HELLP Syndrome a Severe Form of Preeclampsia: a Comparative Study of Clinical and Laboratorial Parameters

The objective of this study was to compare clinical, laboratorial, maternal and perinatal results between HELLP Syndrome and severe Preeclampsia. An observational study comparing women with HELLP Syndrome (n=71) to women with severe preeclampsia (n=253) was done. The authors analyzed the early course of the pathologies and the outcomes in both groups. HELLP syndrome occurred in 28% of all the cases and was more frequent at gestational age before 32 weeks (n=39 – 55%) than severe preeclampsia (n=108 - 42%), with more newborns weighting less than 1500g (27 – 38.6% vs 65 – 25.6%; p=0.036). Thrombocytopenia below 100 000/μL (aOR, 2.14; 95% CI, 1.49 – 3.06) and LDH>1 000 UI/L (aOR: 5.17; 95% CI 2.19 – 12.16) were risk factors for HELLP. Maternal morbidity (eclampsia, abruptio placentae, and acute renal failure) was similar in both cohorts; eight stillbirths (6 in severe preeclampsia and 2 in HELLP Syndrome) occurred. There were no maternal deaths. In conclusion, in this study the authors confirmed that HELLP Syndrome is a severe form of preeclampsia with an earlier presentation in pregnancy, worst laboratorial findings and more prematurity rates.

Chase-Lloyd House at 250: significance of function and integrity of form

(M. Historic Preservation) -- University of Maryland-College Park, 2015 Faculty Advisor: Dr. Constance Werner Ramirez. Program Director: Dr. Donald W. Linebaugh

Successful Treatment Using Simeprevir, Sofosbuvir and Rituximab of a Severe Form of Hepatitis C Virus-related Mixed Cryoglobulinemia with Cardiac Involvement

Numerous extrahepatic manifestations have been reported in hepatitis C virus (HCV) infection, particularly mixed cryoglobulinemia (MC). MC generally responds to clearance of HCV under pegylated-interferon plus ribavirin treatment. New direct-acting antiviral agents have been licensed for HCV under different combinations but have not been studied in severe forms of MC. Here, we present a case report describing a life-threatening form of MC with multivisceral involvement, which was successfully treated with concomitant rituximab, sofosbuvir and simeprevir. In light of the rapid clinical remission associated with sustained virological response and the excellent side-effect profile, this treatment should be considered as a first-line therapy in severe forms of MC.

Exporting the racial republic: African colonization, national citizenship, and the transformation of U.S. expansion, 1776-1864

The effort to create a colony of African Americans on the west coast of Africa was one of the most celebrated and influential movements in the United States during the first half of the 19th century. While historians have often viewed African colonization through the lens of domestic anti-slavery politics, colonization grew from an imperial impulse which promised to transform the identities of black colonists and indigenous Africans by helping them to build a democratic nation from the foundation of a settler colony. By proposing that persons of African descent could eventually become self-governing subjects, the liberal framework behind colonization offered the possibility of black citizenship rights, but only within racially homogenous nation-states, which some proponents of colonization imagined might lead to a “United States of Africa.” This dissertation examines how the notion of expanding democratic ideals through the export of racial nationhood was crucial to the appeal of colonization. It reveals how colonization surfaced in several crucial debates about race, citizenship, and empire in the antebellum United States by examining discussions about African Americans’ revolutionary claims to political rights, the bounds of US territorial expansion, the removal of native populations in North America, and the racialization of national citizenship, both at home and abroad. By examining African colonization from these perspectives, this dissertation argues that the United States’ efforts to construct a liberal democracy defined by white racial identity were directly connected to the nation’s emerging identity as a defender and exporter of political liberty throughout the world.

Obsolescence and Renewal: Transformation of Post War Concrete Buildings

In this thesis I investigate issues of post-war concrete buildings and how we can both add value and make adaptable what we have traditionally defined as not valuable and not adaptable. 55% of United States’ commercial building stock was built between the years of 1960 and 1980, leaving 36 billion square feet of building material to be adaptively reused or at the bottom of a landfill. Currently, our culture does not value many character defining features of these buildings making the preservation of these buildings difficult, especially at this 50 year critical moment of both the attribution of a “historic” status and time when major renovation of these buildings needs to occur. How can architects add value to a building type, sometimes called “brutalist”, that building culture currently under values and thinks is “obsolete”? I tested this hypothesis using the James Forrestal Building in Washington D.C. After close study of the obsolescence, value,history and existing conditions, I propose a design that adds value to Southwest Washington D.C. and may serve as an example for post-war renewal around the country.

Investigation of un-American propaganda activities in the United States : Hearings before a Special Committee on Un-American Activities, House of Representatives, Seventy-fifth Congress, third session-Seventy-eighth Congress, second session, on H. Res. 282, to investigate (1) the extent, character, and objects of un-American propaganda activities in the United States, (2) the diffusion within the United States of subversive and un-American propaganda that is instigated from foreign countries or of a domestic origin and attacks the principle of the form of government as guaranteed by our Constitution, and (3) all other questions in relation thereto that would aid Congress in any necessary remedial legislation.

Martin Dies, chairman.

Children with Special Health Care Needs: Comparison of the Effects of Home Care Setting, Prescribed Pediatric Extended Care Setting, and Long-Term Care Setting on Child and Family Health Outcomes and Health Care Service Use

Technological advances during the past 30 years have dramatically improved survival rates for children with life-threatening conditions (preterm births, congenital anomalies, disease, or injury) resulting in children with special health care needs (CSHCN), children who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who require health and related services beyond that required by children generally. There are approximately 10.2 million of these children in the United States or one in five households with a child with special health care needs. Care for these children is limited to home care, medical day care (Prescribed Pediatric Extended Care; P-PEC) or a long term care (LTC) facility. There is very limited research examining health outcomes of CSHCN and their families. The purpose of this research was to compare the effects of home care settings, P-PEC settings, and LTC settings on child health and functioning, family health and function, and health care service use of families with CSHCN. Eighty four CSHCN ages 2 to 21 years having a medically fragile or complex medical condition that required continual monitoring were enrolled with their parents/guardians. Interviews were conducted monthly for five months using the PedsQL TM Generic Core Module for child health and functioning, PedsQL TM Family Impact Module for family health and functioning, and Access to Care from the NS-CSHCN survey for health care services. Descriptive statistics, chi square, and ANCOVA were conducted to determine differences across care settings. Children in the P-PEC settings had a highest health care quality of life (HRQL) overall including physical and psychosocial functioning. Parents/guardians with CSHCN in LTC had the highest HRQL including having time and energy for a social life and employment. Parents/guardians with CSHCN in home care settings had the poorest HRQL including physical and psychosocial functioning with cognitive difficulties, difficulties with worry, communication, and daily activities. They had the fewest hours of employment and the most hours providing direct care for their children. Overall health care service use was the same across the care settings.

The Effect of Iron Oxide Nanoparticles on the Fate and Transformation of Arsenic in Aquatic Environments

Iron oxides and arsenic are prevalent in the environment. With the increase interest in the use of iron oxide nanoparticles (IONPs) for contaminant remediation and the high toxicity of arsenic, it is crucial that we evaluate the interactions between IONPs and arsenic. The goal was to understand the environmental behavior of IONPs in regards to their particle size, aggregation and stability, and to determine how this behavior influences IONPs-arsenic interactions. A variety of dispersion techniques were investigated to disperse bare commercial IONPs. Vortex was able to disperse commercial hematite nanoparticles into unstable dispersions with particles in the micrometer size range while probe ultrasonication dispersed the particles into stable dispersions of nanometer size ranges for a prolonged period of time. Using probe ultrasonication and vortex to prepare IONPs suspensions of different particle sizes, the adsorption of arsenite and arsenate to bare hematite nanoparticles and hematite aggregates were investigated. To understand the difference in the adsorptive behavior, adsorption kinetics and isotherm parameters were determined. Both arsenite and arsenate were capable of adsorbing to hematite nanoparticles and hematite aggregates but the rate and capacity of adsorption is dependent upon the hematite particle size, the stability of the dispersion and the type of sorbed arsenic species. Once arsenic was adsorbed onto the hematite surface, both iron and arsenic can undergo redox transformation both microbially and photochemically and these processes can be intertwined. Arsenic speciation studies in the presence of hematite particles were performed and the effect of light on the redox process was preliminary quantified. The redox behavior of arsenite and arsenate were different depending on the hematite particle size, the stability of the suspension and the presence of environmental factors such as microbes and light. The results from this study are important and have significant environmental implications as arsenic mobility and bioavailability can be affected by its adsorption to hematite particles and by its surface mediated redox transformation. Moreover, this study furthers our understanding on how the particle size influences the interactions between IONPs and arsenic thereby clarifying the role of IONPs in the biogeochemical cycling of arsenic.

Changes in Work from the Global Value Change Perspective The Case of Transformation Economies: Bulgaria and Hungary

The core aim of this paper is to evaluate to what extent were companies able to join to the global value chains (GVCs) through some selected company case studies.

What next for unions in Central and Eastern Europe? Invisibility, departure and the transformation of industrial relations

This article examines union revitalization in Central and Eastern Europe, focusing on two countries: Hungary and Latvia. Trade unions have not only had to cope with a declining membership base, but have also had to respond to austerity programmes and government cuts in public sector employment. We argue that the inability of unions to provide a strong voice for alternative policies to the current neoliberal orthodoxy has been driven by a declining membership base, but also by weakened social dialogue mechanisms, limited industrial representation and an ageing membership profile, exacerbated by net outward migration in recent years. However, we find that unions in Latvia and Hungary have responded differently to these issues.

Limitations of spoligotyping and variable-number tandem-repeat typing for molecular tracing of Mycobacterium bovis in a high-diversity setting

This study describes the attempt to trace the first Mycobacterium bovis outbreak in alpacas (Lama pacos) in Spain by spoligotyping and variable-number tandem-repeat (VNTR) analysis. Due to high genotype diversity, no matching source was identified, but local expansion of a clonal group was found and its significance for molecular tracing is discussed.

The Proces of Curriculum and Module Design

The outcome of the inductive decision -making process of the leading project management group (PMG) was the proposal to develop three modules, Human Resource Management and Knowledge Management, Quality Management and Intercultural management, each for 10 ECTS credits. As a result of the theoretical and organisational framework and analytical phase of the project, four strategies informed the development and implemen- tation of the modules: 1. Collaboration as a principle stemming from EU collaborative policy and receiving it’s expression on all implementation levels (designing the modules, modes of learning, delivering the modules, evaluation process). 2. Building on the Bologna process masters level framework to assure ap- propriate academic level of outputs. 3. Development of value -based leadership of students through transforma- tional learning in a cross -cultural setting and continual reflection of theory in practice. 4. Continual evaluation and feedback among teachers and students as a strategy to achieve a high quality programme. In the first phase of designing the modules the collaborative strategy in particular was applied, as each module was led by one university, but members from all other universities participated in the discussions and development of the mod- ules. The Bologna process masters level framework and related standards and guidelines informed the form and method of designing the modules.

Effect of host genotype and prion strain on the phenotypic heterogeneity of Creutzfeldt-Jakob disease: the peripheral nervous system involvement and the spectrum of the genetic form

The first study was designed to assess whether the involvement of the peripheral nervous system (PNS) belongs to the phenotypic spectrum of sporadic Creutzfeldt-Jakob disease (sCJD). To this aim, we reviewed medical records of 117 sCJDVV2, 65 sCJDMV2K, and 121 sCJDMM(V)1 subjects for symptoms/signs and neurophysiological data. We looked for the presence of PrPSc in postmortem PNS samples from 14 subjects by western blotting and real-time quaking-induced conversion (RT-QuIC) assay. Seventy-five (41.2%) VV2-MV2K patients, but only 11 (9.1%) MM(V)1, had symptoms/signs suggestive of PNS involvement and neuropathy was documented in half of the VV2-MV2K patients tested. RT-QuIC was positive in all PNS samples, whereas western blotting detected PrPSc in the sciatic nerve in only one VV2 and one MV2K. These results support the conclusion that peripheral neuropathy, likely related to PrPSc deposition, belongs to the phenotypic spectrum of sCJDMV2K and VV2, the two variants linked to the V2 strain. The second study aimed to characterize the genetic/molecular determinants of phenotypic variability in genetic CJD (gCJD). To this purpose, we compared 157 cases of gCJD to 300 of sCJD. We analyzed: demographic aspects, neurological symptoms/signs, histopathologic features and biochemical characteristics of PrPSc. The results strongly indicated that the clinicopathological phenotypes of gCJD largely overlap with those of sCJD and that the genotype at codon 129 in cis with the mutation (i.e. haplotype) contributes more than the latter to the disease phenotype. Some mutations, however, cause phenotypic variations including haplotype-specific patterns of PrPSc deposition such as the “dense” synaptic pattern (E200K-129M), the intraneuronal dots (E200K-129V), and the linear stripes perpendicular to the surface in the molecular layer of cerebellum (OPRIs-129M). Overall, these results suggest that in gCJD PRNP mutations do not cause the emergence of novel prion strains, but rather confer increased susceptibility to the disease in conjunction with “minor” clinicopathological variations.