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Results of expectant management in singleton and twin pregnancies complicated by preterm premature rupture of membranes

Ginekol Pol. 2022 Feb 2. doi: 10.5603/GP.a2021.0211. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to examine whether expectant management in twin pregnancies with preterm premature rupture of membranes (pPROM) is as safe as in singleton pregnancies.

MATERIAL AND METHODS: It was a retrospective cohort study comparing pregnancy course and outcome in singleton (n = 299) and twin pregnancies (n = 49) complicated by preterm premature rupture of membranes. Analysed factors included maternal diseases, gestational age at (premature rupture of membranes) PROM, management during hospitalization, latency periods between PROM and delivery, gestational age at delivery, neonatal management and outcome.

RESULTS: The difference in the proportion of patients with latency up to 72 hours, latency between 72 hours and seven days, and latency exceeding seven days were insignificant. The percentage of patients who received intravenous tocolysis and antenatal corticosteroids were similar; however, patients in twin pregnancies more often received incomplete steroids dose (p = 0.01). The occurrence of the positive non-stress test result and signs of intrauterine infection were similar between the groups. No statistically significant differences in the prevalence of neonatal complications except transient tachypnoea of the newborn were identified (24% in the singleton vs 13% in the twin group, p = 0.03).

CONCLUSIONS: Expectant management of pPROM in singleton and twin pregnancies results in similar perinatal and neonatal outcome. Consequently, in case of no evident contraindications, expectant management of twin pregnancies seems to be equally as safe as in singleton pregnancies. Patients in twin pregnancies may be at higher risk of delivery before administration of full antenatal corticosteroids dose, therefore require immediate management initiation and transfer to a tertiary referral centre.

PMID:35106749 | DOI:10.5603/GP.a2021.0211

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Live birth, cumulative live birth and perinatal outcome following assisted reproductive treatments using donor sperm in single women vs. women in lesbian couples: a prospective controlled cohort study

J Assist Reprod Genet. 2022 Feb 1. doi: 10.1007/s10815-022-02402-6. Online ahead of print.

ABSTRACT

PURPOSE: Assisted reproductive technology (ART) treatments with donor sperm have been allowed for women in lesbian relationships (WLR) since 2005 in Sweden, but for single women (SW), these became approved only recently in 2016. This study was conducted to compare the outcomes of ART treatments in SW vs. WLR.

METHODS: This is a prospective controlled cohort study of 251 women undergoing intrauterine insemination (D-IUI) or in vitro fertilization (D-IVF) using donor sperm between 2017 and 2019 at the department of Reproductive Medicine, Karolinska University Hospital. The cohort comprised 139 SW and 112 WLR. The main outcomes included differences in live birth rate (LBR) and cumulative live birth rate (cLBR) between the groups. The SW underwent 66 D-IUI and 193 D-IVF treatments and WLR underwent 255 D-IUI and 69 D-IVF treatments. Data on clinical characteristics, treatment protocols and clinical outcomes were extracted from the clinic’s electronic database. The outcomes of D-IUI and D-IVF were separately assessed.

RESULTS: The cohort of SW was significantly older than WLR (37.6 vs. 32.4 years, P < 0.001), and more commonly underwent IVF at first treatment (83% vs. 29%, P < 0.000). Conversely, WLR underwent more frequently D-IUI as a first treatment (71% vs. 17% of SW, P < 0.001) and more often in the natural cycle (89.9% vs. 70.8%, P = 0.019), respectively. There was no statistically significant difference in the main outcome LBR between the two groups, or between the two different types of treatment, when adjusted for age. Perinatal outcomes and cLBR were also similar among the groups.

CONCLUSIONS: SW were, on average, older than WLR undergoing treatment with donor sperm. No significant differences were seen in the LBR and cLBR when adjusted for age between the two groups and between the two types of treatment (D-IVF vs. D-IUI).

TRIAL REGISTRATION: ClinicalTrials.gov NTC04602962.

PMID:35106694 | DOI:10.1007/s10815-022-02402-6

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Significant Association of rs77493513 Polymorphism in 3′-UTR of the NRG1 Gene with the Risk of Multiple Sclerosis Disease

Metab Brain Dis. 2022 Feb 2. doi: 10.1007/s11011-022-00922-9. Online ahead of print.

ABSTRACT

Multiple sclerosis (MS) is a chronic inflammatory and autoimmune disease characterized by demyelination of the central nervous system (CNS). Neuregulin 1 (NRG1) is a signaling protein that plays an important role in a variety of biological processes, including potentiate oligodendrocyte differentiation and myelination in the CNS, immune response regulation, and inflammation. Single nucleotide polymorphism (SNP) rs77493513 is located in the untranslated region of the 3′ mRNA (3′-UTR) of the NRG1 gene, which is predicted to be the binding site of several microRNAs and may play an important role in post-transcriptional regulation. Study aimed to investigate the association of SNP rs77493513 in the NRG1 gene with the risk of MS disease. In this study, genomic DNA was extracted from whole blood samples of 182 patients with relapsing-remitting multiple sclerosis (RRMS) and 198 controls. Different genotypes of rs77493513 polymorphism were determined using RFLP-PCR technique. Statistical analysis was performed using SPSS 21.0 software and by t, χ2 and logistic regression tests. Our data showed that genotypes AC (OR=3.63, CI= 1.93-6.81, p<0.001) and CC (OR=7.90, CI= 4.13-15.11, p<0.001) significantly increased the risk of MS disease and C allele is risk allele. Also, AC (OR=0.16, CI= 0.04-0.63, p= 0.009) and CC (OR=0.14, CI= 0.03-0.53, p=0.04) genotypes significantly decrease the age of onset of the disease. The results show that allele C of rs77493513 polymorphism in the NRG1 gene can be a risk factor for MS.

PMID:35106689 | DOI:10.1007/s11011-022-00922-9

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Quality of life in children with nephrotic syndrome: a cross-sectional study using Hindi version of PedsQL 4.0 Generic Core Scales

Clin Exp Nephrol. 2022 Feb 1. doi: 10.1007/s10157-022-02186-0. Online ahead of print.

ABSTRACT

BACKGROUND: Worldwide, idiopathic nephrotic syndrome (INS) is the most common glomerular disorder in children. Limited studies are available on quality of life (QOL) in children with NS, especially from developing countries. The aim of the current study was to compare the QOL of children having INS with that of matched healthy controls and to evaluate the effects of sub-types on domain scores.

METHODS: This single-center, cross-sectional analytical study was conducted in children between 2 and 18 years with primary INS, at a tertiary care center in India, from September 2018 to November 2018. QOL data were collected using PedsQL™4.0 Generic Core Scales “Hindi-for-India” version (child self-report and parent-report). A total of 102 cases with equal number of matched healthy controls were included.

RESULTS: The mean total PedsQL scores were lower in NS children compared to healthy controls (p-0.0004). They had statistically lower scores in physical (p- < 0.0001), social (p-0.026), and school domains (p- < 0.0001); however, no such difference was noted in emotional functioning. School functioning was the most impacted domain overall, and also across all the clinical types. Worst scores were seen in children with steroid-resistant NS in all domains. Older age-at-enrolment, higher number of relapses, prevalent NS, steroid-resistant disease, calcineurin inhibitor (CNI) use, and higher number of immunosuppressant use were important predictors of poor total QOL scores. On multivariable regression, higher number of immunosuppressant use (p-0.015) and older age-at-enrolment (p-0.016) were main predictors of impaired total scores. Cases with edema and current/previous CNI use were more likely to have impaired emotional (p-0.028) and social (p-0.040) domain sub-scores, respectively.

CONCLUSION: NS has a significant impact on the QOL of children in different domains of functioning, based on their as well as parents’ perspective.

TRIAL REGISTRATION NO: EC/08/18/1414; Date: 30/08/2018.

PMID:35106675 | DOI:10.1007/s10157-022-02186-0

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Clinical correlation between osteoporotic thoracolumbar vertebral compression fractures and lumbar spondylolisthesis

Int Orthop. 2022 Feb 2. doi: 10.1007/s00264-022-05327-y. Online ahead of print.

ABSTRACT

PURPOSE: This study was to explore the clinical correlation between osteoporosis thoracolumbar vertebral compression fracture (thoracolumbar OVCF) and lumbar spondylolisthesis (LS).

METHODS: In total, 208 patients with thoracolumbar OVCF (fracture group) and 250 elderly patients with osteoporosis (non-fracture group) were retrospectively analyzed. The incidence of LS was compared between the two groups. At the same time, 75 cases of elderly patients with osteoporosis were selected, including 25 patients with isthmic spondylolisthesis (IS group), 25 patients with degenerative spondylolisthesis (DS group), and 25 patients without LS (non-LS group). All patients underwent full-length spine anteroposterior and lateral X-ray, and the spinal pelvic imaging parameters were collected for comparison.

RESULTS: The incidence of LS in the fracture group (10.1%, 21/208) was significantly higher than that in the non-fracture group (4.8%, 12/250); the difference was statistically significant (χ2 = 4.763, P = 0.029). The incidence of trauma in the fracture group (51.0%, 106/208) was significantly higher than that in the non-fracture group (13.6%, 34/250); the difference was statistically significant (χ2 = 74.673, P = 0.000). The LS (OR = 2.273, 95% CI = 1.030-5.017, P = 0.042) and trauma (OR = 6.622, 95% CI = 4.203-10.432, P = 0.000) were independently associated with thoracolumbar OVCF. There were significant differences in pelvic incidence (PI), sacral slope (SS), lumbar lordosis (LL), thoracolumbar kyphosis (TLK), and thoracic kyphosis (TK) among the IS, DS, and non-LS groups (P < 0.05). Among them, PI, SS, LL, TLK, and TK of the IS group and the DS group were significantly higher than those of the non-LS group (P < 0.05).

CONCLUSIONS: Patients with LS are more likely to suffer from OVCF in the future, and LS is one of the important risk factors for secondary OVCF.

PMID:35106669 | DOI:10.1007/s00264-022-05327-y

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Radiation dose reduction for chest radiography of infants in intensive care units using a high peak kilovoltage-technique

Pediatr Radiol. 2022 Feb 2. doi: 10.1007/s00247-021-05262-x. Online ahead of print.

ABSTRACT

BACKGROUND: Chest radiography is an important tool in the care of infants in intensive care units. Image optimization must be monitored to minimize radiation exposure in this susceptible population.

OBJECTIVE: To examine the use of a high tube peak kilovoltage technique to achieve radiation dose reduction while maintaining adequate image quality.

MATERIALS AND METHODS: A retrospective study was conducted. Radiation doses of chest radiographs performed in the pediatric intensive care units in our institution were calculated. The radiographs were divided into two groups based on the value of the peak kilovoltage used: above and below 60 kilovolts (kV). Image quality was blindly assessed by two fellowship-trained pediatric radiologists. Air kerma, effective dose and quality score for the high versus the low peak kilovoltage group were compared and analyzed.

RESULTS: The study included 376 radiographs. One hundred and seven radiographs were performed using peak kilovoltage values equal to or above 60 kV and 269 radiographs were performed using values under 60 kV. The average air kerma for the lower peak kilovoltage group was 56.6 microgray (µGy) (30.7-81.9) vs. 22.9 µGy (11.8-34.4) for the higher peak kilovoltage group (P<0.0001). The mean difference in effective dose between the groups was 11.68 (P<0.0001). The mean difference for the quality score was 0.06 (±0.03, P=0.10), not statistically significant.

CONCLUSION: A high peak kilovoltage technique may enable a statistically significant radiation dose reduction without compromising the diagnostic value of the image.

PMID:35106646 | DOI:10.1007/s00247-021-05262-x

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Metabolomics analysis of placental tissue obtained from patients with fetal growth restriction

J Obstet Gynaecol Res. 2022 Feb 1. doi: 10.1111/jog.15173. Online ahead of print.

ABSTRACT

AIM: The aim of this study was to determine whether there was a difference in placental metabolite profiles between patients with fetal growth restriction (FGR) and healthy controls.

METHODS: The study included 10 patients with FGR diagnosis with 14 healthy controls with both matched maternal age and body mass index. 1 H HR-MAS NMR spectroscopy data obtained from placental tissue samples of patients with FGR and healthy control group were analyzed with bioinformatics methods. The obtained results of metabolite levels were further validated with the internal standard (IS) quantification method.

RESULTS: Principal component analysis (PCA) and the partial least squares discriminant analysis (PLS-DA) score plots obtained with the multivariate statistical analysis of preprocessed spectral data shows a separation between the samples from patients with FGR and healthy controls. Bioinformatics analysis results suggest that the placental levels of lactate, glutamine, glycerophosphocholine, phosphocholine, taurine, and myoinositol are increased in patients with FGR compared to the healthy controls.

CONCLUSIONS: Placental metabolic dysfunctions are a common occurrence in FGR.

PMID:35104920 | DOI:10.1111/jog.15173

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Comparison of Interwoven Nitinol and Drug-Eluting Stents for Endovascular Treatment of Femoropopliteal Artery Disease

Surg Technol Int. 2022 Feb 2;40:sti40/1532. Online ahead of print.

ABSTRACT

BACKGROUND: Interwoven nitinol stents (INS) and drug-eluting stents (DES) were designed to improve the mid- and long-term results of femoropopliteal (F-P) angioplasty. The aim of this study was to systematically compare these stents.

METHODS: Between 2015 and 2017, 62 patients with symptomatic peripheral artery disease of the F-P segment treated by INS or DES were identified from a prospectively maintained institutional database. The primary outcome measure was one-year primary patency; secondary outcomes were in-stent restenosis (ISR), stent occlusion, target lesion revascularization (TLR) and mortality.

RESULTS: The mean follow-up was 26.9 ± 11.2 months. No statistically significant difference in primary patency at one year was observed (88.6% vs. 88.9%). Throughout follow-up, overall rates of ISR (5.7% vs. 11.1%, p = 0.645), stent occlusion (25.7% vs. 7.4%, p = 0.094) and TLR (25.7% vs. 18.5%, p = 0.505) were statistically equivalent between the groups. Mortality reached 14.3% in the INS group and 3.7% in the DES group, but this difference was not statistically significant (p=0.196). Multivariable analysis revealed significant correlations between ISR and stent occlusions; popliteal lesion localization (p = 0.016) and poor below the knee vessel outflow (p < 0.001).

CONCLUSION: In the short- and mid-term, the use of an INS or DES in the F-P arterial segment did not result in a difference in primary patency rate, stent occlusion, restenosis, re-intervention or mortality. The overall data do not provide any evidence to favor one stent over the other.

PMID:35104911

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Sinonasal B-cell lymphomas: A nationwide cohort study, with an emphasis on the prognosisand the recurrence pattern of primary diffuse large B-cell lymphoma

Hematol Oncol. 2022 Feb 1. doi: 10.1002/hon.2968. Online ahead of print.

ABSTRACT

Lymphomas of the nasal cavity and paranasal sinuses (NPS) are rare. Knowledge on sinonasal B-cell lymphoma (SNBCL) primarily comes from case series or single-center studies on small cohorts. We sought to determine the subtype distribution, clinical characteristics, disease behavior, and prognosis on a nationwide scale, with an emphasis on prognostic factors for the most common sinonasal lymphoma, primary sinonasal diffuse large B-cell lymphoma (PSDLBCL). We collated all data from medical records and national databases on patients registered with SNBCL from 1980 through 2018 in the national pathology registry and collected all tissue samples for validation of diagnosis. We included 205 patients and found ten different subtypes of lymphoma. Diffuse large B-cell lymphoma (DLBCL) was the predominant subtype (80%). The incidence of sinonasal B-cell lymphoma was 0.14/100,000 person-years. The five-year progression-free survival (PFS) and overall survival (OS) rates for PSDLBCL were 50% and 56%, respectively. For PSDLBCL, Rituximab showed a statistically significant effect (Hazard Ratio 0.22, P < 0.001), whereas consolidative radiotherapy combined with immunochemotherapy was of limited value (PFS, P = 0.93). When treatment failure occurred, DLBCL showed a distinct pattern of recurrence/dissemination to the NPS, skin, breast, CNS, and/or testis. Collectively, DLBCL comprised a clear majority of SNBCLs, although nine other subtypes were represented. Data showed that immunochemotherapy increased survival for PDLBCL and that the addition of radiotherapy did not benefit patients. Furthermore, treatment failure for sinonasal DLBCL showed a possible common pathogenesis with primary extranodal lymphomas of specific locations (e.g., CNS, skin, breast, and testis). This article is protected by copyright. All rights reserved.

PMID:35104916 | DOI:10.1002/hon.2968

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STORCH Infections Among Very Low Birth Weight and Preterm Infants: 2018-2020

Pediatrics. 2022 Jan 1;149(1):e2021053655. doi: 10.1542/peds.2021-053655.

NO ABSTRACT

PMID:35104887 | DOI:10.1542/peds.2021-053655