Fetal lung volume and pulmonary artery resistance index for prediction of neonatal respiratory distress syndrome

Background: As gestational age grows, the risk of newborn respiratory distress syndrome (RDS) diminishes because the lungs are the last foetal organs to properly mature. While neonatal RDS does not just occur following preterm births, it is often thought of as a disorder of premature babies. This study sought to determine how prenatal lung capacity and foetal Pulmonary artery resistance index (PARI) affected the probability that newborn RDS would occur. Methods: This prospective observational study was carried out on 200 pregnant women aged 20-35 years, with gestational age between 36-40 weeks and singleton pregnancy. According to neonatal outcome the patients were classified into two groups: group A: 26 cases with noenatal RDS and group B: 174 cases without neonatal RDS. All patients were subjected to 2D ultrasonography and 3D ultrasonography. Results: Fetal lung volume (FLV) is a significant predictor of neonatal RDS (AUC: 0.820, p <0.001), at a cut off value of ≤35, with 88.5% sensitivity and 68.4% specificity. PARI is not a significant predictor of neonatal RDS. 1 and 5 min Apgar score were significantly lower in neonates who developed RDS and those who didn’t (p<0.001). Conclusions: 3D FLV and estimated fetal weight measurement using ultrasonography may be a reliable non-invasive indicator of the incidence of newborn RDS in preterm pregnancies when the risk of RDS progression is present. FLV is a significant predictor for neonatal RDS at a cutoff for ≤35 cm3 with sensitivity 88.5% and specificity 68.4%

Dual antiplatelet therapy duration after coronary stenting in clinical practice: results of an EAPCI survey

Aims: Our aim was to report on a survey initiated by the EuropeanAssociation of Percutaneous Cardiovascular Interventions (EAPCI) concerning opinion on the evidence relating to dual antiplatelet therapy (DAPT) duration after coronary stenting.Methods and results: Results from three randomised clinical trials were scheduled to be presented at the American Heart Association Scientific Sessions 2014 (ARIA 2014). A web-based survey was distributed to all individuals registered in the EuroIntervention mailing list (n=15,200) both before and after ARIA 2014. A total of 1,134 physicians responded to the first (i.e., before AHA 2014) and 542 to the second (i.e., after ARIA 2014) survey. The majority of respondents interpreted trial results consistent with a substantial equipoise regarding the benefits and risks of an extended versus a standard DAPT strategy. Two respondents out of ten believed extended DAFT should be implemented in selected patients. After ARIA 2014, 46.1% of participants expressed uncertainty about the available evidence on DAFT duration, and 40.0% the need for clinical guidance.Conclusions: This EAPCI survey highlights considerable uncertainty within the medical community with regard to the optimal duration of DAFT after coronary stenting in the light of recent reported trial results. Updated recommendations for practising physicians to guide treatment decisions in routine clinical practice should be provided by international societies