Search

Due to concentration or development strategies, in recent years, worldwide, farmers are faced with a fundamental strategic decisions, namely to choose how to act better, in conditions of uncertainty, to make farms viable, profitable, resistance to competition, with markets and efficiency in accessing financial funds. Alternatively, farmers realize different forms of association, from which highlights cooperatives, producer groups and producer associations. In extension of Romanian agricultural cooperative should be considered the experience of countries economically developed, where an expansion was and diversification of agricultural cooperatives forms. In these countries agricultural cooperative was one of the main levers for concentration of agricultural production, of the transition from agrarian structure characterized by small farms and less specialized, to intensive ones, of large economic dimensions. [ABSTRACT FROM AUTHOR]

Acquired brachial plexus injury historically has been linked with excessive lateral traction applied to the fetal head, usually in association with shoulder dystocia. Recent reports in the obstetric literature, however, have suggested that in utero forces may underlie a significant portion of these injuries. Brachial plexus palsies may therefore precede the delivery itself and may occur independent of the actions of the accoucheur. Thus we propose that the long-held notions of a traction-mediated pathophysiologic mechanism for all brachial plexus injuries warrant critical reappraisal. [ABSTRACT FROM AUTHOR]

Objective: Our goal was to evaluate the effectiveness of therapy with a specific pulmonary vasodilator, nitric oxide, in a woman with Eisenmenger syndrome during pregnancy.Study Design: Eisenmenger syndrome consists of a congenital communication between the systemic and pulmonary circulation with secondary pulmonary hypertension causing reversal of flow through the shunt. Maternal morbidity is approximately 50% with the greatest risk of death being in the peripartum period. Pharmacologic therapy to relieve worsening pulmonary hypertension is confounded by the undesired effects of vasodilators on the systemic circulation. Therapy with a specific pulmonary vasodilator, nitric oxide, was attempted.Results: A 27-year-old woman with Eisenmenger syndrome at 36 weeks' gestation was treated with inhaled nitric oxide during the second stage of labor and the postpartum period when she experienced progressive refractory hypoxemia. Administration of nitric oxide was followed by improved oxygenation and lowering of pulmonary artery pressures. A brief episode of methemoglobinemia responded to lowering of the nitric oxide concentration and administration of intravenous methylene blue. Nitric oxide was discontinued after 48 hours. The patient died 2 days later despite continued vasodilator therapy including intra-pulmonary artery prostacyclin.Conclusion: Inhaled nitric oxide can be used to correct the hypoxemia of Eisenmenger syndrome. Nitric oxide inhalation is easily performed, and pulmonary vasodilatory effects commence within minutes after administration. [ABSTRACT FROM AUTHOR]

Objective: We sought to determine the fetal injury rate associated with shoulder dystocia and to determine whether there is a higher rate of brachial plexus injury or bone fracture when fetal manipulation techniques are required for delivery.Study Design: A retrospective review of 285 cases of shoulder dystocia that occurred between January 1991 and December 1995 was performed. The type, sequence, and combination of obstetric maneuvers used to relieve the shoulder dystocia were noted. These cases were divided into two groups, as follows: (1) those resolved with McRoberts' maneuver, suprapubic pressure, or proctoepisiotomy or a combination of these and (2) those that required the addition of direct fetal manipulative maneuvers (Woods, posterior arm, or Zavanelli). Fetal injury was defined as the occurrence of brachial plexus palsy, clavicular fracture, humeral fracture, or fetal death caused by asphyxial complications.Results: The fetal injury rate was 24.9% (71/285), including 48 (16.8%) brachial plexus palsies, 27 (9.5%) clavicular fractures, and 12 (4.2%) humeral fractures. Sixteen infants had both nerve injury and bone fracture. Four (8.9%) brachial plexus palsies had documented persistence at 1 year of follow-up. One neonatal death occurred at age 3 months after an episode of hypoxic ischemic encephalopathy. The incidence of bone fracture was not higher when direct fetal manipulation was required: 21 of 127 (16.5%) versus 18 of 158 (11.4%), p = 0.21. The incidence of brachial plexus palsy was also similar in both groups (27/127 vs 21/158, p = 0.1).Conclusions: Direct fetal manipulation techniques used to alleviate shoulder dystocia are not associated with an increased rate of bone fracture or brachial plexus injury. [ABSTRACT FROM AUTHOR]

Objective: Our purpose was to describe the effect of oral methylprednisolone on the course of refractory hyperemesis gravidarum.Study Design: Patients with intractable hyperemesis gravidarum were candidates for oral methylprednisolone. Forty-eight milligrams per day was given for 3 days followed by a tapering dose over 2 weeks. If vomiting recurred after 2 weeks of therapy or during tapering, the medication was restarted or extended but not longer than 1 month total.Results: Seventeen of 18 patients (94%) were free of vomiting and were able to tolerate a regular diet within 3 days. Seven did not have further symptoms during their pregnancies. Nine vomited during or after tapering, but 7 of these responded to extension or reinstitution of therapy. Four of 6 patients on total parenteral nutrition at the start of therapy had a complete response within 3 days.Conclusions: A short course of oral methylprednisolone appears to be a reasonable therapeutic alternative for intractable hyperemesis. [ABSTRACT FROM AUTHOR]

Objective: Our purpose was to determine whether Erb's palsies occurring in the absence of shoulder dystocia differ from those occurring after shoulder dystocia.Study Design: We compared the time course of resolution and incidence of persistent injury at 1 year of age in 17 cases of Erb's palsy without shoulder dystocia and 23 cases associated with shoulder dystocia.Results: The rate of persistence at 1 year was significantly higher in those Erb's cases without identified shoulder dystocia, 7 of 17 (41.2%) versus 2 of 23 (8.7%), p = 0.04. These cases of Erb's palsies also took longer to resolve (6.4 +/- 0.9 vs 2.6 +/- 0.7 months, p = 0.002), had a higher rate of associated clavicular fracture (12 of 17 vs 5 of 23, p = 0.006), and were more likely to occur in the posterior arm (10 of 15 vs 4 of 21, p = 0.009).Conclusions: Erb's palsy occurring without shoulder dystocia may be a qualitatively different injury than that occurring with shoulder dystocia. [ABSTRACT FROM AUTHOR]

The continuous glucose monitoring (CGM) makes it possible to record an increased number of glucose measurements per day than the usual method of using repeated blood tests. The increase in the number of measurements allows this method to identify the extreme glycaemic values in the patients under supervision, even when the usual symptoms of hypo- and hyperglycaemia are not yet present. A total of 33 adult patients with type 1 diabetes, with previously well balanced glycaemic values confirmed by measurements of glycated haemoglobin of less than 8% and without significant associated diseases were included in the study. 15 patients were included in the CGM group for 3 days, while the other 18 patients were asked to measure their glycaemia 7 times a day at regular intervals. The results confirmed that the CGM was better suited for identifying extreme glycaemic values (under 70 mg/dl and above 180 mg/dl). [ABSTRACT FROM AUTHOR]

The continuous glucose monitoring (CGM) makes it possible to record an increased number of glucose measurements per day than the usual method of using repeated blood tests. The increase in the number of measurements allows this method to identify the extreme glycaemic values in the patients under supervision, even when the usual symptoms of hypo- and hyperglycaemia are not yet present. A total of 33 adult patients with type 1 diabetes, with previously well balanced glycaemic values confirmed by measurements of glycated haemoglobin of less than 8% and without significant associated diseases were included in the study. 15 patients were included in the CGM group for 3 days, while the other 18 patients were asked to measure their glycaemia 7 times a day at regular intervals. The results confirmed that the CGM was better suited for identifying extreme glycaemic values (under 70 mg/dl and above 180 mg/dl). [ABSTRACT FROM AUTHOR]

Desmoid tumors are locally invasive fibrous neoplasms that arise from musculoaponeurotic structures. We report the first case of a desmoid tumor of the larynx complicating pregnancy. At 21 weeks' gestation fiberoptic and indirect otolaryngologic examination of the patient's larynx revealed a submucosal tumor involving the left true vocal cord, ventricle of the larynx, and false vocal cord. Histopathologic examination revealed areas of extensive fibrosis intermixed with degenerated vocal cord skeletal muscle. Despite a subtotal excisional biopsy, growth of the desmoid tumor continued during pregnancy. Endoscopic evaluation 9 weeks post partum revealed complete regression of the tumor. [ABSTRACT FROM AUTHOR]

Many authors have recommended the McRoberts' maneuver as the initial technique in the management of shoulder dystocia. There have been, however, no reported adverse maternal outcomes associated with this technique. We report a case of symphyseal separation and transient femoral neuropathy associated with the McRoberts' maneuver. An overly exaggerated lithotomy position and thigh abduction stretches the articular surfaces of the symphysis pubis and places increased pressure on the femoral nerve by the overlying inguinal ligament. [ABSTRACT FROM AUTHOR]

Specific agricultural production showed very different dynamics, both sector (plant and animal) and the regional profile, depending on the diversity of agro-climatic suitability, and the utilization of production factors. The structure of cultivated areas is a technical indicator of the major influences on economic performance and reflect the share that each culture deals with arable land. It does not take random values, but must be directed strictly according to the demand for food products shown on the agricultural products market. Lowland area of Timis county is occupied by the Western Plain. This is the second largest pool of grain production after the Romanian Plain and the Lower Danube. The structure of grain growing areas have 70-75% share, well above normal values. Typically grain must not exceed the maximum weight of two thirds of the arable land. Among cereal grains, namely wheat, barley, barley, rye and oats together have 40-50% share. Local climatic conditions offer many possibilities for agricultural development. Natural landscape is favorable most types of specific crops and continental temperate zone as a consequence of the West region has extensive agricultural land, Arad and Timis counties topping, in this respect among the first in the country. Cereals is one of the oldest and most important agricultural activity in Arad and Timis counties, which have the largest areas of arable. Romanian agricultural production in general, including the west of the country, turned to grain production, not to put too much problem recovery products. Farmer has no means of production, so that technological support has been achieved and is still performed in the services system. In 2008, global agricultural production calculated in current prices was 2,415,821 thousand. Of that total global production plant is 1,708,457 thousand, which meant 70, 7% of total world production was 674 351 Animal thousand, respectively 27, 9%, and the difference, ie 1.4% is represented by various services of the agriculture holdings. Structure of gross agricultural production in an agrarian economy healthy, normally should take the following value: 48-55% global production plant, animal production 45-52% overall, Romania is still far from these value. We could say that we have developed an agricultural production sector in the Western states of Europe, where animal production will exceed the overall 50% share of total gross agricultural production structure. [ABSTRACT FROM AUTHOR]

Although organic farming is still an industry shortage, its importance in the agricultural sector has grown into a large number of countries with different development levels. In some developed countries, organic agriculture is an important segment of the agro-food (such as 10% in Austria and 7.8% in Switzerland), and in many other countries organic agriculture is growing more than 20% annually (the example in the USA, France, Japan, Singapore). A number of developing countries within small markets organic products (Egypt) and others have begun to explore the export opportunities offered by organic agriculture (eg exports of Mexican coffee and cotton in Uganda). In villages, where peasants from their land when they know the country, agriculture is still poorly integrated market economy. According to the Ministry of Agriculture and Rural Development (MARD), the country's agricultural area is 14.7 million hectares, representing 61.7% of Romania. Each incumbent Romanian 0.42 hectares of arable land, which is almost double the European average. Therefore, Romania is among countries with high agricultural potential. However in many regions, however, people cultivate land just to have something put on the table. In recent years, people have been talking about organic farming, a new trend in plant cultivation and animal husbandry. Organic farming does not make good home with the conventional, but differs fundamentally from the latter. The role of agriculture practiced in organic food production is clean, suitable for human metabolism and in full accord with nature. Many people complain that tomatoes and apples they buy from the market no longer have the taste of old and sometimes does not taste at all. Organic farming comes practically to solve this problem: to give the world food with authentic taste and quality. Pesticides are totally banned and genetically modified organisms are boycotted from the start. Bio-organic agriculture does not exclude, but requires the use of advanced equipment and technology, modern. To obtain bio-organic agricultural products, equipment and technologies must be more sophisticated, more developed and more adapted to the requirements of environmental protection and that of obtaining healthy products. A bio-organic farm will have a better chance to become sustainable if it will become multifunctional. In addition work will be to develop production and the processing and marketing is not. But equally important is it to develop and agro-tourism, so as to obtain additional income. [ABSTRACT FROM AUTHOR]

Despite high demand for gold film nanostructuring, patterning gold at the nanoscale still presents considerable challenges for current foundry-compatible processes. Here, we present a method based on abrasive-free chemical mechanical planarization (CMP) to planarize nanostructured gold surfaces with high selectivity against SiO 2 . The method is efficient in a damascene process and industry-compatible. Investigations into the material removal mechanism explore the effects of CMP parameters and show that the material removal rate is highly tunable with changes in slurry composition. Millimeter-scale arrays of gold nanostructures embedded in SiO 2 were fabricated and the planarization dynamics were monitored over time, leading to the identification of distinct planarization phases and their correlation with the material removal mechanism. Finally, plasmonic cavities of gold nanostructure arrays over a gold mirror were fabricated. The cavities exhibited efficient plasmonic resonance in the visible range, aligning well with simulation results.

Food security is a matter of global concern, as the supply of food is one of the basic needs, ensuring the survival of the species. The trend of globalization and development of the global economy has shifted the responsible, local consumption patterns towards an increased homogeneity of diets, with food products being disconnected from their source, leading to two major results: (1) increased global consumption and (2) increased uncertainty in the supply chain. To determine what is the nutritional model of Romanians, we developed a questionnaire of 32 questions and distributed it using simple random sampling method. The questionnaire was issued both in physical and digital form and received 1053 responses. The survey was conducted during 2021 and 2022, both in urban and rural areas with the aim of investigating the consumption pattern of the population. The analysis of the questionnaire data reveals overconsumption of animal products, starchy vegetables and bread and pastry products. This nutritional pattern with a high intake in animal protein, correlated with a lack of diversification, is extremely unsustainable, having a negative impact on human health and environmental health.

The Metabolic Food Waste MFW (kg of food) first developed in 2016 as a new indicator by Serafini and Toti, indicates the amount of food consumed above the nutritional requirements, and the impact of this overconsumption on the environment. It is necessary to identify the causes and to develop potential methods to prevent and reduce MFW, at the same time as increasing consumer awareness about unsustainable diets and changing diet habits towards more environmentally conscious consumption patterns. This study was conducted by collecting and analysing existing reports and studies regarding nutritional requirements, consumer behaviour related to food consumption and food waste, environmental impacts of food waste, and the concept of Metabolic Food Waste. The process of data collection involved searching the studies available online, using keywords related to the subject of MFW and overconsumption. The references in the initial studies consulted were also analysed in order to further identify new data relevant to overconsumption and MFW. The materials studied and analysed related to the environmental impact of MFW were published by E. Toti and M. Serafini in 2016 and 2019; additionally, in order to understand the causes of overconsumption numerous studies were reviewed regarding consumer behaviour, the relationship between economic development and overconsumption, mental health and dietary habits, physical context and dietary habits, genetic predisposition, also childhood and early adulthood environment. By analysing and corroborating external data available for food waste, nutritional requirements, and the environmental impact of food waste and consumer behaviour, we identified as primary causes for MFW the lack of nutritional education and little understanding of the nutritional requirements amongst all categories of consumers, poor access to appropriate food resources or reduced availability of fresh produced food. We conclude that for the quantification of the negative impact of MFW on both the environment and human health we need decisive action to raise consumer awareness for healthy and sustainable diets, together with a uniform worldwide distribution system for nutritious food.

Under the direction of U.S. Northern Command for COVID-19 pandemic response efforts, approximately 500 Navy Reserve medical professionals were deployed to the New York City area from April to June 2020. Some of these providers were asked to serve in 11 overburdened local hospitals to augment clinic staffs that were exhausted from the battle against coronavirus. Two maternal/fetal medicine physicians were granted emergency clinical providers to assist in these efforts. KEY POINTS: · Maternal-fetal medicine physicians contributed significantly to the COVID-19 pandemic by managing ICU patients.. · Disparate, diverse medical professionals can pull together to form cohesive and functional teams.. · The Department of Defense can mobilize a large group of providers in a short amount of time.., Competing Interests: None declared., (Thieme. All rights reserved.)

Background: Adult granulosa cell tumor associated with antecedent use of tamoxifen as adjuvant hormonotherapy for breast cancer is rare. The pathogenesis of this occurrence remains difficult to explain. The estrogenic effect of tamoxifen can be one such explanation., Case Presentation: A 47 year-old women was treated with surgery, chemotherapy, radiotherapy and tamoxifen for stage III estrogen receptor positive breast carcinoma. Ten months after stopping tamoxifen, we diagnosed a stage Ic granulosa cell tumor of the ovary., Conclusions: Use of tamoxifen has been found to be associated with gynecological tumors like endometrial carcinoma. Its association with granulosa cell tumor of the ovary is uncommon. Only two previous cases have been reported in literature.

Our objective was to compare national guidelines regarding shoulder dystocia. Along with the American College of Obstetricians and Gynecologists (ACOG) practice bulletin on shoulder dystocia, guidelines from England, Canada, Australia, and New Zealand were reviewed. The Royal College of Obstetricians and Gynaecologists (RCOG) guideline agrees with the ACOG definition of shoulder dystocia, but there are variances in the management of suspected macrosomia and resolution of impacted shoulders. How recommendations are categorized differ also. Only 53% (20 of 38) of eligible references are cited by both publications. The two national guidelines on shoulder dystocia have differences and disagreements with each other, raising concerns about how the literature is synthesized and which is more comprehensive., (Thieme Medical Publishers.)

Background: Recent studies have noted a striking similarity between amniotic fluid embolism (AFE) and anaphylaxis. Serum tryptase levels may therefore serve as a marker of mast cell degranulation in AFE cases., Case: A 40-year-old woman, gravida 6, para 4, experienced the acute onset of facial erythema, eclampsia-type seizures, severe hypoxia, cardiac arrest and disseminated intravascular coagulation while in early active labor. The patient was declared dead 37 minutes after the onset of resuscitative efforts. At autopsy, fetal squames were found within the pulmonary tree, uterine blood vessels and brain. A peripheral venous blood specimen, obtained approximately one and a half hours postmortem, revealed a tryptase level of 4.7 ng/mL (normal, < 1)., Conclusion: An elevated serum tryptase level, in conjunction with our patient's clinical history, adds further supporting evidence to the concept of AFE as an anaphylactoid syndrome of pregnancy.

Objective: To compare orally administered misoprostol with intravaginal prostaglandin E2 for cervical ripening and labor induction., Study Design: Patients presenting with medical or obstetric indications for labor induction whose Bishop's score was < or = 6 were randomly allocated to receive either 50 micrograms of oral misoprostol or 4 mg of intravaginal prostaglandin E2. If adequate cervical ripening (Bishop score of 9 or cervical dilatation of 3) or active labor did not ensue, repeat doses of each medication were administered every four hours. A maximum of six doses of either oral misoprostol or intravaginal prostaglandin E2 was permitted. Intravenous oxytocin was subsequently administered according to a standardized infusion protocol., Results: Sixty patients were enrolled, with 29 randomized to the oral misoprostol arm and 31 to the prostaglandin E2 group. The data on 58 patients were eligible for analysis. Delivery occurred within 48 hours in 96.4% (27/28) of those administered oral misoprostol as compared to 76.7% (23/30) of those who received intravaginal prostaglandin E2 (P = .03). The mean time intervals from the start of induction to delivery were similar between the two groups (1,496 +/- 120 vs. 1,723 +/- 230 minutes, P = .40). No statistically significant differences existed between the two groups with respect to intrapartum complications, tachysystole, uterine hyperstimulation or adverse neonatal outcomes., Conclusion: Oral administration of misoprostol is an effective alternative to intravaginal prostaglandin E2 for preinduction cervical ripening.

Recurrence of fetal cystic hygroma in subsequent pregnancies is extremely rare. A review of the literature to date revealed only two other reports of recurrence with normal fetal karyotypes documented in at least two of the affected pregnancies. At 11 weeks' gestation, the fetus of a 19-year-old gravida 3 para 0 was discovered to have a large cystic hygroma. Subsequent evaluation during the second trimester revealed increasing size of the septated nuchal mass and ascites. A 46,XX fetal karyotype was noted in her two prior pregnancies, both of which had also been complicated by the development of cystic hygroma and nonimmune hydrops. Cystic hygroma, associated with a normal karyotype, can be inherited as an autosomal recessive trait.