The Arabin pessary for the treatment of threatened mid-trimester miscarriage or premature labour and miscarriage: a case series.

OBJECTIVE: The Arabin pessary may be beneficial in the treatment of cervical incompetence. The aim of the study was to analyse the efficacy of the treatment method of pregnant women with cervical incompetence. METHODS: A non-randomised study performed in the obstetrical wards in Lodz, Poland utilising 54 pregnant women with cervical incompetence was developed to assess the efficiency of treatment methods of cervically incompetent women. These women were diagnosed by vaginal ultrasound examination during the course of the study. Patients with a cervical length of 15-30 mm before 28 weeks an Arabin cervical pessary were inserted, women whose cervical length was less than 15 mm were treated with cervical cerclage. The main end points of the study were preterm or term delivery. RESULTS: In the Arabin pessary group, 1.9% of women delivered before the 29th week of gestation and 83.3% of women delivered after 37 weeks of pregnancy. Eighty-seven per cent of pregnant women treated for cervical incompetence by Arabin pessary delivered by normal spontaneous labour, 1.9% delivered by forceps labour and 11.1% of patients by caesarean section. Among pregnant women treated by Arabin pessary, 3.7% of newborns were estimated as having a score of 0-4 on the Apgar scale, 13% a score of 5-7 and 83.3% a score of 8-10. CONCLUSIONS: Cervical incompetence treatment effectively prolongs the duration of gestation. Application of the Arabin pessary is an effective method of cervical incompetence treatment.

[Value of cardiovascular magnetic resonance in acute myocarditis]. / Wertigkeit der kardialen Magnetresonanztomografie bei akuter Myokarditis.

Cardiovascular magnetic resonance imaging (MRI) demonstrates location, activity and extent of inflammation in acute myocarditis. A combined approach, using different imaging modalities (T2-IR-weighted imaging, early and late gadolinium enhancement) provides high diagnostic accuracy. The type of myocardial virus infection (PVB19, HHV6) may be related to the pattern of inflammation demonstrated by cardiovascular MRI and the clinical course. Whether specific patterns of late gadolinium enhancement in myocarditis are associated with poor prognosis remains a subject for further investigation. Cardiovascular MRI in myocarditis is believed to become a significant imaging tool in identifying patients at risk for heart failure and ventricular arrhythmias. These patients may need specific treatment, such as antiviral or immunosuppressive medication, dependent on the result of endomyocardial biopsy.

Hyperthermia effect on lipolytic processes in rat blood and adipose tissue.

Rats anaesthetized with Brevinarcon were placed in a high-temperature chamber (air temperature 50 degrees C, relative humidity 50%) for induction of hyperthermia (rectal temperature 41.0 +/- +/- 0.5 degrees C). The control group comprised rats anaesthetized in the same way but kept at room temperature. In the serum in both groups glucose, free fatty acids, immunoreactive insulin, lipolytic activity and ability to mobilize lipids in vitro were determined. It was shown that the glucose and free fatty acid levels and the activity mobilizing serum lipids in vitro in the rats subjected to hyperthermia were lower than in the control group by 12%, 23% and 150% respectively. The lipolytic activity of the serum of rats subjected to hyperthermia was 42% higher, and the level of immunoreactive insulin rose by about 224% in relation to the control group. These results point to inhibition of lipolysis in the adipose tissue with simultaneous activation of intravascular lipolysis during hyperthermia in rats.

Effect of hyperthermia on blood levels of corticosterone and certain metabolites in rats during thiobutabarbital anaesthesia.

No changes were found in the serum levels of corticosterone, pyruvate and lactate in rats during general anaesthesia with thiobutabarbital (Brevinarcon) subjected to short-lasting hyperthermia in a high-temperature chamber (air temperature 50 degrees C, relative humidity 50%) in relation to a control group of rats during similar general anaesthesia at room temperature. However, in the serum of rats during hyperthermia (rectal temperature 40-41 degrees C) the glucose level was about 52% lower and FFA were about 39% lower than in rats kept under normothermic conditions (rectal temperature 36.5-37.5 degrees C) which may point to an increased requirement of tissues for energy-yielding substrates at higher body temperatures and/or increased insulin secretion.