scholarly journals Effect of Antioxidants on the Occurrence of Pre-eclampsia in Women at Increased Risk

2015 ◽  
Vol 1 (1) ◽  
Author(s):  
Mahmoud. A. Sultan - Hassan Salim - Y. Elmesallawy - E.A.Elt
Keyword(s):  
High Risk ◽  
Gestational Age ◽  
Uterine Artery ◽  
Resistance Index ◽  
Secondary Outcome ◽  
Control Group ◽  
High Risk Population ◽  
Elevated Liver Enzymes ◽  
Increased Risk ◽  
Pai 1

The objective of this work is: Asses the potential benefit of antioxidant supplementation on the occurrence of preeclampsia at high risk women. Patients and Methods: The number of primigravida women's collected was " 294" with gestational age ranged from 18-22 wks. .from (294) prim gravida cases ,(25) women were identified as being at increased risk of pre-eclampsia by abnormal Doppler wave form in either uterine artery at 18-22 weeks' gestation ( defined as a resistance index < 95th centile for gestation or the presence of an early diastolic notch ) , Another (25) women with history in the preceding pregnancy of pre-eclampsia, eclampsia or HELLP (Hemolysis, elevated liver enzymes, low platelets ) . -Total number of eligible participants were, (50) cases. Design and procedure: Cases divided randomly into two groups each 25 cases one group received tablets of 1000 mg vitamin C, (Cevitil efferecent. EPICO) + 400 iu of vitamin E (E-Viton 400 pharco). Venous blood for measurement of PAI-1 and PAI-2, The primary outcome measure was the ratio PAI-1 / PAI-2 and the secondary outcome prospectively according to guidelines of international society for the study of hypertension in pregnancy. Results: Doppler screening was done on, 294 prim gravidae with gestational age ranged from 18-22 weeks; only 42 women showed abnormal Doppler study so asked to come for rescanning at 24 weeks' gestation. 31 out of 42 patients (75%) have persistent abnormal study. The remainders of the 42 women (25%) were withdrawn from the study at 24 wks.' gestation because they have normal uterine-artery scan. Development of mild preeclampsia was statistically lower (p<0.5) in the study than that in the control group. However, development of sever preeclampsia or superimposed preeclampsia was statistically insignificant between both groups. PAI-1 was significantly increased in women developed preeclampsia more than normotensive (167±71.2, 113.8±35.6ng/ml respectively) with P=0.03 IN contrast PAI-2 was significantly decreased in women developed preeclampsia less than normotensive (105±34.9, 181.1±67.9ng/ml respectively) with P=0.018. Conclusion: Treatment and prevention trials of preeclampsia have been disappointing to date. However, this study has suggested causal links between oxidative stress and the development of preeclampsia indicate that may be a role for antioxidant vitamins in the prevention of preeclampsia. a high- risk population can be successfully identified on the basis of uterine-artery Doppler screening and pervious history of the disease.

CORRELATION OF ABNORMAL UTERINE ARTERY DOPPLER IN THE SECOND TRIMESTER OF PREGNANCY WITH MATERNAL AND FETAL OUTCOME.

2021 ◽  
pp. 18-19
Author(s):  
Sangeetha Menon ◽  
Jyotsna Nalinan
Keyword(s):  
High Risk ◽  
Uterine Artery ◽  
Subsequent Development ◽  
High Risk Population ◽  
Age Group ◽  
Second Trimester ◽  
Risk Population ◽  
Uterine Artery Doppler ◽  
Increased Risk ◽  
Doppler Indices

Introduction: Maternal – fetal circulation can be studied non-invasively by using doppler which can be used as a screening tool for fetal and maternal disease. Morphological changes in the uterine vasculature can be demonstrated by colour and pulsed doppler studies. The majority of the studies on uterine artery doppler have focused on a high risk population. The effectiveness of the uterine artery doppler to predict pre eclampsia or FGR in a low risk population has been shown to have a low to moderate predictive value1. Also the criteria for normal and abnormal uterine artery doppler continue to vary with no well accepted denition. Aim: To nd out the correlation between abnormal uterine artery doppler in the second trimester of pregnancy between 18-22 weeks, with the subsequent development of pre eclampsia and FGR. Materials and methods: This is a prospective cohort study carried out in the Department of Obstetrics and Gynecology for a period of one year. Antenatal patients in the age group of 18-35 years, between 18-22 weeks of gestation, who were included in the study underwent a uterine artery doppler. They were followed up until delivery. SPSS software was used to analyze the data. Results: 193 Obstetric patients in the age group 18-35 years were evaluated with uterine artery doppler. 77.7% had normal doppler indices. In the abnormal doppler group, 81.4% were in the high risk category and 48.8% of those with abnormal dopplers developed pre eclampsia and 34.9% with abnormal dopplers developed FGR. Conclusion: Patients with abnormal uterine artery doppler indices in the second trimester of pregnancy, had an 18 times increased risk of developing pre eclampsia and a 6 times increased risk of developing FGR when compared to those with normal doppler indices.

scholarly journals Effects of Yoga on Utero-Fetal-Placental Circulation in High-Risk Pregnancy: A Randomized Controlled Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Abbas Rakhshani ◽  
Raghuram Nagarathna ◽  
Rita Mhaskar ◽  
Arun Mhaskar ◽  
Annamma Thomas ◽  
...  
Keyword(s):  
High Risk ◽  
Standard Care ◽  
Uterine Artery ◽  
Controlled Trial ◽  
Resistance Index ◽  
High Risk Pregnancy ◽  
Trophoblast Invasion ◽  
Control Group ◽  
Risk Pregnancy ◽  
Yoga Group

Introduction. Impaired placentation and inadequate trophoblast invasion have been associated with the etiology of many pregnancy complications and have been correlated with the first trimester uterine artery resistance. Previous studies have shown the benefits of yoga in improving pregnancy outcomes and those of yogic visualization in revitalizing the human tissues.Methods. 59 high-risk pregnant women were randomized into yoga (n= 27) and control (n= 32) groups. The yoga group received standard care plus yoga sessions (1 hour/day, 3 times/week), from 12th to 28th week of gestation. The control group received standard care plus conventional antenatal exercises (walking). Measurements were assessed at 12th, 20th, and 28th weeks of gestation.Results. RM-ANOVA showed significantly higher values in the yoga group (28th week) for biparietal diameter (P= 0.001), head circumference (P= 0.002), femur length (P= 0.005), and estimated fetal weight (P= 0.019). The resistance index in the right uterine artery (P= 0.01), umbilical artery (P= 0.011), and fetal middle cerebral artery (P= 0.048) showed significantly lower impedance in the yoga group.Conclusion. The results of this first randomized study of yoga in high-risk pregnancy suggest that guided yogic practices and visualization can improve the intrauterine fetal growth and the utero-fetal-placental circulation.

scholarly journals Irisin levels in relation to metabolic and liver functions in Egyptian patients with metabolic syndrome

2016 ◽  
Vol 94 (4) ◽  
pp. 359-362 ◽  
Author(s):  
Fatma H. Rizk ◽  
Samah A. Elshweikh ◽  
Amira Y. Abd El-Naby
Keyword(s):  
Metabolic Syndrome ◽  
Liver Enzymes ◽  
Resistance Index ◽  
Control Group ◽  
Model Assessment ◽  
Group Iii ◽  
Group I ◽  
Elevated Liver Enzymes ◽  
Liver Functions ◽  
Group Ii

Irisin is a new myokine that is suspected to influence metabolic syndrome (MetS). However, there is a great controversy with respect to its level in cases of MetS and its correlation with different metabolic parameters. The present study assesses irisin levels in MetS patients and studies its relationship to metabolic and liver functions to evaluate the possible role of the liver in regulation of this level. Sixty subjects were included in this experiment, who were divided into 3 groups: group I (normal control), group II (MetS patients with normal liver enzymes), and group III (MetS with elevated liver enzymes and fatty liver disease). Serum irisin levels showed significant increases in groups II and III compared with group I, and significant increases in group III compared with group II. Also, irisin levels were positively correlated with body mass index, serum triglycerides, homeostatic model assessment of insulin resistance index (HOMA-IR), and liver enzymes. We concluded that serum irisin levels increased in patients with MetS, especially those with elevated liver enzymes, and had a positive correlation with parameters of lipid metabolism and glucose homeostasis with the possibility of hepatic clearance to irisin.

Armed and prohibited: characteristics of unlawful owners of legally purchased firearms

2020 ◽  
pp. injuryprev-2019-043479 ◽  
Author(s):  
Veronica A Pear ◽  
Christopher D McCort ◽  
Yueju Li ◽  
Laurel Beckett ◽  
Daniel Tancredi ◽  
...  
Keyword(s):  
High Risk ◽  
Random Sample ◽  
High Risk Population ◽  
Bivariate Statistics ◽  
Felony Conviction ◽  
Increased Risk ◽  
Hispanic People ◽  
The Usa ◽  
The Mean ◽  
Race Ethnicity

BackgroundA substantial proportion of individuals who lawfully purchase firearms later become unlawful owners ('prohibited firearm owners'), usually following events associated with an increased risk for future violence. This high-risk population has not previously been described. We aimed to characterise all individuals in California's Armed and Prohibited Persons System (APPS), a statewide programme for recovering firearms from individuals who legally purchased them and later became prohibited from ownership.MethodsWe used univariate and bivariate statistics to describe and compare prohibited firearm owners in APPS with a random sample of non-prohibited firearm owners in relation to age, sex, race/ethnicity and type of firearms owned as of 1 February 2015. We also characterised the geographical distribution of prohibited firearm owners and described their prohibitions.ResultsOf the 18 976 prohibited firearm owners, most were men (93%), half were white (53%) and the mean age was 47 years. Prohibited firearm owners were more likely to be male and to be black or Hispanic people than non-prohibited owners. Both prohibited and non-prohibited firearm owners had an average of 2.6 firearms, mostly handguns. Nearly half (48%) of prohibited firearm owners had a felony conviction. Extrapolating from our findings, we estimated that there are approximately 100 000 persons in the USA who unlawfully maintained ownership of their firearms following a felony conviction.ConclusionsRetention of firearms among persons who become lawfully prohibited from possessing them is common in California. Given the nationwide dearth of a programme to recover such weapons, this is likely true in other states as well.

Primary Cardioprotection Reduces Mortality in Lymphoma Patients with Increased Risk of Anthracycline Cardiotoxicity, Treated by R-CHOP Regimen

Chemotherapy ◽  
2018 ◽  
Vol 63 (4) ◽  
pp. 238-245 ◽  
Author(s):  
Monika Długosz-Danecka ◽  
Alicja M. Gruszka ◽  
Sebastian Szmit ◽  
Agnieszka Olszanecka ◽  
Tomasz Ogórka ◽  
...  
Keyword(s):  
Heart Failure ◽  
Overall Survival ◽  
High Risk ◽  
Cardiovascular Mortality ◽  
Control Group ◽  
Close Monitoring ◽  
Historical Cohort ◽  
Anthracycline Cardiotoxicity ◽  
Clinical Issue ◽  
Increased Risk

Background: Advances in anti-lymphoma therapy prolong overall survival, making late adverse effects, like doxorubicin-related cardiotoxicity, an even more important clinical issue. The effectiveness of cardioprotective strategies with close monitoring, angiotensin-converting enzyme inhibitors and/or β-blockers as well as liposomal doxorubicin are still unconfirmed in clinical practice. Methods: This study evaluated the role of a primary cardioprotection strategy in preventing cardiovascular mortality and heart failure occurrence in non-Hodgkin lymphoma (NHL) patients with a high risk of anthracycline cardiotoxicity. Thirty-five NHL patients were subjected prospectively to ramipril and/or bisoprolol at NHL diagnosis, before implementing doxorubicin-containing regimens. Additionally, patients with a diagnosis of asymptomatic/mild heart failure received the liposomal form of doxorubicin. The clinical outcome and frequency of all serious cardiac events were compared with the results in a historical cohort of 62 high-risk cases treated without primary cardioprotection. Results: NHL patients with a primary cardioprotection strategy did not experience cardiovascular deaths in contrast to the retrospective control group where cardiovascular mortality was 14.5% at 3 years (p < 0.05). Primary cardioprotection also decreased the frequency of new cardiotoxicity-related clinical symptoms (2.8 vs. 24.1%; p < 0.05) and prevented the occurrence of cardiac systolic dysfunction (0 vs. 8.5%, respectively; p < 0.05). Although the study was not planned to detect any survival benefit, it demonstrated a trend towards increased response rates (complete response 82 vs. 67%; p not significant) and prolonged survival (projected 5-year overall survival 74 vs. 60%; p < 0.05) for patients treated with primary cardioprotection. Conclusions: A primary personalized cardioprotection strategy decreases the number of cardiac deaths and may potentially prolong overall survival in NHL patients with increased risk of anthracycline cardiotoxicity.

scholarly journals P0255THE SHORT TERM MATERNAL OUTCOME OF PREGNANT CHRONIC KIDNEY DISEASE PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Christopher thiam seong Lim ◽  
Yun Jin Ong ◽  
Shao Wei Yong ◽  
Wee Ven Hing [email protected] ◽  
Mohammad Zulkarnain Bidin ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
High Risk ◽  
Kidney Disease ◽  
Blood Pressure Monitoring ◽  
Post Partum ◽  
Antibiotic Usage ◽  
High Risk Population ◽  
Multiple Pregnancies ◽  
Fetal Outcomes ◽  
Increased Risk

Abstract Background and Aims Pregnancy in chronic kidney disease (CKD) is associated with increased risk of adverse maternal outcomes and fetal outcomes. The risks are noticeable even in early stages of CKD. Despite the rising concern, there are few follow-up studies in this high-risk group. Method We followed up and analysed 538 pregnancies in 173 women with pre-existing of primary renal disease who were seen at a tertiary nephrology centre from January 2007 until December 2015. We sought to investigate the changes in laboratory and clinical parameters, maternal and fetal outcomes. Results Figure 1 showed the changes of parameters intra and post-partum period. Increase in weight (p=0.034, OR 1.135, 95% CI 1.01-1.276), antibiotics consumption (p=0.022, OR 0.088, 95% CI 0.011-0.0703), pregnancy-related hypertension (p=0.056, OR 0.161, 95% CI 0.025-1.05) and gromerulonephritis (p=0.049, OR 14.22, 95% CI 1.009- 200.52) were associated with worsening of proteinuria intra-pregnancy and post-pregnancy period. Age more than 30-year-old (p=0.024, OR 0.644, 95% CI 0.439-0.945), multiple pregnancies (p = 0.032, OR 14.4, 95% CI 1.25-165 , antibiotics usage (p=0.033, OR 27.59, 95% CI 1.302-585.169), diuretic usage (p=0.034, OR 0.003, 95% CI 1.26-0.646), pregnancy-related hypertension (p=0.06, OR 21.838, 95% CI 0.878-543.376) and proteinuria (&gt; 1.5g/d) (p=0.025, OR 0.235 95% CI 0.067-0.717) and fetal complications such as fetal death (p=0.013, OR 3.608 95% CI 1.311-9.930) was associated with rapid renal function decline of 25-50% . Elevation of serum uric acid is associated with a higher risk of adverse fetal outcome (r=0.845 p=0.004). Conclusion Multiple pregnancies, antibiotic usage, pregnancy-related hypertension are strong predictors of rapid maternal rapid function decline. Pre-conception counselling, minimization of antibiotic usage and aggressive blood pressure monitoring and treatment should be part of the standard treatment for this high-risk population.

People at risk of schizophrenia

1999 ◽  
Vol 174 (6) ◽  
pp. 547-553 ◽  
Author(s):  
Ann Hodges ◽  
Majella Byrne ◽  
Elizabeth Grant ◽  
Eve Johnstone
Keyword(s):  
At Risk ◽  
High Risk ◽  
Social Isolation ◽  
High Risk Group ◽  
Control Group ◽  
Psychiatric Interview ◽  
Increased Risk ◽  
Sample Characteristics ◽  
And Gender ◽  
Disordered Speech

BackgroundThe Edinburgh High-Risk Study is designed to explore the underlying pathogenesis of schizophrenia.AimsTo establish the sample characteristics of the first 100 subjects in this study of young adults at risk of schizophrenia for genetic reasons, and to compare them with appropriate controls.MethodDetails of the recruitment of the first 100 high-risk subjects aged 16–25 years into a prospective Scotland-wide study are given. Subjects and 30 age- and gender-matched normal controls were interviewed using the PSE, SADS-L and SIS and an unstructured psychiatric interview.ResultsSome significant differences emerged between the high-risk group and the control group, namely in previous psychiatric history (31 v. 6.3%), forensic contacts (19 v. 3.1%) and delinquent behaviour (20 v. 3.1%). There were also differences in some parameters from the SIS: childhood social isolation, interpersonal sensitivity, social isolation, suicidal ideation, restricted affect, oddness and disordered speech.ConclusionsThese differences may represent increased risk of developing schizophrenia although their true significance will not be revealed until the cohort has been followed through the at-risk years.

scholarly journals Associations between childhood trauma, bullying and psychotic symptoms among a school-based adolescent sample

2008 ◽  
Vol 193 (5) ◽  
pp. 378-382 ◽  
Author(s):  
Ian Kelleher ◽  
Michelle Harley ◽  
Fionnuala Lynch ◽  
Louise Arseneault ◽  
Carol Fitzpatrick ◽  
...  
Keyword(s):  
Domestic Violence ◽  
High Risk ◽  
Childhood Trauma ◽  
Psychotic Disorders ◽  
Traumatic Events ◽  
High Risk Group ◽  
Traumatic Experiences ◽  
Psychotic Symptoms ◽  
High Risk Population ◽  
Increased Risk

BackgroundChildren and adolescents who report psychotic symptoms appear to be at increased risk for psychotic disorders in adulthood – a putative ‘symptomatic’ high-risk group. However, little research has investigated whether those in this high-risk population have increased rates of exposure to traumatic events in childhood, as seen in patients who have a psychotic illness.AimsTo examine whether adolescents with psychotic symptoms have an increased rate of traumatic experiences.MethodPsychiatric interviews were carried out with 211 adolescents aged between 12 and 15 years and their parents as part of a population-based study. The interview enquired about a number of early traumatic events including physical and sexual abuse, exposure to domestic violence and bullying.ResultsFourteen adolescents (6.6% of those interviewed) reported experiencing at least one psychotic symptom. Adolescents who reported psychotic symptoms were significantly more likely to have been physically abused in childhood, to have been exposed to domestic violence and to be identified as a bully/victim (that is, both a perpetrator and victim of bullying) than those who did not report such symptoms. These findings were not confounded by comorbid psychiatric illness or family history of psychiatric history.ConclusionsOur findings suggest that childhood trauma may increase the risk of psychotic experiences. The characteristics of bully/victims deserve further study.

Molecular Analysis Of Patients With Deep Venous Thrombosis

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 4799-4799
Author(s):  
Soudabeh Hosseeini ◽  
Ebrahim Kalantari ◽  
Akbar Dorgalaleh ◽  
Arash Rozei ◽  
Marzieh Jafari ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Mthfr C677t ◽  
Control Group ◽  
Mthfr A1298c ◽  
Increased Risk ◽  
Fv Leiden ◽  
The Impact ◽  
Pai 1

Background Deep venous thrombosis (DVT) refers to the formation of a thrombus within a deep vein that frequently occurs after surgical procedures, trauma, in the presence of cancer and immobilization conditions. DVT is a major health problem that causes high rate of morbidity and mortality in the general population. Hyper coagulation states such as antithrombin-III, protein-C and protein-S deficiencies, contribute to formation of DVT. Congenital and acquired gene mutations are other risk factors that stimulate formation of thrombus. Our aims in this study was to molecularly analyze the patients with DVT and assess the impact of common mutations of MTHFR (C677T) (A1298C), PAI-1, Prothrombin 20210 and FV Leiden mutation on occurrence of deep venous thrombosis. Methods This long-term study was conducted from June 2009 to July 2013 on 221 patients with deep venues thrombosis. Two hundred and twenty-one age and sex matched individuals were also chosen as control group. The diagnosis of venous thromboembolic disease was based on patient’s history, clinical findings and D-dimer test. Finally deep venous thrombosis was confirmed with Doppler ultrasonography. In addition, all participants were asked to complete a standardized questionnaire on acquired risk factors for venous thrombosis. After confirmation of DVT, both groups were assessed molecularly for five mutations including, MTHFR C677T, MTHFR A1298C, PAI-1 4G/5G, Prothrombin 20210 and FV Leiden. The relationship between these mutations and the risk of DVT was calculated using logistic regression and expressed as an OR with a 95% confidence interval (CI). Results The mean age of patients and control group were 38±0.8 and 3.7± 0.7 years. Our results revealed that the MTHFR C677T (OR 2.9, 95% 95% CI 1.1 to 7.5) and MTHFR A1298C in heterozygote manner (OR 4.3, 95% CI 1.4 to 13.7) were each associated with an increased risk of DVT. The OR associated with being a carrier of the PAI-1 4G/5G genotype was 2.9 (95% CI 1.14 to 7.5). There was a 4-fold increased risk of DVT associated with Prothrombin 20210 mutation in heterozygote manner (OR 4.3, 95% CI 1.4 to 13.7). For patients who were heterozygous for FV Leiden mutation OR DVT was 2.6 (95% CI 1.3 to 5.0). Conclusion Our findings suggest that genetic risk factors have a contributory role on occurrence of DVT. Disclosures: No relevant conflicts of interest to declare.

Development of intermediate and high-risk prostate cancer after testicular cancer.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 177-177 ◽  
Author(s):  
Andrew John Riggin ◽  
Mohummad Minhaj Siddiqui
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Testicular Cancer ◽  
Cox Proportional Hazards ◽  
Control Group ◽  
Testis Cancer ◽  
Survival Curves ◽  
Primary Malignancy ◽  
Increased Risk ◽  
History Of

177 Background: Men with a history of testicular cancer are known to have an increased risk of developing prostate cancer (PCa) in epidemiologic studies. We hypothesized they may also have an increased risk of developing intermediate to high-risk PCa. Herein, we present a case-control study to assess the association of a history of testicular cancer and intermediate to high-risk PCa. Methods: We used the eighteen Surveillance, Epidemiology and End Results (SEER) registries to compare men with a history of testicular cancer to a control population of men with a history of melanoma. Melanoma was used as a control group because, to our knowledge, there is no association of melanoma and PCa. Men were excluded if they were not 60 years of age or older to allow for sufficient PCa diagnosis. PCa incidence was only counted if it occurred at least 5 years after the diagnosis of their primary cancer to allow for possible temporal effect of the primary malignancy. Incidence of total and intermediate to high-risk PCa(Gleason score ≥ 7) was compared using Kaplan-Meier (KM) curves. Cox proportional hazards models were utilized to assess for associations of PCa (JMP 10, SAS Inc). Results: 119,781 men with melanoma and 10,365 men with testicular cancer were identified. The incidence of all PCa by age 80 was 2.7% in the control melanoma cohort and 12.3% in the case cohort of men with history of testicular cancer (p<0.0001 for KM survival curves). For intermediate/high-risk disease, the incidence was 1.1% versus 5.7% for each cohort respectively (p<0.0001 for KM survival curves). Testis cancer (versus the control melanoma cohort) was associated with an increased risk of all PCa (HR 4.7, p<0.0001) and intermediate/high-risk PCa (HR 5.5, p<0.0001). These associations persisted even when controlling for race. Conclusions: A history of testicular cancer is associated with a significantly increased risk of developing both PCa and intermediate/high risk PCa.

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