Comparison of active vs. expectant management of the third stage of labor in women with low risk of postpartum hemorrhage: a randomized controlled trial

Objectives: To compare the ‘strictly’ active management protocol in women with low risk of postpartum hemorrhage using the expectant management protocol with respect to changes in hematologic parameters, uterotonics, blood transfusions, or additional interventions. Material and methods: A randomized controlled prospective trial in which 934 singleton parturients enrolled; 654 were randomly assigned to the active and mixed management groups. The primary outcome parameter was the reduction in hemoglobin concentrations due to delivery, and the secondary outcome parameters were changes in hemoglobin of more than 3 g/dL (ΔHb ≥ 3 g/dL), durations of the third stage of labor, need for additional uterotonic agents, blood transfusions, manual removal of the placenta, and surgical evacuation of retained products of conception. Results: The mean postpartum hemoglobin concentration was significantly higher (P = 0.04) in the active management group with a significantly lower reduction (P = 0.03). Falls of hemoglobin levels of more than 3 g/dL (ΔHb ≥ 3g/dL) were less common in the active management group though not significantly (P = 0.32). The mean duration of the third stage of labor was significantly (P < 0.001) shorter in the active management group. There was no significant difference between the two groups with regard to the need for additional uterotonic agents, uterine atony, blood transfusion, manual removal of the placenta, surgical evacuation of retained products of conception, and prolonged third stage of labor. Conclusions: Although active management of the third stage of labor was associated with higher postpartum hemoglobin levels, it did not influence the risk of ‘severe postpartum hemorrhage’ in women with low risk of postpartum hemorrhage

Comparison of human B cell activation by TLR7 and TLR9 agonists

Research articl

RORγt + Treg to Th17 ratios correlate with susceptibility to Giardia infection

Funder: Fundacion Alfonso Martin EscuderoFunder: RCUK | Biotechnology and Biological Sciences Research Council (BBSRC); doi: https://doi.org/10.13039/501100000268Funder: Isaac Newton Trust; doi: https://doi.org/10.13039/501100004815Abstract: Infections with Giardia are among the most common causes of food and water-borne diarrheal disease worldwide. Here, we investigated Th17, Treg and IgA responses, and alterations in gut microbiota in two mouse lines with varying susceptibility to Giardia muris infection. Infected BALB/c mice shed significantly more cysts compared with C57BL/6 mice. Impaired control of infection in BALB/c mice was associated with lower Th17 activity and lower IgA levels compared with C57BL/6 mice. The limited metabolic activity, proliferation and cytokine production of Th17 cells in BALB/c mice was associated with higher proportions of intestinal Foxp3+RORγt+ regulatory T cells and BALB/c mice developed increased RORγt+ Treg:Th17 ratios in response to G. muris infection. Furthermore, G. muris colonization led to a significantly reduced evenness in the gut microbial communities of BALB/c mice. Our data indicate that differential susceptibility to Giardia infections may be related to RORγt+ Treg controlling Th17 activity and that changes in the microbiota composition upon Giardia infection partially depend on the host background

Conservative Treatment of a Gossypiboma Causing Uterine Wound Dehiscence

We present a rare case with gossypiboma following cesarean section which led to uterine wound dehiscence. A 30-year-old woman had been submitted to an emergency cesarean section 4 months previously at another hospital. Clinical and ultrasound findings revealed a large intra-abdominal mass and diffuse peritonitis. At laparotomy, a gossypiboma causing an abscess and uterine wound dehiscence with necrosis of the margins was detected. We performed repetitive wound debridements under broad-spectrum antibiotic cover and eventually resutured the incision. Although hysterectomy has so far been the choice of treatment in the literature once a uterine wound dehiscence had occurred, it was possible in this case to preserve the uterus

EVALUATION OF SILVER CONTENT AND ANTIBACTERIAL ACTIVITIES OF SILVER LOADED FIBER/COTTON BLENDED TEXTILE FABRICS

WOS: 000279625200009The aims of this work were to analyze the antibacterial activity and laundering durability of the silver loaded cellulosic fiber/cotton blended antibacterial textile fabrics, to quantify the silver content present in fabrics, and to examine the relationship between the antibacterial activity and silver content. For this aims knitting fabrics consisting of SeaCell (R) Active, which is the cellulosic fiber incorporated with seaweed and silver ions, and cotton fibers blended with five different ratios were produced. All fabric samples bleached and washed 60 times. The antibacterial efficiency was evaluated according to AATCC 100-1999 method after each ten laundry cycles. Silver content of the fabrics were determined by atomic absorption spectroscopy (AAS). Fiber and fabric surfaces were investigated using Scanning Electron Microscopy (SEM) and by X-Ray Photoelectron Spectroscopy (XPS) views. Antibacterial tests showed that good antibacterial activity can be achieved after several washings even with 3% of SeaCell Active fibers in blended fabrics. Significant correlation was found between silver content and bacterial reduction.Ege UniversityEge University [06 MUH 036]This research work is a part of a research project financially supported by Ege University Research Funds,(Project No: 06 MUH 036)