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Objective: This research was designed to assess the influence of the administration of a lithogenic diet, hydrogen peroxide, and vitamin AD3E on rabbits' gallstone formation and to envisage the expression of osteopontin (OPN) in their hepatic tissues. Materials and Methods: Twenty-four healthy local mature rabbits of both genders were divided into four equal groups. At the end of the feeding period, samples of blood were taken from all rabbits after they had fasted overnight to estimate the serum lipid profile. And some of the hepatic tissue has been preserved at -28°C for molecular analysis and gene expression. Results: The gallstones were formed 100% in the GIII and 50% in the GIV. The mRNA OPN expression showed a significant increase in the GIII when compared with other groups. In Groups III and II, the serum levels of total cholesterol, Triglyceride, L-C, low-density lipoprotein-choles, and VLDL-C were significantly increased when compared with GI, while in GIII, the serum level of high-density lipoprotein-cholesterol was significantly decreased when compared with GI. Conclusion: It was concluded that the expression of the mRNA OPN was increased in the hepatic tissue of gallstone-formed rabbits.
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ImportanceThe SARS-CoV-2 alpha variant posed increased risk for COVID-19 complications in pregnant women. However, its impact on the maternal humoral response and placental IgG transport remains unclear. ObjectiveTo characterize the maternal humoral waning and neonate immunity acquired during the 3rd COVID-19 wave in Israel, dominated by the Alpha variant, as compared to earlier Wildtype infections and humoral response to vaccination across gestation. DesignMaternal and fetal blood serum were collected at delivery since April 2020 from parturients. Sera IgG and IgM titers were measured using the Milliplex MAP SARS-CoV-2 Antigen Panel supplemented with additional HA-coupled microspheres. SettingA nationwide multicenter cohort study on SARS-CoV-2 infections and vaccination during pregnancy. ParticipantsExpectant women presenting for delivery were recruited at 8 medical centers across Israel and assigned to 3 primary groups: SARS-CoV-2 positive (n = 157) and fully vaccinated during pregnancy (n = 125), and unvaccinated noninfected controls matched to the infected group by BMI, maternal age, comorbidities and gestational age (n = 212). Eligibility criteria included pregnant women without active COVID-19 disease, age [≥]18 years and willingness to provide informed consent. Main Outcome(s) and Measure(s)Pregnant womens humoral response is dependent on the SARS-CoV-2 strain. ResultsThe humoral response to infection as detected at birth, showed a gradual and significant decline as the interval between infection/vaccination and delivery increased. Significantly faster decay of antibody titers was found for infections occurring during the 3rd wave compared to earlier infections/vaccination. Cord blood IgG antigens levels correlated with maternal IgG. However, cord IgG-HA variance significantly differed in SARS-CoV2 infections as compared to the other groups. No sexual dimorphism in IgG transfer was observed. Lastly, high fetal IgM response to SARS-CoV-2 was detected in 17 neonates, all showing elevated IgM to N suggesting exposure to SARS-Cov-2 antigens. Conclusions and RelevanceInfections occurring during the 3rd wave induced a faster decline in humoral response when compared to Wildtype infections or mRNA BNT162b2 vaccination during pregnancy, consistent with a shift in disease etiology and severity induced by the Alpha variant. Vaccination policies in previously infected pregnant women should consider the timing of exposure along pregnancy as well as the risk of infection to specific variants of concern. Key PointsO_ST_ABSQuestionC_ST_ABSWhat is the difference in the maternal-fetal humoral response between Alpha variant and SARS-CoV-2 Wildtype infections? FindingsIn this nationwide multicenter study including 494 pregnant women, the maternal humoral response to Alpha variant infection was weaker and shorter when compared to Wildtype infections. Placental transport compensated for the maternal waning of immunity. Fetal sex did not affect humoral response. MeaningVaccination policies should be adjusted to account for the timing of infection and the SARS-CoV-2 variant.
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BACKGROUND: Management of placenta percreta invading the urinary bladder usually requires radical surgery, which may include partial or total resection of the bladder. CASE: A multigravida presented with placenta previa percreta invading the urinary bladder. Preoperatively, prophylactic occlusive balloon catheters were placed in the internal iliac arteries and were inflated after cesarean delivery of a healthy newborn. Subtotal hysterectomy with removal of a large part of the placental volume was then performed. Part of the placenta that was adherent to the bladder was left in situ. This way we were able to avoid severe blood loss and preserve the bladder intact. The woman was discharged healthy, on day 9 postoperatively. CONCLUSION: We suggest an alternative approach for managing placenta percreta invading the bladder, which may reduce blood loss and preserve an intact bladder.
