High Fasting Insulin Levels and Insulin Resistance May Be Linked to Idiopathic Recurrent Pregnancy Loss: A Case-Control Study

Objective. Patients with more than two spontaneous pregnancy losses are diagnosed with recurrent pregnancy loss. The aim of this study was to evaluate the IR (insulin resistance) in patients with idiopathic recurrent pregnancy loss. Material and Method. A single center, case control study was performed on one hundred eighteen women divided into case group (with at least two pregnancy losses, earlier than 20 weeks of gestation, and negative for the recurrent pregnancy loss testing) and control group (with at least one live birth, no pregnancy loss). FG (fasting glucose) and FI (fasting insulin) were determined for all patients. IR was evaluated by HOMA-IR index. Results. There were not significant differences between the mean age and BMI in cases and controls ( > 0.05). Fasting glucose was significantly higher in the control group (85.6 versus 79.8 < 0.01), but fasting insulin (15.24 versus 12.83, < 0.001) and HOMA-IR (2.98 versus 2.69, < 0.05) were significantly higher in the case group. Conclusion. In women with idiopathic recurrent pregnancy loss FI and IR are higher than those in women without spontaneous abortion

VEGF +936 C/T Genetic Polymorphism in Patients with Cervical Dysplasia

Aim. The present study aims to analyze the potential role of VEGF +936 C/T polymorphism in cervical intraepithelial neoplasia. Material and Method. One hundred and eighty-six patients were included in the study: 75 cases (patients diagnosed with CIN) and 111 controls (negative for both HPV testing and cytology). For each patient a single visit was scheduled when colposcopy was performed. From cervical specimen, cytology and HPV testing were performed and from peripheral blood VEGF +936 genotyping was determined. For statistical analysis purposes OR and chi-square were used at a level of significance of <0.05. Results. No link has been found in the detection of CT genotype in cases versus controls, OR = 0.8295, [0.42, 1.62]. An inverse correlation has been found between T allele and HSIL, OR = 0.2121, [0.0473, 0.9517], p=0.0866. Conclusion. No link has been found between VEGF +936 C/T and cervical intraepithelial neoplasia

Guidelines for the management of spontaneous preterm labor: identification of spontaneous preterm labor, diagnosis of preterm premature rupture of membranes, and preventive tools for preterm birth

Preterm premature rupture of the membranes (preterm PROM) is a common and significant cause of preterm birth and perinatal morbidity and mortality. The obstetric caregiver has the opportunity significantly to alter pregnancy and perinatal outcome for women suffering from this complication. Although management is often predetermined by the presence of clinical infection, vaginal bleeding, labor, or nonreassuring fetal heart-rate pattern on admission, a gestational age-based approach to the management of the stable patient with preterm PROM offers the potential to reduc

Continuing education The place of ultrasonography in detecting fetal heart malformations

Abstract Most newborns with cardiac malformations are born without obvious risk factors, so the prenatal diagnosis depends on screening protocols. Fetal cardiac ultrasound should be a part of every ultrasound examination, especially when other malformations are discovered. Contrary to neural tube defects or trisomy 21, detecting fetal heart malformations implies therapeutically termination of pregnancy in only half of the cases. Echocardiographic exam (2D, 3D, Doppler) allows the diagnosis of 90% of cardiac defects, given performing machinery and an experimented examiner. Keywords: echocardiography, congenital heart malformations, standard sections, prenatal screening Rezumat Majoritatea nou-născuţilor cu malformaţii cardiace se nasc din mame fără factori de risc evidenţi, aşadar depistarea acestora înainte de naştere este dependentă de protocoalele de screening. Ecocardiografi a fetală ar trebui inclusă în fi ecare examinare ecografi că, mai ales în condiţiile depistării altor malformaţii. Spre deosebire de defectele de tub neural sau trisomia 21, depistarea unei malformaţii cardiace fetale nu implică decât în jumatate din cazuri întreruperea terapeutică a sarcinii. Examinarea ecocardiografi că (2D, 3D, Doppler) permite depistarea unui procent de 90% dintre malformaţiile cardiace, în condiţiile unei aparaturi performante şi a unui ecografi st experimentat. Cuvinte cheie: ecocardigrafi e, malformaţii cardiace congenitale, secţiuni standard, screening prenata

High Fasting Insulin Levels and Insulin Resistance May Be Linked to Idiopathic Recurrent Pregnancy Loss: A Case-Control Study

Objective. Patients with more than two spontaneous pregnancy losses are diagnosed with recurrent pregnancy loss. The aim of this study was to evaluate the IR (insulin resistance) in patients with idiopathic recurrent pregnancy loss. Material and Method. A single center, case control study was performed on one hundred eighteen women divided into case group (with at least two pregnancy losses, earlier than 20 weeks of gestation, and negative for the recurrent pregnancy loss testing) and control group (with at least one live birth, no pregnancy loss). FG (fasting glucose) and FI (fasting insulin) were determined for all patients. IR was evaluated by HOMA-IR index. Results. There were not significant differences between the mean age and BMI in cases and controls (). Fasting glucose was significantly higher in the control group (85.6 versus 79.8 ), but fasting insulin (15.24 versus 12.83, ) and HOMA-IR (2.98 versus 2.69, ) were significantly higher in the case group. Conclusion. In women with idiopathic recurrent pregnancy loss FI and IR are higher than those in women without spontaneous abortion

Internal Structures of the Developing Brain Assessed by HDlive Imaging

OBJECTIVES: The aim of this observational descriptive study of morphological research is to assess the nervous structures within the embryonic and early fetal brains not previously documented in literature by HDlive and Silhouette® modes. STUDY DESIGN: A total of 26 subjects were examined in vivo, i.e. 15 embryos and 11 fetuses in the first trimester of pregnancy (7 to 13 gestational weeks (GW)), using a transvaginal ultrasound using a Voluson E10, BT 15 scanner (GE Healthcare, Zipf, Austria). RESULTS: The clear visualization of the brain structures by HDlive rendering mode was possible in all 26 selected optimal volumes. The most representative images for each week of gestation are shown. At 7 GW the ultrasound semiology of the brain is simple. The choroid plexuses can be seen in the 4th ventricle at 8 GW and in the lateral ventricles at 9 GW by HDlive mode. At 9 GW the brain is developed enough so that the walls of the cerebral hemispheres, the ventricular system and the rhombic lips could be visualized by HDlive mode. At 10 GW we depicted the ganglionic eminences within the brain by HDlive mode. At 11 GW the thalamus was noticed. At 12 GW and 13 GW, HDlive images of choroid plexus asymmetry and choroid plexuses cysts are shown. CONCLUSION: The HDlive combined with Silhouette® mode can provide almost natural images of the internal structures of the embryonic and early fetal brain. Small-sized nervous structures such as th

Barriers in the Implementation of Health Information Systems: A Scoping Review

<p>Context. A well-developed health information system which is implemented according to present standards allows a healthcare quality increase. Our study aims at providing an overview of the barriers which were encountered in the process of implementing the health information systems by reviewing the literature connected to Europe and the United States of America. Methodology. We searched within five databases (Cochrane Library, Google Scholar, PubMed, ScienceDirect and Scopus) for the exact phrase ‘implementation health information system’ along with the name of each European country/USA state. Relevance was then tested by scanning titles and abstracts. The third and final step involved assessing all the articles in order to set their relevance and a data extraction tool was created, containing the name of the state/country that the article reports data on, the article citation and the challenges identified. Results. The barriers identified were classified in four major categories: technical, organizational, behavioral/human and financial. Seemingly, Europe (41 articles) and USA (20 articles) are facing the same issues in the implementation of a health information system. No major difference between EU and non-EU countries was found after our analysis with regards to the identified barriers. Discussion. Even if recommendations and solutions are continuously being developed in order to solve these barriers, the implementation of a new health information system must be very detailed in order to face all these problems. Additionally, further research is required in order to evaluate their impact on the successful implementation of a health information system.</p

Managementul informației în spital - o provocare pentru spitalele din România

eHealth is a very complex domain in a continuous change that is very hard to model. Romania has many actors involved in this domain that don’t communicate with each other and this is one of the reasons why Romania is on the end of the list with countries members of European Union in eHealth domain. The use of a hospital information system for the management of information will lower the total costs but in the same time will improve the medical act and will lower the rate of errors. Creating a complete hospital information system can be done only by using different software products from different vendors that are interoperable on semantic level. For creating hospital information system, Romania needs to create a proper legislation that will specify the most important parameters of software products from eHealth domain.</p

Early changes of placenta-derived messenger RNA in maternal plasma – potential value for preeclampsia prediction?

Objective: the pourpose of the study was to determine if there are any differences between placenta derived plasmatic levels of messenger RNA in normal and future preeclamptic pregnancies and if these placental transcripts can predict preeclampsia long before clinical onse