Mortality in patients treated with intravitreal bevacizumab for age-related macular degeneration

Abstract Background The aim of this study is to analyze mortality in patients treated with bevacizumab for wet AMD. Methods We conducted a retrospective case-control study between patients who received intravitreal injections of bevacizumab as the sole treatment for exudative AMD between September 2008 and October 2014 (n = 5385) and age and gender matched controls (n = 10,756). All individuals included in the study were reviewed for sociodemographic data and comorbidities. Survival analysis was performed using adjusted Cox regression, using relevant adjusted variables. Results During follow-up (maximum: 73 months), 1063 (19.7%) individuals after bevacizumab died compared with 1298 (12.1%) in the control group (P < .001). After adjusted Cox survival regression, mortality differed significantly between the groups, Odds ratio = 1.69, (95% C.I. 1.54–1.84), P < .001. Conclusions We found an increased long-term mortality in individuals with wet AMD treated with bevacizumab compared to a same age and gender group without wet AMD

The impact of minor trauma during pregnancy on maternal and neonatal outcomes: A tertiary centre experience

Introduction: The aim of this study was to evaluate the impact of minor trauma during pregnancy on maternal and fetal outcomes in patients managed in a tertiary setting. Materials and methods: A retrospective single centre case-controlled study was performed between 2005 and 2017 in a university affiliated tertiary obstetric and trauma centre. All pregnant women of 13–36 weeks gestation that presented to the department of emergency medicine with an Injury Severity Score of <9 were identified. Maternal and neonatal outcomes were compared with a control group of non-trauma pregnant women during the study at a ratio of 1:4. Variables found significant on univariate analysis were included in a multivariate regression analysis. Results: There were 388 patients allocated to the study group and 2528 to the control group. The groups were demographically similar, however trauma was more common amongst first-time mothers and those pregnant with twins. On univariate analysis, minor trauma was associated with lower gestation age at delivery, lower birth weight, more caesarean sections, lower Apgar scores at 1 and 5 min, longer neonatal hospital admissions and an increased incidence of neonatal intensive care admission. On multivariate analysis, minor trauma remained associated with an earlier gestational age at birth (OR 0.863, 95% CI 0.787-0.946, p = 0.002). Conclusion: Pregnant women who sustained minor trauma during pregnancy should be considered at high-risk of early labour

Association of toll-like receptors polymorphism and intrauterine transmission of cytomegalovirus

<div><p>Background</p><p>Congenital Cytomegalovirus (CMV) is a very common intrauterine infection which can cause severe developmental disabilities. Transmission of the virus to the fetus occurs in only 40% of primarily infected women. The probability of intrauterine transmission is higher when infection occurs during the second trimester of pregnancy than in the first trimester. The Toll-like receptors (TLRs) protein family plays a key role in both innate immune response to CMV infections and in normal pregnancy. Specific single nucleotide polymorphisms (SNPs) in TLRs can affect CMV infections and maternal–fetal interface expression. Therefore, TLR SNPs could be involved in intrauterine transmission determination.</p><p>Study aim</p><p>To establish a correlation between TLR2 (rs4696480, rs3804100, rs1898830), TLR3 (rs3775291) and TLR7(rs179008) SNPs with CMV intrauterine transmission during the first and second trimester.</p><p>Methods</p><p>SNPs of 83 pregnant women with primary CMV were analyzed by Real-Time PCR and PCR-RFLP assay and compared to intrauterine transmission state.</p><p>Results</p><p>Women bearing the GG genotype in the rs1898830 TLR2 SNP who were infected with CMV during the second trimester did not transmit the virus to the fetus. Likewise, in the co-dominant or recessive models of this SNP, a significant association was found between the genotypes and CMV intrauterine transmission. In all cohort women or in women infected during the first trimester, no such associations were found between the tested SNPs and intrauterine transmission of the virus.</p><p>Conclusion</p><p>Women bearing the GG genotype in the rs1898830 SNP, who are infected with CMV during the second trimester of pregnancy, have a low likelihood of transmitting the virus to the fetus.</p></div

The distribution of genotype frequencies of TLR2 (rs4696480, rs3804100, rs1898830), TLR3(rs3775291) and TLR7(rs179008) SNPs in pregnant women who were infected with primary CMV in the first trimester, and intrauterine transmission.

<p>The distribution of genotype frequencies of TLR2 (rs4696480, rs3804100, rs1898830), TLR3(rs3775291) and TLR7(rs179008) SNPs in pregnant women who were infected with primary CMV in the first trimester, and intrauterine transmission.</p

Clinical characteristics of CMV-infected pregnant women.

<p>Clinical characteristics of CMV-infected pregnant women.</p

The genotype frequencies of TLR2 (rs4696480, rs3804100, rs1898830), TLR3(rs3775291) and TLR7(rs179008) SNPs, in transmitters and non-transmitters, were in H-W equilibrium.

<p>The genotype frequencies of TLR2 (rs4696480, rs3804100, rs1898830), TLR3(rs3775291) and TLR7(rs179008) SNPs, in transmitters and non-transmitters, were in H-W equilibrium.</p