scholarly journals COURSE OF THREATENED ABORTION IN CHRONIC GASTRITIS OF DIFFERENT TYPES

2020 ◽  
Vol 115 (1) ◽  
pp. 53-62
Author(s):  
Nadiia Zherebak ◽  
Olena Gnatko
Keyword(s):  
Gastrointestinal Tract ◽  
Pregnant Women ◽  
Chronic Gastritis ◽  
Clinical Course ◽  
Clinical Manifestations ◽  
Gastrointestinal Disorders ◽  
Different Types ◽  
Threatened Abortion ◽  
Group 2 ◽  
Group 1

Abortion is one of the most important medical and social problems in the world. Functional and morphological sexual changes associated with the normal fetal growth and development during physiological pregnancy involve other maternal organs and systems to varying extent, and provide changes in metabolic and homeostasis processes in new conditions to preserve pregnancy. Gastrointestinal motility disorders can be a leading pathogenetic factor that contributes to the development of many common gastrointestinal disorders. During pregnancy, decreased intestinal motility may play a pathogenetic role in pregnancy as a factor leading to decreased intestinal motor and evacuation function and negative impact on pregnancy. The aim of the study was to determine the clinical course of threatened abortion in early gestation in women with different types of chronic gastritis to optimize the management of pregnancy. 67 pregnant women with threatened abortion at 8-12 weeks of gestation were examined. They were divided into 2 groups: Group 1 - 35(52.2%) women with chronic gastritis and Group 2 - 32(47.8%) patients without gastritis. At the beginning of pregnancy, all women with chronic gastritis had remission. A comparative assessment of the frequency and severity of manifestations of this complication at an early stage on the leading clinical signs: pain, bleeding, retrochorial hematoma in combination with major (vomiting, constipation) motor-evacuation function of the gastrointestinal tract in different types of gastritis was performed to determine the role of motor and evacuation function of the gastrointestinal tract in the development of the risk of abortion in pregnant women with gastritis. The type of gastritis was confirmed according to the level of basal secretion of serum gastrin 17 (G-17) with the stimulation test. The obtained results were processed by mathematical and statistical analysis methods with determination of average values ​​(M±m), Student's test and confidence index (statistically significant difference was considered as р˂0,05). Results. All women were of reproductive age, the average age of pregnant women in groups had no statistical difference. Analysis of the frequency of clinical manifestations of threatened abortion showed that 35(100%) had pain symptoms, 30(85.7%) had bloody discharge and 10(28.6%) had retrochorial hematoma in Group 1, and 32(100%), 12(37.5%), 5(15.6%), respectively, in Group 2. Assessment of the intensity of threatened abortion symptoms showed that moderate pain was most often observed in all types of gastritis. Mild symptoms were in normoacidic women of Group 1 (11.4%) and Group 2 (9.4%). 2.9% of hyperacidic pregnant women in Group 1 and 3.1% of hypoacidic women in Group 2 reported severe pain. Analysis of the bleeding nature and intensity showed that women in Group 1 with all types of gastritis had spotting: 11.4% of hyperacidic type, 20.0% of normoacidic type and 11.4% of hypoacidic type. Moderate bleeding was observed in different types of chronic gastritis in pregnant women of Group 1 and various acidic conditions in Group 2. Moderate bleeding was significantly more common (7.4-fold) in hyperacidic pregnant women of Group 1 compared with Group 2. Retrochorial hematomas were registered in Group 1 as 14.3% in hyperacidic patients, 5.7% in normoacidic patients and 8.6% in hypoacidic women. Retrochorial hematomas were 2.5-fold more common in hyperacidic gastritis compared with normoacidic and 1.7-fold more common in hypoacidic gastritis. Estimation of the frequency of combined clinical manifestations of functional gastrointestinal diseases in pregnant women with threatened abortion showed that the manifestations of threatened abortion only were observed in 65.6% without gastritis, and only in 5.7% with gastritis. Different variants of combined clinical manifestations of gastrointestinal functional disorders and threatened abortion significantly prevailed in women with chronic gastritis: threatened abortion and vomiting were 3-fold more common, threatened abortion and vomiting and constipation - 4.3-fold, threatened abortion and constipation - 1.6-fold. The combination of threatened abortion and vomiting with various acidity was most common in hyperacidic condition (2,7-fold more common in Group 1 than in Group 2). The variant of the combination of threatened abortion, vomiting and constipation in hyperacid state was 3.6 times more common in Group 1 than in Group 2. Threatened abortion with constipation was registered in 17.1% of women in Group 1 with hyperacidity, which was 2.7 times more often than in women of Group 2. The most common clinical manifestations of threatened abortion and functional gastrointestinal disorders were seen in pregnant women with chronic hyperacidic gastritis. Conclusion. Dysfunction of the motor and evacuation gastrointestinal activity is important in the clinical course of threatened abortion based on the type of chronic gastritis, mediated by the different acid-producing gastric function which indicates the need to optimize treatment of threatened abortion in pregnant women with different types of chronic gastritis.

scholarly journals EFFECT OF HELICOBACTER PYLORY ON THE COURSE OF EARLY EMESIS GRAVIDARUM IN PREGNANT WOMEN WITH CHRONIC GASTRITIS

2020 ◽  
pp. 72-79
Author(s):  
Nadiia Zherebak ◽  
Olena Hnatko ◽  
Nataliia Skuriatina
Keyword(s):  
Positive Result ◽  
Pregnant Women ◽  
Chronic Gastritis ◽  
Clinical Course ◽  
Igg Antibodies ◽  
Study Objective ◽  
Reliability Indicator ◽  
Group 2 ◽  
Group 1

Introduction. The questions of the role of the infectious factor in the course of pregnancy, delivery and the newborn state are important due to the need of the determination of the appropriate management to prevent adverse maternal and fetal outcomes. Currently, the issues of extragastric manifestations associated with Helicobacter pylori (Hp) are being investigated, suggesting possible involvement of Hp in pregnancy complications. Study objective is to evaluate the course of early gestosis (emesis gravidarum), depending on the presence of Helicobacter infection in women with chronic gastritis. Material and methods. We examined 120 pregnant women in the gestation period of 8-12 weeks who had early gestational complications: emesis gravidarum, threatened miscarriage, spontaneous miscarriage and stillbirth, which were divided into 2 groups according to the presence of chronic gastritis: group 1 of 58 pregnant women with gastritis and Group 2 of 62 pregnant women without gastritis. Pregnant women with this form of pregnancy complication were additionally examined to perform the study objective of determining the features and frequency of early gestosis (emesis gravidarum). In addition to clinical and laboratory studies performed in accordance with the protocols of the Ministry of Health of Ukraine for the monitoring of pregnant women, the examined patients were diagnosed with a non-invasive Helicobacter pylory method by rapid chromatographic immunoassay for the detection of serum IgG antibodies to Hp. To determine the type of gastritis, the determination of the level of basal secretion of gastrin 17 (G-17) in the serum was performed with the stimulating test with which the presence and severity of atrophy of the mucous membrane of the antral gastric department can be determined. Pregnant women of both groups who had early gestosis (emesis gravidarum) were evaluated for the severity of pregnancy vomiting using a questionnaire method that included an evaluation of clinical and laboratory parameters. The obtained results were processed by methods of mathematical and statistical analysis with the determination of mean values (M ± m), Student’s test and reliability indicator (difference р<0.05 was considered statistically significant). Results. Among the early gestational complications in pregnant women of groups 1 and 2, early gestosis (emesis gravidarum) had the same frequency and was 29.3% among pregnant women with chronic gastritis and 29.0% among women without gastritis. The positive result of detection of IgG antibodies to Helicobacter pylory in group 1 was 88,2%, in group 2 – 27,8%. When comparing the frequency of detection of antibodies in pregnant groups examined at different severity of emesis gravidarum, it was found that positive results were more common in group 1 with moderate (66,7%) and severe (26,7%) course. In group 2, a positive result was observed in mild emesis gravidarum (60,0%). When investigating the frequency of Hp detection in women with different types of gastritis and emesis gravidarum, it was found that Hp antibodies were more common in women of group 1 with hyperacid type of gastritis (53.3%), and in group 2 with hypoacid type of gastritis (80.0). The evaluation of the clinical course and laboratory data showed the difference, which was more often associated with the type of gastritis, which was responsible for the clinical course of pregnancy in women with chronic gastritis and early gestosis and the degree of emesis gravidarum. Conclusion. The presence of Helicobacter pylory infection is more common in pregnant women with chronic gastritis and vomiting of pregnant women. The clinical course of early gestosis in these conditions depends on the level of gastric acidity, which determines the severity of emesis gravidarum.

scholarly journals The Systematic Effect of Mesenchymal Stem Cell Therapy in Critical COVID-19 Patients: A Prospective Double Controlled Trial

2021 ◽  
Vol 30 ◽  
pp. 096368972110249
Author(s):  
G Adas ◽  
Z Cukurova ◽  
K Kart Yasar ◽  
R Yilmaz ◽  
N Isiksacan ◽  
...  
Keyword(s):  
Growth Factors ◽  
Critically Ill ◽  
Inflammatory Cytokines ◽  
Clinical Manifestations ◽  
Systematic Effect ◽  
Cytokine Storm ◽  
Group 3 ◽  
Anti Inflammatory ◽  
Group 2 ◽  
Group 1

The aim of this clinical trial was to control the cytokine storm by administering mesenchymal stem cells (MSCs) to critically-ill COVID-19 patients, to evaluate the healing effect, and to systematically investigate how the treatment works. Patients with moderate and critical COVID-19 clinical manifestations were separated as Group 1 (moderate cases, n = 10, treated conventionally), Group 2 (critical cases, n = 10, treated conventionally), and Group 3 (critical cases, n = 10, treated conventionally plus MSCs transplantation therapy of three consecutive doses on treatment days 0, 3, and 6, (as 3 × 106 cells/kg, intravenously). The treatment mechanism of action was investigated with evaluation markers of the cytokine storm, via biochemical parameters, levels of proinflammatory and anti-inflammatory cytokines, analyses of tissue regeneration via the levels of growth factors, apoptosis markers, chemokines, matrix metalloproteinases, and granzyme-B, and by the assessment of the immunomodulatory effects via total oxidant/antioxidant status markers and the levels of lymphocyte subsets. In the assessment of the overall mortality rates of all the cases, six patients in Group-2 and three patients in Group-3 died, and there was no loss in Group-1. Proinflammatory cytokines IFNγ, IL-6, IL-17A, IL-2, IL-12, anti-inflammatory cytokines IL-10, IL-13, IL-1ra, and growth factors TGF-β, VEGF, KGF, and NGF levels were found to be significant in Group-3. When Group-2 and Group-3 were compared, serum ferritin, fibrinogen and CRP levels in Group-3 had significantly decreased. CD45 +, CD3 +, CD4 +, CD8 +, CD19 +, HLA-DR +, and CD16 + / CD56 + levels were evaluated. In the statistical comparison of the groups, significance was only determined in respect of neutrophils. The results demonstrated the positive systematic and cellular effects of MSCs application on critically ill COVID-19 patients in a versatile way. This effect plays an important role in curing and reducing mortality in critically ill patients.

scholarly journals Antiphospholipid antibodies, genetic thrombophilia and fetal growth retardation

2022 ◽  
Vol 15 (6) ◽  
pp. 695-704
Author(s):  
E. A. Orudzhova
Keyword(s):  
Pregnant Women ◽  
Fetal Growth ◽  
Growth Retardation ◽  
Antiphospholipid Antibodies ◽  
Controlled Trial ◽  
Factor V Leiden ◽  
Control Group ◽  
Fetal Growth Retardation ◽  
Group 2 ◽  
Group 1

Aim: to study the role of antiphospholipid antibodies (AРA) and genetic thrombophilia as a potential cause of the development or a component in the pathogenesis of early and late fetal growth retardation (FGR).Materials and Methods. There was conducted a prospective randomized controlled trial with 118 women enrolled. The main group consisted of 83 patients, whose pregnancy was complicated by FGR degrees II and III, stratified into two groups: group 1 – 36 pregnant women with early FGR, group 2 – 47 pregnant women with late FGR. Women were subdivided into subgroups according to the FGR severity. The control group consisted of 35 pregnant women with a physiological course of pregnancy. АРА were determined according to the Sydney antiphospholipid syndrome criteria by enzyme immunoassay (ELISA): against cardiolipin, β2 -glycoprotein 1, annexin V, prothrombin, etc. (IgG/IgM isotypes); lupus anticoagulant – by the three-stage method with Russell's viper venom; antithrombin III and protein C levels – by chromogenic method; prothrombin gene polymorphisms G20210A and factor V Leiden – by polymerase chain reaction; homocysteine level – by ELISA.Results. AРA circulation (medium and high titers), genetic thrombophilic defects and/or hyperhomocysteinemia were detected in 40 (48.2 %) patients with FGR, which was significantly higher than that in the control group (p < 0.05): in group 1 (41.7 % of women) AРA (30.6 %) and AРA with genetic thrombophilia or hyperhomocysteinemia (11.1 %) were revealed; in group 2 (51.1 % of women) AРA (21.3 %), AРA with hyperhomocysteinemia (4.3 %), genetic thrombophilia (25.5 %), and due to hyperhomocysteinemia (2.1 %) were found. No differences in prevalence of thrombophilia rate in patients were observed related to FGR severity, but a correlation between the FGR severity and AРA titers was found.Conclusion. Testing for the presence of AРA, genetic thrombophilia and hyperhomocysteinemia should be recommended for patients with FGR (including those with FGR in medical history), especially in the case of its early onset. It is recommended to determine the full AРA spectrum.

scholarly journals The role of uterine artery Doppler index and nuchal translucency measurement in predicting perinatal problems and the gestational age in patients diagnosed with hyperemesis gravidarum

2020 ◽  
Vol 2 (3) ◽  
pp. 19-22
Author(s):  
Dilek Kartal ◽  
Azra Arıcı Yurtkul ◽  
Ayşe Rabia Şenkaya
Keyword(s):  
Pregnant Women ◽  
Uterine Artery ◽  
Hyperemesis Gravidarum ◽  
Systemic Disease ◽  
Nuchal Translucency ◽  
Control Group ◽  
Uterine Artery Doppler ◽  
Tertiary Center ◽  
Group 2 ◽  
Group 1

Objective: We aimed to investigate the effectiveness of uterine artery Doppler index and nuchal translucency (NT) measurement in determining perinatal problems in patients diagnosed with hyperemesis gravidarum (HEG). Material and methods: We included 80 pregnant women between the ages of 19–40 years with a singleton, noncomplicated pregnancy, no systemic disease, and no structural and chromosomal disorders in the fetus, who were admitted to our hospital which is a tertiary center with a large patient population in the region, between October 2015 and October 2016 in this study. Further, two group were formed as 40 pregnant women with the diagnosis of HEG (group 1) and 40 pregnant women for control group (group 2). Age, body mass index (BMI), educational status,pregnancy history (live birth, miscarriages), smoking, alcohol consumption, substance use, last menstrual period, serum pregnancy-associated plasma protein A (PAPP-A), free beta-human chorionic gonadotropin, (free ß-hCG), thyroid stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4) levels, nuchal translucency (NT), and uterine artery Doppler measurement values were recorded. The data between two groups were compared. Results: The education level of the group 1 was found higher (p = 0.001). The frequency of smoking in group 1 (n = 18; 45%) was found significantly higher than group 2 (n = 3; 7.5%) (p = 0.001). In group 1, uterine artery Doppler pulsatility index (PI) and resistance index (RI) values were found higher than group 2 (p = 0.026 and 0.024, respectively). Conclusion: The uterine artery Doppler PI, RI values measured at 20–24 weeks in patients with HEG were statistically significantly higher than those without HEG.

scholarly journals Prevention and treatment of non-complicated infections of the lower urinary tract in pregnant women

2021 ◽  
Vol 4 (2) ◽  
pp. 119-123
Author(s):  
N.A. Nashivochnikova ◽  
◽  
V.N. Krupin ◽  
V.E. Leanovich ◽  
◽  
...  
Keyword(s):  
Urinary Tract ◽  
Pregnant Women ◽  
Treatment Efficacy ◽  
Asymptomatic Bacteriuria ◽  
Control Group ◽  
Chronic Cystitis ◽  
Acute Cystitis ◽  
Total Treatment ◽  
Group 2 ◽  
Group 1

Aim: to assess the efficacy of biologically active additive Cystenium II as a component of combined antimicrobial treatment of acute cystitis or exacerbation of chronic cystitis and asymptomatic bacteriuria (ASB) in pregnant women. Patients and Methods: 65 pregnant women with urinary tract infections were enrolled. Group 1 included 22 women with acute cystitis or exacerbation of chronic cystitis and group 2 included 20 women with ASB. These women received standard antimicrobial therapy (fosfomycin trometamol 3 g) and Cystenium II (1 tablet twice daily with food for 14 days). The control group included 23 women with acute cystitis or exacerbation of chronic cystitis or ASB who received standard antimicrobial therapy only. Treatment results were evaluated after 14 days and 2 months. Results: complete resolution of cystitis occurred on days 2 and 3 in group 1 and days 4 and 5 in group 2. Eradication of causative agent as demonstrated by inoculation of urine samples after 14 days was reported in 77.3% of women in group 1, 70% of women in group 2, and 61% of women in group 3. Total treatment efficacy in group 1 was 81.9%, i.e., exacerbations of chronic cystitis were diagnosed in 3 women (13.6%), acute pyelonephritis in 1 woman (4.5%). Total treatment efficacy in group 2 was 90%, i.e., recurrence of ASB was diagnosed in 2 women (10%). Meanwhile, treatment efficacy in the control group was 56.5%, i.e., clinical exacerbation of chronic cystitis was diagnosed in 6 women (26%). Moreover, in 4 women (17.4%), the disease was complicated by acute pyelonephritis. Conclusions: Cystenium II for acute cystitis or exacerbation of chronic cystitis and ASB in pregnant women improves treatment success and also maintains the effect. KEYWORDS: cystitis, asymptomatic bacteriuria, pregnancy, treatment, cranberry, prevention of recurrences. FOR CITATION: Nashivochnikova N.A., Krupin V.N., Leanovich V.E. Prevention and treatment of non-complicated infections of the lower urinary tract in pregnant women. Russian Journal of Woman and Child Health. 2021;4(2):119–123. DOI: 10.32364/2618-8430- 2021-4-2-119-123.

scholarly journals Reproductive health of women after abdominal delivery living in different regions of the Kyrgyz Republic

2018 ◽  
Vol 99 (2) ◽  
pp. 291-296
Author(s):  
A E Samigullina ◽  
V A Vybornykh
Keyword(s):  
Pregnant Women ◽  
Medical Institute ◽  
Kyrgyz Republic ◽  
Third Place ◽  
The Third ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Abdominal Delivery ◽  
Group 1

Aim. Study of somatic and obstetric and gynecologic morbidity of women of the Kyrgyz Republic after Cesarean section. Methods. Retrospective cohort study was conducted in 2016 in Kyrgyz state medical institute of retraining and advanced training. Three regions of the Kyrgyz Republic were selected: Bishkek, Jalal-Abad and Issyk-Kul regions. 908 pregnant women after abdominal delivery were chosen as the subject of the study and divided into three groups: group 1 (Bishkek) - 305 pregnant women, group 2 (Jalal-Abad region) - 300 females, group 3 (Issyk-Kul region) - 303 females. The age was 15 to 49 years. The incidence of gynecologic and extragenital pathology and complications during previous pregnancies were studied. Results. Gynecologic pathology in past medical history was revealed in 15.8% of females, while women from group 1 are statistically significantly more likely to have gynecologic diseases than women from group 3. Females from group 2 had gynecologic pathology more rarely. In the structure of gynecologic incidence, sexually transmitted infections take the first place, cervical ectopy takes the second place and uterine fibroids - the third place. Extragenital pathology was detected in 38.2% of pregnant women. In its structure the first ranked place is taken by urinary tract diseases (12.3%), the second one - by infectious and parasitic diseases (11.6%), and the third place - by cardiovascular diseases (3.2%). Pathological course of pregnancy was also more frequent in group 1 than in group 2; there was no significant difference with group 3. Spontaneous abortion interrupted previous pregnancy in 19.8% of women, 5% had premature births, significantly more frequently in group 1, as well as preeclampsia. Conclusion. The most unfavorable region is the city of Bishkek, female residents of Jalal-Abad region are less susceptible to diseases; in general, gynecologic pathology was revealed in 15.8% of females, extragenital pathology - in 38.2% of pregnant women; pathological course of pregnancy was statistically more frequent in group 1 than in group 2, without significant difference with group 3.

scholarly journals The role of the new coronavirus infection (COVID-19) in the progression and development of cerebrovascular diseases. A competent choice of pathogenic treatment is the key to success in treatment and prevention. An expert’s view from the ‘red zone’

2021 ◽  
Vol 13 (1) ◽  
pp. 57-66
Author(s):  
V. V. Kovalchuk
Keyword(s):  
Emotional Disorders ◽  
Clinical Manifestations ◽  
Cerebrovascular Diseases ◽  
Recent Experience ◽  
Treatment And Prevention ◽  
State Recovery ◽  
Group 2 ◽  
State Examination ◽  
Group 1

COVID-19 worsens the course of cerebrovascular diseases (CVD), including chronic cerebral ischaemia (CCI). The Actovegin drug, which has long been widely used in CCI treatment, has an antioxidant and endothelium protective effect. It makes sense to study the effect of Actovegin therapy on the clinical manifestations of CCI in patients with a recent experience of COVID-19.Objective: to evaluate Actovegin efficacy in the treatment of CCI in patients with a recent experience of COVID-19.Patients and methods. The study included 440 patients (234 female; 206 male) with a recent experience of COVID-19, suffering from CCI, their average age being 67.8 years (from 54 to 85 years). All patients were broken down into two groups of 220 people (the patients in Group 1 were administrated Actovegin, the ones in Group 2 – were not). All patients were followed up for 90 days; their condition was assessed by the severity of clinical manifestations of CCI, using special scales and questionnaires.Results and discussion. After 90 days of follow-up, the frequency of complaints of cognitive impairment, sleep disorder, dizziness, fatigue, emotional disorders, and headache in Group 1 was significantly lower than in Group 2 (p<0.05). According to Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), Multidimensional Fatigue Inventory (MFI-20), and Spiegel Sleep Questionnaire (SSQ), the average indicators improved significantly more in Group 1 than in Group 2 (p<0.05). The absence of quality of life impairment and their minimal severity were observed in Group 1 in 77.9%; in Group 2 – in 33.7% (p<0.001). Statistically significant differences between the groups of patients were also observed in relation to emotional state recovery according to the Wakefield Questionnaire and the Spielberger State Trait Anxiety inventory.Conclusion. The observational study demonstrated the efficacy of Actovegin in the treatment of main clinical manifestations of CCI in patients with recent COVID-19 experience.

scholarly journals Evaluation of Iron Status, Haemoglobin and Protein Levels of Pregnant Women in Owerri Metropolis

2021 ◽  
pp. 36-43
Author(s):  
I. L. Okoroiwu ◽  
Jane Ugochi Chinedu-Madu ◽  
Emmanuel Ifeanyi Obeagu ◽  
C. C. N. Vincent ◽  
O. M. T. B. Ochiabuto ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Serum Iron ◽  
Iron Deficiency Anaemia ◽  
Iron Status ◽  
Second Trimester ◽  
Protein Levels ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Group 1

The study was done to determine iron status, haemoglobin and protein levels of pregnant women in owerri metropolis. A total of 100 pregnant women were recruited for this study. The mean Hb levels in group 1, group 2, and group 3· were 12.00±1.68g/dl, 10.06±1.J4g/dl and 10.96±1.19g/dl respectively. The mean Serum ferritin level of group 1 was 67.00±88.38ng/ml, group 2, 52.48±52.47ng/ml and group 3, 51.26±48.70ng/ml. The mean Serum iron in group 1, 2 and 3 were 46.72±16.41 g/dl, 79.59±63.24 g/dl and 83.35±53.04 g/dl respectively. In group 1, 2 and 3 the mean results. ( g/dl) of TIBC were 295.58 ± 109.53, 324.06 ± 178.00 and 319.88 ± 92.95 and % T.S (%) were 18.78 ± 11.77,26.59 ± 19.40 and 17.97 ± 10.87 percent respectively. The mean total protein was group 1,6.83±l1.77g/dl, group 2,6.39±0.70g/dl and group 3, 6.39 ±0.98 g/dl while the mean albumin (g/dl) in group 1, 2 and 3 were 4.84±0.47, 4.13±0.28 and 4.14±0.29 respectively. The mean values of globulin (g/dl) were 1.98 ± 0.91, 2.29 ± 0.87 and 1.89 ± 0.90 in groups 1, 2 and 3 respectively. As gestational age increased; serum ferritin, total protein, and albumin levels decreased while serum" iron and TIBC increased. The differences in the mean results between the groups were statistically significant (p<0.05) while % T.S and globulin levels when compared showed no significant difference (p>0.05). Iron status showed no statistical difference with increasing parity (p>0.05). However, from this study iron deficiency anaemia was most prevalent in second trimester; hence iron status estimation should be an integral part of routine antenatal care test during second trimester of each pregnancy for proper assessment and management of iron deficiency anaemia in pregnancy.

13q14 Chromosome Deletion Size and Number of Deleted Cells Influence Prognosis In Chronic Lymphocytic Leukemia

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 3578-3578
Author(s):  
Francesca Maria Rossi ◽  
Davide Rossi ◽  
Clara Deambrogi ◽  
Francesco Bertoni ◽  
Michele Dal Bo ◽  
...  
Keyword(s):  
Clinical Course ◽  
Lymphocytic Leukemia ◽  
Single Institution ◽  
Group 4 ◽  
Median Size ◽  
Mutational Status ◽  
Genome Wide ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Abstract 3578 Introduction: Chronic lymphocytic leukemia (CLL) patients bearing 13q14 deletion are known to experience a more favorable clinical course. Recent studies, focusing on patients with loss of 13q as the sole cytogenetic aberration at diagnosis (del13q-only cases), showed that the number of malignant cells carrying this genetic lesion correlates with a more aggressive clinical behavior. However, whether the size of the 13q deletion may also influence the clinical outcome remains to be elucidated. Patients and Methods: Probes for chromosome 13q (LSI-RB1, LSI-D13S319), 11q (LSI-ATM), 17p (LSI-p53) and chromosome 12 (CEP12) were utilized on nuclei collected at diagnosis from: i) a multi-institutional CLL cohort (342 del13q-only cases) and ii) a consecutive unselected single-institution cohort of 265 cases. RB1 deleted cases (delRB1) were defined as having at least 5% of deleted nuclei. Time to treatment (TTT) intervals, as well as Rai staging, IGHV mutational status, CD38 and ZAP70 expression, B2-microglobulin levels, all evaluated at diagnosis, were also available for all cases that entered the study. Genome wide DNA profile was performed in a pilot series of 90 CLL samples using Affymetrix GeneChip Human SNP6 arrays. Results: According to genome wide DNA analysis, delRB1 occurred in a proportion of del13q-only cases (36/90; 40%), always comprising the deleted region detected with the LSI-D13S319 probe (that covers the miR-15a/16-1 cluster and the DLEU2 gene) and characterized by a larger chromosome loss (median size 2.07 Mb vs. a median size of 0.86 Mb for the canonical del13S319). Maximally selected log-rank statistics identified the 70% of nuclei bearing del13S319 as the most appropriate cut-off value capable of separating del13q-only cases into two subgroups with different TTT distributions. Consistently, del13q-only cases with at least 70% of nuclei bearing del13S319 showed a significantly shorter TTT than del13q-only cases with less than 70% deleted nuclei (p=0.0001). Del13q-only cases were then divided in four subsets according to the percentage of nuclei bearing del13S319 with or without a concomitant delRB1: del13S319 <70% (group 1), 144 cases; del13S319 <70% + delRB1 (group 2), 95 cases; del13S319 >70% (group 3), 64 cases; del13S319 >70% + delRB1 (group 4), 39 cases. The median TTT of group 1 (not reached) was significantly longer than the median TTT of group 2 (92 months, p=0.012), group 3 (68 months, p<0.0001), and group 4 (82 months, p=0.0025; see Fig. 1A). Multivariate Cox proportional hazard analyses selected the presence of delRB1 (p=0.029), along with the IGHV mutational status (p<0.0001), as an independent negative prognosticator in the context of del13q-only cases with low/intermediate Rai risk (Rai stage of 0/I at diagnosis) and <70% of del13S319. Cases belonging to the consecutive unselected single-institution CLL cohort were divided into subsets according to the classification proposed by Döhner et al (NEJM, 2000). Notably, the presence of del13S319 in <70% of cells in the absence of delRB1 identified a patient subset with particularly stable and benign clinical course (group A in Fig. 1B, 48 cases; median TTT not reached). Conversely, patients characterized by del13S319 in <70% of cells but with a larger deletion, as determined by concomitant delRB1 (group B, 24 cases), or del13S319 in >70% of cells (with or without delRB1, group C, 25 cases) or a normal karyotype (group D, 75 cases) had shorter median TTT intervals (ranging from 105 to 129 months, p<0.01 in all the comparisons). Finally, patients affected by CLL bearing trisomy 12 (group E, 48 cases) and del11q or del17p (group F, 45 cases) experienced the worst clinical courses (p<0.0001). Conclusion: In the context of del13q-only cases, different clinical outcomes were associated to the percentage of 13q14 deleted cells, as well as to the size of the 13q14 deletion, as detected by the LSI-RB1 probe. Moreover, the presence of delRB1 emerged as a feature capable of refining the prognostic assessment in the context of CLL cases with <70% del13S319. The underlying genetic mechanisms correlated with the different clinical outcomes and associated with the size of the 13q deletion are presently under investigation. Disclosures: No relevant conflicts of interest to declare.

Serial D-dimer in Pregnant Women Compared to Antiphospholipid-antibodies Level, a History of Fetal Loss Syndrome and Invitro Fertilization

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4364-4364
Author(s):  
Tubagus Djumhana Atmakusuma
Keyword(s):  
Pregnant Women ◽  
Conflicts Of Interest ◽  
Post Partum ◽  
Fetal Loss ◽  
Assay Method ◽  
Chromogenic Assay ◽  
Group 2 ◽  
High Level ◽  
D Dimer ◽  
Group 1

Abstract 4364 Background We have reported in abstract P-Th-374 in a 2011 Kyoto ISTH Congress that an increased level of D-dimer in combination with umbilical artery systolic diastolic (UASD) ratio can be used as a timing to start with prophylactic anticoagulants In women with pregnancy failure, regardles of the antibody antiphospholipids (APAs) level. The question is: Are there any differences of a serial D-dimer level if is compared to the APAs level?. Methods. A retrospective Cohort study was conducted on a total sampling subjects of pregnancy women who visited two hospitals in Jakarta, Indonesia, at a periode of January 2009 – December 2010. Serial D-dimer using chromogenic assay method (cut off normal level < 500 ng/ml) was tested during antenatal and post partum period. The data were analysed to compare a mean D-dimer with the level of APAs (ACA IgG/IgM, AntiB2GP1 IgG/IgM) tested using ELISA method Results Of 83 pregnant women,19 women with high level of APAs (group 1) showed a mean D-dimer level as follows: Trimester I: 892.15 ± 785.15 ng/ml, trimester II: 782.59 ± 440.53 ng/ml, trimester III:1282.62 ± 601.22 ng/ml, post partum 1367.45 ± 581.19 ng/ml; 31 women with normal APAs (group 2) showed: Trimester I: 666.23 ± 396.24 ng/ml, trimester II: 896.66 ± 396.24 ng/ml, trimester II: 896.66 ± 496.32 ng/ml, trimester III: 1313.45 ± 850.20 ng/ml, post partum: 1991.75 ± 1388.70 ng/ml; 33 women with no data of APAs (group 3) showed: Trimester I: 568.47 ± 482.70 ng/ml, trimester 2: 797.95 ± 934.59 ng/ml, trimester III: 966.89 ± 862.10 ng/ml, post partum: 1078.50 ± 836.29 ng/ml Conclusion Either in group 1, 2, and 3 mean D-dimer tend to increase from trimester I to trimester II and from trimester II to trimester III, except in group 1 from trimester I to trimester II of pregnancy. Meanwhile, all groups showed a higher mean D-dimer post partum compared to antenatal period. Disclosures: No relevant conflicts of interest to declare.

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