The pregnancy at risk for delivery at the threshold of viability.

PURPOSE OF REVIEW: To examine updated recommendations for obstetrical interventions that may improve neonatal outcomes in extremely preterm births. RECENT FINDINGS: Several recent studies of antenatal steroids at the threshold of viability have demonstrated benefits in both survival and survival without major morbidity. This has led to revised recommendations from the American College of Obstetricians and Gynecologist regarding the timing of antenatal steroids in these extremely preterm fetuses. SUMMARY: These recent developments have important implications for clinical care in patients at risk for extremely preterm birth based on a model of best practices and shared decision-making.

Match performance and physical capacity of players in the top three competitive standards of English professional soccer.

The aim of this study was to compare the match performance and physical capacity of players in the top three competitive standards of English soccer. Match performance data were collected from players in the FA Premier League (n=190), Championship (n=155) and League 1 (n=366) using a multiple-camera system. In addition, a selection of players from the Premier League (n=56), Championship (n=61) and League 1 (n=32) performed the Yo-Yo intermittent endurance test level 2 (Yo-Yo IE2) to determine physical capacity. Players in League 1 and the Championship performed more (p<.01) high-intensity running than those in the Premier League (Effect Size [ES]: 0.4-1.0). Technical indicators such as pass completion, frequency of forward and total passes, balls received and average touches per possession were 4-39% higher (p<.01) in the Premier League compared to lower standards (ES: 0.3-0.6). Players also covered more (p<.05) high-intensity running when moving down (n=20) from the Premier League to the Championship (ES: 0.4) but not when players moved up (n=18) standards (ES: 0.2). Similar Yo-Yo IE2 test performances were observed in Premier League, Championship and League 1 players (ES: 0.2-0.3). Large magnitude relationships (p<.05) were observed between Yo-Yo IE2 test performances and the total and high-intensity running distance covered in both Championship (r=.56 and .64) and Premier League matches (r=.61 and .54). The data demonstrate that high-intensity running distance was greater in players at lower compared to higher competitive standards despite a similar physical capacity in a subsample of players in each standard. These findings could be associated with technical characteristics inherent to lower standards that require players to tax their physical capacity to a greater extent but additional research is still required to confirm these findings.

Bilateral dermoid cysts of the ovary in a pregnant woman: case report and review of the literature.

OBJECTIVE: Most nonphysiological ovarian masses discovered during pregnancy are benign dermoid cysts. The association of dermoid cysts with pregnancy has been increasingly reported since 1918. They usually present the dilemma of weighing the risks of surgery and anesthesia versus the risks of untreated adnexal mass. METHOD: We are reporting an illustrative case and presenting a review of the literature for recommendations regarding the management of such cases. RESULT: The bilateral dermoid cysts were surgically treated in the second trimester. CONCLUSION: Most references state that it is more feasible to treat bilateral dermoid cysts of the ovaries discovered during pregnancy if they grow beyond 6 cm in diameter. This is usually performed through laparotomy or very carefully through laparoscopy and should preferably be done in the second trimester.