Effect of low-dose aspirin during pregnancy on fibrinolytic variables before and after parturition

OBJECTIVE: We assessed the effects of a daily oral dose of 60 to 80 mg of aspirin from 12 weeks gestation until delivery on fibrinolytic variables before and after parturition. STUDY DESIGN: In a prospective controlled study labor was electively induced in 24 patients, eight receiving low-dose aspirin and 16 controls. Levels were determined in maternal and cord plasma of tissue-type plasminogen activator antigen and activity, plasminogen activator inhibitor-1 antigen, plasminogen activator inhibitor activity, and plasminogen activator inhibitor-2 antigen. We also determined metabolites of vascular prostacycin and platelet thromboxane A2. RESULTS: The only maternal fibrinolytic variable affected by low-dose aspirin was plasminogen activator inhibitor activity, which showed a significant reduction before and after parturition of 40% and 70%, respectively, in low-dose aspirin users compared with controls. Concentrations of thromboxane B2 in women using low-dose aspirin were 7% (maternal serum) and 17% (cord serum) of values in controls, but concentrations of 6-keto-prostaglandin F1α were not affected. CONCUSIONS: Low-dose aspirin reduces plasminogen activator inhibitor activity and platelet reactivity, but not prostacyclin synthesis, before and after parturition. The reduction in plasminogen activator inhibitor activity may be caused by inhibition of platelet reactivity

Aspirin in pregnancy : clinical and biochemical studies

Aspirin, acetylsalicylic acid, is the most frequently consumed drug in pregnancy,47 mostly taken without a prescription because of headache or a minor ailment. 226,277 Numerous preparations containing acetylsalicylic acid are freely available over the counter under a variety of proprietary names, and in many cases pregnant women and their doctors may be unaware that aspirin is being taken. For many years obstetricians have advised against the use of aspirin as a simple analgesic in pregnancy, based on a general tendency to discourage all drug taking in pregnancy as well as on fears of specific complications of aspirin, such as teratogenic effects, maternal and fetal hcmorrhage, and premature closure of the ductus arteriosus. But the negative attitude towards the usc of aspirin in pregnancy is changing rapidly since evidence has become available that a daily low dose of aspirin (60-80 mg) may markedly reduce the incidence of hypertensive disorders and fetal growth retardation in pregnant women at risk

A comparison of an Australian bluetongue virus isolate (CSIRO 19) with other bluetongue virus serotypes by cross-hybridization and cross-immune precipitation

No major differences in size were observed when both the double-stranded RNA and the polypeptides of the Australian bluetongue virus (BTV) isolate CSIRO 19 (BTV-20) were compared with those of other BTV serotypes such as BTV-10 and BTV-4. Minor capsid polypeptide P6 of both BTV-20 and BTV-4, which electrophoreses as a single band on continuous phosphate buffered gels, is separated into 2 distinct bands on discontinuous glycine-buffered gels. This was not the case with BTV-10. Cross-immune precipitation of BTV-20 with BTV-10, BTV-17, BTV-4 and BTV-3 indicated strong immunological cross-reaction of the group-specific antigen P7 of the different serotypes. There was also some cross-immune precipitation of the serotype-specific polypeptide P2 of BTV-20 and BTV-4. This result is in agreement with the observed cross neutralization of these 2 viruses. The main distinction between BTV-20 and the other BTV serotypes was observed in crosshybridization experiments. The homology between the nucleic acid of BTV-20 and other BTV serotypes was less than 30%, whereas homology normally found between BTV serotypes is at least 70%. The hybridization products of the different BTV serotypes were analysed by electrophoresis and fluorography. Two main hybrid segments were observed in all heterologous hybridizations with BTV-20 as compared with 7 hybrid segments in hybridizations between BTV-4 and BTV-10. In order to determine from which genome segment of BTV -20 these 2 hybrid segments were derived, the hybridizations were carried out with individually purified double-stranded RNA segments. These results indicate that the 2 segments of BTV-20 that show the largest homology to corresponding segments of a heterologous BTV serotype are No. 7 and 10.The articles have been scanned in colour with a HP Scanjet 5590; 600dpi. Adobe Acrobat XI Pro was used to OCR the text and also for the merging and conversion to the final presentation PDF-format

The nucleic acid and proteins of epizootic haemorrhagic disease virus

Purified epizootic haemorrhagic disease virus (EHDV) was shown to contain 10 double-stranded RNA segments and a double-layered protein capsid with 4 major and 4 minor polypeptides. The virus differed from bluetongue virus (BTV), the orbivirus prototype, in that EHDV had an additional minor polypeptide component. This component, together with the major polypeptides P2 and P5, formed the outer capsid layer of the virus. The extra polypeptide apparently stabilizes this layer since, unlike BTV, EHDV was quite stable on CsC1 gradients at both pH 7,0 and 8,0. EHD virions were found to have a density of 1,36 g/mℓ, while particles without the outer capsid layer were isolated and had a density of 1,40 g/mℓ. Two non-capsid polypeptides, P5A and P6A, were identified in addition to the 8 capsid polypeptides. Polypeptide P5A was synthesized in excess of all the others. There was little homology between the nucleic acids of EHDV and BTV with only 5-10% cross-hybridization. No hybrid double-stranded RNA segments were identified. We found by cross-immune precipitation that the major core polypeptides of the 2 viruses (P7 and P3) have common antigenic determinants.This article has been scanned in colour with a HP Scanjet 5590; 300dpi. Adobe Acrobat XI Pro was used to OCR the text and also for the merging and conversion to the final presentation PDF-Format

Integrated population modeling identifies low duckling survival as a key driver of decline in a European population of the Mallard

Europe’s highest densities of breeding Mallards (Anas platyrhynchos) are found in the Netherlands, but the breeding population there has declined by ~30% since the 1990s. The exact cause of this decline has remained unclear. Here, we used an integrated population model to jointly analyze Mallard population survey, nest survey, duckling survival, and band-recovery data. We used this approach to holistically estimate all relevant vital rates, including duckling survival rates for years for which no explicit data were available. Mean vital rate estimates were high for nest success (0.38 ± 0.01) and egg hatch rate (0.96 ± 0.001), but relatively low for clutch size (8.2 ± 0.05) compared to populations in other regions. Estimates for duckling survival rate for the three years for which explicit data were available were low (0.16–0.27) compared to historical observations, but were comparable to rates reported for other regions with declining populations. Finally, the mean survival rate was low for ducklings (0.18 ± 0.02), but high and stable for adults (0.71 ± 0.03). Population growth rate was only affected by variation in duckling survival, but since this is a predominantly latent state variable, this result should be interpreted with caution. However, it does strongly indicate that none of the other vital rates, all of which were supported by data, was able to sufficiently explain the population decline. Together with a comparison with historic vital rates, these findings point to a reduced duckling survival rate as the likely cause of the decline. Candidate drivers of reduced duckling survival are increased predation pressure and reduced food availability, but this requires future study. Integrated population modeling can provide valuable insights into population dynamics even when empirical data for a key parameter are partly missing

Perinatal death in a term fetal growth restriction randomized controlled trial:the paradox of prior risk and consent

BACKGROUND: The disproportionate intrauterine growth intervention trial at term was an intention to treat analysis and compared labor induction with expectant monitoring in pregnancies complicated by fetal growth restriction at term and showed equivalence for neonatal outcomes. OBJECTIVE: To evaluate trial participation bias and to examine the generalizability of the results of an obstetrical randomized trial. STUDY DESIGN: We used data from participants and nonparticipants of a randomized controlled trial-the disproportionate intrauterine growth intervention trial at term (n=1116) -to perform a secondary analysis. This study compared induction of labor and expectant management in women with term growth restriction. Data were collected in the same manner for both groups. Baseline characteristics and neonatal and maternal outcomes were compared. The primary outcome was a composite measure of adverse neonatal outcome. Secondary outcomes were delivery by cesarean delivery and instrumental vaginal delivery; length of stay in the neonatal intensive care, neonatal ward, and the maternal hospital; and maternal morbidity. RESULTS: Nonparticipants were older, had a lower body mass index, had a higher level of education, smoked less, and preferred expectant management. The time between study inclusion and labor onset was shorter in participants than in nonparticipants. Notably, 4 perinatal deaths occurred among nonparticipants and none among participants. Among nonparticipants, there were more children born with a birthweight below the third centile. The nonparticipants who had expectant management were monitored less frequently than the participants in both the intervention and the expectant arm. CONCLUSION: We found less favorable outcomes and more perinatal deaths in nonparticipants. Protocol-driven management, differences between participants and nonparticipants, or the fact that nonparticipants had a preference for expectant management might explain the findings

Основные положения формирования нового единого сельскохозяйственного налога

Обосновывается введение единого сельскохозяйственного налога как постоянной ставки от стоимости валового дохода предприятий.Обгрунтовується введене єдиного сільськогосподарського податку як постійної ставки до вартості валового доходу підприємств.Introduction of the united agricultural tax is grounded as a permanent size to the cost of gross profit of enterprises

Early nasogastric tube feeding in optimising treatment for hyperemesis gravidarum: The MOTHER randomised controlled trial (Maternal and Offspring outcomes after Treatment of HyperEmesis by Refeeding)

Background: Hyperemesis gravidarum (HG), or intractable vomiting during pregnancy, is the single most frequent cause of hospital admission in early pregnancy. HG has a major impact on maternal quality of life and has repeatedly been associated with poor pregnancy outcome such as low birth weight. Currently, women with HG are admitted to hospital for intravenous fluid replacement, without receiving specific nutritional attention. Nasogastric tube feeding is sometimes used as last resort treatment. At present no randomised trials on dietary or rehydration interventions have been performed. Small observational studies indicate that enteral tube feeding may have the ability to effectively treat dehydration and malnutrition and alleviate nausea and vomiting symptoms. We aim to evaluate the effectiveness of early enteral tube feeding in addition to standard care on nausea and vomiting symptoms and pregnancy outcomes in HG patients. Methods/Design: The MOTHER trial is a multicentre open label randomised controlled trial ( www.studies-obsgyn.nl/mother ). Women ≥ 18 years hospitalised for HG between 5 + 0 and 19 + 6 weeks gestation are eligible for participation. After informed consent participants are randomly allocated to standard care with intravenous rehydration or early enteral tube feeding in addition to standard care. All women keep a weekly diary to record symptoms and dietary intake until 20 weeks gestation. The primary outcome will be neonatal birth weight. Secondary outcomes will be the 24-h Pregnancy Unique Quantification of Emesis and nausea score (PUQE-24), maternal weight gain, dietary intake, duration of hospital stay, number of readmissions, quality of life and side-effects. Also gestational age at birth, placental weight, umbilical cord plasma lipid concentration and neonatal morbidity will be evaluated. Analysis will be according to the intention to treat principle. Discussion: With this trial we aim to clarify whether early enteral tube feeding is more effective in treating HG than intravenous rehydration alone and improves pregnancy outcome. Trial registration: Trial registration number: NTR4197. Date of registration: October 2nd 2013

Induction versus expectant monitoring for intrauterine growth restriction at term: Randomised equivalence trial (DIGITAT)

Objective: To compare the effect of induction of labour with a policy of expectant monitoring for intrauterine growth restriction near term. Design: Multicentre randomised equivalence trial (the Disproportionate Intrauterine Growth Intervention Trial At Term (DIGITAT)). Setting: Eight academic and 44 non-academic hospitals in the Netherlands between November 2004 and November 2008. Participants: Pregnant women who had a singleton pregnancy beyond 36+0 weeks' g

Hyperemesis gravidarum severity, enteral tube feeding and cardiometabolic markers in offspring cord blood

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