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1.
Vínculo ; 18(3): 55-59, set.-dez. 2021.
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1347948

ABSTRACT

Este artigo apresenta o atendimento de uma família com gêmeos com três anos e meio de idade. Discute brevemente a importância do atendimento familiar nos casos de suspeita de autismo e no caso de gêmeos, para apresentar a complexidade dos vínculos, da configuração edípica e da própria configuração do ego de cada gêmeo. Traz o relato de uma sessão de família com o referencial da psicanálise dos vínculos que nos dá uma ideia clara das situações importantes que emergem em uma sessão e das intervenções psicanalíticas possíveis neste setting.


This article presents the care of a family with three-and-a-half-year-old twins. Briefly discuss the importance of family care in cases of suspected autism and in the case of twins, to present the complexity of the bonds, the oedipal configuration, and the ego configuration of each twin. It brings the report of a family session with the psychoanalysis of bonds framework that gives us a clear idea of the important situations that emerge in a session and the possible psychoanalytic interventions in thissetting.


Este artículo presenta el cuidado de una familia con gemelos de tres anos y medio de edad. Discute brevemente la importancia del cuidado familiar en casos de sospecha de autismo y en el caso de gemelos, para presentar la complejidad de los lazos, la configuración edípica y la configuración del ego de cada gemelo. Trae el informe de una sesión familiar con el marco de vínculos de psicoanálisis que nos da una idea clara de las situaciones importantes que surgen en una sesión y las posibles intervenciones psicoanalíticas en este entorno.


Subject(s)
Humans , Child, Preschool , Psychoanalysis , Autistic Disorder , Twins , Family , Family Relations
2.
Article in Chinese | WPRIM | ID: wpr-879840

ABSTRACT

OBJECTIVE@#To study the perinatal complications of late preterm twins (LPTs) versus early term twins (ETTs).@*METHODS@#A retrospective analysis was performed for the complications of 246 LPTs, 496 ETTs, and their mothers. The risk factors for late preterm birth were analyzed. According to gestational age, the twins were divided into five groups: 34-34@*RESULTS@#Maternal hypertension, maternal thrombocytopenia, placenta previa, and premature rupture of membranes were independent risk factors for late preterm birth in twins (@*CONCLUSIONS@#Compared with ETTs, LPTs have an increased incidence of perinatal complications. The incidence of perinatal complications is associated with gestational ages in the LPTs and ETTs.


Subject(s)
Female , Gestational Age , Humans , Infant , Infant, Newborn , Pregnancy , Premature Birth , Respiratory Distress Syndrome, Newborn , Retrospective Studies , Twins
3.
Gac. méd. boliv ; 43(2): 228-231, dic. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1249989

ABSTRACT

TRAP describe la perfusión crónica de un gemelo acardíaco por un gemelo de bomba a través de canales vasculares entrelazados permeables. La secuencia TRAP ocurre en 1 de cada 35.000 nacimientos o en 1 de cada 100 pares de gemelos monocigóticos. Se diagnostica mediante los hallazgos ecográficos de un feto de desarrollo normal y una masa amorfa con frecuencia con partes fetales perceptibles. El Doppler color revela el flujo sanguíneo reverso hacia el gemelo acardíaco dentro de la arteria umbilical lo que lleva a las complicaciones típicas del cuadro. El manejo expectante es razonable en ausencia de características pronósticas deficientes. El propósito de este artículo es revisar los aspectos básicos y el estado actual de esta condición, haciendo énfasis en el diagnóstico y el manejo expectante.


TRAP describes the chronic perfusion of an acardiac twin by a pump twin through permeable interlocking vascular channels. TRAP occurs in 1 in 35,000 births or 1 in 100 pairs of monozygotic twins. It is diagnosed by ultrasound findings of a normally developing fetus and an amorphous mass often with noticeable fetal parts. Color Doppler reveals the reverse blood flow to the acardiac twin within the umbilical artery, leading to typical complications of the condition. Expectant management is reasonable in the absence of poor prognostic characteristics. The purpose of this article is to review the basic aspects and current status of this condition, emphasizing the diagnosis and expectant management.


Subject(s)
Female , Adult , Fetus , Perfusion , Twins , Blood
4.
Rev. Assoc. Med. Bras. (1992) ; 66(11): 1526-1529, Nov. 2020. graf
Article in English | LILACS, SES-SP | ID: biblio-1143652

ABSTRACT

SUMMARY BACKGROUND: Asymmetric or heteropagus conjoined twins is a rare occurrence, with an incidence of one case in 1-2 million. Conjoined twins are classified according to their symmetry, place of fusion, and grade of duplication. METHODS: We report here an extremely rare presentation of parasitic twins not described before. We describe macro and micro anatomic alterations and discuss the aspects of this peculiar presentation and the importance of prenatal diagnosis. RESULTS: The case of a twenty-three-year-old patient, with monochorionic, monoamniotic asymmetrically-conjoined twin pregnancy, discovered at 29 weeks of gestational age. We believe that this report calls attention to this presentation and the importance of prenatal care and management. The twins were delivered vaginally without life. The twins' combined weight was 1.300 gr. They were bonded in the left cervical region. CONCLUSION: This report may help to find strategies for clinical decisions in future cases. Antepartum diagnosis is important to the management, preoperative planning, and outcomes. Prenatal imaging exams like echocardiography, CT, MRI, and ultrasonography are feasible and can provide relevant information about malformation severity and prognosis.


RESUMO BACKGROUND: Gêmeos parasitas assimétricos ou heterópagos são uma ocorrência rara, com incidência de um caso em 1-2 milhões. Os gêmeos siameses são classificados de acordo com sua simetria, local de fusão e grau de duplicação. MÉTODOS: Relatamos aqui uma apresentação extremamente rara de gêmeos parasitários não descritos anteriormente. São descritas alterações macro e microscópicas e discutidos aspectos relevantes dessa malformação e da importância do diagnóstico pré-natal. RESULTADOS: Um caso de uma paciente de 23 anos de idade, com gestação monocoriônica, monoamniótica de gêmeos siameses assimétricos diagnosticada com 29 semanas de idade gestacional. Acreditamos que este relato chama a atenção para esta apresentação e para a importância do cuidado e manejo pré-natal. Os fetos nasceram de parto vaginal já sem vida, pesando em conjunto 1.300 gramas, e eram unidos pela região cervical esquerda. CONCLUSÃO: Este relato pode ajudar a encontrar estratégias para a decisão clínica em casos futuros. O diagnóstico pré-natal é fundamental para o manejo e planejamento pré-operatório. Exames de imagem como ecocardiografia, tomografia computadorizada, ressonância magnética e ultrassonografia são factíveis e podem fornecer informações-chave sobre a gravidade e prognóstico da malformação.


Subject(s)
Humans , Female , Pregnancy , Young Adult , Twins, Conjoined , Pregnancy, Twin , Prenatal Diagnosis , Twins , Ultrasonography, Prenatal
5.
Gerais (Univ. Fed. Juiz Fora) ; 13(1): 1-10, jan.-abr. 2020. tab
Article in Portuguese | LILACS | ID: biblio-1090453

ABSTRACT

O processo de individualização em gêmeos se mostra mais complexo se comparado com filhos singulares, envolvendo maiores questões em relação à separação entre o bebê e a mãe, também entre os próprios cogêmeos. Devido ao aumento de nascimentos de gêmeos, o assunto é atual, porém ainda são poucos os estudos na área. O trabalho teve por objetivo investigar a produção científica brasileira sobre o processo de individualização em gêmeos na atualidade. Para isso, realizou-se uma revisão bibliográfica integrativa em bases de dados online, de artigos e teses referentes à temática. Foram selecionados e analisados 14 trabalhos científicos que atenderam aos critérios de inclusão. Verificou-se dificuldade em estudar o processo de individualização em gêmeos devido a algumas de suas particularidades, como a genética e ambiente de criação compartilhados, intensificando, consequentemente, as ideações e práticas culturais sobre o desenvolvimento gemelar. Assim, entende-se a necessidade de estudos mais aprofundados.


The process of individualization of twins appears to be more complex when compared with individual children, involving major issues regarding the separation between the baby and the mother and also among the twins themselves. Because of the increase in births of twins, this is a current subject, although there are still few studies in the area. This study aimed to investigate the Brazilian scientific production about the individualization process in twins today. For this, an integrative literature review of online databases was conducted, including papers and theses concerning the subject. A total of 14 scientific studies that met the inclusion criteria were selected and analyzed. While studying the process of individualization of twins, some challenges appeared, mainly due to particularities like shared genetics and raising environment, which consequently intensify the ideation and cultural practices related to the growth of twins. Thus, further studies are considered necessary.


Subject(s)
Twins , Individuality , Psychology, Social , Sibling Relations , Family Relations
6.
Article in Chinese | WPRIM | ID: wpr-879509

ABSTRACT

OBJECTIVE@#To delineate the blood group for a pair of twins with inconclusive ABO blood typing result.@*METHODS@#Serological test for blood group was carried out by using ABO and Rh Blood Grouping Cards (Microcolumn Gel Immunoassay). Sequence specific primer-PCR (PCR-SSP), direct sequencing and TA clone sequencing were used to analyze the ABO gene. Genetic status was analyzed by using 16 short tandem repeat (STR) markers.@*RESULTS@#Red blood cells of the twins displayed 2+ mixed agglutination phenomenon with anti-A, anti-A1 and anti-E. PCR-SSP and DNA sequencing of exons 6 to 7 revealed that they have an ABO*O.01.01/ABO*O.01.02 genotype. DNA sequencing of microsatellite enhancer region revealed presence of A gene. STR analysis revealed more than two haplotypes for 9 loci between the twins. After clustered by anti-A, the red blood cells were divided into two groups: A, CcDEe and O, CcDee, respectively.@*CONCLUSION@#Serological and molecular techniques have characterized the twins as blood group chimeras.


Subject(s)
ABO Blood-Group System/genetics , Alleles , Chimera/genetics , Genotype , Humans , Twins/genetics
7.
CoDAS ; 32(2): e20180107, 2020. tab
Article in Portuguese | LILACS | ID: biblio-1055900

ABSTRACT

RESUMO Objetivo Investigar o desempenho lexical e a habilidade de memória de curto prazo verbal em crianças prematuras em idade pré-escolar, e comparar os resultados com seus pares nascidos a termo. Método Participaram do estudo 40 pré-escolares com idade entre 4 e 5 anos e 11 meses divididos em dois grupos, sendo 20 nascidos prematuros e 20 nascidos a termo. Os grupos não diferiram quanto à idade, renda familiar e escolaridade materna. Foram utilizados testes de vocabulário expressivo e memória de curto prazo verbal. A análise estatística inferencial foi realizada por meio dos testes de Mann-Whitney e exato de Fisher. Resultados O desempenho dos grupos não diferiu na tarefa de vocabulário, mas o grupo de prematuros apresentou desempenho inferior ao de seus pares na tarefa de repetição de não palavras. Conclusão Nesta amostra, o desempenho dos pré-escolares que nasceram prematuros foi estatisticamente inferior ao daqueles nascidos a termo apenas na tarefa de repetição de não palavras. Assim, o nascimento prematuro esteve associado a desempenho no vocabulário expressivo compatível com o esperado para a idade, porém com prejuízos na memória de curto prazo verbal.


ABSTRACT Purpose To investigate lexical performance and verbal short-term memory ability in premature infants at preschool age and compare the results with their full-term peers. Methods Forty preschool children aged between 4 and 5 years and 11 months participated on the study and were equally divided into two groups considering their gestational age: preterm and full-term. Groups did not differ on age, family income and maternal education. Participants were paired according to their chronological age and their socioeconomic status. Their performance was assessed using expressive vocabulary and verbal short-term memory tests. Inferential statistical analysis was performed using the Mann-Whitney and the Fisher exact test. Results Group performance did not differ on vocabulary, but premature children showed an inferior performance on nonword repetition tasks. Conclusion These data indicates that preschoolers born premature performed statistically lower than their peers born full-term on nonword repetition task. Thus, premature birth was associated to vocabulary development on typically developing range, but also to verbal short-term memory impairments.


Subject(s)
Humans , Male , Female , Child, Preschool , Vocabulary , Memory, Short-Term/physiology , Socioeconomic Factors , Twins , Infant, Premature , Child Development/physiology , Surveys and Questionnaires , Gestational Age , Language Development , Language Tests
8.
Journal of Biomedical Engineering ; (6): 1089-1094, 2020.
Article in Chinese | WPRIM | ID: wpr-879240

ABSTRACT

Hemispheric asymmetry is a fundamental organizing principle of the human brain. Answering the genetic effects of the asymmetry is a prerequisite for elucidating developmental mechanisms of brain asymmetries. Multi-modal magnetic resonance imaging (MRI) has provided an important tool for comprehensively interpreting human brain asymmetry and its genetic mechanism. By combining MRI data, individual differences in brain structural asymmetry have been investigated with quantitative genetic brain mapping using gene-heritability. Twins provide a useful natural model for studying the effects of genetics and environment on the brain. Studies based on MRI have found that the asymmetry of human brain structure has a genetic basis. From the perspective of quantitative genetic analysis, this article reviews recent findings on the genetic effects of asymmetry and genetic covariance between hemispheres from three aspects: the asymmetry of heritability, the heritability of asymmetry and the genetic correlation. At last, the article shows the limitations and future research directions in this field. The purpose of this systematic review is to quickly guide researchers to understand the origins and genetic mechanism of interhemispheric differences, and provide a genetic basis for further understanding and exploring individual differences in laterized cognitive behavior.


Subject(s)
Brain/diagnostic imaging , Brain Mapping , Humans , Magnetic Resonance Imaging , Twins/genetics
9.
Med. UIS ; 32(2): 59-65, mayo-ago. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1114969

ABSTRACT

Resumen El síndrome 3M es un desorden autosómico recesivo, heterogéneo, poco común, llamado así por los tres investigadores que lo describieron por primera vez, Miller, Mckusck y Malvaux. Las características principales son retraso en el crecimiento prenatal y postnatal severo, dismorfias faciales y anomalías radiológicas. En sus manifestaciones estomatológicas presentan dolicocefalia, abombamiento frontal, cara triangular, labios gruesos, cejas pobladas, hipoplasia maxilar severa, facies melancólicas, retraso en la erupción dental severa y falta de crecimiento del macizo facial. El objetivo del artículo es la descripción de casos gemelares de 8 años y 6 meses de edad, que acuden a la Clínica de Atención Dental Avanzada de la Universidad de Monterrey, con confirmación del síndrome 3M por prueba sanguínea a los 4 años de edad por parte del Servicio de Genética del Hospital Universitario. Se realiza rehabilitación bucal de ambas niñas, y, posteriormente, son referidas a interconsulta con ortodoncia interceptiva. MÉD.UIS.2019;32(2): 59-65


Abstract 3M syndrome is very rare, it's a heterogeneous autosomal recessive disorder named after 3 researches who described it for the first time, Miller, Mckusck and Malvaux. Whose main characteristic are; delayed prenatal growth, severe postnatal growth, facial dysmorphia, radiological abnormalities, presence of dolichocephaly, frontal bulging, triangular face, thick lips, raised eyebrows, severe maxillary hypoplasia, melancholic facies, delayed severe dental eruption, lack of facial mass growth. The objective of the article is the description of twin cases that come to the Advanced Dental Care Clinic of the University of Monterrey; 8 years 6 months old, with confirmation of the 3M syndrome, with a blood test at 4 years of age by the Genetics Service of the University Hospital. MÉD.UIS.2019;32(2): 59-65


Subject(s)
Humans , Female , Child , Syndrome , Dwarfism , Orthodontics, Interceptive , Tooth Eruption , Twins , Women , Dental Care , Facies , Eyebrows , Face , Genes , Genetics , Growth , Hematologic Tests , Lip , Maxilla , Mouth Rehabilitation
10.
Rev. colomb. anestesiol ; 47(2): 120-123, Apr.-June 2019.
Article in English | LILACS, COLNAL | ID: biblio-1003826

ABSTRACT

Abstract Fetal surgery in utero is an alternative for treatable congenital malformations. Prognosis will improve with early correction. Once the surgical technique is planned, the anesthetist's knowledge of maternal and fetal physiology is crucial for the selection of the ideal anesthetic technique for each individual case, considering the type of surgical procedure and the expected degree of fetal stimulation. In this way, the optimal surgical field with maternal and fetal safety will be ensured. This article describes 1 case of twin-to-twin transfusion syndrome under spinal anesthesia and sedation, and a second case of hydrothorax drainage under sedation.


Resumen La cirugía fetal in útero es una alternativa para las malformaciones congénitas tratables, su intervención temprana mejora el pronóstico del feto. Una vez planeada la técnica quirúrgica el conocimiento del anestesiólogo sobre la fisiología materna y fetal es fundamental, puesto que deberá determinar la técnica anestésica ideal acorde al contexto de cada caso considerando el tipo de procedimiento quirúrgico a realizarse y el grado de estimulación fetal esperado. De esta manera se asegura un campo quirúrgico óptimo ofreciendo seguridad materno fetal. En este artículo se describen dos casos: el primero síndrome de transfusión gemelar se realizó bajo anestesia raquídea y sedación, en el segundo caso de drenaje de hidrotórax bajo sedación.


Subject(s)
Humans , Female , Pregnancy , Adult , Twins , Blood Transfusion, Intrauterine , Hydrothorax , Anesthesia , Pain , Surgical Procedures, Operative , Congenital Abnormalities
11.
Rev. cuba. med. mil ; 48(2): e233, abr.-jun. 2019. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1126610

ABSTRACT

Introducción: Diversos estudios evidencian que las desarmonías del esqueleto provocan disfunciones temporomandibulares, pues la oclusión dentaria condiciona la posición de los cóndilos en la cavidad glenoidea. Los requisitos del tratamiento ortodóncico incluyen lograr una oclusión estable y equilibrada, una estética facial óptima y el funcionamiento saludable de la articulación temporomandibular. Objetivo: Describir los resultados obtenidos con los bloques gemelos en pacientes con síndrome de clase II, división 1, con trastornos temporomandibulares. Métodos: Se realizó un estudio descriptivo en los pacientes que ingresaron a la consulta de ortodoncia del policlínico "Juan Manuel Páez Inshausty", con edades entre 11 y 14 años, con síndrome de clase ΙΙ, división 1 y trastornos temporomandibulares, en el período comprendido entre febrero 2017 y enero 2018. Se describen 8 pacientes, con el análisis del índice de Helkimo al inicio y a los seis meses de instalados los bloques gemelos básicos. Resultados: Predominaron los pacientes leves con un 62,5 por ciento y el 87,5 por ciento presentó alteración en el funcionamiento de la articulación temporomandibular. A los 6 meses de tratamiento, se encontró que 7 estaban asintomáticos y solo un paciente persistía con alteraciones de la función de la articulación temporomandibular. Conclusiones: La mayoría de los pacientes pasaron a estar asintomáticos a los seis meses del tratamiento con los bloques gemelos(AU)


Introduction: Several studies show that disharmonies of the skeleton cause temporomandibular dysfunctions, since the dental occlusion determines the position of the condyles in the glenoid cavity. The requirements of orthodontic treatment includes achieving stable and balanced occlusion, optimal facial aesthetics and healthy functioning of the temporomandibular joint. Objective: To describe the results obtained with the twin blocks in patients with class II syndrome, division 1, with temporomandibular disorders. Methods: A descriptive study was carried out in the patients who entered the orthodontic clinic of the "Juan Manuel Páez Inshausty" polyclinic, aged between 11 and 14 year old, with class II syndrome, division 1 and temporomandibular disorders, in the period included between February 2017 and January 2018. 8 patients are described, with the analysis of the Helkimo index at the beginning and six months after the basic twin blocks were installed. Results: Mild patients predominated with 62.5 percent and 87.5 percent presented alteration in the temporomandibular joint function. After 6 months of treatment, 7 were found to be asymptomatic and only one patient persisted with alterations in temporomandibular joint function. Conclusions: Most patients became asymptomatic six months after treatment with the twin blocks


Subject(s)
Humans , Child , Adolescent , Orthodontics , Temporomandibular Joint , Twins , Temporomandibular Joint Disorders , Dental Occlusion , Glenoid Cavity , Epidemiology, Descriptive
12.
Psicol. ciênc. prof ; 39: e176715, jan.-mar.2019. graf
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1098502

ABSTRACT

Resumo A intervenção comportamental, por meio da orientação parental, vem alcançando resultados positivos no manejo da insônia em crianças. Contudo, questiona-se a efetividade de tais intervenções em irmãos gêmeos, pelo fato de os pais partilharem os cuidados de duas crianças da mesma idade e nível de desenvolvimento. O objetivo deste estudo é apresentar um relato de caso de intervenção comportamental para insônia infantil em irmãos gêmeos por meio de um programa dirigido aos pais e verificar o efeito da intervenção no sono e comportamentos diurnos das crianças. A mãe dos gêmeos foi orientada quanto as técnicas de extinção e reforço positivo no manejo do problema de sono infantil. Os resultados demonstraram que depois da intervenção houve melhora nos hábitos de sono, na qualidade do sono e nos comportamentos internalizantes e externalizantes das crianças. Os achados apresentados neste estudo mostraram os efeitos positivos que a intervenção baseada na aprendizagem operante teve sobre o sono e o comportamento infantil. Este aspecto ressalta a importância de uma inserção maior da questão do sono na Psicologia, a partir de práticas preventivas e interventivas.


Abstract Behavioral intervention by means of parental guidance has been achieving positive results in the management of insomnia in children. However, the effectiveness of such interventions in twins is questioned because parents share the care of two children of the same age and level of development. This is a case report of behavioral intervention for childhood insomnia in twins through a program for parents. The objective of this study is to analyze the effect of such intervention on children's sleep and daytime behaviors. The mother of the twins was instructed on the techniques of extinction and positive reinforcement in the management of children's sleep problems. The results showed that after the intervention there was an improvement in the children's sleep habits, sleep quality and internalizing and externalizing behaviors. The findings of this case report show the positive effects that an intervention based on operant learning had on children's sleep and behavior. This highlights the importance of a greater inclusion of issues related to sleep in psychological studies based on preventive and intervention practices.


Resumen La intervención comportamental, por medio de la orientación parental, viene alcanzando resultados positivos en el manejo del insomnio en niños. Sin embargo, se cuestiona la efectividad de tales intervenciones en hermanos gemelos, por el hecho de que los padres comparten los cuidados de dos niños de la misma edad y nivel de desarrollo. El objetivo de este estudio es presentar un relato de caso de intervención comportamental para insomnio infantil en hermanos gemelos por medio de un programa dirigido a los padres y verificar el efecto de la intervención en el sueño y comportamientos diurnos de los niños.. La madre de los gemelos fue orientada en cuanto a las técnicas de extinción y refuerzo positivo en el manejo del problema del sueño infantil. Los resultados demostraron que después de la intervención hubo mejoría en los hábitos de sueño, en la calidad del sueño y en los comportamientos internalizantes y externalizantes de los niños. Los hallazgos presentados en este estudio mostraron los efectos positivos que la intervención basada en el aprendizaje operante tuvo sobre el sueño y el comportamiento infantil. Este aspecto resalta la importancia de una inserción mayor de la cuestión del sueño en la psicología, a partir de prácticas preventivas e interventivas.


Subject(s)
Humans , Child , Sleep , Twins , Child , Child Behavior , Psychology, Child , Siblings , Sleep Initiation and Maintenance Disorders , Parents , Reinforcement, Psychology , Behavior , Behavior Control , Growth and Development , Sleep Hygiene , Habits , Maternal Behavior , Mothers
13.
Article in Chinese | WPRIM | ID: wpr-775088

ABSTRACT

OBJECTIVE@#To investigate the short-term prognosis of the co-twin who survives after single intrauterine fetal demise (sIUFD).@*METHODS@#A total of 52 infants who survived after sIUFD were enrolled as the case group, and 104 twins, matched for gestational age, from a pair of live-born twins without sIUFD were enrolled as the control group. Related clinical data were compared between the two groups.@*RESULTS@#Among the 52 infants who survived after sIUFD, 42 (80.8%) were preterm infants, 13 (25.0%) had brain injury, and 3 (5.8%) died in the neonatal period. Compared with the control group, the case group had significantly higher incidence rates of meconium stained amniotic fluid/bloody amniotic fluid/polyhydramnios/hypamnion, torsion of cord/nuchal cord, and placenta previa/placenta abruption, as well as significantly higher incidence rates of birth asphyxia, anemia or polycythemia at birth, and coagulation disorder at birth (P<0.05). The case group also had significantly higher incidence rates of nosocomial infection and brain injury than the control group during hospitalization (P<0.05).@*CONCLUSIONS@#There is an increase in the incidence rate of complications in the co-twin who survives after sIUFD. Prenatal evaluation and long-term follow-up should be performed for the surviving co-twin.


Subject(s)
Female , Fetal Death , Humans , Infant, Newborn , Infant, Premature , Pregnancy , Pregnancy Outcome , Prognosis , Twins
14.
Article in Chinese | WPRIM | ID: wpr-781709

ABSTRACT

OBJECTIVE@#To investigate the influence of genetic and environmental factors on aggressive behavior in twin children, and to provide clues for further exploring the causal relationship between such factors and aggressive behavior.@*METHODS@#A questionnaire was used to investigate aggressive behavior, temperament type and parenting style among 261 twin children aged 4-12.8 years. The Holzinger method and the maximum likelihood method were used to construct a structural equation model for the estimation of heritability. Binary logistic regression analysis, multivariate linear regression analysis and general linear model analysis were used to analyze the association between aggressive behavior and environmental factors in twin children.@*RESULTS@#The heritability of aggressive behavior was 44.4% in twin children and the score of aggressive behavior showed moderate heritability (60.9% in boys and 65.6% in girls). The multivariate analysis showed that the score of aggressive behavior in twin children was affected by the mother's emotional warmth/understanding, the mother's punishment/severity and the father's overprotection (P<0.05). There was an interaction between the mother's emotional warmth/understanding and the father's overprotection (P<0.05).@*CONCLUSIONS@#Both genetic and environmental factors have influence on children's aggressive behavior, and parenting style is the main environmental factor affecting the aggressive behavior of twin children.


Subject(s)
Child , Child Behavior , Child, Preschool , Fathers , Female , Humans , Male , Mothers , Parenting , Surveys and Questionnaires , Twins
15.
Article in English | WPRIM | ID: wpr-719574

ABSTRACT

BACKGROUND: The purpose of this study was to determine prognostic factors that can affect the fetal survival immediate after fetoscopic laser ablation. METHODS: The study population consisted of consecutive twin pregnant women who underwent fetoscopic laser ablation with the diagnosis of twin to twin transfusion syndrome (TTTS) from 2011 to 2018 in Seoul National University Hospital. Fetal survival immediate after procedure was defined as survival to 48 hours after procedure and neonatal survival was defined as survival to 28 days of life. Clinical characteristics and ultrasound findings were compared according to the fetal survival immediate after procedure. RESULTS: A total of 57 pregnant women with TTTS were included, and the overall fetal survival immediate after procedure was 71.1% (81/114) after fetoscopic laser ablation. Fetuses who survived immediate after procedure had higher gestational age at procedure and lower frequency of abnormal Doppler studies than those did not survive. However, the frequency of hydrops was not different between cases with fetal survival and those with fetal death. The earlier gestational age at procedure and the presence of abnormal Doppler studies were significant risk factors for fetal death even after adjustment. CONCLUSION: Based on this data, the fetal survival immediate after procedure (fetoscopic laser treatment) in TTTS can be affected by the gestational age at procedure and the presence of abnormal Doppler studies.


Subject(s)
Diagnosis , Edema , Female , Fetal Death , Fetofetal Transfusion , Fetus , Gestational Age , Humans , Laser Therapy , Pregnancy , Pregnant Women , Risk Factors , Seoul , Twins , Ultrasonography
16.
Article in English | WPRIM | ID: wpr-719317

ABSTRACT

OBJECTIVE: The purpose of this study was to investigate the influence of heritability on the craniofacial soft tissue cephalometric characteristics of monozygotic (MZ) twins, dizygotic (DZ) twins, and their siblings (SIB). METHODS: The samples comprised Korean adult twins and their siblings (mean age, 39.8 years; MZ group, n = 36 pairs; DZ group, n = 13 pairs of the same gender; and SIB group, n = 26 pairs of the same gender). Thirty cephalometric variables were measured to characterize facial profile, facial height, soft-tissue thickness, and projection of nose and lip. Falconer's method was used to calculate heritability (low heritability, h2 0.9). After principal components analysis (PCA) was performed to extract the models, we calculated the intraclass correlation coefficient (ICC) value and heritability of each component. RESULTS: The MZ group exhibited higher ICC values for all cephalometric variables than DZ and SIB groups. Among cephalometric variables, the highest h2 (MZ-DZ) and h2 (MZ-SIB) values were observed for the nasolabial angle (NLA, 1.544 and 2.036), chin angle (1.342 and 1.112), soft tissue chin thickness (2.872 and 1.226), and upper lip thickness ratio (1.592 and 1.026). PCA derived eight components with 84.5% of a cumulative explanation. The components that exhibited higher values of h2 (MZ-DZ) and h2 (MZ-SIB) were PCA2, which includes facial convexity, NLA, and nose projection (1.026 and 0.972), and PCA7, which includes chin angle and soft tissue chin thickness (2.107 and 1.169). CONCLUSIONS: The nose and soft tissue chin were more influenced by genetic factors than other soft tissues.


Subject(s)
Adult , Chin , Humans , Lip , Methods , Nose , Passive Cutaneous Anaphylaxis , Siblings , Twins , Twins, Dizygotic , Twins, Monozygotic
17.
Article in English | WPRIM | ID: wpr-741745

ABSTRACT

OBJECTIVE: To investigate the perinatal outcomes of twin pregnancies according to maternal age. METHODS: This is a retrospective cohort study of twin pregnancies delivered ≥24 weeks' gestation at a tertiary academic hospital from 1995 to 2016. Subjects were categorized into 5 groups according to maternal age: < 25, 25–29, 30–34, 35–39, and ≥40 years. Maternal and neonatal outcomes of each maternal age group were analyzed using the Jonckheere-Terpstra test and the linear-by-linear association test. RESULTS: A total of 1,936 twin pregnant women were included, of which 47 (2.4%), 470 (24.3%), 948 (49.0%), 417 (21.5%), and 54 (2.7%) women were aged < 25, 25–29, 30–34, 35–39, and ≥40 years, respectively. Higher maternal age was significantly associated with a higher rate of dichorionic twins and a higher risk of gestational diabetes and placenta previa. However, rates of preterm labor, preterm premature rupture of membranes, cervical incompetence, preterm delivery, preeclampsia, placenta abruption, and cesarean section were not associated with maternal age. Birth weight increased and the rate of admission to the neonatal intensive care unit (NICU) decreased with older maternal age, but other neonatal outcomes did not change with age. Maternal age was significantly associated with a lower rate of NICU admission after controlling for potential confounding factors in multivariable analysis. CONCLUSION: Advanced maternal age in twin pregnancies was associated with increased risk of gestational diabetes, placenta previa, and higher birth weight but a lower rate of NICU admission. However, other outcomes were not significantly associated with maternal age.


Subject(s)
Birth Weight , Cesarean Section , Cohort Studies , Diabetes, Gestational , Female , Humans , Infant, Newborn , Intensive Care, Neonatal , Maternal Age , Membranes , Obstetric Labor, Premature , Placenta , Placenta Previa , Pre-Eclampsia , Pregnancy , Pregnancy, Twin , Pregnant Women , Retrospective Studies , Rupture , Twins
18.
Article in English | WPRIM | ID: wpr-760679

ABSTRACT

OBJECTIVE: The lack of obstetricians in Japan has prevented the implementation of a 24–hour delivery monitoring system for high-risk deliveries such as twin vaginal delivery at many obstetric facilities. To examine the outcomes of a 1-day trial of the vaginal delivery of twins at 36–37 weeks' gestation. METHODS: We induced the vaginal delivery of twins at 36–37 weeks' gestation of 256 women who provided consent between January 2007 and December 2016 using the following protocol: 1) administration of 0.5 mg oral prostaglandin E2 every 1 hour (maximum: 1.5 mg) in the morning; 2) intravenous administration of oxytocin and amniotomy in the afternoon; and 3) selection of caesarean delivery when vaginal delivery was not expected by evening. We examined their perinatal outcomes in a chart review. RESULTS: The completion rates of vaginal delivery in total, nulliparous, and multiparous women were 79%, 72%, and 84%, respectively. There were no cases of neonatal asphyxia. The total incidence of neonatal respiratory disorders was 2.1%, but there were no cases of persistent pulmonary hypertension. The total incidence of postpartum hemorrhage requiring transfusion was 2.7%. CONCLUSION: The 1-day planned vaginal delivery of twins at 36–37 weeks' gestation appears valid and safe, and our findings suggest that it can be an option for the delivery of twins.


Subject(s)
Administration, Intravenous , Asphyxia , Dinoprostone , Female , Humans , Hypertension, Pulmonary , Incidence , Japan , Oxytocin , Postpartum Hemorrhage , Pregnancy , Pregnancy, Twin , Trial of Labor , Twins
19.
Article in English | WPRIM | ID: wpr-763503

ABSTRACT

Primary cardiac tumors are rare, with a prevalence of 0.001–0.2%. Among such tumors, cardiac hemangioendotheliomas are some of the most uncommon. In Korea, there have been no reports of hemangioendothelioma occurring in the heart of infants. We herein report a case of an infant that was admitted to our medical center and presented with cough and a runny nose. The initial diagnosis was acute bronchiolitis. Cardiomegaly was observed on chest radiography. Echocardiography revealed a tumor measuring 3.5×4.0 cm in the right atrium. The infant was transferred to a tertiary medical center for tumor excision. The excised lesion was 3.8×3×3.2 cm in size, and biopsy confirmed a diagnosis of hemangioendothelioma. In this case report, we describe our experience with a rare case involving cardiac tumor in an infant with an upper respiratory tract infection.


Subject(s)
Biopsy , Bronchiolitis , Cardiomegaly , Cough , Diagnosis , Echocardiography , Heart , Heart Atria , Heart Neoplasms , Hemangioendothelioma , Humans , Infant , Korea , Nose , Prevalence , Radiography , Respiratory Tract Infections , Thorax , Twins
20.
Clin. biomed. res ; 39(2): 107-115, 2019.
Article in Portuguese | LILACS | ID: biblio-1022678

ABSTRACT

Cândido Godói (CG) é um pequeno município brasileiro localizado no noroeste do Rio Grande do Sul e é conhecido como "Cidade dos Gêmeos" devido à alta taxa de nascimentos gemelares na região. Diante de um fato tão notável, muitas explicações foram sugeridas. Entre estas teorias, a que mais recebeu atenção da mídia, mesmo sem base científica, foi a de que a gemelaridade seria fruto de experimentos de um médico nazista alemão foragido após a Segunda Guerra Mundial. A convite da própria comunidade de CG, nosso grupo de pesquisa trabalha para resolver este mistério desde 1994, analisando diferentes fatores possivelmente relacionados, em especial suas características genéticas. Aqui, nós sumarizamos os principais resultados obtidos em mais de duas décadas de pesquisa, com foco nas particularidades do processo de comunicação dos resultados, aspectos éticos e como os achados científicos naquela comunidade contribuem não apenas com a resolução de um mistério histórico e local, mas também com o estudo de outras questões, como a reprodução humana e as bases biológicas da gemelaridade. (AU)


Cândido Godói (CG) is a small town located in the northwest region of Rio Grande do Sul state which is known as "Town of Twins" because of the high rate of twin births. Many explanations have been suggested for such a noteworthy fact. The theory that has received most attention from the press, despite a lack of scientific evidence, was that twinning would result from experiments conducted by a Nazi German physician who had been a fugitive after World War II. Invited by the local community, our research team has been dedicated to solving this mystery since 1994 by analyzing different possibly related factors, especially genetic characteristics. In this paper, we summarize the main results obtained in more than two decades of research, focusing on the particular communication process of the results, ethical aspects, and how the scientific findings in that community have contributed not only to the resolution of a historical and localized mystery, but also with the study of other issues such as human reproduction and biological basis of the twinning process. (AU)


Subject(s)
Humans , Twins , Reproductive Isolation , Genetics, Population , Founder Effect , Fertility
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