Coagulation defects in obstetrics

A paper read at a WHO/UNICEF Seminar on "Anemia and the Use of Blood Transfusion in M.C.H. Work" 6th June, 1967. Kampala. Coagulation defects are only rarely met with in obstetrics. It is probable that the complication is nowadays being diagnosed with increasing frequency, owing mainly to a greater awareness of the condition. In Mulago Hospital where the author practises, it occurred 11 times in about 33,500 deliveries in the period 1964-66. This gives an incidence of about 0.03%. In cases of concealed accidental hemorrhage the incidence is however higher; it appears to occur in some 5% of cases. A historical background of this condition is presented, and a description of how the clotting mechanism takes place is also explained. Furthermore, a detailed diagram describes the mechanism by which coagulation failure is produced. The author analysed cases at Mulago Hospital, indicating the relative clinical diagnosis and treatment, the latter consisting of two forms, preventive and curative.peer-reviewe

International cooperative study on drug use in pregnancy : results from Malta

The risks of teratogenesis and other adverse effects on the neonate have created a cautious attitude towards the use of drugs during pregnancy. It is generally believed that drug intake in pregnancy is high and variable in different countries, but the quality of prescriptions and use of drugs by the majority of physicians and women has by no means been adequately clarified. To identify the pattern of drug use in pregnancy a collaborative network was set up by WHO - IRO to collect comparable data on a population large enough to represent the current situation across various ’cultural’ and health care settings. This study has shown that, except in the case of the prophylactic administration of haematologicals during the antenatal period and the intrapartum prescriptions to manage labour actively, the majority of pregnant women and health care professionals in Malta have a conservative attitude towards drug prescription in pregnancy and lactation using medications only when they are considered essential.peer-reviewe

The computerization of maternity information

Paper written in collaboration with the Department of obstetrics and gynaecology at Karin Grech Hospital MaltaThe collection and evaluation of obstetric data is essentia1 for measuring the adequacy and effectiveness of the health and social services in a country, rendering possible the reallocation of resources end long-term planning on the basis of changing health needs. Organization of a standard maternity and neonatal record on a regional or national level is difficult though ideal, but this is possible in a situation where the majority of deliveries are conducted under the supervision of one department. During 1986, Department of Health in conduction with the World Health Organisation introduced a computer-based Individual Health Profile aimed as a person-based record for all patients who encounter government medical services with the aim of providing readily available clinical information to medical practitioners on the patients they are treating, of scheduling appointments and follow-up procedures, of managing immunization and the preventive programmes, and of conducting surveys and research.peer-reviewe

Prognostic significance of slfn11 methylation in plasma cell-free dna in advanced high-grade serous ovarian cancer

Background: Epigenetic alterations in ctDNA are highly promising as a source of novel potential liquid biopsy biomarkers and comprise a very promising liquid biopsy approach in ovarian cancer, for early diagnosis, prognosis and response to treatment. Methods: In the present study, we examined the methylation status of six gene promoters (BRCA1, CST6, MGMT, RASSF10, SLFN11 and USP44) in high-grade serous ovarian cancer (HGSOC). We evaluated the prognostic significance of DNA methylation of these six gene promoters in primary tumors (FFPEs) and plasma cfDNA samples from patients with early, advanced and metastatic HGSOC. Results: We report for the first time that the DNA methylation of SLFN11 in plasma cfDNA was significantly correlated with worse PFS (p = 0.045) in advanced stage HGSOC. Conclusions: Our results strongly indicate that SLFN11 epigenetic inactivation could be a predictor of resistance to platinum drugs in ovarian cancer. Our results should be further validated in studies based on a larger cohort of patients, in order to further explore whether the DNA methylation of SLFN11 promoter could serve as a potential prognostic DNA methylation biomarker and a predictor of resistance to platinum-based chemotherapy in ovarian cancer. © 2021 by the authors. Licensee MDPI, Basel, Switzerland

The ISMRM Open Science Initiative for Perfusion Imaging (OSIPI): Results from the OSIPI–Dynamic Contrast-Enhanced challenge

Purpose: K trans has often been proposed as a quantitative imaging biomarker for diagnosis,prognosis,andtreatmentresponseassessmentforvarioustumors.Noneofthe many software tools for K trans quantification are standardized. The ISMRM OpenScience Initiative for Perfusion Imaging–Dynamic Contrast-Enhanced (OSIPI-DCE)challenge was designed to benchmark methods to better help the efforts to standardize K trans measurement. Methods: A framework was created to evaluate K trans values produced by DCE-MRI analysis pipelines to enable benchmarking. The perfusion MRI community was invited to apply their pipelines for K trans quantification in glioblastoma from clinical and synthetic patients. Submissions were required to include the entrants’ K trans values, the applied software, and a standard operating procedure. These were evaluated using the proposed OSIPIgold score defined with accuracy, repeatability, and reproducibility components. Results: Across the 10 received submissions, the OSIPIgold score ranged from28% to 78% with a 59% median. The accuracy, repeatability, and reproducibility scores ranged from 0.54 to 0.92, 0.64 to 0.86, and 0.65 to 1.00, respectively(0–1=lowest–highest). Manual arterial input function selection markedly affected the reproducibility and showed greater variability in K trans analysis than automated methods. Furthermore, provision of a detailed standard operating procedure was critical for higher reproducibility. Conclusions: This study reports results from the OSIPI-DCE challenge and high-lights the high inter-software variability within K trans estimation, providing a framework for ongoing benchmarking against the scores presented. Through this challenge, the participating teams were ranked based on the performance of their software tools in the particular setting of this challenge. In a real-world clinical setting, many of these tools may perform differently with different benchmarking methodology