Can the nonstress test predict congenital sepsis?

The possible role of the nonstress test (NST) in the prediction of congenital sepsis in pregnancies complicated by prolonged premature rupture of the membranes (PROM) was investigated in a retrospective controlled study. Thirteen NSTs performed within 24 hours of the delivery of infants with congenital sepsis were coded, blinded, and mixed with an equal number of blinded NSTs derived from randomly selected patients matched for gestational age with PROM but without neonatal or maternal infection. Eleven of 13 infants with congenital sepsis had a reactive NST, and two had a nonreactive test. Among the controls, there were also 11 reactive and two nonreactive NSTs. The sensitivity and specificity of the NST in predicting congenital sepsis in patients with PROM were 15.4% and 84.6%, respectively. The positive predictive value and the negative predictive value were 50%. Our results suggest that the NST is not a useful tool for prediction of congenital sepsis.     

Simultaneous 3D NMR spectroscopy of proton-decoupled fluorine and phosphorus in human liver during 5-fluorouracil chemotherapy

Simultaneous acquisition of ¹H-decoupled ³¹P and ¹⁹F 3D CSI is demonstrated in the liver of a patient undergoing 5-fluorouracil chemotherapy. Both ³¹P and ¹⁹F shared the same voxel size (64 or 27 ml), bi-level ¹H-decoupling and 0.35 s TR. The measurements were done in a 1.5 Tesla clinical imager with three radio-frequency (RF) channels and a triple-tuned surface-coil. The overall MRI and MRS examination time was under 90 min. Simultaneous acquisition of ³¹P and ¹⁹F permits localized study of the influence of hepatic metabolism on the uptake and catabolism of fluoropyrimidine drugs without extra measurement time or higher SAR.     

A new guidance system for freehand, obstetric ultrasound-guided procedures.

OBJECTIVE: To assess the performance of the UltraGuide 1000 system, and to compare ultrasound-guided freehand mid-trimester amniocentesis with and without the new guidance system. METHODS: One hundred and sixty-nine women referred for mid-trimester genetic amniocentesis were divided into two groups: a control group of 99 women who underwent the procedure by the freehand technique with scored needles and 70 patients who had the procedure carried out with the aid of a guidance system (UltraGuide 1000) with non-scored needles. The procedures were compared for duration, number of punctures and repositionings of the needle, the visibility of the needle during the puncture and the number of bloody taps. RESULTS: The study group had significantly lower rates of reinsertion (none vs. 7.1%), repositioning (7.1% vs. 17.7%), bloody taps (none vs. 6.1%), touching the fetus (5.7% vs. 22.2%) and prolonged duration of the procedure (4.3% vs. 14.4%) compared with the control group. There was one fetal loss in the control group. Non-visibility of the needle before reaching the amniotic sac occurred in 18.6% of cases in the study group and in 38.4% of cases in the control group. CONCLUSIONS: The new guidance system combines the benefits of an attached guide with the flexibility of the 'freehand' technique. Use of the new guidance system for mid-trimester genetic amniocentesis increases needle visibility and lowers the incidence of common complications.     

Comparison of the electrophysiological pattern of fatigue between athletes required to perform explosive and endurance sports

The electrophysiological behavior of an isometric contraction sustained to fatigue, was examined in 6 long distance runners and 9 athletes involved in explosive (burst) sports, by on line computer analysis of the electrical activity of vastus medialis, rectus femoris and vastus lateralis. The experiments were carried out with a counterload of 50% of the maximal strength of the muscle. The duration of spike increased and the frequency decreased in the 3 examined muscles, in both types of sport. In the burst sports the changes of value of both parameters were statistically significant in the 3 muscles. In endurance sports the variations of duration were not significant and the changes of frequency were statistically significant only in the vastus lateralis. These results could be explained by the gradual activation of motor units of more strikingly different sizes in burst sports. Thus it may be speculated that prolonged training in burst sports may result in the automatic mobilization of higher number of small motor units, for the initiation of contraction while in endurance sports the onset of contraction is more gradual and carried out by large motor units.     

The efficacy of interferon alpha on colchicine-resistant familial Mediterranean fever attacks: a pilot study

About a quarter of familial Mediterranean fever (FMF) patients have recurrent painful attacks of polyserositis despite regular colchicine treatment. There is no known alternative drug for colchicine-resistant cases. We had previously observed a patient with FMF whose painful attacks disappeared during the 6 month period of interferon alpha (IFN) treatment for his chronic hepatitis B. The objective of the present study was to investigate the possible beneficial effect of IFN on these episodes. Twenty-one consecutive attacks in seven adult patients with FMF were treated at early onset with IFN, the dosage being 3-10 million I U s.c. Eighteen of the 21 attacks could be halted in a mean time of 3.05 h, while the intensity of abdominal pain remained very low. Observed side-effects were generally mild and acceptable. IFN may be a useful adjunct for the treatment of colchicine-resistant attacks in FMF patients.