Gestational age at delivery and Doppler waveforms in very preterm intrauterine growth-restricted fetuses as predictors of perinatal mortality.

OBJECTIVE: The aim of this study was to compare gestational age at delivery and the performance of middle cerebral artery (MCA), ductus venosus (DV), and umbilical artery Doppler parameters in the prediction of perinatal mortality and morbidity in intrauterine growth-restricted (IUGR) fetuses delivered at 32 weeks or earlier. METHODS: The study population consisted of 41 patients with IUGR fetuses. Delivery occurred for maternal or fetal indications. Two-tailed chi(2) and Fisher exact tests, an independent t test, and logistic regression were used for the analysis. P < .05 was considered statistically significant. RESULTS: Gestational age at delivery ranged between 23.1 and 32 weeks (median, 27.6 weeks). There were 17 perinatal deaths. Ninety-four percent of the perinatal deaths occurred when the fetuses were delivered before 29 weeks. No fetus survived when delivered before 25 weeks. Two parameters predicted the perinatal mortality: gestational age at delivery (odds ratio, 0.52; 95% confidence interval, 0.31-0.88) and the combination of abnormal MCA peak systolic velocity + DV reversed flow (odds ratio, 10.2; 95% confidence interval, 1.8-57). For each week of pregnancy, there was a reduction in perinatal mortality of 48%. No Doppler parameters were significantly associated with perinatal morbidity. CONCLUSIONS: Gestational age at delivery and the combination of abnormal MCA peak systolic velocity + DV reversed flow in very preterm IUGR fetuses were the best parameters in predicting perinatal mortality. The decreased perinatal mortality that is found for each week IUGR fetuses remain in utero should be taken into account when a decision to deliver an IUGR fetus before 30 weeks is made.     

Retinal Vessel Segmentation,a Review of Classic and Deep Methods

Annals of Biomedical Engineering - Retinal illnesses such as diabetic retinopathy (DR) are the main causes of vision loss. In the early recognition of eye diseases, the segmentation of blood...     

Type 2 alveolar epithelial cell-derived circulating extracellular vesicle-encapsulated surfactant protein C as a mediator of cardiac inflammation in COVID-19

Inflammation Research - Among the countless endeavours made at elucidating the pathogenesis of COVID-19, those aimed at the histopathological alterations of type 2 alveolar epithelial cells (AT2)...     

Effect of fentanyl and vitamin B12 on abdominal pain in patients addicted to oral opium: A clinical trial

Background: Pain is a common complaint among patients referring to the emergency department. This study aimed at comparing the effect of fentanyl and vitamin B₁₂ to decrease the abdominal pain in patients who are addicted to oral opium.

Methods: This study conducted a double-blind randomized clinical trial on patients addicted to oral opium during a one-year period. The effects of fentanyl and vitamin B12 were compared for the relief of abdominal pain in such patients.

Results: The 136 patients studied had a mean age of 47.77 ± 13.6 years (mean ± SD). There was a significant difference in mean pain severity at 10, 15, 30, 45, 60, and 120 min (P < .05). The mean pain severity in the fentanyl group was significant at 30 min compared to the earlier times and showed a decreasing trend in pain severity (P < .05). This decreasing trend was observed up to 120 min for the fentanyl + vitamin B12 group, which showed a significant difference between each time and the time preceding it (P < .05).

Conclusions: The proper and permanent control of abdominal pain experienced by patients addicted to oral opium is essential. The combined use of fentanyl and vitamin B12 is effective in reaching this goal.     

High incidence of Pellethane 90A lead malfunction.

AIMS: The long-term performance of Pellethane 80A (P80A) endocardial pacing leads has previously been called into question. We report our experience with an endocardial pacemaker lead with silicone outer and Pellethane 2363-90A (P90) inner insulator. METHODS: Between November 1993 and March 1998, 129 P90A and 189 non-P90A ventricular leads were implanted. Lead malfunction was defined as > or = 25%) deviation in lead impedance or a two-fold reduction in sensing threshold during follow-up. Sensing and capture thresholds and lead impedance were assessed intraoperatively, immediately postoperatively, at 24 h and 6-12 weeks following implant and semiannually thereafter. Adequacy of lead positioning and lead-header interface were documented radiographically in each case. RESULTS: During 204 patient years of follow-up, 10/129 (8%) Oscor RX P90A leads malfunctioned. Average time to malfunction was 14 +/- 11 months. During 166 patient years of follow-up, none of the 189 non-P90A ventricular leads met criteria for malfunction (P < 0.05). There was no difference in patient age, sex, and arrhythmia indication between groups. Sensing problems were overcome with pacemaker reprogramming. CONCLUSION: We conclude that Oscor RX passive fixation ventricular leads with external silicone and inner P90A insulation exhibit an 8%, insulation malfunction rate within 14 +/- 11 months of implant. This is significantly higher than non-P90A leads implanted with identical technique and follow-up regimen. More frequent follow up may be warranted in patients with P90A containing leads.     

The effects of Snoezelen (multi-sensory behavior therapy) and psychiatric care on agitation, apathy, and activities of daily living in dementia patients on a short term geriatric psychiatric inpatient unit

A randomized, controlled, single-blinded, between group study of 24 participants with moderate to severe dementia was conducted on a geriatric psychiatric unit. All participants received pharmacological therapy, occupational therapy, structured hospital environment, and were randomized to receive multi sensory behavior therapy (MSBT) or a structured activity session. Greater independence in activities of daily living (ADLs) was observed for the group treated with MSBT and standard psychiatric inpatient care on the Katz Index of Activities of Daily Living (KI-ADL; P = 0.05) than standard psychiatric inpatient care alone. The combination treatment of MSBT and standard psychiatric care also reduced agitation and apathy greater than standard psychiatric inpatient care alone as measured with the Pittsburgh Agitation Scale and the Scale for the Assessment of Negative Symptoms in Alzheimer's Disease (P = 0.05). Multiple regression analysis predicted that within the multi-sensory group, activities of daily living (KI-ADL) increased as apathy and agitation reduced (R2 = 0.42; p = 0.03). These data suggest that utilizing MSBT with standard psychiatric inpatient care may reduce apathy and agitation and additionally improve activities of daily living in hospitalized people with moderate to severe dementia more than standard care alone.     

Regulation of endothelial progenitor cells by prostaglandin E1 via inhibition of apoptosis

Bone marrow derived endothelial progenitor cells (EPC) improve endothelial function and neoangiogenesis. Prostaglandin E1 (PGE1) is used for the treatment of patients with peripheral artery disease (PAD). However, the molecular effects are only partially understood. Treatment of C57/Bl6 mice with PGE1, 10 microg/kg BW increased the number of circulating Sca-1/VEGFR-2 positive EPC in the blood compared to vehicle (122+/-7% and 119+/-6% after 10 and 20 days). EPC in the bone marrow were upregulated to 125+/-11% (10 days) and 142+/-15% (20 days). PGE1 increased DiLDL/Lectin positive spleen-derived EPC to 170+/-20% and 174+/-14% after 10 and 20 days. Treatment with PGE1 enhanced in-vivo neoangiogenesis by 2-fold (disk assay, 218+/-27%). PGE1 enhanced the SDF-1 induced migratory capacity per number of EPC to 140+/-11%, 146+/-22% and 160+/-16% after 10, 14 and 20 days. Greater migratory capacity was associated with upregulation of expression of telomere repeat-binding factor (TRF2). EPC of PGE1-treated mice were characterized by reduced apoptosis. Similarly, PGE1 prevented H(2)O(2)-induced apoptosis in cultured human EPC. The effect is mediated by PI3-kinase. The effects of PGE1 on EPC were completely prevented by co-treatment with the NO-inhibitor L-NAME, 50 mg kg(-1) p.o. Treatment with the prostaglandin I2 derivative iloprost (10 microg/kg BW, 20 days) did not alter EPC numbers or function. Physical exercise is the basis of the treatment of patients with PAD. Voluntary running increased EPC numbers in mice. Treatment with PGE1 resulted in an additional increase of Sca-1/VEGFR-2- and DiLDL/lectin positive EPC as well as migration. n=10-24 for all groups, all effects p<0.05. In summary, prostaglandin E1 increases the number of EPC in the blood and the bone marrow in mice. The effect is additive to physical exercise, depends on nitric oxide and is characterized by reduction of PI3-kinase mediated apoptosis. PGE1-mediated upregulation of EPC is associated with improved EPC function and enhanced angiogenesis.     

The effects of phytochemicals and herbal bio-active compounds on tumour necrosis factor-α in overweight and obese individuals: a clinical review

Inflammopharmacology - Obesity is abnormal fat accumulation in the body which acts as a risk factor for various cardiometabolic states. Adipose tissue in excess can release inflammatory factors,...     

Patterns of facial fractures in children

Morbidity and mortality among children is usually the result of trauma. Because a child’s face is retruded relative to the protecting skull, has a thicker layer of adipose tissue, more elastic bones, flexible sutures lines, the presence of tooth buds within the jaws, and the lack of pneumatisation of the sinuses, the facial bones fracture less commonly than in adults. Our aim was to assess the patterns of such fractures in children who presented to the department of Oral and Maxillofacial Surgery, King Edward Medical University/Mayo Hospital Lahore, Pakistan. All 535 eligible children between the ages of 1-16 years who presented during the two years December 2009 - December 2011 were included in the study. Facial fractures were diagnosed by clinical examination, plain radiographs, and computed tomography, and the pattern of fractures of the facial bones including the frontal bone, orbital bones, maxilla, zygoma, naso-orbito-ethmoidal complex, mandible, and dentoalveolar region was documented. The male:female ratio was 2:1 with 369 male (70%) and 166 female (31%) patients. Fall was the cause in 212 (39%), and in 167 (31%) it was road traffic accidents, while sports were the cause in 135 (25%). The naso-orboto-ethmoid complex was fractured in 37 cases (7%) while 104 children (19%) presented with isolated fractures of the zygomatic bone. The maxilla was fractured in 195 cases (36%), the mandible in 380 (71%), and dentoalveolar trauma was the cause in 256 (50%). The mandible was the bone that was most often fractured (mostly in boys and usually as a result of falls during summer vacations), with the peak occurring in those aged 8-12 years.