Can the neutrophil-to-lymphocyte ratio (NLR) predicts fetal loss in preeclampsia with severe features?

INTRODUCTION

Preeclampsia (PE) is one of the most common causes of major maternal and fetal adverse events including mortality and preterm birth Grill et al. (2009). The neutrophil-to-lymphocyte ratio (NLR) and other hematologic indexes of systemic inflammation have been investigated in patients with PE for the prediction of the severity or presence of the disease. Despite these studies, we found no trials investigating the relationship between NLR and fetal outcomes in PE patients. In this study, we aimed to investigate the relationship between NLR and fetal outcomes.

METHODS

We retrospectively analyzed the demographic data and laboratory tests to determine the NLR of 175 pregnant women with severe PE admitted to our clinic between January 2015 and December 2018.

RESULTS

NLR in the first (2.4 ± 1.1 vs 2.9 ± 1.4, P = 0.18) and second trimesters (3.6 ± 0.7 vs 3.8 ± 1.3, P = 0.25) were not different between the groups, but third trimester NLR was significantly higher in patients with fetal loss (6.5 ± 5.4 vs 4.2 ± 2.7, P = 0.009). The area under the receiver operating characteristic curve for NLR in the third trimester was 0.66 and NLR > 3.9 predicted fetal loss with a sensitivity of 75% and a specificity of 61% (0.684, 95% confidence interval 0.48-0.83, P = 0.05).

CONCLUSION

We demonstrated that third trimester NLR is associated with fetal loss in patients with severe PE.

Responses of oxidative stress and inflammatory cytokines after zearalenone exposure in human kidney cells

Zearalenone is a mycotoxin widely found worldwide that is produced by several fungal species. Due to its similarity to estradiol, it has been shown to have toxic effects on the reproductive system. Although various animal studies have been conducted to investigate the toxic effects of zearalenone, the mechanisms of toxicity have not been fully elucidated. The aim of the study was to investigate the dose-dependent toxic effects of zearalenone exposure in human kidney cells. The half-maximal inhibitory concentration values of zearalenone in HK-2 cells were found to be 133.42 and 101.74 µM in MTT- and NRU-tests, respectively. Zearalenone exposure at concentrations of 1, 10 and 50 µM decreased cell proliferation by 2.1, 11.07 and 24.34%, respectively. Reactive oxygen species levels increased significantly in a dose-dependent manner. A significant increase was observed in the expressions of MGMT, α-GST, Hsp70 and HO-1 genes, which are associated with oxidative damage, while a significant decrease in L-Fabp gene expression was observed. Moreover, zearalenone increased gene expression of inflammatory cytokines, such as IL-6, IL-8, TNFα and MAPK8. Significant increases were observed at the level of global DNA methylation and expression of DNMT1 in all exposure groups. These results indicate that changes in DNA methylation and oxidative damage may play an important role in the toxicity of zearalenone.

Polymorphism of the Oxytocin Receptor (OXTR) Gene Affects the Circulating Oxytocin Receptor Levels in Late-Term Pregnancy in a Turkish Population

INTRODUCTION

Postterm and late-term pregnancies still remain a serious health problem, and underlying exact mechanisms are not fully elucidated. These mechanisms are influenced by many factors.

OBJECTIVE

The aim of this study was to investigate the relationship between plasma oxytocin and oxytocin receptor levels and oxytocin receptor polymorphisms in term and late-term pregnant women.

METHODS

Sixty-eight singleton pregnant women with late-term pregnancy and 83 singleton pregnant women with term parturition were included in this study. A comparison was performed between pregnancies and neonates born at term (37 0/7 and 41 6/7 weeks' gestation). Plasma oxytocin, oxytocin receptor, estradiol, and progesterone levels were measured by using enzyme-linked immunosorbent assay kits. TaqMan® SNP Genotyping Assays and qPCR ProbesMaster were used to investigate the polymorphisms of rs237911, rs2228485, rs53576, and rs2254298.

RESULTS

There was not any difference in gene distributions of 4 common single-nucleotide polymorphisms of oxytocin receptor of rs237911, rs2228485, rs53576, and rs2254298 between subjects in late-term and term pregnancy groups. With rs53576 of the GG genotype, serum oxytocin levels were 21.50 ± 10.69 (ng/L) in the late-term group and 62.71 ± 18.01 (ng/L) in the term group (p = 0.049). Oxytocin receptor levels in the late-term and term pregnancy groups of the GG genotype were 17.92 ± 8.15 (pg/mL) and 45.77 ± 11.66 (pg/mL), respectively (p = 0.046).

CONCLUSION

Our findings suggest that the rs53576 oxytocin receptor single-nucleotide polymorphism is associated with late-term pregnancy through acting by direct modulation of oxytocin and oxytocin receptor levels.

Functionalized boron nitride porous solids

A demonstration of the chemical functionalization of h-BN flakes and a template free approach for the development of macroscopic porous h-BN solids.

Enhanced field emission properties from CNT arrays synthesized on Inconel superalloy

One of the most promising materials for fabricating cold cathodes for next generation high-performance flat panel devices is carbon nanotubes (CNTs). For this purpose, CNTs grown on metallic substrates are used to minimize contact resistance. In this report, we compare properties and field emission performance of CNTs grown via water assisted chemical vapor deposition using Inconel vs silicon (Si) substrates. Carbon nanotube forests grown on Inconel substrates are superior to the ones grown on silicon; low turn-on fields (∼1.5 V/μm), high current operation (∼100 mA/cm(2)) and very high local field amplification factors (up to ∼7300) were demonstrated, and these parameters are most beneficial for use in vacuum microelectronic applications.

Stabilising the Structure of HDPE by the Use of Highly-dispersed Mixture of Fe/FeO

An oxygen acceptive catalyser Fe/FeO mixture was added to the high density polyethylene (HDPE) at different amounts and the stabilisation effects of this additive on the structure of HDPE was investigated. It was shown that the mechanical behaviour and the temperature stability of HDPE was significantly improved with the application of the additive. The experimental results were found to be in accordance with analytical approaches.

An Assessment of Thermal Stresses in Injection Moulded ABS Copolymer

Thermal residual stresses in injection mouldings result from the non-uniform cooling of the melt in the mould. Normally, compressive stresses develop at the surface and tensile ones within the core of the mouldings. The magnitude of these residual stresses was examined for an acrylonitrile-butadienestyrene copolymer (ABS) under various injection moulding conditions. Although the occurrences of thermal stresses are inevitable, the warpage results only when the residual stresses are out of balance. The imbalance of the residual stresses are caused by the non-uniform temperature distribution through the thickness of the mouldings which may be caused by variation in cross section, part geometry and temperature difference between the two surfaces. The magnitudes of thermal residual stresses in injection moulded ABS flat plaques were determined using a layer removal technique. The development of warpage in a 3D component (an L-shaped bracket) was modelled using the residual stresses obtained for the flat plaques and the predictions were compared with the experimental warpage measurements.

Inhibition of Thermal Oxidation Destruction of PBT/HDPE Blends by Organic Compounds of Five-valent Phosphorus

Polybutylene terephthalate (PBT) and highy density polyethylene (HDPE) were blended and stabilized with four different stabilizers obtained from the organic derivatives of five-valent phosphorus. These stabilizers were cyclohexylphosphonic acid, its metallic salts of cyclohexyl phosponates of bivalent nickel, bivalent iron and trivalent iron. The stabilization improved the thermal stability of the PBT/HDPE blends and increased their mass loss temperature. The blend melts were thermally aged inside a viscometer barrel and the Melt flow Index (MFIs) was measured. All stabilizers increased the melt stability of the blends when used in low rates (< 0.2 % in mass). At higher stabilizer rates, some stabilizers further enhanced the thermal stability, while others decreased it. A melt parameter was introduced to determine the melt stability of the PBT/HDPE blends during extrusion. The best stabilization was obtained with cyclohexylphosphonic acid based on the metallic salts of bivalent nickel. The mechanisms that lead to the inhibition of thermal destruction of the blends were explained in terms of the stabilizers.

Evaluation of the relationship between heart type fatty acid binding protein levels and the risk of maternal cardiac ischemia in low risk obstetric population during delivery

AIM

To investigate the heart type fatty acid binding protein (hFABP) changes during delivery in low-risk obstetric population.

METHODS

Pregnant women who are at term and met the inclusion criteria were included the study. Maternal echocardiography, electrocardiography, arterial blood pressure monitoring, CK-MB, serum heart type fatty acid binding protein and troponin I levels were evaluated before and after delivery. Of the total of 100 pregnant women, mean age was 26.7±5, 51 pregnant had vaginal delivery and the remaining 49 had caesarean section.

RESULTS

The h-FABP positivity was detected in nine (9%) subjects after the delivery as compared to values before the delivery (p=0.0035). Troponin levels were 0.013±0.001 before the delivery and 0.025±0.002 after the delivery (p= 0.0001). In the comparison of vaginal and Cesarean deliveries, h-FABP positivity was detected in five of 51 subjects in the vaginal delivery group and four of 49 subjects in the cesarean delivery group (p=0.95). The changes in troponin levels were 0.01 ng/mL (-0.02 to 0.2) in the vaginal delivery group and 0.01ng/mL (-0.07 to 0.06) in the cesarean delivery group (p= 0.24).

CONCLUSION

Delivery stress is associated with maternal cardiac damage as evaluated by heart type fatty acid binding protein and troponin. There was no difference between the two delivery routes in the risk of maternal cardiac damage.

Assessment of bone mineral density in the jaws and its relationship to radiomorphometric indices

OBJECTIVES

The aim of this study was to evaluate maxillary, mandibular and femoral neck bone mineral density using dual energy X-ray absorptiometry (DXA) and to determine any correlation between the bone mineral density of the jaws and panoramic radiomorphometric indices.

METHODS

49 edentulous patients (18 males and 31 females) aged between 41 and 78 years (mean age 60.2 +/- 11.04) were examined by panoramic radiography. Bone mineral density (BMD) of the jaws and femoral neck was measured with a DXA; bone mineral density was calculated at the anterior, premolar and molar regions of the maxilla and mandible.

RESULTS

The mean maxillary molar BMD (0.45 g cm(-2)) was significantly greater than the maxillary anterior and premolar BMD (0.31 g cm(-2), P < 0.05). Furthermore, the mean mandibular anterior and premolar BMD (1.39 g cm(-2) and 1.28 g cm(-2), respectively) was significantly greater than the mean mandibular molar BMD (1.09 g cm(-2), P < 0.01). Although BMD in the maxillary anterior and premolar regions were correlated, BMD in all the mandibular regions were highly correlated. Maxillary and mandibular BMD were not correlated with femoral BMD. In addition, mandibular cortical index (MCI) classification, mental index (MI) or panoramic mandibular index (PMI) values were not significantly correlated with the maxillary and mandibular BMDs (P > 0.05).

CONCLUSIONS

The BMD in this study was highest in the mandibular anterior region and lowest in the maxillary anterior and premolar regions. The BMD of the jaws was not correlated with either femoral BMD or panoramic radiomorphometric indices.

Comparison of colour Doppler indices of pelvic arteries in women with bilateral hypogastric artery ligation and controls

The aim of this study is to compare the blood flows of bilateral uterine, ovarian and arcuate arteries in patients who underwent bilateral hypogastric ligation (BHL), with the controls having similar characteristics. The S/D, the RI and the PI were measured on uterine, arcuate and ovarian arteries in 7 women with BHL and compared with 10 controls. There were not significant differences between the Doppler indices of the two groups. In conclusion, our study suggests that BHL preserves pelvic function and fertility.

Comparison of the intrapartum analysis of Doppler blood flow velocity waveform of the umbilical artery and fetal heart rate tracing for the prediction of perinatal outcome

This study was performed to determine the value of umbilical artery Doppler flow velocity waveform (FVW) analysis and fetal heart rate (FHR) tracing in the course of labour for predicting poor perinatal outcome. The randomised, controlled and prospective study was carried out on 99 singleton term pregnant women in labour at the Zeynep Kamil Women and Children's Hospital, Istanbul. All patients were evaluated by both methods during the intrapartum period. Blood gases and pH of umbilical venous blood and 1 and 5 minute Apgar scores of the newborn infants were determined immediately after delivery. For the prediction of poor perinatal outcome, the sensitivity, specificity, negative predictive value and positive predictive value of FHR were 72.0%, 85.1%, 60.1% and 90.0%, respectively. FHR was pathological in all four cases with a neonatal death, whereas only two had pathological Doppler FVW. We conclude that FHR is a more sensitive method than umbilical artery Doppler FVW analysis (72.0% versus 36.0%) in the prediction of poor perinatal outcome during the intrapartum period. A combination of the two tests increases the specificity of the prediction of poor perinatal outcome from 89.2% and 85.1% to 94.9%. High negative predictive values of both tests should reassure the clinician when the test results are normal.

Thrombotic thrombocytopenic purpura and pregnancy treated with fresh-frozen plasma infusions after plasmapheresis: a case report

Thrombotic thrombocytopenic purpura is a serious, highly mortal disease that goes with pregnancy. The diagnosis may be difficult due to similar symptoms to other pregnancy-related diseases. Treatment of the patient differs with the clinic. Plasmapheresis continued with fresh-frozen plasma infusion may be a good choice.