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Perinatal practices such as breast-feeding, kangaroo mother care, rooming-in, and delayed cord clamping have varied by institution during the COVID-19 pandemic. The goal of this systematic review was to examine the success of different practices in preventing viral transmission between SARS-CoV-2 positive mothers and their infants.

Electronic searches were performed in the Ovid MEDLINE, Ovid Embase, Cochrane Library, EBSCOhost CINAHL Plus, Web of Science, and Scopus databases. Studies involving pregnant or breastfeeding patients who tested positive for SARS-CoV-2 by RT-PCR were included. Infants tested within 48 hours of birth who had two tests before hospital discharge were included. Infants older than one week with a single test were also included.

Twenty eight studies were included. In the aggregated data, among 190 breastfeeding infants, 22 tested positive for SARS-CoV-2 (11.5%), while 4 of 152 (2.63%) among bottle-fed (Fisher's exact test p = 0.0006). The positivity rates for roomed in infants (20/103, 19.4%) were significantly higher than those isolated (5/300, 1.67%) (P <  0.0001). There was no significant difference in positivity rate among infants who received kangaroo care (25%vs 9%, p = 0.2170), or delayed cord clamping (3.62%vs 0.9%, p = 0.1116).

Lack of robust studies involving large patient population does not allow meaningful conclusions from this systematic review. Aggregated data showed increased positivity rates of SARS-CoV-2 among infants who were breast fed and roomed-in. There were no differences in SARS-CoV-2 positivity rates in infants received skin to skin care or delayed cord clamping.

Lack of robust studies involving large patient population does not allow meaningful conclusions from this systematic review. Aggregated data showed increased positivity rates of SARS-CoV-2 among infants who were breast fed and roomed-in. There were no differences in SARS-CoV-2 positivity rates in infants received skin to skin care or delayed cord clamping.Delayed cord clamping has been shown to be beneficial in both preterm and term babies. Practice guidelines have not been consistent between centers and the practice of delayed cord clamping has not been standardized. The concept of physiologic-based cord clamping emerged into practice as well. Cord milking has different physiological effect and might be harmful in preterm babies.

Perinatal stroke is one of the principal causes of cerebral palsy (CP) in preterm infants. Stroke in preterm infants is different from stroke in term infants, given the differences in brain maturation and the mechanisms of injury exclusive to the immature brain. We conducted a systematic review to explore the epidemiology and pathogenesis of periventricular hemorrhagic infarction (PVHI), perinatal arterial ischemic stroke (PAIS) and cerebral sinovenous thrombosis (CSVT) in preterm infants.

Studies were identified based on predefined study criteria from MEDLINE, EMBASE, SCOPUS and WEB OF SCIENCE electronic databases from 2000 -2019. Results were combined using descriptive statistics.

Fourteen studies encompassed 546 stroke cases in preterm infants between 23 -36 weeks gestational ages and birth weights between 450 -3500 grams. Eighty percent (436/546) of the stroke cases were PVHI, 17%(93/546) were PAIS and 3%(17/546) were CSVT. Parietal PVHI was more common than temporal and frontal lobe PVHI. For PAIS,.The use of artificial intelligence (AI) to help diagnose and manage disease is of increasing interest to researchers and clinicians. Volumes of health data are generated from smartphones and ubiquitous inexpensive sensors. By using these data, AI can offer otherwise unobtainable insights about disease burden and patient status in a free-living environment. Moreover, from clinical datasets AI can improve patient symptom monitoring and global epidemiologic efforts. While these applications are exciting, it is necessary to examine both the utility and limitations of these novel analytic methods. The most promising uses of AI remain aspirational. For example, defining the molecular subtypes of Parkinson's disease will be assisted by future applications of AI to relevant datasets. This will allow clinicians to match patients to molecular therapies and will thus help launch precision medicine. Until AI proves its potential in pushing the frontier of precision medicine, its utility will primarily remain in individualized monitoring, complementing but not replacing movement disorders specialists.Technology has transformed the science and practice of medicine. In this special mini-forum, data using digital neuropsychological technology are reported. https://www.selleckchem.com/pharmacological_epigenetics.html All of these papers demonstrate how coupling digital technology with standard paper and pencil neuropsychological tests are able to extract behavior not otherwise obtainable. As digital assessment methods mature, early identification of persons with emergent neurodegenerative and other neurological illness may be possible.

Quantitative flow ratio (QFR) is a novel angiography-based physiological index for fast computation of fractional flow reserve without use of pressure wire or induction of hyperemia.

We sought to investigate the prevalence and prognostic implications of achieving physiology-consistent percutaneous coronary intervention (PCI) according to the baseline angiographic QFR in an all-comers cohort.

QFR was retrospectively analyzed from the angiograms of 1,391 patients enrolled in the randomized PANDA III trial. Patients in whom all functionally ischemic vessels (baseline QFR ≤0.80) were treated and in whom all non-ischemic vessels (baseline QFR >0.80) were deferred were termed to have had QFR-consistent treatment; otherwise they were termed to have QFR-inconsistent treatment. The major outcome was 2-year major adverse cardiac events (MACE, composite of all-cause death, all MI, or any ischemia-driven revascularization).

Overall, 814 (58.5%) patients had QFR-consistent PCI, while 577 (41.5%) patients received QFR-inconsistent PCI. Patients with QFR-consistent vs. those with QFR-inconsistent treatment had a lower risk of 2-year MACE (8.4% vs. 14.7%; hazard ratio [HR] 0.56 [95%CI, 0.41-0.78]). After adjusting for differences in baseline covariates, 2-year rates of MACE remained significantly lower in the QFR-consistent group (8.8% vs. 13.6%; adjusted HR 0.64 [95% CI, 0.44-0.93]), mainly due to reduced ischemia-driven revascularization (2.9% vs. 8.0%; adjusted HR 0.35 [95% CI, 0.20-0.60]).

In this post hoc analysis of an all-comers PCI trial, approximately 60% of patients were treated in accordance with what QFR measurement would have recommended, the achievement of which was associated with improved 2-year clinical outcomes.

In this post hoc analysis of an all-comers PCI trial, approximately 60% of patients were treated in accordance with what QFR measurement would have recommended, the achievement of which was associated with improved 2-year clinical outcomes.