Envíos recientes

Esclerosis múltiple y embarazo

Reyes, Marco Aurelio | 2016-03-01

Is it prudent to consent to or recommend pregnancy in breast cancer survivors?

Monterrosa Blanco, Angélica | 2020-06

Background: Female breast cancer survivors and some health professionals may have doubts about the advisability of pregnancy after breast cancer. Such doubts concern possible recurrences, increased mortality, and adverse effects on the newborn. Purpose: The aim of this report is to present the case of a woman who, after 48 months of breast cancer survival, wished to start a pregnancy. A further aim is to indicate whether it is prudent to consent to or to recommend pregnancy after a breast cancer diagnosis. Case report: This report concerns a patient without satisfied parity, who, at the age of 36 years, presented left breast carcinoma with negative nodes: estrogen receptors in less than 2% of the studied cells and negative progesterone receptors. She received surgical management, chemotherapy and radiotherapy. At 48 months of survival, she wished to start a new pregnancy. On requesting a risk/benefit recommendation from her treating doctors, she did not obtain a unanimous position. By her own decision, she sought and achieved a spontaneous pregnancy, which led to a live birth. Five years later, her child shows normal growth. Conclusion: Evidence suggests increased survival in mothers with a breast cancer history and subsequent pregnancy. Despite being high-risk pregnancies due to the increased possibility of low birth weight, preterm delivery, and small fetus for gestational age, studies suggest that pregnancy may be consented to or recommended in breast cancer survivors.

Movimientos anormales y embarazo

Palacios, Eduardo | 2016-06-01

Quality Assessment of Clinical Practice Guidelines for the Prescription of Antidepressant Drugs During Pregnancy

Santos, Fabiano | 2012-07

Antidepressant use during the gestational period remains a controversial issue. The objective of this study was to appraise the quality of the available clinical practice guidelines (CPGs) that includes recommendations for antidepressant use during pregnancy. We systematically searched for documents published between January 2000 and September 2010 in MEDLINE / TRIP database and on clearinghouses and main scientific societies websites. Four appraisers evaluated each guideline using the Appraisal of Guidelines for Research and Evaluation tool (AGREE II). Intra-class correlation coefficients (ICC) with 95% confidence intervals (CI) were calculated as an overall indicator of agreement. Twelve CPGs were included from a total of 539 references. Only two guidelines were specifically addressed to pregnant women. The overall agreement among reviewers was high (ICC: 0.94, 95% CI: 0.86-0.98). The mean scores and standard deviation (SD) for each of the AGREE II domains were: scope and purpose: 84.4% (12); stakeholder involvement: 67.4% (29.8); rigor of development: 68.6% (19.8); clarity and presentation: 83.4% (17.4); applicability: 44% (37.3); and editorial independence: 62.1% (30.4). After standardizing the scores of the 12 guidelines, 5 were considered as being “recommended”, 5 as “recommended with modifications, and 2 as “not recommended”. Among the five recommended guidelines, two were specifically conceived to the gestational period. CPGs containing recommendations for antidepressant use during pregnancy were of moderate to high quality. Future guidelines should take into account the observed drawbacks in some domains, and specifically focus a more in depth approach of depression during pregnancy

Separación de la sínfisis púbica postparto

Rondón Tapia, Martha | 2019-07-01