Antonio González

Maternal serum interleukin 1, 2, 6, 8 and interleukin-2 receptor levels in preterm labor and delivery

OBJECTIVE To determine the concentrations of maternal serum interleukins (ILs) 1, 2, 6, 8 and IL-2 receptors (IL-2R) in patients in their second and third trimesters of pregnancy and in preterm labor and delivery without evidence of chorioamnionitis. STUDY DESIGN The study was conducted in La Paz Maternal Hospital, Madrid. Maternal serum IL concentrations were measured in 103 gravidas during preterm labor and delivery. The Mann-Whitney U test was used for analysis. RESULTS Women in preterm labor and delivery had significantly higher median IL-2R concentration. Women who responded to tocolysis had significantly lower serum concentrations of IL-6. IL-2R and IL-6 serum concentrations predict delivery in 48 h and before 34 weeks gestation. CONCLUSIONS Compared with non-laboring gravidas, those in idiopathic preterm labor or delivery had significantly higher concentrations of maternal serum IL-2R. Both IL-6 and IL-2R may predict failure of tocolysis. IL-2 does not seem to play an important role in pregnancy.

Fetal myocardial morphological and functional changes associated with well-controlled gestational diabetes.

OBJECTIVE To make a global evaluation of the fetal myocardial changes in a well-controlled gestational diabetic population. STUDY DESIGN Twenty-four pregnant well-controlled diabetic patients were selected. Sixteen normal pregnancies were randomly collected as a control group. Measurements of morphological and functional myocardial parameters were performed. Data from the left ventricular outflow tract and peripheral Doppler data were obtained. RESULT The thickness of the interventricular septum was increased in diabetic pregnancies (p < 0.001). Tricuspid E/A index was the only functional parameter showing a significant variation, with lower values in diabetic pregnancies. Doppler parameters from the left ventricular outflow tract and peripheral Doppler waveforms were similar between groups. CONCLUSION A tendency towards interventricular septum hypertrophy was observed even in well-controlled diabetic pregnancies. Mild hypertrophic cardiac changes were not associated with abnormal cardiac function or signs of left ventricular outflow obstruction, although minor changes in right ventricular diastolic function were recorded.

Single Object Long-term Tracker for Smart Control of a PTZ camera

In this paper, we present a single-object long-term tracker that supports high appearance changes in the tracked target, occlusions, and is also capable of recovering a target lost during the tracking process. The initial motivation was real time automatic speaker tracking by a static camera in order to control a PTZ camera capturing a lecture. The algorithm consists of a novel combination of state-of-the-art techniques. Subjective evaluation, over existing and newly recorded sequences, shows that the tracker is able to overcome the problems and difficulties of long-term tracking in a real lecture. Additionally, in order to further assess the performance of the proposed approach, a comparative evaluation over the VOT2013 dataset is presented.

Maternal Characteristics and Temporal Trends in Birth Outcomes: Comparison between Spanish and Migrant Mothers

Low birth weight and preterm babies have been increasing in Spain since 1980, coinciding with important changes in the social and demographic structure of childbearing populations—including the contribution of a 25% of foreign mothers—and with increasing medical intervention in births. This study, based on 5,990,613 births, compares the temporary trends in reproductive patterns and birth outcomes in Spanish and foreign mothers during the period 1996–2009 and evaluates for the years 2007 to 2009 the relative contribution of mothers origin and Caesarean section to birth weight variability. Foreign mothers maintain their own reproductive pattern, whereas negative birth outcomes increase in all groups. Results from logistic regression analysis show that besides late maternity and primiparity also Caesarean section increases the risk for low birth weight. The reduction in Caesarean section rates between 2007 and 2009 might explain the reduction of low birth weight detected. A change of tendency simultaneously appears in most maternal and newborn characteristics, and in the mode of delivery in all ethnic groups since 2008. Coincidence in the timing of the change of trends points to a common factor. We suggest that the current world financial crisis could be this common cause, a hypothesis to be contrasted in future research.

Variable length-based genetic representation to automatically evolve wrappers

The Web has been the star service on the Internet, however the outsized information available and its decentralized nature has originated an intrinsic difficulty to locate, extract and compose information. An automatic approach is required to handle with this huge amount of data. In this paper we present a machine learning algorithm based on Genetic Algorithms which generates a set of complex wrappers, able to extract information from theWeb. The paper presents the experimental evaluation of these wrappers over a set of basic data sets.

CORIOAMNIONITIS HISTOLÓGICA Y MORBIMORTALIDAD NEONATAL: APROXIMACIÓN AL SÍNDROME DE RESPUESTA INFLAMATORIA FETAL

SUMMARY Background: The fetal inflammatory response syndrome (FIRS) is an entity related to intrauterine inflam mation which is commonly associated with intraamniotic infection. The most serious consequence is the neurologic damage and the subsequent development of cerebral palsy. Aims: To evaluate the relationship between the fetal inflammatory response syndrome and the development of neonatal complications. Method: Descriptive and retrospective study realized in “La Paz” University Hospital of Madrid, looking for an approximation to the FIRS from histologic chorioamnionitis/funisitis. Group of study constituted by 35 single preterm gestations collected during the first semester of 2008 and in which the pathologic anatomy study of the placenta and annexes showed the presence of histological corioamnionitis and / or funisitis. Results: Suspicious clinic was found in 7 cases (20%) but in 28 cases (80%) risk factors associated to

Nueva terapia con inmunoglobulinas en un caso de hemocromatosis neonatal

La hemocromatosis neonatal es una enfermedad hepatica muy severa del recien nacido y se asocia a una alta mortalidad. Se cree que su etiologia es de tipo aloinmune, debido a la presencia de un anticuerpo materno hasta ahora desconocido que interfiere con el metabolismo ferrico del feto, llegando a producir gran morb i mortal idad. Basandonos en esta teoria, el tratamiento materno con inmunoglobulinas intravenosas en gestaciones sucesivas podria prevenir el desarrollo de un nuevo cuadro de hemocromatosis neonatal. Se describe el caso de una gestante con un hijo anterior diagnosticado y fallecido neonatalmente por hemocromatosis, a la que en el embarazo actual se le trato con inmunoglobulinas intravenosas consiguiendo un hijo sano y vivo. Es el primer caso descrito en Espana y demuestra el exito de esta terapia, tal como describe la literatura.

Hiperhomocisteinemia y preeclampsia

Resumen Objetivo Comparar las concentraciones plasmaticas de homocisteina en gestantes con preeclampsia con respecto a un grupo control de gestantes sanas durante el tercer trimestre de gestacion, asi como determinar la prevalencia de hiperhomocisteinemia entre ambos grupos Sujetos y metodos Estudio transversal de 100 gestantes durante el tercer trimestre de gestacion (50 con preeclampsia y 50 gestantes sanas) en el Servicio de Obstetricia del Hopital La Paz entre enero y diciembre de 1999 Resultados Las concentraciones de homocisteina plasmatica estan significativamente elevadas en las pacientes con preeclampsia con respecto a las gestantes normales (media ± desviacion estandar [DE], 12,1 ± 4,2; intervalo de confianza [IC] del 95%, 11,7–12,9 frente a 5,9 ± 2,4; IC del 95%, 5,1–7,4 μmol/l; p = 0,01). La prevalencia de hiperhomocisteinemia (homocisteina > 8,3 μmol/l) es mayor en gestantes con preeclampsia respecto al grupo control (el 78 frente al 18%; p = 0,03) Conclusiones Las concentraciones plasmaticas de homocisteina estan elevadas significativamente en gestantes con preeclampsia en comparacion con gestantes sanas durante el tercer trimestre de gestacion. La prevalencia de hiperhomocisteinemia es significativamente mayor en pacientes con preeclampsia respecto al grupo control

Influencia de la gestación de bajo riesgo en la calidad de vida relacionada con la salud percibida por las gestantes

Resumen Objetivos Valorar la calidad de vida relacionada con la salud (CVRS) percibida por las gestantes de bajo riesgo en comparacion con los valores poblacionales de referencia para mujeres del mismo grupo de edad; determinar si la gestacion de bajo riesgo puede modificar la CVRS percibida; relacionar los «cambios fisiologicos de la gestacion» con la perdida de calidad de vida percibida; obtener valores de CVRS de referencia del cuestionario Medical Outcomes Study (MOS) 36-Item Short Form, o cuestionario SF-36, para gestantes del primer y tercer trimestres, dado que hasta la actualidad no hemos encontrado publicaciones espanolas similares. Material y metodos Encuesta transversal de prevalencia y comparacion de 2 grupos independientes. Como instrumento de medicion se utilizo el Medical Outcomes Study 36-Item Short Form (SF-36). Conclusiones Las gestantes presentan una perdida estadisticamente significativa de las dimensiones fisicas cuando se comparan con los valores poblacionales de referencia para mujeres del mismo intervalo de edad; esta perdida es mas significativa al progresar la gestacion, es decir, la progresion cronologica del embarazo normal puede alterar la percepcion en la calidad de vida percibida por las gestantes, especialmente en el campo fisico. No se observan alteraciones en las dimensiones relacionadas con la funcion emocional o social. Los sintomas propios de la gestacion, como las nauseas y los vomitos, son capaces de alterar las funciones fisica y emocional.

Pronóstico perinatal y materno de la gestación múltiple en función del protocolo intraparto

Resumen Objetivo Valorar el pronostico materno y fetal de las gestaciones multiples en funcion de la via del parto. Material y metodos Se ha realizado un estudio retrospectivo de los partos gemelares de los ultimos 5 anos evaluando la via de finalizacion de la gestacion analizando mas detalladamente los del ultimo ano. La informacion se proceso mediante el programa informatico para bases de datos Microsoft Excel y se analizo mediante el programa estadistico SPSS 12.0 para Windows. Resultados La edad gestacional media fue de 35,3 semanas. El 59,8% de los partos fueron cesareas. El intervalo medio entre ambos gemelos cuando el primero fue por via vaginal fue 7,82 min. El 49% de los neonatos presento morbilidad perinatal, que fue mayor en el segundo gemelo y en prematuros. Conclusiones Las gestaciones multiples se asocian a un elevado numero de complicaciones tanto maternas como perinatales. Esta comorbilidad se acompana de una mayor tasa de cesareas y es fundamental el adecuado manejo intraparto para disminuir en lo posible la morbilidad maternofetal.