The HPV cellular transactivator Brn-3a can be used to predict cervical adenocarcinoma and squamous carcinoma precancer lesions in the developed and developing worlds

The cellular transactivator Brn-3a has previously been shown to be expressed at elevated levels in the cervix of women with squamous cell carcinoma of the cervix (SCC) and to activate the expression of HPV E6 mRNA. In this study, we show that common and rare cervical precancer lesions, including those of adenocarcinoma (AC), which are usually difficult to diagnose using classical procedures, also expressed high levels of Brn-3a and can be diagnosed by measuring the levels of Brn-3a and E6 mRNAs

On the design of an Ohmic RF MEMS switch for reconfigurable microstrip antenna applications

This paper presents the analysis, design and simulation of a direct contact (dc) RF MEMS switch specified for reconfigurable microstrip array antennas. The proposed switch is indented to be built on PCB via a monolithic technology together with the antenna patches. The proposed switch will be used to allow antenna beamforming in the operating frequency range between 2GHz and 4GHz. This application requires a great number of these switches to be integrated with an array of microstrip patch elements. The proposed switch fulfills the switching characteristics as concerns the five requirements (loss, linearity, voltage/power handling, small size/power consumption, temperature), following a relatively simple design, which ensures reliability, robustness and high fabrication yiel

Differential regulation of different human papilloma virus variants by the POU family transcription factor Brn-3a

The Brn-3a POU family transcription factor is over-expressed in human cervical carcinoma biopsies and is able to activate expression of the human papilloma virus type 16 (HPV-16) upstream regulatory region (URR), which drives the expression of the E6 and E7 oncoproteins. Inhibition of Brn-3a expression in human cervical cancer cells inhibits HPV gene expression and reduces cellular growth and anchorage independence in vitro as well as the ability to form tumours in vivo. Here we show that Brn-3a differentially regulates different HPV-16 variants that have previously been shown to be associated with different risks of progression to cervical carcinoma. In human cervical material Brn-3a levels correlate directly with HPV E6 levels in individuals infected with a high risk variant of HPV-16 whereas this is not the case for a low risk variant. Moreover, the URRs of high and intermediate risk variants are activated by Brn-3a in transfection assays whereas the URR of a low risk variant is not. The change of one or two bases in a low risk variant URR to their equivalent in a higher risk URR can render the URR responsive to Brn-3a and vice versa. These results help explain why the specific interplay between viral and cellular factors necessary for the progression to cervical carcinoma, only occurs in a minority of those infected with HPV-16

The Bolbos technique for the management of uncontrollable intra-caesarean uterine bleeding

Objective: We describe a new conservative surgical technique for the management of intra-operative post-caesarean bleeding. Methods: This technique involves the application of ligation sutures to the main branches of the right and left uterine arteries at the level of the lower segment transverse uterine incision and a constriction suture to the lower segment of the posterior uterine wall. Results: We have used this method in nine cases and it was effective in controlling the bleeding in eight, thus avoiding the need for a more extensive procedure. Conclusion: If medical management fails to control intra-operative post-caesarean bleeding, conservative surgery or even a caesarean hysterectomy may be required. Our technique is presented as a safe, simple, effective and readily reproducible alternative. Also, its effectiveness can be promptly assessed and if the bleeding persists, another, more complex procedure can be performed. © Springer-Verlag 2005

Prenatal diagnosis of sirenomelia with anencephaly and craniorachischisis totalis: A case report study

Rationale:Sirenomelia and anencephaly are well-defined congenital malformations that usually occur independently.Patient concerns:We report a case of combined sirenomelia, anencephaly and complete rachischisis, diagnosed in the 16th week of gestation.Diagnoses:To our knowledge, this is the 7th case in the literature and the first that is diagnosed so early in pregnancy.Interventions:The final diagnosis is confirmed with radiological examination after the termination of pregnancy.Outcomes:Prenatal diagnosis of sirenomelia is difficult due to the presence of kidney agenesis and severe oligohydramnios.Lessons:The combination of sirenomelia and craniorachischisis totalis is extremely rare and prenatal ultrasound scan are a challenge, even for experts in the field. Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc

Trends in twin pregnancies and mode of delivery during the last 30 years: Inconsistency between guidelines and clinical practice

Aim: To investigate the characteristics of twin pregnancies and their mode of delivery over a 30-year period, in order to define the current trends in clinical practice regarding twin deliveries and the factors that influence these practices. Materials and methods: A retrospective study of twin deliveries at ≥?24 weeks of gestation between January 1 st , 1981 and December 31, 2010. Data concerning number of twin deliveries, mode of delivery, maternal age, use of ART techniques, parity, gestational age at delivery, birth weight and Apgar scores were collected from labor ward records. Results: Over the years there has been a statistically significant increase in the number of twin deliveries, twins after IVF, cesarean section rate, maternal age, nulliparity and a statistically significant reduction in term deliveries, mean birth weight and assisted vaginal deliveries. Maternal age, gestational age, parity and conception after IVF are factors related to the risk of performing a cesarean section. Conclusions: Despite the lack of adequate scientific evidence concerning the optimal route of delivery in twin pregnancies it seems that over time cesarean section has become the standard of care in most of twin pregnancies. Changes in the demographic characteristics contribute among other factors to this practice. © 2013 Walter de Gruyter GmbH

Can isosorbide mononitrate be useful in second trimester termination of pregnancies?

Background Isosorbide mononitrate (IMN) administration is thought to enhance in the cervical ripening process. We sought to identify the clinical usefulness and safety of IMN administration for shortening the time to termination of the second trimester pregnancy procedures when used in addition to misoprostol. Study Design Women were randomly selected to receive either the standard misoprostol treatment (control group) or, additionally, receive vaginally IMN as well as the misoprostol treatment. Results The mean induction to complete abortion interval was 20.4 h [95% confidence interval (CI)=16.63-24.17] in the misoprostol group compared with 12.4 h (95% CI=10.33-14.47) in the misoprostol plus IMN group. This difference was statistically significant (p<.05). In the subgroups of nulliparas and multiparas, the shortening effect of the IMN was also statistically significant. Conclusions A net benefit after the combined use of IMN and misoprostol was noted. Therefore, we believe that IMN has a clinical role in the ripening process. © 2013 Elsevier Inc. All rights reserved

Invasive prenatal diagnosis: Chorionic villus sampling

Chorionic villus sampling (CVS) is the method of choice for first trimester invasive prenatal diagnosis. In expert hands, it is nowadays considered as safe as amniocentesis and has the advantage of an earlier diagnosis. In this review, we des cribe the technique of the procedure, its indications and contra indications and the requirements concerning adequate training and optimum clinical practice. We also discuss issues concerning the safety of the procedure in singleton and multiple pregnancies, other complications and controversies, such as the association with limb reduction defects and pre-eclampsia, as well as diagnostic problems and dilemmas, such as maternal cell contamination and confined placental mosaicism. We also describe new and promising methods of non-invasive diagnosis, based on the isolation and analysis of fetal cells or cell-free fetal genetic material from the maternal circulation, that aim to replace the invasive methods of prenatal diagnosis in the future. © 2015, Jaypee Brothers Medical Publishers (P) Ltd. All rights reserved

Maternal age as a predictive factor of pre-term birth. An epidemiological study from 1999 to 2008 in Greece

The aim of the study was to estimate the risk of pre-term birth in women giving birth in Greece in different age groups. Data about women giving birth in Greece were retrieved from the Hellenic Vital Statistics covering the years from 1999 to 2008. Relative risk using χ2 contingency tables was estimated among maternal age groups formed. These groups included mothers < 15 years of age, 15-19, 20-34 (used as a control group) and women > 34 (35-39, 40-44, 45-49 and ≥ 50) years of age. Relative risk of each age group was compared with mothers 20-34 years of age. A total of 1,069,413 valid births were included in the study and 72,156 of them were pre-term (6.75% of total count). Results exhibit a 'U'-shaped distribution of risk. Higher risk of pre-term birth is noted in the groups of < 15 years (Pearson χ2 = 14.964, p < 0.001, risk = 1.569, CI = 1.249-1.970) and above 34 years of age (Pearson χ2 = 2991.26, p < 0.001, risk = 1.572, CI = 1.546-1.597). For older women, a steep rise in the relative risk for pre-term birth was noted beyond the 40-44 years of age group. Finally, of interest is the fact that 'late' pre-terms (34-36 gestational weeks) account for most of the pre-term birth in mothers beyond 34 years of age. © 2013 Informa UK, Ltd

Chorionic Villus Sampling in Assisted Versus Spontaneous Conception Twins

Purpose To compare the outcome of chorionic villus sampling (CVS) in twin pregnancies following assisted reproduction technology (ART) versus twins that have been conceived spontaneously. Materials and Methods Retrospective analysis of dichorionic twin pregnancies that underwent CVS between 1986 and 2013at our department which is a tertiary center for fetal medicine. 32 twin pregnancies after ART and 130 spontaneously conceived twin pregnancies, which underwent CVS, were analyzed. Results No difference was observed in the pregnancy loss rate between the two groups (0% in the ART group vs. 3% in the spontaneous twins group). The rate of preterm delivery before 28 weeks was higher in the ART group (18.8%) compared to the control group (1.6%). The perinatal mortality rate was similar in the two groups. Conclusion The pregnancy loss rate following CVS is similar in ART twins and in spontaneous twins. However, the risk of prematurity before 28 weeks is significantly higher in the ART group. © Georg Thieme Verlag KG, Stuttgart · New York