Mcmahoncarroll1355

in English, French La prise en charge prénatale permet d’anticiper les complications afin de minimiser les risques au moment de l’accouchement et de la naissance. En Suisse, elle s’organise autour d’une collaboration du réseau libéral et hospitalier avec une hiérarchisation du niveau de risque de la grossesse pour le suivi. La structure de la prise en charge périnatale doit être construite de façon à identifier les risques obligeant les professionnels à sortir de la voie physiologique classique pour une escalade thérapeutique anticipative, appropriée selon les niveaux de risque. Une collaboration efficace autour du couple mère-enfant (ou même de la famille) dépend donc d’une plateforme d’interaction multidisciplinaire privilégiée dans laquelle la communication interprofessionnelle, et particulièrement sage-femme-obstétricien-néonatologue, est essentielle.BACKGROUND In multiple sclerosis (MS), insufficient blood supply might worsen energy deficiency of the brain tissue. Thus, cerebrovascular reactivity (CVR), which is the capacity of cerebral circulation to match blood supply to metabolic demand, might be important in MS pathology. OBJECTIVES The objective of this study was to investigate the relationship of CVR to disease activity and neuroimaging markers of disease progression in patients with MS. MATERIAL AND METHODS In 43 patients with relapsing remitting MS (RRMS) in clinical remission, 30 patients with a relapse of MS and 30 healthy controls, we measured CVR with transcranial Doppler as a relative change in flow velocity after breath-holding (breath-holding index) and voluntary hyperventilation (hyperventilation index). All patients in remission underwent brain magnetic resonance imaging at baseline and 33 underwent repeated imaging after 12 months, with various brain volume measurements taken. RESULTS Cerebrovascular reactivity indices did not differ between patients in remission, patients with a relapse and controls. In patients in remission, CVR did not differ between those with or without contrast-enhancing lesions. In patients with a relapse, glucocorticoids significantly reduced both CVR indices. Cerebrovascular reactivity was not related to brain volume, white matter lesion volume, percent brain volume change, and the change in total white matter lesion volume. CONCLUSIONS In RRMS, CVR appeared normal and unrelated to disease activity. There was no substantial association of CVR to brain atrophy and accumulation of white matter lesions.BACKGROUND Childhood acute lymphoblastic leukemia (ALL) survivors are at an increased risk of cardiovascular disease development. It is believed that in the general population, this risk can be predicted with carotid intima-media thickness (CIMT) measurement. OBJECTIVES The objective of this study was to assess CIMT and to investigate the effects of blood pressure (BP) and lipid profile values on CIMT in childhood ALL survivors. MATERIAL AND METHODS The study group comprised 81 childhood ALL survivors aged 5-25 years. The control group consisted of 52 ageand sex-comparable healthy children. Carotid intima-media thickness measurement, 24-hour BP monitoring and lipid profiles were evaluated in patients and controls. RESULTS Despite significantly higher proportion of subjects with arterial hypertension (AH) (30/81 vs 10/52; p = 0.0315), the mean values of CIMT were not statistically different in childhood ALL survivors as compared to controls (0.4303 ±0.03 vs 0.4291 ±0.03; p = 0.81 and 1.096 ±0.74 vs 1.027 ±0.55ed to predict cardiovascular risk in childhood ALL survivors at the early stage of the follow-up.BACKGROUND Rotational atherectomy (RA) used in elderly patients treated with percutaneous coronary interventions (PCI) could enable revascularization or the omission of cardiac surgery. Knowledge about factors affecting the prognosis may improve the results of treatment. OBJECTIVES We aimed to assess the relationship of gender and age with long-term clinical outcomes expressed as major adverse cardiac and cerebrovascular events (MACCEs). MATERIAL AND METHODS The study included 97 consecutive patients treated with PCI and RA at the mean age of 71. The study group contained 73.2% men and 26.8% women, 36.1% of patients older than 75 and 63.9% younger than 75. The mean time of follow-up was 695.3 ±560.9 days. The rate of MACCEs (deaths, myocardial infarctions (MIs), reinterventions, coronary artery by-pass surgeries, or cerebral strokes (CSs)/transient ischemic attacks (TIAs)) in the overall group of patients was calculated at 33.7%. RESULTS The comparison of Kaplan-Meier survival curves did not depict significant differences in the frequency of MACCEs for age (p = 0.36) and gender (p = 0.07). We noticed that the death rate was higher in females than in males and in patients older than 75 compared to those younger, and was statistically significant for age (p = 0.04). The rate of periprocedural complications was significantly higher among women than among men (p = 0.005) and in patients older than 75 compared to the younger ones (p = 0.003). CONCLUSIONS Age and gender are not significantly associated with an increased rate of MACCEs during follow-up in elderly patients treated with PCI and RA.BACKGROUND Extracts from the Rosaceae family fruits are rich in natural, biologically active polyphenols, but their antibacterial properties are still poorly understood. Therefore, we focused our research on their activity against uropathogenic Escherichia coli strains. This research also concerned the proof of their ability to reduce oxidative stress and modulate the activity of lipoxygenase-1 (LOX-1). It is well-known that plants represent a source of bioactive compounds whose antioxidant activity may be useful in protecting against oxidative damage in cells, which have been linked to the pathogenesis of many oxidative diseases. OBJECTIVES The study determined the biological activity of methanol (ME) and water (WE) extracts rich in polyphenols from the hawthorn (Crataegus monogyna Jacq.), dog rose (Rosa canina L.), quince (Cydonia oblonga Mill.), and Japanese quince (Chaenomeles speciosa (Sweet) Nakai). MATERIAL AND METHODS The antioxidant capacity was evaluated using 1,1diphenyl-2-picrylhydrazyl (DPPH▪) anlial cells, and reduce the ability of these bacteria to form biofilm. CONCLUSIONS The extracts examined, showing very promising biological properties, seem to be able to join the list of substances that can be used as dietary supplements aimed at preventing, for example, urinary tract infections, or as support of drug treatment in many diseases.BACKGROUND Down syndrome (DS) is the most frequent cause of intellectual disability. In 95% of cases, it is caused by simple trisomy of chromosome 21 resulting from nondisjunction of chromosomes in meiotic division. Currently, the molecular and cellular mechanisms responsible for the phenomenon of nondisjunction are unknown. OBJECTIVES To investigate the incidence of 5 single-nucleotide polymorphisms (SNPs) of the MTHFR gene in a population of Polish mothers who had given birth to children with trisomy 21 in comparison with a control group of women with healthy offspring. MATERIAL AND METHODS The test material comprised venous blood collected from mothers who had given birth to a child with DS (study group, n = 130) as well as from women who had given birth to children without trisomy 21 (control group, n = 88). DNA was isolated using a kit manufactured by Qiagen. Amplification was carried out using a Qiagen Multiplex PCR Kit (Qiagen); genotyping was performed using SNaPshot Genotyping MasterMix (Applied Biosystems). RESULTS No statistically significant differences were observed in the frequency of genotypes between the examined groups in terms of the polymorphisms of the MTHFR gene. CONCLUSIONS In the Polish population studied, no relationship was found between the occurrence of particular genotypes of the MTHFR gene, i.e., 677CT, 1298AC, rs3737964, rs4846048, and rs1994798, in women and the birth of children with trisomy 21. The results contradict the validity of research on polymorphisms of the MTHFR gene as potential predisposing factors for the occurrence of trisomy 21 in children.BACKGROUND Many previous studies reported secular trend of lung cancer incidence and mortality, but little is known about the possible reasons for these trends. METHODS Data were obtained from Shanghai Cancer Registry. Age-standardized rates were calculated and average annual percent changes (AAPCs) were evaluated by Joinpoint regression. Age, period, and birth cohort effects were assessed by age-period-cohort models. RESULTS From 1973 to 2010, compared with long-time slowly increasing trend in women, male lung cancer incidence had significantly decreased between 2001 and 2009. After that lung cancer incidence rising sharply in women (AAPC = 14.13%, 95%CI 2.68%-26.86%, P = .016) and similar rising trends without statistical significance in men (AAPC = 2.96, 95%CI -2.47%-8.69%, P = .281) between 2010 and 2014. Age-period cohort model showed the different patterns of period effects for lung cancer incidence between men and women. The period effects for lung cancer incidence showed rising effect for women, whereas there was decline effect for lung cancer incidence for men. On the other hand, the model showed a significant period effect in both genders with a similar fashion in mortality, yielding steady falling trends during the entire study period. CONCLUSIONS The distinctive patterns of lung cancer incidence between men and women may be attributable to significant period effects, which reflected the changes in public health policies or diagnostic practices and highlighted the urgent of continued monitoring of gender-specific risk factors for lung cancer incidence. © 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.Currently, some 50% of the US population has a chronic disease, creating an epidemic, and 86% of health care costs are attributable to chronic disease. The medical profession and its leadership did not recognize or respond appropriately to the rising prevalence of chronic disease. As a consequence, a health care crisis emerged, with inadequate access to care and quality of care together with excessive costs. In the years since the 1950s, when the chronic disease prevalence grew, the clinical literature did not follow. It remained preoccupied with acute disease. Similarly, medical education did not change. Plinabulin Studies and critiques gave little or modest attention to the rising dominance of chronic disease and neglected elements of good care. Recently, some health services responding to their growing number of patients with chronic illness have designed and tested new ways of providing care. They have found that, as a result, the patient's health outcomes were improved, costs of care were lower, and patient satisfaction was higher. These results and experiences provide examples of what can be done. The health care crisis and the emergence of a chronic disease epidemic coincided to a substantial degree. Although the epidemic did not cause the crisis, it contributed significantly. Now, the medical profession and its leadership are confronted by the responsibility to build a practice of medicine and a health care system that better meet the needs of patients with chronic illness and reduces the health care crisis. © 2020 The Authors. ACR Open Rheumatology published by Wiley Periodicals, Inc. on behalf of American College of Rheumatology.