Objective: To evaluate the impact of amniotic fluid “sludge” (AFS) on the risk of preterm delivery and to describe the effect of antibiotic treatment in that situation.
Methods: Case–control study including singleton pregnancies with or without AFS, between 15–32 weeks of gestation. Factors associated with preterm delivery before 32 weeks, 34 weeks and 37 weeks were evaluated with univariate and multivariate logistic regression. Since all women with AFS in this study were treated with antibiotics, a historical comparison was performed with similar patients with AFS found before 2007 and not treated with antibiotics.
Results: AFS was observed in 90/1220 patients (7.4%). AFS was associated with shorter cervical length, greater body mass index, cervical cerclage and preterm birth before 28 weeks. However, after adjustment, AFS did not remain associated with preterm delivery before 32 or 34 weeks. The historical comparison suggested that azithromycin could significantly reduce the risk of preterm delivery before 34 weeks (odds ratio: 0.2; 95% CI: 0.04–0.92).
Conclusions: AFS, treated with azithromycin, was associated with a higher risk of prematurity, but not independently after adjustment for cervical length and second trimester vaginal bleeding. Further studies need to evaluate the effect of antibiotics in pregnancies with AFS. 相似文献
目的探讨宫颈小细胞神经内分泌癌(small cell neuroendocrine carcinoma of the cervix,SCNEC)的临床病理特征和免疫组化特点。方法对四川省妇幼保健院病理科和四川省人民医院病理科2006年1月至2014年6月诊治的8例宫颈小细胞神经内分泌癌进行组织形态学、免疫组化观察,并对其临床资料进行整理分析。结果 8例患者平均年龄45.6岁,均以阴道不规则出血或宫颈接触性出血就诊。组织学显示肿瘤由大小较为一致的圆形、卵圆形细胞构成。其中单纯性小细胞神经内分泌癌7例,合并腺癌成分1例。免疫组化:所有病例癌细胞细胞角蛋白(CK)不同程度阳性,且均有两种以上神经内分泌标记阳性,其中6例突触素(Syn)和嗜铬素(Cg A)均阳性,4例神经细胞黏附分子(CD56)阳性。随访7例患者,死亡3例。结论宫颈小细胞癌作为一种少见的高度恶性肿瘤,进展快,预后差,免疫组化神经内分泌标志阳性有助于诊断。 相似文献
A cell culture system is described in which purified mononuclear phagocytes may be cultured with a cartilage substrate which is radiolabelled in its proteoglycan. Resident mouse peritoneal macrophages degraded this substrate, and did so more avidly if cultured in direct contact with it. There was no evidence for complete intralysosomal degradation of the proteoglycan of the cartilage. Lysates were found to contain considerable activity at pH 7, which was inhibited by the presence of 10% serum, or by boiling the lysate.Proximity of macrophages to the substrate did not induce selective release of the lysosomal marker enzyme hexosaminidase, and concentrated enzymes secreted from the macrophages after treatment with the lysosomotropic agent ammonium chloride were ineffective in degrading cartilage at neutral pH.The active enzyme in macrophage lysates at neutral pH was found to be sedimentable by 100,000 × g centrifugation for 1 hour, in absence of lysosomal protective agents. There is evidence for a cell membrane-associated process in the degradation of cartilage by these cells, which may be a proteolytic, endoglycosidic or free radical-mediated event. 相似文献
OBJECTIVES: To report our experience with five cases of apparently isolated small-vessel vasculitis of the uterine cervix. METHODS: Case study of five patients with necrotizing vasculitis discovered incidentally in surgical specimens of the female genital tract, and a review of the pertinent literature on this subject. RESULTS: All patients lacked clinical and serological features of the well-delineated vasculitic syndromes. Comprehensive workup failed to yield any evidence of an underlying disorder. All patients were managed expectantly and did not develop systemic vasculitis during follow-up ranging from 6 months to 5 years. CONCLUSIONS: Isolated vasculitis of the female genital tract can be encountered as an innocuous finding in otherwise healthy individuals. The cause and pathogenesis of this disorder remain obscure. Rheumatologists should be familiar with this rare and vexing form of vasculitis and with its benign prognosis. 相似文献