Fiskervalenzuela2181

To evaluate the efficacy of the fetal heart diameter (HD) in predicting fetal hemoglobin (Hb) Bart disease at midpregnancy.

Video clips of fetal chest ultrasound examinations performed on fetuses at risk of Hb Bart disease at 18 to 22 weeks' gestation were randomly retrieved from our video clip database. The clips were replayed for fetal HD measurements, and the measured HDs were converted to z scores based on the z score model as a function of biparietal diameter. An HD z score greater than 2 or an actual HD value above the 95th percentile for gestational age was used as a cutoff in predicting Hb Bart disease. The best cutoff value of HD for identifying affected fetuses during midpregnancy was also evaluated by a receiver operating characteristic curve.

A total of 90 video clips, including 37 affected and 53 unaffected fetuses, were measured. An HD z score greater than 2 had sensitivity of 94.6% (95% confidence interval [CI], 81.8%-99.3%) and specificity of 84.9% (95% CI, 72.4%-93.3%). An actual HD value above the 95th percentile for gestational age had sensitivity of 100% (95% CI, 90.5%-100%) and specificity of 69.8% (95% CI, 55.7%-81.7%). The best cutoff values of the HD z score and actual HD value were 2.27 (with sensitivity of 94.6% and specificity of 88.7%) and 18.15 mm (with sensitivity of 91.9% and specificity of 77.4%), respectively.

The fetal HD is highly effective in predicting fetal Hb Bart disease among fetuses at risk at midpregnancy. Both the HD z score and the actual value can be used for noninvasive prenatal screening of fetal cardiomegaly in clinical practice.

The fetal HD is highly effective in predicting fetal Hb Bart disease among fetuses at risk at midpregnancy. Both the HD z score and the actual value can be used for noninvasive prenatal screening of fetal cardiomegaly in clinical practice.Coronavirus disease 2019 (COVID-19) has become a pandemic, but its reported characteristics and outcomes vary greatly amongst studies. We determined pooled estimates for clinical characteristics and outcomes in COVID-19 patients including subgroups by disease severity (based on World Health Organization Interim Guidance Report or Infectious Disease Society of America/American Thoracic Society criteria) and by country/region. We searched Pubmed, Embase, Scopus, Cochrane, Chinese Medical Journal, and preprint databases from 1 January 2020 to 6 April 2020. Studies of laboratory-confirmed COVID-19 patients with relevant data were included. Two reviewers independently performed study selection and data extraction. From 6007 articles, 212 studies from 11 countries/regions involving 281 461 individuals were analyzed. Overall, mean age was 46.7 years, 51.8% were male, 22.9% had severe disease, and mortality was 5.6%. Underlying immunosuppression, diabetes, and malignancy were most strongly associated with severe COVID-19 (coefficient =  53.9, 23.4, 23.4, respectively, all P  less then  .0007), while older age, male gender, diabetes, and hypertension were also associated with higher mortality (coefficient = 0.05 per year, 5.1, 8.2, 6.99, respectively; P = .006-.0002). Gastrointestinal (nausea, vomiting, abdominal pain) and respiratory symptoms (shortness of breath, chest pain) were associated with severe COVID-19, while pneumonia and end-organ failure were associated with mortality. COVID-19 is associated with a severe disease course in about 23% and mortality in about 6% of infected persons. Individuals with comorbidities and clinical features associated with severity should be monitored closely, and preventive efforts should especially target those with diabetes, malignancy, and immunosuppression.The rheophilic hillstream loaches (Balitoridae) of South and Southeast Asia possess a range of pelvic girdle morphologies, which may be attributed to adaptations for locomotion against rapidly flowing water. Specifically, the connectivity of the pelvic plate (basipterygium) to the vertebral column via a sacral rib, and the relative size and shape of the sacral rib, fall within a spectrum of three discrete morphotypes long, narrow rib that meets the basipterygium; thicker, slightly curved rib meeting the basipterygium; and robust crested rib interlocking with the basipterygium. Species in this third category with more robust sacral rib connections between the basipterygium and vertebral column are capable of walking out of water with a tetrapod-like lateral-sequence, diagonal-couplet gait. This behavior has not been observed in species lacking direct skeletal connection between the vertebrae and the pelvis. The phylogenetic positions of the morphotypes were visualized by matching the morphological features onto a novel hypothesis of relationships for the family Balitoridae. mTOR activation The morphotypes determined through skeletal morphology were correlated with patterns observed in the pelvic muscle morphology of these fishes. Transitions towards increasingly robust pelvic girdle attachment were coincident with a more anterior origin on the basipterygium and more lateral insertion of the muscles on the fin rays, along with a reduction of the superficial abductors and adductors with more posterior insertions. These modifications are expected to provide a mechanical advantage for generating force against the ground. Inclusion of the enigmatic cave-adapted balitorid Cryptotora thamicola into the most data-rich balitorid phylogeny reveals its closest relatives, providing insight into the origin of the skeletal connection between the axial skeleton and basipterygium.

Bordetella bronchiseptica (Bb) infection commonly causes respiratory disease in dogs. Gentamicin delivered by aerosol maximizes local drug delivery without systemic absorption but clinical response to protocols remains undetermined.

To compare the clinical response to 2 protocols of aerosolized delivery of gentamicin in bordetellosis.

Forty-six dogs with Bb infection confirmed by culture or quantitative polymerase chain reaction on bronchoalveolar lavage.

Retrospective study. Administration of aerosolized gentamicin for ≥10 minutes q12h for ≥3 weeks using 4 mg/kg diluted with saline (group 1) or undiluted 5% solution (group 2). Clinical response firstly assessed after 3-4 weeks and treatment pursued by 3-weeks increments if cure not reached. Cure defined as absence of cough persisting at least a week after treatment interruption.

Demographic data were similar between both groups. Clinical cure at 3-4 weeks was more frequently observed with the use of undiluted solution (19/33 vs 3/13 dogs, P = .03) in association with a shorter median duration of treatment (4 vs 6 weeks, P = .