Human papillomavirus vaccine and systemic lupus erythematosus
Colentina Clinical Emergency Hospital, Bucharest, Romania The prevalence of obesity is rising globally in developed and developing countries, including Eastern European ones and, above all, Romania.
We report on this occasion the case of a year-old pregnant woman with a postterm pregnancy, without obstetric specialisation supervision, in whom morbid obesity has led to multiple obstetric complications with vital maternal-fetal risk and, implicitly, to caesarean delivery. The case was particularly well publicized in the press because none of the three clinics which the patient was transferred to was willing to assume its completion.
In the current context, in which the incidence of obesity meets new limits, becoming a disease with a significant impact on pregnancy evolution, an increase in caesarean delivery and in pre- and postoperative complications due to obesity can be expected. Systemic lupus erythematosus SLE is a multi-system autoimmune disorder which often affects women at childbearing years. Both maternal and human papillomavirus vaccine and systemic lupus erythematosus mortality and morbidity are severely altered, with high risk of preeclampsia and premature delivery, and in the case of positive antiphospholipidic and anti-DNA antibodies, miscarriage and stillbirth are common.
Systemic lupus erythematosus is a common autoimmune condition that affects women of childbearing age. We present the case of a year-old primiparous woman at 29 weeks of gestation, diagnosed with SLE with multiple organ involvement at the age of 13 years old, when she suffered from a stroke.
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The patient condition improved significantly after high doses of dexamethasone, liver protective drugs, anticoagulants, and antihipertensive medication. The patient was discharged after 14 days of hospitalization. The child was discharged, in good condition, after 65 days.
The management of pregnant women with SLE is extremely challenging, and a multidisciplinary approach — including an obstetrician, rheumatologist, intensive care physician and neonatologist — should be achieved.
Keywords: preeclampsia, systemic lupus erythematosus SLESLE flare, autoimmune disorder, fatty liver, pregnancy Medico-social implications of newborns with extremely low birthweight Implicaţiile medico-sociale ale nou-născuţilor cu greutate extrem de mică la naştere Aniko Manea1, Daniela Cioboată2, Oana Costescu1, Nicoleta Lungu2, Florina Doandeş2, Mărioara Boia1 1.
Immediate and late complications determine the necessity of long-term monitoring of this category of newborns.
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In this study, the authors aim at determining the main complications occurred in a lot of ELBW newborns, complications with an impact on the subsequent neurological and development prognosis.
Materials and method.
Human papillomavirus vaccine and systemic lupus erythematosus.
Results and discussion. The objective analysis of the occured complications, and the monitoring through a follow-up program lead to the early interpretation of the alert signs. The reduction of rate of sequelae at distance, of neurological and motor disabilities, as well as the reduction of mortality are proportional with this early approach.
Keywords: extreme prematurity, complications Chronic lung disease — is outpatient treatment possible? Boala pulmonară human papillomavirus vaccine and systemic lupus erythematosus a prematurului poate fi tratată în ambulatoriu? The main risk factors for CLD are low gestational age, very low birth weight, and prolonged mechanical ventilation.
CLD leads to multiple and severe complications, caused by the disease itself or by its specific treatment. The disease may have a long clinical course that can go peritoneal cancer from asbestos beyond neonatal age or standard discharge weight. Prolonged hospitalization in human papillomavirus vaccine and systemic lupus erythematosus NICU is difficult due to the overcrowding of these facilities.
It is not possible to transfer these oxygen-dependent pediatric-aged patients in pediatric hospitals, or in other birth centers; therefore, a solution for patients with CLD could be to continue the treatment at home. As in Romania neither the home care services, nor the primary health care network are prepared to take care of patients with this pathology, their treatment and monitoring would fall into the full responsibility of the neonatologist.
We present our experience with few cases of premature babies with severe CLD who were hospitalized in our clinic for several months and then discharged at home with oxigenotherapy, oral treatment, and continuous cardiorespiratory monitoring; the babies were enroled in a strict follow-up program coordinated by the neonatologist.
All cases had a favorable clinical course to complete resolution, demonstrating that CLD can be treated succesfully in outpatient care, if the families are able and willing to involve themselves in the care of their baby, and they respect human papillomavirus vaccine and systemic lupus erythematosus the medical recommendations.
Keywords: chronic lung disease, bronchopulmonary dysplasia A rare cause of brachial plexus palsy Cauză rară de pareză de plex brahial Cristina Chiriac1, Adriana Dan2, Liliana Pădure 3 1. We hereby present the case of a premature baby, extracted by emergency caesarean section at 28 gestational weeks for signs of fetal distress, therefore in an apparently non-traumatic context except for a transverse presentation.
The clinical examination at birth revealed an impressing edema on the entire left superior limb, axillary area, left subscapular and cervical area with extensive bruising; the left hand was stiff and human papillomavirus vaccine and systemic lupus erythematosus in ulnar deviation and no active movement of the limb could be observed. The medical interventions consisted in systemic and local treatment with heparin, group B vitamin infusion, and upper positioning of the affected arm.
The clinical course of the case was favorable, with the progressive reduction of the edema and bruising, and progressive recovery of limb movements starting from human papillomavirus vaccine and systemic lupus erythematosus shoulder down to the elbow. The ulnar deviation and persistent altered mobility of the hand required kinesiotherapy performed by both medical staff and the mother.
Both clinical aspect and the neurological function of the affected limb humaan papillomavirus zwanger worden improved remarkably and relatively fast under this treatment, despite the clinical severity shown at birth. The particularity of the case consisted in the association of an antenatal pregnancy pathology multiple fibroma protrusive into the utero cavity which could led to brachial plexus palsy of the newborn extracted through caesarean section by compression and intrauterine vicious position.
Keywords: brachial plexus palsy, traumatic perinatal complications Diagnostic issues in a neonatal thyrotoxicosis case Probleme de diagnostic într-un caz de tireotoxicoză neonatală Cristina Chiriac1, Adriana Dan2 1. Usually, these cases are found in newborns from mothers with Graves disease.
We hereby present the case of a premature baby 29 gestational weeks, g from a pregnancy without any known endocrine pathology, with maternal hypertension of unknown etiology; the baby was admitted in NICU for mild respiratory distress syndrome. Our first diagnostic suspicion of neonatal sepsis was not confirmed because the lack of inflammatory markers and repeated negative blood cultures. The cardiac examination ruled out any cardiac structural anomaly and diagnosed the episodes of arrythmia as being sinus tachycardia.
TSH and thyroid hormones determination in the newborn was recommended, which revealed a congenital hyperthyroidism. At that point, an endocrinology examination for the mother was considered, and blood tests showed the presence of stimulatory antibodies and we diagnosed Graves disease. The newborn received treatment with propanolol, which controlled the arrythmia episodes, and during next weeks the thyroid hormones levels decreased.
The particularity of the case consisted in the fact that the newborn had a poor clinical picture and an unknown family history for endocrine disease. Keywords: neonatal hyperthyroidism, thyrotoxicosis Intrauterine testicular torsion — case presentation Torsiune testiculară intrauterină — prezentare de caz Adriana Dan1, Magdalena Mihai2, Cristina Buzduga3 1. In most cases, it is unilateral, the testicle being ectopic located in the abdomen or in the inguinal canalbut it may also be absent due to agenesis or testicular atrophy.
Although in most cases the missing testicle at birth will descend in the following months, neonatal cryptorchidism should be followed by further investigations. The first step in the differential diagnostic algorithm is the scrotum and abdominal ultrasound examination. We present the case of a newborn with a false unilateral cryptorchidism, without any other clinical sign; the routine postnatal ultrasound revealed a small, sclerotic, calcified testicle into the scrotum.
At this point, reviewing the pregnancy history, we discovered that some vascular alterations in the testes were noted at 28 human papillomavirus vaccine and systemic lupus erythematosus of gestation by the papillomavirus avant grossesse ultrasound examination, but no therapeutic intervention was discussed.
The pediatric surgeon to whom the baby was referred confirmed the diagnosis of a testicular necrosis after intrauterine torsion, and scheduled a later intervention for the excision of the necrotic tissues and the fixation of the normal contralateral testicle. This case emphasizes the importance of paraclinical investigations and surgical consult when neonatal cryptorchidism is found, prior to the discharge from the neonatology unit; this would avoid possible future legal cancers caused by hpv 16, because a later identification of testicular sclerosis may lead to the diagnostic of neglected postnatal testicular torsion, when emergency surgical procedure is mandatory.
Human papillomavirus vaccine and systemic lupus erythematosus possible intrauterine intervention in such cases is questionable.
Keywords: testicular torsion, cryptorchidism, ectopic testicle What can we say today about pollution and breastmilk? Ce se poate spune azi despre poluare şi despre laptele de mamă? Breastmilk is the most natural nourichement; we expect to be pure, but it is invaded with a lot of chemical pollutants.
We live in times when everything around us is polluted. The exposure to dichlorodiphenyltrichloroethane DDT affects the reproductive system and decrease the fertility; it can affect the quality of seminal fluid cum ar fi glazurarea copilului pentru prevenire it can also influence the period of gestation and the lactation.
The exposure human papillomavirus vaccine and systemic lupus erythematosus DDE in the first trimester increases the risk for neurological disorders of the fetus. In this study, it was analyzed the human milk collected from different patients who lived in rural and urban areas of Cluj district. The milk human papillomavirus vaccine and systemic lupus erythematosus were collected in sterile vials 40 mL closed with teflon lined screw cap, fixed with 16 mg K2Cr2O7 and kept at 4°C until analysis.
After the analysis of milk sample on gas chromatography coupled quadrupole mass spectrometer detector Focus GC — DSQ II MS, Thermo Electron Corporation using selective ion monitoring methods and for the quantitative analysis of human papillomavirus vaccine and systemic lupus erythematosus organochlorine pollutants, the samples were analyzed also with gas chromatography equipped with ECD and FID detectors. C2HCl3 TR: 1. Breastmilk is contaminated with the pollutants found in the habitat area.
Forum Perinatologia: abstracts
These contaminates are suspected as being carcinogenetic for human beings, and represent a concern for public health authorities. Keywords: pollutants, breast milk, newborn Correlation between neonatal seizures and hypoxic-ischemic encephalopathy Corelaţie între convulsiile neonatale şi encefalopatia hipoxic-ischemică perinatală Florina Doandeş1,2, Aniko Manea1,2, Oana Costescu1,2, Nicoleta Lungu1,2, Daniela Cioboată1,2, Mărioara Boia1,2 1.
They reflect a variety of pre- peri- and postnatal disorders of central nervous system.
The etiology of neonatal seizures is very heterogeneous. They commonly occur in the setting of an encephalopathy, most commonly due to hypoxia-ischemia. Hypoxia-ischemia may occur either acutely or chronically, and is most commonly associated with maternal factors hypotension, severe hypoxiacord factors prolapse, occlusionplacental factors insufficiency or abruption and uterine factors rupture.
Neonatal events shock, respiratory or cardiac arrest can also lead to hypoxic-ischemic injury.
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Asphyxia has been shown to be the third most common cause of neonatal hepatic cancer and nausea, after preterm birth and severe infections. Neonatal encephalopathy — a frequent complication of asphyxia — is an important cause for neonatal seizures. We studied in our neonatal intensive care unit the cases of patients who wart treatment dermnet been admitted for neonatal seizures or who had experienced seizures in evolution, and their correlation with hypoxic-ischemic encephalopathy.
The three most common etiologies of neonatal seizures are hypoxic-ischemic encephalopathy, ischemic stroke and intracranial hemorrhage. Hypoxic-ischemic encephalopathy is the most studied clinical condition, producing the most serious neurological sequelae.
It is the leading cause of long-term neurological morbidity and an important cause of mortality. Keywords: neonatal seizures, etiology, hypoxic-ischemic encephalopathy Autoimmune diseases in pregnancy — management and neonatal outcome Managementul bolilor autoimune la gravide şi impactul neonatal Andreea Boiangiu1, Andra Bălănescu2, Radu Vlădăreanu1, Simona Vlădăreanu1 1.
Autoimmune diseases primarily affect females at fertile ages, thus affecting the fertility and the outcome of a future pregnancy. If until recently these pregnancies were contraindicated, with the emergence of new revolutionary treatments they are now possible. However, the central element to be taken into account is that these patients will have a pregnancy with increased maternal-fetal risk and will require a strict multidisciplinary monitoring.
Human papillomavirus vaccine and systemic lupus erythematosus Archives - Page 8
Per se, pregnancy induces a number of immunological changes, including an increase in complement level, a change in cell adhesion molecule expression, a decrease in CD4 cells, decreased IL2 production, and a decrease in NK cell activity.
Also, the endocrinological storm during pregnancy, birth and postpartum, with dramatic changes in the levels of estrogen, progesterone, cortisol, norepinephrine and dehydroepiandrotestosterone, will potentiate the immunological changes.
All these immunological adaptations are designed to accommodate the mother with the semialogenic fetus, but at the same time will lead to changes in the evolution of autoimmune diseases that will influence the maternal-fetal outcome.
The maternal autoantibodies and some substances used as the primary treatment of the disease crossing the feto-placental barrier are the main concern of the perinatal medicine team. Also, knowing the bidirectional impact of the disease on the pregnancy and of the pregnancy on the disease will human papillomavirus vaccine and systemic lupus erythematosus to a better maternal-fetal outcome.
Furthermore, pregnancy affects the inflammatory and immune processes. Several medications may not be compatible with pregnancy, but recent data showed that effective treatment of active inflammatory rheumatic diseases particularly with biological agents is possible with reasonable safety, leading to important changes in the current management guidelines and standards of care.
So, nowadays, pregnancy is possible for most patients with immune-mediated rheumatic diseases, and good outcomes can be expected for both mother and child.
This became possible as a consequence of increasingly better monitoring and new treatment options of pregnant women with this pathology, and by the collaboration of an experienced multidisciplinary team.
Keywords: pregnancy, breastfeeding, rheumatic diseases, biologics Enteral nutrition — determinant factor for an optimal growth of premature newborns Nutriţia enterală — factor determinant al optimizării creşterii la nou-născutul prematur C. Angelescu-Coptil1,2, D.
Iacob1,2, M. Pantea1,2, G. Noditi1, C. Ilie1,2 1. Also, there are presented new results which target the initialization of enteral nutrition as soon as possible after birth, even for extremely-low-birth-weight ELBW premature babies who require total parenteral nutrition for a variable period of time.
For premature newborns an early alimentation represents a trigger factor for the structural-functional development of digestive and metabolic processes. This factor has an essential contribution to the nutritional rehabilitation of the ELBW preterm and for minimizing postnatal growth restrictions.
The postnatal growth of premature newborns is analyzed based on the holistic concept of days, a growth and development period which is rapid, unique and essential for the whole life.
The nutritional deficiencies or errors in this time, beside postnatal growth restriction, can be determinant factors for some adult pathologies, such as diabetes, obesity and arteriosclerosis. It has been shown that these pathologies have their roots in the early stages of life, even in the fetal period. Based on this information flamini în giardiază the recommendations from international committees, regarding the nutrition of premature babies, there are presented the main practical guidelines for nutritional needs and the ways to achieve them, based on human milk.
In conclusion, it is clear that the fetal and postnatal period of preterm babies represents a critical milestone for the health of the future adult. Keywords: enteral nutrition, premature babies Human papillomavirus and the associated risk of prematurity Virusul papiloma uman şi riscul asociat de prematuritate Simona-Daniela Cancer cai biliare, Andreea Mădălina Bănică², Simona Vlădăreanu³ 1.
It is known that HPV infection is the most common sexually transmitted disease in women and the major cause of cervical cancer. Recently, the purpose of the researchers was to identify the association between HPV infection and adverse pregnancy outcomes. It is considered that HPV infection of trophoblast induces placental dysfunction by preventing the attachment to the uterine wall and thus adverse obstetric outcomes, such as preterm delivery, spontaneous abortion and preeclampsia.
It has been shown that decreased serum levels of plasma protein A during the first trimester of pregnancy are associated with an increased risk of premature birth.
Regarding HPV vaccination, this has been shown to reduce the incidence of prematurity, but further studies are needed to evaluate the association human papillomavirus vaccine and systemic lupus erythematosus nine-valent vaccine and the risk of adverse pregnancy outcomes.
Keywords: human papillomavirus, placental dysfunction, prematurity, pregnancy adverse outcomes, HPV vaccine Ivemark syndrome — a rare entity, with specific anatomical features Sindromul Ivemark — o entitate rară, cu caracteristici anatomice specifice Margareta Pîrvănoiu1, Dana Hodiş1, Bogdan Lucian1, Adrian Hruşcă2, Andreea Răchişan2, Simona Manole3, Simona Opriţa4, Simona Căinap2 1. Ivemark syndrome IS — or right atrial isomerism RAI — is known as a rare congenital condition, being the result of an anomaly in the embryonic period.
It is usually associated with cardiac, splenic, pulmonary, hepatic anomalies, and abnormalities of other organs, being a common cause of death in newborns.