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Uterine artery Doppler in predicting pregnancy outcome in women with connective tissue disorders
No full textSIR, We read with great interest the article by Le Thi Huong et al.
[1] on the second trimester Doppler ultrasound as best predictor
of late pregnancy outcome in patients with systemic lupus
erythematosus (SLE) and antiphospholipid syndrome (APS).
The authors prospectively examined 100 high-risk pregnancies
and concluded that Doppler examination and history of
thrombophlebitis were independent predictors of fetal and
neonatal death in SLE and APS pregnancies progressing beyond
22 weeks. Infact, six out of eight fetal/neonatal deaths and other
major and minor obstetric complications occurred in patients
with abnormal second trimester Doppler ultrasound.
In order to investigate the role of uterine Doppler ultrasound
abnormalities as a risk factor for adverse pregnancy outcome,
we have prospectively followed 40 pregnancies in 40 patients with
SLE and other connective tissue diseases including vasculitis: six
patients were affected by APS, nine patients by SLE, 12 patients
by undifferentiated connective tissue disorder (UCTD), three
patients by Behc ̧ et’s disease (BD), four patients by scleroderma
(Scl) and five patients by Sjo ̈ gren’s syndrome (SS).
The second trimester fetal Doppler ultrasound examination was
abnormal in 14 pregnancies: in 45% of the SLE patients (four out
of nine), in 67% of the APS patients (four out of six), in 75% of
patients with BD (three out of four) and 100% of the Scl patients.
Out of 14 pregnacies, 11 were complicated by premature deliveries
associated, with pre-eclampsia in four cases and with premature
membrane ruptures (PROM) in the other four. There was one
delivery of a growth-restricted liveborn (intrauterine growth
retardation, IUGR). Only two of these 14 pregnancies progressed
until the end of the third trimester and delivered spontaneously.
The mean gestational age at delivery was 35 weeks, the mean birth
weight was 2142 g and the mean APGAR scores at 5 and 10 min
were, respectively, 8 and 8.
All the 26 patients with a normal arterial uterine Doppler
ultrasound examination at the second trimester delivered uneventfully.
There was only one premature delivery due to PROM in an
SLE patient. The mean gestational age at delivery was 39 weeks,
the mean birth weight was 3200 g and the mean APGAR scores
at 5 and 10 min were, respectively, 9 and 10.
Although literature data addressing the role of uterine artery
Doppler screening as predictor of poor outcome are contradictory
[2-7], in agreement with Le Thi Huong et al.’s [1] result, our study
confirms how pregnancy outcome of patients with abnormal
uterine waves is worse when compared with a woman with normal
Doppler. In fact, abnormal Doppler velocimetry was related
to an increased prevalence of PROM, IUGR, maternal and
perinatal complications (low birth weight and low APGAR score).
Not surprisingly, due to the important role of vascular damage,
apart from APS and SLE patients, Scl and BD patients were at
very high risk as well.
In contrast to Le Thi Huong et al. [1] data and probably due
to the lower number of patients examined, Doppler abnormalities
were not associated with an increased rate of neonatal or fetal
death.
In conclusion, it is our opinion that Doppler velocimetry
should be considered as a reliable and useful tool to identify SLE
and other CTD patients at higher risk in order to start a proper
therapy
UTERINE-UMBILICAL ARTERY DOPPLER VELOCIMETRY IN PREGNANT WOMEN WITH CONNECTIVE TISSUE DISORDERS
No full textBackground: Pregnancy in connective tissue disorders (CTD) can be at high risk to the mother and fetus. Prothrombotic risk factors and vascular damage can impair utero-placental perfusion affecting pregnancy outcome.
Objectives: We prospectively evaluated continuous wave uterine-umbilical artery Doppler velocimetry in order to determine if some CTD patients (pts) have a higher prevalence of Doppler alterations with a higher risk of adverse pregnancy outcome.
Methods: Blood flow velocity waveforms of the umbilical and uterine arteries were studied by transabdominal Doppler ultrasound in 40 women attending our high risk pregnancy clinic. Nine patients (pts) were affected from Systemic Lupus Erythematosus (SLE) [1 with secondary antiphospholipid syndrome and 4 with positive antiphospholipid antibodies (aPL) or Lupus anticoagulant (LA)], 12 from undifferentiated connective tissue disorder (UCTD) (2 with positive LA), 4 from primary antiphospholipid syndrome (APS), 4 from Systemic Sclerosis (Scl), 3 from Seronegative Spondyloarthritis (SpA), 3 from Sjogren Syndrome (SS), 3 from Behcet disease and 1 from Rheumatoid Arthritis (RA). Resistance index (RI) of umbilical and uterine arteries was measured every 4 weeks from week 21 (corresponding to morphological examination) to week 32.
Results: Abnormal umbilical-uterine artery blood flow velocity was found in 13 pts, 4 affected from SLE of whom 1 with secondary APS and 2 with positive aPL (1 IgG aPL high title and positive LA and 2 IgG and IgM aPL high title), 2 affected from APS (with positive IgG aPL high title and 1 with positive LA and IgG aPL high title), 3 with Scl, 2 with Behcet, 1 with UCTD and 1 with SpA. All 13 pts delivered uneventfully. Nine out of 13 pts performed a caesarian section (CS) at a mean gestational age of 35.7 weeks; reasons for CS were 4 premature membrane ruptures, 1 intrauterine growth retardation, 1 preeclampsia and 2 SLE flares with nephritis. The mean birth weight was 2142 gram and the mean APGAR score at 5 and at 10 minutes was respectively 8 and 8.
The 27 mothers with normal Doppler waves delivered uneventfully. Eighteen had a spontaneous delivery and 9 experienced CS (1 PROM). Mean gestational age was 39 weeks. Mean birth weight was 3200 gram and mean APGAR score at 5 and 10 minutes was respectively 9 and 10.
Conclusion: This study confirm how pregnancy outcome of patients with abnormal waves (at maternal i.e.umbilical and at feto-maternal i.e. uterine level) is worse compared to woman with normal Doppler. Infact in this study, despite the aPL status (data not shown), abnormal Doppler velocimetry was related to an increased prevalence of PROM, IUGR, maternal and perinatal complications (low birth weight, low APGAR score). Not surprisingly due to the important role of vascular damage, pts at higher risks were those with SLE (50% had abnormal flow), APS (50% with abnormal flow), Scl (75% with abnormal flow) and Behcet disease (66%). We suggest that in these CTD pts besides the aPL status which is a well known factor associated with adverse pregnancy outcome, Doppler velocimetry must be performed in order to identify patients at higher risk and in order to start a proper therapy
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
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