ABSTRACT
Context: Gestational diabetes mellitus (GDM) is one of the most common complications during pregnancy. It is also a growing problem worldwide and is associated with many maternal and fetal complications during and after pregnancy. Objective: This study aimed to investigate the neonatal and maternal complications of gestational diabetes in the Iranian population of pregnant women. Design: This prospective cohort study was carried out on the health assessment data of pregnant women in the age range of 18-45 years who were referred to health centers affiliated with Mashhad University of Medical Sciences, Mashhad, Iran, from March 2019 to September 2020. Subjects and Methods: Overall, 2,500 pregnant women with GDM and 7,700 healthy pregnant women were enrolled in the GDM and healthy groups, respectively. Individuals' data were recorded in an electronic health record system (SINA System) and were later collected and analyzed. Results: Significant between-group differences were observed in terms of cesarean delivery risk, hypertension, fetal macrosomia, preeclampsia, preterm birth, fetal birth weight, and neonatal icterus in GDM and non-GDM groups. However, no significant differences were found in terms of stillbirth, and low birth weight between the two groups. Based on the logistic regression model, GDM significantly increased the risk of cesarean delivery, fetal macrosomia, and neonatal icterus. Conclusions: The fetal macrosomia leading to the cesarean delivery, and neonatal icterus were determined as the significant complications of GDM in the Iranian population. These results can provide valuable insight into healthcare planning.
ABSTRACT
El síndrome de May-Hegglin es un trastorno hematológico, tan infrecuente que su incidencia es aún desconocida, caracterizado por macrotrombocitopenia con función plaquetaria normal e inclusiones citoplasmáticas en los granulocitos. Se presenta el caso de una primípara de 28 años, quien solicitó analgesia epidural y posteriormente requirió cesárea urgente por fracaso de la inducción. La paciente no tenía antecedente de hemorragias anormales. Se descartaron otras posibles causas asociadas de trombocitopenia o disfunción plaquetaria como la preeclampsia, el síndrome de HELLP o abruptio placentae. El recuento de plaquetas previo a la cesárea fue de 20.900/mm3, con una función plaquetaria normal. Se realizó una anestesia general. La hemorragia no fue mayor de lo habitual y no precisó transfusión plaquetaria (AU)
The May-Hegglin anomaly is an inherited disorder, so uncommon that the incidence is still unknown. It is characterized by macro-thrombocytopenia with normal platelet function and cytoplasmic inclusion bodies in granulocytes. The case is reported of a 28-year-old primiparous patient who had an urgent caesarean section due to failed induction of labour. The patient had no history of abnormal bleeding. Other causes of thrombocytopenia or platelet dysfunction, such as preeclampsia, HELLP syndrome, or placental abruption, were ruled out. The platelet count prior to surgery was 20,900/mm3 with normal platelet function. General anaesthesia was performed. No excessive bleeding occurred and a platelet transfusion was not needed (AU)
Subject(s)
Humans , Female , Pregnancy , Adult , Anesthesia/adverse effects , Anesthesia, Obstetrical/adverse effects , Thrombocytopenia/drug therapy , Thrombocytopenia/surgery , Anesthesia, Conduction/instrumentation , Anesthesia, Conduction/methods , Anesthesia, General/instrumentation , Anesthesia, General/methods , Anesthesia, General , Pregnancy Complications, Hematologic/drug therapy , Anesthesia, Conduction/standards , Anesthesia, Conduction/trends , Anesthesia, General/trends , Anesthesia, Conduction , Hematologic Diseases/complications , Hematologic Diseases/drug therapy , Anesthesia, Spinal/methodsABSTRACT
UNLABELLED: Spasmus nutans is a syndrome occurring in infants comprising a symptomatic triad: torticollis, head nodding and nystagmus. Neuropediatric and ophthalmologic investigation are normal. No case of association with non-evolutive encephalopathy has been reported to date. We report on a case of spasmus nutans-associated agenesis of the median vermian cerebellum. OBSERVATION: A 3-month-old female infant was hospitalized for head nodding lasting 1 week and nystagmus of the left eye with no other signs. A lung infection had preceded the clinical signs. The ophthalmologic examination and electroencephalography (EEG) were normal. The cerebral MRI showed an objective partial agenesis of the median vermian cerebellum. The diagnosis of spasmus nutans-associated brain malformation was retained. CONCLUSION: The discovery of non-evolutive encephalopathy was associated with spasmus nutans. A genetic study is required.
Subject(s)
Cerebellar Vermis/abnormalities , Spasms, Infantile/complications , Female , Humans , Infant , Spasms, Infantile/diagnosisABSTRACT
Parents often have misperceptions about childhood fever, and little information is available about the home management of feverish children in Morocco. In this study of the perceptions, knowledge and practices of families regarding children's fever, the parents of 264 febrile children aged 0-16 years were interviewed in a paediatric emergency department in Rabat in 2011. Only 3.5% of parents knew the correct temperature definition for fever, 54.4% determined their children's fever using a thermometer, and the preferred site was rectal. Most of them (96.8%) considered that fever was a very serious condition, which could lead to side-effects such as brain damage (28.9%), seizures (18.8%) paralysis (19.5%), dyspnoea (14.8%) and coma (14.8%). Paracetamol was used by 85.9% and traditional treatments by 45.1%. Knowledge about the correct definition of fever was significantly associated with parents' profession, educational level and receipt of previous information and advice from health professionals.
Subject(s)
Fever/therapy , Health Knowledge, Attitudes, Practice , Parents/psychology , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , MoroccoABSTRACT
The May-Hegglin anomaly is an inherited disorder, so uncommon that the incidence is still unknown. It is characterized by macro-thrombocytopenia with normal platelet function and cytoplasmic inclusion bodies in granulocytes. The case is reported of a 28-year-old primiparous patient who had an urgent caesarean section due to failed induction of labour. The patient had no history of abnormal bleeding. Other causes of thrombocytopenia or platelet dysfunction, such as preeclampsia, HELLP syndrome, or placental abruption, were ruled out. The platelet count prior to surgery was 20,900/mm(3) with normal platelet function. General anaesthesia was performed. No excessive bleeding occurred and a platelet transfusion was not needed.
Subject(s)
Anesthesia, General/methods , Anesthesia, Obstetrical/methods , Hearing Loss, Sensorineural/blood , Pregnancy Complications, Hematologic/etiology , Thrombocytopenia/congenital , Thrombocytopenia/etiology , Adult , Analgesia, Epidural , Analgesia, Obstetrical/methods , Cesarean Section , Contraindications , Emergencies , Female , Humans , Platelet Count , Pregnancy , Thrombocytopenia/bloodABSTRACT
كثرا ما يكون لدى الآباء أفكار خاطئة عن الحمى التي تصيب الأطفال، كما أن المعلومات المتاحة عن التدبير العلاجي المنزلي للطفل المصاب بالحمى قليلة في المغرب. وقد استهدفت هذه الدراسة معرفة مدركات ومعارف وممارسات الأسر حول الحمى التي تصيب الأطفال، فأجرى الباحثون مقابلات مع 264 من آباء الأطفال الذين أصيبوا بالحمى في أعمار تراوحت بين 0 - 16 عاما، وذلك في قسم طوارئ الأطفال في الرباط في عام 2011 . واتضح للباحثين أن 3.5 % فقط من الآباء يعرفون التعريف الصحيح لدرجة الحرارة أثناء الحمى، وأن 54.4 % منهم يتعرفون على إصابة الطفل بالحمى باستخدام مقياس الحرارة، وأن الموضع المفضل لقياس درجة الحرارة هو الشرج، وأن معظم الآباء [96.8 % منهم]يعترون الحمى حالة خطرة قد تقود إلى تأثرات جانبية مثل تخرب الدماغ [28.9 %]، والاختلاجات [18.8 %]، والشلل [19.5 %]، وضيق النفس [14.8 %]، والسبات [14.8 %]. وقد تم استخدام الباراسيتامول في 85.9 % من الحالات، والمعالجات التقليدية في % 45.1 من الحالات. وقد ترابطت المعرفة المتعلقة بالتعريف الصحيح للحمى بمقدار يعتد به إحصائيا مع مهنة الآباء، ومستواهم التعليمي ومع تلقيهم معلومات مسبقة ومنشورات من المهنيين الصحيين
ABSTRACT Parents often have misperceptions about childhood fever, and little information is available about thehome management of feverish children in Morocco. In this study of the perceptions, knowledge and practicesof families regarding children’s fever, the parents of 264 febrile children aged 0–16 years were interviewed in apaediatric emergency department in Rabat in 2011. Only 3.5% of parents knew the correct temperature definitionfor fever, 54.4% determined their children’s fever using a thermometer, and the preferred site was rectal. Most ofthem (96.8%) considered that fever was a very serious condition, which could lead to side-effects such as braindamage (28.9%), seizures (18.8%) paralysis (19.5%), dyspnoea (14.8%) and coma (14.8%). Paracetamol was usedby 85.9% and traditional treatments by 45.1%. Knowledge about the correct definition of fever was significantlyassociated with parents’ profession, educational level and receipt of previous information and advice from healthprofessionals.
RÉSUMÉ Les parents ont souvent des perceptions erronées concernant la fièvre chez l'enfant, et les informationssur la prise en charge des enfants fébriles à domicile sont rares au Maroc. Dans la présente étude sur lesperceptions, les connaissances et les pratiques des familles au sujet de la fièvre chez l'enfant, les parents de 264enfants fébriles âgés de 0 à 16 ans ont été interrogés au sein d'un service d'urgence pédiatrique de la ville deRabat en 2011. Seuls 3,5 % des parents connaissaient la température exacte définissant un état fébrile et 54,4 %déterminaient la fièvre de leur enfant à l'aide d'un thermomètre, de préférence par voie rectale. La plupartd'entre eux (96,8 %) considéraient que la fièvre était une affection très grave qui pouvait conduire à des effetssecondaires tels que des lésions cérébrales (28,9 %), des convulsions (18,8 %), une paralysie (19,5 %), une dyspnée(14,8 %) et un coma (14,8 %). Le paracétamol a été utilisé par 85,9 % des parents et les traitements traditionnelspar 45,1 %. La connaissance de la définition exacte de la fièvre était significativement associée à la profession desparents, à leur niveau d'études et à la prise de conseils et d'informations préalable auprès des professionnels desanté.
Subject(s)
Fever , Knowledge , Disease Management , Parents , Perception , Child , Acetaminophen , Surveys and QuestionnairesABSTRACT
INTRODUCTION: The use of an umbilical venous catheter (UVC) is common practice in neonatal units and is subjected to strict rules of insertion and monitoring to detect potential complications. Hepatic abscess is one of these rare complications. OBSERVATION: We report the observation of a 15-day-old female newborn admitted for a hepatic abscess. The patient had been hospitalized at birth in a neonatal intensive care unit. With the appearance of hemodynamic instability on the 4th day of life, a nosocomial infection was suspected and was treated with ceftazidime, vancomycin and amikacin. Later, as the need for O(2) increased and plasma C-reactive protein (CRP) was 190 mg/L, the patient received imipenem and vancomycin, while an abdominal ultrasound examination showed a hepatic abscess. A triple antibiotic treatment was initiated with imipenem, vancomycin, and metronidazole, while the initial examination showed a clinically stable patient with a CRP at 208 mg/L. Abdominal ultrasounds showed a hepatic abscess measuring 53.4×24.9 mm on day 21 and 51.4 mg/L CRP. Then the abscess dimensions decreased to 35.7×14 mm. The antibiotic therapy was maintained for 4 weeks. CONCLUSION: Hepatic abscess should be suspected in neonates with UVC with sepsis and persistent signs of inflammation in spite of adequate antibiotic treatment.
Subject(s)
Catheter-Related Infections/etiology , Catheterization/adverse effects , Liver Abscess/etiology , Female , Humans , Infant, Newborn , UmbilicusABSTRACT
Objetivo. Evaluar la preocupación por el dolor de los futuros padres frente a otras variables que pueden afectar al bienestar de sus mujeres durante el parto, y estudiar posibles diferencias de opinión entre padres y madres al respecto. Pacientes y métodos. Estudio transversal descriptivo realizado mediante encuesta anónima y voluntaria a padres y madres en el último mes de gestación de estas. Se solicitaba de ambos por separado, que puntuaran de 0 a 10 las variables expuestas en función del grado de preocupación que suponían para ellos, y su importancia para el bienestar durante el proceso del parto (escala 0: no preocupa y/o mínima importancia a 10: máxima preocupación y/o importancia. Los ítem sobre los que se cuestionó fueron: 1) secuelas estéticas, 2) pudor, 3) información continuada, 4) caminar, 5) beber durante la dilatación, 6) compañía, 7) dolor, 8) guardar la compostura, 9) amabilidad y 10) habitabilidad de la sala. Se registraron también edad, paridad, estudios y nacionalidad. Resultados. Se realizaron 147 encuestas, 99 a madres y 48 a padres. El dolor es la variable que más preocupaba a los futuros padres con una media (DE) de 8,1 (2,0), mientras que para las madres tuvo mayor relevancia la información 7,7 (2,5), amabilidad 7,9 (2,1) y compañía 8,2 (2,3) durante el parto, observándose además diferencias significativas entre padres y madres para las variables: dolor (p=0,001); caminar (p=0,003) y beber (p=0,009). Conclusiones. Los resultados del estudio muestran que la preocupación por el dolor de parto es mayor en los futuros padres que en las madres, y que estas se muestran más preocupadas por la información y la compañía que por el dolor que puedan llegar a experimentar. Mejorar los aspectos asistenciales que más preocupan a ambos: información, participación paterna y analgesia debería redundar en una mayor calidad percibida por el usuario (AU)
Objective. To evaluate the concerns of the future father about labor pain and another 9 items which could be important to the well-being of the mother during delivery. To investigate any possible differences in opinion between the future father and mother. Patients and methods. An anonymous and voluntary questionnaire was offered to the father and the pregnant patient during the last month of pregnancy. They had to answer the questionnaire separately, scoring 10 items in a 0-10 point ordinal scale, according to their concerns and the importance for the good development of the delivery (0= not concerned about/insignificant to 10=concerned about/great importance). The items included were: 1) esthetic aftermath, 2) embarassment, 3) continous information, 4) walking during labor, 5) drinking during labor, 6) companionship, 7) labor pain, 8) keeping composure, 9) kindness, 10) room comfortability. Data on age, education, parity and nationality were recorded. Results. A total of 147 questionnaires were completed, 99 by mothers, and 48 by fathers. Pain was the most important concern for the future fathers scoring a mean (SD) of 8.15 (2), while continuous information 7.71 (2.5), kindness 7.9 (2.1), and companionship 8.21 (2.3) were more important than pain for mothers. A statistically significant difference was found between fathers and mothers regarding labor pain (P=.001), walking during labor (P=.003), and drinking during labor (P=.009). Conclusions. The result of our study suggests that increasing the presence of the father during the delivery process, and taking care of the emotional aspects and the quality of the information given could be very important for the perception of satisfaction (AU)
Subject(s)
Humans , Male , Female , Pregnancy , Child , Labor Pain/psychology , Analgesia, Obstetrical/methods , Analgesia, Obstetrical/psychology , Labor, Obstetric , Labor, Obstetric/psychology , Patient Satisfaction , Parents/psychology , Labor Pain/epidemiology , Pain/prevention & control , Pain/psychology , Cross-Sectional Studies/methods , Cross-Sectional Studies , Analgesia, Obstetrical/trends , Analgesia, Epidural/methods , Analgesia, Epidural/psychologyABSTRACT
OBJECTIVE: To evaluate the concerns of the future father about labor pain and another 9 items which could be important to the well-being of the mother during delivery. To investigate any possible differences in opinion between the future father and mother. PATIENTS AND METHODS: An anonymous and voluntary questionnaire was offered to the father and the pregnant patient during the last month of pregnancy. They had to answer the questionnaire separately, scoring 10 items in a 0-10 point ordinal scale, according to their concerns and the importance for the good development of the delivery (0= not concerned about/insignificant to 10=concerned about/great importance). The items included were: 1) esthetic aftermath, 2) embarassment, 3) continous information, 4) walking during labor, 5) drinking during labor, 6) companionship, 7) labor pain, 8) keeping composure, 9) kindness, 10) room comfortability. Data on age, education, parity and nationality were recorded. RESULTS: A total of 147 questionnaires were completed, 99 by mothers, and 48 by fathers. Pain was the most important concern for the future fathers scoring a mean (SD) of 8.15 (2), while continuous information 7.71 (2.5), kindness 7.9 (2.1), and companionship 8.21 (2.3) were more important than pain for mothers. A statistically significant difference was found between fathers and mothers regarding labor pain (P=.001), walking during labor (P=.003), and drinking during labor (P=.009). CONCLUSIONS: The result of our study suggests that increasing the presence of the father during the delivery process, and taking care of the emotional aspects and the quality of the information given could be very important for the perception of satisfaction.
Subject(s)
Anxiety/epidemiology , Fathers/psychology , Labor Pain , Mothers/psychology , Surveys and Questionnaires , Adult , Anxiety/etiology , Cross-Sectional Studies , Female , Humans , Male , PregnancyABSTRACT
Diffuse arterial calcified elastopathy is a very rare and little known hereditary disease, characterized by diffuse calcifications of the arterial wall. It seems common in North Africa and in the Caucasian region. Its incidence appears to be underestimated in Morocco. Clinical pattern is dominated by renovascular hypertension often associated with symptoms of heart failure. Risk of sudden death from myocardial infarction is particularly important. Thus, the diagnosis of diffuse arterial calcified elastopathy must always be suspected in front of an apparently unexplained heart failure or renovascular hypertension occurring in an infant. We report a case of diffuse arterial calcified elastopathy discovered in a neonatal intensive care unit, during management of a cardiogenic shock in a 3-months old infant. This observation demonstrates the importance of systematic measurement of the arterial tension, family screening and the impact of the ultrasound in the detection of vascular calcifications. Treatment remains essentially symptomatic.
Subject(s)
Arterial Occlusive Diseases/genetics , Calcinosis/genetics , Connective Tissue Diseases/genetics , Elastic Tissue , Shock, Cardiogenic/genetics , Arterial Occlusive Diseases/diagnosis , Calcinosis/diagnosis , Cardiomyopathy, Hypertrophic/diagnosis , Cardiomyopathy, Hypertrophic/genetics , Connective Tissue Diseases/diagnosis , Diagnosis, Differential , Echocardiography , Elastic Tissue/pathology , Fatal Outcome , Female , Humans , Hypertension, Renovascular/diagnosis , Hypertension, Renovascular/genetics , Infant , Morocco , Nephrocalcinosis/diagnosis , Nephrocalcinosis/genetics , Shock, Cardiogenic/diagnosis , Ultrasonography, DopplerABSTRACT
INTRODUCTION: The aetiological inquiry in the presence of systemic granulomatosis should consider some uncommon forms of tuberculosis infections. For instance, Poncet's tuberculous rheumatism is a rare entity subject to controversy. CASE REPORT: A 32-year-old man presenting febrile polyarthritis associated with spontaneously vanishing erythematous papular skin rash. The tests revealed a biological inflammatory syndrome and mediastinal lymph nodes. The biopsies showed cutaneous and mediastinal adenoid granulomatosis. The cutaneous lesions resolved spontaneously. The culture of the ganglionic sample was positive. The evolution was favourable under treatment and the articular pain disappeared within a few days. CONCLUSION: Poncet's tuberculous rheumatism may underly evolving visceral tuberculosis. It's presence requires a search for tuberculosis when systemic granulomatosis with cutaneous and articular involvement may simulate sarcoidosis.
Subject(s)
Lymphatic Diseases/microbiology , Mediastinal Diseases/microbiology , Tuberculosis/diagnosis , Adult , Antitubercular Agents/therapeutic use , Arthritis, Reactive/diagnosis , Arthritis, Reactive/drug therapy , Diagnosis, Differential , Granuloma/diagnosis , Humans , Lymphatic Diseases/drug therapy , Male , Mediastinal Diseases/drug therapy , Sarcoidosis/diagnosis , Tuberculosis/drug therapyABSTRACT
Pulmonary actinomycosis is a rare bacteriological disease, characterized by local suppuration and an extensive fibro-inflammatory process, with a possible pseudotumoral outcome. We report on a case in a 15-year-old boy, admitted in our department for prolonged pleuropneumopathy. Clinical and radiological findings were not contributive. The diagnosis of actinomycosis was obtained by pathology after surgical resection. This disease can mimic on lung X-rays a number of disorders, such as pulmonary tuberculoma, invasive tuberculosis or lung carcinoma. Pleuropulmonary actinomycosis is a rare intrathoracic infection during childhood, of which poor outcome and tough diagnosis lead usually to a surgical attitude given a picture of recurrent pulmonary abnormality. When the diagnosis is established, the treatment is medical.
Subject(s)
Actinomycosis , Lung Diseases , Actinomycosis/diagnosis , Actinomycosis/diagnostic imaging , Actinomycosis/drug therapy , Actinomycosis/pathology , Actinomycosis/surgery , Adolescent , Biopsy , Diagnosis, Differential , Follow-Up Studies , Humans , Lung/pathology , Lung Diseases/diagnosis , Lung Diseases/diagnostic imaging , Lung Diseases/drug therapy , Lung Diseases/pathology , Lung Diseases/surgery , Male , Penicillin G/administration & dosage , Penicillin G/therapeutic use , Penicillin V/administration & dosage , Penicillin V/therapeutic use , Radiography, Thoracic , Thoracotomy , Time Factors , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
UNLABELLED: Oesophageal duplication is a rare form of digestive duplication. This congenital malformation can be asymptomatic or manifest itself through respiratory signs due to airway compression. We report 2 cases of oesophageal duplication discovered in the neonatal period. CASE REPORT: In both cases, symptoms were dominated by respiratory distress and vomiting. Diagnosis was confirmed by oesophageal contrast X-rays, which revealed a total tubular form in the 1st case and a cystic form in the 2nd case. CONCLUSION: Oesophageal duplication is a rare abnormality of benign nature, which can be revealed in neonatal period by a noisy compression picture. Diagnosis of this anomaly should trigger a search for other digestive duplications, as well as associated malformations, in particular vertebral.
Subject(s)
Esophagus/abnormalities , Esophagus/diagnostic imaging , Female , Follow-Up Studies , Gastrointestinal Transit , Humans , Infant , Infant, Newborn , Male , Radiography, Thoracic , Respiratory Distress Syndrome, Newborn/etiology , Time Factors , Vomiting/etiologyABSTRACT
OBJECTIVES: To analyse the radioclinical forms of pulmonary hydatid cyst in children, and to evaluate the results of surgical treatment. PATIENTS AND METHODS: During a period of 4 years (2002-2005), 26 surgical procedures were performed for pulmonary hydatid cyst in 23 children (16 boys and 7 girls, mean age 13, 5 years). Symptoms were chest pain (87%), broncho-pulmonary infection (32%) and hemoptysis (22%). Chest x-ray showed a non-complicated cyst in 62% of cases. The CT scan was performed in 15 cases (65%), mainly for complicated forms. Abdominal echography for all patients showed 3 hepatic localisations of hydatid cyst. All the patients underwent surgical treatment by thoracotomy. RESULTS: In a total of 34 cysts, 21 were uncomplicated, 13 complicated (intra-bronchial rupture: 11 cases, pleural rupture: 2 cases). Cystectomy or pericystectomy were performed in 91% of cases, segmentectomy in 6% and a lobectomy in 3%. Decortication was done in the 2 pleural-ruptured cases. There was no mortality. One lower left lobe atelectasis was observed post-operatively. CONCLUSION: Conservative surgical techniques for pulmonary hydatid cysts in children are preferred to parenchyma resection. In our practice the treatment of bilateral hydatidosis in 2 times decreases the complication rate.
Subject(s)
Echinococcosis, Pulmonary/surgery , Adolescent , Age Factors , Child , Echinococcosis, Pulmonary/diagnosis , Echinococcosis, Pulmonary/diagnostic imaging , Female , Humans , Male , Postoperative Complications , Radiography, Thoracic , Sex Factors , Thoracotomy , Tomography, X-Ray Computed , Treatment Outcome , UltrasonographyABSTRACT
OBJECTIVES: To determine the efficacy of 200 microg single dose oral misoprostol as a cervical priming agent at term. METHODS: In this double-blind randomized trial, 156 pregnant women requiring induction of labor with gestational age of 37-42 weeks and Bishop score < or =5, were randomized to receive either 200 microg of misoprostol or a placebo, orally. Labor was induced with intravenous oxytocin infusion 12 h after oral medication if the patient did not go into labor. The primary outcome was the change in the Bishop score 12 h after oral medication. The secondary outcomes were the timings starting from the drug administration to the onset of uterine activity, interval between oral medication and delivery, oxytocin need for induction, mode of delivery, frequency of side effects, and neonatal and maternal outcome. The chi-square or Fisher exact test, Student's t-test, and Mann-Whitney U-test were used for analysis of the data. RESULTS: There were no significant differences in maternal characteristics or indications of induction. The Bishop score 12 h after oral medication significantly improved in the misoprostol group compared with the control group [55 (70%)>8 vs. 4 (5%)>8; P<0.001]. The induction rate was significantly reduced in the misoprostol group (P<0.001). The interval between oral medication and the onset of uterine activity was significantly shorter in the misoprostol group (P<0.001). The interval between oral medication and delivery was also significantly shorter in the misoprostol group (P<0.001). The cesarean delivery rate was significantly lower in the misoprostol group (P<0.001). There were no differences between the groups with respect to the incidence of tachysystole, hyperstimulation, adverse neonatal or maternal outcome. CONCLUSIONS: Oral administration of 200 microg single dose of misoprostol is an effective agent not only for cervical priming but also for induction of labor at term. Furthermore, it reduces the rate of cesarean deliveries.
Subject(s)
Cervical Ripening/drug effects , Misoprostol/therapeutic use , Administration, Oral , Adult , Analysis of Variance , Double-Blind Method , Drug Therapy, Combination , Female , Humans , Infusions, Intravenous , Labor, Induced/methods , Oxytocin/administration & dosage , Pregnancy , Pregnancy Outcome , Pregnancy Trimester, Third , Reference Values , Statistics, Nonparametric , Treatment OutcomeABSTRACT
An iron superoxide dismutase (FeSOD) gene of the protozoan parasite Trypanosoma brucei has been cloned and its gene product functionally characterized. The gene encodes a protein of 198 residues which shows 80% identity with FeSODs from other trypanosomatids. Inhibitor studies with purified recombinant FeSOD expressed in Escherichia coli confirmed that the enzyme is an iron-containing SOD. The FeSOD is developmentally regulated in the parasite, expression being lowest in the cell-cycle-arrested, short stumpy bloodstream forms. Differential expression of the FeSOD protein contrasts with only minor quantitative changes in the FeSOD mRNA, indicating post-transcriptional regulation of the enzyme. As the level of FeSOD increases during differentiation of cell-cycle-arrested short stumpy into dividing procyclic forms, it is suggested that the enzyme is only required in proliferating stages of the parasite for the elimination of superoxide radicals which are released during the generation of the iron-tyrosyl free-radical centre in the small subunit of ribonucleotide reductase.
Subject(s)
Superoxide Dismutase/chemistry , Superoxide Dismutase/genetics , Trypanosoma brucei brucei/enzymology , Animals , Cell Differentiation , Cloning, Molecular , Escherichia coli/metabolism , Gene Expression Regulation, Developmental , Immunoblotting , RNA, Messenger/metabolism , Recombinant Proteins/metabolism , Reverse Transcriptase Polymerase Chain Reaction , Ribonucleotide Reductases/chemistry , Sequence Analysis, DNA , Superoxide Dismutase/biosynthesis , Time Factors , Transcription, GeneticABSTRACT
In Trypanosoma brucei, uptake of host transferrin is mediated by a heterodimeric, glycosylphosphatidylinositol-anchored receptor derived from the 2 expression site-associated genes 6 and 7 (ESAG6 and ESAG7). By using specific antibodies, it is shown here that T. evansi, a trypanosome species transmitted mechanically by biting flies, also expresses a transferrin receptor composed of ESAG6 and ESAG7. The cellular uptake of transferrin in T. evansi is completely inhibited with anti-T. brucei (ESAG6/7 heterodimer) antibodies. The demonstration of a functional ESAG6/7 transferrin receptor in T. evansi supports further its close relationship to T. brucei.
