Comparative intrauterine development and placental function of ART concepti: implications for human reproductive medicine and animal breeding

Science.gov (United States)

Bloise, Enrrico; Feuer, Sky K.; Rinaudo, Paolo F.

2014-01-01

BACKGROUND The number of children conceived using assisted reproductive technologies (ART) has reached >5 million worldwide and continues to increase. Although the great majority of ART children are healthy, many reports suggest a forthcoming risk of metabolic complications, which is further supported by the Developmental Origins of Health and Disease hypothesis of suboptimal embryo/fetal conditions predisposing adult cardiometabolic pathologies. Accumulating evidence suggests that fetal and placental growth kinetics are important features predicting post-natal health, but the relationship between ART and intrauterine growth has not been systematically reviewed. METHODS Relevant studies describing fetoplacental intrauterine phenotypes of concepti generated by in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI) and somatic cell nuclear transfer (SCNT) in the mouse, bovine and human were comprehensively researched using PubMed and Google Scholar. Intrauterine growth plots were created from tabular formatted data available in selected reports. RESULTS ART pregnancies display minor but noticeable alterations in fetal and placental growth curves across mammalian species. In all species, there is evidence of fetal growth restriction in the earlier stages of pregnancy, followed by significant increases in placental size and accelerated fetal growth toward the end of gestation. However, there is a species-specific effect of ART on birthweights, that additionally vary in a culture condition-, strain-, and/or stage at transfer-specific manner. We discuss the potential mechanisms that underlie these changes, and how they are affected by specific components of ART procedures. CONCLUSIONS ART may promote measurable alterations to intrauterine growth trajectory and placental function. Key findings include evidence that birthweight is not a reliable marker of fetal stress, and that increases in embryo manipulation result in more deviant fetal growth curves

Intrauterine Devices Penetrated and Migrated: CT Findings

International Nuclear Information System (INIS)

Mejia Restrepo, Jorge; Lopez, Juan Esteban; Aldana Sepulveda, Natalia; Ruiz Zabaleta, Tania; Mazzaro Mauricio

2011-01-01

Intrauterine devices have been used for over 40 years, and they constitute the most widely accepted method of contraception among women because of the low rates of complications and low cost. Although uncommon, with the growing use of multidetector CT penetrated and migrated intrauterine devices have become a more common incidental finding. In some cases, intrauterine devices migrate to adjacent viscera, in particular the bladder and bowel and may give rise to symptoms. Consequently tomographic localization and characterization are essential for treatment planning.

Cardiovascular adaptation to extrauterine life after intrauterine growth restriction.

Science.gov (United States)

Rodriguez-Guerineau, Luciana; Perez-Cruz, Miriam; Gomez Roig, María D; Cambra, Francisco J; Carretero, Juan; Prada, Fredy; Gómez, Olga; Crispi, Fátima; Bartrons, Joaquim

2018-02-01

Introduction The adaptive changes of the foetal heart in intrauterine growth restriction can persist postnatally. Data regarding its consequences for early circulatory adaptation to extrauterine life are scarce. The aim of this study was to assess cardiac morphometry and function in newborns with late-onset intrauterine growth restriction to test the hypothesis that intrauterine growth restriction causes cardiac shape and functional changes at birth. A comprehensive echocardiographic study was performed in 25 neonates with intrauterine growth restriction and 25 adequate-for-gestational-age neonates. Compared with controls, neonates with intrauterine growth restriction had more globular ventricles, lower longitudinal tricuspid annular motion, and higher left stroke volume without differences in the heart rate. Neonates with intrauterine growth restriction also showed subclinical signs of diastolic dysfunction in the tissue Doppler imaging with lower values of early (e') diastolic annular peak velocities in the septal annulus. Finally, the Tei index in the tricuspid annulus was higher in the intrauterine growth restriction group. Neonates with history of intrauterine growth restriction showed cardiac remodelling and signs of systolic and diastolic dysfunction. Overall, there was a significant tendency to worse cardiac function results in the right heart. The adaptation to extrauterine life occurred with more globular hearts, higher stroke volumes but a similar heart rate compared to adequate-for-gestational-age neonates.

A suspicious reason for Raynaud's phenomenon: Intrauterine device.

Science.gov (United States)

Diken, Adem I; Yalçınkaya, Adnan; Aksoy, Eray; Yılmaz, Seyhan; Çağlı, Kerim

2015-06-01

Primary Raynaud's phenomenon may be insistent in patients under medical therapy, and intrauterine devices may be an unnoticed reason in these patients. Fluctuations in female sex hormone status were reported to be associated with the emergence of primary Raynaud's phenomenon symptoms. The use of intrauterine devices was not reported to be associated with Raynaud's phenomenon previously. Intrauterine device may stimulate vascular hyperactivity regarding hormonal or unknown mechanisms that result in Raynaud's phenomenon. We present a postmenopausal patient who complained of primary Raynaud's phenomenon symptoms and had recovery after the removal of her copper intrauterine device. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Consequences in Infants That Were Intrauterine Growth Restricted

Directory of Open Access Journals (Sweden)

Erich Cosmi

2011-01-01

Full Text Available Intrauterine growth restriction is a condition fetus does not reach its growth potential and associated with perinatal mobility and mortality. Intrauterine growth restriction is caused by placental insufficiency, which determines cardiovascular abnormalities in the fetus. This condition, moreover, should prompt intensive antenatal surveillance of the fetus as well as follow-up of infants that had intrauterine growth restriction as short and long-term sequele should be considered.

Implication of Oxidative Stress in Fetal Programming of Cardiovascular Disease

Science.gov (United States)

Rodríguez-Rodríguez, Pilar; Ramiro-Cortijo, David; Reyes-Hernández, Cynthia G.; López de Pablo, Angel L.; González, M. Carmen; Arribas, Silvia M.

2018-01-01

Lifestyle and genetic background are well known risk factors of cardiovascular disease (CVD). A third contributing factor is suboptimal fetal development, due to nutrient or oxygen deprivation, placental insufficiency, or exposure to toxic substances. The fetus adapts to adverse intrauterine conditions to ensure survival; the immediate consequence is low birth weight (LBW) and the long-term effect is an increased susceptibility to develop CVD in adult life. This process is known as Developmental Origins of Health and Disease (DOHaD) or fetal programming of CVD. The influence of fetal life for the future cardiovascular health of the individual has been evidenced by numerous epidemiologic studies in populations suffering from starvation during intrauterine life. Furthermore, experimental animal models have provided support and enabled exploring the underlying mechanisms. Oxidative stress seems to play a central role in fetal programming of CVD, both in the response of the feto-placental unit to the suboptimal intrauterine environment and in the alterations of physiologic systems of cardiovascular control, ultimately leading to disease. This review aims to summarize current knowledge on the alterations in oxidative balance in response to fetal stress factors covering two aspects. Firstly, the evidence from human studies of the implication of oxidative stress in LBW induced by suboptimal conditions during intrauterine life, emphasizing the role of the placenta. In the second part we summarize data on specific redox alterations in key cardiovascular control organs induced by exposure to known stress factors in experimental animals and discuss the emerging role of the mitochondria. PMID:29875698

Intrauterine temperature during intrapartum amnioinfusion: a prospective observational study.

Science.gov (United States)

Tomlinson, T M; Schaecher, C; Sadovsky, Y; Gross, G

2012-07-01

To determine the influence of routine intrapartum amnioinfusion (AI) on intrauterine temperature. Prospective observational study. Maternity unit, Barnes Jewish Hospital, St Louis, MO, USA. Forty women with singleton gestations and an indication for intrapartum intrauterine pressure catheter placement. Using a temperature probe, we digitally recorded intrauterine temperature every 10 minutes during labour. Amnioinfusion was administered according to a standard protocol using saline equilibrated to the ambient temperature. Mean intrauterine temperature during labour. Participants were monitored for a mean of 280 minutes (range 20-820). A total of 164 intrauterine temperature readings in the AI cohort were compared with 797 control measurements. When compared with controls, we observed a lower intrauterine temperature in the AI cohort (36.4 versus 37.4°C, P<0.01). More measurements in the AI cohort were recorded in the presence of intrapartum fever (40% versus 30%). A subgroup analysis of measurements recorded in afebrile parturients revealed an even greater effect of AI (1.5°C decrease, 37.3 versus 35.8°C, P<0.01). Routine intrapartum AI using saline equilibrated to a mean ambient temperature of 25.0°C reduces intrauterine temperature and may thereby affect fetal core temperature. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

Strategies in intrauterine growth restriction at term

NARCIS (Netherlands)

Boers, Kim Esther

2012-01-01

To establish consensus and to collect evidence on the best management policy in intrauterine growth restriction (IUGR) at term, the DIGITAT-trial (Disproportionate Intrauterine Growth Intervention Trial At Term) was designed. The aim of the DIGITAT study was to compare the effect of induction of

Intrauterine fetal death and risk of shoulder dystocia at delivery.

Science.gov (United States)

Larsen, Sandra; Dobbin, Joanna; McCallion, Oliver; Eskild, Anne

2016-12-01

Vaginal delivery is recommended after intrauterine fetal death. However, little is known about the risk of shoulder dystocia in these deliveries. We studied whether intrauterine fetal death increases the risk of shoulder dystocia at delivery. In this population-based register study using the Medical Birth Registry of Norway, we included all singleton pregnancies with vaginal delivery of offspring in cephalic presentation in Norway during the period 1967-2012 (n = 2 266 118). Risk of shoulder dystocia was estimated as absolute risk (%) and odds ratio with 95% confidence interval. Adjustment was made for offspring birthweight (in grams). We performed sub-analyses within categories of birthweight (dystocia occurred in 1.1% of pregnancies with intrauterine fetal death and in 0.8% of pregnancies without intrauterine fetal death (p dystocia occurred in 14.6% of pregnancies with intrauterine fetal death and in 2.8% of pregnancies without intrauterine fetal death (p dystocia occurred in 57.1% of pregnancies with intrauterine fetal death and 9.6% of pregnancies without intrauterine fetal death (p dystocia at delivery, and the absolute risk of shoulder dystocia was particularly high if offspring birthweight was high and the mother had diabetes. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

Comparative intrauterine development and placental function of ART concepti: implications for human reproductive medicine and animal breeding.

Science.gov (United States)

Bloise, Enrrico; Feuer, Sky K; Rinaudo, Paolo F

2014-01-01

The number of children conceived using assisted reproductive technologies (ART) has reached >5 million worldwide and continues to increase. Although the great majority of ART children are healthy, many reports suggest a forthcoming risk of metabolic complications, which is further supported by the Developmental Origins of Health and Disease hypothesis of suboptimal embryo/fetal conditions predisposing adult cardiometabolic pathologies. Accumulating evidence suggests that fetal and placental growth kinetics are important features predicting post-natal health, but the relationship between ART and intrauterine growth has not been systematically reviewed. Relevant studies describing fetoplacental intrauterine phenotypes of concepti generated by in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI) and somatic cell nuclear transfer (SCNT) in the mouse, bovine and human were comprehensively researched using PubMed and Google Scholar. Intrauterine growth plots were created from tabular formatted data available in selected reports. ART pregnancies display minor but noticeable alterations in fetal and placental growth curves across mammalian species. In all species, there is evidence of fetal growth restriction in the earlier stages of pregnancy, followed by significant increases in placental size and accelerated fetal growth toward the end of gestation. However, there is a species-specific effect of ART on birthweights, that additionally vary in a culture condition-, strain-, and/or stage at transfer-specific manner. We discuss the potential mechanisms that underlie these changes, and how they are affected by specific components of ART procedures. ART may promote measurable alterations to intrauterine growth trajectory and placental function. Key findings include evidence that birthweight is not a reliable marker of fetal stress, and that increases in embryo manipulation result in more deviant fetal growth curves. Because growth kinetics in early life are

Design considerations for a suboptimal Kalman filter

Science.gov (United States)

Difilippo, D. J.

1995-06-01

In designing a suboptimal Kalman filter, the designer must decide how to simplify the system error model without causing the filter estimation errors to increase to unacceptable levels. Deletion of certain error states and decoupling of error state dynamics are the two principal model simplifications that are commonly used in suboptimal filter design. For the most part, the decisions as to which error states can be deleted or decoupled are based on the designer's understanding of the physics of the particular system. Consequently, the details of a suboptimal design are usually unique to the specific application. In this paper, the process of designing a suboptimal Kalman filter is illustrated for the case of an airborne transfer-of-alignment (TOA) system used for synthetic aperture radar (SAR) motion compensation. In this application, the filter must continuously transfer the alignment of an onboard Doppler-damped master inertial navigation system (INS) to a strapdown navigator that processes information from a less accurate inertial measurement unit (IMU) mounted on the radar antenna. The IMU is used to measure spurious antenna motion during the SAR imaging interval, so that compensating phase corrections can be computed and applied to the radar returns, thereby presenting image degradation that would otherwise result from such motions. The principles of SAR are described in many references, for instance. The primary function of the TOA Kalman filter in a SAR motion compensation system is to control strapdown navigator attitude errors, and to a less degree, velocity and heading errors. Unlike a classical navigation application, absolute positional accuracy is not important. The motion compensation requirements for SAR imaging are discussed in some detail. This TOA application is particularly appropriate as a vehicle for discussing suboptimal filter design, because the system contains features that can be exploited to allow both deletion and decoupling of error

Levonorgestrel Intrauterine System

Science.gov (United States)

... removed during the first 7 days of your menstrual period, you should start using your new form of birth control 7 days before your intrauterine system is removed.Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

Hysteroscopic Management Of Intrauterin Adhesion

Directory of Open Access Journals (Sweden)

Ayşegül Dikmen

2013-03-01

Full Text Available Objective: Assessment of preoperative and postoperative outcomes of patients that were performed hysterescopic intrauterine adhesiolysis. Material and method: We reviewed 24 patients that underwent hysterescopy with the complaints of amenorrhea, hypomenorrhea, recurrent pregnancy loss between 2004-2008. The most complaints of patients were infertilty amenorrhea. Results: Adhesions occurs mainly as a result of trauma to the gravid uterine cavity in 14 patients. When classifying patients with their intrauterine adhesions, Grade 3 was the most frequently seen. Adhesiolisis was performed with hysteresopic scissors in all patients. In postoperative period following synechiolysis, 10 patients were treated with estrogen and progestogen, 11 of them used intrauterine device with estrogen and progestogen therapy, foley catheter was used in 3 patients. Hysterescopy was performed in 5 patients for second time because of adhesion suspicions. The re-adhesiolysis performed to 3 patients because of determined to mild adhesion. Conclusion: After hysterescopic adhesiolysis, all patients with the complaint of amenorrhea had regular menstruation. Pregnancy after treatment occured in 4 patients but live birth rate was 75%.

Vesical Calculus 10 Years Post Missing Intrauterine Contraceptive ...

African Journals Online (AJOL)

Vesical Calculus 10 Years Post Missing Intrauterine. Contraceptive Device. Abdullahi Abdulwahab-Ahmed, Oluwagbemiga Olabisi Ogunleye. INTRODUCTION. Intrauterine contraceptive devices (IUCD) are acceptable means of contraception world over.[1-4] There have been reports of its migration to other adjourning sites ...

Changes in GH/IGF-1 axis in intrauterine growth retardation: consequences of fetal programming?

Science.gov (United States)

Setia, S; Sridhar, M G

2009-11-01

Fetal growth is a complex process that depends on the genotype and epigenotype of the fetus, maternal nutrition, the availability of nutrients and oxygen to the fetus, intrauterine insults, and a variety of growth factors and proteins of maternal and fetal/placental origin. In the fetus, growth hormone (GH) plays little or no role in regulating fetal growth, and insulin-like growth factors (IGFs) control growth directly independent of fetal GH secretion. Placental growth hormone (PGH) is the prime regulator of maternal serum IGF-1 during pregnancy. Total as well as free PGH and IGFs are significantly lower in pregnancies with intrauterine growth retardation (IUGR). The GH/IGF axis is significantly affected by intrauterine growth retardation and some of these alterations may lead to permanent pathological programming of the IGF axis. Alterations in the IGF axis may play a role in the future occurrence of insulin resistance and hypertension. In this review we focus on the regulation of fetal growth and the role of fetal programming in the late consequences of a poor fetal environment reflected in IUGR.

Consequences of intrauterine growth restriction for the kidney

NARCIS (Netherlands)

M.F. Schreuder; A. van Wijk (Ans); H.A. Delemarre-van de Waal (Henriette)

2006-01-01

textabstractLow birth weight due to intrauterine growth restriction is associated with various diseases in adulthood, such as hypertension, cardiovascular disease, insulin resistance and end-stage renal disease. The purpose of this review is to describe the effects of intrauterine growth restriction

Suboptimal palliative sedation in primary care: an exploration.

Science.gov (United States)

Pype, Peter; Teuwen, Inge; Mertens, Fien; Sercu, Marij; De Sutter, An

2018-02-01

Palliative sedation is a therapeutic option to control refractory symptoms in terminal palliative patients. This study aims at describing the occurrence and characteristics of suboptimal palliative sedations in primary care and at exploring the way general practitioners (GPs) experience suboptimal palliative sedation in their practice. We conducted a mixed methods study with a quantitative prospective survey in primary care and qualitative semi-structured interviews with GPs. The research team defined suboptimal palliative sedation as a time interval until deep sleep >1.5 h and/ or >2 awakenings after the start of the unconsciousness. Descriptive statistics were calculated on the quantitative data. Thematic analysis was used to analyse interview transcripts. We registered 63 palliative sedations in 1181 home deaths, 27 forms were completed. Eleven palliative sedations were suboptimal: eight due to the long time span until deep sleep; three due the number of unintended awakenings. GPs' interview analysis revealed two major themes: the shifting perception of failure and the burden of responsibility. Suboptimal palliative sedation occurs frequently in primary palliative care. Efficient communication towards family members is needed to prevent them from having unrealistic expectations and to prevent putting pressure on the GP to hasten the procedure. Sharing the burden of decision-making during the procedure with other health care professionals might diminish the heavy responsibility as perceived by GPs.

Intrauterine Environment and PCOS

OpenAIRE

Dumesic, Daniel A.; Goodarzi, Mark O.; Chazenbalk, Gregorio D.; Abbott, David H.

2014-01-01

The maternal-fetal environment plays an important role in developmental programming of adult disease. Metabolic and hormonal dysfunction during human fetal development accompanies gestational diabetes as a common occurrence in polycystic ovary syndrome (PCOS) mothers, while human fetal androgen excess from congenital adrenal hyperplasia or virilizing tumors precedes PCOS-like symptoms after birth. To date, clinical studies of infant blood levels at term have yet to confirm that human fetal an...

How suboptimal are linear sharing rules?

DEFF Research Database (Denmark)

Jensen, Bjarne Astrup; Nielsen, Jørgen Aase

2016-01-01

that significant losses can arise when investors are diverse in their risk attitude. We also show that an investor with a low degree of risk aversion, like the logarithmic or the square root investor, often applied in portfolio choice models, can either inflict or be subject to severe losses when being forced...... two sources of suboptimal investment decisions as seen from each of the two investors individually. One is the suboptimal choice of portfolio, the other is the forced linear sharing rule. We measure the combined consequence for each investor by their respective loss in wealth equivalent. We show...

On the Origins of Suboptimality in Human Probabilistic Inference

Science.gov (United States)

Acerbi, Luigi; Vijayakumar, Sethu; Wolpert, Daniel M.

2014-01-01

Humans have been shown to combine noisy sensory information with previous experience (priors), in qualitative and sometimes quantitative agreement with the statistically-optimal predictions of Bayesian integration. However, when the prior distribution becomes more complex than a simple Gaussian, such as skewed or bimodal, training takes much longer and performance appears suboptimal. It is unclear whether such suboptimality arises from an imprecise internal representation of the complex prior, or from additional constraints in performing probabilistic computations on complex distributions, even when accurately represented. Here we probe the sources of suboptimality in probabilistic inference using a novel estimation task in which subjects are exposed to an explicitly provided distribution, thereby removing the need to remember the prior. Subjects had to estimate the location of a target given a noisy cue and a visual representation of the prior probability density over locations, which changed on each trial. Different classes of priors were examined (Gaussian, unimodal, bimodal). Subjects' performance was in qualitative agreement with the predictions of Bayesian Decision Theory although generally suboptimal. The degree of suboptimality was modulated by statistical features of the priors but was largely independent of the class of the prior and level of noise in the cue, suggesting that suboptimality in dealing with complex statistical features, such as bimodality, may be due to a problem of acquiring the priors rather than computing with them. We performed a factorial model comparison across a large set of Bayesian observer models to identify additional sources of noise and suboptimality. Our analysis rejects several models of stochastic behavior, including probability matching and sample-averaging strategies. Instead we show that subjects' response variability was mainly driven by a combination of a noisy estimation of the parameters of the priors, and by

On the origins of suboptimality in human probabilistic inference.

Directory of Open Access Journals (Sweden)

Luigi Acerbi

2014-06-01

Full Text Available Humans have been shown to combine noisy sensory information with previous experience (priors, in qualitative and sometimes quantitative agreement with the statistically-optimal predictions of Bayesian integration. However, when the prior distribution becomes more complex than a simple Gaussian, such as skewed or bimodal, training takes much longer and performance appears suboptimal. It is unclear whether such suboptimality arises from an imprecise internal representation of the complex prior, or from additional constraints in performing probabilistic computations on complex distributions, even when accurately represented. Here we probe the sources of suboptimality in probabilistic inference using a novel estimation task in which subjects are exposed to an explicitly provided distribution, thereby removing the need to remember the prior. Subjects had to estimate the location of a target given a noisy cue and a visual representation of the prior probability density over locations, which changed on each trial. Different classes of priors were examined (Gaussian, unimodal, bimodal. Subjects' performance was in qualitative agreement with the predictions of Bayesian Decision Theory although generally suboptimal. The degree of suboptimality was modulated by statistical features of the priors but was largely independent of the class of the prior and level of noise in the cue, suggesting that suboptimality in dealing with complex statistical features, such as bimodality, may be due to a problem of acquiring the priors rather than computing with them. We performed a factorial model comparison across a large set of Bayesian observer models to identify additional sources of noise and suboptimality. Our analysis rejects several models of stochastic behavior, including probability matching and sample-averaging strategies. Instead we show that subjects' response variability was mainly driven by a combination of a noisy estimation of the parameters of the

Effects of intrauterine contraception on the vaginal microbiota.

Science.gov (United States)

Bassis, Christine M; Allsworth, Jenifer E; Wahl, Heather N; Sack, Daniel E; Young, Vincent B; Bell, Jason D

2017-09-01

There have been conflicting reports of altered vaginal microbiota and infection susceptibility associated with contraception use. The objectives of this study were to determine if intrauterine contraception altered the vaginal microbiota and to compare the effects of a copper intrauterine device (Cu-IUD) and a levonorgestrel intrauterine system (LNG-IUS) on the vaginal microbiota. DNA was isolated from the vaginal swab samples of 76 women using Cu-IUD (n=36) or LNG-IUS (n=40) collected prior to insertion of intrauterine contraception (baseline) and at 6 months. A third swab from approximately 12 months following insertion was available for 69 (Cu-IUD, n=33; LNG-IUS, n=36) of these women. The V4 region of the bacterial 16S rRNA-encoding gene was amplified from the vaginal swab DNA and sequenced. The 16S rRNA gene sequences were processed and analyzed using the software package mothur to compare the structure and dynamics of the vaginal bacterial communities. The vaginal microbiota from individuals in this study clustered into 3 major vaginal bacterial community types: one dominated by Lactobacillus iners, one dominated by Lactobacillus crispatus and one community type that was not dominated by a single Lactobacillus species. Changes in the vaginal bacterial community composition were not associated with the use of Cu-IUD or LNG-IUS. Additionally, we did not observe a clear difference in vaginal microbiota stability with Cu-IUD versus LNG-IUS use. Although the vaginal microbiota can be highly dynamic, alterations in the community associated with the use of intrauterine contraception (Cu-IUD or LNG-IUS) were not detected over 12 months. We found no evidence that intrauterine contraception (Cu-IUD or LNG-IUS) altered the vaginal microbiota composition. Therefore, the use of intrauterine contraception is unlikely to shift the composition of the vaginal microbiota such that infection susceptibility is altered. Copyright © 2017 Elsevier Inc. All rights reserved.

[Intrauterine intestinal volvulus].

Science.gov (United States)

Gawrych, Elzbieta; Chojnacka, Hanna; Wegrzynowski, Jerzy; Rajewska, Justyna

2009-07-01

Intrauterine intestinal volvulus is an extremely rare case of acute congenital intestinal obstruction. The diagnosis is usually possible in the third trimester of a pregnancy. Fetal midgut volvulus is most likely to be recognized by observing a typical clockwise whirlpool sign during color Doppler investigation. Multiple dilated intestinal loops with fluid levels are usually visible during the antenatal ultrasound as well. Physical and radiographic findings in the newborn indicate intestinal obstruction and an emergency surgery is required. The authors describe intrauterine volvulus in 3 female newborns in which surgical treatment was individualized. The decision about primary or delayed anastomosis after resection of the gangrenous part of the small bowel was made at the time of the surgery and depended on the general condition of the newborn, as well as presence or absence of meconium peritonitis. Double loop jejunostomy was performed in case of two newborns, followed by a delayed end-to-end anastomosis. In case of the third newborn, good blood supply of the small intestine after untwisting and 0.25% lignocaine injections into mesentery led to the assumption that the torsion was not complete and ischemia was reversible. In the two cases of incomplete rotation the cecum was sutured to the left abdominal wall to prevent further twisting. The postoperative course was uneventful and oral alimentation caused no problems. Physical development of all these children has been normal (current age: 1-2 years) and the parents have not observed any disorders or problems regarding passage of food through the alimentary canal. Prompt antenatal diagnosis of this surgical emergency and adequate choice of intervention may greatly reduce mortality due to intrauterine volvulus.

Experimental intrauterine growth retardation.

Science.gov (United States)

van Marthens, E; Harel, S; Zamenshof, S

1975-01-01

The effects of experimental intrauterine growth retardation on subsequent fetal development, especially with respect to brain development, were studied in a new animal model. The rabbit was chosen since it has a perinatal pattern of brain development similar to that of the human. Experimental ischemia was induced during the last trimester by ligation of spiral arterioles and the differential effects on fetal development at term (30th gestational day) are reported. Specific brain regions were examined for wet weight, total cell number (DNA) and total protein content. Highly significant decreases in all these parameters were found in both the cortex and cerebellum following experimental intrauterine growth retardation; these two organs were differentially affected. The prospects and advantages of using this animal model for the study of the postnatal "catch-up growth" are discussed.

Intrauterine growth restriction

Directory of Open Access Journals (Sweden)

Bernardita Donoso Bernales

2012-07-01

Full Text Available It is estimated that the true prevalence of intrauterine growth restriction is 3-10% of all pregnancies, making this fetal condition one of the most frequent obstetric problems, together with premature labor and premature rupture of membranes. The article stresses the importance of early diagnosis because of the associated risks.

Intrauterine application of flavonoids in puerperal dairy cows: reproductive tract involution and fertility at high-altitude environments

Directory of Open Access Journals (Sweden)

Gutierrez-Reinoso MA

2016-12-01

Full Text Available The main objective of the present study was to evaluate the effects of postpartum intrauterine administration of flavonoids in order to hasten reproductive tract involution and to shorten the parturition-to-conception interval in dairy cows. A total of 40 Holstein cows (2nd-3rd lactation; BC: 3-3.5 were divided randomly into 4 groups [1 control group (T1 and 3 treatment groups (T2, T3 and T4]. Treatments consisted of one single intrauterine administration on day 10 postpartum of 90 mg (T2, 180 mg (T3 and 360 mg (T4 of ultrapure flavonoids (20 ml. Ultrasonographic measurements of different reproductive tract anatomical structures were scored from cervix (length, width and thickness, uterus (diameter and thickness and ovaries (length and width during the postpartum period (day 10, 15 and 21 postpartum. As fertility parameters rate of return to estrus, pregnancy rate and calving-to-conception interval were scored as well. Pregnancy status was performed using ultrasonography (day 35 post-insemination. There were multiple differences (p 0.05 in ovarian dimensions from T1, T2, T3 and T4 groups during the postpartum period after ultrasonographic analysis at day 10, 15 and 21. Return to estrus index, pregnancy rate and calving-to-conception interval differed between T1 and T2-T3-T4 groups (p 0.05. In conclusion, intrauterine application of flavonoids enhanced the cervical and uterine involution. Finally, although no significant differences among treatments, theintrauterine application of flavonoids improved the return to estrus index, pregnancy rate and calving-to-conception interval compared with non-treated dairy cows.

Intrauterin graviditet efter Cavatermbehandling

DEFF Research Database (Denmark)

Shokouh-Amiri, Ali; Kjaergaard, Niels

2009-01-01

A case of intrauterine pregnancy occurring after successful balloon thermal endometrial ablation is described. Although rare, pregnancy after endometrial ablation is possible, and use of a supplemental contraceptive method should be planned. In case of pregnancy after endometrial ablation...

Alteration of placental haemostatic mechanisms in idiopathic intrauterine growth restriction

Directory of Open Access Journals (Sweden)

Jaime Eduardo Bernal Villegas

2012-08-01

Full Text Available Intrauterine growth restriction is a complication of pregnancy with a high probability of perinatal morbidity and mortality. It appears tobe caused by abnormal development of placental vasculature. Haemostatic processes are important for the development of the placenta,and an imbalance between procoagulant and anticoagulant factors has been associated with risk of intrauterine growth restriction.Objective. To evaluate coagulation abnormalities in placenta of pregnancies complicated with idiopathic intrauterine growth restriction.Materials and methods. Five placentas from pregnancies with idiopathic intrauterine growth restriction were compared to 19 controls.We performed gross and histological examination of the placenta. Analysis was made of both mRNA expression by real-time PCRand protein by ELISA of tissue factor and thrombomodulin in placental tissue. Results. Results based on histological evaluation wereconsistent with an increased prothrombotic state in placentas from pregnancies with idiopathic intrauterine growth restriction, andthrombosis of chorionic vessels was the most important finding. The study showed an increased expression of tissue factor protein(p=0.0411 and an increase in the ratio of tissue factor/thrombomodulin mRNA (p=0.0411 and protein (p=0.0215 in placentas frompregnancies with idiopathic intrauterine growth restriction. There were no statistically significant differences neither between cases andcontrols in the mRNA levels of tissue factor or thrombomodulin nor at the protein level of thrombomodulin. Conclusion. Evidence ofalteration of local haemostatic mechanisms at the level of the placenta, including abnormal expression of tissue factor and tissue factor/thrombomodulin ratio, in pregnancies that occur with idiopathic intrauterine growth restriction is presented.

The effect of plant-based diet and suboptimal environmental conditions on digestive function and diet-induced enteropathy in rainbow trout (Oncorhynchus mykiss)

NARCIS (Netherlands)

Mosberian-Tanha, P.; Schrama, J.W.; Landsverk, T.; Mydland, L.T.; Øverland, M.

2018-01-01

This experiment investigated intestinal enteropathy and digestive function of rainbow trout challenged with soybean meal-based diet (SBM) at optimal or suboptimal environments created by normal or reduced water flow, respectively. Oxygen level remained above 7 mg L-1 for optimal environment and

Optimal inference with suboptimal models: Addiction and active Bayesian inference

Science.gov (United States)

Schwartenbeck, Philipp; FitzGerald, Thomas H.B.; Mathys, Christoph; Dolan, Ray; Wurst, Friedrich; Kronbichler, Martin; Friston, Karl

2015-01-01

When casting behaviour as active (Bayesian) inference, optimal inference is defined with respect to an agent’s beliefs – based on its generative model of the world. This contrasts with normative accounts of choice behaviour, in which optimal actions are considered in relation to the true structure of the environment – as opposed to the agent’s beliefs about worldly states (or the task). This distinction shifts an understanding of suboptimal or pathological behaviour away from aberrant inference as such, to understanding the prior beliefs of a subject that cause them to behave less ‘optimally’ than our prior beliefs suggest they should behave. Put simply, suboptimal or pathological behaviour does not speak against understanding behaviour in terms of (Bayes optimal) inference, but rather calls for a more refined understanding of the subject’s generative model upon which their (optimal) Bayesian inference is based. Here, we discuss this fundamental distinction and its implications for understanding optimality, bounded rationality and pathological (choice) behaviour. We illustrate our argument using addictive choice behaviour in a recently described ‘limited offer’ task. Our simulations of pathological choices and addictive behaviour also generate some clear hypotheses, which we hope to pursue in ongoing empirical work. PMID:25561321

Efficacy of Intrauterine Device in the Treatment of Intrauterine Adhesions

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Umme Salma

2014-01-01

Full Text Available The primary purpose of this paper is to assess the efficacy of the use of the intrauterine device (IUD as an adjunctive treatment modality, for intrauterine adhesions (IUAs. All eligible literatures were identified by electronic databases including PubMed, Scopus, and Web of Science. Additional relevant articles were identified from citations in these publications. There were 28 studies included for a systematic review. Of these, 5 studies were eligible for meta-analysis and 23 for qualitative assessment only. Twenty-eight studies related to the use of IUDs as ancillary treatment following adhesiolysis were identified. Of these studies, 25 studies at least one of the following methods were carried out as ancillary treatment: Foley catheter, hyaluronic acid gel, hormonal therapy, or amnion graft in addition to the IUD. There was one study that used IUD therapy as a single ancillary treatment. In 2 studies, no adjunctive therapy was used after adhesiolysis. There was a wide range of reported menstrual and fertility outcomes which were associated with the use of IUD combined with other ancillary treatments. At present, the IUD is beneficial in patients with IUA, regardless of stage of adhesions. However, IUD needs to be combined with other ancillary treatments to obtain maximal outcomes, in particular in patients with moderate to severe IUA.

Cytosine methylation dysregulation in neonates following intrauterine growth restriction.

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Francine Einstein

2010-01-01

Full Text Available Perturbations of the intrauterine environment can affect fetal development during critical periods of plasticity, and can increase susceptibility to a number of age-related diseases (e.g., type 2 diabetes mellitus; T2DM, manifesting as late as decades later. We hypothesized that this biological memory is mediated by permanent alterations of the epigenome in stem cell populations, and focused our studies specifically on DNA methylation in CD34+ hematopoietic stem and progenitor cells from cord blood from neonates with intrauterine growth restriction (IUGR and control subjects.Our epigenomic assays utilized a two-stage design involving genome-wide discovery followed by quantitative, single-locus validation. We found that changes in cytosine methylation occur in response to IUGR of moderate degree and involving a restricted number of loci. We also identify specific loci that are targeted for dysregulation of DNA methylation, in particular the hepatocyte nuclear factor 4alpha (HNF4A gene, a well-known diabetes candidate gene not previously associated with growth restriction in utero, and other loci encoding HNF4A-interacting proteins.Our results give insights into the potential contribution of epigenomic dysregulation in mediating the long-term consequences of IUGR, and demonstrate the value of this approach to studies of the fetal origin of adult disease.

Antenatal taurine reduces cerebral cell apoptosis in fetal rats with intrauterine growth restriction.

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Liu, Jing; Wang, Xiaofeng; Liu, Ying; Yang, Na; Xu, Jing; Ren, Xiaotun

2013-08-15

From pregnancy to parturition, Sprague-Dawley rats were daily administered a low protein diet to establish a model of intrauterine growth restriction. From the 12(th) day of pregnancy, 300 mg/kg rine was daily added to food until spontaneous delivery occurred. Brain tissues from normal neonatal rats at 6 hours after delivery, neonatal rats with intrauterine growth restriction, and neonatal rats with intrauterine growth restriction undergoing taurine supplement were obtained for further experiments. The terminal deoxyribonucleotidyl transferase (TdT)-mediated biotin-16-dUTP nick-end labeling assay revealed that the number of apoptotic cells in the brain tissue of neonatal rats with intrauterine growth restriction significantly increased. Taurine supplement in pregnant rats reduced cell apoptosis in brain tissue from neonatal rats with intrauterine growth restriction. nohistochemical staining revealed that taurine supplement increased glial cell line-derived neurotrophic factor expression and decreased caspase-3 expression in the cerebral cortex of intrauterine growth-restricted fetal rats. These results indicate that taurine supplement reduces cell apoptosis through the glial cell line-derived neurotrophic factor-caspase-3 signaling pathway, resulting in a protective effect on the intrauterine growth-restricted fetal rat brain.

INTRAUTERINE FETAL DEATH CASES AT TERTIARY CENTER

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Babu Lal Bishnoi

2018-01-01

Full Text Available BACKGROUND Intrauterine fetal death is a tragic event for the parents and a great cause of stress for the caregiver. It is an important indicator of maternal and perinatal health of a given population. This study was undertaken to study the maternal and fetal factors associated with intrauterine fetal death. Aim and Objective- This was an Analytical study aimed to evaluate and understand the prevalence, socio-epidemiological and etiological factors of IUFD methodology should not be mixed with aims and objectives MATERIALS AND METHODS The study was carried out at March 2017 to June 2017 (4 months study which was conducted at Dr. S. N. Medical College, Jodhpur, Rajasthan. The details were entered in a preformed proforma. IUD is defined as fetal death beyond 20 weeks of gestation and/or birth weight >500g. The details of complaints at admission, obstetrics history, menstrual history, examination findings, per vaginal examination findings, mode and method of delivery and fetal outcomes and investigation reports were recorded. RESULTS A total of 227 intrauterine fetal deaths were reported amongst 6264 deliveries conducted during the study period. The incidence rate of intrauterine fetal death was 36/1000 live births. 192 (84.56% deliveries were unbooked and unsupervised and 133 (58.59% belonged to rural population and 126 (55.5% were preterm and 221 (97.55% were singleton pregnancy. Among the identifiable causes hypertensive disorders (24.22% and severe anemia (13.10% were most common followed by placental causes (9.97%. Congenital malformations were responsible for 12.39% and unidentifiable causes were 11.01%. Induction was done in 103 patients, 94 patients had spontaneous onset of labour and caesarean section was done in 30 patients. Incidence of intrauterine foetal demise gradually decreased as parity advanced. CONCLUSION Institutional deliveries should be promoted to prevent intrapartum fetal deaths. Decrease in the incidence of IUD would

Ultimate explanations and suboptimal choice.

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Vasconcelos, Marco; Machado, Armando; Pandeirada, Josefa N S

2018-07-01

Researchers have unraveled multiple cases in which behavior deviates from rationality principles. We propose that such deviations are valuable tools to understand the adaptive significance of the underpinning mechanisms. To illustrate, we discuss in detail an experimental protocol in which animals systematically incur substantial foraging losses by preferring a lean but informative option over a rich but non-informative one. To understand how adaptive mechanisms may fail to maximize food intake, we review a model inspired by optimal foraging principles that reconciles sub-optimal choice with the view that current behavioral mechanisms were pruned by the optimizing action of natural selection. To move beyond retrospective speculation, we then review critical tests of the model, regarding both its assumptions and its (sometimes counterintuitive) predictions, all of which have been upheld. The overall contention is that (a) known mechanisms can be used to develop better ultimate accounts and that (b) to understand why mechanisms that generate suboptimal behavior evolved, we need to consider their adaptive value in the animal's characteristic ecology. Copyright © 2018 Elsevier B.V. All rights reserved.

Suboptimal control for drag reduction in turbulent pipe flow

International Nuclear Information System (INIS)

Choi, Jung Il; Sung, Hyung Jin; Xu, Chun Xiao

2001-01-01

A suboptimal control law in turbulent pipe flow is derived and tested. Two sensing variables ∂ρ/∂θ / w and ∂ν θ /∂r / w are applied with two actuations φ θ and φ γ . To test the suboptimal control law, direct numerical simulations of turbulent pipe flow at Re τ =150 are performed. When the control law is applied, a 13∼23% drag reduction is achieved. The most effective drag reduction is made at the pair of ∂υ θ /∂r / w and φ γ . An impenetrable virtual wall concept is useful for analyzing the near-wall suction and blowing. The virtual wall concept is useful for analyzing the near-wall behavior of the controlled flow. Comparison of the present suboptimal control with that of turbulent channel flow reveals that the curvature effect is insignificant

Genomic biomarkers of prenatal intrauterine inflammation in umbilical cord tissue predict later life neurological outcomes.

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Sloane K Tilley

Full Text Available Preterm birth is a major risk factor for neurodevelopmental delays and disorders. This study aimed to identify genomic biomarkers of intrauterine inflammation in umbilical cord tissue in preterm neonates that predict cognitive impairment at 10 years of age.Genome-wide messenger RNA (mRNA levels from umbilical cord tissue were obtained from 43 neonates born before 28 weeks of gestation. Genes that were differentially expressed across four indicators of intrauterine inflammation were identified and their functions examined. Exact logistic regression was used to test whether expression levels in umbilical cord tissue predicted neurocognitive function at 10 years of age.Placental indicators of inflammation were associated with changes in the mRNA expression of 445 genes in umbilical cord tissue. Transcripts with decreased expression showed significant enrichment for biological signaling processes related to neuronal development and growth. The altered expression of six genes was found to predict neurocognitive impairment when children were 10 years old These genes include two that encode for proteins involved in neuronal development.Prenatal intrauterine inflammation is associated with altered gene expression in umbilical cord tissue. A set of six of the differentially expressed genes predict cognitive impairment later in life, suggesting that the fetal environment is associated with significant adverse effects on neurodevelopment that persist into later childhood.

Low Cost, Simple, Intrauterine Insemination Procedure

African Journals Online (AJOL)

AJRH Managing Editor

quite simple intrauterine insemination technique which may be performed in developing countries, without the need of sophisticated ... Cytoplasmic Sperm Injection (ICSI), are quite ... were administered only once by intramuscular injection ...

Cytosine Methylation Dysregulation in Neonates Following Intrauterine Growth Restriction

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Bhagat, Tushar D.; Fazzari, Melissa J.; Verma, Amit; Barzilai, Nir; Greally, John M.

2010-01-01

Background Perturbations of the intrauterine environment can affect fetal development during critical periods of plasticity, and can increase susceptibility to a number of age-related diseases (e.g., type 2 diabetes mellitus; T2DM), manifesting as late as decades later. We hypothesized that this biological memory is mediated by permanent alterations of the epigenome in stem cell populations, and focused our studies specifically on DNA methylation in CD34+ hematopoietic stem and progenitor cells from cord blood from neonates with intrauterine growth restriction (IUGR) and control subjects. Methods and Findings Our epigenomic assays utilized a two-stage design involving genome-wide discovery followed by quantitative, single-locus validation. We found that changes in cytosine methylation occur in response to IUGR of moderate degree and involving a restricted number of loci. We also identify specific loci that are targeted for dysregulation of DNA methylation, in particular the hepatocyte nuclear factor 4α (HNF4A) gene, a well-known diabetes candidate gene not previously associated with growth restriction in utero, and other loci encoding HNF4A-interacting proteins. Conclusions Our results give insights into the potential contribution of epigenomic dysregulation in mediating the long-term consequences of IUGR, and demonstrate the value of this approach to studies of the fetal origin of adult disease. PMID:20126273

Maternal morbidity and mortality associated with delivery after intrauterine death

International Nuclear Information System (INIS)

Ifnan, F.; Jameel, M.B.

2006-01-01

To determine the maternal morbidity and mortality associated with delivery after intrauterine fetal death (IUFD) and to find out the place of fetal destructive procedures and cesarean section. All women were included in the present study who presented before the onset of labour pains, after intrauterine fetal death at 26 weeks or onward with singleton pregnancy. Assessment of maternal demographic characteristics, gestational age at fetal demise, delivery-IUFD interval, mode of delivery; vaginal with or without fetal destructive procedures/cesarean section and maternal complications were the main outcome measures. There were 1834 live birth and 63 deliveries with intrauterine fetal death. Mode of delivery was vaginal in 87.4% and cesarean section in 12.6% of the cases. Twelve (21%) of the vaginal deliveries were complicated by lower urogenital tract injuries in certain cases, whereas 75% (6/8) of patients delivered by cesarean section developed major postoperative complications like postpartum haemorrhage, shock, endometritis, peritonitis and wound dehiscence. No maternal death was identified. Rate of delivery with intrauterine fetal death was 34.3/1000 live-birth deliveries. (author)

Suboptimal maternal and paternal mental health are associated with child bullying perpetration.

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Shetgiri, Rashmi; Lin, Hua; Flores, Glenn

2015-06-01

This study examines associations between maternal and paternal mental health and child bullying perpetration among school-age children, and whether having one or both parents with suboptimal mental health is associated with bullying. The 2007 National Survey of Children's Health, a nationally-representative, random-digit-dial survey, was analyzed, using a parent-reported bullying measure. Suboptimal mental health was defined as fair/poor (vs. good/very good/excellent) parental self-reported mental and emotional health. Of the 61,613 parents surveyed, more than half were parents of boys and were white, 20% were Latino, 15% African American, and 7% other race/ethnicity. Suboptimal maternal (OR 1.4; 95% CI 1.1-1.8) and paternal (OR 1.5; 95% CI 1.1-2.2) mental health are associated with bullying. Compared with children with no parents with suboptimal mental health, children with only one or both parents with suboptimal mental health have higher bullying odds. Addressing the mental health of both parents may prove beneficial in preventing bullying.

Kidney outer medulla mitochondria are more efficient compared to cortex mitochondria as a strategy to sustain ATP production in a suboptimal environment.

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Schiffer, Tomas A; Gustafsson, Håkan; Palm, Fredrik

2018-05-30

The kidneys receive approximately 25% of cardiac output, which is a prerequisite in order to maintain sufficient glomerular filtration rate. However, both intrarenal regional renal blood flow and tissue oxygen levels are heterogeneous with decreasing levels in the inner part of the medulla. These differences in combination with the heterogeneous metabolic activity of the different nephron segment located in the different parts of the kidney may constitute a functional problem when challenged. The proximal tubule and the medullary thick ascending limb of Henle are considered to have the highest metabolic rate, which is relating to the high mitochondria content needed to sustain sufficient ATP production from oxidative phosphorylation in order to support high electrolyte transport activity in these nephron segments. Interestingly, the cells located in kidney medulla functions at the verge of hypoxia and the mitochondria may have adapted to the surrounding environment. However, little is known about intrarenal differences in mitochondria function. We therefore investigated functional differences between mitochondria isolated from kidney cortex and medulla of healthy normoglycemic rats were estimated using high-resolution respirometry. The results demonstrate that medullary mitochondria had a higher degree of coupling, are more efficient and have higher oxygen affinity, which would make them more suitable to function in an environment with limited oxygen supply. Furthermore, these results support the hypothesis that mitochondria of medullary cells have adapted to the normal hypoxic in vivo situation as a strategy of sustaining ATP production in a suboptimal environment.

Altered resting-state whole-brain functional networks of neonates with intrauterine growth restriction.

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Batalle, Dafnis; Muñoz-Moreno, Emma; Tornador, Cristian; Bargallo, Nuria; Deco, Gustavo; Eixarch, Elisenda; Gratacos, Eduard

2016-04-01

The feasibility to use functional MRI (fMRI) during natural sleep to assess low-frequency basal brain activity fluctuations in human neonates has been demonstrated, although its potential to characterise pathologies of prenatal origin has not yet been exploited. In the present study, we used intrauterine growth restriction (IUGR) as a model of altered neurodevelopment due to prenatal condition to show the suitability of brain networks to characterise functional brain organisation at neonatal age. Particularly, we analysed resting-state fMRI signal of 20 neonates with IUGR and 13 controls, obtaining whole-brain functional networks based on correlations of blood oxygen level-dependent (BOLD) signal in 90 grey matter regions of an anatomical atlas (AAL). Characterisation of the networks obtained with graph theoretical features showed increased network infrastructure and raw efficiencies but reduced efficiency after normalisation, demonstrating hyper-connected but sub-optimally organised IUGR functional brain networks. Significant association of network features with neurobehavioral scores was also found. Further assessment of spatiotemporal dynamics displayed alterations into features associated to frontal, cingulate and lingual cortices. These findings show the capacity of functional brain networks to characterise brain reorganisation from an early age, and their potential to develop biomarkers of altered neurodevelopment. Copyright © 2016 Elsevier Ltd. All rights reserved.

Guideline adherence is worth the effort: a cost-effectiveness analysis in intrauterine insemination care.

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Haagen, E C; Nelen, W L D M; Adang, E M; Grol, R P T M; Hermens, R P M G; Kremer, J A M

2013-02-01

Is optimal adherence to guideline recommendations in intrauterine insemination (IUI) care cost-effective from a societal perspective when compared with suboptimal adherence to guideline recommendations? Optimal guideline adherence in IUI care has substantial economic benefits when compared with suboptimal guideline adherence. Fertility guidelines are tools to help health-care professionals, and patients make better decisions about clinically effective, safe and cost-effective care. Up to now, there has been limited published evidence about the association between guideline adherence and cost-effectiveness in fertility care. In a retrospective cohort study involving medical record analysis and a patient survey (n = 415), interviews with staff members (n = 13) and a review of hospitals' financial department reports and literature, data were obtained about patient characteristics, process aspects and clinical outcomes of IUI care and resources consumed. In the cost-effectiveness analyses, restricted to four relevant guideline recommendations, the ongoing pregnancy rate per couple (effectiveness), the average medical and non-medical costs of IUI care, possible additional IVF treatment, pregnancy, delivery and period from birth up to 6 weeks after birth for both mother and offspring per couple (costs) and the incremental net monetary benefits were calculated to investigate if optimal guideline adherence is cost-effective from a societal perspective when compared with suboptimal guideline adherence. Seven hundred and sixty five of 1100 randomly selected infertile couples from the databases of the fertility laboratories of 10 Dutch hospitals, including 1 large university hospital providing tertiary care and 9 public hospitals providing secondary care, were willing to participate, but 350 couples were excluded because of ovulatory disorders or the use of donated spermatozoa (n = 184), still ongoing IUI treatment (n = 143) or no access to their medical records (n = 23). As

Intrauterine fertilization capsules--a clinical trial

DEFF Research Database (Denmark)

Lenz, S; Lindenberg, S; Sundberg, K

1991-01-01

Treatment of 26 women with tubal infertility was attempted using intrauterine capsules loaded with oocytes and spermatozoa. The stimulation protocol was as used for in vitro fertilization and embryo transfer and consisted of short-term use of Buserelin, human menopausal gonadotropin, and human...... and piston from an intrauterine device. Six complete capsules and parts of two other capsules were expelled. None of the women became pregnant, compared with a pregnancy rate of 21% per aspiration following in vitro fertilization and embryo transfer during the same period....... chorionic gonadotropin. Oocytes were collected by ultrasonically guided transvaginal aspiration, and spermatozoa were prepared by swim-up technique. The gametes were placed in agar capsules 4 hr after oocyte collection, and the capsules were introduced to the uterine fundus using an insertion tube...

Maternal determinants of intrauterine growth restriction in Goa, India: a case-control study

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DD Motghare

2014-01-01

Full Text Available Objective: To study the maternal determinants of intrauterine growth restriction. Methods: A case-control study was conducted at a tertiary care Hospital in the year 2009. Ninety eight cases of intrauterine growth restriction were compared to 98 controls, matched for newborns sex and type of delivery. Data was collected by interviewing the mother using a structured pretested schedule and perusal of antenatal records. Intrauterine growth restriction was defined as occurring if birth weight of the newborn is below 10th percentile for gestational age on the intrauterine growth curve. Data was analyzed using SPSS software version 17 package. Percentages, odds ratios with 95% CI and multiple logistic regression analysis were used wherever appropriate. Results: Maternal age, education, socioeconomic status and number of antenatal visits were found to be the significant socio-demographic factors associated with Intrauterine growth restriction while, maternal height, parity, previous spontaneous abortion, direct obstetric morbidity, indirect obstetric morbidity and anemia were the maternal biological factors found to be significantly associated on bivariate analysis. Multiple logistic regression analysis identified parity, previous spontaneous abortion, direct obstetric morbidity, indirect obstetric morbidity and antenatal visits as significant maternal determinants of intrauterine growth restriction. Conclusions: A focus on good antenatal care, especially on high risk pregnancies would go a long way in reducing the problem of intrauterine growth restriction in the community thereby ensuring a safe and healthy future for our youngest generation.

Intrauterine adhesions as a risk factor for failed first-trimester pregnancy termination.

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Luk, Janelle; Allen, Rebecca H; Schantz-Dunn, Julianna; Goldberg, Alisa B

2007-10-01

Risk factors for failed first-trimester surgical abortion include endometrial distortion caused by leiomyomas, uterine anomalies and malposition and cervical stenosis. This report introduces intrauterine adhesions as an additional risk factor. A multiparous woman presented for pregnancy termination at 6 weeks' gestation. Three suction-curettage attempts failed to remove what appeared to be an intrauterine pregnancy. Rising beta-hCG levels and concern for an interstitial ectopic pregnancy prompted a diagnostic laparoscopy and exploratory laparotomy without the identification of an ectopic pregnancy. After methotrexate treatment failed, the patient underwent ultrasound-guided hysteroscopy and suction curettage using a cannula with a whistle-cut aperture for the successful removal of a pregnancy implanted behind intrauterine adhesions. Intrauterine adhesions are a cause of failed surgical abortion. Ultrasound-guided hysteroscopy may be required for diagnosis.

Intra-uterine hematoma in pregnancy

DEFF Research Database (Denmark)

Glavind, K; Nøhr, S; Nielsen, P H

1991-01-01

In 60 patients with a live fetus and an intra-uterine hematoma (IUH) proven by ultrasonic scanning the outcome of pregnancy was spontaneous abortion in 12% and premature delivery in 10%. No correlation between the outcome of the pregnancy and the maximum size of the hematoma or the week...

Intrauterine Cannabis Exposure Affects Fetal Growth Trajectories: The Generation R Study

Science.gov (United States)

El Marroun, Hanan; Tiemeier, Henning; Steegers, Eric A. P.; Jaddoe, Vincent W. V.; Hofman, Albert; Verhulst, Frank C.; van den Brink, Wim; Huizink, Anja C.

2009-01-01

Objective: Cannabis is the most commonly consumed illicit drug among pregnant women. Intrauterine exposure to cannabis may result in risks for the developing fetus. The importance of intrauterine growth on subsequent psychological and behavioral child development has been demonstrated. This study examined the relation between maternal cannabis use…

Suboptimal performance on neuropsychological tests in patients with suspected chronic toxic encephalopathy

NARCIS (Netherlands)

van Hout, Moniek S. E.; Schmand, Ben; Wekking, Ellie M.; Hageman, Gerard; Deelman, Betto G.

2003-01-01

Suboptimal performance during neuropsychological testing can seriously complicate assessment in behavioral neurotoxicology. We present data on the prevalence of suboptimal performance in a group of Dutch patients with suspected chronic toxic encephalopathy (CTE) after long-term occupational exposure

Suboptimal performance on neuropsychological tests in patients with suspected chronic toxic encephalopathy

NARCIS (Netherlands)

van Hout, MSE; Schmand, B; Wekking, EM; Hageman, G; Deelman, BG

Suboptimal performance during neuropsychological testing can seriously complicate assessment in behavioral neurotoxicology. We present data on the prevalence of suboptimal performance in a group of Dutch patients with suspected chronic toxic encephalopathy (CTE) after long-term occupational exposure

Hysteroscopic sterilization of patient with intrauterine device Mirena®

Science.gov (United States)

Depes, Daniella De Batista; Pereira, Ana Maria Gomes; Yatabe, Salete; Lopes, Reginaldo Guedes Coelho

2013-01-01

ABSTRACT Tubal sterilization is the definitive procedure most often used worldwide to control fecundity. Laparoscopic ligature is safe, but invasive and with possible surgical and anesthetic risks. The hysteroscopic approach enables tubal occlusion at outpatient's setting without the need of incisions or anesthesia. A microdevice (Essure®) is inserted directly into the tubes and its polyethelene fibers cause obstruction of tubes in about three months. During this period, it is recommended that patients continue the use of a temporary birth control method. Several women use the levonorgestrel-releasing intrauterine system, which is called in the market as Mirena®. This report evaluated the possibility of inserting Essure® without remove the intrauterine device; patient tolerance to the procedure was also assessed. The tubal device was successfully placed in the patient without the need to remove Mirena®. After three months the intrauterine device was removed with no intercurrent events. PMID:23579753

Clinical and Demographic Characteristics of Women with Intrauterine Adhesion in Abuja, Nigeria

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Efena R. Efetie

2012-01-01

Full Text Available Objective. Infertility menstrual abnormalities continue to constitute a significant bulk of gynecological consultation in Africa. Both of these problems are sometimes traced to intrauterine adhesions which are preventable in the majority of cases. Study Design. A retrospective analysis of intrauterine adhesions at the National Hospital Abuja, Nigeria, was carried out, covering the period from 1st September 1999 to 1st September 2004. A total of 72 cases were analyzed. Statical analysis was done using 2. Results. The incidence of intrauterine adhesions was 1.73% of new patients. Mean age ± SD was 29.97±4.82 years. Patients who were Para 0 to 1 constituted 81.9% of the total. Intrauterine adhesions significantly (<0.02 occurred in nulliparae. The majority (68% were educated only up to secondary level which was significant (<0.05. Menstrual abnormalities were present in 90.3%. The commonest predisposing factor identified was a history of dilatation and curettage or uterine evacuation. Conclusion. Intrauterine adhesions are associated with lower educational status and low parity. Increasing educational targets nationally, poverty alleviation, nationwide retraining in manual vacuum aspiration, and wider application of this technique are recommended.

Trend in the use of Intra-uterine Contraceptive Device (IUCD ,TCU ...

African Journals Online (AJOL)

OBJECTIVE: To estimate the acceptance rate and trend of Intrauterine Contraceptive Device (IUCD) use in Enugu,Nigeria PATIENTS AND METHODS: A review of all new acceptors of intrauterine contraceptive device (IUCD) over a nine year period(1999-2007) . RESULTS: A total of 133,375 clients were seen at the UNTH ...

Intrauterine exposure to tobacco and executive functioning in high school.

Science.gov (United States)

Rose-Jacobs, Ruth; Richardson, Mark A; Buchanan-Howland, Kathryn; Chen, Clara A; Cabral, Howard; Heeren, Timothy C; Liebschutz, Jane; Forman, Leah; Frank, Deborah A

2017-07-01

Executive functioning (EF), an umbrella construct encompassing gradual maturation of cognitive organization/management processes, is important to success in multiple settings including high school. Intrauterine tobacco exposure (IUTE) correlates with negative cognitive/behavioral outcomes, but little is known about its association with adolescent EF and information from real-life contexts is sparse. We evaluated the impact of IUTE on teacher-reported observations of EF in urban high school students controlling for covariates including other intrauterine and adolescent substance exposures. A prospective low-income birth cohort (51% male; 89% African American/Caribbean) was followed through late adolescence (16-18 years old). At birth, intrauterine exposures to cocaine and other substances (52% cocaine, 52% tobacco, 26% marijuana, 26% alcohol) were identified by meconium and/or urine assays, and/or maternal self-report. High school teachers knowledgeable about the student and unaware of study aims were asked to complete the Behavior Rating Inventory of Executive Functioning-Teacher Form (BRIEF-TF) annually. Teachers completed at least one BRIEF-TF for 131 adolescents. Multivariable analyses included controls for: demographics; intrauterine cocaine, marijuana, and alcohol exposures; early childhood exposures to lead; and violence exposure from school-age to adolescence. IUTE was associated with less optimal BRIEF-TF Behavioral Regulation scores (p <0.05). Other intrauterine substance exposures did not predict less optimal BRIEF-TF scores, nor did exposures to violence, lead, nor adolescents' own substance use. IUTE is associated with offspring's less optimal EF. Prenatal counseling should emphasize abstinence from tobacco, as well as alcohol and illegal substances. Copyright © 2017 Elsevier B.V. All rights reserved.

Frequency and predictors of suboptimal glycemic control in an African diabetic population

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Kibirige D

2017-02-01

Full Text Available Davis Kibirige,1 George Patrick Akabwai,2 Leaticia Kampiire,3 Daniel Ssekikubo Kiggundu,4 William Lumu5 1Department of Medicine/Diabetic and Hypertension Clinics, Our Lady of Consolota Hospital, Kisubi, 2Baylor College of Medicine, Children’s Foundation, 3Infectious Diseases Research Collaboration, Kampala, 4Nephrology Unit, Mulago National Referral and Teaching Hospital, Kampala, 5Department of Medicine and Diabetes/Endocrine Unit, Mengo Hospital, Mengo, Uganda Background: Persistent suboptimal glycemic control is invariably associated with onset and progression of acute and chronic diabetic complications in diabetic patients. In Uganda, studies documenting the magnitude and predictors of suboptimal glycemic control in adult ambulatory diabetic patients are limited. This study aimed at determining the frequency and predictors of suboptimal glycemic control in adult diabetic patients attending three urban outpatient diabetic clinics in Uganda. Methods: In this hospital-based cross-sectional study, eligible ambulatory adult diabetic patients attending outpatient diabetic clinics of three urban hospitals were consecutively enrolled over 11 months. Suboptimal glycemic control was defined as glycated hemoglobin (HbA1c level ≥7%. Multivariable analysis was applied to determine the predictors. Results: The mean age of the study participants was 52.2±14.4 years, and the majority of them were females (283, 66.9%. The median (interquartile range HbA1c level was 9% (6.8%–12.4%. Suboptimal glycemic control was noted in 311 study participants, accounting for 73.52% of the participants. HbA1c levels of 7%–8%, 8.1%–9.9%, and ≥10% were noted in 56 (13.24%, 76 (17.97%, and 179 (42.32% study participants, respectively. The documented predictors of suboptimal glycemic control were metformin monotherapy (odds ratio: 0.36, 95% confidence interval: 0.21–0.63, p<0.005 and insulin therapy (odds ratio: 2.41, 95% confidence interval: 1.41–4.12, p=0

Intrauterine thrombosis of umbilical artery - case report

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Gustavo Henrique de Oliveira

Full Text Available ABSTRACT: CONTEXT: Umbilical cord thrombosis is related to greater fetal and perinatal morbidity and mortality. It is usually associated with umbilical cord abnormalities that lead to mechanical compression with consequent vascular ectasia. Its correct diagnosis and clinical management remains a challenge that has not yet been resolved. CASE REPORT: This study reports a case of umbilical artery thrombosis that occurred in the second half of a pregnancy. The umbilical cord was long, thin and overly twisted and the fetus presented severe intrauterine growth restriction. The clinical and histopathological findings from this case are described. CONCLUSIONS: This case report emphasizes the difficulty in diagnosing and clinically managing abnormalities of intrauterine life with a high chance of perinatal complications.

Predictive factors for pregnancy outcome following controlled ovarian stimulation and intrauterine insemination

International Nuclear Information System (INIS)

Yildrim, G.; Turkgeldi, L.S.; Koroglu, N.; Mervetalmac, A.

2017-01-01

To establish predictive factors for positive pregnancy outcome in cases of controlled ovarian stimulation and intrauterine insemination. Methods: The retrospective study was conducted at Kanuni Sultan Suleyman Training and Research Hospital and comprised subjects having undergone ovulation induction cycles and intrauterine insemination between June 2010 and June 2015. Data was analysed in terms of various parameters affecting clinical pregnancy rates. SPSS 23 was used for statistical analysis. Results: There were 475 patients having undergone a total of 923 cycles. Pregnancy was established in 133(28%) patients. Univariate analysis of biological/clinical variables revealed the presence of secondary infertility, high endometrial thickness, antral follicle number, post wash total motile sperm count and midluteal progesterone levels following intrauterine insemination to be associated with positive pregnancy outcomes (p<0.05 each). Multiple logistic regression analysis was performed to establish factors that affected the pregnancy rate. The aetiology and type of infertility and high midluteal progesterone levels following intrauterine insemination were found to be statistically significant predictors of pregnancy (p<0.05 each). Conclusion: The best chance of pregnancy was found in cases with anovulatory infertility, a history of prior pregnancy, and high midluteal progesterone levels following treatment with gonadotrophins and intrauterine insemination. (author)

Embryo transcriptome response to environmental factors: implication for its survival under suboptimal conditions.

Science.gov (United States)

Salilew-Wondim, Dessie; Tesfaye, Dawit; Hoelker, Michael; Schellander, Karl

2014-09-01

After its formation, the mammalian zygote undergoes a series of morphological, physiological and biochemical alterations prior to undergoing cell differentiation. The zygote is then transformed into a complex multicellular organism in a defined time window which may differ between species. These orderly embryonic developmental events are tightly regulated by temporal and spatial activation and/or deactivation of genes and gene products. This phenomenon may in turn be dependent on the intrinsic characteristics of the embryo itself, the physiological and biochemical composition of the maternal environment or by in vitro culture condition. In fact, when embryos are subjected to suboptimal culture condition, some of the embryos may escape the environmental stress by activating certain transcripts and some others which are unable to activate anti-stress agents may die or exhibit abnormal development. This phenomenon may partly depend on transcripts and proteins stored during oogenesis. Indeed after embryonic genome activation, the embryo destiny is governed by its own transcripts and protein synthesized over time. Therefore, this review begins by highlighting the type and quality of transcripts accumulated or degraded during oogenesis and its impact on the embryo survival. Thereafter, emphasis is given to the transcriptome response of preimplantation embryos to suboptimal culture conditions. In addition, the long term effect of preimplantation culture environment on the transcriptome response embryos/fetus during peri and post implantation has been addressed. Finally, a brief summary of the epigenetic control of culture induced genetic variation of the embryos has been highlighted. Copyright © 2014 Elsevier B.V. All rights reserved.

Intra-uterine insemination for male subfertility

NARCIS (Netherlands)

Bensdorp, A. J.; Cohlen, B. J.; Heineman, M. J.; Vandekerckhove, P.

2007-01-01

BACKGROUND: Intra-uterine insemination (IUI) is one of the most frequently used fertility treatments for couples with male subfertility. Its use, especially when combined with ovarian hyperstimulation (OH) has been subject of discussion. Although the treatment itself is less invasive and expensive

Assessment of Risk Factors of Intrauterine Adhesions in Patients With Induced Abortion and the Curative Effect of Hysteroscopic Surgery.

Science.gov (United States)

Mo, Xiaoliang; Qin, Guirong; Zhou, Zhoulin; Jiang, Xiaoli

2017-10-03

To explore the risk factors for intrauterine adhesions in patients with artificial abortion and clinical efficacy of hysteroscopic dissection. 1500 patients undergoing artificial abortion between January 2014 and June 2015 were enrolled into this study. The patients were divided into two groups with or without intrauterine adhesions. Univariate and Multiple logistic regression were conducted to assess the effects of multiple factors on the development of intrauterine adhesions following induced abortion. The incidence rate for intrauterine adhesions following induced abortion is 17.0%. Univariate showed that preoperative inflammation, multiple pregnancies and suction evacuation time are the influence risk factors of intrauterine adhesions. Multiple logistic regression demonstrates that multiple pregnancies, high intrauterine negative pressure, and long suction evacuation time are independent risk factors for the development of intrauterine adhesions following induced abortion. Additionally, intrauterine adhesions were observed in 105 mild, 80 moderate, and 70 severe cases. The cure rates for these three categories of intrauterine adhesions by hysteroscopic surgery were 100.0%, 93.8%, and 85.7%, respectively. Multiple pregnancies, high negative pressure suction evacuation and long suction evacuation time are independent risk factors for the development of intrauterine adhesions following induced abortions. Hysteroscopic surgery substantially improves the clinical outcomes of intrauterine adhesions.

Prevalence and Determinants of Suboptimal Vitamin D Levels in a Multiethnic Asian Population.

Science.gov (United States)

Man, Ryan Eyn Kidd; Li, Ling-Jun; Cheng, Ching-Yu; Wong, Tien Yin; Lamoureux, Ecosse; Sabanayagam, Charumathi

2017-03-22

This population-based cross-sectional study examined the prevalence and risk factors of suboptimal vitamin D levels (assessed using circulating 25-hydroxycholecalciferol (25(OH)D)) in a multi-ethnic sample of Asian adults. Plasma 25(OH)D concentration of 1139 Chinese, Malay and Indians (40-80 years) were stratified into normal (≥30 ng/mL), and suboptimal (including insufficiency and deficiency, 65 years), Malay and Indian ethnicities (compared to Chinese ethnicity), and higher body mass index, HbA1c, education and income levels were associated with suboptimal 25(OH)D concentration ( p < 0.05). In a population-based sample of Asian adults, approximately 75% had suboptimal 25(OH)D concentration. Targeted interventions and stricter reinforcements of existing guidelines for vitamin D supplementation are needed for groups at risk of vitamin D insufficiency/deficiency.

Motor and cortico-striatal-thalamic connectivity alterations in intrauterine growth restriction.

Science.gov (United States)

Eixarch, Elisenda; Muñoz-Moreno, Emma; Bargallo, Nuria; Batalle, Dafnis; Gratacos, Eduard

2016-06-01

Intrauterine growth restriction is associated with short- and long-term neurodevelopmental problems. Structural brain changes underlying these alterations have been described with the use of different magnetic resonance-based methods that include changes in whole structural brain networks. However, evaluation of specific brain circuits and its correlation with related functions has not been investigated in intrauterine growth restriction. In this study, we aimed to investigate differences in tractography-related metrics in cortico-striatal-thalamic and motor networks in intrauterine growth restricted children and whether these parameters were related with their specific function in order to explore its potential use as an imaging biomarker of altered neurodevelopment. We included a group of 24 intrauterine growth restriction subjects and 27 control subjects that were scanned at 1 year old; we acquired T1-weighted and 30 directions diffusion magnetic resonance images. Each subject brain was segmented in 93 regions with the use of anatomical automatic labeling atlas, and deterministic tractography was performed. Brain regions included in motor and cortico-striatal-thalamic networks were defined based in functional and anatomic criteria. Within the streamlines that resulted from the whole brain tractography, those belonging to each specific circuit were selected and tractography-related metrics that included number of streamlines, fractional anisotropy, and integrity were calculated for each network. We evaluated differences between both groups and further explored the correlation of these parameters with the results of socioemotional, cognitive, and motor scales from Bayley Scale at 2 years of age. Reduced fractional anisotropy (cortico-striatal-thalamic, 0.319 ± 0.018 vs 0.315 ± 0.015; P = .010; motor, 0.322 ± 0.019 vs 0.319 ± 0.020; P = .019) and integrity cortico-striatal-thalamic (0.407 ± 0.040 vs 0.399 ± 0.034; P = .018; motor, 0.417 ± 0.044 vs 0

Review: Neuroinflammation in intrauterine growth restriction.

Science.gov (United States)

Wixey, Julie A; Chand, Kirat K; Colditz, Paul B; Bjorkman, S Tracey

2017-06-01

Disruption to the maternal environment during pregnancy from events such as hypoxia, stress, toxins, inflammation, and reduced placental blood flow can affect fetal development. Intrauterine growth restriction (IUGR) is commonly caused by chronic placental insufficiency, interrupting supply of oxygen and nutrients to the fetus resulting in abnormal fetal growth. IUGR is a major cause of perinatal morbidity and mortality, occurring in approximately 5-10% of pregnancies. The fetal brain is particularly vulnerable in IUGR and there is an increased risk of long-term neurological disorders including cerebral palsy, epilepsy, learning difficulties, behavioural difficulties and psychiatric diagnoses. Few studies have focused on how growth restriction interferes with normal brain development in the IUGR neonate but recent studies in growth restricted animal models demonstrate increased neuroinflammation. This review describes the role of neuroinflammation in the progression of brain injury in growth restricted neonates. Identifying the mediators responsible for alterations in brain development in the IUGR infant is key to prevention and treatment of brain injury in these infants. Copyright © 2016 Elsevier Ltd. All rights reserved.

Action-Dependent Photobiomodulation on Health, Suboptimal Health, and Disease

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Timon Cheng-Yi Liu

2014-01-01

Full Text Available The global photobiomodulation (PBM on an organism was studied in terms of function-specific homeostasis (FSH and scale-free functional network in this paper. A function can be classified into a normal function in its FSH and a dysfunctional function far from its FSH. An FSH-specific stress (FSS disrupting an FSH can also be classified into a successful stress in its FSS-specific homeostasis (FSSH and a chronic stress far from its FSSH. The internal functions of an organism can be divided into essential, special nonessential, and general nonessential functions. Health may be defined as a state of an organism in which all the essential and special nonessential functions are normal or their stresses are successful. Suboptimal health may be defined as a state of a disease-free organism in which only some special nonessential functions are dysfunctional in comparison with its healthy state. Disease may be defined as a state of an organism which is not in both health and suboptimal health. The global PBM of health, suboptimal health, or disease suggested that the PBM may depend on the organism action.

Exogenous recombinant human growth hormone effects during suboptimal energy and zinc intake

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Duro Debora

2005-04-01

Full Text Available Abstract Background Energy and Zinc (Zn deficiencies have been associated with nutritional related growth retardation as well as growth hormone (GH resistance. In this study, the relationship between suboptimal energy and/or Zn intake and growth in rats and their response to immunoreactive exogenous recombinant human GH (GHi, was determined. Results Rats treated with GHi and fed ad-libitum energy and Zn (100/100 had increased IGFBP-3 (p Conclusion These results suggest that GHi enhances weight gain in rats with suboptimal energy and Zn intake but does not modify energy expenditure or physical activity index. Suboptimal Zn intake did not exacerbate the reduced growth or decrease in energy expenditure observed with energy restriction.

Inherited thrombophilia in pregnant women with intrauterine growth restriction.

Science.gov (United States)

Coriu, Letitia; Copaciu, Elena; Tulbure, Dan; Talmaci, Rodica; Secara, Diana; Coriu, Daniel; Cirstoiu, Monica

2014-12-01

Intrauterine growth restriction (IUGR) is a major cause of fetal morbidity and mortality during pregnancy. The role of mutation in the factor V gene, prothrombin gene, MTHFR gene, as risk factors for intrauterine growth restriction during pregnancy, is not very well known so far. This is a retrospective study of 151 pregnant women with a history of complicated pregnancy: intrauterine growth restriction, preeclampsia, recurrent pregnancy loss or maternal venous thromboembolism, who were admitted in Bucharest Emergency University Hospital, during the period January 2010 to July 2014. Genetic testing was performed for all the cases to detect: factor V Leiden mutation, G20210A mutation in the prothrombin gene, C677T mutation and A1298C mutation in methylenetetrahydrofolate reductase (MTHFR) gene. Blood samples were obtained as soon as the diagnosis of intrauterine growth restriction was established with ultrasonography. The following gene mutations were associated with increased risk of IUGR: G20210A prothrombin gene mutation (OR 4.81, 95% CI 1.05 - 2.22, p= 0.043), G1691A factor V gene mutation (factor V Leiden) (OR 1.58, 95% CI 0.61 - 4.080, p= 0.347), C677T MTHFR gene mutation (OR 1.61, 95% CI 0.79 to 3.26, p= 0.186), compound heterozygous MTHFR C677T and A1298C (OR 1.66, 95% CI 0.81- 3.42, p= 0.169). Particularly, for G20210A prothrombin gene mutation we found statistically significant risk (p≤0.05) of IUGR.

Sacral Nerve Stimulation for Constipation: Suboptimal Outcome and Adverse Events

DEFF Research Database (Denmark)

Maeda, Yasuko; Lundby, Lilli; Buntzen, Steen

2010-01-01

Sacral nerve stimulation is an emerging treatment for patients with severe constipation. There has been no substantial report to date on suboptimal outcomes and complications. We report our experience of more than 6 years by focusing on incidents and the management of reportable events.......Sacral nerve stimulation is an emerging treatment for patients with severe constipation. There has been no substantial report to date on suboptimal outcomes and complications. We report our experience of more than 6 years by focusing on incidents and the management of reportable events....

The Probable Effects of Cytokines in Intrauterine Infections and Perinatal Brain Injury

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Mehmet Oflaz

2013-10-01

Full Text Available Perinatal brain injuries and the subsequent development of cerebral palsy are closely associated with intrauterine infections and inflammatory response. Premature prenatal rupture of membranes and premature births are also closely linked to infections and inflammation, and the presence of both infection / inflammation and premature birth together greatly increase the risk for cerebral palsy. Periventricular leukolamacia, a common neonatal brain white matter lesion, is a major risk factor for cerebral palsy. Inflammatory cytokines released during the course of intrauterine infection play an important role in the genesis of brain white matter lesion. Maternal intrauterine infection appears to increase the risk of preterm delivery, which in turn is associated with an increased risk of intraventricular hemorrhage, neonatal white matter damage, and subsequent cerebral palsy. Proinflammatory cytokines IL-1, IL-6 and Tumor necrosis factor-%u03B1 might be the link between prenatal intrauterine infection and neonatal brain damage, and interrupting the proinflammatory cytokine cascade might prevent later disability in those born near the end of the second trimester.

Comparison of genital microbial isolates between intrauterine ...

African Journals Online (AJOL)

Background:In the past, the use of intrauterine contraceptive device (IUCD), in particular, Dalkon Shield was found to be associated with ... of these residing in Asia. .... to air dry, labeled and transferred to the laboratory for Gram staining.

Fetal environment

International Nuclear Information System (INIS)

Kinare, Arun

2008-01-01

The intrauterine environment has a strong influence on pregnancy outcome. The placenta and the umbilical cord together form the main supply line of the fetus. Amniotic fluid also serves important functions. These three main components decide whether there will be an uneventful pregnancy and the successful birth of a healthy baby. An insult to the intrauterine environment has an impact on the programming of the fetus, which can become evident in later life, mainly in the form of cardiovascular diseases, diabetes, and certain learning disabilities. The past two decades have witnessed major contributions from researchers in this field, who have included ultrasonologists, epidemiologists, neonatologists, and pediatricians. Besides being responsible for these delayed postnatal effects, abnormalities of the placenta, umbilical cord, and amniotic fluid also have associations with structural and chromosomal disorders. Population and race also influence pregnancy outcomes to some extent in certain situations. USG is the most sensitive imaging tool currently available for evaluation of these factors and can offer considerable information in this area. This article aims at reviewing the USG-related developments in this area and the anatomy, physiology, and various pathologies of the placenta, umbilical cord, and the amniotic fluid

Gibberellin Is Involved in Inhibition of Cucumber Growth and Nitrogen Uptake at Suboptimal Root-Zone Temperatures.

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Longqiang Bai

Full Text Available Suboptimal temperature stress often causes heavy yield losses of vegetables by suppressing plant growth during winter and early spring. Gibberellin acid (GA has been reported to be involved in plant growth and acquisition of mineral nutrients. However, no studies have evaluated the role of GA in the regulation of growth and nutrient acquisition by vegetables under conditions of suboptimal temperatures in greenhouse. Here, we investigated the roles of GA in the regulation of growth and nitrate acquisition of cucumber (Cucumis sativus L. plants under conditions of short-term suboptimal root-zone temperatures (Tr. Exposure of cucumber seedlings to a Tr of 16°C led to a significant reduction in root growth, and this inhibitory effect was reversed by exogenous application of GA. Expression patterns of several genes encoding key enzymes in GA metabolism were altered by suboptimal Tr treatment, and endogenous GA concentrations in cucumber roots were significantly reduced by exposure of cucumber plants to 16°C Tr, suggesting that inhibition of root growth by suboptimal Tr may result from disruption of endogenous GA homeostasis. To further explore the mechanism underlying the GA-dependent cucumber growth under suboptimal Tr, we studied the effect of suboptimal Tr and GA on nitrate uptake, and found that exposure of cucumber seedlings to 16°C Tr led to a significant reduction in nitrate uptake rate, and exogenous application GA can alleviate the down-regulation by up regulating the expression of genes associated with nitrate uptake. Finally, we demonstrated that N accumulation in cucumber seedlings under suboptimal Tr conditions was improved by exogenous application of GA due probably to both enhanced root growth and nitrate absorption activity. These results indicate that a reduction in endogenous GA concentrations in roots due to down-regulation of GA biosynthesis at transcriptional level may be a key event to underpin the suboptimal Tr

Defining and predicting 'intrauterine fetal renal failure' in congenital lower urinary tract obstruction.

Science.gov (United States)

Ruano, Rodrigo; Safdar, Adnan; Au, Jason; Koh, Chester J; Gargollo, Patricio; Shamshirsaz, Alireza A; Espinoza, Jimmy; Cass, Darrell L; Olutoye, Oluyinka O; Olutoye, Olutoyin A; Welty, Stephen; Roth, David R; Belfort, Michael A; Braun, Michael C

2016-04-01

The aim of this study was to identify predictors of 'intrauterine fetal renal failure' in fetuses with severe congenital lower urinary tract obstruction (LUTO). We undertook a retrospective study of 31 consecutive fetuses with a diagnosis of LUTO in a tertiary Fetal Center between April 2013 and April 2015. Predictors of 'intrauterine fetal renal failure' were evaluated in those infants with severe LUTO who had either a primary composite outcome measure of neonatal death in the first 24 h of life due to severe pulmonary hypoplasia or a need for renal replacement therapy within 7 days of life. The following variables were analyzed: fetal bladder re-expansion 48 h after vesicocentesis, fetal renal ultrasound characteristics, fetal urinary indices, and amniotic fluid volume. Of the 31 fetuses included in the study, eight met the criteria for 'intrauterine fetal renal failure'. All of the latter had composite poor postnatal outcomes based on death within 24 h of life (n = 6) or need for dialysis within 1 week of life (n = 2). The percentage of fetal bladder refilling after vesicocentesis at time of initial evaluation was the only predictor of 'intrauterine fetal renal failure' (cut-off <27 %, area under the time-concentration curve 0.86, 95 % confidence interval 0.68-0.99; p = 0.009). We propose the concept of 'intrauterine fetal renal failure' in fetuses with the most severe forms of LUTO. Fetal bladder refilling can be used to reliably predict 'intrauterine fetal renal failure', which is associated with severe pulmonary hypoplasia or the need for dialysis within a few days of life.

Left ventricular dimensions, systolic functions, and mass in term neonates with symmetric and asymmetric intrauterine growth restriction.

Science.gov (United States)

Cinar, Bahar; Sert, Ahmet; Gokmen, Zeynel; Aypar, Ebru; Aslan, Eyup; Odabas, Dursun

2015-02-01

Previous studies have demonstrated structural changes in the heart and cardiac dysfunction in foetuses with intrauterine growth restriction. There are no available data that evaluated left ventricular dimensions and mass in neonates with symmetric and asymmetric intrauterine growth restriction. Therefore, we aimed to evaluate left ventricular dimensions, systolic functions, and mass in neonates with symmetric and asymmetric intrauterine growth restriction. We also assessed associated maternal risk factors, and compared results with healthy appropriate for gestational age neonates. In all, 62 asymmetric intrauterine growth restriction neonates, 39 symmetric intrauterine growth restriction neonates, and 50 healthy appropriate for gestational age neonates were evaluated by transthoracic echocardiography. The asymmetric intrauterine growth restriction group had significantly lower left ventricular end-systolic and end-diastolic diameters and posterior wall diameter in systole and diastole than the control group. The symmetric intrauterine growth restriction group had significantly lower left ventricular end-diastolic diameter than the control group. All left ventricular dimensions were lower in the asymmetric intrauterine growth restriction neonates compared with symmetric intrauterine growth restriction neonates (p>0.05), but not statistically significant except left ventricular posterior wall diameter in diastole (3.08±0.83 mm versus 3.54 ±0.72 mm) (pintrauterine growth restriction groups had significantly lower relative posterior wall thickness (0.54±0.19 versus 0.48±0.13 versus 0.8±0.12), left ventricular mass (9.8±4.3 g versus 8.9±3.4 g versus 22.2±5.7 g), and left ventricular mass index (63.6±29.1 g/m2 versus 54.5±24.4 g/m2 versus 109±28.8 g/m2) when compared with the control group. Our study has demonstrated that although neonates with both symmetric and asymmetric intrauterine growth restriction had lower left ventricular dimensions, relative

Meckel's diverticulum: the lead point of intrauterine intussusception ...

African Journals Online (AJOL)

Meckel's diverticulum: the lead point of intrauterine intussusception with subsequent intestinal atresia in a newborn. Viet H. Le, Paul A. Perry, Allyson L. Hale, Robert L. Gates, John C. Chandler ...

Interventions for intrauterine resuscitation in suspected fetal distress during term labor : A systematic review

NARCIS (Netherlands)

Bullens, L.; van Runnard Heimel, P.J.; van der Hout-van der Jagt, M.B.; Oei, G.

IMPORTANCE: Intrauterine resuscitation techniques during term labor are commonly used in daily clinical practice. Evidence, however, to support the beneficial effect of intrauterine resuscitation techniques on fetal distress during labor is limited and sometimes contradictory. In contrast, some of

Sub-optimal birth weight in newborns of a high socioeconomic status population

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Conceição Aparecida de Mattos Segre

2008-09-01

Full Text Available Objective: To compare sub-optimal birth weight (2,500 to 2,999 g term newborns to appropriate for gestational age (birth weight ≥ 3,000 g term newborns, regarding maternal data and newborn morbidity and mortality. Methods: Single term newborns, appropriate for gestational age from a high socioeconomic population (n = 1,242 with birth weight ranging from 2,500 to 2,999 g (Group I were compared to 4,907 newborns with birth weight ≥ than 3,000 g (Group II. Maternal and newborn characteristics were compared between the groups. The Mann-Whitney test, χ2 test and multivariate analysis were used. The significance level adopted was p < 0.05. Rresults: The frequency of sub-optimal birth weight newborns in the population studied was 20.2%. There was a significant association between sub-optimal birth weight and maternal weight before pregnancy and body mass index, maternal weight gain, height, smoking habit and hypertension. Newborns’ 1-minute Apgar score, neonatal hypoglycemia, jaundice, transient tachypnea, congenital pneumonia and hospital stay were significantly different between the groups (p < 0.05. A significant relationship could not be established with the 5-minute Apgar score and pulmonary hypertension in both groups. Neonatal mortality did not differ between the groups. Cconclusions: Socioeconomic status was not a risk factor for sub-optimal birth weight in the studied population. Genetic and environmental factors were associated to sub-optimal weight and neonatal diseases. According to these data, this group of newborns should receive special attention from the health team.

Nomogram for suboptimal cytoreduction at primary surgery for advanced stage ovarian cancer.

Science.gov (United States)

Gerestein, Cornelis G; Eijkemans, Marinus J; Bakker, Jeanette; Elgersma, Otto E; van der Burg, Maria E L; Kooi, Geertruida S; Burger, Curt W

2011-11-01

Maximal cytoreduction to minimal residual tumor is the most important determinant of prognosis in patients with advanced stage epithelial ovarian cancer (EOC). Preoperative prediction of suboptimal cytoreduction, defined as residual tumor >1 cm, could guide treatment decisions and improve counseling. The objective of this study was to identify predictive computed tomographic (CT) scan and clinical parameters for suboptimal cytoreduction at primary cytoreductive surgery for advanced stage EOC and to generate a nomogram with the identified parameters, which would be easy to use in daily clinical practice. Between October 2005 and December 2008, all patients with primary surgery for suspected advanced stage EOC at six participating teaching hospitals in the South Western part of the Netherlands entered the study protocol. To investigate independent predictors of suboptimal cytoreduction, a Cox proportional hazard model with backward stepwise elimination was utilized. One hundred and fifteen patients with FIGO stage III/IV EOC entered the study protocol. Optimal cytoreduction was achieved in 52 (45%) patients. A suboptimal cytoreduction was predicted by preoperative blood platelet count (p=0.1990; odds ratio (OR)=1.002), diffuse peritoneal thickening (DPT) (p=0.0074; OR=3.021), and presence of ascites on at least two thirds of CT scan slices (p=0.0385; OR=2.294) with a for-optimism corrected c-statistic of 0.67. Suboptimal cytoreduction was predicted by preoperative platelet count, DPT and presence of ascites. The generated nomogram can, after external validation, be used to estimate surgical outcome and to identify those patients, who might benefit from alternative treatment approaches.

Induction versus expectant monitoring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT)

NARCIS (Netherlands)

Boers, K.E.; Vijgen, S.M.C.; Bijlenga, D.; van der Post, J.A.M.; Bekedam, D.J.; Kwee, A.; van der Salm, P.C.M.; van Pampus, M.G.; Spaanderman, M.E.A.; Boer, K.; Duvekot, J.J.; Bremer, H.A.; Hasaart, T.H.M.; Delemarre, F.M.C.; Bloemenkamp, K.W.M.; van Meir, C.A.; Willekes, C.; Wijnen, E.J.; Rijken, M.; le Cessie, S.; Roumen, F.J.M.E.; Thornton, J.G.; van Lith, J.M.M.; Mol, B.W.J.; Scherjon, S.A.

2010-01-01

Objective To compare the effect of induction of labour with a policy of expectant monitoring for intrauterine growth restriction near term. Design Multicentre randomised equivalence trial (the Disproportionate Intrauterine Growth Intervention Trial At Term (DIGITAT)). Setting Eight academic and 44

Induction versus expectant monitoring for intrauterine growth restriction at term : randomised equivalence trial (DIGITAT)

NARCIS (Netherlands)

Boers, K. E.; Vijgen, S. M. C.; Bijlenga, D.; van der Post, J. A. M.; Bekedam, D. J.; Kwee, A.; van der Salm, P. C. M.; van Pampus, M. G.; Spaanderman, M. E. A.; de Boer, K.; Duvekot, J. J.; Bremer, H. A.; Hasaart, T. H. M.; Delemarre, F. M. C.; Bloemenkamp, K. W. M.; van Meir, C. A.; Willekes, C.; Wijnen, E. J.; Rijken, M.; le Cessie, S.; Roumen, F. J. M. E.; Thornton, J. G.; van Lith, J. M. M.; Mol, B. W. J.; Scherjon, S. A.

2010-01-01

Objective To compare the effect of induction of labour with a policy of expectant monitoring for intrauterine growth restriction near term. Design Multicentre randomised equivalence trial (the Disproportionate Intrauterine Growth Intervention Trial At Term (DIGITAT)). Setting Eight academic and 44

Diagnostic Criteria for Transient Myocardial Ischemia in Newborn Infants with Intrauterine Growth Retardation

Directory of Open Access Journals (Sweden)

Umida F. Nasirova, PhD

2012-06-01

Full Text Available Metabolic and hemodynamic disturbances in newborns with intrauterine growth retardation resulting from the transferred intrauterine hypoxia, lead to the development of transient myocardial ischemia. Study included 158 newborn infants with intrauterine growth retardation, 83% of which have the asymmetric and 17% - the symmetric form of IUGR, revealed differences in heart rate due to higher dispersion parameters of cardiac rhythm. It was determined that in infants with intrauterine growth retardation heart rate, respiratory rate accelerated and blood pressure increased in compare with the newborns in the control group. According to the ECG examination results, were revealed the signs of focal changes of ST-T, accompanied by inversion of the ST-T segment below the isoline, which accompanied with the positive and peaked T waves, considered as myocardial ischemia. In infants with intrauterine growth retardation, survived after perinatal damage of the central nervous system, the prolongation of the QRST interval was noted in compare with the control group newborns, which could be an indicator of conjunction of hypoxic and ischemic changes in the myocardium. Clinical manifestations of transient myocardial ischemia followed by pale skin, acrocyanosis, and perioral cyanosis against dullness of heart sounds. Obtained results deepened an understanding of posthypoxic myocardial dysfunction, which is characterized by cardiac rhythm and conductivity disturbances, as well as changes in ventricular complex, and causing the need for electrocardiographic screening in the neonatal period

Management of foetal asphyxia by intrauterine foetal resuscitation

Science.gov (United States)

Velayudhareddy, S.; Kirankumar, H

2010-01-01

Management of foetal distress is a subject of gynaecological interest, but an anaesthesiologist should know about resuscitation, because he should be able to treat the patient, whenever he is directly involved in managing the parturient patient during labour analgesia and before an emergency operative delivery. Progressive asphyxia is known as foetal distress; the foetus does not breathe directly from the atmosphere, but depends on maternal circulation for its oxygen requirement. The oxygen delivery to the foetus depends on the placental (maternal side), placental transfer and foetal circulation. Oxygen transport to the foetus is reduced physiologically during uterine contractions in labour. Significant impairment of oxygen transport to the foetus, either temporary or permanent may cause foetal distress, resulting in progressive hypoxia and acidosis. Intrauterine foetal resuscitation comprises of applying measures to a mother in active labour, with the intention of improving oxygen delivery to the distressed foetus to the base line, if the placenta is functioning normally. These measures include left lateral recumbent position, high flow oxygen administration, tocolysis to reduce uterine contractions, rapid intravenous fluid administration, vasopressors for correction of maternal hypotension and amnioinfusion for improving uterine blood flow. Intrauterine Foetal Resuscitation measures are easy to perform and do not require extensive resources, but the results are encouraging in improving the foetal well-being. The anaesthesiologist plays a major role in the application of intrauterine foetal resuscitation measures. PMID:21189876

Management of foetal asphyxia by intrauterine foetal resuscitation

Directory of Open Access Journals (Sweden)

S Velayudhareddy

2010-01-01

Full Text Available Management of foetal distress is a subject of gynaecological interest, but an anaesthesiologist should know about resuscitation, because he should be able to treat the patient, whenever he is directly involved in managing the parturient patient during labour analgesia and before an emergency operative delivery. Progressive asphyxia is known as foetal distress; the foetus does not breathe directly from the atmosphere, but depends on maternal circulation for its oxygen requirement. The oxygen delivery to the foetus depends on the placental (maternal side, placental transfer and foetal circulation. Oxygen transport to the foetus is reduced physiologically during uterine contractions in labour. Significant impairment of oxygen transport to the foetus, either temporary or permanent may cause foetal distress, resulting in progressive hypoxia and acidosis. Intrauterine foetal resuscitation comprises of applying measures to a mother in active labour, with the intention of improving oxygen delivery to the distressed foetus to the base line, if the placenta is functioning normally. These measures include left lateral recumbent position, high flow oxygen administration, tocolysis to reduce uterine contractions, rapid intravenous fluid administration, vasopressors for correction of maternal hypotension and amnioinfusion for improving uterine blood flow. Intrauterine Foetal Resuscitation measures are easy to perform and do not require extensive resources, but the results are encouraging in improving the foetal well-being. The anaesthesiologist plays a major role in the application of intrauterine foetal resuscitation measures.

Expression of von Willebrand factor and caldesmon in the placental tissues of pregnancies complicated with intrauterine growth restriction.

Science.gov (United States)

Göksever Çelik, Hale; Uhri, Mehmet; Yildirim, Gökhan

2017-11-02

The decreased placental perfusion is the underlying reason for intrauterine growth restriction that in turn leads to reduced placental perfusion and ischemia. However, there are several issues to be understood in the pathophysiology of intrauterine growth restriction. We aimed to study whether any compensatory response in placental vascular bed occur in pregnancies complicated with intrauterine growth restriction by the immunohistochemical staining of von Willebrand factor and caldesmon in placental tissues. A total of 103 pregnant women was enrolled in the study including 50 patients who were complicated with IUGR and 50 uncomplicated control patients. The study was designed in a prospective manner. All placentas were also stained with von Willebrand factor and caldesmon monoclonal kits. The immunohistochemical staining of von Willebrand factor and caldesmon expressions in placental tissues were different between normal and intrauterine growth restriction group. The percentages of 2+ and 3+ von Willebrand factor expression were higher in the intrauterine growth restriction group comparing with the normal group, although the difference was not statistically significant. The intensity of caldesmon expression was significantly lower in the intrauterine growth restriction group in comparison with the normal group (p intrauterine growth restriction which is a hypoxic condition. But newly formed vessels are immature and not strong enough. Our study is important to clarify the pathophysiology and placental compensatory responses in intrauterine growth restriction.

A levonorgestrel-releasing intrauterine system embedded in the omentum in a woman with abdominal pain: a case report

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Phillips Kevin

2009-11-01

Full Text Available Abstract Introduction The Mirena intrauterine system has been licensed as a contraceptive in the United Kingdom since May 1995. The use of an intrauterine system as a primary method of contraception among women has been slowly increasing over the last few years and they now account for about 3% of contraceptive use in England. The Mirena intrauterine system now also has a license for the management of idiopathic menorrhagia. Women may be informed that the rate of uterine perforation associated with intrauterine contraceptive use is low (0-2.3 per 1000 insertions. The rate of perforation reported with the Mirena intrauterine system in a large observational cohort study was 0.9 per 1000 insertions. Case presentation In this case report, the diagnosis of an intraperitoneal Mirena intrauterine system was noted nearly four years after its insertion, despite the patient having had a vaginal hysterectomy and admissions to hospital in the interim with complaints of abdominal pain. Conclusion This case report demonstrates clearly that whenever there is a question of a intrauterine system having fallen out following an ultrasound scan report showing an empty uterus, clinicians should also perform an abdominal X-ray.

Suboptimal investments and M&A deals in emerging capital markets

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Cherkasova Victoria

2016-01-01

Full Text Available This paper focuses on the efficiency of target-company investment decisions before and after Merger & Acquisition deals. We study whether M&A deals help to solve the problem of suboptimal investment after the acquisition. Using a sample of 145 target companies from BRICS countries that were acquired during the period 2004-2014, we outline those that had over- or underinvested before the deal and show that more than half the companies managed to optimize the investment level after the deal. We determine the key factors that improve the inefficiency of investment decisions and demonstrate that the industry and country have an impact on the degree of suboptimal investment.

Suboptimal treatment adherence in bipolar disorder: impact on clinical outcomes and functioning

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Montes JM

2013-01-01

Full Text Available Jose Manuel Montes1, Jorge Maurino2, Consuelo de Dios3, Esteban Medina21Department of Psychiatry, Hospital Universitario del Sureste, 2AstraZeneca Medical Department, 3Department of Psychiatry, Hospital Universitario La Paz, Madrid, SpainBackground: The primary aim of this study was to assess drug treatment adherence in patients with bipolar disorder and to identify factors associated with adherence. The secondary aim was to analyze the impact of suboptimal adherence on clinical and functional outcomes.Methods: A cross-sectional study was conducted in a sample of outpatients receiving an oral antipsychotic drug. Medication adherence was assessed combining the 10-item Drug Attitude Inventory, the Morisky Green Adherence Questionnaire, and the Compliance Rating Scale. Logistic regression was used to determine significant variables associated with suboptimal adherence to medication.Results: Three hundred and three patients were enrolled into the study. The mean age was 45.9 ± 12.8 years, and 59.7% were females. Sixty-nine percent of patients showed suboptimal adherence. Disease severity and functioning were significantly worse in the suboptimal group than in the adherent group. Multivariate analysis showed depressive polarity of the last acute episode, presence of subsyndromal symptoms, and substance abuse/dependence to be significantly associated with suboptimal treatment adherence (odds ratios 3.41, 2.13, and 1.95, respectively.Conclusion: A high prevalence of nonadherence was found in an outpatient sample with bipolar disorder. Identification of factors related to treatment adherence would give clinicians the opportunity to select more adequately patients who are eligible for potential adherence-focused interventions.Keywords: bipolar disorder, treatment adherence, functioning, polarity, subsyndromal symptoms

[Associated factors in newborns with intrauterine growth retardation].

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Thompson-Chagoyán, Oscar C; Vega-Franco, Leopoldo

2008-01-01

To identify the risk factors implicated in the intrauterine growth retardation (IUGR) of neonates born in a social security institution. Case controls design study in 376 neonates: 188 with IUGR (weight RCIU in the population.

Intrauterine Growth Restriction: Hungry for an Answer

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Chu, Alison

2016-01-01

Intrauterine growth restriction (IUGR) has been defined in several ways, but in general describes a condition in which the fetus exhibits poor growth in utero. This complication of pregnancy poses a significant public health burden as well as increased morbidity and mortality for the offspring. In human IUGR, alteration in fetal glucose and insulin homeostasis occurs in an effort to conserve energy and survive at the expense of fetal growth in an environment of inadequate nutrient provision. Several animal models of IUGR have been utilized to study the effects of IUGR on fetal glucose handling, as well as the postnatal reprogramming of energy metabolite handling, which may be unmasked in adulthood as a maladaptive propensity for cardiometabolic disease. This developmental programming may be mediated in part by epigenetic modification of essential regulators of glucose homeostasis. Several pharmacological therapies and nonpharmacological lifestyle modifications have shown early promise in mitigating the risk for or severity of adult metabolic phenotypes but still require further study of unanticipated and/or untoward side effects. PMID:26889018

Intrauterine hypoxia: clinical consequences and therapeutic perspectives

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Thompson LP

2015-09-01

Full Text Available Loren P Thompson,1 Sarah Crimmins,1 Bhanu P Telugu,2 Shifa Turan1 1Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, USA; 2Department of Animal Sciences, University of Maryland, College Park, MD, USA Abstract: Intrauterine hypoxia is a significant clinical challenge in obstetrics that affects both the pregnant mother and fetus. Intrauterine hypoxia can occur in pregnant women living at high altitude and/or with cardiovascular disease. In addition, placental hypoxia can be generated by altered placental development and spiral artery remodeling leading to placental insufficiency and dysfunction. Both conditions can impact normal maternal cardiovascular homeostasis leading to preeclampsia and/or impair transfer of O2/nutrient supply resulting in fetal growth restriction. This review discusses the mechanisms underlying altered placental vessel remodeling, maternal and fetal consequences, patient management, and potential future therapies for improving these conditions. Keywords: fetal growth restriction, oxidative stress, extravillous trophoblast invasion, Doppler ultrasound, pulsatility index, preeclampsia 

Suboptimal care and maternal mortality among foreign-born women in Sweden

DEFF Research Database (Denmark)

Esscher, Annika; Binder-Finnema, Pauline; Bødker, Birgit

2014-01-01

that occurred in Sweden from 1988-2010. METHODS: A subset of maternal death records (n = 75) among foreign-born women from low- and middle-income countries and Swedish-born women were audited using structured implicit review. One case of foreign-born maternal death was matched with two native born Swedish cases...... language and suboptimal interpreter system or usage. Inadequate care occurred more often among the foreign-born (p = 0.04), whereas delays in consultation/referral and miscommunication between health care providers where equally common between the two groups. CONCLUSIONS: Suboptimal care factors, major...

A Suboptimal Power-Saving Transmission Scheme in Multiple Component Carrier Networks

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Chung, Yao-Liang; Tsai, Zsehong

Power consumption due to transmissions in base stations (BSs) has been a major contributor to communication-related CO2 emissions. A power optimization model is developed in this study with respect to radio resource allocation and activation in a multiple Component Carrier (CC) environment. We formulate and solve the power-minimization problem of the BS transceivers for multiple-CC networks with carrier aggregation, while maintaining the overall system and respective users' utilities above minimum levels. The optimized power consumption based on this model can be viewed as a lower bound of that of other algorithms employed in practice. A suboptimal scheme with low computation complexity is proposed. Numerical results show that the power consumption of our scheme is much better than that of the conventional one in which all CCs are always active, if both schemes maintain the same required utilities.

Low Cost, Simple, Intrauterine Insemination Procedure with ...

African Journals Online (AJOL)

During the last 30 years however, intrauterine insemination has evolved with the introduction of ovulation stimulating protocols and sperm preparation methods taken from assisted reproduction techniques. Costs have risen, but the success rate has not risen to the same extent. We have therefore developed a quite simple ...

Visually suboptimal bananas: How ripeness affects consumer expectation and perception.

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Symmank, Claudia; Zahn, Susann; Rohm, Harald

2018-01-01

One reason for the significant amount of food that is wasted in developed countries is that consumers often expect visually suboptimal food as being less palatable. Using bananas as example, the objective of this study was to determine how appearance affects consumer overall liking, the rating of sensory attributes, purchase intention, and the intended use of bananas. The ripeness degree (RD) of the samples was adjusted to RD 5 (control) and RD 7 (more ripened, visually suboptimal). After preliminary experiments, a total of 233 participants were asked to judge their satisfaction with the intensity of sensory attributes that referred to flavor, taste, and texture using just-about-right scales. Subjects who received peeled samples were asked after tasting, whereas subjects who received unpeeled bananas judged expectation and, after peeling and tasting, perception. Expected overall liking and purchase intention were significantly lower for RD 7 bananas. Purchase intention was still significantly different between RD 5 and RD 7 after tasting, whereas no difference in overall liking was observed. Significant differences between RD 5 and RD 7 were observed when asking participants for their intended use of the bananas. Concerning the sensory attributes, penalty analysis revealed that only the firmness of the RD 7 bananas was still not just-about-right after tasting. The importance that consumers attribute to the shelf-life of food had a pronounced impact on purchase intention of bananas with different ripeness degree. In the case of suboptimal bananas, the results demonstrate a positive relationship between the sensory perception and overall liking and purchase intention. Convincing consumers that visually suboptimal food is still tasty is of high relevance for recommending different ways of communication. Copyright © 2017 Elsevier Ltd. All rights reserved.

Screening, diagnosis, and management of intrauterine growth restriction.

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Lausman, Andrea; McCarthy, Fergus P; Walker, Melissa; Kingdom, John

2012-01-01

To provide comprehensive background knowledge relevant to the SOGC Maternal-Fetal Medicine Committee-approved guideline entitled "Intrauterine Growth Restriction: Screening, Diagnosis, and Management." Publications in English were retrieved through searches of PubMed or Medline, CINAHL, and the Cochrane Library in January 2011 using appropriate controlled vocabulary via MeSH terms (fetal growth restriction and small for gestational age) and any key words (fetal growth, restriction, growth retardation, intrauterine growth restriction [IUGR], low birth weight, small for gestational age). Results were restricted to systematic reviews, randomized controlled trials or controlled clinical trials, and high-quality prospective and retrospective observational studies. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. Evidence obtained from at least one properly randomized controlled trial, Cochrane Reviews, and high quality cohort data have been combined to provide clinicians with evidence to optimize their practice for screening, diagnosis, and management of intrauterine growth restriction. Considerable advances have been made to improve clinicians' ability to screen, diagnose, and manage pregnancies with suspected IUGR more effectively, including several properly randomized controlled trials. Pregnancies with late-onset IUGR may be managed equally effectively by early delivery or delayed delivery (with increased surveillance) anticipating favourable outcomes. By contrast, many aspects of the management of early-onset IUGR require further clinical trials.

An Estimation of the Risk of Pseudotumor Cerebri among Users of the Levonorgestrel Intrauterine Device

DEFF Research Database (Denmark)

Valenzuela, Reuben M; Rai, Ruju; Kirk, Brian H

2017-01-01

Because of a previous association of pseudotumor cerebri (PTC) with levonorgestrel, we wished to evaluate the use of levonorgestrel-eluting intrauterine devices ("levonorgestrel intrauterine systems", LNG-IUS) in our University of Utah and Rigshospitalet PTC patients. In our retrospective series,...

Language development in preschool children born after asymmetrical intrauterine growth retardation.

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Simić Klarić, Andrea; Kolundžić, Zdravko; Galić, Slavka; Mejaški Bošnjak, Vlatka

2012-03-01

After intrauterine growth retardation, many minor neurodevelopmental disorders may occur, especially in the motor skills domain, language and speech development, and cognitive functions. The assessment of language development and impact of postnatal head growth in preschool children born with asymmetrical intrauterine growth retardation. Examinees were born at term with birth weight below the 10th percentile for gestational age, parity and gender. Mean age at the time of study was six years and four months. The control group was matched according to chronological and gestational age, gender and maternal education with mean age six years and five months. There were 50 children with intrauterine growth retardation and 50 controls, 28 girls and 22 boys in each group. For the assessment of language development Reynell Developmental Language Scale, the Naming test and Mottier test were performed. There were statistically significant differences (p language comprehension, total expressive language (vocabulary, structure, content), naming skills and non-words repetition. Statistically significant positive correlations were found between relative growth of the head [(Actual head circumference - head circumference at birth)/(Body weight - birth weight)] and language outcome. Children with neonatal complications had lower results (p language comprehension and total expressive language. Intrauterine growth retardation has a negative impact on language development which is evident in preschool years. Slow postnatal head growth is correlated with poorer language outcome. Neonatal complications were negatively correlated with language comprehension and total expressive language. Copyright © 2011 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Hungry pigeons make suboptimal choices, less hungry pigeons do not.

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Laude, Jennifer R; Pattison, Kristina F; Zentall, Thomas R

2012-10-01

Hungry animals will often choose suboptimally by being attracted to reliable signals for food that occur infrequently (they gamble) over less reliable signals for food that occur more often. That is, pigeons prefer an option that 50 % of the time provides them with a reliable signal for the appearance of food but 50 % of the time provides them with a reliable signal for the absence of food (overall 50 % reinforcement) over an alternative that always provides them with a signal for the appearance of food 75 % of the time (overall 75 % reinforcement). The pigeons appear to choose impulsively for the possibility of obtaining the reliable signal for reinforcement. There is evidence that greater hunger is associated with greater impulsivity. We tested the hypothesis that if the pigeons were less hungry, they would be less impulsive and, thus, would choose more optimally (i.e., on the basis of the overall probability of reinforcement). We found that hungry pigeons choose the 50 % reinforcement alternative suboptimally but less hungry pigeons prefer the more optimal 75 % reinforcement. Paradoxically, pigeons that needed the food more received less of it. These findings have implications for how level of motivation may also affect human suboptimal choice (e.g., purchase of lottery tickets and playing slot machines).

Fatal illness associated with pulmonary hypertension in a neonate caused by intrauterine echovirus 11 infection

NARCIS (Netherlands)

Willems, A.; Benne, CA; Timmer, A; Bergman, K.A.

Nonpolio enterovirus (NPEV) infections are known to cause a wide range of illnesses in the neonatal period. In most cases, NPEV is presumed to be contracted during birth. Intrauterine NPEV infections occur infrequently. A case of Intrauterine echovirus 11 infection with pneumonia, persistent

Limited Uptake of Planned Intrauterine Devices During the Postpartum Period.

Science.gov (United States)

Salcedo, Jennifer; Moniaga, Natalie; Harken, Tabetha

2015-08-01

The primary objective of this study was to determine the percentage of women with a documented plan for postpartum intrauterine device (IUD) insertion who had a device inserted within 8 weeks of delivery. The secondary objective was to determine factors associated with successful initiation of postpartum IUDs as planned. We conducted a retrospective chart review of women who had at least one prenatal visit and delivered a viable pregnancy at our academic medical center. Methods of planned and established postpartum contraceptive methods were recorded, as well as demographic information and documented reasons for failure to initiate planned intrauterine contraception. A total of 110 women planned postpartum IUD placement. Of these women, 84 (76%) presented for at least one postpartum appointment. Only 22.6% (95% confidence interval 13.7-31.5) of those presenting for postpartum follow-up underwent IUD placement within 8 weeks of delivery. Women planning postpartum IUD insertion were just as likely as women with no planned postpartum contraceptive method to fail to establish contraception within 8 weeks (P = 0.55). Failure to establish planned postpartum intrauterine contraception occurs frequently, even in a setting with a high rate of postpartum follow-up.

Effect of intrauterine position on the radiosensitivity of rat embryos

International Nuclear Information System (INIS)

Ward, W.F.; Aceto, H. Jr.; Karp, C.H.

1977-01-01

Rats were exposed to gamma rays or helium ions on one of days 4 to 9 of gestation. Embryonic survival was recorded as a function of intrauterine position at autopsy on day 20 of gestation. Embryos located at the ovarian and cervical ends of the uterus experienced higher rates of mortality than did their littermates located at the middle of the uterine horn. This effect was observed in litters exposed to both radiation modalities on all days studied. The influence of intrauterine position on embryonic survival was directly proportional to radiation dose and to the number of fetuses occupying the uterus horn. Under the least advantageous conditions (i.e., a crowded uterine horn exposed to a moderately high radiation dose), the cervical embryo's probability of survival was less than half that of the litter as a whole. A disproportionately high rate of embryonic mortality at the cervical position was also observed in litters irradiated under hypoxic conditions, suggesting that the non-random distribution of radiation effect was not the result of variations in oxygen concentration within the uterus. In contrast, there was no indication that intrauterine position influenced the distribution of gross morphologic abnormalities in irradiated litters

Prognostic factors affecting outcome of intrauterine insemination ...

African Journals Online (AJOL)

for a rational use of the procedure so that couples do not waste time and money on ineffective therapy if it is not indicated. Objective: ... of intrauterine insemination procedures at a fertility center in Ondo, ... significant reduction in the side effects associated with the .... HMG alone or in combination with other drugs for ovarian.

Fetal programming of schizophrenia: select mechanisms.

Science.gov (United States)

Debnath, Monojit; Venkatasubramanian, Ganesan; Berk, Michael

2015-02-01

Mounting evidence indicates that schizophrenia is associated with adverse intrauterine experiences. An adverse or suboptimal fetal environment can cause irreversible changes in brain that can subsequently exert long-lasting effects through resetting a diverse array of biological systems including endocrine, immune and nervous. It is evident from animal and imaging studies that subtle variations in the intrauterine environment can cause recognizable differences in brain structure and cognitive functions in the offspring. A wide variety of environmental factors may play a role in precipitating the emergent developmental dysregulation and the consequent evolution of psychiatric traits in early adulthood by inducing inflammatory, oxidative and nitrosative stress (IO&NS) pathways, mitochondrial dysfunction, apoptosis, and epigenetic dysregulation. However, the precise mechanisms behind such relationships and the specificity of the risk factors for schizophrenia remain exploratory. Considering the paucity of knowledge on fetal programming of schizophrenia, it is timely to consolidate the recent advances in the field and put forward an integrated overview of the mechanisms associated with fetal origin of schizophrenia. Copyright © 2014 Elsevier Ltd. All rights reserved.

Comparative Performance Analysis of G-RAKE Receivers with Suboptimal Finger Placement

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K. B. Baltzis

2014-07-01

Full Text Available Generalized RAKE (G-RAKE reception reduces the total amount of interference and provides enhanced diversity by comprising extra fingers to collect information about interference and further using channel and impairment correlation estimates for fingers allocation. However, the hardware complexity and the excessive computational requirements of GRAKE receivers may restrict their application in real systems; thus, suboptimal solutions are commonly used. In this paper, we propose and evaluate three maximum likelihood G-RAKE structures for colored noise with suboptimal finger placement. In all implementations, the fingers are optimally distributed within a time window that spans from several chip periods before the first arriving multipath to several chip periods after the latest one. The first receiver has its fingers at integer multiples of the chip period while in the rest two structures the search window is segmented in halves and tenths of the chip duration. This work also extends earlier studies by thoroughly investigating the impact of fractionally spaced finger placement on system performance. Our analysis shows that a suboptimal finger allocation reduces hardware complexity with negligible performance loss. The impact of channel delay spread and processing gain on system performance is also investigated and gives interesting results.

Can extrauterine growth approximate intrauterine growth? Should it?

NARCIS (Netherlands)

Sauer, Pieter J. J.

Most studies evaluating the growth of preterm infants use the so-called intrauterine growth curve and reference fetus as standards. These curves might not be the optimal standards, however, for several reasons. The curves were constructed from small numbers of infants with uncertainty about

Non-contraceptive benefits of hormonal and intrauterine reversible contraceptive methods.

Science.gov (United States)

Bahamondes, Luis; Valeria Bahamondes, M; Shulman, Lee P

2015-01-01

Most contraceptive methods present benefits beyond contraception; however, despite a large body of evidence, many healthcare professionals (HCPs), users and potential users are unaware of those benefits. This review evaluates the evidence for non-contraceptive benefits of hormonal and non-hormonal contraceptive methods. We searched the medical publications in PubMed, POPLINE, CENTRAL, EMBASE and LILACS for relevant articles, on non-contraceptive benefits of the use of hormonal and intrauterine reversible contraceptive methods, which were published in English between 1980 and July 2014. Articles were identified using the following search terms: 'contraceptive methods', 'benefits', 'cancer', 'anaemia', 'heavy menstrual bleeding (HMB)', 'endometrial hyperplasia', 'endometriosis' and 'leiomyoma'. We identified, through the literature search, evidence that some combined oral contraceptives have benefits in controlling HMB and anaemia, reducing the rate of endometrial, ovarian and colorectal cancer and ectopic pregnancy as well as alleviating symptoms of premenstrual dysphoric disorder. Furthermore, the use of the levonorgestrel-releasing intrauterine system also controls HMB and anaemia and endometrial hyperplasia and cancer, reduces rates of endometrial polyps in users of tamoxifen and alleviates pain associated with endometriosis and adenomyosis. Depot medroxyprogesterone acetate controls crises of pain associated with sickle cell disease and endometriosis. Users of the etonogestrel-releasing contraceptive implant have the benefits of a reduction of pain associated with endometriosis, and users of the copper intrauterine device have reduced rates of endometrial and cervical cancer. Despite the high contraceptive effectiveness of many hormonal and intrauterine reversible contraceptive methods, many HCPs, users and potential users are concerned mainly about side effects and safety of both hormonal and non-hormonal contraceptive methods, and there is scarce information

Brain metabolite alterations in infants born preterm with intrauterine growth restriction: association with structural changes and neurodevelopmental outcome.

Science.gov (United States)

Simões, Rui V; Muñoz-Moreno, Emma; Cruz-Lemini, Mónica; Eixarch, Elisenda; Bargalló, Núria; Sanz-Cortés, Magdalena; Gratacós, Eduard

2017-01-01

Intrauterine growth restriction and premature birth represent 2 independent problems that may occur simultaneously and contribute to impaired neurodevelopment. The objective of the study was to assess changes in the frontal lobe metabolic profiles of 1 year old intrauterine growth restriction infants born prematurely and adequate-for-gestational-age controls, both premature and term adequate for gestational age and their association with brain structural and biophysical parameters and neurodevelopmental outcome at 2 years. A total of 26 prematurely born intrauterine growth restriction infants (birthweight intrauterine growth restriction infants had slightly smaller brain volumes and increased frontal lobe white matter mean diffusivity compared with both prematurely born but adequate for gestational age and term adequate for gestational age controls. Frontal lobe N-acetylaspartate levels were significantly lower in prematurely born intrauterine growth restriction than in prematurely born but adequate for gestational age infants but increased in prematurely born but adequate for gestational age compared with term adequate-for-gestational-age infants. The prematurely born intrauterine growth restriction group also showed slightly lower choline compounds, borderline decrements of estimated glutathione levels, and increased myoinositol to choline ratios, compared with prematurely born but adequate for gestational age controls. These specific metabolite changes were locally correlated to lower gray matter content and increased mean diffusivity and reduced white matter fraction and fractional anisotropy. Prematurely born intrauterine growth restriction infants also showed a tendency for poorer neurodevelopmental outcome at 2 years, associated with lower levels of frontal lobe N-acetylaspartate at 1 year within the preterm subset. Preterm intrauterine growth restriction infants showed altered brain metabolite profiles during a critical stage of brain maturation, which

Fetal exposure to a diabetic intrauterine environment resulted in a failure of cord blood endothelial progenitor cell adaptation against chronic hypoxia

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Dincer UD

2014-12-01

Full Text Available U Deniz Dincer Department of Basic and Clinical Pharmacology, School of Medicine, Bezmialem Vakif University (BAVU, Fatih/Istanbul, Turkey Abstract: Gestational diabetes mellitus (GDM has long-term health consequences, and fetal exposure to a diabetic intrauterine environment increases cardiovascular risk for her adult offspring. Some part of this could be related to their endothelial progenitor cells (EPCs. Understanding the vessel-forming ability of human umbilical cord blood (HUCB-derived endothelial colony-forming cells (ECFCs against pathological stress such as GDM response to hypoxia could generate new therapeutic strategies. This study aims to investigate the role of chronic hypoxia in EPCs functional and vessel-forming ability in GDM subjects. Each ECFC was expressed in endothelial and pro-angiogenic specific markers, namely endothelial nitric oxide synthase (eNOS, platelet (PECAM-1 endothelial cell adhesion molecule 1, vascular endothelial-cadherin CdH5 (Ca-dependent cell adhesion molecule, vascular endothelial growth factor A, (VEGFA and insulin-like growth factor 1 (IGF1. Chronic hypoxia did not affect CdH5, but PECAM1 MRNA expressions were increased in control and GDM subjects. Control hypoxic and GDM normoxic VEGFA MRNA expressions and hypoxia-inducible factor 1-alpha (HIF1α protein expressions were significantly increased in HUCB ECFCs. GDM resulted in most failure of HUCB ECFC adaptation and eNOS protein expressions against chronic hypoxia. Chronic hypoxia resulted in an overall decline in HUCB ECFCs' proliferative ability due to reduction of clonogenic capacity and diminished vessel formation. Furthermore, GDM also resulted in most failure of cord blood ECFC adaptation against chronic hypoxic environment. Keywords: endothelial progenitor cells, gestational diabetes mellitus, chronic hypoxia, human cord blood

profile of intrauterine contraceptive device acceptors at the university

African Journals Online (AJOL)

ANNALS

Conclusion: The acceptors of intrauterine contraceptive devices in our center were ... Conclusion: Les accepteurs de la contraception de substances médicamentenses dans notre centre .... sterilization due to cultural reasons is very low,13 the.

Sub-optimal breastfeeding and its associated factors in rural ...

African Journals Online (AJOL)

Similarly, not attending formal education, low birth order and lack of knowledge about exclusive breastfeeding were also negatively associated with exclusive breastfeeding practice. Conclusion: In this study, sub-optimal breast feeding was found to be high. Delayed initiation and non-exclusive breastfeeding practices were ...

Reducing suboptimal employee decisions can build the business case for employee benefits.

Science.gov (United States)

Goldsmith, Christopher; Cyboran, Steven F

2013-01-01

Suboptimal employee decisions are prevalent in employee benefit plans. Poor decisions have significant consequences for employees and employers. Improving participant decisions produces beneficial outcomes such as lower labor costs, higher productivity and better workforce management. The business case for employee benefits can be strengthened by applying lessons learned from the field of behavioral economics to employee benefit plan design and to workforce communication. This article explains the types of behavioral biases that influence suboptimal decisions and explores how enlightened employee benefit plan choice architecture and vivid behavioral messaging contribute to human and better organizational outcomes.

Prognosis and risk factors for intrauterine growth retardation

DEFF Research Database (Denmark)

Sehested, Line Thousig; Pedersen, Pernille

2014-01-01

INTRODUCTION: Intrauterine growth retardation (IUGR) is the term describing a foetus that has not reached its genetic growth potential. There is no international consensus on the definition of IUGR. The aim of this study was to describe a cohort of weight-restricted neonates and their mothers...

Comparison of placebo and intrauterine lidocaine with/or without rectal diclofenac sodium suppositories used in office endometrial biopsy.

Science.gov (United States)

Kaya, Cengiz; Sener, Elif Bengi; Koksal, Ersin; Ustun, Yasemin Burcu; Celik, Handan; Sahinoglu, Ali Haydar

2015-01-01

To compare the effects of intrauterine lidocaine, intrauterine lidocaine plus rectal diclofenac, and a placebo on analgesia and to determine the satisfaction of patients and surgeons in cases of endometrial biopsy. The double-blind, randomised, placebo-controlled study was conducted in the Department of Obstetrics and Gynaecology of the Ondokuz Mayis University, Samsun,Turkey, from April 2013 to January 2014, and comprised patients scheduled for in-office endometrial biopsy.They were divided into three groups: Group P, 5ml of 0.9% saline intrauterine; Group L, 5ml of 2% lidocaine intrauterine; and Group LD, 5ml of 2% lidocaine intrauterine ± 10min before the procedure plus 50mg of rectal diclofenac sodium. Haemodynamic changes and visual analogue scale scores were recorded during the preoperative period, when the cervix was grasped with a tenaculum, immediately after intrauterine instillation, during uterine curettage and at postoperative 10 min. The patient and the surgeon were questioned about their satisfaction 15 min after the procedure. SPSS 21 was used for statistical analysis. The 90 patients in the study were divided into three equal groups of 30(33.33%) each. There were no statistically significant inter-group differences in age, bodyweight, parity, number of postmenopausal patients, haemodynamic parameters and American Society of Anesthesiologists scores (p>0.05 in all categories). In Group P, the visual analogue scale score estimated when the cervix was grasped with the tenaculum was lower when compared with Group L and Group LD (p=0.029 and p=0.007, respectively). At other measurement time points, the scores did not differ between the groups. The groups did not differ with respect to patient and surgeon satisfaction and complication rates (p>0.05). Intrauterine lidocaine or intrauterine lidocaine plus rectal diclofenac application had no effect on visual analogue scale scores, patient satisfaction and vasovagal reaction.

Desferrioxamine treatment of iron overload secondary to RH isoimmunization and intrauterine transfusion in a newborn infant.

Science.gov (United States)

Yalaz, Mehmet; Bilgin, Betül Siyah; Köroğlu, Ozge Altun; Ay, Yılmaz; Arıkan, Ciğdem; Sagol, Sermet; Akısü, Mete; Kültürsay, Nilgün

2011-11-01

Intrauterine transfusion is the standard of care in the management of severe Rh isoimmunization. Desferrioxamine has been used for the treatment of iron overload secondary to hemolysis and intrauterine transfusions in Rh isoimmunization cases. Here, we report a preterm infant born at 34 weeks of gestational age who had formerly received intrauterine transfusions for Rhesus hemolytic disease and presented with severe hyperferritinemia and elevated liver enzymes in the first week of life. Desferrioxamine treatment was started due to a ferritin level of 28,800 ng/ml and continued for 13 weeks. Although the treatment was successful, we observed resistant leukopenia which resolved after the cessation of treatment. In conclusion, iron overload secondary to intrauterine transfusions can be treated successfully with desferrioxamine; however, neonatologists must be aware of the possible side effects of this drug which has been used in only a limited number of newborns.

Association of cord blood chemokines and other biomarkers with neonatal complications following intrauterine inflammation.

Directory of Open Access Journals (Sweden)

Yoshikazu Otsubo

Full Text Available Intrauterine inflammation has been associated with preterm birth and neonatal complications. Few reports have comprehensively investigated multiple cytokine profiles in cord blood and precisely identified surrogate markers for intrauterine inflammation.To identify the cytokines and surrogate markers associated with intrauterine inflammation and subsequent neonatal complications.We analyzed cord blood samples from 135 patients admitted to the neonatal intensive care unit at Sasebo City General Hospital. We retrospectively determined the associations between the presence of neonatal complications and cord blood cytokines, prenatal factors, and laboratory data at birth. A total of 27 cytokines in the cord blood were measured using a bead-based array sandwich immunoassay.Both Th1 and Th2 cytokine levels were low, whereas the levels of growth factors and chemokines were high. In particular, chemokines IL-8, MCP-1, and MIP-1α were significantly higher in very premature neonates when compared with more mature neonates. In addition, some have been shown to be associated with multiple neonatal complications, including patent ductus arteriosus (PDA, respiratory distress syndrome (RDS, and chronic lung disease (CLD. Similarly, the levels of N-terminal pro-brain natriuretic peptide, nucleated RBC, and urinary β2-microglobulin were associated with these complications and chemokine levels.Our results suggest the association of inflammatory chemokines IL-8, MCP-1, and MIP-1α with intrauterine inflammation, premature birth, and neonatal complications in these perinatal subjects. Furthermore, the association of the aforementioned biomarkers with PDA, RDS, and CLD may help establish early diagnostic measures to predict such neonatal complications following intrauterine inflammation.

Clinical value of detection of HPL-expressing intermediate trophoblasts in abortion or curettage-obtained specimens for diagnosis of intrauterine or ectopic pregnancies

International Nuclear Information System (INIS)

He Xiaomei; Wang Yuping; Wang Lisha; Yang Jingxiu; Gao Xueyan

2005-01-01

Objective: To investigate the value of detection of HPL-expressing intermediate trophoblasts in endometrial specimens for diagnosis of intrauterine and ectopic pregnancies. Methods: The examined specimens included: (1) Group I, 35 specimens with suspected intermediate trophoblast in decidua (2) Group II, 30 specimens with decidua-like plump endometrial stroma cells and/ or A-S phenomena in glandular epithelium (3) 30 specimens from proven intrauterine pregnancies serving as controls. Histochemistry (SP method) was used for HPL detection in all these specimens. Results: In the 30 proven intrauterine pregnancies, decidua and villa were present in all the specimens. Only 24 of the 30 were found to be HPL(+) with 6 HPL negatives (20%). In Group I , 28 of the 35 specimens were found to be HPL(+) and all of 28 were from intrauterine pregnancies: Of the 7 HPL negative cases, 5 were later confirmed as with ectopic pregnancy, the remaining 2 were with intrauterine pregnancy. In Group II, 22 of 30 specimens were HPL(+) and all were from intrauterine pregnancy. Of the 8 HPL negative cases, 6 were later confirmed as with ectopic pregnancy and 2 were with intrauterine pregnancy. Combining the data from Group I and II, we could see that in the total 15 HPL negative cases, 11 were with ectopic pregnancy (11/15=73.3%) and 4 were with intrauterine pregnancy (4/15=26.7%). Conclusion: In specimens of intrauterine contents, demonstration of HPL (+) cells could be regarded as confirmative evidence of intrauterine pregnancy. However, the reverse did not hold true. Many of the HPL negative specimens were from intrauterine pregnancies (in this study 4/15 or 26.7%). Therefore, in HPL negative cases, there was a high possibility of ectopic pregnancy but further examinations were required to ascertain the diagnosis. (authors)

Unprotected intercourse in the 2 weeks prior to requesting emergency intrauterine contraception.

Science.gov (United States)

Sanders, Jessica N; Howell, Laura; Saltzman, Hanna M; Schwarz, E Bimla; Thompson, Ivana S; Turok, David K

2016-11-01

Previous emergency contraception studies have excluded women who report >1 episode of unprotected or underprotected intercourse. Thus, clinical recommendations are based on exposure to a single episode of underprotected intercourse. We sought to assess the prevalence and timing of underprotected intercourse episodes among women requesting emergency contraception and to examine the probability of pregnancy following an emergency contraception regimen including placement of either a copper intrauterine device or a levonorgestrel intrauterine device with simultaneous administration of an oral levonorgestrel pill in women reporting multiple underprotected intercourse episodes, including episodes beyond the Food and Drug Administration-approved emergency contraception time frame (6-14 days). Women seeking emergency contraception who had a negative pregnancy test and desired either a copper intrauterine device or levonorgestrel emergency contraception regimen enrolled in this prospective observational study. At enrollment, participants reported the number and timing of underprotected intercourse episodes in the previous 14 days. Two weeks later, participants reported the results of a self-administered home pregnancy test. Of the 176 women who presented for emergency contraception and received a same-day intrauterine device, 43% (n = 76) reported multiple underprotected intercourse episodes in the 14 days prior to presenting for emergency contraception. Women with multiple underprotected intercourse episodes reported a median of 3 events (range 2-20). Two-week pregnancy data were available for 172 (98%) participants. Only 1 participant had a positive pregnancy test. Pregnancy occurred in 0 of 97 (0%; 95% confidence interval, 0-3.7%) women with a single underprotected intercourse episode and 1 of 75 (1.3%; 95% confidence interval, 0-7.2%) women reporting multiple underprotected intercourse episodes; this includes 1 of 40 (2.5%; 95% confidence interval, 0-13.2%) women

Intrauterine Intervention for the Treatment of Fetal Growth Restriction.

Science.gov (United States)

Spiroski, A-M; Oliver, M H; Harding, J E; Bloomfield, F H

2016-01-01

Fetal growth restriction (FGR) is associated with an increased incidence of fetal and neonatal death, and of neonatal morbidity. Babies born following FGR also are at risk of a range of postnatal complications, which may contribute to an increased incidence of disease later in life. There currently are no effective clinical interventions which improve perinatal survival, intrauterine growth and later outcomes of the FGR baby. Postnatal interventions aimed at promoting or accelerating growth in FGR babies to improve outcome, particularly neurodevelopmental outcomes, may further increase the risk of metabolic dysregulation and, therefore, the risk of developing chronic disease in adulthood. An intrauterine intervention to improve nutrition and growth in the FGR fetus may have the potential to decrease mortality and improve long-term outcomes by delaying preterm delivery and mitigating the need for and risks of accelerated postnatal growth.

Suboptimality of Sales Promotions and Improvement Through Channel Coordination

NARCIS (Netherlands)

B. Wierenga (Berend); H. Soethoudt (Han)

2002-01-01

textabstractThis paper deals with sales promotions in the form of consumer price discounts in fast-moving consumer goods. First, we show analytically that suboptimality is to be expected with respect to the size of the consumer price discount. This is due to the separate decision making of the

Impact of HBV replication in peripheral blood mononuclear cell on HBV intrauterine transmission.

Science.gov (United States)

Shi, Xiaohong; Wang, Xuefei; Xu, Xixi; Feng, Yongliang; Li, Shuzhen; Feng, Shuying; Wang, Bo; Wang, Suping

2017-12-01

This study determined the effect of hepatitis B virus (HBV) replication in peripheral blood mononuclear cell (PBMC) from HBsAg-positive mothers on HBV intrauterine transmission. A total of 150 HBsAg-positive mothers and their neonates were recruited in this study. Within 24 h after birth, HBV serological markers, serum HBV DNA, PBMC HBV relaxed circular DNA (rcDNA), and covalently closed circular DNA (cccDNA) were measured in the HBsAg-positive mothers and their neonates before passive-active immune prophylaxis. The relationship between HBV replication in PBMC and HBV intrauterine transmission was examined through Chisquare test and logistic regression. The rate of HBV intrauterine transmission was 8.00% (12/150) in the 150 neonates born to HBsAg-positive mothers. The positivities of PBMC HBV rcDNA and cccDNA in the HBsAg-positive mothers were 36.67% (55/150) and 10% (15/150), respectively. Maternal PBMC HBV cccDNA was a risk factor of HBV intrauterine transmission (OR = 6.003, 95% CI: 1.249-28.855). Maternal serum HBeAg was a risk factor of PBMC HBV rcDNA (OR = 3.896, 95% CI: 1.929-7.876) and PBMC HBV cccDNA (OR = 3.74, 95% CI: 1.186-11.793) in the HBsAg-positive mothers. Administration of hepatitis B immune globulin was a protective factor of PBMC HBV cccDNA (OR = 0.312, 95%CI: 0.102-0.954) during pregnancy. The positivity of PBMC HBV rcDNA was related to that of cccDNA in the HBsAg-positive mothers (χ 2 = 5.087, P = 0.024). This study suggests that PBMC is a reservoir of HBV and an extrahepatic site for virus replication and plays a critical role in HBV intrauterine transmission.

Reactive oxygen species are involved in lipopolysaccharide-induced intrauterine growth restriction and skeletal development retardation in mice.

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Xu, De-Xiang; Chen, Yuan-Hua; Zhao, Lei; Wang, Hua; Wei, Wei

2006-12-01

Maternal infection is a cause of adverse developmental outcomes including embryonic resorption, intrauterine fetal death, and preterm labor. Lipopolysaccharide-induced developmental toxicity at early gestational stages has been well characterized. The purpose of the present study was to investigate the effects of maternal lipopolysaccharide exposure at late gestational stages on intrauterine fetal growth and skeletal development and to assess the potential role of reactive oxygen species in lipopolysaccharide-induced intrauterine fetal growth restriction and skeletal development retardation. The timed pregnant CD-1 mice were intraperitoneally injected with lipopolysaccharide (25 to 75 microg/kg per day) on gestational day 15 to 17. To investigate the role of reactive oxygen species on lipopolysaccharide-induced intrauterine fetal growth restriction and skeletal development retardation, the pregnant mice were injected with alpha-phenyl-N-t-butylnitrone (100 mg/kg, intraperitoneally) at 30 minutes before lipopolysaccharide (75 microg/kg per day, intraperitoneally), followed by an additional dose of alpha-phenyl-N-t-butylnitrone (50 mg/kg, intraperitoneally) at 3 hours after lipopolysaccharide. The number of live fetuses, dead fetuses, and resorption sites was counted on gestational day 18. Live fetuses in each litter were weighed. Crown-rump and tail lengths were examined and skeletal development was evaluated. Maternal lipopolysaccharide exposure significantly increased fetal mortality, reduced fetal weight and crown-rump and tail lengths of live fetuses, and retarded skeletal ossification in caudal vertebrae, anterior and posterior phalanges, and supraoccipital bone in a dose-dependent manner. Alpha-phenyl-N-t-butylnitrone, a free radical spin-trapping agent, almost completely blocked lipopolysaccharide-induced fetal death (63.2% in lipopolysaccharide group versus 6.5% in alpha-phenyl-N-t-butylnitrone + lipopolysaccharide group, P intrauterine growth restriction

The fate of suboptimal anastomosis after colon resection: An experimental study.

Science.gov (United States)

Yıldız, Mehmet Kamil; Okan, İsmail; Nazik, Hasan; Bas, Gurhan; Alimoglu, Orhan; İlktac, Mehmet; Daldal, Emin; Sahin, Mustafa; Kuvat, Nuray; Ongen, Betugul

2014-11-01

The fate of suboptimal anastomosis is unknown and early detection of anastomotic leakage after colon resection is crucial for the proper management of patients. Twenty-six rats were assigned to "Control", "Leakage" and "Suboptimal anastomosis" groups where they underwent either sham laparotomy, cecal ligation, and puncture or anastomosis with four sutures following colon resection, respectively. At the fifth hour and on the third and ninth days; peripheral blood and peritoneal washing samples through relaparotomy were obtained. The abdomen was inspected macroscopically for anastomotic healing. Polymerase chain reaction (PCR) with 16s rRNA and E.coli-specific primers were run on all samples along with aerobic and anaerobic cultures. The sensitivity and specificity of PCR on different bodily fluids with 16s rRNA and E.coli-specific primers were 100% and 78%, respectively. All samples of peritoneal washing fluids on the third and ninth days showed presence of bacteria in both PCR and culture. The inspection of the abdomen revealed signs of anastomotic leakage in eight rats (80%), whereas mortality related with anastomosis was detected in two (20%). Anastomotic leakage with suboptimal anastomosis after colon resection is high and the early detection is possible by running PCR on peritoneal samples as early as 72 hours.

Intravesical Migration of a Failed and Forgotten Intrauterine ...

African Journals Online (AJOL)

Intrauterine contraceptive device (IUCD) is a commonly utilized reversible contraceptive technique especially in the developing world. Though effective, it is not immune to complications. Migration of the device is a rare but serious complication which may be symptomatic or asymptomatic. We report a case of a 45yr old ...

Vesical Calculus 10 Years Post Missing Intrauterine Contraceptive ...

African Journals Online (AJOL)

Intravesical migration of intrauterine contraceptive device (IUCD) is rare. Early diagnosis of this rare entity is difficult because of its non‑specific manifestations and very low index of suspicion. We present this case of bladder stone following intravesical migration of IUCD found to have been missing since insertion 10 years ...

Meckel's diverticulum: the lead point of intrauterine intussusception ...

African Journals Online (AJOL)

management of a newborn with intrauterine intussusception of a Meckel's diverticulum as a cause of the vascular malformation leading to ileal atresia. To our knowledge, this is the fifth case report of this phenomenon. In all cases, definitive management required ... dense collection of small bowel and a small rim of proximal.

Is dilatation and curettage obsolete for diagnosing intrauterine disorders in premenopausal patients with persistent abnormal uterine bleeding?

NARCIS (Netherlands)

Emanuel, M. H.; Wamsteker, K.; Lammes, F. B.

1997-01-01

To determine the predictive value of dilatation and curettage (D&C) for diagnosing intrauterine disorders in patients with persistent abnormal uterine bleeding. An observational descriptive study was performed in a large university-affiliated teaching hospital. The suspicion of intrauterine

Long QT Syndrome–Associated Mutations in Intrauterine Fetal Death

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Crotti, Lia; Tester, David J.; White, Wendy M.; Bartos, Daniel C.; Insolia, Roberto; Besana, Alessandra; Kunic, Jennifer D.; Will, Melissa L.; Velasco, Ellyn J.; Bair, Jennifer J.; Ghidoni, Alice; Cetin, Irene; Van Dyke, Daniel L.; Wick, Myra J.; Brost, Brian; Delisle, Brian P.; Facchinetti, Fabio; George, Alfred L.; Schwartz, Peter J.; Ackerman, Michael J.

2013-01-01

Importance Intrauterine fetal death or stillbirth occurs in approximately 1 out of every 160 pregnancies and accounts for 50% of all perinatal deaths. Postmortem evaluation fails to elucidate an underlying cause in many cases. Long QT syndrome (LQTS) may contribute to this problem. Objective To determine the spectrum and prevalence of mutations in the 3 most common LQTS susceptible genes (KCNQ1, KCNH2, and SCN5A) for a cohort of unexplained cases. Design, Setting, and Patients In this case series, retrospective postmortem genetic testing was conducted on a convenience sample of 91 unexplained intrauterine fetal deaths (mean [SD] estimated gestational age at fetal death, 26.3 [8.7] weeks) that were collected from 2006-2012 by the Mayo Clinic, Rochester, Minnesota, or the Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. More than 1300 ostensibly healthy individuals served as controls. In addition, publicly available exome databases were assessed for the general population frequency of identified genetic variants. Main Outcomes and Measures Comprehensive mutational analyses of KCNQ1 (KV7.1, LQTS type 1), KCNH2 (HERG/KV11.1, LQTS type 2), and SCN5A (NaV1.5, LQTS type 3) were performed using denaturing high-performance liquid chromatography and direct DNA sequencing on genomic DNA extracted from decedent tissue. Functional analyses of novel mutations were performed using heterologous expression and patch-clamp recording. Results The 3 putative LQTS susceptibility missense mutations (KCNQ1, p.A283T; KCNQ1, p.R397W; and KCNH2[1b], p.R25W), with a heterozygous frequency of less than 0.05% in more than 10000 publicly available exomes and absent in more than 1000 ethnically similar control patients, were discovered in 3 intrauterine fetal deaths (3.3% [95% CI, 0.68%-9.3%]). Both KV7.1-A283T (16-week male) and KV7.1-R397W (16-week female) mutations were associated with marked KV7.1 loss-of-function consistent with in utero LQTS type 1, whereas the HERG1b-R25W mutation

Reoperation for suboptimal outcomes after deep brain stimulation surgery.

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Ellis, Tina-Marie; Foote, Kelly D; Fernandez, Hubert H; Sudhyadhom, Atchar; Rodriguez, Ramon L; Zeilman, Pamela; Jacobson, Charles E; Okun, Michael S

2008-10-01

To examine a case series of reoperations for deep brain stimulation (DBS) leads in which clinical scenarios revealed suboptimal outcome from a previous operation. Suboptimally placed DBS leads are one potential reason for unsatisfactory results after surgery for Parkinson's disease (PD), essential tremor (ET), or dystonia. In a previous study of patients who experienced suboptimal results, 19 of 41 patients had misplaced leads. Similarly, another report commented that lead placement beyond a 2- to 3-mm window resulted in inadequate clinical benefit, and, in 1 patient, revision improved outcome. The goal of the current study was to perform an unblinded retrospective chart review of DBS patients with unsatisfactory outcomes who presented for reoperation. Patients who had DBS lead replacements after reoperation were assessed with the use of a retrospective review of an institutional review board-approved movement disorders database. Cases of reoperation for suboptimal clinical benefit were included, and cases of replacement of DBS leads caused by infection or hardware malfunction were excluded. Data points studied included age, disease duration, diagnosis, motor outcomes (the Unified Parkinson Disease Rating Scale III in PD, the Tremor Rating Scale in ET, and the Unified Dystonia Rating Scale in dystonia), quality of life (Parkinson's Disease Questionnaire-39 in PD), and the Clinician Global Impression scale. The data from before and after reoperation were examined to determine the estimated impact of repeat surgery. There were 11 patients with PD, 7 with ET, and 4 with dystonia. The average age of the PD group was 52 years, the disease duration was 10 years, and the average vector distance of the location of the active DBS contact was adjusted 5.5 mm. Six patients (54%) with PD had preoperative off medication on DBS Unified Parkinson Disease Rating Scale scores that could be compared with postoperative off medication on DBS scores. The average improvement across this

A Real-Time Intrauterine Catheter Technique for Fetal Electrocardiogram Monitoring

National Research Council Canada - National Science Library

Horner, S

2001-01-01

..., two sensors that include the invasive scalp electrode and intrauterine pressure catheter are used clink ally, Signal processing is required to obtain a FECG via the IC, Usually the maternal electrocardiogram (ECG...

Intrauterine neuromuscular blockade in fetus.

Science.gov (United States)

Fan, S Z; Huang, F Y; Lin, S Y; Wang, Y P; Hsieh, F J

1990-03-01

Antenatal intrauterine fetal therapy has now become the target of numerous invasive diagnostic and therapeutic maneuvers. Fetal motion during intrauterine fetal therapy not only makes these procedures technically more difficult but also increases the likelihood of trauma to the umbilical vessels and the fetus. Combination of high doses of sedatives, tranquilizers, and narcotics rarely results in adequate suppression of fetal movement. Such medication puts the mother at risk of respiratory depression, regurgitation and aspiration. The use of pancuronium or atracurium to temporarily arrest fetal movement in ten fetus is reported. After an initial ultrasound assessment of fetal lie, placental location, and umbilical cord insertion site, the fetal weight was calculated by the ultrasound parameters of biparietal diameter and abdominal circumference. Under ultrasound guidance, we injected pancuronium 0.15 mg/kg or atracurium 1.0 mg/kg using a 23-gauge spinal needle into the fetal gluteal muscle. Short-term paralysis of the fetus was induced in all cases. Fetal movement stopped by sonographic observation within 5.8 +/- 2.3 min in the pancuronium group and 4.7 +/- 1.8 min in the atracurium group. Fetal movements returned both to maternal sensation or ultrasonic observation by 92 +/- 23 min in the first group and 36 +/- 11 min in the second group. No adverse effect of the relaxant has been observed in any of the mothers. There was no evidence of local soft tissue, nerve or muscle damage at the site of injection on initial examination of the neonates after delivery. The use of neuromuscular relaxant in fetus was a safe and useful method.

Influence of intrauterine and extrauterine growth on neurodevelopmental outcome of monozygotic twins

Directory of Open Access Journals (Sweden)

R.K. Reolon

2008-08-01

Full Text Available There have been indications that intrauterine and early extrauterine growth can influence childhood mental and motor function. The objective of the present study was to evaluate the influence of intrauterine growth restriction and early extrauterine head growth on the neurodevelopmental outcome of monozygotic twins. Thirty-six monozygous twin pairs were evaluated at the corrected age of 12 to 42 months. Intrauterine growth restriction was quantified using the fetal growth ratio. The effects of birth weight ratio, head circumference at birth and current head circumference on mental and motor outcomes were estimated using mixed-effect linear regression models. Separate estimates of the between (interpair and within (intrapair effects of each measure on development were thus obtained. Neurodevelopment was assessed with the Bayley Scales of Infant Development, 2nd edition, by a psychologist blind to the exposure. A standardized neurological examination was performed by a neuropediatrician who was unaware of the exposures under investigation. After adjustment, birth weight ratio and head circumference at birth were not associated with motor or mental outcomes. Current head circumference was associated with mental but not with motor outcomes. Only the intrapair twin effect was significant. An increase of 1 cm in current head circumference of one twin compared with the other was associated with 3.2 points higher in Mental Developmental Index (95%CI = 1.06-5.32; P < 0.03. Thus, no effect of intrauterine growth was found on cognition and only postnatal head growth was associated with cognition. This effect was not shared by the co-twin.

Relationship of Total Motile Sperm Count and Percentage Motile Sperm to Successful Pregnancy Rates Following Intrauterine Insemination

OpenAIRE

Pasqualotto, Eleonora B.; Daitch, James A.; Hendin, Benjamin N.; Falcone, Tommaso; Thomas, Anthony J.; Nelson, David R.; Agarwal, Ashok

1999-01-01

Purpose:This study sought (i) to investigate the relationship between postwash total motile sperm count and postwash percentage motile sperm in predicting successful intrauterine insemination and (ii) to determine the minimal postwash total motile sperm count required to achieve pregnancy with intrauterine insemination.

Suboptimal Partial Transmit Sequence-Active Interference Cancellation with Particle Swarm Optimization

Directory of Open Access Journals (Sweden)

Tarasak Poramate

2010-01-01

Full Text Available Active interference cancellation (AIC is an effective technique to provide interference avoidance feature for an ultrawideband (UWB OFDM transmitter. Partial transmit sequence-AIC (PTS-AIC, which was recently proposed as an improvement of AIC, requires high computational complexity by doing the exhaustive search of all possible weighting factors whose number grows exponentially with the number of subblocks used. To reduce the complexity of PTS-AIC, this paper proposes a suboptimal way, called particle swarm optimization (PSO, to choose the weighting factors suboptimally without much performance degradation. Both continuous and discrete versions of PSO have been evaluated, and it has been shown that the discrete PSO is able to reduce the complexity significantly without sacrificing the performance of PTS-AIC in many cases.

Indicators of suboptimal performance embedded in the Wechsler Memory Scale-Fourth Edition (WMS-IV)

OpenAIRE

Bouman, Zita; Hendriks, Marc PH; Schmand, Ben A; Kessels, Roy PC; Aldenkamp, Albert

2016-01-01

Introduction. Recognition and visual working memory tasks from the Wechsler Memory Scale-Fourth Edition (WMS-IV) have previously been documented as useful indicators for suboptimal performance. The present study examined the clinical utility of the Dutch version of the WMS-IV (WMS-IV-NL) for the identification of suboptimal performance using an analogue study design. Method. The patient group consisted of 59 mixed-etiology patients; the experimental malingerers were 50 healthy individuals...

Indicators of suboptimal performance embedded in the Wechsler Memory Scale-Fourth Edition (WMS-IV)

OpenAIRE

Bouman, Zita; Hendriks, Marc P.H.; Schmand, Ben A.; Kessels, Roy P.C.; Aldenkamp, Albert P.

2016-01-01

Introduction. Recognition and visual working memory tasks from the Wechsler Memory Scale-Fourth Edition (WMS-IV) have previously been documented as useful indicators for suboptimal performance. The present study examined the clinical utility of the Dutch version of the WMS-IV (WMS-IV-NL) for the identification of suboptimal performance using an analogue study design.Method. The patient group consisted of 59 mixed-etiology patients; the experimental malingerers were 50 healthy individuals who ...

A non-destructive selection method for faster growth at suboptimal temperature in common bean (Phaseolus vulgaris)

NARCIS (Netherlands)

Drijfhout, E.; Oeveren, J.C. van; Jansen, R.C.

1991-01-01

A non-destructive method has been developed to select common bean (Phaseolus vulgaris L.) plants whose growth is less effected at a suboptimal temperature. Shoot weight was determined at a suboptimal (14°C) and optimal temperature (20°C), 38 days after sowing and accessions identified with a

Evaluation of quality of life and sexual functioning of women using levonorgestrel-releasing intrauterine contraceptive system--Mirena.

Science.gov (United States)

Skrzypulec, Violetta; Drosdzol, Agnieszka

2008-12-01

The advantages ensuing from the high contraceptive efficacy, positive effect on the parameters of the menstrual cycle as well as other values of the levonorgestrel-releasing intrauterine system may play an important role in women's sexual life. The aim of the study was to evaluate the effect of the levonorgestrel-releasing intrauterine system on the quality of life and sexual functioning of women. The research encompassed 200 women aged between 30 and 45. 52 women using the levonorgestrel-releasing intrauterine system were qualified to the study as the research group (Mirena Group). The control groups consisted of 48 women using a different type of intrauterine device (Control Group I--Other IUD) and 50 women using no contraception (Control Group II). A specific questionnaire with a general part concerning socio-demographic conditions, a part dealing with contraception and Polish version of self-evaluation inventories: Short Form-36 Health Survey, Female Sexual Function Index and Mell-Krat Scale was used as a research tool. Quality of life parameters for women using the Mirena system were higher than for the control groups, especially in the aspect of general health, energy/fatigue and emotional well-being. A significant beneficial effect of the levonorgestrel-releasing intrauterine system on sexual functioning (sexual desire and arousal) was also revealed in the study. Sexual dysfunctions were diagnosed in 20.8% of Other IUD, 34.7% of Control Group II and 9.6% of Mirena Group. Levonorgestrel-releasing intrauterine system increases female quality of life and sexual functioning parameters.

The echoic pseudogestational sac of ectopic pregnancy simulating early intrauterine pregnancy.

Science.gov (United States)

Schaffer, R M; Stein, K; Shih, Y H; Goodman, J D

1983-05-01

The sonographic features of ectopic pregnancy have been well documented. When an early intrauterine pregnancy is identified or an obvious extrauterine sac is visualized, diagnosis is not a problem; but often a sac is seen within the uterus that may contain a well-defined rind and even internal echoes simulating an early fetal pole. This has been mistaken for an early intrauterine pregnancy. In this review, four patients with pseudogestational sacs had internal echoes within the sac, and two of them ultimately underwent dilatation and curettage, which revealed blood clots. This supports the assertion that fetal cardiac activity and/or fetal motion should be demonstrated within a fetal pole before the diagnosis of ectopic pregnancy is excluded.

Effects of social stress and intrauterine position on sexual phenotype in wild-type house mice (Mus musculus)

Science.gov (United States)

William J. Zielinski; John G. Vandenbergh; Monica M. Montano

1991-01-01

Wild-type house mice were used to test the effect of intrauterine position on anogenital distance (AGD) and to verify whether crowding stress would masculinize female pups, developing at all intrauterine positions, as has been demonstrated in CF-1 mice stressed by restraint, heat, and...

Fetal Programming of Body Composition, Obesity, and Metabolic Function: The Role of Intrauterine Stress and Stress Biology

Directory of Open Access Journals (Sweden)

Sonja Entringer

2012-01-01

Full Text Available Epidemiological, clinical, physiological, cellular, and molecular evidence suggests that the origins of obesity and metabolic dysfunction can be traced back to intrauterine life and supports an important role for maternal nutrition prior to and during gestation in fetal programming. The elucidation of underlying mechanisms is an area of interest and intense investigation. In this perspectives paper we propose that in addition to maternal nutrition-related processes it may be important to concurrently consider the potential role of intrauterine stress and stress biology. We frame our arguments in the larger context of an evolutionary-developmental perspective that supports roles for both nutrition and stress as key environmental conditions driving natural selection and developmental plasticity. We suggest that intrauterine stress exposure may interact with the nutritional milieu, and that stress biology may represent an underlying mechanism mediating the effects of diverse intrauterine perturbations, including but not limited to maternal nutritional insults (undernutrition and overnutrition, on brain and peripheral targets of programming of body composition, energy balance homeostasis, and metabolic function. We discuss putative maternal-placental-fetal endocrine and immune/inflammatory candidate mechanisms that may underlie the long-term effects of intrauterine stress. We conclude with a commentary of the implications for future research and clinical practice.

Training contraceptive providers to offer intrauterine devices and implants in contraceptive care: a cluster randomized trial.

Science.gov (United States)

Thompson, Kirsten M J; Rocca, Corinne H; Stern, Lisa; Morfesis, Johanna; Goodman, Suzan; Steinauer, Jody; Harper, Cynthia C

2018-06-01

US unintended pregnancy rates remain high, and contraceptive providers are not universally trained to offer intrauterine devices and implants to women who wish to use these methods. We sought to measure the impact of a provider training intervention on integration of intrauterine devices and implants into contraceptive care. We measured the impact of a continuing medical education-accredited provider training intervention on provider attitudes, knowledge, and practices in a cluster randomized trial in 40 US health centers from 2011 through 2013. Twenty clinics were randomly assigned to the intervention arm; 20 offered routine care. Clinic staff participated in baseline and 1-year surveys assessing intrauterine device and implant knowledge, attitudes, and practices. We used a difference-in-differences approach to compare changes that occurred in the intervention sites to changes in the control sites 1 year later. Prespecified outcome measures included: knowledge of patient eligibility for intrauterine devices and implants; attitudes about method safety; and counseling practices. We used multivariable regression with generalized estimating equations to account for clustering by clinic to examine intervention effects on provider outcomes 1 year later. Overall, we surveyed 576 clinic staff (314 intervention, 262 control) at baseline and/or 1-year follow-up. The change in proportion of providers who believed that the intrauterine device was safe was greater in intervention (60% at baseline to 76% at follow-up) than control sites (66% at both times) (adjusted odds ratio, 2.48; 95% confidence interval, 1.13-5.4). Likewise, for the implant, the proportion increased from 57-77% in intervention, compared to 61-65% in control sites (adjusted odds ratio, 2.57; 95% confidence interval, 1.44-4.59). The proportion of providers who believed they were experienced to counsel on intrauterine devices also increased in intervention (53-67%) and remained the same in control sites (60

Suboptimal bonding impairs hormonal, epigenetic and neuronal development in preterm infants, but these impairments can be reversed

NARCIS (Netherlands)

Kommers, D.R.; Oei, S.G.; Chen, W.; Feijs, L.M.G.; Bambang Oetomo, S.

This review aimed to raise awareness of the consequences of suboptimal bonding caused by prematurity. In addition to hypoxia–ischaemia, infection and malnutrition, suboptimal bonding is one of the many unnatural stimuli that preterm infants are exposed to, compromising their physiological

The hepatic transcriptome of young suckling and aging intrauterine growth restricted male rats.

Science.gov (United States)

Freije, William A; Thamotharan, Shanthie; Lee, Regina; Shin, Bo-Chul; Devaskar, Sherin U

2015-04-01

Intrauterine growth restriction leads to the development of adult onset obesity/metabolic syndrome, diabetes mellitus, cardiovascular disease, hypertension, stroke, dyslipidemia, and non-alcoholic fatty liver disease/steatohepatitis. Continued postnatal growth restriction has been shown to ameliorate many of these sequelae. To further our understanding of the mechanism of how intrauterine and early postnatal growth affects adult health we have employed Affymetrix microarray-based expression profiling to characterize hepatic gene expression of male offspring in a rat model of maternal nutrient restriction in early and late life. At day 21 of life (p21) combined intrauterine and postnatal calorie restriction treatment led to expression changes in circadian, metabolic, and insulin-like growth factor genes as part of a larger transcriptional response that encompasses 144 genes. Independent and controlled experiments at p21 confirm the early life circadian, metabolic, and growth factor perturbations. In contrast to the p21 transcriptional response, at day 450 of life (d450) only seven genes, largely uncharacterized, were differentially expressed. This lack of a transcriptional response identifies non-transcriptional mechanisms mediating the adult sequelae of intrauterine growth restriction. Independent experiments at d450 identify a circadian defect as well as validate expression changes to four of the genes identified by the microarray screen which have a novel association with growth restriction. Emerging from this rich dataset is a portrait of how the liver responds to growth restriction through circadian dysregulation, energy/substrate management, and growth factor modulation. © 2014 Wiley Periodicals, Inc.

Immunohistochemical structural pecularities of uterine tube of fetuses with signs of intrauterine infection

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Лариса Сергеевна Куприянова

2015-05-01

Full Text Available Aim - immunohistochemical detection of structural features of the uterine tubes of fetuses with signs of intrauterine infection.Methods: anthropometric, macroscopic, organometric, histological, immunohistochemical, statistical.Object of research - the uterine tubes of antenatal dead fetuses. The control group consisted of 25 fetuses of healthy mothers; the comparison group is 15 fetuses with signs of intrauterine infection. Fetal infection confirmed by laboratory methods; the presence of TORCH infections, cytomegalovirus, herpes infection and chlamydial infection is determined.Results: indicators of weight and body length of the fetus of the comparison group were significantly reduced. Unidirectional changes are established in the definition of the mass and the length of the uterine tubes of fetuses with signs of intrauterine infection. Massive growth of connective tissue in the mucosa, the mucous membrane and muscle membrane of wall of the uterine tube of fetus in the comparison group is shown by histological methods. Violation of collagen formation in the connective tissue in the uterine tubes of fetuses with signs of intrauterine infection is found by immunohistochemistry method.Conclusions: The reduction of anthropometric and organometric indicators in fetuses of comparison group is shown. Sclerosis and atrophy, as well as violations of collagen-synthesizing function are predominated in the main structural components of the wall of the uterine tube of fetuses in the comparison group. The revealed changes in the future ontogenesis may lead to the development of primary infertility

Enteral feeding of intrauterine growth restriction preterm infants: theoretical risks and practical implications

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Valentina Bozzetti

2017-06-01

Full Text Available Intrauterine growth restriction (IUGR infants are thought to have impaired gut function after birth secondary to intrauterine redistribution of the blood flow, due to placental insufficiency, with a consequent reduction of gut perfusion. For this reason, infants complicated by IUGR have been considered at higher risk of feeding intolerance. Postnatal evaluation of splanchnic perfusion, through Doppler of the superior mesenteric artery, and of splanchnic oxygenation, through near infrared spectroscopy measurements, may be useful in evaluating the persistence (or not of the redistribution of blood flow occurred in utero.

Statin therapy reduces the likelihood of suboptimal blood pressure control among Ugandan adult diabetic patients

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Lumu W

2017-02-01

Full Text Available William Lumu,1 Leaticia Kampiire,2 George Patrick Akabwai,3 Daniel Ssekikubo Kiggundu,4 Davis Kibirige5 1Department of Medicine and Diabetes/Endocrine Unit, Mengo Hospital, 2Infectious Disease Research Collaboration, 3Baylor College of Medicine Children’s Foundation, 4Nephrology Unit, Mulago National Referral and Teaching Hospital, 5Department of Medicine, Uganda Martyrs Hospital Lubaga, Kampala, Uganda Background: Hypertension is one of the recognized risk factors of cardiovascular diseases in adult diabetic patients. High prevalence of suboptimal blood pressure (BP control has been well documented in the majority of studies assessing BP control in diabetic patients in sub-Saharan Africa. In Uganda, there is a dearth of similar studies. This study evaluated the prevalence and correlates of suboptimal BP control in an adult diabetic population in Uganda.Patients and methods: This was a cross-sectional study that enrolled 425 eligible ambulatory adult diabetic patients attending three urban diabetic outpatient clinics over 11 months. Data about their sociodemographic characteristics and clinical history were collected using pre-tested questionnaires. Suboptimal BP control was defined according to the 2015 American Diabetes Association standards of diabetes care guideline as BP levels ≥140/90 mmHg.Results: The mean age of the study participants was 52.2±14.4 years, with the majority being females (283, 66.9%. Suboptimal BP control was documented in 192 (45.3% study participants and was independently associated with the study site (private hospitals; odds ratio 2.01, 95% confidence interval 1.18–3.43, P=0.01 and use of statin therapy (odds ratio 0.5, 95% confidence interval 0.26–0.96, P=0.037.Conclusion: Suboptimal BP control was highly prevalent in this study population. Strategies to improve optimal BP control, especially in the private hospitals, and the use of statin therapy should be encouraged in adult diabetic patients

Suboptimal control of pressurized water reactor power plant using approximate model-following method

International Nuclear Information System (INIS)

Tsuji, Masashi; Ogawa, Yuichi

1987-01-01

We attempted to develop an effective control system that can successfully manage the nuclear steam supply (NSS) system of a PWR power plant in an operational mode requiring relatively small variations of power. A procedure is proposed for synthesizing control system that is a simple, yet practiced, suboptimal control system. The suboptimal control system is designed in two steps; application of the optimal control theory, based on the linear state-feedback control and the use of an approximate model-following method. This procedure can appreciably reduce the complexity of the structure of the controller by accepting a slight deviation from the optimality and by the use of the output-feedback control. This eliminates the engineering difficulty caused by an incompletely state-feedback that is sometimes encountered in practical applications of the optimal state-feedback control theory to complex large-scale dynamical systems. Digital simulations and graphical studies based on the Bode-diagram demonstrate the effectiveness of the suboptimal control, and the applicability of the proposed design method as well. (author)

Burnout and self-reported suboptimal patient care amongst health care workers providing HIV care in Malawi

Science.gov (United States)

Mazenga, Alick C.; Simon, Katie; Yu, Xiaoying; Ahmed, Saeed; Nyasulu, Phoebe; Kazembe, Peter N.; Ngoma, Stanley; Abrams, Elaine J.

2018-01-01

Background The well-documented shortages of health care workers (HCWs) in sub-Saharan Africa are further intensified by the increased human resource needs of expanding HIV treatment programs. Burnout is a syndrome of emotional exhaustion (EE), depersonalization (DP), and a sense of low personal accomplishment (PA). HCWs’ burnout can negatively impact the delivery of health services. Our main objective was to examine the prevalence of burnout amongst HCWs in Malawi and explore its relationship to self-reported suboptimal patient care. Methods A cross-sectional study among HCWs providing HIV care in 89 facilities, across eight districts in Malawi was conducted. Burnout was measured using the Maslach Burnout Inventory defined as scores in the mid-high range on the EE or DP subscales. Nine questions adapted for this study assessed self-reported suboptimal patient care. Surveys were administered anonymously and included socio-demographic and work-related questions. Validated questionnaires assessed depression and at-risk alcohol use. Chi-square test or two-sample t-test was used to explore associations between variables and self-reported suboptimal patient care. Bivariate analyses identified candidate variables (p burnout. In the three dimensions of burnout, 55% reported moderate-high EE, 31% moderate-high DP, and 46% low-moderate PA. The majority (89%) reported engaging in suboptimal patient care/attitudes including making mistakes in treatment not due to lack of knowledge/experience (52%), shouting at patients (45%), and not performing diagnostic tests due to a desire to finish quickly (35%). In multivariate analysis, only burnout remained associated with self-reported suboptimal patient care (OR 3.22, [CI 2.11 to 4.90]; pBurnout was common among HCWs providing HIV care and was associated with self-reported suboptimal patient care practices/attitudes. Research is needed to understand factors that contribute to and protect against burnout and that inform the

Relationship between stress-related psychosocial work factors and suboptimal health among Chinese medical staff: a cross-sectional study.

Science.gov (United States)

Liang, Ying-Zhi; Chu, Xi; Meng, Shi-Jiao; Zhang, Jie; Wu, Li-Juan; Yan, Yu-Xiang

2018-03-06

The study aimed to develop and validate a model to measure psychosocial factors at work among medical staff in China based on confirmatory factor analysis (CFA). The second aim of the current study was to clarify the association between stress-related psychosocial work factors and suboptimal health status. The cross-sectional study was conducted using clustered sampling method. Xuanwu Hospital, a 3A grade hospital in Beijing. Nine hundred and fourteen medical staff aged over 40 years were sampled. Seven hundred and ninety-seven valid questionnaires were collected and used for further analyses. The sample included 94% of the Han population. The Copenhagen Psychosocial Questionnaire (COPSOQ) and the Suboptimal Health Status Questionnaires-25 were used to assess the psychosocial factors at work and suboptimal health status, respectively. CFA was conducted to establish the evaluating method of COPSOQ. A multivariate logistic regression model was used to estimate the relationship between suboptimal health status and stress-related psychosocial work factors among Chinese medical staff. There was a strong correlation among the five dimensions of COPSOQ based on the first-order factor model. Then, we established two second-order factors including negative and positive psychosocial work stress factors to evaluate psychosocial factors at work, and the second-order factor model fit well. The high score in negative (OR (95% CI)=1.47 (1.34 to 1.62), Pwork factors increased and decreased the risk of suboptimal health, respectively. This relationship remained statistically significant after adjusting for confounders and when using different cut-offs of suboptimal health status. Among medical staff, the second-order factor model was a suitable method to evaluate the COPSOQ. The negative and positive psychosocial work stress factors might be the risk and protective factors of suboptimal health, respectively. Moreover, negative psychosocial work stress was the most associated

Sub-optimal control of fuzzy linear dynamical systems under granular differentiability concept.

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Mazandarani, Mehran; Pariz, Naser

2018-05-01

This paper deals with sub-optimal control of a fuzzy linear dynamical system. The aim is to keep the state variables of the fuzzy linear dynamical system close to zero in an optimal manner. In the fuzzy dynamical system, the fuzzy derivative is considered as the granular derivative; and all the coefficients and initial conditions can be uncertain. The criterion for assessing the optimality is regarded as a granular integral whose integrand is a quadratic function of the state variables and control inputs. Using the relative-distance-measure (RDM) fuzzy interval arithmetic and calculus of variations, the optimal control law is presented as the fuzzy state variables feedback. Since the optimal feedback gains are obtained as fuzzy functions, they need to be defuzzified. This will result in the sub-optimal control law. This paper also sheds light on the restrictions imposed by the approaches which are based on fuzzy standard interval arithmetic (FSIA), and use strongly generalized Hukuhara and generalized Hukuhara differentiability concepts for obtaining the optimal control law. The granular eigenvalues notion is also defined. Using an RLC circuit mathematical model, it is shown that, due to their unnatural behavior in the modeling phenomenon, the FSIA-based approaches may obtain some eigenvalues sets that might be different from the inherent eigenvalues set of the fuzzy dynamical system. This is, however, not the case with the approach proposed in this study. The notions of granular controllability and granular stabilizability of the fuzzy linear dynamical system are also presented in this paper. Moreover, a sub-optimal control for regulating a Boeing 747 in longitudinal direction with uncertain initial conditions and parameters is gained. In addition, an uncertain suspension system of one of the four wheels of a bus is regulated using the sub-optimal control introduced in this paper. Copyright © 2018 ISA. Published by Elsevier Ltd. All rights reserved.

The Intra-uterine Device in Soweto and Other Townships | Spilhaus ...

African Journals Online (AJOL)

South African Medical Journal ... all the tribes found in South Africa, though Zulus and Sothos predominate, The variation of ... The performance of the intra-uterine device (IUD) is discussed against a background of well over 25000 insertions, ...

Robotic fish tracking method based on suboptimal interval Kalman filter

Science.gov (United States)

Tong, Xiaohong; Tang, Chao

2017-11-01

Autonomous Underwater Vehicle (AUV) research focused on tracking and positioning, precise guidance and return to dock and other fields. The robotic fish of AUV has become a hot application in intelligent education, civil and military etc. In nonlinear tracking analysis of robotic fish, which was found that the interval Kalman filter algorithm contains all possible filter results, but the range is wide, relatively conservative, and the interval data vector is uncertain before implementation. This paper proposes a ptimization algorithm of suboptimal interval Kalman filter. Suboptimal interval Kalman filter scheme used the interval inverse matrix with its worst inverse instead, is more approximate nonlinear state equation and measurement equation than the standard interval Kalman filter, increases the accuracy of the nominal dynamic system model, improves the speed and precision of tracking system. Monte-Carlo simulation results show that the optimal trajectory of sub optimal interval Kalman filter algorithm is better than that of the interval Kalman filter method and the standard method of the filter.

Maternal protein restriction induces alterations in insulin signaling and ATP sensitive potassium channel protein in hypothalami of intrauterine growth restriction fetal rats.

Science.gov (United States)

Liu, Xiaomei; Qi, Ying; Gao, Hong; Jiao, Yisheng; Gu, Hui; Miao, Jianing; Yuan, Zhengwei

2013-01-01

It is well recognized that intrauterine growth restriction leads to the development of insulin resistance and type 2 diabetes mellitus in adulthood. To investigate the mechanisms behind this "metabolic imprinting" phenomenon, we examined the impact of maternal undernutrition on insulin signaling pathway and the ATP sensitive potassium channel expression in the hypothalamus of intrauterine growth restriction fetus. Intrauterine growth restriction rat model was developed through maternal low protein diet. The expression and activated levels of insulin signaling molecules and K(ATP) protein in the hypothalami which were dissected at 20 days of gestation, were analyzed by western blot and real time PCR. The tyrosine phosphorylation levels of the insulin receptor substrate 2 and phosphatidylinositol 3'-kinase p85α in the hypothalami of intrauterine growth restriction fetus were markedly reduced. There was also a downregulation of the hypothalamic ATP sensitive potassium channel subunit, sulfonylurea receptor 1, which conveys the insulin signaling. Moreover, the abundances of gluconeogenesis enzymes were increased in the intrauterine growth restriction livers, though no correlation was observed between sulfonylurea receptor 1 and gluconeogenesis enzymes. Our data suggested that aberrant intrauterine milieu impaired insulin signaling in the hypothalamus, and these alterations early in life might contribute to the predisposition of the intrauterine growth restriction fetus toward the adult metabolic disorders.

Growth patterns in children with intrauterine growth retardation and their correlation to neurocognitive development.

Science.gov (United States)

Fattal-Valevski, Aviva; Toledano-Alhadef, Hagit; Leitner, Yael; Geva, Ronny; Eshel, Rina; Harel, Shaul

2009-07-01

The relationship between somatic growth and neurocognitive outcome was studied in a cohort of 136 children with intrauterine growth retardation. The children were followed up from birth to 9 to 10 years of age by annual measurements of growth parameters, neurodevelopmental evaluations, and IQ. The rate of catch-up for height between 1 and 2 years of age was significantly higher than the catch-up for weight (P importance for prediction of subsequent neurodevelopmental outcome in children with intrauterine growth retardation.

Reducing barriers to the use of the intrauterine contraceptive device ...

African Journals Online (AJOL)

AJRH Managing Editor

The use of the IUD as a LARC method is increasing in many developed and developing countries. New technology should .... Margules spiral(Gynecoil). Copper T (TCu200 ..... health benefit to an intrauterine system, not just an improvement in ...

Intrauterine Growth Restriction and the Fetal Programming of the Hedonic Response to Sweet Taste in Newborn Infants

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Caroline Ayres

2012-01-01

Full Text Available Intrauterine growth restriction is associated with increased risk for adult metabolic syndrome and cardiovascular disease, which seems to be related to altered food preferences in these individuals later in life. In this study, we sought to understand whether intrauterine growth leads to fetal programming of the hedonic responses to sweet. Sixteen 1-day-old preterm infants received 24% sucrose solution or water and the taste reactivity was filmed and analyzed. Spearman correlation demonstrated a positive correlation between fetal growth and the hedonic response to the sweet solution in the first 15 seconds after the offer (r=0.864, P=0.001, without correlation when the solution given is water (r=0.314, P=0.455. In fact, the more intense the intrauterine growth restriction, the lower the frequency of the hedonic response observed. IUGR is strongly correlated with the hedonic response to a sweet solution in the first day of life in preterm infants. This is the first evidence in humans to demonstrate that the hedonic response to sweet taste is programmed very early during the fetal life by the degree of intrauterine growth. The altered hedonic response at birth and subsequent differential food preference may contribute to the increased risk of obesity and related disorders in adulthood in intrauterine growth-restricted individuals.

Design Of Real-Time Implementable Distributed Suboptimal Control: An LQR Perspective

KAUST Repository

Jaleel, Hassan; Shamma, Jeff S.

2017-01-01

of establishing a communication link between two base stations with minimum energy consumption. We show through simulations that the performance under the proposed framework is close to the optimal performance and the suboptimal policy can be efficiently

Comparing Transcervical Intrauterine Lidocaine Instillation with Rectal Diclofenac for Pain Relief During Outpatient Hysteroscopy: A Randomized Controlled Trial

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Sussan S. Mohammadi

2015-05-01

Full Text Available Objectives: There are a number of potential advantages to performing hysteroscopy in an outpatient setting. However, the ideal approach, using local uterine anesthesia or rectal non-steroidal anti-inflammatory drugs, has not been determined. Our objective was to compare the efficacy of intrauterine lidocaine instillation with rectal diclofenac for pain relief during diagnostic hysteroscopy. Methods: We conducted a double-blind randomized controlled trial on 70 nulliparous women with primary infertility undergoing diagnostic hysteroscopy. Subjects were assigned into one of two groups to receive either 100mg of rectal diclofenac or 5mL of 2% intrauterine lidocaine. The intensity of pain was measured by a numeric rating scale 0–10. Pain scoring was performed during insertion of the hysteroscope, during visualization of the intrauterine cavity, and during extrusion of the hysteroscope. Results: There were no statistically significant differences between the groups with regard to the mean pain score during intrauterine visualization (p=0.500. The mean pain score was significantly lower during insertion and extrusion of the hysteroscope in the diclofenac group (p=0.001 and p=0.030, respectively. Nine patients in the lidocaine group and five patients in diclofenac group needed supplementary intravenous propofol injection for sedation (p=0.060. Conclusions: Rectal diclofenac appears to be more effective than intrauterine lidocaine in reducing pain during insertion and extrusion of hysteroscope, but there are no significant statistical and clinical differences between the two methods with regard to the mean pain score during intrauterine inspection.

Monitoring of fetuses with intrauterine growth restriction: a longitudinal study

NARCIS (Netherlands)

Hecher, K.; Bilardo, C. M.; Stigter, R. H.; Ville, Y.; Hackelöer, B. J.; Kok, H. J.; Senat, M. V.; Visser, G. H.

2001-01-01

To describe the time sequence of changes in fetal monitoring variables in intrauterine growth restriction and to correlate these findings with fetal outcome at delivery. This was a prospective longitudinal observational multicenter study on 110 singleton pregnancies with growth-restricted fetuses

Patient knowledge about and intention to use the intrauterine ...

African Journals Online (AJOL)

The intrauterine contraceptive device (IUCD) is a highly effective and safe method of ... A prospective cross-sectional study was conducted at Pelonomi Tertiary Hospital. A total ... Overall qualitative knowledge was poor, even among those aware of the ..... Nine percent of the 53 women who had heard about the IUCD in the.

Angiogenic factors for prediction of preeclampsia and intrauterine growth restriction onset in high-risk women: AngioPred study.

Science.gov (United States)

Raia-Barjat, Tiphaine; Prieux, Carole; Gris, Jean-Christophe; Chapelle, Céline; Laporte, Silvy; Chauleur, Céline

2017-09-22

The study aimed to compare the level of two angiogenic factors, soluble fms-like tyrosine kinase-1 (sFlt1) and soluble endoglin (sEng), for the prediction of preeclampsia and intrauterine growth restriction in high-risk pregnant women. A prospective multicenter cohort study of 200 pregnant patients was conducted between June 2008 and October 2010. sFlt1 and sEng were measured by enzyme-linked immunosorbent assay. Forty-five patients developed a placenta-mediated adverse pregnancy outcome. Plasma levels of sFlt1 and sEng were higher in patients who will experience a preeclampsia at 28, 32, and 36 weeks compared with patients with no complication. The same results were observed for intrauterine growth restriction. Plasma levels of sFlt1 and sEng were not significantly different for patients with preeclampsia compare to patients with intrauterine growth restriction. Patients with early pre-eclampsia (PE) had very high rates of angiogenic factors at 20, 24, and 28 weeks. Patients with late PE and early and late intrauterine growth retardation (IUGR) had high rates at 32 and 36 weeks. In high-risk women, angiogenic factors are disturbed before the onset of preeclampsia and this is true for intrauterine growth restriction.

A randomized, multi-center, clinical trial to assess the efficacy and safety of alginate carboxymethylcellulose hyaluronic acid compared to carboxymethylcellulose hyaluronic acid to prevent postoperative intrauterine adhesion.

Science.gov (United States)

Kim, Tak; Ahn, Ki Hoon; Choi, Doo Seok; Hwang, Kyung Joo; Lee, Byoung Ick; Jung, Min Hyung; Kim, Jae Weon; Kim, Jong Hyuk; Cha, Sun Hee; Lee, Ki Hwan; Lee, Kyu Sup; Oh, Sung Tack; Cho, Chi Heum; Rhee, Jeong Ho

2012-01-01

To estimate the efficacy of alginate carboxymethylcellulose hyaluronic acid (ACH) gel to prevent intrauterine adhesions after hysteroscopic surgery in comparison with carboxymethylcellulose hyaluronic acid (CH) gel, which is known as an effective adhesion inhibitor. Randomized, multicenter, single-blind, clinical trial (Canadian Task Force classification I). Tertiary university hospital. One hundred eighty-seven patients with a surgically treatable intrauterine lesion (myomas, polyps, septa, intrauterine adhesion, dysfunctional uterine bleeding). Patients were randomized to 2 groups: hysteroscopic surgery plus intrauterine application of ACH or CH. The rate of adhesion formation and the adhesion severity score with type and extent were calculated 4 weeks after surgery. The ACH group had results that were comparable to the CH group in terms of the development of intrauterine adhesions at 4 weeks follow-up. The adhesion severities were not different between the 2 groups. In a subgroup without baseline intrauterine adhesion, the ACH group showed a lower intrauterine adhesion rate than the CH group (p = .016). ACH had a comparable efficacy to CH in terms of the adhesion rate and severity. In the case of no baseline intrauterine adhesion, intrauterine application of ACH after hysteroscopic surgery had a lower rate of intrauterine adhesion than application of CH. Copyright © 2012 AAGL. Published by Elsevier Inc. All rights reserved.

Placental pathology in early intrauterine growth restriction associated with maternal hypertension.

Science.gov (United States)

Veerbeek, J H W; Nikkels, P G J; Torrance, H L; Gravesteijn, J; Post Uiterweer, E D; Derks, J B; Koenen, S V; Visser, G H A; Van Rijn, B B; Franx, A

2014-09-01

To identify key pathological characteristics of placentas from pregnancies complicated by early intrauterine growth restriction, and to examine their relations with maternal hypertensive disease and umbilical artery Doppler waveform abnormalities. Single-center retrospective cohort study of singleton pregnancies with abnormal umbilical artery Doppler flow patterns resulting in a live birth intrauterine growth restriction with or without hypertensive disease and pathological characteristics were compared between these various conditions according to predefined scoring criteria. Among 164 placentas studied, we found high rates of characteristic histopathological features that were associated with intrauterine growth restriction, including infarction (>5% in 42%), chronic villitis (21%), chronic chorioamnionitis (36%), membrane necrosis (20%), elevated nucleated red blood cells (89%), increased syncytial knotting (93%), increased villous maturation (98%), fetal thrombosis (32%) and distal villous hypoplasia (35%). Chronic inflammation of fetal membranes and syncytial knotting were more common in women with concomitant hypertensive disease as compared to women with normotensive IUGR (p < 0.05). Placentas from women with umbilical artery AREDF were more likely to show increased numbers of nucleated red blood cells and distal villous hypoplasia (p < 0.05). Placentas of women with early IUGR show high rates of several histological aberrations. Further, concomitant maternal hypertension is associated with characteristic inflammatory changes and umbilical artery AREDF with signs of chronic hypoxia. Copyright © 2014 Elsevier Ltd. All rights reserved.

Arterio-venous flow between monochorionic twins determined during intra-uterine transfusion

Energy Technology Data Exchange (ETDEWEB)

Gemert, Martin J C van; Wijngaard, Jeroen P H M van den [Laser Centre and Department of Obstetrics, Laser Center, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Lopriore, Enrico [Division of Neonatology, Department of Pediatrics, Leiden University Medical Centre, Leiden (Netherlands); Pasman, Suzanne A; Vandenbussche, Frank P H A [Division of Fetal Medicine, Department of Obstetrics, Leiden University Medical Centre, Leiden (Netherlands)], E-mail: m.j.vangemert@amc.uva.nl

2008-04-07

Twin-twin transfusion syndrome (TTTS) is a severe complication of monozygotic (identical) twin fetuses sharing one single (monochorionic) placenta. TTTS is caused by a net inter-twin transfusion of blood through placental anastomoses, from one twin (the donor) to the other (the recipient), which link the two feto-placental circulations. Currently, the only reliable method to measure the net inter-twin transfusion clinically is when incomplete laser therapy of TTTS occurs and one of the twins becomes anemic and requires an intra-uterine transfusion of adult red blood cells. Then, differences between adult hemoglobin concentrations measured during the transfusion and at birth relate not only to the net inter-twin transfusion but also to the finite lifetime of the adult red blood cells. We have analyzed this situation, derived the differential equations of adult hemoglobin in the donor and recipient twins, given the solutions and given expressions relating the net inter-twin flow with clinically measured parameters. We have included single and multiple intra-uterine transfusions. In conclusion, because incomplete laser therapy occurs frequently, and some cases require an intra-uterine transfusion, this method may allow collecting a wealth of net inter-twin flow data from clinicians involved in laser therapy of TTTS. To aid to the widespread use of this method, we have presented the equations as clearly as possible in tables for easy use by others. (note)

Arterio-venous flow between monochorionic twins determined during intra-uterine transfusion

International Nuclear Information System (INIS)

Gemert, Martin J C van; Wijngaard, Jeroen P H M van den; Lopriore, Enrico; Pasman, Suzanne A; Vandenbussche, Frank P H A

2008-01-01

Twin-twin transfusion syndrome (TTTS) is a severe complication of monozygotic (identical) twin fetuses sharing one single (monochorionic) placenta. TTTS is caused by a net inter-twin transfusion of blood through placental anastomoses, from one twin (the donor) to the other (the recipient), which link the two feto-placental circulations. Currently, the only reliable method to measure the net inter-twin transfusion clinically is when incomplete laser therapy of TTTS occurs and one of the twins becomes anemic and requires an intra-uterine transfusion of adult red blood cells. Then, differences between adult hemoglobin concentrations measured during the transfusion and at birth relate not only to the net inter-twin transfusion but also to the finite lifetime of the adult red blood cells. We have analyzed this situation, derived the differential equations of adult hemoglobin in the donor and recipient twins, given the solutions and given expressions relating the net inter-twin flow with clinically measured parameters. We have included single and multiple intra-uterine transfusions. In conclusion, because incomplete laser therapy occurs frequently, and some cases require an intra-uterine transfusion, this method may allow collecting a wealth of net inter-twin flow data from clinicians involved in laser therapy of TTTS. To aid to the widespread use of this method, we have presented the equations as clearly as possible in tables for easy use by others. (note)

Correlation between the umbilical artery flow ultrasound parameters of intrauterine fetal distress and fetal ischemic hypoxic damage

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Hai-Ying Gu

2017-08-01

Full Text Available Objective: To study the correlation between the umbilical artery flow ultrasound parameters of intrauterine fetal distress and fetal ischemic hypoxic damage. Methods: A total of 158 puerperae who gave birth in our hospital between July 2016 and June 2017 were selected and divided into the intrauterine distress group (Apgar<7 points and normal pregnancy group (Apgar≥7 points according to the neonatal Apgar score, the umbilical artery flow ultrasound parameters at 24-30 weeks, 31-36 weeks and 37-41 weeks of gestation were determined, and the umbilical arterial blood gas parameters and oxidative stress molecule levels were determined. Results: At 24-30 weeks, 31-36 weeks and 37-41 weeks of gestation, umbilical arterial RI, PI and S/D of intrauterine distress group were significantly higher than those of normal pregnancy group; umbilical arterial pH and PaO2 of intrauterine distress group were significantly lower than those of normal pregnancy group and negatively correlated with RI, PI and S/D while PaCO2 and lactic acid levels were significantly higher than those of normal pregnancy group and positively correlated with RI, PI and S/D; SOD, GSH-px and CAT levels in umbilical artery of intrauterine distress group were significantly lower than those of normal pregnancy group and negatively correlated with RI, PI and S/D while MDA and 8-OHdG levels were significantly higher than those of normal pregnancy group and positively correlated with RI, PI and S/D. Conclusion: Umbilical artery flow ultrasound characteristics of intrauterine fetal distress are characterized by the increased resistance and decreased blood flow and are correlated with the degree of fetal hypoxia and oxidative stress.

Comparison of Zygote Intrafallopian Transfer and Intrauterine Embryo Transfer for Male-factor Infertility After Intracytoplasmic Sperm Injection

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Ying-Hui Lin

2004-03-01

Conclusion: The data presented in this report demonstrate that there was no therapeutic improvement associated with the increased complexity of ZIFT as compared with intrauterine ET after ICSI for the treatment of male-factor infertility. With the advent of improvements in culture techniques in the IVF laboratory, intrauterine ET remains the technique of choice.

Indicators of suboptimal performance embedded in the Wechsler Memory Scale-Fourth Edition (WMS-IV).

Science.gov (United States)

Bouman, Zita; Hendriks, Marc P H; Schmand, Ben A; Kessels, Roy P C; Aldenkamp, Albert P

2016-01-01

Recognition and visual working memory tasks from the Wechsler Memory Scale-Fourth Edition (WMS-IV) have previously been documented as useful indicators for suboptimal performance. The present study examined the clinical utility of the Dutch version of the WMS-IV (WMS-IV-NL) for the identification of suboptimal performance using an analogue study design. The patient group consisted of 59 mixed-etiology patients; the experimental malingerers were 50 healthy individuals who were asked to simulate cognitive impairment as a result of a traumatic brain injury; the last group consisted of 50 healthy controls who were instructed to put forth full effort. Experimental malingerers performed significantly lower on all WMS-IV-NL tasks than did the patients and healthy controls. A binary logistic regression analysis was performed on the experimental malingerers and the patients. The first model contained the visual working memory subtests (Spatial Addition and Symbol Span) and the recognition tasks of the following subtests: Logical Memory, Verbal Paired Associates, Designs, Visual Reproduction. The results showed an overall classification rate of 78.4%, and only Spatial Addition explained a significant amount of variation (p < .001). Subsequent logistic regression analysis and receiver operating characteristic (ROC) analysis supported the discriminatory power of the subtest Spatial Addition. A scaled score cutoff of <4 produced 93% specificity and 52% sensitivity for detection of suboptimal performance. The WMS-IV-NL Spatial Addition subtest may provide clinically useful information for the detection of suboptimal performance.

Low-grade inflammation in young adults exposed to intrauterine hyperglycemia

DEFF Research Database (Denmark)

Kelstrup, Louise; Clausen, Tine Dalsgaard; Mathiesen, Elisabeth R

2012-01-01

AIM: To investigate associations between fetal exposure to intrauterine hyperglycemia and plasma concentrations of interleukin-6 (IL-6) and high sensitivity C-reactive protein (hs-CRP) in adult offspring. METHOD: We studied 597 offspring, aged 18-27years, from four different groups concerning...

Neonatal morbidity after induction vs expectant monitoring in intrauterine growth restriction at term: a subanalysis of the DIGITAT RCT

NARCIS (Netherlands)

Boers, Kim E.; van Wyk, Linda; van der Post, Joris A. M.; Kwee, Anneke; van Pampus, Maria G.; Spaanderdam, Marc E. A.; Duvekot, Johannes J.; Bremer, Henk A.; Delemarre, Friso M. C.; Bloemenkamp, Kitty W. M.; de Groot, Christianne J. M.; Willekes, Christine; Rijken, Monique; Roumen, Frans J. M. E.; Thornton, Jim G.; van Lith, Jan M. M.; Mol, Ben W. J.; le Cessie, Saskia; Scherjon, Sicco A.

2012-01-01

OBJECTIVE: The Disproportionate Intrauterine Growth Intervention Trial at Term (DIGITAT) compared induction of labor and expectant management in suspected intrauterine growth restriction (IUGR) at term. In this subanalysis, we report neonatal morbidity between the policies based on the Morbidity

Detection of suboptimal effort with symbol span: development of a new embedded index.

Science.gov (United States)

Young, J Christopher; Caron, Joshua E; Baughman, Brandon C; Sawyer, R John

2012-03-01

Developing embedded indicators of suboptimal effort on objective neurocognitive testing is essential for detecting increasingly sophisticated forms of symptom feigning. The current study explored whether Symbol Span, a novel Wechsler Memory Scale-fourth edition measure of supraspan visual attention, could be used to discriminate adequate effort from suboptimal effort. Archival data were collected from 136 veterans classified into Poor Effort (n = 42) and Good Effort (n = 94) groups based on symptom validity test (SVT) performance. The Poor Effort group had significantly lower raw scores (p Span test. A raw score cutoff of Span can effectively differentiate veterans with multiple failures on established free-standing and embedded SVTs.

Morphometry of megakaryocytes in the liver of New Zealand White rabbits during intrauterine and postnatal development

Directory of Open Access Journals (Sweden)

Pacheco Maria Rita

2002-01-01

Full Text Available The hepatic megakaryocytic cells of New Zealand White rabbit in the intrauterine phase and in the immediate postnatal period were studied. Statistical analysis of the data concerning the cytoplasm and nucleus of those cells, i.e., area, perimeter, maximum diameter, minimum diameter, volume and shape factor, presented significant differences (p<0.01 for F values concerning the life phases studied on15th, 22nd and 29th day of intrauterine life and 10th day of postnatal life, and for F values for animal within each phase. The Tukey?s test showed that most of the parameters studied in the cytoplasm and nucleus of these megakaryocytic cells presented the lowest values on the 15th day of intrauterine life and the highest on the 22nd day of the same phase.

Caspase Activation in Fetal Rat Brain Following Experimental Intrauterine Inflammation

Science.gov (United States)

Sharangpani, Aditi; Takanohashi, Asako; Bell, Michael J.

2009-01-01

Intrauterine inflammation has been implicated in developmental brain injuries, including the development of periventricular leukomalacia (PVL) and cerebral palsy (CP). Previous studies in our rat model of intrauterine inflammation demonstrated apoptotic cell death in fetal brains within the first 5 days after lipopolysaccharide (LPS) administration to mothers and eventual dysmyelination. Cysteine-containing, aspartate-specific proteases, or caspases, are proteins involved with apoptosis through both intracellular (intrinsic pathway) and extracellular (extrinsic pathway) mechanisms. We hypothesized that cell death in our model would occur mainly via activation of the extrinsic pathway. We further hypothesized that Fas, a member of the tumor necrosis factor receptor (TNFR) superfamily, would be increased and the death inducing signaling complex (DISC) would be detectable. Pregnant rats were injected intracervically with LPS at E15 and immunoblotting, immunohistochemical and immunoprecipitation analyses were performed. The presence of the activated form of the effector caspase (caspase-3) was observed 24 h after LPS administration. Caspase activity assays demonstrated rapid increases in (i) caspases-9 and -10 within 1 h, (ii) caspase-8 at 2 h and (iii) caspase-3 at 4 h. At 24 h after LPS, activated caspase-3+/Fas+ cells were observed within the developing white matter. Lastly, the DISC complex (caspase-8, Fas and Fas-associated Death Domain (FADD)) was observed within 30 min by immunoprecipitation. Apoptosis in our model occurs via both extrinsic and intrinsic pathways, and activation of Fas may play a role. Understanding the mechanisms of cell death in models of intrauterine inflammation may affect development of future strategies to mitigate these injuries in children. PMID:18289516

Is intrauterine exchange transfusion a safe procedure for management of fetal anaemia?

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Garabedian, C; Philippe, M; Vaast, P; Wibaut, B; Salleron, J; Delsalle, A; Rakza, T; Subtil, D; Houfflin-Debarge, V

2014-08-01

To study modalities and complications of intrauterine exchange transfusion (IUET) for the management of severe fetal anaemia. Retrospective study of all IUET procedures performed between January 1999 and January 2012 at a regional centre. Characteristics of each procedure were studied to identify risk factors for complications. Survival rates according to the different aetiologies of anaemia were evaluated. In total, 225 IUET procedures were performed in 96 fetuses. Major indications were feto-maternal erythrocyte alloimmunization (n=80/96, 83.3%) and parvovirus B19 infection (n=13/96, 13.5%). Twenty-six percent of the fetuses (25/96) had hydrops fetalis before the first IUET. Intrauterine fetal death occurred after 2.7% (6/225) of procedures, premature rupture of the membranes occurred after 0.9% (2/225) of procedures, and emergency caesarean section was required after 3.6% (8/225) of procedures. Fetal bradycardia [odds ratio (OR) 37, 95% confidence interval (CI) 8.3-170; prate in the study cohort was 87.5% (84/96): 90% (72/80) in the alloimmunization group and 76.9% (10/13) in the parvovirus-infected group (NS). IUET has a higher complication rate than simple intrauterine transfusion, and should be performed by well-trained specialists. Copyright © 2014. Published by Elsevier Ireland Ltd.

Patterns of marijuana and tobacco use associated with suboptimal self-rated health among US adult ever users of marijuana

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James Tsai

2017-06-01

In conclusion, among adult ever users of marijuana, current tobacco use is high and strongly associated with suboptimal SRH; regular marijuana smoking with or without current tobacco use is significantly associated with suboptimal SRH.

Intra-uterine exposure of horses to Sarcocystis spp. antigens

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A.M. Antonello

2016-04-01

Full Text Available The aim of this study was to examine the intra-uterine exposure to Sarcocystis spp. antigens, determining the number of foals with detectable concentrations of antibodies against these agents in the serum, before colostrum ingestion and collect data about exposure of horses to the parasite. Serum samples were collected from 195 thoroughbred mares and their newborns in two farms from southern Brazil. Parasite specific antibody responses to Sarcocystis antigens were detected using the indirect immunofluorescent antibody test (IFAT and immunoblot analysis. In 84.1% (159/189 of the pregnant mares and in 7.4% (14/189 of foals we detected antibodies anti-Sarcocystis spp. by IFAT. All samples seropositive from foals were also positive in their respective mares. Serum samples of seropositive foals by IFAT, showed no reactivity on the immunoblot, having as antigens S. neurona merozoites. In conclusion, the intra-uterine exposure to Sarcocystis spp. antigens in horses was demonstrated, with occurrence not only in mares, but also in their foals, before colostrum ingestion these occurrences were reduced.

Intrauterine programming mechanism for hypercholesterolemia in prenatal caffeine-exposed female adult rat offspring.

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Xu, Dan; Luo, Hanwen W; Hu, Wen; Hu, Shuwei W; Yuan, Chao; Wang, Guihua H; Zhang, Li; Yu, Hong; Magdalou, Jacques; Chen, Liaobin B; Wang, Hui

2018-05-02

Clinical and animal studies have indicated that hypercholesterolemia and its associated diseases have intrauterine developmental origins. Our previous studies showed that prenatal caffeine exposure (PCE) led to fetal overexposure to maternal glucocorticoids (GCs) and increased serum total cholesterol levels in adult rat offspring. This study further confirms the intrauterine programming of PCE-induced hypercholesterolemia in female adult rat offspring. Pregnant Wistar rats were intragastrically administered caffeine (30, 60, and 120 mg/kg/d) from gestational day (GD)9 to 20. Female rat offspring were euthanized at GD20 and postnatal wk 12; several adult rat offspring were additionally subjected to ice-water swimming stimulation to induce chronic stress prior to death. The effects of GCs on cholesterol metabolism and epigenetic regulation were verified using the L02 cell line. The results showed that PCE induced hypercholesterolemia in adult offspring, which manifested as significantly higher levels of serum total cholesterol and LDL cholesterol (LDL-C) as well as higher ratios of LDL-C/HDL cholesterol. We further found that the cholesterol levels were increased in fetal livers but were decreased in fetal blood, accompanied by increased maternal blood cholesterol levels and reduced placental cholesterol transport. Furthermore, analysis of PCE offspring in the uterus and in a postnatal basal/chronic stress state and the results of in vitro experiments showed that hepatic cholesterol metabolism underwent GC-dependent changes and was associated with cholesterol synthase via abnormalities in 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) histone acetylation. We concluded that, to compensate for intrauterine placentally derived decreases in fetal blood cholesterol levels, high intrauterine GC levels activated fetal hepatic CCAAT enhancer binding protein α signaling and down-regulated Sirtuin1 expression, which mediated the high levels of histone acetylation ( via H3K9

Sub-Optimal Management of Type 2 Diabetes Mellitus – A Local Audit

African Journals Online (AJOL)

Original Research: Sub-Optimal Management of Type 2 Diabetes Mellitus – A Local Audit ... despite clinical trial data documenting improved outcomes associated not ... were used to define the Metabolic Syndrome.9 Central obesity was.

Intrauterine Idiopathic Amputation of the Head of a Porcine Foetus

DEFF Research Database (Denmark)

Agerholm, J. S.; Garoussi, M. T.

2013-01-01

Contents An anencephalic full-term porcine foetus accompanied by a mummified head was submitted for examination. The neck almost entirely lacked skin and was covered by granulation tissue as were the exposed parts of the spine and spinal cord. The case represents a rare case of intrauterine...

Long-acting reversible contraceptives: intrauterine devices and the contraceptive implant.

Science.gov (United States)

Espey, Eve; Ogburn, Tony

2011-03-01

The provision of effective contraception is fundamental to the practice of women's health care. The most effective methods of reversible contraception are the so-called long-acting reversible contraceptives, intrauterine devices and implants. These methods have multiple advantages over other reversible methods. Most importantly, once in place, they do not require maintenance and their duration of action is long, ranging from 3 to 10 years. Despite the advantages of long-acting reversible contraceptive methods, they are infrequently used in the United States. Short-acting methods, specifically oral contraceptives and condoms, are by far the most commonly used reversible methods. A shift from the use of short-acting methods to long-acting reversible contraceptive methods could help reduce the high rate of unintended pregnancy in the United States. In this review of long-acting reversible contraceptive methods, we discuss the intrauterine devices and the contraceptive implant available in the United States, and we describe candidates for each method, noncontraceptive benefits, and management of complications.

Intrauterine infection/inflammation during pregnancy and offspring brain damages: Possible mechanisms involved

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Golan Hava

2004-04-01

Full Text Available Abstract Intrauterine infection is considered as one of the major maternal insults during pregnancy. Intrauterine infection during pregnancy could lead to brain damage of the developmental fetus and offspring. Effects on the fetal, newborn, and adult central nervous system (CNS may include signs of neurological problems, developmental abnormalities and delays, and intellectual deficits. However, the mechanisms or pathophysiology that leads to permanent brain damage during development are complex and not fully understood. This damage may affect morphogenic and behavioral phenotypes of the developed offspring, and that mice brain damage could be mediated through a final common pathway, which includes over-stimulation of excitatory amino acid receptor, over-production of vascularization/angiogenesis, pro-inflammatory cytokines, neurotrophic factors and apoptotic-inducing factors.

Effect of perioperative fetal intrauterine hypoxia on maternal oxidative stress injury after cesarean section

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Xue-Hong Zou

2017-03-01

Full Text Available Objective: To study the effect of perioperative fetal intrauterine hypoxia on maternal oxidative stress injury after cesarean section. Methods: 37 puerperae receiving cesarean section for fetal intrauterine hypoxia between May 2014 and December 2016 were selected as hypoxia group and 40 puerperae receiving cesarean section during the same period and without complications during pregnancy or fetal intrauterine hypoxia were selected as control group. Umbilical arterial blood was collected after delivery of placenta for blood gas analysis, and the placenta tissue and serum samples were collected to test the content of oxidative stress products and antioxidants. Results: Umbilical arterial blood gas analysis parameters pH value as well as PO2, HCO3 - and BE content of hypoxia group were significantly lower than those of control group (P＜0.05; NADPH, reactive oxide species (ROS and reactive nitrogen species (RNS content in placenta tissue of hypoxia group were significantly higher than those of control group (P ＜0.05 while glutathione S-transferase (GST, glutathione peroxidase (GPx, superoxide dismutase (SOD, Trx, vitamin C (VitC, VitE and coenzyme Q10 (CoQ10 content were significantly lower than those of control group (P＜0.05; serum malondialdehyde (MDA and 8-iso-prostaglandin F2α (8-iso-PGF2α content of hypoxia group were significantly higher than those of control group (P＜0.05. Conclusions: Perioperative fetal intrauterine hypoxia can lead to maternal oxidative stress injury after cesarean section and increase the generation of free radicals and the consumption of antioxidants.

Histomorphometric evaluation of the testicular parenchyma of rats submitted to protein restriction during intrauterine and postnatal life

OpenAIRE

OLIVEIRA, JESSICA; SILVA, ALLUANAN; SOUZA, SANDRA; MORAIS, ROSANA; MELO, ELIZABETH NEVES; MAIA, FREDERICO; JUNIOR, VALDEMIRO SILVA

2017-01-01

The critical period of development is highly susceptible to disorders. Environmental contaminants, stress, and poor nutrition may permanently affect structurally and functionally an organism during adulthood. Protein restriction in intrauterine and neonatal periods may impair testicular cells and reduce steroidogenic activity. The current study investigated the effect of low protein diet during intrauterine and postnatal life on testicular function in immature and adult rats. Pregnant Wistar ...

Intrauterine growth restriction affects the preterm infant's hippocampus.

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Lodygensky, Gregory A; Seghier, Mohammed L; Warfield, Simon K; Tolsa, Cristina Borradori; Sizonenko, Stephane; Lazeyras, François; Hüppi, Petra S

2008-04-01

The hippocampus is known to be vulnerable to hypoxia, stress, and undernutrition, all likely to be present in fetal intrauterine growth restriction (IUGR). The effect of IUGR in preterm infants on the hippocampus was studied using 3D magnetic resonance imaging at term-equivalent age Thirteen preterm infants born with IUGR after placental insufficiency were compared with 13 infants with normal intrauterine growth age matched for gestational age. The hippocampal structural differences were defined using voxel-based morphometry and manual segmentation. The specific neurobehavioral function was evaluated by the Assessment of Preterm Infants' Behavior at term and at 24 mo of corrected age by a Bayley Scales of Infant and Toddler Development. Voxel-based morphometry detected significant gray matter volume differences in the hippocampus between the two groups. This finding was confirmed by manual segmentation of the hippocampus with a reduction of hippocampal volume after IUGR. The hippocampal volume reduction was further associated with functional behavioral differences at term-equivalent age in all six subdomains of the Assessment of Preterm Infants' Behavior but not at 24 mo of corrected age. We conclude that hippocampal development in IUGR is altered and might result from a combination of maternal corticosteroid hormone exposure, hypoxemia, and micronutrient deficiency.

NOTE: Arterio-venous flow between monochorionic twins determined during intra-uterine transfusion

Science.gov (United States)

van Gemert, Martin J. C.; van den Wijngaard, Jeroen P. H. M.; Lopriore, Enrico; Pasman, Suzanne A.; Vandenbussche, Frank P. H. A.

2008-04-01

Twin-twin transfusion syndrome (TTTS) is a severe complication of monozygotic (identical) twin fetuses sharing one single (monochorionic) placenta. TTTS is caused by a net inter-twin transfusion of blood through placental anastomoses, from one twin (the donor) to the other (the recipient), which link the two feto-placental circulations. Currently, the only reliable method to measure the net inter-twin transfusion clinically is when incomplete laser therapy of TTTS occurs and one of the twins becomes anemic and requires an intra-uterine transfusion of adult red blood cells. Then, differences between adult hemoglobin concentrations measured during the transfusion and at birth relate not only to the net inter-twin transfusion but also to the finite lifetime of the adult red blood cells. We have analyzed this situation, derived the differential equations of adult hemoglobin in the donor and recipient twins, given the solutions and given expressions relating the net inter-twin flow with clinically measured parameters. We have included single and multiple intra-uterine transfusions. In conclusion, because incomplete laser therapy occurs frequently, and some cases require an intra-uterine transfusion, this method may allow collecting a wealth of net inter-twin flow data from clinicians involved in laser therapy of TTTS. To aid to the widespread use of this method, we have presented the equations as clearly as possible in tables for easy use by others.

Predicting the intrauterine fetal death of fetuses with cystic hygroma in early pregnancy.

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Shimura, Mai; Ishikawa, Hiroshi; Nagase, Hiromi; Mochizuki, Akihiko; Sekiguchi, Futoshi; Koshimizu, Naho; Itai, Toshiyuki; Odagami, Mizuha

2018-01-11

We investigated whether it was possible to predict the prognosis of fetuses with cystic hygroma in early pregnancy based on the degree of neck thickening. We retrospectively analyzed 57 singleton pregnancies with fetuses with cystic hygroma who were examined before the 22nd week of pregnancy. The fetuses were categorized according to the outcome, structural abnormalities at birth, and chromosomal abnormalities. Here, we proposed a new sonographic predictor with which we assessed neck thickening by dividing the width of the neck thickening by the biparietal diameter, which is expressed as the cystic hygroma width/biparietal diameter ratio. The median cystic hygroma width/biparietal diameter ratio in the intrauterine fetal death group (0.51) was significantly higher than that in the live birth group (0.27). No significant difference in the median cystic hygroma width/biparietal diameter ratio was found between the structural abnormalities group at birth and the no structural abnormalities group, and no significant difference in the median cystic hygroma width/biparietal diameter ratio was found between the chromosomal abnormality group and the no chromosomal abnormality group. We used receiver operating characteristic analysis to evaluate the cystic hygroma width/biparietal diameter ratio to predict intrauterine fetal death. When the cystic hygroma width/biparietal diameter ratio cut-off value was 0.5, intrauterine fetal death could be predicted with a sensitivity of 52.9% and a specificity of 100%. It is possible to predict intrauterine fetal death in fetuses with cystic hygroma in early pregnancy if cystic hygroma width/biparietal diameter ratio is measured. However, even if cystic hygroma width/biparietal diameter ratio is measured, predicting the presence or absence of a structural abnormality at birth or a chromosomal abnormality is difficult. © 2018 Japanese Teratology Society.

Creatinine concentrations of accumulated intrauterine fluid to confirm the clinical diagnosis of urometra in mares.

Science.gov (United States)

Schnobrich, M R; Gordon, D L; Scoggin, C F; Bradecamp, E A; Canisso, I F

2017-03-25

Urine pooling, as a persistent condition, is a cause of infertility in mares due to endometrial inflammation and sperm toxicity. Identification of urometra can be challenging in mares presenting with the condition intermittently, or when urine flows into the uterus but is undetectable in the vagina. Currently, there are no reported objective methods to confirm the clinical diagnosis of urine contamination in intrauterine-fluid accumulations. Since creatinine is present in high concentrations in urine and does not diffuse across cell membranes, creatinine concentration should be increased in mares with urometra, but negligible in normal and mares with intrauterine fluid accumulation (non-urometra cases). To test this hypothesis, creatinine concentrations of intrauterine fluid were measured in mares with a clinical diagnosis of urine accumulation (n=9) or intrauterine fluid containing no urine (n=10). Results showed that creatinine concentrations (mg/dl) were significantly higher in mares that had a clinical diagnosis of urometra (42.8±12.6, range 4.1-109.2) compared with those that did not (0.38±0.1, range 0-0.9). Also, two mares after urethral extension surgery demonstrated a remarkable reduction in creatinine concentrations. This study highlights an undocumented approach to confirm a clinical diagnosis of urometra in mares; the authors anticipate that testing for creatinine in the uterine fluid of mares may become a standard tool for identifying urometra in mares and confirming the success of urogenital surgeries. British Veterinary Association.

Intrauterine radiation exposures and mental retardation

International Nuclear Information System (INIS)

Miller, R.W.

1988-01-01

Small head size and mental retardation have been known as effects of intrauterine exposure to ionizing radiation since the 1920s. In the 1950s, studies of Japanese atomic-bomb survivors revealed that at 4-17 wk of gestation, the greater the dose, the smaller the brain (and head size), and that beginning at 0.5 Gy (50 rad) in Hiroshima, mental retardation increased in frequency with increasing dose. No other excess of birth defects was observed. Otake and Schull (1984) pointed out that the period of susceptibility to mental retardation coincided with that for proliferation and migration of neuronal elements from near the cerebral ventricles to the cortex. Mental retardation could be the result of interference with this process. Their analysis indicated that exposures at 8-15 wk to 0.01-0.02 Gy (1-2 rad) doubled the frequency of severe mental retardation. This estimate was based on small numbers of mentally retarded atomic-bomb survivors. Although nuclear accidents have occurred recently, new cases will hopefully be too rare to provide further information about the risk of mental retardation. It may be possible, however, to learn about lesser impairment. New psychometric tests may be helpful in detecting subtle deficits in intelligence or neurodevelopmental function. One such test is PEERAMID, which is being used in schools to identify learning disabilities due, for example, to deficits in attention, short- or long-term memory, or in sequencing information. This and other tests could be applied in evaluating survivors of intrauterine exposure to various doses of ionizing radiation. The results could change our understanding of the safety of low-dose exposures

Essential nutrient supplementation prevents heritable metabolic disease in multigenerational intrauterine growth-restricted rats

Science.gov (United States)

Goodspeed, Danielle; Seferovic, Maxim D.; Holland, William; Mcknight, Robert A.; Summers, Scott A.; Branch, D. Ware; Lane, Robert H.; Aagaard, Kjersti M.

2015-01-01

Intrauterine growth restriction (IUGR) confers heritable alterations in DNA methylation, rendering risk of adult metabolic syndrome (MetS). Because CpG methylation is coupled to intake of essential nutrients along the one-carbon pathway, we reasoned that essential nutrient supplementation (ENS) may abrogate IUGR-conferred multigenerational MetS. Pregnant Sprague-Dawley rats underwent bilateral uterine artery ligation causing IUGR in F1. Among the F2 generation, IUGR lineage rats were underweight at birth (6.7 vs. 8.0 g, P 30% elevated, P 5-fold less central fat mass, normal hepatic glucose efflux, and >70% reduced circulating triglycerides and very-LDLs compared with IUGR control-fed F2 offspring (P intrauterine growth-restricted rats. PMID:25395450

Level of suboptimal adherence to first line antiretroviral treatment & its determinants among HIV positive people in India.

Science.gov (United States)

Joshi, Beena; Chauhan, Sanjay; Pasi, Achhelal; Kulkarni, Ragini; Sunil, Nithya; Bachani, Damodar; Mankeshwar, Ranjit

2014-07-01

National Anti-retroviral treatment (ART) programme in India was launched in 2004. Since then, there has been no published country representative estimate of suboptimal adherence among people living with HIV (PLHIV) on first line ART in public settings. Hence a multicentric study was undertaken in 15 States of India to assess the level of suboptimal adherence and its determinants among PLHIV. Using a prospective observational study design, 3285 PLHIV were enrolled and followed up to six months across 30 ART centres in India. Adherence was assessed using pill count and self-reported recall method and determinants of suboptimal adherence were explored based on the responses to various issues as perceived by them. Suboptimal adherence was found in 24.5 per cent PLHIV. Determinants of suboptimal adherence were illiteracy (OR--1.341, CI--1.080-1.665), on ART for less than 6 months (OR--1.540, CI--1.280-1.853), male gender (OR for females--0.807, CI--0.662-0.982), tribals (OR--2.246, CI--1.134-4.447), on efavirenz (EFA) regimen (OR--1.479, CI--1.190-1.837), presence of anxiety (OR--1.375, CI--1.117-1.692), non-disclosure of HIV status to family (OR--1.549, CI--1.176-2.039), not motivated for treatment (OR--1.389, CI--1.093-1.756), neglect from friends (OR--1.368, CI--1.069-1.751), frequent change of residence (OR--3.373, CI--2.659-4.278), travel expenses (OR--1.364, CI--1.138-1.649), not meeting the PLHIV volunteer/community care coordinator at the ART center (OR--1.639, CI--1.330-2.019). To enhance identification of PLHIV vulnerable to suboptimal adherence, the existing checklist to identify the barriers to adherence in the National ART Guidelines needs to be updated based on the study findings. Quality of comprehensive adherence support services needs to be improved coupled with vigilant monitoring of adherence measurement.

Level of suboptimal adherence to first line antiretroviral treatment & its determinants among HIV positive people in India

Directory of Open Access Journals (Sweden)

Beena Joshi

2014-01-01

Full Text Available Background & objectives: National Anti-retroviral treatment (ART programme in India was launched in 2004. Since then, there has been no published country representative estimate of suboptimal adherence among people living with HIV (PLHIV on first line ART in public settings. Hence a multicentric study was undertaken in 15 States of India to assess the level of suboptimal adherence and its determinants among PLHIV. Methods: Using a prospective observational study design, 3285 PLHIV were enrolled and followed up to six months across 30 ART centres in India. Adherence was assessed using pill count and self-reported recall method and determinants of suboptimal adherence were explored based on the responses to various issues as perceived by them. Results: Suboptimal adherence was found in 24.5 per cent PLHIV. Determinants of suboptimal adherence were illiteracy (OR-1.341, CI-1.080-1.665 , on ART for less than 6 months (OR-1.540, CI- 1.280-1.853, male gender (OR for females -0.807, CI- 0.662-0.982, tribals (OR-2.246, CI-1.134-4.447, on efavirenz (EFA regimen (OR- 1.479, CI - 1.190 - 1.837, presence of anxiety (OR- 1.375, CI - 1.117 - 1.692, non-disclosure of HIV status to family (OR- 1.549, CI - 1.176 - 2.039, not motivated for treatment (OR- 1.389, CI - 1.093 - 1.756, neglect from friends (OR-1.368, CI-1.069-1.751, frequent change of residence (OR- 3.373, CI - 2.659 - 4.278, travel expenses (OR- 1.364, CI - 1.138-1.649, not meeting the PLHIV volunteer/community care coordinator at the ART center (OR-1.639, CI-1.330-2.019. Interpretation & conclusions: To enhance identification of PLHIV vulnerable to suboptimal adherence, the existing checklist to identify the barriers to adherence in the National ART Guidelines needs to be updated based on the study findings. Quality of comprehensive adherence support services needs to be improved coupled with vigilant monitoring of adherence measurement.

A prospective study on intrauterine cannabis exposure and fetal blood flow

NARCIS (Netherlands)

El Marroun, H.; Tiemeier, H.; Steegers, E.A.P.; Roos-Hesselink, J.W.; Jaddoe, V.W.V.; Hofman, A.; Verhulst, F.C.; van den Brink, W.; Huizink, A.C.

2010-01-01

Background: Cannabis is commonly used among pregnant women. It is unclear whether cannabis exposure causes hemodynamic modifications in the fetus, like tobacco does. Aims: This study aims to ascertain fetal blood redistribution due to intrauterine cannabis exposure. Methods: This study was embedded

Predictive factors for intrauterine growth restriction.

Science.gov (United States)

Albu, A R; Anca, A F; Horhoianu, V V; Horhoianu, I A

2014-06-15

Reduced fetal growth is seen in about 10% of the pregnancies but only a minority has a pathological background and is known as intrauterine growth restriction or fetal growth restriction (IUGR / FGR). Increased fetal and neonatal mortality and morbidity as well as adult pathologic conditions are often associated to IUGR. Risk factors for IUGR are easy to assess but have poor predictive value. For the diagnostic purpose, biochemical serum markers, ultrasound and Doppler study of uterine and spiral arteries, placental volume and vascularization, first trimester growth pattern are object of assessment today. Modern evaluations propose combined algorithms using these strategies, all with the goal of a better prediction of risk pregnancies.

Intrauterine photoacoustic and ultrasound imaging probe

Science.gov (United States)

Miranda, Christopher; Barkley, Joel; Smith, Barbara S.

2018-04-01

Intrauterine photoacoustic and ultrasound imaging are probe-based imaging modalities with translational potential for use in detecting endometrial diseases. This deep-tissue imaging probe design allows for the retrofitting of commercially available endometrial sampling curettes. The imaging probe presented here has a 2.92-mm diameter and approximate length of 26 cm, which allows for entry into the human endometrial cavity, making it possible to use photoacoustic imaging and high-resolution ultrasound to characterize the uterus. We demonstrate the imaging probes' ability to provide structural information of an excised pig uterus using ultrasound imaging and detect photoacoustic signals at a radial depth of 1 cm.

Assessment of reproductive results of infertile patients who had undergone operative hysteroscopy for intrauterine pathology

Directory of Open Access Journals (Sweden)

Röyale Seferli

2015-03-01

Full Text Available Objectives: We aimed to evaluate the reproductive outcomes of infertile patients who had undergone operative hysteroscopy (HS with the diagnoses of uterine septum, endometrial polyp, submucous myoma, and intrauterine adhesion. Methods: This retrospective study included 334 patients who had been diagnosed with primary and secondary infertility, aged between 18–35 years and diagnosed with uterine septum (group 1, endometrial polyp (group 2, submucous myoma (group 3, and intrauterine adhesion (group 4 by hysterosalpingography or office HS and who were treated via hysteroscopic operation between January 2009 and January 2013. Pregnancy results were obtained from the patients’ files and hospital database; when this was not possible, the patients were queried by phone calls. Groups were then compared in terms of characteristics, prognoses, and pregnancy outcomes. Results: The cumulative pregnancy rate was 58.7% in infertile patients who underwent operative HS due to intrauterine pathology. The mean length of time from operation to conception was 10.8±9.6 months in all groups. Mean age, infertility duration, infertility type, and smoking status were statistically different among the groups (p<0.05. Following surgery, 95 (66.4% of 143 patients in group 1 conceived and 57 (60% of these pregnancies resulted in term birth. There were 64 (54.2% pregnancies in group 2 and 34 (53.1% resulted in term birth. Sixteen (47.1% patients conceived in group 3, and 6 (37.5% of them had term birth. Twenty-one (53.8% patients conceived in group 4. Twelve out of 21 patients (57.1% had term birth. The most common mode of delivery was cesarean section in all groups. Conclusion: Thus, operative HS increases pregnancy rates in patients with intrauterine pathology. In future, large-scale prospective studies should be carried out to reveal the effects of the hysteroscopic method and compare this approach with other methods in order to achieve better pregnancy outcomes in

Soluble CD30 in normotensive pregnant women with isolated fetal intrauterine growth restriction: a comparison with preeclamptic women.

Science.gov (United States)

Laskowska, Marzena; Laskowska, Katarzyna; Oleszczuk, Jan

2010-11-01

This study investigated the serum concentration of soluble CD30 (sCD30) in pregnant women with isolated fetal intrauterine growth restriction, in pregnancies complicated by preeclampsia with and without accompanying intrauterine growth restriction, and in normotensive healthy pregnant controls. Lower serum concentrations of sCD30 were observed in the group of normotensive pregnant women with a growth-restricted fetus in comparison with the group of healthy pregnant controls, and also in comparison with both preeclamptic groups of pregnant women with and without fetal growth restriction. The concentration of sCD30 in maternal serum from preeclamptic women did not differ in comparison with values from healthy controls or pregnancies complicated by isolated fetal intrauterine growth restriction. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Recurrent chronic histiocytic intervillositis with intrauterine growth restriction, osteopenia, and fractures.

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Crawford, April; Moore, Lynette; Bennett, Gregory; Savarirayan, Ravi; Manton, Nicholas; Khong, Yee; Barnett, Christopher P; Haan, Eric

2016-11-01

Chronic histiocytic intervillositis (CHI) is characterized by the presence of histiocytes within the intervillous space of the placenta. The pathogenesis is unclear but available evidence supports an alloimmune mechanism on the basis of the presence in maternal blood of HLA antibodies directed against paternal HLA antigens. CHI has a high risk of recurrence and of abnormal perinatal outcomes. Little is known about the effects of CHI on the developing fetus, in particular on the growth and development of the skeleton. We have studied a woman whose third pregnancy was terminated after ultrasonography showed severe intrauterine growth restriction, raising the possibility of a lethal skeletal dysplasia. Postmortem radiographs showed multiple fractures and other signs of osteogenesis imperfecta (OI). However, bone histology was not typical of OI and no abnormalities were identified by sequencing OI genes. The subsequent pregnancy was also severely growth restricted and was terminated. The placenta showed chronic histiocytic intervillositis, which, on retrospective review, had also been present in her second and third pregnancies. Her fifth pregnancy was again associated with intrauterine growth restriction and CHI but resulted in a premature birth. CHI can be associated with radiographic features that mimic OI and should be considered when fetal fractures occur in the context of recurrent miscarriage, fetal death in utero, and intrauterine growth restriction. The correct diagnosis can be made by histopathology of the placenta, supported by bone histology and normal results of molecular studies for OI. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Value of endometrial thickness measurement for diagnosing focal intrauterine pathology in women without abnormal uterine bleeding

DEFF Research Database (Denmark)

Dreisler, E; Sorensen, S Stampe; Ibsen, P H

2009-01-01

OBJECTIVE: To assess the diagnostic value of transvaginal sonographic (TVS) measurement of endometrial thickness for diagnosing focal intrauterine pathology in women without abnormal uterine bleeding (AUB). METHODS: A random selection from the Danish Civil Registration System was made: 1660 women...... of endometrial thickness is a poor diagnostic test, but is apparently efficacious in excluding focal intrauterine pathology, especially in postmenopausal women. The 4-5-mm threshold conventionally used to exclude endometrial malignancy in women with postmenopausal bleeding is not transferable to women without...

Fetal uptake of intra-amniotically delivered dendrimers in a mouse model of intrauterine inflammation and preterm birth.

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Burd, Irina; Zhang, Fan; Dada, Tahani; Mishra, Manoj K; Borbiev, Talaibek; Lesniak, Wojciech G; Baghlaf, Haitham; Kannan, Sujatha; Kannan, Rangaramanujam M

2014-08-01

Intrauterine inflammation is associated with preterm birth and can lead to fetal neuroinflammation and neurobehavioral disorders in newborns. Dendrimers can intrinsically target and deliver drugs for the treatment of neuroinflammation. We explore whether hydroxyl polyamidoamine (PAMAM) dendrimer (G4-OH)-based nanomedicines can be delivered to the fetus by intra-amniotic administration, in a mouse model of intrauterine inflammation. The time-dependent accumulation of G4-OH-fluorophore conjugate was quantified by fluorescence. These studies suggest that, after intra-amniotic administration, there is significant accumulation of dendrimer in the fetus gut and brain. In addition, there is some fetal-maternal transport of the dendrimer. Confocal microscopy confirmed the presence of G4-OH in the fetal brain, with a large accumulation in the brain blood vessels and the brain parenchyma, and some microglial uptake. We believe that intra-amniotic administration of G4-OH-drug nanomedicines may enable the treatment of diseases related to intrauterine inflammation and fetal neuroinflammation. Using a mouse model of intrauterin inflammation leading to neuroinflammation in the fetus, these investigators demonstrate that intra-amniotic delivery of hydroxyl polyamidoamine (PAMAM) dendrimer (G4-OH)-based nanomedicines may provide an effective method in preventing this complication. Copyright © 2014 Elsevier Inc. All rights reserved.

Intrauterine insemination versus fallopian tube sperm perfusion for non-tubal infertility

NARCIS (Netherlands)

Cantineau, Astrid E. P.; Cohlen, Ben J.; Heineman, Maas Jan; Marjoribanks, Jane; Farquhar, Cindy

2013-01-01

Background Intrauterine insemination (IUI) is a common treatment for couples with subfertility that does not involve the fallopian tubes. It is used to bring the sperm close to the released oocyte. Another method of introducing sperm is fallopian tube sperm perfusion (FSP). Fallopian tube sperm

A prospective study on intrauterine cannabis exposure and fetal blood flow

NARCIS (Netherlands)

El Marroun, Hanan; Tiemeier, Henning; Steegers, Eric A. P.; Roos-Hesselink, Jolien W.; Jaddoe, Vincent W. V.; Hofman, Albert; Verhulst, Frank C.; van den Brink, Wim; Huizink, Anja C.

2010-01-01

Cannabis is commonly used among pregnant women. It is unclear whether cannabis exposure causes hemodynamic modifications in the fetus, like tobacco does. This study aims to ascertain fetal blood redistribution due to intrauterine cannabis exposure. This study was embedded in the Generation R Focus

Effect of intrauterine autoplasma application on mare fertility

OpenAIRE

ŠTĚRBOVÁ, Hana

2010-01-01

The objective of this study was to evaluate the effect of intrauterine plasma infusion on conceiving rate in selected group of mares during the breeding seasons 2008 and 2009. The fresh sperm insemination was followed by the infusion of self-plasma and subsequently the successivity of the insemination was compared with the control group of mares. Next, there were observed following factors which could influence the effectiveness of conceiving: age of the mares, number of insemination doses, s...

Features of newborns with intrauterine growth restriction (according to the data of perinatal center of the Saratov region

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Chernenkov Yu.V.

2017-03-01

Full Text Available Objective: to identify risk factors that adversely affect the development of fetus and child small for gestational age; to assess the incidence of the intrauterine development of fetus and newborn; to analyze the health indicators of these children. Material and Methods. Cases of 226 children (6.6% with diagnosed intrauterine growth restriction of the fetus were examined, including 134 of prematurity (59%. Results. The most common risk factors for the intrauterine development of the fetus were: violation of the utero-placental circulation — 196 cases, the uterine scar — 78 women, urinary tract infection — 94. Extragenital pathology was found in all women, the threat of termination of pregnancy in 109 cases, medical history of abortions in 106 women and 83 anaemia in women. Birth asphyxia was observed in 102 children (45%, prematurity in 71 cases (31.4%. Asphyxia of severe degree accounted 1 (0.5% premature and 1 (0.45% full-term baby. Asphyxia of moderate severity (4-6 points accounted 70 (30.9% preterm and 31 (13.7% full-term infants. The most common form of the intrauterine development of the fetus asymmetrical revealed 178 cases (79.1%. Conclusion: Perinatal factors such as medical abortion, urinary tract infection, extragenital pathology are preventable. The predominant form of the intrauterine development of the fetus is asymmetric form, symmetric and dysplastic revealed to a greater degree in premature infants. Children with low weight for gestational age should be adequately provided with the necessary nutrients, fortifiers, vitamins and in the process of rehabilitation — cerebropro-tective therapy.

Role of peripheral blood mononuclear cell transportation from mother to baby in HBV intrauterine infection.

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Shao, Qingliang; Zhao, Xiaxia; Yao Li, M D

2013-12-01

We aimed to investigate the role of peripheral blood mononuclear cell transportation from mother to baby in hepatitis B virus (HBV) intrauterine infection. Thirty HBsAg-positive pregnant women in the second trimester and their aborted fetuses were included in this study. Enzyme-linked-immunosorbent-assay was utilized to detect HBsAg in the peripheral blood of pregnant women and the femoral vein blood of their aborted fetuses. HBV-DNA in serum and peripheral blood mononuclear cells (PBMC) and GSTM1 alleles of pregnant women and their aborted fetuses were detected by nested polymerase chain reaction (PCR) and seminested PCR, respectively. We also examined the location of placenta HBsAg and HBcAb using immunohistochemical staining. The expression of placenta HBV-DNA was detected by in situ hybridization. For the 30 aborted fetuses, the HBV intrauterine infection rate was 43.33%. The HBV-positive rates of HBsAg in peripheral blood, serum, and PBMC were 10% (3/30), 23.33% (7/30), and 33.33% (10/30), respectively. Maternal-fetal PBMC transport was significantly positively correlated with fetal PBMC HBV-DNA (P = 0.004). Meanwhile, the rates of HBV infection gradually decreased from the maternal side to the fetus side of placenta (decidual cells > trophoblastic cells > villous mesenchymal cells > villous capillary endothelial cells). However, no significant correlation between placenta HBV infection and HBV intrauterine infection was observed (P = 0.410). HBV intrauterine infection was primarily due to peripheral blood mononuclear cell maternal-fetal transportation in the second trimester in pregnant women.

Specific features of a neonatal period in infants following intrauterine intravascular blood transfusion for fetal hemolytic disease

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A. V. Ivanova

2015-01-01

Full Text Available The paper gives data on the characteristics of a neonatal period in infants following intrauterine blood transfusion for Rh-induced fetal hemolytic disease. It is shown that the early diagnosis and detection of the signs of fetal hemolytic disease, and intrauterine intravascular blood transfusion may prolong pregnancy, ensure the birth of a baby with normal anthropometric indicators, optimize his/her neonatal period and prognosis of severe hemolytic disease in the fetus and newborn.

Recurrent pneumonias following intrauterine irradiation of the thymus

International Nuclear Information System (INIS)

Rieger, H.L.; Eife, R.F.; Muenchen Univ.

1978-01-01

A 9 year old girl is described who was born without thyroid function as a result of maternal 131 I treatment during early pregnancy. The patient had 15 pneumonias since her second year of life. Immunological investigations showed normal humoral immunity and a normal in vitro responsiveness of circulating lymphocytes. The patient was, however, anergic to 5 skintest antigens and exhibited a primary vaccination reaction after a smallpox revaccination. The findings suggest that intrauterine irradiation primarily affected memory-lymphocytes. (orig.) [de

Investigation of knowledge level about intrauterine device

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Hediye Dagdeviren

2013-06-01

Full Text Available Objective: To investigate a level of knowledge about intrauterine device between females who were examined in our gynecology department. Metods: The study was conducted at Gynecology and Obstetric Department of Bakirkoy Dr. Sadi Konuk Teaching and Research Hospital between August 2012-November 2012. The study were included 189 patients who accepted to participate. For collecting data; a form of questionnaire was used which has gived information about the intrauterine device (IUD and status of socio-demographic characteristics of the patients. The questionnaire were administered by the researchers in a separate room as a face-to-face interviews. SPSS 20.0 (SPSS Inc, Chicago, IL, USA program was used for statistical analysis. Results: The mean age of the women in the study was 31.1 ± 9.9. 44.7% of women were not using any modern contraceptive method. IUD utilization rate was 3.2%. 1.6% of women had never heard IUD, %76.1 women heard copper IUD. 42% of respondents gave the wrong answer to IUD inserted into ovaries. Conclusion: The IUD which is a cheap, does not require patient compliance, and has high efficacy. In this study, we were not found a statisfically significant difference for answers to questions in patients with different socio-demographic characteristics. The main result of the study was; among all parcipitians ,even health care workers there was an important disability about level of knowledge for IUD. It is great importance the whole society, including health professionals must train about family planning. [Cukurova Med J 2013; 38(3.000: 440-445

Intrauterine photoacoustic and ultrasound imaging probe.

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Miranda, Christopher; Barkley, Joel; Smith, Barbara

2018-04-01

Intrauterine photoacoustic and ultrasound imaging are probe-based imaging modalities with translational potential for use in detecting endometrial diseases. This deep-tissue imaging probe design allows for the retrofitting of commercially available endometrial sampling curettes. The imaging probe presented here has a 2.92-mm diameter and approximate length of 26 cm, which allows for entry into the human endometrial cavity, making it possible to use photoacoustic imaging and high-resolution ultrasound to characterize the uterus. We demonstrate the imaging probes' ability to provide structural information of an excised pig uterus using ultrasound imaging and detect photoacoustic signals at a radial depth of 1 cm. (2018) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE).

Intrauterine supraventricular tachyarrhythmias and transplacental digitalisation.

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Nagashima, M; Asai, T; Suzuki, C; Matsushima, M; Ogawa, A

1986-10-01

Six newborn infants with intrauterine supraventricular tachyarrhythmias (five cases of atrial flutter and one of supraventricular tachycardia) are described. Transplacental digitalisation was attempted in three cases. Supraventricular tachycardia associated with hydrops fetalis, detected in a fetus at a gestation of 31 weeks, was successfully converted to normal sinus rhythm eight days after the mother began treatment with digoxin. The serum concentration of digoxin in cord blood almost equalled the maternal concentration in three cases. In the remaining three cases treatment with digitalis was effective in converting tachyarrhythmias to sinus rhythm after delivery. With maintenance digoxin therapy, the prognosis of fetal tachyarrhythmias seems to be good, once conversion to sinus rhythm has been accomplished.

Timing of insertion of levonorgestrel-releasing intrauterine system : a randomised controlled trial

NARCIS (Netherlands)

van der Heijden, Pahh; Geomini, Pmaj; Herman, M C; Veersema, S; Bongers, M Y

OBJECTIVE: The objective was to assess whether patient-perceived pain during the insertion of the levonorgestrel-releasing intrauterine system (LNG-IUS) depends on the timing during the menstrual cycle. DESIGN: A stratified two-armed non-inferiority randomised controlled trial. SETTING: Large

Applications of sub-optimality in dynamic programming to location and construction of nuclear fuel processing plant

International Nuclear Information System (INIS)

Thiriet, L.; Deledicq, A.

1968-09-01

First, the point of applying Dynamic Programming to optimization and Operational Research problems in chemical industries are recalled, as well as the conditions in which a dynamic program is illustrated by a sequential graph. A new algorithm for the determination of sub-optimal politics in a sequential graph is then developed. Finally, the applications of sub-optimality concept is shown when taking into account the indirect effects related to possible strategies, or in the case of stochastic choices and of problems of the siting of plants... application examples are given. (authors) [fr

Endometrial Injury May Increase the Pregnancy Rate in Patients Undergoing Intrauterine Insemination: An Interventional Randomized Clinical Trial.

Science.gov (United States)

Bahaa Eldin, Ahmed M; Abdelmaabud, Karim H; Laban, Mohamed; Hassanin, Alaa S; Tharwat, Ahmed A; Aly, Tarek R; Elbohoty, Ahmed E; Elsayed, Helmy M; Ibrahim, Ahmed M; Ibrahim, Mohammed E; Sabaa, Haitham M; Abdelrazik, Azza A; Abdelhady, Ibrahim

2016-10-01

This study aimed to investigate the effect of endometrial injury using Pipelle catheter in the follicular phase (cycle day 5, 6, or 7) of the stimulation cycle on pregnancy rates in patients undergoing intrauterine insemination. This prospective randomized controlled study was carried out in the Assisted Reproductive Technology Unit of Ain Shams University Maternity Hospital, Cairo, Egypt, from July 1, 2013 to August 31, 2015. Three hundred sixty women, 20 to 35 years of age, with patent fallopian tubes, mild male factor infertility, or unexplained infertility were recruited. Participants were allocated randomly into 2 groups: experimental arm and control arm. Women in the experimental arm underwent endometrial biopsy using a Pipelle catheter on day 5, 6, or 7 of the stimulation cycle combined with intrauterine insemination. Women in the control group underwent intrauterine insemination with no endometrial biopsy done. The primary outcomes were the clinical and chemical pregnancy rates. Data of 344 participants were statistically analyzed. The chemical pregnancy rate was 23.66% in the experimental arm and 10.85% in the control arm (P = .002). The clinical pregnancy rate was 18.93% in the experimental arm and 7.42% in the control arm (P = .003). Endometrial injury using a Pipelle catheter in the stimulation cycle may improve pregnancy rates in women undergoing intrauterine insemination. © The Author(s) 2016.

Sub-optimal vitamin B-12 levels among ART-naive HIV-positive individuals in an urban cohort in Uganda.

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Aggrey S Semeere

Full Text Available Malnutrition is common among HIV-infected individuals and is often accompanied by low serum levels of micronutrients. Vitamin B-12 deficiency has been associated with various factors including faster HIV disease progression and CD4 depletion in resource-rich settings. To describe prevalence and factors associated with sub-optimal vitamin B-12 levels among HIV-infected antiretroviral therapy (ART naïve adults in a resource-poor setting, we performed a cross-sectional study with a retrospective chart review among individuals attending either the Mulago-Mbarara teaching hospitals' Joint AIDS Program (MJAP or the Infectious Diseases Institute (IDI clinics, in Kampala, Uganda. Logistic regression was used to determine factors associated with sub-optimal vitamin B-12. The mean vitamin B-12 level was 384 pg/ml, normal range (200-900. Sub-optimal vitamin B-12 levels (<300 pg/ml were found in 75/204 (36.8%. Twenty-one of 204 (10.3% had vitamin B-12 deficiency (<200 pg/ml while 54/204 (26.5% had marginal depletion (200-300 pg/ml. Irritable mood was observed more among individuals with sub-optimal vitamin B-12 levels (OR 2.5, 95% CI; 1.1-5.6, P=0.03. Increasing MCV was associated with decreasing serum B-12 category; 86.9 fl (± 5.1 vs. 83 fl (± 8.4 vs. 82 fl (± 8.4 for B-12 deficiency, marginal and normal B-12 categories respectively (test for trend, P=0.017. Compared to normal B-12, individuals with vitamin B-12 deficiency had a longer known duration of HIV infection: 42.2 months (± 27.1 vs. 29.4 months (± 23.8; P=0.02. Participants eligible for ART (CD4<350 cells/µl with sub-optimal B-12 had a higher mean rate of CD4 decline compared to counterparts with normal B-12; 118 (± 145 vs. 22 (± 115 cells/µl/year, P=0.01 respectively. The prevalence of a sub-optimal vitamin B-12 was high in this HIV-infected, ART-naïve adult clinic population in urban Uganda. We recommend prospective studies to further clarify the causal relationships of sub-optimal

Kell hemolytic disease of the fetus. Combination treatment with plasmapheresis and intrauterine blood transfusion.

Science.gov (United States)

Lakhwani, S; Machado, P; Pecos, P; Coloma, M; Rebollo, S; Raya, J M

2011-08-01

We report the case of a 36-year old pregnant woman with a Kell alloimmunization (anti-K1), probably secondary to a previous blood transfusion, and a severe hemolytic disease of the fetus. Once the first fetal blood transfusion by cordocentesis was performed, we started treatment with repeated plasmapheresis to maintain anti-K1 titer below 1:32. With this scheme we did not need to perform a second intrauterine fetal blood transfusion and only mild anemia was found in the newborn. Taking into account that the rate of serious complications with plasmapheresis is lower than that related with intrauterine blood transfusion, this could be an alternative approach to repeated transfusions. Copyright © 2011 Elsevier Ltd. All rights reserved.

Suboptimal Choice in Pigeons: Stimulus Value Predicts Choice over Frequencies.

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Aaron P Smith

Full Text Available Pigeons have shown suboptimal gambling-like behavior when preferring a stimulus that infrequently signals reliable reinforcement over alternatives that provide greater reinforcement overall. As a mechanism for this behavior, recent research proposed that the stimulus value of alternatives with more reliable signals for reinforcement will be preferred relatively independently of their frequencies. The present study tested this hypothesis using a simplified design of a Discriminative alternative that, 50% of the time, led to either a signal for 100% reinforcement or a blackout period indicative of 0% reinforcement against a Nondiscriminative alternative that always led to a signal that predicted 50% reinforcement. Pigeons showed a strong preference for the Discriminative alternative that remained despite reducing the frequency of the signal for reinforcement in subsequent phases to 25% and then 12.5%. In Experiment 2, using the original design of Experiment 1, the stimulus following choice of the Nondiscriminative alternative was increased to 75% and then to 100%. Results showed that preference for the Discriminative alternative decreased only when the signals for reinforcement for the two alternatives predicted the same probability of reinforcement. The ability of several models to predict this behavior are discussed, but the terminal link stimulus value offers the most parsimonious account of this suboptimal behavior.

Self-care practices of Malaysian adults with diabetes and sub-optimal glycaemic control.

Science.gov (United States)

Tan, Ming Yeong; Magarey, Judy

2008-08-01

To investigate the self-care practices of Malaysian adults with diabetes and sub-optimal glycaemic control. Using a one-to-one interviewing approach, data were collected from 126 diabetic adults from four settings. A 75-item questionnaire was used to assess diabetes-related knowledge and self-care practices regarding, diet, medication, physical activity and self-monitoring of blood glucose (SMBG). Most subjects had received advice on the importance of self-care in the management of their diabetes and recognised its importance. Sixty-seven subjects (53%) scored below 50% in their diabetes-related knowledge. Subjects who consumed more meals per day (80%), or who did not include their regular sweetened food intakes in their daily meal plan (80%), or who were inactive in daily life (54%), had higher mean fasting blood glucose levels (p=0.04). Subjects with medication non-adherence (46%) also tended to have higher fasting blood glucose levels. Only 15% of the subjects practiced SMBG. Predictors of knowledge deficit and poor self-care were low level of education (p = <0.01), older subjects (p=0.04) and Type 2 diabetes subjects on oral anti-hyperglycaemic medication (p = <0.01). There were diabetes-related knowledge deficits and inadequate self-care practices among the majority of diabetic patients with sub-optimal glycaemic control. This study should contribute to the development of effective education strategies to promote health for adults with sub-optimal diabetes control.

Relationship between in utero sonographic evaluation and subcutaneous plicometry after birth in infants with intrauterine growth restriction: an exploratory study

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Giannì Maria L

2010-10-01

Full Text Available Abstract Background Intrauterine growth restriction (IUGR is associated with several medical complications before and after delivery. The aim of this study was to evaluate the concordance between the fetal ultrasonographic measurement of subcutaneous tissue thicknesses and the skinfold thicknesses assessment in intrauterine growth restricted newborns. Methods We designed an exploratory study. Fetal ultrasonographic measurement of subcutaneous tissue thicknesses, according to Bernstein's and Galan's method, and neonatal skinfold thicknesses were evaluated in 13 intrauterine growth restricted newborns within 4 hours before delivery and on the first day of life, respectively. Concordance between fetal and neonatal measurements was assessed using the Lin's correlation coefficient and the Bland-Altman method. Results The data obtained by the measurements of neonatal skinfold thicknesses was significantly correlated with the prenatal measurements (Lin's coefficients, arm: 0.60; subscapular: 0.72; abdomen: 0.51. Bland-Altman analysis showed moderate agreement between the fetal ultrasonographic measurement of subcutaneous tissue thicknesses and the neonatal skinfold thicknesses assessment. Conclusions The present study provides preliminary evidence that fetal sonographic measurements may represent additional indices of intrauterine growth restriction.

N-acetyl cysteine in ovulation induction of PCOS women underwent intrauterine insemination: An RCT

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Tahereh Behrouzi Lak

2017-08-01

Full Text Available Background: N-acetyl cysteine (NAC was proposed as an adjuvant to clomiphene citratefor ovulation induction in patients with polycystic ovary syndrome (PCOS without clomiphene citrate resistance. Objective: To evaluate the effect of NAC on pregnancy rate in PCOS patients who were candidates for intrauterine insemination. Materials and Methods: In this randomized clinical trial 97 PCOS women aged 18-38 years were enrolled in two groups, randomly. For the case group (n=49, NAC (1.2 gr+ clomiphene citrate (100 mg + letrozole (5mg were prescribed Daily from the third day of menstruation cycle for five days. The control group (n=48 had the same drug regimen without NAC. In order to follicular development, GONALF was injected on days of 7-11 menstrual cycles in all participants. When the follicle size was 18mm or more, HCG (10000 IU was injected intramuscular and the intrauterine insemination was performed after 34-36 hr. Results: There were not significant differences between study groups regarding mean endometrial thickness (p=0.14, mean number of mature follicles (p=0.20 and the pregnancy rate (p=0.09. Conclusion: NAC is ineffective in inducing or augmenting ovulation in PCOS patients who were candidates for intrauterine insemination and cannot be recommended as an adjuvant to CC in such patients.

Risk of suboptimal iodine intake in pregnant Norwegian women.

Science.gov (United States)

Brantsæter, Anne Lise; Abel, Marianne Hope; Haugen, Margaretha; Meltzer, Helle Margrete

2013-02-06

Pregnant women and infants are exceptionally vulnerable to iodine deficiency. The aims of the present study were to estimate iodine intake, to investigate sources of iodine, to identify predictors of low or suboptimal iodine intake (defined as intakes below 100 μg/day and 150 μg/day) in a large population of pregnant Norwegian women and to evaluate iodine status in a sub-population. Iodine intake was calculated based on a validated Food Frequency Questionnaire in the Norwegian Mother and Child Cohort. The median iodine intake was 141 μg/day from food and 166 μg/day from food and supplements. Use of iodine-containing supplements was reported by 31.6%. The main source of iodine from food was dairy products, contributing 67% and 43% in non-supplement and iodine-supplement users, respectively. Of 61,904 women, 16.1% had iodine intake below 100 μg/day, 42.0% had iodine intake below 150 μg/day and only 21.7% reached the WHO/UNICEF/ICCIDD recommendation of 250 μg/day. Dietary behaviors associated with increased risk of low and suboptimal iodine intake were: no use of iodine-containing supplements and low intake of milk/yogurt, seafood and eggs. The median urinary iodine concentration measured in 119 participants (69 μg/L) confirmed insufficient iodine intake. Public health strategies are needed to improve and secure the iodine status of pregnant women in Norway.

Suboptimal processor for anomaly detection for system surveillance and diagnosis

Energy Technology Data Exchange (ETDEWEB)

Ciftcioglu, Oe.; Hoogenboom, J.E.; Dam, H. van

1989-06-01

Anomaly detection for nuclear reactor surveillance and diagnosis is described. The residual noise obtained as a result of autoregressive (AR) modelling is essential to obtain high sensitivity for anomaly detection. By means of the method of hypothesis testing a suboptimal anomaly detection processor is devised for system surveillance and diagnosis. Experiments are carried out to investigate the performance of the processor, which is in particular of interest for on-line and real-time applications.

Neuropsychological development in preschool children born with asymmetrical intrauterine growth restriction and impact of postnatal head growth.

Science.gov (United States)

Klaric, Andrea Simić; Galić, Slavka; Kolundzić, Zdravko; Bosnjak, Vlatka Mejaski

2013-07-01

Neuropsychological development and the impact of postnatal head growth were studied in preschool children with asymmetrical intrauterine growth restriction. Examinees born at term with a birth weight below the 10th percentile were matched to the control group according to chronological and gestational age, gender, and maternal education. Fifty children were in each group, with a mean age of 6 years, 4 months. The Touwen neurological examination, the Čuturić developmental test, an imitative hand positions test, and a visual attention test were performed. There were significant differences (Pmotor variables, the developmental quotient, and the imitative hand positions test. Fine motor skills had the most discriminative power. Relative growth of the head in relation to weight gain was positively correlated to neurocognitive outcome. Intrauterine growth-restricted children with a current head circumference ≤10th percentile had poorer outcomes. Conclusively, intrauterine growth restriction has a negative impact on neurocognitive development. Slow postnatal head growth is correlated with a poorer neuropsychological outcome.

Intra-uterine experimental infection by Ureaplasma diversum induces TNF-α mediated womb inflammation in mice

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Jamile R. Silva

2016-01-01

Full Text Available Ureaplasma diversum is an opportunistic pathogen associated with uterine inflammation, impaired embryo implantation, infertility, abortions, premature birth of calves and neonatal pneumonia in cattle. It has been suggested that the intra-uterine infection by Ureaplasma diversum can cause vascular changes that hinder the success of pregnancy. Thus, the aim of this study was to evaluate the changes of intrauterine site of A/J mice in estrus or proestrus phase inoculated with Ureaplasma diversum. The infection was monitored at 24, 48 and 72 hours by the PCR methodology to detect the Ureaplasma in the inoculation site and the profile of circulating blood cells. Morphological changes, intensity of inflammation and the production of cytokines were compared. The infected mice showed local inflammation through the production of IFN-γ and TNF-α. Ureaplasma diversum infections in the reproductive tract of studied mice seemed to be associated with the production of pro-inflammatory cytokines in uterine parenchyma. The levels of TNF-α of infected mice were dependent on the bacterial load of inoculated Ureaplasma. Uterine experimental infections by Ureaplasma diversum have not been mentioned yet and herein we presented the first report of an intrauterine infection model in mice.

Intra-uterine experimental infection by Ureaplasma diversum induces TNF-α mediated womb inflammation in mice.

Science.gov (United States)

Silva, Jamile R; Ferreira, Lício F A A; Oliveira, Percíllia V S; Nunes, Ivanéia V; Pereira, Ítalo S; Timenetsky, Jorge; Marques, Lucas M; Figueiredo, Tiana B; Silva, Robson A A

2016-01-01

Ureaplasma diversum is an opportunistic pathogen associated with uterine inflammation, impaired embryo implantation, infertility, abortions, premature birth of calves and neonatal pneumonia in cattle. It has been suggested that the intra-uterine infection by Ureaplasma diversum can cause vascular changes that hinder the success of pregnancy. Thus, the aim of this study was to evaluate the changes of intrauterine site of A/J mice in estrus or proestrus phase inoculated with Ureaplasma diversum. The infection was monitored at 24, 48 and 72 hours by the PCR methodology to detect the Ureaplasma in the inoculation site and the profile of circulating blood cells. Morphological changes, intensity of inflammation and the production of cytokines were compared. The infected mice showed local inflammation through the production of IFN-γ and TNF-α. Ureaplasma diversum infections in the reproductive tract of studied mice seemed to be associated with the production of pro-inflammatory cytokines in uterine parenchyma. The levels of TNF-α of infected mice were dependent on the bacterial load of inoculated Ureaplasma. Uterine experimental infections by Ureaplasma diversum have not been mentioned yet and herein we presented the first report of an intrauterine infection model in mice.

Immediate metabolic consequences of intrauterine growth restriction and low birthweight.

Science.gov (United States)

Bhatia, Jatinder; Gates, Amy

2013-01-01

Optimal fetal growth resulting in a 'normally grown' term infant is of paramount importance for assuring a healthy start for postnatal growth and development. Fetal, infant and childhood growth restriction is an important clinical problem for obstetricians, neonatologists, pediatricians and globally, for public health. Worldwide, an estimated 20 million infants are born with low birthweight and a substantial proportion are small for gestational age. Many advances have been made in defining growth restriction by prenatal techniques, thus allowing the recognition of intrauterine growth restriction. Distinguishing infants who are small but have appropriate growth potential from those with growth restriction is important in order to apply obstetric surveillance, anticipate neonatal problems and plan for postneonatal guidance. It is clear that the fetus in growth-restricted pregnancies has limited supply of nutrients and oxygen. The resultant changes, if involving the placenta as well, can lead to circulatory and metabolic changes affecting both short- and long-term survival and development. In this paper, the causes and immediate consequence of being born with low birthweight, intrauterine growth restriction or small for gestational age will be discussed. Copyright © 2013 Nestec Ltd., Vevey/S. Karger AG, Basel.

Gene expression patterns of vascular endothelial growth factor (VEGF-A) in human placenta from pregnancies with intrauterine growth restriction.

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Szentpéteri, Imre; Rab, Attila; Kornya, László; Kovács, Péter; Joó, József Gábor

2013-07-01

In this study, we describe changes in gene expression pattern of vascular endothelial growth factor (VEGF)-A in human placenta obtained from pregnancies with intrauterine growth restriction using placenta from normal pregnancies as control. We compared gene expression of VEGF-A in placental samples from Intrauterine growth restriction (IUGR) pregnancies versus placenta obtained from normal pregnancies. Among potential confounders, important clinical informations were also analyzed. In the IUGR group, the VEGF-A gene was overexpressed compared to the normal pregnancy group (Ln 2(α)β-actin: 1.32; Ln 2(α)GADPH: 1.56). There was no correlation between the degree of growth restriction and VEGF-A gene expression (Ln 2(α)(0-5)percentile: 0.58; Ln 2(α)(5-10)percentile: 0.64). Within the IUGR group, there was a trend toward a positive correlation between placental VEGF-A gene activity and gestational age at delivery (Ln 2(α) 37 weeks: 1.35). Our findings suggest that the increase in placental expression of the VEGF-A gene and the resultant stimulation of angiogenesis are a response to hypoxic environment developing in the placental tissue in IUGR. Thus, it appears to be a secondary event rather than a primary factor in the development of IUGR There is a trend toward a positive correlation between gestational age and placental VEGF-A gene activity.

The results of virological surveillance for intrauterine infections in Saint-Petersburg

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E. A. Murina

2014-01-01

Full Text Available The purpose of researchis the determiningthe etiological structure ofintrauterine infections in Saint-Petersburg pediatric patients, pregnant women andinfants born to them using a variety of virological methods.Methods: serum from 164 children aged from 1 month to 14 years with diagnosis of «intrauterine infection». Serum from 80 pregnant women, collected in each trimester (total – 240 samples, their 42 children (at the age of 1–2 and 4–6  months of life, total – 82 samples. Immunoglobulin Mand G (IgM and IgGto herpes virus type 1, cytomegalovirus (CMV, Toxoplasma gondii, mycoplasma and chlamydia, rubella, Epstein-Barr virus (EBV and parvovirus B19, as well as IgG avidity,were determined by ELISA in all these samples. Theimmunoblot (Western blot, using the «Immunoblot2000» with test kits from «Euroimmun AG» (Germany, was applied to confirm cases. Statistical analysis wasperformed with theprograms Microsoft Excel, Statistica6.Results: cytomegalovirus, herpes virus 1st type and Epstein-Barr virus infections are dominate in the structure of intrauterine ones (45%, 23% and 14%, respectively. Laboratory evidence ofreactivationof cytomegalovirus (35% ofpregnant womenin the 2nd and/or 3rd trimesters and acuteparvovirus infection (15% of cases were found. Specific IgM to cytomegalovirus were detected in 6,2% ofchildren in the firstsix months of life.Conclusions: with the aim of early detection of cytomegalovirus reactivation and acute parvovirus infection it isnecessary to monitor pregnant women with the definition of specific IgM, IgG and avidity IgG. The procedure to using immunoblotting in the diagnosis of intrauterine infectionsneeds to be further study.

Intrauterine extremity gangrene and cerebral infarction at term

DEFF Research Database (Denmark)

Tanvig, M; Jørgensen, J S; Nybo, M

2011-01-01

Intrauterine extremity gangrene in combination with cerebral infarction is a serious and rare event. We present a case with a healthy mother who gave birth to a child with this condition. At term, the mother presented at the antenatal clinic with decreased fetal movements. Cardiotocography (CTG...... resonance imaging (MRI). At one year of age the boy was doing well and had prosthesis as a left arm. He had no signs of further complications. Despite thorough examination of the parents and the child, the reason for the thrombosis is still unknown....

Maternal health-related quality of life after induction of labor or expectant monitoring in pregnancy complicated by intrauterine growth retardation beyond 36 weeks

NARCIS (Netherlands)

Bijlenga, D.; Boers, K.E.; Birnie, E.; Mol, B.W.J.; Vijgen, S.C.M.; van der Post, J.A.M.; de Groot, C.J.; Rijnders, R.J.P.; Pernet, P.J.; Roumen, F.J.; Stigter, R.H.; Delemarre, F.M.C.; Bremer, H.A.; Porath, M.; Scherjon, S.A.; Bonsel, G.J.

2011-01-01

Pregnancies complicated by intrauterine growth retardation (IUGR) beyond 36 weeks of gestation are at increased risk of neonatal morbidity and mortality. Optimal treatment in IUGR at term is highly debated. Results from the multicenter DIGITAT (Disproportionate Intrauterine Growth Intervention Trial

Does measurement of intrauterine pressure have predictive value during oxytocin-augmented labor?

NARCIS (Netherlands)

Mol, Ben Willem J.; Logtenberg, Sabine L. M.; Verhoeven, Corine J. M.; Bloemenkamp, Kitty W. M.; Papatsonis, Dimitri N. M.; Bakker, Jannet J. H.; van der Post, Joris A. M.

2016-01-01

In a previous randomized trial that compared monitoring uterine contractions with an intrauterine pressure catheter (IUPC) versus external monitoring, we demonstrated that use of an IUPC did not improve the outcome of labor. To provide insight in the lack of a positive effect, we evaluated level of

Sub-optimal vitamin B-12 levels among ART-naïve HIV-positive individuals in an urban cohort in Uganda.

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Semeere, Aggrey S; Nakanjako, Damalie; Ddungu, Henry; Kambugu, Andrew; Manabe, Yukari C; Colebunders, Robert

2012-01-01

Malnutrition is common among HIV-infected individuals and is often accompanied by low serum levels of micronutrients. Vitamin B-12 deficiency has been associated with various factors including faster HIV disease progression and CD4 depletion in resource-rich settings. To describe prevalence and factors associated with sub-optimal vitamin B-12 levels among HIV-infected antiretroviral therapy (ART) naïve adults in a resource-poor setting, we performed a cross-sectional study with a retrospective chart review among individuals attending either the Mulago-Mbarara teaching hospitals' Joint AIDS Program (MJAP) or the Infectious Diseases Institute (IDI) clinics, in Kampala, Uganda. Logistic regression was used to determine factors associated with sub-optimal vitamin B-12. The mean vitamin B-12 level was 384 pg/ml, normal range (200-900). Sub-optimal vitamin B-12 levels (ART (CD4ART-naïve adult clinic population in urban Uganda. We recommend prospective studies to further clarify the causal relationships of sub-optimal vitamin B-12, and explore the role of vitamin B-12 supplementation in immune recovery.

TECHNOLOGICAL INNOVATION AND BUSINESS DIVERSIFICATION: SUSTAINABILITY LIVELIHOODS IMPROVEMENT SCENARIO OF RICE FARMER HOUSEHOLD IN SUB-OPTIMAL LAND

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Adriani D.

2017-09-01

Full Text Available The increased role of the sub-optimal land to support food security continue to be encouraged in Indonesia, given the more limited expansion for potential land. But until recently, development of sub-optimal land becomes not an easy thing. Ecological and technical barriers became the main issue. A series of these issues resulted in a high number of underemproleymeny and poverty in agriculture region. Technological inovation of agriculture and the business diversification can be seen be the solution to those issues. This research aims to analyze the impact of the technological innovation and business diversification on underemployment, working time, household income and also sustainable livelihoods of farmers on the sub-optimal land. The research was carried out in Pemulutan District, Ogan Ilir Regency, South Sumatra Province, Indonesia. The objects of research are farmers which adopter and non adopter technological innovation, and also work outside of paddy farming (business diversification. The research method is the survey. Method of sampling is stratified random sampling. Data obtained in the field analyses using descriptive statistics and inferesia. The results showed there are positive impact of technological innovation on the allocation of working time farmer households, the numbers underemployment, household income and livelihood sustainability. Determinant factors for farmers in applying technology and business diversification are paddy farming income, off-farm income, and age. The use of technology and business diversification proves to be one of the positive scenarios for sustainable livelihood of farmers in sub-optimal land.

Characteristics influencing therapy switch behavior after suboptimal response to first-line treatment in patients with multiple sclerosis.

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Teter, Barbara; Agashivala, Neetu; Kavak, Katelyn; Chouhfeh, Lynn; Hashmonay, Ron; Weinstock-Guttman, Bianca

2014-06-01

Factors driving disease-modifying therapy (DMT) switch behavior are not well understood. The objective of this paper is to identify patient characteristics and clinical events predictive of therapy switching in patients with suboptimal response to DMT. This retrospective study analyzed patients with relapsing-remitting multiple sclerosis (MS) and a suboptimal response to initial therapy with either interferon β or glatiramer acetate. Suboptimal responders were defined as patients with ≥1 MS event (clinical relapse, worsening disability, or MRI worsening) while on DMT. Switchers were defined as those who changed DMT within six to 12 months after the MS event. Of 606 suboptimal responders, 214 (35.3%) switched therapy. Switchers were younger at symptom onset (p = 0.012), MS diagnosis (p = 0.004), DMT initiation (p < 0.001), and first MS event (p = 0.011) compared with nonswitchers. Compared with one relapse alone, MRI worsening alone most strongly predicted switch behavior (odds ratio 6.3; 95% CI, 3.1-12.9; p < 0.001), followed by ≥2 relapses (2.8; 95% CI, 1.1-7.3; p = 0.040), EDSS plus MRI worsening (2.5; 95% CI, 1.1-5.9; p = 0.031) and EDSS worsening alone (2.2; 95% CI, 1.2-4.1; p = 0.009). Younger patients with disease activity, especially MRI changes, are more likely to have their therapy switched sooner than patients who are older at the time of MS diagnosis and DMT initiation. © The Author(s) 2013.

Pre- and/or postnatal protein restriction in rats impairs learning and motivation in male offspring.

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Reyes-Castro, L A; Rodriguez, J S; Rodríguez-González, G L; Wimmer, R D; McDonald, T J; Larrea, F; Nathanielsz, P W; Zambrano, E

2011-04-01

Suboptimal developmental environments program offspring to lifelong health complications including affective and cognitive disorders. Little is known about the effects of suboptimal intra-uterine environments on associative learning and motivational behavior. We hypothesized that maternal isocaloric low protein diet during pregnancy and lactation would impair offspring associative learning and motivation as measured by operant conditioning and the progressive ratio task, respectively. Control mothers were fed 20% casein (C) and restricted mothers (R) 10% casein to provide four groups: CC, RR, CR, and RC (first letter pregnancy diet and second letter lactation diet), to evaluate effects of maternal diet on male offspring behavior. Impaired learning was observed during fixed ratio-1 operant conditioning in RC offspring that required more sessions to learn vs. the CC offspring (9.4±0.8 and 3.8±0.3 sessions, respectively, pmotivational effects during the progressive ratio test revealed less responding in the RR (48.1±17), CR (74.7±8.4), and RC (65.9±11.2) for positive reinforcement vs. the CC offspring (131.5±7.5, plearning and motivation behavior with the nutritional challenge in the prenatal period showing more vulnerability in offspring behavior. Copyright © 2010 ISDN. Published by Elsevier Ltd. All rights reserved.

Apparent rarity of asymptomatic herpes cervicitis in a woman with intra-uterine contraceptive device

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Adeola Fowotade

2013-12-01

Full Text Available Infection with genital herpes simplex virus (HSV remains a common viral sexually transmitted disease, often subclinical and a major worldwide problem of women of reproductive age group. Herpes cervicitis is an unusual presentation of Herpes simplex virus infection in females. The finding of herpes cervicitis on routine pap smear of an asymptomatic woman on Intrauterine contraceptive device still further supports the need for increased awareness on the possibility of Herpes simplex virus infection among women, particularly those on Intrauterine contraceptive device. The index case is a 28 years old Nigerian female who was referred to our Special Treatment Clinic on account of an abnormal pap smear cytology which was in keeping with Herpes cervicitis. There was no history of genital ulcer in this patient; however ELISA for HSV 2 IgM was positive in her. We therefore describe a case of herpes cervicitis in an asymptomatic woman on intrauterine contraceptive device. This case highlights to clinicians the need to be aware of the possibility of this association and to carry out relevant investigations so as to identify and treat these patients appropriately. Therefore, there is a need to put in place adequate public health intervention strategy to prevent genital herpes in women of reproductive age group with a view to preventing the possibility of congenital herpes in subsequent pregnancy.

Morphofunctional state of reproductive system in the male-rats, which were intrauterine irradiated

International Nuclear Information System (INIS)

Fedosenko, O.L.

2008-01-01

The changes in cytogenetic studies and morphofunctional state of reproductive system in the male-rats, which were intrauterine irradiated. The alterations in relative mass organs, increase of number sperm cells and abnormal form of sperm cells in epididymis were ascertained. (authors)

Intrauterine Transmission of Anaplasma phagocytophilum in Persistently Infected Lambs

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Snorre Stuen

2018-02-01

Full Text Available Anaplasma phagocytophilum, which causes the disease tick-borne fever (TBF, is the most important tick-borne pathogen in European animals. TBF may contribute to severe welfare challenges and economic losses in the Norwegian sheep industry. The bacterium causes a persistent infection in sheep and several other animal species. The objective of this study was to investigate whether intrauterine transmission occurs in persistently infected sheep. The study included thirteen 5–6-month-old unmated ewes, of which twelve were experimentally infected with A. phagocytophilum (GenBank acc. no. M73220. Four to six weeks later, all ewes were mated, and nine became pregnant. Blood samples were collected from these ewes and their offspring. If the lamb died, tissue samples were collected. The samples were analyzed with real-time PCR (qPCR targeting the msp2 gene. PCR-positive samples were further analyzed by semi-nested PCR and 16S rDNA sequencing. A total of 20 lambs were born, of which six died within two days. Six newborn lambs (30% were PCR-positive (qPCR, of which one was verified by 16S rDNA sequencing. The present study indicates that intrauterine transmission of A. phagocytophilum in persistently infected sheep may occur. The importance of these findings for the epidemiology of A. phagocytophilum needs to be further investigated.

High Prevalence of Suboptimal Vitamin D Status and Bone Loss in Adult Short Bowel Syndrome Even After Weaning Off Parenteral Nutrition.

Science.gov (United States)

Fan, Shengxian; Ni, Xiaodong; Wang, Jian; Zhang, Yongliang; Tao, Shen; Kong, Wencheng; Li, Yousheng; Li, Jieshou

2017-04-01

Previous studies have noticed the high incidence of suboptimal vitamin D (VtD) status and bone loss in short bowel syndrome (SBS) with parenteral nutrition (PN) dependence. However, limited data have focused on adult SBS without PN dependence. Therefore, our objective was to investigate the incidence and risk factors of suboptimal VtD status and bone loss in adult SBS even after weaning off PN. We performed a prospective study of 60 adult patients with SBS. Serum 25-hydroxyvitamin D (25-OHD) was measured by radioimmunoassay. Bone mineral density (BMD) was measured using dual-energy x-ray absorptiometry (DEXA). Medical records and various laboratory parameters were collected in all participants. Suboptimal VtD status was identified in all individuals, including 3 (5.0%) with VtD insufficiency and 57 (95.0%) with VtD deficiency. Residual small bowel length (B, 0.072, P = .001) and duration of SBS (B, -0.066, P = .020) were both significantly correlated with suboptimal VtD levels. Overall, only 2 patients presented a normal BMD; osteopenia and osteoporosis were noted in 41 (68.3%) and 17 (28.3%) individuals, respectively. Low 25-OHD concentration was associated with a decreased BMD (B, 0.065, P = .029). There were no other demographic characteristics or clinical examinations associated with suboptimal VtD levels and bone loss. Suboptimal VtD status and bone loss were common in adult SBS even after weaning off PN. Despite routine oral VtD supplementation, most patients did not achieve satisfactory status. This emphasizes the critical importance of routine surveillance of 25-OHD and BMD, as well as consideration of alternative methods of supplementation after weaning off PN.

Prevalence and correlates of suboptimal vitamin D status in people living with psychotic disorders: Data from the Australian Survey of High Impact Psychosis.

Science.gov (United States)

Suetani, Shuichi; Saha, Sukanta; Eyles, Darryl W; Scott, James G; McGrath, John J

2017-09-01

Having sufficient sera concentrations of 25-hydroxyvitamin D is important for a range of health outcomes including cardiometabolic diseases. Clinical studies in people with psychotic disorders suggest that a sizable proportion has suboptimal vitamin D status (i.e. vitamin D deficiency or insufficiency). Individuals with psychosis also have many of the risk factors associated with suboptimal vitamin D status such as smoking, obesity, and reduced physical activity. The aim of this study was to examine the prevalence and socio-demographic and clinical correlates of vitamin D status using a large, population-based sample of adults with psychotic disorders. Data were collected as part of the Survey of High Impact Psychosis, a population-based survey of Australians aged 18-64 years with a psychotic disorder. 25-Hydroxyvitamin D concentration was measured in 463 participants. 25-Hydroxyvitamin D concentration was dichotomised into optimal (above 50 nmol/L) and suboptimal (below 50 nmol/L). The influence of a range of socio-demographic and clinical variables on vitamin D status was examined using logistic regression. Nearly half (43.6%) of the participants had suboptimal vitamin D status. Those with (a) increased physical activity or (b) positive symptoms had significantly reduced odds of having suboptimal vitamin D status. However, there were no significant associations between suboptimal vitamin D status and other psychiatric symptom measures or cardiometabolic risk factors. Many people with psychotic disorders have suboptimal vitamin D status. As part of the routine assessment of physical health status, clinicians should remain mindful of vitamin D status in this vulnerable population and encourage the use of appropriate vitamin D supplements.

Hysteroscopic morcellator for removal of intrauterine polyps and myomas: a randomized controlled pilot study among residents in training.

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van Dongen, Heleen; Emanuel, Mark Hans; Wolterbeek, Ron; Trimbos, J Baptist; Jansen, Frank Willem

2008-01-01

The purpose of this randomized controlled study was to compare conventional resectoscopy and hysteroscopic morcellation among residents in training (Canadian Task Force classification I). Sixty women with an intrauterine polyp or myoma were randomized to either hysteroscopic removal by conventional resectoscopy or hysteroscopic morcellation performed by 6 residents in training for obstetrics and gynecology (10 procedures per resident). The mean operating time for resectosocpy and morcellation was 17.0 (95% confidence interval [95% CI] 14.1-17.9, standard deviation [SD] 8.4) and 10.6 (95% CI 7.3-14.0, SD 9.5) min, respectively (p = .008). Multiple linear regression analysis showed that operating time increased significantly, for both resectoscopy and morcellator, when volume of intrauterine disorder increased. The use of the hysteroscopic morcellator reduced operating time more than 8 min in comparison to conventional resectoscopy (p learning curve was observed. In conclusion, the hysteroscopic morcellator for removal of intrauterine polyps and myomas offers a good alternative to conventional resectoscopy for residents in training.

Comparison of pregnancy rates between patients with and without local endometrial scratching before intrauterine insemination.

Science.gov (United States)

Senocak, G C; Yapca, O E; Borekci, B

2017-11-01

To determine the implantation success of local endometrial injury in patients undergoing intrauterine insemination following ovulation induction with gonadotropins as an infertility treatment. In this prospective randomized controlled trial, ovulation induction was performed with gonadotropins in 80 patients following intrauterine insemination. In 40 patients, local endometrial injury (scratch) was performed in the midluteal phase of the cycle preceding ovarian stimulation with a Novak curette to the posterior side of the endometrial cavity. Fifteen pregnancies (37.5%) and 11 clinical pregnancies (27.5%) occurred in the intervention group, whereas eight pregnancies (20%) and five clinical pregnancies (12.5%) occurred in the control group. Although the pregnancy rates and clinical pregnancy rates were increased in the intervention group, no statistically significant difference was found between the intervention and control groups (pregnancy rates: P=0.084; clinical pregnancy rates: P=0.094). Performing local endometrial injury (scratch) in the cycle preceding ovulation induction in patients with a diagnosis of infertility and indication for intrauterine insemination increased the pregnancy and clinical pregnancy rates. This increase was not, however, statistically significant. More randomized, controlled, prospective studies with larger patient numbers are required before the use of iatrogenic induction of local endometrial injury can be recommended in routine clinical practice. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Synthesis of copolymers suitable for the storage and slow release of reactants. Cases of copper salts for intra-uterine devices

International Nuclear Information System (INIS)

Gaussens, Gilbert; Duchemin-Berthet, Jeanne.

1976-01-01

This research has been carried out to determine whether a grafted poly(ethylene-vinyl acetate) matrix could be prepared which would release useful amounts of copper salts when used in intra-uterine devices. Intra-uterine devices were prepared by grafting hydroxyethyl acrylate onto ethylene-vinylacetate copolymers (EVA). The kinetics of the grafting reaction were studied. The grafting reaction was initiated by cobalt 60 gamma rays using the simultaneous method. The conditions of copper salts absorption by the grafted copolymers were selected. The average quantity of copper salts released daily from the intra-uterine device was meaured as a function of grafting ratio and the amount of copper salt initially incorporated in the grafted polymeric matrix. In vitro experiments samples showed constant release rates during a period of 18 months

A study to examine the relationship between metritis severity and depletion of oxytetracycline in plasma and milk after intrauterine infusion.

Science.gov (United States)

Gorden, P J; Ydstie, J A; Kleinhenz, M D; Wulf, L W; Gehring, R; Lee, C J; Wang, C; Coetzee, J F

2016-10-01

Metritis is a frequent problem in postpartum dairy cows. Intrauterine therapy with the antimicrobial oxytetracycline (OTC) is often used, although this therapy has not been shown to be superior to systemic therapy. The objectives of this study were to (1) determine the plasma and milk concentrations of OTC following intrauterine infusion in postpartum dairy cows with varying degrees of metritis severity; (2) determine the depletion time of OTC in an attempt to provide veterinarians withdrawal guidelines, should they use this therapy; and (3) correlate metritis severity scores with OTC concentrations in plasma and milk. Our hypothesis was that cows with more severe metritis would have higher OTC concentrations in milk following intrauterine therapy. Thirty-two cows were selected to participate in the study after farm personnel had determined that they had metritis based on evaluation of vaginal discharge between 4 and 14 DIM, in accordance with the farm's treatment protocols. Metritis scores (1-4) were assigned based on a published scheme: 1 represented yellow-to-orange thick discharge or translucent mucus with no fetid smell; 2 represented blood-tinged vaginal mucus, slightly watery, with little or no fetid smell; 3 represented red to red/brown watery discharge with moderate fetid smell; and 4 represented red to red/brown watery discharge containing pieces of placenta and an intense fetid smell. Trial cows received a single treatment of 4g of OTC (approximately 6.7mg/kg) via intrauterine infusion. Blood samples were collected over 96h, and milk samples were collected before intrauterine therapy and 3 times a day for 4 d following infusion. Following treatment, OTC rapidly diffused to plasma and subsequently to milk. Maximum OTC concentrations in plasma and milk occurred within the first 24h following intrauterine infusion, and 25 of the 32 cows had detectable OTC concentrations in milk at 4 d after intrauterine infusion. Cows with clinical metritis (metritis

Care quality following intrauterine death in Spanish hospitals: results from an online survey.

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Cassidy, Paul Richard

2018-01-10

The objective of the study was to evaluate practices in Spanish hospitals after intrauterine death in terms of medical/ technical care and bereavement support care. A cross-sectional descriptive study using an online self-completion questionnaire. The population was defined as women who had experienced an intrauterine fetal death between sixteen weeks and birth, either through spontaneous late miscarriage/stillbirth or termination of pregnancy for medical reasons. Respondents were recruited through an online advertisement on a stillbirth charity website and social media. The analysis used Pearson's chi-squared (p ≤ 0.05) test of independence to cross-analyse for associations between objective measures of care quality and independent variables. Responses from 796 women were analysed. Half of the women (52.9%) had postmortem contact with their baby. 30.4% left the hospital with a least one linking object or a photograph. In 35.8% of cases parents weren't given any option to recover the body/remains. 22.9% of births ≥26 weeks gestation were by caesarean, with a significant (p < 0.001) difference between public hospitals (16.8%) and private hospitals (41.5%). 29.3% of respondents were not accompanied during the delivery. 48.0% of respondents recalled being administered sedatives at least once during the hospital stay. The autopsy rate in stillbirth cases (≥ 20 weeks) was 70.5% and 44.4% in cases of termination of pregnancy (all gestational ages). Consistent significant (p < 0.05) differences in care practices were found based on gestational age and type of hospital (public or private), but not to other variables related to socio-demographics, pregnancy history or details of the loss/death. Intrauterine deaths at earlier gestational ages received poorer quality care. Supportive healthcare following intrauterine death is important to women's experiences in the hospital and beneficial to the grief process. Many care practices that are standard in

Indications for suboptimal low-dose direct oral anticoagulants for non-valvular atrial fibrillation patients

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Masahiko Umei, MD

2017-10-01

Conclusions: With good adherence, the clinical course associated with DOACs is comparatively good. In the future, suboptimal low-dose DOAC therapy may serve as an appropriate choice for some patients with a high risk of stroke and bleeding.

Knowledge and attitudes of Latin American obstetricians and gynecologists regarding intrauterine contraceptives

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Bahamondes L

2015-07-01

Full Text Available Luis Bahamondes,1 Maria Y Makuch,1 Ilza Monteiro,1 Victor Marin,2 Richard Lynen3 1Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, Brazil; 2Department of Obstetrics and Gynecology, Hospital Central, Petróleos Mexicanos, México City, Mexico; 3Bayer HealthCare, Newark, NJ, USA Background: Intrauterine contraceptives (IUCs, including the copper intrauterine device and the levonorgestrel-releasing intrauterine system (LNG-IUS, are among the reversible contraceptive methods with high effectiveness. However, use is low in many settings, including some Latin American countries, mainly due to the influences of myths, fears, and negative attitudes, not only of users and potential users, but also of different cadres of health care professionals. The purpose of this study was to assess the knowledge and attitudes of a group of Latin American obstetricians and gynecologists regarding IUCs.Methods: A survey was conducted during a scientific meeting organized in Chile in 2014 to present and discuss updated information about contraception. Obstetricians and gynecologists from 12 Latin American countries, who reported that they provide daily contraception services in both the public and private sectors, participated in the meeting. Participants who agreed to take part in the survey responded to a multiple-choice questionnaire on issues regarding knowledge, use, and attitudes about IUCs.Results: Of the 210 obstetricians and gynecologists participating in the meeting, the respondents to each question varied from 168 (80.0% to 205 (97.6%. Almost 50% recognized that the failure rate of combined oral contraceptives, patches, and vaginal rings is 8%–10%. Furthermore, 10% of the participants did not recognize the high contraceptive effectiveness of long-acting reversible contraceptive methods. Additionally, almost 80% of the respondents answered that they did not offer IUCs to nulligravidas and almost 10% did

First trimester screening for intra-uterine growth restriction and early-onset pre-eclampsia

NARCIS (Netherlands)

Vandenberghe, G.; Mensink, I.; Twisk, J.W.; Blankenstein, M.A.; Heijboer, A.C.; van Vugt, J.M.

2011-01-01

Objective: To assess first trimester placental growth factor (PlGF) and pregnancy-associated plasma protein-A (PAPP-A) as screening markers for early-onset pre-eclampsia (PE) and intra-uterine growth restriction (IUGR). Methods: PlGF concentration was retrospectively measured in first trimester

Intrauterine contraception: the role of general practitioners in four Dutch general practices.

NARCIS (Netherlands)

Vos, A.A.; Veldhuis, H.M.; Lagro-Janssen, A.L.M.

2004-01-01

The intrauterine device (IUD) use in the Netherlands and the United States is limited to a small group of women, though the risk of infection and pregnancy is small. Therefore, it was of interest to investigate the characteristics of women who choose an IUD as contraceptive method and the influence

Abnormal endothelium-dependent microvascular dilator reactivity in pregnancies complicated by normotensive intrauterine growth restriction

NARCIS (Netherlands)

Koopmans, C.M.; Blaauw, Judith; van Pampus, Maria; Rakhorst, G.; Aarnoudse, J.G.

OBJECTIVE: Normotensive intrauterine growth restriction and preeclampsia share a similar placenta pathophysiology, whereas maternal clinical manifestations differ. Clinical symptoms of preeclampsia are partly attributed to vascular endothelial dysfunction, but it is unclear whether this phenomenon

Maternal health-related quality of life after induction of labor or expectant monitoring in pregnancy complicated by intrauterine growth retardation beyond 36 weeks

NARCIS (Netherlands)

D. Bijlenga (Denise); K.E. Boers (Kim); E. Birnie (Erwin); B.W.J. Mol (Ben); S.C.M. Vijgen (Sylvia); J.A.M. van der Post (Joris); C.J.M. de Groot (Christianne); R.J.P. Rijnders (Robbert); P.J. Pernet (Paula); F.J.M.E. Roumen (Frans); R.H. Stigter (Rob); F.M.C. Delemarre (Friso); H.A. Bremer (Henk); M. Porath (Martina); S.A. Scherjon (Sico); G.J. Bonsel (Gouke)

2011-01-01

textabstractObjective: Pregnancies complicated by intrauterine growth retardation (IUGR) beyond 36 weeks of gestation are at increased risk of neonatal morbidity and mortality. Optimal treatment in IUGR at term is highly debated. Results from the multicenter DIGITAT (Disproportionate Intrauterine

The levonorgestrel-releasing intrauterine device potentiates stress reactivity.

Science.gov (United States)

Aleknaviciute, Jurate; Tulen, Joke H M; De Rijke, Yolanda B; Bouwkamp, Christian G; van der Kroeg, Mark; Timmermans, Mirjam; Wester, Vincent L; Bergink, Veerle; Hoogendijk, Witte J G; Tiemeier, Henning; van Rossum, Elisabeth F C; Kooiman, Cornelis G; Kushner, Steven A

2017-06-01

The levonorgestrel-releasing intrauterine device (LNG-IUD) is currently recommended as a first-line contraceptive with an exclusively local intrauterine influence. However, recent clinical trials have identified side effects of LNG-IUD that appear to be systemically mediated, including depressed mood and emotional lability. We performed two experimental studies and a cross-sectional study. For each study, women were included from three groups: LNG-IUD (0.02mg/24h), oral ethinylestradiol/levonorgestrel (0.03mg/0.15mg; EE30/LNG) and natural cycling (NC). Study 1-Salivary cortisol was measured at baseline and at defined intervals following the Trier Social Stress Test (TSST). Heart rate was monitored continuously throughout the TSST. Study 2-Salivary cortisol and serum total cortisol were evaluated relative to low-dose (1μg) adrenocorticotropic hormone (ACTH) administration. Study 3-Hair cortisol was measured as a naturalistic index of long-term cortisol exposure. Women using LNG-IUD had an exaggerated salivary cortisol response to the TSST (24.95±13.45 nmol/L, 95% CI 17.49-32.40), compared to EE30/LNG (3.27±2.83 nmol/L, 95% CI 1.71-4.84) and NC (10.85±11.03nmol/L, 95% CI 6.30-15.40) (Pcontraception induces a centrally-mediated sensitization of both autonomic and hypothalamic-pituitary-adrenal (HPA) axis responsivity. LNG-IUD sensitization of HPA axis responsivity was observed acutely under standardized laboratory conditions, as well as chronically under naturalistic conditions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Preserved ex vivo inflammatory status in decidual cells from women with preterm labor and subclinical intrauterine infection.

Directory of Open Access Journals (Sweden)

Violeta Castro-Leyva

Full Text Available OBJECTIVE: To compare the inflammatory response preserved ex vivo by decidual cells isolated from women who experienced preterm labor with and without subclinical intrauterine infection. METHODS: Fetal membranes were obtained after cesarean section from 35 women who delivered before 37 weeks of gestation following spontaneous preterm labor, with no clinical evidence of intrauterine infection. Decidua was microbiologically tested and cultured. Concentrations of anti-inflammatory cytokines (IL-2, IL-4, IL-10, pro-inflammatory cytokines (IL-6, IL-8, IL-1β and TNF-α, and matrix metalloproteinases (MMP-1, MMP-2, MMP-3, MMP-7, MMP-8, MMP-9 were measured in the supernatants using Bio-Plex, and prostaglandin E(2 (PGE(2 was measured by enzyme immunoassay. RESULTS: Subclinical infection was confirmed in 10 women (28.5%. Microorganisms isolated were Ureaplasma urealyticum (4, group B streptococci (3, Gardnerella vaginalis (1, and Escherichia coli (2. We found a significant increase of pro-inflammatory cytokines and a significant decrease of anti-inflammatory cytokines in supernatants from decidual cells obtained from women with preterm labor and subclinical intrauterine infection compared to women without infection. Secretion of MMP-1, MMP-8, MMP-9 and PGE(2 was significantly higher in infected women. Secretion of IL-8 by decidual cells from infected women persisted upon repeated in vitro culture passages. CONCLUSIONS: Almost 30% of idiopathic preterm labor cases were associated with subclinical intrauterine infection, and decidual cells isolated from these cases preserved an ex vivo inflammatory status after in vivo bacterial exposure.

Intrauterine exposure to mild analgesics is a risk factor for development of male reproductive disorders in human and rat

DEFF Research Database (Denmark)

Kristensen, David Møbjerg; Hass, Ulla; Lesné, Laurianne

2011-01-01

; BACKGROUND: More than half of pregnant women in the Western world report intake of mild analgesics, and some of these drugs have been associated with anti-androgenic effects in animal experiments. Intrauterine exposure to anti-androgens is suspected to contribute to the recent increase in male ...... results suggest that intrauterine exposure to mild analgesics is a risk factor for development of male reproductive disorders.......; BACKGROUND: More than half of pregnant women in the Western world report intake of mild analgesics, and some of these drugs have been associated with anti-androgenic effects in animal experiments. Intrauterine exposure to anti-androgens is suspected to contribute to the recent increase in male...... reproductive problems, and many of the anti-androgenic compounds are like the mild analgesics potent inhibitors of prostaglandin synthesis. Therefore, it appears imperative to further investigate the potential endocrine disrupting properties of mild analgesics. ; METHODS: In a prospective birth cohort study...

Design Of Real-Time Implementable Distributed Suboptimal Control: An LQR Perspective

KAUST Repository

Jaleel, Hassan

2017-09-29

We propose a framework for multiagent systems in which the agents compute their control actions in real time, based on local information only. The novelty of the proposed framework is that the process of computing a suboptimal control action is divided into two phases: an offline phase and an online phase. In the offline phase, an approximate problem is formulated with a cost function that is close to the optimal cost in some sense and is distributed, i.e., the costs of non-neighboring nodes are not coupled. This phase is centralized and is completed before the deployment of the system. In the online phase, the approximate problem is solved in real time by implementing any efficient distributed optimization algorithm. To quantify the performance loss, we derive upper bounds for the maximum error between the optimal performance and the performance under the proposed framework. Finally, the proposed framework is applied to an example setup in which a team of mobile nodes is assigned the task of establishing a communication link between two base stations with minimum energy consumption. We show through simulations that the performance under the proposed framework is close to the optimal performance and the suboptimal policy can be efficiently implemented online.

Intrauterin Device Migration to the Bladder and Endoscopic Treatment; Case Report

Directory of Open Access Journals (Sweden)

Ižsmail Nalbant

2014-08-01

Full Text Available An intrauterine device (IUD is a long term, efficient, reversible and common method of contraception. IUD migration into the bladder is a rarely observed complication. Chronic pelvic pain, vaginal discharge, resistant urinary tract infections and bladder irritative voiding symptoms in the presence of IUD migration should be considered. This study aimed to report cases of bladder petrified IUD.

Impaired Angiogenic Potential of Human Placental Mesenchymal Stromal Cells in Intrauterine Growth Restriction.

Science.gov (United States)

Mandò, Chiara; Razini, Paola; Novielli, Chiara; Anelli, Gaia Maria; Belicchi, Marzia; Erratico, Silvia; Banfi, Stefania; Meregalli, Mirella; Tavelli, Alessandro; Baccarin, Marco; Rolfo, Alessandro; Motta, Silvia; Torrente, Yvan; Cetin, Irene

2016-04-01

Human placental mesenchymal stromal cells (pMSCs) have never been investigated in intrauterine growth restriction (IUGR). We characterized cells isolated from placental membranes and the basal disc of six IUGR and five physiological placentas. Cell viability and proliferation were assessed every 7 days during a 6-week culture. Expression of hematopoietic, stem, endothelial, and mesenchymal markers was evaluated by flow cytometry. We characterized the multipotency of pMSCs and the expression of genes involved in mitochondrial content and function. Cell viability was high in all samples, and proliferation rate was lower in IUGR compared with control cells. All samples presented a starting heterogeneous population, shifting during culture toward homogeneity for mesenchymal markers and occurring earlier in IUGR than in controls. In vitro multipotency of IUGR-derived pMSCs was restricted because their capacity for adipocyte differentiation was increased, whereas their ability to differentiate toward endothelial cell lineage was decreased. Mitochondrial content and function were higher in IUGR pMSCs than controls, possibly indicating a shift from anaerobic to aerobic metabolism, with the loss of the metabolic characteristics that are typical of undifferentiated multipotent cells. This study demonstrates that the loss of endothelial differentiation potential and the increase of adipogenic ability are likely to play a significant role in the vicious cycle of abnormal placental development in intrauterine growth restriction (IUGR). This is the first observation of a potential role for placental mesenchymal stromal cells in intrauterine growth restriction, thus leading to new perspectives for the treatment of IUGR. ©AlphaMed Press.

Optimizing the definition of intrauterine growth restriction: the multicenter prospective PORTO Study.

LENUS (Irish Health Repository)

Unterscheider, Julia

2013-04-01

The objective of the Prospective Observational Trial to Optimize Pediatric Health in Intrauterine Growth Restriction (IUGR) (PORTO Study), a national prospective observational multicenter study, was to evaluate which sonographic findings were associated with perinatal morbidity and mortality in pregnancies affected by growth restriction, originally defined as estimated fetal weight (EFW) <10th centile.

Intrauterine dwarfism, peculiar facies and thin bones with multiple fractures - a new syndrome

International Nuclear Information System (INIS)

Kozlowski, K.; Kan, A.; Royal Alexandra Hospital for Children, Sydney

1988-01-01

Three newborns with thin ribs and thin long bones with multiple fractures are reported. Whereas one patient presents a syndromic association of bone dysplasia and intrauterine dwarfism two other patients cannot be appropriately evaluated due to lack of basic clinical and pathologic data. (orig.)

First trimester screening for intra-uterine growth restriction and early-onset pre-eclampsia

NARCIS (Netherlands)

Vandenberghe, G.; Mensink, I.; Twisk, J. W. R.; Blankenstein, M. A.; Heijboer, A. C.; van Vugt, J. M. G.

2011-01-01

To assess first trimester placental growth factor (PlGF) and pregnancy-associated plasma protein-A (PAPP-A) as screening markers for early-onset pre-eclampsia (PE) and intra-uterine growth restriction (IUGR). PlGF concentration was retrospectively measured in first trimester serum specimens of 23

Endometrial cancer treated with levonorgestrel-releasing intrauterine device for almost three years in an elderly woman with comorbidity

DEFF Research Database (Denmark)

Andreasen, Lisbeth Anita; Antonsen, Sofie Leisby; Settnes, Annette

2016-01-01

but with a minimum of symptoms and side effects. At the final examination there were no signs of extra uterine disease. The levonorgestrel-releasing intrauterine device may be an acceptable alternative to surgery in severely comorbid patients, or if the patient refuses surgical treatment. © 2016, Springer......In this case report we describe the treatment of a 95-year-old woman with endometrioid adenocarcinoma. She suffered from cardiovascular comorbidity and did not want surgical treatment. Instead a levonorgestrel-releasing intrauterine device (Mirena) was inserted. She had progression of the tumor...

Analysis of morbidity of children irradiated intrauterine as a result of the Chernobyl accident

International Nuclear Information System (INIS)

Sychik, S.I.; Stozharov, A.N.

1999-01-01

The purpose of the investigation was analysis of the influence of intrauterine irradiation of radioactive iodine on the structure and dynamics of prenatal irradiated children morbidity. It was examined children's group ( 10 years old aged ) irradiated in intrauterine status and having been lived constantly on polluted by radionuclide area of the Stolyn District of the Brest Region with contamination density of caesium 137 up to 15 Ci/km 2 . Control group were children aged 9 years old born after the accident and lived constantly in the same points that prenatal irradiated. The observation of morbidity since 1987 to 1995 years has shown that among prenatal irradiated children were more high parameters of general and primary morbidity in the structure of morbidity. It was established that thyroid gland participated in the forming of pathology of other organs and systems

Influence of Suboptimally and Optimally Presented Affective Pictures and Words on Consumption-Related Behavior

Science.gov (United States)

Winkielman, Piotr; Gogolushko, Yekaterina

2018-01-01

Affective stimuli can influence immediate reactions as well as spontaneous behaviors. Much evidence for such influence comes from studies of facial expressions. However, it is unclear whether these effects hold for other affective stimuli, and how the amount of stimulus processing changes the nature of the influence. This paper addresses these issues by comparing the influence on consumption behaviors of emotional pictures and valence-matched words presented at suboptimal and supraliminal durations. In Experiment 1, both suboptimal and supraliminal emotional facial expressions influenced consumption in an affect-congruent, assimilative way. In Experiment 2, pictures of both high- and low-frequency emotional objects congruently influenced consumption. In comparison, words tended to produce incongruent effects. We discuss these findings in light of privileged access theories, which hold that pictures better convey affective meaning than words, and embodiment theories, which hold that pictures better elicit somatosensory and motor responses. PMID:29434556

Investigating the prevalence, predictors, and prognosis of suboptimal statin use early after a non-ST elevation acute coronary syndrome.

Science.gov (United States)

Turner, Richard M; Yin, Peng; Hanson, Anita; FitzGerald, Richard; Morris, Andrew P; Stables, Rod H; Jorgensen, Andrea L; Pirmohamed, Munir

High-potency statin therapy is recommended in the secondary prevention of cardiovascular disease but discontinuation, dose reduction, statin switching, and/or nonadherence occur in practice. To determine the prevalence and predictors of deviation from high-potency statin use early after a non-ST elevation acute coronary syndrome (NSTE-ACS) and its association with subsequent major adverse cardiovascular events (MACE) and all-cause mortality (ACM). A total of 1005 patients from a UK-based prospective NSTE-ACS cohort study discharged on high-potency statin therapy (atorvastatin 80 mg, rosuvastatin 20 mg, or 40 mg daily) were included. At 1 month, patients were divided into constant high-potency statin users, and suboptimal users incorporating statin discontinuation, dose reduction, switching statin to a lower equivalent potency, and/or statin nonadherence. Follow-up was a median of 16 months. There were 156 suboptimal (∼15.5%) and 849 constant statin users. Factors associated in multivariable analysis with suboptimal statin occurrence included female sex (odds ratio 1.75, 95% confidence interval [CI] 1.14-2.68) and muscular symptoms (odds ratio 4.28, 95% CI 1.30-14.08). Suboptimal statin use was associated with increased adjusted risks of time to MACE (hazard ratio 2.10, 95% CI 1.25-3.53, P = .005) and ACM (hazard ratio 2.46, 95% CI 1.38-4.39, P = .003). Subgroup analysis confirmed that the increased MACE/ACM risks were principally attributable to statin discontinuation or nonadherence. Conversion to suboptimal statin use is common early after NSTE-ACS and is partly related to muscular symptoms. Statin discontinuation or non-adherence carries an adverse prognosis. Interventions that preserve and enhance statin utilization could improve post NSTE-ACS outcomes. Copyright © 2017 National Lipid Association. Published by Elsevier Inc. All rights reserved.

Point prevalence of suboptimal footwear features among ambulant older hospital patients: implications for fall prevention.

Science.gov (United States)

Chari, Satyan R; McRae, Prue; Stewart, Matthew J; Webster, Joan; Fenn, Mary; Haines, Terry P

2016-09-01

Objective The aim of the present study was to establish the point prevalence of 'suboptimal' features in footwear reported to have been used by older hospital patients when ambulating, and to explore underpinning factors for their choice of footwear. Method A cross-sectional investigation was undertaken on 95 of 149 eligible in-patients across 22 high fall-risk wards in a large metropolitan hospital in Brisbane, Australia. Results Over 70% of participants experienced an unplanned admission. Although most participants had access to some form of footwear in hospital (92%), nearly all reported ambulating in footwear with 'suboptimal' features (99%). Examples included slippers (27%), backless slippers (16%) or bare feet (27%). For patients who ambulated in bare feet, only one-third reported 'lack of access to footwear' as the primary cause, with others citing foot wounds, pain, oedema and personal choice as the main reason for bare foot ambulation. Conclusions Admitted patients frequently use footwear with 'suboptimal' features for ambulation in hospital. While some footwear options (for example well-fitting slippers) could be suited for limited in-hospital ambulation, others are clearly hazardous and might cause falls. Since footwear choices are influenced by multiple factors in this population, footwear education strategies alone may be insufficient to address the problem of hazardous footwear in at-risk patients. Footwear requirements may be more effectively addressed within a multidisciplinary team approach encompassing foot health, mobility and safety. What is known about the topic? Accidental falls while ambulating are an important health and safety concern for older people. Because certain footwear characteristics have been negatively linked to posture and balance, and specific footwear types linked to falls among seniors, the use of footwear with fewer suboptimal characteristics is generally recommended as a means of reducing the risk of falling. While footwear

Non-invasive transabdominal uterine electromyography correlates with the strength of intrauterine pressure and is predictive of labor and delivery.

Science.gov (United States)

Maul, H; Maner, W L; Olson, G; Saade, G R; Garfield, R E

2004-05-01

The study was conducted to investigate whether the strength of uterine contractions monitored invasively by intrauterine pressure catheter could be determined from transabdominal electromyography (EMG) and to estimate whether EMG is a better predictor of true labor compared to tocodynamometry (TOCO). Uterine EMG was recorded from the abdominal surface in laboring patients simultaneously monitored with an intrauterine pressure catheter (n = 13) or TOCO (n = 24). Three to five contractions per patient and corresponding electrical bursts were randomly selected and analyzed (integral of intrauterine pressure; integral, frequency, amplitude of contraction curve on TOCO; burst energy for EMG). The Mann-Whitney test, Spearman correlation and receiver operator characteristics (ROC) analysis were used as appropriate (significance was assumed at a value of p TOCO parameters were different. In addition, burst energy levels were highly predictive of delivery within 48 h (AUC = 0.9531; p TOCO, transabdominal uterine EMG can be used reliably to predict labor and delivery.

The tissue and plasma concentration of polyols and sugars in sheep intrauterine growth retardation

NARCIS (Netherlands)

T.R.H. Regnault (Timothy); C. Teng (Cecilia); B. de Vrijer (Barbra); H.L. Galan (Henry); R.B. Wilkening (Randall); F.C. Battaglia (Frederick)

2010-01-01

textabstractIn an ovine model of placental insufficiency-induced intrauterine growth retardation (PI-IUGR), characterized by hypoxia, hypoglycemia and a significant reduction in fetal weight, we assessed alterations in fetal and placental polyols. Arterial maternal-fetal concentration differences of

Maternal hyperthyroidism after intrauterine insemination due to hypertrophic action of human chorionic gonadotropin: a case report.

Science.gov (United States)

Bakas, P; Tzouma, C; Creatsa, M; Boutas, I; Hassiakos, D

2016-01-01

To report a rare case of maternal hyperthyroidism after intrauterine insemination due to hypertrophic action of hCG. A 36-year-old woman after successful intrauterine insemination and triplet pregnancy, developed hyperthyroidism with resistance to medical treatment. All signs of hyperthyroidism resolved and the results of thyroid function tests returned to normal without any medication after embryo meiosis. De novo maternal hyperthyroidism may develop during pregnancy as a result of pathological stimulation of the thyroid gland from the high levels of hCG hormone that can be seen in multiple pregnancies. The risk of hyperthyroidism is related to the number of fetuses. Reversibility of symptomatology can be seen after fetal reduction of multiple pregnancies.

The association between intrauterine inflammation and spontaneous vaginal delivery at term: a cross-sectional study.

Directory of Open Access Journals (Sweden)

Michiel L Houben

Full Text Available BACKGROUND: Different factors contribute to the onset of labor at term. In animal models onset of labor is characterized by an inflammatory response. The role of intrauterine inflammation, although implicated in preterm birth, is not yet established in human term labor. We hypothesized that intrauterine inflammation at term is associated with spontaneous onset of labor. METHODS/RESULTS: In two large urban hospitals in the Netherlands, a cross-sectional study of spontaneous onset term vaginal deliveries and elective caesarean sections (CS, without signs of labor, was carried out. Placentas and amniotic fluid samples were collected during labor and/or at delivery. Histological signs of placenta inflammation were determined. Amniotic fluid proinflammatory cytokine concentrations were measured using ELISA. A total of 375 women were included. In term vaginal deliveries, more signs of intrauterine inflammation were found than in elective CS: the prevalence of chorioamnionitis was higher (18 vs 4%, p = 0.02 and amniotic fluid concentration of IL-6 was higher (3.1 vs 0.37 ng/mL, p<0.001. Similar results were obtained for IL-8 (10.93 vs 0.96 ng/mL, p<0.001 and percentage of detectable TNF-alpha (50 vs 4%, p<0.001. CONCLUSIONS: This large cross-sectional study shows that spontaneous term delivery is characterized by histopathological signs of placenta inflammation and increased amniotic fluid proinflammatory cytokines.

Sex differences in the fetal programming of hypertension.

Science.gov (United States)

Grigore, Daniela; Ojeda, Norma B; Alexander, Barbara T

2008-01-01

Numerous clinical and experimental studies support the hypothesis that the intrauterine environment is an important determinant of cardiovascular disease and hypertension. This review examined the mechanisms linking an adverse fetal environment and increased risk for chronic disease in adulthood with an emphasis on gender differences and the role of sex hormones in mediating sexual dimorphism in response to a suboptimal fetal environment. This review focuses on current findings from the PubMed database regarding animal models of fetal programming of hypertension, sex differences in phenotypic outcomes, and potential mechanisms in offspring of mothers exposed to an adverse insult during gestation. For the years 1988 to 2007, the database was searched using the following terms: fetal programming, intrauterine growth restriction, low birth weight, sex differences, estradiol, testosterone, high blood pressure, and hypertension. The mechanisms involved in the fetal programming of adult disease are multifactorial and include alterations in the regulatory systems affecting the long-tterm control of arterial pressure. Sex differences have been observed in animal models of fetal programming, and recent studies suggest that sex hormones may modulate activity of regulatory systems, leading to a lower incidence of hypertension and vascular dysfunction in females compared with males. Animal models of fetal programming provide critical support for the inverse relationship between birth weight and blood pressure. Experimental models demonstrate that sex differences are observed in the pathophysiologic response to an adverse fetal environment. A role for sex hormone involvement is strongly suggested,with modulation of the renin-angiotensin system as a possible mechanism.

Isolated intrauterine growth restriction: a survey of Central Association of Obstetricians Gynecologists (CAOG) members

NARCIS (Netherlands)

Chauhan, Suneet P.; Dahlke, Joshua D.; Magann, Everett F.; Chang, Eugene; Gupta, Lata; Mol, Ben W.; Lewis, David F.

2013-01-01

The objective was to ascertain clinicians' opinions and current management with isolated (no concomitant morbidity) intrauterine growth restriction (IUGR). Members of the Central Association of Obstetricians and Gynecologists (CAOG) were surveyed. We considered consensus to be agreement among 90% of

Intrauterine Defensive Mechanism of Amniotic Fluid and Fetal Membranes

OpenAIRE

金山, 尚裕

1994-01-01

To determine the intrauterine defensive role of urinary trypsin inhibitor (UTI), we studied the effects of UTI in amniotic fluid, fetal membranes and myometrium. The level of UTI was 94±34U/ml in neonatal urine (compared to adult urine 8.0±6.0U/ml) and 88±37U/ml in amniotic fluid. This may indicate that the main source of UTI in the amniotic fluid is the fetal urine. UTI was found to be concentrated in vernix, fetal intestine, amniotic membranes and uterine myometrium. Immunostaining of term ...

Evaluation of Efficacy of Herbal Intrauterine Infusion Uterofix Liquid in Treatment of Various Reproductive Disorders in Cows: A Field Study

OpenAIRE

Verma, Satinder; Choudhary, Adarsh; Maini, Shivi; Ravikanth, K.

2016-01-01

Objective: To evaluate the efficacy of herbal intrauterine infusion Uterofix liquid in the treatment of various reproductive disorders in cows. Materials and Methods: Based on symptoms of endometritis, anestrous, metritis, and repeat breeders, 28 cows were selected to study the efficacy of herbal intrauterine infusion Uterofix liquid (M/S Ayurvet Limited) in uterine infections study. Group T0 (n = 8) cows served as control group, no treatment was given to this group, Group T1 (n = 5) repeat b...

Evaluation of Efficacy of Herbal Intrauterine Infusion Uterofix Liquid in Treatment of Various Reproductive Disorders in Cows: A Field Study.

Science.gov (United States)

Verma, Satinder; Choudhary, Adarsh; Maini, Shivi; Ravikanth, K

2016-01-01

To evaluate the efficacy of herbal intrauterine infusion Uterofix liquid in the treatment of various reproductive disorders in cows. Based on symptoms of endometritis, anestrous, metritis, and repeat breeders, 28 cows were selected to study the efficacy of herbal intrauterine infusion Uterofix liquid (M/S Ayurvet Limited) in uterine infections study. Group T0 (n = 8) cows served as control group, no treatment was given to this group, Group T1 (n = 5) repeat breeder cows, Group T2 (n = 5) endometritis effected cows, Group T3 (n = 5) anoestrus cows, and Group T4 (n = 5) metritis suffered cows were treated with Uterofix liquid (25 ml as intrauterine infusion once a day for 3-5 days). Total observational period was 60 days. Number of treatments needed, nature of discharge in first posttreatment estrus (physical examination), after treatment number of animal showing heat/estrus out of total treated, and posttreatment conception rate were used as criteria to judge the success or failure of treatment. Results revealed that 18 out of 20 animals (90%) showed signs of heat with clear discharge, recovered completely without causing any irritation, or severe irritation/sloughing of genital mucous membrane after Uterofix liquid treatment. Herbal intrauterine infusion Uterofix liquid significantly treated the uterine infections in cows. Uterine infection is a major problem in reproductive management. A wide variety of genital tract diseases of female domestic animals are known to produce significant losses and responsible for poor fertility. Amongst these highly prevalent are metritis and repeat breeding in high-producing dairy cows which if remains untreated are associated with low conception rate per artificial insemination (AI), extended interval to pregnancy, increased culling, and economic losses. As herbal remedy the Uterofix liquid (Ayurvet Limited, India) was highly efficacious as an intrauterine infusion to treat different reproductive disorders.

[Effects of intrauterine cigarette smoking exposure on expression of 3-mercaptopyruvate sulfurtransferase in medulla oblongata of neonatal rats].

Science.gov (United States)

Nie, Li-Hong; Hu, Ya-Jie; Li, Xian-Ke; Xue, Lian; Jia, Qing-Yi; Yang, Yi-Wen; Zheng, Yu

2013-07-01

To investigate the expression of 3-mercaptopyruvate sulfurtransferase (3MST) in medulla oblongata of neonatal rats and effects of intrauterine cigarette exposure on its expression. Sprague Dawley pregnant rats were randomly divided into 2 groups, control group and cigarette smoke exposure group (n = 8). 3MST mRNA and protein expression in medulla oblongata of neonatal rats were analysed by RT-PCR and Western blot, respectively, and the expression of 3MST in the neurons of respiratory-related nuclei in medulla oblongata of neonatal rats was investigated with immunohistochemical technique. The RT-PCR and Western blot analyses showed that 3MST mRNA and protein were expressed in the medulla oblogata of neonatal rats and intrauterine cigarette exposure promoted their expression (P < 0.05). Immunohistochemical staining indicated that 3MST existed in the neurons of pre-Bötzinger complex (pre-BötC), hypoglossal nucleus (12N), ambiguous nucleus (Amb), facial nucleus (FN) and nucleus tractus solitarius (NTS) in control group of the animals and the mean optical densities of 3MST-positive neurons in the pre-BötC, 12N, Amb and FN, but not NTS, were significantly increased in cigarette smoke exposure group (P < 0.05). 3MST exists in the neurons of medullary respiratory nuclei of neonatal rats and its expression can be up-regulated by intrauterine cigarette exposure, suggesting that the 3MST-H2S pathway may be involved in protection of medullary respiratory centers against injury induced by intrauterine cigarette exposure.

Indicators of suboptimal performance embedded in the Wechsler Memory Scale-Fourth Edition (WMS-IV)

NARCIS (Netherlands)

Bouman, Z.; Hendriks, M.P.H.; Schmand, B.A.; Kessels, R.P.C.; Aldenkamp, A.P.

2016-01-01

INTRODUCTION: Recognition and visual working memory tasks from the Wechsler Memory Scale-Fourth Edition (WMS-IV) have previously been documented as useful indicators for suboptimal performance. The present study examined the clinical utility of the Dutch version of the WMS-IV (WMS-IV-NL) for the

Indicators of suboptimal performance embedded in the Wechsler Memory Scale-Fourth Edition (WMS-IV)

NARCIS (Netherlands)

Bouman, Zita; Hendriks, Marc P. H.; Schmand, Ben A.; Kessels, Roy P. C.; Aldenkamp, Albert P.

2016-01-01

Recognition and visual working memory tasks from the Wechsler Memory Scale-Fourth Edition (WMS-IV) have previously been documented as useful indicators for suboptimal performance. The present study examined the clinical utility of the Dutch version of the WMS-IV (WMS-IV-NL) for the identification of

Indicators of suboptimal performance embedded in the Wechsler Memory Scale : Fourth Edition (WMS-IV)

NARCIS (Netherlands)

Bouman, Z.; Hendriks, M.P.H.; Schmand, B.A.; Kessels, R.P.C.; Aldenkamp, A.P.

2016-01-01

INTRODUCTION: Recognition and visual working memory tasks from the Wechsler Memory Scale-Fourth Edition (WMS-IV) have previously been documented as useful indicators for suboptimal performance. The present study examined the clinical utility of the Dutch version of the WMS-IV (WMS-IV-NL) for the

Indicators of suboptimal performance embedded in the Wechsler Memory Scale-Fourth Edition (WMS-IV)

NARCIS (Netherlands)

Bouman, Zita; Hendriks, Marc P.H.; Schmand, Ben A.; Kessels, Roy P.C.; Aldenkamp, Albert P.

2016-01-01

Introduction. Recognition and visual working memory tasks from the Wechsler Memory Scale-Fourth Edition (WMS-IV) have previously been documented as useful indicators for suboptimal performance. The present study examined the clinical utility of the Dutch version of the WMS-IV (WMS-IV-NL) for the

Early Environmental Enrichment Enhances Abnormal Brain Connectivity in a Rabbit Model of Intrauterine Growth Restriction.

Science.gov (United States)

Illa, Miriam; Brito, Verónica; Pla, Laura; Eixarch, Elisenda; Arbat-Plana, Ariadna; Batallé, Dafnis; Muñoz-Moreno, Emma; Crispi, Fatima; Udina, Esther; Figueras, Francesc; Ginés, Silvia; Gratacós, Eduard

2017-10-12

The structural correspondence of neurodevelopmental impairments related to intrauterine growth restriction (IUGR) that persists later in life remains elusive. Moreover, early postnatal stimulation strategies have been proposed to mitigate these effects. Long-term brain connectivity abnormalities in an IUGR rabbit model and the effects of early postnatal environmental enrichment (EE) were explored. IUGR was surgically induced in one horn, whereas the contralateral one produced the controls. Postnatally, a subgroup of IUGR animals was housed in an enriched environment. Functional assessment was performed at the neonatal and long-term periods. At the long-term period, structural brain connectivity was evaluated by means of diffusion-weighted brain magnetic resonance imaging and by histological assessment focused on the hippocampus. IUGR animals displayed poorer functional results and presented altered whole-brain networks and decreased median fractional anisotropy in the hippocampus. Reduced density of dendritic spines and perineuronal nets from hippocampal neurons were also observed. Of note, IUGR animals exposed to enriched environment presented an improvement in terms of both function and structure. IUGR is associated with altered brain connectivity at the global and cellular level. A strategy based on early EE has the potential to restore the neurodevelopmental consequences of IUGR. © 2017 S. Karger AG, Basel.

Effectiveness of intrauterine treatment with cephapirin in dairy cows with purulent vaginal discharge.

Science.gov (United States)

Tison, N; Bouchard, E; DesCôteaux, L; Lefebvre, R C

2017-02-01

The objective of this study was to assess the efficacy of cephapirin intrauterine treatment preceding a timed artificial insemination protocol in lactating dairy cows with purulent vaginal discharges (PVDs). Holstein dairy cows (n = 1247) from 18 herds were enrolled in a controlled randomized clinical trial. At 34 days in milk (DIM; ±7 days), cows had a genital examination (transrectal palpation, vaginoscopy, and uterine bacteriology). They were randomly assigned to either the control group (CONT, no treatment) or the treatment group (CEPH) consisting of 1 intrauterine infusion of 500-mg cephapirin benzathine (RCL) (Metricure, Merck Animal Health, Montreal, Canada) regardless of the uterine health status. All cows were systematically enrolled in a presynch-ovsynch protocol for the first insemination. A second genital examination was made 2 weeks later. Cows that received any systemic or local antibiotics 10 days prior sampling to the end of the synchronization protocol were excluded from the study. Reproductive data of cows were collected for at least 300 DIM, entered in a databank, and validated (health record management software, DSAHR). Pregnancy diagnosis was done by transrectal palpation at the routinely scheduled veterinarian visits. On the basis of the highest sum of sensibility and specificity for pregnancy status at 120 DIM, the optimal cutoff for vaginal discharge score was determined as the presence of cloudy discharge with or without purulent material (PVD+, score 2). With a prevalence of 21.6% at 34 DIM, PVD+ was detrimental to the first-service conception rate (FSCR; PVD+: 26 ± 5%; PVD-: 40 ± 3%; P = 0.02). The negative effect of PVD+ was indicated by a hazard ratio of 0.72 (chi-square = 8.58; P < 0.01; 95% confidence interval = 0.56-0.91). Treatment with cephapirin was associated with a significant improvement of the FSCR in PVD+ cows (PVD+ CEPH: 36 ± 5%, PVD+ CONT: 23 ± 5%; P < 0.05), although it did not produce a

[Placental gene activity of significant angiogenetic factors in the background of intrauterine growth restriction].

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Kovács, Péter; Rab, Attila; Szentpéteri, Imre; Joó, József Gábor; Kornya, László

2017-04-01

Placental vascular endothelial growth factor A (VEGF-A) gene and endoglin gene are both overexpressed in placental samples obtained from pregnancies with intrauterine growth restriction compared to normal pregnancies. In the background of these changes a mechanism can be supposed, in which the increased endoglin activity in intrauterine growth restriction (IUGR) leads to impaired placental circulation through an antioangiogenetic effect. This results in the development of placental vascular dysfunction and chronic fetal hypoxia. It is chronic hypoxia that turns on VEGF-A as a compensatory mechanism to improve fetal vascular blood supply by promoting placental blood vessel formation. Although the maternal serum placental growth factor (PlGF) level is a potential predictor for both IUGR and praeeclampsia, placental PlGF gene activity may be less of an active in the regulation of placental circulation in IUGR pregnancies during the later stages of gestation. Orv. Hetil., 2017, 158(16), 612-617.

Causes and Mechanisms of Intrauterine Hypoxia and Its Impact on the Fetal Cardiovascular System: A Review

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Damian Hutter

2010-01-01

Full Text Available Until today the role of oxygen in the development of the fetus remains controversially discussed. It is still believed that lack of oxygen in utero might be responsible for some of the known congenital cardiovascular malformations. Over the last two decades detailed research has given us new insights and a better understanding of embryogenesis and fetal growth. But most importantly it has repeatedly demonstrated that oxygen only plays a minor role in the early intrauterine development. After organogenesis has taken place hypoxia becomes more important during the second and third trimester of pregnancy when fetal growth occurs. This review will briefly adress causes and mechanisms leading to intrauterine hypoxia and their impact on the fetal cardiovascular system.

The intrauterine device: dispelling the myths.

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Kimble-Haas, S L

1998-11-01

The worldwide popularity and usage of intrauterine devices (IUDs) plummeted in the 1970s, when grim reports of septic abortions and pelvic inflammatory disease were published. Although the Dalkon Shield ultimately was determined to be the culprit for these problems, the reputation of all IUDs was damaged, and their popularity spiraled downward. The stigma continues, despite the proven safety and efficacy of newer IUDs, particularly the ParaGard T 380A and the Progestasert, which are now the only two IUDs approved for use in the United States. This article will review how the IUD works and will focus on dispelling the misconceptions surrounding its use. Rigid patient-selection guidelines and strict aseptic insertion techniques can provide safe, long-term, cost-effective, and highly efficacious contraception for monogamous women. Practitioners who follow these guidelines should not fear prescribing IUDs as a contraceptive device in the appropriate female population.

Intrauterine growth restriction - part 2.

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Sharma, Deepak; Farahbakhsh, Nazanin; Shastri, Sweta; Sharma, Pradeep

2016-12-01

Small for gestational age (SGA) infants have been classically defined as having birth weight less than two standard deviations below the mean or less than the 10th percentile of a population-specific birth weight for specific gestational age, whereas intrauterine growth restriction (IUGR) has been defined as a rate of foetal growth that is less than normal for the population and for the growth potential of a specific infant. SGA infants have more frequent problems such as perinatal asphyxia, hypothermia, hypoglycaemia, polycythaemia and many more when compared with their appropriate for gestational age counterpart. They too have growth retardation and various major and subtle neurodevelopmental handicaps, with higher rates of perinatal and neonatal mortality. With the advent of newer technologies, even though the perinatal diagnosis of these SGA/IUGR foetuses has increased, but still perinatal morbidity and mortality rates are higher than normal foetuses and infants. In this part, we have covered neonatal IUGR classification, postnatal diagnosis, short-term and long-term complications faced by these IUGR infants.

Management of twin anemia-polycythemia sequence using intrauterine blood transfusion for the donor and partial exchange transfusion for the recipient.

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Genova, L; Slaghekke, F; Klumper, F J; Middeldorp, J M; Steggerda, S J; Oepkes, D; Lopriore, E

2013-01-01

Twin anemia-polycythemia sequence (TAPS) is a rare condition which may occur either spontaneously in uncomplicated monochorionic twin pregnancies or may develop after laser treatment in twin-twin transfusion syndrome. TAPS is characterized by a large intertwin discordance in hemoglobin levels without discordance in amniotic fluid levels, and may lead to severe complications including fetal hydrops, hematological morbidity and perinatal mortality. Several treatments have been proposed including intrauterine transfusion, laser surgery, elective delivery and expectant management. The optimal treatment remains unclear. In this case series we report 3 TAPS cases managed recently at our center with a combination of intrauterine blood transfusion for the anemic twin and intrauterine partial exchange transfusion for the polycythemic twin. In 1 case, the donor was found to have severe cerebral injury on neuroimaging examination. We propose etiologic mechanisms for cerebral injury in TAPS, discuss the rationale behind this treatment alternative, and evaluate the pros and cons of the various management options. Copyright © 2013 S. Karger AG, Basel.

Prenatal ethanol exposure-induced adrenal developmental abnormality of male offspring rats and its possible intrauterine programming mechanisms

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Huang, Hegui; He, Zheng; Zhu, Chunyan; Liu, Lian; Kou, Hao; Shen, Lang [Department of Pharmacology, Wuhan University School of Basic Medical Sciences, Wuhan 430071 (China); Wang, Hui, E-mail: wanghui19@whu.edu.cn [Department of Pharmacology, Wuhan University School of Basic Medical Sciences, Wuhan 430071 (China); Hubei Provincial Key Laboratory of Developmentally Originated Disorder, Wuhan 430071 (China)

2015-10-01

Fetal adrenal developmental status is the major determinant of fetal tissue maturation and offspring growth. We have previously proposed that prenatal ethanol exposure (PEE) suppresses fetal adrenal corticosterone (CORT) synthesis. Here, we focused on PEE-induced adrenal developmental abnormalities of male offspring rats before and after birth, and aimed to explore its intrauterine programming mechanisms. A rat model of intrauterine growth retardation (IUGR) was established by PEE (4 g/kg·d). In PEE fetus, increased serum CORT concentration and decreased insulin-like growth factor 1 (IGF1) concentration, with lower bodyweight and structural abnormalities as well as a decreased Ki67 expression (proliferative marker), were observed in the male fetal adrenal cortex. Adrenal glucocorticoid (GC)-metabolic activation system was enhanced while gene expression of IGF1 signaling pathway with steroidogenic acute regulatory protein (StAR), 3β-hydroxysteroid dehydrogenase (3β-HSD) was decreased. Furthermore, in the male adult offspring of PEE, serum CORT level was decreased but IGF1 was increased with partial catch-up growth, and Ki67 expression demonstrated no obvious change. Adrenal GC-metabolic activation system was inhibited, while IGF1 signaling pathway and 3β-HSD was enhanced with the steroidogenic factor 1 (SF1), and StAR was down-regulated in the adult adrenal. Based on these findings, we propose a “two-programming” mechanism for PEE-induced adrenal developmental toxicity: “the first programming” is a lower functional programming of adrenal steroidogenesis, and “the second programming” is GC-metabolic activation system-related GC-IGF1 axis programming. - Highlights: • Prenatal ethanol exposure induces adrenal developmental abnormality in offspring rats. • Prenatal ethanol exposure induces intrauterine programming of adrenal steroidogenesis. • Intrauterine GC-IGF1 axis programming might mediate adrenal developmental abnormality.

Prenatal ethanol exposure-induced adrenal developmental abnormality of male offspring rats and its possible intrauterine programming mechanisms

International Nuclear Information System (INIS)

Huang, Hegui; He, Zheng; Zhu, Chunyan; Liu, Lian; Kou, Hao; Shen, Lang; Wang, Hui

2015-01-01

Fetal adrenal developmental status is the major determinant of fetal tissue maturation and offspring growth. We have previously proposed that prenatal ethanol exposure (PEE) suppresses fetal adrenal corticosterone (CORT) synthesis. Here, we focused on PEE-induced adrenal developmental abnormalities of male offspring rats before and after birth, and aimed to explore its intrauterine programming mechanisms. A rat model of intrauterine growth retardation (IUGR) was established by PEE (4 g/kg·d). In PEE fetus, increased serum CORT concentration and decreased insulin-like growth factor 1 (IGF1) concentration, with lower bodyweight and structural abnormalities as well as a decreased Ki67 expression (proliferative marker), were observed in the male fetal adrenal cortex. Adrenal glucocorticoid (GC)-metabolic activation system was enhanced while gene expression of IGF1 signaling pathway with steroidogenic acute regulatory protein (StAR), 3β-hydroxysteroid dehydrogenase (3β-HSD) was decreased. Furthermore, in the male adult offspring of PEE, serum CORT level was decreased but IGF1 was increased with partial catch-up growth, and Ki67 expression demonstrated no obvious change. Adrenal GC-metabolic activation system was inhibited, while IGF1 signaling pathway and 3β-HSD was enhanced with the steroidogenic factor 1 (SF1), and StAR was down-regulated in the adult adrenal. Based on these findings, we propose a “two-programming” mechanism for PEE-induced adrenal developmental toxicity: “the first programming” is a lower functional programming of adrenal steroidogenesis, and “the second programming” is GC-metabolic activation system-related GC-IGF1 axis programming. - Highlights: • Prenatal ethanol exposure induces adrenal developmental abnormality in offspring rats. • Prenatal ethanol exposure induces intrauterine programming of adrenal steroidogenesis. • Intrauterine GC-IGF1 axis programming might mediate adrenal developmental abnormality.

Risk-Based Maintenance Assessment in the Manufacturing Industry: Minimisation of Suboptimal Prioritisation

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Ratnayake R.M. Chandima

2017-03-01

Full Text Available Manufacturing firms continuously strive to increase the efficiency and effectiveness in the maintenance management processes. Focus is placed on eliminating the unexpected failures which cause unnecessary costs and the production losses. Risk-based maintenance (RBM strategies enable to address the above through the identification of probability and consequences of potential failures whilst providing a way for prioritisation of maintenance actions based on the risk of possible failures. Such prioritisations enable to identify the optimal maintenance strategy, intervals of maintenance tasks, and optimal level of spare parts inventory. However, the risk assessment activities are performed with the support of a risk matrix. Suboptimal classifications and/or prioritisations arise due to the inherent nature of the risk matrix. This is caused by the fact that there are no means to incorporate actual circumstances at the boundary of the input ranges or at the levels of linguistic data and risk categories. In this paper, a risk matrix is first developed in collaboration with one of the manufacturing firms in Poland. Then, it illustrates the use of fuzzy logic for minimisation of suboptimal prioritisation and/or classifications using a fuzzy inference system (FIS together with illustrative membership functions and a rule base. Finally, an illustrative risk assessment is also demonstrated to illustrate the methodology.

Vascular dysfunction in women with a history of preeclampsia and intrauterine growth restriction: insights into future vascular risk.

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Yinon, Yoav; Kingdom, John C P; Odutayo, Ayodele; Moineddin, Rahim; Drewlo, Sascha; Lai, Vesta; Cherney, David Z I; Hladunewich, Michelle A

2010-11-02

Women with a history of placental disease are at increased risk for the future development of vascular disease. It is unknown whether preexisting endothelial dysfunction underlies both the predisposition to placental disease and the later development of vascular disease. The aim of this study was to assess vascular function in postpartum women and to determine whether differences emerged depending on the presentation of placental disease. Women with a history of early-onset preeclampsia (n=15), late-onset preeclampsia (n=9), intrauterine growth restriction without preeclampsia (n=9), and prior normal pregnancy (n=16) were studied 6 to 24 months postpartum. Flow-mediated vasodilatation and flow-independent (glyceryl trinitrate-induced) vasodilatation were studied through the use of high-resolution vascular ultrasound examination of the brachial artery. Arterial stiffness was assessed by pulse-wave analysis (augmentation index). Laboratory assessment included circulating angiogenic factors (vascular endothelial growth factor, soluble fms-like tyrosine kinase 1, placental growth factor, and soluble endoglin). Flow-mediated vasodilatation was significantly reduced in women with previous early-onset preeclampsia and intrauterine growth restriction compared with women with previous late-onset preeclampsia and control subjects (3.2±2.7% and 2.1±1.2% versus 7.9±3.8% and 9.1±3.5%, respectively; Pwomen with previous early-onset preeclampsia and intrauterine growth restriction, but not among late preeclamptic women and control subjects (P=0.0105). Circulating angiogenic factors were similar in all groups. Only women with a history of early-onset preeclampsia or intrauterine growth restriction without preeclampsia exhibit impaired vascular function, which might explain their predisposition to placental disease and their higher risk of future vascular disease.

Use of a levonorgestrel-releasing intrauterine device in the treatment of adenomyosis associated heavy menstrual bleeding

International Nuclear Information System (INIS)

Uysal, A.; Taner, C.E.; Mun, S.; Celimli, F.H.; Uysal, F.

2013-01-01

To evaluate the effects of a levonorgestrel-releasing intrauterine device in the treatment of adenomyosis associated with heavy menstrual bleeding. Methods: The retrospective study was conducted at a tertiary referral hospital in Izmir, Turkey, and comprised data on adenomyosis patients who were implanted with a levonorgestrel-releasing intrauterine device for heavy menstrual bleeding between December 2004 and January 2008. After the insertion of the device, all patients were followed up by transvaginal ultrasonography and serum haemoglobin levels and menstrual patterns were determined at the 6th and 12th month. Data was analysed using SPSS 10. Results: The mean age of the 42 women in the study was 43.2+-0.8 years. At the sixth month, amenorrhoea, oligomenorrhoea, spotting and regular menstrual flow were 9.5% (n=4), 7% (n=3), 19% (n=8), and 64% (n=27), respectively. At the 12th month, the same parametres were 9.5% (n=4), 7% (n=3), 12% (n=5), and 71% (n=30), respectively. Haemoglobin levels had increased and endometrial thickness had decreased, and these differences were statistically significant (p<0.001). Conclusion: The easy-to-use levonorgestrel-releasing intrauterine device can be added to the treatment options as a well-tolerated alternative in cases where a woman who has completed her fertility and does not request a hysterectomy has anaemia associated with adenomyosis. (author)

Application of spectroscopy (1HMRS) to assess liver metabolite concentrations in rats with intrauterine growth restriction.

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Wang, Tao; Chen, Pingyang; Bian, Dujun; Chen, Juncao

2017-04-01

Proton magnetic resonance spectroscopy ( 1 H-MRS) measurement of liver metabolism in intrauterine growth restriction rats has seldom been reported. This study investigated the application of 1 H-MRS in assessing liver metabolism in newborn pups that experienced intrauterine growth restriction. Intra-uterine growth restriction was established by feeding rats low-protein diets during pregnancy. Newborn pups received conventional magnetic resonance imaging and 1 H-MRS using a 3.0T whole body MR scanner at 3, 8 and 12 weeks post birth. The success rate of 1 H-MRS was 83.33%. Significantly lower body weight, BMI and body length at 3 weeks as well as significantly lower body weight, BMI and waist circumference at 8 and 12 weeks were observed in newborn pups of IUGR rats compared with pups of control rats. Significant differences in ACho/H 2 O, ACr/H 2 O, AGlx/H 2 O and ALipid/H 2 O at 3 and 8 weeks as well as significant differences in ACr/H 2 O, ALipid/H 2 O and AGlx/H 2 O at 12 weeks were observed between pups of control rats and pups of IUGR rats. 1 H-MRS allows noninvasive assessment of liver metabolism in the rat and demonstrated the poor liver development of rats that experienced IUGR.

Study of foetal heart rate patterns in pregnancy with intra-uterine growth restriction during antepartum period

International Nuclear Information System (INIS)

Fardiazar, Z.; Abassalizade, F.

2013-01-01

Objectives: To evaluate foetal heart rate pattern during antepartum period in pregnancies suffering from intra-uterine growth restriction. Methods: The case control study was conducted at the Alzahra Hospital, Tabriz, Iran from April 2008 to April 2011. It comprised 100 pregnancies with intra-uterine growth restriction and 92 normal pregnancies. The foetal heart rate pattern including basal heart rate, beat-to-beat variation, non-stress test (NST) result and acceleration and deceleration patterns of the heart rate were determined in both groups during the antepartum period. Findings were compared between the two groups and their relation with pregnancy-foetal outcomes was specified in the case group. SPSS 15 was used for statistical analysis. Results: There was no statistically significant difference between the foetus mean basal heart rate in the two groups (p <0.960). Frequency of cases with non-reactive non-stress test in the Cases was significantly higher than Controls (p <0.005). The difference in heart rate acceleration was also not statistically significant (p <0.618). Frequency of cases with low birth weight and caesarian was non-significantly but borderline higher among the Cases (p <0.081 and 0.060, respectively). Conclusion: Abnormal foetal heart rate pattern is more common in pregnancies marked by intra-uterine growth restriction and is directly associated with worse pregnancy/foetal outcomes. (author)

Disproportionate Intrauterine Growth Intervention Trial At Term: DIGITAT

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Huisjes Anjoke JM

2007-07-01

Full Text Available Abstract Background Around 80% of intrauterine growth restricted (IUGR infants are born at term. They have an increase in perinatal mortality and morbidity including behavioral problems, minor developmental delay and spastic cerebral palsy. Management is controversial, in particular the decision whether to induce labour or await spontaneous delivery with strict fetal and maternal surveillance. We propose a randomised trial to compare effectiveness, costs and maternal quality of life for induction of labour versus expectant management in women with a suspected IUGR fetus at term. Methods/design The proposed trial is a multi-centre randomised study in pregnant women who are suspected on clinical grounds of having an IUGR child at a gestational age between 36+0 and 41+0 weeks. After informed consent women will be randomly allocated to either induction of labour or expectant management with maternal and fetal monitoring. Randomisation will be web-based. The primary outcome measure will be a composite neonatal morbidity and mortality. Secondary outcomes will be severe maternal morbidity, maternal quality of life and costs. Moreover, we aim to assess neurodevelopmental and neurobehavioral outcome at two years as assessed by a postal enquiry (Child Behavioral Check List-CBCL and Ages and Stages Questionnaire-ASQ. Analysis will be by intention to treat. Quality of life analysis and a preference study will also be performed in the same study population. Health technology assessment with an economic analysis is part of this so called Digitat trial (Disproportionate Intrauterine Growth Intervention Trial At Term. The study aims to include 325 patients per arm. Discussion This trial will provide evidence for which strategy is superior in terms of neonatal and maternal morbidity and mortality, costs and maternal quality of life aspects. This will be the first randomised trial for IUGR at term. Trial registration Dutch Trial Register and ISRCTN

Intra-uterine tissue engineering of full-thickness skin defects in a fetal sheep model

NARCIS (Netherlands)

Hosper, Nynke A.; Eggink, Alex J.; Roelofs, Luc A. J.; Wijnen, Rene M. H.; van Luyn, Marja J. A.; Bank, Ruud A.; Harmsen, Martin C.; Geutjes, Paul J.; Daamen, Willeke F.; van Kuppevelt, Toin H.; Tiemessen, Dorien M.; Oosterwijk, Egbert; Crevels, Jane J.; Blokx, Willeke A. M.; Lotgering, Fred K.; van den Berg, Paul P.; Feitz, Wout F. J.

In spina bifida the neural tube fails to close during the embryonic period and it is thought that prolonged exposure of the unprotected spinal cord to the amniotic fluid during pregnancy causes additional neural damage. Intra-uterine repair might protect the neural tissue from exposure to amniotic

High T-cell immune activation and immune exhaustion among individuals with suboptimal CD4 recovery after 4 years of antiretroviral therapy in an African cohort

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Colebunders Robert

2011-02-01

Full Text Available Abstract Background Antiretroviral therapy (ART partially corrects immune dysfunction associated with HIV infection. The levels of T-cell immune activation and exhaustion after long-term, suppressive ART and their correlation with CD4 T-cell count reconstitution among ART-treated patients in African cohorts have not been extensively evaluated. Methods T-cell activation (CD38+HLA-DR+ and immune exhaustion (PD-1+ were measured in a prospective cohort of patients initiated on ART; 128 patient samples were evaluated and subcategorized by CD4 reconstitution after long-term suppressive treatment: Suboptimal [median CD4 count increase 129 (-43-199 cells/μl], N = 34 ], optimal [282 (200-415 cells/μl, N = 64] and super-optimal [528 (416-878 cells/μl, N = 30]. Results Both CD4+ and CD8 T-cell activation was significantly higher among suboptimal CD4 T-cell responders compared to super-optimal responders. In a multivariate model, CD4+CD38+HLADR+ T-cells were associated with suboptimal CD4 reconstitution [AOR, 5.7 (95% CI, 1.4-23, P = 0.014]. T-cell exhaustion (CD4+PD1+ and CD8+PD1+ was higher among suboptimal relative to optimal (P P = 0.022]. Conclusion T-cell activation and exhaustion persist among HIV-infected patients despite long-term, sustained HIV-RNA viral suppression. These immune abnormalities were associated with suboptimal CD4 reconstitution and their regulation may modify immune recovery among suboptimal responders to ART.

Congenital infantile myofibroma causing intrauterine death in a twin

Science.gov (United States)

Aye, Christina Yi Ling; Gould, Steve; Akinsola, S Adeyemi

2011-01-01

While infantile myofibromatosis is the most common mesenchymal tumour of infancy, only around 300 cases have been reported. The authors report a 33-year-old para 1 with an uncomplicated, dichorionic diamniotic twin pregnancy who was diagnosed with an intrauterine death of one twin at 36+5 weeks gestation. At caesarean section, a macerated male stillborn weighing 2.72 kg was delivered. Postmortem examination revealed a pedunculated lesion attached to the left shoulder and underlying muscle consistent with a congenital myofibroma. The cause of death was postulated to be haemorrhage from the tumour surface causing fetal anaemia. PMID:22674951

Differences in the association between maternal serum homocysteine and ADMA levels in women with pregnancies complicated by preeclampsia and/or intrauterine growth restriction.

Science.gov (United States)

Laskowska, Marzena; Laskowska, Katarzyna; Oleszczuk, Jan

2013-01-01

The aim of our study was to investigate the association between homocysteine and asymmetric dimethylarginine in preeclamptic women with and without intrauterine growth restriction compared with normal healthy uncomplicated pregnancies and normotensive pregnancies complicated by idiopathic isolated intrauterine fetal growth restriction. The maternal serum homocysteine and asymmetric dimethylarginine concentrations were determined using a sandwich enzyme-linked immunosorbent assays. A statistically significant positive correlation of maternal serum homocysteine levels with the serum asymmetric dimethylarginine levels was observed in healthy normotensive uncomplicated pregnant women from the control group and in preeclamptic patients with appropriate-for-gestational-age fetuses (R = 0.380079, p-value = 0.002311* and R = 0.455797, p-value = 0.004030* for the control and the P groups, respectively). However, this correlation was not significant in women with pregnancy complicated by intrauterine growth restriction, both isolated and in the course of severe preeclampsia. These findings provide support for the hypothesis that elevated levels of asymmetric dimethylarginine in pregnancy complicated by preeclampsia are associated with elevated homocysteine levels. But our results also demonstrate that in pregnancies complicated by intrauterine growth restriction, this mechanism is important, although not the only one.

Clinical Efficiency of Application of Intravenous Immunoglobulin in Pregnant Women with Intrauterine Infection

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O.L. Ishchenko

2016-02-01

Full Text Available The problem of intrauterine infection (IUI is still relevant today. Ineffective treatment of this pathology is associated with physiological decline of the immunity in these patients. We have proposed the additional use of intravenous immunoglobulin for the treatment of pregnant women with IUI. There were examined 75 patients with IUI, which was diagnosed in the II trimester. The I group consisted of 40 individuals who received conventional treatment, the II group was formed from 35 women who additionally received intravenous immunoglobulin. On the background of IUI, pregnancy was characterized by an increased incidence of threatened miscarriage and premature labor, gestosis and placental dysfunction; during delivery, premature rupture of amniotic membrane and fetal distress were more common. These patients had placenta with both ultrasonic and histological signs of infection. Among newborns, there was a significant increase in the incidence of pathology associated with intrauterine infection. Additional use of intravenous immunoglobulin in the treatment of IUI during the II trimester of pregnancy in comparison with conventional therapy leads to a significant reduction in the incidence of both obstetric complications and perinatal pathology.

A PROCEDURE FOR DETERMINING OPTIMAL FACILITY LOCATION AND SUB-OPTIMAL POSITIONS

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P.K. Dan

2012-01-01

Full Text Available

ENGLISH ABSTRACT: This research presents a methodology for determining the optimal location of a new facility, having physical flow interaction of various degrees with other existing facilities in the presence of barriers impeding the shortest flow-path as well as the sub-optimal iso-cost positions. It also determines sub-optimal iso-cost positions with additional cost or penalty for not being able to site it at the computed optimal point. The proposed methodology considers all types of quadrilateral barrier or forbidden region configurations to generalize and by-pass such impenetrable obstacles, and adopts a scheme of searching through the vertices of the quadrilaterals to determine the alternative shortest flow-path. This procedure of obstacle avoidance is novel. Software has been developed to facilitate computations for the search algorithm to determine the optimal and iso-cost co-ordinates. The test results are presented.

AFRIKAANSE OPSOMMING: Die navorsing behandel ‘n procedure vir die bepaling van optimum stigtingsposisie vir ‘n onderneming met vloei vanaf ander bestaande fasiliteite in die teenwoordigheid van ‘n verskeidenheid van randvoorwaardes. Die prodedure lewer as resultaat suboptimale isokoste-stigtingsplekke met bekendmaking van die koste wat onstaan a.g.v. afwyking van die randvoorwaardlose optimum oplossingskoste, die prosedure maak gebruik van ‘n vindingryke soekmetode wat toegepas word op niersydige meerkundige voorstellings vir die bepaling van korste roetes wat versperring omseil. Die prosedure word onderskei deur programmatuur. Toetsresultate word voorgehou.

Heterotropic pregnancy: Rare occurrence of a 12- week ruptured right isthmo-cornual ectopic along with a viable intrauterine pregnancy

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Priya Selvaraj

2012-01-01

Full Text Available Heterotropic pregnancy, although a rare condition, is associated with a greater frequency in assisted reproduction. It occurs in approximately 1 in 100 pregnancies conceived by in vitro fertilization (IVF particularly when multiple embryos are transferred into the uterus. We report a case of heterotropic pregnancy following IVF with the rupture of an isthmo-cornual pregnancy at 12 weeks of gestation with uneventful progression of the intrauterine pregnancy. Laparotomy was performed for the excision of the isthmo-cornual pregnancy. The intrauterine pregnancy continued uneventfully. A female baby was delivered by elective cesarean section at 33 weeks.

Cardiac Development and Transcription Factors: Insulin Signalling, Insulin Resistance, and Intrauterine Nutritional Programming of Cardiovascular Disease

Science.gov (United States)

Govindsamy, Annelene; Naidoo, Strinivasen

2018-01-01

Programming with an insult or stimulus during critical developmental life stages shapes metabolic disease through divergent mechanisms. Cardiovascular disease increasingly contributes to global morbidity and mortality, and the heart as an insulin-sensitive organ may become insulin resistant, which manifests as micro- and/or macrovascular complications due to diabetic complications. Cardiogenesis is a sequential process during which the heart develops into a mature organ and is regulated by several cardiac-specific transcription factors. Disrupted cardiac insulin signalling contributes to cardiac insulin resistance. Intrauterine under- or overnutrition alters offspring cardiac structure and function, notably cardiac hypertrophy, systolic and diastolic dysfunction, and hypertension that precede the onset of cardiovascular disease. Optimal intrauterine nutrition and oxygen saturation are required for normal cardiac development in offspring and the maintenance of their cardiovascular physiology. PMID:29484207

Challenges in nourishing the intrauterine growth-restricted foetus - Lessons learned from studies in the intrauterine growth-restricted foetal sheep.

Science.gov (United States)

Hay, William W; Brown, Laura D; Rozance, Paul J; Wesolowski, Stephanie R; Limesand, Sean W

2016-08-01

Previous attempts to improve growth and development of the intrauterine growth-restricted (IUGR) foetus during pregnancy have not worked or caused harm. Our research identifies tissue-specific mechanisms underlying foetal growth restriction and then tests strategies to improve growth and ameliorate many of the metabolic problems before the infant is born. The goal of our studies is to reduce the impact of foetal growth restriction at critical stages of development on the lifelong complications of IUGR offspring. Defining specific mechanisms that cause growth restriction in the foetus might identify specific nutrients and hormones that could be given to the mother to improve foetal growth and reduce metabolic complications, using strategies first tested in our IUGR animal model. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

A Suboptimal Scheme for Multi-User Scheduling in Gaussian Broadcast Channels

KAUST Repository

Zafar, Ammar; Alouini, Mohamed-Slim; Shaqfeh, Mohammad

2014-01-01

This work proposes a suboptimal multi-user scheduling scheme for Gaussian broadcast channels which improves upon the classical single user selection, while considerably reducing complexity as compared to the optimal superposition coding with successful interference cancellation. The proposed scheme combines the two users with the maximum weighted instantaneous rate using superposition coding. The instantaneous rate and power allocation are derived in closed-form, while the long term rate of each user is derived in integral form for all channel distributions. Numerical results are then provided to characterize the prospected gains of the proposed scheme.

A Suboptimal Scheme for Multi-User Scheduling in Gaussian Broadcast Channels

KAUST Repository

Zafar, Ammar

2014-05-28

This work proposes a suboptimal multi-user scheduling scheme for Gaussian broadcast channels which improves upon the classical single user selection, while considerably reducing complexity as compared to the optimal superposition coding with successful interference cancellation. The proposed scheme combines the two users with the maximum weighted instantaneous rate using superposition coding. The instantaneous rate and power allocation are derived in closed-form, while the long term rate of each user is derived in integral form for all channel distributions. Numerical results are then provided to characterize the prospected gains of the proposed scheme.

Intrauterine contraceptive device embedded in the omentum – case report

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Zolnierczyk P

2015-12-01

Full Text Available Piotr Zolnierczyk, Krzysztof Cendrowski, Wlodzimierz Sawicki Department of Obstetrics, Gynecology and Oncology, 2nd Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland Abstract: This report describes the case of a 29-year-old patient, female (nulliparous who had an intrauterine device (IUD inserted in 2010 and who has had no gynecological control since then (for 4 years. After this time, the asymptomatic patient had a gynecological appointment, during which a doctor did not find the strings of IUD in the speculum. Ultrasound examination did not reveal the presence of the IUD in the uterine cavity, which led to the suspicion of its presence outside the uterus. The patient was referred to a hospital, where she underwent ultrasound and X-ray examination of the pelvis that confirmed the presence of the IUD outside the uterus. Laparoscopy was performed during which the IUD was localized as being embedded in the omentum. It was removed by performing a resection of a part of the omentum with inflammatory infiltration. The patient was discharged home on the second postoperative day in a good condition. This case confirms the need for gynecological control and ultrasound examination shortly after insertion. An ultrasound or/and X-ray is mandatory in any case of absence of IUD strings previously visible in the vagina, if the patient did not observe its expulsion. Keywords: intrauterine device, myometrium, IUD threads, uterine cavity, ultrasound examination

Umbilical blood flow ultrasound characteristics of perioperative fetal intrauterine hypoxia and their relationship with maternal and fetal oxidative stress injury

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Yu-Mei He

2017-05-01

Full Text Available Objective: To study the relationship between umbilical blood flow ultrasound characteristics of perioperative fetal intrauterine hypoxia and maternal as well as fetal oxidative stress injury. Methods: 108 puerperae giving birth in our hospital between May 2014 and October 2016 were selected and divided into normal pregnancy group with neonatal Apgar score >7 points and intrauterine hypoxia group with neonatal Apgar score ≤7 points, color Doppler diasonograph was used to determine umbilical blood flow ultrasound parameters, umbilical cord blood was collected to determine the levels of oxidative stress products, and the placenta was collected to determine the levels of oxidative stress products and related apoptosis molecules. Results: During 24–30 weeks, 31–36 weeks and 37–41 weeks of pregnancy, umbilical blood flow resistance index (RI, pulsatility index (PI and diastolic velocity/systolic velocity (S/D of intrauterine hypoxia group were significantly higher than those of normal pregnancy group (P<0.05; malondialdehyde (MDA, oxidized low-density lipoprotein (ox- LDL, 8-isoprostanes (8-iso, and heat shock protein 70 (HSP-70 levels in umbilical cord blood of intrauterine hypoxia group were significantly higher than those of normal pregnancy group (P<0.05, MDA, oxLDL, 8-ios, HSP-70, Fas, FasL and Bax levels in placenta tissue were significantly higher than those of normal pregnancy group (P<0.05, and Bcl-2 and XIAP levels were significantly lower than those of normal pregnancy group (P<0.05; RI, PI and S/ D were positively correlated with MDA, oxLDL, 8-ios and HSP-70 levels in umbilical cord blood and placenta tissue, positively correlated with Fas, FasL and Bax levels in placenta tissue, and negatively correlated with Bcl-2 and XIAP levels in placental tissue. Conclusions: The increased umbilical blood flow resistance and decreased flow volume of fetal intrauterine hypoxia are closely related to maternal, fetal and placental oxidative

Suboptimal and optimal order policies for fixed and varying replenishment interval with declining market

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Yu, Jonas C. P.; Wee, H. M.; Yang, P. C.; Wu, Simon

2016-06-01

One of the supply chain risks for hi-tech products is the result of rapid technological innovation; it results in a significant decline in the selling price and demand after the initial launch period. Hi-tech products include computers and communication consumer's products. From a practical standpoint, a more realistic replenishment policy is needed to consider the impact of risks; especially when some portions of shortages are lost. In this paper, suboptimal and optimal order policies with partial backordering are developed for a buyer when the component cost, the selling price, and the demand rate decline at a continuous rate. Two mathematical models are derived and discussed: one model has the suboptimal solution with the fixed replenishment interval and a simpler computational process; the other one has the optimal solution with the varying replenishment interval and a more complicated computational process. The second model results in more profit. Numerical examples are provided to illustrate the two replenishment models. Sensitivity analysis is carried out to investigate the relationship between the parameters and the net profit.

Growth hormone, insulin-like growth factor I and its binding proteins 1 and 3 in last trimester intrauterine growth retardation with increased pulsatility index in the umbilical artery

DEFF Research Database (Denmark)

Larsen, T; Main, K; Andersson, A M

1996-01-01

The interrelationships between maternal hormone levels and placental dysfunction in mothers bearing children with intrauterine growth retardation remain unclear. We have examined some endocrinological aspects of intrauterine growth retardation and, in particular, tested whether low levels of GH...

Intrauterine human chorionic gonadotropin infusion in oocyte donors promotes endometrial synchrony and induction of early decidual markers for stromal survival: a randomized clinical trial.

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Strug, Michael R; Su, Renwei; Young, James E; Dodds, William G; Shavell, Valerie I; Díaz-Gimeno, Patricia; Ruíz-Alonso, Maria; Simón, Carlos; Lessey, Bruce A; Leach, Richard E; Fazleabas, Asgerally T

2016-07-01

Does a single intrauterine infusion of human chorionic gonadotropin (hCG) at the time corresponding to a Day 3 embryo transfer in oocyte donors induce favorable molecular changes in the endometrium for embryo implantation? Intrauterine hCG was associated with endometrial synchronization between endometrial glands and stroma following ovarian stimulation and the induction of early decidual markers associated with stromal cell survival. The clinical potential for increasing IVF success rates using an intrauterine hCG infusion prior to embryo transfer remains unclear based on previously reported positive and non-significant findings. However, infusion of CG in the non-human primate increases the expression of pro-survival early decidual markers important for endometrial receptivity, including α-smooth muscle actin (α-SMA) and NOTCH1. Oocyte donors (n=15) were randomly assigned to receive an intrauterine infusion of 500 IU hCG (n=7) or embryo culture media vehicle (n=8) 3 days following oocyte retrieval during their donor stimulation cycle. Endometrial biopsies were performed 2 days later, followed by either RNA isolation or tissue fixation in formalin and paraffin embedding. Reverse transcription of total RNA from endometrial biopsies generated cDNA, which was used for analysis in the endometrial receptivity array (ERA; n = 5/group) or quantitative RT-PCR to determine relative expression of ESR1, PGR, C3 and NOTCH1. Tissue sections were stained with hematoxylin and eosin followed by blinded staging analysis for dating of endometrial glands and stroma. Immunostaining for ESR1, PGR, α-SMA, C3 and NOTCH1 was performed to determine their tissue localization. Intrauterine hCG infusion was associated with endometrial synchrony and reprograming of stromal development following ovarian stimulation. ESR1 and PGR were significantly elevated in the endometrium of hCG-treated patients, consistent with earlier staging. The ERA did not predict an overall positive impact of

Consumer behaviour towards price-reduced suboptimal foods in the supermarket and the relation to food waste in households.

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Aschemann-Witzel, Jessica; Jensen, Jacob Haagen; Jensen, Mette Hyldetoft; Kulikovskaja, Viktorija

2017-09-01

To combat food waste, supermarkets offer food items at a reduced price in-store when they are close to the expiration date or perceived as suboptimal. It is yet unknown, however, which considerations consumers engage in when deciding about the offer, and whether focusing particularly on the price during food purchase might be related to greater food waste at home. Knowledge about both the consumers' food purchase process for these price-reduced foods and the potential wastage of price-focused consumers can contribute to the assessment of whether or not offering suboptimal food at reduced prices in-store actually reduces food waste across the supply chain. We explore these questions in a mixed-method study including 16 qualitative accompanied shopping interviews and a quantitative online experimental survey with 848 consumers in Denmark. The interviews reveal that the consumers interviewed assess their ability to consume the price-reduced suboptimal food at home already while in the store. Consumers consider the relation between product-related factors of package unit, expiration date, and product quality, in interaction with household-related factors of freezing/storing, household size/demand, and possible meal/cooking. The survey shows that consumers who are more price-focused report lower food waste levels and lower tendency to choose the optimal food item first at home, than those who are not emphasizing the price-quality relation or do not search for price offers to the same extent. Higher age and high education also played a role, and the price-focus is lower in high-income groups and among single households. The findings allow deriving recommendations for retailers and policy makers to support both the marketability and the subsequent actual consumption of price-reduced suboptimal food, but they also raise questions for further research of this underexplored area. Copyright © 2017 Elsevier Ltd. All rights reserved.

A Common Profile of Disordered Angiogenic Factor Production and the Exacerbation of Inflammation in Early Preeclampsia, Late Preeclampsia, and Intrauterine Growth Restriction.

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Kwiatkowski, Sebastian; Dołęgowska, Barbara; Kwiatkowska, Ewa; Rzepka, Rafał; Torbè, Andrzej; Bednarek-Jędrzejek, Magdalena

2016-01-01

Preeclampsia and intrauterine growth restriction are two separate disease entities that, according to numerous reports, share the same pathogenesis. In both, angiogenesis disorders and generalized inflammation are the dominant symptoms. In this study, we hypothesized that both diseases demonstrate the same profile in early preeclampsia, late preeclampsia, and intrauterine growth restriction patients, with the only difference being the degree of exacerbation of lesions. One hundred sixty-seven patients were enrolled in the study and divided into four groups: early preeclampsia, late preeclampsia, and intrauterine growth restriction groups, and one control group. Concentrations of the angiogenesis and inflammatory markers soluble fms-like tyrosine kinase receptor 1, placental growth factor, high-sensitivity C-reactive protein, and interleukin-6 were determined, and the behavior of these markers and correlations among them were studied. Higher concentrations of soluble fms-like tyrosine kinase receptor 1, high-sensitivity C-reactive protein, and interleukin-6 and a lower concentration of placental growth factor were observed in the study groups compared with the control group. No differences in concentrations of the studied markers were found among the study groups but significant correlations were observed. The higher values for the angiogenesis and inflammatory markers both in preeclampsia patients and patients with intrauterine growth restriction of placental origin compared with the control group suggest the existence of the same underlying disorders in the development of these pathologies. The observed mutual correlations for disordered angiogenesis and inflammatory markers are suggestive of a mutual relationship between these processes in the development of pathologies evolving secondary to placental ischemia. The same lesion profile was observed for both preeclampsia and 'placental' intrauterine growth restriction patients, which could be used in developing

Intrauterine position affects fetal weight and crown-rump length throughout gestation.

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Jang, Y D; Ma, Y L; Lindemann, M D

2014-10-01

To investigate the effect of intrauterine positions on fetal growth throughout gestation, data from a total of 65 gilts (n = 784 fetuses) that were slaughtered at assigned days of gestation (d 43, 58, 73, 91, 101, and 108) on a project to evaluate fetal mineral deposition were used. Placenta units were removed from the uterus, and position, sex, weight, and crown-rump length (CRL) of each fetus were recorded. Fetuses were classified into 5 categories within a uterine horn for the absolute intrauterine position: the ovarian end (OE) of the uterine horn, next to the ovarian end (NOE), the middle (MD), next to the cervical end (NCE), and the cervical end (CE), and also classified for the relative fetal position with respect to the sex of adjacent fetuses. Fetuses at the OE and NOE of the uterine horn tended to be heavier (P = 0.06) and longer (P sex (fetuses surrounded by the opposite sexes) in weight or length. Male fetuses were heavier than female fetuses at d 43, 58, 73, and 108 of gestation (P position affects fetal growth more than the sex of the adjacent fetus in the uterine horn, 2) each end of the uterine horn (OE and CE) has heavier fetuses than the MD, and 3) male pigs grow faster than female pigs even before birth.

Predictive value of sperm morphology and progressively motile sperm count for pregnancy outcomes in intrauterine insemination

NARCIS (Netherlands)

Lemmens, L.; Kos, S.; Beijer, C.; Brinkman, J.W.; Horst, F.A. van der; Hoven, L. van den; Kieslinger, D.C.; Trooyen-van Vrouwerff, N.J.; Wolthuis, A.; Hendriks, J.C.M.; Wetzels, A.M.M.

2016-01-01

OBJECTIVE: To investigate the value of sperm parameters to predict an ongoing pregnancy outcome in couples treated with intrauterine insemination (IUI), during a methodologically stable period of time. DESIGN: Retrospective, observational study with logistic regression analyses. SETTING: University

Suboptimal care and maternal mortality among foreign-born women in Sweden: maternal death audit with application of the 'migration three delays' model.

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Esscher, Annika; Binder-Finnema, Pauline; Bødker, Birgit; Högberg, Ulf; Mulic-Lutvica, Ajlana; Essén, Birgitta

2014-04-12

Several European countries report differences in risk of maternal mortality between immigrants from low- and middle-income countries and host country women. The present study identified suboptimal factors related to care-seeking, accessibility, and quality of care for maternal deaths that occurred in Sweden from 1988-2010. A subset of maternal death records (n = 75) among foreign-born women from low- and middle-income countries and Swedish-born women were audited using structured implicit review. One case of foreign-born maternal death was matched with two native born Swedish cases of maternal death. An assessment protocol was developed that applied both the 'migration three delays' framework and a modified version of the Confidential Enquiry from the United Kingdom. The main outcomes were major and minor suboptimal factors associated with maternal death in this high-income, low-maternal mortality context. Major and minor suboptimal factors were associated with a majority of maternal deaths and significantly more often to foreign-born women (p = 0.01). The main delays to care-seeking were non-compliance among foreign-born women and communication barriers, such as incongruent language and suboptimal interpreter system or usage. Inadequate care occurred more often among the foreign-born (p = 0.04), whereas delays in consultation/referral and miscommunication between health care providers where equally common between the two groups. Suboptimal care factors, major and minor, were present in more than 2/3 of maternal deaths in this high-income setting. Those related to migration were associated to miscommunication, lack of professional interpreters, and limited knowledge about rare diseases and pregnancy complications. Increased insight into a migration perspective is advocated for maternity clinicians who provide care to foreign-born women.

Cost-effectiveness of extended-release methylphenidate in children and adolescents with attention-deficit/hyperactivity disorder sub-optimally treated with immediate release methylphenidate.

Directory of Open Access Journals (Sweden)

Jurjen van der Schans

Full Text Available Attention-Deficit/Hyperactivity Disorder (ADHD is a common psychiatric disorder in children and adolescents. Immediate-release methylphenidate (IR-MPH is the medical treatment of first choice. The necessity to use several IR-MPH tablets per day and associated potential social stigma at school often leads to reduced compliance, sub-optimal treatment, and therefore economic loss. Replacement of IR-MPH with a single-dose extended release (ER-MPH formulation may improve drug response and economic efficiency.To evaluate the cost-effectiveness from a societal perspective of a switch from IR-MPH to ER-MPH in patients who are sub-optimally treated.A daily Markov-cycle model covering a time-span of 10 years was developed including four different health states: (1 optimal response, (2 sub-optimal response, (3 discontinued treatment, and (4 natural remission. ER-MPH options included methylphenidate osmotic release oral system (MPH-OROS and Equasym XL/Medikinet CR. Both direct costs and indirect costs were included in the analysis, and effects were expressed as quality-adjusted life years (QALYs. Univariate, multivariate as well as probabilistic sensitivity analysis were conducted and the main outcomes were incremental cost-effectiveness ratios.Switching sub-optimally treated patients from IR-MPH to MPH-OROS or Equasym XL/Medikinet CR led to per-patient cost-savings of €4200 and €5400, respectively, over a 10-year treatment span. Sensitivity analysis with plausible variations of input parameters resulted in cost-savings in the vast majority of estimations.This study lends economic support to switching patients with ADHD with suboptimal response to short-acting IR-MPH to long-acting ER-MPH regimens.

HEARING FUNCTION IN PREMATURE CHILDREN WITH INTRAUTERINE GROWTH RESTRICTION

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I. V. Rakhmanova

2012-01-01

Full Text Available Initial audiological test was performed in 136 premature children with various gestational age born from single fetation. The children were divided into 2 groups: prematures with intrauterine growth restriction (IUGR and prematures with normal weight for their gestational age (normotrophy. The study showed that the rate of passing the initial audiological test using the method of DPOAE was lower in both ears in children with IUGR, than in children with normotrophy. The correlation between the results of initial audiological test and birth weight was found: the lower was weight, the higher was risk of absence of acoustic response registration on initial examination.

Effect of intrauterine resuscitation on umbilical cord blood parameters of full-term fetal distress and evaluation of neonatal nerve function

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Mei-Hao Luo

2016-04-01

Full Text Available Objective: To study the effect of intrauterine resuscitation on umbilical cord blood parameters of fullterm fetal distress and neonatal nerve function. Methods: A total of 74 cases of women who gave birth in Gynecology and Obstetrics Department of our hospital and had fetal distress during labor from February 2008 to October 2010 were selected for study and randomly divided into two groups, observation group received intrauterine resuscitation, control group received conventional treatment, and then contents of umbilical arterial blood gas parameters and cytokines of two groups of patients, contents of serum nerve injury molecules of neonates as well as neonatal asphyxia condition and nerve function were compared. Results: pH value, PO2 and HCO3- in umbilical cord blood of observation group were higher than those of control group, and PCO2 and BE absolute value were lower than those of control group; IL-6, IL-8 and IFN-γ contents in umbilical arterial blood and umbilical venous blood of observation group of patients were significantly lower than those of control group; 1 d, 3 d, 5 d and 7 d after birth, serum NSE and S-100 protein contents of observation group of neonates were significantly lower than those of control group; neonatal asphyxia condition and nerve function were better than those of control group. Conclusion: Intrauterine resuscitation can improve intrauterine fetal anoxia and reduce acidosis while reduce neonatal nerve function injury and prevent neonatal asphyxia, and it is an ideal method to treat full-term fetal distress.

[Customized and non-customized French intrauterine growth curves. II - Comparison with existing curves and benefits of customization].

Science.gov (United States)

Ego, A; Prunet, C; Blondel, B; Kaminski, M; Goffinet, F; Zeitlin, J

2016-02-01

Our aim is to compare the new French EPOPé intrauterine growth curves, developed to address the guidelines 2013 of the French College of Obstetricians and Gynecologists, with reference curves currently used in France, and to evaluate the consequences of their adjustment for fetal sex and maternal characteristics. Eight intrauterine and birthweight curves, used in France were compared to the EPOPé curves using data from the French Perinatal Survey 2010. The influence of adjustment on the rate of SGA births and the characteristics of these births was analysed. Due to their birthweight values and distribution, the selected intrauterine curves are less suitable for births in France than the new curves. Birthweight curves led to low rates of SGA births from 4.3 to 8.5% compared to 10.0% with the EPOPé curves. The adjustment for maternal and fetal characteristics avoids the over-representation of girls among SGA births, and reclassifies 4% of births. Among births reclassified as SGA, the frequency of medical and obstetrical risk factors for growth restriction, smoking (≥10 cigarettes/day), and neonatal transfer is higher than among non-SGA births (P<0.01). The EPOPé curves are more suitable for French births than currently used curves, and their adjustment improves the identification of mothers and babies at risk of growth restriction and poor perinatal outcomes. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Exogenous recombinant human growth hormone effects during suboptimal energy and zinc intake

OpenAIRE

Rising, Russell; Scaglia, Julio F; Cole, Conrad; Tverskaya, Rozalia; Duro, Debora; Lifshitz, Fima

2005-01-01

Abstract Background Energy and Zinc (Zn) deficiencies have been associated with nutritional related growth retardation as well as growth hormone (GH) resistance. In this study, the relationship between suboptimal energy and/or Zn intake and growth in rats and their response to immunoreactive exogenous recombinant human GH (GHi), was determined. Results Rats treated with GHi and fed ad-libitum energy and Zn (100/100) had increased IGFBP-3 (p < 0.05) as compared with NSS (215 ± 23 vs. 185 ± 17 ...

Intrauterine growth and intelligence within sibling pairs: findings from the Mater-University study of pregnancy and its outcomes.

Science.gov (United States)

Lawlor, Debbie A; Bor, William; O'Callaghan, Michael J; Williams, Gail M; Najman, Jake M

2005-04-01

To examine the association between intrauterine growth and intelligence. Population based birth cohort study of sibling pairs born within a maximum of three years of each other. Mater-University women and children's hospital, Brisbane, Australia. 235 (470 children) sibling pairs. Among one randomly selected sibling from each pair verbal comprehension at age 5, general intelligence at age 14, and reading ability at age 14 increased linearly with increasing gestational age and sex standardised birth weight z scores. With adjustment for maternal age, race, and smoking during pregnancy, birth order, family income, and parental education the associations with verbal comprehension at age 5 and general intelligence at age 14 remained, whereas the association with reading ability at age 14 was attenuated to the null. Within sibling pairs, differences in intrauterine growth were positively associated with differences in verbal comprehension at age 5 (test score difference per one unit difference in birth weight z score = 1.52 (0.11 to 3.26)) and general intelligence at age 14 (1.09 (0.01 to 2.18)), but not with reading ability at age 14. Socioeconomic position or other fixed maternal characteristics do not seem to explain the positive association between intrauterine growth and childhood intelligence.

Potential adverse effects of antenatal melatonin as a treatment for intrauterine growth restriction: findings in pregnant sheep.

Science.gov (United States)

González-Candia, Alejandro; Veliz, Marcelino; Araya, Claudio; Quezada, Sebastian; Ebensperger, Germán; Serón-Ferré, María; Reyes, Roberto V; Llanos, Aníbal J; Herrera, Emilio A

2016-08-01

Intrauterine growth restriction is a condition in which the fetus has a birthweight and/or length Intrauterine growth restriction can be associated with various causes, among which is low uteroplacental perfusion and chronic hypoxia during gestation. Often, intrauterine growth-restricted fetuses have increased oxidative stress; therefore, agents that decrease oxidative stress and increase utero, placental, and umbilical perfusion have been proposed as a beneficial therapeutic strategy. In this scenario, melatonin acts as an umbilical vasodilator and a potent antioxidant that has not been evaluated in pregnancies under chronic hypoxia that induce fetal growth restriction. However, this neurohormone has been proposed as a pharmacologic therapy for complicated pregnancies. The aim of this study was to determine the effects of prenatal administration of melatonin during the last trimester of pregnancy on the biometry of the growth-restricted lambs because of developmental hypoxia. Further, we aimed to determine melatonin and cortisol levels and oxidative stress markers in plasma of pregnant ewes during the treatment. High-altitude pregnant sheep received either vehicle (n = 5; 5 mL 1.4% ethanol) or melatonin (n = 7; 10 mg/kg(-1)day(-1) in 5 mL 1.4% ethanol) daily during the last one-third of gestation. Maternal plasma levels of melatonin, cortisol, antioxidant capacity, and oxidative stress were determined along treatment. At birth, neonates were examined, weighed, and measured (biparietal diameter, abdominal diameter, and crown-rump length). Antenatal treatment with melatonin markedly decreased neonatal biometry and weight at birth. Additionally, melatonin treatment increased the length of gestation by 7.5% and shifted the time of delivery. Furthermore, the prenatal treatment doubled plasma levels of melatonin and cortisol and significantly improved the antioxidant capacity of the pregnant ewes. Our findings indicate that antenatal melatonin induces further

Socioeconomic factors explain suboptimal adherence to antiretroviral therapy among HIV-infected Australian adults with viral suppression

NARCIS (Netherlands)

Siefried, Krista J; Mao, Limin; Kerr, Stephen; Cysique, Lucette A; Gates, Thomas M; McAllister, John; Maynard, Anthony; de Wit, John; Carr, Andrew

2017-01-01

BACKGROUND: Missing more than one tablet of contemporary antiretroviral therapy (ART) per month increases the risk of virological failure. Recent studies evaluating a comprehensive range of potential risk factors for suboptimal adherence are not available for high-income settings. METHODS: Adults on

The Effects of Intrauterine Malnutrition on Maternal-Fetal Cholesterol Transport and Fetal Lipid Synthesis in Mice

NARCIS (Netherlands)

van Meer, Hester; van Straten, Esther M. E.; Baller, Julius F. W.; van Dijk, Theo H.; Kuipers, Folkert; Verkade, Henkjan J.; Plosch, Torsten

Intrauterine malnutrition is associated with increased susceptibility to chronic diseases in adulthood. Growth-restricted infants display a less favorable lipid profile already shortly postnatal. Maternal low protein diet (LPD) during gestation is a well-defined model of fetal programming in rodents

Sub-optimal parenting is associated with schizotypic and anxiety personality traits in adulthood.

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Giakoumaki, S G; Roussos, P; Zouraraki, C; Spanoudakis, E; Mavrikaki, M; Tsapakis, E M; Bitsios, P

2013-05-01

Part of the variation in personality characteristics has been attributed to the child-parent interaction and sub-optimal parenting has been associated with psychiatric morbidity. In the present study, an extensive battery of personality scales (Trait Anxiety Inventory, Behavioural Inhibition/Activation System questionnaire, Eysenck Personality Questionnaire-Revised, Temperament and Character Inventory, Schizotypal Traits Questionnaire, Toronto Alexithymia Scale) and the Parental Bonding Instrument (PBI) were administered in 324 adult healthy males to elucidate the effects of parenting on personality configuration. Personality variables were analysed using Principal Component Analysis (PCA) and the factors "Schizotypy", "Anxiety", "Behavioural activation", "Novelty seeking" and "Reward dependence" were extracted. Associations between personality factors with PBI "care" and "overprotection" scores were examined with regression analyses. Subjects were divided into "parental style" groups and personality factors were subjected to categorical analyses. "Schizotypy" and "Anxiety" were significantly predicted by high maternal overprotection and low paternal care. In addition, the Affectionless control group (low care/high overprotection) had higher "Schizotypy" and "Anxiety" compared with the Optimal Parenting group (high care/low overprotection). These results further validate sub-optimal parenting as an important environmental exposure and extend our understanding on the mechanisms by which it increases risk for psychiatric morbidity. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Intrauterine nicotine exposure, birth weight, gestational age and the risk of infantile colic

DEFF Research Database (Denmark)

Milidou, Ioanna; Søndergaard, Charlotte; Jensen, Morten Søndergaard

Background and aim: Infantile colic is characterised by crying bouts in a healthy infant during the first months. Smoking in pregnancy and low birth weight (BW) have been previously identified as risk factors for infantile colic. Nicotine acts as a neurotransmitter and is known to affect the intr......Background and aim: Infantile colic is characterised by crying bouts in a healthy infant during the first months. Smoking in pregnancy and low birth weight (BW) have been previously identified as risk factors for infantile colic. Nicotine acts as a neurotransmitter and is known to affect...... the intrauterine central nervous system development, while low BW and premature birth have both been related to adverse neurodevelopmental outcomes. We investigated the association between intrauterine nicotine exposure, BW, gestational age (GA) and infantile colic in a large cohort study. Materials and methods......: We used data from the Danish National Birth Cohort. The study on nicotine exposure included 63,128 infants and the study on BW and GA included 62, 785 infants with complete data. Infantile colic was defined according to the modified Wessel’s criteria based on maternal interview 6 months postpartum...

Early childhood neurodevelopment after intrauterine growth restriction: a systematic review.

Science.gov (United States)

Levine, Terri A; Grunau, Ruth E; McAuliffe, Fionnuala M; Pinnamaneni, RagaMallika; Foran, Adrienne; Alderdice, Fiona A

2015-01-01

Children who experienced intrauterine growth restriction (IUGR) may be at increased risk for adverse developmental outcomes in early childhood. The objective of this study was to carry out a systematic review of neurodevelopmental outcomes from 6 months to 3 years after IUGR. PubMed, Embase, PsycINFO, Maternity and Infant Care, and CINAHL databases were searched by using the search terms intrauterine, fetal, growth restriction, child development, neurodevelopment, early childhood, cognitive, motor, speech, language. Studies were eligible for inclusion if participants met specified criteria for growth restriction, follow-up was conducted within 6 months to 3 years, methods were adequately described, non-IUGR comparison groups were included, and full English text of the article was available. A specifically designed data extraction form was used. The methodological quality of included studies was assessed using well-documented quality-appraisal guidelines. Of 731 studies reviewed, 16 were included. Poorer neurodevelopmental outcomes after IUGR were described in 11. Ten found motor, 8 cognitive, and 7 language delays. Other delays included social development, attention, and adaptive behavior. Only 8 included abnormal Doppler parameters in their definitions of IUGR. Evidence suggests that children are at risk for poorer neurodevelopmental outcomes following IUGR from 6 months to 3 years of age. The heterogeneity of primary outcomes, assessment measures, adjustment for confounding variables, and definitions of IUGR limits synthesis and interpretation. Sample sizes in most studies were small, and some examined preterm IUGR children without including term IUGR or AGA comparison groups, limiting the value of extant studies. Copyright © 2015 by the American Academy of Pediatrics.

MRI Differences Associated with Intrauterine Growth Restriction in Preterm Infants.

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Bruno, Christie J; Bengani, Shreyans; Gomes, William A; Brewer, Mariana; Vega, Melissa; Xie, Xianhong; Kim, Mimi; Fuloria, Mamta

2017-01-01

Preterm infants are at risk for neurodevelopmental impairment. Intrauterine growth restriction (IUGR) further increases this risk. Brain imaging studies are often utilized at or near term-equivalent age to determine later prognosis. To evaluate the association between intrauterine growth and regional brain volume on MRI scans performed in preterm infants at or near term-equivalent age. This is a retrospective case-control study of 24 infants born at gestational age ≤30 weeks and cared for in a large, inner-city, academic neonatal intensive-care unit from 2012 to 2013. Each IUGR infant was matched with 1-2 appropriate for gestational age (AGA) infants who served as controls. Predischarge MRI scans routinely obtained at ≥36 weeks' adjusted age were analyzed for regional brain volumetric differences. We examined the association between IUGR and thalamic, basal ganglion, and cerebellar brain volumes in these preterm infants. Compared to AGA infants, IUGR infants had a smaller thalamus (7.88 vs. 5.87 mL, p = 0.001) and basal ganglion (8.87 vs. 6.92 mL, p = 0.002) volumes. There was no difference in cerebellar volumes between the two study groups. Linear regression analyses revealed similar trends in the associations between IUGR and brain volumes after adjusting for sex, gestational age at birth, and postconceptual age and weight at MRI. Thalamus and basal ganglion volumes are reduced in growth-restricted preterm infants. These differences may preferentially impact neurodevelopmental outcomes. Further research is needed to explore these relationships. © 2017 S. Karger AG, Basel.

Pelvic endometriosis with peritoneal fluid reduces pregnancy rates in women undergoing intrauterine insemination

OpenAIRE

Wu, Hong-Ming; Tzeng, Chii-Ruey; Chen, Chi-Hung; Chen, Pi-Hua

2013-01-01

Objective: This study investigated the occurrence of peritoneal fluid in women undergoing intrauterine insemination (IUI) and its correlation with the stage of pelvic endometriosis and its influence on pregnancy outcomes. Materials and Methods: A retrospective case–control design was used to recruit 272 infertile women with pelvic endometriosis. The treatment protocol consisted of controlled ovarian hyperstimulation with downregulation and gonadotropin for IUI treatment following ultrasoun...

Ultrasonographic visualization of bleeding sites can help control postpartum hemorrhage using intrauterine balloon tamponade.

Science.gov (United States)

Kondoh, Eiji; Konishi, Mitsunaga; Kariya, Yoshitaka; Konishi, Ikuo

2015-01-01

Identification of precise bleeding sites is generally important to control hemorrhage. Nevertheless, the optimal technique to detect the bleeding sites has not yet been fully defined for patients with life-threatening post partum hemorrhage. We describe that ultrasonographic visualization of bleeding sites can help control post partum hemorrhage using intrauterine balloon tamponade. © 2014 Wiley Periodicals, Inc.

Intrauterine transfusion combined with partial exchange transfusion for twin anemia polycythemia sequence: modeling a novel technique

NARCIS (Netherlands)

Slaghekke, F.; van den Wijngaard, J. P. H. M.; Akkermans, J.; van Gemert, M. J. C.; Middeldorp, J. M.; Klumper, F. J.; Oepkes, D.; Lopriore, E.

2015-01-01

Twin anemia-polycythemia sequence (TAPS) is a newly described disease in monochorionic twin pregnancies, characterized by large inter-twin hemoglobin differences. Optimal management for TAPS is not clear. One of the possible treatment modalities is intrauterine blood transfusion (IUT) in the donor

Cytokine production and visualized effects in the feto-maternal unit. Quantitative and topographic data on cytokines during intrauterine disease.

Science.gov (United States)

Stallmach, T; Hebisch, G; Joller-Jemelka, H I; Orban, P; Schwaller, J; Engelmann, M

1995-09-01

A large array of cytokines show high activity in amniotic fluid. Attempts have been made to quantify the concentrations or to track rising levels for diagnostic purposes when examining disturbances of the feto-maternal unit. However, the kinetics of cytokine production in the amniotic fluid are not well understood, and there is lack of knowledge about concomitant levels in fetal and maternal blood. The presence of cytokines in fetal and placental cells was demonstrated by immunohistochemistry using mAb. Cytokines were quantified by enzymimmunoassay in amniotic fluid and fetal and maternal blood. This was done with regard to two disease states that quite frequently complicate the course of pregnancy, namely chorioamnionitis and intrauterine growth retardation. The cytokines examined were G-CSF, GM-CSF, TNF-alpha, IL-1, IL-6, and IL-8. In chorioamnionitis, all cytokines, except GM-CSF, were elevated about 100 times in the amniotic fluid. An accompanying increase in maternal and fetal blood was only found for IL-6 and G-CSF; IL-8 was elevated in fetal blood only. Intrauterine growth retardation was characterized by elevated levels of TNF-alpha in the amniotic fluid, whereas G-CSF, GM-CSF, and IL-1 beta were significantly reduced. Immunohistochemistry showed that under normal conditions the cytokines are to be found in a characteristic distribution in certain cell types in the fetus, the placenta, and the placental bed. With rising concentrations, more cells seemed to be recruited for cytokine production, especially macrophages and decidual cells. In chorioamnionitis, fetal extramedullary granulopoiesis was augmented, and in intrauterine growth retardation, erythropoiesis as well as granulopoiesis were depressed. Not only inflammatory disease but also intrauterine growth retardation is characterized by a changing cytokine pattern. Alterations in fetal hematopoiesis observed at postmortem examination of perinatal deaths can be correlated to changes in cytokine

SU-D-BRF-05: A Novel System to Provide Real-Time Image-Guidance for Intrauterine Tandem Insertion and Placement

Energy Technology Data Exchange (ETDEWEB)

Price, M; Fontenot, J [pF Biomedical Solutions LLC, Baton Rouge, LA (United States)

2014-06-01

Purpose: To develop a system that provides real-time image-guidance for intrauterine tandem insertion and placement for brachytherapy. Methods: The conceptualized system consists of an intrauterine tandem with a transparent, lensed tip, a flexible miniature fiber optic scope, light source and interface for CCD coupling. The tandem tip was designed to act as a lens providing a wide field-of-view (FOV) with minimal image distortion and focus length appropriate for the application. The system is designed so that once inserted, the image-guidance component of the system can be removed and brachytherapy can be administered without interfering with source transport or disturbing tandem placement. Proof-of-principle studies were conducted to assess the conceptualized system's (1) lens functionality (clarity, focus and FOV) (2) and ability to visualize the cervical os of a female placed in the lithotomy position. Results: A prototype of this device was constructed using a commercial tandem modified to incorporate a transparent tip that internally coupled with a 1.9mm diameter fiber optic cable. The 900mm-long cable terminated at an interface that provided illumination as well as facilitated visualization of patient anatomy on a computer. The system provided a 23mm FOV with a focal length of 1cm and provided clear visualization of the cervix, cervical fornix and cervical os. The optical components of the system are easily removed without perturbing the position of a tandem placed in a common fixation clamp. Conclusion: Clinicians frequently encounter difficulty inserting an intrauterine tandem through the cervical os, circumventing fibrotic tissue or masses within the uterus, and positioning the tandem without perforating the uterus. To mitigate these challenges, we have designed and conducted proof-of- principle studies to discern the utility of a prototype device that provides real-time image-guidance for intrauterine tandem placement using fiber optic components.

Premature delivery due to intrauterine Candida infection that caused neonatal congenital cutaneous candidiasis: a case report.

Science.gov (United States)

Ito, Fumitake; Okubo, Tomoharu; Yasuo, Tadahiro; Mori, Taisuke; Iwasa, Koichi; Iwasaku, Kazuhiro; Kitawaki, Jo

2013-01-01

Congenital cutaneous candidiasis is a very rare disease with less than 100 cases published in the medical literature. Neonates having this disease present with systemic skin lesions caused by intrauterine Candida infections. We present a case of threatened premature delivery due to Candida chorioamnionitis, which caused both maternal postpartum endometritis and neonatal congenital cutaneous candidiasis. A 34-year-old woman who was admitted for fetal membrane bulging at 20 weeks of gestation underwent McDonald cervical cerclage. We diagnosed threatened premature delivery due to intrauterine infection; therefore, we terminated the gestation by cesarean section at 24 weeks of gestation. Fungi-like yeast was detected in infantile gastric juice. Histopathological findings of the placenta revealed that Candida albicans mycelium invaded the placenta, chorioamniotic membrane and umbilical cord. © 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.

Role of the levonorgestrel intrauterine system in effective contraception

Directory of Open Access Journals (Sweden)

Attia AM

2013-08-01

Full Text Available Abdelhamid M Attia,1 Magdy M Ibrahim,1 Ahmed M Abou-Setta21Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt; 2George and Fay Yee Centre for Healthcare Innovation, University of Manitoba/Winnipeg Regional Health Authority, Winnipeg, MB, CanadaAbstract: Norgestrel, a synthetic progestin chemically derived from 19-nortestosterone, is six times more potent than progesterone, with variable binding affinity to various steroid receptors. The levonorgestrel-releasing intrauterine system (LNG IUS provides a long-acting, highly effective, and reversible form of contraception, with a pearl index of 0.18 per 100 women-years. The locally released hormone leads to endometrial concentrations that are 200–800 times those found after daily oral use and a plasma level that is lower than that with other forms of levonorgestrel-containing contraception. The contraceptive effect of the LNG IUS is achieved mainly through its local suppressive effect on the endometrium, leading to endometrial thinning, glandular atrophy, and stromal decidualization without affecting ovulation. The LNG IUS is generally well tolerated. The main side effects are related to its androgenic activity, which is usually mild and transient, resolving after the first few months. Menstrual abnormalities are also common but well tolerated, and even become desirable (eg, amenorrhea, hypomenorrhea, and oligomenorrhea with proper counseling of the patient during the choice of the method of contraception. The satisfaction rates after 3 years of insertion are high, reaching between 77% and 94%. The local effect of the LNG IUS on the endometrium and low rates of systemic adverse effects have led to its use in other conditions rather than contraception, as for the treatment of endometrial hyperplasia, benign menorrhagia, endometriosis, adenomyosis, and uterine fibroids.Keywords: levonorgestrel, intrauterine device, contraception, family planning, Mirena, Skyla

Common experiences of patients following suboptimal treatment outcomes: implications for epilepsy surgery.

Science.gov (United States)

Fernando, Dinusha K; McIntosh, Anne M; Bladin, Peter F; Wilson, Sarah J

2014-04-01

Few studies have investigated the patient experience of unsuccessful medical interventions, particularly in the epilepsy surgery field. The present review aimed to gain insight into the patient experience of seizure recurrence after epilepsy surgery by examining the broader literature dealing with suboptimal results after medical interventions (including epilepsy surgery). To capture the patient experience, the literature search focused on qualitative research of patients who had undergone medically unsuccessful interventions, published in English in scholarly journals. Twenty-two studies were found of patients experiencing a range of suboptimal outcomes, including seizure recurrence, cancer recurrence and progression, unsuccessful joint replacement, unsuccessful infertility treatment, organ transplant rejection, coronary bypass graft surgery, and unsuccessful weight-loss surgery. In order of frequency, the most common patient experiences included the following: altered social dynamics and stigma, unmet expectations, negative emotions, use of coping strategies, hope and optimism, perceived failure of the treating team, psychiatric symptoms, and control issues. There is support in the epilepsy surgery literature that unmet expectations and psychiatric symptoms are key issues for patients with seizure recurrence, while other common patient experiences have been implied but not systematically examined. Several epilepsy surgery specific factors influence patient perceptions of seizure recurrence, including the nature of postoperative seizures, the presence of postoperative complications, and the need for increased postoperative medications. Knowledge of common patient experiences can assist in the delivery of patient follow-up and rehabilitation services tailored to differing outcomes after epilepsy surgery. Copyright © 2014 Elsevier Inc. All rights reserved.

Molecular mechanisms of intrauterine growth restriction.

Science.gov (United States)

Gurugubelli Krishna, Rao; Vishnu Bhat, B

2017-07-10

Intrauterine growth restriction (IUGR) is a pregnancy specific disease characterized by decreased growth rate of fetus than the normal growth potential at particular gestational age. In the current scenario it is a leading cause of fetal and neonatal morbidity and mortality. In the last decade exhilarating experimental studies from several laboratories have provided fascinating proof for comprehension of molecular basis of IUGR. Atypical expression of enzymes governed by TGFβ causes the placental apoptosis and altered expression of TGFβ due to hyper alimentation causes impairment of lung function. Crosstalk of cAMP with protein kinases plays a prominent role in the regulation of cortisol levels. Increasing levels of NOD1 proteins leads to development of IUGR by increasing the levels of inflammatory mediators. Increase in leptin synthesis in placental trophoblast cells is associated with IUGR. In this review, we emphasize on the regulatory mechanisms of IUGR and its associated diseases. They may help improve the in-utero fetal growth and provide a better therapeutic intervention for prevention and treatment of IUGR.

Levonorgestrel-releasing intrauterine device in the treatment of abnormal uterine bleeding: a 6- and 12-month morphological and clinical follow-up.

Science.gov (United States)

Palmara, Vittorio; Sturlese, Emanuele; Villari, Daniela; Giacobbe, Valentina; Retto, Annalisa; Santoro, Giuseppe

2013-08-01

Abnormal uterine bleeding is defined as any alteration in the pattern or volume of menstrual blood flow, and it is preferably treated using hysterectomy, endometrial destruction or the levonorgestrel-releasing intrauterine system (Mirena(®) ). Recently, it has been demonstrated that studies of Mirena(®) were generally small and consequently imprecise. Our study was aimed at assessing the effects of a slow-release levonorgestrel (20 μg/day) intrauterine device in fertile and postmenopausal women experiencing abnormal uterine bleeding that did not respond to traditional medical management. A total of 40 women, of whom 24 were of reproductive capacity and 16 were postmenopausal, were enrolled in the trial. Removal of the intrauterine device was required for only 2 of the 24 fertile women and for only 3 of the 16 postmenopausal women. After 6 and 12 months of treatment, the remaining women were clinically evaluated and underwent ultrasound and hysteroscopy using biopsy specimens as a control. The EuroQol Group EQ-5D questionnaire was used for evaluation of quality of life. The device showed good tolerability and efficacy. It resulted in a reduction in the endometrial mucosal thickness with a regression of bleeding and collateral effects, which were more evident after 12 months of treatment. A positive effect of the device on the woman's quality of life was demonstrated. The slow-release levonorgestrel intrauterine device may be a valid therapeutic tool for treating basic symptomatology and increasing quality of life in women with abnormal uterine bleeding. © 2013 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Effect of different seed treatments on maize seed germination parameters under optimal and suboptimal temperature conditions

Directory of Open Access Journals (Sweden)

Vujošević Bojana

2017-01-01

Full Text Available The aim of this study was to determine the effect of different seed treatments on germination parameters of three maize genotypes under optimal and suboptimal temperature conditions. Seed was treated with recommended doses of three commercial pesticide formulations: metalaxyl-m 10 g/L + fludioxonil 25 g/L, metalaxyl 20 g/kg + prothioconazole 100 g/kg and thiacloprid 400 g/L. Testing was conducted at 25°C and 15°C. Results of the study indicate that there are differences in response of maize genotypes to applied seed treatments, as well as to a specific treatment at optimal and suboptimal temperatures. Some treatments, depending on the mixing partner and temperature conditions, can affect final germination. In other cases, germination rate can be accelerated or prolonged, but with no effect on final germination. In order to provide fast and uniform emergence under different temperature conditions, further examination of the response of maize genotypes to specific seed treatments would be beneficial.

Association of Suboptimal Antiretroviral Therapy Adherence With Inflammation in Virologically Suppressed Individuals Enrolled in the SMART Study

DEFF Research Database (Denmark)

Castillo-Mancilla, Jose R; Phillips, Andrew N; Neaton, James D

2018-01-01

Suboptimal (ie, <100%) antiretroviral therapy (ART) adherence has been associated with heightened inflammation in cohort studies, even among people with virologic suppression. We aimed to evaluate this association among participants in the Strategies for Management of Antiretroviral Therapy (SMAR...

Intra-uterine contraceptive devices.

Science.gov (United States)

Elias, J

1985-05-01

Among the advantages of IUDs are the device's high continuation rate, the lack of systemic side effects, and the absence of a need for continual motivation to practice contraception. The effectiveness of plastic IUDs is directly proportional to their surface area, but the degree of excessive bleeding experienced is inversely related to device size. Thus, devices represent a compromise between large size for effectiveness and small size for acceptability. The optimum time to fit an IUD is during the 1st hald of the menstrual cycle. Absolute contraindications to IUD use include the presence of active pelvic inflammatory disease, undiagnosed irregular bleeding, a history of ectopic pregnancy or tubal surgery, and a distorted uteine cavity. Failure rates associated with IUD use range from 2-3% in the 1st year and then decrease. Since the main mechanism of action appears to be production of a sterile inflammatory reaction in the uterine cavity, the IUD prevents intrauterine pregnancy more effectively than ectopic pregnancy. Nonetheless, there is little evidence to suggest that IUD use actually increases the incidence of ectopic pregnancy. Resumption of fertility after IUD removal is not delayed. There is not need to change inert plastic IUDs in women who remain symptom free. The copper devices should be changed every 3-4 years. A search is under way for antifertility agents that can be incorporated into the device to reduce side effects. In general, the IUD is most suitable for older, parous women.

A new familial intrauterine growth retardation syndrome the "3-M syndrome".

Science.gov (United States)

Spranger, J; Opitz, J M; Nourmand, A

1976-09-01

Two pairs of siblings are described with proportionate dwarfism due to skeletal hypoplasia of prenatal onset. The head size was normal for age and disproportionately large for height. The patients had a characteristic face different from that seen in the Silver-Russell syndrome. The family data are in accordance with autosomal recessive inheritance. In spite of some similarities, the bulk of clinical and genetic evidence suggests that the described intrauterine growth retardation syndrome is different from the Silver-Russell syndrome and presents an apparently "new" entity which has been designated 3-M syndrome.

Introduction of the levonorgestrel intrauterine system in Kenya through mobile outreach: review of service statistics and provider perspectives.

Science.gov (United States)

Hubacher, David; Akora, Vitalis; Masaba, Rose; Chen, Mario; Veena, Valentine

2014-02-01

The levonorgestrel intrauterine system (LNG IUS) was developed over 30 years ago, but the product is currently too expensive for widespread use in many developing countries. In Kenya, one organization has received donated commodities for 5 years, providing an opportunity to assess impact and potential future role of the product. We reviewed service statistics on insertions of the LNG IUS, copper intrauterine device (IUD), and subdermal implant from 15 mobile outreach teams during the 2011 calendar year. To determine the impact of the LNG IUS introduction, we analyzed changes in uptake and distribution of the copper IUD and subdermal implant by comparing periods of time when the LNG IUS was available with periods when it was not available. In addition, we interviewed 27 clinicians to assess their views of the product and of its future role. When the LNG IUS was not available, intrauterine contraception accounted for 39% of long-acting method provision. The addition of the LNG IUS created a slight rise in intrauterine contraception uptake (to 44%) at the expense of the subdermal implant, but the change was only marginally significant (P = .08) and was largely attributable to the copper IUD. All interviewed providers felt that the LNG IUS would increase uptake of long-acting methods, and 70% felt that the noncontraceptive benefits of the product are important to clients. The LNG IUS was well-received among providers and family planning clients in this population in Kenya. Although important changes in service statistics were not apparent from this analysis (perhaps due to the small quantity of LNG IUS that was available), provider enthusiasm for the product was high. This finding, above all, suggests that a larger-scale introduction effort would have strong support from providers and thus increase the chances of success. Adding another proven and highly acceptable long-acting contraceptive technology to the method mix could have important reproductive health

Immediate vs. delayed insertion of intrauterine contraception after second trimester abortion: study protocol for a randomized controlled trial

Directory of Open Access Journals (Sweden)

Soon Judith A

2011-06-01

Full Text Available Abstract Background We describe the rationale and protocol for a randomized controlled trial (RCT to assess whether intrauterine contraception placed immediately after a second trimester abortion will result in fewer pregnancies than current recommended practice of intended placement at 4 weeks post-abortion. Decision analysis suggests the novel strategy could substantially reduce subsequent unintended pregnancies and abortions. This paper highlights considerations of design, implementation and evaluation of a trial expected to provide rigorous evidence for appropriate insertion timing and health economics of intrauterine contraception after second trimester abortion. Methods/Design Consenting women choosing to use intrauterine contraception after abortion for a pregnancy of 12 to 24 weeks will be randomized to insertion timing groups either immediately (experimental intervention or four weeks (recommended care post abortion. Primary outcome measure is pregnancy rate at one year. Secondary outcomes include: cumulative pregnancy rates over five year follow-up period, comprehensive health economic analyses comparing immediate and delayed insertion groups, and device retention rates, complication rates (infection, expulsion and, contraceptive method satisfaction. Web-based Contraception Satisfaction Questionnaires, clinical records and British Columbia linked health databases will be used to assess primary and secondary outcomes. Enrolment at all clinics in the province performing second trimester abortions began in May 2010 and is expected to complete in late 2011. Data on one year outcomes will be available for analysis in 2014. Discussion The RCT design combined with access to clinical records at all provincial abortion clinics, and to information in provincial single-payer linked administrative health databases, birth registry and hospital records, offers a unique opportunity to evaluate such an approach by determining pregnancy rate at one

Empty-bladder (hysterographic) view on US for evaluation of intrauterine devices. Work in progress.

Science.gov (United States)

Carroll, R; Gombergh, R

1987-06-01

Ultrasound scanning of the pelvis with an empty bladder permits a true frontal view of the uterus to be easily obtained. This view is comparable to the en face view seen at hysterography performed with contrast material. Good definition both of the endometrium and the uterine wall makes this the optimal method for the evaluation of an intrauterine contraceptive device.

Consumer perception and preference for suboptimal food under the emerging practice of expiration date based pricing in supermarkets

DEFF Research Database (Denmark)

Aschemann-Witzel, Jessica

2017-01-01

, it is unclear which contextual, individual, and product-related factors impact consumer likelihood of choice and thus acceptance of the practice in the long run. The study aimed at exploring the effect of communicating different motives for purchase, the product being organic, familiarity with the practice...... and the interaction with gender is observed for milk in particular. Overall, perceived quality and estimated likelihood of consumption at home majorly determine likelihood of choice. Consumer acceptance of expiration date based pricing of suboptimal food can be increased through furthering consumer familiarity......Consumers have been found to majorly prefer ‘optimal’ food over ‘suboptimal’ when purchasing food. To provide an incentive for consumers to select suboptimal food and thus decrease food waste in the supply chain, expiration date based pricing is suggested and increasingly applied. However...

Use of frameless intrauterine devices and systems in young nulliparous and adolescent women: results of a multicenter study

Directory of Open Access Journals (Sweden)

Wildemeersch D

2014-08-01

Full Text Available Dirk Wildemeersch,1 Sohela Jandi,2 Ansgar Pett,2 Kilian Nolte,3 Thomas Hasskamp,4 Marc Vrijens5 1Gynecological Outpatient Clinic and IUD Training Center, Ghent, Belgium; 2Gynecological Outpatient Clinic, Berlin, 3Gynecological Outpatient Clinic, Uetze, 4GynMünster, Münster, Germany; 5Gynecological Outpatient Clinic, Ghent, Belgium Background: The purpose of this study was to provide additional data on the experience with frameless copper and levonorgestrel (LNG intrauterine devices (IUDs in nulliparous and adolescent women. Methods: Nulliparous and adolescent women, 25 years of age or younger, using the frameless copper IUD or the frameless LNG-releasing intrauterine system (IUS, were selected from previous studies and a current multicenter post-marketing study with the frameless copper IUD. The small copper-releasing GyneFix® 200 IUD consists of four copper cylinders, each 5 mm long and only 2.2 mm wide. The frameless FibroPlant® LNG-IUS consists of a fibrous delivery system releasing the hormone levonorgestrel (LNG-IUS. The main features of these intrauterine contraceptives are that they are frameless, flexible, and anchored to the fundus of the uterus. Results: One hundred and fifty-four nulliparous and adolescent women participated in the combined study. One pregnancy occurred with the GyneFix 200 IUD after unnoticed early expulsion of the device (cumulative pregnancy rate 1.1 at one year. Two further expulsions were reported, one with the GyneFix 200 IUD and the other with the FibroPlant LNG-IUS. The cumulative expulsion rate at one year was 1.1 with the copper IUD and 2.2 with the LNG-IUS. The total discontinuation rate at one year was low (3.3 and 4.3 with the copper IUD and LNG-IUS, respectively and resulted in a high rate of continuation of use at one year (96.7 with the copper IUD and 95.7 with the LNG-IUS, respectively. Continuation rates for both frameless copper IUD and frameless LNG-IUS remained high at 3 years (>90%. There

Effects of intrauterine infusion of Escherichia coli lipopolysaccharide on uterine health, resolution of purulent vaginal discharge, and reproductive performance of lactating dairy cows.

Science.gov (United States)

Moraes, João G N; Silva, Paula R B; Mendonça, Luís G D; Scanavez, Alexandre A; Silva, Joseane C C; Chebel, Ricardo C

2017-06-01

The objectives of the current experiment were to evaluate the effects of intrauterine infusion of Escherichia coli lipopolysaccharide (LPS) in cows diagnosed with purulent vaginal discharge (PVD) on intrauterine cell population, resolution of PVD, uterine health, and reproductive performance. Jersey cows (n = 3,084) were examined using the Metricheck device to diagnose PVD at 35 ± 6 d postpartum. Purulent vaginal discharge was defined as the presence of purulent (≥50% pus) discharge detectable in the vagina. Of the 310 cows positive for PVD, 267 cows were enrolled in the current experiment. To ensure proper timing of treatment and collection of samples, only 9 PVD-positive cows were treated per day. Selected cows were balanced at 35 ± 6 d postpartum for lactation number, body condition score, and milk yield and were randomly assigned to receive an intrauterine infusion of 20 mL of phosphate-buffered saline (PBS; control, n = 87), 20 mL of PBS with 150 µg LPS (LPS150, n = 91), or 20 mL of PBS with 300 µg of LPS (LPS300, n = 89). Uterine cytology was performed immediately before treatment and 1, 2, and 7 d after treatment to evaluate the effect of LPS treatment on intrauterine cell population. Cows were examined with the Metricheck device at 7 and 28 d after treatment to evaluate the effects of treatment on resolution of PVD. Reproductive status was recorded up to 200 d postpartum. Cows diagnosed with PVD had greater incidence of twinning, dystocia, retained placenta, and metritis after calving than cows without PVD. Count of polymorphonuclear leukocytes (PMNL) in uterine cytology 1, 2, and 7 d after intrauterine infusion was not statistically different among treatments. From d 0 to 1, however, PMNL count in uterine cytology of PBS cows increased by 5%, whereas the PMNL count in uterine cytology of LPS150 and LPS300 cows increased by 54 and 48%, respectively. Treatment did not affect the likelihood of cows being diagnosed with PVD 7 and 28 d after intrauterine

Leptin administration affects growth and skeletal development in a rat intrauterine growth restriction model: preliminary study.

Science.gov (United States)

Bar-El Dadon, Shimrit; Shahar, Ron; Katalan, Vered; Monsonego-Ornan, Efrat; Reifen, Ram

2011-09-01

Skeletal abnormalities are one of the hallmarks of growth delay during gestation. The aim of this study was to determine changes induced by leptin in skeletal growth and development in a rat model of intrauterine growth retardation (IUGR) and to elucidate the possible underlying mechanisms. Intrauterine growth retardation was induced prepartum and the effects of leptin to mothers prenatally or to offspring postnatally were studied. Radii were harvested and tested mechanically and structurally. Tibias were evaluated for growth-plate morphometry. On day 40 postpartum, total bone length and mineral density and tibial growth-plate width and numbers of cells within its zones of offspring treated with leptin were significantly greater than in the control group. Postnatal leptin administration in an IUGR model improves the structural properties and elongation rate of bone. These findings could pave the way to preventing some phenotypic presentations of IUGR. Copyright © 2011 Elsevier Inc. All rights reserved.

Intrauterine Growth Restriction: Antenatal and Postnatal Aspects

Science.gov (United States)

Sharma, Deepak; Shastri, Sweta; Sharma, Pradeep

2016-01-01

Intrauterine growth restriction (IUGR), a condition that occurs due to various reasons, is an important cause of fetal and neonatal morbidity and mortality. It has been defined as a rate of fetal growth that is less than normal in light of the growth potential of that specific infant. Usually, IUGR and small for gestational age (SGA) are used interchangeably in literature, even though there exist minute differences between them. SGA has been defined as having birth weight less than two standard deviations below the mean or less than the 10th percentile of a population-specific birth weight for specific gestational age. These infants have many acute neonatal problems that include perinatal asphyxia, hypothermia, hypoglycemia, and polycythemia. The likely long-term complications that are prone to develop when IUGR infants grow up includes growth retardation, major and subtle neurodevelopmental handicaps, and developmental origin of health and disease. In this review, we have covered various antenatal and postnatal aspects of IUGR. PMID:27441006

Methanol degradation in granular sludge reactors at sub-optimal metal concentrations: role of iron, nickel and cobalt

NARCIS (Netherlands)

Zandvoort, M.H.; Geerts, R.; Lettinga, G.; Lens, P.N.L.

2003-01-01

The effect of sub-optimal trace metal concentrations on the conversion of methanol in an upflow anaerobic sludge bed (UASB) reactor was investigated by studying the effect of decreased influent trace metal concentrations on the reactor efficiency, methanol conversion route and sludge

Inflammatory Markers in the Second Trimester Prior to Clinical Onset of Preeclampsia, Intrauterine Growth Restriction, and Spontaneous Preterm Birth

DEFF Research Database (Denmark)

Haedersdal, Sofie; Salvig, Jannie Dalby; Aabye, Martine

2013-01-01

Low-grade inflammation has been associated with pregnancy complications including preeclampsia (PE), intrauterine growth restriction (IUGR), and spontaneous preterm birth (SPB). In an unmatched, nested case-control study, we assessed the possible predictive association of maternal C-reactive prot......Low-grade inflammation has been associated with pregnancy complications including preeclampsia (PE), intrauterine growth restriction (IUGR), and spontaneous preterm birth (SPB). In an unmatched, nested case-control study, we assessed the possible predictive association of maternal C...... to normotensive healthy pregnant controls (n = 127). We found no statistically significant difference in CRP, IP-10, or suPAR in second trimester plasma samples from pregnant women with later PE, IUGR, and SPB when compared to normotensive healthy controls. Second trimester plasma samples of CRP, IP-10, and su...

School-age effects of the newborn individualized developmental care and assessment program for preterm infants with intrauterine growth restriction: preliminary findings.

Science.gov (United States)

McAnulty, Gloria; Duffy, Frank H; Kosta, Sandra; Weisenfeld, Neil I; Warfield, Simon K; Butler, Samantha C; Alidoost, Moona; Bernstein, Jane Holmes; Robertson, Richard; Zurakowski, David; Als, Heidelise

2013-02-19

The experience in the newborn intensive care nursery results in premature infants' neurobehavioral and neurophysiological dysfunction and poorer brain structure. Preterms with severe intrauterine growth restriction are doubly jeopardized given their compromised brains. The Newborn Individualized Developmental Care and Assessment Program improved outcome at early school-age for preterms with appropriate intrauterine growth. It also showed effectiveness to nine months for preterms with intrauterine growth restriction. The current study tested effectiveness into school-age for preterms with intrauterine growth restriction regarding executive function (EF), electrophysiology (EEG) and neurostructure (MRI). Twenty-three 9-year-old former growth-restricted preterms, randomized at birth to standard care (14 controls) or to the Newborn Individualized Developmental Care and Assessment Program (9 experimentals) were assessed with standardized measures of cognition, achievement, executive function, electroencephalography, and magnetic resonance imaging. The participating children were comparable to those lost to follow-up, and the controls to the experimentals, in terms of newborn background health and demographics. All outcome measures were corrected for mother's intelligence. Analysis techniques included two-group analysis of variance and stepwise discriminate analysis for the outcome measures, Wilks' lambda and jackknifed classification to ascertain two-group classification success per and across domains; canonical correlation analysis to explore relationships among neuropsychological, electrophysiological and neurostructural domains at school-age, and from the newborn period to school-age. Controls and experimentals were comparable in age at testing, anthropometric and health parameters, and in cognitive and achievement scores. Experimentals scored better in executive function, spectral coherence, and cerebellar volumes. Furthermore, executive function, spectral coherence

Gestational age dependent content, composition and intrauterine accretion rates of fatty acids in fetal white adipose tissue

NARCIS (Netherlands)

Kuipers, Remko S.; Luxwolda, Martine F.; Offringa, Pieter J.; Martini, Ingrid A.; Boersma, E. Rudy; Dijck-Brouwer, D. A. Janneke; Muskiet, Frits A. J.

2012-01-01

Background: Little is known about the gestational age (GA) dependent content, composition and intrauterine accretion rates of fatty acids (FA) in fetal white adipose tissue (WAT). Objective & design: To acquire this information, we collected abdominal subcutaneous WAT samples from 40 preterm and

Long-term neurodevelopmental outcome after intrauterine transfusion for hemolytic disease of the fetus/newborn: the LOTUS study

NARCIS (Netherlands)

Lindenburg, Irene T.; Smits-Wintjens, Vivianne E.; van Klink, Jeanine M.; Verduin, Esther; van Kamp, Inge L.; Walther, Frans J.; Schonewille, Henk; Doxiadis, Ilias I.; Kanhai, Humphrey H.; van Lith, Jan M.; van Zwet, Erik W.; Oepkes, Dick; Brand, Anneke; Lopriore, Enrico

2012-01-01

To determine the incidence and risk factors for neurodevelopmental impairment (NDI) in children with hemolytic disease of the fetus/newborn treated with intrauterine transfusion (IUT). Neurodevelopmental outcome in children at least 2 years of age was assessed using standardized tests, including the

Provision of intrauterine contraception in association with first trimester induced abortion reduces the need of repeat abortion: first-year results of a randomized controlled trial.

Science.gov (United States)

Pohjoranta, Elina; Mentula, Maarit; Gissler, Mika; Suhonen, Satu; Heikinheimo, Oskari

2015-11-01

Can the need of subsequent abortion be reduced by providing intrauterine contraception as a part of the abortion service? Provision of intrauterine devices (IUDs) in association with first trimester abortion more than halved the incidence of repeat abortion during the first year of follow-up. Following abortion, the incidence of subsequent abortion is high, up to 30-40%. In cohort studies, intrauterine contraception has reduced the need of repeat abortion by 60-70%. A randomized controlled trial. The main outcome measure was the incidence of subsequent induced abortions during the follow-up. Altogether 751 women seeking first trimester induced abortion were recruited and randomized into two groups. Randomization was accomplished by computer-assisted permuted-block randomization with random block sizes of four to six. The investigators did not participate in randomization, which was done before commencing the study. The participants were recruited between 18 October 2010 and 21 January 2013. The inclusion criteria were age ≥18 years, duration of pregnancy ≤12 weeks, accepting intrauterine contraception, residence in Helsinki and signing the informed consent form. Women with contraindications to intrauterine contraception, such as uterine anomaly, acute genital infection or pap-smear change requiring surgical treatment were ineligible to participate.This study was conducted in collaboration between the Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, and Centralized family planning of the City of Helsinki.The intervention group (n = 375) was provided with intrauterine contraception (either the levonorgestrel-releasing intrauterine system or copper-releasing intrauterine device) immediately following surgical abortion (18.1%) or at a follow-up 2-4 weeks after medical abortion (81.9%). Women in the control group were prescribed oral contraceptives and advised to contact their primary healthcare unit for a follow

Effect of endometrial biopsy on intrauterine insemination outcome in controlled ovarian stimulation cycle

OpenAIRE

Wadhwa, Leena; Pritam, Amrita; Gupta, Taru; Gupta, Sangeeta; Arora, Sarika; Chandoke, Rajkumar

2015-01-01

OBJECTIVE: The objective was to evaluate the effect of endometrial biopsy (EB) on intrauterine insemination (IUI) outcome in controlled ovarian stimulation (COS) cycle. DESIGN: Prospective randomized control study. SETTING: Tertiary care center. MATERIALS AND METHODS: A total of 251 subjects were enrolled in the study. Subjects undergoing COS with IUI were randomly allocated into three groups. Group A: EB was taken between D19 and 24 of the spontaneous menstrual cycles that precedes the ferti...

Segmentation precedes face categorization under suboptimal conditions

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Carlijn eVan Den Boomen

2015-05-01

Full Text Available Both categorization and segmentation processes play a crucial role in face perception. However, the functional relation between these subprocesses is currently unclear. The present study investigates the temporal relation between segmentation-related and category-selective responses in the brain, using electroencephalography (EEG. Surface segmentation and category content were both manipulated using texture-defined objects, including faces. This allowed us to study brain activity related to segmentation and to categorization. In the main experiment, participants viewed texture-defined objects for a duration of 800 ms. EEG results revealed that segmentation-related responses precede category-selective responses. Three additional experiments revealed that the presence and timing of categorization depends on stimulus properties and presentation duration. Photographic objects were presented for a long and short (92 ms duration and evoked fast category-selective responses in both cases. On the other hand, presentation of texture-defined objects for a short duration only evoked segmentation-related but no category-selective responses. Category-selective responses were much slower when evoked by texture-defined than by photographic objects. We suggest that in case of categorization of objects under suboptimal conditions, such as when low-level stimulus properties are not sufficient for fast object categorization, segmentation facilitates the slower categorization process.

Segmentation precedes face categorization under suboptimal conditions.

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Van Den Boomen, Carlijn; Fahrenfort, Johannes J; Snijders, Tineke M; Kemner, Chantal

2015-01-01

Both categorization and segmentation processes play a crucial role in face perception. However, the functional relation between these subprocesses is currently unclear. The present study investigates the temporal relation between segmentation-related and category-selective responses in the brain, using electroencephalography (EEG). Surface segmentation and category content were both manipulated using texture-defined objects, including faces. This allowed us to study brain activity related to segmentation and to categorization. In the main experiment, participants viewed texture-defined objects for a duration of 800 ms. EEG results revealed that segmentation-related responses precede category-selective responses. Three additional experiments revealed that the presence and timing of categorization depends on stimulus properties and presentation duration. Photographic objects were presented for a long and short (92 ms) duration and evoked fast category-selective responses in both cases. On the other hand, presentation of texture-defined objects for a short duration only evoked segmentation-related but no category-selective responses. Category-selective responses were much slower when evoked by texture-defined than by photographic objects. We suggest that in case of categorization of objects under suboptimal conditions, such as when low-level stimulus properties are not sufficient for fast object categorization, segmentation facilitates the slower categorization process.

The Future of Coral Reefs Subject to Rapid Climate Change: Lessons from Natural Extreme Environments

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Emma F. Camp

2018-02-01

Full Text Available Global climate change and localized anthropogenic stressors are driving rapid declines in coral reef health. In vitro experiments have been fundamental in providing insight into how reef organisms will potentially respond to future climates. However, such experiments are inevitably limited in their ability to reproduce the complex interactions that govern reef systems. Studies examining coral communities that already persist under naturally-occurring extreme and marginal physicochemical conditions have therefore become increasingly popular to advance ecosystem scale predictions of future reef form and function, although no single site provides a perfect analog to future reefs. Here we review the current state of knowledge that exists on the distribution of corals in marginal and extreme environments, and geographic sites at the latitudinal extremes of reef growth, as well as a variety of shallow reef systems and reef-neighboring environments (including upwelling and CO2 vent sites. We also conduct a synthesis of the abiotic data that have been collected at these systems, to provide the first collective assessment on the range of extreme conditions under which corals currently persist. We use the review and data synthesis to increase our understanding of the biological and ecological mechanisms that facilitate survival and success under sub-optimal physicochemical conditions. This comprehensive assessment can begin to: (i highlight the extent of extreme abiotic scenarios under which corals can persist, (ii explore whether there are commonalities in coral taxa able to persist in such extremes, (iii provide evidence for key mechanisms required to support survival and/or persistence under sub-optimal environmental conditions, and (iv evaluate the potential of current sub-optimal coral environments to act as potential refugia under changing environmental conditions. Such a collective approach is critical to better understand the future survival of

Real-time discrete suboptimal control for systems with input and state delays: Experimental tests on a dehydration process.

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Rodríguez-Guerrero, Liliam; Santos-Sánchez, Omar-Jacobo; Cervantes-Escorcia, Nicolás; Romero, Hugo

2017-11-01

This article presents a suboptimal control strategy with finite horizon for affine nonlinear discrete systems with both state and input delays. The Dynamic Programming Approach is used to obtain the suboptimal control sequence, but in order to avoid the computation of the Bellman functional, a numerical approximation of this function is proposed in every step. The feasibility of our proposal is demonstrated via an experimental test on a dehydration process and the obtained results show a good performance and behavior of this process. Then in order to demonstrate the benefits of using this kind of control strategy, the results are compared with a non optimal control strategy, particularly with respect to results produced by an industrial Proportional Integral Derivative (PID) Honeywell controller, which is tuned using the Ziegler-Nichols method. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

Verbal Short-Term Memory Span in Children: Long-Term Modality Dependent Effects of Intrauterine Growth Restriction

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Geva, R.; Eshel, R.; Leitner, Y.; Fattal-Valevski, A.; Harel, S.

2008-01-01

Background: Recent reports showed that children born with intrauterine growth restriction (IUGR) are at greater risk of experiencing verbal short-term memory span (STM) deficits that may impede their learning capacities at school. It is still unknown whether these deficits are modality dependent. Methods: This long-term, prospective design study…

Serial blood donations for intrauterine transfusions of severe hemolytic disease of the newborn with the use of recombinant erythropoietin in a pregnant woman alloimmunized with anti-Ku.

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Lydaki, Evaggelia; Nikoloudi, Irene; Kaminopetros, Petros; Bolonaki, Irene; Sifakis, Stavros; Kikidi, Katerina; Koumantakis, Evgenios; Foundouli, Kaliopi

2005-11-01

The management of a pregnant woman with the rare Ko phenotype and anti-Ku is a special challenge, because matched blood is extremely rare and the possibility of severe hemolytic disease of the newborn is high. A 30-year-old woman with rare Ko (Knull) phenotype presented at 18 weeks of gestation with positive indirect agglutination test results. She had anti-Ku due to previous blood transfusion, one pregnancy, and two abortions. During this pregnancy, anti-Ku titers ranged from 1024 to 4096. At the 26th week of gestation ultrasound showed a hydropic fetus and urgent intrauterine exchange transfusion was performed with the maternal red blood cells (RBCs). Recombinant human erythropoietin (rHu-EPO) and intravenous (IV) iron were administered to the mother to ensure an adequate supply of matched RBCs for intrauterine transfusions and possible perinatal hemorrhage. Intrauterine transfusions were repeated every 1 to 3 weeks. By 35 weeks 2 days of gestation, the mother had donated 4 units of blood, and four intrauterine transfusions had been performed. Cesarean section was then decided and a healthy male newborn was born. He was treated with phototherapy but without exchange transfusions. By the 15th day of life rHu-EPO was administrated to the newborn because of anemia. The maternal RBCs completely disappeared from the child's blood by Day 100. As shown in this case, treatment with rHu-EPO and IV Fe has effectively increased the mother's capacity to donate RBCs for autologous use and intrauterine transfusions, with no adverse effects to the mother or the child.

Readiness and Adjustments to School for Children with Intrauterine Growth Restriction (IUGR): An Extreme Test Case Paradigm

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Geva, Ronny; Yosipof, Rina; Eshel, Rina; Leitner, Yael; Valevski, Aviva Fattal; Harel, Shaul

2009-01-01

This long-term, prospective study evaluated repeatedly school readiness and adjustment at kindergarten and first grade of children with extreme intrauterine growth restriction (IUGR; n = 20) in relation to controls (n = 19). Methods included individual testing of cognitive competence, self-perception, motivation, loneliness and academic…

Effective salvage of acute massive uterine bleeding using intrauterine balloon tamponade in a uterine adenomyosis patient on dienogest.

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Nishino, Kimihiro; Hayashi, Kazumasa; Chaya, Jyunya; Kato, Noriko; Yamamuro, Osamu

2013-03-01

We present the case of a 37-year-old nulliparous woman in whom acute massive uterine bleeding during dienogest therapy was successfully treated using intrauterine balloon tamponade. Abnormal uterine bleeding and several cases of profuse bleeding causing severe anemia in association with dienogest therapy have been reported, but this is the first reported case involving hypovolemic shock. While successful control of postpartum hemorrhage with intrauterine balloon tamponade has been well described, applications for non-obstetric bleeding, particularly in the presence of underlying diseases, such as adenomyosis, have only rarely been reported. This procedure can be easily, promptly, and safely implemented without analgesia, anesthesia, or laparotomy; it can be used with a minimally dilated external cervical os or narrow uterine cavity; and it can preserve fertility. © 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.

Intrauterine devices and other forms of contraception: thinking outside the pack.

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Allen, Caitlin; Kolehmainen, Christine

2015-05-01

A variety of contraception options are available in addition to traditional combined oral contraceptive pills. Newer long-acting reversible contraceptive (LARC) methods such as intrauterine devices and subcutaneous implants are preferred because they do not depend on patient compliance. They are highly effective and appropriate for most women. Female and male sterilization are other effective but they are irreversible and require counseling to minimize regret. The contraceptive injection, patch, and ring do not require daily administration, but their typical efficacy rates are lower than LARC methods and similar to those for combined oral contraceptive pills. Copyright © 2015 Elsevier Inc. All rights reserved.

Structure of a radiate pseudocolony associated with an intrauterine contraceptive device

International Nuclear Information System (INIS)

O'Brien, P.K.; Lea, P.J.; Roth-Moyo, L.A.

1985-01-01

Transmission electron microscopy of a radiate pseudocolony associated with an intrauterine contraceptive device (IUCD) showed central bundles of extracellular fibers averaging 35 nm in diameter, surrounded by layered mantles of electron-dense, amorphous granular material. No bacterial, viral, or fungal structures were present. X-ray microanalysis revealed copper, sulfur, chloride, iron, and phosphorus; no calcium was found. It is postulated that these structures and histologically identical non-IUCD-associated granules from the female genital tract, as well as similar structures from other body locations, including those reported in colloid cysts of the third ventricle, are of lipofuscin origin

Pre- and postnatal imaging of Pai syndrome with spontaneous intrauterine closure of a frontal cephalocele

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Dobrocky, Tomas; Ebner, Lukas; Stranzinger, Enno [Inselspital University Hospital, University of Bern, Department of Interventional, Pediatric and Diagnostic Radiology, Bern (Switzerland); Liniger, Benjamin [Inselspital University Hospital, University of Bern, Department of Pediatric Surgery, Bern (Switzerland); Weisstanner, Christian [Inselspital University Hospital, University of Bern, Department of Diagnostic and Interventional Neuroradiology, Bern (Switzerland)

2015-06-15

Pai syndrome is a rare congenital disorder characterized by cutaneous polyps of the face, pericallosal lipoma and median cleft lip. We report on a newborn girl with a variant of Pai syndrome presenting with all typical findings except a median cleft. In addition, fetal sonography and MRI showed the unique intrauterine evolution of a cephalocele into an atretic cephalocele. (orig.)

A randomized comparison of a novel nitinol-frame low-dose-copper intrauterine contraceptive and a copper T380S intrauterine contraceptive.

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Reeves, Matthew F; Katz, Bob H; Canela, Juan M; Hathaway, Mark J; Tal, Michael G

2017-06-01

We sought to compare VeraCept (VC175), a novel nitinol intrauterine contraceptive (IUC) with 175 square-mm of copper surface area, to a copper T380S IUC. We enrolled parous women into a randomized subject-blinded comparison of VC175 and a copper T380S in a 2:1 fashion at a single clinic. The primary outcomes were total adverse events and continuation at 12 months. We also examined pain on insertion, ease of placement, expulsion, tolerability and pregnancy. Subjective ratings were on a 5-point Likert scale (0, no pain to 5, worst pain). We followed subjects through 24-month follow-up. We enrolled 300 women with 199 randomized to VC175 and 101 to the T380S. Insertion was successful in 198 subjects for VC175 and 100 for the T380S. Mean age was 25 years (range 18, 41), and median parity was 2 (range 1, 8), with 39% having only had Cesarean deliveries. No subjects developed clinical infection or reported serious adverse events. In the VC175 and T380S groups, mean pain at insertion was 1.4 and 2.4, respectively (p<.01). At the 12-month primary endpoint for VC175 and T380S, respectively, continuation was 84% and 68% (p<.002) with expulsions in 5.0% and 12.0% (p<.05) and removal for pain/bleeding in 3.5% and 17.0% (p<.01). At the 24-month visit for VC175 and T380S, respectively, continuation was 77% and 62% (p<.02 by log-rank). One ectopic pregnancy was identified at the 12-month follow-up in a VC175 user. No other pregnancies were diagnosed. With 297.3 and 132.4 woman-years, pregnancy rates were 0.3 and 0.0 per 100 woman-years for VC175 and T380S, respectively. VC175 resulted in less pain at insertion, fewer expulsions and higher total continuation than the T380S, with similar contraceptive efficacy. VC175 is a promising new intrauterine copper contraceptive on a nitinol frame that warrants further clinical trials. Copyright © 2017 Elsevier Inc. All rights reserved.

The role of transvaginal power Doppler ultrasound in the differential diagnosis of benign intrauterine focal lesions.

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Cogendez, Ebru; Eken, Meryem Kurek; Bakal, Nuray; Gun, Ismet; Kaygusuz, Ecmel Isik; Karateke, Ates

2015-10-01

The purpose of this prospective study was to assess the role of power Doppler imaging in the differential diagnosis of benign intrauterine focal lesions such as endometrial polyps and submucous myomas using the characteristics of power Doppler flow mapping. A total of 480 premenopausal patients with abnormal uterine bleeding were evaluated by transvaginal ultrasonography (TVS) searching for intrauterine pathology. Sixty-four patients with a suspicious focal endometrial lesion received saline infusion sonography (SIS) after TVS. Fifty-eight patients with focal endometrial lesions underwent power Doppler ultrasound (PDUS). Three different vascular flow patterns were defined: Single vessel pattern, multiple vessel pattern, and circular flow pattern. Finally, hysteroscopic resection was performed in all cases, and Doppler flow characteristics were then compared with the final histopathological findings. Histopathological results were as follows: endometrial polyp: 40 (69 %), submucous myoma: 18 (31 %). Of the cases with endometrial polyps, 80 % demonstrated a single vessel pattern, 7.5 % a multiple vessel pattern, and 0 % a circular pattern. Vascularization was not observed in 12.5 % of patients with polyps. Of the cases with submucousal myomas, 72.2 % demonstrated a circular flow pattern, 27.8 % a multiple vessel pattern, and none of them showed a single vessel pattern. The sensitivity, specificity, and positive and negative predictive values of the single vessel pattern in diagnosing endometrial polyps were 80, 100, 100, and 69.2 %, respectively; and for the circular pattern in diagnosing submucous myoma, these were 72.2, 100, 100, and 88.9 %, respectively. Power Doppler blood flow mapping is a useful, practical, and noninvasive diagnostic method for the differential diagnosis of benign intrauterine focal lesions. Especially in cases of recurrent abnormal uterine bleeding, recurrent abortion, and infertility, PDUS can be preferred as a first-line diagnostic method.

Potential roles of placental human beta-defensin-3 and apolipoprotein B mRNA-editing enzyme catalytic polypeptide 3G in prevention of intrauterine transmission of hepatitis B virus.

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Bai, Xiaoxia; Tian, Ting; Wang, Peng; Yang, Xiaofu; Wang, Zhengping; Dong, Minyue

2015-03-01

Approximately 5% of newborns were infected by hepatitis B virus (HBV) via intrauterine transmission and this is the main reason for high prevalence of HBV in endemic regions. However, the mechanisms by which intrauterine transmission is avoided in most cases remain elusive and placental natural anti-microbial factors may play a role in the prevention of HBV intrauterine transmission. The expression levels of human β-defensin-3 (HBD-3), apolipoprotein B mRNA-editing enzyme catalytic polypeptide 3G (A3G) and mannose binding lectin (MBL) were determined in the placenta of 30 HBV-seronegative pregnant women (controls), 7 HBV-seropositive pregnant women with infants infected via intrauterine transmission (infected group) and 30 HBV-seropositive pregnant women with non-infected infants (non-infected group). The expression of HBD-3, A3G, and MBL of placental trophoblast cell line Swan71 was determined after exposed to HBV. There were significant differences in placental HBD-3 and A3G levels among three groups, but the expression of MBL did not significantly differ. The expressions of HBD-3 and A3G were higher in non-infected group than controls and infected group, but not significantly different between infected group and controls. The exposure to HBV increased significantly the expression of HBD-3, A3G, and MBL by Swan 71. It may be concluded HBV up-regulates HBD-3 and A3G expression in vivo and in vitro in placental trophoblast and lack of this up-regulation is possibly associated with intrauterine transmission of HBV. © 2014 Wiley Periodicals, Inc.

The risk of childhood cancer from intrauterine and preconceptional exposure to ionizing radiation

International Nuclear Information System (INIS)

Wakeford, R.

1995-01-01

The findings of studies investigating whether exposures to ionizing radiation before birth, either pre- or post-conception, increase the risk of childhood cancer have provoked much scientific controversy. An epidemiological association between the abdominal exposure or pregnant women to diagnostic X-rays and childhood cancer was first reported in the 1950s, while an association between the recorded dose of radiation received occupationally by fathers before the conception of their offspring and childhood leukemia was reported only recently in 1990. The scientific interpretation of these particular statistical associations is by no means straightforward, but the latest analyses of intrauterine irradiation and childhood cancer indicate that a causal inference is likely. Scientific committees have adopted risk coefficients for the intrauterine exposure of somatic tissues, which for childhood leukemia are comparable to those accepted for exposure in infancy, although questions remain about the level of risk of childhood solid tumors imparted by exposure to radiation in utero and shortly after birth. In contrast, the association has been found to be restricted to children born in one village, it does not extend to cancers other than leukemia, and it is markedly inconsistent with the established body of knowledge on radiation-induced hereditary disease. A causal interpretation of this association has effectively been abandoned by scientific authorities. 84 refs., 1 tab

Intrauterine endometrial cyst after low uterine incision: A case report with literature review.

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Yin, Weiyao; Zhang, Jiawen; Xu, Liangzhi; Luo, Li

2018-04-01

During the surgical procedure, endometrial cells can be seeded into the wound edge of the uterine wall, developing into scar endometriosis. Due to the extremely low incidence, estimation of its prevalence is still unavailable. Even rarer might be the scar endometriosis in uterine cavity, to our best knowledge, a situation has not been reported yet. A 37-year-old woman complained of heavier and prolonged menstruation as well as pelvic pain during menses for more than 4 months. An endometrial cyst in diameter of 6 cm in uterine cavity was revealed by transvaginal ultrasound. Her surgical history was significant for 1 caesarean section and 1 abdominal myomectomy through transverse incision of lower uterine segment. Space-occupying lesions in uterine cavity, moderate anemia and scar uterus. The hysteroscopy was performed and a multilocular cyst full of chocolate-like fluid was removed. Pathological examination confirmed endometrial glands in the removed cyst tissue. During the follow-up visits at 1 and 6 months after surgery, the patient denied any special discomfort. Her postoperative transvaginal ultrasound showed an enlarged uterus with no lesion in uterine cavity. To achieve a better surveillance, a 3-year period of follow-up after surgery at a 6-month interval was suggested. Intrauterine endometriosis should be considered in patients of pelvic surgery history with pelvic pain, menstrual disorder, and intrauterine cystic mass.

Clinical application of Lin's biopsy grasper for intrauterine targeted biopsy and polypectomy during office hysteroscopy.

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Cheng, Hsin-Yi; Lin, Bao-Liang; Tseng, Jen-Yu; Ueno, Kazunori; Nakada, Sakura

2018-06-01

Hysteroscopy has widely been used for diagnosis of the uterine cavity; however, target biopsy has often been difficult in part to the inherent limitations of ancillary instruments. Lin's biopsy grasper was specifically designed to work in conjunction with a flexible hysteroscope to obtain intrauterine biopsy under transabdominal sonography. Herein, we share our clinical experience in the management of endometrial abnormalities with the use of Lin's biopsy grasper during office-based hysteroscopy. From February 2006 to November 2016, the use of Lin's biopsy grasper for tissue biopsy was attempted on 126 cases. We retrospectively recorded and analyzed the patients' preoperative characteristics and biopsy outcomes to demonstrate the feasibility and efficacy of Lin's biopsy grasper. Out of the one hundred and twenty-six enrolled patients, satisfactory targeted biopsies were achieved; including high diagnostic rate (92.1%, with 116 cases confirmed histologically) and adequate tissue retrieval (77.8%, with 98 cases obtaining optimal specimen volume). All patients tolerated the procedure without analgesics or anesthesia. Diagnostic flexible hysteroscopy combined with the use of Lin's biopsy grasper has proven to be an effective tool for intrauterine evaluation and obtaining tissue sample. Copyright © 2018. Published by Elsevier B.V.

Use of industrial wireless endoscope in intrauterine artificial insemination in sheep

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Gutierrez EF

2017-08-01

Full Text Available The aim of this study was to evaluate the use of an industrial wireless endoscope on the pregnancy rate of Hampshire Down sheep with intrauterine insemination. The work was carried out in a farm of the community Sullkataca Baja of the municipality of Laja, department of La Paz, Bolivia. The conditioning of an endoscopy equipment (Wifi Endoscope®, Teslong which had a portable and multifunctional Wi-Fi camera with fiber optic 8.5mm diameter, LED light and real-time video transmission at 720P. Also, 2 metal trocars (used in cattle were adapted to facilitate the entrance of the endoscopy and the insemination pipette. The estrus synchronization was performed in 10 nulliparas and 10 multiparas by means of intravaginal sponges with 60 mg of medroxyprogesterone acetate (Progespon®, Lab. Syntex Argentina for 14 days. A dose of 500 IU of eCG (Sergon®, Lab. Bioveta Czech Republic is applied to the removal of the sponges. At 52.31 ± 0.31 hours post removal of the sponges, artificial insemination fixed time (FTAI was performed with frozen semen in straws of 0.25cc with 40 million spermatozoa. During insemination, the values of 80% and 100% of uterine horn turgor were determined for the group of pluriparas and nulliparas respectively. The pregnancy diagnosis was performed at 50 days post insemination using ultrasound transrectal (EMP 820 vet plus®, Emperor China. Gestation rates were 60% for lambs and 70% for ewes (P≥0.05. In conclusion, the industrial wireless endoscope is an economical, versatile equipment and can be used efficiently to perform intrauterine IATF with frozen semen in sheep.

Social media and the intrauterine device: a YouTube content analysis.

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Nguyen, Brian T; Allen, Allison J

2017-11-23

YouTube's online archive of video testimonials related to health information are more commonly viewed than those developed by clinicians and professional groups, suggesting the importance of the patient experience to viewers. We specifically sought to examine the accuracy of information on, and projected acceptability of, the intrauterine device (IUD) from these YouTube testimonials. We searched YouTube for videos about individual uploaders' IUD experiences, using the search terms 'intrauterine device', 'IUD', 'Mirena' and 'Paragard'. Given interest in user testimonials, we excluded professional and instructional videos belonging to commercial or non-profit entities. Two reviewers independently analysed the videos using a structured guide, with attention to inaccurate information. Of 86 identified videos, four videos featured clinicians and were excluded; 62 met inclusion criteria. Interrater agreement on IUD portrayal was good (K=0.73). Young (mean age 25, range 19-38, years), white (75%), nulliparous (61%) women primarily uploaded content. Most described placement of the LNG-IUS (65%), were posted within 1 month of insertion (45%), and mentioned side effects (66%) - bleeding, pain, and partner sensation of the strings. About one-third of videos contained inaccurate information (34%) and were thought to project an overall negative experience (30%). Videos portraying IUDs negatively were associated with inaccurate information and/or mention of side effects. While one-third of IUD user testimonials on YouTube contained inaccurate information, the majority of IUD experiences were perceived by our study viewers to be positive. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Copper intrauterine device for emergency contraception: clinical practice among contraceptive providers.

Science.gov (United States)

Harper, Cynthia C; Speidel, J Joseph; Drey, Eleanor A; Trussell, James; Blum, Maya; Darney, Philip D

2012-02-01

The copper intrauterine device (IUD) is the most effective emergency contraceptive available but is largely ignored in clinical practice. We examined clinicians' recommendations of the copper IUD for emergency contraception in a setting with few cost obstacles. We conducted a survey among clinicians (n=1,246; response rate 65%) in a California State family planning program, where U.S. Food and Drug Administration-approved contraceptives are available at no cost to low-income women. We used multivariable logistic regression to measure the association of intrauterine contraceptive training and evidence-based knowledge with having recommended the copper IUD for emergency contraception. The large majority of clinicians (85%) never recommended the copper IUD for emergency contraception, and most (93%) required two or more visits for an IUD insertion. Multivariable analyses showed insertion skills were associated with having recommended the copper IUD for emergency contraception, but the most significant factor was evidence-based knowledge of patient selection for IUD use. Clinicians who viewed a wide range of patients as IUD candidates were twice as likely to have recommended the copper IUD for emergency contraception. Although more than 93% of obstetrician-gynecologists were skilled in inserting the copper IUD, they were no more likely to have recommended it for emergency contraception than other physicians or advance practice clinicians. Recommendation of the copper IUD for emergency contraception is rare, despite its high efficacy and long-lasting contraceptive benefits. Recommendation would require clinic flow and scheduling adjustments to allow same-day IUD insertions. Patient-centered and high-quality care for emergency contraception should include a discussion of the most effective method. III.

Intrauterine administration of human chorionic gonadotropin (hCG) for subfertile women undergoing assisted reproduction.

Science.gov (United States)

Craciunas, Laurentiu; Tsampras, Nikolaos; Coomarasamy, Arri; Raine-Fenning, Nick

2016-05-20

Subfertility affects 15% of couples and represents the inability to conceive naturally following 12 months of regular unprotected sexual intercourse. Assisted reproduction refers to procedures involving the in vitro handling of both human gametes and represents a key option for many subfertile couples. Most women undergoing assisted reproduction treatment will reach the stage of embryo transfer (ET) but the proportion of embryos that successfully implant following ET has remained small since the mid-1990s. Human chorionic gonadotropin (hCG) is a hormone synthesised and released by the syncytiotrophoblast and has a fundamental role in embryo implantation and the early stages of pregnancy. Intrauterine administration of synthetic or natural hCG via an ET catheter during a mock procedure around the time of ET is a novel approach that has recently been suggested to improve the outcomes of assisted reproduction. To investigate whether the intrauterine administration of hCG around the time of ET improves the clinical outcomes in subfertile women undergoing assisted reproduction. We performed a comprehensive literature search of the Cochrane Gynaecology and Fertility Group Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, PsycINFO, registers of ongoing trials andreference lists of all included studies and relevant reviews (from inception to 10 November 2015), in consultation with the Cochrane Gynaecology and Fertility Group Trials Search Co-ordinator. We included all randomised controlled trials (RCTs) evaluating intrauterine administration of hCG around the time of ET in this review irrespective of language and country of origin. Two authors independently selected studies, assessed risk of bias, extracted data from studies and attempted to contact the authors where data were missing. We performed statistical analysis using Review Manager 5 in accordance with the Cochrane Handbook for Systematic Reviews of

Comparing the Effect of Mefenamic Acid and Vitex Agnus on Intrauterine Device Induced Bleeding

OpenAIRE

Yavarikia, Parisa; Shahnazi, Mahnaz; Hadavand Mirzaie, Samira; Javadzadeh, Yousef; Lutfi, Razieh

2013-01-01

Introduction: Increased bleeding is the most common cause of intrauterine device (IUD) removal. The use of alternative therapies to treat bleeding has increased due to the complications of medications. But most alternative therapies are not accepted by women. Therefore, conducting studies to find the right treatment with fewer complications and being acceptable is necessary. This study aimed to compare the effect of mefenamic acid and vitex agnus castus on IUD induced bleeding.

Comparing the Effect of Mefenamic Acid and Vitex Agnus on Intrauterine Device Induced Bleeding

OpenAIRE

Parisa Yavarikia; Mahnaz Shahnazi; Samira Hadavand Mirzaie; Yousef Javadzadeh; Razieh Lutfi

2013-01-01

Introduction: Increased bleeding is the most common cause of intrauterine device (IUD) removal. The use of alternative therapies to treat bleeding has increased due to the complications of medications. But most alternative therapies are not accepted by women. Therefore, conducting studies to find the right treatment with fewer complications and being acceptable is necessary. This study aimed to compare the effect of mefenamic acid and vitex agnus castus on IUD induced bleeding.Methods: This w...

Sub-optimal breastfeeding of infants during the first six months and associated factors in rural communities of Jimma Arjo Woreda, Southwest Ethiopia

Directory of Open Access Journals (Sweden)

Tamiru Dessalegn

2012-05-01

Full Text Available Abstract Background Studies have shown that sub-optimal breastfeeding is major contributor to infant and young child mortality in Ethiopia. To address this problem, infant and young child feeding guideline was developed in 2004 and interventions have been going on based on the guidelines. There is no study that assessed whether the infant and child feeding practices are according the guideline or not. This study was carried out to assess sub-optimal breastfeeding practices and associated factors among infants from birth to six months in rural communities of Jimma Arjo Woreda in the Southwest Ethiopia. Methods A cross-sectional study was carried out from December to January 2009. Quantitative data were collected from a sample of 382 respondents supplemented by qualitative data generated using in-depth interviews of 15 index mothers. Multivariable logistic regression model was used to identify predictors of timely initiation of breast feeding and non-exclusive breast feeding among mother-infant pairs. Results More than three fourth of mothers breastfeed their infants sub-optimally. Thirty-seven percent of mothers initiated breastfeeding later than one hour after delivery, which was significantly associated with not attending formal education (AOR = 1.05[95%CI: 1.03, 1.94] and painful breastfeeding experiences (AOR = 5.02[95%CI: 1.01, 10.08]. The majority (67.02% of mothers had no knowledge about exclusive breastfeeding. Non-exclusive breastfeeding was negatively associated with child’s age of 0-2 months (AOR: 0.27[95%CI: 0.16, 0.47 and 3-4 months (AOR = 0.43 [95%CI: 0.25, 0.73 and ownership of radio (AOR = 0.56[95%CI: 0.37, 0.88], but positively associated with the practice of discarding colostrums (AOR = 1.78[95%CI: 1.09, 4.94]. Conclusion The findings showed that the majority of mothers sub-optimally breastfeed their children in the study area. As most of the mothers do not have knowledge on the exclusive breast feeding. Enhancing community

Clinicians' knowledge and practices regarding family planning and intrauterine devices in China, Kazakhstan, Laos and Mexico.

Science.gov (United States)

Hoffman, Steven J; Guindon, G Emmanuel; Lavis, John N; Randhawa, Harkanwal; Becerra-Posada, Francisco; Boupha, Boungnong; Shi, Guang; Turdaliyeva, Botagoz S

2016-06-10

It is widely agreed that the practices of clinicians should be based on the best available research evidence, but too often this evidence is not reliably disseminated to people who can make use of it. This "know-do" gap leads to ineffective resource use and suboptimal provision of services, which is especially problematic in low- and middle-income countries (LMICs) which face greater resource limitations. Family planning, including intrauterine device (IUD) use, represents an important area to evaluate clinicians' knowledge and practices in order to make improvements. A questionnaire was developed, tested and administered to 438 individuals in China (n = 115), Kazakhstan (n = 110), Laos (n = 105), and Mexico (n = 108). The participants responded to ten questions assessing knowledge and practices relating to contraception and IUDs, and a series of questions used to determine their individual characteristics and working context. Ordinal logistic regressions were conducted with knowledge and practices as dependent variables. Overall, a 96 % response rate was achieved (n = 438/458). Only 2.8 % of respondents were able to correctly answer all five knowledge-testing questions, and only 0.9 % self-reported "often" undertaking all four recommended clinical practices and "never" performing the one practice that was contrary to recommendation. Statistically significant factors associated with knowledge scores included: 1) having a masters or doctorate degree; and 2) often reading scientific journals from high-income countries. Significant factors associated with recommended practices included: 1) training in critically appraising systematic reviews; 2) training in the care of patients with IUDs; 3) believing that research performed in their own country is above average or excellent in quality; 4) being based in a facility operated by an NGO; and 5) having the view that higher quality available research is important to improving their work. This

Suboptimal etravirine activity is common during failure of nevirapine-based combination antiretroviral therapy in a cohort infected with non-B subtype HIV-1.

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Taiwo, Babafemi; Chaplin, Beth; Penugonda, Sudhir; Meloni, Seema; Akanmu, Sulaimon; Gashau, Wadzani; Idoko, John; Adewole, Isaac; Murphy, Robert; Kanki, Phyllis

2010-04-01

The primary objective of this study was to estimate etravirine activity in a cohort of patients infected with non-B subtype HIV-1 and failing nevirapine-based therapy. Genotypic resistance testing was performed if viral load was >OR= 1,000 copies/ml after receiving at least six months of therapy. Suboptimal response to etravirine was predicted by a score >OR= 2.5 on the Tibotec weighting schema, >OR= 4 in the Monogram schema, or classification as high to low-level resistant by a modification of the Stanford HIVdb algorithm (Version 5.1.2). Bivariate and multivariate analyses were conducted to determine the risk factors for suboptimal etravirine activity. The patients (n=91) were receiving nevirapine and lamivudine plus stavudine (57.1%) or zidovudine (42.9%). Median duration of nevirapine exposure was 53 weeks (IQR 46-101 weeks). The most common etravirine resistance associated mutations were Y181C (42.9%), G190A (25.3%), H221Y (19.8%), A98G (18.7%), K101E (16.5%), and V90I (12.1%). Suboptimal etravirine activity was predicted in 47.3 to 56.0%. There were disparities in mutations listed in Tibotec versus Monogram Schemas. Predicted suboptimal activity was not associated with nucleoside reverse transcriptase inhibitor (NRTI) used, gender, pretreatment or current CD4 cell count or viral load, subtype or NRTI mutations. Etravirine has compromised activity in approximately half of the patients failing nevirapine-based first-line treatment in this cohort, which supports guidelines that caution against using it with NRTIs alone in such patients.

Maternal amino acid supplementation for intrauterine growth restriction

Science.gov (United States)

Brown, Laura D; Green, Alice S; Limesand, Sean W; Rozance, Paul J

2011-01-01

Maternal dietary protein supplementation to improve fetal growth has been considered as an option to prevent or treat intrauterine growth restriction. However, in contrast to balanced dietary supplementation, adverse perinatal outcomes in pregnant women who received high amounts of dietary protein supplementation have been observed. The responsible mechanisms for these adverse outcomes are unknown. This review will discuss relevant human and animal data to provide the background necessary for the development of explanatory hypotheses and ultimately for the development therapeutic interventions during pregnancy to improve fetal growth. Relevant aspects of fetal amino acid metabolism during normal pregnancy and those pregnancies affected by IUGR will be discussed. In addition, data from animal experiments which have attempted to determine mechanisms to explain the adverse responses identified in the human trials will be presented. Finally, we will suggest new avenues for investigation into how amino acid supplementation might be used safely to treat and/or prevent IUGR. PMID:21196387

Energy expenditures & physical activity in rats with chronic suboptimal nutrition

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Lifshitz Fima

2006-01-01

Full Text Available Abstract Background Sub-optimally nourished rats show reduced growth, biochemical and physiological changes. However, no one has assessed metabolic rate adaptations in rats subjected to chronic suboptimal nutrition (CSN. In this study energy expenditure (EE; kcal/100 g body weight and physical activity (PA; oscillations in weight/min/kg body weight were assessed in rats subjected to three levels of CSN. Results Body weight gain was diminished (76.7 ± 12.0 and 61.6 ± 11.0 g in rats fed 70 and 60% of the ad-libitum fed controls which gained more weight (148.5 ± 32.3 g. The rats fed 80% gained weight similarly to controls (136.3 ± 10.5 g. Percent Fat-free body mass was reduced (143.8 ± 8.7 and 142.0 ± 7.6 g in rats fed 70 and 60% of ad-libitum, but not in those fed 80% (200.8 ± 17.5 g as compared with controls (201.6 ± 33.4 g. Body fat (g decreased in rats fed 80% (19.7 ± 5.3, 70% (15.3 ± 3.5 and 60% (9.6 ± 2.7 of ad-libitum in comparison to controls (26.0 ± 6.7. EE and PA were also altered by CSN. The control rats increased their EE and PA during the dark periods by 1.4 ± 0.8 and 1.7 ± 1.1 respectively, as compared with light the period; whereas CSN rats fed 80 and 70% of ad-libitum energy intake had reduced EE and PA during the dark periods as compared with the light period EE(7.5 ± 1.4 and 7.8 ± 0.6 vs. 9.0 ± 1.2 and 9.7 ± 0.8; p Conclusion CSN rats adapt to mild energy restriction by reducing body fat, EE and PA mainly during the dark period while growth proceeds and lean body mass is preserved. At higher levels of energy restrictions there is decreased growth, body fat and lean mass. Moreover EE and PA are also reduced during both light and dark periods.

Prospective investigation of serum anti-Müllerian hormone concentration in ovulatory intrauterine insemination patients: a preliminary study

DEFF Research Database (Denmark)

Freiesleben, N la Cour; Rosendahl, Mikkel; Johannsen, Trine Holm

2010-01-01

cycle before intrauterine insemination. Mean age of the patients was 33 years. Serum AMH significantly correlated to age (r=-0.38), antral follicle count (AFC) (r=0.68), ovarian volume (r=0.40), FSH (r=-0.31), (P2-3 mature follicles or dose reduction). There was a significant trend over response groups...

Successful intrauterine treatment of a patient with cobalamin C defect

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Friedrich K. Trefz

2016-03-01

Full Text Available Cobalamin C (cblC defect is an inherited autosomal recessive disorder that affects cobalamin metabolism. Patients are treated with hydroxycobalamin to ameliorate the clinical features of early-onset disease and prevent clinical symptoms in late-onset disease. Here we describe a patient in whom prenatal maternal treatment with 30 mg/week hydroxycobalamin and 5 mg/day folic acid from week 15 of pregnancy prevented disease manifestation in a girl who is now 11 years old with normal IQ and only mild ophthalmic findings. The affected older sister received postnatal treatment only and is severely intellectually disabled with severe ophthalmic symptoms. This case highlights the potential of early, high-dose intrauterine treatment in a fetus affected by the cblC defect.

Genital mycoplasmosis in rats: a model for intrauterine infection.

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Brown, M B; Peltier, M; Hillier, M; Crenshaw, B; Reyes, L

2001-09-01

Microbial infections of the chorioamnion and amniotic fluid have devastating effects on pregnancy outcome and neonatal morbidity and mortality. The mechanisms by which bacterial pathogens cause adverse effects are best addressed by an animal model of the disease with a naturally-occurring pathogen. Intrauterine infection in humans as well as genital mycoplasmosis in humans and rodents is reviewed. We describe a genital infection in rats, which provides a model for the role of infection in pregnancy, pregnancy wastage, low birth weight, and fetal infection. Infection of Sprague-Dawley rats with Mycoplasma pulmonis either vaginally or intravenously resulted in decreased litter size, increased adverse pregnancy outcome, and in utero transmission of the microorganism to the fetus. Mycoplasma pulmonis is an ideal model to study maternal genital infection during pregnancy, the impact of infections on pregnancy outcome, fetal infection, and maternal-fetal immune interactions.

Mother's prior intrauterine position affects the sex ratio of her offspring in house mice.

OpenAIRE

Vandenbergh, J G; Huggett, C L

1994-01-01

Sex ratio alterations related to environmental factors occur in several mammals, but no mechanism has been identified to explain the adjustment. Intrauterine position (IUP) may provide the context in which such alterations occur. Previous studies on house mice and gerbils reveal that the position of a fetus in the uterus in relation to the sex of its neighbors influences its later anatomy, physiology, and behavior. The anogenital distance (AGD) of females located between two males (2M) is lon...

Colonoscopic Removal of an Intrauterine Device That Had Perforated the Rectosigmoid Colon

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Huh, Jin Myeong; Kim, Ki Seok; Cho, Yong Seok; Lee, Jae Uk; Baek, Seong Deuk; Moon, Sin Kil

2018-01-01

The intrauterine device (IUD) is a widely used contraceptive method. One of the most serious and rare complications of using an IUD is colon perforation. We report a case of colonoscopic removal of an IUD that had perforated into the rectosigmoid colon in a 42-year-old woman who presented with no symptoms. Colonoscopy showed that the IUD had penetrated into rectosigmoid colon wall and that an arm of the IUD was embedded in the colon wall. We were able to remove the IUD easily by using colonoscopy. The endoscopic approach may be considered the first choice therapy for selected patients. PMID:29742863

Sensor-augmented pump therapy lowers HbA(1c) in suboptimally controlled Type 1 diabetes; a randomized controlled trial

NARCIS (Netherlands)

Hermanides, J.; Nørgaard, K.; Bruttomesso, D.; Mathieu, C.; Frid, A.; Dayan, C. M.; Diem, P.; Fermon, C.; Wentholt, I. M. E.; Hoekstra, J. B. L.; DeVries, J. H.

2011-01-01

To investigate the efficacy of sensor-augmented pump therapy vs. multiple daily injection therapy in patients with suboptimally controlled Type 1 diabetes. In this investigator-initiated multi-centre trial (the Eurythmics Trial) in eight outpatient centres in Europe, we randomized 83 patients with

Treatment of Women With an Endometrial Polyp and Heavy Menstrual Bleeding: A Levonorgestrel-Releasing Intrauterine Device or Hysteroscopic Polypectomy?

NARCIS (Netherlands)

van Dijk, Myrthe M.; van Hanegem, Nehalennia; de Lange, Maria E.; Timmermans, Anne

2015-01-01

We performed a literature review of reports comparing a levonorgestrel-releasing intrauterine device (LNG-IUD) with transcervical polyp resection (TCRP) as a treatment for heavy menstrual bleeding (HMB). Our second objective was to investigate the effectiveness of LNG-IUD and TCRP in reducing

Levonorgestrel-releasing intrauterine device versus dydrogesterone for management of endometrial hyperplasia without atypia.

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El Behery, Manal M; Saleh, Hend S; Ibrahiem, Moustafa A; Kamal, Ebtesam M; Kassem, Gamal A; Mohamed, Mohamed El Sayed

2015-03-01

To compare the efficacy and safety of the levonorgestrel-releasing intrauterine device (LNG-IUD) with dydrogesterone applied for the same duration in patients having endometrial hyperplasia (EH) without atypia. One hundred thirty eight women aged between 30 and 50 years with abnormal uterine bleeding and diagnosed as EH by transvaginal ultrasound were randomized to receive either LNG-IUD or dydrogesterone for 6 months. Primary outcome measures were regression of hyperplasia after 6 months of therapy. Secondary outcome measures were occurrence of side effects during treatment or recurrence of hyperplasia during follow-up period. After 6 months of treatment, regression of EH occurs in 96% of women in the levonorgestrel-releasing intrauterine system (LNG-IUS) group versus 80% of women in the oral group (P < .001). Adverse effects were relatively common with minimal differences between the 2 groups. Intermenstrual vaginal spotting and amenorrhea were more common in the LNG-IUD group (P value .01 and .0001). Patient satisfaction was significantly higher in the LNG-IUS group (P value .0001). Hysterectomy rates were lower in the LNG-IUS group than in the oral group (P = .001). Recurrence rate was 0% in the LNG-IUD group compared to 12.5% in the oral group. In management of EH without atypia, LNG-IUS achieves a higher regression and a lower hysterectomy rate than oral progesterone and could be used as a first-line therapy. © The Author(s) 2014.

Importance of Maternal Diabetes on the Chronological Deregulation of the Intrauterine Development: An Experimental Study in Rat

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Salazar García, Marcela; Reyes Maldonado, Elba; Revilla Monsalve, María Cristina; Villavicencio Guzmán, Laura; Reyes López, Alfonso; Sánchez-Gómez, Concepción

2015-01-01

We investigated whether maternal diabetes induced in rats using streptozotocin (STZ) on Day 5 of pregnancy affects the intrauterine developmental timeline. A total of 30 pregnant Sprague-Dawley diabetic rats (DRs) and 20 control rats (CRs) were used to obtain 21-day fetuses (F21) and newborn (NB) pups. Gestational age, weight, and body size were recorded as were the maxillofacial morphometry and morphohistological characteristics of the limbs. In DRs, pregnancy continued for ∼1.7 days, and delivery occurred 23 days postcoitus (DPC). In this group, the number of pups was lower, and 13% had maxillofacial defects. F21 in the DR group had lower weights and were smaller; moreover, the morphological characteristics of the maxillofacial structures, derived from the neural crest, were discordant with their chronological gestational age, resembling 18- to 19-day-old fetuses. These deficiencies were counterbalanced in NB pups. We conclude that hyperglycemia, which results from maternal diabetes and precedes embryo implantation, deregulates the intrauterine developmental timeline, restricts embryo-fetal growth, and primarily delays the remodeling and maturation of the structures derived from neural crest cells. PMID:25756053

Repeated maternal intramuscular or intraamniotic erythromycin incompletely resolves intrauterine Ureaplasma parvum infection in a sheep model of pregnancy.

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Kemp, Matthew W; Miura, Yuichiro; Payne, Matthew S; Watts, Rory; Megharaj, Smruthi; Jobe, Alan H; Kallapur, Suhas G; Saito, Masatoshi; Spiller, O Brad; Keelan, Jeffrey A; Newnham, John P

2014-08-01

Ureaplasma spp are the most commonly isolated microorganisms in association with preterm birth. Maternal erythromycin administration is a standard treatment for preterm prelabor rupture of membranes. There is little evidence of its effectiveness in eradicating Ureaplasma spp from the intrauterine cavity and fetus. We used a sheep model of intrauterine Ureaplasma spp infection to investigate the efficacy of repeated maternal intramuscular and intraamniotic erythromycin treatment to eradicate such an infection. Thirty ewes with singleton pregnancies received an intraamniotic injection of 10(7) color change units of erythromycin-sensitive Ureaplasma parvum serovar 3 at 55 days' gestation. At 116 days' gestation, 28 ewes with viable fetuses were randomized to receive (1) intraamniotic and maternal intramuscular saline solution treatment (n = 8), (2) single intraamniotic and repeated maternal intramuscular erythromycin treatment (n = 10), or (3) single maternal intramuscular and repeated intraamniotic erythromycin treatment (n = 10). Fetuses were surgically delivered at 125 days' gestation. Treatment efficacy was assessed by culture, quantitative polymerase chain reaction, and histopathologic evaluation. Animals treated with intraamniotic erythromycin had significantly less viable U parvum serovar 3 in the amniotic fluid at delivery. However, neither combination of maternal intramuscular and intraamniotic erythromycin treatment successfully cleared U parvum serovar 3 from the amniotic fluid or fetal tissues. Three de novo erythromycin-resistant U parvum isolates were identified in erythromycin-treated animals. Erythromycin treatment, given both to the ewe and into the amniotic cavity, fails to eradicate intrauterine and fetal U parvum serovar 3 infection and may lead to development of erythromycin resistant U parvum. Copyright © 2014 Mosby, Inc. All rights reserved.

Intrauterine Insemination: Fundamentals Revisited.

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Allahbadia, Gautam N

2017-12-01

Intrauterine insemination (IUI) is an assisted conception technique that involves the deposition of a processed semen sample in the upper uterine cavity, overcoming natural barriers to sperm ascent in the female reproductive tract. It is a cost-effective, noninvasive first-line therapy for selected patients with functionally normal tubes, and infertility due to a cervical factor, anovulation, moderate male factor, unexplained factors, immunological factor, and ejaculatory disorders with clinical pregnancy rates per cycle ranging from 10 to 20%. It, however, has limited use in patients with endometriosis, severe male factor infertility, tubal factor infertility, and advanced maternal age ≥ 35 years. IUI may be performed with or without ovarian stimulation. Controlled ovarian stimulation, particularly with low-dose gonadotropins, with IUI offers significant benefit in terms of pregnancy outcomes compared with natural cycle or timed intercourse, while reducing associated COH complications such as multiple pregnancies and ovarian hyperstimulation syndrome. Important prognostic indicators of success with IUI include age of patient, duration of infertility, stimulation protocol, infertility etiology, number of cycles, timing of insemination, number of preovulatory follicles on the day of hCG, processed total motile sperm > 10 million, and insemination count > 1 × 106 with > 4% normal spermatozoa. Alternative insemination techniques, such as Fallopian tube sperm perfusion, intracervical insemination, and intratubal insemination, provide no additional benefit compared to IUI. A complete couple workup that includes patient history, physical examination, and clinical and laboratory investigations is mandatory to justify the choice in favor of IUI and guide alternative patient management, while individualizing the treatment protocol according to the patient characteristics with a strict cancelation policy to limit multi-follicular development may help optimize IUI

Intrauterine Zn Deficiency Favors Thyrotropin-Releasing Hormone-Increasing Effects on Thyrotropin Serum Levels and Induces Subclinical Hypothyroidism in Weaned Rats

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Viridiana Alcántara-Alonso

2017-10-01

Full Text Available Individuals who consume a diet deficient in zinc (Zn-deficient develop alterations in hypothalamic-pituitary-thyroid axis function, i.e., a low metabolic rate and cold insensitivity. Although those disturbances are related to primary hypothyroidism, intrauterine or postnatal Zn-deficient adults have an increased thyrotropin (TSH concentration, but unchanged thyroid hormone (TH levels and decreased body weight. This does not support the view that the hypothyroidism develops due to a low Zn intake. In addition, intrauterine or postnatal Zn-deficiency in weaned and adult rats reduces the activity of pyroglutamyl aminopeptidase II (PPII in the medial-basal hypothalamus (MBH. PPII is an enzyme that degrades thyrotropin-releasing hormone (TRH. This hypothalamic peptide stimulates its receptor in adenohypophysis, thereby increasing TSH release. We analyzed whether earlier low TH is responsible for the high TSH levels reported in adults, or if TRH release is enhanced by Zn deficiency at weaning. Dams were fed a 2 ppm Zn-deficient diet in the period from one week prior to gestation and up to three weeks after delivery. We found a high release of hypothalamic TRH, which along with reduced MBH PPII activity, increased TSH levels in Zn-deficient pups independently of changes in TH concentration. We found that primary hypothyroidism did not develop in intrauterine Zn-deficient weaned rats and we confirmed that metal deficiency enhances TSH levels since early-life, favoring subclinical hypothyroidism development which remains into adulthood.

Level of Intrauterine Cocaine Exposure and Neuropsychological Test Scores in Preadolescence: Subtle Effects on Auditory Attention and Narrative Memory

Science.gov (United States)

Beeghly, Marjorie; Rose-Jacobs, Ruth; Martin, Brett M.; Cabral, Howard J.; Heeren, Timothy C.; Frank, Deborah A.

2014-01-01

Neuropsychological processes such as attention and memory contribute to children's higher-level cognitive and language functioning and predict academic achievement. The goal of this analysis was to evaluate whether level of intrauterine cocaine exposure (IUCE) alters multiple aspects of preadolescents' neuropsychological functioning assessed using a single age-referenced instrument, the NEPSY: A Developmental Neuropsychological Assessment (NEPSY) [71], after controlling for relevant covariates. Participants included 137 term 9.5-year-old children from low-income urban backgrounds (51% male, 90% African American/Caribbean) from an ongoing prospective longitudinal study. Level of IUCE was assessed in the newborn period using infant meconium and maternal report. 52% of the children had IUCE (65% with lighter IUCE, and 35% with heavier IUCE), and 48% were unexposed. Infants with Fetal Alcohol Syndrome, HIV seropositivity, or intrauterine exposure to illicit substances other than cocaine and marijuana were excluded. At the 9.5-year follow-up visit, trained examiners masked to IUCE and background variables evaluated children's neuropsychological functioning using the NEPSY. The association between level of IUCE and NEPSY outcomes was evaluated in a series of linear regressions controlling for intrauterine exposure to other substances and relevant child, caregiver, and demographic variables. Results indicated that level of IUCE was associated with lower scores on the Auditory Attention and Narrative Memory tasks, both of which require auditory information processing and sustained attention for successful performance. However, results did not follow the expected ordinal, dose-dependent pattern. Children's neuropsychological test scores were also altered by a variety of other biological and psychosocial factors. PMID:24978115

Mother's prior intrauterine position affects the sex ratio of her offspring in house mice.

Science.gov (United States)

Vandenbergh, J G; Huggett, C L

1994-11-08

Sex ratio alterations related to environmental factors occur in several mammals, but no mechanism has been identified to explain the adjustment. Intrauterine position (IUP) may provide the context in which such alterations occur. Previous studies on house mice and gerbils reveal that the position of a fetus in the uterus in relation to the sex of its neighbors influences its later anatomy, physiology, and behavior. The anogenital distance (AGD) of females located between two males (2M) is longer than that of females not between two males (OM). We have found that the IUP, as determined by cesarean section and by an index of the AGD, correlates with the sex ratio of the litters produced by female mice. The sex ratio of the first litter born to 2M females was 58% males, for 1M females was 51% males and for OM females was 42% males. The effect on sex ratio continues into the second litter. The number of pups produced by mothers of different IUPs in her first two litters did not differ, suggesting that the sex ratio adjustment occurs prior to parturition. These results provide a basis for the natural variability observed in sex ratios of litter-bearing mammals and suggest that one or more intrauterine mechanisms may be responsible for environmentally related sex ratio alterations.

High frequency of sub-optimal semen quality in an unselected population of young men

DEFF Research Database (Denmark)

Andersen, A G; Jensen, T K; Carlsen, E

2000-01-01

for military service, this provided a unique opportunity to study the reproductive function in an unbiased population. Altogether 891 young men delivered a blood sample in which reproductive hormones were measured. From 708 of these men data were also obtained on semen quality and testis size. The median sperm...... immotile spermatozoa and follicle stimulating hormone. Possible causes for this high frequency of young men with suboptimal semen quality are obscure and need to be explored. Whether these findings apply for young male populations of comparable countries remains to be seen....

Clinical characteristic and intraoperative findings of uterine perforation patients in using of intrauterine devices (IUDs).

Science.gov (United States)

Sun, Xin; Xue, Min; Deng, Xinliang; Lin, Yun; Tan, Ying; Wei, Xueli

2018-01-01

Intrauterine devices (IUDs) are the most popular form of contraception used worldwide; however, IUD is not risk-free. IUD migrations, especially uterine perforations, were frequently occurred in patients. The aim of this study was to investigate the clinical characteristics and intraoperative findings in patients with migrated IUDs. 29 cases of uterine perforation associated with migrated IUDs and 69 control patients were followed between January 2008 to March 2015. Patients who used IUDs within first 6 months from the last delivery experienced a characteristically high rate of the perforation of the uterine wall. A significantly larger number of IUD insertion associated with uterine perforation were performed in rural hospitals or operated at a lower level health care system. There was no clear difference in the age and presented symptoms in patients between two groups. Majority of contraceptive intrauterine devices was the copper-releasing IUDs. Furthermore, patients who used V-shaped IUD showed significantly higher incidence of pelvic adhesions when compared with the users of O-shaped IUDs. Unique clinical characteristics of IUD migration were identified in patients with uterine perforation. Hysteroscopy and/or laparoscopy were the effective approaches to remove the migrated IUDs. Improving operating skills is required at the lower level of health care system.

Effect of copper intrauterine device vs. injectable contraceptive on serum hormone levels and cell mitotic activity in endometrium

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Ebtesam Moustafa Kamal

2013-09-01

Conclusion: Either copper intrauterine device or injectable contraceptive usage for more than 9 months results in significant decrease in endometrial proliferative or cell mitotic activity. While copper IUD has no effect on serum estradiol or progesterone levels, DMPA usage increased serum progesterone level with no effect on serum estradiol.

Optimal and Suboptimal Finger Selection Algorithms for MMSE Rake Receivers in Impulse Radio Ultra-Wideband Systems

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Chiang Mung

2006-01-01

Full Text Available The problem of choosing the optimal multipath components to be employed at a minimum mean square error (MMSE selective Rake receiver is considered for an impulse radio ultra-wideband system. First, the optimal finger selection problem is formulated as an integer programming problem with a nonconvex objective function. Then, the objective function is approximated by a convex function and the integer programming problem is solved by means of constraint relaxation techniques. The proposed algorithms are suboptimal due to the approximate objective function and the constraint relaxation steps. However, they perform better than the conventional finger selection algorithm, which is suboptimal since it ignores the correlation between multipath components, and they can get quite close to the optimal scheme that cannot be implemented in practice due to its complexity. In addition to the convex relaxation techniques, a genetic-algorithm- (GA- based approach is proposed, which does not need any approximations or integer relaxations. This iterative algorithm is based on the direct evaluation of the objective function, and can achieve near-optimal performance with a reasonable number of iterations. Simulation results are presented to compare the performance of the proposed finger selection algorithms with that of the conventional and the optimal schemes.

Symptoms of an Intrauterine Hematoma Associated with Pregnancy Complications: A Systematic Review

Science.gov (United States)

Xiang, Lan; Wei, Zhaolian; Cao, Yunxia

2014-01-01

Objective To evaluate the predictive value of the symptoms of an intrauterine hematoma (IUH) for adverse pregnancy outcomes. Methods A literature review was performed with the search terms, including intrauterine/subchorionic/retroplacental/subplacental hematoma/hemorrhage/bleeding/collection/fluid, covering the period from January, 1981 to January, 2014. We just focused on the pregnancy outcomes associated with different symptoms of an IUH. Results It is generally agreed that a retroplacental, posterior or subchorionic in the fundus of uterus, and/or persistent IUH is associated with adverse outcomes in the ongoing pregnancy. However, the prognosis value of both volume and gestational age at diagnosis of IUH still remains controversial. Some researchers argue that a large IUH is associated with an increased risk of adverse events during pregnancy while others refuted. It is believed by some that the earlier an IUH was detected, the higher the risk for adverse outcomes would be, while no or weak association were reported by other studies. The prognostic value of the simultaneous presence of vaginal bleeding on pregnancy outcome is also controversial. Conclusions Both the position relative to the placenta or uterus and duration of IUH have strong predictive value on the prognosis in the ongoing pregnancy. However, the prognostic values of the IUH volume, gestational age at diagnosis and the simultaneous presence of vaginal bleeding remain controversial up to now. Moreover, most of previous reports are small, uncontrolled studies with incomplete information. Prospective, large sample, cohorts studies which take all detailed symptoms of an IUH into consideration are needed when we evaluate its clinical significance in the prognosis of pregnancy. PMID:25369062

The effect of prolonged intrauterine hyperinsulinemia on iron utilization in fetal sheep.

Science.gov (United States)

Georgieff, M K; Widness, J A; Mills, M M; Stonestreet, B S

1989-11-01

Newborn infants of poorly controlled insulin-dependent diabetic mothers demonstrate a redistribution of iron from serum and tissue stores into red blood cells. These changes may be due to increases in iron utilization during augmented Hb synthesis, which compensates for chronic intrauterine hypoxemia induced by prolonged fetal hyperinsulinemia. We tested this hypothesis by measuring plasma iron, total iron-binding capacity, percent iron-binding capacity saturation (total iron-binding capacity saturation), Hb concentration, total red cell Hb, and total red cell iron in the arterial blood of 11 chronically instrumented fetal sheep after 7-12 d of infusion with 15 U/day of insulin (n = 5) or placebo (n = 6). The insulin-infused fetal sheep had higher mean +/- SD plasma insulin concentrations (448 +/- 507 versus 11 +/- 8 mU/L; p less than 0.001) and lower arterial oxygen saturations (38 +/- 7 versus 54 +/- 9%; p less than 0.02). The insulin-infused group had a lower mean plasma iron concentration (20.8 +/- 10.9 versus 42.1 +/- 14.7 microM/L; p less than 0.02) and total iron-binding capacity saturation (36 +/- 20 versus 64 +/- 22%; p less than 0.02) and a higher total red cell Hb (45.4 +/- 8.7 versus 32.6 +/- 8.8 g; p less than 0.02) and total red cell iron content (154 +/- 29 versus 111 +/- 29 mg; p less than 0.02) when compared with the placebo group. Seven to 12 d of intrauterine hyperinsulinemia decreases serum iron and increases total red cell iron, most likely by stimulating increased Hb synthesis in response to low arterial oxygen saturation.(ABSTRACT TRUNCATED AT 250 WORDS)

Risk factors for suboptimal antiretroviral therapy adherence in HIV-infected adolescents in Gaborone, Botswana: a pilot cross-sectional study

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Ndiaye M

2013-09-01

Full Text Available Maimouna Ndiaye,1,2 Peter Nyasulu,1 Hoang Nguyen,6,7 Elizabeth D Lowenthal,8,9 Robert Gross,10 Edward J Mills,3 Jean B Nachega4–6 1School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; 2Central Medical Stores, Ministry of Health, Gaborone, Botswana; 3Faculty of Health Sciences, University of Ottawa, Ottawa, Canada; 4Department of Medicine and Centre for Infectious Diseases, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; 5Department of Epidemiology, Infectious Disease Epidemiology Research Program, Pittsburgh University Graduate School of Public Health, Pittsburgh, PA, USA; 6Departments of Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; 7Tay Ho Clinics, Department of Medicine, Hanoi Health Services, Hanoi, Vietnam; 8Departments of Pediatrics and Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; 9Center for Pediatric Clinical Effectiveness, Children’s Hospital of Philadelphia, Philadelphia, PA, USA; 10Departments of Medicine and Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA Objective: Little is known about factors associated with suboptimal antiretroviral treatment (ART adherence among adolescents in Sub-Saharan Africa. Our objective was to determine the level of ART adherence and predictors of non-adherence among human immunodeficiency virus (HIV-infected adolescents at the Botswana-Baylor Children's Clinical Centre of Excellence in Gaborone, Botswana. Methods: In a cross-sectional study, 82 HIV-infected adolescents receiving ART and their caregivers were administered a structured questionnaire. The patient's clinical information was retrieved from medical records. Outcome measures included excellent pill count ART adherence (>95% and virologic suppression

High prevalence of suboptimal vitamin B12 status in young adult women of South Asian and European ethnicity.

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Quay, Teo A W; Schroder, Theresa H; Jeruszka-Bielak, Marta; Li, Wangyang; Devlin, Angela M; Barr, Susan I; Lamers, Yvonne

2015-12-01

Suboptimal vitamin B12 (B12) status has been associated with an increased risk of congenital anomalies, preterm birth, and childhood insulin resistance. South Asians - Canada's largest minority group - and women of reproductive age are vulnerable to B12 deficiency. This study aimed to assess the prevalence of and factors associated with B12 deficiency and suboptimal B12 status in a convenience sample of young adult women of South Asian and European descent in Metro Vancouver. We measured serum B12, holotranscobalamin, plasma methylmalonic acid, red blood cell and plasma folate, and hematologic parameters in 206 nonpregnant, healthy women aged 19-35 years. Categorization for B12 status adhered to serum B12 cutoffs for deficiency (women is higher than in the general Canadian population. In light of maternal and fetal health risks associated with B12 inadequacy in early-pregnancy, practitioners should consider monitoring B12 status before and during early pregnancy, especially in immigrants and women with low dietary B12 intakes including non-users of vitamin supplements.

Energy expenditures & physical activity in rats with chronic suboptimal nutrition.

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Rising, Russell; Lifshitz, Fima

2006-01-31

Sub-optimally nourished rats show reduced growth, biochemical and physiological changes. However, no one has assessed metabolic rate adaptations in rats subjected to chronic suboptimal nutrition (CSN). In this study energy expenditure (EE; kcal/100 g body weight) and physical activity (PA; oscillations in weight/min/kg body weight) were assessed in rats subjected to three levels of CSN. Body weight gain was diminished (76.7 +/- 12.0 and 61.6 +/- 11.0 g) in rats fed 70 and 60% of the ad-libitum fed controls which gained more weight (148.5 +/- 32.3 g). The rats fed 80% gained weight similarly to controls (136.3 +/- 10.5 g). Percent Fat-free body mass was reduced (143.8 +/- 8.7 and 142.0 +/- 7.6 g) in rats fed 70 and 60% of ad-libitum, but not in those fed 80% (200.8 +/- 17.5 g) as compared with controls (201.6 +/- 33.4 g). Body fat (g) decreased in rats fed 80% (19.7 +/- 5.3), 70% (15.3 +/- 3.5) and 60% (9.6 +/- 2.7) of ad-libitum in comparison to controls (26.0 +/- 6.7). EE and PA were also altered by CSN. The control rats increased their EE and PA during the dark periods by 1.4 +/- 0.8 and 1.7 +/- 1.1 respectively, as compared with light the period; whereas CSN rats fed 80 and 70% of ad-libitum energy intake had reduced EE and PA during the dark periods as compared with the light period EE(7.5 +/- 1.4 and 7.8 +/- 0.6 vs. 9.0 +/- 1.2 and 9.7 +/- 0.8; p vs. 4.1 +/- 0.9 and 2.4 +/- 0.4; p vs. 0.95 +/- 0.03 and 0.91 +/- 0.05 p light (7.1 +/- 1.4) and dark period (6.2 +/- 1.0) EE and PA (3.4 +/- 0.9 and 2.5 +/- 0.5 respectively) were reduced in rats fed 60% of ad-libitum energy intake. CSN rats adapt to mild energy restriction by reducing body fat, EE and PA mainly during the dark period while growth proceeds and lean body mass is preserved. At higher levels of energy restrictions there is decreased growth, body fat and lean mass. Moreover EE and PA are also reduced during both light and dark periods.

Design of a study on suboptimal cognitive acts in the diagnostic process, the effect on patient outcomes and the influence of workload, fatigue and experience of physician

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van der Wal Gerrit

2009-04-01

Full Text Available Abstract Background Diagnostic error is an important error type since diagnostic adverse events are regularly judged as being preventable and the consequences are considered to be severe. Existing research often focuses on either diagnostic adverse events or on the errors in diagnostic reasoning. Whether and when an incorrect diagnostic process results in adverse outcomes has not been studied extensively. The present paper describes the design of a study that aims to study the relationship between a suboptimal diagnostic process and patient outcomes. In addition, the role of personal and circumstantial factors on the quality of the diagnostic process will be examined. Methods/Design The research questions were addressed using several data sources. First, the differential diagnosis was assessed concurrently to the diagnostic process. Second, the patient records of 248 patients suffering from shortness of breath were reviewed by expert internists in order to reveal suboptimal cognitive acts and (potential consequences for the patient. The suboptimal cognitive acts were discussed with the treating physicians and classified with the taxonomy of unsafe acts. Third, workload, fatigue and work experience were measured during the physicians work. Workload and fatigue were measured during the physicians shift using the NASA tlx questionnaire on a handheld computer. Physicians participating in the study also answered questions about their work experience. Discussion The design used in this study provides insight into the relationship between suboptimal cognitive acts in the diagnostic process and possible consequences for the patient. Suboptimal cognitive acts in the diagnostic process and its causes can be revealed. Additional measurements of workload, fatigue and experience allow examining the influence of these factors on the diagnostic process. In conclusion, the present design provides a method with which insights in weaknesses of the diagnostic

Effect of stress induced by suboptimal growth factors on survival of Escherichia coli O157:H7.

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Uyttendaele, M; Taverniers, I; Debevere, J

2001-05-21

This study investigated the growth and survival of E. coli O157:H7 exposed to a combination of suboptimal factors (22 degrees C, 7 degrees C, -18 degrees C/0.5% NaCl, 5.0% NaCl/pH 7.0, pH 5.4, pH 4.5/addition of lactic acid) in a simulation medium for red meat (beef gravy). Prolonged survival was noted as the imposed stress was more severe, and as multiple growth factors became suboptimal. At a defined temperature (7 degrees C or -18 degrees C), survival was prolonged at the more acid, more suboptimal pH (pH 4.5 > pH 5.4 > pH 7.0) while at a defined pH (pH 4.5), better survival was observed at 7 degrees C than at 22 degrees C. This suggests that application of the hurdle concept for preservation of food may inhibit outgrowth but induce prolonged survival of E. coli O157:H7 in minimal processed foods. At both 22 degrees C and 7 degrees C, the addition of lactic acid instead of HCl to reduce pH (to pH 4.5) resulted in a more rapid decrease of E. coli O157:H7. High survival was observed in beef gravy, pH 5.4 at -18 degrees C (simulation of frozen meat)-reduction of log 3.0 to log 1.9 after 43 days--and in beef gravy, pH 4.5 and 5% NaCl at 7 degrees C (simulation of a fermented dried meat product kept in refrigeration)--less than 1 log reduction in 43 days. In these circumstances, however, a high degree of sublethal damage of the bacterial cells was noted. The degree of sublethal damage can be estimated from the difference in recovery of the pathogen on the non-selective TSA medium and the selective SMAC medium.

Blastocysts production and collection in albino Syrian hamster using superovulation and intrauterine artificial insemination in non-breeding season

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A. Amiri Divani

2017-06-01

Full Text Available In vivo blastocyst production and collection using superovulation and intrauterine insemination was established in albino Syrian hamsters. Twenty female albino hamsters were injected pregnant mare serum gonadotropin (PMSG, 25 IU in non-breeding season and 48 h or 56 h later, 25 IU of human chorionic gonadotropin (hCG were injected. Both groups were divided into two subgroups of natural mating and artificial insemination. The former group was mated with a fertile male (1 male for 2 fe-males after hCG injection and in the next morning, the hamsters with vaginal plug were regarded as pregnant. In the artificial insemination group, intrauterine artificial insemination of 1×108 sperms was done 12 h after hCG injection. Blastocysts were counted at 3.5 days after mating or insemination. However, 48 h and 56 h hCG and natural mating and 48 h hCG and artificial insemination were without blastocyst; however the method of 56 h hCG and artificial insemination produced of 15±5 (mean and standard deviation blastocysts in each albino hamster in the winter.

Reproductive performance of primiparous and multiparous Saanen goats after laparoscopic intrauterine insemination: a field study

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KULAKSIZ, Recai; DAŞKIN, Ali

2014-01-01

The objective of this study was to evaluate the reproductive performance of primiparous and multiparous Saanen goats after intrauterine laparoscopic artificial insemination with frozen semen. Twenty-four Saanen goats, divided in 2 groups: group 1 consisted of 11 primiparous goats and group 2 consisted of 13 multiparous goats. Estrus was synchronized by 20 mg fluorogestone acetate (FGA)-impregnated intravaginal sponges and the IM administration of 125 mg of cloprostenol (PGF2a) and eCG (400 IU...

Level of intrauterine cocaine exposure and neuropsychological test scores in preadolescence: subtle effects on auditory attention and narrative memory.

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Beeghly, Marjorie; Rose-Jacobs, Ruth; Martin, Brett M; Cabral, Howard J; Heeren, Timothy C; Frank, Deborah A

2014-01-01

Neuropsychological processes such as attention and memory contribute to children's higher-level cognitive and language functioning and predict academic achievement. The goal of this analysis was to evaluate whether level of intrauterine cocaine exposure (IUCE) alters multiple aspects of preadolescents' neuropsychological functioning assessed using a single age-referenced instrument, the NEPSY: A Developmental Neuropsychological Assessment (NEPSY) (Korkman et al., 1998), after controlling for relevant covariates. Participants included 137 term 9.5-year-old children from low-income urban backgrounds (51% male, 90% African American/Caribbean) from an ongoing prospective longitudinal study. Level of IUCE was assessed in the newborn period using infant meconium and maternal report. 52% of the children had IUCE (65% with lighter IUCE, and 35% with heavier IUCE), and 48% were unexposed. Infants with Fetal Alcohol Syndrome, HIV seropositivity, or intrauterine exposure to illicit substances other than cocaine and marijuana were excluded. At the 9.5-year follow-up visit, trained examiners masked to IUCE and background variables evaluated children's neuropsychological functioning using the NEPSY. The association between level of IUCE and NEPSY outcomes was evaluated in a series of linear regressions controlling for intrauterine exposure to other substances and relevant child, caregiver, and demographic variables. Results indicated that level of IUCE was associated with lower scores on the Auditory Attention and Narrative Memory tasks, both of which require auditory information processing and sustained attention for successful performance. However, results did not follow the expected ordinal, dose-dependent pattern. Children's neuropsychological test scores were also altered by a variety of other biological and psychosocial factors. Copyright © 2014 Elsevier Inc. All rights reserved.

Factor VIII levels and the risk of pre-eclampsia, HELLP syndrome, pregnancy related hypertension and severe intrauterine growth retardation.

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Witsenburg, C P J; Rosendaal, F R; Middeldorp, J M; Van der Meer, F J M; Scherjon, S A

2005-01-01

Recently, acquired as well as genetic prothrombotic factors are associated with thrombotic events. These factors have also been related to conditions of uteroplacental insufficiency such as pre-eclampsia, HELLP syndrome and severe intrauterine growth restriction (IUGR). The aim of this study was to determine whether elevated factor VIII levels are associated with uteroplacental insufficiency, in particular pre-eclampsia, HELLP syndrome or pregnancy-induced hypertension and intrauterine growth retardation. Plasma samples of 75 women with a history of pregnancy complicated by pre-eclampsia, HELLP syndrome, pregnancy induced hypertension or intrauterine growth restriction were tested for factor VIII:C (FVIII:C) levels at a minimum of 10 weeks post-partum. Laboratory results were compared to factor VIII:C levels found in a healthy control group of 272 women. Mean factor VIII:C levels were similar at 123 IU/dl in both the patient group and the controls. In a logistic regression model, after adjusting for age and blood group, no effect of factor VIII:C levels on the risk of pregnancy complications was observed, with the exception of IUGR with (OR 2.9, CI 1.0-8.7) or without hypertension (OR 2.0, CI 0.7-6.4). If the elevated level of factor VIII would be the sole factor responsible for the increased risk observed, one would expect to find an effect of blood group on risk as well (blood group being an important determinant of FVIII:C). While no such effect could be shown a causal relationship between elevated levels of factor VIII and conditions of uteroplacental insufficiency such as pre-eclampsia, HELLP syndrome, pregnancy-induced hypertension and IUGR is not very likely.

Identification of messenger RNA of fetoplacental source in maternal plasma of women with normal pregnancies and pregnancies with intrauterine growth restriction.

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Ayala Ramírez, Paola; García Robles, Reggie; Rojas, Juan Diego; Bermúdez, Martha; Bernal, Jaime

2012-07-01

to quantify placenta-specific RNA in plasma of women carrying foetuses with intrauterine growth restriction and pregnant women with normal pregnancies. 8 pregnant women with foetuses with intrauterine growth restriction were studied as well as 18 women with uncomplicated pregnancies in the third pregnancy trimester. Total free RNA was quantified in maternal plasma by spectrophotometry and the gene expression of hPL (Human Placental Lactogen) at the messenger RNA level through technical Real Time-Chain Reaction Polymerase. plasma RNA of fetoplacental origin was successfully detected in 100% of pregnant women. There were no statistically significant differences between the values of total RNA extracted from plasma (p= 0.5975) nor in the messenger RNA expression of hPL gene (p= 0.5785) between cases and controls. messenger RNA of fetoplacental origin can be detected in maternal plasma during pregnancy.

Alterations in expression of imprinted genes from the H19/IGF2 loci in a multigenerational model of intrauterine growth restriction (IUGR).

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Gonzalez-Rodriguez, Pablo; Cantu, Jessica; O'Neil, Derek; Seferovic, Maxim D; Goodspeed, Danielle M; Suter, Melissa A; Aagaard, Kjersti M

2016-05-01

The H19/IGF2 imprinted loci have attracted recent attention because of their role in cellular differentiation and proliferation, heritable gene regulation, and in utero or early postnatal growth and development. Expression from the imprinted H19/IGF2 locus involves a complex interplay of 3 means of epigenetic regulation: proper establishment of DNA methylation, promoter occupancy of CTCF, and expression of microRNA-675. We have demonstrated previously in a multigenerational rat model of intrauterine growth restriction the epigenetic heritability of adult metabolic syndrome in a F2 generation. We have further demonstrated abrogation of the F2 adult metabolic syndrome phenotype with essential nutrient supplementation of intermediates along the 1-carbon pathway and shown that alterations in the metabolome precede the adult onset of metabolic syndrome. The upstream molecular and epigenomic mediators underlying these observations, however, have yet to be elucidated fully. In the current study, we sought to characterize the impact of the intrauterine growth-restricted lineage and essential nutrient supplementation on both levels and molecular mediators of H19 and IGF2 gene expression in the F2 generation. F2 intrauterine growth-restricted and sham lineages were obtained by exposing P1 (grandmaternal) pregnant dams to bilateral uterine artery ligation or sham surgery at gestational day 19.5. F1 pups were allocated to the essential nutrient supplemented or control diet at postnatal day 21, and bred at 6-7 weeks of age. Hepatic tissues from the resultant F2 offspring at birth and at weaning (day 21) were obtained. Bisulfite modification and sequencing was employed for methylation analysis. H19 and IGF2 expression was measured by quantitative polymerase chain reaction. Promoter occupancy was quantified by the use of chromatin immunoprecipitation, or ChIP, against CTCF insulator proteins. Growth-restricted F2 on control diet demonstrated significant down-regulation in H19

Increased lipolysis but diminished gene expression of lipases in subcutaneous adipose tissue of healthy young males with intrauterine growth retardation

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Højbjerre, Lise; Alibegovic, Amra C; Sonne, Mette P

2011-01-01

Intrauterine growth retardation (IUGR) is associated with a central fat distribution and risk of developing type 2 diabetes in adults when exposed to a sedentary Western lifestyle. Increased lipolysis is an early defect of metabolism in IUGR subjects, but the sites and molecular mechanisms involv...

Socioeconomic factors explain suboptimal adherence to antiretroviral therapy among HIV-infected Australian adults with viral suppression.

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Krista J Siefried

Full Text Available Missing more than one tablet of contemporary antiretroviral therapy (ART per month increases the risk of virological failure. Recent studies evaluating a comprehensive range of potential risk factors for suboptimal adherence are not available for high-income settings.Adults on ART with undetectable viral load (UDVL were recruited into a national, multi-centre cohort, completing a comprehensive survey assessing demographics, socio-economic indicators, physical health, well-being, life stressors, social supports, HIV disclosure, HIV-related stigma and discrimination, healthcare access, ART regimen, adherence, side effects, costs and treatment beliefs. Baseline data were assessed, and suboptimal adherence was defined as self-reported missing ≥1 ART dose/month over the previous 3-months; associated factors were identified using bivariate and multivariate binary logistic regression.We assessed 522 participants (494 [94.5%] men, mean age = 50.8 years, median duration UDVL = 3.3 years [IQR = 1.2-6.8] at 17 sexual health, hospital, and general practice clinics across Australia. Seventy-eight participants (14.9% reported missing ≥1 dose/month over the previous three months, which was independently associated with: being Australian-born (AOR [adjusted odds ratio] = 2.4 [95%CI = 1.2-4.9], p = 0.014, not being in a relationship (AOR = 3.3 [95%CI = 1.5-7.3], p = 0.004, reaching the "Medicare safety net" (capping annual medical/pharmaceutical costs (AOR = 2.2 [95%CI = 1.1-4.5], p = 0.024, living in subsidised housing (AOR = 2.5 [95%CI = 1.0-6.2], p = 0.045, receiving home-care services (AOR = 4.4 [95%CI = 1.0-18.8], p = 0.046, HIV community/outreach services linkage (AOR = 2.4 [95%CI = 1.1-5.4], p = 0.033, and starting ART following self-request (AOR = 3.0 [95%CI = 1.3-7.0], p = 0.012.In this population, 15% reported recent suboptimal ART adherence at levels associated in prospective studies with subsequent virological failure, despite all having an

Importance of Maternal Diabetes on the Chronological Deregulation of the Intrauterine Development: An Experimental Study in Rat

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Marcela Salazar García

2015-01-01

Full Text Available We investigated whether maternal diabetes induced in rats using streptozotocin (STZ on Day 5 of pregnancy affects the intrauterine developmental timeline. A total of 30 pregnant Sprague-Dawley diabetic rats (DRs and 20 control rats (CRs were used to obtain 21-day fetuses (F21 and newborn (NB pups. Gestational age, weight, and body size were recorded as were the maxillofacial morphometry and morphohistological characteristics of the limbs. In DRs, pregnancy continued for ∼1.7 days, and delivery occurred 23 days postcoitus (DPC. In this group, the number of pups was lower, and 13% had maxillofacial defects. F21 in the DR group had lower weights and were smaller; moreover, the morphological characteristics of the maxillofacial structures, derived from the neural crest, were discordant with their chronological gestational age, resembling 18- to 19-day-old fetuses. These deficiencies were counterbalanced in NB pups. We conclude that hyperglycemia, which results from maternal diabetes and precedes embryo implantation, deregulates the intrauterine developmental timeline, restricts embryo-fetal growth, and primarily delays the remodeling and maturation of the structures derived from neural crest cells.

[Pathophysiological changes of umbilical vessels in intrauterine growth restriction].

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Jakó, Mária; Surányi, Andrea; Kaiser, László; Domokos, Dóra; Gáspár, Róbert; Bártfai, György

2014-12-14

The prevalence of intrauterine growth restriction is 4-5000/100,000 births, and they give the majority of perinatal morbidity. The aim of the authors was to compare the pathomorphologic data and vasoreactivity of umbilical vessels and placenta of small for date newborns to that of the normal pregnancies. Samples of the umbilical cord and placenta were divided into case and control groups. Two 10 cm long segments were cut of the umbilical cord at placental insertion. Tissue bath experiment was performed on umbilical vessels and pathomorphologic data were collected according to the Royal College of Pathologists' protocol. After the development of basal tone, oxytocin and desmopressin did not enhance the vascular contraction, but the pathomorphological and ultrasonographic data were significantly different in the two groups. The results indicate that umbilical vessels might not have oxytocin or vasopressin receptors. The pathomorphologic and flowmetric differences could be the causes of small birth weight.

Impact of intrauterine growth restriction on preterm lung disease.

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Sasi, Arun; Abraham, Vinita; Davies-Tuck, Miranda; Polglase, Graeme R; Jenkin, Graham; Miller, Suzanne L; Malhotra, Atul

2015-12-01

Intrauterine growth restriction (IUGR) is an important cause for prematurity and adversely influences prematurity-related morbidities. This study evaluates the impact of IUGR on respiratory outcomes in infants CLD), CLD or death, and need for home oxygen at discharge. Subgroup analysis by gestation-based stratification (CLD (45% vs. 17%, p = 0.0001), death (16% vs. 4.6%, p = 0.0001), CLD or death (46% vs. 21.5%, p = 0.0001), home oxygen rates (13.7% vs. 6.5%, p = 0.01) and duration of respiratory support was significantly higher in the IUGR group. IUGR emerged as the strongest predictor of CLD (adjusted OR, 95%CI: (8.4 [2, 35]) and CLD or death (12.7 [3, 54]) across all gestation. IUGR is a major risk factor for adverse short-term pulmonary outcomes as reflected by higher rates of CLD, CLD or death, and oxygen dependency at discharge in preterm infants. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Superimposition of postnatal calorie restriction protects the aging male intrauterine growth- restricted offspring from metabolic maladaptations.

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Dai, Yun; Thamotharan, Shanthie; Garg, Meena; Shin, Bo-Chul; Devaskar, Sherin U

2012-09-01

Intrauterine growth restriction (IUGR) results in dysregulated glucose homeostasis and adiposity in the adult. We hypothesized that with aging, these perturbations will wane, and superimposition of postnatal growth restriction (PNGR) on IUGR [intrauterine and postnatal growth restriction (IPGR)] will reverse the residual IUGR phenotype. We therefore undertook hyperinsulinemic-euglycemic clamp, energy balance, and physical activity studies during fed, fasted, and refed states, in light and dark cycles, on postweaned chow diet-fed more than 17-month aging male IUGR, PNGR, and IPGR vs. control (CON) rat offspring. Hyperinsulinemic-euglycemic clamp revealed similar whole-body insulin sensitivity and physical activity in the nonobese IUGR vs. CON, despite reduced heat production and energy expenditure. Compared with CON and IUGR, IPGR mimicking PNGR was lean and growth restricted with increased physical activity, O(2) consumption (VO(2)), energy intake, and expenditure. Although insulin sensitivity was no different in IPGR and PNGR, skeletal muscle insulin-induced glucose uptake was enhanced. This presentation proved protective against the chronologically earlier (5.5 months) development of obesity and dysregulated energy homeostasis after 19 wk on a postweaned high-fat diet. This protective role of PNGR on the metabolic IUGR phenotype needs future fine tuning aimed at minimizing unintended consequences.

Suboptimal decision making by children with ADHD in the face of risk

DEFF Research Database (Denmark)

Sørensen, Lin; Sonuga-Barke, Edmund; Eichele, Heike

2017-01-01

Objective: Suboptimal decision making in the face of risk (DMR) in children with attention-deficit hyperactivity disorder (ADHD) may be mediated by deficits in a number of different neuropsychological processes. We investigated DMR in children with ADHD using the Cambridge Gambling Task (CGT......-matched group of typically developing children (n = 34) performed the CGT. Results: As predicted, children with ADHD were not more prone to making risky choices (i.e., risk proneness). However, they had difficulty adjusting to changing risk levels and were more delay aversive-with these 2 effects being...... correlated. Conclusions: Our findings add to the growing body of evidence that children with ADHD do not favor risk taking per se when performing gambling tasks, but rather may lack the cognitive skills or motivational style to appraise changing patterns of risk effectively....

The effect of intrauterine infusion of dextrose on clinical endometritis cure rate and reproductive performance of dairy cows.

Science.gov (United States)

Machado, V S; Oikonomou, G; Ganda, E K; Stephens, L; Milhomem, M; Freitas, G L; Zinicola, M; Pearson, J; Wieland, M; Guard, C; Gilbert, R O; Bicalho, R C

2015-06-01

The main objective of this study was to evaluate the intrauterine administration use of 200 mL of 50% dextrose solution as a treatment against clinical endometritis (CE); CE cure rate and reproductive performance were evaluated. Additionally, the association of several relevant risk factors, such as retained placenta (RP), metritis, CE, anovulation, hyperketonemia, and body condition score with reproductive performance, early embryonic mortality, and CE were evaluated. A total of 1,313 Holstein cows housed on 4 commercial dairy farms were enrolled in the study. At 7±3 DIM cows were examined for metritis and had blood collected to determine serum β-hydroxybutyrate concentration. To determine if cows had ovulated at least once before 44±3 DIM, the presence of a corpus luteum was evaluated by ovarian ultrasonography at 30±3 DIM and at 44±3 DIM. At 30±3 DIM, CE was diagnosed using the Metricheck device (SimcroTech, Hamilton, New Zealand); cows with purulent or mucopurulent vaginal discharge were diagnosed as having CE. Cows diagnosed with CE (n=175) were randomly allocated into 2 treatment groups: treatment (intrauterine infusion of 200 mL of 50% dextrose) or control (no infusion). Clinical endometritis cows were re-evaluated as described above at 44±3 DIM, and cows that were free of purulent or mucopurulent vaginal discharge were considered cured. Intrauterine infusion of dextrose tended to have a detrimental effect on CE cure rate, and treatment did not have an effect on first-service conception rate and early embryonic mortality. A multivariable Cox's proportional hazard model was performed to evaluate the effect of several variables on reproductive performance; the variables RP, CE, parity, anovulation, and the interaction term between parity and anovulation were associated with hazard of pregnancy. Cows that did not have RP or CE were more likely to conceive than cows that were diagnosed with RP or CE. Cows that had RP were at 3.36 times higher odds of

Nutritional and Hormonal Status of Premature Infants Born with Intrauterine Growth Restriction at the Term Corrected Age.

Science.gov (United States)

Belyaeva, I A; Namazova-Baranova, L S; Bombardirova, E P; Okuneva, M V

Inadequate nutrition supply during the period of intrauterine growth and the first year of life leads to persistent metabolic changes and provokes development of various diseases. Тo compare physical development, body composition, and hormonal status (insulin, insulin-like growth factor-1 (IGF-1), somatotropic hormone (STH), C-Peptide, cortisol) indices in premature infants born with intrauterine growth restriction (IUGR) at the term corrected age with the same indices in mature infants with IUGR and premature infants with weight appropriate for their gestational age (GA). А crossover study of anthropometric measures, body composition and growth hormones changes assessment was carried out. It included 140 premature infants with weight appropriate for their GA, 58 premature infants with IUGR and 64 mature infants with IUGR. Anthropometric measures were assessed with Fenton and Anthro growth charts (WHO, 2009); body composition was studied with the air plethysmography method (РЕA POD, LMi, USA). Level of hormones in blood serum was assessed with biochemical methods. It is found that anthropometric measures in premature infants with weight appropriate for their GA and premature infants with IUGR at the term corrected age did not have any significant differences while premature infants with IUGR tended to have lower weight. Studying body composition we found that both groups of premature infants had slightly higher level of fat mass in comparison with mature infants. High concentration of insulin, cortisol, IGF-1, and C-peptide was found in premature and mature infants with IUGR. Instead, lower levels of STH was found in infants with IUGR. Formula fed premature infants (comparing to breastfed ones) had higher levels of fat mass, insulin, IGF-1, and C-peptide. Mature infants with IUGR did not tend to have the correlation between levels of fat mass, insulin, IGF-1, C-peptide, and type of feeding. Not only insufficient intrauterine growth but also nutrition pattern

Pyometra caused by carrying of an intrauterine device for a period of forty years and chronic endometritis

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Todorović Nada 1

2002-01-01

Full Text Available Pyometra is the accumulation of pus in the uterine cavity, thus streaching its walls and thinning and enlarging the uterus. This change is characteristic of the senium period of life, when the uterus is atrophie with a stenotic cervical canal. It most frequently occurs as a result of secondary infection of the cancerogenic tissue of the uterus and additional stenosation and clogging up of cervical canal by a malignant process. Apart from carcinomas of the body and uterus cervix, pyometra less often can occur in other illnesses such as senile endometritis and senile colpitis. As pyometra most frequently occurs in uterine carcinomas, in detection of this state, we must think of malignancy and direct our examination to this direction. In this paper we present a patient in whom pyometra developed because she carried an intrauterine device for forty years that resulted in chronic endometritis. The main symptoms for which the patient was admited to hospital were abdominal pain and intensive suppurative vaginal excretion a month after removal of intrauterine device. The diagnosis of pyometra was made by gynaecological and ultrasound examinations, and also on the basis of gynecological and ultrasound examinations one month after chronic endometritis was confirmed. On the basis of this finding we suspected that chronic endometritis was caused by this state. By cytological, PAP and histopathological examinations of samples obtained by explorative curettage and biopsy of the uterine cervix, malignant changes were eliminated a possible cause. By laboratory analysis and bacteriological examination of the uterine cavity and vaginal excretion, inflammatory changes of the uterine mocous membrane were confirmed as a cause of the pyometra. This conditions was due to carrying the intrauterine device for more decades. The therapy consisted of dilatation of the cervical canal and evacuation of accumulated suppurative contents and irrigation of uterine cavity with 3

Robust Adaptive LCMV Beamformer Based On An Iterative Suboptimal Solution

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Xiansheng Guo

2015-06-01

Full Text Available The main drawback of closed-form solution of linearly constrained minimum variance (CF-LCMV beamformer is the dilemma of acquiring long observation time for stable covariance matrix estimates and short observation time to track dynamic behavior of targets, leading to poor performance including low signal-noise-ratio (SNR, low jammer-to-noise ratios (JNRs and small number of snapshots. Additionally, CF-LCMV suffers from heavy computational burden which mainly comes from two matrix inverse operations for computing the optimal weight vector. In this paper, we derive a low-complexity Robust Adaptive LCMV beamformer based on an Iterative Suboptimal solution (RAIS-LCMV using conjugate gradient (CG optimization method. The merit of our proposed method is threefold. Firstly, RAIS-LCMV beamformer can reduce the complexity of CF-LCMV remarkably. Secondly, RAIS-LCMV beamformer can adjust output adaptively based on measurement and its convergence speed is comparable. Finally, RAIS-LCMV algorithm has robust performance against low SNR, JNRs, and small number of snapshots. Simulation results demonstrate the superiority of our proposed algorithms.

Use of uterine artery Doppler ultrasonography to predict pre-eclampsia and intrauterine growth restriction: a systematic review and bivariable meta-analysis

NARCIS (Netherlands)

Cnossen, Jeltsje S.; Morris, Rachel K.; ter Riet, Gerben; Mol, Ben W. J.; van der Post, Joris A. M.; Coomarasamy, Arri; Zwinderman, Aeilko H.; Robson, Stephen C.; Bindels, Patrick J. E.; Kleijnen, Jos; Khan, Khalid S.

2008-01-01

BACKGROUND: Alterations in waveforms in the uterine artery are associated with the development of pre-eclampsia and intrauterine growth restriction. We investigated the predictive accuracy of all uterine artery Doppler indices for both conditions in the first and second trimesters. METHODS: We

Coadministration of Hedera helix L. Extract Enabled Mice to Overcome Insufficient Protection against Influenza A/PR/8 Virus Infection under Suboptimal Treatment with Oseltamivir.

Science.gov (United States)

Hong, Eun-Hye; Song, Jae-Hyoung; Shim, Aeri; Lee, Bo-Ra; Kwon, Bo-Eun; Song, Hyuk-Hwan; Kim, Yeon-Jeong; Chang, Sun-Young; Jeong, Hyeon Gun; Kim, Jong Geal; Seo, Sang-Uk; Kim, HyunPyo; Kwon, YongSoo; Ko, Hyun-Jeong

2015-01-01

Several anti-influenza drugs that reduce disease manifestation exist, and although these drugs provide clinical benefits in infected patients, their efficacy is limited by the emergence of drug-resistant influenza viruses. In the current study, we assessed the therapeutic strategy of enhancing the antiviral efficacy of an existing neuraminidase inhibitor, oseltamivir, by coadministering with the leaf extract from Hedera helix L, commonly known as ivy. Ivy extract has anti-inflammatory, antibacterial, antifungal, and antihelminthic properties. In the present study, we investigated its potential antiviral properties against influenza A/PR/8 (PR8) virus in a mouse model with suboptimal oseltamivir that mimics a poor clinical response to antiviral drug treatment. Suboptimal oseltamivir resulted in insufficient protection against PR8 infection. Oral administration of ivy extract with suboptimal oseltamivir increased the antiviral activity of oseltamivir. Ivy extract and its compounds, particularly hedrasaponin F, significantly reduced the cytopathic effect in PR8-infected A549 cells in the presence of oseltamivir. Compared with oseltamivir treatment alone, coadministration of the fraction of ivy extract that contained the highest proportion of hedrasaponin F with oseltamivir decreased pulmonary inflammation in PR8-infected mice. Inflammatory cytokines and chemokines, including tumor necrosis factor-alpha and chemokine (C-C motif) ligand 2, were reduced by treatment with oseltamivir and the fraction of ivy extract. Analysis of inflammatory cell infiltration in the bronchial alveolar of PR8-infected mice revealed that CD11b+Ly6G+ and CD11b+Ly6Cint cells were recruited after virus infection; coadministration of the ivy extract fraction with oseltamivir reduced infiltration of these inflammatory cells. In a model of suboptimal oseltamivir treatment, coadministration of ivy extract fraction that includes hedrasaponin F increased protection against PR8 infection that could be

Coadministration of Hedera helix L. Extract Enabled Mice to Overcome Insufficient Protection against Influenza A/PR/8 Virus Infection under Suboptimal Treatment with Oseltamivir.

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Eun-Hye Hong

Full Text Available Several anti-influenza drugs that reduce disease manifestation exist, and although these drugs provide clinical benefits in infected patients, their efficacy is limited by the emergence of drug-resistant influenza viruses. In the current study, we assessed the therapeutic strategy of enhancing the antiviral efficacy of an existing neuraminidase inhibitor, oseltamivir, by coadministering with the leaf extract from Hedera helix L, commonly known as ivy. Ivy extract has anti-inflammatory, antibacterial, antifungal, and antihelminthic properties. In the present study, we investigated its potential antiviral properties against influenza A/PR/8 (PR8 virus in a mouse model with suboptimal oseltamivir that mimics a poor clinical response to antiviral drug treatment. Suboptimal oseltamivir resulted in insufficient protection against PR8 infection. Oral administration of ivy extract with suboptimal oseltamivir increased the antiviral activity of oseltamivir. Ivy extract and its compounds, particularly hedrasaponin F, significantly reduced the cytopathic effect in PR8-infected A549 cells in the presence of oseltamivir. Compared with oseltamivir treatment alone, coadministration of the fraction of ivy extract that contained the highest proportion of hedrasaponin F with oseltamivir decreased pulmonary inflammation in PR8-infected mice. Inflammatory cytokines and chemokines, including tumor necrosis factor-alpha and chemokine (C-C motif ligand 2, were reduced by treatment with oseltamivir and the fraction of ivy extract. Analysis of inflammatory cell infiltration in the bronchial alveolar of PR8-infected mice revealed that CD11b+Ly6G+ and CD11b+Ly6Cint cells were recruited after virus infection; coadministration of the ivy extract fraction with oseltamivir reduced infiltration of these inflammatory cells. In a model of suboptimal oseltamivir treatment, coadministration of ivy extract fraction that includes hedrasaponin F increased protection against PR8

[Effects of different NO3--N/NH4+-N ratios on cucumber seedlings growth, nitrogen absorption and metabolism under suboptimal temperature and light intensity].

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Zhang, Xiao Cui; Liu, Yu Mei; Bai, Long Qiang; He, Chao Xing; Yu, Xian Chang; Li, Yan Su

2016-08-01

Cucumber (cv. Zhongnong 26) was used as material, the effects of NO 3 - -N/NH 4 + -N ratios on growth and physiological characteristics of cucumber seedlings under suboptimal temperature and light intensity (18 ℃/10 ℃,180 ± 20 μmol·m -2 ·s -1 ) were studied. Total nitrogen in the nutrient solution was equal and three NO 3 - -N/NH 4 + -N ratios, 26:2, 21:7 and 14:14, were applied as treatments. The results showed that cucumber treated by NO 3 - -N/NH 4 + -N=21:7 had the longest total root length, the biggest root volume and root surface area, and the maximum number of root tips. H + -ATPase activity and relative expression of genes encoding nitrate transporter (NRT) and ammonium transporter (AMT) in cucumber roots were increased significantly by the treatment of NO 3 - -N/NH 4 + -N=21:7. In addition, nitrate reductase (NR), glutamine synthetase (GS) and glutamate synthase (GOGAT) in cucumber leaves under the treatment of NO 3 - -N/NH 4 + -N=21:7 were higher. As a result, the nitrogen content and biomass of cucumber were significantly increased. Compared with the plants under the treatment of NO 3 - -N/NH 4 + -N=26:2 or 14:14, cucumber seedlings under the treatment of NO 3 - -N/NH 4 + -N=21:7 had the highest biomass and total dry mass (DM) which were increased by 14.0% and 19.3% respectively under suboptimal temperature and light intensity. In conclusion, under suboptimal environmental conditions, NO 3 - -N/NH 4 + -N ratio could be adjusted to increase nitrogen absorption and metabolism of cucumber and alleviate the de-trimental effects caused by suboptimal conditions and promoted the cucumber growth.

Pilot study on the additive effects of berberine and oral type 2 diabetes agents for patients with suboptimal glycemic control

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Di Pierro F

2012-07-01

Full Text Available Francesco Di Pierro,1 Nicola Villanova,2 Federica Agostini,2 Rebecca Marzocchi,2 Valentina Soverini,2 Giulio Marchesini21Scientific Department, Velleja Research, Milano, 2Diseases of Metabolism, S Orsola Malpighi Hospital, Bologna, ItalyBackground: Suboptimal glycemic control is a common situation in diabetes, regardless of the wide range of drugs available to reach glycemic targets. Basic research in diabetes is endeavoring to identify new actives working as insulin savers, use of which could delay the introduction of injectable insulin or reduce the insulin dose needed. Commonly available as a nutraceutical, berberine is a potential candidate.Methods and results: Because its low oral bioavailability can be overcome by P-glycoprotein inhibitors like herbal polyphenols, we have tested the nutraceutical combination of Berberis aristata extract and Silybum marianum extract (Berberol® in type 2 diabetes in terms of its additive effect when combined with a conventional oral regimen for patients with suboptimal glycemic control. After 90 days of treatment, the nutraceutical association had a positive effect on glycemic and lipid parameters, significantly reducing glycosylated hemoglobin, basal insulin, homeostatic model assessment of insulin resistance, total and low-density lipoprotein cholesterol, and triglycerides. A relevant effect was also observed in terms of liver function by measuring aspartate transaminase and alanine transaminase. The product had a good safety profile, with distinctive gastrointestinal side effects likely due to its acarbose-like action.Conclusion: Although further studies should be carried out to confirm our data, Berberol could be considered a good candidate as an adjunctive treatment option in diabetes, especially in patients with suboptimal glycemic control.Keywords: berberine, silymarin, glycosylated hemoglobin, diabetes

Prevalence of intrauterine adhesions after the application of hyaluronic acid gel after dilatation and curettage in women with at least one previous curettage: short-term outcomes of a multicenter, prospective randomized controlled trial.

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Hooker, Angelo B; de Leeuw, Robert; van de Ven, Peter M; Bakkum, Erica A; Thurkow, Andreas L; Vogel, Niels E A; van Vliet, Huib A A M; Bongers, Marlies Y; Emanuel, Mark H; Verdonkschot, Annelies E M; Brölmann, Hans A M; Huirne, Judith A F

2017-05-01

To examine whether intrauterine application of auto-crosslinked hyaluronic acid (ACP) gel, after dilatation and curettage (D&C), reduces the incidence of intrauterine adhesions (IUAs). Multicenter; women and assessors blinded prospective randomized trial. University and university-affiliated teaching hospitals. A total of 152 women with a miscarriage of Gynecological Endoscopy classifications systems of adhesions. Intrauterine application of ACP gel after D&C for miscarriage in women with at least one previous D&C seems to reduce the incidence and severity of IUAs but does not eliminate the process of adhesion formation completely. Future studies are needed to confirm our findings and to evaluate the effect of ACP gel on fertility and reproductive outcomes. NTR 3120. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Long-term Cognitive Implications of Intrauterine Hyperglycemia in Adolescent Offspring of Women With Type 1 Diabetes (the EPICOM Study)

DEFF Research Database (Denmark)

Bytoft, Birgitte; Knorr, Sine; Vlachova, Zuzana

2016-01-01

OBJECTIVE: Exposure to maternal diabetes in utero may have a negative impact on the developing brain. The objective was to examine long-term cognitive consequences of intrauterine hyperglycemia in adolescent offspring of women with type 1 diabetes and to ascertain a possible association with mate......OBJECTIVE: Exposure to maternal diabetes in utero may have a negative impact on the developing brain. The objective was to examine long-term cognitive consequences of intrauterine hyperglycemia in adolescent offspring of women with type 1 diabetes and to ascertain a possible association...... using Reynolds Intellectual Assessment Scales and classified into indices of composite intelligence, verbal and nonverbal intelligence, and composite memory. Frequencies of reading and writing problems and attendance to classes for children with learning difficulties were assessed. RESULTS: Offspring...... of women with type 1 diabetes scored lower in all normalized and standardized intelligence indices compared with controls: composite intelligence (95.7 vs. 100, P = 0.001), verbal intelligence (96.2 vs. 100, P = 0.004), nonverbal intelligence (96.4 vs. 100, P = 0.008), and composite memory (95.7 vs. 100, P...

Associations between intrauterine bacterial infection, reproductive tract inflammation, and reproductive performance in pasture-based dairy cows.

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de Boer, Melvin; Buddle, Bryce M; Heuer, Cord; Hussein, Hassan; Zheng, Tao; LeBlanc, Stephen J; McDougall, Scott

2015-06-01

Reproductive tract bacterial infections, particularly those caused by Escherichia coli and Trueperella pyogenes, can have a negative impact on reproductive performance. It has been hypothesized that the presence of E coli early postpartum may increase the risk of isolation of T pyogenes later postpartum. The objective of the present study was to examine associations between intrauterine bacterial infections with E coli and T pyogenes and any bacterial growth (irrespective of bacterial species), purulent vaginal discharge (PVD), cytologic evidence of endometritis (an increased proportion of polymorphonuclear cells [PMNs]), and reproductive performance. Dairy cows (n = 272) from six herds were examined at Days 0 (median, 2 days in milk), 21 and 42 postpartum. From each cow two intrauterine samples were collected via triple-guarded cytobrush at Days 0 and 21. The first cytobrush was used for bacteriologic culture. Escherichia coli and T pyogenes were isolated by culture, and E coli isolates were assigned to one of four phylogenetic groups using a two-step triplex polymerase chain reaction. In addition, T pyogenes was confirmed by polymerase chain reaction. The second cytobrush was used to prepare a cytology slide. Nucleated cells (n = 200) were categorized as epithelial cells, PMNs, or macrophages. Cows were also assessed for body condition score, PVD score, the presence of a CL, and pregnancy. Statistical analysis was performed using multivariable models. There was no association between the presence of E coli at Day 0 and probability of isolation of T pyogenes 3 weeks later; however, E coli positive cows at Day 0 were more likely to be diagnosed with E coli at Day 21 (relative risk [RR] = 2.0, P bacterial growth at Day 21, irrespective of species, were less likely to conceive within 3 weeks after the start of the seasonal breeding program (RR = 0.8; P = 0.05). Interestingly, cows with 25% PMNs or greater at Day 0 had shorter time to pregnancy (hazard ratio = 1.32; P

Levonorgestrel intrauterine system: Current role in management of heavy menstrual bleeding

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Navneet Magon

2013-01-01

Full Text Available A review of literature was conducted to report on the effectiveness of levonorgestrel intrauterine system (LNG-IUS in women with heavy menstrual bleeding (HMB. The relevant data were obtained by computerized searches of PubMed up to December 2012 and other references available with the authors. Information was obtained from references listed. Studies and case reports were excluded if they did not specifically provide information about LNG-IUS usage in women with HMB. After perusal, each relevant publication was summarized and appraised in terms of whether it contained information relevant to the stated objective. Available data shows that LNG-IUS therapy is effective and safe, providing significant reduction of menstrual bleeding in patients with HMB. LNG-IUS is a good strategy to reduce the number of hysterectomies in women with HMB.

Performance of the postwash total motile sperm count as a predictor of pregnancy at the time of intrauterine insemination: a meta-analysis

NARCIS (Netherlands)

van Weert, Janne-Meije; Repping, Sjoerd; van Voorhis, Bradley J.; van der Veen, Fulco; Bossuyt, Patrick M. M.; Mol, Ben W. J.

2004-01-01

Objective: To assess the performance and clinical value of the postwash total motile sperm count (postwash TMC) as a test to predict intrauterine insemination (IUI) outcome. Design: Meta-analysis of diagnostic tests. Setting: Tertiary fertility center. Patient(s): Patients undergoing IUI.

Is blood pressure increased 19 years after intrauterine growth restriction and preterm birth? A prospective follow-up study in the Netherlands

NARCIS (Netherlands)

Keijzer-Veen, M.G.; Finken, M.J.J.; Nauta, J.; Dekker, F.W.; Hille, E.T.M.; Frölich, M.; Wit, J.M.; Heijden, A.J. van der

2005-01-01

Objective. To determine whether intrauterine growth restriction (IUGR) is a predisposing factor for high blood pressure (BP) in 19-year-olds who were born (very) preterm. Methods. A prospective follow-up study was conducted at age 19 in individuals who born preterm in the Netherlands in 1983.

Intrauterine Growth Restriction Programs the Hypothalamus of Adult Male Rats: Integrated Analysis of Proteomic and Metabolomic Data.

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Pedroso, Amanda P; Souza, Adriana P; Dornellas, Ana P S; Oyama, Lila M; Nascimento, Cláudia M O; Santos, Gianni M S; Rosa, José C; Bertolla, Ricardo P; Klawitter, Jelena; Christians, Uwe; Tashima, Alexandre K; Ribeiro, Eliane B

2017-04-07

Programming of hypothalamic functions regulating energy homeostasis may play a role in intrauterine growth restriction (IUGR)-induced adulthood obesity. The present study investigated the effects of IUGR on the hypothalamus proteome and metabolome of adult rats submitted to 50% protein-energy restriction throughout pregnancy. Proteomic and metabolomic analyzes were performed by data independent acquisition mass spectrometry and multiple reaction monitoring, respectively. At age 4 months, the restricted rats showed elevated adiposity, increased leptin and signs of insulin resistance. 1356 proteins were identified and 348 quantified while 127 metabolites were quantified. The restricted hypothalamus showed down-regulation of 36 proteins and 5 metabolites and up-regulation of 21 proteins and 9 metabolites. Integrated pathway analysis of the proteomics and metabolomics data indicated impairment of hypothalamic glucose metabolism, increased flux through the hexosamine pathway, deregulation of TCA cycle and the respiratory chain, and alterations in glutathione metabolism. The data suggest IUGR modulation of energy metabolism and redox homeostasis in the hypothalamus of male adult rats. The present results indicated deleterious consequences of IUGR on hypothalamic pathways involved in pivotal physiological functions. These results provide guidance for future mechanistic studies assessing the role of intrauterine malnutrition in the development of metabolic diseases later in life.

Coxsackie Virus A16 Infection of Placenta with Massive Perivillous Fibrin Deposition Leading to Intrauterine Fetal Demise at 36 Weeks Gestation.

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Yu, Weiming; Tellier, Raymond; Wright, James R

2015-01-01

Massive perivillous fibrin deposition (MPFD) is an uncommon placental disorder, associated with significant fetal morbidity, mortality, and recurrence; its etiology is unknown. We describe a 31-year-old mother, diagnosed with Coxsackievirus infection and hand-foot-and-mouth disease at 35 weeks gestation. Ultrasound at 35 weeks revealed a normal fetus and placenta. One week later, the mother experienced decreased fetal movement and ultrasound demonstrated intrauterine demise. The autopsy showed mild, acute pericarditis and hypoxic-ischemic encephalopathy. Placenta examination showed MPFD involving 80% of the parenchyma. Molecular viral analysis and serotyping showed Coxsackie A16 virus. The mother had an uneventful pregnancy 15 months later. Coxsackievirus infections in pregnant mothers are often asymptomatic. Transplacental Coxsackievirus infection is very rare but is associated with spontaneous abortion, intrauterine demise, or serious neonatal morbidity. Mild, nonspecific histologic changes have been reported in the placenta. To our knowledge, this is the first report of MPFD associated with Coxsackievirus infection.

Intrauterine hematomas in the second and third trimesters associated with adverse pregnancy outcomes: a retrospective study.

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Ji, Wanqing; Li, Weidong; Mei, Shanshan; He, Ping

2017-09-01

To carry out a retrospective study of the clinical features of patients with intrauterine hematoma in the second and third trimesters, and discuss the risk factors for poor pregnancy outcomes. A total of 398 patients who underwent routine examination in our hospital from January 2011 to December 2015 were classified into normal pregnancy (NP) group (N = 265) and adverse pregnancy (AP) group (N = 133), according to their pregnancy outcomes. Maternal clinical demographics, gestational age, location of hematoma, volume of hematoma, and accompanying contraction and vaginal bleeding were recorded. The average age of pregnant women in the NP and AP groups was 28.25 ± 4.06 and 29.5 ± 5.06 years, respectively (p = 0.007). Gestational age at first detection of hematoma was 15.11 ± 5.13 weeks in the NP group compared with 21.22 ± 8.25 weeks in the AP group (p hematoma (54.1%) and palpable contractions (62.8%) was significantly higher than in the NP group (25.7% and 12.1%, respectively; p hematoma and incidence of vaginal bleeding were found. Intrauterine hematoma in the second and third trimesters is a sign of pathological pregnancy, resulting in adverse outcomes. Maternal age, gestational age at first diagnosis, location of hematoma and accompanying contraction are risk factors for poor pregnancy outcomes.

Work-Recreation Balance, Health-Promoting Lifestyles and Suboptimal Health Status in Southern China: A Cross-Sectional Study

OpenAIRE

Wu, Shengwei; Xuan, Zhengzheng; Li, Fei; Xiao, Wei; Fu, Xiuqiong; Jiang, Pingping; Chen, Jieyu; Xiang, Lei; Liu, Yanyan; Nie, Xiaoli; Luo, Ren; Sun, Xiaomin; Kwan, Hiuyee; Zhao, Xiaoshan

2016-01-01

Suboptimal health status (SHS)—an intermediate state between health and illness—refers to functional somatic symptoms that are medically undiagnosed. Although SHS has become a great challenge for global public health, very little about its etiology and mechanisms are known. Work-recreation balance is a part of work−life balance, and is related to stress which greatly influences health status. We therefore carried out a cross-sectional investigation between 2012 and 2013 within a clustered sam...

Differences in the association between sickness absence and long-term sub-optimal health by occupational position: a 14-year follow-up in the GAZEL cohort.

Science.gov (United States)

Ferrie, Jane E; Kivimäki, Mika; Westerlund, Hugo; Head, Jenny; Melchior, Maria; Singh-Manoux, Archana; Zins, Marie; Goldberg, Marcel; Alexanderson, Kristina; Vahtera, Jussi

2011-10-01

Although sickness absence is a strong predictor of health, whether this association varies by occupational position has rarely been examined. The aim of this study was to investigate overall and diagnosis-specific sickness absence as a predictor of future long-term sub-optimal health by occupational position. This was a prospective occupational cohort study of 15 320 employees (73% men) aged 37-51. Sickness absences (1990-1992), included in 13 diagnostic categories, were examined by occupational position in relation to self-rated health measured annually during 1993-2006. 60% of employees in higher occupational positions and 22% in lower positions had no sickness absence. Conversely, 9.5% of employees in higher positions and 40% in lower positions had over 30 sick-leave days. Repeated-measures logistic regression analyses adjusted for age, sex and chronic disease showed employees with over 30 days absence, compared to those with no absence, had approximately double the risk of sub-optimal health over the 14-year follow-up in all occupational positions. 1-30 days sick-leave was associated with greater odds of sub-optimal health in the high (OR 1.48; 95% CI 1.27 to 1.72) and intermediate (1.29; 1.15 to 1.45) but not lower occupational positions (1.06; 0.82 to 1.38). Differences by occupational position in the association between sickness absence in 13 specific diagnostic categories and sub-optimal health over the ensuing 14 years were limited to stronger associations observed with cancer and mental disorders in the higher occupational positions. The association between sickness absence of more than 30 days over 3 years and future long-term self-rated health appears to differ little by occupational position.

Cleavage events and sperm dynamics in chick intrauterine embryos.

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Hyung Chul Lee

Full Text Available This study was undertaken to elucidate detailed event of early embryogenesis in chicken embryos using a noninvasive egg retrieval technique before oviposition. White Leghorn intrauterine eggs were retrieved from 95 cyclic hens aged up to 54-56 weeks and morphogenetic observation was made under both bright field and fluorescent image in a time course manner. Differing from mammals, asymmetric cleavage to yield preblastodermal cells was observed throughout early embryogenesis. The first two divisions occurred synchronously and four polarized preblastodermal cells resulted after cruciform cleavage. Then, asynchronous cleavage continued in a radial manner and overall cell size in the initial cleavage region was smaller than that in the distal area. Numerous sperms were visible, regardless of zygotic nuclei formation. Condensed sperm heads were present mainly in the perivitelline space and cytoplasm, and rarely in the yolk region, while decondensed sperm heads were only visible in the yolk. In conclusion, apparent differences in sperm dynamics and early cleavage events compared with mammalian embryos were detected in chick embryo development, which demonstrated polarized cleavage with penetrating supernumerary sperm into multiple regions.

Expression of Myostatin in Intrauterine Growth Restriction and Preeclampsia Complicated Pregnancies and Alterations to Cytokine Production by First-Trimester Placental Explants Following Myostatin Treatment.

Science.gov (United States)

Peiris, Hassendrini N; Georgiou, Harry; Lappas, Martha; Kaitu'u-Lino, Tu'uhevaha; Salomón, Carlos; Vaswani, Kanchan; Rice, Gregory E; Mitchell, Murray D

2015-10-01

Preeclampsia (PE) and intrauterine growth restriction (IUGR) are major obstetric health problems. Higher levels of T-helper (Th) 1 (proinflammatory) cytokines have been observed in pregnancies complicated with PE and IUGR; this is in contrast to the predominant Th2 (anti-inflammatory) cytokine environment found in uncomplicated pregnancies. Myostatin is best known as a negative regulator of muscle development and reportedly has a role in fat deposition, glucose metabolism, and cytokine modulation (outside the placenta). Myostatin concentrations in plasma and protein expression in placental tissue are significantly higher in women with PE. Expression of myostatin in IUGR and PE-IUGR and the effect of this protein on the cytokine production from the placenta is unknown. In the current study, significant differences were identified in the expression of myostatin in pregnancies complicated with IUGR, PE, and PE with IUGR. Furthermore, cytokine production by first-trimester placental tissues was altered following myostatin treatment. © The Author(s) 2015.

Foreign body granuloma in the anterior abdominal wall mimicking an acute appendicular lump and induced by a translocated copper-T intrauterine contraceptive device: a case report

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Ansari Maulana Mohammed

2009-04-01

Full Text Available Abstract Introduction Intrauterine contraceptive devices may at times perforate and migrate to adjacent organs. Such uterine perforation usually passes unnoticed with development of potentially serious complications. Case presentation A 25-year-old woman of North Indian origin presented with an acute tender lump in the right iliac fossa. The lump was initially thought to be an appendicular lump and treated conservatively. Resolution of the lump was incomplete. On exploratory laparotomy, a hard suspicious mass was found in the anterior abdominal wall of the right iliac fossa. Wide excision and bisection of the mass revealed a copper-T embedded inside. Examination of the uterus did not show any evidence of perforation. The next day, the patient gave a history of past copper-T Intrauterine contraceptive device insertion. Conclusions Copper-T insertion is one of the simplest contraceptive methods but its neglect with inadequate follow-up may lead to uterine perforation and extra-uterine migration. Regular self-examination for the "threads" supplemented with abdominal X-ray and/or ultrasound in the follow-up may detect copper-T migration early. To the best of our knowledge, this is the first report of intrauterine contraceptive device migration to the anterior abdominal wall of the right iliac fossa.

Cabin Environment Physics Risk Model

Science.gov (United States)

Mattenberger, Christopher J.; Mathias, Donovan Leigh

2014-01-01

This paper presents a Cabin Environment Physics Risk (CEPR) model that predicts the time for an initial failure of Environmental Control and Life Support System (ECLSS) functionality to propagate into a hazardous environment and trigger a loss-of-crew (LOC) event. This physics-of failure model allows a probabilistic risk assessment of a crewed spacecraft to account for the cabin environment, which can serve as a buffer to protect the crew during an abort from orbit and ultimately enable a safe return. The results of the CEPR model replace the assumption that failure of the crew critical ECLSS functionality causes LOC instantly, and provide a more accurate representation of the spacecraft's risk posture. The instant-LOC assumption is shown to be excessively conservative and, moreover, can impact the relative risk drivers identified for the spacecraft. This, in turn, could lead the design team to allocate mass for equipment to reduce overly conservative risk estimates in a suboptimal configuration, which inherently increases the overall risk to the crew. For example, available mass could be poorly used to add redundant ECLSS components that have a negligible benefit but appear to make the vehicle safer due to poor assumptions about the propagation time of ECLSS failures.

Intrauterine Linear Echogenicities in the Gravid Uterus: What Radiologists Should Know.

Science.gov (United States)

Jensen, Kyle K; Oh, Karen Y; Kennedy, Anne M; Sohaey, Roya

2018-01-01

Intrauterine linear echogenicity (ILE) is a common ultrasonographic finding in the gravid uterus and has variable causes and variable maternal and fetal outcomes. Correctly categorizing ILE during pregnancy is crucial for guiding surveillance and advanced imaging strategies. Common causes of ILE include membranes in multiple gestations, uterine synechiae with amniotic sheets, and uterine duplication anomalies. Less common causes include circumvallate placenta, chorioamniotic separation, and hemorrhage between membranes. Amniotic band syndrome is a rare but important diagnosis to consider, as it causes severe fetal defects. Imaging findings enable body stalk anomaly, a lethal defect, to be distinguished from amniotic bands, which although destructive are not necessarily lethal. This review describes the key imaging findings used to differentiate the various types of ILE in pregnancy, thus enabling accurate diagnosis and appropriate patient counseling. Online supplemental material is available for this article. © RSNA, 2018.

A survey of four years intrauterine insemination at Shariati Hospital

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Aghahosseini M

1998-08-01

Full Text Available Intrauterine insemination (IUI has been practiced since the late 1800's primarily for idiopathic infertility, and in men with deficient semen parameters. The procedure is done by placing washed sperm in uterus a few hours before ovulation. The records of 427 couples receiving IUI for treatment of infertility at Shariati hospital in 1370-74 were reviewed retrospectively. These patients had IUI in 574 cycles. Eighty patients became pregnant and delivery rate was 14% per cycle. Pregnancy rate is impressive when ovulation induction is combined with insemination timed just before ovulation. The success rate in Shariati hospital is comparable to other infertility centers in the world and cost of a cycle of IUI with HMG superovulation is approximately one third the cost of IVF-ET or GIFT cycle and avoids invasive oocyte retrieval and extracorporeal fertilization. So we suggest that women with refractory infertility without anatomic distortion of pelvis can have at least 3-6 cycles of IUI before IVF or GIFT.

Neonatal cardiovascular system adaptation in babies with intrauterine growth retardation

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I. N. Petrova

2016-01-01

Full Text Available Objective: to reveal the adaptive features of the cardiovascular system in newborn infants with intrauterine growth retardation (IUGR on the basis of a clinical instrumental study.Subjects and methods. A study group included 100 newborn infants with IUGR; a control group consisted of 40 babies with normal anthropometric measurements at birth. Medical history and clinical data and electrocardiographic and echocardiographic findings were analyzed.Results. All the examinees with IUGR had manifestations of cardiovascular system dysadaptation. There was a high rate of electrocardiographic changes, such as cardiac arrhythmias; low voltage; systolic overload of the right heart and left ventricle; signs of ventricular hypertrophy; and transient myocardial ischemia. The specific features of cardiac hemodynamics were decreased sizes of the left ventricle, lower parameters of its systolic function, and longer functioning of fetal communications.Conclusion. IUGR is associated with the development of cardiovascular system dysadaptation syndrome, which is due to prior perinatal hypoxia. The findings necessitate a follow-up of children by involving a cardiologist.

Application of the tuning algorithm with the least squares approximation to the suboptimal control algorithm for integrating objects

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Kuzishchin, V. F.; Merzlikina, E. I.; Van Va, Hoang

2017-11-01

The problem of PID and PI-algorithms tuning by means of the approximation by the least square method of the frequency response of a linear algorithm to the sub-optimal algorithm is considered. The advantage of the method is that the parameter values are obtained through one cycle of calculation. Recommendations how to choose the parameters of the least square method taking into consideration the plant dynamics are given. The parameters mentioned are the time constant of the filter, the approximation frequency range and the correction coefficient for the time delay parameter. The problem is considered for integrating plants for some practical cases (the level control system in a boiler drum). The transfer function of the suboptimal algorithm is determined relating to the disturbance that acts in the point of the control impact input, it is typical for thermal plants. In the recommendations it is taken into consideration that the overregulation for the transient process when the setpoint is changed is also limited. In order to compare the results the systems under consideration are also calculated by the classical method with the limited frequency oscillation index. The results given in the paper can be used by specialists dealing with tuning systems with the integrating plants.

Efficacy of Intrauterine Bakri Balloon Tamponade in Cesarean Section for Placenta Previa Patients.

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Hee Young Cho

Full Text Available The aims of this study were to analyze the predictive factors for the use of intrauterine balloon insertion and to evaluate the efficacy and factors affecting failure of uterine tamponade with a Bakri balloon during cesarean section for abnormal placentation.We reviewed the medical records of 137 patients who underwent elective cesarean section for placenta previa between July 2009 and March 2014. Cesarean section and Bakri balloon insertion were performed by a single qualified surgeon. The Bakri balloon was applied when blood loss during cesarean delivery exceeded 1,000 mL.Sixty-four patients (46.7% required uterine balloon tamponade during cesarean section due to postpartum bleeding from the lower uterine segment, of whom 50 (78.1% had placenta previa totalis. The overall success rate was 75% (48/64 for placenta previa patients. Previous cesarean section history, anterior placenta, peripartum platelet count, and disseminated intravascular coagulopathy all significantly differed according to balloon success or failure (all p<0.05. The drainage amount over 1 hour was 500 mL (20-1200 mL in the balloon failure group and 60 mL (5-500 mL in the balloon success group (p<0.01.Intrauterine tamponade with a Bakri balloon is an adequate adjunct management for postpartum hemorrhage following cesarean section for placenta previa to preserve the uterus. This method is simple to apply, non-invasive, and inexpensive. However, possible factors related to failure of Bakri balloon tamponade for placenta previa patients such as prior cesarean section history, anterior placentation, thrombocytopenia, presence of DIC at the time of catheter insertion, and catheter drainage volume more than 500 mL within 1 hour of catheter placement should be recognized, and the next-line management should be prepared in advance.

A low-volume polyethylene glycol solution was associated with an increased suboptimal bowel preparation rate but had similar recommendations for an early repeat colonoscopy, procedure times, and adenoma detection rates.

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Sam C Hankins

Full Text Available Low-volume polyethylene glycol (PEG bowel preparations are better tolerated by patients than high-volume preparations and may achieve similar preparation quality. However, there is little data comparing their effects on a recommendation for an early repeat colonoscopy (because of a suboptimal preparation, procedure times, adenoma detection rate (ADR, and advanced adenoma detection rate (AADR.This is a retrospective cohort study of outpatient colonoscopies performed during a one-year period at a single academic medical center in which low-volume MoviPrep® (n = 1841 or high-volume Colyte® (n = 1337 was used. All preparations were split-dosed. Appropriate covariates were included in regression models assessing suboptimal preparation quality (fair, poor, or inadequate, procedure times, recommendation for an early repeat colonoscopy, ADR, and AADR.MoviPrep® was associated with an increase in having a suboptimal bowel preparation (OR 1.36; 95% CI: 1.06-1.76, but it was not associated with differences in insertion (p = 0.43, withdrawal (p = 0.22, or total procedure times (p = 0.10. The adjusted percentage with a suboptimal preparation was 11.7% for patients using MoviPrep® and 8.8% for patients using Colyte®. MoviPrep® was not associated with a significant difference in overall ADR (OR 0.93; 95% CI: 0.78-1.11, AADR (OR 1.18; 95% CI: 0.87-1.62, or recommendation for early repeat colonoscopy (OR 1.16; 95% CI: 0.72-1.88.MoviPrep® was associated with a small absolute increase in having a suboptimal preparation, but did not affect recommendations for an early repeat colonoscopy, procedure times, or adenoma detection rates. Mechanisms to reduce financial barriers limiting low-volume preparations should be considered because of their favorable tolerability profile.

Do pigeons (Columba livia) use information about the absence of food appropriately? A further look into suboptimal choice.

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Fortes, Inês; Machado, Armando; Vasconcelos, Marco

2017-11-01

In the natural environment, when an animal encounters a stimulus that signals the absence of food-a 'bad-news' stimulus-it will most likely redirect its search to another patch or prey. Because the animal does not pay the opportunity cost of waiting in the presence of a bad-news stimulus, the properties of the stimulus (e.g., its duration and probability) may have little impact in the evolution of the decision processes deployed in these circumstances. Hence, in the laboratory, when animals are forced to experience a bad-news stimulus they seem to ignore its duration, even though they pay the cost of waiting. Under certain circumstances, this insensitivity to the opportunity cost can lead to suboptimal preferences, such as a preference for an option yielding a low rather than a high rate of reinforcement. In 2 experiments, we tested Vasconcelos, Monteiro, and Kacelnik's (2015) assumption that, if given the opportunity, animals will escape the bad-news stimulus. To predict when an escape response should occur, we incorporated ideas from the prey choice model into Vasconcelos et al. (2015) model and made 2 novel predictions. Namely, both longer intertrial intervals and longer durations of signals predicting food or no food should lead to higher proportions of escape responses. The results of 2 experiments with pigeons supported these predictions. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Arterio-venous flow between monochorionic twins determined during intra-uterine transfusion. Nonlinear decay of adult red blood cells

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Gemert, Martin J C van; Wijngaard, Jeroen P H M van den [Laser Centre and Department of Obstetrics, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Pasman, Suzanne A; Vandenbussche, Frank P H A [Division of Fetal Medicine, Department of Obstetrics, Leiden University Medical Centre, Leiden (Netherlands); Lopriore, Enrico [Division of Neonatology, Department of Pediatrics, Leiden University Medical Centre, Leiden (Netherlands)], E-mail: m.j.vangemert@amc.uva.nl

2008-07-07

Recently, we derived equations relating the flow of adult red blood cells through a placental arterio-venous anastomosis with intra-uterine and post-natal measured adult hemoglobin concentrations. In this letter, we re-derived the equations, now including a more realistic nonlinear decay of adult red blood cells, and re-evaluated the measurement accuracy of the arterio-venous flow and the lifetime of the red blood cells. (letter to the editor)

[Associations between health-promoting lifestyle and suboptimal health status in Guangdong: a cross sectional study].

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Chen, Jie-Yu; Yang, Le-Bin; Jiang, Ping-Ping; Sun, Xiao-Min; Yu, Ke-Qiang; Li, Fei; Wu, Sheng-Wei; Ji, Yan-Zhao; Zhao, Xiao-Shan; Luo, Ren

2016-04-01

To investigate associations between health-promoting lifestyle and suboptimal health status (SHS) in the population of Guangdong province. A cross-sectional survey was conducted in a clustered sample of 24 159 individuals aged 12-80 years from 2012 to 2013. Health-promoting lifestyle was assessed via the Health-Promoting Lifestyle Profile (HPLP-II), and SHS was evaluated using the medical examination report and Sub-health Measurement Scale V1.0 (SHMS V1.0). Of the 24159 participants, subjects with SHS (46.0%) and disease status (35.2%) accounted for a much higher percentage than healthy subjects (18.8%). Regression analyses revealed a significant association between health status and healthy lifestyle (PUnhealthy lifestyle was an important risk factor for SHS and disease, especially the former. Compared with the participants with a healthy lifestyle (minimal exposure), after demographic adjustment, subjects with a 'poor' lifestyle (maximal exposure) were at a 43 times higher risk of developing SHS (OR: 42.825, 95% CI: 30.567-59.997), those with a general lifestyle were at a 21 times higher risk of SHS (OR: 21.072, 95%CI: 17.258-25.729), and those with a suboptimal lifestyle had a 4 times higher risk (OR: 4.085, 95%CI: 3.352-4.979). In the general population, the major risk factors for SHS included poor stress management, poor self-actualization, inactive exercise and poor interpersonal relationship. s Unhealthy lifestyles are significantly related to an increased risk of SHS. Intervention of unhealthy lifestyles, controlling the risk factors of SHS, and rigorous management of the time window of SHS are necessary to promote the heath status.

Adaptive suboptimal second-order sliding mode control for microgrids

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Incremona, Gian Paolo; Cucuzzella, Michele; Ferrara, Antonella

2016-09-01

This paper deals with the design of adaptive suboptimal second-order sliding mode (ASSOSM) control laws for grid-connected microgrids. Due to the presence of the inverter, of unpredicted load changes, of switching among different renewable energy sources, and of electrical parameters variations, the microgrid model is usually affected by uncertain terms which are bounded, but with unknown upper bounds. To theoretically frame the control problem, the class of second-order systems in Brunovsky canonical form, characterised by the presence of matched uncertain terms with unknown bounds, is first considered. Four adaptive strategies are designed, analysed and compared to select the most effective ones to be applied to the microgrid case study. In the first two strategies, the control amplitude is continuously adjusted, so as to arrive at dominating the effect of the uncertainty on the controlled system. When a suitable control amplitude is attained, the origin of the state space of the auxiliary system becomes attractive. In the other two strategies, a suitable blend between two components, one mainly working during the reaching phase, the other being the predominant one in a vicinity of the sliding manifold, is generated, so as to reduce the control amplitude in steady state. The microgrid system in a grid-connected operation mode, controlled via the selected ASSOSM control strategies, exhibits appreciable stability properties, as proved theoretically and shown in simulation.

INTRAUTERINE GROWTH RETARDATION AND ITS IMPACT ON CHILDREN'S HEALTH IN LATER LIFE. THE POSSIBILITY OF NUTRITIONAL SUPPORT

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T. V. Belousova

2015-01-01

Full Text Available The sources of development, homeostasis and metabolism habits, long-term effects on the health of infants delivered with intrauterine growth retardation are considered. Principals and aspects of nutrition choice for these particular infants as well as some controversial aspects on this topic are discussed. Research data represents nutrition of newborns and up to 3 months infants, including those with the IGR and moderate postnatal inanition, fed with goat milk based formula, containing pre- and probiotics. 

Reduced telomere length is not associated with early signs of vascular aging in young men born after intrauterine growth restriction: a paradox?

DEFF Research Database (Denmark)

Laganovic, M.; Bendix, L.; Rubelj, I.

2014-01-01

Objective: The mechanisms that increase cardiovascular risk in individuals born small for gestational age (SGA) are not well understood. Telomere shortening has been suggested to be a predictor of disease onset. Our aim was to determine whether impaired intrauterine growth is associated with earl...... of cardiovascular risk in SGA participants. Follow-up of this cohort will clarify hypothesis and validate telomere dynamics as indicators of future health risks.......Objective: The mechanisms that increase cardiovascular risk in individuals born small for gestational age (SGA) are not well understood. Telomere shortening has been suggested to be a predictor of disease onset. Our aim was to determine whether impaired intrauterine growth is associated with early......IMT, and a trend to increased SBP and heart rate in comparison to the AGA group. Interestingly, SGA men exhibited a 42% longer LTL than the AGA group. LTL was inversely associated with age, BMI, BP and birth parameters. In multiple regression analysis, BMI was the key determinant of SBP and cIMT. Conclusion: Young...

High-response intrauterine insemination cycles converted to low-cost in vitro fertilization

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Aletebi F

2011-05-01

Full Text Available Fatma AletebiAssisted Reproduction Unit, Department of Obstetrics and Gynaecology, King Abdulaziz University, Soliman Fakeeh Hospital, Jeddah, Saudi ArabiaBackground: There is a trend to cancel intrauterine insemination (IUI in women with a high response. The aim of this study was to evaluate the efficacy of low-cost in vitro fertilization (IVF in high-response IUI cycles in comparison with conventional IVF.Methods and materials: A total of 46 women were included in the study. Group A (study group included 23 women with hyper-response to IUI cycles who were converted to IVF. They received oral letrozole 2.5 mg twice daily from days 3–7 of the menstrual cycle, along with 75 International Units (IU of recombinant follicle-stimulating hormone on days 3 and 8. Group B (control group underwent conventional IVF, and received downregulation with a gonadotrophin-releasing hormone agonist followed by stimulation with recombinant follicle-stimulating hormone 150–300 IU/day. Ovulation was triggered by 10,000 IU of human chorionic gonadotrophin, followed by IVF and embryo transfer. The primary outcome measure analyzed was pregnancy rates in both groups.Results: The study group received a significantly lower (P = 0.001 total dose of follicle-stimulating hormone and had significantly (P = 0.002 decreased levels of terminal estradiol. Although the pregnancy rate (30.43% in the study group versus 39.13% in the conventional group per stimulated cycle was higher in the conventional IVF group, the miscarriage rate (study group 4.34% versus conventional group 13.04% was also higher, and hence the take-home baby rate (study group 26.08% versus conventional group 30.43% was more or less similar in both the groups.Conclusion: IVF can be offered to women having a high response to IUI cycles with good pregnancy rates and at low cost compared with use of a conventional protocol, and therefore can be considered more patient-friendly in selected cases.Keywords: low

Placental gene expression of the placental growth factor (PlGF) in intrauterine growth restriction.

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Joó, József Gábor; Rigó, János; Börzsönyi, Balázs; Demendi, Csaba; Kornya, László

2017-06-01

We analyzed changes in gene expression of placental growth factor (PIGF) in human placental samples obtained postpartum from pregnancies with IUGR. During a twelve-month study period representing the calendar year of 2012 placental samples from 101 pregnancies with IUGR and from 140 normal pregnancies were obtained for analysis of a potential difference in PIGF gene expression. There was no significant difference in gene activity of the PIGF gene between the IUGR versus normal pregnancy groups (Ln2 α : 0.92; p intrauterine growth restriction PIGF expression does show a significant decrease indicating its potential role in the profound defect in angiogenesis in these cases.

Short- and long-term reproductive effects of prenatal and lactational growth restriction caused by maternal diabetes in male rats

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Amorim Elaine MP

2011-12-01

Full Text Available Abstract Background A suboptimal intrauterine environment may have a detrimental effect on gonadal development and thereby increases the risk for reproductive disorders and infertility in adult life. Here, we used uncontrolled maternal diabetes as a model to provoke pre- and perinatal growth restriction and evaluate the sexual development of rat male offspring. Methods Maternal diabetes was induced in the dams through administration of a single i.v. dose of 40 mg/kg streptozotocin, 7 days before mating. Female rats presenting glycemic levels above 200 mg/dL after the induction were selected for the experiment. The male offspring was analyzed at different phases of sexual development, i.e., peripuberty, postpuberty and adulthood. Results Body weight and blood glucose levels of pups, on the third postnatal day, were lower in the offspring of diabetic dams compared to controls. Maternal diabetes also provoked delayed testicular descent and preputial separation. In the offspring of diabetic dams the weight of reproductive organs at 40, 60 and 90 days-old was lower, as well as sperm reserves and sperm transit time through the epididymis. However the plasma testosterone levels were not different among experimental groups. Conclusions It is difficult to isolate the effects directly from diabetes and those from IUGR. Although the exposure to hyperglycemic environment during prenatal life and lactation delayed the onset of puberty in male rats, the IUGR, in the studied model, did not influenced the structural organization of the male gonads of the offspring at any point during sexual development. However the decrease in sperm reserves in epididymal cauda and the acceleration in sperm transit time in this portion of epididymis may lead to an impairment of sperm quality and fertility potential in these animals. Additional studies are needed in attempt to investigate the fertility of animals with intrauterine growth restriction by maternal diabetes and

Effects of feeding frequency on apparent energy and nutrient digestibility/availability of channel catfish, Ictalurus punctatus, reared at optimal and suboptimal temperatures

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This study examined the effects of feeding frequency (daily versus every other day [EOD]) on nutrient digestibility/availability of channel catfish, Ictalurus punctatus, reared at optimal (30 C) and suboptimal (24 C) temperatures. A 28% protein practical diet was used as the test diet, and chromic o...

Doppler changes as the earliest parameter in fetal surveillance to detect fetal compromise in intrauterine growth-restricted fetuses

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Bansal Saloni

2016-01-01

Full Text Available Introduction. It is estimated that 3-10% of infants are growth restricted. Growth disturbances may have long-term issues. Doppler allows insight into the fetal response to intrauterine stress. Objective. The aim of this study was to detect fetal compromise in intrauterine growth-restricted (IUGR fetuses by means of biophysical profile (BPP vis-а-vis Doppler velocimetry studies of the fetal umbilical artery, and to find out which of the two is a better and earlier predictor of fetal compromise. Methods. A prospective study was conducted on a total of 50 singleton pregnancies with IUGR between 28 and 42 weeks of gestation. Study patients were managed expectantly with nonstress testing and amniotic fluid assessment, BPP and Doppler velocimetry studies of the fetal umbilical artery. Results. Fetal outcome was poor in 5/50 (10% of the fetuses, defined as presence of all of the following: poor Apgar test score, neonatal intensive care unit stay, necrotizing enterocolitis, and low birth weight. Of the four with abnormal BPP, 50% had poor fetal outcomes. Out of 46 with normal BPP, 6.5% had poor fetal outcomes. Conclusion. Inference drawn from the study is that the Doppler technology provides us the opportunity for repetitive noninvasive hemodynamic monitoring in IUGR pregnancies.

Provider and lay perspectives on intra-uterine contraception: a global review.

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Daniele, Marina A S; Cleland, John; Benova, Lenka; Ali, Moazzam

2017-09-26

Intra-uterine contraception (IUC) involves the use of an intra-uterine device (IUD), a highly effective, long-acting, reversible contraceptive method. Historically, the popularity of IUC has waxed and waned across different world regions, due to policy choices and shifts in public opinion. However, despite its advantages and cost-effectiveness for programmes, IUC's contribution to contraceptive prevalence is currently negligible in many countries. This paper presents the results of a systematic review of the global literature on provider and lay perspectives on IUC. It aims to shed light on the reasons for low use of IUC and reflect on potential opportunities for the method's promotion. A systematic search of the literature was conducted in four peer-reviewed journals and four electronic databases (MEDLINE, EMBASE, POPLINE, and Global Health). Screening resulted in the inclusion of 68 relevant publications. Most included studies were conducted in areas where IUD use is moderate or low. Findings are similar across these areas. Many providers have low or uneven levels of knowledge on IUC and limited training. Many wrongly believe that IUC entails serious side effects such as pelvic inflammatory disease (PID), and are reluctant to provide it to entire eligible categories, such as HIV-positive women. There is particular resistance to providing IUC to teenagers and nulliparae. Provider opinions may be more favourable towards the hormonal IUD. Some health-care providers choose IUC for themselves. Many members of the public have low knowledge and unfounded misconceptions about IUC, such as the fear of infertility. Some are concerned about the insertion and removal processes, and about its effect on menses. However, users of IUC are generally satisfied and report a number of benefits. Peers and providers exert a strong influence on women's attitudes. Both providers and lay people have inaccurate knowledge and misconceptions about IUC, which contribute to explaining its low

LEVONORGESTREL-RELEASING INTRAUTERINE SYSTEM AS AN ALTERNATIVE THERAPY IN ABNORMAL UTERINE BLEEDING

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Kunjamma Roy

2017-05-01

Full Text Available BACKGROUND Abnormal uterine bleeding is one of the most frequent reasons for gynaecological consultation, occurring in approximately 30% of women of reproductive age. Menorrhagia by definition implies a menstrual blood loss equal to or greater than 80 mL. Many women seek consultation for bleeding episodes of less than this amount because of the stress associated with it. Most frequently used medications are combinations of prostaglandin synthetase inhibitors and antifibrinolytic drugs, nonsteroidal antiinflammatory drugs, oral progesterone like Norethisterone or medroxyprogesterone acetate and combined oral contraceptives. The usual treatment for women with menorrhagia not desiring further pregnancies and those not responding to medical managements is either hysterectomy or endometrial ablation. Endometrial ablation less commonly performed due to low success rate. Levonorgestrel intrauterine system (LNG-IUS is a new modality in the treatment of AUB. The objective of this study is to evaluate the use of Levonorgestrel intrauterine system as a treatment for women with menorrhagia. MATERIALS AND METHODS This is a prospective interventional comparative study conducted on women with abnormal uterine bleeding. The duration of study was from March 2012 to October 2013. The respondents include those outpatients attending Gynaecology Department of Government Medical College, Kottayam with menorrhagia. The samples size was 50 of which 25 were in experimental groups and remaining 25 in control group. Experimental group were given LNG IUS for menorrhagia and the remaining 25 patients were given oral progestins for heavy menstrual bleeding. In order to make a comparison of the impact of the two different kinds of interventions, the Hb level as well as the amount of blood loss were systematically estimated at frequent intervals. Accordingly, these measurements were carried for the said both groups at the commencement of research study and thereafter at an

Conception rate and litter size in multiparous sows after intrauterine insemination using frozen-thawed boar semen in a commercial swine herd in Thailand.

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Chanapiwat, Panida; Olanratmanee, Em-On; Kaeoket, Kampon; Tummaruk, Padet

2014-10-01

The aim of the present study was to determine the conception rate and litter size in sows after fixed time intra-uterine insemination using frozen-thawed boar semen in a commercial swine herd in Thailand. Sixty-nine Landrace multiparous sows were randomly allocated into two groups, including control (n=36) and treatment (n=33). The control sows were inseminated with extended fresh semen (3 × 10(9) motile sperm/dose, 100 ml) at 24, 36 and 48 hr after the onset of estrus. The treatment sows were inseminated with frozen-thawed semen (2 × 10(9) motile sperm/dose, 20 ml) at 24 and 36 hr after induction of ovulation by human chorionic gonadotropin. All inseminations were carried out by using an intra-uterine insemination technique. The time of ovulation was determined by using transrectal real-time B-mode ultrasonography. The conception rate, farrowing rate, total number of piglets born/litter (TB) and number of piglets born alive/litter (BA) were evaluated. The sows inseminated with extended fresh semen yield a higher TB (10.8 versus 9.0 piglets/l, P=0.015) and tended to have a higher conception rate (88.9% versus 75.8%, P=0.150) than sows inseminated with frozen-thawed semen. In conclusion, insemination using frozen-thawed boar semen can be practiced with convinced fertility under field conditions by fixed-time intrauterine insemination with 2 × 10(9) sperm/ dose of 20 ml at 24 and 36 hr after the onset of estrus.

Conception Rate and Litter Size in Multiparous Sows after Intrauterine Insemination Using Frozen-Thawed Boar Semen in a Commercial Swine Herd in Thailand

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CHANAPIWAT, Panida; OLANRATMANEE, Em-On; KAEOKET, Kampon; TUMMARUK, Padet

2014-01-01

ABSTRACT The aim of the present study was to determine the conception rate and litter size in sows after fixed time intra-uterine insemination using frozen-thawed boar semen in a commercial swine herd in Thailand. Sixty-nine Landrace multiparous sows were randomly allocated into two groups, including control (n=36) and treatment (n=33). The control sows were inseminated with extended fresh semen (3 × 109 motile sperm/dose, 100 ml) at 24, 36 and 48 hr after the onset of estrus. The treatment sows were inseminated with frozen-thawed semen (2 × 109 motile sperm/dose, 20 ml) at 24 and 36 hr after induction of ovulation by human chorionic gonadotropin. All inseminations were carried out by using an intra-uterine insemination technique. The time of ovulation was determined by using transrectal real-time B-mode ultrasonography. The conception rate, farrowing rate, total number of piglets born/litter (TB) and number of piglets born alive/litter (BA) were evaluated. The sows inseminated with extended fresh semen yield a higher TB (10.8 versus 9.0 piglets/l, P=0.015) and tended to have a higher conception rate (88.9% versus 75.8%, P=0.150) than sows inseminated with frozen-thawed semen. In conclusion, insemination using frozen-thawed boar semen can be practiced with convinced fertility under field conditions by fixed-time intrauterine insemination with 2 × 109 sperm/ dose of 20 ml at 24 and 36 hr after the onset of estrus. PMID:24954517

Long-term neurodevelopmental outcome after intrauterine transfusion for hemolytic disease of the fetus/newborn: the LOTUS study.

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Lindenburg, Irene T; Smits-Wintjens, Vivianne E; van Klink, Jeanine M; Verduin, Esther; van Kamp, Inge L; Walther, Frans J; Schonewille, Henk; Doxiadis, Ilias I; Kanhai, Humphrey H; van Lith, Jan M; van Zwet, Erik W; Oepkes, Dick; Brand, Anneke; Lopriore, Enrico

2012-02-01

To determine the incidence and risk factors for neurodevelopmental impairment (NDI) in children with hemolytic disease of the fetus/newborn treated with intrauterine transfusion (IUT). Neurodevelopmental outcome in children at least 2 years of age was assessed using standardized tests, including the Bayley Scales of Infant Development, the Wechsler Preschool and Primary Scale of Intelligence, and the Wechsler Intelligence Scale for Children, according to the children's age. Primary outcome was the incidence of neurodevelopmental impairment defined as at least one of the following: cerebral palsy, severe developmental delay, bilateral deafness, and/or blindness. A total of 291 children were evaluated at a median age of 8.2 years (range, 2-17 years). Cerebral palsy was detected in 6 (2.1%) children, severe developmental delay in 9 (3.1%) children, and bilateral deafness in 3 (1.0%) children. The overall incidence of neurodevelopmental impairment was 4.8% (14/291). In a multivariate regression analysis including only preoperative risk factors, severe hydrops was independently associated with neurodevelopmental impairment (odds ratio, 11.2; 95% confidence interval, 1.7-92.7). Incidence of neurodevelopmental impairment in children treated with intrauterine transfusion for fetal alloimmune anemia is low (4.8%). Prevention of fetal hydrops, the strongest preoperative predictor for impaired neurodevelopment, by timely detection, referral and treatment may improve long-term outcome. Copyright © 2012 Mosby, Inc. All rights reserved.

Predictive value of sperm morphology and progressively motile sperm count for pregnancy outcomes in intrauterine insemination.

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Lemmens, Louise; Kos, Snjezana; Beijer, Cornelis; Brinkman, Jacoline W; van der Horst, Frans A L; van den Hoven, Leonie; Kieslinger, Dorit C; van Trooyen-van Vrouwerff, Netty J; Wolthuis, Albert; Hendriks, Jan C M; Wetzels, Alex M M

2016-06-01

To investigate the value of sperm parameters to predict an ongoing pregnancy outcome in couples treated with intrauterine insemination (IUI), during a methodologically stable period of time. Retrospective, observational study with logistic regression analyses. University hospital. A total of 1,166 couples visiting the fertility laboratory for their first IUI episode, including 4,251 IUI cycles. None. Sperm morphology, total progressively motile sperm count (TPMSC), and number of inseminated progressively motile spermatozoa (NIPMS); odds ratios (ORs) of the sperm parameters after the first IUI cycle and the first finished IUI episode; discriminatory accuracy of the multivariable model. None of the sperm parameters was of predictive value for pregnancy after the first IUI cycle. In the first finished IUI episode, a positive relationship was found for ≤4% of morphologically normal spermatozoa (OR 1.39) and a moderate NIPMS (5-10 million; OR 1.73). Low NIPMS showed a negative relation (≤1 million; OR 0.42). The TPMSC had no predictive value. The multivariable model (i.e., sperm morphology, NIPMS, female age, male age, and the number of cycles in the episode) had a moderate discriminatory accuracy (area under the curve 0.73). Intrauterine insemination is especially relevant for couples with moderate male factor infertility (sperm morphology ≤4%, NIPMS 5-10 million). In the multivariable model, however, the predictive power of these sperm parameters is rather low. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

(Ir)rational choices of humans, rhesus macaques, and capuchin monkeys in dynamic stochastic environments.

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Watzek, Julia; Brosnan, Sarah F

2018-05-28

Human and animal decision-making is known to violate rational expectations in a variety of contexts. Previous models suggest that statistical structures of real-world environments can favor such seemingly irrational behavior, but this has not been tested empirically. We tested 16 capuchin monkeys, seven rhesus monkeys, and 30 humans in a computerized experiment that implemented such stochastic environments. Subjects chose from among up to three options of different value that disappeared and became available again with different probabilities. All species overwhelmingly chose transitively (A > B > C) in the control condition, where doing so maximized overall gain. Most subjects also adhered to transitivity in the test condition, where it was suboptimal, but ultimately led to negligible losses compared to the optimal, non-transitive strategy. We used a modelling approach to show that differences in temporal discounting may account for this pattern of choices on a proximate level. Specifically, when short- and long-term goals are valued similarly, near-optimal decision rules can map onto rational choice principles. Such cognitive shortcuts have been argued to have evolved to preserve mental resources without sacrificing good decision-making, and here we provide evidence that these heuristics can provide almost identical outcomes even in situations in which they lead to suboptimal choices. Copyright © 2018 Elsevier B.V. All rights reserved.

Combined Laparoscopic and Cystoscopic Retrieval of Forgotten Translocated Intrauterine Contraceptive Device

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Taiwo O Alabi

2018-01-01

Full Text Available The most commonly used long-term reversible female contraception is intrauterine contraceptive device (IUCD. Its use is however associated with documented complications. Uterine perforation, though rare, is arguably the most surgically important of all these complications. We report a case of a 48-year-old para 4+0 (4 alive woman who had IUCD insertion 17 years earlier and had forgotten she had the device having had two children thereafter. The IUCD was subsequently translocated through the dome of the bladder into the peritoneal cavity with calculus formation around the tail and thread of the IUCD in the urinary bladder causing recurrent urinary tract infection. This “Collar Stud” effect made either cystoscopic or laparoscopic retrieval alone unsuccessful necessitating a combined approach. This case report highlights the need for a combined laparoscopic and cystoscopic approach in the retrieval of the unusual presentation of translocated IUCD.

Invading of intrauterine contraceptive device into the sigmoid colon through uterine perforation caused by a blunt trauma.

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Davoodabadi, Abdoulhossein; Mohammadzadeh, Mahdi; Amirbeigi, Mahdieh; Jazayeri, Hoda

2015-01-01

Intrauterine contraceptive device (IUCD) is relatively safe but still with some serious risks. Uterus perforation is rare and would be fatal. A case of Cu-7 IUCD invading into the sigmoid colon through uterine perforation caused by a pelvic blunt trauma was presented. Our case showed that uterus perforation by an IUCD could induce utero-sigmoid fistula which is likely to be missed. Imaging is required when the patients with IUCD present abdominal pain, particularly with a history of trauma.

Suboptimal vitamin D status in a population-based study of Asian children: prevalence and relation to allergic diseases and atopy.

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Tsung-Chieh Yao

Full Text Available BACKGROUND: New evidence shows high prevalence of vitamin D deficiency in many countries and some studies suggest a possible link between vitamin D status and allergic diseases. The objectives of this study were to determine the prevalence of suboptimal vitamin D status in a population sample of Asian children and to investigate the relationship of vitamin D status with allergic diseases and atopy. METHODS: Children aged 5-18 years (N = 1315 in the Prediction of Allergies in Taiwanese CHildren (PATCH study were evaluated using questionnaires, anthropometric measurements, and serum levels of 25-hydroxyvitamin D [25(OHD] and total and specific immunoglobulin E (IgE. RESULTS: The mean concentration of serum 25(OHD was 20.4 ng/mL (SD: 7.1 ng/mL. Vitamin D deficiency (defined as serum 25(OHD0.05. CONCLUSIONS: Low serum 25(OHD levels are remarkably common in this population sample of Asian children, suggesting that millions of children living in Taiwan may have suboptimal levels of vitamin D, which should be a matter of public health concern. Our results provides epidemiological evidence against the association of vitamin D status with various allergic diseases and atopy in Asian children.

Chromosomal aberrations as etiological factors of intrauterine growth retardation

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Petrović Bojana

2008-01-01

Full Text Available Background/Aim. Intrauterine growth retardation (IUGR is a pathological condition of pregnancy characterised by birth weight below the 10th centile. A number of fetal, placental and maternal causes can lead to IUGR; although, in most cases no specific causes can be identified. The aim of this study was to determine the part of chromosomal abnormalities in IUGR etiology. Methods. Fetal blood karyotype taken by cordocentesis from 168 fetuses with diagnosed IUGR was analyzed. Results. Chromosomal rearrangements both numerical and structural were detected in 14 cases (12.2%. Two cases were triploid. Patau syndrome, Edwards syndrome and Down syndrome were found in two cases each. There was one case of trisomy 7 (47, XY, +7 and one case of trisomy 16 (47, XX, +16; one translocation, 46, XY, t (2; 14(q23; q32 and a deletion 46, XYdel (12 (p12 as well as two cases of sex chromosomes abnormalities, 45, X (Turner syndrome and 47, XYY. Conclusion. These findings suggest that a consistent number of symmetrical IUGR cases (about 12% can be associated with chromosomal rearrangements. Chromosomal aberrations that cause IUGR are heterogeneous, aberration of autosomes, mostly autosomal trisomies, being the most common.

Lack of supportive leadership behavior predicts suboptimal self-rated health independent of job strain after 10 years of follow-up: findings from the population-based MONICA/KORA study.

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Schmidt, Burkhard; Herr, Raphael M; Jarczok, Marc N; Baumert, Jens; Lukaschek, Karoline; Emeny, Rebecca T; Ladwig, Karl-Heinz

2018-04-23

Emerging cross-sectional research has identified lack of supportive leadership behavior (SLB) as a risk factor for workforce health. However, prospective evidence is hitherto lacking. SLB denotes support in difficult situations, recognition and feedback on work tasks. This study aims to determine the effect of SLB on suboptimal self-rated health (SRH) after 10 years considering potential moderators such as ages, sex, occupation and job strain. The sample included 884 employed participants drawn from the population-based prospective MONICA/KORA Study. SLB, SRH, as well as job strain were assessed by questionnaire. Logistic regressions estimated odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for the effect of SLB at baseline on suboptimal SRH at follow-up. Analyses were adjusted for age, gender, lifestyle (alcohol, smoking, physical activity), socioeconomic status as well as for SRH and job strain at baseline. Lack of SLB was associated with suboptimal SRH at baseline [OR 2.00, (95% CI 1.19-3.46)] and at follow-up [OR 2.33, (95% CI 1.40-3.89)]. Additional adjustment for job strain did not substantially alter this association [OR 2.06, (95% CI 1.20-3.52)]. However, interactions between SLB and job strain as well as gender became evident, indicating moderating influences on the association between SLB and SRH. Lack of supportive leadership was associated with suboptimal SRH at 10 years' follow-up in men, even if SRH at baseline and other risk factors were taken into account. This effect is likely to be moderated by job strain.

Patient satisfaction for levonorgestrel intrauterine system and norethisterone for treatment of dysfunctional uterine bleeding

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Naqaish, T.; Rizvi, F.; Khan, A.; Afzal, M.

2012-01-01

Background: Dysfunctional uterine bleeding (DUB) is a common problem with complex management. It can be quite harrowing for the physicians as in most instances they are unable to pinpoint the cause of abnormal bleeding even after a thorough history and physical examination. Aim was to compare patient satisfaction for Levonorgestrel intra uterine system (LNG-IUS) and Norethisterone for the treatment of Dysfunctional Uterine Bleeding (DUB). It is Descriptive case series conducted in Department Obstetrics and Gynaecology, Shifa International Hospital, Islamabad from September, 2011 to September, 2012. Methods: One hundred and nineteen (119) female patients of reproductive age Group with DUB were selected by consecutive sampling. Informed written consent was obtained. A structural patient satisfaction questionnaire (PSQ) was used to collect information regarding age of patients, type of method used for treatment of DUB (Levonorgestrel or Norethisterone), treatment outcome in terms of patient satisfaction scale, and decrease in bleeding after 6 months. Results: The mean age of the patients was 41.03+-4.415 year ranging from 28-60 years. The mean parity of women in the study was 3.22+-1.188 with a range of 1-7. The satisfaction level was significantly (p<0.05) greater (90% versus 20%) in Group A (levonorgesterol-releasing intrauterine system) as compared with Group B (Norethisterone). The blood loss was significantly (p<0.05) decreased in Group A (98%) as compared with Group B (80%). The preference of continuing the method as well as recommendation to a friend was significantly greater in Group A as compared to Group B. Conclusion: The levonorgesterol-releasing intrauterine system (LNG-IUS) is a better choice as compared to Norethisterone, for treatment of DUB with 90% patients highly satisfied. (author)

Bone marrow concentrate promotes bone regeneration with a suboptimal-dose of rhBMP-2.

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Egashira, Kazuhiro; Sumita, Yoshinori; Zhong, Weijian; I, Takashi; Ohba, Seigo; Nagai, Kazuhiro; Asahina, Izumi

2018-01-01

Bone marrow concentrate (BMC), which is enriched in mononuclear cells (MNCs) and platelets, has recently attracted the attention of clinicians as a new optional means for bone engineering. We previously reported that the osteoinductive effect of bone morphogenetic protein-2 (BMP-2) could be enhanced synergistically by co-transplantation of peripheral blood (PB)-derived platelet-rich plasma (PRP). This study aims to investigate whether BMC can effectively promote bone formation induced by low-dose BMP-2, thereby reducing the undesirable side-effects of BMP-2, compared to PRP. Human BMC was obtained from bone marrow aspirates using an automated blood separator. The BMC was then seeded onto β-TCP granules pre-adsorbed with a suboptimal-dose (minimum concentration to induce bone formation at 2 weeks in mice) of recombinant human (rh) BMP-2. These specimens were transplanted subcutaneously to the dorsal skin of immunodeficient-mice and the induction of ectopic bone formation was assessed 2 and 4 weeks post-transplantation. Transplantations of five other groups [PB, PRP, platelet-poor plasma (PPP), bone marrow aspirate (BM), and BM-PPP] were employed as experimental controls. Then, to clarify the effects on vertical bone augmentation, specimens from the six groups were transplanted for on-lay placement on the craniums of mice. The results indicated that BMC, which contained an approximately 2.5-fold increase in the number of MNCs compared to PRP, could accelerate ectopic bone formation until 2 weeks post-transplantation. On the cranium, the BMC group promoted bone augmentation with a suboptimal-dose of rhBMP-2 compared to other groups. Particularly in the BMC specimens harvested at 4 weeks, we observed newly formed bone surrounding the TCP granules at sites far from the calvarial bone. In conclusion, the addition of BMC could reduce the amount of rhBMP-2 by one-half via its synergistic effect on early-phase osteoinduction. We propose here that BMC transplantation

Pain from copper intrauterine device insertion: randomized trial of prophylactic ibuprofen.

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Hubacher, David; Reyes, Veronica; Lillo, Sonia; Zepeda, Ana; Chen, Pai-Lien; Croxatto, Horacio

2006-11-01

This study was undertaken to determine whether 400 mg of prophylactic ibuprofen can alleviate pain from insertion of an intrauterine device (IUD) and to measure level of pain with improved techniques. We conducted a randomized, double-blind, placebo-controlled trial of 2019 first-time IUD users: 1008 women received placebo and 1011 women received 400 mg of ibuprofen. Participants took the single tablet at least 45 minutes before IUD insertion. Immediately after insertion, participants recorded level of pain by using a 10-cm visual analog scale, with the value of 10 meaning "worst imaginable pain." Median level of pain was 1.0 for both ibuprofen and placebo participants; rank test statistics confirmed no difference. Some subgroups of women experienced higher pain (eg, nulliparous women), but ibuprofen still had no important impact on level of pain. Even among first-time users, pain from IUD insertion is generally low. Prophylactic ibuprofen as used in this protocol does not reduce IUD insertion pain.

Refeeding syndrome in very-low-birth-weight intrauterine growth-restricted neonates.

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Ross, J R; Finch, C; Ebeling, M; Taylor, S N

2013-09-01

Determine the incidence of refeeding syndrome, defined by the presence of hypophosphatemia in very-low-birth-weight (VLBW) infants with intrauterine growth restriction (IUGR) compared with those without IUGR. In this retrospective cohort study, VLBW infants admitted over a 10-year period (271 IUGR and 1982 non-IUGR) were evaluated for specific electrolyte abnormalities in the first postnatal week. IUGR infants were significantly more likely to have hypophosphatemia (41% vs 8.9%, relative risk (95% confidence interval: 7.25 (5.45, 9.65)) and severe hypophosphatemia (11.4% vs 1%, 12.06 (6.82, 21.33)) in the first postnatal week. The incidence of hypophosphatemia was significantly associated with the presence of maternal preeclampsia in all VLBW infants (odds ratio (OR): 2.58 (1.96, 3.40)) when controlling for birth weight and gestational age. Refeeding syndrome occurs in VLBW infants with IUGR and born to mothers with preeclampsia. Close monitoring of electrolytes, especially phosphorus, is warranted in this population.

Intrauterine growth restriction programs an accelerated age-related increase in cardiovascular risk in male offspring

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Dasinger, John Henry; Intapad, Suttira; Backstrom, Miles A.; Carter, Anthony J.

2016-01-01

Placental insufficiency programs an increase in blood pressure associated with a twofold increase in serum testosterone in male growth-restricted offspring at 4 mo of age. Population studies indicate that the inverse relationship between birth weight and blood pressure is amplified with age. Thus, we tested the hypothesis that intrauterine growth restriction programs an age-related increase in blood pressure in male offspring. Growth-restricted offspring retained a significantly higher blood pressure at 12 but not at 18 mo of age compared with age-matched controls. Blood pressure was significantly increased in control offspring at 18 mo of age relative to control counterparts at 12 mo; however, blood pressure was not increased in growth-restricted at 18 mo relative to growth-restricted counterparts at 12 mo. Serum testosterone levels were not elevated in growth-restricted offspring relative to control at 12 mo of age. Thus, male growth-restricted offspring no longer exhibited a positive association between blood pressure and testosterone at 12 mo of age. Unlike hypertension in male growth-restricted offspring at 4 mo of age, inhibition of the renin-angiotensin system with enalapril (250 mg/l for 2 wk) did not abolish the difference in blood pressure in growth-restricted offspring relative to control counterparts at 12 mo of age. Therefore, these data suggest that intrauterine growth restriction programs an accelerated age-related increase in blood pressure in growth-restricted offspring. Furthermore, this study suggests that the etiology of increased blood pressure in male growth-restricted offspring at 12 mo of age differs from that at 4 mo of age. PMID:27147668

Intrauterine Morcellator Devices: The Icon of Hysteroscopic Future or Merely a Marketing Image? A Systematic Review Regarding Safety, Efficacy, Advantages, and Contraindications.

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Noventa, Marco; Ancona, Emanuele; Quaranta, Michela; Vitagliano, Amerigo; Cosmi, Erich; D'Antona, Donato; Gizzo, Salvatore

2015-10-01

The aim of this study was to analyze all available evidence regarding the use of intrauterine morcellator (IUM), for treatment of the most prevalent intrauterine benign lesions, compared to both traditional resectoscopy and conventional outpatient operative hysteroscopy in terms of safety, efficacy, contraindications, perioperative complications, operating time, and estimated learning curve. We reported data regarding a total of 1185 patients. Concerning polypectomy and myomectomy procedures, IUM systems demonstrated a better outcome in terms of operative time and fluid deficit compared to standard surgical procedures. Complication rates in the inpatient setting were as follows: 0.02% for IUM using Truclear 8.0 (Smith & Nephew Endoscopy, Andover, Massachusetts) and 0.4% for resectoscopic hysteroscopy. No complications were described using Versapoint devices. Office polipectomy reported a total complication rate of 10.1% using Versapoint device (Ethicon Women's Health and Urology, Somerville, New Jersey) and 1.6% using Truclear 5.0 (Smith & Nephew Endoscopy). The reported recurrence rate after polypectomy was 9.8% using Versapoint device and 2.6% using Truclear 8.0. Finally, the reported intraoperative and postoperative complication rate of IUM related to removal of placental remnants using Truclear 8.0 and MyoSure (Hologic, Marlborough, Massachusetts) was 12.3%. The available evidence allows us to consider IUM devices as a safe, effective, and cost-effective tool for the removal of intrauterine lesions such as polyps, myomas (type 0 and type 1), and placental remnants. Evidence regarding Truclear 5.0 suggests that it may represent the best choice for office hysteroscopy. Further studies are needed to confirm the available evidence and to validate the long-term safety of IUM in procedures for which current data are not exhaustive (placental remnants removal). © The Author(s) 2015.