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To compare unused phacoemulsification tips and those used different times with different techniques of cataract surgery (divide and conquer and chop), in vivo phacoemulsifications were performed with tips of different numbers of operation. These were compared with the same number of sterilized-only and unused tips with the help of an atomic force microscope. Comparison of roughness values (Sa, Sq), geometric and measurable flange length and surface was also performed (profile length %, area %). The differences between the parameters that can be measured during surgery (average ultrasound percentage, US ave %, Average Phaco Time, APT) were also analyzed. We found significant correlations between age and lens hardness (p = 0.0045), area % and APT (p = 0.03), between area % and US ave% (p = 0.03) and also between the two surgical techniques in terms of area% (p = 0.04) and US ave % (p < 0.01). Roughness increased with the number of uses. An increase in profile length% can be observed up to the twentieth operation. This can result from scratches and microscopic damages and also from abrasion and possible material additions on the surface of the needles. The divide and conquer technique causes less microscopic damage to the surface, and smaller average US energy is required during surgery.
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Facoemulsificação , Facoemulsificação/métodos , Facoemulsificação/efeitos adversos , Humanos , Idoso , Feminino , Masculino , Pessoa de Meia-Idade , Extração de Catarata/métodos , Catarata/patologia , Idoso de 80 Anos ou mais , Microscopia de Força AtômicaRESUMO
Galectin-13 (Gal-13) is predominantly produced by the syncytiotrophoblast, while laeverin is expressed on the outgrowing extravillous trophoblast, and both are thought to be biomarkers of preeclampsia. The aim of this study was to assess the correlation between concentrations of Gal-13 and laeverin measured in maternal serum and amniotic fluid at 16-22 weeks of gestation and the sonographic assessment of the fetoplacental measurements. Fetal biometric data and placental volume and perfusion indices were measured in 62 singleton pregnancies. Serum and amniotic levels of Gal-13 and laeverin levels were measured using a sandwich ELISA. Both amniotic fluid and serum Gal-13 levels expressed a negative correlation to the plasma laeverin level in mid-pregnancy. Serum laeverin level correlated positively with the gestational length at delivery (ß = 0.39, p < 0.05), while the amniotic laeverin level correlated well with the abdominal circumference of the fetus (ß = 0.44, p < 0.05). Furthermore, laeverin level in the amnion correlated positively with the estimated fetal weight (ß = 0.48, p < 0.05) and with the placental volume (ß = 0.32, p < 0.05). Logistic regression analyses revealed that a higher circulating Gal-13 level represents a slightly significant risk factor (OR: 1.01) for hypertension-related diseases during pregnancy. It is a novelty that laeverin can be detected in the amniotic fluid, and amnion laeverin concentration represents a potential biomarker of fetoplacental growth.
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Líquido Amniótico , Galectinas , Placenta , Humanos , Gravidez , Feminino , Adulto , Galectinas/sangue , Galectinas/metabolismo , Placenta/metabolismo , Líquido Amniótico/metabolismo , Biomarcadores/sangue , Pré-Eclâmpsia/sangue , Desenvolvimento Fetal , Idade Gestacional , Proteínas da Gravidez , MetaloproteasesRESUMO
Background: Swept-source anterior segment optical coherence tomography (SS-AS-OCT) is a suitable examination for the vitreolenticular interface. Methods: In a prospective study using Anterion (Heidelberg Engineering, Heidelberg, Germany), 102 eyes of 102 patients were examined in pupil dilation, preoperatively and 6 times over 1-year follow-up. Preoperatively anterior hyaloid membrane (AHM) visibility was determined with Imaging App with high reliability. Postoperatively capsular bag-AHM distance was measured on six points by using Metrics App. Results: The AHM was visible in 18.6% preoperatively and postoperatively as well (Group 1), 49% of the preoperatively adherent AHMs became visible (Group 2A), 32.4% remained attached (Group 2B). Group 1: the average deepest point on the first day was 782.5 ± 324.1 microns, and it significantly differed from the later follow-up values. Group 2A: the average deepest value was 184.1 ± 220.1 microns, and there was no statistically significant difference between the postoperative visit values. The difference between the groups was statistically significant at every location and at each time point. Conclusions: AS-SS-OCT can be used to check BS both preoperatively (with limitations) and postoperatively.
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Introduction: Trophoblast-derived angiogenic factors are considered to play an important role in the pathophysiology of various complications of pregnancy. Human Leukocyte Antigen-G (HLA-G) belongs to the non-classical human major histocompatibility complex (MHC-I) molecule and has membrane-bound and soluble forms. HLA-G is primarily expressed by extravillous cytotrophoblasts located in the placenta between the maternal and fetal compartments and plays a pivotal role in providing immune tolerance. The aim of this study was to establish a relationship between concentrations of soluble HLA-G (sHLA-G) in maternal serum and amniotic fluid at 16-22 weeks of gestation and the sonographic measurements of fetal and placental growth. Materials and methods: sHLA-G in serum and amniotic fluid, as well as fetal biometric data and placental volume and perfusion indices, were determined in 41 singleton pregnancies with no complications. The level of sHLA-G (U/mL) was tested with a sandwich enzyme-linked immunosorbent assay (ELISA) kit. Results: The sHLA-G levels were unchanged both in amniotic fluid and serum during mid-pregnancy. The sHLA-G level in serum correlated positively with amniotic sHLA-G level (ß = 0.63, p < 0.01). Serum sHLA-G level was significantly correlated with abdominal measurements (ß = 0.41, p < 0.05) and estimated fetal weight (ß = 0.41, p < 0.05). Conversely, amniotic sHLA-G level and placental perfusion (VI: ß = -0.34, p < 0.01 and VFI: ß = -0.44, p < 0.01, respectively) were negatively correlated. A low amniotic sHLA-G level was significantly associated with nuchal translucency (r = -0.102, p < 0.05). Conclusions: sHLA-G assayed in amniotic fluid might be a potential indicator of placental function, whereas the sHLA-G level in serum can be a prognostic factor for feto-placental insufficiency.
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Adequate vitamin D (VD) intake during pregnancy is needed for fetal development and maternal health maintenance. However, while there is no doubt regarding its importance, there is not a unified recommendation regarding adequate intake. The main aim of our study was to measure the VD serum level of studied women, together with its potential influencing factors: demographic (i.e., age, level of education, relationship status and type of residence), conception and pregnancy related factors. Results are based on secondary data analyses of a retrospective case-control study of 100 preterm and 200 term pregnancies, where case and control groups were analyzed together. Data collection was based on a self-administered questionnaire, health documentation, and maternal serum VD laboratory tests. VD intake was evaluated by diet and dietary supplement consumption. According to our results, 68.1% of women took some kind of prenatal vitamin, and only 25.9% of them knew about its VD content. Only 12.1% of included women reached the optimal, 75 nmol/L serum VD level. Higher maternal serum levels were associated with early pregnancy care visits (p = 0.001), assisted reproductive therapy (p = 0.028) and advice from gynecologists (p = 0.049). A correlation was found between VD intake and serum levels (p < 0.001). Despite the compulsory pregnancy counselling in Hungary, health consciousness, VD intake and serum levels remain below the recommendations. The role of healthcare professionals is crucial during pregnancy regarding micronutrients intake and the appropriate supplementation dose.
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Suplementos Nutricionais , Estado Nutricional , Deficiência de Vitamina D , Vitamina D , Humanos , Feminino , Gravidez , Hungria , Vitamina D/sangue , Vitamina D/administração & dosagem , Estudos de Casos e Controles , Adulto , Estudos Retrospectivos , Deficiência de Vitamina D/epidemiologia , Deficiência de Vitamina D/sangue , Fenômenos Fisiológicos da Nutrição Materna , Complicações na Gravidez/sangue , Complicações na Gravidez/epidemiologia , Adulto Jovem , Cuidado Pré-Natal , Gestantes , Inquéritos e QuestionáriosRESUMO
Background and Objectives: Increasing evidence points to the significant role of the angiogenic factor levels in screening for pregnancy outcome. To examine the potential relationship between concentrations of placental protein 13 (PP13) and soluble human leukocyte antigen-G (sHLA-G) in maternal serum and amniotic fluid at 16-23 weeks of gestation and the sonographic features of pregnancy as well as pregnancy outcome. Materials and Methods: PP13 and sHLA-G in serum and amniotic fluid, fetal biometrical data, and placental volume and perfusion indices were determined in 71 euploid, singleton pregnancies. Results: The serum sHLA-G level exhibits a negative correlation with the serum PP13 level (r = -0.186, p < 0.001) and a positive correlation with the sHLA-G level in amniotic fluid (r = 0.662, p < 0.001). A significant correlation was found between serum sHLA-G level and placental volume (r = 0.142, p < 0.05) and between amniotic sHLA-G level and placental perfusion (r = -0.450, p < 0.001). A low amniotic PP13 level significantly predicted the birth weight (r = -0.102, p < 0.05), the duration of pregnancy (r = -0.155, p < 0.05), and the fetal abdominal circumference (r = -0.098, p < 0.05). Conclusions: PP13 assayed in amniotic fluid might be a potential marker of fetal growth, and sHLA-G can be an adjunct modality reflecting placental sonographic parameters.
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Líquido Amniótico , Resultado da Gravidez , Feminino , Humanos , Gravidez , Galectinas , Antígenos HLA , PlacentaRESUMO
Chiral stationary phases (CSPs) with coated amylose tris(3,5-dimethylphenylcarbamate) (ADMPC) selector have long been recognized for their excellent chiral recognition ability in liquid chromatography. The conformational versatility behind this feature is the source of their known hysteretic behavior, which has been previously observed in polar organic (PO) mode eluents containing 2-propanol (IPA). Mixtures of IPA and acetonitrile (MeCN), a typical PO mode eluent system, have not been examined in this aspect yet, even though hysteresis is promising for finding unique unexplored enantioselectivities. Not only was the hysteresis detectable on ADMPC using mixtures of IPA and MeCN, but it was the typical behavior in a diverse set of test compounds. The difference in the retention time of the same analyte under conditions which only differed in the eluent history on the column can go up to 20-fold. The assumed hindered conformational changes of the selector were reflected in retention drift at certain eluent compositions. On the two sides of the transitions, distinct, useful states of the selector were detected. A series of IPA - MeCN compositions with defined pretreatment was selected and recommended as an extension of the preliminary, first choice method screening set that used only alcohols. The incorporation of a solvent possessing substantially different characteristics enhances the potential in practical applications, while keeping the technical simplicity. Stability and robustness of the additional states of the CSP were characterized. The examined columns of different brands shared the observed behavior. Kinetic stability of a column state is adequate for successful application. The evaluated states of ADMPC provide multiple enantiorecognition potential by using mixtures of IPA and MeCN also considering the pretreatment of the column. Unprecedented double and triple elution order reversals along the composition range supported the versatility of the available states. Our findings further enhance the usefulness of ADMPC-containing CSPs. We provide instructions for the application of the widespread chiral selector in common eluent mixtures to avoid pitfalls regarding reproducibility and robustness.
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2-Propanol , Fenilcarbamatos , 2-Propanol/química , Reprodutibilidade dos Testes , Solventes/química , Fenilcarbamatos/química , Amilose/química , Acetonitrilas , Estereoisomerismo , Cromatografia Líquida de Alta Pressão/métodosRESUMO
Background and Objectives: Preterm birth as a complex phenomenon is influenced by numerous endogenic and exogenic factors, although its exact cause often remains obscure. According to epidemiological studies, maternal periodontal diseases, in addition to affecting general health, can also cause adverse pregnancy outcomes. Nonetheless, the existing results in the literature regarding this topic remain controversial. Consequently, our study aimed to determine the connection between poor maternal periodontal status and neonatal birth weight. Materials and Methods: A total of 111 primigravida-primiparous pregnant, healthy women underwent a periodontal examination in the second trimester of their pregnancies. Probing depth (PD) and bleeding on probing (BOP) were determined, and based on these diagnostic measurements, the patients were divided into three subgroups according to their dental status: healthy (H, n = 17), gingivitis (G, n = 67), and periodontitis (P, n = 27). Results: Considering that poor maternal oral status is an influencing factor for obstetrical outcomes, the presence of PD and BOP (characterized by the sulcus bleeding index, SBI) was evaluated. In the case of P, defined as PD ≥ 4 mm in at least one site and BOP ≥ 50% of the teeth, a significant correlation between BOP and a low neonatal birth weight at delivery (p = 0.001) was found. An analysis of the relationship between SBI and gestational age (GA) at the time of the periodontal examination in the different dental status groups showed a significant correlation between these parameters in the G group (p = 0.04). Conclusions: Our results suggest that a worse periodontal status during pregnancy may negatively affect obstetrical outcomes, especially the prematurity rate and newborn weight. Therefore, the importance of periodontal screening to prevent these complications is undeniable.
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Periodontite , Nascimento Prematuro , Gravidez , Recém-Nascido , Humanos , Feminino , Peso ao Nascer , Nascimento Prematuro/epidemiologia , Nascimento Prematuro/etiologia , Recém-Nascido de Baixo Peso , Periodontite/complicações , Periodontite/epidemiologia , Resultado da Gravidez/epidemiologiaRESUMO
INTRODUCTION: Placental perfusion can be evaluated using three-dimensional power-Doppler (3DPD) indices with sonobiopsy acquisition in a sphere or throughout the entire placenta. OBJECTIVE: We aimed to explore the relation between these two measurement methods. METHOD: A prospective cohort study was conducted among normal pregnant women recruited at 11 to 40 gestational weeks. Placental vascularization was evaluated using the 3DPD indices (vascularization index [VI]; flow index [FI]; vascularization flow index [VFI]) with the application of the sphere ultrasound technique or scanned from the entire placenta. RESULTS: A total of 150 women were recruited at a mean gestational age of 20.8 ± 7.22 weeks. We observed that scanned 3DPD indices using sphere technique decrease by gestational age between 11 and 40 weeks, whereas whole placental volume scanning yielded stable, non-decreasing indices during gestation. The indices were correlated to each other at least moderately, irrespectively of the method of scanning (r≥0.30). LIMITATIONS: As gestation advances, less and less placentas can be visualized in one sweep for a whole view and at late period of gestation only a minority of placentas can be visualized as a whole. CONCLUSION: 3DPD indices acquired in a sphere of the placenta at umbilical cord insertion may reflect more to the decreasing vascularity of the exponentially growing placenta during gestation. Hence, sphere technique may have a greater screening opportunity in pathological pregnancies. Orv Hetil. 2023; 164(8): 300-307.
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Placenta , Ultrassonografia Pré-Natal , Gravidez , Feminino , Humanos , Lactente , Placenta/diagnóstico por imagem , Estudos Prospectivos , Ultrassonografia Pré-Natal/métodos , Ultrassonografia Doppler/métodos , Perfusão , Imageamento Tridimensional/métodos , Idade GestacionalRESUMO
Introduction: The cardiovascular system of women adapts to pregnancy to maintain the growth of the fetus. Objective: The aim of this prospective study is to measure the mean arterial pressure of each gestational week. Hemo-dynamical changes in pregnancy are different in every trimester. Normally the mean arterial pressure decreases at the beginning of the pregnancy, and starts to increase in the third trimester. Method: We have examined 185 pregnant women between May 2020 and July 2020. We used a validated device, TensioMed Arteriograph 2020, which can monitor blood pressure parameters non-invasively. We measured the following parameters: mean arterial pressure, central systolic blood pressure, pulse wave velocity, ankle-brachial index. Results: We found that the mean arterial pressure and the central systolic blood pressure decrease from the 12th to the 15th week, and then start to rise. We did not find significant difference considering the ankle-brachial index and pulse wave velocity. Discussion: The change at the 15th gestational week is the result of circulatory redistribution, histological change when the placenta replaces the chorion. Thus, a high-flow and low-resistance blood flow is created. Compared to the reference values in non-pregnant women, we can say that the values vary significantly within the normal range. Conclusion: Hereafter, we would like to extend our studies to the third trimester as well as to include not only healthy pregnant women, but also pregnant women at risk of developing hypertension. This would create a Hungarian database, which could become a useful pillar in national prenatal care in screening for gestational hypertension.
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Hipertensão , Análise de Onda de Pulso , Gravidez , Feminino , Humanos , Estudos Prospectivos , Pressão Sanguínea/fisiologia , Índice Tornozelo-BraçoRESUMO
The current work investigates the shear stress distribution in hydrodynamic cavitation reactors with two different geometries using CFD simulations. Venturi type (positive geometry) and bore (negative geometry) were used to induce cavitation. Experimental validation of the predictions from simulations was also conducted by calculating the reduction rate in the colony count of Legionella pneumophila, a pathogenic bacterial strain. Both the numerical and experimental studies revealed the significant influence of the shape of the cavitation-inducing geometry on the flow characteristics and the distribution of shear stress. The simulation data indicated high shear stress formation in the positive geometry as a venturi, with the cavitation ranges for the two reactors being far apart from each other. The experimental study also confirmed that the flow conditions in the venturi-type reactor were more favourable compared to the bore geometry, resulting in a bacterial reduction efficiency as high as 99.98%. It was clearly demonstrated that the geometry of the cavitating device plays a crucial role in deciding the shear stress and its efficacy for the desired applications as per the predictions of the simulation model validated by the experimental results.
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Hidrodinâmica , Estresse Mecânico , Simulação por ComputadorRESUMO
AIM: To learn the association between sociodemographic and obstetric factors and lifestyle characteristics of pregnant women, and to identify factors that can influence pregnant women's health consciousness. METHODS: A cross-sectional, questionnaire-based study was performed among women who gave birth in Szeged in 2014-2015. Data collection was based on a self-administered questionnaire and health documentations. Overall maternal health promoting behavior (MHPB) index was defined by summarizing the scores obtained from diet, physical activity, smoking status, and alcohol consumption. RESULTS: The final analysis included 1548 mothers; 41.3% (n = 602) of the sample had healthy diet, 9.0% (n = 134) were physically active and attended special pregnancy exercise classes, 84.4% (n = 1279) did not drink alcohol, and 93.5% (n = 1447) were nonsmokers. Regarding the MHPB index, 0.8% (n = 11) of the women reached the maximum score (20), while the average was 14.8 (SD = 2.58). Advanced maternal age (p < 0.001), having a spouse or partner (p < 0.001), higher educational level (p < 0.001), planned pregnancy (p < 0.001), and early visit at pregnancy care (p = 0.046) were significantly associated with higher MHPB index. CONCLUSION: The lifestyle of pregnant women can have a great impact on the developing fetus, either in a positive or negative way. In order to evaluate maternal lifestyle, overall health behavior should be considered. Lifestyle of the included women was not satisfactory, an improvement in health consciousness is needed at every social level; however, the differences between the various social classes may suggest the importance of further promotion and improvement of pregnancy planning and pregnancy care among younger and lower educated women.
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Estilo de Vida , Gestantes , Estudos Transversais , Feminino , Humanos , Hungria/epidemiologia , Parto , GravidezRESUMO
Alteration of the enantiorecognition ability of polysaccharide-based chiral columns in the shipping normal phase (NP) eluent after exposition to polar organic (PO) mode eluents can be conceived as an incomplete hysteresis cycle. Non-standard solvents provide a solution to overcome this issue with immobilized stationary phases, but a procedure was missing so far to regenerate coated stationary phases from the altered state. Recent results with alcohol mixtures within the PO mode showed that an appropriate order of standard solvents may also be suitable to complete hysteresis. Using an analogous approach, a simple protocol was established to regenerate the original NP retentions on various stationary phases containing amylose tris(3,5-dimethylphenylcarbamate) (ADMPC) chiral selector after the change induced by flushing with 2-propanol or ethanol. The members of a chemically diverse compound set indicated that alterations in retentions and selectivities using different brands and types of ADMPC-based stationary phases can be quite different, but the recovery of the original state was very good for all of them. The proposed protocol eliminates the need of the costly dedication of a chiral column with ADMPC selector to either NP or PO mode. Furthermore, the limits of the alcohol content in the mobile phase compositions where the system is free of hysteresis were determined.
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Amilose , Aniversários e Eventos Especiais , Amilose/análogos & derivados , Amilose/química , Cromatografia Líquida de Alta Pressão/métodos , Etanol/química , Fenilcarbamatos/química , Solventes/química , EstereoisomerismoRESUMO
Previously, we have studied the trifluoroacetic acid (TFA)-catalyzed rearrangements of unsubstituted and alkoxy-substituted ortho-(pivaloylaminomethyl)benzaldehydes and revealed the formation of rearranged, regioisomeric aldehydes along with dimer-like products ("TFA dimers"). In the present study, related reactions of ortho-(pivaloylaminomethyl)benzaldehydes are described with the difference that boron trifluoride diethyl etherate (BF3·OEt2) is used as the catalyst. Although in these reactions the formation of the same "TFA dimers" can be observed after a couple of hours reaction time, during further stirring these are transformed into a new dimer-like keto compound ("BF3 dimer") that gradually becomes the main product. Apart from this, an oxoindene-type by-product is also formed. The new products are characterized by detailed NMR studies and two of them also by single-crystal X-ray diffraction. DFT calculations support the mechanism proposed for the transformations and explain the differences observed in the product distribution.
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PURPOSE: To assess the accuracy of the intraocular lens (IOL) power calculation based on three methods using artificial intelligence (AI) and one formula using no AI. METHODS: During cataract surgery on 114 eyes, one type of IOL was implanted, calculated with the Hill-RBF 2.0 method. The theoretical postoperative refractions were calculated using the Kane and the Pearl-DGS methods and a vergence based formula (Barrett Universal II, BUII). The differences between the manifest and objective postoperative refractions and the predicted refractions were calculated. The percentage of eyes within ±0.5 D and ±1.0 D prediction error (PE), the mean, and the median absolute errors (MAE and MedAE) were also determined. RESULTS: The mean age of the patients was 69.48 years; the axial length was between 21.19 and 25.39 mm. The number of eyes within ±0.5/±1.0 D PE was 96/108 (84.21%/94.73%) using the Hill-RBF 2.0 method, 92/107 (80.70%/93.85%) with the Kane method, 91/107 (79.82%/93.85%) with the Pearl-DGS method, and 91/106 (79.82%/92.98%) with the BUII formula, using subjective refraction. With objective refractometric data, PEs were within ±0.5 D in 88 (77.19%), 83 (72.80%), 82 (71.92%), and 80 (70.17%) cases (Hill-RBF, Kane, Pearl-DGS, BUII, respectively). MAE and MedAE were also best with the Hill-RBF 2.0 method (0.3 D; 0.18 D). CONCLUSION: Better accuracy of PE might be obtained by the Hill-RBF 2.0 method compared with BUII. The Kane and Pearl-DGS methods showed similar accuracy when compared with BUII.
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Lentes Intraoculares , Facoemulsificação , Idoso , Inteligência Artificial , Comprimento Axial do Olho , Biometria , Humanos , Óptica e Fotônica , Refração Ocular , Estudos RetrospectivosRESUMO
PURPOSE: The revision of any total knee replacement is carried out in a significant number of cases, due to the excessive internal rotation of the tibial component. The goal was to develop a personalized method, using only the geometric parameters of the tibia, without the femoral guidelines, to calculate the postoperative rotational position of tibial component malrotation within a tolerable error threshold in every case. METHODS: Preoperative CT scans of eighty-five osteoarthritic knees were examined by three independent medical doctors twice over 7 weeks. The geometric centre of the tibia was produced by the ellipse annotation drawn 8 mm below the tibial plateau, the sagittal and frontal axes of the ellipse were transposed to the slice of the tibial tuberosity. With the usage of several guide lines, a right triangle was drawn within which the personalized Berger angle was calculated. RESULTS: A very good intra-observer (0.89-0.925) and inter-observer (0.874) intra-class correlation coefficient (ICC) was achieved. Even if the average of the personalized Berger values were similar to the original 18° (18.32° in our case), only 70.6% of the patients are between the clinically tolerable thresholds (12.2° and 23.8°). CONCLUSION: The method, measured on the preoperative CT scans, is capable of calculating the required correction during the planning of revision arthroplasties which are necessary due to the tibial component malrotation. The personalized Berger angle isn't altered during arthroplasty, this way it determines which one of the anterior reference points of the tibia (medial 1/3 or the tip of the tibial tuberosity, medial border or 1/6 or 1/3 or the centre of the patellar tendon) can be used during the positioning of the tibial component. LEVEL OF EVIDENCE: Level II, Diagnostic Study (Methodological Study).
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This study was designed to determine the level of vascular endothelial growth factor-A (VEGF-A), basic fibroblast growth factor (bFGF) and endothelial nitric oxide synthase (eNOS) in chorionic villi during in first and second trimester, and their association with nuchal translucency (NT) measured by ultrasound. Seventy-five singleton healthy pregnancies with no detected congenital malformation were collected for NT measurements and chorionic villus sampling (CVS). Concentrations of angiogenic factors were assayed in chorionic villi sampled between 10 + 6 and 18 + 3 weeks of gestation. ENOS level was steady during this gestational period, while the concentrations of VEGF-A and bFGF significantly decreased. Placental concentrations of VEGF-A and bFGF correlated positively with each other (semi-partial correlation in multivariable linear regression (r): 0.90) and both correlated negatively with the eNOS level (r: -0.64 and r: -0.83, respectively). NT was positively correlated with eNOS concentration and negatively correlated with bFGF levels (r: 0.85 and r: -0.78, respectively). Inverse correlation was found between gestational age and VEGF-A and bFGF concentrations (r: -0.57 and r: 0.73, respectively). Alterations of angiogenic factors in chorionic villi might be an adjunct modality to NT and foetal growth as sonographic markers.
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Fatores de Crescimento de Fibroblastos/metabolismo , Neovascularização Fisiológica/fisiologia , Óxido Nítrico Sintase Tipo III/metabolismo , Placenta/metabolismo , Fator A de Crescimento do Endotélio Vascular/metabolismo , Adulto , Estudos Transversais , Feminino , Fatores de Crescimento de Fibroblastos/genética , Regulação da Expressão Gênica , Humanos , Óxido Nítrico Sintase Tipo III/genética , Gravidez , Estudos Prospectivos , Fator A de Crescimento do Endotélio Vascular/genéticaRESUMO
Összefoglaló. Terhességben az élettani és anatómiai változások miatt bizonyos patológiás szervi eltérések nem specifikus tünettannal járhatnak. A várandósság alatt fellépo hasi panaszok esetén lényeges felállítani a gyors és pontos diagnózist, a minél korábbi adekvát terápia érdekében. A klinikai tünetek hátterében többek között állhatnak szülészeti betegségek, illetve appendicitis, megnagyobbodott ovariumcysta, nephrolithiasis vagy diverticulitis is. Esetismertetésünkben egy 32 hetes gravida ellátását prezentáljuk, aki jobb alhasi panaszok miatt jelentkezett a Szegedi Tudományegyetem Szülészeti és Nogyógyászati Klinikáján. A magzati paraméterek megfeleloek voltak. A klinikai vizsgálatok appendicitis gyanúját vetették fel, mely miatt laparoszkópia történt. Torquálódott jobb oldali tuba uterina miatt jobb oldali salpingectomiát végeztünk, az appendix kóros elváltozása nem igazolódott. Magzati, illetve anyai szövodmény a posztoperatív szakban nem volt. A további terhesgondozás során szövodményt nem észleltünk, majd a betöltött 40. terhességi héten hüvelyi úton egészséges újszülött született. A méhfüggelék megcsavarodásának operatív megoldása laparoszkópos úton alkalmazható módszernek tekintheto terhességben is. Az adnexcsavarodás ritka sürgosségi nogyógyászati kórképnek számít, bár szakirodalmi adatok alapján az adnexum torsiójának rizikója fokozott lehet a terhesség korai szakaszában, kiváltképp asszisztált reprodukciós technikák alkalmazása esetén. Várandósság alatt hirtelen jelentkezo alhasi panaszok esetén az anamnesztikus adatok tükrében, a klinikai vizsgálatok során szükséges az adnextorsio lehetoségére is gondolni. Orv Hetil. 2021; 162(35): 1418-1421. Summary. Due to physiological and anatomical changes in pregnancy, certain pathological organ abnormalities may be associated with non-specific symptoms. In the case of abdominal complaints during pregnancy, it is important to make a quick and accurate diagnosis to apply an early adequate therapy. The cause of the clinical symptoms can be obstetrical diseases, appendicitis, large ovarial cyst, rarely nephrolithiasis or diverticulitis. Through our case study, we present the treatment of a 32-week gravida. Examination of the pregnant patient occured at the Department of Obstetrics and Gynecology of the University of Szeged due to right lower abdominal pain. The fetal parameters were satisfactory. We assumed appendicitis, so after proper preparation laparoscopy was performed. Salpingectomy was performed because of torqued right fallopian tube and no pathological changes were detected on the appendix. In the postoperative period, there were no fetal or maternal complications. During further care of pregnancy, there were no complications and a healthy newborn was born by vaginal delivery at the 40th week of gestation. The operative procedure of adnexal rotation by laparoscopy can be considered as an applicable method even in pregnancy. Adnexal torsion is a rare emergency gynecological disease, although literature data suggest an increased risk in early pregnancy, especially in the case of assisted reproductive technology. In the case of sudden abdominal pain during pregnancy, in the light of anamnestic data, it is recommended to consider the possibility of adnexal torsion, too. Orv Hetil. 2021; 162(35): 1418-1421.
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Apendicite , Apêndice , Laparoscopia , Apendicite/cirurgia , Serviço Hospitalar de Emergência , Feminino , Humanos , Recém-Nascido , Torção Ovariana , GravidezRESUMO
The scale-up of a chiral bicyclic homopiperazine of pharmaceutical interest was investigated. The outcome and safety profile of a key batch ring-expansion step via Schmidt rearrangement was improved using continuous-flow chemistry. The selectivity of nitrogen insertion for the ring expansion was improved via an alternative photochemical oxaziridine rearrangement under mild conditions, which when converted to continuous-flow in a simple and efficient flow reactor allowed the first photochemical scale-up of a homopiperazine.
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PURPOSE: The aim was to assess the postoperative results of a biometric method using artificial intelligence (Hill-radial basis function 2.0), and data from a modern formula (Barrett Universal II) and the Sanders-Retzlaff-Kraft/Theoretical formula. METHODS: Phacoemulsification and biconvex intraocular lens implantation were performed in 186 cataractous eyes. The diopters of intraocular lens were established with the Hill-radial basis function method, based on biometric data obtained using the Aladdin device. The required diopters of the intraocular lens were also calculated by the Barrett Universal II formula and with the Sanders-Retzlaff-Kraft/Theoretical formula. The differences between the manifest postoperative refractive errors and the planned refractive errors were calculated, as well as the percentage of eyes within ±0.5 D of the prediction error. The mean- and the median absolute refractive errors were also determined. RESULTS: The mean age of the patients was 70.13 years (SD = 10.67 years), and the mean axial length was 23.47 mm (range = 20.72-28.78 mm). The percentage of eyes within a prediction error of ±0.5 D was 83.62% using the Hill-radial basis function method, 79.66% with the Barrett Universal II formula, and 74.01% in the case of the Sanders-Retzlaff-Kraft/Theoretical formula. The mean- and the median absolute refractive errors were not statistically different. CONCLUSION: Clinical success was the highest when using the biometric method, based on pattern recognition. The results obtained using Barrett Universal II came a close second. Both methods performed better compared to a traditionally used formula.