Are congenital malformations more frequent in fetuses with intrahepatic persistent right umbilical vein? A comparative study

Objective Persistent right umbilical vein (PRUV) is a vascular anomaly where the right umbilical vein remains as the only conduit that returns oxygenated blood to the fetus. It has classically been described as associated with numerous defects. We distinguish the intrahepatic variant (better prognosis) and the extrahepatic variant (associated with worse prognosis). The objective of this study was to compare rates of congenital malformations in fetuses with intrahepatic PRUV (I-PRUV) versus singleton pregnancies without risk factors. Materials and Methods A multicenter, crossover design, comparative study was performed between 2003 and 2013 on fetuses diagnosed with I-PRUV (n = 56), and singleton pregnancies without congenital malformation risk factors (n = 4050). Results Fifty-six cases of I-PRUV were diagnosed (incidence 1:770). A statistically significant association between I-PRUV and the presence of congenital malformations (odds ratio 4.321; 95% confidence interval 2.15–8.69) was found. This positive association was only observed with genitourinary malformations (odds ratio 3.038; 95% confidence interval 1.08–8.56). Conclusion Our rate of malformations associated with I-PRUV (17.9%) is similar to previously published rates. I-PRUV has shown a significant increase in the rate of associated malformations, although this association has only been found to be statistically significant in the genitourinary system. Noteworthy is the fact that this comparative study has not pointed to a significant increase in the congenital heart malformation rate. Diagnosis of isolated I-PRUV does not carry a worse prognosis

Risk factors for premature aging of placenta: comparative study of perinatal outcomes between grannum grade III placentas and grannum grade I-II placentas

Introduction: The placenta aging has been related with intrauterine fetal growth, low maternal age, Caucasian, multiparity, hypertensive states and smoking habit. Grannum P. classification is the most used for its assessment. The association between grade III placenta (G3P) and ex-smoking or smokeexposed pregnants has not been studied Main outcome: To asses if smoking, being an ex-smoker or a passive-smoker is a risk factor for developing grade III placenta, as well as if there is a smoking-free period of time to avoid the effect of smoking over placenta Material and methods: A retrospective case-control study of single pregnancies followed-up at the Obstetric Ultrasound Unit between January 2013 and January 2014. Placental grading according to Grannum classification was stablished through abdominal approach between 34-36 weeks of gestation and two groups were established: grade III placenta and grade I-II placenta (G1-2P) Maternal and paternal characteristics, type of delivery and perinatal outcomes were collected Results: Baseline characteristics were similar between the two groups. In G3P the incidence of hypertensive disease of pregnancy was higher(p=0,0107). The percentage was similar for premature birth, 1st and 5th minute Apgar, type of delivery and cesarean due to risk of loss of fetal wellbeing. A lower neonatal weight was found in G3P, at the same median days at delivery, with a mean difference of 148,156(p=0,008313. Regarding weight percentile, it was found a p35 in G3P and a p47,5 in G1- 2P(p=0,08235) 15% of the total pregnant were smokers. In G3P group it was found a higher frequency of smokers and ex-smokers since 1st trimester of pregnancy (p=0.0001), as well as pregnant non-smokers with an smoking partner(p=0,0001). There was an strong evidence for association between pregnant smokers and smoking partners(p=0,0001). No difference was found regarding to neonatal weight comparing smokers, ex-smokers and ex-smokers since 1st trimester of pregnancy. The length of pregnancy was lower between G3P pregnant smokers compared to G1-2P pregnant smokers, with a mean difference of 8 days (p=0,00091) Conclusions: There is a strong evidence for association between smoking during pregnancy, quitting smoking at the beginning of the pregnancy or being a passive smoker with development of G3P Some pregnant smokers don`t develop premature aging of placenta, it could be due to either other parameters or a later aging (data were collected between 34-36 weeks). The association between quitting smoking at the beginning of the pregnancy and not having a smoking partner reduces the risk of developing G3

Nicotinamide Prevents Apolipoprotein B-Containing Lipoprotein Oxidation, Inflammation and Atherosclerosis in Apolipoprotein E-Deficient Mice

Altres ajuts: Fundació La Marató de TV3 2016 (303/C/2016) (201602.31) (to J.J.) and (97/C/2016) (201605-31) (to A.F.V.).The potential of nicotinamide (NAM) to prevent atherosclerosis has not yet been examined. This study investigated the effect of NAM supplementation on the development of atherosclerosis in a mouse model of the disease. The development of aortic atherosclerosis was significantly reduced (NAM low dose: 45%; NAM high dose: 55%) in NAM-treated, apolipoprotein (Apo)E-deficient mice challenged with a Western diet for 4 weeks. NAM administration significantly increased (1.8-fold) the plasma concentration of proatherogenic ApoB-containing lipoproteins in NAM high-dose (HD)-treated mice compared with untreated mice. However, isolated ApoB-containing lipoproteins from NAM HD mice were less prone to oxidation than those of untreated mice. This result was consistent with the decreased (1.5-fold) concentration of oxidized low-density lipoproteins in this group. Immunohistochemical staining of aortas from NAM-treated mice showed significantly increased levels of IL-10 (NAM low-dose (LD): 1.3-fold; NAM HD: 1.2-fold), concomitant with a significant decrease in the relative expression of TNFα (NAM LD: −44%; NAM HD: −57%). An improved anti-inflammatory pattern was reproduced in macrophages cultured in the presence of NAM. Thus, dietary NAM supplementation in ApoE-deficient mice prevented the development of atherosclerosis and improved protection against ApoB-containing lipoprotein oxidation and aortic inflammation

Paragangliomas. Static cytometric studies of nuclear DNA patterns

<p>The biologic behavior of most paragangliomas cannot be predicted from their histologic appearance. Recently, cytometric studies have found an association between an aggressive clinical behavior and the presence of a hyperdiploid or tetraploid range in the DNA nuclear content.<br> The authors have studied morphometric (nuclear area and nuclear form factor) and DNA densitometric (integral optical density and DNA ploidy) features of 23 cases of paraganglioma by means of slide cytophotometry with the microTICAS system (University of Chicago, Chicago, IL). The samples were selected from paraffin-embedded tissue, and representative sections were stained with the Feulgen technique. The differences between groups (cervical versus extracervical paragangliomas) were investigated with the Mann-Whitney test and Fisher discriminant linear function.<br> The densitometric study showed aneuploid cell lines in 15 of 16 noncervical paragangliomas (with a DNA index within the tetraploid range), whereas 3 of 7 cervical paragangliomas were aneuploid and only 1 case did not have not a diploid cell line (with a DNA index within the peridiploid range). Mean ploidy (4.33 arbitrary units [AU] and 2.72 AU, respectively), nuclear area (58.74 microns 2 and 32.08 microns 2, respectively), the minor and major DNA indices (1.09-1.24 and 1.83-1.96, respectively), and DNA content variability (2c deviation indices [2cDI] of 8.62 and 1.88 AU, respectively) were higher in noncervical paragangliomas. With Fisher linear discriminant function, mean nuclear area (P = 0.0008), 2cDI (P = 0.0030), and the minor DNA index of each cell proliferation were correlated with location. None of the variables established statistically significant differences in comparisons of malignant and benign paragangliomas.<br> Karyometric and DNA densitometric parameters have limited value in determining the prognosis of paragangliomas, although they are correlated with tumoral location, which is still an indicator in establishing the prognosis of these neoplasms.</p

Nuclear DNA patterns in adrenal cortex proliferative lesions

<p>In cortical adrenal gland tumours there are discrepancies between morphological criteria for malignancy and biological behaviour. This makes it difficult to select the appropriate treatment. We have studied morphometric and DNA densitometric features of 24 adrenal proliferative lesions (hyperplasia, adenoma, and carcinoma) by means of slide cytometry. All variables have been correlated with pathological diagnosis. The samples were selected from paraffin-embedded tissue, and representative lesions were Feulgen stained. Densitometric study showed aneuploid cell lines in every carcinoma, 5 of 8 adenomas, and 5 of 10 hyperplastic lesions. Both DNA nuclear content (mean ploidy of 2.11 c, 2.41 c, and 3.05 c) mean nuclear area (average of 31.26 microns 2, 35.92 microns 2, and 42.39 microns 2) showed progressive increase from hyperplasia to adenoma, and carcinoma. Mean shape factors were lowest in adenomas (1.69) and highest in carcinomas (1.82). Those karyometric variables which showed statistically significant differences (p < 0.05) among diagnostic groups were included in a stepwise three-way discriminant analysis. Only three parameters, shape factor (p = 0.0008), mean ploidy (p = 0.0012), and adrenal weight (p = 0.0055) persisted as independent predictive factors. Using the three variables selected by discriminant analysis on our cases, 100% of the adenomas were correctly classified, 83% of the carcinomas, and 80% of the hyperplasias. Tumour weight and nuclear shape factor differentiated adrenal cortex adenoma from carcinoma, while mean ploidy distinguished adrenal cortical hyperplasia from carcinoma. Nuclear pleomorphism (shape factor) and DNA-ploidy are the most important nuclear features in predicting the biological course of proliferative adrenal cortex lesions, although by themselves they are not bona-fide discriminators.</p