Induced termination of pregnancy and low birthweight and preterm birth: a systematic review and meta-analyses

Background  History of induced termination of pregnancy (I-TOP) is suggested as a precursor for infant being born low birthweight (LBW), preterm (PT) or small for gestational age (SGA). Infection, mechanical trauma to the cervix leading to cervical incompetence and scarred tissue following curettage are suspected mechanisms.
Objective  To systematically review the risk of an infant being born LBW/PT/SGA among women with history of I-TOP.
Search strategy  Medline, Embase, CINAHL and bibliographies of identified articles were searched for English language studies.
Selection criteria  Studies reporting birth outcomes to mothers with or without history of induced abortion were included.
Data collection and analyses  Two reviewers independently collected data and assessed the quality of the studies for biases in sample selection, exposure assessment, confounder adjustment, analytical, outcome assessments and attrition. Meta-analyses were performed using random effect model and odds ratio (OR), weighted mean difference and 95% confidence interval (CI) were calculated.
Main results  Thirty-seven studies of low–moderate risk of bias were included. A history of one I-TOP was associated with increased unadjusted odds of LBW (OR 1.35, 95% CI 1.20–1.52) and PT (OR 1.36, 95% CI 1.24–1.50), but not SGA (OR 0.87, 95% CI 0.69–1.09). A history of more than one I-TOP was associated with LBW (OR 1.72, 95% CI 1.45–2.04) and PT (OR 1.93, 95% CI 1.28–2.71). Meta-analyses of adjusted risk estimates confirmed these findings.
Conclusions  A previous I-TOP is associated with a significantly increased risk of LBW and PT but not SGA. The risk increased as the number of I-TOP increased.     

Epidural needle for recipient site preparation in hair restoration surgery

Background The mini‐ and micro‐grafting method is still one of the most current treatment methods for male pattern baldness and female androgenic alopecia. The preparation of the recipient area with 16G needle has been reported in the literature. However, during the insertion of grafts, the neighboring grafts tend to `pop out'. The study presents our experience in the hair implantation for recipient site preparation with 16G epidural needle. Methods The 16G epidural needle was used during preparation of the recipient field in eight patients. Approximately 500 micrografts were grafted in each patient to reconstruct the anterior hairline. Results During insertion of the micrografts, almost none of the previously inserted grafts tended to `pop out'. The anterior hairline of the patients was natural without obvious scarring. The mean follow‐up period of these patients was 1.5 years. The amount of graft survival was found to be satisfactory. Conclusion According to the surgeon’s clinical observations, application of this technique was found to be easier than standard needle techniques. It can be used by inexperienced surgeons. Use of epidural needle for recipient hole preparation works well in reducing the popping out, and the curved fashion of the holes reduced the angle of the hair follicle.     

Trends in the rates of hospitalizations for acute stroke among patients over 90 years of age with atrial fibrillation in the United States: from 2005 to 2014

Background Acute stroke (AS) rates in patients over 90 years of age (very elderly) with atrial fibrillation (AF) in the United States (US) are not known. We assessed trends in hospitalizations for AS among very elderly with AF in the US from 2005 to 2014. Methods We used the nationwide inpatient sample (NIS) from the USA; 2005–2014. AF and AS diagnoses were abstracted using international classification of diseases, 9^th Revision, clinical modification (ICD-9-CM) codes. Results From 2005–2014, 3,606,073 hospitalizations of very elderly with AF were reported. Of these, 188,948 hospitalizations (141,822 hospitalizations in women and 47,126 hospitalizations in men) had AS as the primary diagnosis. Age adjusted AS hospitalizations increased in the total cohort (3217/million in 2005 to 3871/million in 2014), in women (3540/million in 2005 to 4487/million in 2014) and in men (2490/million in 2005 to 3173/million in 2014) (P < 0.001). Anticoagulation rates increased in women (8% in 2005 to 19.9% in 2014) and in men (8.9% in 2005 to 21.6% in 2014). AS rates, though numerically lower than the total cohort, showed an increasing trend in anticoagulated patients as well (all anticoagulated patients: 212/million in 2005 to 513/million in 2014; anticoagulated women: 224/million in 2005 to 529/million in 2014, anticoagulated men: 184/million in 2005 to 518/million in 2014). Conclusions There is an increasing trend in AS hospitalizations among nonagenarians with AF in the US despite improving utilization of anticoagulants in this patient population. The etiologies driving this alarming trend are unclear and require fur?ther study.     

Antioxidant properties of Viburnum opulus and Viburnum lantana growing in Turkey

In the present study, antioxidant properties of the water extracts of different parts of Viburnum opulus and Viburnum lantana (Caprifoliaceae) were investigated using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) scavenging and superoxide anion scavenging methods. The extracts were prepared from the fruits, branches, and leaves of V lantana and V opulus species. The branch extracts of V lantana and V opulus inhibited superoxide anion in a concentration-dependent manner. Compared with t-tocopherol, the fruit extract of V lantana did not show any scavenging effect on superoxide anion formation. V lantana leaf extracts, however, showed a moderate scavenging effect on superoxide anion formation, whereas V lantana branch extracts showed a strong scavenging effect (IC50 = 3.1 mg/ml) on superoxide anion in higher concentration. On the other hand, all extracts exhibited a scavenging effect on the DPPH radical with various potencies. When compared with butylated hydroxytoluene, V opulus branch and V lantana leaf extracts, as well as V lantana branch, V opulus fruit and V lantana fruit extracts, showed strong DPPH radical scavenging activity with IC50 values of 0.014, 0.035, 0.052, 0.057 and 0.085 mg/ml, respectively.     

Serum sIL-2R, TNF-α and IFN-γ in alveolar echinococcosis

AIM: To approach the relationship between alveolar echinococcosis (AE) pathology and level of sIL-2R,TNF-αand IFN-γ in sera and the significance of cytokines in development of AE.METHODS: After 23 patients with AE were confirmed by ELISA and ultrasound, their sera were collected and the concentrations of sIL-2R,TNF-α and IFN-γ were detected by double antibody sandwich. Twelve healthy adults served as controls. According to the status of livers of AE patients by ultrasound scanning, they were divided into 4 groups: P2,P3, P4 groups and C group (control). Average of concentrations of sIL-2R, TNF-α and IFN-yin homologous group was statistically analyzed by both ANOV and Newman-Keuls, respectively.RESULTS: The mean of sIL-2R in P2 group was 97±29, P3:226±80, P4:194±23 and control group (111±30)x103 u/L(P<0.01). The mean of TNF-α in P2 group was 1.12±0.20, P3:3.67±1.96, P4: 1.30±0.25 and control group 0.40±0.19 μg/L(P<0.01). The mean of IFN-y in P2 group was 360±20, P3:486±15, P4: 259±19 and control group: 16±2 ng/L (P<0.01).Judged by ANOV and Newman-Keuls, the mean concentrations of sIL-2R, TNF-α and IFN-y had a significant difference among groups. Except for P2group, the mean sIL-2R between other groups of AE patients had a significant difference (P<0.05). The mean of TNF-α concentration in P3 group was the highest (P<0.01). The mean of IFN-y concentration in all patients was higher than that in control group (P<0.01),but there was no difference between AE groups (P>0.05).CONCLUSION:Low sIL-2R level indicates an early stage of AE or stable status, per contra, a progression stage. Higher level of TNF-α might be related to the lesion of liver. The role of single IFN-y is limited in immunological defense against AE and it can not fully block pathological progression.