Chorioangioma with pre-eclampsia and IUGR: a case report

Chorioangioma is a non-trophoblastic benign tumour of the placenta, arising from the primitive chorionic mesenchyme with an estimated incidence of 0.6% diagnosed antenatal on ultrasound imaging. Small chorioangiomas are often asymptomatic with a frequency of about 1%, giant chorioangiomas more than >5 cm in diameter, are rare seen in 1:3500 to 1:16000 births and are associated with maternal and fetal complications. We report a case of 23-year-old, primigravida 36.4 weeks of gestation with pre-eclampsia with asymmetrical intrauterine growth restriction (IUGR), ultrasound suggestive of large placental chorioangioma 8×6.8 cm. This patient despite having large tumour and being diagnosed late at 35 weeks had a favourable maternal and fetal outcome. Histopathology confirmed the diagnosis

Perioperative concerns and outcomes in obstetric patients undergoing lower segment caesarean section in the wake of the COVID-19 pandemic: a retrospective analysis

Background: In the current COVID-19 pandemic, pregnant women are considered high risk due to adverse maternal and foetal complications that are known to occur with antepartum viral infections. In addition to immunological changes in pregnancy that alter the response to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, the disruption of routine antenatal services as a result of the pandemic has also adversely affected expectant mothers.Methods: We conducted this retrospective observational study as a comprehensive comparative analysis of the method of delivery in COVID positive women, the choice of anaesthesia and maternal and foetal outcomes in women undergoing lower segment caesarean sections with COVID infection as well as the COVID negative patients during the first wave of the pandemic.Results: The rate of caesarean section was comparable between the two groups. The rates of general and regional anaesthesia did not change with COVID positive status. However, we found that meconium-stained liquor with foetal distress as an indication for lower segment caesarean section (LSCS) was markedly higher in COVID positive patients. There was also a significantly higher requirement for ICU admission and ventilator support in the positive patients as a result of COVID-related complications. No significant difference was observed in the maternal and neonatal mortality rate between the two groups.Conclusions: In our experience, COVID-19 positive status did not impact the rate of LSCS, but significantly increased the need for intensive care

Comparison of lea gratings with cardiff acuity cards for vision testing of preverbal children

Aims: To create a normative data for lea grating (LG) in the Indian population and to compare LG with Cardiff Acuity Card (CAC). Settings and Design: Normative Data was acquired from normal children between 6 months-3 years coming to the ′Immunisation Clinic′ and ′Well-Baby Clinic′ at a Civil Hospital. To compare LG with CAC, normal and amblyopic children between 6 months-3 years were evaluated, Materials and Methods: Monocular and binocular visual acuity (VA) was measured using LG and then CAC. VA and time taken to perform the test were compared. Statistical Analysis Used: Pearson′s Correlation Coefficient to compare VA and Student paired t-test (significance P<0.005) to compare time. Results: Two standard deviations of VA of 100 normal children overlapped with that published by Lea. Of the 30 amblyopic children aged 18.32 ± 10.5 months (2-36), 18 were females. VA was 0.95 ± 0.3 logMAR (0.7-1.2) and 1.0 ± 0.6 logMAR (0.5-2.1) binocularly and 1.32 ± 0.08 logMAR (0.2-0.6) and 1.15 ± 0.15 logMAR (0.88-1.48) monocularly on CAC and LG respectively. Pearson′s correlation coefficient was 0.98 and 0.63 for binocular and monocular assessment respectively. Time taken to perform LG monocularly and binocularly was significantly less (P<0.001) than CAC. Conclusion: Normative data acquired in Indian pre-verbal children is similar to that published by Lea. Though VA by CAC is better than LG, the two tests are comparable

Small Business Engagement in the SHOP: The Environment for Developing the Illinois Health Insurance Exchange for Small Business

This report is on Small Business in Illinois and its potential engagement in the Small Business Health Options Program (SHOP), the Health Insurance Exchange being developed by the State of Illinois to promote and facilitate the provision of health coverage by small businesses. The SHOP will be established in 2014 under the Affordable Care Act (ACA). The study was commissioned by the Illinois Department of Insurance (DOI) and funded through a grant provided by the United States Department of Health and Human Services (HHS). The study is based on a substantive telephone survey of the owners of small businesses in Illinois, supplemented by a small set of focus groups. The survey of small businesses was conducted by the Survey Research Laboratory (SRL) at UIC

Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and COVID-19-related outcomes: A patient-level analysis of the PCORnet blood pressure control lab.

SARS-CoV-2 accesses host cells via angiotensin-converting enzyme-2, which is also affected by commonly used angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), raising concerns that ACEI or ARB exposure may portend differential COVID-19 outcomes. In parallel cohort studies of outpatient and inpatient COVID-19-diagnosed adults with hypertension, we assessed associations between antihypertensive exposure (ACEI/ARB vs. non-ACEI/ARB antihypertensives, as well as between ACEI- vs. ARB) at the time of COVID-19 diagnosis, using electronic health record data from PCORnet health systems. The primary outcomes were all-cause hospitalization or death (outpatient cohort) or all-cause death (inpatient), analyzed via Cox regression weighted by inverse probability of treatment weights. From February 2020 through December 9, 2020, 11,246 patients (3477 person-years) and 2200 patients (777 person-years) were included from 17 health systems in outpatient and inpatient cohorts, respectively. There were 1015 all-cause hospitalization or deaths in the outpatient cohort (incidence, 29.2 events per 100 person-years), with no significant difference by ACEI/ARB use (adjusted HR 1.01; 95% CI 0.88, 1.15). In the inpatient cohort, there were 218 all-cause deaths (incidence, 28.1 per 100 person-years) and ACEI/ARB exposure was associated with reduced death (adjusted HR, 0.76; 95% CI, 0.57, 0.99). ACEI, versus ARB exposure, was associated with higher risk of hospitalization in the outpatient cohort, but no difference in all-cause death in either cohort. There was no evidence of effect modification across pre-specified baseline characteristics. Our results suggest ACEI and ARB exposure have no detrimental effect on hospitalizations and may reduce death among hypertensive patients diagnosed with COVID-19

The Alzheimer's Disease Prediction Of Longitudinal Evolution (TADPOLE) Challenge: Results after 1 Year Follow-up

Accurate prediction of progression in subjects at risk of Alzheimer's disease is crucial for enrolling the right subjects in clinical trials. However, a prospective comparison of state-of-the-art algorithms for predicting disease onset and progression is currently lacking. We present the findings of "The Alzheimer's Disease Prediction Of Longitudinal Evolution" (TADPOLE) Challenge, which compared the performance of 92 algorithms from 33 international teams at predicting the future trajectory of 219 individuals at risk of Alzheimer's disease. Challenge participants were required to make a prediction, for each month of a 5-year future time period, of three key outcomes: clinical diagnosis, Alzheimer's Disease Assessment Scale Cognitive Subdomain (ADAS-Cog13), and total volume of the ventricles. The methods used by challenge participants included multivariate linear regression, machine learning methods such as support vector machines and deep neural networks, as well as disease progression models. No single submission was best at predicting all three outcomes. For clinical diagnosis and ventricle volume prediction, the best algorithms strongly outperform simple baselines in predictive ability. However, for ADAS-Cog13 no single submitted prediction method was significantly better than random guesswork. Two ensemble methods based on taking the mean and median over all predictions, obtained top scores on almost all tasks. Better than average performance at diagnosis prediction was generally associated with the additional inclusion of features from cerebrospinal fluid (CSF) samples and diffusion tensor imaging (DTI). On the other hand, better performance at ventricle volume prediction was associated with inclusion of summary statistics, such as the slope or maxima/minima of patient-specific biomarkers. On a limited, cross-sectional subset of the data emulating clinical trials, performance of the best algorithms at predicting clinical diagnosis decreased only slightly (2 percentage points) compared to the full longitudinal dataset. The submission system remains open via the website https://tadpole.grand-challenge.org, while TADPOLE SHARE (https://tadpole-share.github.io/) collates code for submissions. TADPOLE's unique results suggest that current prediction algorithms provide sufficient accuracy to exploit biomarkers related to clinical diagnosis and ventricle volume, for cohort refinement in clinical trials for Alzheimer's disease. However, results call into question the usage of cognitive test scores for patient selection and as a primary endpoint in clinical trials.</jats:p