scholarly journals Preeclampsia link to gestational hypoxia

2019 ◽  
Vol 10 (3) ◽  
pp. 322-333 ◽  
Author(s):  
W. Tong ◽  
D. A. Giussani
Keyword(s):  
Gestational Hypertension ◽  
Treatment Options ◽  
Clinical Manifestations ◽  
Adverse Outcomes ◽  
Complex Disorders ◽  
Placental Dysfunction ◽  
Short And Long Term ◽  
Complicated Pregnancy ◽  
Maternal Hypoxia

AbstractComplications of pregnancy remain key drivers of morbidity and mortality, affecting the health of both the mother and her offspring in the short and long term. There is lack of detailed understanding of the pathways involved in the pathology and pathogenesis of compromised pregnancy, as well as a shortfall of effective prognostic, diagnostic and treatment options. In many complications of pregnancy, such as in preeclampsia, there is an increase in uteroplacental vascular resistance. However, the cause and effect relationship between placental dysfunction and adverse outcomes in the mother and her offspring remains uncertain. In this review, we aim to highlight the value of gestational hypoxia-induced complications of pregnancy in elucidating underlying molecular pathways and in assessing candidate therapeutic options for these complex disorders. Chronic maternal hypoxia not only mimics the placental pathology associated with obstetric syndromes like gestational hypertension at morphological, molecular and functional levels, but also recapitulates key symptoms that occur as maternal and fetal clinical manifestations of these pregnancy disorders. We propose that gestational hypoxia provides a useful model to study the inter-relationship between placental dysfunction and adverse outcomes in the mother and her offspring in a wide array of examples of complicated pregnancy, such as in preeclampsia.

scholarly journals Pregnancy Complications Can Foreshadow Future Disease—Long-Term Outcomes of a Complicated Pregnancy

Medicina ◽  
2021 ◽  
Vol 57 (12) ◽  
pp. 1320
Author(s):  
Anca Maria Panaitescu ◽  
Mihaela Roxana Popescu ◽  
Anca Marina Ciobanu ◽  
Nicolae Gica ◽  
Brindusa Ana Cimpoca-Raptis
Keyword(s):  
Pregnancy Complications ◽  
Gestational Hypertension ◽  
Stress Test ◽  
Clinical Manifestations ◽  
Long Term Outcomes ◽  
Age Related ◽  
Diet And Exercise ◽  
Unique Manner ◽  
Complicated Pregnancy

During gestation, the maternal body should increase its activity to fulfil the demands of the developing fetus as pregnancy progresses. Each maternal organ adapts in a unique manner and at a different time during pregnancy. In an organ or system that was already vulnerable before pregnancy, the burden of pregnancy can trigger overt clinical manifestations. After delivery, symptoms usually reside; however, in time, because of the age-related metabolic and pro-atherogenic changes, they reappear. Therefore, it is believed that pregnancy acts as a medical stress test for mothers. Pregnancy complications such as gestational hypertension, preeclampsia and gestational diabetes mellitus foreshadow cardiovascular disease and/or diabetes later in life. Affected women are encouraged to modify their lifestyle after birth by adjusting their diet and exercise habits. Blood pressure and plasmatic glucose level checking are recommended so that early therapeutic intervention can reduce long-term morbidity. Currently, the knowledge of the long-term consequences in women who have had pregnancy-related syndromes is still incomplete. A past obstetric history may, however, be useful in determining the risk of diseases later in life and allow timely intervention.

Considering a Potential Role of Linalool as a Mood Stabilizer for Bipolar Disorder

2020 ◽  
Vol 26 (40) ◽  
pp. 5128-5133
Author(s):  
Kate Levenberg ◽  
Wade Edris ◽  
Martha Levine ◽  
Daniel R. George
Keyword(s):  
Bipolar Disorder ◽  
Treatment Options ◽  
Mood Stabilizer ◽  
Well Being ◽  
Epidemiologic Studies ◽  
Treatment Regimens ◽  
Bipolar Spectrum Disorders ◽  
Short And Long Term

Epidemiologic studies suggest that the lifetime prevalence of bipolar spectrum disorders ranges from 2.8 to 6.5 percent of the population. To decrease morbidity and mortality associated with disease progression, pharmacologic intervention is indicated for the majority of these patients. While a number of effective treatment regimens exist, many conventional medications have significant side effect profiles that adversely impact patients’ short and long-term well-being. It is thus important to continue advancing and improving therapeutic options available to patients. This paper reviews the limitations of current treatments and examines the chemical compound Linalool, an alcohol found in many plant species, that may serve as an effective mood stabilizer. While relatively little is known about Linalool and bipolar disorder, the compound has been shown to have antiepileptic, anti-inflammatory, anxiolytic, anti-depressive, and neurotrophic effects, with mechanisms that are comparable to current bipolar disorder treatment options.

Glucocorticosteroids effects on brain development in the preterm infants: a role for microglia?

2021 ◽  
Vol 19 ◽  
Author(s):  
Zinni Manuela ◽  
Pansiot Julien ◽  
Elodie Billion ◽  
Baud Olivier ◽  
Mairesse Jérôme
Keyword(s):  
Brain Development ◽  
Preterm Infants ◽  
Adverse Outcomes ◽  
Mortality And Morbidity ◽  
Respiratory Problems ◽  
Neurodevelopmental Impairment ◽  
Short And Long Term ◽  
Abnormal Brain

: Prematurity, observed in 15 million births worldwide each year, is a clinical condition that is a major cause of neonatal mortality and morbidity in short and long term. Preterm infants are at high risk for developing respiratory problems, sepsis, and other morbidities leading to neurodevelopmental impairment and neurobehavioral disorders. Perinatal glucocorticosteroids have been widely used for the prevention and treatment of adverse outcomes linked to prematurity. However, despite their shortterm benefits due to their maturational properties, some clinical trials have shown an association between steroids exposure and abnormal brain development in infants born preterm. Neuroinflammation has emerged as a preeminent factor for brain injury in preterm infants, and the major role of microglia, the brain resident immune cells, has been recently highlighted. Considering the role of microglia in the modulation of brain development, the aim of this review is to summarize the effects of endogenous and exogenous glucocorticosteroids on brain development and discuss the possible role of microglia as a mediator of these effects.

Renal Protection in Critically Ill Patients

2019 ◽  
pp. 163-174
Author(s):  
Ryan W. Haines ◽  
John R. Prowle
Keyword(s):  
Chronic Kidney Disease ◽  
Intensive Care Unit ◽  
Kidney Injury ◽  
Adverse Outcomes ◽  
Renal Protection ◽  
High Quality ◽  
Hemodynamic Stability ◽  
Secondary Sources ◽  
Short And Long Term

Acute kidney injury complicates over 50% of critical care admissions and is associated with both increased short and long-term mortality and the development or acceleration of chronic kidney disease. While in certain settings, such as cardiac surgery, primary prevention of AKI is possible, in most cases AKI is present or evolving at intensive care unit admission and the main clinical focus is secondary prevention of further kidney injury. In the absence of evidence for specific AKI-targeted therapies, high quality supportive care to maximize hemodynamic stability and avoidance of secondary sources of kidney injury are the cornerstones of renal protection. Fluid overload is particularly associated with adverse outcomes in critical illness complicated by AKI. Continuous methods of renal replacement therapy may promote hemodynamic stability and have been associated with better longer term renal outcomes.

scholarly journals P451 Short-and long-term effectiveness of ustekinumab in patients with Crohn’s disease: real-world data from a German IBD cohort

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S405-S405
Author(s):  
A Kubesch ◽  
L Rueter ◽  
K Farrag ◽  
T Krause ◽  
K Stienecker ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Real World ◽  
Treatment Options ◽  
Real World Data ◽  
Free Response ◽  
Faecal Calprotectin ◽  
Short And Long Term

Abstract Background The IL-12/23 inhibitor ustekinumab (UST) opened up new treatment options for patients with Crohn’s disease (CD). Due to the recent approval, Real-World German data on long-term efficacy and safety are lacking. This study aimed to assess the clinical course of CD patients under UST therapy and to identify potential predictive markers. Methods Patients with CD receiving UST treatment in three hospitals and two outpatient centres were included and retrospectively analysed. Rates for short- and long-term remission and response were analysed with the help of clinical (Harvey–Bradshaw Index [HBI]) and biochemical (C-reactive protein [CRP], faecal calprotectin [fCal]) parameters for disease activity. Results Data from 180 patients were evaluated. One hundred six patients had a follow-up of at least 8 weeks and were included. 96.2% of the patients were pre-exposed to anti- TNFα agents and 34.4% to both anti-TNFα and anti-integrin. The median follow-up was 49.1 weeks (95% CI 42.03–56.25). At week 8, 51 patients (54.8%) showed response to UST, and 24 (24.7%) were in remission. At week 48, 39 (41.9%) responded to UST, and 20 patients (21.5%) were in remission. Steroid-free response and remission at week eight were achieved by 30.1%, and 19.3% of patients. At week 48, 26.9% showed steroid-free response to UST, and 15.1% of the initial patient population was in steroid-free remission. Clinical response at week 16 was independently associated with remission at week 48. Conclusion Our study confirms short- and long-term UST effectiveness and tolerability in a cohort of multi-treatment exposed patients.

Cardiac Surgery for Carcinoid Heart Disease: A Weapon Not to Be Misused

Cardiology ◽  
2016 ◽  
Vol 136 (4) ◽  
pp. 243-251 ◽  
Author(s):  
Maria Bonou ◽  
Chris J. Kapelios ◽  
Gregory Kaltsas ◽  
Konstantinos Perreas ◽  
Konstantinos Toutouzas ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Heart Disease ◽  
Treatment Options ◽  
Optimal Timing ◽  
Special Focus ◽  
Carcinoid Heart Disease ◽  
Term Survival ◽  
Patient Profile ◽  
Short And Long Term

Carcinoid heart disease (CHD) complicates approximately 25% of patients with a carcinoid tumor and carcinoid syndrome and leads to heart valve degeneration with mixed-stenotic and regurgitation pathology and consequent heart failure (HF) leading to significant morbidity and mortality. Cardiac surgery in symptomatic, severe CHD leads to significantly better functional capacity and prolonged survival when compared to medical treatment alone. Recent studies have shown improvement in postoperative outcomes of patients undergoing surgery for CHD over the last decades. The trend for early diagnosis and application of surgery prior to the manifestation of HF symptoms, which tended to develop during the previous years, does not seem justifiable based on the findings of recent studies. Therefore, the optimal timing of intervention in CHD and the type of valve that should preferably be used remain issues of controversy. This review comprehensively examines the existing literature on the treatment options for patients with CHD, with a special focus on short- and long-term survival after cardiac surgery, and discusses the selection of the exact patient profile and intervention timing that are more likely to optimize the benefit-to-risk ratio for surgical intervention.

scholarly journals PS118. Extent of COPD Is Associated with Short and Long-term Adverse Outcomes in Patients Undergoing Elective AAA Repair

2012 ◽  
Vol 55 (6) ◽  
pp. 57S
Author(s):  
David H. Stone ◽  
Philip P. Goodney ◽  
Andres Schanzer ◽  
Jeffrey Kalish ◽  
Jeffrey Indes ◽  
...  
Keyword(s):  
Adverse Outcomes ◽  
Short And Long Term

scholarly journals Recent Insights on Prevalence and Corelations of Hypoactive Delirium

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Vaios Peritogiannis ◽  
Maria Bolosi ◽  
Charalampos Lixouriotis ◽  
Dimitrios V. Rizos
Keyword(s):  
Adverse Outcomes ◽  
Future Research ◽  
Clinical Settings ◽  
Symptom Presentation ◽  
Treatment Interventions ◽  
Benzodiazepine Use ◽  
Short And Long Term ◽  
Hypoactive Delirium ◽  
Long Term Mortality

Delirium is a complex neuropsychiatric syndrome which is common in all medical settings. It often goes unrecognized due to difficulties in the detection of its hypoactive variant. This review aims to provide an up-to-date account on recent research on hypoactive delirium (HD). Thirty-eight studies, which were conducted in various clinical settings, including the Intensive Care Unit (ICU), were included in this review. Those studies involved recent research that has been published during the last 6 years. Prevalence of HD was found to vary considerably among different settings. HD seems to be more common in critically ill patients and less common in patients examined by consultation-liaison psychiatric services and in mixed patient populations. The presence of HD in ICU patients was associated with higher short- and long-term mortality and other adverse outcomes, but no such association was reported in other settings. Research on other possible associations of HD with clinical variables and on symptom presentation yielded inconclusive results, although there is some evidence for a possible association of HD with benzodiazepine use. There are several methodological issues that need to be addressed by future research. Future studies should examine HD in the primary care setting; treatment interventions should also be the objective of future research.

scholarly journals Automated lung sound analysis using the LungPass platform: A sensitive and specific tool for identifying lower respiratory tract involvement in COVID-19.

2021 ◽  
Author(s):  
Elena A Lapteva ◽  
Olga N Kharevich ◽  
Victoria V. Khatsko ◽  
Natalia A. Voronova ◽  
Maksim V. Chamko ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Adverse Outcomes ◽  
Lung Sound ◽  
Sound Analysis ◽  
Abnormal Sound ◽  
Tract Involvement ◽  
Short And Long Term ◽  
Analysis Platform

Background: Lower respiratory tract (LRT) involvement, observed in about 20% of patients suffering from coronavirus disease 2019 (COVID-19) is associated with a more severe clinical course, adverse outcomes and long-term sequelae. Early identification of LRT involvement could facilitated targeted and timely interventions that could alter the short- and long-term disease outcomes. The LungPass is an automated lung sound analysis platform developed using neural network technology and previously trained. We hypothesised that the LungPass could be used as a screening tool for LRT involvement in patients with COVID-19. Methods: In a prospective observational study involving 282 individuals with presenting in the emergency department with a strong clinical suspicion of COVID-19 and imaging findings consistent with COVID-19 LRT involvement (25.5% had concomitant hypoxia), and 32 healthy controls, we assessed the sensitivity and specificity of the LungPass in identifying LRT involvement in COVID-19. We also compared the auscultatory findings of the LungPass compared to a chest physician using a traditional, high-quality stethoscope. Results: Among individuals with COVID-19 LRT involvement, the LungPass identified crackles in at least one auscultation site in 93.6% and in two or more points in 84%. Moreover, the LungPass identified any abnormal lung sound (crackles or wheeze) in at least one auscultation site in 98.6% and in at least two points in 94% of the participants. The respective percentages for the respiratory physicians were lower. Considering the presence of any added abnormal sound (crackles or wheeze) in at least two auscultation points as evidence of LRT involvement, LungPass demonstrated a sensitivity of 98.6% (95% confidence intervals [CI]: 96.4%-99.6%) and a specificity of 96.9% (95% CI: 83.8%-99.9%) in identifying COVID-19 LRT involvement. Conclusion: This exploratory study suggests the LungPass is a sensitive and specific platform for identifying LRT involvement due to COVID-19, even before the development of hypoxia.

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