OBJECTIVE: To study whether patients with HIV-1 associated lipodystrophy (LD) on highly active antiretroviral treatment (HAART) have more psychopathology and worse psychosocial adjustment than a similar group without this syndrome. METHODS: In a cross-sectional, observational study we compared 47 HIV-1 infected patients with LD (LD group) with 39 HIV-1 infected patients without LD (non-LD group). All participants were on HAART. The Beck Depression Inventory (BDI), the State and Trait Anxiety Inventory (STAI) and the Goldberg Health Questionnaire (GHQ-60) were administered. Levels of familial, work and social adjustment and adjustment to stressful events were evaluated in a semi-structured interview. Clinical information was extracted from the clinical records. RESULTS: In the univariate analysis patients with LD showed higher state anxiety scores (p = 0.009) and worse work adjustment (p = 0.019) than those without LD. A total of 45.3% of LD patients scored above the cut-off point on the trait anxiety scale, and over 33.3% scored above the cut-off point on the BDI, GHQ and state anxiety scales. However, in multivariate analyses LD was not independently associated with psychopathology or with worse adjustment in the studied areas. CONCLUSIONS: The finding that LD was not a predictor of greater psychopathology or worse psychosocial adjustment in HIV-1 infected patients, despite the high scores found, suggests that factors not taken into account in this study, such as LD severity and self-perception should have been included in the analysis. Further studies including a greater number of variables and a larger sample size will advance our understanding of this complex condition.

Introducción: el aumento de la translucencia nucal (TN) fetal aumentada, en la gestación entre las 11 y 14 semanas, es una expresión fenotípica común de anormalidades cromosómicas, incluyendo la trisomía 21. Sin embargo, incluso en ausencia de aneuploidía, el engrosamiento nucal es un dato relevante desde el punto de vista clínico, porque se asocia con un aumento en el resultado perinatal adverso causado por una variedad de malformaciones fetales, displasias, deformaciones, disrupciones y de síndromes genéticos. Se presenta este caso con el objetivo de resaltar la importancia de la TN como marcador de patologías diferentes de las aneuploidías cuando la misma se encuentra por encima del percentil 99. Discusión: una vez descartada la aneuploidía, el riesgo del resultado perinatal adverso no disminuye de forma estadística, si este engrosamiento nucal alcanza los3,5 milímetros o más(percentil 99).Este aumento del riesgo ocurre de manera exponencial a medida que aumenta la TN. Sin embargo, si el feto sobrevive, el riesgo de presentar una cardiopatía congénita es elevado. Por lo tanto, un ultrasonido entre las 20 a 22semanas puede revelar las diferentes anormalidades cardiacas.

Introduction: increased foetal nuchal translucency (NT) from 11 to 14 weeks’ gestation is a common phenotypicexpressionofchromosomeabnormality, including trisomy 21. Nevertheless, in the absence of aneuploidy, nuchal thickening is clinically relevant because it is associated with increased adverse perinatal result caused by a variety of foetal malformations, dysplasias, deformations, disruptions and genetic syndromes. The object of presenting this case was to show the importance of NT as a marker for different aneuploid pathologies when being above the 99th percentile. Discussion: once the presence of aneuploidy has been eliminated, the risk of an adverse perinatal result does not become statistically reduced until nuchal measurement of translucency reaches 3.5 millimeters (99th percentile). Risk increases exponentially as NT increases. Nevertheless, if the foetus survives, there is an increased risk of congenital cardiopathy occurring. Ultrasound at 20-22 weeks can reveal cardiac abnormality.

El síndrome de transfusión intergemelar severo sin tratamiento presenta una mortalidad virtual de 100 % en ambos fetos. Se han descrito múltiples opciones terapéuticas para esta entidad. La fotocoagulación láser de las anastomosis placentarias intergemelares es la única terapia capaz de revertir el síndrome preservando la vida de los fetos. Presentamos un caso de síndrome de transfusión intergemelar estadio III con severas complicaciones maternas en el cual se realizó fotocoagulación láser selectiva de los vasos comunicantes. Discutimos la utilidad de ésta y otras alternativas terapéuticas

Severe twin-twin transfusion syndrome without treatment presents a virtual mortality of 100 % of both fetuses. Multiple therapeutic options have been described for this disease. Laser photocoagulation of the communicating vessels is the unique treatment able to revert the syndrome preserving the life of the fetuses. We present a case of stage III twin-twin transfusion syndrome with severe maternal complications treated with selective laser photocoagulation of the placental anastomoses. We discuss the utility of this and other therapeutic alternatives.