673 resultados para PTB, Raoul Hedebouw


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Mode of access: Internet.

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Thesis (doctoral)--Konigl. Christian-Albrechts-Universitat Kiel.

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Objective - During pregnancy, the human cervix undergoes angiogenic transformations. VEGF is expressed in cervical stroma and is proposed to play key roles in the process of cervical ripening and dilation. This study was conducted to evaluate whether cervical secretion of VEGF can be of clinical value in predicting impending PTB. Study Design - In an observational prospective cohort study, we analyzed cervical fluid samples from 103 pregnant women (GA: median [IQR]: 28 [25-31] wks) who presented for either a routine prenatal visit (n=61) or for evaluation of threatened preterm labor (n=42). Cervical secretions were collected under a standard protocol which was followed in all cases. Cervical length (CL) was assessed by transvaginal ultrasound using well-established criteria. Dilation was evaluated by digital exam performed only after collection of the biological samples. VEGF levels were immunoassayed by investigators unaware of the clinical outcome. Main exclusion criteria were ruptured membranes, active labor, vaginal bleeding, vaginal exam or intercourse within 24h. Results were analyzed with and without normalization for total protein. Results - 1) Clinical characteristics of the cohort are presented in Table;2) VEGF was detectable in all specimens, with no correlation between its levels, CL, twins or GA at collection; 3) There was an inverse correlation between VEGF and cervical dilation (R=-0.646, P=0.003); 4) Women with cervical dilation =1 cm had lower VEGF compared to those with a closed cervix (P=0.003); 5) Women who experienced PTB within 14 days (n=11) had lower VEGF (P=0.003); 6) A free VEGF level of =600 pg/mL had a sensitivity, specificity, +LR and -LR of 70%, 95%, 13.5 and 0.3, respectively in predicting PTB within 14 days. Conclusions - Low VEGF levels in the cervicovaginal secretions of pregnant women are associated with an increased risk of PTB within 2 weeks of collection. Active engagement of VEGF in the process of cervical ripening and dilatation and/or increased affinity of extracellular matrix components for VEGF may provide explanation for our findings.

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Lately, there has been increasing interest in the association between temperature and adverse birth outcomes including preterm birth (PTB) and stillbirth. PTB is a major predictor of many diseases later in life, and stillbirth is a devastating event for parents and families. The aim of this study was to assess the seasonal pattern of adverse birth outcomes, and to examine possible associations of maternal exposure to temperature with PTB and stillbirth. We also aimed to identify if there were any periods of the pregnancy where exposure to temperature was particularly harmful. A retrospective cohort study design was used and we retrieved individual birth records from the Queensland Health Perinatal Data Collection Unit for all singleton births (excluding twins and triplets) delivered in Brisbane between 1 July 2005 and 30 June 2009. We obtained weather data (including hourly relative humidity, minimum and maximum temperature) and air-pollution data (including PM10, SO2 and O3) from the Queensland Department of Environment and Resource Management. We used survival analyses with the time-dependent variables of temperature, humidity and air pollution, and the competing risks of stillbirth and live birth. To assess the monthly pattern of the birth outcomes, we fitted month of pregnancy as a time-dependent variable. We examined the seasonal pattern of the birth outcomes and the relationship between exposure to high or low temperatures and birth outcomes over the four lag weeks before birth. We further stratified by categorisation of PTB: extreme PTB (< 28 weeks of gestation), PTB (28–36 weeks of gestation), and term birth (≥ 37 weeks of gestation). Lastly, we examined the effect of temperature variation in each week of the pregnancy on birth outcomes. There was a bimodal seasonal pattern in gestation length. After adjusting for temperature, the seasonal pattern changed from bimodal, to only one peak in winter. The risk of stillbirth was statistically significant lower in March compared with January. After adjusting for temperature, the March trough was still statistically significant and there was a peak in risk (not statistically significant) in winter. There was an acute effect of temperature on gestational age and stillbirth with a shortened gestation for increasing temperature from 15 °C to 25 °C over the last four weeks before birth. For stillbirth, we found an increasing risk with increasing temperatures from 12 °C to approximately 20 °C, and no change in risk at temperatures above 20 °C. Certain periods of the pregnancy were more vulnerable to temperature variation. The risk of PTB (28–36 weeks of gestation) increased as temperatures increased above 21 °C. For stillbirth, the fetus was most vulnerable at less than 28 weeks of gestation, but there were also effects in 28–36 weeks of gestation. For fetuses of more than 37 weeks of gestation, increasing temperatures did not increase the risk of stillbirth. We did not find any adverse affects of cold temperature on birth outcomes in this cohort. My findings contribute to knowledge of the relationship between temperature and birth outcomes. In the context of climate change, this is particularly important. The results may have implications for public health policy and planning, as they indicate that pregnant women would decrease their risk of adverse birth outcomes by avoiding exposure to high temperatures and seeking cool environments during hot days.

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The legend of Hunter S. Thompson*the great gonzo*has grown deeper and more layered since his death in February 2005 than it was even in his exotic and controversyfilled life. The most recent addition to the mythology*The Rum Diary(Bruce Robinson, 2011)*stars Johnny Depp, possibly Thompson’s greatest fan, and certainly a man dedicated to keeping the man’s memory alive. Not for the first time, Depp brings his A-list status and good looks to playing the Thompson character on the big screen. In Terry Gilliam’s adaptation of Fear and Loathing in Las Vegas (1998) he played the writer’s alter ego, Raoul Duke. Duke was Thompson, and Fear and Loathing in Las Vegas a fictionalized account of what is generally accepted to have been a real-life episode. In The Rum Diary he plays Paul Kemp, the young journalist who lands a job as a crime reporter on a struggling Puerto Rican newspaper. Again, the protagonist is a version of Thompson himself, who did indeed spend time in 1960 working for the Puerto Rican press. Both films join Gonzo (Alex Gibney, 2008) to form a trilogy of Depp-infused movies about a journalist some regard as one of the greatest of the twentieth century, and others view as an overrated charlatan who leveraged his one big idea into a four decades-long career brought low by drugs, booze, dysfunctional sex and, finally, Hemingwayesque despair...

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This thesis explores Raphael Rubinstein’s notion of provisionality as detailed in his influential article from 2009, Provisional Painting and his subsequent exhibition of the same name from 2011. Rubenstein’s writing is discussed in relation to modern art’s rhetoric around the many ‘deaths’ or ‘ends’ of painting as a contemporary art‐making medium, particularly in reference to Yve‐Alain Bois’ 1986 article, Painting: the task of mourning. While Rubenstein predominantly views the provisional via an abstract lens, it is through the work of Sigmar Polke and then Luc Tuymans, Peter Doig and Daniel Richter, that I build an argument to include the work of contemporary representational painters within his notion of provisionality. These new ideas of provisionality are then examined in the context of my recent paintings, which are viewed as contemporary examples of provisionality extended into the representational.