ABSTRACT
PURPOSE: To explore the contribution of maternal and fetal parameters in predicting the time interval between diagnosis and development of adverse events leading to delivery in singleton pregnancies complicated with fetal microsomia. METHODS: Prospective study on singleton pregnancies referred to a tertiary center because of suspicion of fetal smallness in the third trimester. The study cohort included cases with fetal abdominal circumference (AC) ≤ 10th centile or estimated fetal weight ≤ 10th centile or umbilical artery pulsatitlity index ≥ 90th centile. Development of pre-eclampsia, fetal demise, and fetal deterioration diagnosed by fetal Doppler studies or fetal heart rate monitoring and leading to delivery were considered as adverse events. Maternal demographics, obstetric history, blood pressure, serum PLGF, and fetal Doppler studies were explored as predictors of the time interval between the first visit to the clinic and the diagnosis of complications. RESULTS: In 59 women, the median incubation period from presentation to the clinic to an adverse event was 6, 2 weeks, whereas half of the pregnancies (52.5%) did not develop any adverse event. PLGF was the strongest predictor of adverse events. Both PLGF in raw values and PLGF MOM had equally good predictive ability (AUC 0.82 and 0.78 respectively). Optimal cut-off points were 177.7 pg/ml for PLGF raw values (sensitivity 83% and specificity 66.7%) and 0.277 MoM (sensitivity 76% and specificity 86.7%). On multiple Cox regression analysis, maternal systolic blood pressure, PLGF, fetal increased umbilical artery PI, and reduced CP ratio were independently associated with adverse events. Half of the pregnancies with low PLGF and only one in ten with high PLGF were delivered within two weeks after the initial visit. CONCLUSION: Half of the pregnancies carrying a small fetus in the third trimester will not develop maternal or fetal complications. PLGF is a strong predictor of adverse events that can be used to customize antenatal care.
Subject(s)
Pre-Eclampsia , Prenatal Care , Infant, Newborn , Pregnancy , Female , Humans , Prospective Studies , Placenta Growth Factor , Infant, Small for Gestational Age , Biomarkers , Fetal Growth Retardation/diagnosis , Fetus/blood supply , Ultrasonography, Prenatal , Predictive Value of TestsABSTRACT
PURPOSE: Amniotic Fluid Sludge (AFS) has been theorized to be sonographic evidence of an underlying infection/inflammation and studies have concluded that approximately 10% of the patients who show signs of preterm labor with intact membranes have an underlying intraamniotic infection, mostly subclinical, carrying an increased risk for preterm birth with its subsequent neonatal and maternal complications. The purpose of the present systematic review is to evaluate the impact of antibiotic therapy on preterm birth rates of women diagnosed with AFS. METHODS: We searched Medline, Scopus, the Cochrane Central Register of Controlled Trials CENTRAL, Google Scholar, and Clinicaltrials.gov databases for relevant articles published until the 30th of September 2022. Observational studies (prospective and retrospective) that evaluated the impact of antibiotics on preterm delivery rates of patients with AFS were considered eligible for inclusion. Statistical meta-analysis was performed with RStudio and we calculated pooled risk ratios (OR) and 95% confidence intervals (CI). To evaluate the information size, we performed trial sequential analysis (TSA) and the methodological quality of the included studies was assessed using RoBINS tools. RESULTS: Overall, four retrospective cohort studies were included in the present systematic review and 369 women were enrolled. We demonstrated that preterm delivery prior to 34, 32 and 28 weeks of gestational age was comparable among the groups of women that had antibiotics and those that did not (OR: 0.34, 95% CI 0.05, 2.14, 0.40 [0.09, 1.66], 0.35 [0.08, 1.58], respectively) but the statistical heterogenicity of the studies included was high for every gestational period that was examined. CONCLUSIONS: According to our study, we cannot conclude that the use of antibiotics in women with amniotic fluid sludge benefit the prognostic risk to deliver prematurely. It is quite clear that data from larger sample sizes and more well adjusted and designed studies are needed.
Subject(s)
Premature Birth , Humans , Infant, Newborn , Female , Premature Birth/drug therapy , Retrospective Studies , Sewage , Amniotic Fluid , Prospective Studies , Anti-Bacterial Agents/therapeutic useABSTRACT
OBJECTIVE: To assess the effect of non-steroidal anti-inflammatory drugs (NSAIDs) on blood pressure when administered for postpartum analgesia in women with hypertensive disorders of pregnancy. METHODS: MEDLINE, Scopus, CENTRAL, Clinicaltrials.gov and Google Scholar databases were searched systematically from inception to 5 December 2019 for studies evaluating the safety of postpartum NSAIDs in women with any gestational hypertensive disorder. Randomized controlled trials (RCTs) and cohort studies were eligible for inclusion. Case-control studies, case series and case reports were excluded. The primary outcomes of interest were the incidence of severe hypertension and systolic, diastolic and mean arterial blood pressure. Pooled estimates were obtained by fitting a random-effects statistical model. The quality of evidence was assessed according to Grading of Recommendations, Assessment, Development and Evaluations (GRADE) guidelines. RESULTS: Ten studies were included, comprising five RCTs and five retrospective cohort studies and involving a total of 1647 women. All studies were evaluated qualitatively and eight of them were included in the quantitative meta-analysis. Administration of NSAIDs was not associated with a significantly higher risk of severe postpartum hypertension (odds ratio, 1.52 (95% CI, 0.77-3.01)). Similarly, no significant differences were found in postpartum systolic blood pressure (mean difference (MD), -3.03 mmHg (95% CI, -6.21 to 0.15 mmHg)) and mean arterial pressure (MD, -0.38 mmHg (95% CI, -1.88 to 1.11 mmHg)) between women who received NSAIDs and those who did not, whereas postpartum diastolic blood pressure was marginally lower in women treated with NSAIDs (MD, -2.28 mmHg (95% CI, -4.44 to -0.13 mmHg)). The same effects were observed when studies with a large sample size, RCTs, women with severe pre-eclampsia and studies using ibuprofen as the study drug and acetaminophen as the control treatment were examined separately. The credibility of evidence was judged to be very low according to GRADE, owing to concerns about study limitations, inconsistency and imprecision. CONCLUSIONS: This meta-analysis suggests that postpartum administration of NSAIDs is not associated with elevated blood pressure in women with hypertensive disorders of pregnancy. However, the existing evidence is of very low quality, thus future large-scale RCTs are warranted to verify the safety of postpartum NSAIDs in this population. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Hypertension, Pregnancy-Induced , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Blood Pressure , Female , Humans , Postpartum Period , PregnancyABSTRACT
OBJECTIVE: To determine the difference of serum levels of 10 adipokines (apelin, chemerin, fatty acid-binding protein-4, fibroblast growth factor-21, monocyte chemoattractant protein-1, nesfatin-1, omentin-1, resistin, vaspin, and visfatin) among women with gestational diabetes and healthy pregnant controls. MATERIALS AND METHODS: Literature search was conducted using the Medline (1966-2018), Scopus (2004-2018), Cochrane Central Register of Controlled Trials (CENTRAL) (1999-2018), Clinicaltrials.gov (2008-2018) and Google Scholar (2004-2018) databases, along with the reference list of the included studies. RESULTS: Ninety-one studies were included in the present review, with a total number of 11,074 pregnant women. A meta-analysis was not conducted due to the high inter-study heterogeneity. Current evidence suggests that fatty acid-binding protein-4 levels are significantly increased in pregnancies complicated with gestational diabetes, while no association of serum apelin and monocyte chemoattractant protein-1 with the disease can be supported. Data regarding the rest adipokines are conflicting, since the available studies did not unanimously indicate a significant change of their levels in gestational diabetes. CONCLUSIONS: The findings of the present systematic review suggest the promising role of fatty acid-binding protein-4 in the prediction of gestational diabetes, while inconsistent evidence exists regarding the rest novel adipokines. Future cohorts are needed to assess their predictive efficacy and fully elucidate their contribution in the disease.
Subject(s)
Adipokines/blood , Biomarkers/blood , Diabetes, Gestational/diagnosis , Diabetes, Gestational/blood , Female , Humans , Pregnancy , PrognosisABSTRACT
Isolated left ventricular non-compaction (LVNC) is a rare disorder, classified as a primary genetic cardiomyopathy by the American Heart Association or as an unclassified cardiomyopathy by the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. The key features are the prominent trabeculae and deep intratrabecular recesses resulting in thickened myocardium with the two layers consisting of compacted and non-compacted myocardium. These recesses are in continuity with the left ventricular cavity and are filled with blood without evidence of communication to the epicardial coronary artery system. We present a case of LVNC detected prenatally at 25 + 4 weeks of gestation.
Subject(s)
Heart Ventricles/diagnostic imaging , Isolated Noncompaction of the Ventricular Myocardium/diagnostic imaging , Prenatal Diagnosis , Adult , Female , Heart Ventricles/embryology , Heart Ventricles/physiopathology , Humans , Infant, Newborn , Isolated Noncompaction of the Ventricular Myocardium/embryology , Isolated Noncompaction of the Ventricular Myocardium/physiopathology , Male , Pregnancy , Pregnancy Outcome , Ultrasonography, Doppler, ColorABSTRACT
The diagnosis and assessment of brain damage is currently based on the clinical examination and the modern neuro-imaging techniques. Electrophysiology, haemodynamic monitoring and invasive neuromonitoring constitute additional tools for monitoring of the brain function and clinical course of the patient. However, despite the substantial progress, clinical and neuro-monitoring methods are quite often not sufficient to evaluate and quantify the severity of the initial and secondary destructive processes and hence they cannot guide efficient therapeutic measures and prognosticate effectively the outcome. During the last decades, researchers and clinicians have focused on specific markers of brain cell damage to improve the diagnosis and monitoring of neurological insults. Lactate dehydrogenase, creatine kinase, neuron specific enolase, have been proposed as potential markers of brain injury. More recently, other glial markers such as the Myelin Basic Protein, the glial fibrillary acidic protein and the S-100B protein have been measured in blood and used as surrogate biochemical markers for brain injury. This review summarizes published findings on the above brain specific serum biochemical markers with emphasis on those with clinical utility.
Subject(s)
Biomarkers/metabolism , Brain Injuries/diagnosis , Brain Injuries/metabolism , Animals , Biomarkers/blood , Brain Injuries/blood , Humans , Inflammation/blood , Inflammation/metabolism , Nerve Tissue Proteins/blood , Nerve Tissue Proteins/metabolism , Reproducibility of ResultsABSTRACT
Vertical transmission of hepatitis B virus (HBV) infection during the perinatal period is the major cause of HBV transmission. The aim of our study was to evaluate the serological and virological profiles of HBV infection in cord blood samples obtained from HBeAg-negative chronic HBV-infected women, at delivery, and to investigate their relationship with the clinical outcome (possible transmission of HBV) in neonates receiving the currently approved passive-active immunoprophylaxis schedule. Sixteen women (32%) exhibited HBsAg positivity in the cord blood but HBV-DNA has not been detected in any of the 50 cord blood samples evaluated. We conclude that HBsAg can be transferred through the placental barrier, as with other proteins, in about one third of HBeAg-negative chronic HBV-infected pregnant women, irrespective of the maternal viral load, the mode of delivery or the placenta HBV pathology. The clinical impact of this phenomenon on the intrauterine-transplacental or perinatal transmission of HBV infection and/or passive-active immunoprophylaxis failure does not seem to be important.
Subject(s)
DNA, Viral/blood , Fetal Blood/virology , Hepatitis B Surface Antigens/blood , Hepatitis B e Antigens/blood , Hepatitis B virus/isolation & purification , Hepatitis B, Chronic/transmission , Infectious Disease Transmission, Vertical/prevention & control , Female , Hepatitis B, Chronic/diagnosis , Humans , Immunization, Passive , Immunotherapy, Active , Infant, Newborn , PregnancyABSTRACT
OBJECTIVE: To determine the value of amniotic fluid interleukin-18 (AF IL-18) in the diagnosis of microbial invasion of the amniotic cavity and prediction of preterm delivery (PTD). DESIGN: Analysis of the results of AF collected prospectively following genetic amniocentesis between February 2006 and September 2007. SETTING: A tertiary referral centre for fetal medicine. METHODS: Following amniocentesis, a sample of amniotic fluid was transferred to the laboratory for aerobic and anaerobic bacterial cultures, Ureaplasma urealyticum culture and IL-18 assays. All women who delivered preterm (<37 weeks of gestation) formed the study group. The control group consisted of the two subsequent women who also underwent amniocentesis during the same time period and delivered a normal neonate at term, matched for maternal age, parity and indication for amniocentesis. MAIN OUTCOME MEASURES: The relationship between AF IL-18 levels and the risk of both microbial invasion of the amniotic cavity and PTD. RESULTS: Forty-eight women who delivered preterm (<37 weeks) were matched with 96 controls. The preterm delivery group had significantly higher concentrations of IL-18 (median=609 pg/ml, interquartile range: 445.7-782.7) compared to controls (median=322.1 pg/ml, interquartile range: 277.7-414.4), (P<0.001). IL-18 level was also significantly higher (P<0.001) in cases with positive amniotic fluid cultures (median=697.7, interquartile range: 609.0-847.2) compared to those with negative ones (median=330.9 pg/ml, interquartile range: 235.2-440.8). CONCLUSIONS: Elevated mid-trimester concentrations of AF IL-18 can identify women at risk for intraamniotic infection and spontaneous PTD.
Subject(s)
Amniotic Fluid/microbiology , Bacterial Infections/diagnosis , Interleukin-18/analysis , Pregnancy Complications, Infectious/diagnosis , Premature Birth/microbiology , Adult , Amniocentesis , Amniotic Fluid/chemistry , Biomarkers/analysis , Female , Gestational Age , Humans , Maternal Age , Parity , Pregnancy , Premature Birth/diagnosis , Prospective StudiesABSTRACT
In the present case, ultrasound examination ruled out the presence of hematosalpinx or other gynecological tumors. This was of great importance to the surgical intervention, especially for avoiding laparotomy. Dilatation of the vagina and uterus, due to imperforate hymen with retrograde menstruation should be considered in the differential diagnosis of abdominal pain in premenarchal girls (Fig. 2, Ref. 15). Full Text (Free, PDF) www.bmj.sk.
Subject(s)
CA-125 Antigen/blood , Hematometra/diagnostic imaging , Hymen/abnormalities , Adolescent , Diagnosis, Differential , Female , Genital Neoplasms, Female/diagnosis , Hematometra/complications , Humans , UltrasonographyABSTRACT
OBJECTIVES: The aim of this study was to present a systematic review of the use of three-dimensional ultrasound for the detection and evaluation of intrauterine device malposition in a patient of our department. BACKGROUND: Transvaginal sonography failed to detect IUD misplacement in about 9% of cases. Whereas the three-dimensional ultrasound (3D), a new emerging technology, that could provide precise evaluation of IUD malposition. METHODS: The data were extracted from the literature using computerised Medline system. The use-effectiveness and acceptance of three-dimensional imaging in the detection of IUD malposition was examined as an alternative method to two-dimensional ultrasound. RESULTS: Three-dimensional ultrasound was more accurate than two-dimensional for the identifying IUD device. Three-dimensional technique enables assessment of IUD length in the longitudinal section synchronically with imaging arms of the device. Examination with 2D ultrasound is limited to transverse views of the shaft. The arms or other smaller parts cannot be investigated completely because of the frontal view of an IUD is rarely presented. CONCLUSION: Three-dimensional ultrasound is a new and promising imaging tool which provides much better view of the endometrial cavity. This is especially useful in uterus examination and in the detection of IUDs because structures that are not located in one single plane can be imaged simultaneously. Three-dimensional ultrasound is considered to be more secure and safer diagnostic technique to determine the location of IUDs than hysteroscopic evaluation (Fig. 2, Ref. 17). Full Text (Free, PDF) www.bmj.sk.
Subject(s)
Imaging, Three-Dimensional , Intrauterine Devices , Uterus/diagnostic imaging , Female , Humans , UltrasonographyABSTRACT
Irrigation with treated wastewater could produce excessive accumulations within the plant and soil, negatively affecting the yield and production quality. In addition, the presence of biological and chemical contaminants could harm the agricultural environment, as well as the health of farmers and consumers. During this work, the suitability of secondary and tertiary treated wastewater for use in young grapevines was evaluated by studying the effect of the wastewater irrigation on the soil-plant system, crop yield, fruit quality and the presence of inorganic chemical contamination (salts, elements and heavy metals), organic chemical contamination (polycyclic aromatic hydrocarbons) and microbial contamination (E. coli, total coliforms). The results show that tertiary treated wastewater had positive impact on plant growth and yield while secondary treated wastewater had negative impact on fruit safety in comparison with tap water. Sodium levels in soils irrigated with treated wastewater increased at the end of the irrigation period while decreased during the wet season. The total polycyclic aromatic hydrocarbon concentrations in the soils ranged from 363⯵g/kg to 374⯵g/kg at the end of the experiment for all irrigation treatments applied. The use of tertiary treated wastewater was recommended for the irrigation of young grapevines as an alternative water source secured protection of environment, plant health and fruit quality.
Subject(s)
Vitis/growth & development , Waste Disposal, Fluid/methods , Wastewater/analysis , Agricultural Irrigation , Enterobacteriaceae/isolation & purification , Enterobacteriaceae/physiology , Escherichia coli/isolation & purification , Escherichia coli/physiology , Fruit/growth & development , Fruit/physiology , Soil Pollutants/metabolism , Vitis/drug effects , Vitis/physiologyABSTRACT
Recent evidence suggests that the oxidative stress is an important factor in the pathophysiology of pre-eclampsia. The purpose of this study was to evaluate the possible relationship between increased resistance at the Doppler assessment of the uterine arteries between 20-23 gestational weeks and biochemical markers of oxidative stress, with the development of pre-eclampsia and/or growth restricted infants. This was a prospective study of 34 pregnant women with normal uteroplacental flow and 30 women with abnormal uterine arteries Doppler analysis (mean PI >or= 1.60) during the transvaginal assessment of the uterine arteries at the routine anomaly scan. Blood samples were obtained in order to assess the plasma oxidative stress, namely malondialdehyde (MDA) and uric acid levels. The MDA was significantly higher in the group of women with abnormal uterine arteries Dopplers. This group is at increased risk for the development of pre-eclampsia. The uric acid levels did not differ significantly between the two groups of women. There was no significant difference regarding the sensitivity or the specificity of the uterine arteries Doppler examination in detecting pre-eclampsia in comparison to the combination of oxidative stress and Doppler's. Our study provides additional evidence regarding the role of oxidative stress in the pathophysiology of pre-eclampsia. Whether antioxidant supplementation in the group of women with abnormal uterine Doppler's is effective in reducing the incidence of the disease remains to be established.
Subject(s)
Malondialdehyde/blood , Mass Screening/methods , Oxidative Stress , Pre-Eclampsia/diagnosis , Ultrasonography, Prenatal , Uterus/blood supply , Adult , Biomarkers , Case-Control Studies , Female , Fetal Growth Retardation/blood , Fetal Growth Retardation/diagnostic imaging , Follow-Up Studies , Gestational Age , Humans , Malondialdehyde/analysis , Pre-Eclampsia/blood , Predictive Value of Tests , Pregnancy , Pregnancy Outcome , Pregnancy Trimester, Second , Probability , Prospective Studies , ROC Curve , Regional Blood Flow/physiology , Risk Assessment , Sensitivity and Specificity , Ultrasonography, Doppler, Color , Uric Acid/analysis , Uric Acid/metabolismABSTRACT
Henoch-Schonlein purpura (HSP) is a hypersensitivity vasculitis. This is a case report of HSP during pregnancy and a review of the literature in this rare pregnant disease. We present a case of a 32-year-old woman with HSP. Treatment with low-dose oral corticosteroids was administered leading to a beneficial outcome for the fetus and the mother. Henoch-Schonlein purpura is the most common connective tissue disorder of children. It is rarely reported in adults. Only 16 cases of HSP during pregnancy have been described in the literature worldwide, and this is the 17th reported case.
Subject(s)
IgA Vasculitis/diagnosis , Pregnancy Complications, Hematologic/diagnosis , Adult , Female , Glucocorticoids/administration & dosage , Humans , IgA Vasculitis/drug therapy , Methylprednisolone/administration & dosage , Pregnancy , Pregnancy Complications, Hematologic/drug therapyABSTRACT
OBJECTIVE: To compare outcomes for fetuses at term in breech presentation during 2 periods when different delivery policies were in effect. METHODS: Outcomes of the 392 planned vaginal deliveries and 1160 elective cesarean sections (CSs) performed from January 1, 1988, through December 31, 2000, were compared with those of the 24 emergency vaginal deliveries, the 403 planned CSs, and 75 emergency CSs performed from January 1, 2001 through December 31, 2004 at Alexandra Hospital, Athens, Greece. RESULTS: A significant difference was found in rates of low 5-minute Apgar score, birth trauma, serious neonatal morbidity, and admission to the neonatal intensive care unit (0% vs. 1.02% [P=0.004], 1.02% vs. 0% [P=0.004], 3.06% vs. 0.43% [P<0.001], and 2.8% vs. 0.43% [P<0.001], respectively) between neonates born by planned vaginal delivery and those born by elective CS during the first period. Only a reduction in rates of admission to the neonatal intermediate care unit was found between the first and second periods. CONCLUSIONS: Planned CS was found to be safer than planned vaginal delivery for fetuses at term in breech presentation. However, the study did not demonstrate that the change in policy improved neonatal outcome.
Subject(s)
Breech Presentation , Cesarean Section/statistics & numerical data , Delivery, Obstetric/statistics & numerical data , Pregnancy Outcome , Adult , Apgar Score , Birth Injuries/epidemiology , Birth Weight , Cohort Studies , Emergencies , Female , Humans , Infant, Newborn , Intensive Care Units, Neonatal , Patient Admission/statistics & numerical data , Pregnancy , Retrospective StudiesABSTRACT
PURPOSE OF INVESTIGATION: To determine the value of three-dimensional (3D) sonography and 3D power Doppler in distinguishing borderline ovarian tumors from benign cysts and malignant tumors. METHODS: One hundred and seventy-two women with a mean age of 37 years (range 28-45) and diagnosis of a confirmed pelvic mass were referred for preoperative evaluation with 3D sonography and 3D power Doppler. Sonographic criteria used for the diagnosis of borderline tumors were based on a system that included morphological characteristics, histological evaluation and power Doppler imaging. RESULTS: Ten lesions were histopathologically diagnosed as borderline ovarian tumors, 42 as malignant and 120 as benign. Three-dimensional sonography revealed 120 ovarian tumors which scored below 7 (benign), according to Kurjak's scale, 12 tumors which scored between 7-8 and 40 tumors between 9-13 (malignant). CONCLUSIONS: Preoperative assessment of borderline tumors by 3D imaging may promote improved patient care and introduce laparoscopic management as an alternative surgical approach.
Subject(s)
Imaging, Three-Dimensional , Ovarian Neoplasms/diagnostic imaging , Ultrasonography, Doppler , Adult , Female , Humans , Middle Aged , Ovarian Cysts/diagnostic imaging , Ovarian Neoplasms/pathologyABSTRACT
OBJECTIVE: Most minimally invasive procedures are now performed in operating rooms that were originally designed for traditional open surgery. We designed an endoscopic theatre based on our experience with special features specific for gynaecological endoscopy. METHOD: We designed a detailed plan with an architect's aid of a gynaecological unit (based on a Greek presidential decree published in 1991). The space utilized was that of a conventional theatre. RESULTS: With the architectural plan we anticipated every area needed in a gynaecological endoscopic theatre. A twin theatre was considered appropriate in order for the surgical team to operate alternatively in one theatre while the other is being cleaned and prepared for use. CONCLUSION: The design of a unit dedicated to gynaecologic laparoscopy is a multidisciplinary task where the endoscopic surgeon undertakes an active and prominent role. It is a project with great benefits and rewards for all parties involved. We present our design for evaluation.
Subject(s)
Endoscopy , Gynecologic Surgical Procedures , Hospital Design and Construction , Operating Rooms , Female , HumansABSTRACT
S-100 protein, described initially by Moore, constitutes a large family of at least 20 proteins with calcium binding ability. It is found as homo- or hetero-dimers of two different subunits (A and B). Types S-100AB and S-100BB are described as S-100B protein and are shown to be highly specific for nervous tissue. It is present in the cytosol of glial and Schwann cells, and also in adipocytes and chondrocytes, although in very low concentrations in the latter two. The role of protein S-100B is not yet fully understood. It is suggested that it has intracellular and extracellular neurotropic as well as neurotoxic function. At nanomolar levels, S-100B stimulates neurite outgrowth and enhances survival of neurons. However, at micromolar levels it stimulates the expression of inflammatory cytokines and induces apoptosis. Recently, serum S-100B protein has been proved to be an attractive surrogate marker of primary severe brain injury and secondary insults. It can be measured in the arterial and venous serum; it is not affected by haemolysis and remains stable for several hours without the need for immediate analysis. Its short half-life makes measurements crucial in the emergency and intensive care settings. This review summarises published findings on S-100B regarding its role as a serum biochemical marker of brain injury, i.e., after severe, moderate or mild neuro-trauma, subarachnoid haemorrhage, thrombo-embolic stroke, cerebral ischaemia and brain tumours, as well as extracranial trauma, neurodegenerative and psychiatric disorders.
Subject(s)
Brain Injuries/diagnosis , Nerve Growth Factors/blood , S100 Proteins/blood , Brain Injuries/physiopathology , Humans , Nerve Growth Factors/physiology , S100 Calcium Binding Protein beta Subunit , S100 Proteins/physiologyABSTRACT
Tomato and cucumber seedlings were distributed into 10 groups (five for each plant) of 15 plants each. The plants were irrigated for 10 weeks with primary treated wastewater (group A), secondary treated wastewater (group B), chlorinated secondary treated wastewater (group C), a fertilizer dilution (group F), and tap water (group M). All precautions were taken to secure that there was no direct contact between the wastewater and the edible portions of the crops. During this period and on a weekly basis, the height and number of leaves was monitored, while, at the end, the dry weight of leaves, stems, and roots for each plant of each group was measured. Based on these growth parameters, both types of plant in groups A and F recorded the most significant development compared to the other three groups. The plants irrigated with tap water recorded the smallest development, in every case. Plants in groups B and C were similar, with a slight (but not significant) superiority for the plants irrigated with secondary treated wastewater, probably as a result of some phytotoxic effects of residual chloride in the chlorinated wastewater. The presence of nutrients and specifically nitrogen in the various solutions explains the differences satisfactorily. The vegetables grown on the plants of each group were harvested, and their surface tissue analyzed for total coliforms (TC) and enterococci (EC). Tomatoes grown on the plants of groups A and B recorded the highest values for TC, with 505 and 490 cfu/g, respectively, whereas, for cucumbers, those values were 342 and 450 cfu/g, respectively. Enterococci were detected on the surface of harvested vegetables from groups A and B, but the small number of cases and their random character cannot support any strong relations between the used wastewater and their presence. The TC values in group C were very low, far lower than those if group F. No EC were found in either group C or group F. These primary results suggested that irrigation with appropriate disinfected wastewater, even of such high-risk cultivations of vegetables eaten raw, should not be discarded completely as unsafe, but be reconsidered and studied further. However, the use of undisinfected wastewater in such greenhouse cultivations, where all safety precautions have been taken to prevent any contact of the fruits with the soil or the wastewater, does not prove to be 100% safe.