Placental pathologic lesions associated with stroke in term neonates.

Objective: To determine the birth prevalence of perinatal stroke in term born infants at our high-volume delivery center and assess the frequency of both gross and histologic placental pathologies associated with perinatal stroke using the Amsterdam Placental Workshop Group Consensus Statement guidelines and definitions. Study Design: A single-center retrospective cohort study spanning 2010-2020. Results: There were 129,759 live births at Parkland Hospital during the study period and a total of 18 term born infants leading to a birth prevalence of 1 in 6,829 infants. Perinatal risk factors were found in all but one patient, and 74% presented with seizures. Pathologic placental examination was available in 56% of the cohort and only one patient had normal placental examination. Acute histologic chorioamnionitis was described in five placentas (50%) and an additional two had isolated umbilical and/or chorionic plate vasculitis with or without funisitis compared to a rate of 28% with acute inflammation in a Control group. Chronic inflammation in the form of villitis of unknown etiology was described in three of the acutely inflamed placentas and was high-grade in each of those while none of the placentas from our Control group showed evidence of any chronic lesion. Conclusion: Both acute and chronic placental inflammation are common in perinatal stroke; placental examination should be considered an essential component to the diagnostic workup.

Accuracy of magnetic resonance imaging in predicting anterior cruciate ligament tear location and tear degree.

PURPOSE: The purpose of this study is to evaluate the reliability of magnetic resonance imaging (MRI) in predicting the location of ACL tears in preoperative planning for anterior cruciate ligament (ACL) repair. METHODS: Thirty-four patients who underwent ACL repair were retrospectively analyzed to compare intraoperative arthroscopic findings with preoperative MRIs. RESULTS: For identifying type I tears, the sensitivity of MRI was 9.0% and the accuracy of MRI was 8.8%. There was moderate interrater agreement between MRI findings for tear location and tear degree. CONCLUSION: MRI alone may not necessarily be accurate in identifying which ACL tears are amenable to repair. STUDY DESIGN: Retrospective case series; Level of Evidence: IV.

Measures of vocal attack time for healthy young adults.

OBJECTIVE: To determine the vocal attack time (VAT) in a healthy young adult population. STUDY DESIGN: Sound pressure (SP) and electroglottographic (EGG) recordings were obtained for 57 female and 55 male subjects while performing multiple tokens of three tasks (sustained /a/, "always," and "hallways") at comfortable pitch and loudness. METHODS: Generalized sinusoidal models were obtained for SP and EGG signals to compare rates of amplitude change. VAT was computed from the time lag of the cross-correlation function using a fully automated process accompanied by operator validation. RESULTS: Adjusted mean VAT values were significantly shorter for females than for males. There was no systematic effect of age on VAT. However, 25- to 29-year-old men showed longer VAT than did the other age and sex subgroups. CONCLUSIONS: Normative data are presented for a new measure of the duration of vocal initiation, VAT. Acquiring this measure requires very little intervention by the user and, thereby, eliminates the influence of subjective decision making. Although beyond the scope of this article, we suggest several factors that might underlie VAT as a function of speaker sex and age.

Anaesthesia - what has the University of Cape Town contributed?

From humble beginnings, the University of Cape Town's Department of Anaesthesia has played a major role in the development of anaesthesia as a speciality, in South Africa and internationally. We highlight these contributions in clinical service, teaching and research, with particular emphasis on the department's leading role in the evolution of anaesthetic safety in adults and children: from the development of the treatment of malignant hyperthermia, to unique studies in mortality associated with anaesthesia, and modern contributions to improved drug safety. Innovations in anaesthetic techniques have contributed to significant surgical developments, including the first heart transplant. Furthermore, our research has contributed to major advances in obstetric and endocrine anaesthesia, and training in the department is recognised as being among the best in the world.