Use of umbilical artery Doppler velocimetry in the monitoring of pregnancy in women with pre-existing diabetes

Background: The usefulness of umbilical artery Doppler velocimetry for the monitoring of diabetic pregnancies is controversial. The aim of the present study was to assess whether umbilical artery Doppler velocity waveform analysis can predict adverse perinatal outcomes for pregnancies complicated by pre-existing diabetes mellitus. Methods: All diabetic pregnancies (type 1 and 2) delivered at Mater Mothers' Hospital, Queensland, between 1 January 1995 and 31 December 1999 were included. All pregnant diabetic women were monitored with umbilical artery Doppler velocimetry at 28, 32, 36, and 38 weeks' gestation. Adverse perinatal outcome was defined as pregnancies with one or more of the following: small-for-gestational age, Caesarean section for non-reassuring cardiotocography, fetal acidaemia at delivery, 1-min Apgar of 3 or less, 5-min Apgar of less than 7, hypoxic ischaemic encephalopathy or perinatal death. Abnormal umbilical artery Doppler velocimetry was defined as a pulsatility index of 95th centile or higher for gestation. Results: One hundred and four pregnancies in women with pre-existing diabetes had umbilical arterial Doppler studies carried out during the study period. Twenty-three pregnancies (22.1%) had an elevated pulsatility index. If the scans were carried out within 2 weeks of delivery, 71% of pregnancies with abnormal umbilical Doppler had adverse outcomes (P < 0.01; likelihood ratio, 4.2). However, the sensitivity was 35%; specificity was 94%; positive predictive value was 80%; and negative predictive value was 68%. Only 30% of women with adverse perinatal outcomes had abnormal umbilical arterial Doppler flow. Conclusion: Umbilical artery Doppler velocimetry is not a good predictor of adverse perinatal outcomes in diabetic pregnancies.

Complete Integrability of a Nonlinear Elliptic System, Generating Bi-umbilical Foliated Semi-symmetric Hypersurfaces in R^4

Николай Кутев, Величка Милушева - Намираме експлицитно всичките би-омбилични фолирани полусиметрични повърхнини в четиримерното евклидово пространство R^4

Totally Umbilical Pseudo-Slant Submanifolds of a Nearly Cosymplectic Manifold

2000 Mathematics Subject Classification: 53C40, 53B25.

Outcomes after Unrelated Umbilical Cord Blood Transplantation for Children with Osteopetrosis.

Hematopoietic stem cell transplantation (HSCT) is the only curative treatment for most children with osteopetrosis (OP). Timing of HSCT is critical; therefore, umbilical cord blood transplantation (UCBT) is an attractive option. We analyzed outcomes after UCBT in 51 OP children. Median age at UCBT was 6 months. Seventy-seven percent of the cord blood grafts had 0 or 1 HLA disparity with the recipient. Conditioning regimen was myeloablative (mostly busulfan-based in 84% and treosulfan-based in 10%). Antithymocyte globulin was given to 90% of patients. Median number of total nucleated and CD34(+) cells infused was 14 × 10(7)/kg and 3.4 × 10(5)/kg, respectively. Median follow-up for survivors was 74 months. Cumulative incidence (CI) of neutrophil recovery was 67% with a median time to recovery of 23 days; 33% of patients had graft failure, 81% of engrafted patients had full donor engraftment, and 19% had mixed donor chimerism. Day 100 CI of acute graft-versus-host disease (grades II to IV) was 31% and 6-year CI of chronic graft-versus-host disease was 21%. Mechanical ventilation was required in 28%, and veno-occlusive disease was diagnosed in 16% of cases. Six-year overall survival rate was 46%. Comparative studies with other alternative donors should be performed to evaluate whether UCBT remains a valid alternative for children with OP without an HLA-matched donor.

Tiempo de alumbramiento con drenaje y sin drenaje de sangre del cordón umbilical en pacientes anémicas y no anémicas en el Hospital Vicente Corral Moscoso, Cuenca-Ecuador 2007

Con un diseño experimental se realizó un estudio clínico, controlado, aleatorizado La muestra incluyó 200 pacientes, el grupo experimental comprendió 100 pacientes en las que se drenó la sangre de cordón umbilical 50 anémicas y 50 no anémicas, y el grupo de control con pinzamiento del cordón lo integraron 100 pacientes, 50 anémicas y 50 no anémicas. Resultados: al comparar la duración del tercer período del parto del grupo con drenaje se obtuvo una media de 4,6 ñ 1,4 min y en el grupo con pinzamiento 9,07 ñ 2,5 min. La diferencia fue significativa (P = 0,0001).Cuando se comparó la duración del tercer período del parto de 1 a 5 min vs 6 a 10 min, la mayoría de las pacientes del grupo con drenaje, estuvo entre 1 a 5 min, con un RR 0.239 (IC 95: 0.188 - 0.358), RRA 70.1, RRR 76.1, NNT 1.426, en las anémicas, y un RR 0.250 (IC 95: 0.179 - 0.383), RRA 66.1, RRR 75, NNT 1.513 en las no anémicas. El volumen de drenaje en el grupo de estudio, tuvo una media de 60.3 ñ 19.5 ml en las anémicas y 56.9 ñ 18 ml en las no anémicas (P = 0.369). La hemorragia del tercer período del parto del grupo con drenaje tuvo una media de 197.6 ñ 36 ml vs el grupo con pinzamiento 277.4 ñ 49 ml con un valor (P = 0,0001) lo cual es estadísticamente significativo a favor del drenaje. Cuando se comparó la hemorragia del tercer período del parto de menor que 250 ml vs 250 a 500 ml la mayoría de las pacientes del grupo con drenaje, estuvo en menor que 250 ml, con un RR 0.070 (IC 95: 0.025 - 0.168), RRA 80, RRR 93, NNT 1.25, en las anémicas, y un RR 0.074 (IC 95: 0.020 - 0.246), RRA 50, RRR 92.6, NNT 2 en las no anémicas. Conclusiones. La maniobra del drenaje de sangre del cordón umbilical reduce el tiempo y la hemorragia del tercer período del parto en pacientes con anemia leve y no anémicas sin producir efectos deletéreos

Effects of hypoxic culture conditions on umbilical cord-derived human mesenchymal stem cells

Following cultivation of distinct mesenchymal stem cell (MSC) populations derived from human umbilical cord under hypoxic conditions (between 1.5% to 5% oxygen (O-2)) revealed a 2- to 3-fold reduced oxygen consumption rate as compared to the same cultures at normoxic oxygen levels (21% O-2). A simultaneous measurement of dissolved oxygen within the culture media from 4 different MSC donors ranged from 15 mu mol/L at 1.5% O-2 to 196 mu mol/L at normoxic 21% O-2. The proliferative capacity of the different hypoxic MSC populations was elevated as compared to the normoxic culture. This effect was paralleled by a significantly reduced cell damage or cell death under hypoxic conditions as evaluated by the cellular release of LDH whereby the measurement of caspase 3/7 activity revealed little if any differences in apoptotic cell death between the various cultures. The MSC culture under hypoxic conditions was associated with the induction of hypoxia-inducing factor-alpha (HIF-1 alpha) and an elevated expression of energy metabolism-associated genes including GLUT-1, LDH and PDK1. Concomitantly, a significantly enhanced glucose consumption and a corresponding lactate production could be observed in the hypoxic MSC cultures suggesting an altered metabolism of these human stem cells within the hypoxic environment.

Cuidados del cordón umbilical en el recién nacido: revisión de la evidencia científica

Objetivos: En este trabajo se realiza una revisión de la evidencia científica sobre las pautas de cuidado de la herida umbilical del recién nacido recomendadas en la actualidad con el objetivo de determinar cuál es el mejor cuidado posible. Metodología: En mayo de 2015 se realizó una revisión, siguiendo los criterios PRISMA, de la literatura científica que se completó con una revisión manual. La herramienta utilizada para la evaluación de los trabajos seleccionados fueron las "Fichas de Lectura Crítica" de OSTEBA del Servicio de Evaluación de Tecnologías Sanitarias del Gobierno Vasco. Resultados: Incluimos en la revisión 9 artículos, de los cuales 5 son revisiones previas y 4 ensayos clínicos aleatorizados y controlados. La mayoría de los trabajos comparan la utilización de un antiséptico para la cura del ombligo (generalmente clorhexidina) frente al cuidado seco de la herida. Conclusiones: De acuerdo a la evidencia científica resumida en esta revisión sobre las recomendaciones para la cura del ombligo del recién nacido el método a recomendar será diferente según el país en el que nos encontremos ya sea desarrollado o en vías de desarrollo.

Que técnica usar nos cuidados ao cordão umbilical do recém-nascido

É durante o puerpério que o Enfermeiro ESMO cuida do RN de forma a promover o bem-estar e potenciar a sua saúde, incluindo os cuidados ao coto umbilical. Parece existirem diferentes práticas nos cuidados ao coto umbilical do RN, que se caraterizam pela não uniformização e nem sempre baseadas em evidência científica. Na prestação de cuidados surgem, às vezes, dúvidas. A primeira premissa para sanar estas questões, baseia-se no recurso à evidência, sendo a prática baseada na evidência a mais aceite e deverá ser praticada.

Cuidados ao cordão umbilical do recém-nascido: que técnica usar?

O Enfermeiro Especialista de Saúde Materna e 0bstetrícia é confrontado diariamente com a necessida de prestar cuidados ao coto umbilical do recém-nascido. Estes cuidados foram, ao longo dos anos, sofrendo alterações significativas devido ao impacto das infecções do colo umbilical na mortalidade neonatal. Parecem existir diferentes práticas nos cuidados ao coto umbilical do recém-nascido, que se caracterizam pela não uniformização nos cuidados e incidem sobretudo em técnicas enraizadas nas instituições, em vez de baseadas em evidência científica.

Que técnica usar nos cuidados ao cordão umbilical do recém nascido

O Enfermeiro Especialista de Saúde Materna, Obstétrica e Ginecológica possui competências com responsabilidade em diversas áreas de atividade. É durante o puerpério que o Enfermeiro cuida do recém-nascido de forma a promover o bem-estar e potenciar a sua saúde, incluindo os cuidados ao coto umbilical. Estes cuidados foram, ao longo dos anos, sofrendo alterações significativas devido ao impacto das infeções do coto umbilical na mortalidade neonatal. Parece existirem diferentes práticas nos cuidados ao coto umbilical do recém-nascido, que se caraterizam pela não uniformização e nem sempre baseadas em evidência científica. Na prestação de cuidados surgem, às vezes, dúvidas e questões problemáticas. A primeira premissa para sanar estas questões, da forma mais eficaz e eticamente correta, baseia-se no recurso à evidência, sendo a prática baseada na evidência a mais amplamente aceite e deverá ser praticada.

Relacionar la hernia umbilical en neonatos equinos de raza polo argentino con su posible asociación genética en 3 criaderos en la sabana de Bogotá durante los años 2010-2012

Tesis (Médico Veterinario). -- Universidad de La Salle. Facultad de Ciencias Agropecuarias. Programa de Medicina Veterinaria, 2014