Pregnancy complicated by central diabetes insipidus and oligohydramnios.

This is the fourth reported case of central diabetes insipidus with oligohydramnios. Central diabetes insipidus does not adversely affect pregnancy; it can present with oligohydramnios, which can be improved by treating central diabetes insipidus.

Reliability assessment of the functional movement screen for predicting injury risk in Japanese college soccer players.

[Purpose] This study aimed to assess the reliability of the Functional Movement Screen and explore whether this evaluation tool can predict the risks of personal injuries in Japanese soccer players. [Participants and Methods] Seventy-five Japanese college soccer players who participated in our 1 year prospective cohort study underwent a Functional Movement Screen assessment. Demographic data, athletic characteristics, and types and frequency of injuries sustained, were analyzed with the assessment results. [Results] There was no significant difference in the mean Functional Movement Screen composite scores between genders. Although the Functional Movement Screen showed excellent inter-rater reliability (0.92), low overall internal consistency (0.35) was observed. A maximum score of 3 in straight leg raise occurred in 94% of the females and was considered a ceiling effect. None of the cut-off point scores of the Functional Movement Screen were associated with the number of overall injuries, lower limb injuries, and traumatic injuries, or time to return to play. The Functional Movement Screen composite score of ≤15 represented the maximum sensitivity of 76.92% and specificity of 34.78% with 0.56 in the area under the curve. [Conclusion] Functional Movement Screen composite scores do not have sufficient sensitivity and specificity for predicting injuries in Japanese college soccer players.

Analysis of immunological markers associated with pregnancy and HIV-1 infection: relevance in perinatal transmission in HIV-1-infected pregnant women with low plasma viral load.

PROBLEM: In HIV-1-infected pregnant women with low plasma viral load, risk factors associated with perinatal HIV-1 transmission are not clearly understood. METHOD OF STUDY: We analyzed distribution of peripheral CD8 T-cell subsets, plasma cytokines and measured secretory leukocyte peptidase inhibitor (SLPI) and myeloid-related protein (MRP)-8 levels in whole-blood and cervico-vaginal fluid (CVF) specimens obtained from 35 HIV-1-infected pregnant women (group 1), 12 HIV-1-infected non-pregnant women (group 2) and 15 HIV-1 uninfected pregnant women (group 3). RESULTS: The group 1 women had higher expression of CD38, human leukocyte antigen-DR and CD95 on CD8 T-cells and higher levels of plasma tumor necrosis factor-alpha and epidermal growth factor. CVF-SLPI levels were the highest in group-3, while MRP-8 levels were the highest in group 1 women in plasma and CVF (P < 0.01). Although there were no cases of perinatal HIV-1 transmission, group 1 women undergoing HIV-1-indicated cesarean section had lower levels of CVF-SLPI as compared with those undergoing normal vaginal delivery. CONCLUSION: Pregnancy contributes to the activation of peripheral CD8 T cells and increase in pro-inflammatory cytokines. Production of protective mucosal secretory factors such as SLPI is affected by HIV-1 infection in pregnant women and down-regulated SLPI levels may indirectly indicate a higher possibility of perinatal HIV-1 transmission.

[Correlation between measles-neutralizing antibody and HI antibody, between measles-neutralizing antibody and PA antibody among pregnant women, and protective levels of three titration types].

When measles antibody levels among pregnant women were measured with measles hemagglutinin inhibition (HI), 31% of subjects had negative HI antibody titers. When the same blood samples were tested with measles gelatin particle agglutination (PA) and neutralizing (NT), the percentages of those with negative antibody levels were 1% and 3%. We conducted the correlation between antibody titers measured by the three types of titration. Correlation between NT and HI antibody titers higher than 1:8 and that between NT and PA antibody titers were good, but 81% of subjects whose HI antibody titer was below 1:8 and all women with HI antibody of 1:8 were found to have NT antibody titer higher than 1:4. NT antibody titer higher than 1:4 was found in 95% of women having PA antibody titer of 1:256 and in 99% of those with PA antibody titer of 1:512. Based on the relationships to measles NT antibody level, the majority of subjects with HI antibody titer higher than 1:8 or PA antibody level higher than 1:512 was reasonably assumed to be protected against clinical measles. PA seemed superior to HI in finding subjects with insufficient immunity against measles, because the former detects weak immunity more efficiently than the latter.

Plasma levels of alpha-defensins 1-3 are an indicator of neutrophil activation in pregnant and post-partum women.

AIM: In severe preeclampsia and septic shock, excessively activated neutrophils are thought to injure tissue irreversibly. On the other hand, mild neutrophil activation is known to occur during normal pregnancy. The objective of this study was to determine whether elevated plasma levels of alpha-defensins 1-3 could be used as an indicator of neutrophil activation in pregnant and post-partum women. METHODS: Defensin concentrations in 21 non-pregnant women and men, 184 normal pregnant women, and 55 post-partum women were quantified using an enzyme-linked immunosorbent assay (ELISA). The expression of the surface markers, CD11b and Toll-like receptor-4 (TLR-4), on the neutrophils were analyzed by flow cytometry in a cohort of subjects different from that used for the analysis of alpha-defensin levels. RESULTS: The concentrations of alpha-defensins were significantly higher in women that were in labor than in any of the other subjects. These levels diminished after delivery, but remained significantly elevated at one month post-partum. The expression of both CD11b and TLR-4 was significantly higher in women in labor compared to non-pregnant donors (controls). CD11b expression remained high on the third post-partum day, while TLR-4 expression fell to non-pregnant levels. CONCLUSION: Our results suggest that there is a positive association between defensin levels and neutrophil activation in pregnant and post-partum women.