Anatomische Ursachen bei habituellen Aborten: Diagnostik und Therapie

Zusammenfassung: Angeborene Fehlbildungen: Die häufigsten Anomalien des Uterus bei habituellen Aborten sind angeborene Fehlbildungen mit einer Inzidenz von etwa 13 %. Eine frühe, möglichst 3-D-sonographische Diagnostik sollte immer angeboten werden. Der Uterus septus oder subseptus entsteht durch eine fehlende oder mangelnde Resorption des Septums während der Entwicklung. Die Aborte treten meist im späten ersten Trimenon auf. Eine hysteroskopische Septumresektion (Metroplastik) ist angezeigt, da die Geburtenrate auf > 80 % erhöht werden kann. Bei komplizierten Fehlbildungen (Uterus unicornis, bicornis, didelphys) ist eine erweiterte Diagnostik (MRT) sinnvoll, eine operative Korrektur meist aber nicht notwendig, obwohl die Komplikationsrate in der Spätschwangerschaft auf einem hohen Niveau verbleibt. Eine begleitende Nierenfehlbildung sollte stets sonographisch oder MR-diagnostisch ausgeschlossen werden. Erworbene Pathologien: Ob die Diagnose und Behandlung erworbener uteriner Pathologien, z.B. von Myomen, Polypen oder Synechien, das Abortrisiko reduzieren kann, ist noch unklar. Eine operative Behandlung empfiehlt sich dennoch in den meisten Fälle

The \u27Most Favored Lender\u27 Doctrine for Federally Insured Financial Institutions: What Are Its Boundaries?

The legislative history for the DIDMCA amendments is sparse, and agency interpretations have barely begun to explore the possible nuances of a rule that allows one lender to borrow the rate structure authorized for other lenders. Opinions on these issues under the older National Bank Act are limited, and there is little definitive judicial construction of the DIDMCA amendments. Meanwhile, several bills are pending which would completely preempt state usury laws for all consumer credit transactions, thus rendering moot many questions about of the scope of the most favored lender doctrine. But the enactment of such preemptive legislation is speculative, and until it becomes law, the boundaries of most favored lender status for federally chartered and insured institutions will command the careful attention of creditors and debtors, courts, and federal and state supervisory agencies. This article offers some background and preliminary analysis of these issues

Parallelism and Epistasis in Skeletal Evolution Identified through Use of Phylogenomic Mapping Strategies

The identification of genetic mechanisms underlying evolutionary change is critical to our understanding of natural diversity, but is presently limited by the lack of genetic and genomic resources for most species. Here, we present a new comparative genomic approach that can be applied to a broad taxonomic sampling of nonmodel species to investigate the genetic basis of evolutionary change. Using our analysis pipeline, we show that duplication and divergence of fgfr1a is correlated with the reduction of scales within fishes of the genus Phoxinellus. As a parallel genetic mechanism is observed in scale-reduction within independent lineages of cypriniforms, our finding exposes significant developmental constraint guiding morphological evolution. In addition, we identified fixed variation in fgf20a within Phoxinellus and demonstrated that combinatorial loss-of-function of fgfr1a and fgf20a within zebrafish phenocopies the evolved scalation pattern. Together, these findings reveal epistatic interactions between fgfr1a and fgf20a as a developmental mechanism regulating skeletal variation among fishes

Oxidation Behavior of Glassy Carbon in Acidic Electrolyte

Glassy carbon is frequently used in electrochemical research due to its presumed robust electrochemical performance. Although it is widely utilized as a rotating disc electrode material, the modification of glassy carbon during electro-catalytic process is rarely emphasized or characterized. In this report, we investigated the structural modification of glassy carbon imparted by electrochemical oxidation in acidic media and compared the behavior with graphite. The functional groups generated from electrochemical oxidation in both electrodes possess similar electrochemical properties. However, above an oxidation potential of 1.8 V (vs. reversibly hydrogen electrode), glassy carbon exhibits a lower electrochemical capacitance compared to graphite. We propose that the existence of electrochemically inactive species, originating from the non-graphitic portion of glassy carbon is attributed to such deterioration. Additionally, high resolution scanning electron microscopy (HR-SEM) and high-resolution transmission electron microscopy (HR-TEM) images corroborate how electrochemical oxidation prevails for glassy carbon electrodes at oxidative potentials. The overall analysis leads us to propose a corrosion mechanism for glassy carbon in acidic solution

A role for suppressed thermogenesis favoring catch-up fat in the pathophysiology of catch-up growth

Catch-up growth is a risk factor for later obesity, type 2 diabetes, and cardiovascular diseases. We show here that after growth arrest by semistarvation, rats refed the same amount of a low-fat diet as controls show 1) lower energy expenditure due to diminished thermogenesis that favors accelerated fat deposition or catch-up fat and 2) normal glucose tolerance but higher plasma insulin after a glucose load at a time point when their body fat and plasma free fatty acids (FFAs) have not exceeded those of controls. Isocaloric refeeding on a high-fat diet resulted in even lower energy expenditure and thermogenesis and increased fat deposition and led to even higher plasma insulin and elevated plasma glucose after a glucose load. Stepwise regression analysis showed that plasma insulin and insulin-to-glucose ratio after the glucose load are predicted by variations in efficiency of energy use (i.e., in thermogenesis) rather than by the absolute amount of body fat or plasma FFAs. These studies suggest that suppression of thermogenesis per se may have a primary role in the development of hyperinsulinemia and insulin resistance during catch-up growth and underscore a role for suppressed thermogenesis directed specifically at catch-up fat in the link between catch-up growth and chronic metabolic diseases

Predictors of anemia in preschool children: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project.

Background: A lack of information on the etiology of anemia has hampered the design and monitoring of anemia-control efforts.Objective: We aimed to evaluate predictors of anemia in preschool children (PSC) (age range: 6-59 mo) by country and infection-burden category.Design: Cross-sectional data from 16 surveys (n = 29,293) from the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project were analyzed separately and pooled by category of infection burden. We assessed relations between anemia (hemoglobin concentration <110 g/L) and severe anemia (hemoglobin concentration <70 g/L) and individual-level (age, anthropometric measures, micronutrient deficiencies, malaria, and inflammation) and household-level predictors; we also examined the proportion of anemia with concomitant iron deficiency (defined as an inflammation-adjusted ferritin concentration <12 μg/L). Countries were grouped into 4 categories on the basis of risk and burden of infectious disease, and a pooled multivariable logistic regression analysis was conducted for each group.Results: Iron deficiency, malaria, breastfeeding, stunting, underweight, inflammation, low socioeconomic status, and poor sanitation were each associated with anemia in >50% of surveys. Associations between breastfeeding and anemia were attenuated by controlling for child age, which was negatively associated with anemia. The most consistent predictors of severe anemia were malaria, poor sanitation, and underweight. In multivariable pooled models, child age, iron deficiency, and stunting independently predicted anemia and severe anemia. Inflammation was generally associated with anemia in the high- and very high-infection groups but not in the low- and medium-infection groups. In PSC with anemia, 50%, 30%, 55%, and 58% of children had concomitant iron deficiency in low-, medium-, high-, and very high-infection categories, respectively.Conclusions: Although causal inference is limited by cross-sectional survey data, results suggest anemia-control programs should address both iron deficiency and infections. The relative importance of factors that are associated with anemia varies by setting, and thus, country-specific data are needed to guide programs

Speed versus stability-structure-activity effects on the assembly of two-component gels

This paper reports the structural modification of a two-component gelation system comprising a 1:1 complex formed between a peptide carboxylic acid and phenylethylamine. Changing amino acids has a profound effect on the speed of gel formation and the minimum gelation concentration (MGC) yet the thermal stability of the gel remains unchanged. Variable temperature NMR studies demonstrate that at room temperature, the speed at which the gel forms is controlled by the solubility of the acid-amine complexes, which mediates the initial nucleation step required for gel assembly. On increasing the temperature, however, a thermodynamic enthalpy-entropy balance means all of the gels break down at around the same temperature. Those gels which are more favourably and rapidly formed at room temperature on enthalpic grounds are also more temperature sensitive as a consequence of the greater entropic cost of efficient packing within the gel fibres. This constitutes a rare example in which the time required for gelation can be structurally controlled, with NMR providing unique insight into the dynamics of these gel-phase materials. We suggest that in the future, combining solvent and solute (gelator) solubility parameters may provide further insight into these materials