Abstract Background Intrauterine fetal death (IUFD) is a tragic event and, despite efforts to reduce rates, its incidence remains difficult to reduce. The objective of the present study was to ...examine the etiological factors that contribute to the main causes and conditions associated with IUFD, over an 11-year period in a region of North-East Italy (Friuli Venezia Giulia) for which reliable data in available. Methods Retrospective analysis of all 278 IUFD cases occurred between 2005 and 2015 in pregnancies with gestational age ≥ 23 weeks. Results The incidence of IUFD was 2.8‰ live births. Of these, 30% were small for gestational age (SGA), with immigrant women being significantly over-represented. The share of SGA reached 35% in cases in which a maternal of fetal pathological condition was present, and dropped to 28% in the absence of associated pathology. In 78 pregnancies (28%) no pathology was recorded that could justify IUFD. Of all IUFDs, 11% occurred during labor, and 72% occurred at a gestational age above 30 weeks. Conclusion The percentage of IUFD cases for which no possible cause can be identified is quite high. Only the adoption of evidence-based diagnostic protocols, with integrated immunologic, genetic and pathologic examinations, can help reduce this diagnostic gap, contributing to the prevention of future IUFDs.
Este trabajo se propone mostrar cómo la pandemia originada por el COVID-19 ha provocado el replanteamiento de la mirada liberal de los derechos humanos que venía invalidando ya todo discurso acerca ...de su interdependencia e indivisibilidad. Al legitimar la limitación de ciertas libertades, a la vez que se ponderaba la urgencia de asegurar un nivel de vida adecuado para todos, la particular situación de emergencia mostró la postergación de la cual los derechos sociales vienen siendo objeto en el modelo jurídico vigente desde la Modernidad. La primacía y fundamentalidad de los derechos relacionados con un nivel de vida adecuado se ha postergado por un derecho que los dio por presupuestos. La situación de crisis presenta una nueva oportunidad para su reivindicación, en cuanto condición de realización de cualquier otro derecho, de cualquier convivencia social.
Intrauterine fetal death (IUFD) is a tragic event and, despite efforts to reduce rates, its incidence remains difficult to reduce. The objective of the present study was to examine the etiological ...factors that contribute to the main causes and conditions associated with IUFD, over an 11-year period in a region of North-East Italy (Friuli Venezia Giulia) for which reliable data in available.
Retrospective analysis of all 278 IUFD cases occurred between 2005 and 2015 in pregnancies with gestational age ≥ 23 weeks.
The incidence of IUFD was 2.8‰ live births. Of these, 30% were small for gestational age (SGA), with immigrant women being significantly over-represented. The share of SGA reached 35% in cases in which a maternal of fetal pathological condition was present, and dropped to 28% in the absence of associated pathology. In 78 pregnancies (28%) no pathology was recorded that could justify IUFD. Of all IUFDs, 11% occurred during labor, and 72% occurred at a gestational age above 30 weeks.
The percentage of IUFD cases for which no possible cause can be identified is quite high. Only the adoption of evidence-based diagnostic protocols, with integrated immunologic, genetic and pathologic examinations, can help reduce this diagnostic gap, contributing to the prevention of future IUFDs.
Depressive symptoms and impaired physical functioning are prevalent among older adults. Supplementation with vitamin D might improve both conditions, particularly in persons with low vitamin D ...status.
The D-Vitaal study primarily aimed to investigate the effect of vitamin D supplementation on depressive symptoms, functional limitations, and physical performance in a high-risk older population with low vitamin D status. Secondary aims included examining the effect of vitamin D supplementation on anxiety symptoms, cognitive functioning, mobility, handgrip strength, and health-related quality of life.
This study was a randomized placebo-controlled trial with 155 participants aged 60–80 y who had clinically relevant depressive symptoms, ≥1 functional limitations, and serum 25-hydroxyvitamin D 25(OH)D concentrations of 15–50/70 nmol/L (depending on season). Participants received 1200 IU/d vitamin D3 (n = 77) or placebo tablets (n = 78) for 12 mo. Serum 25(OH)D was measured at baseline and 6 mo; outcomes were assessed at baseline, 6 mo, and 12 mo. Linear mixed-models analyses were conducted to assess the effect of the intervention.
The supplementation increased serum 25(OH)D concentrations in the intervention group to a mean ± SD of 85 ± 16 nmol/L compared with 43 ± 18 nmol/L in the placebo group after 6 mo (P < 0.001). No relevant differences between the treatment groups were observed regarding depressive symptoms, functional limitations, physical performance, or any of the secondary outcomes.
Supplementation with 1200 IU/d vitamin D for 12 mo had no effect on depressive symptoms and physical functioning in older persons with relatively low vitamin D status, clinically relevant depressive symptoms, and poor physical functioning. This trial is registered with the Netherlands Trial Register (www.trialregister.nl) under NTR3845.
Freezing of gait (FoG) is among the most disabling symptoms of Parkinson’s disease (PD) patients. Recent studies showed that action observation training (AOT) with repetitive practice of the observed ...actions represents a strategy to induce longer-lasting effects compared with standard physiotherapy. We investigated whether AOT may improve FoG and mobility in PD, when AOT is applied in a group-based setting. Sixty-four participants with PD and FoG were assigned to the experimental (AO) or control groups and underwent a 45-minute training session, twice a week, for 5 weeks. AOT consisted in physical training combined with action observation whereas the control group executed the same physical training combined with landscape-videos observation. Outcome measures (FoG questionnaire, Timed Up and Go test, 10-meter walking test, and Berg balance scale) were evaluated before training, at the end of training, and 4 weeks later (FU-4w). Both groups showed positive changes in all outcome measures at posttraining assessment. Improvements in FoG questionnaire, Timed Up and Go test, and Berg balance scale were retained at FU-4w evaluation only in the AOT group. AOT group-based training is feasible and effective on FoG and motor performance in PD patients and may be introduced as an adjunctive option in PD rehabilitation program.
Depressive symptoms and decreased physical functioning are interrelated conditions and common in older persons, causing significant individual and societal burden. Evidence suggests that vitamin D ...supplementation may be beneficial for both mental and physical functioning. However, previous randomized controlled trials have yielded inconsistent results and often had suboptimal designs. This study examines the effect of vitamin D supplementation on both depressive symptoms and physical functioning in a high-risk population of older persons with low vitamin D status.
The D-Vitaal study is a randomized, double-blind, placebo-controlled trial investigating the effects of a daily dose of 1200 IU vitamin D3 versus placebo for one year on depressive symptoms and physical functioning (primary outcomes) in older adults. Participants (N = 155, age 60-80 years) were recruited from the general population. Eligibility criteria included the presence of depressive symptoms, ≥1 functional limitation and serum 25-hydroxyvitamin D levels between 15 and 50/70 nmol/L (depending on season). Secondary outcomes include incidence of major depressive disorder, anxiety symptoms, health-related quality of life, cognitive function and cost-effectiveness of the intervention.
With this study, we aim to elucidate the effects of vitamin D supplementation on depressive symptoms and physical functioning in older persons who are at high risk of developing more substantial mental and physical problems. If effective, vitamin D supplementation can be a preventive intervention strategy that is easy to implement in the primary care setting.
Netherlands Trial Register NTR3845. Registered 6 February 2013.
Treadmill training (TT) has been indicated as a potential therapeutic tool for improving balance and gait in patients with Parkinson's disease (PD). However, the lack of evidences about the best ...modality of intervention (e.g.: number of sessions) and the lack of reliable follow-up measures, made difficult to hand down these results into the clinical practice.
The aim of this study was to compare the efficacy of 3 different modalities of TT program on gait performance in PD patients.
A randomized, single-blind pilot study.
Outpatients clinic, Department of Neuroscience, University of Genoa.
Thirty patients (out of 42 screened) with PD were randomized.
Participants underwent the same TT program (ten sessions, 45 minute each) but with a different frequency throughout a week: 1) low-frequency (LF) group: 2-times a week; 2) intermediate-frequency (IF) group: 3-times a week; and 3) high-frequency (HF) group: 5-times a week. Patients were evaluated by Timed Up and Go (TUG) test, 10-meter walking test (10M-WT), Berg Balance Scale (BBS), Falls Efficacy Scale (FES) and falls diary before TT, immediately after the training was stopped, and 2 and 4 months later.
At baseline, no significant differences were found among groups. Immediately after the end of the TT, TUG Test, 10 MWT, FES and falls diary scores significantly improved in the LF and IF groups, whereas they did not change in the HF group. Improvements were sustained for up 2-months in the IF and LF groups. At 4-months evaluation, outcome measures were either comparable or sometimes even better than at baseline in the LF and IF groups, whereas in the HF group, 10M-WT and FES score worsened.
According to the results of this study, we might postulate that the frequency of TT influences short and long-lasting effects on walking performance and falls.
The present study confirms that TT is effective in improving gait disturbances and reducing falls risk in patients with PD. The short- and long-lasting effects induced by TT on walking performance are specifically affected by the frequency of training, possibly in relationship to learning mechanisms and fatigue.
In non-pulsatile cardiopulmonary bypass surgery, middle cerebral artery blood flow velocity (BFV) is characterized by infra-slow oscillations of approximately 0.06Hz, which are paralleled by changes ...in total EEG power variability (EEG-PV), measured in 2s intervals. Since the origin of these BFV oscillations is not known, we explored their possible causative relationships with oscillations in EEG-PV at around 0.06Hz. We monitored 28 patients undergoing non-pulsatile cardiopulmonary bypass using transcranial Doppler sonography and scalp electroencephalography at two levels of anesthesia, deep (prevalence of burst suppression rhythm) and moderate (prevalence of theta rhythm).
Under deep anesthesia, the EEG bursts suppression pattern was highly correlative with BFV oscillations. Hence, a detailed quantitative picture of the coupling between electrical brain activity and BFV was derived, both in deep and moderate anesthesia, via linear and non linear processing of EEG-PV and BFV signals, resorting to widely used measures of signal coupling such as frequency of oscillations, coherence, Granger causality and cross-approximate entropy. Results strongly suggest the existence of coupling between EEG-PV and BFV. In moderate anesthesia EEG-PV mean dominant frequency is similar to frequency of BFV oscillations (0.065±0.010Hz vs 0.045±0.019Hz); coherence between the two signals was significant in about 55% of subjects, and the Granger causality suggested an EEG-PV→BFV causal effect direction. The strength of the coupling increased with deepening anesthesia, as EEG-PV oscillations mean dominant frequency virtually coincided with the BFV peak frequency (0.062±0.017Hz vs 0.060±0.024Hz), and coherence became significant in a larger number (65%) of subjects. Cross-approximate entropy decreased significantly from moderate to deep anesthesia, indicating a higher level of synchrony between the two signals.
Presence of a subcortical brain pacemaker that drives vascular infra-slow oscillations in the brain is proposed. These findings allow to suggest an original hypothesis explaining the mechanism underlying infra-slow neurovascular coupling.
► We examined infra-slow brain neurovascular coupling during cardiopulmonary bypass. ► Highly synchrony exists between EEG bursts and ISO of BFV during deep anesthesia. ► Highly synchrony exists between EEG-PV and ISO of BFV during moderate anesthesia.► Brain electrical ISO triggers BFV oscillations in the middle cerebral arteries.
Mitomycin C toxicity in rabbit corneal endothelium Silva, Maria Rosa Bet de Moraes; Gregório, Elisa Aparecida
Arquivos brasileiros de oftalmologia,
2009 Mar-Apr, Letnik:
72, Številka:
2
Journal Article
Recenzirano
Odprti dostop
To evaluate corneal endothelium alterations after applying mitomycin C to the sclera using transmission and scanning electron microscopy, correlating alterations with time, concentration, and ...evaluation methods.
The corneal endothelium of both eyes of 32 albino rabbits was evaluated and distributed into four groups of 8. Mitomycin C was applied under a scleral flap in the right eye for 5 minutes. Mitomycin C concentrations were 0.5 mg/ml for G1 and G2 and 0.2 mg/ml for G3 and G4. Examinations were performed 15 days after application to G1 and G3, and 30 days after application to G2 and G4. Four cornea in each group were prepared for transmission electron microscopy and four for scanning electron microscopy. Left eyes of all animals were used as controls.
Transmission electron microscopy showed corneal endothelium alterations in all groups: rarefied cytoplasm, dilation and fragmentation of rough endoplasmic reticulum cisternae, Golgi apparatus with cisternal dilation, reduced vacuoles, and irregularities of internal membrane more noticeable in G1 and G2. Scanning electron microscopy revealed alterations in all groups except G1: changes in the shape and size of cells and longer filopodial projections.
1 - Corneal endothelium alterations were seen at both 0.5 and 0.2 mg/ml concentrations and at 15 and 30 days after mytomicin C application; 2 - Alterations were more intense with higher mytomicin C concentration by transmission electron but not by scanning electron microscopy; 3 - The alterations correlated with time by scanning electron microscopy but not by transmission electron microscopy.
OBJETIVO: Avaliar alterações do endotélio corneano após aplicação de mitomicina C na esclera por meio de microscopia eletrônica de transmissão e de varredura e correlacionar as alterações com tempo, ...concentração e entre os dois métodos de avaliação. MÉTODOS: Foi avaliado o endotélio corneano dos olhos de 32 coelhos albinos distribuídos em 4 grupos experimentais com 8 coelhos cada um. A mitomicina C foi aplicada sob retalho escleral no olho direito por 5 minutos. Nos grupos G1 e G2 a concentração da mitomicina C foi de 0,5 mg/ml e nos grupos G3 e G4 a concentração foi de 0,2 mg/ml. O exame foi realizado com 15 dias após nos grupos G1 e G3 e com 30 dias nos grupos G2 e G4. Dos 8 animais 4 foram preparados para microscopia eletrônica de transmissão e 4 para microscopia eletrônica de varredura. Os olhos esquerdos de todos animais serviram como controle. RESULTADOS: À microscopia eletrônica de transmissão foram observadas alterações do endotélio corneano em todos os grupos experimentais: rarefação do citoplasma, dilatação e fragmentação das cisternas do retículo endoplasmático rugoso, aparelhos de Golgi com dilatação das cisternas, redução de vacúolos e irregularidades da membrana celular interna sendo mais intensas em G1 e G2. À microscopia eletrônica de varredura foram observadas alterações em todos grupos experimentais, exceto G1: alteração de forma e tamanho das células e projeções filopoidais mais longas. CONCLUSÕES: 1 - A mitomicina C causou alteração no endotélio da córnea tanto na concentração de 0,5 mg/ml como de 0,2 mg/ml observadas 15 e 30 dias após a aplicação; 2 - As alterações foram mais intensas com a maior concentração de mitomicina C (0,5 mg/ml) na microscopia eletrônica de transmissão e não na microscopia eletrônica de varredura; 3 - As alterações tiveram correlação com o tempo na microscopia eletrônica de varredura e não na microscopia eletrônica de transmissão.
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