scholarly journals Examination of the relation of localization of placenta at 18-24 weeks of gestation by ultrasonography with the development of preeclampsia later in pregnancy

2020 ◽  
Vol 9 (11) ◽  
pp. 4567
Author(s):  
Seema Pundir ◽  
Neelam Namdeo ◽  
Sandhya Jain
Keyword(s):  
Odds Ratio ◽  
Ultrasound Examination ◽  
Observational Cohort Study ◽  
Term Study ◽  
Urine Albumin ◽  
Group A ◽  
Observational Cohort ◽  
Group B ◽  
Lateral Localization ◽  
In Pregnancy

Background: The aim of the study was to examine the relation of localization of placenta at 18-24 weeks of gestation by ultrasonography with the development of preeclampsia later in pregnancy.Methods: Hospital based Prospective observational Cohort study at department of Obstetrics and Gynecology, Dr. BSA Hospital Delhi. 150 pregnant women of gestational age18-24 weeks attending ANC clinic were enrolled for ultrasound examination and on the basis of ultrasonography (USG) findings placenta was classified as Group-A (patient found to have laterally located placenta). And Group-B (patients found to have centrally located placenta). All women in both the group were followed up regularly till term. Study duration was 1 year, June 2017-June 2018.Results: The overall risk of developing Preeclampsia with a late rally located placenta was 8.5(odds ratio) with 95% confidence interval (4.0339 to17.9108). This difference was highly statistically significant (p<.0001). Placental laterality has a sensitivity of 77.27%, beside that it has a good specificity of 71.43% and negative predictive value of 80%. Lateral localization of placenta by ultrasonography at mid trimester can be used as a screening test. The presence of urine albumin in group A was found in 70.67% as compared to 13.33% in group B. This difference was statistically significant. (p=0.0001). Around 72% of total complications were seen in Group-A as compared to 28% in Group-B. This difference was found to be statistically significant (p=0.028).Conclusions: Significant correlation exists between placental laterality and the development of preeclampsia and thus placental localization by ultrasonography in midtrimester (at 18-24 weeks) can be used for prediction of development of preeclampsia later in pregnancy.

scholarly journals Changes in pulmonary function and functional capacity in adolescents with mild idiopathic scoliosis: observational cohort study

2017 ◽  
Vol 46 (1) ◽  
pp. 381-391 ◽  
Author(s):  
Ashraf Abdelaal Mohamed Abdelaal ◽  
Ehab Mohamed Abo El Soad Abd El Kafy ◽  
Mohamed Salah Eldien Mohamed Elayat ◽  
Mohamed Sabbahi ◽  
Mohamed Salem Saed Badghish
Keyword(s):  
Cohort Study ◽  
Idiopathic Scoliosis ◽  
Forced Expiratory Volume ◽  
Observational Cohort Study ◽  
Mean Values ◽  
Functional Exercise ◽  
Group A ◽  
Observational Cohort ◽  
Group B ◽  
6 Minute Walk Test

Objective This observational cohort study aimed to evaluate ventilatory function (VF) and functional exercise capacity (FEC) in mild adolescent idiopathic scoliosis (AIS). Methods Seventy-three adolescents with idiopathic scoliosis, aged approximately 10 to 17 years (mean age: 13.43 ± 1.27 years), with a Cobb angle less than 20° (mean: 16.44° ± 1.59°), met the inclusion criteria and were assigned to group A. Another 34 healthy adolescents with normal VF and FEC served as controls (group B). Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), maximum voluntary ventilation (MVV), and FEC (by the 6-minute walk test [6MWT]) were the main outcome measures. Results Post-study mean values of FVC, FEV1, FEV1/FVC, MVV, and the 6MWT were 2.42 ± 0.36 L and 3.26 ± 0.59 L, 2.14 ± 0.31 L and 3.03 ± 0.43 L, 88.13% ± 3.89% and 91.14% ± 4.67%, 76.96 ± 6.85 L/m and 107.61 ± 11.44 L/m, and 581.12 ± 12.25 m and 627.74 ± 15.27 m in groups A and B, respectively. Between-group comparisons showed significant differences in FVC, FEV1, FEV1/FVC, MVV, and the 6MWT. Conclusion Mild pulmonary and functional restrictions start early in mild AIS. This issue requires immediate intervention to prevent further deterioration.

scholarly journals Switching natalizumab to fingolimod within 6 weeks reduces recurrence of disease activity in MS patients

2017 ◽  
Vol 24 (11) ◽  
pp. 1453-1460 ◽  
Author(s):  
Cyra E Leurs ◽  
Zoé LE van Kempen ◽  
Iris Dekker ◽  
Lisanne J Balk ◽  
Mike P Wattjes ◽  
...  
Keyword(s):  
Disease Activity ◽  
Lymphocyte Count ◽  
Odds Ratio ◽  
Jc Virus ◽  
Observational Cohort Study ◽  
Relapsing Remitting ◽  
Natalizumab Treatment ◽  
Observational Cohort ◽  
Carry Over ◽  
Relapsing Remitting Multiple Sclerosis

Background: Natalizumab is an effective treatment in relapsing-remitting multiple sclerosis (MS). Mainly because of the risk of progressive multifocal leukoencephalopathy (PML), a substantial proportion of John Cunningham (JC) virus–positive patients switch to fingolimod. Previous reports show a clear benefit when the duration of a washout (WO) period of natalizumab is 0–3 months in comparison to longer WO periods. However, there is no consensus regarding the optimal duration of a WO period under 3 months. Objective: We compared MS disease activity after different WO periods. In addition, we investigated several factors that possibly influence recurrence of disease activity, including serum natalizumab concentration and lymphocyte counts. Methods: From a prospective observational cohort study of natalizumab-treated patients, we selected 52 patients who switched to fingolimod. We divided the patients in three groups (<6 weeks, 6–8 weeks, >8 weeks WO). Serum natalizumab concentration and lymphocyte count were assessed during and after natalizumab treatment. Results: Patients with a WO period of >8 weeks had a significant higher recurrence of disease activity (odds ratio, 6.8; 95% confidence interval, 1.4–32.8) compared to patients with a WO period of <6 weeks. Serum natalizumab concentration and lymphocyte count did not predict recurrence of disease activity. Interpretation: A short WO period decreases the risk of recurrence of disease activity. The possible impact of a short WO period on the risk of carry-over PML in JC virus–positive patients remains uncertain.

scholarly journals To study levels of serum fibrinogen in type 2 diabetes mellitus and its association with diabetic microvascular complications

2017 ◽  
Vol 4 (1) ◽  
pp. 10
Author(s):  
Gurinder Mohan ◽  
Ranjeet Kaur ◽  
Aakash Aggarwal ◽  
Parminder Singh
Keyword(s):  
Diabetes Mellitus ◽  
Microvascular Complications ◽  
Vascular Complications ◽  
High Serum ◽  
Diabetic Patients ◽  
Coagulation Disorder ◽  
Urine Albumin ◽  
Group A ◽  
Diabetic Microvascular Complications ◽  
Group B

Background: Diabetes mellitus is a hypercoagulable state associated with atherosclerosis leading to development of vascular complications, including microvascular complications.Methods: In our study a total of 60 diabetic patients with duration of diabetes more than 5 years, attending the OPD/ indoor of SGRDIMSR, Amritsar, Punjaqqb, India were included. They were divided in two groups, group A of 30 patients including diabetics with any of the three microvascular complications (diabetic nephropathy, diabetic retinopathy and diabetic neuropathy) and group B of 30 patients including diabetics without any microvascular complication. Group C comprised of 30 age and sex matched non-diabetic subjects who served as controls. Subjects with liver cirrhosis, malignancy or coagulation disorder were excluded. After taking the consent, detailed history taking and detailed physical examination and relevant investigations were done. The serum fibrinogen (hemostasis marker), HBA1C and UACR (urine albumin creatinine ratio) along with routine investigations were measured.Results: It was observed that serum fibrinogen levels were significantly higher in diabetic patients (266.16±54.73 mg/dl) as compared to non-diabetic controls (174.66±18.32 mg/dl); p <0.001.Further, serum fibrinogen levels were found to be significantly higher in diabetic patients with microvascular complications (293.43±51.09 mg/dl) as compared to those without microvascular complications (238.90±44.12); p<0.001.Conclusions: Significantly high serum fibrinogen level was found in diabetic patients as compared to controls and was in positive correlation with development of microvascular complications.

β-Blockers, Tachycardia, and Survival Following Sepsis: An Observational Cohort Study

2021 ◽  
Author(s):  
Dmitri Guz ◽  
Shira Buchritz ◽  
Alina Guz ◽  
Alon Ikan ◽  
Tania Babich ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Cohort Study ◽  
Mortality Rate ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Observational Cohort Study ◽  
Observational Cohort ◽  
Internal Medicine Wards ◽  
Β Blockers

Abstract Background Sepsis is associated with excessive release of catecholamines, which causes tachycardia and is correlated with poor clinical outcome. β-Blockers (BBs) may blunt this effect on heart rate (HR). The objective of this study is to assess whether long-term BB therapy is associated with better clinical outcomes in patients with sepsis admitted to internal medicine wards. Methods We performed a single-center, observational cohort study. We included adult patients who were hospitalized in medicine departments due to sepsis. A propensity score model for BB therapy was used to match patients. The primary outcome was the 30-day all-cause mortality rate. A multivariate analysis was performed to identify risk factors for an adverse outcome. Patients were stratified according to absolute tachycardia (HR ≥100/min) or relative tachycardia at presentation (tachycardia index above the third quartile, with tachycardia index defined as the ratio of HR to temperature). Results A total of 1186 patients fulfilled the inclusion criteria. In the propensity-matched cohort patients given BB treatment were younger (median age [interquartile range], 74 [62–82] vs 81 [68–87] years; P ≤ .001). BB treatment was associated with reduction in 30-day mortality rates for patients with absolute tachycardia (odds ratio, 0.406; 95% confidence interval, .177–.932). Final model with interaction variable of BB treatment with HR was associated with short-term survival (odds ratio, 0.38; 95% confidence interval, .148–.976). Selective BB therapy had a stronger protective effect than nonselective BB therapy. Conclusions Long-term BB therapy was associated with decreased mortality rate in patients hospitalized with sepsis in internal medicine wards exhibiting absolute and relative tachycardia.

Increased Plasma Thrombin-Antithrombin III Complex Levels in Non-Insulin Dependent Diabetic Patients with Albuminuria Are Reduced by Ethyl Icosapentatenoate

1995 ◽  
Vol 74 (05) ◽  
pp. 1231-1234 ◽  
Author(s):  
Hiroyuki Shimizu ◽  
Ken-Ichi Ohtani ◽  
Yoshito Tanaka ◽  
Akira Fukatsu ◽  
Yutaka Uehara ◽  
...  
Keyword(s):  
Antithrombin Iii ◽  
Diabetic Patients ◽  
Clotting System ◽  
Urine Albumin ◽  
Group A ◽  
Insulin Dependent ◽  
Group B ◽  
Insulin Dependent Diabetic ◽  
Thrombin Antithrombin Iii Complex ◽  
Niddm Patients

SummaryHypercoagulability may increase the risk of cardiovascular disease (CVD) in diabetic patients with albuminuria. Plasma thrombin-antithrombin III complex (TAT) levels, representing a functional state of clotting system, were studied in one hundred and fifteen non-insulin- dependent diabetic (NIDDM) patients. The patients were divided into three groups according to the urine albumin index (UAI: mg/g Cr): Group A; UAI<30, Group B; 30<UAI<300, Group C; UAI>300. The effect of albuminuria on plasma TAT levels was significant (p<0.02). Ethyl icosapentatenoate (EPA: 1800 mg/day) for 4 weeks significantly (p<0.0005) decreased plasma TAT levels. These data indicate that the degree of diabetic albuminuria is related to plasma TAT levels in NIDDM patients and that treatment with EPA may reduce TAT levels and possibly therefore the rate of development of CVD in patients with NIDDM.

scholarly journals Low molecular weight heparins use in pregnancy: a practice survey from Greece and a review of the literature

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
E. Papadakis ◽  
A. Pouliakis ◽  
Α. Aktypi ◽  
A. Christoforidou ◽  
P. Kotsi ◽  
...  
Keyword(s):  
Major Bleeding ◽  
Scientific Evidence ◽  
Vascular Complications ◽  
Bleeding Events ◽  
History Of ◽  
Group A ◽  
Major Bleeding Events ◽  
Diagnostic Work ◽  
Group B ◽  
In Pregnancy

Abstract Background Use of LMWH in pregnancy is not only limited to VTE management, but it extends, to the management of vascular gestational complications and the optimization of IVF pregnancies despite the lack of concrete scientific evidence. In this context, we conducted the present study aiming to gain insights regarding the use of LMWH during pregnancy and puerperium. We recorded indication for use, diagnostic work-up as well as the safety and efficacy of the treatment, trying to elucidate the clinical practice in our country. Methods We analyzed data regarding 818 pregnant women received LMWH during 2010–2015.Our cohort had a median age of 33.9 years and a BMI of 23.6.There were 4 groups: those with a history of VTE [Group-A: 76], those with pregnancy complications [Group-B: 445], those undergoing IVF [Group-C: 132] and those carrying prothrombotic tendency (thrombophilia, family history of VTE, other) [Group-D: 165]. Mean duration of LMWH administration was 8.6 ± 1.5 months. Out of the total number, 440 received LMWH in fixed prophylactic dose, 272 in higher prophylactic-weight adjusted dose and 106 in therapeutic dose. Moreover, 152 women received in addition low-dose acetylsalicylic acid (ASA). 93.8% of pregnancies were single and 6.2% were multiple ones. Live births occurred in 98.7% of pregnancies. Results Anticoagulation was efficacious and well tolerated. Seventeen VTE events were recorded; 7 of them antepartum and 10 postpartum. No major bleeding events were observed while 13 clinical relevant non-major bleeding events were recorded. Regarding gestational vascular complications, 28 IUGR events were recorded, as well as 48 cases of preterm labor of which 12 were concomitant with IUGR (25%). Six early pregnancy losses were recorded; there were 3 fetal deaths and 3 cases of pre-eclampsia/eclampsia. Conclusions LMWHs are used extensively during pregnancy and puerperium in Greece for VTE treatment and prophylaxis and for a variety of other indications as well. Although the drug has been shown to be both safe and efficacious, its use for some indications has no proven scientific evidence. In order to clearly define the role of LMWHs in pregnancy, beyond thromboprophylaxis, large prospective studies are required, which could be based on the conclusions of this study.

Continuous Exercise Coaching Through Smartphone to Improve Quality of Sleep for Pregnant Women: A Prospective Cohort Study (Preprint)

2020 ◽  
Author(s):  
Guiying Wang ◽  
Xiao-Xian Yang ◽  
Ziyu Xiong ◽  
Daniel J Corsi ◽  
Shi Wu Wen ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Pregnant Women ◽  
Categorical Variables ◽  
Global Score ◽  
Subjective Sleep Quality ◽  
Continuous Exercise ◽  
Group A ◽  
Improve Sleep Quality ◽  
Group B ◽  
In Pregnancy

BACKGROUND Sleep quality is often affected by pregnancy, and exercise may improve sleep quality in pregnancy. However, the literature on the effect of integrating smartphones with continuous exercise coaching to improve sleep is sparse. OBJECTIVE This study aimed to explore the effect of continuous exercise coaching through smartphone on sleep quality for pregnant women. METHODS Pregnant women who met the eligibility criteria and agreed to participate at their first prenatal visit were enrolled and divided into two groups: group A (with continuous exercise coaching through smartphone) and group B (without exercise coaching). Pittsburgh Sleep Quality Index (PSQI) scale was used to measure the sleep quality. Chi-square test was used for categorical variables and t-test was used for continuously distributed variables for the comparison between the two groups. RESULTS In the 2nd trimester, means (SDs) of global score (9.46 (SD 3.46)), subjective sleep quality score (1.64 (SD 0.72)), and daytime dysfunction score (0.98 (SD 0.82) in group A (50 women)) were lower than in group B (50 women): 11.34 (SD 3.93), 2.02 (SD 0.74), and 1.48 (SD 0.84), respectively. In the 3rd trimester, means (SDs) of global score (10.16 (SD 3.00)), sleep efficiency score (1.64 (SD 0.72)), and daytime dysfunction score (1.86 (SD 0.67)) in group A were lower than in group B: 12.10 (SD 3.51), 1.82 (SD 0.80), and 1.78 (SD 0.76), respectively. In group A, global score of PSQI decreased from the 1st to 2nd trimester and from the 2nd to 3rd trimester. No inter-trimester change in global score of PSQI was observed in group B. CONCLUSIONS Our preliminary analysis suggests that continuous exercise coaching through smartphone by health professionals may be an effective way to improve sleep quality in pregnancy.

Bone Marrow Hypocellularity, Decreased Platelet Counts and Colony Forming Units Serve as Prognostics Parameters for Early Complications after Autologous Peripheral Blood Stem Cell Transplantation.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 5514-5514
Author(s):  
Antonia M.S. Mueller ◽  
Gabriele Ihorst ◽  
Denz Ulrich ◽  
Doeing Carsten ◽  
Wider Dagmar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Odds Ratio ◽  
Peripheral Blood Stem Cell ◽  
Median Number ◽  
Early Complications ◽  
Platelet Counts ◽  
Colony Forming Units ◽  
Group A ◽  
Group B ◽  
Blood Stem Cell Transplantation

Abstract High-dose chemotherapy with autologous peripheral blood stem cell transplantation (auto-PBSCT) offers a valid treatment option in cancer patients (pts) with advanced, relapsed or high-risk (HR) disease. Auto-PBSCT is in general a safe procedure, however, some pts may have a dismal outcome due to treatment related mortality (TMR), early relapse (ER) and/or failure of blood cell reconstitution (FBR). Risk factors predisposing for early complications after PBSCT have not yet been clearly assessed. From a total of 796 pts having been transplanted over a 10 year (y) period (6/93-5/03), we determined 50 pts (group A, m:f=29:21), who had primary FBR or died within 3 months after PBSCT. As a control group, 50 pts who had undergone PBSCT over the same period, were randomly selected (group B; m:f=25:25). Pre-PBSCT-parameters associated with early complications were examined by univariate analysis. Median age at transplant was similar in group A (52y) and group B (54y). Group A vs. B had underlying lymphoma in 31 vs. 17, solid tumors in 13 vs. 21 and leukemias in 6 vs. 12 pts, respectively. Notable differences were a lower performance status, more pretreatment chemotherapy (CX)-cycles, higher LDH levels, lower platelet counts, hypocellular bone marrow (BM) and lower colony forming units (CFU) in group A. Treatment before PBSCT in group A consisted of a median number of 7 CX (group B: 4 CX) cycles. Median number of retransfused CD34+-cells were similar (group A 4.1 vs. group B 3.7x10e6/kg bw). Total CFUs/1.5e5, determined by methylcellulose culture of PBSC grafts in group A were considerably decreased with 128 vs. 187 (group B), and BFU-E, CFU-GM, and CFU-GEMM were 51 vs. 79, 55 vs. 87 and 5 vs. 4, respectively. Hypocellular BM was observed in group A and B in 46% vs. 4% of pts (odds ratio 20.44 [p&lt;0.001]), platelet counts were 98 vs. 170x10e9/L (odds ratio 13.5 [p&lt;0.001]), respectively. Advanced stage at transplant was present in 90% vs. 78%, and residual BM-infiltration in 36% vs. 58% in group A and B, respectively. Age, number of CX-cycles and CD34+-transfused cells showed no significantly increased risk. Of pts in group A, 21 had early TRM (group A1: sepsis and multi-organ failure in 81%, fatal bleeding in 14%, CX-toxicity in 5%, leading to early death after a median of 23 days [d]). 26 pts (52%) died of early progression (group A2: after a median of 62d) and 3 pts (6%) had FBR (group A3). Median BFU-E, CFU-GM and CFU-GEMM were similar in group A1 and A2 and correlated with comparable CD34+-numbers. However, in group A1, 29% reached no WBC and 81% no platelet engraftment, whereas in group A2 only 12% and 23% did not reach WBC- and platelet reconstitution, respectively. Engraftment in group B (control pts) was regular with median WBC and platelet reconstitution on d+10. With a TRM of 2.64% and FBR in 0.38% in this HR-pt cohort, auto-PBSCT is in general a well tolerable treatment option. Nevertheless, distinct risk factors for early transplant complications can be determined and should be considered. We identified BM-hypocellularity and a decreased platelet count &lt;100x10e9/L as the strongest prognostic parameters. Our analysis also suggests, that other pre-transplant parameters, including CFUs - more reliably than CD34+-cell numbers - provide additional valuable information on engraftment and complications after auto-PBSCT.

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