Perinatal complications associated with preterm deliveries at 24 to 33 weeks and 6 days gestation (2011- 2012): A hospital-based retrospective study

Background: Morbidity and mortality of preterm babies are important issues in perinatal medicine. In developed countries, preterm delivery is the cause of about 70% of mortality and 75% of morbidity in the neonatal period, respectively. Objective: The aim of this study was to determine the risk factors for preterm labor and the outcomes, in terms of perinatal mortality and morbidity at the time of discharge home, among preterm infants at less than 34 weeks gestation. Materials and Methods: A retrospective study was conducted and all infants with a gestational age of 24 to 33 weeks and 6 days who were born from November 1st , 2011 to March 31, 2012 were enrolled in this study. Results: From 1185 preterm infants were born during this period, 475 (40.08%) infants with less than 34 weeks gestational age were included in the study. Our study showed the major obstetrical risk factors for preterm labor were as follows: preeclampsia (21%), premature rupture of membranes (20.3%), abruption of placenta (10%), and idiopathic cases (48.7%). The neonatal mortality rate in less than 34 weeks was 9.05%. Significant perinatal morbidity causesd in less than 34 weeks were as follows: sepsis (46.94%), respiratory distress syndrome (41.47%), patent ductus arteriosus (21.47%), retinopathy of prematurity (3.57%), necrotizing entrocolitis (1.68%), intra-ventricular hemorrhage (9%), and broncho-pulmonary dysplasia (0.84%). Conclusion: Preterm birth is associated with adverse perinatal outcome. This situation needs to be improved by directing appropriately increased resources for improving prenatal health services and providing advanced neonatal care.

A further investigation of the kinetic demixing/decomposition of La0.6Sr0.4Co0.2Fe0.8O3- δ oxygen separation membranes

Kinetic demixing and decomposition were studied on three La_0.6Sr_0.4Co_0.2Fe_0.8O_{3- δ} oxygen-separation hollow fibre membrane modules, which were operated under a 0.21/0.009bar oxygen partial pressure difference at 950°C for 1128, 3672 and 5512h, respectively. The post-operation membranes were characterized by Secondary Ion Mass Spectrometry, Scanning Electronic Microscope, Energy Dispersive Spectrum and X-ray Diffraction. The occurrence of kinetic demixing and decomposition was confirmed through the microstructural evolution of the membranes. Secondary-phase grains were found on the air-side surface of the membranes after the long-term operation and Co and Fe enrichment as well as La depletion was found on the surface and in the bulk at the air side. Cation diffusivities were found to be in the order Co>Fe>Sr>La. Kinetic demixing and decomposition rates of the membranes at the air side were found to be self-accelerating with time; the role of A-site deficiency in the perovskite lattice in the bulk near the air side surface is implicated in the mechanism. The oxygen permeability was not affected by the kinetic demixing and decomposition of the material during long-term operation (up to 5512h), however, we may expect permeability to be affected by secondary phase formation on the air-side surface at even longer operational times. © 2010 Elsevier B.V.

Análise quantitativa da expressão de IL-4 e IL-10 em membrans corioamnióticas de gestantes com rotura prematura de membranas pré-termo

Pós-graduação em Patologia - FMB

β Defensinas em membranas corioamnióticas de gestações complicadas por prematuridade: expressão gênica e imunolocalização

Pós-graduação em Patologia - FMB

Análise quantitativa da expressão de citocinas inflamatórias em membranas corioamnióticas de gestantes com rotura prematura de membranas pré-termo

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Rotura prematura de membranas pré-termo e corioamnionite histológica: aspectos da resposta imune inata e repercussões no período neonatal

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Fator de necrose tumoral-α, interleucinas-8 e 10 em sangue de cordão umbilical como marcadores de infecção neonatal precoce na rotura prematura de membranas pré-termo

Pós-graduação em Pediatria - FMB

Polimorfismo do gene IL6 candidato à predisposição à rotura prematura de membranas pré-termo e ao trabalho de parto pré-termo

Introduction: Preterm Labor (PTL) and Preterm Premature Rupture of Membranes (PPROM) cause severe complications for both mother and fetus. Among the risk factors associated with preterm labor and PPROM, genetic predisposition has been gaining importance. However, the association between polymorphic genes and the pathogenesis of PTL and PPROM remains elusive. A better understanding of the genetic mechanisms underlying these adverse pregnancy outcomes may enable the identification of high risk patients and allow new approaches to minimize the deleterious effects of prematurity. Aim: To determine the association between maternal IL-6 polymorphism gene and the occurrence of PTL and PPROM. Patients and Methods: The study included 109 patients with prior history of PL and/or PPROM that delivered prematurely at the Obstetrical Unit Care of Botucatu Medical School, UNESP between 2003 and 2012. The control group consisted of 68 patients that delivered at term, matched to the case group by age, ethnicity, and sex of the newborn. Oral swabs (Cath-AllTM – Epicentre Biotechnologies) were collected for analysis of genetic polymorphisms by PCR. Statistical tests were performed to compare genotype, clinical and socio-demographic data from the groups. A p-value of <0.05 was considered significant. Results: The sociodemographic characteristics in both groups were homogeneously distributed. The frequency of the polymorphic allele C, associated with less production of IL-6, and therefore thought to be protective against PTL and PPROM, was 32,5% in the study group and 30,9% in the control group, without statistically significant differences. Conclusion: Considering the sample size included in this study, the frequency of the mutated allele is similar in pregnant women who delivered at term and gestational complications as PTL and PPROM

Spontaneous combined rupture of a pelvicalyceal cyst into the collector system and retroperitoneal space during the acquisition of computed tomography scan images: a case report

Abstract Introduction Pelvicalyceal cysts are common findings in autopsies and can manifest with a variety of patterns. These cystic lesions are usually a benign entity with no clinical significance unless they enlarge enough to cause compression of the adjacent collecting system and consequently obstructive uropathy. Few cases of the spontaneous rupture of pelvicalyceal renal cysts have been published and to the best of our knowledge there is no report of a combined rupture to collector system and retroperitoneal space documented during a multiphase computed tomography. Case presentation We report a case of a ‘real-time’ spontaneous rupture of a pelvicalyceal cyst into the collecting system with fistulization into the retroperitoneum. The patient was a 78-year-old Caucasian man with a previous history of renal stones and a large pelvicalyceal renal cyst who was admitted to our Emergency department with acute right flank pain. A multiphase computed tomography was performed and the pre-contrast images demonstrated a right pelvicalyceal renal cyst measuring 12.0 × 6.1cm in the lower pole causing moderate dilation of the upper right renal collection system. In addition, a partially obstructive stone on the left distal ureter with mild left hydronephrosis was noted. The nephrographic phase did not add any new information. The excretory phase (10-minute delay) demonstrated a spontaneous rupture of the cyst into the pelvicalyceal system with posterior fistulization into the retroperitoneal space. Conclusion In this case study we present time-related changes of a rare pelvicalyceal cyst complication, which to the best of our knowledge has fortunately not been previously documented. Analysis of the sequential images and comparison with an earlier scan allowed us to better understand the physiopathological process of the rupture, the clinical presentation and to elaborate hypotheses for its etiopathogenesis.

Apoptosis of ligamentous cells of the cranial cruciate ligament from stable stifle joints of dogs with partial cranial cruciate ligament rupture

OBJECTIVE To describe the presence and amount of apoptotic ligamentous cells in different areas of partially ruptured canine cranial cruciate ligaments (prCCLs) and to compare these findings with apoptosis of ligamentous cells in totally ruptured cranial cruciate ligaments (trCCLs). ANIMALS 20 dogs with prCCLs and 14 dogs with trCCLs. PROCEDURES Dogs with prCCLs or trCCLs were admitted to the veterinary hospital for stifle joint treatment. Biopsy specimens of the intact area of prCCLs (group A) and the ruptured area of prCCLs (group B) as well as specimens from trCCLs (group C) were harvested during arthroscopy. Caspase-3 and poly (ADP-ribose) polymerase (PARP) detection were used to detect apoptotic ligamentous cells by immunohistochemistry. RESULTS No difference was found in the degree of synovitis or osteophytosis between prCCLs and trCCLs. No difference was found in degenerative changes in ligaments between groups A and B. A substantial amount of apoptotic cells could be found in > 90% of all stained slides. A correlation (r(s) = 0.71) was found between the number of caspase-3-and PARP-positive cells. No significant difference was found in the amount of apoptotic cells among the 3 groups. No significant correlation could be detected between the degree of synovitis and apoptotic cells or osteophyte production and apoptotic cells. CONCLUSIONS AND CLINICAL RELEVANCE The lack of difference between the 3 groups indicates that apoptosis could be a factor in the internal disease process leading to CCL rupture and is not primarily a consequence of the acute rupture of the ligament.

Maternal Role & High-Risk Pregnancy Experience with Antepartum Hospitalization

Purpose. The focus of maternal role development, historically, has been on the tasks and processes during pregnancy as they relate to postpartum role transition. The purpose of this study was to investigate how women hospitalized with high-risk pregnancy cognitively construct pregnancy and impending motherhood. ^ Design. The study employed a triangulation design using a convergence model with a dominant focused ethnographic approach. ^ Setting. The antepartum units of two tertiary care centers in a large metropolitan city in southeast Texas. ^ Sample. Data saturation was determined with thirteen (13) primigravid women who had been hospitalized more than 72 hours with preterm labor (PTL) or preterm premature rupture of membranes (PPROM) who subsequently delivered seventeen (17) infants which included 4 sets of twins. ^ Methods. Open-ended, semi-structured interviews and field work were used to explore the development of maternal role in this population. After collecting descriptive data, long individual interviews were conducted and the Prenatal Self Evaluation Questionnaire (PSEQ), an instrument to measure prenatal adaptation to pregnancy, was administered. The interview focused on exploring the woman's experiences of pregnancy and impending motherhood while hospitalized. Interview data and field notes were coded and analyzed using qualitative thematic analytic techniques. The PSEQ was scored and the findings of the qualitative data and PSEQ data were compared. ^ Findings. Thematic analysis of the qualitative data provided an understanding of the cognitive process that occurs as the pregnant woman builds a relationship with the fetus. Thematic analysis resulted in a conceptual model with two complementary components that occur throughout the pregnancy: Establishing a Relationship and Dynamic Equilibrium. Establishing a Relationship includes subthemes of: Courting, Building a Connection, and Engagement. Dynamic equilibrium is the balance between expectations and reality and exists regardless of pregnancy complications. The negotiation of this potential imbalance is triggered by uncertainty, loss of autonomy and control, and isolation and is exacerbated by the high-risk pregnancy and subsequent hospitalization. These triggers can serve as obstacles to maternal role development, but may be mediated by external support from friends and family or health care providers. Support from others may come in the form of anticipatory guidance, presence, or activities that promote self-agency. PSEQ scores were similar to previous reports, but due to the small sample, scores were used primarily for comparison to qualitative data. The qualitative findings were congruent with the PSEQ findings in all of the subscales except in the concern for the well-being of the baby. Interview reports included comments demonstrating significant concern for the well-being of the infant, yet the related subscale did not demonstrate such concern. ^ Conclusions. An understanding of the cognitive process involved in establishing a relationship with the developing fetus related to impending motherhood and the importance of dynamic equilibrium can allow healthcare providers and those who interact with pregnant women to support development of the maternal role and anticipate those barriers that may impede that process. Findings from this study identify those triggers and mediators that influence development of the maternal role and suggest potential intervening strategies for those involved in the care of childbearing families. ^

Experimental Studies of the Material Properties of the Forewing of Cicada (Homoptera, Cicadidae)

Detailed investigations on the structural and mechanical properties of the forewing of the cicada were carried out. Measurement of the structures of the wings showed that the thickness of the membrane of each cell and the diameter of each vein were non-uniform in both the longitudinal and transverse directions, and their means were approximately 12.2 and 133.3 mum, respectively. However, the aspect ratios of the wings and the bodies were quite uniform and were approximately equal to 2.98 and 2.13, respectively. Based on the measured thickness, mass and area of the membranes of the cells, the mean density and the mean area density of the wing were approximately 2.3 g cm(-3) and 2.8 x 10(-3) g cm(-2), respectively. In addition, the diameters of the veins of the wings, including the diameters of the holes in the vein of the leading edge, were examined. The mechanical properties of the wing were investigated separately by nanoindentation and tensile testing. The results indicated that the mean Young's modulus, hardness and yield stress of the membranes of the wings were approximately 3.7 Gpa, 0.2 Gpa and 29 Mpa, respectively, and the mean Young's modulus and strength of the veins along the direction of the venation of wings were approximately 1.9 Gpa and 52 Mpa, respectively. Finally, the relevant results were briefly analyzed and discussed, providing a guideline to the biomimetic design of the aerofoil materials of micro air vehicles.

Experimental study on the microstructure and nanomechanical properties of the wing membrane of dragonfly

Detailed investigations on the microstructure and the mechanical properties of the wing membrane of the dragonfly are carried out. It is found that in the direction of the thickness the membrane was divided into three layers rather than a single entity as traditionally considered, and on the surfaces the membrane displays a random distribution rough microstructure that is composed of numerous nanometer scale columns coated by the cuticle wax secreted. The characteristics of the surface structure are measured and described. The mechanical properties of the membranes taken separately from the wings of live and dead dragonflies are investigated by the nanoindentation technique. The Young's moduli obtained here are approximately two times greater than the previous result, and the reasons that yield the difference are discussed.

Microstructure and nanomechanical properties of the wing membrane of dragonfly

Detailed investigations on the microstructure and the mechanical properties of the wing membrane of the dragonfly were carried out. It was found that in the direction of the thickness the membrane was divided into three layers rather than as traditionally considered as a single entity, and on the surfaces the membrane displayed a random distribution rough microstructure that was composed of numerous nanometer scale columns coated by the cuticle wax secreted. The characteristics of the surfaces were accurately measured and a statistical radial distribution function of the columns was presented to describe the structural properties of the surfaces. Based on the surface microstructure, the mechanical properties of the membranes taken separately from the wings of living and dead dragonflies were investigated by the nanoindentation technique. The Young's moduli obtained here are approximately two times greater than the previous result, and the reasons that yield the difference are discussed. (C) 2007 Elsevier B.V. All rights reserved.

Evaporation-induced evolution of the capillary force between two grains

© 2014, Springer-Verlag Berlin Heidelberg.The evolution of capillary forces during evaporation and the corresponding changes in the geometrical characteristics of liquid (water) bridges between two glass spheres with constant separation are examined experimentally. For comparison, the liquid bridges were also tested for mechanical extension (at constant volume). The obtained results reveal substantial differences between the evolution of capillary force due to evaporation and the evolution due to extension of the liquid bridges. During both evaporation and extension, the change of interparticle capillary forces consists in a force decrease to zero either gradually or via rupture of the bridge. At small separations between the grains (short & wide bridges) during evaporation and at large volumes during extension, there is a slight initial increase of force. During evaporation, the capillary force decreases slowly at the beginning of the process and quickly at the end of the process; during extension, the capillary force decreases quickly at the beginning and slowly at the end of the process. Rupture during evaporation of the bridges occurs most abruptly for bridges with wider separations (tall and thin), sometimes occurring after only 25% of the water volume was evaporated. The evolution (pinning/depinning) of two geometrical characteristics of the bridge, the diameter of the three-phase contact line and the “apparent” contact angle at the solid/liquid/gas interface, seem to control the capillary force evolution. The findings are of relevance to the mechanics of unsaturated granular media in the final phase of drying.