A study on the measurement of the nucleated red blood cell (nRBC) count based on birth weight and its correlation with perinatal prognosis in infants with very low birth weights

PurposeThe aim of this study was conducted to investigate the mean nRBC count in very low births weight infants (VLBWIs) and to determine the usefulness of the nRBC as an independent prognostic factors of perinatal complications in VLBWIs.MethodsThis study was conducted on 112 VLBWIs who were hospitalized in the neonatal intensive care unit (NICU) of the author's hospital within the period from March 2003 to and May 2008. Based on the infants' nucleated red blood cells (nRBC) counts at birth, on the third day after birth, on the seventh day after birth, in the second week after birth, and in the fourth week after birth in the medical records, the correlation between nRBC or absolute nRBC counts with birth weight, gestational age, and other perinatal outcomes were retrospectively investigated.ResultsIn VLBWIs, their mean nRBC and absolute nRBC counts were showing a gradual decrease after birth, and they were consisteantly kept at low values since one week after and inversely proportional to the birth weights. The mean nRBC counts based on the stage after birth showed a significant correlation with perinatal death, necrotizing enterocolitis, and severe intraventricular hemorrhage.ConclusionThe increase in the nRBC count showed a significant correlation with having a severe intraventricular hemorrhage, necrotizing enterocolitis, and perinatal death in VLBWIs. If an increase or no decrease in the nRBC count after birth is observed, newborn-infant care precautions should be required

Evaluation of GeneXpert and advanced biological laboratories UltraGene HCV diagnostic detection and performance against Roche real time PCR in Myanmar

BackgroundDeveloping countries experience limited access to HCV laboratory tests for different reasons. Providing near to real-time HCV testing and results especially to at-risk populations including those in rural settings for timely initiation to treatment is key. Within a rural Myanmar setting, we compared HCV diagnostic detection and quantification of the GeneXpert, and Advanced Biological Laboratories UltraGene-HCV assays against the gold standard and reference method Roche real-time HCV in Myanmar.MethodsBlood samples from 158 high-risk individuals were assessed using three different methods at baseline. Results were checked for normality and log transformed. Log differences and bias between methods were calculated and correlated. Pearson's correlation coefficient was used to determine the association of HCV viral loads across all methods. The level of agreement with the standard method (Roche real time HCV) was assessed using Bland-Altman analyses.ResultsThere was a strong positive correlation coefficient between all three methods with GeneXpert and Roche having the strongest, r = 0.96, (p<0.001). Compared to Roche, ABL (mean difference, 95 % limits of agreement; -0.063 and -1.4 to 1.3 Log10IU/mL) and GeneXpert (mean difference, 95 % limits of agreement; -0.28 and -0.7 to 1.8 Log10IU/mL) showed a good level of agreement with the GeneXpert being slightly superior.ConclusionWe demonstrate the excellent performance and no-inferiority, in terms of levels of agreements of both GeneXpert and ABL compared to the Roche platform and supporting the use of the POC assays as alternative a cost-effective methods in HCV detection and diagnosis in developing and low resource settings countries

Disproportionate Intrauterine Growth Intervention Trial At Term: DIGITAT

Contains fulltext : 65628.pdf ( ) (Open Access)BACKGROUND: Around 80% of intrauterine growth restricted (IUGR) infants are born at term. They have an increase in perinatal mortality and morbidity including behavioral problems, minor developmental delay and spastic cerebral palsy. Management is controversial, in particular the decision whether to induce labour or await spontaneous delivery with strict fetal and maternal surveillance. We propose a randomised trial to compare effectiveness, costs and maternal quality of life for induction of labour versus expectant management in women with a suspected IUGR fetus at term. METHODS/DESIGN: The proposed trial is a multi-centre randomised study in pregnant women who are suspected on clinical grounds of having an IUGR child at a gestational age between 36+0 and 41+0 weeks. After informed consent women will be randomly allocated to either induction of labour or expectant management with maternal and fetal monitoring. Randomisation will be web-based. The primary outcome measure will be a composite neonatal morbidity and mortality. Secondary outcomes will be severe maternal morbidity, maternal quality of life and costs. Moreover, we aim to assess neurodevelopmental and neurobehavioral outcome at two years as assessed by a postal enquiry (Child Behavioral Check List-CBCL and Ages and Stages Questionnaire-ASQ). Analysis will be by intention to treat. Quality of life analysis and a preference study will also be performed in the same study population. Health technology assessment with an economic analysis is part of this so called Digitat trial (Disproportionate Intrauterine Growth Intervention Trial At Term). The study aims to include 325 patients per arm. DISCUSSION: This trial will provide evidence for which strategy is superior in terms of neonatal and maternal morbidity and mortality, costs and maternal quality of life aspects. This will be the first randomised trial for IUGR at term. TRIAL REGISTRATION: Dutch Trial Register and ISRCTN-Register: ISRCTN10363217

Oxidative stress in placental pathology

The most important function of the placenta is the exchange of nutrients and oxygen between a mother and her fetus. To establish a healthy functioning placenta, placentation needs to occur with adequate remodelling of spiral arteries by extravillous trophoblasts. When this process is impaired, the resulting suboptimal and inadequate placenta function results in the manifestation of pregnancy complications. Impaired placenta function can cause preeclampsia and leads to fetal growth restriction due to hypoxia. Presence of hypoxia leads to oxidative stress due to an imbalance between reactive oxygen species and antioxidants, thereby causing damage to proteins, lipids and DNA. In the placenta, signs of morphological adaptation in response to hypoxia can be found. Different placental lesions like maternal or fetal vascular malperfusion or chronic villitis lead to a decreased exchange of oxygen between the mother and the fetus. Clinically, several biomarkers indicative for oxidative stress, e.g. malondialdehyde and reduced levels of free thiols are found. This review aims to give an overview of the causes and (potential) role of placental oxidative stress in the development of placental parenchymal pathology and its clinical consequences. Also, therapeutic options aiming at prevention or treatment of hypoxia of the placenta and fetus are described. (c) 2018 The Authors. Published by Elsevier Ltd

Interpersonal Discrimination and the Health of Illicit Drug Users

Although discrimination has been shown to adversely affect the health of marginalized populations, there is a paucity of research on the health impacts of discrimination experienced by illicit drug users. The purpose of this study was to examine the association between interpersonal discrimination and the mental and physical health of illicit drug users taking into account several potential confounding factors. A sample of 1,008 active illicit substance users (defined as having used cocaine, crack, or heroin in the previous 2 months) were recruited in three New York City neighborhoods between August 2000 and January 2001 using street-outreach techniques. Discrimination due to illicit drug use was the most common form of interpersonal discrimination experienced and more than one-half the study participants reported experiencing discrimination due to more than one attribute. Discrimination was significantly associated with poor mental health (measured by the SF-36 mental health score), depression (measured by the CES-D), and the number of self-reported chronic physical health conditions. The presence of multiple stigmatizing characteristics was associated with poorer mental and physical health. Discrimination may contribute to poor mental and physical health in this marginalized population, potentially complicating the provision of substance abuse treatment.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/40280/2/Young_Interpersonal Discrimination and the Health_2005.pd

State-church relations in the People's Republic of Poland in the years 1965-1979

W okresie Polskiej Republiki Ludowej, Polski Kościół stanowił istotną siłę opozycyjną w stosunku do komunistycznych władz państwowych. Od samego początku pojawienia się w Polsce socjalistycznego ustroju, polski Kościół Katolicki i jego duchowieństwo dbało o interes nie tylko Polski ale i jej obywateli. To własnie Kościół rozpoczął proces polonizacji Ziem Odzyskanych i Północnych, przyznanych Polsce po zakończeniu II wojny światowej, tworząc tam kościelną administrację jeszcze przed administracją państwową i zajmując się przesiedleńcami. Polski Kościół wpływał także na sytuację międzynarodową państwa Polskiego. To własnie m.in. przez jego działania i wydanie "Orędzia do biskupów niemieckich", doszło do podpisania układu pomiędzy PRL, a Republiką Federalną Niemiec i zatwierdzenia nienaruszalności polskich granic zachodnich na Odrze i Nysie Łużyckiej. Szczególnie ciężkim dla Polskiego Kościoła był okres władzy Władysława Gomułki na stanowisku I Sekretarza PZPR. W tym okresie Kościół zmagał się wieloma represjami, jakimi było nie wątpliwie upaństwowienie "Caritasu", powoływanie kleryków do wojska, infiltracja środowisk około kościelnych czy choćby liczne zakazy wyjazdów za granicę dla biskupów oraz brak pozwoleń na budowę nowych świątyń. Mimo wszystkich tych utrudnień ze strony państwowej, Polski Kościół wraz z kardynałem Stefanem Wyszyńskim na czele nie poddał się i kontynuował swoją misję. Okazją do pokazania jak wielką siłą w społeczeństwie jest Polski Kościół, w 1966 z inicjatywy Prymasa Wyszyńskiego, zorganizowano wielkie obchody "Millenium Chrztu Polski", w których, mimo konkurencyjnych państwowych uroczystości "Tysiąclecia Państwa Polskiego", udział wzięło miliony Polaków w całym kraju. Przebieg obchodów w 1966 roku pokazał, że to Kościół i jego hierarchowie sprawują w Polsce tzw."rząd dusz" i jest moralnym i duchownym przewodnikiem Narodu. Państwo zdawało sobie sprawę z autorytetu jakim w Polsce darzeni są duchowni i że mogą go wykorzystać przeciwko władzy ludowej, do czego nigdy Polski Episkopat się nie posunął, a wręcz hamował nastroje rewolucyjne w społeczeństwie jak m.in w Marcu 1968 i Grudniu 1970. Dopiero dekada Edwarda Gierka u sterów partii, sprawiła, że stosunki pomiędzy państwem, a kościołem uległy względnej normalizacji.During the period of the People's Republic of Poland, the Polish Church was a significant opposition force towards the communist state authorities. From the very beginning of the emergence of the socialist system in Poland, the Polish Catholic Church and its clergy cared for the interests of not only Poland but also its citizens. It was the Church that started the process of the Polonization of the Recovered and Northern Territories, granted to Poland after the end of World War II, creating a church administration there before the state administration and dealing with the displaced. The Polish Church also influenced the international situation of the Polish state. It is, among others through his actions and the publication of the "Message to German Bishops", an agreement between the Polish People's Republic and the Federal Republic of Germany was signed and the inviolability of the Polish western borders on the Oder and Nysa Łużycka was confirmed. The period of Władysław Gomułka's power as the First Secretary of the Polish United Workers' Party was particularly difficult for the Polish Church. During this period, the Church struggled with many repressions, which were undoubtedly the nationalization of "Caritas", the appointment of clerics to the army, the infiltration of church-related circles or even numerous bans on traveling abroad for bishops and the lack of permits to build new churches. Despite all these difficulties on the part of the state, the Polish Church, along with Cardinal Stefan Wyszyński at the head, did not give up and continued its mission. An opportunity to show the great strength of the Polish Church in society, in 1966, on the initiative of Primate Wyszyński, a great celebration of the "Millennium of the Baptism of Poland" was organized, in which, despite the competitive state celebrations of the "Millennium of the Polish State", millions of Poles all over the country took part. The course of the celebrations in 1966 showed that the Church and its hierarchs in Poland exercise the so-called "government of souls" and are the moral and spiritual guide of the Nation. The state was aware of the authority that clergymen are given in Poland and that they can use it against the people's government, which the Polish Episcopate never did, and even inhibited revolutionary moods in society, such as in March 1968 and December 1970. Only a decade Edward Gierek at the helm of the party, made the relations between the state and the church relatively normalized