76 research outputs found
Fetal major cardiac defects and placental dysfunction at 11-13 weeks' gestation
Objectives: To investigate the relationship between fetal major cardiac defects and markers of placental perfusion and function.
Methods: This was a prospective screening study in singleton pregnancies at 11-13 weeks’ gestation. Uterine artery pulsatility index (UTPI), serum pregnancy associated plasma protein-A (PAPP-A) and placental growth factor (PLGF) were measured and the values were converted into multiples of the normal median (MoM). Median MoM values in fetuses with isolated major cardiac defects were compared to those in fetuses without major defects.
Results: The 50,094 singleton pregnancies fulfilling the entry criteria included 49,898 pregnancies with a normal cardiac anatomy and 196 (0.39%) with major congenital cardiac defects; 73 (37.2%) with conotruncal defects, 63 (32.1%) with left ventricular outflow tract (LVOT) defects and 60 (30.6%) with valvular defects. In the group of cardiac defects, compared to controls, there was lower median PAPP-A MoM (0.81 vs 1.00, p<0.0001) and PLGF MoM (0.78 vs 1.00, p<0.0001) but no significant difference in UTPI MoM (1.01 vs 1.00, p=0.162).
Conclusions: In pregnancies with isolated major cardiac defects there is evidence of placental dysfunction in the absence of impaired placental perfusion
Initial Experience of Superb Microvascular Imaging for Key Cardiac Views in Foetal Assessment before 15 Weeks Gestation
Background: In the first trimester, ultrasound confirmation of normal or abnormal cardiac anatomy is difficult. B-mode and colour flow Doppler (CFD) are used to assess the foetal heart. Superb microvascular imaging (SMI) can visualise blood flow within the heart and vessels in early gestation.
Objective: We report an initial experience of SMI for visualisation of normal and abnormal cardiac anatomy in the first trimester.
Methods: Transabdominal foetal echocardiography was performed between 11 + 6 and 14 + 3 weeks (Aplio 500 US system, Toshiba Medical Systems, Tokyo, Japan) from January 2017 to December 2017. All scans were performed at a tertiary foetal cardiology unit. To assess the potential utility of the technique for early gestation screening, normal scans were reviewed by foetal medicine trainees with respect to the B-mode, CFD and SMI. Three key views were selected to compare modalities: the 4-chamber view, outflow tracts and the 3-vessel and trachea view (VTV). Visualisation rates of key echocardiographic features of significant cardiac abnormalities by SMI were reviewed.
Results: Fifty-five normal echocardiograms and 34 cardiac abnormalities were included. In the normal heart, when B-mode, CFD and SMI were assessed separately, SMI had the highest rate of visualisation of 4-chamber, outflow tracts and 3-VTV (93, 85 and 83%, respectively). Intra-observer reliability was moderate for SMI of the 3 standard views (kappa 1, 0.64 and 0.64); inter-observer for 4-chamber and outflow tract views was moderate (kappa 0.64 and 0.77). In 29/34 abnormal cases, SMI showed key features, enhancing greyscale visualisation.
Conclusion: SMI has potential to become a useful, complementary modality for early foetal echocardiography. Further prospective studies are warranted to establish the place of the technique in assessment of the first trimester foetal heart.info:eu-repo/semantics/publishedVersio
Symphytum Species: A Comprehensive Review on Chemical Composition, Food Applications and Phytopharmacology
Symphytum species belongs to the Boraginaceae family and have been used for centuries for
bone breakages, sprains and rheumatism, liver problems, gastritis, ulcers, skin problems, joint pain
and contusions, wounds, gout, hematomas and thrombophlebitis. Considering the innumerable
potentialities of the Symphytum species and their widespread use in the world, it is extremely
important to provide data compiling the available literature to identify the areas of intense research
and the main gaps in order to design future studies. The present review aims at summarizing the
main data on the therapeutic indications of the Symphytum species based on the current evidence,
also emphasizing data on both the e cacy and adverse e ects. The present review was carried
out by consulting PubMed (Medline), Web of Science, Embase, Scopus, Cochrane Database, Science
Direct and Google Scholar (as a search engine) databases to retrieve the most updated articles on this
topic. All articles were carefully analyzed by the authors to assess their strengths and weaknesses,
and to select the most useful ones for the purpose of review, prioritizing articles published from 1956
to 2018. The pharmacological e ects of the Symphytum species are attributed to several chemical
compounds, among them allantoin, phenolic compounds, glycopeptides, polysaccharides and some
toxic pyrrolizidine alkaloids. Not less important to highlight are the risks associated with its use.
In fact, there is increasing consumption of over-the-counter drugs, which when associated with
conventional drugs can cause serious and even fatal adverse events. Although clinical trials sustain
the folk topical application of Symphytum species in musculoskeletal and blunt injuries, with minor
adverse e ects, its antimicrobial potency was still poorly investigated. Further studies are needed to
assess the antimicrobial spectrum of Symphytum species and to characterize the active molecules both
in vitro and in vivo
The battle over Syria's reconstruction
Reconstruction is becoming the new battleground in the Syrian conflict—its continuation by other means. It is instrumentalized by the regime as a way to reconsolidate its control over the country and by rival regional and international powers to shape the internal balance of power and establish spheres of influence in the country. The paper examines the Asad regime’s practices, including co-optation of militia leaders via reconstruction concessions and use of reconstruction to clear strategic areas of opposition-dominated urban settlements. The paper then surveys how the geopolitical struggle in Syria has produced an asymmetry as regards reconstruction: those powers that lost the geo-political contest on the ground seek to use geo-economic superiority to reverse the geo-political outcome. Then the impact of proxy wars and spheres of influence in the country on the security context for reconstruction is examined. Finally, the reconstruction initiatives of the various external parties are assessed, including Russia, Iran and Turkey as well as the spoiler role by which the US seeks to obstruct reconstruction that would spell victory in Syria for its Russian and Iranian rivals.PostprintPeer reviewe
Gene polymorphisms against DNA damage induced by hydrogen peroxide in leukocytes of healthy humans through comet assay: a quasi-experimental study
<p>Abstract</p> <p>Background</p> <p>Normal cellular metabolism is well established as the source of endogenous reactive oxygen species which account for the background levels of oxidative DNA damage detected in normal tissue. Hydrogen peroxide imposes an oxidative stress condition on cells that can result in DNA damage, leading to mutagenesis and cell death. Several potentially significant genetic variants related to oxidative stress have already been identified, and angiotensin I-converting enzyme (ACE) inhibitors have been reported as possible antioxidant agents that can reduce vascular oxidative stress in cardiovascular events.</p> <p>Methods</p> <p>We investigate the influences of haptoglobin, manganese superoxide dismutase (MnSOD Val9Ala), catalase (CAT -21A/T), glutathione peroxidase 1 (GPx-1 Pro198Leu), ACE (I/D) and gluthatione S-transferases GSTM1 and GSTT1 gene polymorphisms against DNA damage and oxidative stress. These were induced by exposing leukocytes from peripheral blood of healthy humans (N = 135) to hydrogen peroxide (H<sub>2</sub>O<sub>2</sub>), and the effects were tested by comet assay. Blood samples were submitted to genotyping and comet assay (before and after treatment with H<sub>2</sub>O<sub>2 </sub>at 250 μM and 1 mM).</p> <p>Results</p> <p>After treatment with H<sub>2</sub>O<sub>2 </sub>at 250 μM, the GPx-1 polymorphism significantly influenced results of comet assay and a possible association of the Pro/Leu genotype with higher DNA damage was found. The highest or lowest DNA damage also depended on interaction between GPX-1/ACE and Hp/GSTM1T1 polymorphisms when hydrogen peroxide treatment increased oxidative stress.</p> <p>Conclusions</p> <p>The GPx-1 polymorphism and the interactions between GPX-1/ACE and Hp/GSTM1T1 can be determining factors for DNA oxidation provoked by hydrogen peroxide, and thus for higher susceptibility to or protection against oxidative stress suffered by healthy individuals.</p
Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine
[This corrects the article DOI: 10.1186/s13054-016-1208-6.]
Microwave Assisted Combustion Synthesis and Characterization of Nanocrystalline Nickel-doped Cobalt Ferrites
The NAD-dependent deacetylase sirtuin 2 is a suppressor of microglial activation and brain inflammation
THE EFFECT OF SLEEVE GASTRECTOMY IN DAYTIME SLEEPINESS AT MONTHS FOR MORBIDLY OBESE PATIENTS Sleeve gastrectomy
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