Perinatal Outcomes of Small for Gestational Age Neonates Born With an Isolated Single Umbilical Artery

Objective: To investigate pregnancy outcomes of small for gestational age (SGA) neonates born with isolated single umbilical artery (iSUA) compared to SGA neonates without iSUA.Study Design: This was a population-based retrospective cohort analysis. The study group was defined as a singleton SGA neonate born with iSUA, while an SGA neonate without iSUA comprised the comparison group. We evaluated adverse perinatal outcomes in all SGA neonates born at the Soroka University Medical Center between the years 1998–2013. Multiple gestations, fetuses with known congenital malformations or chromosomal abnormalities and patients with lack of prenatal care were excluded from the study. Multivariate logistic regression models were constructed to identify independent factors associated with adverse perinatal outcomes.Results: Of 12,915 SGA deliveries, 1.2% (162) were complicated with iSUA. Women in the study group were older with a significantly lower gestational age at delivery compared with the comparison group. Rates of women who conceived after infertility treatments were higher in the study group. Additionally, patients in the study group had significantly higher rates of preterm deliveries, placental abruption, cord prolapse, non-reassuring fetal heart rates and cesarean delivery were noted in the study group. These neonates had a significantly lower birth weight (1988.0 ± 697 vs. 2388.3 ± 481 p < 0.001) and higher rates of low APGAR scores at the first and fifth minutes after birth compared with controls. Perinatal mortality was also found to be significantly higher among SGA neonates complicated with iSUA. Preterm delivery as well as perinatal mortality were found independently associated with iSUA among SGA neonates (aOR 4.01, 95% CI 2.88–5.59, aOR 2.24, 95% CI 1.25–4.01, respectively).Conclusion: SGA pregnancies complicated with iSUA are at higher risk for adverse pregnancy and perinatal outcomes as compared to SGA pregnancies without iSUA

Three Notes on Distributed Property Testing

In this paper we present distributed property-testing algorithms for graph properties in the CONGEST model, with emphasis on testing subgraph-freeness. Testing a graph property P means distinguishing graphs G = (V,E) having property P from graphs that are epsilon-far from having it, meaning that epsilon|E| edges must be added or removed from G to obtain a graph satisfying P. We present a series of results, including: - Testing H-freeness in O(1/epsilon) rounds, for any constant-sized graph H containing an edge (u,v) such that any cycle in H contain either u or v (or both). This includes all connected graphs over five vertices except K_5. For triangles, we can do even better when epsilon is not too small. - A deterministic CONGEST protocol determining whether a graph contains a given tree as a subgraph in constant time. - For cliques K_s with s >= 5, we show that K_s-freeness can be tested in O(m^(1/2-1/(s-2)) epsilon^(-1/2-1/(s-2))) rounds, where m is the number of edges in the network graph. - We describe a general procedure for converting epsilon-testers with f(D) rounds, where D denotes the diameter of the graph, to work in O((log n)/epsilon)+f((log n)/epsilon) rounds, where n is the number of processors of the network. We then apply this procedure to obtain an epsilon-tester for testing whether a graph is bipartite and testing whether a graph is cycle-free. Moreover, for cycle-freeness, we obtain a corrector of the graph that locally corrects the graph so that the corrected graph is acyclic. Note that, unlike a tester, a corrector needs to mend the graph in many places in the case that the graph is far from having the property. These protocols extend and improve previous results of [Censor-Hillel et al. 2016] and [Fraigniaud et al. 2016]

Risk factors associated with recurrent referral to the emergency room following surgical treatment of Bartholin’s gland abscess

There is no consensus regarding the best surgical modality for the treatment of Bartholin’s gland abscess. The aim of the study was to evaluate the risk factors associated with the recurrent referral of the emergency room (ER) following surgical treatment for a Bartholin’s gland abscess. A retrospective cohort study was done. Clinical and microbiological characteristics were retrieved from the patients’ hospital records. A univariate analysis was followed using multiple logistic regression model. During the study period, 320 women were managed surgically, of those 54 (37.0%) had had a recurrent referral to the ER. The rate of positive previous cultured abscesses was significantly higher among patients with a recurrent referral to the ER (66.7% vs. 51.3%, p value < .05). The mode of a previous abscess drainage (Word catheterisation or marsupialisation) was not associated with recurrent referral to the ER or with recurrent hospitalisation. The possible association between positive cultures and recurrence warrants re-consideration of routine antimicrobial administration for Bartholin’s gland abscess.IMPACT STATEMENT What is already known on this subject? A recurrence of a Bartholin’s gland abscess following surgical treatment varies greatly and there is no consensus regarding the best surgical modality for treatment. None of the studies have examined a recurrent referral to the emergency room (ER) as a primary outcome. What do the results of this study add? Our study strengthens previous studies and reassures that recurrence is not associated with surgical modality. Specifically, a recurrent referral to the ER and hospitalisation were not found to be associated with surgical modality, both which may be attributed to various reasons other than the recurrence of the abscess. An association was found between positive culture results and a recurrent referral to the ER. What are the implications of these findings for clinical practice and/or further research? The association found that positive results warrant further larger studies in order to determine which of the patients may benefit from antibiotic treatment in addition to the surgical treatment