Effect of malaria on placental volume measured using three-dimensional ultrasound: a pilot study

Background: The presence of malaria parasites and histopathological changes in the placenta are associated with a reduction in birth weight, principally due to intrauterine growth restriction. The aim of this study was to examine the feasibility of studying early pregnancy placental volumes using three-dimensional (3D) ultrasound in a malaria endemic area, as a small volume in the second trimester may be an indicator of intra-uterine growth restriction and placental insufficiency. Methods: Placenta volumes were acquired using a portable ultrasound machine and a 3D ultrasound transducer and estimated using the Virtual Organ Computer-aided AnaLysis (VOCAL) image analysis software package. Intraobserver reliability and limits of agreement of the placenta volume measurements were calculated. Polynomial regression models for the mean and standard deviation as a function of gestational age for the placental volumes of uninfected women were created and tested. Based on these equations each measurement was converted into a z -score. The z-scores of the placental volumes of malaria infected and uninfected women were then compared. Results: Eighty-four women (uninfected = 65; infected = 19) with a posterior placenta delivered congenitally normal, live born, single babies. The mean placental volumes in the uninfected women were modeled to fit 5th, 10th, 50th, 90th and 95th centiles for 14-24 weeks’ gestation. Most placenta volumes in the infected women were below the 50th centile for gestational age; most of those with Plasmodium falciparum were below the 10th centile. The 95% intra-observer limits of agreement for first and second measurements were ± 37.0 mL and ± 25.4 mL at 30 degrees and 15 degrees rotation respectively. Conclusion: The new technique of 3D ultrasound volumetry of the placenta may be useful to improve our understanding of the pathophysiological constraints on foetal growth caused by malaria infection in early pregnancy

Fetal thigh volumetry by three-dimensional ultrasound: comparison between multiplanar and VOCAL (TM) techniques

Objectives To evaluate the agreement between multiplanar and Virtual Organ Computer-aided Analysis (VOCAL (TM)) techniques for the measurement of total fetal thigh volume and to assess the repeatability and reproducibility of measurements performed using these methods; to derive birth weight-predicting models for both methods and to compare their accuracies. Methods This was a cross-sectional study of 150 singleton pregnancies at 30-42 weeks of gestation in which ultrasound volumes of the fetal thigh were obtained within 48 hours of delivery and measured using multiplanar and VOCAL techniques. Bland-Altman analyses were performed to determine the agreement between the two methods, and to evaluate intraobserver and interobserver variability in a subset of 40 patients. Birth weight-predicting models were derived using total fetal thigh volumes obtained using the VOCAL (ThiV) and multiplanar (ThiM) methods as independent variables. The accuracies of these formulas were compared. Results The mean percentage difference between measurements performed using the VOCAL technique and the multiplanar technique was -0.04 and the 95% limits of agreement were -8.17 and 8.09. The mean percentage difference and 95% limits of agreement between paired measurements in the assessment of intraobserver and interobserver variability were -1.10 (-7.67 to 5.47) and 0.61 (-7.68 to 8.91) for the VOCAL technique and 1.03 (-6.35 to 8.41) and -0.68 (-11.42 to 10.06) for the multiplanar method, respectively. The best-fit formulas for predicting birth weight (B W) were: BW = 1025.383 + 12.775 x ThiV; and BW = 1033.286 + 12.733 x ThiM. There was no significant difference between the accuracies of these formulas. Conclusions There is good agreement between the VOCAL and multiplanar techniques for assessment of total fetal thigh volume. Measurements performed using both methods are repeatable and reproducible. For prediction of birth weight, the formulas generated in this study can be used interchangeably. Copyright (C) 2010 ISUOG. Published by :John Wiley & Sons, Ltd.35441742

Produção de biomassa, acúmulo de nitrato, teores e exportação de macronutrientes da alface sob sombreamento Yield, accumulation of nitrate, content and export of nutrients of lettuce cultivated under shade

Objetivou-se avaliar produção de biomassa, acúmulo de nitrato, teores e exportação de macronutrientes das cultivares de alface Regina e Verônica, em cultivo a céu aberto e sob duas malhas termorrefletoras (Aluminet®30%-O e Aluminet®40%-O) e uma difusora (ChromatiNet Difusor®30%), em experimento conduzido na Universidade Federal de Viçosa (MG). As malhas termorrefletoras e difusora foram instaladas em estruturas tipo telados retangulares fechados, com 2 x 4 x 36 m (altura, largura e comprimento). A semeadura foi realizada em bandejas de 200 células, preenchidas com substrato comercial, sob ambiente protegido, em 31/05/02. O transplante foi realizado em 26/06/02 e a colheita em 06/08/02, ocasião em que foram feitas as avaliações. Avaliou-se a produção de biomassa, teor de nitrato, teores e exportação de macronutrientes. 'Regina' apresentou folhas mais tenras do que a 'Verônica', portanto mais adequadas a mercados mais exigentes, porém, com maior teor de nitrato. Considerando os aspectos quantitativo e qualitativo da produção sugere-se o uso das malhas Aluminet®40%-O e ChromatiNet Difusor®30%; todavia, deve-se ajustar adequadamente a adubação nitrogenada para que não haja acúmulo de nitrato a níveis elevados devido a restrição de luz promovida pelas malhas. Ambientes e cultivares influenciaram nos teores e quantidades exportadas dos nutrientes. Com relação à exportação de nutrientes observou-se a ordem K>N>Ca>P>Mg>S.<br>In this experiment we evaluated the production, accumulation of nitrate, content and exportable mineral nutrient (N, P, K, Ca, Mg e S) of lettuce cultivars Regina and Verônica cultivated under two thermo-reflective screens (Aluminet®30%-O and Aluminet®40%-O), and a diffusive screen (ChromatiNet Difusor®30%). The trial was carried out in Viçosa, Minas Gerais State, Brazil. Seeds were sown in trays of 200 cells, under protected atmosphere, on 05/31/02. The transplant was accomplished on 06/26/02 and the harvest on 08/06/02, when the evaluations were performed. The thermo-reflective and diffusive screens were installed in structures type 'shut rectangular fence', with 2 x 4 x 36 m (height, width and length), close to the cultivation under open sky (control). We evaluated the production of mass, content of nitrate, content and exportable mineral nutrient (N, P, K, Ca, Mg e S). 'Regina' presented more tender leaves than the 'Verônica', therefore being more appropriate to the high quality demanding markets, even so, with larger content of nitrate. Considering the quantitative and qualitative aspects, the Aluminet®40% and ChromatiNet Difusor®30% screens should be recommended; though, the nitrogen should be adjusted to avoid the accumulation of nitrate. The growing conditions and cultivars influenced content and exportable mineral nutrients. With relation to the export of nutrients the following order was observed: K>N>Ca>P>Mg>S