Aurora magazine

On July 24, the Centers for Disease Prevention and Control (CDC) published the new guidelines on Zika in pregnancy. The guidelines refer to the US context, where exposure to the virus is most likely.

The update comes after some changes in the spread of the disease. The World Health Organization (WHO) region of America has reported a decline in the spread of the virus. The WHO has also shown increasingly evident evidence of the appearance of antibodies to Zika.

Despite the positive news, the results are difficult to interpret. Decreased virus spread increases the likelihood of false positives and antibodies can be detected 12th weeks after infection. However, the presence or absence of antibodies does not help to understand whether the infection occurred before or during pregnancy.

The guidelines are always based on the same definition of virus exposure. An individual is exposed if traveling or living in an area affected by the contagion. A further source of risk is sexual contact with those who may have been exposed to the virus.

CDCs recommend prenatal screening for all pregnant women at risk of exposure. They also recommend reporting any signs of Zika, such as fever, conjunctivitis, and joint pain. The best thing is, however, not to travel in the affected areas and use the condom even during pregnancy.

The NAT test to detect the virus is recommended in the event of obvious symptoms in the mother or in the fetus. The routine recommendation declines if there is no symptoms in the puerpera. If there has been a possible exposure, it is up to the woman to decide whether or not to perform the tests.
The updates emphasize the importance of jointly agreed decisions by mother and doctor. The gynecologist must take into account the individual patient's situation, his / her preferences and values.

Source: medscape.com

Under the definition of Niemann Pick disease (NPD) there are actually many metabolism disorders. At the basis of the pathologies there are specific genetic mutations leading to the deficiency of the basic enzymes. The most common typologies are types A, B and C.

Type A and type B Niemann Pick are related to the abnormal behavior of the sphingomyelinase acid (ASM) enzyme. The enzyme is located within cells called lysosomes and is responsible for metabolizing the sphingomyel lipid. If the enzyme is scarce, the lipid accumulates in the cells and causes death. With time the damage accumulates, with a progressive deterioration of the organs and their functions.

The prognosis for type A and type B of Niemann Pick is very different, despite the basic problem being similar. Type A involves predominantly brain and nervous system, leading to death before the age of 4 years. Type B, however, has almost no neurological implications and allows a much longer life. The bigger problem with Niemann Pick type B sufferers is the enlargement of the organs, which in the long run leads to heart problems.

Type C has a different biochemical and genetic base of types A and B. Those suffering from it can not metabolize cholesterol, which accumulates in the liver. It also fails to metabolize other lipids, which are concentrated in the brain. Sometimes the disease occurs in adulthood, although the first neurological symptoms appear mostly between 4 and 10 years.

Researchers at the University of Missouri have discovered how to facilitate assisted fertilization. Thanks to a study on pig stem cells, they found a way to lower IVF costs. In this way technology will be more accessible and available for many more couples.

The researchers were studying the way stem cells proliferate, communicate with each other, and grow. To do so were piglets, which required the production of specific embryos and their implantation. An expensive and often bankrupt operation, just like IVF in humans. During one of the tests, they identified a special liquid medium that increases the probability of successful in vitro fertilization.

Under normal conditions, scientists extract oocytes and ovules from females. They put them in a chemical environment designed to ripen the eggs, then fertilize them. They make the zygotes obtained for 6 days, after which they transfer them to a female. The operation has about 1-2% chance of success in piglets. For this reason Ye Yuan and Lee Spate had the task of looking for alternative solutions.

The team analyzed growth factors used for stem cell cultures. They have added three new factors: FGF2, LIF and IGF. From the combination, the researchers obtained a fluid for the development of oocytes. The new compound makes them more suitable for fertilization and allows a higher rate of success in pigs IVF. Further studies will have to check the effectiveness even on humans.

Source: phys.org

The researchers compared women who suffered from hypertension in pregnancy and women who did not suffer. It emerged that women in the first group are more likely to develop chronic hypertension disorders in the decade after childbirth. Disorders also expose them to cardiovascular disease.

The study analyzed gestational events between 1995 and 2012 lasting more than 20 weeks. It has emerged that women under the age of 30 with hypertension in gestation have 11% of the chance of becoming hypertensive. If you consider women around 40, the percentage reaches about 33%. Forty, with normal pregnancy pressure, have only 4-11% chance.

4.8% of the women examined (23,235) had hypertension problems during their first pregnancy. Of these, 16,611 developed chronic hypertension in later years. About five years after delivery, the hypertension rate was 10 times higher than the average. In the next 20 years, however, it was 1 time higher.
A second study instead analyzed the role of weight in the development of chronic hypertension problems. Overweight and obesity causes an increase in hypertensive disorders beyond pregnancy health conditions. If linked to hypertension during gestation, the risk of chronic hypertension increases.

According to the study, in normal cases the best approach is prevention. A specific diet lowers the risk of hypertension: less sodium, less potassium and physical activity have important beneficial effects. However, this approach has no impact on chronic hypertension caused by hypertension. The authors therefore advise on regular physical activity and increased attention to weight, thereby reducing the risk of hypertension during gestation.

Source: medpagetoday.com