Alteration of vascularization in preeclamptic placentas measured by three-dimensional power Doppler ultrasound

Abstract

Objective: To evaluate the alteration of vascularization in preeclamptic placentas measured by three-dimensional (3D) power Doppler ultrasound.

Methods: We performed a prospective study of placental vascularization and placental volume in 27 singleton pregnancies complicated by preeclampsia and 41 normal pregnancies from 27 to 39 weeks of gestation. The placental volume was analyzed using the VOCAL imaging analysis program and 3D power histogram was used to calculate the placental vascular indices including vascularization index (VI), flow index (FI) and vascularization flow index (VFI).

Results: Of the 27 preeclamptic pregnancies, 9 were complicated by intrauterine growth restriction and 15 were severe preeclampsia. Furthermore, nine of the preeclamptic pregnancies had abnormal end diastolic flow in the umbilical artery. No significant correlation was noted between the placental vascular indices and gestational age in normal pregnancies. The placental vascular indices including VI, FI and VFI were significantly lower in preeclamptic placentas compared with controls (VI, p?<?0.001; FI, p?=?0.022; VFI, p?<?0.001). Preeclamptic placental volume was also decreased compared with that of the controls (p?=?0.002). After adjustment for confounding factors, significant differences were observed in VI and placental volume. However, no correlation was found between 3D power Doppler vascular indices and umbilical artery flow velocities, and neither intrauterine growth restriction nor the severity of preeclampsia could be predicted by the vascular indices.

Conclusion: VI and placental volume are reduced in preeclamptic placenta. Placental vascular indices using 3D power Doppler ultrasound provide insights of placental vascularization in preeclampsia.     

Menstrual cycles are influenced by sunshine

Introduction.?The study determined the effect of seasons and meteorological variables on ovarian-menstrual function.

Methods.?Women (N?=?129) living in Novosibirsk (55°N), Russia, provided data on normal menstrual cycles for over 1 year between 1999 and 2008. Of these, 18 together with 20 other healthy women were investigated once in winter and once in summer in 2006–2009. The investigated variables included serum levels of follicle-stimulating hormone (FSH), luteinising hormone (LH) and prolactin on day ～7 of the menstrual cycle, ovary follicle size (by ultrasound) on day ～12 and ovulation occurrence on subsequent days.

Results.?In summer vs. winter, there was a trend towards increased FSH secretion, significantly larger ovarian follicle size, higher frequency of ovulation (97% vs. 71%) and a shorter menstrual cycle (by 0.9 days). LH and prolactin levels did not change. In all seasons combined, increased sunshine (data derived from local meteorological records) 2–3 days before the presumed ovulation day (calculated from the mean menstrual cycle) led to a shorter cycle length. Air/perceived temperature, atmospheric pressure, moon phase/light were not significant predictors.

Conclusions.?Ovarian activity is greater in summer vs. winter in women living in a continental climate at temperate latitudes; sunshine is a factor that influences menstrual cycle.     

A preliminary retrospective study about the relationship between ductus venosus Doppler indices,nuchal translucency (NT) and biochemical markers in the first and second trimester screening tests

In our study, we tried to assess the relation between ductus venosus Doppler indices [pulsatility index (PI), resistance index (RI) and S/D] and first-trimester screening markers (MoM of serum pregnancy-associated plasma protein A, pappalysin 1 (PAPP-A), MoM of serum free β-human chorionic gonadotrophin (β-hCG), and nuchal translucency (NT) and second trimester screening markers (MoM of serum α-fetoprotein, MoM of serum total β-hCG and MoM of serum estriol). We analyzed the data of 121 singleton pregnancies. Roche cobas e 601ECLIA (electrochemiluminescence immunoassay) was used to measure MoM of serum PAPP-A and Roche cobas e 602 ECLIA (electrochemiluminescence immunoassay) was used to measure MoM of serum free β-hCG in the first trimester. Beckman Coulter Access 2 Immunoassay was used to measure MoM of serum α-fetoprotein, MoM of serum total β-hCG and MoM of serum estriol in the second trimester. The first author performed all ultrasound screenings and ductus venosus Doppler studies. What we found new in our study is presented as following; MoM of serum α-fetoprotein had a negative correlation with RI of ductus venosus Doppler, MoM of serum estriol had a negative correlation with RI of ductus venosus Doppler and MoM of serum estriol had a negative correlation with S/D of ductus venosus doppler. The results of our study suggest that ductus venosus Doppler can be used to increase the effectiveness of the second trimester screening test.     

Utility of color duplex sonography in the assessment of efficacy of the stellate ganglion blockade

Purpose: 
To assess the hemodynamic changes in the upper extremity arteries after sympathetic ganglion blockade (SGB) by using spectral Doppler parameters and to determine the applicability of these parameters for the evaluation of SGB efficacy. Material and Methods: 
Spectral Doppler parameters (peak systolic velocity (PSV), end diastolic velocity (EDV), mean velocity (mean V), flow volume, resistive and pulsatility indices (RI, PI), inner arterial diameters (intima to intima) (D) with simultaneous recordings of heart rate (HR), systolic and diastolic blood pressures and upper extremity surface temperature changes) were recorded before and 5 min after during the first, fifth and tenth SGB procedures. Results: 
SGB induced an increase in skin temperature in the ipsilateral hand and persistent dilatation of the radial diameter accompanied by reduction of RI and PI in the radial and third digital arteries in all patients. Conclusion: 
Hemodynamic changes assessed by spectral Doppler parameters could be used as sensitive and objective measurements of peripheral sympathetic nervous activity and vascular tonus, and may confirm a successfully performed SGB.     

Platelet count, mean platelet volume and thrombocytopoietic indices in healthy women and men

Gender-dependent differences in platelet count have been demonstrated in few studies. In women platelet count is higher than in men, which seems to reflect different hormonal profiles or a compensatory mechanism associated with menstrual blood loss. The aim of the study was to assess platelet count, mean platelet volume and thrombocytopoietic indices in women and men. The study was conducted on healthy blood donors divided into groups: F - 60 women and M - 65 men. Platelet count and mean platelet volume were determined on a haematological analyser Advia 120, Bayer. The following thrombocytopoietic indices were measured: thrombopoietin concentration (ELISA), percentage of reticulated platelets (flow cytometry, COULTER EPICS XL) and absolute reticulated platelet count. RESULTS: Higher platelet count was noted in the group of women 252.35 +/- 41.25 x 10(9)/l as compared to men 221.87 +/- 37.63 x 10(9)/l (p = 0.0002). At the same time women had lower thrombopoietin concentration 156.50 +/- 57.18 pg/ml compared to men 180.46 +/- 60.98 pg/ml, (p = 0.03). No statistically significant differences were found in the mean platelet volume, percentage of reticulated platelets or absolute reticulated platelet count between group F and M. CONCLUSIONS: Platelet count is gender-dependent, being higher in women than in men. Thrombopoietin concentration is gender-dependent and is lower in women than in men. In physiological conditions, there is no correlation between platelet count and thrombopoietin concentration in women (r = -0.155) and men (r = -0.2586).     

Effect of kolaviron,a biflavonoid complex from Garcinia kola seeds,on the antioxidant,hormonal and spermatogenic indices of diabetic male rats

The antihyperglycaemic effect of kolaviron (KV), a biflavonoid from Garcinia kola has been established in previous studies. In this study, we investigated the effect of KV (200 mg kg^?1) on the antioxidant, hormonal and spermatogenic indices of alloxan‐diabetic male rats, and metformin hydrochloride (MET) (30 mg kg^?1) served as standard drug. The results showed that KV and MET significantly (P < 0.05) decreased the fasting blood glucose of the diabetic rats. Also, untreated and MET‐treated diabetic groups had significantly (P < 0.05) lower body‐weight gain and relative weights of testes. In addition, epididymal sperm abnormalities were increased, whereas sperm count, motility, testicular protein and sialic acid were decreased in untreated diabetic group. Also, antioxidant parameters, reduced glutathione, catalase, superoxide dismutase, glutathione‐S‐transferase and glutathione peroxidase were significantly (P < 0.05) reduced in the testes with a concomitant increase in lipid peroxidation in untreated diabetic group. Furthermore, untreated diabetic group had significantly (P < 0.05) lower levels of testosterone, luteinising and follicle‐stimulating hormones relative to controls. Treatment with KV restored the relative weights of testes, activities of antioxidant enzymes, sperm and hormonal indices of the diabetic animals. This study demonstrated the role of KV to promote fertility in diabetic male rats by enhancing the hormonal and antioxidant status of the rats.     

Comparison of different obesity indices related with hypertension among different sex and age groups in China

Background and aimsTo compare the relationships of five obesity-related routine anthropometric indicators (body mass index (BMI), body adiposity index (BAI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR)) for hypertension in both sexes and among different age groups of the Chinese population.Methods and resultsA total of 12,064 adult participants (5638 males and 6426 females) were included. Odds ratios (OR) and 95% confidence intervals were used with binary logistic regression models to estimate the risk of hypertension for each obesity index. For the males, WHtR had the highest OR value in all age groups. The degrees of correlation between hypertension and the obesity indices for different age groups were different among the females. WC, BMI, and WHtR were the highest in the 18–44, 45–59, and ≥60 years age groups, respectively. Furthermore, we compared the area under the ROC curve (AUC) of each obesity index for the criterion of hypertension under the influence of risk factors. For the males, the AUC of WHtR was the largest (0.814, 0.710, and 0.662). WC (AUC = 0.820), BMI (AUC = 0.765), and WHtR (AUC = 0.668) tended to be the best criteria for hypertension among females in the 18–44, 45–59, and ≥60 years age groups respectively. In addition, BAI, as an obesity indicator proposed in recent years, has a positive association with hypertension except in 18–44 years women, which was not stronger than other obesity indicators.ConclusionsFor males, WHtR appears to be the best obesity index related with hypertension. For young, middle-aged, and elderly women, the best obesity indices related with hypertension are WC, BMI, and WHtR, respectively.     

Correlation between ocular pulse amplitude measured by dynamic contour tonometer and visual field defects

Purpose To investigate the correlation between ocular pulse amplitude and visual field defects in patients with glaucoma, ocular hypertension, and glaucoma suspicion when measured with the Pascal Dynamic Contour Tonometer, and to verify if the ocular pulse amplitude is an independent predictor for visual field parameters. Methods Seventy-seven eyes (42 patients) with glaucoma, ocular hypertension or glaucoma suspicion were examined. Ocular pulse amplitude was measured with the dynamic contour tonometer by one investigator masked to the visual field data. Visual fields were performed within three months of ocular pulse amplitude measurement by the Octopus or Humphrey Field Analyser, and were analysed with Peridata Software. Mean defect, pattern standard deviation (√ Loss Variance) and regression analysis of those parameters (Trend Indices) were correlated with the ocular pulse amplitude for each eye. Results Forty-nine eyes had glaucoma, 14 had ocular hypertension, and 14 were glaucoma suspects. The mean follow-up was 46.5 (range 6–96) months. There was a significant correlation between OPA and MD and OPA and PSD, even after correction for IOP (and diagnostic group and eye): the estimated slope equals 2.68 (S.E. = 0.82, p = 0.003) and −0.86 (S.E. = 0.33, p = 0.014), respectively. There was even a weak correlation between OPA and the evolution of MD (dB/year). The slope estimate for OPA equals 0.070 (S.E. = 0.033), p = 0.037. However, after correction for IOP (and diagnostic group and eye), the strength of the relationship is reduced and the evidence disappears: the slope estimate for OPA now equals 0.039 (S.E. = 0.041), p = 0.34. There is no evidence for an association between OPA and the evolution of Trend-PSD. Conclusion A small ocular pulse amplitude, as measured with a dynamic contour tonometer, is correlated with moderate to severe glaucomatous visual field loss and might be a risk factor for the development of glaucomatous visual field defects.