We report a β‐hairpin dual stabilizing strategy: a d‐proline‐l‐proline (d‐Pro‐l‐Pro) dipeptide as the nucleating turn, and a thioether tether as a side‐chain linkage at a precisely designed position ...to stabilize the β‐hairpin. This method was used to modify the C‐terminal β‐hairpin moiety of the plant defensin, pv‐defensin, in order to obtain a stabilized peptide with enhanced anti‐Candida albicans activity (MIC 84–3.0 μm), high serum stability (50 % remaining after 48 h) and low hemolysis (<10 % at 152 μm). This modified peptide penetrated the C. albicans cell membrane within 5 min and showed high activity against clinically isolated antibiotic‐resistant C. albicans and Candida glabrata strains.
Using the d‐Pro‐l‐Pro dipeptide as the nucleating turn and a thioether tether as a side‐chain linkage can constrain peptides to the β‐hairpin conformation. We modified the C‐terminal β‐hairpin moiety of pv‐defensin, and obtained stabilized peptide with enhanced anti‐C. albicans activity, high serum stability, and low hemolysis.
Objective: The objective of this study is to identify the maternal and neonatal outcomes in women with placenta increta or placenta percreta in China.
Materials and methods: We retrospectively ...analyzed 2219 cases from 20 tertiary care centers in China between January 2011 and December 2015. All cases were diagnosed of placenta increta or placenta percreta, based on either intraoperative findings or histopathological findings.
Results: The incidence of placenta increta and placenta percreta progressively increased from 0.18% in 2011 to 0.78% in 2015. Compared with the placenta increta, placenta percreta was strongly related to serious adverse outcomes: postpartum hemorrhage (65.9% versus 38.6%, p = .003), blood transfusion (86.2% versus 46.5%, p < .001), hysterectomy (43.3% versus 11.2%, p < .001), preterm birth (65.7% versus 49.9%, p < .001), and the need for neonatal intensive care unit (NICU) admission (54.5% versus 36.7%, p < .001).
Conclusion: The incidence of placenta increta and placenta percreta is likely to increase in China. The depth of placenta implantation is associated with the severity of outcomes. Placenta percreta tends to have worse maternal and neonatal outcomes.
This study aimed to determine the clinical characteristics and in vitro susceptibilities of
Candida parapsilosis
sensu stricto,
Candida orthopsilosis
and
Candida metapsilosis
isolates from patients ...with vulvovaginal candidiasis (VVC). We analysed 63 vaginal
C. parapsilosis
specimens. After the molecular analyses, the isolates were characterised as
C. parapsilosis
sensu stricto (77.8 %),
C. orthopsilosis
(7.9 %) and
C. metapsilosis
(14.3 %). The signs and symptoms of VVC caused by
C. parapsilosis
sensu lato, including itching, erythema and abnormal discharge, were milder than those caused by
C. albicans
. None of the
C. parapsilosis
sensu lato isolates were resistant to fluconazole, miconazole or itraconazole. The resistance rates of
C. albicans
to fluconazole, itraconazole, miconazole and clotrimazole were 2.3, 1.5, 3.1 and 0.8 %, respectively. Both
C. parapsilosis
sensu lato and
C. albicans
were susceptible to nystatin. The mycological eradication rate at follow-up days 7–14 and 30–35 were 77.8 % (49/63) and 76.2 % (48/63), respectively, when treated with various antifungal agents and regimens. We conclude that
C. parapsilosis
sensu stricto and the closely related species
C. orthopsilosis
and
C. metapsilosis
were present in the vaginal samples of VVC patients. The symptoms and signs of VVC caused by
C. parapsilosis
are milder than those caused by
C. albicans
. The antifungal susceptibility and therapeutic efficacy in patients colonised by
C. parapsilosis
sensu lato were similar to those observed in
C. albicans
-colonised patients.
Terconazole is a new, broad-spectrum, triazole antifungal agent. The aim of this study was to compare the efficacy and safety of a 6-day course of a terconazole vaginal suppository (80 mg) with two ...doses of oral fluconazole (150 mg) for the treatment of severe vulvovaginal candidiasis (SVVC). In this prospective, randomized case-control study, 140 consecutive patients with SVVC were enrolled at the Department of Obstetrics and Gynecology of Peking University Shenzhen Hospital from July 1, 2013, through June 31, 2014. Patients with SVVC, initially at a 1:1 ratio, were randomly assigned to receive treatment with either the terconazole vaginal suppository or oral fluconazole. The patients had follow-up visits at 7–14 days and 30–35 days following the last dose of therapy. The clinical cure rates in the terconazole group and the fluconazole group were, respectively, 81.0% (47/58) and 75.8% (50/66) at follow-up day 7–14 and 60.3% (35/58) and 56.1% (37/66) at day 30–35. The mycological cure rates in the two groups were, respectively, 79.3% (46/58) and 71.2% (47/66) at follow-up day 7–14 and 62.1% (36/58) and 53.0% (35/66) at day 30–35 (P > .05 for all). Local irritation was the primary adverse event associated with terconazole, whereas systemic side effects were associated with fluconazole; however, these effects were minimal. This study demonstrated that a terconazole vaginal suppository (80 mg daily for 6 days) was as effective as two dose of oral fluconazole (150 mg) in the treatment of patients with SVVC; as such, terconazole could be a choice for therapy of this disorder.
Objective
To create a model for prediction of success of uterine‐preserving procedures in women with placenta accreta spectrum (PAS).
Methods
PAS‐ID is a multicenter study that included 11 centers ...from 9 countries. Women with PAS, who were managed between January 1, 2010 and December 31, 2019, were retrospectively included. Data were split into model development and validation cohorts, and a prediction model was created using logistic regression. Main outcome was success of uterine preservation.
Results
Out of 797 women with PAS, 587 were eligible. Uterus‐preserving procedures were successful in 469 patients (79.9%). Number of previous cesarean sections (CS) was inversely associated with management success (adjusted odds ratio aOR 0.02, 95% confidence interval CI 0.001–3.63 with five previous CS). Other variables were complete placental invasion (aOR 0.14, 95% CI 0.05–0.43), type of CS incision (aOR 0.04, 95% CI 0.01–0.25 for classical incision), compression sutures (aOR 2.48, 95% CI 1.00–6.16), accreta type (aOR 3.76, 95% CI 1.13–12.53), incising away from placenta (aOR 5.09, 95% CI 1.52–16.97), and uterine resection (aOR 102.57, 95% CI 3.97–2652.74).
Conclusion
The present study provides a prediction model for success of uterine preservation, which may assist preoperative and intraoperative decisions, and promote incorporation of uterine preservation procedures in comprehensive PAS protocols.
Synopsis
CON‐PAS score is a novel prediction model that may facilitate decision making and promote uterine preservation in women with placenta accreta spectrum.
Placenta accreta spectrum is a major obstetric disorder that is associated with significant morbidity and mortality. The objective of this study is to establish a prediction model of clinical ...outcomes in these women
PAS-ID is an international multicenter study that comprises 11 centers from 9 countries. Women who were diagnosed with PAS and were managed in the recruiting centers between 1 January 2010 and 31 December 2019 were included. Data were reanalyzed using machine learning (ML) models, and 2 models were created to predict outcomes using antepartum and perioperative features. ML model was conducted using python
®
programing language. The primary outcome was massive PAS-associated perioperative blood loss (intraoperative blood loss ≥2500 ml, triggering massive transfusion protocol, or complicated by disseminated intravascular coagulopathy). Other outcomes include prolonged hospitalization >7 days and admission to the intensive care unit (ICU).
727 women with PAS were included. The area under curve (AUC) for ML antepartum prediction model was 0.84, 0.81, and 0.82 for massive blood loss, prolonged hospitalization, and admission to ICU, respectively. Significant contributors to this model were parity, placental site, method of diagnosis, and antepartum hemoglobin. Combining baseline and perioperative variables, the ML model performed at 0.86, 0.90, and 0.86 for study outcomes, respectively. Ethnicity, pelvic invasion, and uterine incision were the most predictive factors in this model.
ML models can be used to calculate the individualized risk of morbidity in women with PAS. Model-based risk assessment facilitates a priori delineation of management.
We report a beta-hairpin dual stabilizing strategy: a d-proline-l-proline (d-Pro-l-Pro) dipeptide as the nucleating turn, and a thioether tether as a side-chain linkage at a precisely designed ...position to stabilize the beta-hairpin. This method was used to modify the C-terminal beta-hairpin moiety of the plant defensin, pv-defensin, in order to obtain a stabilized peptide with enhanced anti-Candida albicans activity (MIC 84-3.0µm), high serum stability (50% remaining after 48h) and low hemolysis (<10% at 152µm). This modified peptide penetrated the C.albicans cell membrane within 5min and showed high activity against clinically isolated antibiotic-resistant C.albicans and Candida glabrata strains.
This study aimed at investigating the genetic diversity of a panel of
strains recovered from vaginal samples in different countries. All fungal strains were heterozygous at the mating-type-like locus ...and belonged to the genotype A of
. Moreover, all examined
strains lack
-acetylglucosamine assimilation and sequence analysis of the
gene showed a distinctive polymorphism that impair the utilization of this amino sugar in this yeast. Multi-locus sequencing of seven housekeeping genes revealed a substantial genetic homogeneity among the strains, except for the
and
loci which contributed significantly to the classification of our set of
strains into six existing diploid sequence types. Amplified fragment length polymorphism fingerprint analysis yielded greater genotypic heterogeneity among the
strains. Overall the data reported here show that in
genetic diversity occurs and the existence of this intriguing group of
strains with specific phenotypes associated could be useful for future comparative studies in order to better understand the genetics and evolution of this important human pathogen.
To explore the risk factors and clinical characteristics of shoulder dystocia.
The data of 44 580 single pregnancy and full-term head delivery were colleceted in the Third Affiliated Hospital of ...Guangzhou Medical University, Nanfang Hospital, Shenzhen Nanshan Hospital, Peking University Shenzhen Hospital and Yue Bei People's Hospital from January 2008 to September 2013. Totally 116 cases of shoulder dystocia were defined as the shoulder dystocia group, and the others were in the control group. The clinical data of the two groups were analyzed retrospectively, including the maternal age, maternal height, pre-gestational body mass index, weight gain during pregnancy, gestational weeks, gravidity, parity, fundal height, fetal abdominal perimeter, shoulder dystocia medical history, macrosomia, gestational diabetes mellitus, pre-gestational diabetes mellitus, post-term pregnancy and the condition of labor stages.
(1) The incidence of shoulder dystocia was 0.260% (116/44 580). The maternal age, pre-gestational body
PDF
