Ultrasound measurements of fetal facial profile markers and their associations with congenital malformations during early pregnancy.

BACKGROUND: Fetal facial profile could be measured during the early pregnancy. Its abnormalities might be associated with certain congenital malformations. We aimed to study the associations between fetal facial profile measurements with crown-rump length and congenital malformations (cleft lip and palate, micrognathia, and open spina bifida) during early pregnancy. METHODS: We performed a prospective cross-sectional study between June 2019 and April 2022. Pregnant women at a gestational age between 11-13+ 6 weeks were enrolled. Two sonographers performed fetal facial profile measurements independently. The associations between these measurements with crown-rump length and congenital malformations were evaluated. RESULTS: There were 406 and 25 fetuses without or with congenital malformations, respectively. Two sonographers showed satisfactory inter- and intra-observer agreements and reproducibility. The maxillary gap was only observed in 7.6% of normal fetuses, whereas all cleft lip and palate fetuses had a maxillary gap ≥ 0.8 mm. The crown-rump length was negatively correlated with frontomaxillary facial angle, inferior facial angle, and profile line distance but positively correlated with maxilla-nasion-mandible angle, facial maxillary angle, frontal space distance, and palatine maxillary diameter. These measurements showed various significant changes with different congenital malformations. CONCLUSIONS: Measurements of fetal facial profile in early pregnancy were feasible with satisfactory reproducibility. These measurements correlated with crown-rump length and showed significant differences with certain fetal congenital malformations.

The efficiency of quick response code versus telephone contact for post-discharge follow-up after ophthalmic day surgery: a randomized controlled trial.

PURPOSE: To assess and compare the efficiency of quick response (QR) code versus telephone contact for post-discharge follow-up in patients receiving low-risk ophthalmic day surgery. METHODS: One hundred and sixty patients undergoing strabismus day-care surgery with general anesthesia were randomly allocated to either the intervention group using QR code (QR group) or the control group receiving telephone call (TEL group) for post-discharge follow-up. The primary outcome was the follow-up overall attendance rate on the second postoperative day. Secondary outcomes included attendance rate at the first scheduled follow-up, number of text message reminders, elapsed time and estimated cost for follow-up, omission rate of follow-up responses, and patient satisfaction. RESULTS: The overall attendance rate of follow-up was significantly higher in the QR group than that in the TEL group (97.5% vs. 87.5%, p = 0.016). As compared with the TEL group, the QR group significantly reduced the number of text message reminders with higher attendances at the first scheduled follow-up (p < 0.001, p = 0.001). Besides, the TEL group cost a median time of 258 s and a median cost of RMB 5.8 yuan to complete a follow-up consultant, but was associated with a significantly high omission rate of follow-up responses comparing to the QR group (p = 0.002). Patient satisfaction was comparable between two groups. CONCLUSION: QR code follow-up can be more efficient than traditional telephone contact in assessing the post-discharge recovery after strabismus day surgery, which provides a safe and intuitively alternative follow-up pathway for identifying issues that may necessitate further clinical care for more low-risk ophthalmic day surgeries.

Sedation effects of intranasal dexmedetomidine delivered as sprays versus drops on pediatric response to venous cannulation.

OBJECTIVES: Mucosal atomization device (MAD) was designed to increase the bioavailability of intranasal medications by facilitating absorption, the present study aimed to evaluate and compare the sedation effects of intranasal dexmedetomidine delivered as drops versus sprays on pediatric responses to intravenous cannulation. METHODS: One hundred and six pediatric patients (aged from 2 to 5years) scheduled for elective ophthalmic surgery were intranasally received a dose of 2µg/kg in 20µl/kg of dexmedetomidine for sedation to reduce response to venous cannulation. The patients were randomized into syringe group and MAD group in which dexmedetomidine was delivered as drops or sprays via syringe or MAD respectively. The primary outcome was the response to peripheral vein cannulation assessed by the FLACC scores (faces, legs, activity, cry and consolability) 30min after intranasal administration of dexmedetomidine. The secondary outcomes included acceptance for intranasal medication, sedation onset time, and needle insertion times and any adverse event at the preoperative holding area. RESULTS: The FLACC scores in MAD group were significantly decreased than that treated by drops (P=0.021). The acceptance for intranasal administration between both groups was comparable (P>0.05), the onset time and the incidences in two and more times of needle insertion did not differ significantly between syringe and MAD groups (all P>0.05). None of patients were required to clinically intervene in heart rates reduction and none suffered respiratory depression after administrations of dexmedetomidine in either group. CONCLUSION: Intranasal dexmedetomidine by sprays offers better sedation effects to reduce responses to venous cannulation than drops.

Prenatal ultrasound evaluation of fetal cutaneous hemangioma and related complications.

OBJECTIVES: Congenital hemangiomas are rare benign vascular tumors but can lead to serious adverse pregnancy outcomes. Its prenatal diagnosis is a challenge. We explored the clinical applications of prenatal ultrasound for evaluating fetal cutaneous hemangioma and associated complications. METHODS: A retrospective observational study was conducted comprising a population of pregnant women with fetal cutaneous hemangioma, the latter diagnosed by prenatal ultrasound, between January 2016 and December 2020. The clinical characteristics, sonographic images, complications, and pregnancy outcomes were documented and analyzed. RESULTS: We identified 20 cases of fetal cutaneous hemangioma diagnosed by prenatal ultrasound and confirmed by postpartum examinations. Most hemangiomas were in the head and neck (55%), with either solid isoechoicity (25%) or solid mildly hyperechoic (25%), and well-circumscribed (80%) mass. Eight (40%) fetuses experienced complications, which often occurred in fetuses with large hemangiomas (67% with maximum diameter ≥5 cm; 100% with a volume ≥40 cm3). The most common complications were cardiac-related (88%), including elevated cardiothoracic area ratio, atrioventricular valve regurgitation, and fetal hydrops. A large hemangioma was usually associated with advanced gestational age and a fast hemangioma growth rate. In five (25%) cases, the pregnancy was terminated; these involved hemangioma of the head or neck. One newborn developed Kasabach-Merritt phenomenon, pulmonary hemorrhage and respiratory distress, and died 3 days after birth. Among the 14 (70%) fetuses that survived birth, all hemangiomas disappeared or regressed after treatments with propranolol, interventional surgery, or observed routinely. CONCLUSIONS: Prenatal ultrasound examination can accurately diagnose fetal cutaneous hemangioma and related complications to facilitate appropriate management during the pregnancy. RATIONALE: Prenatal diagnosis of cutaneous hemangiomas is a clinical challenge. Prenatal ultrasound examination could be a method to accurately diagnose and monitor these hemangiomas.

Wearable Sensor-Based Monitoring of Environmental Exposures and the Associated Health Effects: A Review.

Recent advances in sensor technology have facilitated the development and use of personalized sensors in monitoring environmental factors and the associated health effects. No studies have reviewed the research advancement in examining population-based health responses to environmental exposure via portable sensors/instruments. This study aims to review studies that use portable sensors to measure environmental factors and health responses while exploring the environmental effects on health. With a thorough literature review using two major English databases (Web of Science and PubMed), 24 eligible studies were included and analyzed out of 16,751 total records. The 24 studies include 5 on physical factors, 19 on chemical factors, and none on biological factors. The results show that particles were the most considered environmental factor among all of the physical, chemical, and biological factors, followed by total volatile organic compounds and carbon monoxide. Heart rate and heart rate variability were the most considered health indicators among all cardiopulmonary outcomes, followed by respiratory function. The studies mostly had a sample size of fewer than 100 participants and a study period of less than a week due to the challenges in accessing low-cost, small, and light wearable sensors. This review guides future sensor-based environmental health studies on project design and sensor selection.

Congenital Visceral Vascular Variation Causing Gastrointestinal Hemorrhage: A Case Report.

Variations in the visceral vasculature are often encountered, but rarely cause clinical symptoms. We report a 12-year-old girl with portal hypertension caused by congenital variations in visceral vessels. The clinical manifestations included gastrointestinal hemorrhage and ascites. The common hepatic artery and splenic artery stem shared the same trunk from the aorta, and the common hepatic artery was directly connected with the main portal vein to form an arteriovenous fistula. In addition, the left hepatic artery and the left gastric artery shared a common trunk termed the "hepatic-gastric trunk" which originated from the anterior wall of the aorta, while the right hepatic artery originated from the superior mesenteric artery and supplied the right liver. The patient was treated with interventional embolization and remained in good condition throughout the follow-up and at the time of publication.

Effects of three different rehabilitation games' interaction on brain activation using functional near-infrared spectroscopy.

OBJECTIVE: This study reveals the changes in brain activation due to different game interaction states based on functional near-infrared spectroscopy signals and discusses their significance for stroke rehabilitation. APPROACH: The oxygenated hemoglobin concentration (Delta [HbO2]) signals and the deoxygenated hemoglobin (Delta [HbR]) signals were recorded from the prefrontal cortex (PFC), the motor cortex (MC), the occipital lobe (OL) and the temporal lobe of 21 subjects (mean age: 24.6 ± 1.9 years old) in three game interaction states: physical, motion-sensing, and button-push training. The subjects were also asked to complete user-satisfaction survey scales after the experiment. MAIN RESULTS: Compared with the button-training state, several channels in the PFC and MC region of the physical-training state were significantly altered as were several channels in the RMC region of the motion-sensing training state (P < 0.05 after adjustment). The motion-sensing state of the PFC had a significant correlation with that of the MC and the OL. The subjective scale results show that the acceptability of the physical and motion-sensing states was greater than the acceptability of the button-push training state. SIGNIFICANCE: The results show that the brain regions responded more strongly when activated by the physical and motion-sensing states compared with the button-push training state, and the physical and motion-sensing states are more conducive to the rehabilitation of the nervous system. The design of rehabilitation products for stroke patients is discussed and valuable insights are offered to support the selection of better interactive training methods.