160 research outputs found
Auditive direct in utero observation (Audio): A randomized controlled trial for a prenatal demonstration of fetal hearing
Introduction: The objective of this randomized controlled study was to demonstrate whether acoustic stimulation in utero is associated with fetal reactivity which is documentable by car-diotocography. Materials and methods: A monocentric randomized controlled trial was performed at a single university tertiary hospital between September 2016 and July 2017. This study was registered as a randomized clinical trial on clinicaltrail.gov (registration number NCT04622059). Unselected pregnancies at term of gestation were consecutively recruited for the purpose of this study. After 10 min of normal cardiotocography without accelerations (non-stress-test with a basal frequency between 110 and 150 beats/min, normal variability between 6 and 15 b/min, no accelerations, and no fetal movements), fetuses were randomized at a 1:1 ratio to either of the two groups. Fetuses in group A (n = 105) received acoustic stimulation after 10 min from the beginning of the CTG, whereas fetuses in group B received no stimulation (n = 105). The outcome variables investigated were the lapse of time between the beginning of the CTG and the occurrence of the first accelera-tion, and the lapse of time between the beginning of the CTG and the first fetal movement noticed. Results: The lapse of time between the beginning of the CTG and the occurrence of the first acceleration was significantly shorter in the group with acoustic stimulation compared to the other group (14.87 ± 5.01 vs. 21.90 ± 6.94 min, p-value < 0.001 log-rank test). Similarly, the lapse of time between the beginning of the CTG and the occurrence of the first fetal movement was significantly shorter in group A compared to group B (17.77 ± 7.62 vs. 23.28 ± 7.61 min, p-value < 0.001, log-rank test). Fetal cardiac acceleration and the occurrence of a fetal movement during the first 20 min of the CTG were more frequently recorded in group A compared to group B (respectively, 15% vs. 5% and 20% vs. 8%). Conclusion: This RCT showed an early fetal reaction following auditive stimulus, documentable by cardiotocography. Further research is needed to investigate a possible role of acoustic stimulation in utero for the prenatal diagnosis of congenital hypoacusis
Variability of Forebrain Commissures in Callosal Agenesis: A Prenatal MR Imaging Study
BACKGROUND AND PURPOSE: Agenesis of the corpus callosum, even when isolated, may be characterized by anatomic variability. The aim of this study was to describe the types of other forebrain commissures in a large cohort of randomly enrolled fetuses with apparently isolated agenesis of the corpus callosum at prenatal MR imaging. MATERIALS AND METHODS: All fetuses with apparent isolated agenesis of the corpus callosum undergoing prenatal MR imaging from 2004 to 2014, were evaluated for the presence of the anterior or a vestigial hippocampal commissure assessed in consensus by 2 pediatric neuroradiologists. RESULTS: Overall, 62 cases of agenesis of the corpus callosum were retrieved from our data base. In 3/62 fetuses (4.8%), no forebrain commissure was visible at prenatal MR imaging, 23/62 fetuses (37.1%) presented with only the anterior commissure, and 20/62 fetuses (32.3%) showed both the anterior commissure and a residual vestigial hippocampal commissure, whereas in the remaining 16/62 fetuses (25.8%), a hybrid structure merging a residual vestigial hippocampal commissure and a rudiment of the corpus callosum body was detectable. Postnatal MR imaging, when available, confirmed prenatal forebrain commissure findings. CONCLUSIONS: Most fetuses with apparent isolated agenesis of the corpus callosum showed at least 1 forebrain commissure at prenatal MR imaging, and approximately half of fetuses also had a second commissure: a vestigial hippocampal commissure or a hybrid made of a hippocampal commissure and a rudimentary corpus callosum body. Whether such variability is the result of different genotypes and whether it may have any impact on the long-term neurodevelopmental outcome remains to be assessed. AC : anterior commissure ACC : agenesis of the corpus callosum CC : corpus callosum GA : gestational age HC : hippocampal commissure HS : hybrid structur
PLASMA MEMBRANE REDOX SYSTEM IN THE ERYTHROCYTES OF ROWERS: PILOT STUDY
Background: The oxidative stress results from a change in the physiological balance
between oxidant and antioxidant species. The purpose of this study is twofold: first, to investigate
the effects of long-term training in sports with high energy requirements on the redox balance
which exists between the plasma vs. the erythrocytes; second, to study the activity of the PMRS
(Plasma Membrane Redox System), which is a compensatory mechanism of cellular redox
homeostasis, in the rowersâ erythrocytes in order to determine the rowersâ counteraction to
oxidative stress.
Methods: Venous blood samples was collected from rowers and control group; then FRAP
(Ferric Reducing Activity Power) method has been used to determine the antioxidant capabilities
both in the plasma and in the erythrocytes of 22 rowers vs. 26 sedentary subjects. For the same
groups of subjects, the PMRS in erythrocytes has been also evaluated.
Results: The plasmatic antioxidant activity was 21% lower in the group of rowers compared
to the sedentary group (p = 0,02). In contrast, no significant differences were found in the reducing
activity of the erythrocytes; however the erythrocytes of the rowers have shown values of the
PMRS 35% higher than the untrained group (p < 0.0001).
Conclusions: Rowing induces a significant oxidative stress in the plasma corresponding to
the high intensity training, while this effect lacks in erythrocytes. At the same time an increased
quantity of the PMRS has been observed in the erythrocytes. In conclusion, in well trained athletes
this not lead to established an oxidative stress condition because long-term training adaptatively
improves the efficiency of the antioxidant syste
Association between the ACE I/D polymorphism and physical activity in Polish women
Angiotensin converting enzyme gene (ACE) is the most
frequently investigated genetic marker in the context of genetic
conditioning of athletic predispositions. However, the knowledge
of ACE\u2019s potential modifying effect on changes in selected body
traits achieved through a training programme is still limited.
Therefore, we have decided to check whether selected body
mass, body composition variables, oxygen uptake parameters as
well as strength/speed parameters observed in physically active
participants will be modulated by the ACE I/D polymorphism.
The genotype distribution was examined in a group of 201
young healthy women measured for chosen traits before and
after the completion of a 12-week moderate-intensive aerobic
training programme. Our results revealed the significant
genotype
7 training interactions for VEmax and power of
countermovement jump, whereas training improvements
were demonstrated for almost all parameters. In addition,
main effects of the ACE I/D genotype on TGL, HDL, glucose
and 10 m run were observed. A significant increase in VEmax
was demonstrated for II and DD genotypes, but not for ID
heterozygotes. The greatest gain in power of countermovement
jump was observed in II homozygotes, although DD and ID
were associated with a significant increase as well. Our study
indicated that the polymorphism was associated with changes
in VEmax and power of countermovement jump in response to
a 12-week aerobic training programme in Caucasian women.
However, more experimental studies are needed to establish the
ACE gene
7 physical activity interaction
Paediatric palliative home care by general paediatricians: a multimethod study on perceived barriers and incentives
<p>Abstract</p> <p>Background</p> <p>Non-specialist palliative care, as it is delivered by general practitioners, is a basic component of a comprehensive palliative care infrastructure for adult patients with progressive and far advanced disease. Currently palliative care for children and adolescents is recognized as a distinct entity of care, requiring networks of service providers across different settings, including paediatricians working in general practice. In Germany, the medical home care for children and adolescents is to a large extent delivered by general paediatricians working in their own practice. However, these are rarely confronted with children suffering from life-limiting diseases. The aim of this study was therefore to examine potential barriers, incentives, and the professional self-image of general paediatricians with regard to paediatric palliative care.</p> <p>Methods</p> <p>Based on qualitative expert interviews, a questionnaire was designed and a survey among general paediatricians in their own practice (n = 293) was undertaken. The survey has been developed and performed in close cooperation with the regional professional association of paediatricians.</p> <p>Results</p> <p>The results showed a high disposition on part of the paediatricians to engage in palliative care, and the majority of respondents regarded palliative care as part of their profile. Main barriers for the implementation were time restrictions (40.7%) and financial burden (31.6%), sole responsibility without team support (31.1%), as well as formal requirements such as forms and prescriptions (26.6%). Major facilitations were support by local specialist services such as home care nursing service (83.0%), access to a specialist paediatric palliative care consultation team (82.4%), as well as an option of exchange with colleagues (60.1%).</p> <p>Conclusions</p> <p>Altogether, the high commitment to this survey reflects the relevance of the issue for paediatricians working in general practice. Education in basic palliative care competence and communication skills was seen as an important prerequisite for the engagement in paediatric palliative home care. A local network of specialist support on site and a 24/7 on-call service are necessary in order to facilitate the implementation of basic palliative care by paediatricians in their own practice.</p
How reliable is assessment of true vocal cord-arytenoid unit mobility in patients affected by laryngeal cancer? a multi-institutional study on 366 patients from the ARYFIX collaborative group
Purpose: In clinical practice the assessment of the "vocal cord-arytenoid unit" (VCAU) mobility is crucial in the staging, prognosis, and choice of treatment of laryngeal squamous cell carcinoma (LSCC). The aim of the present study was to measure repeatability and reliability of clinical assessment of VCAU mobility and radiologic analysis of posterior laryngeal extension. Methods: In this multi-institutional retrospective study, patients with LSCC-induced impairment of VCAU mobility who received curative treatment were included; pre-treatment endoscopy and contrast-enhanced imaging were collected and evaluated by raters. According to their evaluations, concordance, number of assigned categories, and inter- and intra-rater agreement were calculated. Results: Twenty-two otorhinolaryngologists evaluated 366 videolaryngoscopies (total evaluations: 2170) and 6 radiologists evaluated 237 imaging studies (total evaluations: 477). The concordance of clinical rating was excellent in only 22.7% of cases. Overall, inter- and intra-rater agreement was weak. Supraglottic cancers and transoral endoscopy were associated with the lowest inter-observer reliability values. Radiologic inter-rater agreement was low and did not vary with imaging technique. Intra-rater reliability of radiologic evaluation was optimal. Conclusions: The current methods to assess VCAU mobility and posterior extension of LSCC are flawed by weak inter-observer agreement and reliability. Radiologic evaluation was characterized by very high intra-rater agreement, but weak inter-observer reliability. The relevance of VCAU mobility assessment in laryngeal oncology should be re-weighted. Patients affected by LSCC requiring imaging should be referred to dedicated radiologists with experience in head and neck oncology
Autoantibodies against type I IFNs in patients with life-threatening COVID-19
Interindividual clinical variability in the course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is vast. We report that at least 101 of 987 patients with life-threatening coronavirus disease 2019 (COVID-19) pneumonia had neutralizing immunoglobulin G (IgG) autoantibodies (auto-Abs) against interferon-w (IFN-w) (13 patients), against the 13 types of IFN-a (36), or against both (52) at the onset of critical disease; a few also had auto-Abs against the other three type I IFNs. The auto-Abs neutralize the ability of the corresponding type I IFNs to block SARS-CoV-2 infection in vitro. These auto-Abs were not found in 663 individuals with asymptomatic or mild SARS-CoV-2 infection and were present in only 4 of 1227 healthy individuals. Patients with auto-Abs were aged 25 to 87 years and 95 of the 101 were men. A B cell autoimmune phenocopy of inborn errors of type I IFN immunity accounts for life-threatening COVID-19 pneumonia in at least 2.6% of women and 12.5% of men
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