scholarly journals “Near miss” maternal morbidity following repeat rescue cerclage for twin pregnancy

2020 ◽  
Vol 28 (2) ◽  
pp. 142-144
Author(s):  
Ayse Filiz Gökmen Karasu ◽  
Irana Gorchiyeva ◽  
Rana Dural ◽  
Mehmet Serdar Kutuk
Keyword(s):  
Maternal Morbidity ◽  
Pregnancy Termination ◽  
Treatment Options ◽  
Intrauterine Infection ◽  
Therapeutic Benefit ◽  
Infectious Complications ◽  
Cervical Length ◽  
Near Miss ◽  
Rule Out

Objective Repeat cervical cerclage is one of the treatment options described in the literature for when the primary cerclage suture fails. However, infectious complications of cerclage placement may be encountered which are more obvious for the newborn. In our presented case, severe acute maternal morbidity was encountered for the sake of prolonging pregnancy. Case(s) Twenty-seven year old nullipar patient at 23+5 gestational weeks with dichorionic diamniotic pregnancy was admitted to our emergency clinic with complaints of “pain” and “vaginal bleeding”. At 18 weeks of pregnancy she had a Shirodkar cerclage procedure indicated by a short cervical length (14 mm) at our hospital. She presented with “bulging of membranes” to a different institution and underwent a repeat cerclage at 23+3 weeks. Chorioamnionitis was suspected and the patient was counselled for a pregnancy termination. After termination of pregnancy, “cardiac arrest” developed. After 2 minutes of resuscitation sinus rythm was obtained. The patient was admitted to the ICU. Conclusion The role of repeat cerclage is controversial. Efforts should be maximized to rule out underlying intrauterine infection prior to placement of a cerclage suture for there to be a therapeutic benefit of prolonging the pregnancy.

scholarly journals DETECTION OF HERPESVIRUS INFECTIONS IN CHILDREN OF THE FIRST SIX MONTHS OF LIFE

2018 ◽  
pp. 87-92
Author(s):  
E. M. Burmistrov ◽  
T. N. Rybalkina ◽  
N. V. Karazhas ◽  
R. E. Boshyan ◽  
P. A. Veselovsky ◽  
...  
Keyword(s):  
Breast Milk ◽  
Blood Cells ◽  
Intrauterine Infection ◽  
Infectious Complications ◽  
Infectious Gastroenteritis ◽  
Intestinal Infections ◽  
Common Antigens ◽  
Simplex Virus ◽  
Positive Results

Aim. To evaluate a possible role of herpes viruses in the pathogenesis of various infectious diseases of children in the first six months of life, including acute gastroenteritis and identify the markers of herpesvirus infections which occur most frequently. Materials and methods. Samples of biological materials (blood serum and blood cells, breast milk, urine, feces) were studied in 35 children aged 14 days to 5 months who are being treated in MRRCI Vladimirsky with diagnoses of «acute infectious gastroenteritis of unspecified etiology» (n=24), «urinary tract infection» (n=6), «intrauterine infection» (n=5) and of their mothers. To determine the antibodies of IgM, IgG in serum, an enzyme immunoassay was used, to detect common antigens of viruses in blood cells, urine, breast milk - an indirect reaction of immunofluorescence, to detect early antigens of viruses and their reproduction - a rapid cultural method. Results. Infection with herpesviruses was found in 85% of children and 91% of mothers, with the most often identified markers of active forms of infection caused by the herpes simplex virus. In children with a diagnosis of acute infectious gastroenteritis of unspecified etiology, no pathogens of viral and bacterial intestinal infections were detected in a large number of active forms of herpesviral infections in both children and their mothers (33% and 91%, respectively). As well as mothers and their children, there have been cases of mixed infections caused by associations of herpesviruses, most often with HSV. Conclusion. Detection of active forms of herpesviral infections in the absence of positive results in studies on viral and bacterial intestinal infections make it possible to assume that herpesviruses can participate in the etiology of these diseases and cause infectious complications in this pathology, as well as often act as a co-infection. An important epidemiological importance has a large number of identified latent forms of herpesvirus infections, because when exposed to adverse factors they can go into active forms.

scholarly journals Microbiome of human skin - its immunohomeostatic role and the role in pathogenesis of skin diseases

2018 ◽  
Vol 15 (1) ◽  
pp. 63-81
Author(s):  
D D Petrunin
Keyword(s):  
Human Skin ◽  
Skin Diseases ◽  
Secondary Infection ◽  
Treatment Options ◽  
Infectious Complications ◽  
Special Importance ◽  
Skin Microbiome ◽  
Inflammatory Dermatoses ◽  
Pathogenic Microbes

In the last decade new methods of metagenomic analysis allowed to obtain important data regarding the microbiome of human skin. The problem of colonization and secondary infection by pathogenic microbes is of special importance for allergic dermatoses that require topical immunosuppressive therapy. One of treatment options in this case could be topical multicomponent drugs that allow successful treatment of infectious complications of inflammatory dermatoses. But there are still a lot of blanks regarding both fundamental questions regarding human skin microbiome and practice aspects of treatment of skin diseases where it plays a pathogenetic role. This literature review systematizes and structures the accumulated data regarding the composition and the role of human skin microbiome in normal conditions and in various skin diseases as well as summarizes clinical data of use of combinational topical glucocorticosteroid drugs. Furthermore, some algorithms concerning the choice and optimization of topical treatment of secondary infected dermatoses are outlined.

scholarly journals Role of the Angiogenic Factors in Cholangiocarcinoma

2019 ◽  
Vol 9 (7) ◽  
pp. 1393 ◽  
Author(s):  
Romina Mancinelli ◽  
Caterina Mammola ◽  
Roberta Sferra ◽  
Simona Pompili ◽  
Antonella Vetuschi ◽  
...  
Keyword(s):  
Growth Factor ◽  
Treatment Options ◽  
Therapeutic Benefit ◽  
Angiogenic Factors ◽  
Anatomical Location ◽  
Vascular Endothelial ◽  
Distal Cholangiocarcinoma ◽  
Clinic Management ◽  
Endothelial Growth Factor

Angiogenesis plays a fundamental role in tumor growth and progression. It is regulated by several growth factors, including vascular endothelial growth factor protein family (VEGF) and its receptors, which are probably the most important factors responsible for the development of new vessels. The VEGF family includes several members: VEGF-A, VEGF-B, VEGF-C, VEGF-D, VEGF-E, placental growth factor (PlGF), and their receptors VEGFR-1, VEGFR-2 and VEGFR-3. Other relevant factors are represented by angiopoietins, thrombospondin-1, and endothelins. However, since the therapeutic benefit associated with VEGF-targeted therapy is really complex, a better understanding of these pathways will lead to future advances in the use of these agents for clinic management of tumors. Here we present a review regarding the role of angiogenic factors in cholangiocarcinoma, which arise from cholangiocytes, the epithelial cells of bile ducts. They are rare and aggressive neoplasms with a poor prognosis and limited treatment options, classified as intrahepatic, perihilar, and distal cholangiocarcinoma based on their anatomical location. Therefore, the identification of specific signaling pathways or new tumor biomarkers is crucial in order to develop more effective anti-angiogenic therapies.

scholarly journals LACTOFERRIN, FLUORESCENT TECHNOLOGIES AND THEIR ROLE IN THE DIAGNOSIS AND TREATMENT OF INFLAMMATORY DISEASES OF THE FEMALE SEXUAL SPHERE

2018 ◽  
Vol 5 (2) ◽  
pp. 101-105
Author(s):  
V. M Zuev ◽  
D. G Gulenkova ◽  
I. L Goldman ◽  
E. R Sadchikova ◽  
M. T Aleksandrov
Keyword(s):  
Inflammatory Diseases ◽  
Scientific Evidence ◽  
Treatment Options ◽  
Rapid Assessment ◽  
Intrauterine Infection ◽  
Infectious Complications ◽  
Vaginal Infections ◽  
Vaginal Microflora ◽  
Relationship Of ◽  
The Relationship

The article reflects a modern view on the introduction of fluorescent methods of diagnostics and treatment of vaginal infections using lactoferrin in clinical microbiology, which made it possible to expand microecological studies. The suppression of the normal vaginal microflora was shown to promote a diverse pathology of both inflammatory and non-inflammatory genesis. Bacterial and fungal vaginosis were proved to be the most important risk factors for the development of infectious complications in the gynecological practice. There are given substantiated scientific evidence, indicating a large number of recurrences of bacterial and candidal vaginitis, despite the numerous studies and various treatment options. The relationship of bacterial vaginitis with infertility, the threat of miscarriage, premature birth, intrauterine infection of the fetus, etc. was established. Based on this, the search for alternative combined methods is relevant. The aim of the study was to increase the effectiveness of the treatment of recurrent candid vulvovaginitis and bacterial vaginosis by using lactoferrin. In the study, there were used fluorescent methods of the diagnosis, which made it possible to verify the diagnosis in the rapid assessment mode, as well as monitor treatment and improve its effectiveness.

Treatment Options in COVID-19: The Role of Bioavailable Antiviral Ribonucleoside Analog on NHC in vitro

2020 ◽  
Author(s):  
Lara Bittmann
Keyword(s):  
World Health Organization ◽  
Clinical Picture ◽  
Treatment Options ◽  
World Health ◽  
Wuhan City ◽  
The World ◽  
Novel Coronavirus ◽  
Health Organization

On December 31, 2019, WHO was informed of cases of pneumonia of unknown cause in Wuhan City, China. A novel coronavirus was identified as the cause by Chinese authorities on January 7, 2020 and was provisionally named "2019-nCoV". This new Coronavirus causes a clinical picture which has received now the name COVID-19. The virus has spread subsequently worldwide and was explained on the 11th of March, 2020 by the World Health Organization to the pandemic.

Monitoring Maternal Near Miss/Severe Maternal Morbidity: A Systematic Review

2019 ◽  
Author(s):  
Natalie England ◽  
Julia Madill ◽  
Amy Metcalfe ◽  
Laura Magee ◽  
Stephanie Cooper ◽  
...  
Keyword(s):  
Systematic Review ◽  
Maternal Morbidity ◽  
Near Miss ◽  
Severe Maternal Morbidity ◽  
Maternal Near Miss

Microbiota, Immune System and Autism Spectrum Disorders: An Integrative Model towards Novel Treatment Options

2020 ◽  
Vol 27 (31) ◽  
pp. 5119-5136 ◽  
Author(s):  
Barbara Carpita ◽  
Donatella Marazziti ◽  
Lionella Palego ◽  
Gino Giannaccini ◽  
Laura Betti ◽  
...  
Keyword(s):  
Immune System ◽  
Familial Aggregation ◽  
Treatment Options ◽  
Autism Spectrum ◽  
Integrative Model ◽  
Neural Basis ◽  
Integrative Framework ◽  
Intermediate Phenotypes ◽  
Close Relatives

Background: Autism Spectrum Disorder (ASD) is a condition strongly associated with genetic predisposition and familial aggregation. Among ASD patients, different levels of symptoms severity are detectable, while the presence of intermediate autism phenotypes in close relatives of ASD probands is also known in literature. Recently, increasing attention has been paid to environmental factors that might play a role in modulating the relationship between genomic risk and development and severity of ASD. Within this framework, an increasing body of evidence has stressed a possible role of both gut microbiota and inflammation in the pathophysiology of neurodevelopment. The aim of this paper is to review findings about the link between microbiota dysbiosis, inflammation and ASD. Methods: Articles ranging from 1990 to 2018 were identified on PUBMED and Google Scholar databases, with keyword combinations as: microbiota, immune system, inflammation, ASD, autism, broad autism phenotype, adult. Results: Recent evidence suggests that microbiota alterations, immune system and neurodevelopment may be deeply intertwined, shaping each other during early life. However, results from both animal models and human samples are still heterogeneous, while few studies focused on adult patients and ASD intermediate phenotypes. Conclusion: A better understanding of these pathways, within an integrative framework between central and peripheral systems, might not only shed more light on neural basis of ASD symptoms, clarifying brain pathophysiology, but it may also allow to develop new therapeutic strategies for these disorders, still poorly responsive to available treatments.

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.

Benign Intracranial Lesions - Radiotherapy: An Overview of Treatment Options, Indications and Therapeutic Results

2020 ◽  
Vol 15 (2) ◽  
pp. 93-121
Author(s):  
Vasileios Tzikoulis ◽  
Areti Gkantaifi ◽  
Filippo Alongi ◽  
Nikolaos Tsoukalas ◽  
Haytham Hamed Saraireh ◽  
...  
Keyword(s):  
Effective Treatment ◽  
Treatment Modality ◽  
Radiation Effects ◽  
Treatment Options ◽  
Proton Beam Therapy ◽  
Tumor Control ◽  
Control Growth ◽  
Effective Treatment Modality ◽  
Intracranial Lesions

Background: Radiation Therapy (RT) is an established treatment option for benign intracranial lesions. The aim of this study is to display an update on the role of RT concerning the most frequent benign brain lesions and tumors. Methods: Published articles about RT and meningiomas, Vestibular Schwannomas (VSs), Pituitary Adenomas (PAs), Arteriovenous Malformations (AVMs) and craniopharyngiomas were reviewed and extracted data were used. Results: In meningiomas RT is applied as an adjuvant therapy, in case of patientrefusing surgery or in unresectable tumors. The available techniques are External Beam RT (EBRT) and stereotactic ones such as Stereotactic Radiosurgery (SRS), Fractionated Stereotactic RT (FSRT), Intensity Modulated RT (IMRT) and proton-beam therapy. The same indications are considered in PAs, in which SRS and FSRT achieve excellent tumor control rate (92-100%), acceptable hormone remission rates (>50%) and decreased Adverse Radiation Effects (AREs). Upon tumor growth or neurological deterioration, RT emerges as alone or adjuvant treatment against VSs, with SRS, FSRT, EBRT or protonbeam therapy presenting excellent tumor control growth (>90%), facial nerve (84-100%), trigeminal nerve (74-99%) and hearing (>50%) preservation. SRS poses an effective treatment modality of certain AVMs, demonstrating a 3-year obliteration rate of 80%. Lastly, a combination of microsurgery and RT presents equal local control and 5-year survival rate (>90%) but improved toxicity profile compared to total resection in case of craniopharyngiomas. Conclusion: RT comprises an effective treatment modality of benign brain and intracranial lesions. By minimizing its AREs with optimal use, RT projects as a potent tool against such diseases.

Thrombopoietin Receptor Agonists in Children with Immune Thrombocytopenia: A New Therapeutic Era

2020 ◽  
Vol 20 ◽  
Author(s):  
Giuseppe Lassandro ◽  
Valentina Palladino ◽  
Giovanni Carlo Del Vecchioa ◽  
Viviana Valeria Palmieri ◽  
Paola Carmela Corallo ◽  
...  
Keyword(s):  
Immune Thrombocytopenia ◽  
Treatment Options ◽  
Thrombopoietin Receptor Agonists ◽  
Receptor Agonists ◽  
Thrombopoietin Receptor ◽  
Related Quality ◽  
Health Related

Background and Objective: Immune thrombocytopenia (ITP) is a common bleeding disorder in childhood. The management of ITP in children is controversial, requiring personalized assessment of patients and therapeutic choices. Thrombopoietin receptor agonists (TPO-RAs), eltrombopag and romiplostim, have been shown to be safety and effective for the treatment of pediatric ITP. The aim of our research is defining the role of thrombopoietin receptor agonists in the management of pediatric ITP. Method: This review focuses on the use of TPO-RAs in pediatric ITP, in randomized trials and in clinical routine, highlighting their key role in management of the disease. Results: Eltrombopag and romiplostim appear effective treatment options for children with ITP. Several clinical studies have assessed that the use of TPO-RAs increases platelet count, decreases bleeding symptoms and improves health-related quality of life. Moreover, TPO-RAs are well tolerated with minor side effects. Conclusion: Although TPO-RAs long term efficacy and safety still require further investigations, their use is gradually expanding in clinical practice of children with ITP.

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