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3, 95% CI 1.26-67.74) and meconium stained amniotic fluid (aOR 2.1, 95% CI 1.10-3.85). Parturients who underwent re-suturing had significantly higher rates of postpartum hemorrhage (78.5% vs. 11.4%) blood transfusions (36.2% vs. 1.3%), puerperal fever, and longer hospitalizations (P less then 0.01 for all). Conclusion In our population, early re-suturing of puerperal perineal tears is rare, however, it is associated with increased short term maternal morbidity.Objective Addressing management controversies in the treatment of pre-invasive cervical disease is a key priority for the European Federation for Colposcopy/European Society of Gynaecologic Oncology who aim to develop a practical handbook of European centred guidelines to address areas where there is a lack of high-quality evidence or identifiable practice variation. Clinical opinion across the EFC network was sought to identify topics likely to have the most impact on clinical practice for systematic review and development of practice recommendations. Study design A scoping exercise comprising of a three-iteration modified Delphi with representation from each member society of the EFC was conducted in 2018. selleck products Round one identified 19 potential topics which were scored for importance using a five-point Likert scale by EFC members in round two and ranked. Results from round two were discussed at an open EFC satellite meeting resulting in exclusion of five topics. A third round of the 14 remaining topics was conducted to allow members to modify scores after viewing the second-round rankings. Responses were analysed and topics were allocated a weighted score. Results Strategies for management of persistent HPV infection in the context of normal colposcopy and negative cytology was the highest overall weighted topic (4.40) followed by identification of appropriate length of follow up for ASCUS or LSIL prior to excisional treatment (3.95) and the impact of length of excision on patient outcomes (3.95). Topics to identify best practice for management of challenging topics scored highly including optimising follow up strategies for cervical stenosis (3.91) and management of HSIL in the under 25 year olds (3.64) or pregnancy (3.64). Conclusion A European wide systematic modified-Delphi has prioritised six topics for systematic review and generation of clinical practice recommendations aiming to assist management in areas of controversy in pre-invasive cervical disease.Objective The aim of this study was to evaluate the oncological outcomes of vaginal fertility-sparing surgery plus laparoscopic sentinel lymph node biopsy in patients with early cervical cancer over a 15-years period. Patients and methods From March 2005 to April 2018, 38 patients diagnosed with early stage cervical cancer underwent vaginal fertility-sparing surgery at the Hospital Clínic, Barcelona, Spain. Patients with FIGO stage IA1 with lymphovascular space invasion and stage IA2 underwent simple trachelectomy and patients with stage IB1 underwent radical vaginal trachelectomy. All cases underwent laparoscopic sentinel lymph node biopsy. In the first 19 cases, laparoscopic bilateral pelvic lymphadenectomy was completed immediately after sentinel lymph node biopsy. Clinical and oncological follow-up data were collected. Results The median age at diagnosis was 33.5 years (range 22-44). Simple trachelectomy was performed in seven cases (18.4%) and vaginal radical trachelectomy in 31 (81.6%). Nineteen patient seems to be an important risk factor for recurrence.The present study examined the effect of titanium dioxide nanoparticles (nanoTiO2) and mercury (Hg) compounds on the green alga, Chlamydomonas reinhardtii. Mixtures containing nanoTiO2 of different primary sizes (5 nm, 15 nm and 20 nm), inorganic Hg (IHg) or monomethyl Hg (CH3Hg+, MeHg) were studied and compared with individual treatments. Oxidative stress and membrane damage were examined. Stability of nanoTiO2 materials in terms of hydrodynamic size and surface charge as well as Hg adsorption on different nanoTiO2 materials were characterized. The uptake of Hg compounds in the absence and presence of nanoTiO2 was also quantified. Results show that increasing concentrations of nanoTiO2 with different primary size diminished oxidative stress and membrane damage induced by high concentrations of IHg or MeHg, due to the adsorption of Hg on the nanoTiO2 aggregates and consequent decrease of cellular Hg concentrations. The observed alleviation effect of nanoTiO2 materials on Hg biouptake and toxicity was more pronounced for the materials with smaller primary size. IHg adsorbed onto the nanoTiO2 materials to a higher extent than MeHg. The present study highlights that the effects of contaminants are modulated by the co-existing engineered nanomaterials; therefore, it is essential to get a better understanding of their combined effect in the environment.Hypoxia, a low environmental oxygen level, is a common problem in the ocean globally. Hypoxia has been known to cause disruption to the endocrine system of marine organisms in both laboratory and field studies. Our previous studies have demonstrated the sex-specific response to hypoxia in the neural and reproductive systems of marine fish. In the current report, we aim to study the sex-specific hepatic response of fish at the transcriptome level to hypoxic stress. By using a comparative transcriptome analysis, followed by a systematic bioinformatics analysis including Database for Annotation, Visualization and Integrated Discovery (DAVID) and Ingenuity Pathway Analysis (IPA), we found that hypoxia altered expression of genes related to cell proliferation and apoptosis of hepatocytes, which are associated with human pathologies, such as liver inflammation hepatic steatosis and steatohepatitis. Furthermore, we observed sex-specific responses in the livers of fish through different cell signaling pathways. In female fish, hypoxia causes dysregulation of expression of genes related to impairment in endoplasmic reticulum structure and liver metabolism. In male fish, genes associated with redox homeostasis and fatty acid metabolism were altered by hypoxic stress. The findings of this study support the notion that hypoxia could cause sex-specific changes (hepatic toxicity and changes) in marine fish.