By the end of the first trimester, nearly all of the AFP is produced by the fetal liver. A small amount also is produced by the gastrointestinal tract. If results are positive, the patient is typically offered counseling and diagnostic testing.ĪFP is a fetal protein that is initially produced in the fetal yolk sac and liver. The information from both trimesters is combined and a report is issued. The blood sample is tested for AFP, unconjugated estriol (uE3), human chorionic gonadotropin (hCG), and inhibin A. If the risk from the first trimester is below the established cutoff, an additional serum specimen is collected in the second trimester for this test. For a stand-alone NTD-risk assessment, order MAFP1 / Alpha-Fetoprotein (AFP), Single Marker Screen, Maternal, Serum. When the part 1 screen is completed, a NTD risk is not provided. In that event, the patient is typically offered counseling and diagnostic testing. If the result from part 1 indicates a risk for Down syndrome that is higher than the screen cutoff, the screen is completed, and a report is issued. The results of the ultrasound measurement and blood work along with the maternal age and demographic information are used to calculate Down syndrome and trisomy 18 risk estimates. Along with the NT measurement, a maternal serum specimen is collected to measure pregnancy-associated plasma protein A. Therefore, NT data is accepted only from NT-certified sonographers. The ultrasound measurement, referred to as the NT measurement, is difficult to perform accurately. SEQA / Sequential Maternal Screening, Part 1, Serum involves an ultrasound and a blood collection. Sequential screening combines biochemical and ultrasound markers (nuchal translucency: NT) measured in both trimesters of the pregnancy. Sequential screening is a type of cross-trimester screening, which has an improved detection rate as compared to either first- or second-trimester screening. Various options for maternal serum screening are available and include: first trimester, second trimester, and cross-trimester. The mean VMR% in the PIS groups with and without PSD were similar (32.3 ± 19.5% and 41.2 ± 24.8%, respectively, NS).Conclusions – VMR cannot predict the development of dementia after AIS and cannot identify patients with dementia in the late phase of stroke.Maternal serum screening is used to identify pregnancies that may have an increased risk for certain birth defects, such as trisomy 21 (Down syndrome), neural tube defect (NTD) and trisomy 18. VMR% values in the AIS groups with and without PSD were similar (25.3 ± 20.3% and 36.5 ± 22.4%, respectively, NS). An additional group of 37 patients was studied in the late post-stroke period (PIS). VMR% values were compared to verify correlation with dementia.Results – Thirty patients with acute IS (AIS) were studied and followed for 3–6 months. PSD was confirmed by the National Institute of Neurological Disorders and Stroke and the Association Internationale pour la Recherche et I’Enseignement en Neurosciences (NINDS-AIREN) and the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. VMR was also assessed and compared in demented and non-demented patients in the late phase of IS.Materials and methods – VMR was assessed by transcranial Doppler and the Diamox test (1 g acetazolamide i.v.). We compared cerebral vasomotor reactivity (VMR) assessed in the acute phase of ischemic stroke (IS) in patients with and without PSD. © 2010 The Authors Journal compilation © 2010 Blackwell Munksgaard.Objectives – Cerebral hemodynamic features of patients with post-stroke dementia (PSD) are still obscure. Cerebral vasomotor reactivity and dementia after ischemic stroke. Gur AY, Gücüyener D, Korczyn AD, Üzüner N, Gilutz Y, Özdemir G, Bornstein NM.
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