Zhaorosenthal5780

BACKGROUND Heterotopic pregnancy refers to the simultaneous coexistence of an intrauterine and extrauterine pregnancy. In natural conception it is very rare, with a rising incidence in patients undergoing assisted reproduction technologies. It presents a serious diagnostic problem which is often misdiagnosed. Currently, there are no standard protocols for the treatment and diagnosis of heterotopic pregnancy. METHODS Two rare cases of spontaneous heterotopic pregnancy are presented. RESULT The first patient had a complete abortion upon which an extrauterine pregnancy was detected. The second patient, after an extrauterine pregnancy removal, progressed with an intrauterine pregnancy until full term and it ended with the delivery of a healthy infant. CONCLUSION Two demonstrated cases underscore that whenever abnormal adnexal findings are presented and the beta-hCG blood test is positive, the possibility of a heterotopic pregnancy should be suspected. © Georg Thieme Verlag KG Stuttgart · New York.INTRODUCTION  The efficacy of a stabilization exercise for the relief of neck pain remains controversial. We conducted a systematic review and meta-analysis to explore the effectiveness of a stabilization exercise on neck pain. METHODS  We searched Embase, Web of Science, EBSCO Information Services, and the Cochrane Library databases through May 2019 for randomized controlled trials (RCTs) assessing the impact of a stabilization exercise on neck pain. This meta-analysis was performed using the random effects model. RESULTS  Six RCTs are included in the meta-analysis. Compared with the control group of patients with neck pain, a stabilization exercise can significantly reduce pain scores at 4 to 6 weeks (mean difference [MD] -2.41; 95% confidence interval [CI], -4.46 to -0.35; p = 0.02), Neck Disability Index [NDI] at 10 to 12 weeks (MD- 6.75; 95% CI, -11.71 to -1.79; p = 0.008), and depression scale at 4 to 6 weeks (MD -4.65; 95% CI, -7.00 to -2.31; p = 0.02), but it has no obvious impact on pain scores at 10 to 12 weeks (MD -1.07; 95% CI, -3.42 to 1.28; p = 0.37) or at 6 months (MD -1.02; 95% CI, -3.43 to 1.39; p = 0.41). CONCLUSIONS  A stabilization exercise can provide some benefits to control neck pain. Georg Thieme Verlag KG Stuttgart · New York.OBJECTIVE  Antenatal magnesium sulfate (MgSO4) treatment is associated with reduced risk of cerebral palsy in preterm infants. We aimed to investigate whether this treatment leads to any alterations on cerebral hemodynamics which could be detected by near-infrared spectroscopy (NIRS) readings in early postnatal life. STUDY DESIGN  Infants with gestational ages (GAs) ≤ 32 weeks were divided into two groups regarding their exposure to antenatal neuroprotective MgSO4 treatment or not. NIRS monitoring was performed to all infants, and readings were recorded for 2 hours each day during the first 3 days of life. selleck The primary aim was to compare regional cerebral oxygen saturation (rcSO2) and cerebral fractional tissue oxygen extraction (cFTOE) between the groups. RESULTS  Sixty-six infants were exposed to antenatal MgSO4, while 64 of them did not. GA and birth weight were significantly lower in the treatment group (p  0.05). An insignificant reduction in severe intraventricular hemorrhage rates was observed (8 vs. 15%, p = 0.24). CONCLUSION  We could not demonstrate any effect on cerebral oxygenation of preterm infants in early postnatal life that could be attributed to antenatal neuroprotective MgSO4 treatment. Future studies are warranted to clarify the exact underlying mechanisms of neuroprotection. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.OBJECTIVE  The aim of this study is to model the association between gestational age at birth and early child development through 3 years of age. STUDY DESIGN  Development of 5,868 children in Upstate KIDS (New York State; 2008-2014) was assessed at 7 time points using the Ages and Stages Questionnaire (ASQ). The ASQ was implemented using gestational age corrected dates of birth at 4, 8, 12, 18, 24, 30, and 36 months. Whether children were eligible for developmental services from the Early Intervention Program was determined through linkage. Gestational age was based on vital records. Statistical models adjusted for covariates including sociodemographic factors, maternal smoking, and plurality. RESULTS  Compared with gestational age of 39 weeks, adjusted odds ratios (aOR) and 95% confidence intervals of failing the ASQ for children delivered at less then 32, 32-34, 35-36, 37, 38, and 40 weeks of gestational age were 5.32 (3.42-8.28), 2.43 (1.60-3.69), 1.38 (1.00-1.90), 1.37 (0.98-1.90), 1.29 (0.99-1.67), 0.73 (0.55-0.96), and 0.51 (0.32-0.82). Similar risks of being eligible for Early Intervention Program services were observed (aOR 4.19, 2.10, 1.29, 1.20, 1.01, 1.00 [ref], 0.92, and 0.78 respectively for less then 32, 32-34, 37, 38, 39 [ref], 40, and 41 weeks). CONCLUSION  Gestational age was inversely associated with developmental delays for all gestational ages. Evidence from our study is potentially informative for low-risk deliveries at 39 weeks, but it is notable that deliveries at 40 weeks exhibited further lower risk. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.OBJECTIVE  The lead-in-water impact of the Flint water crisis on the youngest and most neurodevelopmentally vulnerable population was largely unknown. The objective of this study was to investigate and compare cord blood lead levels (CBLLs) in newborns in Flint, Michigan, after the Flint water crisis, to a group of Detroit newborns. STUDY DESIGN  Mothers of 99 Flint newborns were surveyed about potential lead exposures. These neonates were born after the recognition of population-wide lead-in-water contamination. CBLLs were measured and maternal-fetal metrics were reviewed. CBLLs and maternal-fetal metrics were then compared with those of a retrospective cohort of 116 Detroit newborns who previously shared the same water source. Analysis involved descriptive statistics, independent t-test, and χ 2 analysis. RESULTS  CBLLs greater than or equal to 1 μg/dL (0.05 μmol/L) were more prevalent among Flint newborns (14%), as compared with Detroit newborns (2%; p = 0.001). This was a sevenfold disparity between Flint and Detroit newborns.