Assisted reproductive technology and obstetric outcome in couples when the male partner has a chronic viral disease.

BACKGROUND Assisted reproductive technology (ART) with washed semen can achieve pregnancy with minimal risk of horizontal and vertical transmission of chronic viral diseases (CVD) such as human immunodeficiency virus (HIV), hepati- tis C virus (HCV) and hepatitis B virus (HBV) among serodiscordant couples. How- ever, few studies have been made of the use made by these couples of ARTs or of the obstetric results achieved. MATERIALS AND METHODS In this retrospective study, 93 men who were seropositive for HIV, HCV or HBV and who underwent assisted reproduction treatment at our centre (Hospital Universitario Virgen de las Nieves, Granada, Spain) were included. Washed semen was tested to detect viral particles. Non-infected women were tested before and after each treatment, as were the neonates at birth and after three months. RESULTS A total of 62 sperm samples were washed, and none were positive for the detec- tion of viral molecules. Semen samples from 34 HBV positive males were not washed since the female partner had immunity to hepatitis B. In total, 38 clinical pregnancies were achieved (22% per cycle and 40.9% per couple) out of 173 cycles initiated, and 28 births were achieved (16.2% per cycle and 30.1% per couple), producing 34 live births. The rate of multiple pregnancies was 21.4%. Obstetric and neonatal results were similar in the groups of couples studied. At follow-up, no seroconversion was detected in the women or neonates. CONCLUSION Sperm washing and intracytoplasmic sperm injection are shown to be a safe and effective option for reducing the risk of transmission or super infection in serodiscordant or concordant couples who wish to have a child. Pregnancies ob- tained by ART in couples when the male is CVD infected achieve good obstetric and neonatal results.

Impacto de la crisis económica en la salud

Equipo de trabajo EASP: Guadalupe Carmona López, Luis Andrés López Fernández, Oscar Javier Mendoza García, Ignacio Oleaga de Usategui. No contiene fecha de edición.

Salud pública en MERCOSUR

AUTORES Informe Uruguay DPTO. DE MEDICINA PREVENTIVA Y SOCIAL UDELAR Prof. Dra. Marisa Buglioli Prof. Agda. Dra. Ima León Prof. Adj. Dra. Cecilia Severi Asist. Dr. Miguel Alegretti Asist. Dr. Mario Romero Doc. Colaboradora: Dra. Lucia Alonso Informe Argentina UNIVERSIDAD ISALUD Prof. Martín Langsam Informe Paraguay Prof. Natalia Meza Prof. María Noce Prof. Julia Pineda Informe Brasil UNIVERSIDADE SÃO PAULO FACULTADE SAÚDE PUBLICA CEPEDOC Prof. Daniele Sacardo Nigro Prof. Juan Carlos Aneiros Fernandez Introducción a la Salud Internacional Prof. Martin Langsam Escuela Andaluza de Salud Pública COORDINACIÓN Prof. Luis Andrés López Fernández Prof. Juan Ignacio Martínez Millán ASISTENCIA TÉCNICA Y LOGÍSTICA Elisabeth María Ilidio Paulo

Efficacy of prescribed injectable diacetylmorphine in the Andalusian trial: Bayesian analysis of responders and non-responders according to a multi domain outcome index.

BACKGROUND The objective of this research was to evaluate data from a randomized clinical trial that tested injectable diacetylmorphine (DAM) and oral methadone (MMT) for substitution treatment, using a multi-domain dichotomous index, with a Bayesian approach. METHODS Sixty two long-term, socially-excluded heroin injectors, not benefiting from available treatments were randomized to receive either DAM or MMT for 9 months in Granada, Spain. Completers were 44 and data at the end of the study period was obtained for 50. Participants were determined to be responders or non responders using a multi-domain outcome index accounting for their physical and mental health and psychosocial integration, used in a previous trial. Data was analyzed with Bayesian methods, using information from a similar study conducted in The Netherlands to select a priori distributions. On adding the data from the present study to update the a priori information, the distribution of the difference in response rates were obtained and used to build credibility intervals and relevant probability computations. RESULTS In the experimental group (n = 27), the rate of responders to treatment was 70.4% (95% CI 53.287.6), and in the control group (n = 23), it was 34.8% (95% CI 15.354.3). The probability of success in the experimental group using the a posteriori distributions was higher after a proper sensitivity analysis. Almost the whole distribution of the rates difference (the one for diacetylmorphine minus methadone) was located to the right of the zero, indicating the superiority of the experimental treatment. CONCLUSION The present analysis suggests a clinical superiority of injectable diacetylmorphine compared to oral methadone in the treatment of severely affected heroin injectors not benefiting sufficiently from the available treatments. TRIAL REGISTRATION Current Controlled Trials ISRCTN52023186.

Use of Granada medium to detect group B streptococcal colonization in pregnant women.

Direct inoculation onto Granada medium (GM) in plates and tubes was compared to inoculation into a selective Todd-Hewitt broth (with 8 microg of gentamicin per ml and 15 microg of nalidixic acid per ml) for detection of group B streptococci (GBS) in pregnant women with 800 vaginal and 450 vaginoanorectal samples. Comparatively, GM was found to be as sensitive as the selective broth for the detection of GBS in vaginal specimens and more sensitive than selective broth for the detection of GBS in vaginoanorectal samples (96 versus 82%). The use of GM improved the time to reporting of a GBS-positive result by at least 24 h and reduced the direct cost of screening. We have also found that the inconvenience of anaerobic incubation of GM plates can be avoided when a cover slide is placed upon the inoculum, because aerobic incubation in GM plates with cover slides causes GBS to develop the same pigmentation that it develops with incubation under anaerobic conditions. These data support the routine use of GM plates or tubes as a more accurate, easier, and cheaper method of identification of GBS-colonized women compared to the enrichment broth technique.

New Granada Medium for detection and identification of group B streptococci.

A methotrexate-containing medium for the detection of beta-hemolytic group B streptococci from clinical specimens on the basis of detection of pigment is described. The medium contained peptone, starch, serum, MgSO4, glucose, pyruvate, methotrexate (as pigment enhancer), phosphate-morpholine-propanesulfonic acid buffer, and selective agents. The recovery of beta-hemolytic group B streptococci was comparable to that obtained with selective broth.

Projeto copiadora do CAPS Luis Cerqueira: do trabalho de reproduzir coisas à produção de vida

A necessidade manifesta de inclusão no processo de produção da vida material através do trabalho, de uma parcela da população usuária de serviço de saúde mental, deu origem a este estudo. Para apreender o significado do trabalho utilizou-se o referencial do materialismo histórico e dialético, fundamentado no conceito de reabilitação psicossocial, e o fez através da análise dos discursos dos usuários. O cenário é o Centro de Atenção Psicossocial Prof. Luis Cerqueira (CAPS). Os resultados indicam a compreensão do trabalho como um instrumento que possibilita aos usuários acessar o campo dos direitos sociais.

Embarazo, parto y puerperio: creencias y prácticas de parteras en San Luis Potosí, México

OBJETIVO: Documentar las creencias y las prácticas de las parteras tradicionales respecto al embarazo parto y puerperio. MÉTODOS: Aprovechando un curso de capacitación de 160 parteras tradicionales locales de las regiones Media y Huasteca del Estado de San Luis Potosí, México, dos de las enfermeras-instructoras entrevistaron a 25 de los capacitandos, apoyadas por un miembro de las comunidades náhuatl y tenek. La identidad de los participantes se mantiene anónima y se obtuvo permiso para publicar los resultados mediante consentimiento informado. RESULTADOS: Las prácticas de las parteras (os) tradicionales son comunes en los grupos sociales que carecen de servicios de salud. Sus funciones no están limitadas al parto e incluyen nutrición, cuidados prenatales, del puerperio y la lactancia, así como apoyo afectivo emocional de las madres parturientas y sus familiares. En este estudio se registraron varios mitos y terapias tradicionales. CONCLUSIÓN: Los recursos de la terapia tradicional y de la atención primaria de la salud de las parteras Náhuatl y Tenek son útiles y benéficos para los cuidados perinatales.

Morfogènesi de pilars de terra (earth Pillars, hoodoos). Exemples de la Riera de Gaià (Vallès Occidental, Barcelona) i del Bernal de Yátor (Las Alpujarras, Granada)

The origin and the primary features of the erosive earth pillar-like formations that develop in the Riera de Gaià (Barcelona) and in the Bernal de Yátor (Granada) are described. They are dynamic formations typical of areas subjected to strong water erosion

Aprovechamiento educativo y turístico de formas erosivas tipo pilares de tierra (earth pillars, hoodoos) : ejemplos de la riera de Gaià (Vallès occidental, Barcelona) y del Bernal de Yátor (la Alpujarra, Granada)

Se describen los principales rasgos geomorfológicos de las formas erosivas de tipo pilares de tierra que se desarrollan en la Riera de Gaià (Barcelona) y en el Bernal de Yátor (Granada) Se trata de formas dinámicas, propias de zonas sometidas a una fuerte erosión hídrica, con un elevado interés científico, estético y didáctico

La información especializada en Internet: directorio de recursos de interés académico y profesional (Ángeles Maldonado y Luis Rodríguez-Yunta, coords.)

Los más viejos del lugar recordarán con nostalgia los repertorios clásicos de fuentes de información elaborados por Malclès y Sabor... A los no tan viejos les sonarán los nombres de Sheehy (o Balay) y Walford

Informe sobre el IV Congreso ISKO-España, EOCONSID'99 (Granada,22-24 d'abril de 1999)

El quart EOCONSID (Encuentro de Organización del Conocimiento en Sistemas de Información y Documentación), organitzat per ISKO-España (Capítulo Español de la International Society for Knowledge Organization), ha suposat «situar en el mapa» un congrés i una entitat que fins ara havien tingut poca projecció. Tot i organitzar les trobades regularment ¿cada dos anys¿ des del 1993, el poc coneixement de l'entitat i dels seus objectius comportava una assistència escassa de professionals a les trobades, limitada, es podria dir, als membres de l'entitat i als alumnes de la Universidad Carlos III, ¿entitat que havia acollit les segones i terceres trobades. Igualment, les actes publicades tenien poc ressò, tot i incloure contribucions d'un bon nivell de qualitat. El canvi en els òrgans de govern d'ISKO-España, el 1998, va replantejar la manera d'organitzar el congrés: es va decidir formar un equip independent de la junta directiva que s'hi pogués dedicar plenament i que garantís un major grau de professionalitat.

Luis Cernuda: platonic emotiveness versus presocratic-aristotelian mind

The aim of this article is to show how, although the poet finds himself materialist or both Presocratic and Aristotelian, his poetic emotiveness is truly Platonic or idealist, so that that tension between reality and desire with the help of which his poetry has always been defined becomes once more confirmed thanks to the analysis of his poems from a philosophical rather than a literary point of view.

Luis Cernuda: emotivitat platònica versus mentalitat presocraticoaristotèlica

L'objectiu d'aquest article és mostrar com, malgrat declarar-se materialista o presocraticoaristotèlic, l'emotivitat poètica de Luis Cernuda és clarament platònica o idealista, de manera que la tensió entre la realitat i el desig que sempre ha definit la seva poesia es referma també gràcies a l'anàlisi de la seva obra des d¿una òptica més filosòfica que no pas literària.