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A new technology in the diagnosis of small ventricular septal defects
No full text[No abstract available
[Pregnancy in lupus patients: our experience].
No full textSystematic lupus erythematosus (SLE) is the most common autoimmune disease associated with pregnancy. The aim of this study was to evaluate management and outcome of pregnancy complicated by SLE. Twenty pregnant women affected by SLE were admitted to Prenatal Diagnosis Centre of University "Sapienza" from January 2007 to July 2009. Pregnancy was monitored from diagnosis to delivery by at least a monthly consultation. At each visit general blood laboratory assessment were registered. An ultrasound examination was performed to evaluate fetal growth. From 26 weeks of gestation an estimation of fetal weight was calculated according to the standard of Lubchenco. At birth newborns weight was registered. Patient mean age was 32.9 years. There were 18 live births (90%), and 2 spontaneous abortions; 50% of pregnancy ended with a preterm delivery. 20% of the patient had signs of disease activity during pregnancy. Fifteen percent of women presented gestational hypertension. An high rate of small for gestational age was registered and 2 cases of intrauterine growth retardation (IUGR). Ultrasound evaluation at 28-30 weeks of gestation showed a normal weight (≥ 50th percentile) in 83% fetuses. Only 45% of the newborns presented ≥ 50th percentile. The mean weight of the newborns was 2700 grams. Pregnancy outcome could be improved by close obstetrical and ultrasound monitoring in a multidisciplinary setting
Anti-thrombotic treatment in recurrent pregnancy losses
No full textRecurrent pregnancy loss is a common problem in women (1-5%). One of the leading causes is inherited thrombophilia. We enrolled 361 women (25-38 years-old) with history of at least two abortions due to unknown causes. We study the efficacy of three different antithrombotic treatments, comparing the Results in negative and positive thrombophilic patients. For congenital thrombophilia we studied inhibitors of coagulation (antithrombin, protein C, protein S), Factor V and Factor II (G20210A) mutations. Lupus Anticoagulant (KCT, DRRVVT), Anticardiolipin antibodies and homocysteinemia were considered for acquired thrombophilia. The screening identified 246 negative (68%) and 115 positive (32%). 167 women became pregnant, 80 (48%) negative and 87 (52%) positive. From eight weeks’ gestation they were submitted by three different therapy groups: Acetyl salicylic acid (ASA) 100mg/die until 3rd month of pregnancy; low molecular-weight heparin (LMWH) 40mg/die until 3rd month of pregnancy; ASA100mg plus LMWH 40mg/die until 3rd month of pregnancy. In the 80 negative patients, all three anti-thrombotic regimens were statistically significant effective respect previous untreated pregnancies: 69 live births (86%) versus 11 abortions (14%) (p0.0001) In the 87 patients positive, the treatment with and LMWH combined ASA was statistically significant effective respect to previous untreated pregnancies: 58 (67%) live birth versus 29 abortions (33%) (p0.001). Regimen with ASA alone did not shows any efficacy regarding pregnancy outcome. We suggest that thromboprophylaxis is indicated in women with previous pregnancy loss independently from alterations of thrombophilic factors
Matrix array transducer for the examination of fetal heart
No full textThe X6-1 xmatrix array transducer allows a completely new approach to the diagnostic ultrasound: it permits visualization of fetal heart in real time, without the need for gating, and it is unaffected by motion artefacts. It is obtained in real time, without any spatial reconstruction. The authors compared this technology with the traditional one in two case reports: a diagnostic doubt of small muscular ventricular septal defect was solved using this new technique; a diagnosis of complete atrioventricular septal defect was confirmed. Three-dimensional real-time imaging would seem very precise in the study of fetal heart: the defects were fully visualized from any angulations. This new technology is promising but from the authors' limited experience, there is no evidence to use it in routine practice. It should be very useful to commence a prospective study on fetuses at risk while testing the superiority of this technique.The X6-1 xmatrix array transducer allows a completely new approach to the diagnostic ultrasound: it permits visualization of fetal
heart in real time, without the need for gating, and it is unaffected by motion artefacts. It is obtained in real time, without any spatial reconstruction.
The authors compared this technology with the traditional one in two case reports: a diagnostic doubt of small muscular
ventricular septal defect was solved using this new technique; a diagnosis of complete atrioventricular septal defect was confirmed.
Three-dimensional real-time imaging would seem very precise in the study of fetal heart: the defects were fully visualized from any angulations.
This new technology is promising but from the authors’ limited experience, there is no evidence to use it in routine practice.
It should be very useful to commence a prospective study on fetuses at risk while testing the superiority of this technique
A case of uterine rupture in mid-trimester spontaneous abortion: a complication of gemeprost vaginal administration
No full textThe only prostaglandin analogue licensed in Italy for induction of labour in spontaneous and therapeutic abortion is gemeprost.
The authors report a case of spontaneous uterine rupture of a scarred uterus, for previous caesarean sections, in a woman at 20 weeks
of gestation with a diagnosis of spontaneous abortion. She received a pessary of gemeprost every three hours. After the fifth pessary,
she complained of severe pain. At the ultrasound examination, uterine cavity appeared empty and the dead fetus was dislocated in the
abdomen. Emergency laparotomy was performed and uterine tear was repaired. To induce labour for fetal demise or therapeutic abortion
in second trimester in women with scarred uterus, the authors decided to lengthen the time between administrations of pessary
from four to five hours depending on patient’s symptoms. However the appropriate drug regimen has still to be found and more data
are necessary
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
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