During bladder inflammation, increased production of NGF in urothelial cells induced increased expression and activity of TRPV1 channels in the cell membrane. This effect was primarily mediated by the PI3K pathway.
Sixty patients with previous stillbirths were given active antepartum, intrapartum and early postnatal care. A majority (75%) had a history of repeated stillbirths, and responsible pathology was detected in 55% of the cases. In the present pregnancy, 90% of the patients suffered complications, each of which was diagnosed and treated. Most of the group were hospitalized. Tests for serial urinary estrogens were done for 75% of the women. Other special assessments of maturity with amniotic fluid, oxytocin challenges and fetal monitoring were carried out in selected cases. After confirming maturity and degree of antepartum stress, labor was induced when appropriate. There was liberal recourse to cesarean section (18.3%), but no maternal mortality. Overall fetal salvage was 75%.
Paraesophageal hiatus hernia is rarely seen in the neonatal period. An intrathoracic gastric volvulus complicating such a hernia is rarer. The upper gastrointestinal tract contrast study is diagnostic. Rapid diagnosis and treatment is essential. It avoids lethal complications as gastric dilatation, gangrene and perforation, which in turn may lead to cardiopulmonary arrest.
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