IntroductionMachine learning (ML) corresponds to a wide variety of methods that use mathematics, statistics and computational science to learn from multiple variables simultaneously. By means of pattern recognition, ML methods are able to find hidden correlations and accomplish accurate predictions regarding different conditions. ML has been successfully used to solve varied problems in different areas of science, such as psychology, economics, biology and chemistry. Therefore, we wondered how far it has penetrated into the field of obstetrics and gynecology.AimTo describe the state of art regarding the use of ML in the context of pregnancy diseases and complications.MethodologyPublications were searched in PubMed, Web of Science and Google Scholar. Seven subjects of interest were considered: gestational diabetes mellitus, preeclampsia, perinatal death, spontaneous abortion, preterm birth, cesarean section, and fetal malformations.Current stateML has been widely applied in all the included subjects. Its uses are varied, the most common being the prediction of perinatal disorders. Other ML applications include (but are not restricted to) biomarker discovery, risk estimation, correlation assessment, pharmacological treatment prediction, drug screening, data acquisition and data extraction. Most of the reviewed articles were published in the last five years. The most employed ML methods in the field are non-linear. Except for logistic regression, linear methods are rarely used.Future challengesTo improve data recording, storage and update in medical and research settings from different realities. To develop more accurate and understandable ML models using data from cutting-edge instruments. To carry out validation and impact analysis studies of currently existing high-accuracy ML models.ConclusionThe use of ML in pregnancy diseases and complications is quite recent, and has increased over the last few years. The applications are varied and point not only to the diagnosis, but also to the management, treatment, and pathophysiological understanding of perinatal alterations. Facing the challenges that come with working with different types of data, the handling of increasingly large amounts of information, the development of emerging technologies, and the need of translational studies, it is expected that the use of ML continue growing in the field of obstetrics and gynecology.

Maternal thyroid alterations have been widely associated with the risk of gestational diabetes mellitus (GDM). This study aims to 1) test the first and the second trimester full maternal thyroid profile on the prediction of GDM, both alone and combined with non-thyroid data; and 2) make that prediction independent of the diagnostic criteria, by evaluating the effectiveness of the different maternal variables on the prediction of oral glucose tolerance test (OGTT) post load glycemia. Pregnant women were recruited in Concepción, Chile. GDM diagnosis was performed at 24–28 weeks of pregnancy by an OGTT (n = 54 for normal glucose tolerance, n = 12 for GDM). 75 maternal thyroid and non-thyroid parameters were recorded in the first and the second trimester of pregnancy. Various combinations of variables were assessed for GDM and post load glycemia prediction through different classification and regression machine learning techniques. The best predictive models were simplified by variable selection. Every model was subjected to leave-one-out cross-validation. Our results indicate that thyroid markers are useful for the prediction of GDM and post load glycemia, especially at the second trimester of pregnancy. Thus, they could be used as an alternative screening tool for GDM, independently of the diagnostic criteria used. The final classification models predict GDM with cross-validation areas under the receiver operating characteristic curve of 0.867 (p<0.001) and 0.920 (p<0.001) in the first and the second trimester of pregnancy, respectively. The final regression models predict post load glycemia with cross-validation Spearman r correlation coefficients of 0.259 (p = 0.036) and 0.457 (p<0.001) in the first and the second trimester of pregnancy, respectively. This investigation constitutes the first attempt to test the performance of the whole maternal thyroid profile on GDM and OGTT post load glycemia prediction. Future external validation studies are needed to confirm these findings in larger cohorts and different populations.

Gestational Diabetes Mellitus (GDM) is characterized by abnormal maternal D-glucose metabolism and altered insulin signaling. Dysregulation of thyroid hormones (TH) tri-iodethyronine (T3) and L-thyroxine (T4) Hormones had been associated with GDM, but the physiopathological meaning of these alterations is still unclear. Maternal TH cross the placenta through TH Transporters and their Deiodinases metabolize them to regulate fetal TH levels. Currently, the metabolism of TH in placentas with GDM is unknown, and there are no other studies that evaluate the fetal TH from pregnancies with GDM. Therefore, we evaluated the levels of maternal TH during pregnancy, and fetal TH at delivery, and the expression and activity of placental deiodinases from GDM pregnancies. Pregnant women were followed through pregnancy until delivery. We collected blood samples during 10-14, 24-28, and 36-40 weeks of gestation for measure Thyroid-stimulating hormone (TSH), Free T4 (FT4), Total T4 (TT4), and Total T3 (TT3) concentrations from Normal Glucose Tolerance (NGT) and GDM mothers. Moreover, we measure fetal TSH, FT4, TT4, and TT3 in total blood cord at the delivery. Also, we measured the placental expression of Deiodinases by RT-PCR, western-blotting, and immunohistochemistry. The activity of Deiodinases was estimated quantified rT3 and T3 using T4 as a substrate. Mothers with GDM showed higher levels of TT3 during all pregnancy, and an increased in TSH during second and third trimester, while lower concentrations of neonatal TT4, FT4, and TT3; and an increased TSH level in umbilical cord blood from GDM. Placentae from GDM mothers have a higher expression and activity of Deiodinase 3, but lower Deiodinase 2, than NGT mothers. In conclusion, GDM favors high levels of TT3 during all gestation in the mother, low levels in TT4, FT4 and TT3 at the delivery in neonates, and increases deiodinase 3, but reduce deiodinase 2 expression and activity in the placenta.

The key purpose of this research was to explore the capacity of an anaerobic stirred batch reactor (ASBR) to deal with acid mine drainage (AMD) based on the activity of sulfate reducing bacteria (SRB). The tests showed that SRB produced hydrogen sulfide that precipitated the metals Fe2+, Zn2+, and Cu2+. Ethanol was used as both the only source of carbon and electron donor. Throughout the experiment, the ratio of chemical oxygen demand (COD) to sulfate was constant at 1.0. The reactor was operated for 218 days using synthetic AMD at pH 4.0 containing 1000 and 1500 mg·L-1of sulfate,100 mg·L-1of Fe2+, 20 mg·L-1Zn2+, and 5 mg·L-1Cu2+. The metal removal rates were greater than 99 %with effluent pH of 6.5 to 7.4. The sulfide concentration reached 56.6 mg·L-1 and sulfate removal was 43 to 65 %.

The prevalence of obesity in women of childbearing age around the globe has dramatically increased in the last decades. Obesity is characterized by a low-state chronic inflammation, metabolism impairment and oxidative stress, among other pathological changes. Getting pregnant in this situation involves that gestation will occur in an unhealthy environment, that can potentially jeopardize both maternal and fetal health. In this review, we analyze the role of maternal obesity-induced oxidative stress as a risk factor to develop adverse outcomes during gestation, including reduced fertility, spontaneous abortion, teratogenesis, preeclampsia, and intrauterine growth restriction. Evidences of macromolecule oxidation increase in reactive oxygen species generation and antioxidant defense alterations are commonly described in maternal and fetal tissues. Thus, antioxidant supplementation become an interesting prophylactic and therapeutic tool, that yields positive results in cellular, and animal models. However, the results from most meta-analysis studying the effect of these therapies in complicated gestations in humans are not really encouraging. It is still to be analyzed whether these therapies could work if applied to cohorts of patients at a high risk, such as those with low concentration of antioxidants or obese pregnant women.

The objective of this study was to isolate oral lactic acid bacteria, selecting those with a higher anti-cariogenic potential. 72 LAB were obtained from the dental surface of healthy children, 9 strains of which were preselected and subjected to further analysis. Antimicrobial activity was quantified against 8 native Streptococcus mutans isolates and the strain ATCC S. mutans 25175. Strains CB43, CB44, and CB45 inhibited the growth of each tested pathogen. Using the E-test technique, all 9 strains were susceptible to 13 of the 21 tested antimicrobial agents. A cariogenic model was made using human dental pieces and artificial saliva. Estimated specific growth rate for strains adhered to dental pieces was 0.63h-1±0.09(R2=0.89) for strain CB44, and 0.70h-1±0.18(R2=0.78) for strain CB45. Innocuousness of strains CB44 and CB45 was proved by treating Balb/c mice with 1x109 CFU of each strain. Animals treated with CB44 and CB45 showed no signs of disease. There were no significant differences in the hematocrit, total and differential leukocyte counts, neither IL-6 concentration in the spleen, lymph nodes, and intestines of treated mice when compared to the control group.  Strains CB44 and CB45, identified as Lactobacillus fermentum, show potential to be part of a safe oral probiotic product.

The gastrointestinal tract hosts around 10(14) bacterial microorganisms, in a constantly growing density from the stomach to the distal colon. This microbiota is composed by more than 500 species of bacteria, which are quickly acquired after birth, fairly stable during the host’s life, and essential for human homeostasis. These bacteria have important functions, such as stimulating the immune system, protecting the host from invading bacteria and viruses, and improving digestion, especially of complex carbohydrates. Also, the gut microbiota interacts directly with the immune system. However, the interaction of the intestinal epithelium and its microbiota with the immune system has yet to be fully understood. Secretory immunoglobulin A, produced by the plasma cells in Peyer’s patches and in the lamina propria, maintains non-invasive commensal bacteria and neutralize invasive pathogens. Dendritic cells migrate from the lamina propria of the secondary lymphoid organs to regulate gut immunity. They also have a key role maintaining luminal IgA and inducing the growth of regulatory T cells. Dendritic cells supervise the gut microenvironment too, keeping an immunological equilibrium and tolerance. The importance of the gut microbiota in regulating the immune system lies mostly in the homeostasis-or positive equilibrium. Thus, many diseases are a consequence of poor interactions or a loss of this equilibrium.

The gastrointestinal tract hosts around 10(14) bacterial microorganisms, in a constantly growing density from the stomach to the distal colon. This microbiota is composed by more than 500 species of bacteria, which are quickly acquired after birth, fairly stable during the host’s life, and essential for human homeostasis. These bacteria have important functions, such as stimulating the immune system, protecting the host from invading bacteria and viruses, and improving digestion, especially of complex carbohydrates. Also, the gut microbiota interacts directly with the immune system. However, the interaction of the intestinal epithelium and its microbiota with the immune system has yet to be fully understood. Secretory immunoglobulin A, produced by the plasma cells in Peyer’s patches and in the lamina propria, maintains non-invasive commensal bacteria and neutralize invasive pathogens. Dendritic cells migrate from the lamina propria of the secondary lymphoid organs to regulate gut immunity. They also have a key role maintaining luminal IgA and inducing the growth of regulatory T cells. Dendritic cells supervise the gut microenvironment too, keeping an immunological equilibrium and tolerance. The importance of the gut microbiota in regulating the immune system lies mostly in the homeostasis-or positive equilibrium. Thus, many diseases are a consequence of poor interactions or a loss of this equilibrium.

Chlamydia trachomatis is one of the most common sexually transmitted infections worldwide. Based on sequence variation in the ompA gene encoding the major outer membrane protein, the genotyping scheme distinguishes 17 recognized genotypes, i.e. A, B, Ba, C, D, Da, E, F, G, H, I, Ia, J, K, L1, L2, and L3. Genotyping is an important tool for epidemiological tracking of C. trachomatis infections, including the revelation of transmission pathways and association with tissue tropism and pathogenicity. Moreover, genotyping can be useful for clinicians to establish the correct treatment when LGV strains are detected. Recently a microarray assay was described that offers several advantages, such as rapidity, ease of standardization and detection of mixed infections. The aim of this study was to evaluate the performance of the DNA microarray-based assay for C. trachomatis genotyping of clinical samples already typed by PCR-RFLP from South America. The agreement between both typing techniques was 90.05% and the overall genotype distribution obtained with both techniques was similar. Detection of mixed-genotype infections was significantly higher using the microarray assay (8.4% of cases) compared to PCR-RFLP (0.5%). Among 178 samples, the microarray assay identified 10 ompA genotypes, i.e. D, Da, E, F, G, H, I, J, K and L2. The most predominant type was genotype E, followed by D and F.

This study compared conventional ompA genotyping of Chlamydia trachomatis with multilocus sequence typing (MLST) and multilocus typing (MLT) DNA microarray.DNA extracts of 104 C. trachomatis positive specimens were analyzed by ompA sequencing and MLST and of these 76 by MLT array. Obtained MLST sequence types (STs) were compared to sequences in the database http://mlstdb.uu.se. The resolution obtained for MLST (35 STs) was 2.1 higher than for ompA sequencing (17 variants) and 1.3 higher than MLT array (27 MLT groups). Among the 104 samples the predominant genotype E could be divided into 5 ompA variants and 23 STs of which 16 had not been reported in previous studies. The most common STs, ST3 and ST56, were identified as founders and are common in several countries on a global scale. The MLST and the MLT array provided similar strain discrimination capacity and showed considerably higher resolution than conventional ompA sequencing.

Une étude de base populationnelle suédoise réalisée sur 27 235 patients a démontré en 2012 que les hommes qui vivent seuls se présentent avec un mélanome plus avancé que les hommes qui vivent accompagnés. Nous nous proposons d’analyser si vivre seul est associé au fait de se présenter avec un mélanome plus avancé dans notre unité de mélanome (aux Îles Canaries, avec une population de référence de 335 000 personnes). Étude observationnelle rétrospective. Tous les patients suivis à l’unité de mélanome de notre hôpital sont questionnés lors du diagnostic de la maladie à propos de diverses caractéristiques sociodémographiques, parmi lesquelles nous avons inclus le statut cohabitationnel (« est-ce que vous vivez seul ou en couple ? ») dès janvier 2012. Nous analysons la possible relation entre le fait de vivre seul et l’épaisseur tumorale mesurée en mm (indice de Breslow), chez les patients ayant un diagnostic de mélanome cutané entre janvier 2012 et juin 2015. L’analyse statistique a été réalisée avec SPSS version 20.0. Cent sept patients sont inclus (52 hommes et 55 femmes). Seulement 14 % des patients (7 hommes et 8 femmes) vivaient seuls au moment du diagnostic (versus 37 % dans l’étude suédoise). Ceux-ci se sont présentés avec des mélanomes plus fins que les patients qui vivaient en couple (médiane 0,5 et 0,83 mm respectivement, p < 0,09). Les hommes qui vivaient seuls ont montré une tendance à se présenter avec des mélanomes plus fins que les femmes (médiane de 0,4 contre 0,73 mm). Au contraire de la plus grande étude internationale développée en Suède, vivre seul ne s’est pas révélé comme un facteur pronostique négatif dans la population d’étude aux Îles Canaries. Ce qui a été plus surprenant est que les patients qui vivent seuls ont montré une tendance à présenter un Breslow plus fin, si bien nous n’avons pas atteint un niveau de signification statistique à ce niveau, probablement dû à un échantillon plus petit. Le statut cohabitationnel a prouvé être différent que celui du pays nordique. Les différences socioculturelles pourraient expliquer en partie la disparité des résultats. Nous analysons les causes possibles. Seulement 14 % des patients de notre unité vivent seuls. Vivre seul n’est pas un facteur de risque de se présenter avec un mélanome plus avancé dans notre population.

From 24 December to 24 July 2015, 174 cases were reported in a nationwide salmonellosis outbreak in Sweden: 108 cases were connected to a single restaurant. A spice mix, containing dried vegetables from the restaurant tested positive for the outbreak strain. Additional spice mixes with similar content from different suppliers also tested positive. The outbreak investigation suggests there could be a risk of contaminated products being also on the market in other countries.

Due to an increasing incidence of necrotizing enterocolitis (NEC), as well as its associated mortality and long-term complications seen in surviving patients, the main focus of research in NEC has shifted to the prevention and treatment of the disease. The hypothesis of this work is that the strain Lactobacillus salivarius LPLM-O1 can decrease the intestinal injuries in a model of induced NEC. 26 newborn Sprague-Dawley pups were used in this study and randomized in three groups: control group (n = 6), which were fed with infant formula (Similac NeosureTM, Abbott); probiotic group (n = 10), which were fed with the same infant formula but fortified with 109 colony-forming units (CFU) of Lactobacillus salivarius LPLM-O1, and the NEC-induced group (n = 10). Each group was fed with 100 μl of food formula every three hours, using a modified syringe. The probiotic and NEC groups were exposed to asphyxia- and cold-induced stress to develop experimental NEC. At the end of the experiment (96 hrs), animals were sacrificed, and their small intestines were carefully removed and evaluated for typical signs of NEC, microbiological count and histological analyses. The histological analysis of the NEC-induced group showed transmural necrosis (grade 4); in the probiotic group, the grade was comparatively lower (grade 2). Survival ratewas higher in the probiotic group (83%) than in the NEC-induced group (46%); however, the difference in not statistically significant (p = 0.14). Lactic acid bacteria counts were higher in the probiotic group than in the NEC-induced group (8.4 × 108 and 6.1 × 107 CFU/intestine tissue gram, respectively). According to these results, the model of artificial induction of NEC was effectively establishedin all pups, and the probiotic strain slightly decreases the injuries’ grade in newborn pups.

Since May 2014, an increase in Plasmodium vivax malaria has been observed in Sweden. As of 31 August 2014, 105 malaria cases have been reported in newly arrived Eritrean refugees, 84 of them P. vivax. The patients were mainly young men and reported migration through Ethiopia and/or Sudan. Severe anaemia and long symptom duration reflect inadequate healthcare during migration. Countries currently hosting Eritrean refugees need to consider P. vivax malaria in this group of migrants.

Urinary tract infections (UTIs) affect both healthy and immunocompromised people, and they are treated with antibiotics. However, the high recurrence of UTIs obliges the use of natural mechanisms to regulate the normal microbiota through the use of e.g. lactic acid bacteria. In order to induce a UTI, 20 µl of the Escherichia coli (Ec-01) strain, in doses of 2.7×107 cfu/ml, was inoculated by way of the urethra in female Balb/c mice, all of them immunosuppressed with dexamethasone (10 mg/kg). Lactobacillus plantarum LPLM-O1 was used as a treatment, in daily doses of 1×107 cfu/ml, which were orally administered for seven days before the infection (preventive) or alongside the infection for seven days (curative). The oral administration of LPLM-O1 did not cause any adverse effects when used in an immunosuppressed animal model. It was observed that, when used as a preventive measure, LPLM-O1 induces a decrease in the infection, in the concentration of urinary leukocytes, and in the bacterial load. This study proposes the use of this lactic bacterium as a probiotic.

El uso de los lactobacilos como probioticos en los ultimos anos cobra un interes creciente debido a sus propiedades beneficas en animales y humanos. Con el objetivo de aislar y caracterizar cepas vaginales de Lactobacillus spp., mediante pruebas in vitro para considerar su posterior aplicacion como probiotico se aislaron 24 cepas identificadas a nivel de grupo por el perfil de fermentacion de carbohidratos y la produccion de gas a partir de la glucosa. A todas las cepas se les determino su estabilidad de crecimiento a pH acidos y a diferentes temperaturas. De ellas se seleccionaron 9 que presentaron las mejores caracteristicas como candidatos a probioticas por sus resultados en las pruebas de hidrofobicidad frente a solventes organicos como tolueno, xileno y hexadecano, hemaglutinaron frente a eritrocitos humano, auto-agregaron, coagregaron con Escherichia coli y Candida albicans e inhibieron el crecimiento de estos patogenos. Se evaluo el perfil de susceptibilidad a 17 antimicrobianos y revelaron resistencia a 7 de ellos.