The risk of postpartum hemorrhage in women using high dose of low-molecular-weight heparins during pregnancy

Background: Low-molecular-weight heparins (LMWH) are the most commonly used anticoagulant during pregnancy for prevention or treatment of VTE. However, the size of the associated risk of postpartum haemorrhage (PPH) is unknown. Objective: To assess the bleeding risk of high dose LMWH, also in relation to time between last dose LMWH and delivery. Material and methods: From 1999 to 2009, we followed 88 pregnant women who were started on therapeutic anticoagulation. Controls were pregnant women without LMWH, matched 1:4 for parity, mode of delivery, age, gestational age and delivery date. PPH was defined as >= 500 ml blood loss for vaginal delivery (severe PPH in vaginal delivery as >= 1000 ml) and >= 1000 ml for cesarean section (CS). Women were divided into subgroups by the interval between last dose of anticoagulation and delivery ( 24 hrs). Results: Risk of PPH after vaginal delivery was 30% and 18% for LMWH-users and non-users, respectively (OR 1.9, 95% CI 1.1-3.5). Risk of severe PPH after vaginal delivery was not different (5.6 vs 5.0%; OR 1.1; 0.4-3.6). Risk of PPH after CS was 12% in LMWH-users and 4% in non-users (OR 2.9; 0.5-19.4). Both events of LMWH-users occurred after emergency CS. The risk of PPH associated with delivery within 24 hours after last dose of LMWH was 1.2 fold higher (95% CI 0.4-3.6) compared to a larger interval. Conclusion: High dose LMWH carries an increased risk of more than 500 mL blood loss after vaginal delivery. However, this results not in more clinical relevant severe PPHs. The interval between last dose of LMWH and delivery does not influence the risk of PPH. (C) 2012 Elsevier Ltd. All rights reserved

A stochastic approach to the solution of magnetohydrodynamic equations

The construction of stochastic solutions is a powerful method to obtain localized solutions in configuration or Fourier space and for parallel computation with domain decomposition. Here a stochastic solution is obtained for the magnetohydrodynamics equations. Some details are given concerning the numerical implementation of the solution which is illustrated by an example of generation of long-range magnetic fields by a velocity source.Comment: 21 pages Latex, 5 figure

Elliptic flow in Pb+Pb collisions at sqrt{s_{NN}} = 2.76 TeV: hybrid model assessment of the first data

We analyze the elliptic flow parameter v_2 in Pb+Pb collisions at sqrt{s_{NN}} = 2.76 TeV and in Au+Au collisions at sqrt{s_{NN}} =200 GeV using a hybrid model in which the evolution of the quark gluon plasma is described by ideal hydrodynamics with a state-of-the-art lattice QCD equation of state, and the subsequent hadronic stage by a hadron cascade model. For initial conditions, we employ Monte-Carlo versions of the Glauber and the Kharzeev-Levin-Nardi models and compare results with each other. We demonstrate that the differential elliptic flow v_2(p_T) hardly changes when the collision energy increases, whereas the integrated v_2 increases due to the enhancement of mean transverse momentum. The amount of increase of both v_2 and mean p_T depends significantly on the model of initialization.Comment: 5 pages, 5 figure

Pioglitazone administration alters ovarian gene expression in aging obese lethal yellow mice

<p>Abstract</p> <p>Background</p> <p>Women with polycystic ovary syndrome (PCOS) are often treated with insulin-sensitizing agents, e.g. thiazolidinediones (TZD), which have been shown to reduce androgen levels and improved ovulatory function. Acting via peroxisome proliferator-activated receptor (PPAR) gamma, TZD alter the expression of a large variety of genes. Lethal yellow (LY; C57BL/6J Ay/a) mice, possessing a mutation (Ay) in the agouti gene locus, exhibit progressive obesity, reproductive dysfunction, and altered metabolic regulation similar to women with PCOS. The current study was designed to test the hypothesis that prolonged treatment of aging LY mice with the TZD, pioglitazone, alters the ovarian expression of genes that may impact reproduction.</p> <p>Methods</p> <p>Female LY mice received daily oral doses of either 0.01 mg pioglitazone (n = 4) or an equal volume of vehicle (DMSO; n = 4) for 8 weeks. At the end of treatment, ovaries were removed and DNA microarrays were used to analyze differential gene expression.</p> <p>Results</p> <p>Twenty-seven genes showed at least a two-fold difference in ovarian expression with pioglitazone treatment. These included leptin, angiopoietin, angiopoietin-like 4, Foxa3, PGE1 receptor, resistin-like molecule-alpha (RELM), and actin-related protein 6 homolog (ARP6). For most altered genes, pioglitazone changed levels of expression to those seen in untreated C57BL/6J(a/a) non-mutant lean mice.</p> <p>Conclusion</p> <p>TZD administration may influence ovarian function via numerous diverse mechanisms that may or may not be directly related to insulin/IGF signaling.</p