Search

Background Anticoagulation (AC) is essential to haemodialysis (HD), however the uremic state itself can cause bleeding complications. Purpose The aims of this retrospective cohort study were: To evaluate our current anticoagulation practice focusing on bleeding risk in contrast to thromboembolic events. To analyse potentially severe drug–drug interactions (DIs) to determine drug combinations that should be avoided. Material and methods We reviewed the medical records of 101 chronic HD patients (55 men, age 69±12 years, HD vintage 31 months (IQR:45)) in our hospital. Each patient’s current medical treatment was evaluated by in-person interview and drug interactions were checked with Medscape. Statistical analysis was performed with the SPSS v18.0 software package. Data were expressed as mean ±SD, comparisons between groups were analysed by non-parametric tests, p Results A total of 69 patients received UFH and 31 got LMWH during HD as per dialysis protocol. For other indications 20 patients received LMWH and 11 patients received oral anticoagulation therapy (OAC) off-dialysis days. The majority of patients spent a longer time outside of target international normalisation ratio. Additionally, 41 patients took antiplatelet agents and 29 took NSAIDs. Overall, 34% of the total patients had experienced bleeding, while 30% had suffered thromboembolic complications. Forty-four (45%) patients had 83 severe/contraindicated DIs. The main severe potential drug-drug interactions were caused by combinations of NSAID/ASA (35%), dalteparin/UFH (29%) and dalteparin/clopidogrel (10%). Sixty-eight per cent of these patients (31 out of 45) had manifest bleedings, whereas among those without drug interactions bleeding was observed in 18% (p Conclusion Dialysis patients may experience severe potential DIs. Their anticoagulant regime should be personalised. Clinicians should be cautious when prescribing drugs to them. Involving clinical pharmacists in the primary team is advisable to prevent DIs. References and/or acknowledgements https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4960860/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4765624/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5051256/ https://reference.medscape.com/drug-interactionchecker No conflict of interest.

Pregnant women were examined following healthy pregnancies at term. Amniotic fluids were sampled before arteficial rupture of membranes using closed vacutainer system. Blood samples were also taken from the pregnants simultaneously.Endotoxin concentrations of amniotic fluids were tested by the semiquantitative Limulus amebocyte lysate. Both amniotic fluids and blood samples were tested for the presence of DNA of lymphotropic human herpesviruses. The DNA of human papillomaviruses were tested only in the amniotic fluid samples.One-third of the amniotic fluids tested were found to contain measurable amounts of endotoxin. Lymphotropic herpesvirus DNA was deteced in every fourth amniotic fluid sample and in every 8 th blood sample. The prevalence of papillomaviruses was 7 of 96 samples.No significant correlation was found between the presence of endotoxin and viruses in the amniotic fluids. Epstein-Barr virus, human cytomegalovirus and human herpesvirus type 7 were found more frequently in the amniotic fluids than in blood samples (7 to 1). The prevalence of human herpesvirus 6 and 8 was higher in the blood samples than that in the amniotic fluids.The mean weight of the neonates were not impaired significantly by the presence of either viruses or endotoxin. Possible post partum consequences, i.e. partial immunotolerance to viruses is discussed.

The effect of Clostilbegyt + Humegon + Pregnyl ovulation inductive combination therapy was examined in the woman members of 20 sterile couples appearing at the Outpatient Department of Cryospermatology, Department of Obstetrics and Gynaecology Postgraduate Medical School. In 18 of the 20 cases follicle maturation and ovulation could be induced. In the male members of the couples therapy-resistant sterility existed at the same. By using artificial insemination by donors with cryopreserved sperms, gravidity could be obtained in 14 cases. The importance of the optimal timing of AID has been emphasized. In the course of transvaginal ultrasonography folliculometry was completed with the control of the pre-ovulatory changes of the endometrium. The appearance of the pre-ovulatory ring preceded the occurrence of pregnancy in all cases, being a sign of predictive value considering conception.

The follicle maturation influencing effect of Clostilbegyt (50 mg Clomiphene-citrat) has been examined in 30 women suffering from primary or secondary sterility. For monitoring follicular development a vaginal ultrasound scanner was used. The development of yellow body and its adequate function have been controlled with serum progesterone determination. In the first therapeutical cycle daily 1 tbl. Clostilbegyt was used from the 4th day of the menstruation in a five day period. In the next cycle daily 2 tbl. were administered similarly. If the therapy was unsuccessful, then 3 tbl. per day Clostilbegyt was used as treatment in the 3rd cycle. In the course of monitoring with vaginal ultrasound scanner successful ovulation induction has been proved in 80% of the Clostilbegyt treated cases (in 24 of 30 cases). During the examination period pregnancy occurred in 7 cases (29.2%). Vaginal ultrasound monitoring is recommended by the author for ovulation induction therapy.

Binding capacity (Bmax) and affinity (Kd) of cytoplasmatic estradiol and progesteron receptors were determined in trophoblastic tissue and in decidual endometrium by the authors. Results in normal and pathological endometrium and in mature placenta tissue were compared. Both estrogen and progesteron receptors were proved to exist in the decidual endometrium nearest to the molar tissue. Their binding parameters are similar to those in normal endometrium. No progesterone receptors were found in the molar tissue. Binding capacity of estrogens were found to be similar to that of the normal mature placenta. The lack of progesterone receptors might be an etiological factor in the pathogenesis of trophoblast diseases.

Considering the effect of the simultaneous presence and interaction of the different phases at the contact, a modification of the model presented by Wu and coworkers (Solid-St. Electron. 29 (1986) 489] for explanation of ohmic contact resistance of n-GaAs was developed. The modified model combines the existence of the mixed phase structure of AuGeNi/n-GaAs contact with assumptions proposed by Wu et al. that the specific contact resistance Rc contains two parts Rcl and Rc2, where Rc1 is the specific contact resistance of the alloyed and underlaying doped contact region, and Rc2, is that of the high-low junction between the heavily doped contact region and the bulk semiconductor. The Rc1 depends strongly on the apparent barrier height and the effective impurity concentration formed by doping from the contact alloys during annealing. In the present paper a new theoretical model for Rc1 is proposed and compared with the experimental results.

In a prospective study the foetal movements were simultaneously registered with two real time ultra-sound instruments and compared with the maternal perception of the movements. 35 patients were studied with a mean investigation time of 20 minutes per patient. The mothers pushed a button when they perceived a movements. Synchronous to this registration and storage on a tape were done of the movements of the upper and lower extremities the body movements and the foetal respiratory movements, the foetal heart rate and the uterine contractions. The mothers noticed a total of 38% of all foetal movements. Most frequently the mother noticed in 78% of the cases total foetal movements of the body and extremities. Isolated movements of the foetal body without movements of the extremities were only perceived by the mothers in 31% of the cases and isolated movements of the extremities were only perceived in 15%. In 69% of the cases the mothers correctly indicated that foetal movement took place. In 31% of all maternal signals there was no sonographic evidence of foetal movements of the body or the extremities. In 24% of these cases foetal respiratory movements were evident and in 23% of the cases Braxton-Hicks contractions were found. In 54% of these cases the signal button was used by the mothers without detectable reason. This high failure rate of maternal perception of foetal movements needs to be considered in the evaluation of foetal movements by the mother.

The total fetal movement activity was determined in 111 pregnant patients from 24 weeks to 42 weeks by simultaneous real-time ultrasonography and tocodynamometry. A comparison of the methods of investigation showed that tocodynamometry only detects 37% of all fetal movements with or without movements of the extremities. Movements of the extremities were only recorded in 14% of the cases. A total of only 25% of all fetal movements showed "spikes" in the tocogram. Of all the recorded spikes only 56% corresponded to a fetal movement, whereas 44% of the spikes in the tocogram were false-positive. These data demonstrate that routine clinical cardiotocography has a limited value only in the monitoring of fetal movement activity.

"Total" fetal motor activity was determined in 111 healthy patients between 25 weeks of pregnancy and term using two real-time ultrasound devices simultaneously. Furthermore tocographic findings and also maternal perception of fetal movements of the same patients were stored synchronously on magnetic tape. A comparison was drawn between these three methods, i.e. real-time ultrasonography, maternal perception and tocographic tracings ("spikes" indicating fetal movements). Of all fetal movements, as assessed by real-time ultrasonography, the mothers perceived a total of 38% whereas "spikes" in tocographic tracings corresponded with fetal motor activity (excluding "breathing") in only 25% of the cases (P less than 0.001). Also major statistically significant differences could be found between maternal perception of fetal body movements with or without fetal limb movements in 56% and routine- tocography in 37% (P less than 0.001). Also isolated limb movements were most often detected by mothers (23%) than were revealed by tocographic findings (14%; P less than 0.001). Maternal signals were truly positive in 74% compared to tocography in only 56% of the cases (P less than 0.001). It is concluded that maternal perception of fetal movements is a more reliable method of monitoring fetal motor activity than analysis of tocographic tracings.

Results of photoelectric and galvanomagnetic measurements on p-type Ge with dislocations are presented. The lifetime of the minority carriers was found to be anisotropic. The experimental results are discussed in the light of other results referring to the lifetime, and some ideas on a possible dislocation energy level structure are suggested.

Circulating platelet aggregates have been observed in various thromboembolic states. It is known that severe preeclamsia is associated with features of intravascular coagulation. To evaluate the role of platelets in this disorder we have determined circulating platelet aggregates in 10 patients with severe preeclampsia, in 30 patients in the third trimester of uncomplicated pregnancies and in 35 healthy nonpregnant volunteers. Platelet aggregate ratio /P.A.R./ was measured by a modification of a method described by Wu and Hoak, The mean P.A.R. of severe preeclamptic patients /0.732 ± 0,063 SEM/ was significantly lower than that of the uncomplicated pregnant women /0,860 ± 0,052 SEM/ and of the nonpregnant volunteers /0.880 ± 0,061 SEM/.The results indicate that severe preeclamptic patients have increased levels of circulating platelet aggregates and platelet activation is a feature of preeclampsia.

The total fetal movement activity was determined in 111 pregnant patients from 24 weeks to 42 weeks by simultaneous real-time ultrasonography and tocodynamometry. A comparison of the methods of investigation showed that tocodynamometry only detects 37% of all fetal movements with or without movements of the extremities. Movements of the extremities were only recorded in 14% of the cases. A total of only 25% of all fetal movements showed "spikes" in the tocogram. Of all the recorded spikes only 56% corresponded to a fetal movement, whereas 44% of the spikes in the tocogram were false-positive. These data demonstrate that routine clinical cardiotocography has a limited value only in the monitoring of fetal movement activity.

Frequency, symptomatology, course and therapy of myositis ossificans progressiva are described by means of literature references and personal observation in a patient. The patient was born in 1935 and the disease manifested itself for the first time in 1956 in the right sternocleidomastoid muscle. Despite surgery total trismus could not be prevented and later-on muscles and connective tissue of other areas ossified, too.

The results of complex studies of Si-based MIS layer structures using SIMS with the secondary ion energy distribution analysis and SEM have been analysed. By these methods morphology-type defects in metal layers, the MI interface and the adjacent dielectric layer can be revealed. These structural-impurity complexes at the interfaces MI and IS caused by the impurity and phase-inclusions may stimulate phase-structural transformations in MIS systems subjected to heat treatment. The effect of the conditions under which real MIS structures were fabricated (temperature, method of metallization, orientation of SI substrate, conditions during oxidation) has been studied. The physical and chemical processes in MIS layers affecting the development of morphology-type defects in MIS structures are discussed.

The zinc concentration of the cord blood was measured in several thousand cases. 482 pregnant women were randomised and evaluated right after the delivery. The newborn's weight were normal in 241 cases, while 241 mothers delivered intrauterine retarded babys. The zinc concentration of the sera was significantly higher in this second group. Following the maternal serum zinc measurement the cord blood zinc concentration was established in 182 cases. The zinc content of the 91 intrauterine retarded newborn's cord blood was significantly lower than in their maternal sera respectively comparing the normal newborns with the retarded newborns the maternal serum zinc concentration was higher than the cord blood's. The 59 large-for-dates newborns (higher than 4 000 g) and the 56 normal newborns showed no difference either in the maternal or in the cord blood zinc concentration.

It is known that short term cell culture system offers a reliable and reproducible means for measuring placental PGI2 production in vitro, in which factors controlling its production and metabolism can be studied. The aim of the present investigation was to study the effect of glucose on generation of PGI2 by trophoblast obtained from early pregnancy in short term cell culture. Trophoblast was cultured using the method of Jogee et al and the concentration of 6-oxo-PGF1 alpha in culture supernatans was measured by a specific direct radioimmunoassay (New England Nuclear, USA). There was a significant decrease in 6-oxo-PGF1 alpha production by trophoblast cells when incubating with increased glucose concentrations (300 and 600 mg/dl) compared to controls (without glucose). These data show for the first time that high concentrations of glucose inhibit PGI2 production by cultured trophoblast cells obtained from early pregnancy. The implication of these findings for the mechanism of development of congenital anomalies in diabetic pregnant women is discussed.

Summary The authors have performed comparative examinations on 115 young women having complaints of dysmenorrhea, and compared the efficiency of different treatments. In dysmenorrhea prostaglandins are playing an important role. Besides hormonal products, the prostaglandin-synthetase inhibitor, Colfarit, and a beta-mimetic, Bricanyl, were investigated, and a combined treatment with the two drugs was also studied. It has been stated that the combination of Colfarit and Bricanyl can be utilized favourably in the treatment of dysmenorrhea. The combined effect of these drugs is based partly on their prostaglandin-synthetase-inhibiting effects, and partly on the effect of beta-mimetics upon the beta-receptor. At the same time the characteristic side effects occurring after the administration of a single drug are eliminable by decreasing the dosage. Concerning our results we recommend the combined administration of the two drugs in cases of dysmenorrhea, especially in juvenile patients, where hormonal treatment is not recommended.

Two real-time ultrasound instruments were used simultaneously for comprehensive recording of "total" fetal motor activity in 50 patients in the second half of pregnancy. Synchronously, cardiotocographic findings and maternal perception of fetal movements were stored on magnetic tape. In most cases fetal "gross" movements were perceived by the mothers (mean: 63%). Isolated movements of fetal extremities were reported by the mother in only about 15% of all cases. Mothers registered a total of all movements in 37%. We found a statistically significant difference in the percentage of perceived fetal movements with regard to parity (p less than 0.001) and with regard to gestational age (p less than 0.01). With multiparity or an increasing gestational age the body movements of the fetuses were felt more accurately by the mothers. In 30% of all cases the mothers perceived movements without sonographic confirmation. The findings of this study suggest that maternal perception of major fetal body movements is accurate in the majority of cases. However, the relatively high rate of false positive maternal perception should be taken into consideration if the maternal record of daily fetal movements is to be used for fetal monitoring.

In a prospective study the foetal movements were simultaneously registered with two real time ultra-sound instruments and compared with the maternal perception of the movements. 35 patients were studied with a mean investigation time of 20 minutes per patient. The mothers pushed a button when they perceived a movements. Synchronous to this registration and storage on a tape were done of the movements of the upper and lower extremities the body movements and the foetal respiratory movements, the foetal heart rate and the uterine contractions. The mothers noticed a total of 38% of all foetal movements. Most frequently the mother noticed in 78% of the cases total foetal movements of the body and extremities. Isolated movements of the foetal body without movements of the extremities were only perceived by the mothers in 31% of the cases and isolated movements of the extremities were only perceived in 15%. In 69% of the cases the mothers correctly indicated that foetal movement took place. In 31% of all maternal signals there was no sonographic evidence of foetal movements of the body or the extremities. In 24% of these cases foetal respiratory movements were evident and in 23% of the cases Braxton-Hicks contractions were found. In 54% of these cases the signal button was used by the mothers without detectable reason. This high failure rate of maternal perception of foetal movements needs to be considered in the evaluation of foetal movements by the mother.