A case of hyalohyphomycosis, caused by Paecilomyces variotii, has been described in a 31-year-old female, who had undergone a cesarean section in her 39th week of pregnancy for a trial of labour. Five days following delivery, she complained of sharp, cramp-like pains, localized to the incisional site. She became febrile (38.2 degrees C). An ultrasound examination revealed a complex mass and fluid within the pelvis and upper abdomen. The fluid was drained by a needle aspiration and the patient was administered a regimen of antibacterial drugs. Microscopic examination did not reveal any bacteria in a gram stained preparation and cultures were negative as well. However, the fluid demonstrated a few segments of septate, hyaline hyphae, with cultures yielding a pure growth of P. variotii. An exoantigen procedure, currently under development, was helpful in confirming the identity of the patient's fungus. The patient's condition improved following needle aspiration and her recovery was uneventful. It is reiterated that certain infections, attributed to low-grade opportunistic pathogens, such as P. variotii, may be cured by proper surgical drainage.

The purpose of this study was to examine, through a randomized, controlled trial, the effects of a maternal carbohydrate-restricted diet on maternal and infant outcomes in gestational diabetes mellitus (GDM). Women diagnosed with GDM were randomly allocated into one of two groups: an intervention group that was placed on a lower-carbohydrate diet (35–40% of total calories) or a control group that was placed on the usual pregnancy diet (50–55% carbohydrate). A convenience sample of participants diagnosed with GDM (ages 18–45 years) was recruited from two different sites: one urban and low-income and the other suburban and more affluent. Individual face-to-face diet instruction occurred with certified diabetes educators at both sites. Participants tested their blood glucose four times daily. Specific socioeconomic status indicators included enrollment in the Supplemental Nutrition Program for Women, Infants and Children or Medicaid-funded health insurance, as well as cross-sectional census data. All analyses were based on an intention to treat. Although there were no differences found between the lower-carbohydrate and usual-care diets in terms of blood glucose or maternal-infant outcomes, there were significant differences noted between the two sites. There was a lower mean postprandial blood glucose (100.59 ± 7.3 mg/dL) at the suburban site compared to the urban site (116.3 ± 15 mg/dL) (P <0.01), even though there was no difference in carbohydrate intake. There were increased amounts of protein and fat consumed at the suburban site (P <0.01), as well as lower infant complications (P <0.01). Further research is needed to determine whether these disparities in outcomes were the result of macronutrient proportions or environmental conditions.

In this Latina population of pregnant women, there was no difference in fruit and vegetable intake after receiving education about prenatal flavor learning. These findings suggest that education alone may not be sufficient to change health behaviors.

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