Pre-eclampsia: pathophysiology, diagnosis, and management

The incidence of pre-eclampsia ranges from 3% to 7% for nulliparas and 1% to 3% for multiparas. Pre-eclampsia is a major cause of maternal mortality and morbidity, preterm birth, perinatal death, and intrauterine growth restriction. Unfortunately, the pathophysiology of this multisystem disorder, characterized by abnormal vascular response to placentation, is still unclear. Despite great polymorphism of the disease, the criteria for pre-eclampsia have not changed over the past decade (systolic blood pressure >140 mmHg or diastolic blood pressure ≥90 mmHg and 24-hour proteinuria ≥0.3 g). Clinical features and laboratory abnormalities define and determine the severity of pre-eclampsia. Delivery is the only curative treatment for pre-eclampsia. Multidisciplinary management, involving an obstetrician, anesthetist, and pediatrician, is carried out with consideration of the maternal risks due to continued pregnancy and the fetal risks associated with induced preterm delivery. Screening women at high risk and preventing recurrences are key issues in the management of pre-eclampsia

The Brazilian Soil Spectral Service (BraSpecS): A User-Friendly System for Global Soil Spectra Communication

Although many Soil Spectral Libraries (SSLs) have been created globally, these libraries still have not been operationalized for end-users. To address this limitation, this study created an online Brazilian Soil Spectral Service (BraSpecS). The system was based on the Brazilian Soil Spectral Library (BSSL) with samples collected in the Visible–Near–Short-wave infrared (vis–NIR–SWIR) and Midinfrared (MIR) ranges. The interactive platform allows users to find spectra, act as custodians of the data, and estimate several soil properties and classification. The system was tested by 500 Brazilian and 65 international users. Users accessed the platform (besbbr.com.br), uploaded their spectra, and received soil organic carbon (SOC) and clay content prediction results via email. The BraSpecS prediction provided good results for Brazilian data, but performed variably for other countries. Prediction for countries outside of Brazil using local spectra (External Country Soil Spectral Libraries, ExCSSL) mostly showed greater performance than BraSpecS. Clay R2 ranged from 0.5 (BraSpecS) to 0.8 (ExCSSL) in vis–NIR–SWIR, but BraSpecS MIR models were more accurate in most situations. The development of external models based on the fusion of local samples with BSSL formed the Global Soil Spectral Library (GSSL). The GSSL models improved soil properties prediction for different countries. Nevertheless, the proposed system needs to be continually updated with new spectra so they can be applied broadly. Accordingly, the online system is dynamic, users can contribute their data and the models will adapt to local information. Our community-driven web platform allows users to predict soil attributes without learning soil spectral modeling, which will invite end-users to utilize this powerful technique

Guidelines for assessment of gait and reference values for spatiotemporal gait parameters in older adults: The biomathics and canadian gait consortiums initiative

Abstract: Background: Gait disorders, a highly prevalent condition in older adults, are associated with several adverse health consequences. Gait analysis allows qualitative and quantitative assessments of gait that improves the understanding of mechanisms of gait disorders and the choice of interventions. This manuscript aims (1) to give consensus guidance for clinical and spatiotemporal gait analysis based on the recorded footfalls in older adults aged 65 years and over, and (2) to provide reference values for spatiotemporal gait parameters based on the recorded footfalls in healthy older adults free of cognitive impairment and multi-morbidities.Methods: International experts working in a network of two different consortiums (i.e., Biomathics and Canadian Gait Consortium) participated in this initiative. First, they identified items of standardized information following the usual procedure of formulation of consensus findings. Second, they merged databases including spatiotemporal gait assessments with GAITRite® system and clinical information from the “Gait, cOgnitiOn & Decline” (GOOD) initiative and the Generation 100 (Gen 100) study. Only healthy—free of cognitive impairment and multi-morbidities (i.e., ≤ 3 therapeutics taken daily)—participants aged 65 and older were selected. Age, sex, body mass index, mean values, and coefficients of variation (CoV) of gait parameters were used for the analyses. Results: Standardized systematic assessment of three categories of items, which were demographics and clinical information, and gait characteristics (clinical and spatiotemporal gait analysis based on the recorded footfalls), were selected for the proposed guidelines. Two complementary sets of items were distinguished: a minimal data set and a full data set. In addition, a total of 954 participants (mean age 72.8 ± 4.8 years, 45.8% women) were recruited to establish the reference values. Performance of spatiotemporal gait parameters based on the recorded footfalls declined with increasing age (mean values and CoV) and demonstrated sex differences (mean values). Conclusions: Based on an international multicenter collaboration, we propose consensus guidelines for gait assessment and spatiotemporal gait analysis based on the recorded footfalls, and reference values for healthy older adults

La grossesse et l'accouchement chez la femme de plus de 40 ans, en fonction de la parité (étude sur 322 cas à l'hôpital Foch de Suresnes)

Les grossesses tardives sont devenues un sujet de préoccupation dans les pays occidentaux du fait de leur constante augmentation depuis plus de 20 ans, de leur réputation à haut risque et de leur proportion de primipares croissante (20% environ). Pour évaluer les risques que pouvait engendrer l âge maternel >= à 40 ans sur la grossesse, l accouchement et le nouveau-né, nous avons étudié les dossiers des 322 femmes ayant accouché après 40 ans, en les comparant à ceux des 7143 femmes de moins de 40 ans, entre 2004 et 2006 à la maternité de l hôpital Foch. Nous avons observé une augmentation significative mais faible de diabète gestationnel, d hypertension artérielle gravidique, de prééclampsie, et une augmentation plus nette de césarienne, sans explication médicale évidente. Ces césariennes arbitraires sont le reflet de l appréhension des médecins et des patientes face aux grossesses tardives, et remettent en cause le principe de précaution du fait du risque chirurgical pour la mère.ST QUENTIN EN YVELINES-BU (782972101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Endometriosis and adenomyosis in the crosshair: variants of one disorder or fortuitous coincidence

International audienceAdenomyosis and endometriosis share a common origin as both of them result from the development of endometrial tissue outside the endometrium. Despite this, the 2 disorders were until recently considered as 2 different entities notably, because of their different epidemiology. Today, however, new findings regarding core similarities in pathophysiology and endometrial receptivity – not altered in assisted reproductive technology when using frozen embryo transfers – tend to reunite these 2 ailments as variants of 1 disorder

Iron and Oxidative Stress in Gestational Diabetes

International audienc

Endometriosis in transgender men: recognizing the missing pieces

International audienceEndometriosis, traditionally associated with cisgender women, should be recognized as a significant issue for transgender men. This perspective highlights the need to address the unique experiences and challenges faced by transgender men with endometriosis. Diagnostic difficulties arise due to hormone therapy and surgical interventions, which can alter symptoms. Limited research in transgender men undergoing hysterectomy further complicates the understanding of endometriosis in this population. Healthcare providers must be aware of these challenges and adapt the diagnostic approaches accordingly. Education and inclusive care are essential to ensure timely and appropriate management of endometriosis in transgender men, ultimately improving their quality of life. Copyrigh

Dérivés doublement liés de l'étain et de l'antimoine (stannènes, stannaallènes, stibènes et stibaallènes >Sn=C<, >Sn=C=C<, -Sb=C< et -Sb=C=C< )

TOULOUSE3-BU Sciences (315552104) / SudocSudocFranceF

Epigenetic alterations of the first trimester placenta: insight into preoccupying concerns in assisted reproductive technology

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General infertility workup in times of high assisted reproductive technology efficacy

International audienceThe assessments of oocyte quality and quantity and endocrine profile have traditionally been the cornerstone of the general workup of couples with infertility. Over the years, several clinical, hormonal, and functional biomarkers have been adopted to assess ovarian function and identify endocrine disorders before assisted reproductive technology. Furthermore, the genetic workup of patients has drastically changed, introducing novel markers. This not only allowed the prediction of response to ovarian stimulation but also contributed toward the development of a safer and more efficient management of women undergoing assisted reproductive technology. The scope of this review is to provide an overview of the current and novel strategies adopted for the assessment of ovarian function and ovulatory and endocrine disorders in women planning to conceive. Furthermore, it aims to provide an insight in the role of novel genetic biomarkers and use of expanded carrier screening as part of preliminary workup of women with infertility