglobulin plus glucocorticoids, and 0·84 (0·70-1·00; corrected p value=0·22) for glucocorticoids alone, versus intravenous immunoglobulin alone. Treatment escalation was less frequent for intravenous immunoglobulin plus glucocorticoids (OR 0·15 [95% CI 0·11-0·20]; p<0·0001) and glucocorticoids alone (0·68 [0·50-0·93]; p=0·014) versus intravenous immunoglobulin alone. Persistent fever (from day 2 onward) was less common with intravenous immunoglobulin plus glucocorticoids compared with either intravenous immunoglobulin alone (OR 0·50 [95% CI 0·38-0·67]; p<0·0001) or glucocorticoids alone (0·63 [0·45-0·88]; p=0·0058). Coronary artery aneurysm occurrence and resolution did not differ significantly between treatment groups. INTERPRETATION: Recovery rates, including occurrence and resolution of coronary artery aneurysms, were similar for primary treatment with intravenous immunoglobulin when compared to glucocorticoids or intravenous immunoglobulin plus glucocorticoids. Initial treatment with glucocorticoids appears to be a safe alternative to immunoglobulin or combined therapy, and might be advantageous in view of the cost and limited availability of intravenous immunoglobulin in many countries. FUNDING: Imperial College London, the European Union's Horizon 2020, Wellcome Trust, the Medical Research Foundation, UK National Institute for Health and Care Research, and National Institutes of Health

Complicaciones maternas en pacientes con preeclampsia. Hospital Central Universitario Dr. "Antonio Mar\ueda Pineda"

La Preeclampsia se considera un problema de salud p\ufablica y est\ue1 asociada a una alta morbi-mortalidad materna y fetal. Por tal motivo, el objetivo del presente estudio fue describir las complicaciones maternas en pacientes con diagn\uf3stico de Preeclampsia ingresadas en el Departamento de Obstetricia y Ginecolog\ueda del Hospital Central Universitario \u93Dr. Antonio Mar\ueda Pineda\u94, durante el lapso mayo-diciembre 2014. Para ello, se realiz\uf3 un estudio descriptivo retrospectivo, obteniendo una serie de 152 pacientes, de las cuales 62,50% correspondan al grupo de edad entre 20-34 a\uf1os y 46,05% eran primigestas. Adem\ue1s, 62,50% registraron embarazo pret\ue9rmino, 70,39% estuvieron hospitalizadas entre 2-7 d\uedas y 96,05% reportaron preeclampsia severa; en 75% la v\ueda de terminaci\uf3n fue ces\ue1rea y 84,21% fueron atendidas en sala de parto y las maternidades; sin embargo, 8,55% estuvieron hospitalizadas en el Servicio de Medicina de Agudos y 7,24% en la Unidad de Cuidados Intensivos y Trauma Shock. Entre las Comorbilidades se encuentra hipertensi\uf3n arterial cr\uf3nica (15,79%) y obesidad (3,95%). Asimismo, 32,03% presentaron complicaciones maternas, 28,29% complicaciones tanto maternas como fetales, 11,18% complicaciones fetales y 9,87% muerte materna. A su vez, se registraron como complicaciones maternas m\ue9dicas alteraciones hematol\uf3gicas (83,87%), S\uedndrome de Hellp (62,36%), alteraciones metab\uf3licas (39,78%), alteraciones cardio-respiratorias (20,43%) y alteraciones renales (13,97%); mientras que las complicaciones maternas obst\ue9tricas fueron desprendimiento prematuro de placenta (11,82%) y hemorragia postparto (12,90%). De esta manera, al identificar las principales complicaciones maternas es posible ejecutar una conducta adecuada y realizar una intervenci\uf3n precoz para prevenir la aparici\uf3n de las mismas en su forma m\ue1s grave

Pensamiento Novohispano 19

En este número nos encontramos con investigaciones que tienen por objetivo mostrarnos tanto la diversidad de temas estudiados como la riqueza cultural correspondiente al mundo novohispano. En el trabajo titulado "Algunos puntos de Filosofía Novohispana", el autor nos presenta consideraciones correspondientes a los tres siglos de la colonia. Otra aportación relevante, compilada aquí, en el contexto de la conquista y la evangelización, es "El pecado de avaricia en el Tratado sobre los siete pecados mortales, de fray Andrés de Olmos" en donde su autor nos brinda una serte de reflexiones acerca del pecado de avaricia y sus implicaciones. Además, la investigación "Secularización de los Diezmos piadosos en la Nueva España" tiene como finalidad aclarar cuál fue el verdadero sentido de la práctica "obligatoria" de los diezmos y cuál fue la postura de algunos frailes respecto a esa práctica piadosa en el periodo colonial.Universidad Autónoma del Estado de México

LA INCLUSIÓN EDUCATIVA EN LA PERSPECTIVA INTERDISCIPLINARIA

SE DAN APORTACIONES QUE AYUDAN A COMPRENDER QUE ACCCIONES Y CAMBIOS TOMAR PARA MEJORAR LA EDUCACIÓN.EL LIBR PRESENTA DIVERSOS TRABAJOS QUE ABORDAN LA PROBLEMÁTICA DE LA EDUCACIÓN DESDE LA PERSPECTIVA INTERDISCIPLINARIA.NINGUN

Compilación de Proyectos de Investigacion de 1984-2002

Instituto Politecnico Nacional. UPIICS

NEOTROPICAL ALIEN MAMMALS: a data set of occurrence and abundance of alien mammals in the Neotropics

Biological invasion is one of the main threats to native biodiversity. For a species to become invasive, it must be voluntarily or involuntarily introduced by humans into a nonnative habitat. Mammals were among first taxa to be introduced worldwide for game, meat, and labor, yet the number of species introduced in the Neotropics remains unknown. In this data set, we make available occurrence and abundance data on mammal species that (1) transposed a geographical barrier and (2) were voluntarily or involuntarily introduced by humans into the Neotropics. Our data set is composed of 73,738 historical and current georeferenced records on alien mammal species of which around 96% correspond to occurrence data on 77 species belonging to eight orders and 26 families. Data cover 26 continental countries in the Neotropics, ranging from Mexico and its frontier regions (southern Florida and coastal-central Florida in the southeast United States) to Argentina, Paraguay, Chile, and Uruguay, and the 13 countries of Caribbean islands. Our data set also includes neotropical species (e.g., Callithrix sp., Myocastor coypus, Nasua nasua) considered alien in particular areas of Neotropics. The most numerous species in terms of records are from Bos sp. (n = 37,782), Sus scrofa (n = 6,730), and Canis familiaris (n = 10,084); 17 species were represented by only one record (e.g., Syncerus caffer, Cervus timorensis, Cervus unicolor, Canis latrans). Primates have the highest number of species in the data set (n = 20 species), partly because of uncertainties regarding taxonomic identification of the genera Callithrix, which includes the species Callithrix aurita, Callithrix flaviceps, Callithrix geoffroyi, Callithrix jacchus, Callithrix kuhlii, Callithrix penicillata, and their hybrids. This unique data set will be a valuable source of information on invasion risk assessments, biodiversity redistribution and conservation-related research. There are no copyright restrictions. Please cite this data paper when using the data in publications. We also request that researchers and teachers inform us on how they are using the data