Second-trimester miscarriage: a review of postnatal investigations and subsequent pregnancy outcomes.

BACKGROUND: Second-trimester loss is pregnancy loss after the 12th and before the 24th completed weeks of pregnancy. This study aims to review cases of second-trimester miscarriage who attended a large maternity hospital and to examine pregnancy outcomes in this group of women. METHODS: This study is a review of cases of second-trimester miscarriage using descriptive, exploratory design, involving a retrospective chart review. RESULTS: In this study, 106 cases of second-trimester miscarriage were reviewed. The cause of the miscarriage was found in 42.5% (n = 45) of cases. The majority of women, 84.5% (n = 82) had a normal pelvic ultrasound scan and 18.3% (n = 17) of cases were diagnosed with antiphospholipid syndrome. In women who became pregnant again, 60.9% (n = 39) had a live birth. CONCLUSIONS: Establishing the cause of second-trimester miscarriage can be challenging, despite completing all recommended investigations. Outcomes in subsequent pregnancies are reassuring. This review highlights the need to undertake all recommended investigations to elicit the cause of second-trimester miscarriage and underpins the need for further research in this area.

High prevalence of extrarenal artery involvement in children with fibromuscular dysplasia - a single-center experience.

BACKGROUND: Although the clinical presentation of fibromuscular dysplasia (FMD) and its generalized character has been previously described in adults, data on FMD in children are limited. METHOD: In this study, we aimed to assess visceral artery involvement in pediatric FMD patients with documented renal artery stenosis (RAS) and renovascular hypertension (RVH) in comparison with healthy individuals. We retrospectively analyzed the results of angiographic studies of 16 patients with a median age of 13.9 years (10 girls) in comparison with 16 age- and sex-matched healthy controls. RESULTS: Out of the 16 FMD patients, 10 (63%) had stenotic lesions identifiable only in renal arteries, whereas six (37%) had additional stenoses in other vascular beds - in the celiac trunk (four patients), superior mesenteric artery (four patients), inferior mesenteric artery (one patient), splenic artery (one patient), common hepatic artery (three patients), and abdominal aorta (one patient). The comparison of ostial diameters of vessels, in which no periostial narrowing, stents, or occlusions were found, revealed that patients with FMD had a significantly smaller diameter of the celiac trunk (P = 0.017), splenic arteries (P = 0.007), and common hepatic artery (P = 0.026) than their age- and sex-matched healthy peers. CONCLUSION: We found that 69% of children with RVH caused by FMD had clinically silent stenoses or tortuosity of visceral arteries. The results of our study suggest that pediatric FMD is a generalized arterial condition, and the patients may need screening for both renal as well as nonrenal manifestations of the disease.

Ca:Mg:Zn:CO3 and Ca:Mg:CO3-tri- and bi-elemental carbonate microparticles for novel injectable self-gelling hydrogel-microparticle composites for tissue regeneration.

Injectable composites for tissue regeneration can be developed by dispersion of inorganic microparticles and cells in a hydrogel phase. In this study, multifunctional carbonate microparticles containing different amounts of calcium, magnesium and zinc were mixed with solutions of gellan gum (GG), an anionic polysaccharide, to form injectable hydrogel-microparticle composites, containing Zn, Ca and Mg. Zn and Ca were incorporated into microparticle preparations to a greater extent than Mg. Microparticle groups were heterogeneous and contained microparticles of differing shape and elemental composition. Zn-rich microparticles were 'star shaped' and appeared to consist of small crystallites, while Zn-poor, Ca- and Mg-rich microparticles were irregular in shape and appeared to contain lager crystallites. Zn-free microparticle groups exhibited the best cytocompatibility and, unexpectedly, Zn-free composites showed the highest antibacterial activity towards methicilin-resistant Staphylococcus aureus. Composites containing Zn-free microparticles were cytocompatible and therefore appear most suitable for applications as an injectable biomaterial. This study proves the principle of creating bi- and tri-elemental microparticles to induce the gelation of GG to create injectable hydrogel-microparticle composites.

Radionuclidic purity tests in (18)F radiopharmaceutIcals production process.

Radionuclidic purity tests of (18)F radiopharmaceuticals (Na(18)F and fluorodeoxyglucose [(18)F]FDG) and radionuclide composition analysis of irradiated water [(18)O]H2O were performed. The measurements were conducted using a High-Purity Germanium (HPGe) detector and a liquid scintillation counter. Radionuclide identification and activity measurements were performed for samples from different stages of the production process. Most of the impurities were detected on QMA (quaternary methylammonium) anion exchange columns and in liquid wastes. Using liquid scintillation counting, the activity of (3)H resulting from the (18)O[p, (3)H](16)O reaction was determined. It was shown that all of the impurities were efficiently determined and eliminated in the radiopharmaceuticals synthesis process and that the final products meet the requirements set by relevant regulations.

[Influence of smoking on pregnency course and fetal development]. / Wplyw palenia tytoniu na przebieg ciazy i rozwój plodu.

Smoking is a significant factor which affects not only reproduction and the process of pregnancy but also the offspring. Endangering for tobacco smoke and nicotine either passive or active has an important influence for shortening the time of pregnancy, the weight of the newborn and the Placenta. The occurrence of complications connected with smoking is probably correlated with the amount of cigarettes smoked per day. The aim of the paper was to analyse the influence of passive and active smoking on the course of pregnancy. The study involved a group of 113 women who gave birth in Gynaecological and Obstetrics Clinical Hospital of the Karol's Marcinkowski University of Medical Sciences in Poznan during the period from January to June 2011. Based on data gained from documentation and mothers three groups were separated: 22 women who were active smokers, 32 passive smokers and 59 women from control group who have never been smoking. There were analyzed selected obstetric data and term of pregnancy, condition and weight of newborn, blood pH and alkaline balance from umbilical vessels. In research there were no correlation between groups and/or results of researches of blood Ph, alkaline balance from umbilical vessels and the assessment of the newborn in Apgar score at 1, 3, 5 minute. In fact passive smoking women were younger (the average 27.84) than actively smoking woman (30.23) and non-smokers (30.25) (p = 0.03). The most of small as for their gestational age infants were in the group of active smoking women (14%). Non-smokers more often did have a miscarriage (84%) in the past than other groups (active smokers 60%, passive 33%) (p = 0.04). Smoking women usually come from countryside or small towns, they were not marriage and they had preterm delivery. In this group there was found the biggest percent of too small newborns for their gestational age--14%.

[Influence of smoking on pregnancy]. / Wplyw palenia tytoniu na przebieg i rozwój ciazy.

UNLABELLED: Smoking is a significant factor which affects not only reproduction and the process of pregnancy but also the offspring. Endangering for tobacco smoke and nicotine either passive or active has an important influence for shortening the time of pregnancy, the weight of the newborn and the Placenta. The occurrence of complications connected with smoking is probably correlated with the amount of cigarettes smoked per day. TARGET: The target of the paper was to analyse the influence of passive and active smoking on the course of pregnancy. METHODS AND MATERIALS: The study involved a group of 113 women who gave birth in Gynaecological and Obstetrics Clinical Hospital of the Karol's Marcinkowski University of Medical Sciences in Poznan during the period from January to June 2011. Based on data gained from documentation and mothers three groups were separated: 22 women who were active smokers, 32 passive smokers and 59 women from control group who have never been smoking. There were analyzed selected obstetric data and term of pregnancy, condition and weight of newborn, blood pH and alkaline balance from umbilical vessels. RESULTS: in research there were no correlation between groups and/ or results of researches of blood Ph, alkaline balance from umbilical vessels and the assessment of the newborn in Apgar score at 1, 3, 5 minute. In fact passive smoking women were younger (the average 27,84) than actively smoking woman (30,23) and non-smokers (30,25) (p=0,03). The most of small as for their gestational age infants were in the group of active smoking women (14%). Non-smokers more often did have a miscarriage (84%) in the past than other groups (active smokers 60%, passive 33%) (p=0,04). CONCLUSION: smoking women usually come from countryside or small towns, they were not marriage and they had preterm delivery. In this group there was found the biggest percent of too small newborns for their gestational age - 14%.

[Coexistence of congenital heart diseases with other congenital defects]. / Wspólistnienie Wrodzonych Wad Ukladukrazenia Z Innymi Wadami Rozwojowymi.

AIM: Evaluating the prevalence and type of non-heart malformations in patients hospitalised in the Department of Pediatric Cardiology of the Children's Memorial Health Institute due to congenital pathology of the circulatory system; comparing the frequency of other congenital malformation in the group researched in relation to the population overall and evaluating their relevance to survival. MATERIAL AND METHODS: Research included 266 infants with heart defects. The patients' data were analysed in retrospect on the basis of medical records, taking into account the kind of heart defect, defects of other systems, and mortality in the first year of life. The frequency of non-heart congenital defects were compared with data from the Polish Registry of Congenital Malformations. RESULTS: In 71 children among 266 patients congenital defects of other systems were diagnosed. The group researched presented a significantly greater occurrence of such defects than the population overall (26.7% vs 1.81%). The most frequent diagnoses were: 1. chromosomal abnormalities (N=26; 9.77%), 2. malformations of the digestive system (N=7; 3.01%), 3. syndromes of multiple congenital defects (N=6 ; 2.26%). The defects usually coexisted with the atrio-ventricular septal defect (18 out of 22 patients - 81.8%) and rarely in neonates with duct-dependent defects (19 out of 122 patients - 15.6%). 32 children died, of whom 10 had congenital non-heart malformation in addition to congenital heart defects. No significant difference in the frequency of death was found in children who presented only with heart pathology in comparison to those with other defects (11.2% vs 14%). CONCLUSIONS: In patients with congenital heart defects other congenital malformations occurred more often than in all the population, especially chromosomal abnormalities, malformations of the digestive system and congenital malformation syndromes. Congenital malformations were not connected with higher mortality of children with heart defects.