Frequent Contractions Research Articles

Dynamic changes and influential factors of blowouts in a desert artificial ecosystem at the southeastern margin of Tengger Desert in China.

The wind-blown sand protection system in the Shapotou section of the Baotou-Lanzhou Railway is a representative artificial ecosystem in a desert region. Over the past 70 years, this system has transformed mobile dunes into fixed dunes through vegetation succession, relying solely on natural rainfall without additional irrigation. However, ecosystem sustainability has been endangered by the emergence of numerous blowouts. Therefore, understanding the status and developmental trends of these blowouts is crucial for maintaining the system and ensuring railway safety. In this study, we quantitatively analyzed the number, spatial pattern, and evolution process of blowouts using a landscape pattern index and Spatial-Temporal Analysis of Moving Polygons (STAMP) model with remote sensing images from 2009 to 2022. Currently, blowout areas account for 1.57% of the total area with a clustered distribution. The number of blowouts increased significantly from 308 to 463 between 2009 and 2022 and increased with increasing distance from the railway line. Various evolutionary events have occurred among the blowouts, with peak frequencies in the generation and disappearance events observed by 2022. The average growth rate of blowouts was 7.32% in areas with less than 40 years of sand fixation but less than 1% in areas with more than 40 years, and mid-sized blowouts predominated the overall protection system. There was little difference between the blowout wind-erosion area and the fixed area in the natural environment. However, human activities can accelerate the evolution of blowouts, leading to more frequent contraction and expansion events and significantly increasing the area of wind erosion.

Patient with Herlyn–Werner–Wunderlich syndrome and endometriosis achieves successful full-term pregnancy (40 weeks and 6 days): a case report

IntroductionHerlyn–Werner–Wunderlich syndrome , a rare Müllerian ducts congenital disease, is characterized by a diphtheritic uterus, blind hemivagina, and ipsilateral renal agenesis. Diagnosis is at young age by ultrasound and magnetic resonance imaging, and the prognosis is good. Usually, complications evolve endometriosis and secondary pelvic inflammation.Case reportA 40-year-old female patient, Brazilian, white, primigravida, diagnosed at 30 years with a didelphic uterus on ultrasound, and 4 years later, with a left ovarian endometrioma, multiple ovarian cysts, and left renal agenesis on magnetic resonance imaging. Subsequently, due to dyspareunia and a feeling of swelling, the patient underwent transvaginal ultrasound with bowel preparation, and a hematocolpos was found and Herlyn–Werner–Wunderlich syndrome was suspected; 10 years after the diagnosis she had a planned pregnancy. She presented frequent contractions following the 15th week of pregnancy and fortunately there were no complications or premature labor. Labor was inducted at 40 weeks and 6 days without progress and a cesarean section was indicated and performed without complications. Herlyn–Werner–Wunderlich syndrome often goes unnoticed, leading to inadequate treatment. Individuals with Herlyn–Werner–Wunderlich syndrome commonly face fertility issues, such as high miscarriage rate (21–33%), and obstetric complications, such as spontaneous abortions (40% risk), intrauterine growth restriction, postpartum hemorrhage, increased fetal mortality, preterm delivery (21–29%), and elevated rates of cesarean sections. In addition, there is higher susceptibility of developing endometriosis, especially with hemivaginal obstruction, and pelvic adhesions.ConclusionEarly diagnosis enables timely treatment and, consequently, fewer complications. Still, when these factors are absent, vaginal birth may still be possible. The true prevalence and incidence of complications related to Herlyn–Werner–Wunderlich syndrome are still unknown.

Analysis of Factors Contributing to Antenatal Corticosteroid Administration in Patients Presenting with Threatened Preterm Labor.

This study aimed to analyze characteristics of those seen for threatened preterm labor (tPTL) who receive antenatal corticosteroids (ACS) to better understand clinical decision-making. This retrospective cohort study consisted of patients seen in triage at an urban county hospital in 2021 for tPTL during pregnancy. Demographic variables (maternal age, race/ethnicity, and prior preterm delivery) and obstetrical variables (cervical dilation, effacement, membrane rupture, and tocolytic administration) were evaluated against the primary outcome of ACS administration. After exclusions, a cohort of 290 pregnant people with 372 unique encounters for tPTL remained. The mean maternal age was 26.7, and 15.6% of patients had a history of prior preterm birth. A total of 107 patients in 111 encounters received ACS, which were associated with lower body mass index (BMI), greater cervical dilation, greater effacement, membrane rupture, and more frequent contractions (all ps < 0.01). The mean presentation was at 33.5 weeks. Only 44% of those receiving ACS delivered within 7 days, compared with 11% of those who did not receive ACS (p < 0.001). Half (50%) of the patients receiving ACS delivered at >37 weeks. Adjusting for significant factors in the univariable analysis and limited to first encounter in triage, BMI (odds ratio: 0.91, 95% confidence interval: 0.87-0.95), cervical dilation ≥ 2 cm (2.49, 1.12-5.35), and cervical effacement ≥ 50% (4.80, 2.25-10.24) were significantly associated with patients receiving ACS. Greater cervical dilation and effacement and a lower BMI were associated with ACS administration, although most patients receiving ACS still did not deliver within 7 days. · In a cohort of 290 patients with 373 encounters for threatened preterm labor, 37% received ACS.. · We found that only 40% of those who received ACS delivered within 7 days and half went on to deliver at term.. · Cervical dilation ≥2 cm (odds ratio, 95% confidence interval: 2.49, 1.12-5.35) and effacement ≥50% (4.80, 2.25-10.24) were independently associated with receiving ACS..

Analysis of Factors Contributing to Antenatal Corticosteroid Administration in Threatened Preterm Labor [ID: 1375840

INTRODUCTION: Antenatal corticosteroids (ACS) are recommended for pregnant persons at risk for imminent preterm delivery within 7 days. Many diagnosed with threatened preterm labor (tPTL) are given ACS but do not deliver until term. The objective of this study was to analyze characteristics of those seen for tPTL who receive ACS to better understand clinical decision-making. METHODS: This retrospective cohort study consisted of patients seen in triage at an urban hospital caring for underserved patients in 2021 for tPTL during pregnancy. Demographic variables (maternal age, race and ethnicity, prior preterm delivery) and obstetric variables (cervical dilation, effacement, membrane rupture, tocolytic administration) were evaluated against the primary outcome of ACS administration. RESULTS: Two hundred ninety pregnant people with 372 unique encounters for tPTL were identified. The mean gestational age at presentation was 33.5 weeks. 107 patients in 111 encounters received ACS, which was associated with lower body mass index (BMI), greater cervical dilation and effacement, membrane rupture, and more frequent contractions (all P&lt;.01). Logistic regression, limited to first encounter in triage, found that BMI (odds ratio 0.91, 95% CI 0.87–0.95), cervical dilation 2 cm or greater (2.49, 1.12–5.35), and cervical effacement 50% or higher (4.80, 2.25–10.24) were significantly associated with patients receiving ACS. Forty-four percent of those receiving ACS delivered within 7 days, compared to 11% of those who did not receive ACS (P&lt;.001). CONCLUSION: Greater cervical dilation and effacement and a lower BMI were associated with ACS administration, although most patients receiving ACS did not deliver within 7 days. These findings will contribute to developing a clinical decision model for administering ACS.

Analysis of Factors Contributing to Antenatal Corticosteroid Administration in Threatened Preterm Labor

Introduction: Antenatal corticosteroids (ACS) are recommended for pregnant persons who are between 24 and 36+6/7 weeks’ gestational age (GA) and at risk for imminent delivery within 7 days. Many individuals diagnosed as having threatened preterm labor (tPTL) are given ACS but do not deliver until they reach term. This study aimed to describe characteristics of those seen for tPTL who receive ACS to better understand clinical decision-making. Methods: This retrospective cohort study consisted of mothers seen in triage at Eskenazi Hospital in 2021 for tPTL during pregnancy. Multiple demographic variables were evaluated against the primary outcome of ACS administration including maternal age, race/ethnicity, and prior preterm delivery, as well as obstetrical variables such as cervical dilation, effacement, membrane rupture, and tocolytic administration. Results: After exclusions, a cohort of 290 pregnant people with 372 unique encounters remained. The average maternal age was 26.7, and 15.6% of patients had a history of prior preterm birth. 107 patients in 111 encounters received ACS, which were associated with lower BMI, greater cervical dilation, greater effacement, membrane rupture, and more frequent contractions (all p&lt;0.01). The mean GA at triage was 33.5 weeks. Logistic regression, adjusting for significant factors in the univariable analysis, found that BMI (OR 0.93, 0.89-0.97), cervical dilation (OR 1.34, 1.07-1.71), and cervical effacement (OR 1.02, 1.01-1.03) were significantly associated with giving ACS. 44% of those receiving ACS delivered within 7 days, compared to 11% of those who did not receive ACS (p&lt;0.001). Conclusion: Greater cervical dilation and effacement and a lower BMI were associated with ACS administration, though most patients receiving ACS still did not deliver within 7 days. These findings will be further categorized and used to develop a clinical decisional model for administering ACS in those likely to imminently deliver preterm.

Hemimasticatory spasm: possibilities of treatment with injections of botulinum neuroprotein type A (case report)

Objective: to study the possibilities and effectiveness of treatment of patients with hemimasticatory spasm (HMS) with injections of botulinum neuroprotein type A (BNPA). The authors present a clinical case of long-term HMS: a 50-year-old patient, who suffered from the age of 20 from frequent involuntary muscle contractions that occurred in the temporal and masticatory muscles of the left half of the face. The patient was observed by neurologists for a long time, while the prescribed therapy did not have a satisfactory result. In the process of a comprehensive examination of the patient, in addition to intense involuntary contraction and pronounced hypertrophy of the affected muscles, secondary compensatory changes in other masticatory muscles were revealed, both on the side of the lesion and on the opposite side. BNPA treatment led to a robust improvement in the patient's condition.For patients with a long course of HMS and hypertrophy of the muscles involved in the pathological process, the use of bilateral injections of BNPA is the method of choice, since it not only effectively reduces the number of episodes, but also restores muscle balance, and also restores the motor function of the entire masticatory muscle group.

Combining stereotactic radiotherapy with anti-PD-1 for advanced hepatocellular carcinoma patients with portal vein tumor thrombus.

e16121 Background: Immunotherapy has attracted extensive attention in advanced hepatocellular carcinoma. For unselected patients, the efficacy of PD-1 monotherapy is less than 20%. The addition of radiotherapy to local lesions can significantly enhance the effectiveness of PD-1. However, the efficiency of SBRT combined with PD-1 in the treatment for portal vein tumor thrombus in patients with hepatocellular carcinoma remains unclear. Methods: This phase II study enrolled 17 patients with advanced liver cancer with portal vein tumor thrombus after 1-line or multi-line treatment in our single center, between June 2018 and June 2021. SBRT was delivered to the carcinoma thrombus with or without primary intrahepatic tumor，with a median total dose of 60Gy/10fx (range of 50Gỹ70Gy). Camrelizumab was administered within 2 weeks after SBRT, in cycles of every 3 weeks, until disease progression or patient intolerance. The primary endpoints were overall survival (OS), progression-free survival (PFS) and overall response rate (ORR). Results: At 3 months after SBRT, 6 patients had complete responses (35.3%) and 11 patients had partial responses (64.7%), with an ORR of 100%. The 1-year OS rate was 100%, and 1-year PFS was 84.8%. None of the patients had radiation response. Four patients (23.5%) were unable to tolerate immunotherapy, with one patient stopping after 12 cycles due to frequent preventricular phase contraction (in a double couplet rhythm) and 3 owing to upper gastrointestinal bleeding. Conclusions: SBRT combined with immunotherapy can improve local control and bring survival benefit, suggesting that SBRT could be considered in patients with portal vein tumor thrombus in hepatocellular carcinoma after 1-line or multi-line treatment. Moreover, the adverse reactions were mild. Clinical trial information: ChiCTR1900026188.

Abstract WP222: Outcome Of ESUS With Possible Embolic Sources.

Background and Purpose: Our aim is to investigate the factors of outcome in ESUS with possible embolic source (PES) caused by non-high risk cardiac sources, malignancy, and mild atherosclerosis. Methods: Patients were selected from a comprehensive stroke center between April 2013 and April 2021. Inclusion criteria were: 1) consecutive ischemic stroke patients who fulfilled ESUS criteria based on NAVIGATE-ESUS trial, 2) who underwent TEE 3) who admitted our hospital within 7 days from stroke onset 4) pre stroke modified Rankin scale (mRS) score below 1 and 5) available mRS score at 3 months from stroke onset. PES included atrial cardiopathy (large left atrium diameter, slow out flow in left atrium appendage, and frequent premature atrium contraction), left ventricular dysfunction (history of heart failure, abnormal ventricular wall motion, and reduced ejection fraction), cardiac valve disease, right-to-left shunt, malignancy, and atherosclerosis (ipsilateral carotid plaque and aortic complicated lesion). We compared PES, between mRS score 0-1 (favorable outcome group) and mRS score 2-6 (unfavorable outcome group). Results: We screened 1,824 consecutive ischemic stroke patients, including 191 in ESUS patients. 159 (83%) patients were ESUS with PES. Of all, 33 patients had unfavorable outcomes (25 [76%] male, median age 64 years old, Figure A). Higher National Institute of Health Stroke Scale score on admission (OR 4.50, 95%CI 1.96-10.30, p &lt;0.001) and higher frequency of atherosclerosis (OR 2.67, 95%CI 1.11-6.44, p =0.028) were independently associated with unfavorable outcome (Figure B). Conclusions: Atherothrombotic emboli may contribute to outcome of ESUS with PES.

Tocodynamometry in canine uterine inertia

Early detection of uterine inertia is very crucial for the life of the foetus as well as that of the dam. Suitable methods for early detection of uterine inertia are lacking in canines compared to humans.Non-invasivetocodynamometry is a promising method, which is widely used in humans for the management of uterine inertia.In the present study non-invasive uterine contraction monitoring using the tocodynamometry was performed in dogs with Complete Primary Uterine Inertia (CPUI) and Partial Primary Uterine Inertia (PPUI), as well as in control animals with the Foetal Cause of Dystocia (FCD).In all the dogs belonging to CPUI and PPUI, the contractions were mild and infrequent with force near to the baseline, i.e., less than 15 mm of Hg. There were no reflex contractions in response to the feathering of the vaginal wall in a majority of dogs belonging to these two groups. In the FCD group, there were strong and frequent contractions lasting for two to three minutes with contraction force above 15mm of Hg, reaching up to 30-40 mm of Hg. Those dogs with less than 15 mm of Hg pressure and feeble or infrequent contractions without delivery for more than 30 min, could be considered as uterine inertia and suitable therapeutic options could be considered judiciously. Tocodynamometry was found to be an effective tool for the early detection of uterine inertia,whichhelped arriving at a quick judicious decision which is pertinent for better foetal and maternal survival.

Porro surgery for uterine rupture during childbirth

A woman in labor was taken to the hospital, whose labor pains began the day before in the morning, and by the evening of the same day, the water broke. She gave birth 5 times, and each delivery ended in an operative way - forceps, rotation, extraction and embryotomy. According to the patient, the fetal movement appeared about 3 months ago, and does not remember when the last menstruation was. Very strong and frequent contractions suddenly stopped shortly before admission to the hospital.

Case 3: Emesis in a Term Infant with Dysmorphic Features.

A female infant is born at 38 weeks’ estimated gestational age to a 23-year-old, gravida 2, para 2 woman. Maternal history is significant for poorly controlled chronic hypertension and limited prenatal care. The woman reports she was returning home from vacation when she experienced painful, frequent contractions, prompting presentation to the nearest emergency department. Her initial blood pressure is 152/102 mm Hg. She has spontaneous rupture of membranes and undergoes repeat cesarean section 3 hours after arrival at the academic medical center. In the delivery room, Apgar scores are 7 at 1 minute (0 for skin color, and 1 for respiratory effort) and 9 at 5 minutes (1 for skin color). Growth parameters are consistent with a small-for–gestational age infant; the newborn’s head circumference, weight, and length are all less than the 1st percentile for gestational age. Initial physical examination is remarkable for upper limb abnormalities, including oligodactyly with the presence of only 2 formed digits on the left upper extremity, a single palpable forearm bone in the left upper extremity, a sacral dimple, significant hirsutism, and abnormal facial features, including synophrys and highly arched eyebrows. She is admitted to the NICU for further care. In the NICU, she is initiated on feeds of expressed breast milk and colostrum. She passes meconium on the first day after birth. The neonate initially tolerates small volumes of feeds, but by day 2, she experiences nonbilious emesis 15 to 30 minutes after each feed. Intravenous fluids are initiated and a Replogle tube is placed. An abdominal radiograph is obtained on the second day after …

Elevated methylation levels, reduced expression levels, and frequent contractions in a clinical cohort of C9orf72 expansion carriers

BackgroundA repeat expansion in the C9orf72-SMCR8 complex subunit (C9orf72) is the most common genetic cause of two debilitating neurodegenerative diseases: amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). Currently, much remains unknown about which variables may modify these diseases. We sought to investigate associations between C9orf72 promoter methylation, RNA expression levels, and repeat length, their potential effects on disease features, as well as changes over time and within families.MethodsAll samples were obtained through the ALS Center at Mayo Clinic Florida. Our primary cohort included 75 unrelated patients with an expanded C9orf72 repeat, 33 patients who did not possess this expansion, and 20 control subjects without neurodegenerative diseases. Additionally, 67 members from 17 independent C9orf72 families were selected of whom 33 harbored this expansion. Longitudinally collected samples were available for 35 C9orf72 expansion carriers. To increase our understanding of C9orf72-related diseases, we performed quantitative methylation-sensitive restriction enzyme-based assays, digital molecular barcoding, quantitative real-time PCR, and Southern blotting.ResultsIn our primary cohort, higher methylation levels were observed in patients with a C9orf72 repeat expansion than in patients without this expansion (p = 1.7e-13) or in control subjects (p = 3.3e-07). Moreover, we discovered that an increase in methylation levels was associated with a decrease in total C9orf72 transcript levels (p = 5.5e-05). These findings aligned with our observation that C9orf72 expansion carriers had lower expression levels of total C9orf72 transcripts than patients lacking this expansion (p = 3.7e-07) or control subjects (p = 9.1e-05). We also detected an elevation of transcripts containing intron 1a (upstream of the repeat) in patients carrying a C9orf72 repeat expansion compared to (disease) controls (p ≤ 0.01), an indication of abortive transcripts and/or a switch in transcription start site usage. While methylation and expression levels were relatively stable over time, fluctuations were seen in repeat length. Interestingly, contractions occurred frequently in parent-offspring transmissions (> 50%), especially in paternal transmissions. Furthermore, smaller repeat lengths were detected in currently unaffected individuals than in affected individuals (p = 8.9e-04) and they were associated with an earlier age at collection (p = 0.008).ConclusionsIn blood from C9orf72 expansion carriers, we found elevated methylation levels, reduced expression levels, and unstable expansions that tend to contract in successive generations, arguing against anticipation.

Effectiveness of Treating Patients with Stable Ischemic Heart Disease and Co-Existent Paroxysmal Atrial Fibrillation with Mebicar

Atrial fibrillation is a disturbance of heart rhythm, which is characterized by frequent contractions of atrial muscle fibers. Stable ischemic heart disease, arterial hypertension, heart failure, obesity are risk factors for progression of atrial fibrillation. Psycho-emotional stress, anxiety and depression can be the cause of atrial fibrillation paroxysm as well.&#x0D; The objective of the research was to study the effect of mebicаr in the treatment of paroxysmal atrial fibrillation considering anxiety-depressive symptoms. &#x0D; Materials and Methods. Observations were performed on patients with stable ischemic heart disease and co-existent paroxysmal atrial fibrillation using clinico-psychopathological research method (structured interview). The level of stress was determined on the L. Rider scale and the 10-Item perceived stress scale; the level of anxiety and depression was determined by means of the Hospital Anxiety and Depression Scale and the Patient Health Questionnaire-9. The evaluation of the free radical oxidation state was carried out using a spectrophotometric method to determine the activity of catalase, glutathione peroxidase, superoxide dismutase in the blood serum. &#x0D; Results. As a result of the analysis, it was found that the higher the level of anxiety-depressive disorders, the more frequent paroxysms of atrial fibrillation. High level of stress was found in 37.50% of men (p&lt;0.01) and 31.25% of women (p&lt;0.05) in Group 2b. The manifestations of the clinical level of anxiety and depression in men of Group 2b (p&lt;0.05) were detected.&#x0D; Conclusions. The analysis of electrocardiogram indices showed the signs of atrial fibrillation (p&lt;0.05), repolarization abnormalities (p&lt;0.001), left ventricular hypertrophy (p&lt;0.05), and the appearance of extrasystoles (p&lt;0.001). Echocardiographic indices showed the signs of diffuse cardiosclerosis, severe left atrial dilatation (p&lt;0.05) and reduced myocardial contractility, which was statistically confirmed. The use of anxiolytic medication – mebicar – during treatment helped significantly improve the clinical and hemodynamic parameters, which confirmed treatment effectiveness.

Trinucleotide repeat instability during double-strand break repair: from mechanisms to gene therapy.

Trinucleotide repeats are a particular class of microsatellites whose large expansions are responsible for at least two dozen human neurological and developmental disorders. Slippage of the two complementary DNA strands during replication, homologous recombination or DNA repair is generally accepted as a mechanism leading to repeat length changes, creating expansions and contractions of the repeat tract. The present review focuses on recent developments on double-strand break repair involving trinucleotide repeat tracts. Experimental evidences in model organisms show that gene conversion and break-induced replication may lead to large repeat tract expansions, while frequent contractions occur either by single-strand annealing between repeat ends or by gene conversion, triggering near-complete contraction of the repeat tract. In the second part of this review, different therapeutic approaches using highly specific single- or double-strand endonucleases targeted to trinucleotide repeat loci are compared. Relative efficacies and specificities of these nucleases will be discussed, as well as their potential strengths and weaknesses for possible future gene therapy of these dramatic disorders.

Retrospective analysis of diagnosis and treatment of breast cancer in pregnancy

Objective: To investigate the principles of diagnosis and treatment of breast cancer during pregnancy. Methods: Clinical data of patients with breast cancer during pregnancy admitted to Obstetrics and Gynecology Hospital of Fudan University between January 2012 to July 2017 were analyzed retrospectively. A total of 17 patients were diagnosed with breast cancer in pregnancy, the median age was 32 years (range from 25 to 45 years old), pathological staging revealed 2 patient with stage 0, 1 with stage Ⅱa, 7 with stage Ⅱb, 1 with stage Ⅲa, 2 with stage Ⅲc, 4 with stage Ⅳ. Results: Thirteen patients received surgical treatment in pregnancy, the gestational age at surgery was (27.7±4.6) weeks; 2 patients with ductal carcinoma in situ received mastectomy, 11 patients with breast cancer underwent modified radical mastectomy. In patients undergoing surgery during pregnancy, no prophylactic contractions were used in 4 patients who had been treated earlier, there were 2 patients with frequent contractions within 24 hours after operation in these patients. Follow-up 9 patients were given oral nifedipine to prevent contractions, no obvious contractions occurred after the operation. Seven patients received chemotherapy during pregnancy; the chemotherapy of 4 cases of triple negative breast cancer was weekly paclitaxel sequential epirubicin and cyclophosphamide, the chemotherapy of the other three patients was docetaxel sequential epirubicin and cyclophosphamide. Fifteen patients underwent cesarean section to terminate pregnancy, 2 patients underwent spontaneous labor. The gestational age of birth was (36.9 ±1.3) weeks. Less than 35 weeks of termination of pregnancy occurred in one patient, the fetus was delivered to the neonatal intensive care unit due to neonatal respiratory distress syndrome, and suffered from congenital dysaudia. The prognosis of the other 16 survived infants was good. The median follow-up time was 10 months (range from 4 to 27) months, in 13 patients of stage 0 to Ⅲc, one patient were diagnosed with bone metastasis at 12 months after surgery, the remaining 12 patients had no disease progression, the progression free survival rate was 12/13, the overall survival rate was 13/13. Among the 4 patients with stage Ⅳ, one died in 7 months after delivery, one had new liver metastasis in 8 months after delivery. The remaining 2 patients were in stable condition. Conclusions: Breast cancer in pregnancy can be treated effectively, multidisciplinary cooperation and detailed assessment of maternal-fetal risks and benefits are necessary. Chemotherapy during pregnancy is safe for maternal-fetal, but it needed a large sample of clinical studies and long-term follow-up. The neonatal outcome was associated with gestational age, and therefore premature delivery was avoided as much as possible during treatment.

Urea and Creatinine Levels in Vaginal Fluid as a Predictor for Length of Latency Period in Prelabour Membranes Rupture

Background: The diagnosis of equivocal cases of prelabour rupture of membranes (PROM) with traditional methods has been unreliable therefore various biochemical markers have been sought to confirm the same, this study aims to determine the relation between the concentration of urea and creatinine in vaginal fluid and length of latency period in women with PROM between 32 and 35 weeks gestation. Methods: sixty patients were included in our study with PROM of their singleton pregnancies, their gestational age ranged between 32- 35 gestational weeks by reliable menstrual history and confirmed by pelvi-abdominal ultrasound. All samples were obtained within 6 hours after membranes rupture before vaginal examination and the administration of any drugs All women will be put under observation for 48 hours and time of onset of delivery will be documented, the onset of labor will be diagnosed by either: frequent uterine contractions more than 2 contractions in 10 minutes or CTG showing frequent contractions. Results: The current study was conducted on a total number of 60 pregnant women, 20-35 year old; pregnant between 32 and 35weeks. Our study demonstrated that patients with higher levels of vaginal fluid urea and creatinine concentrations had earlier onset of labor. Patients with vaginal fluid urea and creatinine concentrations above cut-off levels (urea ≥26.0 (mg/dL), creatinine ≥0.64 (mg/dL)) went into labor early within a 48 hours latency period. This suggests vaginal urea and creatinine levels measurement in the prediction of early delivery. Conclusion: Measurement of urea and creatinine in vaginal fluid is a cheap and rapid method with high sensitivity and specificity for the delivery interval after PROM. Therefore, these methods can be integrated as non-invasive tests for the predication of delivery interval after PROM.

Sonographic landmarks to differentiate “false labor” and “early true labor” as a possible new application of ultrasound in labor ward

ObjectiveTo evaluate discrimination of clinical parameters and ultrasound examination to differentiate “false labor” and “true labor”. MethodsIn a prospective study during a period of 6 months, a total of 178 patients in term (37–41 weeks) consulting our obstetric unit for uterine contraction, were enrolled. Patients were examined separately by a midwife and a resident and separated into “true labor group” and “false labor group”. The clinical characteristics of true versus false labor patients were compared. ROC curves were developed to determine an optimal cervical length and uterocervical angle for prediction of true labor. ResultsThe prevalence of real labor was 57.3%. Patients who were in true labor had more painful and more frequent contractions. The “true labor” group had shorter cervical length and larger uterocervical angle. The optimal CL cut-off was 1.4mm with a specificity of 73% (RR 4.3, sensibility 63%, PPV 14%, NPV 95%). The optimal UCA cut off was 123° (RR 6.7, sensitivity 50%, specificity of 83%, PPV 10%, NPV 96%). The best performance was demonstrated by combined testing, yielding LHR+ that rich 13. ConclusionIn this study, we reported a new application of ultrasound to identify false labor and avoid unnecessary hospitalization with obstetric and adverse economic impacts.

Failure analysis of collector circuits associated with wind farms

Wind farm collector circuits generally comprise several wind turbine generators (WTG’s). WTG’s are connected in parallel to a substation. This connection acts as the point-of-connection to the national electricity grid. The electrical load in these circuits is close to component (power cables and accessories) ratings. The objective of this paper is to identify cable joint failure paths; and, develop an understanding of specific contributing factors. All findings presented were established from literature review involving data analysis and discussion with industry experts working across the wind industry. Application of forces, inadequate workmanship, incorrect thermal resistance or other contributing factors, all contribute to high conductor operating temperatures. High conductor operating temperatures highlight issues including insufficient environmental heat transfer due to the use of inadequate cable trenching materials. This in turn results in the imbalanced application of force, experienced at the cable joint, as a direct result of frequent thermal expansion and contraction. For most cable joint failures, the root cause is insulation breakdown due to sustained deterioration of the cross-linked polyethylene insulation. This is a direct result from excessive operating temperatures.

A Pregnancy with Severe Hypertrophic Obstructive Cardiomyopathy after Surgery for an Implantable Cardioverter Defibrillator: A Case Report and Literature Review.

Hypertrophic obstructive cardiomyopathy (HOCM) is cardiac hypertrophy of ventricular myocardium with left ventricular outflow tract obstruction. We report a pregnancy with HOCM after defibrillator implantation surgery. The patient was a 33-year-old nulligravida and was categorized as New York Heart Association class II. Her brain natriuretic peptide (BNP) level was 724.6 pg/dL at preconception. She received careful pregnancy management. However, because frequent uterine contractions were observed at 25 weeks and 6 days of pregnancy, she was hospitalized, and magnesium sulfate was started as a tocolytic agent. At 27 weeks and 5 days of pregnancy, she had respiratory discomfort and orthopnea with a sudden decrease in peripheral oxygen saturation. Cardiac ultrasonography showed a worsened condition of HOCM and her BNP level was 1418.0 pg/mL. We performed an emergent cesarean section and she delivered a boy weighing 999 g. The Apgar score was 8 and 9 points at 1 and 5 minutes, respectively. The mother's heart failure quickly improved after birth and she was discharged at 10 days postoperatively. Fluctuations in circulatory dynamics during pregnancy may sometimes exacerbate heart disease. Therefore, the risks should be fully explained and careful assessment of cardiac function should be performed during pregnancy in patients with severe HOCM.

Risk Behavior and HIV/AIDS Spread among Petty Traders in Namanga Border (Tanzania and Kenya Border)

2 Secondary School Teacher at Tanga Technical School, Tanzania ABSTRACT The prevalence of HIV/AIDS in Tanzania has slightly fallen from 5.7 in 2007/2008 to 5.1% in 2001/2012 for people aged between15-49. However, the epidemic's severity differs from one location to another and from one population segment to another. Petty traders across the border are assumed to be at high risk of contracting the disease. This paper assessed risk behavior among petty traders across Namanga border of Tanzania and Kenya. Using 120 respondents, the paper adopted a cross-sectional research design to collect both quantitative and qualitative data. A well structured questionnaire and checklist of questions were used tools for data collection. The paper revealed that apart from having high knowledge on HIV/AIDS, a number of risk behaviors such as having multiple partners, non use of condoms and excessive consumption of alcohol were practiced by petty traders. Further, frequent contraction of sexual transmitted infections (STIs) other than HIV/AIDS was also reported to increased chances for HIV/AIDS infection. It was concluded that the struggle against poverty by the petty traders increases high risk of contracting STIs such as HIV/AIDS. It is recommended that the government through institutions such as Tanzania Commission for AIDS (TACAIDS) and other Non Government Organizations continue with the campaign against HIV/AIDS to specific group of communities including petty traders. The campaign should go hand in hand with training on life management skills among petty traders.