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The aim of this study was to systematically review the literature on fetal cardiac function, assessed with two-dimensional speckle-tracking echocardiography (2D-STE) in fetuses of mothers with diabetes in comparison to those of mothers without diabetes. RV-GLS values were increased (6 studies), decreased (1 study) or not different (1 study). In fetuses of mothers with diabetes versus mothers without diabetes, LV-GLS values were significantly increased (6 studies), decreased (1 study) or not significantly different (6 studies). [Extracted from the article]

Results The gynecology fellow showed a steep learning curve for both LV- and RV-GLS analysis. He achieved expert competency after 100 analyses for both LV-GLS (ICC 0.75) and RV-GLS (ICC 0.71). The gynecology resident started with a higher ICC value for LV-GLS analysis (ICC 0.55) and RV-GLS analysis (ICC 0.63) and showed a less steep learning curve. [Extracted from the article]

Background/purpose Abdominal compartment syndrome (ACS) is a serious condition with high mortality in critically ill children. Our objectives were to characterize the incidence of ACS in pediatric patients who underwent urgent exploratory laparotomy and to compare outcomes of patients with and without ACS. Methods This retrospective review examined pediatric patients (0–18 years) who underwent urgent exploratory laparotomy over a 2-year period. Primary outcome was mortality; secondary outcomes were achievement of primary fascial closure and necessity of bowel resection. Results One hundred nineteen patients were included, of which 33 (28%) had ACS, with 27 (23%) being primary ACS and 6 (5%) secondary ACS. Twenty-eight-day mortality was higher in the ACS versus non-ACS group (52% versus 0%, p < 0.001) and overall hospitalization (64% versus 2%, p < 0.001). Primary fascial closure was achieved less often in ACS compared to non-ACS patients (46% versus 98%, p < 0.001). Bowel resection was more frequent in ACS versus non-ACS patients, approaching statistical significance (49% versus 30%, p 0.056). Conclusion During the study period, almost one third of children who underwent urgent exploratory laparotomy had ACS and 64% died. Children undergoing evaluation for acute surgical abdomen may benefit from routine intraabdominal pressure measurement. Level of evidence Level III retrospective comparative study [ABSTRACT FROM AUTHOR]

Objective: To evaluate whether in symptomatic women, the combination of quantitative fetal fibronectin (fFN) testing and cervical length (CL) improves the prediction of preterm delivery (PTD) within 7 days compared with qualitative fFN and CL.Design: Post hoc analysis of frozen fFN samples of a nationwide cohort study.Setting: Ten perinatal centres in the Netherlands.Population: Symptomatic women between 24 and 34 weeks of gestation.Methods: The risk of PTD <7 days was estimated in predefined CL and fFN strata. We used logistic regression to develop a model including quantitative fFN and CL, and one including qualitative fFN (threshold 50 ng/ml) and CL. We compared the models' capacity to identify women at low risk (<5%) for delivery within 7 days using a reclassification table.Main Outcome Measures: Spontaneous delivery within 7 days after study entry.Results: We studied 350 women, of whom 69 (20%) delivered within 7 days. The risk of PTD in <7 days ranged from 2% in the lowest fFN group (<10 ng/ml) to 71% in the highest group (>500 ng/ml). Multivariable logistic regression showed an increasing risk of PTD in <7 days with rising fFN concentration [10-49 ng/ml: odds ratio (OR) 1.3, 95% confidence interval (95% CI) 0.23-7.0; 50-199 ng/ml: OR 3.2, 95% CI 0.79-13; 200-499 ng/ml: OR 9.0, 95% CI 2.3-35; >500 ng/ml: OR 39, 95% CI 9.4-164] and shortening of the CL (OR 0.86 per mm, 95% CI 0.82-0.90). Use of quantitative fFN instead of qualitative fFN resulted in reclassification of 18 (5%) women from high to low risk, of whom one (6%) woman delivered within 7 days.Conclusion: In symptomatic women, quantitative fFN testing does not improve the prediction of PTD within 7 days compared with qualitative fFN testing in combination with CL measurement in terms of reclassification from high to low (<5%) risk, but it adds value across the risk range.Tweetable Abstract: Quantitative fFN testing adds value to qualitative fFN testing with CL measurement in the prediction of PTD. [ABSTRACT FROM AUTHOR]

Unlabelled: This review aimed to raise awareness of the consequences of suboptimal bonding caused by prematurity. In addition to hypoxia-ischaemia, infection and malnutrition, suboptimal bonding is one of the many unnatural stimuli that preterm infants are exposed to, compromising their physiological development. However, the physiological consequences of suboptimal bonding are less frequently addressed in the literature than those of other threatening unnatural stimuli.Conclusion: This review found that suboptimal bonding significantly impaired hormonal, epigenetic and neuronal development, but these impairments could be reversed by bonding interventions. This suggests that neonatal intensive care units should focus more on interventions that optimise bonding. [ABSTRACT FROM AUTHOR]

Two-dimensional speckle-tracking echocardiography has been considered as an angle-independent modality. EP19.11: The effect of insonation angles on left and right ventricular global longitudinal strain in fetal speckle-tracking echocardiography However, a subgroup analysis, using only the highest quality ultrasound clips, revealed a significant difference in left ventricular GLS values between the oblique and perpendicular AoI compared to the up/down AoI. [Extracted from the article]

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An abstract of the article "Prelabour fetal ECG in congenital heart disease: a preliminary comparison with neonatal ECG," by S. B. Clur and colleagues is presented.

In this study we used typing based on the eight multilocus sequence typing scheme housekeeping genes (MLST) and 5S-23S rDNA intergenic spacer (IGS) to explore the population structure of Borrelia burgdorferi sensu lato isolates from patients with Lyme borreliosis (LB) and to test the association between the B. burgdorferi s.l. sequence types (ST) and the clinical manifestations they cause in humans. Isolates of B. burgdorferi from 183 LB cases across Europe, with distinct clinical manifestations, and 257 Ixodes ricinus lysates from The Netherlands, were analyzed for this study alone. For completeness, we incorporated in our analysis also 335 European B. burgdorferi s.l. MLST profiles retrieved from literature. Borrelia afzelii and Borrelia bavariensis were associated with human cases of LB while Borrelia garinii , Borrelia lusitaniae and Borrelia valaisiana were associated with questing I. ricinus ticks. B. afzelii was associated with acrodermatitis chronica atrophicans , while B. garinii and B. bavariensis were associated with neuroborreliosis. The samples in our study belonged to 251 different STs, of which 94 are newly described, adding to the overall picture of the genetic diversity of Borrelia genospecies. The fraction of STs that were isolated from human samples was significantly higher for the genospecies that are known to be maintained in enzootic cycles by mammals ( B. afzelii , B. bavariensis , and Borrelia spielmanii ) than for genospecies that are maintained by birds ( B. garinii and B. valaisiana ) or lizards ( B. lusitaniae ). We found six multilocus sequence types that were significantly associated to clinical manifestations in humans and five IGS haplotypes that were associated with the human LB cases. While IGS could perform just as well as the housekeeping genes in the MLST scheme for predicting the infectivity of B. burgdorferi s.l., the advantage of MLST is that it can also capture the differential invasiveness of the various STs. [ABSTRACT FROM AUTHOR]