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Treatment of pregnant women with asymptomatic trichomoniasis does not prevent preterm delivery. Routine screening and treatment of asymptomatic pregnant women for this condition cannot be recommended.

Objective To compare the second‐trimester plasma cell‐free (PCF) transcriptome of women who delivered at term with that of women with spontaneous preterm birth (sPTB) at or before 32 weeks of gestation and identify/validate PCF RNA markers present by 16 weeks of gestation. Design Prospective case–control study. Setting Academic tertiary care centre. Population Pregnant women with known outcomes prospectively sampled. Methods PCF RNAs extracted from women at 22–24 weeks of gestation (five sPTB up to 32 weeks and five at term) were hybridised to gene expression arrays. Differentially regulated RNAs for sPTB up to 32 weeks were initially selected based on P value compared with control (P < 0.01) and fold change (≥1.5×). Potential markers were then reordered by narrowness of distribution. Final marker selection was made by searching the Metacore™ database to determine whether the PCF RNAs interacted with a reported set of myometrial Preterm Initiator genes. RNAs were confirmed by quantitative reverse transcription polymerase chain reaction and tested in a second group of 40 women: 20 with sPTB up to 32 weeks (mean gestation 26.5 weeks, standard deviation ±2.6 weeks), 20 with spontaneous term delivery (40.1 ± 0.9 weeks) sampled at 16–19+5 weeks of gestation. Main outcome measure Identification of PCF RNAs predictive of sPTB up to 32 weeks. Results Two hundred and ninety‐seven PCR RNAs were differentially expressed in sPTB up to 32 weeks of gestation. Further selection retained 99 RNAs (86 mRNAs and 13 microRNAs) and five of these interacted in silica with seven Preterm Initiator genes. Four of five RNAs were confirmed and tested on the validation group. The expression of each confirmed PCF RNA was significantly higher in sPTB up to 32 weeks of gestation. In vitro study of the four mRNAs revealed higher expression in placentas of women with sPTB up to 32 weeks and the potential to interfere with myometrial quiescence. Conclusions The PCF RNA markers are highly associated with sPTB up to 32 weeks by 16 weeks of gestation. Tweetable abstract Women destined for spontaneous preterm birth can be identified by 16 weeks of gestation with a panel of maternal plasma RNAs.

It is well known that hyperglycemia is associated with increased mortality from cardiovascular disease (CVD) and all-cause mortality. It has recently been reported that subjects with low fasting plasma glucose (FPG) levels also had a high risk of CVD and all-cause mortality (1). However, there is a paucity of information about the etiologic basis underlying the association between low FPG and increased CVD and all-cause mortality. Thus, in the present study, we investigated the association of FPG levels with white blood cell (WBC) counts, which indicate a state of low-grade systemic inflammation.We investigated the cross-sectional association of WBC counts with FPG levels among 3,256 Japanese men aged 34 -69 years. The subjects were divided into six categories according to FPG level: Ͻ80 mg/dl, 80 to Ͻ90 mg/dl, 90 to Ͻ100 mg/dl, 100 to Ͻ110 mg/dl, 110 to Ͻ126 mg/dl, and diabetes.The crude mean WBC counts were 6, 409, 6,308, 6,111, 6,111, 6,109, and 6,610 cells/mm 3 in the subjects with FPG levels of Ͻ80 mg/dl, 80 to Ͻ90 mg/dl, 90 to Ͻ100 mg/dl, 100 to Ͻ110 mg/dl, 110 to Ͻ126 mg/dl, and diabetes, respectively. The crude mean WBC counts differed significantly by FPG category and showed a U-shaped association with FPG levels (P value for quadratic trend Ͻ0.001). Even after adjusting for age, BMI, smoking, alcohol, health status, and other factors associated with elevated WBC count or glycometabolism, the respective adjusted-mean WBC counts were 6,273, 6,255, 6,175, 6,165, 6,075, and 6,429 cells/mm 3 . The WBC count maintained a U-shaped association with FPG level (P value for quadratic trend ϭ 0.041).Although it is well known that hyperglycemia is the cause of microvascular complications in several organs, there are few studies on the adverse effect of hypoglycemia. Early studies of hypoglycemia focused on brain damage and heart dysfunction. An acute decrease in FPG is recognized as the cause of them, whereas the long-term effect of low FPG remains unclear.Infection and inflammation may contribute to vascular injury and atherogenesis. Inflammation may also promote atherosclerotic plaque ruptures and thrombosis (2,3). WBC serves as an important biomarker for these disease processes.This study shows that the U-shaped association between WBC counts and FPG levels (especially low FPG levels) involves higher WBC counts that could not be linked to inflammatory disease or other factors or to any disease known to increase WBC counts. These findings suggest that a state of low-grade systemic inflammation may be present not only in diabetic subjects but also in people with low FPG, possibly explaining in part the high risk of CVD and all-cause mortality of such people. • (1) to clinical practice continues to be a major challenge (2,3). Physicians in training present a unique opportunity for shaping practice behavior. We tested the effect of an intramural contest on the outcome of diabetes management by 155 medical residents at a major U.S. teaching hospital. The contest was approved by the house staff leadership and w...

Magnesium sulfate does not have a major impact on disease progression in women with mild preeclampsia. Magnesium use does not seem to increase rates of cesarean delivery, infectious morbidity, obstetric hemorrhage, or neonatal depression.

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Erythrocytes must maintain a biconcave discoid shape in order to efficiently deliver oxygen (O2) molecules and to recycle carbon dioxide (CO 2) molecules. The erythrocyte is a small toroidal dielectrophoretic (DEP) electromagnetic field (EMF) driven cell that maintains its zeta potential (ζ) with a dielectric constant (ԑ) between a negatively charged plasma membrane surface and the positively charged adjacent Stern layer. Here, we propose that zeta potential is also driven by both ferroelectric influences (chloride ion) and ferromagnetic influences (serum iron driven). The Golden Ratio, a function of Phi φ, offers a geometrical mathematical measure within the distinct and desired curvature of the red blood cell that is governed by this zeta potential and is required for the efficient recycling of CO 2 in our bodies. The Bio‐Field Array (BFA) shows potential to both drive/fuel the zeta potential and restore the Golden Ratio in human erythrocytes thereby leading to more efficient recycling of CO 2. Live Blood Analyses and serum CO 2 levels from twenty human subjects that participated in immersion therapy sessions with the BFA for 2 weeks (six sessions) were analyzed. Live Blood Analyses (LBA) and serum blood analyses performed before and after the BFA immersion therapy sessions in the BFA pilot study participants showed reversal of erythrocyte rheological alterations (per RBC metric; P = 0.00000075), a morphological return to the Golden Ratio and a significant decrease in serum CO 2 (P = 0.017) in these participants. Immersion therapy sessions with the BFA show potential to modulate zeta potential, restore this newly defined Golden Ratio and reduce rheological alterations in human erythrocytes.

Attempts at asynchronous deliveries are uncommon and are associated with a high rate of perinatal death. Most fetal survivors have significant damage from preterm birth.