Mullinsjoseph0588

To evaluate the diagnostic performance of a Volume and Solid Vascular Tissue Score (VSVTS) for preoperative risk assessment of pediatric and adolescent adnexal masses.

A retrospective cohort study comprised of all female individuals who presented with an adnexal mass that was managed surgically between April 2011 and March2016.

The Hospital for Sick Children (Toronto, Ontario, Canada).

Female individuals 1-18years of age who presented to a large tertiary pediatric hospital with an adnexal mass that was managed surgically.

Main outcome measures included diagnostic performance of the VSVTS for malignancy via sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), negative likelihood ratio (LR-), and receiver operating characteristic area-under-the-curve (AUC) analysis.

A total of 179 masses in 169 subjects were included. The malignancy rate was 10.6%. The AUC for the VSTVS was 0.919. A VSTVS cut-off value of 4 achieved a sensitivity of 79% (95% CI 0.54-0.93), specificity of 88% (95% CI 0.82-0.93), PPV of 0.44 (95% CI 0.33-0.56), NPV of 0.97 (95% CI 0.94-0.99), LR+ of 6.77 (95% CI 4.18-10.97), and LR- of 0.24 (95% CI 0.10-0.57).

A sonographic scoring system based on the volume and presence of solid vascular tissue improves PPV for preoperative risk stratification of adnexal masses in the pediatric and adolescent population compared to existing ultrasound-only approaches. Further prospective research is needed to determine how best to incorporate components of such scoring systems into clinical management algorithms.

A sonographic scoring system based on the volume and presence of solid vascular tissue improves PPV for preoperative risk stratification of adnexal masses in the pediatric and adolescent population compared to existing ultrasound-only approaches. Further prospective research is needed to determine how best to incorporate components of such scoring systems into clinical management algorithms.We report two cases of Corona Virus Disease-19 (COVID-19) in patients with Down Syndrome (DS) and describe the identification, diagnosis, clinical course and management of the infection. Down Syndrome, which is caused by trisomy 21, is characterized by immune dysregulation, anatomical differences in the upper respiratory tract and higher rate of comorbidities. All these risk factors can contribute to more severe clinical presentations of COVID-19 in this population. It is essential to raise awareness of the clinical relevance of SARS-COV-2 infection in DS patients, as well as in other most vulnerable patients, in order to improve their management and treatment and to encourage vaccinating these individuals early, once a vaccination is available.

Meta-analysis is a statistical method with the ability to increase the power for statistical inference, while it may still face the problem of being underpowered. In this study, we investigated the power to detect certain true effects for published meta-analyses of rare events.

We extracted data from the Cochrane Database of Systematic Reviews for meta-analyses of rare events from January 2003 to May 2018. We retrospectively estimated the power to detect a 10-50% relative risk reduction (RRR) of eligible meta-analyses. The proportion of meta-analyses achieved a sufficient power (≥0.8) were estimated.

We identified 4,177 meta-analyses. The median power to detect 10%, 30%, and 50% RRR were 0.06 (interquartile range [IQR] 0.05 to 0.06), 0.08 (IQR 0.06 to 0.15), and 0.17 (IQR 0.10 to 0.42), respectively); the corresponding proportion of meta-analyses that reached sufficient power were 0.32%, 3.68%, and 11.81%. Meta-analyses incorporating data from more studies had higher probability to achieve a sufficient power (rate ratio=2.49, 95% CI 1.76, 3.52, P<0.001).

Most of the meta-analyses of rare events in Cochrane systematic reviews were underpowered. Future meta-analysis of rare events should report the power of the results to support informative conclusions.

Most of the meta-analyses of rare events in Cochrane systematic reviews were underpowered. Future meta-analysis of rare events should report the power of the results to support informative conclusions.A duration of parturition beyond 300 min negatively impacts the health of the sow and the survival of piglets during parturition. Hence, oxytocin is widely used to speed up the parturition. However, oxytocin's negative side effects raise the need of finding alternative treatments such as those already implemented in human medicine. The aim of this study was to evaluate the efficacy of Prostaglandin E2 (PGE2) applied intravaginally (PGE2-V) (1.0 mg) or intramuscularly (PGE2-M) (2.5 mg) to improve the parturition process after expulsion of the fourth piglet compared to a placebo (P-V), which was sterile intravaginal gel or intramuscular oxytocin application (OXY-M) (20 iu) in free farrowing systems.In total, 201 eutocic sows were examined after stratification by parity and random allocation into groups 54 (P-V), 48 (OXY-M), 50 (PGE2-V), 49 (PGE2-M). Farrowing duration (time between first piglet and last piglet), piglet interval and placenta expulsion duration (time between first and last placenta) were recordedoved.

To identify predictors of visual outcomes in children with open globe injuries.

The medical records of patients (≤18years of age) with open globe injury from 2012 to 2020 at a single institution were retrospectively reviewed. The Pediatric Ocular Trauma Scores (POTS) and Toddler Ocular Trauma Scores (TOTS) were assessed against our cohort. Univariate and multivariate linear regression analysis was performed to identify predictors of visual outcome.

A total of 85 eyes of 85 pediatric patients (63 males [74%]) were included. Median patient age was 8.9years. selleckchem Final best-corrected visual acuity was significantly associated with presenting vision (P=0.0001), age at injury (P=0.02), lens involvement (P<0.0001), retinal detachment (P<0.0001), and location of injury (P<0.0001). In a multivariate linear regression model, only presenting visual acuity and retinal detachment were independent predictors of outcome. When visual acuity was unknown, age at injury, lens involvement, and retinal detachment were independently associated with final visual acuity.