Intrauterine Growth Restriction-Prediction and Peripartum Data on Hospital Care

Background and Objectives: We aimed to prospectively obtain data on pregnancies complicated with intrauterine growth restriction (IUGR) in the Prenatal Diagnosis Unit of the Emergency County Hospital of Craiova. We collected the demographic data of mothers, the prenatal ultrasound (US) features, the intrapartum data, and the immediate postnatal data of newborns. We aimed to assess the detection rates of IUGR fetuses (the performance of the US in estimating the actual neonatal birth weight), to describe the prenatal care pattern in our unit, and to establish predictors for the number of total hospitalization days needed postnatally. Materials and Methods: Data were collected from cases diagnosed with IUGR undergoing prenatal care in our hospital. We compared the percentile of estimated fetal weight (EFW) using the Hadlock 4 technique with the percentile of weight at birth. We retrospectively performed a regression analysis to correlate the variables predicting the number of hospitalization days. Results: Data on 111 women were processed during the period of 1 September 2019-1 September 2022. We confirmed the significant differences in US features between early- (Eo) and late-onset (Lo) IUGR cases. The detection rates were higher if the EFW was lower, and Eo-IUGR was associated with a higher number of US scans. We obtained a mathematical formula for estimating the total number of hospitalization days needed postnatally. Conclusion: Early- and late-onset IUGR have different US features prenatally and different postnatal outcomes. If the US EFW percentile is lower, a prenatal diagnosis is more likely to be made, and a closer follow-up is offered in our hospital. The total number of hospitalization days may be predicted using intrapartum and immediate postnatal data in both groups, having the potential to optimize the final financial costs and to organize the neonatal department efficiently.

Seasonal Changes in Qualitative and Quantitative Characteristics of Humic Substances in Waters of Different Genesis: Membrane Technologies and Equilibrium Processes

Membrane filtration methods were applied in this study to research natural waters specification (and speciation). Lysimetric waters (soil waters) of background territories in different seasons are considered. Features of the change in molecular weights, elemental composition, and zeta potential of organic matter during fractionation from 8 μm to 100 kDa were found. The number of labile and non-labile speciation of some elements obtained by membrane filtration and ion-exchange separation methods were found and compared. The highest molecular weights of organic substances were found in summer samples of lysimetric waters (more than 100 kDa) with a predominance of the aromatic component in the IR spectra of the samples. Several maxima were also found in the molecular weight distribution, including the increase in autochthonous organic substances. The most stable negative zeta potential, as a stabilized colloid matter, are represented in summer (near -26 mV) and in autumn (near -22 mV) lysimetric water. A slight increase in metal ions bound into organic complexes is typical for summer and autumn samples.

Progress Toward Reversed Uterine Diastolic Flow in the Third Trimester - An Inauspicious Sign

BACKGROUND

Increased uteroplacental resistance is associated with high uterine artery pulsatility and resistance indices and early diastolic notching. Evolution toward reversed diastolic uterine flow in the third trimester was scarcely reported previously. The feature was related to severe complications for both mother and fetus.

MATERIAL AND METHODS

Data were collected from 3638 pregnancies undergoing prenatal care in our hospital. In this study, we aimed to identify those pregnancies with development of a reversed diastolic flow at the spectral Doppler interrogation of uterine arteries later than 24 weeks of gestation. A secondary aim was to follow up and actively manage these pregnancies.

RESULTS

Previously, reversed uterine diastolic flow was reported during the third trimester in four cases only. In our study three pregnancies only developed reversed uterine arteries diastolic flow, none being associated with preeclampsia. All cases evolved with complications at birth.

CONCLUSIONS

Progressive deterioration of uterine arteries flow is possible during pregnancy. Reversed diastolic flow is a rare occurrence in the third trimester of pregnancy. Based on current knowledge, it may be considered an ominous sign and should trigger a close follow-up. Future studies using routine investigation of uterine arteries flow late in pregnancy may prove informative.

Early Onset Intrauterine Growth Restriction-Data from a Tertiary Care Center in a Middle-Income Country

Background and Objectives: In this study, we aimed to describe the clinical and ultrasound (US) features and the outcome in a group of patients suspected of or diagnosed with early onset intrauterine growth restriction (IUGR) requiring iatrogenic delivery before 32 weeks, having no structural or genetic fetal anomalies, managed in our unit. A secondary aim was to report the incidence of the condition in the population cared for in our hospital, data on immediate postnatal follow-up in these cases and to highlight the differences required in prenatal and postnatal care. Materials and Methods: We used as single criteria for defining the suspicion of early IUGR the sonographic estimation of fetal weight < p10 using the Hadlock 4 technique at any scan performed before 32 weeks’ gestation (WG). We used a cohort of patients having a normal evolution in pregnancy and uneventful vaginal births as controls. Data on pregnancy ultrasound, characteristics and neonatal outcomes were collected and analyzed. We hypothesized that the gestational age (GA) at delivery is related to the severity of the condition. Therefore, we performed a subanalysis in two subgroups, which were divided based on the GA at iatrogenic delivery (between 27+0 WG and 29+6 WG and 30+0−32+0 WG, respectively). Results: The prospective cohort study included 36 pregnancies. We had three cases of intrauterine fetal death (8.3%). The incidence was 1.98% in our population. We confirmed that severe cases (very early diagnosed and delivered) were associated with a higher number of prenatal visits and higher uterine arteries (UtA) pulsatility index (PI) centile in the third trimester—TT (compared with the early diagnosed and delivered). In the very early suspected IUGR subgroup, the newborns required significantly more NICU days and total hospitalization days. Conclusions: Patients with isolated very early and early IUGR—defined as ultrasound (US) estimation of fetal weight < p10 using the Hadlock 4 technique requiring iatrogenic delivery before 32 weeks’ gestation—require closer care prenatally and postnatally. These patients represent an economical burden for the health system, needing significantly longer hospitalization intervals, GA at birth and UtA PI centiles being related to it.

Consumption of ultra-processed foods and health status: a systematic review and meta-analysis

Increasing evidence suggests that high consumption of ultra-processed foods (UPF) is associated with an increase in non-communicable diseases, overweight and obesity. The present study systematically reviewed all observational studies that investigated the association between UPF consumption and health status. A comprehensive search of MEDLINE, Embase, Scopus, Web of Science and Google Scholar was conducted, and reference lists of included articles were checked. Only cross-sectional and prospective cohort studies were included. At the end of the selection process, twenty-three studies (ten cross-sectional and thirteen prospective cohort studies) were included in the systematic review. As regards the cross-sectional studies, the highest UPF consumption was associated with a significant increase in the risk of overweight/obesity (+39 %), high waist circumference (+39 %), low HDL-cholesterol levels (+102 %) and the metabolic syndrome (+79 %), while no significant associations with hypertension, hyperglycaemia or hypertriacylglycerolaemia were observed. For prospective cohort studies evaluating a total population of 183 491 participants followed for a period ranging from 3·5 to 19 years, highest UPF consumption was found to be associated with increased risk of all-cause mortality in five studies (risk ratio (RR) 1·25, 95 % CI 1·14, 1·37; P < 0·00001), increased risk of CVD in three studies (RR 1·29, 95 % CI 1·12, 1·48; P = 0·0003), cerebrovascular disease in two studies (RR 1·34, 95 % CI 1·07, 1·68; P = 0·01) and depression in two studies (RR 1·20, 95 % CI 1·03, 1·40; P = 0·02). In conclusion, increased UPF consumption was associated, although in a limited number of studies, with a worse cardiometabolic risk profile and a higher risk of CVD, cerebrovascular disease, depression and all-cause mortality.

Mediterranean, but not lacto-ovo-vegetarian, diet positively influence circulating progenitor cells for cardiovascular prevention: The CARDIVEG study

AIM

To evaluate the possible association between dietary habits and progenitor cells using data obtained from a randomized crossover trial using two different diets, lacto-ovo-vegetarian (VD) and Mediterranean (MD), the CARDIVEG study.

METHODS AND RESULTS

Eighty clinically healthy subjects with a low-to-moderate cardiovascular risk profile (61 F; 19 M; mean age: 50.7 ± 11.6 years) were randomly assigned to isocaloric VD and MD diets lasting three months each, and then crossed. The two diets showed no effects on endothelial progenitor cells and circulating endothelial cells but opposite effects on circulating progenitor cells. In fact, VD determined significant (p < 0.05) and negative changes on circulating progenitor cells, with an average geometric variation of -130 cells/10⁶ events for CD34⁺/CD45^-/dim, -80 cells/10⁶ events for CD133⁺/CD45^-/dim, and -84 cells/10⁶ events for CD34⁺/CD133⁺/CD45^-/dim while MD determined significant (p < 0.05) and positive changes for CD34⁺/CD45^-/dim levels, with a geometric mean increase of +54 cells/10⁶ events. No significant correlations were observed between changes in progenitor cells and changes in inflammatory parameters during the VD phase. On the other hand, during the MD phase negative correlations between changes of CD34⁺/CD45^-/dim and interleukin-6 (R = -0.324; p = 0.004) as well as interleukin-8 (R = -0.228; p = 0.04) and monocyte chemotactic protein-1 (R = -0.277; p = 0.01), were observed. These correlations remained significant also after adjustment for confounding factors only for CD34⁺/CD45^-/dim and interleukin-6 (β = -0.282; p = 0.018) and monocyte chemotactic protein-1 (β = -0.254; p = 0.031).

CONCLUSIONS

MD, but not VD, reported a significant and positive effect on circulating progenitor cells in a group of subjects at low-to-moderate cardiovascular risk, probably acting through the modulation of inflammatory parameters.

Mediterranean diet and multiple health outcomes: an umbrella review of meta-analyses of observational studies and randomised trials

Research has shown that a greater adherence to the Mediterranean diet is associated with a reduced risk of major chronic disease. However, the existing literature leads to debate for different issues, such as the measurement of the adherence to the Mediterranean diet, the use of a wide variety of dietary indices with various food components and the large heterogeneity across the studies. In order to summarise the evidence and evaluate the validity of the association between the adherence to the Mediterranean diet and multiple health outcomes, an umbrella review of the evidence across meta-analyses of observational studies and randomised clinical trials (RCTs) was performed. Thirteen meta-analyses of observational studies and 16 meta-analyses of RCTs investigating the association between the adherence to the Mediterranean diet and 37 different health outcomes, for a total population of over than 12 800 000 subjects, were identified. A robust evidence, supported by a P-value<0.001, a large simple size, and not a considerable heterogeneity between studies, for a greater adherence to the Mediterranean diet and a reduced the risk of overall mortality, cardiovascular diseases, coronary heart disease, myocardial infarction, overall cancer incidence, neurodegenerative diseases and diabetes was found. For most of the site-specific cancers, as well as for inflammatory and metabolic parameters, the evidence was only suggestive or weak and further studies are needed to draw firmer conclusions. No evidence, on the other hand, was reported for bladder, endometrial and ovarian cancers, as well as for LDL (low density lipoprotein)-cholesterol levels.

Cascaded all-optical operations in a hybrid integrated 80-Gb/s logic circuit

We demonstrate logic functionalities in a high-speed all-optical logic circuit based on differential Mach-Zehnder interferometers with semiconductor optical amplifiers as the nonlinear optical elements. The circuit, implemented by hybrid integration of the semiconductor optical amplifiers on a planar lightwave circuit platform fabricated in silica glass, can be flexibly configured to realize a variety of Boolean logic gates. We present both simulations and experimental demonstrations of cascaded all-optical operations for 80-Gb/s on-off keyed data.

Generation of 1.024-Tb/s Nyquist-WDM phase-conjugated twin vector waves by a polarization-insensitive optical parametric amplifier for fiber-nonlinearity-tolerant transmission

We experimentally demonstrate the generation of 1.024-Tb/s Nyquist-WDM phase-conjugated vector twin waves (PCTWs), consisting of eight 128-Gb/s polarization-division-multiplexed QPSK signals and their idlers, by a broadband polarization-insensitive fiber optic parametric amplifier. This novel all-optical signal processing approach to generate WDM-PCTWs enables a 2-fold reduction in the needed optical transmitters as compared to the conventional approach where each idler is generated by a dedicated transmitter. Digital coherent superposition of the twin waves at the receiver enables more than doubled reach in a dispersion-managed transmission link. We further study the impact of polarization-mode dispersion on the performance gain brought by the phase-conjugated twin waves, showing a gain of ~3.8 dB in signal quality factors.

Rare renal tumor--mucinous tubular and spindle cell carcinoma

We report a rare case of renal tumor--mucinous tubular and spindle cell carcinoma in a 65-year-old man. The tumor, located in the right kidney, was well circumscribed. Microscopically, the tumoral proliferation was composed of cuboidal cells arranged in tubules, with abrupt transition to spindle cell morphology in a myxoid stroma. Because of the favorable prognosis with this type of tumor, mucinous tubular and spindle cell carcinoma must be differentiated from papillary renal cell carcinoma, especially the variant with sarcomatoid dedifferentiation.

All-optical XOR and XNOR operations at86.4 Gb/s using a pair of semiconductor optical amplifier Mach-Zehnder interferometers

We propose a method for increased-speed all-optical XOR operation using semiconductor optical amplifiers. We demonstrate XOR and XNOR operations at 86.4 Gb/s using a pair of photonic-integrated semiconductor optical amplifier Mach-Zehnder interferometers.

[Foreign bodies in the urogenital tract--between iatrogeny and autoerotism]

INTRODUCTION

Our objective was to evaluate the cause, diagnosis and management of foreign bodies in the urogenital tract reviewing a 7 years experience.

MATERIALS AND METHODS

From 2000 to 2007, 12 patients were treated in our department because of foreign bodies localized in the urogenital tract. We retrospectively analyzed the data regarding presentation, diagnosis and management.

RESULTS

The foreign bodies from the urogenital tract included: mascara, spray cap, wires, candle, swabs, plastic tube, remnants from JJ ureteral stent and nefrostomy tube. Diagnostic investigations varied from case to case and consisted of: KUB (kidney, ureter and bladder), abdominal ultrasound, urography, computer tomography, and also cystoscopy. The management was endoscopic in 4 (33%) cases, but in the great majority of them--8 (67.6%) it was necessary a classical intervention.

CONCLUSIONS

Foreign bodies localized in the urogenital tract, represents a relative rare pathology and in many situations those cases have legal implications. Investigations must include radiologic investigations in order to identify their exact location and size. In many cases the management can not be endoscopic and it is necessary a classic intervention.

[Primary retroperitoneal tumors -- the experience in the Urological Clinic of the Central Military Hospital]

Is a review of the 10 years experience in Urological Clinic of Central Military Hospital concerning the diagnosis and treatment of retroperitoneal tumors, containing personal conclusions about this relatively rare, heterogeneous entity.

[Complicated sigmoid neoplasia with vesico-sigmoid fistula]

Being confronting with two apparently similar cases of entero-vesical fistulas, but complete different concerning the etiopathogeny, surgical management and prognosis, we believe that both communities--urologists and general surgeons--must know how to manage such cases. The tumors involving two or many systems or organs make the surgeon's decision be extremely difficult if not familiarized with both pathologies. We expose these unusual cases in order to demonstrate these affirmations.

[The indications and limits for the use of stents in urological pathology]

It is analyzed the authors' experience regarding the drainage of urinary tracts using autostatic ureteral stents, a widespread therapeutic method for a large variety of dysfunction. There were used double J stents 5 and 7 Ch, with variable length (22, 24, 26 cm) in 314 cases suffering the following dysfunction: renoureteral lithiasis--243 cases, obstructive anuria--37 cases, reconstructive surgery after congenital dysfunction--11 cases, acquired dysfunction--23 cases. In 216 cases (68.7%) double J stents were used before applying mini invasive therapeutic methods: ESWL, NPL, URSR, URSA. There are also mentioned some of the encountered complications: ureteral perforation, intrapelvic and intraureteral bend, spontaneous elimination at women, ascending in ureter, lithiasis of a loop and the resolving methods.

[The conversion of endourological operations: a failure or healthy "clinical thinking"?]

From a lot of 2567 of endourological "low" (TURP, TURB, UIO) and "high" (PNL, URSR, URSA) interventions there are analyzed 48 cases in which there was necessary the conversion to classical surgery. In endourology, just like in laparoscopic surgery, the conversion is divided into conversion of necessity and optional conversion. A reference is made to the way of solving these conversions. The main conclusion is that the urologist has to apply equally and efficiently both classical and endourological procedures.

Optical phase conjugation in a magnetic photorefractive semiconductor CdMnTe

Magneto-optical phase conjugation was performed in a diluted magnetic photorefractive semiconductor crystal CdMnTe under an applied magnetic field. The magnetic field removes time-reversal symmetry and quenches orthogonal components of the phase-conjugate signal for selected field strengths. The experimental results as functions of magnetic field and incident polarization angle are in good agreement with coupled-mode theory with transmission gratings during magneto-photorefractive mixing.

Acetazolamide therapy evaluation in haemorrhagic stroke

The influence of acetazolamide in patients with hemorrhagic stroke was assessed in 54 patients in comparison with the influence of other therapies in 68 patients included in a control group. Modified Rankin Scale and mortality rate were evaluated at three different moments: onset, 72 hours and control (3 weeks-one month from the onset). A better outcome was seen when acetazolamide was given. Mortality rate was significantly lower in the group of acetazolamide. This therapy may be safely used in haemorrhagic stroke, especially when hydrocephalus is associated.

Conservative treatment for multilocular empyema. Case report

The case of a 35-year-old patient is reported. After a two-week interval following an ORL puncture in the frontal sinuses, the patient showed a suppuration on the right hemisphere and was admitted in the territorial neurosurgical clinic. Due to a progressive neurological impairment (loss of consciousness and left hemiplegia) the patient was transferred to the Neurological Clinic of "G. Marinescu" Hospital, in Bucharest. CT-scanning carried out in 1989, showed multiple empyemas (intrahemispheric, basal, etc.) excluding any surgical treatment. A conservative treatment was administered during a long period including antibiotics, notably cephalosporines (the third generation). Repetition of CT-scanning evidenced a progressive diminution of a total disappearance of septic intracranial collection, hence, an obvious improvement of the patient. After a year of treatment, the patient was considered to be recovered even if he still accused rare epileptic seizures, partially controlled by drug therapy.

[Metabolic and cardiovascular changes in experimental diabetes, stress and orchiectomy]

When Aloran (Al) was administered to normal or orchiectomized animals, the adult ones proved to be more sensitive, most normal animals (77.7%) developing a DAla and the remainder (22.3%) a DAlc, while of the orchiectomized animals 66.6 developed a DAlc and 33.4% presented a decreased glucose tolerance. 33.4% of the young normal developed a DAla and 66.7% a DAlc, while of the young orchiectomized ones 33.4% presented a DAlc and 66.7% a STG. No matter of age, orchiectomy induced an increased resistance to the various action of Al. Glycemia and lipid fractions, especially LT and TG were significantly elevated in the normal animals with DAla and in the young orchiectomized animals with DAlc. Insulinemia was elevated in most young animals, except for the orchiectomized ones with DAlc, in which it decreased. Serum cholesterol was the most markedly elevated in the adult animals belonging to the group ACTH + D2 + Al, form DAlc. Histopathologically, in this last group degenerative lesions and microcalcifications in aorta and interstitial infiltrate and homogenization of myocardial fibres in the myocardium were found.

[The effects of vitamin D2 on the lipid profile and on the platelet and cardiovascular activities in castrated or testosterone-treated male rats]

The changes in serum and hepatic lipid fractions (LT, Col, TG, beta-LP), aggregability indices (IAg), platelet adhesiveness (IA), atherogenicity (Ia) and microscopic aspect of aorta and myocardium in three groups of animals injected with vitamin D2: normal, orchiectomized and treated with testosterone, were followed up. In the normal animals the injection of vitamin D2 induced the increase of all lipid fractions, of IA, IAg, Ia and histologically microcalcifications at the coronaries level were present; in the orchiectomized animals the biochemical changes were less marked and histologically thickenings of aortic and coronary endothelium with areas of intestinal sclerosis in the myocardium were found. In the animals with hyperandrogenism, the administration of vitamin D2 induced the decrease of TG and increase of IAg and IA; histologically, aspects similar to those noticed after the administration of testosterone alone were present. It is concluded that hypervitaminosis D induces a marked increase of serum lipid fractions in the normal animals, while the histological examination revealed more marked changes in conditions of sexual function cessation.

Influence of temporal lobe lesions on photic-evoked responses in occipital visual areas

In 20 patients with temporal lobe lesions and 10 controls, the averaged photic-evoked responses (APERs) and their dispersion pattern (DP) were investigated in inion-vertex-lead and bilaterally in inion-parietal leads (I-P3 and I-P4). The patients with temporal lobe lesions, regardless of lesion location in temporal areas, displayed either absence of APER (the whole APER or only the initial components) or a latency increase without amplitude changes. The DP was generally abnormal. The role of the temporal lobe in the organization of APER in visual areas is discussed.