Latency Period to Delivery Among Growth Restricted Fetuses with Abnormal Umbilical Artery Dopplers

The article presents the predictors of placental dysfunction on the early stage of pregnancy. The objective: the search for prognostic markers and criteria for the occurrence of placental insufficiency in the early stages of the gestational process to optimize the pregnancy and labor with improved perinatal outcomes. Patients and methods. To solve this goal in the period from 2013 to 2015 were conducted a comprehensive survey of 334 pregnant women, which depending on the peculiarities of pregnancy and childbirth were divided into groups. The control group consisted of 236 pregnant women with uncomplicated gestational period, no morphological signs of placental dysfunction. The study group included 98 patients with a complicated pregnancy who had revealed violations of the fetal-placental relations, which was confirmed by morphological examination of the placenta in the postpartum period. Results. It was found that pregnant women with placental insufficiency in the first trimester of pregnancy have higher levels of interleukin-1B (IL-1v) and interleukin-3 (IL-3) in comparison with physiological pregnancy, as well as there is a direct significant correlation between IL-1v and pulsative index (PI) in the spiral (r=0.84) and uterine artery (r=0.77), and the inverse correlation between the level of IL-3 and PI in the terminal branches of the umbilical artery (r=-0.69). Verified an inverse relationship between the concentration of endothelin-1, the level of vascular endothelial growth factor (r=-0.87) and placental growth factor (r=-0.73), and also a direct link between the content of endothelin-1 and PI in spiral arteries (r=0.89), uterine artery (r=0.83) and the terminal branches of the umbilical artery (r=0.79). Conclusion. Thus, it is proven that early predictors of placental dysfunction can be considered the concentration of endothelin-1, vascular endothelial growth factor, placental growth factor, interleukin-1, interleukin-3, and the indices of pulsative index. Key words: placental dysfunction, predictors, endothelin-1, vascular endothelial growth factor, placental growth factor, interleukin, pulsative index.

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Tuberculosis, an old disease, still present in Romania

Farmacist ro ◽

10.26416/farm.192.1.2020.2898 ◽

2020 ◽

Vol 1 (1) ◽

pp. 6-13

Author(s):

Cristina Daniela Marineci ◽

Cristina Elena Zbârcea ◽

Simona Negreş

Keyword(s):

Miliary Tuberculosis ◽

Latency Period ◽

Latent Tuberculosis ◽

Multidrug Resistant ◽

Active Immunization ◽

Sputum Smear ◽

The European Union ◽

Directly Observed Therapy ◽

Resistant Tuberculosis ◽

Antituberculosis Treatment

Tuberculosis is a chronic infection, most often affecting the lungs, which usually manifests after a latency period from primary infection with Mycobacterium tuberculosis. Symptoms are generally nonspecific, with fever, cough, weight loss and malaise. The diagnosis is based on microscopic examination of sputum smear and rapid diagnostic molecular tests, which are increasingly used today. Genotypic tests for establishing the strain involved and phenotypic antibiograms for early detection of drug resistance should guide the initiation of treatment but are still expensive. Treatment of active tuberculosis is done with combination of antimycobacterial drugs, administered for at least 6 months. The antituberculosis treatment has several purposes: to cure the patient, to reduce the risk of recurrence, to prevent the installation of chemo-resistance, to prevent complications and to reduce mortality, as well as to limit the spread of the infection. Drug combinations are used to prevent the development of resistance. The administration is long-lasting in order to achieve the sterilization of foci that are difficult to access by medicines, ensuring healing and relapse prevention. Generally, standard pharmacological protocols are used. In order to increase the adherence to the treatment and its completion, often the anti-tuberculosis treatment is done under direct observation, in what is called directly observed therapy. Undesirable effects of anti-tuberculosis drugs should be detected early and managed appropriately. Recently, many cases of tuberculosis are resistant to the first-line drugs isoniazid and rifampicin (multidrug-resistant tuberculosis), or to these drugs, fluoroquinolones and at least one injectable antimycobacterial drugs (extensively drug-resistant tuberculosis). Especially the treatment of the latter is difficult to do, because there are not currently too many therapeutic options. That is why it is important to detect the resistance early and to establish the appropriate treatment. Treatment of latent tuberculosis usually involves the administration of isoniazid for 9 months. BCG vaccination is an active immunization method used in countries with high incidence of tuberculosis (Romania being the country of the European Union with the highest incidence of tuberculosis), protecting mainly against miliary tuberculosis, a spread form of tuberculosis, severe especially in children.

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CLINICAL AND ELECTROMYOGRAPHIC PREDICTION OF FACIAL NERVE NEUROPATHY IN CHILDREN

JOURNAL OF NEUROLOGY AND NEUROSURGICAL RESEARCH ◽

10.26739/2181-0982-2020-3-7 ◽

2020 ◽

Vol 3 (1) ◽

pp. 38-40

Author(s):

Nozima Asadova ◽

◽

Aziza Djurabekova ◽

Saodat Igamova

Keyword(s):

Facial Nerve ◽

Children And Adolescents ◽

Medical Literature ◽

Latency Period ◽

Pain Syndrome ◽

Literature Discussions ◽

Clinical Forms ◽

Diagnosis And Prognosis ◽

Neurological Features ◽

Blinking Reflex

In modern medical literature, discussions continue about neuropathies of the facial nerve in children,disease factors, clinical and neurological features, the severity of the course, the difficulties of diagnosis and prognosis of the disease. The work is devoted to the analysis of the neuropathy of the facial nerve in children and adolescents, depending on the clinical forms of the disease, using electroneurosympathetic indicators, the latency period, the blinking reflex and thenatureof the lesion of the facial nerve accompanied by pain syndrome

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USING DOPPLER TO ASSESS THE FETAL HEALTH FOR THE PREDICTION OF GESTATIONAL OUTCOME

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2014.4_5.1 ◽

2014 ◽

pp. 9-18

Author(s):

Thi Linh Giang Truong ◽

Vu Quoc Huy Nguyen

Keyword(s):

Middle Cerebral Artery ◽

Cerebral Artery ◽

Umbilical Artery ◽

Functional Method ◽

Invasive Technique ◽

Routine Practice ◽

Fetal Health ◽

Uterine Arteries ◽

Non Invasive ◽

Key Words Doppler

Background: Assessment of fetal health plays the most important role in prenatal care because of influence of the prediction of gestational outcome. One of the main aims of routine antenatal care is to identify the ‘ at risk ‘ fetus in order to apply clinical interventions which could results in reduced perinatal morbidity and mortality. Doppler ultrasound is a non invasive technique whereby the movement of blood is studied by detecting the change in frequence of reflected sound, Doppler blood flow velocity waves form of fetal side (umbilical artery, middle cerebral artery ...) and maternal side ( uterine arteries) are discussed and monograms for routine practice are presented. Recently this method is important tool for qualifying high risk pregnancies and help early forecasts the health of the babies and mothers disorder. Doppler sonography in obstetrics is a widely accepted functional method of examining the prediction of gestational outcome. Key words: Doppler, umbilical artery, middle cerebral artery, uterine arteries

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The role of sildenafil citrate in the treatment of fetal growth restriction: a randomized controlled trial

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20191929 ◽

2019 ◽

Vol 8 (5) ◽

pp. 1840

Author(s):

Ahmed Abdelshafy ◽

Khaled Ibrahim Abdullah ◽

Sherif Ashoush ◽

Heba E. Hosni

Keyword(s):

Middle Cerebral Artery ◽

Fetal Growth ◽

Cerebral Artery ◽

Fetal Growth Restriction ◽

Umbilical Artery ◽

Controlled Trial ◽

Maternity Hospital ◽

Growth Restriction ◽

Sildenafil Citrate ◽

Doppler Velocity

Background: This study was aimed to evaluate the effect of sildenafil citrate on Doppler velocity indices in patients with fetal growth restriction (FGR) associated with impaired placental circulation.Methods: A double-blinded, parallel group randomized clinical trial (clinicaltrials.gov NCT02590536) was conducted in Ain Shams Maternity Hospital, in the period between October 2015 and June 2017. Ninety pregnant women with documented intrauterine growth retardation at 24-37 weeks of gestation were randomized to either sildenafil citrate 25 mg orally every 8 hours or placebo visually-identical placebo tablets with the same regimen. The primary outcome of the study was the change in umbilical artery and fetal middle cerebral artery indices.Results: There was a significant improvement in umbilical and middle cerebral artery indices after sildenafil administration p<0.001. Present study observed that, sildenafil group, in comparison to placebo, has a significantly higher mean neonatal birth weight. 1783±241g vs 1570±455g (p<0.001). There was a significantly higher mean gestational age at delivery in women in sildenafil group 35.3±1.67 weeks, whereas it was lower in the placebo group 33.5±1.7 weeks. The side effects as headache, palpitation and facial flushing were significantly higher in sildenafil group compared to placebo group.Conclusions: The use sildenafil citrate in pregnancies with fetal growth restriction (FGR) improved the feto-placental Doppler indices (pulsatility index of umbilical artery and middle cerebral artery) and improved neonatal outcomes.

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