Objectives To examine and compare the reproducibility of measurement of first-and second-trimester uterine artery pulsatility index (UtA-PI) using transabdominal (TAS) and transvaginal (TVS) ultrasound.
Methods
There was good agreement between PlGF tests and limited agreement between PlGF tests and the sFlt-1/PlGF ratio. All tests have heightened predictive accuracy for preterm pre-eclampsia. Abnormal PlGF or sFlt-1/PlGF ratio relates to abnormal uterine artery Doppler but not platelet response to aspirin.
Background: Termination of pregnancy requires a 48-hour ‘window' between mifepristone and misoprostol. Shorter durations have been used in first-trimester termination, but there are few data available in later termination for fetal anomaly. Material and Methods: We reviewed all terminations for fetal anomaly at ≥13 weeks from May 2013 to May 2014. Cases were managed using a short (≤12 h) or standard (≥36 h) mifepristone-to-misoprostol interval. Results: Two hundred and twenty women underwent a termination of pregnancy for fetal anomaly during the study period, of which 119 were included for analysis. Sixty-six (55%) women were managed according to the short regimen and 53 (45%) women with the standard regimen. The short regimen resulted in a shorter mifepristone-to-delivery interval but was less likely to result in delivery within 12 h of misoprostol. Delivery rates at 24 h were equivocal. There was no difference in blood loss, vaginal delivery rates, complications or bed nights. The short regimen did require more doses of misoprostol. Feticide or previous uterine scar had no effect on outcomes. Discussion: There was no significant difference in clinical outcome for women managed with a short (≤12 h) or a standard (≥36 h) regimen for medical termination of pregnancy for fetal anomaly, suggesting that either regimen could be offered.
Demographic rates are shaped by extrinsic (May 1974) and intrinsic (Cam et al. 2002) constraints. In the case of species with large foraging ranges, broader climate effects may lead to significant variation in demographic parameters. Individuals and populations experience climate locally, through temperature, wind, currents and precipitation. However, such meteorological and oceanographic features are often governed by phenomena extending over much larger areas. Even slight changes induced by fluctuations in large-scale climate phenomena may produce large effects at various trophic levels (Post et al. 1999).Seabirds are known to wander over large distances, but still need to concentrate during at least one specific period of their life cycle: the breeding season. While nesting, seabirds are more dependent on local environmental conditions (
A síndrome da mão alienígena (SMA) é definida como uma atividade motora involuntária do membro superior juntamente com percepção estranha do membro. Não está associada a uma etiologia determinada, sendo comum seu surgimento após acidente vascular encefálico (AVE) agudo. Três tipos de SMA são relatados na literatura: envolvendo lesões no corpo caloso, no corpo caloso associado ao córtex frontal medial dominante, e uma variante posterior, que afeta áreas corticais e subcorticais da circulação posterior, este último o mais raro. Existem diferenças entre os tipos em relação aos sintomas apresentados, porém são comuns nos 3 tipos: a percepção estranha do membro e os movimentos involuntários. Após revisão da literatura de 12 casos de SMA posterior por AVE, o principal sinal encontrado é a movimentação involuntária do membro afetado. Outras características clínicas encontradas freqüentemente nesta variante são: ataxia e sinais de levitação do membro, heminegligência, e hemianopsia. Não há correlação direta da topografia dalesão com os sintomas apresentados.
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