Posts filed under ‘Infecciones en embarzadas’

Recommendations for the Use of Antiretroviral Drugs in Pregnant Women with HIV Infection and Interventions to Reduce Perinatal HIV Transmission in the United States.   January 4, 2019. 366 pag

Recommendations for the Use of Antiretroviral Drugs in Pregnant Women with HIV Infection and Interventions to Reduce Perinatal HIV Transmission in the United States.   January 4, 2019.  366 pag

Developed by the HHS Panel on Treatment of Pregnant Women with HIV Infection and Prevention of Perinatal Transmission – A Working Group of the Office of AIDS Research Advisory Council (OARAC)

What’s New in the Guidelines

Text, references, and appendices were updated to include new data and publications where relevant.

The sections that address infant feeding now include links to a new section that was added on March 27, 2018, titled Guidance for Counseling and Managing Women Living with HIV in the United States Who Desire to Breastfeed.

Major content changes are summarized below; all changes are highlighted throughout the guidelines.

PDF

http://aidsinfo.nih.gov/contentfiles/lvguidelines/PerinatalGL.pdf

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January 8, 2019 at 8:08 am

Identification of Epstein-Barr Virus in the Human Placenta and Its Pathologic Characteristics.

J Korean Med Sci. December 2017 V.32 N.12 P.1959-1966.   

Kim Y1,2, Kim HS3, Park JS3, Kim CJ4, Kim WH5.

1 Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.

2 Laboratory of Epigenetics, Cancer Research Institute, Seoul National University, Seoul, Korea.

3 Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.

4 Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

5 Department of Pathology, Seoul National University College of Medicine, Seoul, Korea. woohokim@snu.ac.kr

Abstract

Epstein-Barr virus (EBV), a common pathogen in humans, is suspected as the cause of multiple pregnancy-related pathologies including depression, preeclampsia, and stillbirth. Moreover, transmission of EBV through the placenta has been reported. However, the focus of EBV infection within the placenta has remained unknown to date. In this study, we proved the expression of latent EBV genes in the endometrial glandular epithelial cells of the placenta and investigated the cytological characteristics of these cells. Sixty-eight placentas were obtained from pregnant women. Tissue microarray was constructed. EBV latent genes including EBV-encoding RNA-1 (EBER1), Epstein-Barr virus nuclear antigen 1 (EBNA1), late membrane antigen (LMP1), and RPMS1 were detected with silver in situ hybridization and/or mRNA in situ hybridization. Nuclear features of EBV-positive cells in EBV-infected placenta were compared with those of EBV-negative cells via image analysis. Sixteen placentas (23.5%) showed positive expression of all 4 EBV latent genes; only the glandular epithelial cells of the decidua showed EBV gene expression. EBV infection status was not significantly correlated with maternal, fetal, or placental factors. The nuclei of EBV-positive cells were significantly larger, longer, and round-shaped than those of EBV-negative cells regardless of EBV-infection status of the placenta. For the first time, evidence of EBV gene expression has been shown in placental tissues. Furthermore, we have characterized its cytological features, allowing screening of EBV infection through microscopic examination.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5680494/pdf/jkms-32-1959.pdf

November 9, 2018 at 7:06 am

Epstein-Barr Virus-Induced Mononucleosis as an Imitator of Severe Preeclampsia.

AJP Rep. January 2017 V.7 N.1 P.e5-e7.

Staley SA1, Smid MC2, Dotters-Katz SK2, Stringer EM2.

1 Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina.

2 Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina.

Abstract

Background In pregnancy, conditions presenting with hematologic abnormalities, transaminitis, and proteinuria pose diagnostic challenges in pregnancy. Case We present the case of an 18-year-old woman, G1P0, at 33 weeks’ gestation with fever of unknown cause, who developed progressively elevated liver enzymes, proteinuria, and thrombocytopenia, due to Epstein-Barr virus (EBV) infection. Conclusion Acute infection with EBV should be included in the differential diagnosis of preeclampsia with severe features, particularly in the setting of fever. Supportive treatment and observation may prevent iatrogenic preterm birth.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5303016/pdf/10-1055-s-0036-1597265.pdf

November 9, 2018 at 7:05 am

Maternal depressive symptoms related to Epstein-Barr virus reactivation in late pregnancy.

Sci Rep. October 31, 2013 V.3 P.3096.

Zhu P1, Chen YJ, Hao JH, Ge JF, Huang K, Tao RX, Jiang XM, Tao FB.

1 1] Department of Maternal and Child Health, School of Public Health, Anhui Medical University, Hefei, China [2].

Abstract

We examined the relationship between maternal depressive symptoms in late pregnancy and Epstein-Barr virus reactivation before delivery. In this prospective observational study, prevalence of Epstein-Barr virus reactivation within one week before delivery was compared between 163 pregnant women with depressive symptoms at 33 to 34 weeks of gestation and a computer-generated control group of 163 pregnant healthy women without depressive symptoms. Depressive symptoms at 33 to 34 weeks of gestation were significantly related to the prevalence of Epstein-Barr virus reactivation before delivery after adjustment for potential confounders (adjusted OR = 2.74, 95%CI: 1.23-6.08). Compared to that in the control group, the prevalence of Epstein-Barr virus reactivation was higher in women with depressive symptoms accompanied by higher negative coping (24.2% compared with 7.9%; adjusted OR = 3.67, 95%CI: 1.47-9.16). Maternal depressive symptoms in late pregnancy are associated with Epstein-Barr virus reactivation, and this association could be moderated by maternal coping style.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3813936/pdf/srep03096.pdf

November 9, 2018 at 7:04 am

Rectal Chlamydia trachomatis and Neisseria gonorrhoeae Infections Among Women Reporting Anal Intercourse

Obstetrics & Gynecology September 2018  V.132 N.3  P.692–697

Llata, Eloisa, MD, MPH; Braxton, Jim; Asbel, Lenore, MD; Chow, Joan, PhD; Jenkins, Lindsay; Murphy, Ryan, PhD; Pathela, Preeti, DrPh; Schumacher, Christina, PhD; Torrone, Elizabeth, PhD

OBJECTIVE:

To examine the prevalence and treatment of rectal Chlamydia trachomatis and Neisseria gonorrhoeae infections among women reporting receptive anal intercourse in a network of sexually transmitted disease or sexual health clinics and estimate the proportion of missed infections if women were tested at the genital site only.

METHODS:

We conducted a cross-sectional analysis of C trachomatis and N gonorrhoeae test results from female patients reporting receptive anal intercourse in the preceding 3 months during visits to 24 sexually transmitted disease clinics from 2015 to 2016. Primary outcomes of interest were 1) anatomic site-specific C trachomatis and N gonorrhoeae testing and positivity among women attending selected U.S. sexually transmitted disease clinics who reported receptive anal intercourse and 2) the proportion of rectal infections that would have remained undetected if only genital sites were tested.

RESULTS:

Overall, 7.4% (3,743/50,785) of women reported receptive anal intercourse during the 2 years. Of the 2,818 women tested at both the genital and rectal sites for C trachomatis, 292 women were positive (61 genital only, 60 rectal only, and 171 at both sites). Of the 2,829 women tested at both the genital and rectal sites for N gonorrhoeae, 128 women were positive (31 genital only, 23 rectal only, and 74 at both sites). Among women tested at both anatomic sites, the proportion of missed C trachomatis infections would have been 20.5% and for N gonorrhoeae infections, 18.0%.

CONCLUSION:

Genital testing alone misses approximately one fifth of C trachomatis and N gonorrhoeae infections in women reporting receptive anal intercourse in our study population. Missed rectal infections may result in ongoing transmission to other sexual partners and reinfection.

FULL TEXT

https://journals.lww.com/greenjournal/Fulltext/2018/09000/Rectal_Chlamydia_trachomatis_and_Neisseria.22.aspx

PDF (CLIC en PDF)

August 31, 2018 at 3:52 pm

Respiratory Virus Infection During Pregnancy: Does It Matter?

The Journal of Infectious Diseases August 15, 2018 V.218 N.4 P.512-515

EDITOR’S CHOICE

Janet A Englund; Helen Y Chu

FULL TEXT

https://academic.oup.com/jid/article/218/4/512/4993270

PDF (CLIC en PDF)

 

August 13, 2018 at 6:24 pm

Protecting Mothers and Babies — A Delicate Balancing Act

N Engl J of Medicine July 24, 2018

PERSEPCTIVE

Protecting Mothers and Babies — A Delicate Balancing Act

S.A. Rasmussen, W. Barfield, and M.A. Honein

More than 50 years ago, an epidemic of serious birth defects caused by prenatal exposure to thalidomide shattered the prevailing notion that the placenta served as a barrier against damaging influences and led to recognition that exposures during pregnancy can result in harm to a developing fetus. Since that time, ensuring that a pregnant woman has access to potentially lifesaving treatments while safeguarding her fetus has become a delicate balancing act, one that requires a careful evaluation of risks and benefits to both the mother and her fetus…

FULL TEXT

https://www.nejm.org/doi/full/10.1056/NEJMp1809688?query=RP

PDF

https://www.nejm.org/doi/pdf/10.1056/NEJMp1809688

 

 

 

N Engl J of Medicine July 24, 2018

CORRESPONDENCE

Neural-Tube Defects with Dolutegravir Treatment from the Time of Conception

  1. Zash, J. Makhema, and R.L. Shapiro

Since August 2014, the Botswana Harvard AIDS Institute Partnership has conducted birth outcome surveillance at eight government hospitals throughout Botswana. A primary ongoing aim of the surveillance is to evaluate the prevalence of neural-tube defects associated with exposure to antiretroviral drugs from the time of conception (the risk period for neural-tube defects ends approximately 28 days after conception). At each site, trained government midwives perform surface examinations of consecutive live-born and stillborn infants who are born in the hospital to women infected with human immunodeficiency virus (HIV) and to women without HIV infection. As part of …

FULL TEXT

https://www.nejm.org/doi/full/10.1056/NEJMc1807653?query=RP

PDF

https://www.nejm.org/doi/pdf/10.1056/NEJMc1807653

July 24, 2018 at 11:44 am

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