Assessment of fetal adrenal gland enlargement in term and preterm labor cases

Background: The objective of this study was to compare the Fetal Zone Depth (FZD) of fetal adrenal gland in term and preterm labor cases.  Methods: Twenty nine preterm pregnant women at 29-36 weeks of gestation with single pregnancy admitted with the clinical diagnosis of preterm labor and the comparison group of 33 pregnant women at 37-40 weeks with term pregnancy were included in this study. FZD and Total Gland Depth (TGD) of fetal adrenal gland of the entire fetuses in sagittal plane were ultrasonographically measured and FZD/TGD ratios were calculated. Demographic and clinical features, laboratory findings and fetal adrenal gland FZD/TGD ratios were compared between the two groups.Results: No difference was found between the two groups in respect of age, number of pregnancies and delivery method (P >0.05); yet preterm birth history and duration of hospital stay were higher in preterm group (P <0.05). Fetal adrenal gland FZD/TGD ratio was statistically significantly higher in preterm group compared to the term group (55.4% ± 4.9 vs. 47.7% ± 5.6; P <0.001).Conclusion: The growth in FZ as a fetal adaptation mechanism in increased fetal stress in preterm labor cases was at a significant level. Once supported by more comprehensive studies, we think that this result would be beneficial in the prediction of preterm labor in clinical practice.

Assessment of the relationship between a narrow fragmented QRS complex and coronary slow flow

Background: The coronary slow flow (CSF) phenomenon is a delayed antegrade progression of contrast agent to the distal branch of a coronary artery in the absence of obstructive coronary artery disease (CAD). A narrow fragmented QRS (fQRS) has been reported as a significant predictor of sudden cardiac death in patients with idiopathic dilated cardiomyopathy. The present study aimed to investigate the relationship between a narrow fQRS on the admission electrocardiogram (ECG) and CSF on coronary angiography. Methods: This study included 165 consecutive patients (112 CSF, 53 controls) who underwent first-time diagnostic conventional coronary angiography for suspected CAD. Coronary flow was quantified by thrombolysis in myocardial infarction (TIMI) frame count (TFC). The patients were divided into two groups according to the presence or absence of a narrow fQRS complex on the admission ECG. Results: Forty four patients were in the fQRS group (mean age, 52.97 ± 3.13 years). There was no difference between the two groups with respect to age, gender, body mass index, family history, hyperlipidemia, hypertension, or diabetes mellitus. The extent of CSF was significantly greater in the fQRS group compared to the non-fragmented group (p &lt; 0.001). A significant correlation was also found between mean TFC values and fQRS (p &lt; 0.001). On multivariate analysis, only CSF (p = 0.03) was a significant independent predictor for narrow fQRS, after adjustment for other parameters. Conclusions: The narrow fQRS is a simple, inexpensive, and readily available noninvasive ECG parameter that may be a new potential indicator of myocardial damage in patients with CSF.

Case Report Transitional Cell Carcinoma in Orthotopic Ileal Neobladder

Urothelial carcinoma developing in orthotopic ileal neobladder is an extremely rare entity. Fewer than 10 cases have been reported in the literature describing urothelial carcinoma recurrence in orthotopic ileal neobladder. We report a case of transitional cell carcinoma recurrence in orthotopic ileal neobladder after 11 years of surgery

Serum Copeptin Levels in Adult Patients with a Migraine Attack: A Cross-Sectional Study

Aim:This study investigated the potential role of serum copeptin, a mediator of acute pain via sympathetic stress stimulation, as a biomarker of varying degrees of migraine-related disability. Specifically, we aimed to analyze whether the serum copeptin level can be used to differentiate migraine types (e.g., with and without aura).Methods:The study population included 80 consecutively consenting adult patients who had migraine attacks and attended the emergency department from June 2020 through November 2020, as well as 80 age- and sex-matched healthy controls. Using the Migraine Disability Assessment Scale (MIDAS), the same medical professional assessed each patient’s level of headache-related disability. Based on their MIDAS scores, the patients were separated into four groups: no disability (score 0-5; group MIDAS-I); mild disability (score 6-10; group MIDAS-II); moderate impairment (score 11-20; group MIDAS-III); and severe disability (score >20; group MIDAS-IV). There were also two categories of migraineurs: those with auras and those without auras. Upon admission, comparisons were made between the groups’ serum copeptin values.Results:In comparison to the control group, the patient group’s serum copeptin levels were noticeably higher (2113.30±206.20 vs. 1383.40±488.40; p<0.001). The study of the receiving operator’s characteristics showed that the cut-off copeptin level was 1898.5 pg/mL, with 90% sensitivity and 82.4% specificity for distinguishing patients from controls. There were no noticeable differences in the mean serum copeptin levels between the patient groups when compared by MIDAS score. Additionally, patients with and without aura did not differ notably in terms of mean serum copeptin levels. (2118.70±211.60 vs. 2071.10±160.40).Conclusion:Serum copeptin levels may be used as a diagnostic aid to help anticipate migraine-related headache attacks when combined with clinical signs and symptoms

Short-term effects of transcatheter aortic valve implantation on left atrial appendage function

Background: The beneficial effects of the transcatheter aortic valve implantation (TAVI) on echocardiographic parameters including left atrial (LA) and left ventricular (LV) functions were described by previous studies. The aim of this study was to analyze the effects of TAVI on left atrial appendage (LAA) function assessed by transthoracic and transesophageal echocar­diography. Methods: Fifty-five patients with severe symptomatic aortic stenosis were included in this prospective study. LAA early and late emptying velocities, LAA filling velocity, peak early diastolic (EM), late diastolic (AM), and systolic (SM) velocities were measured with pulsed wave Doppler and tissue Doppler imaging, and E/Em ratio was calculated before and 7.1 ± 2.8 days after TAVI. A subgroup analysis was performed in accordance with the left ventricular ejection fraction (LVEF) of the patients and the severity of their LV diastolic dysfunction. Results: Although the post-procedure peaks and mean gradients of the patients decreased sig­nificantly, the LVEF increased significantly in those who had low LVEF before the procedure. The post-procedure E/Em ratio decreased significantly (p &lt; 0.001). The post-procedural LAA mean filling velocity and EM velocity were significantly higher than the pre-procedural filling velocity (p &lt; 0.001, p = 0.002, respectively). In the subgroup analysis, the post-procedural LAA filling velocity, early and late LAA emptying velocities, in addition to the mean velocity of the EM, AM, and SM were significantly higher than before the procedure in patients with LVEF of &lt; 50% and E/Em ratios of &gt; 15. Conclusions: LAA function improved soon after the TAVI procedure, especially in patients with low LVEF and marked LV diastolic dysfunction

The diagnostic value of serum copeptin levels in an acute pulmonary embolism

Background: Acute pulmonary embolism (APE) is a common disease which is associated with high mortality and morbidity. Circulating level of copeptin, which was demonstrated to be elevated in heart failure, acute myocardial infarction and pulmonary arterial hypertension, were reported to be independent predictors of poor outcome in recent studies. The aim of the present study was to investigate the clinical utility of copeptin in the diagnosis of APE. Methods: A total of 90 consecutive patients, admitted to emergency service due to acute chest pain and/or dyspnea and who underwent pulmonary computerized tomography angiography (CTA) due to suspicion of APE, were included in this prospective study. The patients diagnosed with APE were defined as APE (+) group and the remaining individuals with normal pulmonary CTA result were defined as APE (–) group. Results: Copeptin levels (7.76 ± 4.4 vs. 3.81 ± 1.34 ng/dL; p &lt; 0.001) were higher in the APE (+) group as compared to the APE (–) group. Copeptin was significantly positively correlated with B-type natriuretic peptide (r = 0.434, p &lt; 0.001), D-dimer (r = 0.315, p = 0.003) and troponin I (r = 0.300, p = 0.004) and inversely correlated with arterial oxygen saturations (r = –0.533, p &lt; 0001). When the correlation of copeptin with right ventricular dysfunction parameters was investigated, it was significantly inversely correlated with the tricuspid annular plane systolic excursion (r = –0.521, p &lt; 0.001) and positively correlated with right to left ventricle ratio (r = 0.329, p = 0.024). Copeptin (OR 1.836, 95% CI 1.171–2.878, p = 0.008) was found as a significant independent predictor of APE in a multivariate analysis, after adjusting for other risk parameters.  Conclusions: Copeptin is a promising new biomarker, which may be used to support the need for further investigations and to improve the diagnosis of patients with APE.

Neutrophil/lymphocyte ratio is associated with right ventricular dysfunction in patients with acute inferior ST-segment elevation myocardial infarction

Background: Acute inferior ST-segment elevation myocardial infarction (STEMI) is associated with increased in-hospital morbidity and mortality particularly among patients with coexisting right ventricular (RV) involvement. High neutrophil to lymphocyte ratio (NLR) is an independent predictor of major adverse cardiac events and mortality in patients with myocardial infarction. This study evaluated the relationship between the NLR and RV dysfunction (RVD) in patients with inferior STEMI who underwent primary percutaneous coronary intervention (PCI). Methods: A total of 213 subjects with inferior STEMI were divided into two groups according to the presence of RVD. The groups were compared according to NLR and receiver operating characteristic (ROC) analysis was performed to access the predictability of NLR on having RVD. Results: The NLR was significantly higher in the group with RVD compared to that without RVD (p &lt; 0.001). In ROC analysis, NLR &gt; 3.5 predicted RVD with sensitivity of 83% and specificity of 55%. In a multivariate regression analysis, NLR remained an independent predictor of RVD (OR 1.55, 95% CI 1.285–1.750, p &lt; 0.001). Conclusions: NLR was an independent predictor of RVD in patients with inferior STEMI undergoing primary PCI.

Reactive Statistical Mapping: Towards the Sketching of Performative Control with Data

Part 1: Fundamental IssuesInternational audienceThis paper presents the results of our participation to the ninth eNTERFACE workshop on multimodal user interfaces. Our target for this workshop was to bring some technologies currently used in speech recognition and synthesis to a new level, i.e. being the core of a new HMM-based mapping system. The idea of statistical mapping has been investigated, more precisely how to use Gaussian Mixture Models and Hidden Markov Models for realtime and reactive generation of new trajectories from inputted labels and for realtime regression in a continuous-to-continuous use case. As a result, we have developed several proofs of concept, including an incremental speech synthesiser, a software for exploring stylistic spaces for gait and facial motion in realtime, a reactive audiovisual laughter and a prototype demonstrating the realtime reconstruction of lower body gait motion strictly from upper body motion, with conservation of the stylistic properties. This project has been the opportunity to formalise HMM-based mapping, integrate various of these innovations into the Mage library and explore the development of a realtime gesture recognition tool