Graft function 1 year after pregnancy in an islet‐transplanted patient

Pancreatic islet transplantation is a treatment option for patients with type 1 diabetes (T1D), but pregnancy has generally not been advised for women after receiving an islet allograft. We hereby describe what is to our knowledge the first successful pregnancy and persistent graft function in a woman 4 years after her initial islet transplantation. A 37‐year‐old woman with brittle type 1 diabetes was transplanted with two separate islet graft infusions, eventually becoming insulin independent. Ten months after her second transplantation, her immunosuppression was switched from tacrolimus and sirolimus to tacrolimus, azathioprine, and prednisolone, due to her wish to become pregnant. She became pregnant one year later, and after 38 weeks of uncomplicated pregnancy, she gave birth to a healthy child by C‐section. The current report suggests that pregnancy and childbirth can be accomplished after islet transplantation without loss of islet graft function.     

Diagnostic and Severity-Tracking Biomarkers for Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a neurodevelopmental disorder afflicting about one in every 68 children. It is behaviorally diagnosed based on a triad of symptoms, including impairment in communication, impairment in sociability and abnormal and stereotypic behavior. The subjectivity of behavioral diagnosis urges the need for clinical biomarker tests to improve and complement ASD diagnosis and treatment. Over the past two decades, researchers garnered a broad range of biomarkers associated with ASD and often correlating with the severity of ASD, which includes metabolic and genetic biomarkers or neuroimaging abnormalities. Metabolic biomarkers are either involved in key pathways such as a trans-sulfuration pathway or produced due to the derangement of these pathways in the case of oxidative stress. Recent studies reported several genetic abnormalities related to ASD, encompassing various mechanisms, from copy number variations (CNVs) and single nucleotide polymorphisms (SNPs) to chromosomal anomalies. However, it is still premature to consider these genetic variants as true biomarkers for ASD, due to their low reproducibility and regional-specific nature. Herein, we comprehensively review state of the art about major biomarkers reported in ASD and the association of some biomarkers with ASD symptoms and severity. It is important to establish those biomarkers to be able to help in the diagnosis and to optimize the treatment of ASD.     

Prenatal Diagnosis of BMD in Morocco: Evolution and Limits

The muscular dystrophy is a group of inherited disorders characterized in the most of cases by progressive muscle weakness. The best known are X-linked disorder Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD). BMD is a milder form of the disease with a later age of onset and a slower clinical progression. The DMD gene, located on Xp21, is the largest human gene in the human genome (2.3 Mb). DMD gene consists of 79 exons and codes for dystrophin protein. A 9-year-old boy, who experienced symptoms of the disease, was admitted to the Casablanca University Children’s Hospital. The patient, with no known family history of significant muscle disease, was first examined at 4 years of age because of walking difficulties and a limited hands force. Blood tests revealed elevated serum levels of creatine kinase (7.60 U/L). The electromyogram showed myopathic changes, consisting of polyphasic potentials, and the muscular biopsy revealed dystrophic aspect. Analysis of the dystrophin-encoding gene by PCR deletion analysis of the dystrophin gene was performed by multiplex PCR primer sets of Chamberlain and Beggs. The analysis showed a deletion of exons 45 to 49. Mother genetic testing showed the heterozygosis deletion.     

Placenta percreta with painless uterine rupture at the 2nd trimester

A pregnant lady at 27 weeks and 2 days gestation with a known placenta previa major and a history of previous lower segment cesarean section had a sudden severe painless vaginal bleeding. At laparotomy a uterine rupture was noted, no hemoperitoneum found and placenta percreta was diagnosed. This is the first case reported in the Kingdom of Saudi Arabia, it is rare, only 3 cases of silent or asymptomatic uterine rupture secondary to placenta percreta were reported in the literature in the last 30-years. Non-invasive methods could help in the diagnosis or increase suspicion of placenta percreta, therefore, proper management could be arranged through a multi-disciplinary team.     

Grandmothers and women's health: from fragmentation to coherence

There is a paucity of models that drive integrated research agendas, and coherent approaches to development and progress of knowledge about women's health. In this article, we review four major models of women's health, present conditions supporting more integrative and coherent models of women's health based on the recommendations by two international conferences, and address major paradoxes inherent in women's health areas. For integrative and coherent models of women's health, we propose to incorporate visions and insights of previous models in developing a more coherent model that includes three major components-integration, transition, and marginalization.     

Safe womanhood is not safe motherhood: policy implications

The world continues to be unsafe for girls and women. Although natural disasters and man-made disasters make the world unsafe for all people, the gender divide further compromises safety of women. In addition to being at higher risk for violence, rape, trafficking, and abuse, women's injury and mortality increase because of the limited definition of the nature and type of work they do, the conditions that expose them to such infections as HIV/AIDS, the pregnancy and birthing cycles, as well as unsafe abortions, and because of the inadequacy and inaccessibility of health services. To enhance safe womanhood, not just safe motherhood for women, several urgent actions are outlined in this article.