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Pregnancy and Viral infections: Mechanisms of fetal damage, diagnosis and prevention of neonatal adverse outcomes from cytomegalovirus to SARS-CoV-2 and Zika virus.

Biochim Biophys Acta Mol Basis Dis 2021 Jun 9:166198. Epub 2021 Jun 9.

Fetal and Perinatal Medicine and Surgery Unit, Medical and Surgical Department of Fetus, Newborn and Infant - "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy.

Some maternal infections, contracted before or during pregnancy, can be transmitted to the fetus, during gestation (congenital infection), during labor and childbirth (perinatal infection) and through breastfeeding (postnatal infection). The agents responsible for these infections can be viruses, bacteria, protozoa, fungi. Among the viruses most frequently responsible for congenital infections are Cytomegalovirus (CMV), Herpes simplex 1-2, Herpes virus 6, Varicella zoster. Read More

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Synthesis and Characterization of Mitochondria-Targeted Triphenylphosphonium Bolaamphiphiles.

Methods Mol Biol 2021 ;2275:27-47

CNR-ISB, Sede Secondaria di Roma-Meccanismi di Reazione c/o Department of Chemistry, Sapienza University, Roma, Italy.

In this chapter we describe: (1) the procedure for the synthesis of four single chain bolaamphiphiles, displaying chains of 12, 16, 20 and 30 methylene units and triphenylphosphonium moieties as headgroups (TPP1-TPP4); (2) the methods used to characterize TPP1-TPP4 spontaneous aggregation in aqueous solution. We illustrate the determination of Krafft point and cac by conductivity measurements and the procedures used to investigate dimensions, morphology, and stability by dynamic and dielectrophoretic laser light scattering, dialysis, transmission electron microscopy, and Raman spectroscopy measurements. Read More

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January 2021

Discordance Between Respiratory Drive and Sedation Depth in Critically Ill Patients Receiving Mechanical Ventilation.

Crit Care Med 2021 Jun 9. Epub 2021 Jun 9.

Center for Acute Respiratory Failure, Columbia University College of Physicians and Surgeons and New York-Presbyterian Hospital, New York, NY. Department of Pharmacy, NewYork-Presbyterian Hospital, New York, NY. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Taibah University, Medina, Saudi Arabia. Department of Pharmacy, UC San Diego Health, San Diego, CA. Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY.

Objectives: In mechanically ventilated patients, deep sedation is often assumed to induce "respirolysis," that is, lyse spontaneous respiratory effort, whereas light sedation is often assumed to preserve spontaneous effort. This study was conducted to determine validity of these common assumptions, evaluating the association of respiratory drive with sedation depth and ventilator-free days in acute respiratory failure.

Design: Prospective cohort study. Read More

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Prehospital Airway Management: A Systematic Review.

Prehosp Emerg Care 2021 Jun 11:1-28. Epub 2021 Jun 11.

Department of Emergency Medicine, Oregon Health & Science University, Portland, OR, USA.

To assess comparative benefits and harms across three airway management approaches (bag valve mask [BVM], supraglottic airway [SGA], and endotracheal intubation [ETI]) used by prehospital emergency medical services (EMS) to treat patients with trauma, cardiac arrest, or medical emergencies, and how they differ based on techniques and devices, EMS personnel and patient characteristics. We searched electronic citation databases (Ovid MEDLINE, CINAHL, the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and Scopus) from 1990 to September 2020. We followed Agency for Healthcare Research and Quality Effective Health Care Program Methods guidance. Read More

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Neurodevelopmental outcome of very preterm infants with gastrointestinal tract perforations does not differ compared to controls.

Wien Klin Wochenschr 2021 Jun 10. Epub 2021 Jun 10.

Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz, Auenbruggerplatz 34/2, 8036, Graz, Austria.

Purpose: To evaluate gastrointestinal tract (GIT) perforations in very low birth weight infants and the effects on neurodevelopmental outcome.

Methods: Between 2000 and 2017 all cases with GIT perforation were analyzed regarding causes, associated morbidities and neurodevelopmental outcome and compared with matched (gestational age, birth weight, gender, year of birth) by 1:2 controls.

Results: The incidence of GIT perforation was 2. Read More

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Randomized Trial of Fetal Surgery for Moderate Left Diaphragmatic Hernia.

N Engl J Med 2021 Jun 8. Epub 2021 Jun 8.

From the Department of Obstetrics and Gynecology, University Hospitals KU Leuven (J.A.D., P.L.J.D.) and Academic Department of Development and Regeneration, Biomedical Sciences, KU Leuven, Leuven, Belgium (J.A.D., B.V.C., P.L.J.D.); Hospital Antoine-Béclère, Université Paris-Saclay, Clamart (A.B.), and Necker-Enfants Malades Hospital, Paris (Y.V.) - both in France; Hospital Clinic and Sant Joan de Déu, Barcelona (E.G.); Institute for Women's Health, University College London Hospital (J.A.D.) and King's College Hospital(K.H.N.) - both in London; the University Hospital Bonn, Bonn, Germany (C.B.); Hospital Maggiore Policlinico, Milan (N.P.), and Bambino Gesù Children's Hospital, Rome (F.M.) - both in Italy; Baylor College of Medicine and Texas Children's Hospital (M.B.) and Children's Memorial Hermann Hospital (A.J.) - all in Houston; Mater Mothers' Hospital, Brisbane, QLD, Australia (G.J.G.); the Medical University of Warsaw, Warsaw, Poland (M.W.); and Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands (P.L.J.D.).

Background: Fetoscopic endoluminal tracheal occlusion (FETO) has been associated with increased postnatal survival among infants with severe pulmonary hypoplasia due to isolated congenital diaphragmatic hernia on the left side, but data are lacking to inform its effects in infants with moderate disease.

Methods: In this open-label trial conducted at many centers with experience in FETO and other types of prenatal surgery, we randomly assigned, in a 1:1 ratio, women carrying singleton fetuses with a moderate isolated congenital diaphragmatic hernia on the left side to FETO at 30 to 32 weeks of gestation or expectant care. Both treatments were followed by standardized postnatal care. Read More

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Bedtime Music, Involuntary Musical Imagery, and Sleep.

Psychol Sci 2021 Jun 9:956797621989724. Epub 2021 Jun 9.

Department of Communication Sciences and Disorders, Baylor University.

Many people listen to music for hours every day, often near bedtime. We investigated whether music listening affects sleep, focusing on a rarely explored mechanism: involuntary musical imagery (earworms). In Study 1 ( = 199, mean age = 35. Read More

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Risk score to stratify miscarriage risk levels in preconception women.

Sci Rep 2021 Jun 8;11(1):12111. Epub 2021 Jun 8.

Duke-NUS Medical School, Singapore, 169857, Singapore.

Spontaneous miscarriage is one of the most common complications of pregnancy. Even though some risk factors are well documented, there is a paucity of risk scoring tools during preconception. In the S-PRESTO cohort study, Asian women attempting to conceive, aged 18-45 years, were recruited. Read More

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Endometriosis and adverse pregnancy outcome.

Minerva Obstet Gynecol 2021 Jun 7. Epub 2021 Jun 7.

Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, Foggia, Italy -

Introduction: Endometriosis is a gynecologic disease affecting approximately 10% of reproductive age women, around 21-47% of women presenting subfertility and 71-87% of women with chronic pelvic pain. Main symptoms are chronic pelvic pain, dysmenorrhea, dyspareunia and infertility that seem to be well controlled by oral contraceptive pill, progestogens, GnRh antagonists.

Evidence Acquisition: The aim of this review is to illustrate the modern diagnosis of endometriosis during pregnancy, to evaluate the evolution of endometriotic lesions during pregnancy and the incidence of adverse outcomes. Read More

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COVID-19 pandemic and population-level pregnancy and neonatal outcomes: a living systematic review and meta-analysis.

Acta Obstet Gynecol Scand 2021 Jun 6. Epub 2021 Jun 6.

Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada.

Introduction: Conflicting reports of increases and decreases in rates of preterm birth (PTB) and stillbirth in the general population during the COVID-19 pandemic have surfaced. The objective of our study was to conduct a living systematic review and meta-analyses of studies reporting pregnancy and neonatal outcomes by comparing the pandemic and pre-pandemic periods.

Material And Methods: We searched PubMed and Embase databases, reference lists of articles published up until May 14, 2021 and included English language studies that compared outcomes between the COVID-19 pandemic time period vs. Read More

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The Vaginal Microbial Signatures of Preterm Birth Delivery in Indian Women.

Front Cell Infect Microbiol 2021 13;11:622474. Epub 2021 May 13.

Molecular Genetics Laboratory, Translational Health Science and Technology Institute, National Capital Region (NCR) Biotech Science Cluster, Faridabad, India.

Background: The incidence of preterm birth (PTB) in India is around 13%. Specific bacterial communities or individual taxon living in the vaginal milieu of pregnant women is a potential risk factor for PTB and may play an important role in its pathophysiology. Besides, bacterial taxa associated with PTB vary across populations. Read More

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[Treatment reality of aortic diseases in Switzerland].

L Meuli T Lattmann

Gefasschirurgie 2021 Jun 1:1-9. Epub 2021 Jun 1.

Swissvasc Registry, Klinik für Gefässchirurgie, Kantonsspital Winterthur, Brauerstrasse 15, 8400 Winterthur, Schweiz.

Background: Due to the federally organized healthcare system in Switzerland, aortic interventions are performed in many different hospitals, presumably sometimes with a very small number of cases per institution. The aim of this study was to present the treatment reality of aortic diseases based on the aortic interventions recorded in Switzerland's vascular registry Swissvasc.

Methods: All interventions on the aorta that were carried out between January 2018 and December 2020 in Switzerland and entered in the Swissvasc registry were included in this overview. Read More

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Mechanical ventilation in Spain, 1998-2016: changes in the disconnection of mechanical ventilation.

Med Intensiva (Engl Ed) 2021 Jun 4. Epub 2021 Jun 4.

Hospital Universitario de Getafe, Madrid, España.

Purpose: To evaluate changes in the disconnection of mechanical ventilation in Spain from 1998 to 2016.

Design: Post-hoc analysis of four cohort studies.

Ambit: 138 Spanish ICUs. Read More

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Naproxen inhibits spontaneous lung adenocarcinoma formation in Kras mice.

Neoplasia 2021 Jun 3;23(6):574-583. Epub 2021 Jun 3.

Center for Cancer Prevention and Drug Development, Hem-Onc, Department of Medicine, Stephenson Cancer Center, University of Oklahoma HSC, Oklahoma City, OK, USA; VA Medical Center, Oklahoma City, OK, USA. Electronic address:

Lung cancer is the leading cause of cancer related deaths worldwide. The present study investigated the effects of naproxen (NSAID) on lung adenocarcinoma in spontaneous lung cancer mouse model. Six-week-old transgenic Kras mice (n = 20; male + female) were fed modified AIN-76A diets containing naproxen (0/400 ppm) for 30 wk and euthanized at 36 wk of age. Read More

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Validation of an ICD-10-based algorithm to identify stillbirth in the Sentinel System.

Pharmacoepidemiol Drug Saf 2021 Jun 4. Epub 2021 Jun 4.

Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA.

Purpose: To develop and validate an International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM)-based algorithm to identify cases of stillbirth using electronic healthcare data.

Methods: We conducted a retrospective study using claims data from three Data Partners (healthcare systems and insurers) in the Sentinel Distributed Database. Algorithms were developed using ICD-10-CM diagnosis codes to identify potential stillbirths among females aged 12-55 years between July 2016 and June 2018. Read More

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Association between Physiological Equivalent Temperature (PET) with adverse pregnancy outcomes in Ahvaz, southwest of Iran.

BMC Pregnancy Childbirth 2021 Jun 4;21(1):415. Epub 2021 Jun 4.

Department of Epidemiology and Biostatistics, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Background: There are few epidemiological studies on the relation between temperature changes and adverse pregnancy outcomes. The purpose of this study was to determine the relation between Physiological Equivalent Temperature (PET) with adverse pregnancy outcomes including stillbirth, low birth weight (LBW), preterm labor (PTL), spontaneous abortion (SA), preeclampsia and hypertension in Ahvaz, Iran.

Methods: Distributed Lag Non-linear Models (DLNM) combined with quasi-Poisson regression were used to investigate the effect of PET on adverse pregnancy outcomes. Read More

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A physician survey of poststroke aphasia diagnosis and treatment in China: SPEECH study.

Medicine (Baltimore) 2021 Jun;100(22):e25833

Drug Development Organization, Lundbeck China, Beijing, China.

Abstract: The current status of the diagnosis and management of poststroke aphasia (PSA) in China is unknown.To analyze the physicians' strategy and knowledge about the management of PSA in clinical practice and the needs for standardization of diagnosis and treatment.This survey was conducted in March-August 2019 at 32 tertiary hospitals in 16 provinces/municipalities in China. Read More

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Quantitative characterization of left ventricular function during pulseless electrical activity using echocardiography during out-of-hospital cardiac arrest.

Resuscitation 2021 Jun 1. Epub 2021 Jun 1.

Center for Resuscitation Science, University of Pennsylvania School of Medicine, University of Pennsylvania Blockley Hall, 423 Guardian Drive, Room 414A, Philadelphia, PA 19104, USA.

Background: Several prospective studies have demonstrated that the echocardiographic detection of any myocardial activity during PEA is strongly associated with higher rates of return of spontaneous circulation (ROSC). We hypothesized that PEA represents a spectrum of disease in which not only the presence of myocardial activity, but more specifically that the degree of left ventricular (LV) function would be a predictor of outcomes. The purpose of this study was to retrospectively assess the association between LV function and outcomes in patients with OHCA. Read More

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Awake spine surgery: An eye-opening movement.

Surg Neurol Int 2021 10;12:222. Epub 2021 May 10.

School of Medicine, University of New Mexico, Albuquerque, New Mexico, United States.

Background: Awake surgery is performed in multiple surgical specialties, but historically, awake surgery in the field of neurosurgery was limited to craniotomies. Over the past two decades, spinal surgeons have pushed for techniques that only require regional anesthesia as they may provide reduced financial burdens on patients, faster recovery times, and better outcomes. The list of awake spine surgeries that have been found in the literature include: laminectomies/discectomies, anterior cervical discectomy and fusions (ACDFs), lumbar fusions, and dorsal column (DC) stimulator placement. Read More

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Has the human papillomavirus (HPV) immunization programme improved obstetric outcomes in spontaneous delivery? An ecological study.

Eur J Obstet Gynecol Reprod Biol 2021 May 24;262:221-227. Epub 2021 May 24.

Aberdeen Centre for Women's Health Research, University of Aberdeen, Aberdeen, United Kingdom. Electronic address:

Objective: To measure the rates of adverse obstetric outcomes in spontaneous delivery in a population of young women with high uptake of the bivalent human papillomavirus (HPV) vaccine.

Study Design: This was a population-based ecological study with data from the Aberdeen Maternity and Neonatal Databank, UK. All women born between 1986-1996 with spontaneous singleton live birth at age 20-30 years were included for analysis. Read More

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Acute Liver Failure Etiology is an Independent Predictor of Waitlist Outcome, but not Post-Transplant Survival in a National Cohort.

Liver Transpl 2021 Jun 3. Epub 2021 Jun 3.

Division of Gastroenterology / Transplant Hepatology, University of Pennsylvania, Philadelphia.

The impact of acute liver failure (ALF) etiology on waitlist and post-transplant outcomes, independent of severity of illness is incompletely characterized. All adults (N=1,691) listed for primary liver transplantation (LT) between 2002-2019 with ALF due to acetaminophen (APAP), drug-induced liver injury (DILI), autoimmune hepatitis (AIH) and hepatitis B virus (HBV) were identified in the United Network for Organ Sharing database. ALF etiology was evaluated as an independent predictor of waitlist mortality and spontaneous survivorship (SS; versus outcome of LT), as well as post-LT overall survival, graft survival and in-hospital mortality using multivariable models that accounting for differences in clinical parameters at listing. Read More

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[And what about doctors? Associations between spontaneous chromosomal aberrations and cancer morbidity in healthcare workers].

Magy Onkol 2021 Jun 5;65(2):141-148. Epub 2021 Apr 5.

Sugárterápiás Központ, Országos Onkológiai Intézet, Klinikai Sugárbiológiai és Onkocytogenetikai Osztály, Budapest, Hungary.

Healthcare workers may be occupationally exposed to low dose rate radiation or different chemicals during their work. There are strong associations between the increased frequency of spontaneous chromosomal aberrations in blood lymphocytes and the risk of cancer. Cytogenetic tests were conducted on 1240 healthy medical workers and cancer incidence was followed up between 1997-2018. Read More

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Histone Deacetylase 5 Is an Early Epigenetic Regulator of Intermittent Hypoxia Induced Sympathetic Nerve Activation and Blood Pressure.

Front Physiol 2021 17;12:688322. Epub 2021 May 17.

Institute for Integrative Physiology, Center for Systems Biology of O2 Sensing, The University of Chicago, Chicago, IL, United States.

Intermittent hypoxia (IH) is a hallmark manifestation of obstructive sleep apnea (OSA). Long term IH (LT-IH) triggers epigenetic reprogramming of the redox state involving DNA hypermethylation in the carotid body chemo reflex pathway resulting in persistent sympathetic activation and hypertension. Present study examined whether IH also activates epigenetic mechanism(s) other than DNA methylation. Read More

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Ophthalmic Solution Safety Profile: Active Surveillance of a Sodium Hyaluronate/Chondroitin Sulfate Combination in Peruvian Population.

Drug Healthc Patient Saf 2021 27;13:117-123. Epub 2021 May 27.

Pharmacovigilance Department, Laboratorios Sophia, S.A. de C.V., Guadalajara, Jalisco, Mexico.

Background: Sodium hyaluronate/chondroitin sulfate fixed combination plays an essential role in the treatment of keratoconjunctivitis sicca, a multifactorial disease accompanied by ocular symptoms like alteration of the tear film. Despite low or no absorption of such drugs, these can cause secondary effects. An essential tool in the study of medication behavior is active pharmacovigilance. Read More

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Cervical Ossification of Ligamentum Flavum: Elaborating an Underappreciated but Occasional Contributor to Myeloradiculopathy in Aging Population Based on Synthesis of Individual Participant Data.

Clin Interv Aging 2021 24;16:897-908. Epub 2021 May 24.

Peking University Third Hospital, Department of Orthopaedics, Beijing, 100191, People's Republic of China.

Purpose: Cervical ossification of ligamentum flavum (COLF) is a rare clinical entity which can occasionally contribute to severe myeloradiculopathy. Many orthopedists are unfamiliar with or underestimate this pathology. Therefore, a comprehensive research is obligatory to reappraise the epidemiological, radiological, clinical and histopathological characteristics of COLF-myeloradiculopathy based on synthesis of individual patient data. Read More

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Systemic Inflammatory Response Syndrome is Associated with Hematoma Expansion in Intracerebral Hemorrhage.

J Stroke Cerebrovasc Dis 2021 May 30;30(8):105870. Epub 2021 May 30.

Department of Neurology, NYU Langone University School of Medicine, New York, New York, USA; Department of Neurosurgery, NYU Langone Medical Center, New York, New York, USA.

Objectives: Systemic inflammatory response syndrome (SIRS) and hematoma expansion are independently associated with worse outcomes after intracerebral hemorrhage (ICH), but the relationship between SIRS and hematoma expansion remains unclear.

Materials And Methods: We performed a retrospective review of patients admitted to our hospital from 2013 to 2020 with primary spontaneous ICH with at least two head CTs within the first 24 hours. The relationship between SIRS and hematoma expansion, defined as ≥6 mL or ≥33% growth between the first and second scan, was assessed using univariable and multivariable regression analysis. Read More

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Pregnancy outcomes and factors affecting the clinical effects of emergency cerclage in twin pregnancies with cervical dilation and prolapsed membranes.

Int J Gynaecol Obstet 2021 Jun 2. Epub 2021 Jun 2.

Department of Obstetrics and Gynecology, Xiangya Hospital, Central South University, 410008, Hunan, China.

Objective: To determine the effect of mid-trimester emergency cerclage in twin pregnancies with cervical dilation and prolapsed membranes, and identify risk factors predicting spontaneous preterm birth(sPTB) <28 weeks after cerclage.

Methods: Retrospectively analyse twin gestations with cervical dilation and prolapsed membranes treated with emergency cerclage or expectant management (2015-2020). The primary outcomes were the rate of sPTB <28 weeks and the gestational latency. Read More

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Are Three Weeks of Oral Anticoagulation Sufficient for Safe Cardioversion in Atrial Fibrillation?

Medicina (Kaunas) 2021 May 31;57(6). Epub 2021 May 31.

Department of Internal Diseases "Prof. St. Kirkovich", Medical University of Sofia, 1431 Sofia, Bulgaria.

Patients with atrial fibrillation (AF), lasting >48 h, considered for cardioversion, are recommended ≥3 weeks of oral anticoagulation before sinus rhythm restoration because of high risk of development of left atrial thrombosis (LAT) and stroke. However, the optimal duration of anticoagulation in the presence of overt LAT is unknown. An open-label study aimed to investigate the prevalence of spontaneous echo contrast (SEC) and LAT before and after 3 weeks of direct oral anticoagulant (DOAC) treatment. Read More

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Human Milk Virome Analysis: Changing Pattern Regarding Mode of Delivery, Birth Weight, and Lactational Stage.

Nutrients 2021 May 23;13(6). Epub 2021 May 23.

Department of Pediatrics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir 26040, Turkey.

The human milk (HM) microbiota is a significant source of microbes that colonize the infant gut early in life. The aim of this study was to compare transient and mature HM virome compositions, and also possible changes related to the mode of delivery, gestational age, and weight for gestational age. Overall, in the 81 samples analyzed in this study, reads matching bacteriophages accounted for 79. Read More

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Characteristics and Risk Factors for Intensive Care Unit Cardiac Arrest in Critically Ill Patients with COVID-19-A Retrospective Study.

J Clin Med 2021 May 19;10(10). Epub 2021 May 19.

Department of Intensive Care Medicine, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany.

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causing the coronavirus disease 2019 (COVID-19) led to an ongoing pandemic with a surge of critically ill patients. Very little is known about the occurrence and characteristic of cardiac arrest in critically ill patients with COVID-19 treated at the intensive care unit (ICU). The aim was to investigate the incidence and outcome of intensive care unit cardiac arrest (ICU-CA) in critically ill patients with COVID-19. Read More

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