Sensibilidad antimicrobiana de Escherichia coli causante de infecciones urinarias en mujeres embarazadas entre las edades de 15 a 40 años que asisten al control prenatal en el Hospital Nacional Dr. Jorge Arturo Mena, Santiago de María, departamento de Usulután en el periodo de junio a agosto de 2014

La sensibilidad antimicrobiana es la capacidad que tienen los antibióticos de disminuir el potencial infeccioso de los microorganismos causantes de infección. El método para determinar la sensibilidad antimicrobiana, permite al médico escoger el antibiótico más adecuado con base científica proporcionado por el laboratorio clínico. El objetivo de la investigación fue determinar sensibilidad antimicrobiana de Escherichia coli la causante de infecciones urinarias en mujeres embarazadas entre las edades de 15 a 40 años que asisten al control prenatal en el Hospital Nacional Dr. Jorge Arturo Mena, Santiago de María, departamento de Usulután en el periodo de junio a agosto de 2014. La metodología fue de tipo: prospectiva, transversal, descriptiva. Donde a las muestras de orina de mujeres embarazadas se les realizó un urocultivo en el cual se aisló la bacteria Escherichia coli y a la vez se evaluó la sensibilidad antimicrobiana de la bacteria a nitrofurantoína, gentamicina, amikacina, ampicilina y amoxicilina utilizando el método estandarizado de difusión en agar, Kirby Bauer, estas se procesaron en el laboratorio del Hospital Nacional Dr. Jorge Arturo Mena de Santiago de María. Resultados obtenidos: las cepas de Escherichia coli presentaron una susceptibilidad a la nitrofurantoina del 100%, gentamicina 96.97%, amikacina 90.9%, ampicilina 81.81% y una resistencia a la amoxicilina del 100%. Conclusión: se comprobó estadísticamente que las cepas de Escherichia coli presentaron igual susceptibilidad antimicrobiana ante la nitrofurantoina, gentamicina y amikacina; pero menor susceptibilidad ante ampicilina y amoxicilina.

Does prenatal diagnosis modify neonatal treatment and early outcome of children with esophageal atresia?

International audience

Perfil prenatal en mujeres que reciben atención médica en los Equipos Comunitarios de Salud San Simón, Potrero, Quebradas y Carrizal del Municipio de San Simón, departamento de Morazán

El embarazo es un proceso que debe transcurrir con toda normalidad y sin ningún riesgo en toda mujer en edad fértil. El control prenatal constituye uno de los eventos más importantes para la salud materno fetal. El objetivo de la investigación es determinar el perfil prenatal en mujeres que reciben atención médica en los Equipos Comunitarios de Salud San Simón, Potrero, Quebrada y Carrizal del municipio de San Simón, departamento de Morazán. La metodología empleada fue de tipo prospectivo, transversal, descriptiva, de campo, bibliográfica y de laboratorio, se hizo uso de técnicas documentales y técnicas de laboratorio. Se trabajó con una muestra de 81 embarazadas a quienes se les realizó pruebas de sangre y examen general de orina. Resultados: El examen general de orina presentó mayor porcentaje de alteraciones sugestivas a patologías con un 17.6% en el ECOS San Simón, 25.0% ECOS Potreros, 12.5% en ECOS Quebradas y 27.1% en ECOS Carrizal. El hematócrito y hemoglobina presentaron 11.8% de alteración en el ECOS San Simón, 25.0% en ECOS Potrero, 6.2% en ECOS Carrizal y en ECOS Quebrada no hubo alteración. Se descarta la presencia de incompatibilidad sanguínea materno fetal, VIH, sífilis y diabetes gestacional. Se obtuvo un 14.8% de embarazadas con abortos previos. Conclusiones: A partir de la información presentada en los datos descriptivos y la prueba de hipótesis aplicada, estadísticamente se concluyó que: La prueba que presentó mayor efecto en la alteración del perfil prenatal con sugestividad a patología en las embarazadas es el examen general de orina, seguido de las pruebas de Hematócrito-Hemoglobina.

Asociaciones entre el crecimiento prenatal y la antropometría materna en el Uruguay

Introducción: No se conoce la influencia combinada del índice de masa corporal pregestacional (IMC-PG) y de la ganancia de peso gestacional (GPG) sobre el peso al nacer extremo (<3000 gy ≥4000 g) en el Uruguay. Objetivos: Determinar la prevalencia de diferentes categorías de IMC-PG y de GPG y luego conocer sus riesgos independientes y combinados sobre el peso al nacer <3000 go con retardo de crecimiento intrauterino (RCIU) y ≥ 4000 g (macrosomía) en una muestra nacional de madres y recién nacidos. Métodos: Estudio de cohorte con datos prospectivos de 23.832 embarazadas donde se clasificó el estado nutricional pregestacional según IMC-PG del patrón de Estados Unidos. La GPG se clasificó de acuerdo a una propuesta de Dinamarca. Se determinaron los riesgos independientes y combinados de las distintas categorías de IMC-PG y de GPG con RCIU y macrosomía utilizando el riesgo relativo (RR). Resultados: Los RR de RCIU y macrosomía resultaron estadísticamente significativos en su asociación independiente con IMC-PG y GPG. En embarazadas con bajo IMC-PG se apreció un alto riesgo de RCIU y en embarazadas con elevado IMC-PG (sobrepeso u obesidad) un alto riesgo de macrosomía. También en el análisis de la influencia combinada se mantuvieron las importantes asociaciones de IMC-PG y GPG. Conclusiones: Existe un efecto independiente y combinado de las variables maternas sobre los resultados perinatales. Se sugiere comparar estos resultados, que utilizaron categorías de IMC-PG del patrón de Estados Unidos y categorías de GPG provenientes de Dinamarca, con otros patrones.

Prenatal appetitive learning about ethanol in the rat: possible reinforcers.

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Postnatal Evaluation and Outcome of Prenatal Hydronephrosis

Background: Prenatal hydronephrosis (PNH) is dilation in urinary collecting system and is the most frequent neonatal urinary tract abnormality with an incidence of 1% to 5% of all pregnancies. PNH is defined as anteroposterior diameter (APD) of renal pelvis ≥ 4 mm at gestational age (GA) of < 33 weeks and APD ≥ 7 mm at GA of ≥ 33 weeks to 2 months after birth. All patients need to be evaluated after birth by postnatal renal ultrasonography (US). In the vast majority of cases, watchful waiting is the only thing to do; others need medical or surgical therapy. Objectives: There is a direct relationship between APD of renal pelvis and outcome of PNH. Therefore we were to find the best cutoff point APD of renal pelvis which leads to surgical outcome. Patients and Methods: In this retrospective cohort study we followed 200 patients 1 to 60 days old with diagnosis of PNH based on before or after birth ultrasonography; as a prenatal or postnatal detected, respectively. These patients were referred to the nephrology clinic in Zahedan Iran during 2011 to 2013. The first step of investigation was a postnatal renal US, by the same expert radiologist and classifying the patients into 3 groups; normal, mild/moderate and severe. The second step was to perform voiding cystourethrogram (VCUG) for mild/moderate to severe cases at 4 - 6 weeks of life. Tc-diethylene triamine-pentaacetic acid (DTPA) was the last step and for those with normal VCUG who did not show improvement in follow-up examination, US to evaluate obstruction and renal function. Finally all patients with mild/moderate to severe PNH received conservative therapy and surgery was preserved only for progressive cases, obstruction or renal function ≤35%. All patients’ data and radiologic information was recorded in separate data forms, and then analyzed by SPSS (version 22). Results: 200 screened PNH patients with male to female ratio 3.5:1 underwent first postnatal control US, of whom 65% had normal, 18% mild/moderate and 17% severe hydronephrosis. 167 patients had VCUG of whom 20.82% with VUR. 112 patients performed DTPA with following results: 50 patients had obstruction and 62 patients showed no obstructive finding. Finally 54% of 200 patients recovered by conservative therapy, 12.5% by surgery and remaining improved without any surgical intervention. Conclusions: The best cutoff point of anteroposterior renal pelvis diameter that led to surgery was 15 mm, with sensitivity 88% and specificity 74%.

Effects of Increased Levels of Prenatal Mesotocin on Postnatal Individual Recognition and Stress Responsiveness in Northern bobwhite quail (Colinus Virginianus)

Oxytocin (OT) plays a key role in the mediation of social and stress behaviors across many species; however, the mechanism is still unclear. The present study investigated the influence of prenatal levels of mesotocin (MT; avian homologue of OT) on postnatal social and stress behavior in Northern bobwhite quail. Experiment one determined endogenous levels of MT during prenatal development using an enzyme-linked immunoassay kit. Experiment two examined the influence of increased MT during prenatal development on chicks' individual recognition ability and stress response to a novel environment. Experiment one showed MT levels increased significantly throughout embryonic development. Experiment two showed significant differences in stress behavior for chicks with increased MT during prenatal development; however, no significant differences were found for social behavior. This study suggests MT serves different functions depending on the stage of embryonic development and that increasing MT levels affects postnatal stress behavior, but not social behavior.

Balance ability in 7- and 10-year-old children:associations with prenatal lead and cadmium exposure and with blood lead levels in childhood in a prospective birth cohort study

OBJECTIVES: Most studies reporting evidence of adverse effects of lead and cadmium on the ability to balance have been conducted in high-exposure groups or have included adults. The effects of prenatal exposure have not been well studied, nor have the effects in children been directly studied. The aim of the study was to identify the associations of lead (in utero and in childhood) and cadmium (in utero) exposure with the ability to balance in children aged 7 and 10 years. DESIGN: Prospective birth cohort study. PARTICIPANTS: Maternal blood lead (n=4285) and cadmium (n=4286) levels were measured by inductively coupled plasma mass spectrometry in women enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC) during pregnancy. Child lead levels were measured in a subsample of 582 of ALSPAC children at age 30 months. MAIN OUTCOME MEASURES: Children completed a heel-to-toe walking test at 7 years. At 10 years, the children underwent clinical tests of static and dynamic balance. Statistical analysis using SPSS V.19 included logistic regression modelling, comparing categories of ≥ 5 vs <5 µg/dL for lead, and ≥ 1 vs <1 µg/L for cadmium. RESULTS: Balance at age 7 years was not associated with elevated in utero lead or cadmium exposure (adjusted OR for balance dysfunction: Pb 1.01 (95% CI 0.95 to 1.01), n=1732; Cd 0.95 (0.77 to 1.20), n=1734), or with elevated child blood lead level at age 30 months (adjusted OR 0.98 (0.92 to 1.05), n=354). Similarly, neither measures of static nor dynamic balance at age 10 years were associated with in utero lead or cadmium exposure, or child lead level. CONCLUSIONS: These findings do not provide any evidence of an association of prenatal exposure to lead or cadmium, or lead levels in childhood, on balance ability in children. Confirmation in other cohorts is needed.

Prenatal alcohol exposure and childhood balance ability:findings from a UK birth cohort study

OBJECTIVE: To investigate the association of prenatal alcohol exposure with balance in10-year-old children. DESIGN: Population-based prospective longitudinal study. SETTING: Former Avon region of UK (Southwest England). PARTICIPANTS: 6915 children from the Avon Longitudinal Study of Parents and Children who had a balance assessment at age 10 and had data on maternal alcohol consumption. OUTCOME MEASURES: 3 composite balance scores: dynamic balance (beam-walking), static balance eyes open, static balance eyes closed (heel-to-toe balance on a beam and standing on one leg, eyes open or closed). RESULTS: Most mothers (95.5%) consumed no-to-moderate amounts (3-7 glasses/week) of alcohol during pregnancy. Higher total-alcohol consumption was associated with maternal-social advantage, whereas binge drinking (≥4 units/day) and abstinence were associated with maternal social disadvantage. No evidence was found of an adverse effect of maternal-alcohol consumption on childhood balance. Higher maternal-alcohol use during pregnancy was generally associated with better offspring outcomes, with some specific effects appearing strong (static balance eyes open and moderate total alcohol exposure at 18 weeks, adjusted OR 1.23 (95% CI 1.01 to 1.49); static balance eyes closed and moderate total alcohol exposure at 18 weeks, adjusted OR 1.25 (95% CI 1.06 to 1.48). Similar results were found for both paternal and postnatal maternal alcohol exposure. A Mendelian-randomization approach was used to estimate the association between maternal genotype and offspring balance using the non-synonymous variant rs1229984*A (ADH1B) to proxy for lower maternal alcohol consumption; no strong associations were found between this genotype/proxy and offspring balance. CONCLUSIONS: No evidence was found to indicate that moderate maternal alcohol consumption in this population sample had an adverse effect on offspring balance at age 10. An apparent beneficial effect of higher total maternal alcohol consumption on offspring balance appeared likely to reflect residual confounding.

Prenatal Diagnosis of Infantile Neuroaxonal Dystrophy

Infantile Neuroaxonal Dystrophy (INAD1, MIM # 256600), is a rare autossomal recessive neurodegenerative disorder. The clinical picture is characterized by psychomotor regression and hypotonia, which progresses to spastic tetraplegia, visual impairment and dementia. Onset is within the first 2 years of life and death usually happens before the age of 10. In 2006, Morgan et al described that mutations in PLA2G6 gene localized in chromosome 22 (22q13), caused INAD1. Evidence showed that a large proportion of patients with infantile neuroaxonal dystrophy have a mutation in the PLA2G6 gene. A 36-years-old pregnant woman presented for obstetric follow up. It was the second pregnancy of this healthy, nonconsanguineous couple. Their 7 year-old daughter was affected with Infantile Neuroaxonal Dystrophy. Molecular testing was done in the child and, as a causal mutation was detected, it was possible to offer a specific prenatal diagnosis. The molecular study of PLA2G6 gene by amniocentesis showed the presence of a mutation in heterozygoty and the karyotype was normal for a female foetus. To our knowledge, this is the first molecular prenatal diagnosis of INAD1 in Portugal.

Iowa's Barriers to Prenatal Care Project: 2-14 Data Summary, July 2015

The findings in this summary are based on the Iowa Barriers to Prenatal Care project. Ongoing since 1991, the purpose of this project is to obtain brief, accurate information about women delivering babies in Iowa hospitals. Specifically, the project seeks to learn about women’s experiences getting prenatal or delivery care during their current pregnancy. Other information is included which may be pertinent to health planners or those concerned with the systematic development of health care services. This project is a cooperative venture of all of Iowa’s maternity hospitals, the University of Northern Iowa Center for Social and Behavioral Research, and the Iowa Department of Public Health. The Robert Wood Johnson Foundation funded the first three years of this project. The current funding is provided by the Iowa Department of Public Health. The Director is Dr. Mary Losch, University of Northern Iowa Center for Social and Behavioral Research. The Coordinator for the project is Rodney Muilenburg. The questionnaire is distributed to nearly ninety maternity hospitals across the state of Iowa. Nursing staff or those responsible for obtaining birth certificate information in the obstetrics unit are responsible for approaching all birth mothers prior to dismissal and requesting their participation in the study. The questionnaire takes approximately ten minutes to complete. Completed questionnaires are returned to the University of Northern Iowa Center for Social and Behavioral Research for data entry and analysis. Returns are made monthly, weekly, or biweekly depending on the number of births per week in a given hospital. Except in the case of a mother who is too ill to complete the questionnaire, all mothers are eligible to be recruited for participation. The present yearly report includes an analysis of large Iowa cities, African American mothers, and a trend analysis of the last ten years. Also presented in this report is a frequency analysis of all variables included in the 2012 questionnaire. Unless otherwise noted, all entries reflect percentages. Please note that because percentages were rounded, total values may not equal 100%. Data presented are based upon 2012 questionnaires received to date (n = 23,674). All analyses reflect unweighted percentages of those responding.

Prenatal education: profile and expectations of the couples.

Develop the capacities of women/couples to stay healthy during pregnancy, becoming aware of the rights, needs and potential problems of maternal and newborn health is a challenge for nurses and midwives who work with this population (Departamento de Reducir los Riesgos del Embarazo 2010). Prenatal education is a good strategy to meet the needs of pregnant women/couples, to improve outcomes in health and community development (Svenson, Barclay & Cooke 2006). Knowing the profile and expectations of the participants in these prenatal education groups, improves the quality of prenatal education programs and enables higher qualification of the professionals who promote them.

Prenatal education: profile and expectations of the couples.

Characterize the profile and describe the expectations of a sample of couple's participants in prenatal education programs integrated into the 'Tender Adventure - Preparation for childbirth and parenting' ", an outreach project of Nursing School of Coimbra.

Towards Humane Technologies: Biotechnologies, New Media and Ethics

What are the ethical and political implications when the very foundations of life —things of awe and spiritual significance — are translated into products accessible to few people? This book critically analyses this historic recontextualisation. Through mediation — when meaning moves ‘from one text to another, from one discourse to another’ — biotechnology is transformed into analysable data and into public discourses. The unique book links biotechnology with media and citizenship. As with any ‘commodity’, biological products have been commodified. Because enormous speculative investment rests on this, risk will be understated and benefit will be overstated. Benefits will be unfairly distributed. Already, the bioprospecting of Southern megadiverse nations, legally sanctioned by U.S. property rights conventions, has led to wealth and health benefits in the North. Crucial to this development are biotechnological discourses that shift meanings from a “language of life” into technocratic discourses, infused with neo-liberal economic assumptions that promise progress and benefits for all. Crucial in this is the mass media’s representation of biotechnology for an audience with poor scientific literacy. Yet, even apparently benign biotechnology spawned by the Human Genome Project such as prenatal screening has eugenic possibilities, and genetic codes for illness are eagerly sought by insurance companies seeking to exclude certain people. These issues raise important questions about a citizenship that is founded on moral responsibility for the wellbeing of society now and into the future. After all, biotechnology is very much concerned with the essence of life itself. This book provides a space for alternative and dissident voices beyond the hype that surrounds biotechnology.

Age-related development of a refractive index plateau in the human lens : evidence for a distinct nucleus

The human lens comprises two distinct regions in which the refractive index changes at different rates. The periphery contains a rapidly increasing refractive index gradient, which becomes steeper with age. The inner region contains a shallow gradient, which flattens with age, due to formation of a central plateau, of RI = 1.418, which reaches a maximum size of 7.0 × 3.05 mm around age 60 years. Formation of the plateau can be attributed to compression of fibre cells generated in prenatal life. Present in prenatal but not in postnatal fibre cells, γ-crystallin may play a role in limiting nuclear cell compression.