RESUMO
Our goal was to define the risk factors for Chlamydia trachomatis (CT) infection among pregnant women at a large urban medical centre. In a retrospective study, clinical records at a US maternity unit from July 2005 through February 2008 were reviewed. The study population included all pregnant women with a singleton newborn of at least 20 weeks gestation and antenatal care information. Logistic regression was used to analyse the association between a positive CT test and demographic, behavioural and prenatal care variables. A total of 2127 women were included in this analysis. The prevalence of CT infection was 4.7%. Cases were more likely to be younger, black and single. Other risk factors included tobacco use and Neisseria gonorrhoeae infection. Our findings suggest that factors other than age may impact upon the diagnosis of CT in pregnant women and that a more comprehensive testing strategy should be considered.
Assuntos
Infecções por Chlamydiaceae/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Adulto , Baltimore/epidemiologia , População Negra , Estudos de Casos e Controles , Chlamydia trachomatis , Feminino , Gonorreia/epidemiologia , Humanos , Modelos Logísticos , Idade Materna , Neisseria gonorrhoeae , Guias de Prática Clínica como Assunto , Gravidez , Estudos Retrospectivos , Fatores de Risco , Pessoa Solteira , Fumar/epidemiologia , População UrbanaRESUMO
Our goal was to define the risks of preterm birth associated with Chlamydia trachomatis (CT) and other sexually transmitted infections (STIs) among pregnant women. We accessed clinical records from July 2005 to February 2008. The study population included all pregnant women who gave birth to a singleton newborn of at least 20 weeks' gestation, and who had antenatal care information. We estimated the impact of CT and other STI on the odds of preterm birth using logistic regression. Overall, 2127 women were included in this analysis. The prevalence of CT infection was 4.7%. CT diagnosis was not associated with preterm birth. In conclusion, this study did not find an association between CT and preterm birth. The lack of an association may be explained by early treatment. Future studies evaluating the timing of screening for STIs may help clarify whether pregnant women would benefit more from earlier screening.
Assuntos
Infecções por Chlamydia/epidemiologia , Chlamydia trachomatis , Complicações Infecciosas na Gravidez/epidemiologia , Nascimento Prematuro/epidemiologia , Infecções Sexualmente Transmissíveis/epidemiologia , Adulto , Estudos de Casos e Controles , Infecções por Chlamydia/diagnóstico , Infecções por Chlamydia/tratamento farmacológico , Infecções por Chlamydia/microbiologia , Feminino , Humanos , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas , Modelos Logísticos , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/tratamento farmacológico , Complicações Infecciosas na Gravidez/microbiologia , Cuidado Pré-Natal , Prevalência , Fatores de Risco , Infecções Sexualmente Transmissíveis/diagnóstico , Infecções Sexualmente Transmissíveis/tratamento farmacológico , Infecções Sexualmente Transmissíveis/microbiologia , Adulto JovemRESUMO
A new cytotoxic Annonaceous acetogenin, annojahnin (1), was isolated from the twigs of Annona jahnii (Annonaceae) by bioactivity-directed fractionation using lethality to brine shrimp. Compound 1 represents an unusual type of C-37 Annonaceous acetogenin, lacking either tetrahydrofuran (THF) or epoxide rings, bearing a keto group at C-10, and possessing a double bond located two methylenes away from a vicinal diol. The structure and absolute configuration of 1 were elucidated by 1H and 13C NMR, COSY, and single-relayed COSY and from chemical derivatives. 4-Deoxy-18/21-trans-annomontacin 10-one (4) and 4-deoxy-18/21-cis-annomontacin-10-one (5), two semisynthetic mono-THF acetogenins, were prepared from 1 by reactions that mimic the biogenetic pathways. These acetogenins showed selective cytotoxicities, comparable or superior to adriamycin, among six human solid tumor cell lines. Reduction of the 10-keto of 1, to the racemic 10-OH derivative (3), retained the bioactivities as did the conversion of 1 to 4 and 5.
Assuntos
4-Butirolactona/análogos & derivados , Antineoplásicos Fitogênicos/isolamento & purificação , Álcoois Graxos/isolamento & purificação , Furanos/química , Lactonas/química , Plantas/química , 4-Butirolactona/química , 4-Butirolactona/isolamento & purificação , 4-Butirolactona/farmacologia , Antineoplásicos Fitogênicos/química , Antineoplásicos Fitogênicos/farmacologia , Ensaios de Seleção de Medicamentos Antitumorais , Álcoois Graxos/química , Álcoois Graxos/farmacologia , Humanos , Espectrometria de Massas/métodos , Células Tumorais CultivadasRESUMO
Este trabajo examina diversos aspectos de la formacion acadmica y la capacitacion del personal que atiende a los ancianos. Se discute en particular: programas educaciónales, capacitacion de campo, formacion de los educadores, la investigación cientifica y su efecto en políticas y programas para el anciano. Por ultimo este trabajo presenta un numero de recomendaciones para mejorar la calidad de lea formacion del personal dedidacao al campo del envejecimiento, y enfeztiza la necesidad de que los organismos gubernamentales trabajen estrechamente con las organizaciónes profesionales y educaciónales que regulan los programas de adiestramiento
Assuntos
Avaliação Educacional , Geriatria/educação , Assistência a Idosos , América LatinaRESUMO
Limited information is available on the long-term effects of in utero methadone exposure. This report describes the somatic and neurobehavioral findings of children in the first 18 months of life born to methadone-maintained mothers and to a matched drug-free comparison group of mothers. Findings during the neonatal period were (1) a 75% incidence of moderate-to-severe narcotic abstinence syndrome, (2) a significant incidence of head circumferences below the third percentile, and (3) elevated systolic blood pressure. In follow-up, the methadone children had (1) a significantly higher incidence of otitis media; (2) a significant incidence of head circumferences below the third percentile; (3) neurologic findings of tone discrepancies, developmental delays, and poor fine motor coordination; (4) a high incidence of abnormal eye findings; and (5) significantly lower scores on the Bayley mental and motor developmental indices. These neurobehavioral findings in children of methadone-treated mothers at 18 months of age may be predictors of later learning and behavioral problems.