Serial evaluation of iron stores in pregnant Nigerians with hemoglobin SS or SC

Iron status of nonpregnant and pregnant Nigerian patients with hemoglobin SS or SC were assessed using serial hematological parameters, measured by Coulter counter, and serial serum ferritin concentrations measured by radioimmunoassays. The median value of 393 micrograms/L (range, 175 to 900 micrograms/L) for serum ferritin in nonpregnant patients with Hb SS and SC was significantly higher than that found in nonpregnant patients with Hb AA (median, 89.8 micrograms/L; range, 13 to 250 micrograms/L). Apart from packed cell volume values, there were no other significant differences between patients with Hb SS or SC and Hb AA in the other parameters assessed: mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration. In both the normal pregnant patients (Hb AA) and pregnant patients with Hb SS and SC the serum ferritin values decreased as pregnancy advanced to 28 weeks and rose gradually thereafter. At similar stages of gestation serum ferritin values were significantly higher in patients with Hb SS or SC than in those with Hb AA. Pregnancy seems to have induced a significant rise in mean corpuscular volume and mean corpuscular hemoglobin values in the patients with Hb SS or SC, especially in the third trimester, than in patients with Hb AA. The pattern of change in mean corpuscular hemoglobin concentration values was similar in both groups of patients. From the data obtained, it seems the iron status in the patients with Hb SS or SC was good, and pregnancy did not push the patients into an iron deficiency state. The use of prophylactic iron supplementation in pregnant patients with Hb SS or SC appears unjustified.     

Intravascular receptors and renal responses of monkey to volume expansion

Experiments were performed in anesthetized Macaca fascicularis monkeys to determine the effects of combined thoracic dorsal rhizotomy (C8-T7) and vagotomy-sinoaortic denervation on the renal responses to acute intravascular volume expansion. Expansion of the estimated blood volume by 15% with 6% dextran in isotonic saline produced attenuated diuretic and natriuretic responses in the denervated animals when compared with sham-operated controls. The times to peak diuresis and natriuresis after volume expansion also were significantly earlier in the denervated group. Although central venous pressure increased similarly in both groups, mean arterial pressure increased to a greater extent after volume expansion in the denervated group. As opposed to the previously reported failure of either denervation alone to attenuate the renal responses to hypervolemia in the monkey, our results suggest that these neural pathways may play a role in maintaining salt and water balance in this species. However, because of the possibility of functionally redundant afferent mechanisms, blunted renal responses to volume expansion in the primate can only be demonstrated after an extensive denervation.     

Early weight gain in pregnant adolescents and fetal outcome

While the contribution of total maternal gain to birthweight is well described, less is known about whether there are specific effects of early weight gain. Early weight gain adequacy may be a particular problem among teenage gravidas who are more likely to have low prepregnant weight and in developing countries where chronic undernutrition is endemic. We studied the effects of early weight gain adequacy on infant birthweight in a geographical cohort of 1,790 adolescents from Camden County, New Jersey. Weight gain was calculated for prepregnant weight to 24 weeks' gestation and 24 weeks to delivery. Inadequate early weight gain was defined as gains less than 4.3 kg and inadequate late gains as averaging less than 400 gm/week from 24 weeks' gestation to delivery. In regressions predicting birthweight outcome, we found significant independent effects of timing of weight gain inadequacy. Early inadequate gains were associated with a ?186.6 ± 31.6 gm decrement in birthweight that was not diminished even when later weight gains were compensatory. Late inadequate (?154.4 ± 29.3 gm) and inadequate gains both early and later (?298.6 ± 49.1 gm) were also associated with birthweight decrements. However, overweight (body mass index >24.5) appeared to buffer some of the effects of inadequate weight gains, reducing the decrement to about ?100 gm. Protocols that seek to improve infant outcomes should focus on early weight gain during pregnancy. Affecting weight gain only late in pregnancy may not be able to substantially reduce the risk of fetal growth retardation.     

Splenic function in children with hemoglobin SC disease and sickle beta-thalassemia

Splenic function in children with hemoglobin SC disease and sickle β-thalassemia was evaluated using direct interference contrast microscopy. Children with both disorders demonstrated significant degrees of hyposplenism as evidenced by increased numbers of erythrocytes containing surface “pits.” Patients with these variants of sickle cell disease frequently exhibit splenic dysfunction and may be at increased risk to develop the life-threatening septicemias associated with hyposplenism.     

平均红细胞体积和平均红细胞血红蛋白含量筛查妊娠合并轻型地中海贫血的价值

目的探讨平均红细胞体积(MCV)、平均红细胞血红蛋白含量(MCH)检测在筛查妊娠合并轻型地中海贫血(地贫)中的价值。方法 1514例孕妇在首次产前检查时,同时检查外周血MCV、血红蛋白浓度(Hb)、MCH及血红蛋白电泳等指标,依据首次产前检查时血常规及血红蛋白电泳结果分3组:Ⅰ组127例:Hb<100g/L伴血红蛋白电泳异常;Ⅱ组69例:Hb<100g/L而血红蛋白电泳正常;对照组1318例:Hb>100g/L及血红蛋白电泳正常;以基因诊断作为地贫诊断金标准。结果Ⅰ组MCV及MCH最低,明显低于Ⅱ组和对照组(P<0.01),而Ⅱ组与对照组无显著性差异(P>0.05)。MCV及MCH检测筛查地贫与基因诊断结果比较:灵敏度(Se)98.06%、特异度(Sp)72.04%、假阳性率0.28、假阴性率0.02、准确度90.31%、阳性预测值79.53%、阴性预测值90.30%、阳性似然比3.50、阴性似然比0.028。结论轻型地贫者有MCV、MCH降低的特征,临床上检测MCV、MCH筛查妊娠合并轻型地贫,其灵敏度高,且特异度也较高,假阳性率和假阴性率低。方法简便、实用、经济。可作为基层医院轻型地贫的筛查指标。     

孕妇HCMV感染及妊娠结局分析

目的了解孕妇感染HCMV后对胚胎、胎儿及妊娠结局的影响.方法采用ELISA方法对4148例长沙地区孕妇进行TORCH-IgM检测.结果在对4148例长沙地区孕妇进行TORCH-IgM检测中,发现有62例孕妇为HCMV-IgM阳性,阳性率为1.5%.在随访的58例孕妇中,妊娠结局为自然流产者达31%(18/58);为死胎及胎儿畸形者达19%(11/58),显著高于其他异常妊娠结局者(P＜0.001).结论HCMV宫内感染是导致胚胎和胎儿自然流产的主要原因之一,同时也是导致胎儿宫内死亡、畸形发生的主要原因.因此,提高孕妇免疫能力,加强孕期健康教育,避免和减少易感因素的接触,是降低胎儿宫内感染的主要措施;另外,大力推广孕前优生检测也是防止胎儿宫内感染发生的重要手段.     

超声多普勒预测胎儿生长受限

目的为研究超声多普勒对预测胎儿生长受限(FGR)及预后的作用及意义。方法对我院选取84例FGR组和同期住院的100例正常妊娠组作为对照,进行脐血流彩色多普勒检查。结果 1.FGR组脐动脉及胎儿大脑中动脉搏动指数(PI)较对照组明显减小,两者相比差异有统计学意义(P分别<0.05,<0.01)。2.FGR组脐动脉及胎儿大脑中动脉S/D比值较对照组明显增高,差别有统计学意义。3.脑-胎盘比值越小提示胎儿预后越差。     

First trimester listeriosis with normal fetal outcome

The case of a pregnant woman who in the 13th week of gestation presented with a non-specific influenza-like illness ultimately proven to be symptomatic ofListeria monocytogenes septicemia, is described. The patient elected to continue the pregnancy and following antibiotic therapy recovered and delivered a normal infant. At 18 months of age the child was healthy with normal psychomotor development. This case underscores the need to consider the possibility ofListeria monocytogenes septicemia at any stage of pregnancy, and suggests that early institution of antibiotic treatment may result in complete recovery of both mother and fetus.     

Erythroleukemia with high fetal hemoglobin after therapy for ovarian carcinoma

The authors report the association of erythroleukemia (FAB M6) and fetal hemoglobin (HbF) level of at least 65% after therapy for ovarian carcinoma. The patient's erythrocytes had many signs of reversion to fetal-like erythropoiesis including: elevated HbF with a fetal G gamma/A gamma (gly/ala) of 3/1, low hemoglobin A2 (HbA2), macrocytosis, and increased i antigen. These data and data from other case reports suggest that elevation of HbF to greater than 25% with reversion to fetal-like erythropoiesis is useful in differentiating erythroleukemia from other preleukemic disorders.     

MicroRNAs对胎儿血红蛋白表达的调控作用

正微小RNA(microRNAs,miRNAs,miRs)是指一群小于22个核苷酸的非编码单链RNA分子,它们可以在转录后水平调节靶基因、染色体构象改变、细胞增殖、分化以及凋亡~([1])。这些单链RNA分子在细胞质中与其它蛋白结合形成miRNA诱导沉默复合物(miRNA-induced silencing complex,miRISC),再结合到靶基因mRNA的3’-UTR抑制其翻译,通过这种     

Receiving severe aggression correlates with fetal gender in pregnant pigtailed monkeys

Pregnant females were severely bitten in 220 of 2,822 conceptions among pigtail macaques living in harem groups. These pregnancies yielded 58.6% female offspring compared with 48.5% for nonbitten pregnant animals. The fetal gender difference occurred only after midterm, reaching a peak of 70% female fetuses in the 4th gestational month. Fetal gender thus appeared to influence maternal behavior, appearance, or physiology in some way detectable to other monkeys with the consequence of altering risk for receiving severe aggression.     

Taurine concentrations in fetal, neonatal and pregnant rats

The concentrations of taurine in the fetal and neonatal organs, and the maternal organs, plasma and urine of rats between the 15th day of gestation and the 21st day after birth were determined using an automatic amino acid analyzer. In the fetal liver and brain and in the placenta, the taurine concentration was the highest of all ninhydrin positive compounds. In the fetal liver and placenta, the concentrations of taurine increased significantly with the gestational days. Concentrations of taurine in the brain were much higher in the fetus and neonate than that in the adult. Moreover, the total amount of taurine per fetus increased markedly after the 15th day of gestation, and near term, reached almost the same amount as in the adult rat liver. In contrast to this, a significant decrease was observed in the taurine concentration in the maternal liver and muscle near term. The concentration of taurine in the urine of pregnant rats decreased near term, but in the plasma of pregnant rats the concentration of taurine did not change during pregnancy.     

The relationship between fetal hemoglobin and disease severity in children with sickle cell anemia

A study was conducted in a sample of 140 children with sickle cell anemia to evaluate the relationship between hematological variables (%HbF, %HbA2, %Hb, and mean cell volume) and disease severity. A patient's severity status was determined by whether he/she was hospitalized, had a transfusion, and/or had a pain crisis at 2 evaluation periods; the first was based on a patient's history taken at the initial assessment visit to the Wayne State Comprehensive Sickle Cell Center, and the second was based on a 1-3 year follow-up at the center. Fetal hemoglobin was a strong predictor of a patient's hospitalization and transfusion status. A decrease in %HbF of 4.76% (one SD of %HbF) was associated with a 3.58 fold (95% confidence interval, 1.18-7.28) greater odds of being hospitalized both prior to initial assessment and on follow-up, compared to not being hospitalized at either evaluation. Similarly, a decrease in %HbF of 4.76% was associated with a 5.56 fold (95% confidence interval, 1.67-18.96) greater odds of having a transfusion both prior to initial assessment and on follow-up compared to not having a transfusion at either evaluation. Patients who were both hospitalized and transfused at initial assessment and on follow-up (n = 12) had a mean %HbF of 7.59%, while patients who were not hospitalized or transfused at either evaluation (n = 19) had a mean %HbF of 13.61%. Fetal hemoglobin was not a significant predictor of pain crises in this sample of patients. None of the other hematological variables were significant predictors of disease severity in this study. The strong relationship between %HbF and disease severity identified in this study suggests that a single %HbF measurement may be useful in predicting important aspects of the clinical course of children with sickle cell anemia.