Kardionevroablacija pri zdravljenju refleksne nevrokardiogene sinkope - Prikaz primera

Izvleček Refleksna nevrokardiogena sinkopa je ena izmed najbolj pogostih oblik izgube zavesti, pri kateri prekomeren odziv parasimpatičnega živčnega sistema vodi do padca krvnega pritiska preko vazodilatacije in/ali znižanja srčnega utripa. Gre za sinkopo, ki praviloma ni povezana z organsko boleznijo, zato je njena prognoza dobra in umrljivost ni povečana, lahko pa vpliva na kvaliteto življenja. Z novo metodo zdravljenja - kardionevroablacijo - želimo doseči izboljšanje kvalitete življenja pri pacientih s pogostimi epizodami refleksne nevrokardiogene sinkope s prevladujočo kardioinhibitorno komponento, pri katerih nefarmakološki in farmakološki načini zdravljenja niso učinkoviti, vstavitev srčnega spodbujevalnika pa zaradi mladosti odsvetovana. Gre za perkutani elektrofiziološki poseg, kjer z radiofrekvenčno ablacijo z endokardialne strani uničimo specifične parasimpatične ganglije epikardialno na srcu. Na ta način dosežemo delno parasimpatično denervacijo srca in s tem zmanjšamo ali odpravimo prekomeren vpliv parasimpatičnega živčevja na srce in posledično tudi kardioinhibitorno komponentno refleksne nevrokardiogene sinkope

A comparison of various linear and non-linear signal processing techniques to separate uterine EMG records of term and pre-term delivery groups

Abstract Various linear and non-linear signal-processing techniques were applied to three-channel uterine EMG records to separate term and pre-term deliveries. The linear techniques were root mean square value, peak and median frequency of the signal power spectrum and autocorrelation zero crossing; while the selected non-linear techniques were estimation of the maximal Lyapunov exponent, correlation dimension and calculating sample entropy. In total, 300 records were grouped into four groups according to the time of recording (before or after the 26th week of gestation) and according to the total length of gestation (term delivery records-pregnancy duration C37 weeks and pre-term delivery recordspregnancy duration \37 weeks). The following preprocessing band-pass Butterworth filters were tested: 0.08-4, 0.3-4, and 0.3-3 Hz. With the 0.3-3 Hz filter, the median frequency indicated a statistical difference between those term and pre-term delivery records recorded before the 26th week (p = 0.03), and between all term and all preterm delivery records (p = 0.012). With the same filter, the sample entropy indicated statistical differences between those term and pre-term delivery records recorded before the 26th week (p = 0.035), and between all term and all pre-term delivery records (p = 0.011). Both techniques also showed noticeable differences between term delivery records recorded before and after the 26th week (p B 0.001)

European perinatal health report by the Euro-Peristat project

peer reviewedThe paper provides a framework to evaluate the response of buildings in a community subject to fire following earthquake. First, a model is developed to determine the probability of ignition in buildings of a community due to an earthquake. Second, fragility functions are developed for buildings subject to fire, to quantify the structural damage and the expected losses. The ignition model, combined with the fragility functions, can be implemented in a GIS based risk management platform to evaluate economical losses in a region from fire following an earthquake

INFECTIONS IN PERINATAL PERIOD II. GYNECOLOGICAL AND OBSTETRICAL ANAMNESTIC DATA AND PRETERM DELIVERY

Background. Around 6% of preterm newborns contribute to the 75% perinatal mortality rate. Besides, these newborns are more prone to morbidity. Despite numerous studies and measures the overall preterm delivery rate over the last decade has not decreased. Namely, spontaneous preterm delivery rate has been decreasing, yet the indicated preterm delivery rate has been increasing. There are numerous factors triggering a preterm delivery, one of them being infections. This study is the second in our series of papers dealing with preterm delivery. The aim of this study was to find whether there exists, together with other risk factors, a relationship between gynecological and obstetrical anamnestic data and preterm delivery.Methods. For 133 mothers and their preterm babies (study group) and 127 mothers and their term babies (control group), a questionnaire was filled-in after delivery.Results. Significant differences regarding infections between the study and control group were found in anamnestic data regarding the use of antibiotics in current pregnancy (except for urinary tract infection) and use of antibiotics during current delivery. Besides these, significant differences were observed also in connection with a previous preterm delivery, the interval between a previous and current delivery of less than two years, conization, use of tocolytics in current pregnancy, sick leave in current pregnancy, diseases in current pregnancy which actually led to indicated preterm delivery in favour of mother’s condition.Conclusions. Pregnant women who delivered preterm, were significantly more often treated with antibiotics in current pregnancy. There were no such differences regarding colpitis and cervicitis treatment in current pregnancy or gynecological infections treatment before pregnancy. These pregnant women should be regarded as more prone to preterm delivery. Further studies of the Slovenian population will provide valuable data that will help find a more accurate estimated risk for preterm delivery and thus reduce the group of pregnant women requiring additional methods for estimation of risk for preterm delivery and secondary preventive measures.</p

Javnozdravstveni vidiki preprečevanja napak nevralne cevi s folno kislino

Napake nevralne cevi so heterogena in kompleksna skupina napak centralnega živčnega sistema. Z uživanjem zadostnih odmerkov folne kisline pred zanositvijo in med nosečnostjo lahko preprečimo 60-70 % primarnih in 72 % ponovnih napak nevralne cevi. Za učinkovito zmanjšanje pogostosti napak nevralne cevi so potrebne sočasne dejavnosti na vseh ravneh preventive. Lahko spodbujamo zdravo prehranjevanje, spodbujamo uživanje vitaminskih dodatkov s folno kislino, dodajanje folne kisline nekaterim živilom, zgodnje odkrivanje in zdravljenje. Dodajanje folne kisline nekaterim živilom se je izkazalo tudi kot potencialno koristen ukrep pri preprečevanju nekaterih oblik kroničnih nenalezljivih bolezni, vendar ostajajo pri tem nekatere nerešene strokovne in etične dileme.Neural tube defects are a group of heterogenous and complex congenital anomalies of the central nervous system. Adequate intake of folic acid prior to conception and during early pregnancy prevents 60%-70% of primary and 72% of recurrent neural tube defects. To effectively reduce the prevalence of neural tube defects, numerous activities at all levels of prevention have to be conducted simultaneously. These include: promoting healthy diet, taking folic acid supplements, fortifying staple foods with folic acid, and introducing prenatal screening and treatment. Folic acid fortification of staple foods has proved potentially effective in preventing some chronic noncommunicable diseases. Nonetheless, some ethical dilemmas and professional problems remain unsolved

Variations in rates of severe perineal tears and episiotomies in 20 European countries: a study based on routine national data in Euro-Peristat Project.

To access publisher's full text version of this article click on the hyperlink at the bottom of the pageRates of severe perineal tears and episiotomies are indicators of obstetrical quality of care, but their use for international comparisons is complicated by difficulties with accurate ascertainment of tears and uncertainties regarding the optimal rate of episiotomies. We compared rates of severe perineal tears and episiotomies in European countries and analysed the association between these two indicators.We used aggregate data from national routine statistics available in the Euro-Peristat project. We compared rates of severe (third- and fourth-degree) tears and episiotomies in 2010 by mode of vaginal delivery (n = 20 countries), and investigated time trends between 2004 and 2010 (n = 9 countries). Statistical associations were assessed with Spearman's ranked correlations (rho).In 2010 in all vaginal deliveries, rates of severe tears ranged from 0.1% in Romania to 4.9% in Iceland, and rates of episiotomies from 3.7% in Denmark to 75.0% in Cyprus. A negative correlation between the rates of episiotomies and severe tears was observed in all deliveries (rho = -0.66; p = 0.001), instrumental deliveries (rho = -0.67; p = 0.002) and non-instrumental deliveries (rho = -0.72; p < 0.001). However there was no relation between time trends of these two indicators (rho = 0.43; p = 0.28).The large variations in severe tears and episiotomies and the negative association between these indicators in 2010 show the importance of improving the assessment and reporting of tears in each country, and evaluating the impact of low episiotomy rates on the perineum.info:eu-repo/grantAgreement/EC/FP7/20101301, 2007114, 2003131, 6646