scholarly journals Sulfadiazine plasma concentrations in women with pregnancy-acquired compared to ocular toxoplasmosis under pyrimethamine and sulfadiazine therapy: a case–control study

2020 ◽  
Vol 25 (1) ◽  
Author(s):  
Ingrid Reiter-Owona ◽  
Harald Hlobil ◽  
Martin Enders ◽  
Ute Klarmann-Schulz ◽  
Barbara Gruetzmacher ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Folinic Acid ◽  
Case Control Study ◽  
Plasma Concentrations ◽  
Case Control ◽  
Ocular Toxoplasmosis ◽  
Transmission Risk ◽  
Retrospective Case ◽  
Drug Concentrations ◽  
Control Study

Abstract Background Dosing recommendations for the treatment of pregnancy-acquired toxoplasmosis are empirical and widely based on experimental data. There are no pharmacological data on pregnant women with acute Toxoplasma gondii infection under treatment with pyrimethamine (PY) and sulfadiazine (SA) and our study intends to tighten this gap. Methods In this retrospective case–control study, we included 89 pregnant women with primary Toxoplasma infection (PT) treated with PY (50 mg first dose, then 25 mg/day), SA (50 mg/kg of body weight/day), and folinic acid (10–15 mg per week). These were compared to a group of 17 women with acute ocular toxoplasmosis (OT) treated with an initial PY dose of 75 mg, thereafter 25 mg twice a day but on the same SA and folinic acid regimen. The exact interval between drug intake and blood sampling and co-medication had not been recorded. Plasma levels of PY and SA were determined 14 ± 4 days after treatment initiation using liquid chromatography–mass spectrometry and compared using the Mann–Whitney U test at a p < 0.05 level. Results In 23 PT patients (26%), SA levels were below 20 mg/l. Fifteen of these 23 patients (17% of all patients) in parallel presented with PY levels below 700 µg/l. Both drug concentrations differed remarkably between individuals and groups (PY: PT median 810 µg/l, 95% CI for the median [745; 917] vs. OT 1230 µg/l [780; 1890], p = 0.006; SA: PT 46.2 mg/l [39.9; 54.4] vs. OT 70.4 mg/l [52.4; 89], p = 0.015) despite an identical SA dosing scheme. Conclusions SA plasma concentrations were found in the median 34% lower in pregnant women with PT compared to OT patients and fell below a lower reference value of 50 mg/l in a substantial portion of PT patients. The interindividual variability of plasma concentrations in combination with systematically lower drug levels and possibly a lower compliance in pregnant women may thus account for a still not yet supportable transmission risk. Systematic drug-level testing in PT under PY/SA treatment deserves to be considered.

scholarly journals Association between Birth Plan Use and Maternal and Neonatal Outcomes in Southern Spain: A Case-Control Study

2021 ◽  
Vol 18 (2) ◽  
pp. 456
Author(s):  
Pedro Hidalgo-Lopezosa ◽  
Ana María Cubero-Luna ◽  
Andrea Jiménez-Ruz ◽  
María Hidalgo-Maestre ◽  
María Aurora Rodríguez-Borrego ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Case Control Study ◽  
Neonatal Resuscitation ◽  
Case Control ◽  
Neonatal Outcomes ◽  
Southern Spain ◽  
Retrospective Case ◽  
Apgar Scores ◽  
Primiparous Women ◽  
Control Study

Background: Birth plans are used for pregnant women to express their wishes and expectations about childbirth. The aim of this study was to compare obstetric and neonatal outcomes between women with and without birth plans. Methods: A multicentre, retrospective case–control study at tertiary hospitals in southern Spain between 2009 and 2013 was conducted. A total of 457 pregnant women were included, 178 with and 279 without birth plans. Women with low-risk gestation, at full-term and having been in labour were included. Sociodemographic, obstetric and neonatal variables were analysed and comparisons were established. Results: Women with birth plans were older, more educated and more commonly primiparous. Caesarean sections were less common in primiparous women with birth plans (18% vs. 29%, p = 0.027); however, no significant differences were found in instrumented births, 3rd–4th-degree tears or episiotomy rates. Newborns of primiparous women with birth plans obtained better results on 1 min Apgar scores, umbilical cord pH and advanced neonatal resuscitation. No significant differences were found on 5 min Apgar scores or other variables for multiparous women. Conclusions: Birth plans were related to less intervention, a more natural process of birth and better outcomes for mothers and newborns. Birth plans can improve the welfare of the mother and newborn, leading to birth in a more natural way.

scholarly journals Serum Sestrin2 and PlGF levels in pregnant women with pre-eclampsia and their correlations with the severity of the disease: A case-control study

2021 ◽  
Vol 20 (1) ◽  
pp. 53-60
Author(s):  
Lijun Li ◽  
Zhen Sun ◽  
Shasha Liu ◽  
Hongyan Cui
Keyword(s):  
Pregnant Women ◽  
High Efficiency ◽  
Case Control Study ◽  
Pearson Correlation ◽  
Severity Index ◽  
Case Control ◽  
Control Group ◽  
Retrospective Case ◽  
Severity Prediction ◽  
Control Study

Purpose: Sestrin2, a metabolic regulator with antioxidant activity, might have some certain predictability for the occurrence and severity of pre-eclampsia (PE). The purpose of this work was to explore the levels of serum Sestrin2 and PlGF in pregnant women with PE and their correlation with the severity index of the disease.Methods:This was a retrospective case-control study of pregnant women with PE who planned to give birth in our hospital from 05/2017 to 05/2019. Pearson correlation was used to analyze Sestrin2 and PlGF levels with PE severity. Receiver operating characteristic (ROC) curves were used to evaluate the predictive value of Sestrin2 and PlGF for PE.Results: There were 52 women in the control group, 46 in the mild PE group, and 36 in the severe PE group. As the severity of PE increased, the median levels of Sestrin2 increased (8.1, 9.8, and 11.8 ng/ml), and the levels of PlGF decreased (156, 117, and 67 pg/ml) in the three groups of women (all P<0.05).The levels of Sestrin2 and PlGF were strongly correlated with mean arterial pressure,proteinuria, newborn birth weight and gestational weeks at delivery (all P<0.001). Sestrin2 and PlGF had high efficiency of diagnosing PE (cut-off: 8.90 ng/ml, Area Under Curve [AUC]=0.979; cut-off: 122.50 pg/ml, AUC=0.963). Additionally, Sestrin2 and PlGF showed high value of severity prediction (cut-off: 11.15 ng/ml, AUC=0.857; cut-off: 68.50 pg/ml, AUC=0.837).Conclusion: Sestrin2 and PlGF are correlated with the severity of PE. Both Sestrin2 and PlGF had high value for PE diagnosis and severity prediction. Keywords: pre-eclampsia; Sestrin2; placental growth factor; oxidative stress; severity 

scholarly journals Transmission of SARS-CoV-2 considering shared chairs in outpatient dialysis: a real-world case-control study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ravi Thadhani ◽  
Joanna Willetts ◽  
Catherine Wang ◽  
John Larkin ◽  
Hanjie Zhang ◽  
...  
Keyword(s):  
Case Control Study ◽  
Conditional Logistic Regression ◽  
Case Control ◽  
Positive Patient ◽  
Transmission Risk ◽  
Sensitivity Analyses ◽  
Retrospective Case ◽  
Control Pair ◽  
Logistic Regression Models ◽  
Control Study

Abstract Background SARS-CoV-2 can remain transiently viable on surfaces. We examined if use of shared chairs in outpatient hemodialysis associates with a risk for indirect patient-to-patient transmission of SARS-CoV-2. Methods We used data from adults treated at 2,600 hemodialysis facilities in United States between February 1st and June 8th, 2020. We performed a retrospective case-control study matching each SARS-CoV-2 positive patient (case) to a non-SARS-CoV-2 patient (control) treated in the same dialysis shift. Cases and controls were matched on age, sex, race, facility, shift date, and treatment count. For each case-control pair, we traced backward 14 days to assess possible prior exposure from a ‘shedding’ SARS-CoV-2 positive patient who sat in the same chair immediately before the case or control. Conditional logistic regression models tested whether chair exposure after a shedding SARS-CoV-2 positive patient conferred a higher risk of SARS-CoV-2 infection to the immediate subsequent patient. Results Among 170,234 hemodialysis patients, 4,782 (2.8 %) tested positive for SARS-CoV-2 (mean age 64 years, 44 % female). Most facilities (68.5 %) had 0 to 1 positive SARS-CoV-2 patient. We matched 2,379 SARS-CoV-2 positive cases to 2,379 non-SARS-CoV-2 controls; 1.30 % (95 %CI 0.90 %, 1.87 %) of cases and 1.39 % (95 %CI 0.97 %, 1.97 %) of controls were exposed to a chair previously sat in by a shedding SARS-CoV-2 patient. Transmission risk among cases was not significantly different from controls (OR = 0.94; 95 %CI 0.57 to 1.54; p = 0.80). Results remained consistent in adjusted and sensitivity analyses. Conclusions The risk of indirect patient-to-patient transmission of SARS-CoV-2 infection from dialysis chairs appears to be low.

Assessment of Craniofacial Morphology in Mouth Breathing Children. A retrospective case-control study

2019 ◽  
Vol 70 (10) ◽  
pp. 3649-3653
Author(s):  
David Angelescu ◽  
Teodora Angelescu ◽  
Meda Romana Simu ◽  
Alexandrina Muntean ◽  
Anca Stefania Mesaros ◽  
...  
Keyword(s):  
Case Control Study ◽  
Case Control ◽  
Craniofacial Morphology ◽  
Respiratory Pattern ◽  
Control Group ◽  
Upper Lip ◽  
Retrospective Case ◽  
Oral Breathing ◽  
Facial Height ◽  
Control Study

The aim of this retrospective case-control study is to determine a possible correlation between breathing mode and craniofacial morphology. The study was carried out in the Department of Pedodontics,Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. The sample comprised 80 patients, age between 6 and 13 years, which were divided in two groups based on respiratory pattern: control group composed of 38 nasal breathing children and case group composed of 42 oral breathing children. Three quantitative craniofacial parameters were measured from the frontal and lateral photos: facial index, lower facial height ratio and upper lip ratio. The statistical analysis showed a significant higher facial index (p=0.006*) and an increase lower facial height (p=0.033*) for the oral breathers group. No differences in facial morphology were found between genders and age groups, when comparing the data between the same type of respiratory pattern children. Spearman�s rho Correlation show a significant positive correlation (p=0.002*) between facial index and lower facial height and a significant negative correlation between facial index and upper lip (p=0,005*). Long faces children are more likely to develop oral breathing in certain conditions, which subsequently have a negative effect on increasing the lower facial height by altering the postural behavior of mandible and tongue.

Maternal-Fetal Management in Trombophilia Related and Placenta-Mediated Pregnancy Complications

2018 ◽  
Vol 69 (9) ◽  
pp. 2396-2401
Author(s):  
Costin Berceanu ◽  
Elena Loredana Ciurea ◽  
Monica Mihaela Cirstoiu ◽  
Sabina Berceanu ◽  
Anca Maria Ofiteru ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Complications ◽  
Case Control Study ◽  
Case Control ◽  
Placental Insufficiency ◽  
Management Options ◽  
Specific Therapy ◽  
Pregnancy Morbidity ◽  
The Impact ◽  
Control Study

It is widely accepted that thrombophilia in pregnancy greatly increases the risk of venous thromboembolism. Pregnancy complications arise, at least partly, from placental insufficiency. Any change in the functioning of the gestational transient biological system, such as inherited or acquired thrombophilia, might lead to placental insufficiency. In this research we included 64 pregnant women with trombophilia and 70 cases non-trombophilic pregnant women, with or without PMPC, over a two-year period. The purpose of this multicenter case-control study is to analyze the maternal-fetal management options in obstetric thrombophilia, the impact of this pathology on the placental structure and possible correlations with placenta-mediated pregnancy complications. Maternal-fetal management in obstetric thrombophilia means preconceptional or early diagnosis, prevention of pregnancy morbidity, specific therapy as quickly as possible and fetal systematic surveilance to identify the possible occurrence of placenta-mediated pregnancy complications.

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