scholarly journals Correlation of Anxiety and Uterine Artery Doppler Flow in Pregnant Women with High Risk of Down syndrome: A Prospective Cohort Study

2020 ◽  
Author(s):  
Mahboobeh Shirazi ◽  
Mehnoosh Torkzaban ◽  
Marjan ghaemi ◽  
Maryam Moshfeghi ◽  
Mahmoud Shirazi ◽  
...  
Keyword(s):  
Blood Flow ◽  
Down Syndrome ◽  
High Risk ◽  
Pregnant Women ◽  
Trait Anxiety ◽  
Uterine Artery ◽  
Maternal Anxiety ◽  
State Trait Anxiety Inventory ◽  
And Control

Abstract Background: Maternal anxiety may lead to unfavorable pregnancy outcomes, but the underlying mechanism is unclear. This study aimed to evaluate the correlation between maternal anxiety and uterine blood flow index in pregnant women with high risk of Down syndrome undergoing amniocentesis.Methods: This prospective cohort study was conducted at 15-18 weeks of gestational age on 199 pregnant women with high-risk of Down syndrome, candidates for amniocentesis, and 176 pregnant women at low-risk of Down syndrome in the control group from 2017 to 2019. Anxiety state by Spielberger’s State-Trait Anxiety Inventory (STAI) and uterine artery blood flow indices were assessed at baseline and two weeks follow-up visits (immediately before amniocentesis and after receiving the karyotype results in the amniocentesis group). Results: The mean±SD age of participants was 33.11 ± 5.96 years. There were 176 negative and 23 positive results for Down syndrome in the amniocentesis group. State-Trait Anxiety Inventory scores were significantly different between the amniocentesis and control groups at baseline and follow up (p = 0.033 and p=0.003 respectively) and between baseline and follow-up assessments in the amniocentesis-negative group (p = 0.001, with lower follow-up scores). A significant decrease was observed between baseline and follow-up uterine PI in amniocentesis group (p<0.05), and between baseline and follow-up uterine RI in both amniocentesis and control groups (p <0.001). There was a significant but weak correlation between uterine RI and State-Trait Anxiety Inventory scores at follow-up (r=0.137, p=0.008).Conclusions: Maternal anxiety may decrease uterine artery blood flow in pregnancy.Trial registration: IR.TUMS.IKHC.REC.1397.174

Abstract 09: Ultra-Fast Hypothermia Inhibit Early Cerebral Consumption of Lactate After Experimental Cardiac Arrest in Rabbits : A Microdialysis Study

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Matthias Kohlhauer ◽  
Alexandra Demelos ◽  
Emilie Boissady ◽  
Bijan Ghaleh ◽  
Renaud Tissier
Keyword(s):  
Blood Flow ◽  
Cardiac Arrest ◽  
Spontaneous Circulation ◽  
Therapeutic Window ◽  
Ultra Fast Cooling ◽  
Extracellular Lactate ◽  
Microdialysis Study ◽  
The Right ◽  
And Control

Introduction: Ultra-fast hypothermia through total liquid ventilation (TLV) has been shown to be neuroprotective after cardiac arrest. Hypothesis: The mechanism could involve a modification in brain metabolic substrat. Method: Anesthetized rabbits were instrumented with a carotid flow probe as well as arterial and jugular venous catheters. A microdialysis catether was implanted in the right brain cortex. Animals were then submitted to 10 min of ventricular fibrillation and cardiopulmonary resuscitation. After resumption of spontaneous circulation (ROSC), they were randomly submitted to ultra-fast cooling to 32°C by TLV (TLV group) or normothermic follow-up (Control) during 4h. Cerebral consumption of lactate, glucose and O 2 was calculated using arteriovenous differences in their content times mean carotid blood flow. Results: In Control, cerebral blood flow was significantly and sustainly decreased after ROSC (61±6 vs 101±6 ml/min after 240 min vs baseline), with a further decrease with hypothermia in TLV group (23±2 ml/min after 240 min, p<0.05). As compared to Control, TLV reduced the cerebral consumption of glucose (-69% at 240 min) and O 2 (-73% at 240 min). Importantly, Control animals showed a dramatic but transient cerebral consumption of lactate during the first 120 min after cardiac arrest (e.g. 124±31 mmol/min at 60 min). Concomitantly, this was associated with an increase in pyruvate extracellular stocks in brain (e.g. 57±10 μmol/L at 30 min). In TLV group, hypothermia blunted this initial burst of lactate consumption (e.g. 41±12 mmol/min at 60 min, p<0,05) and led to an accumulation in extracellular lactate ( e.g. 2053±68 vs 1246±278 μmol/L at 60 min, in TLV and Control respectively). This early build-up of lactate was then progressively consumed after 120 min in TLV group, allowing a delayed accumulation in pyruvate extracellular stocks from 120 min until the end of follow-up (103±19 and 17±4 μmol/L of pyruvate at 240 min in TLV vs Control respectively). Conclusion: Ultra-fast hypothermia reduces the cerebral consumption of lactate during the first 120 min after ROSC, allowing a delayed renewal in pyruvate stocks. This could explain the potent benefit of hypothermia during this early therapeutic window of 120 min.

Personality and Relaxation Therapy: Changes among Clinical and Normal Subjects

1988 ◽  
Vol 66 (1) ◽  
pp. 283-289 ◽  
Author(s):  
Evelyn I. Bird ◽  
Vietta E. Wilson
Keyword(s):  
Normal Subjects ◽  
Relaxation Techniques ◽  
Relaxation Therapy ◽  
Demographic Information ◽  
State Trait Anxiety Inventory ◽  
Eysenck Personality Inventory ◽  
Few Data ◽  
And Control ◽  
Multiple Health

There are increasing numbers of self-referral stress-management programs, a few of which use group-relaxation techniques, but few data are available on the personalities of the symptomatic and asymptomatic clients who attend or on any changes in personality after the program. Scores on the Eysenck Personality Inventory, Multiple Health Locus of Control, and State-Trait Anxiety Inventory as well as demographic information were obtained from 255 adults who attended a 10-session, university-based, group-relaxation program. The symptomatic clients reported significantly less anxiety, less neuroticism, were more extraverted and ascribed less of their behavior to chance at a 1 month post-treatment follow-up than at intake. The small group of asymptomatic clients also reported less anxiety and neuroticism at the follow-up. There were no sex differences on the Eysenck inventory or the anxiety scales but there were for the Multiple Health internal and control scales. It was concluded that group relaxation appeared to improve mental health scores effectively for both stressed and nonstressed adults and that age was significantly related to some personality scores.

Efficacy of Booster Sessions after Training in Assertiveness

1986 ◽  
Vol 62 (3) ◽  
pp. 791-798 ◽  
Author(s):  
Helmut P. R. Riedel ◽  
Catherine R. Fenwick ◽  
C. R. Jillings
Keyword(s):  
Training Program ◽  
Trait Anxiety ◽  
Significant Interaction ◽  
Depression Scale ◽  
State Trait Anxiety Inventory ◽  
Self Rating ◽  
Booster Sessions ◽  
Assertion Training ◽  
Significant Superiority

28 subjects participated in a 6-wk. assertion training program. Of these, 22 remained in the study for a 6-mo. follow-up period, during which half received monthly booster sessions and half did not. Assignment to the booster and no-booster groups was random, with the qualification that subjects were equated on trait anxiety before training in assertiveness. Subjects filled out the Gambrill-Richey Assertion Inventory, the Spielberger State-Trait Anxiety Inventory, and the Zung Self-rating Depression Scale before the 6-wk. assertion training, after this program, at a 3-mo. follow-up, and at a 6-mo. follow-up. It was hypothesized that the booster group would exhibit significant superiority on these measures at the 3-mo. and 6-mo. follow-ups. On all measures both groups significantly improved from before to after the training program with good maintenance throughout the follow-ups. There were no differences between the booster and no-booster groups on the measures of assertiveness and anxiety. However, there was a significant interaction for the depression scores when the booster and no-booster groups were compared from posttreatment to 6-mo. follow-up. The depression scores of subjects in the booster group were lower than the depression scores of subjects in the no-booster group at the 6-mo. follow-up. These results were discussed with suggestions for further research.

The Effect of Inhibin A on Prenatal Screening Results for Down Syndrome in the High Risk Czech Pregnant Women

2019 ◽  
Vol 65 (05/2019) ◽  
Author(s):  
Jaroslav Loucký ◽  
Silvie Bělášková ◽  
Richard Průša ◽  
Karel Kotaška
Keyword(s):  
Down Syndrome ◽  
High Risk ◽  
Pregnant Women ◽  
Prenatal Screening ◽  
Inhibin A

Mutation Analysis of JAK-1, 2 and 3 in Children with Down Syndrome and Acute Leukemia.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 5035-5035
Author(s):  
Marjolein Blink ◽  
Trudy Buitenkamp ◽  
Astrid A Danen-van Oorschot ◽  
Valerie de Haas ◽  
Dirk Reinhardt ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Acute Lymphoblastic Leukemia ◽  
High Risk ◽  
Lymphoblastic Leukemia ◽  
Janus Kinase ◽  
Children With Down Syndrome ◽  
Activating Mutations ◽  
Increased Risk ◽  
Frequent Event

Abstract Abstract 5035 Children with Down Syndrome (DS) have an increased risk of developing leukemia, including both acute myeloid (ML-DS), as well as acute lymphoblastic leukemia (DS-ALL). ML-DS can be preceded by a pre-leukemic clone in newborns (transient leukemia-TL), which in most cases resolves spontaneously. Janus Kinase (JAK) 1-3 belongs to a family of intracellular non-receptor protein tyrosine kinases that transduce cytokine-mediated signals via the JAK-STAT pathway. JAK plays an important role in regulating the processes of cell proliferation, differentiation and apoptosis in response to cytokines and growth factors. Mullighan et al. described JAK 1-3 mutations in non-DS high-risk childhood B-cell precursor acute lymphoblastic leukemia (BCP-ALL; PNAS, 2009). In T-ALL, JAK-1 mutations are a frequent event (∼25%) as reported among others by Jeong et al (Clinical Cancer Research, 2008). Mutations in JAK-2 and JAK-3 have been described in TL and ML-DS. Bercovich et al. recently reported mutations within the pseudokinase domain of JAK-2 in DS-ALL patients (Lancet 2008). This activating JAK-2 mutation differs from the V617F exon 14 mutation found in myeloproliferative diseases. However, JAK-1 has never been investigated in Down syndrome leukemias. Therefore we performed mutational analysis of the pseudokinase and kinase domains of JAK-1, 2 and 3 by direct sequencing in 8 TL, 16 ML-DS and 35 DS-ALL samples taken at initial diagnosis. The TL and ML-DS samples were unpaired. In the ML-DS group, 12 patients were classified as FAB M7, 3 as FAB M0 and 1 as FAB M6; all 35 DS-ALL patients were classified as BCP-ALL. Mutations in JAK-1 were found in 1 ML-DS patient (D625R) and in 1 DS-ALL patient (V651M). These mutations were localised in the same region of the pseudokinase domain, but not identical to the activating mutations in JAK1 described in high-risk ALL (Mullighan et al., PNAS 2009). The JAK-1 mutated ML-DS patient had a complex karyogram, and the DS ALL patient a normal karyotype. No events occurred in either of the patients with a follow-up of 2.4 and 3.1 years, respectively. JAK-2 activating mutations at position R683 were found in 5/35 (14.3%) of the DS-ALL patients. These patients had diverse cytogenetic aberrations, and had no events at a median follow up of 4.4 years. In the TL and ML-DS patients no mutations were identified in JAK-2. For JAK-3, 1 TL-patient (13%) and 1 ML-DS patient (6.3%) harboured the A573V-mutation. This activating mutation is previously described in ML-DS patients and the megakaroyblastic cell line CMY ((Kiyoi et al, Leukemia 2007). Because the mutations occur in both TL and ML-DS, this suggests that they do not play a role in the clonal progression model from TL to ML-DS. A mutation at JAK3 R1092C, which to our knowledge has never been reported before, was found in 1 DS-ALL patient. This patient had a deletion on chromosome 12 (p11p13), and was in CCR with a follow up of 5 years. In conclusion, JAK-mutations are rare in DS-leukemias, except for JAK-2 mutations in DS-ALL, which occur in approximately 15% of cases. The rarity of JAK-1 mutations in DS is in accordance with the rarity of T-ALL in DS. Of interest, none of the DS ALL cases with a JAK-2 mutation relapsed so far, which differs from the patients with JAK-2 mutations that were recently in high-risk BCP-ALL. Hence, JAK-2 may be an interesting novel therapeutic target. Disclosures No relevant conflicts of interest to declare.

scholarly journals Potential screening strategies for early prediction of pre-eclampsia

2021 ◽  
Vol 10 (4) ◽  
pp. 1436
Author(s):  
Hymavathi K. ◽  
Sandhya Rani Davuluru ◽  
Sameera Shaik ◽  
Sahithi Kaviti
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Uterine Artery ◽  
Strong Association ◽  
First Trimester ◽  
Maternal Serum ◽  
Screening Tools ◽  
Early Prediction ◽  
Inhibin A ◽  
Study Results

Background: This study was conducted to evaluate the efficacy of different biochemical and biophysical markers in the early weeks of gestation as screening tools for early prediction of preeclampsia.Methods: This hospital-based prospective observational study conducted on 52 pregnant women, at less than 13 weeks of gestation were recruited. Maternal serum inhibin A and USG uterine artery PI levels were analyzed among the pregnant women who subsequently developed PE and compare with those who did not develop PE. Methods used for the detection of markers were: chemiluminescence immunoassay (CLIA) for serum inhibin A levels, and uterine artery Doppler velocimetry was done by PHILIPS HD11XE transabdominal ultrasound machine using a 4-6 MHz probe with the same sonographer.Results: The present study revealed a significant rise of inhibin A in preeclamptic women when compared to normotensive women (p<0.0001). The mean levels of 1st and 2nd trimester uterine artery PI significantly high in women who subsequently developed PE when compared to those who did not develop preeclampsia (p<0.0001). Study results showed a strong association between gestational age at delivery and neonatal outcome (neonatal birth weight and APGAR) with preeclampsia. The maternal serum inhibin A, and uterine artery PI found to have good sensitivity and specificity for early prediction of PE.Conclusions: Study concluded that the women who are prone to develop PE subsequently, had high levels of MAP, UAPI, inhibin A. In our setting, MAP, UAPI, inhibin A, appeared to be better screening modalities. Combination of the biochemical markers with the biophysical markers, demographic characteristics, and other novel markers will establish the effective screening models for early prediction of PE. Early identification of high-risk cases will offer an opportunity for prophylactic therapy, such as Low- dose Aspirin in selected groups of high-risk women screened in the first trimester, thus improving the maternal and perinatal outcome.

scholarly journals Preeclampsia prediction –First trimester screening markers

2021 ◽  
Vol 8 (2) ◽  
pp. 223-229
Author(s):  
Kaliki Hymavathi ◽  
Bhaavya Paturi ◽  
Duvvuru Akshitha ◽  
K Sravya
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Uterine Artery ◽  
First Trimester ◽  
Screening Tools ◽  
Early Prediction ◽  
Creatinine Ratio ◽  
Spot Urine ◽  
Maternal Urine ◽  
Urine Albumin

Preeclampsia is a multi-system disorder manifested primarily by hypertension and proteinuria during second half of pregnancy. It is a major cause of maternal morbidity and mortality worldwide. Despite decades of research into the condition, the ability of clinicians to predict preeclampsia prior to the onset of symptoms has not improved significantly. In this review we will look at potential biomarkers for early prediction and diagnosis of preeclampsia. To evaluate the efficacy of different biochemical and biophysical markers in the early weeks of gestation as screening tools for early prediction of preeclampsia. This hospital-based prospective observational study conducted on 52 pregnant women, at less than 13 weeks of gestation were recruited. Maternal urine microalbumin, urinary albumin to creatinine ratio, and USG uterine artery PI levels were analyzed among the pregnant women who subsequently developed PE and compare with those who did not develop PE. Methods used for the detection of markers are: immunoturbidimetric method for urine albumin, modified kinetic Jaffe reaction without deproteinization for Urine creatinine and Uterine artery Doppler velocimetry was done by PHILIPS HD11XE transabdominal ultrasound machine using a 4-6 MHz probe with the same sonographer. In the present study, spot urine microalbumin and spot urine albumin to creatinine ratio (UACR) at 11-13 were significantly higher in women who developed PE subsequently when compared to nonpreeclamptic women.(P&#60;0.0001). The mean levels of 1st and 2nd-trimester uterine artery PI significantly high in women who subsequently developed PE when compared to those who did not develop preeclampsia (P&#60;0.0001). Study results showed a strong association between gestational age at delivery and neonatal outcome (neonatal birth weight and APGAR) with preeclampsia. The maternal urine microalbumin, albumin to creatinine ratio, and uterine artery PI found to have good sensitivity and specificity for early prediction of PE. Study concluded that the women who are prone to develop PE subsequently, had high levels of MAP, UAPI, microalbuminuria and urine albumin to creatinine ratio than the normotensive women. In our setting, MAP, UAPI, microalbuminuria, and UACR markers appeared to be better screening modalities. The combination of biochemical markers with the biophysical markers, demographic characteristics, and other novel markers will establish the effective screening models for early prediction of PE. Early identification of high-risk cases will offer an opportunity for prophylactic therapy, such as Low- dose Aspirin in selected groups of high-risk women screened in the first trimester, thus improving the maternal and perinatal outcome.

scholarly journals The Effect of Referral Process and Complications to Maternal Mortality

2015 ◽  
Vol 3 (3) ◽  
pp. 400
Author(s):  
Indah Handriani ◽  
Soenarnatalina Melaniani
Keyword(s):  
High Risk ◽  
Maternal Mortality ◽  
Pregnant Women ◽  
Medical Records ◽  
Multivariable Analysis ◽  
Secondary Data ◽  
Case Control ◽  
Referral Process

ABSTRACTMaternal Mortality Rate (MMR) in East Java was still high. in 2013, MMR in sidoarjo district has readed 96.27 per 100,000 live birth. This aim of this study was to the effect of the referral process to maternal mortality in RSUD Sidoarjo. This research was analytic observational with case control design. The Samples of this study were 25 pregnant women who were referred to RSUD Sidoarjo and death. The case controls were 50 pregnant women who were referred to RSUD Sidoarjo who did not experience death. Techniques of data collection using secondary data from the register book maternal and neonatal Emergency (MNE) and medical records and interviews with the mother/family/husband of respondents. The data was analyzed by using univariable, bivariable and multivariable analysis with logistic regression. The results of this study confirmed that the referral process was poor (OR=9,783,95% CI: 2,275 to 42,072, p=0,002) and the complications (OR=0,005,95%CI: 0,001-0,057, p=0,000).thus, the incidence maternal mortality increased. The conclusion of this study is the referral process and the complications to maternal mortality affect the occurrence of maternal mortality. Midwives need to conduct health education should be given to women in their productive age, increase the participation of families, communities and cadres in the process of early detection of complications during pregnancy, childbirth and postpartum, the quality of antenatal care (ANC) and the quality of referrals should be improved by creating a close referral system in a region associated with a high risk pregnant women were detected inventoried and scheduled control/termination and monitored (follow-up) so that high risk always monitored.Keywords: maternal mortality, referral process, complications

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