Poor Correlation between Fetal Tissue Doppler Imaging and Pulsed Wave Myocardial Performance Indices.

Introduction: Both tissue Doppler imaging (TDI) and pulsed wave Doppler (PWD) Myocardial Performance Indices (MPIs) have been proposed as tools for functional fetal cardiology. We wished to determine if there was any correlation between TDI-MPI and PWD-MPI.

Methods: A cohort of uncomplicated women with morphologically normal singleton fetuses between 22 and 39 weeks of gestation was recruited.

The Influence of Hyperoxygenation on Fetal Brain Vascularity Measured Using 3D Power Doppler Ultrasound and the Index "Fractional Moving Blood Volume".

Introduction: Maternal hyperoxygenation effects on fetal cerebral hemodynamics are largely unknown. This study aimed to determine efficacy and reliability of a validated power Doppler ultrasound (US) index, fractional moving blood volume (FMBV), at measuring fetal cerebral vasculature changes during maternal hyperoxia.

Methods: The fetal cerebral effects of 10 min of hyperoxygenation at 2 flow rates (52%/60% FiO2) were evaluated in women in their third trimester of pregnancy.

Feasibility of image registration and fusion for evaluation of structure and perfusion of the entire second trimester placenta by three-dimensional power Doppler ultrasound.

Background: Placental perfusion can be evaluated by 3D power Doppler ultrasound (3D PD-US), particularly using the validated tool 3D Fractional Moving Blood Volume (3D-FMBV); however regional variability and size limitations beyond the first trimester mean that multiple 3D PD-US volumes are required to evaluate the whole organ.

Purpose: We assessed the feasibility of manual offline stitching of second trimester 3D PD-US volumes of the placenta to assess whole organ perfusion using 3D-FMBV.

Materials And Methods: This was a single-centre, prospective, observational cohort study of 36 normal second trimester singleton pregnancies with anterior placentas.

Four-Dimensional Ultrasound for Evaluating Newborn Cardiac Output: A Pilot Study of Healthy Infants.

Background: There is currently no reliable non-invasive method of measuring cardiac output in neonatal intensive care. Spatiotemporal image correlation (STIC) is a novel four-dimensional (4D) ultrasound technique that was developed to assess the foetal heart, and it may be a useful way to assess neonatal haemodynamics.

Objective: This study aimed to evaluate the feasibility and reproducibility of determining neonatal cardiac output using STIC ultrasound in newborn infants.

Applying spatial-temporal image correlation to the fetal kidney: Repeatability of 3D segmentation and volumetric impedance indices.

Introduction: Spatiotemporal image correlation (STIC) can evaluate fetal renal impedance using four-dimensional volumetric indices. We assessed repeatability of three-dimensional kidney segmentation and the repeatability of the resultant indices.

Methods: In each of 57 healthy pregnant women, three renal artery pulsed-wave Doppler (PWD) traces and three STIC volumes were acquired from the same fetal kidney and segmented by two observers.

Use of the Foetal Myocardial Performance Index in monochorionic, diamniotic twin pregnancy: a prospective cohort and nested case-control study.

Aims: Assess clinical utility of the foetal Myocardial Performance Index (MPI) in evaluation and management of monochorionic, diamniotic twin (MCDA) pregnancies.

Methods: Prospective cohort of (a) initially uncomplicated MCDA (b) Complicated MCDA, including twin-twin transfusion syndrome (TTTS), selective intrauterine growth restriction (sIUGR), and liquor and/or growth discordance (L/GD) not meeting TTTS or sIUGR criteria. TTTS and sIUGR were case-control matched.

Use of the Myocardial Performance Index in Decreased Fetal Movement Assessment: A Case-Control Study.

Objectives: To determine whether there are any fetal cardiac function changes, as measured by the myocardial performance index (MPI), in pregnancies complicated by decreased fetal movement (DFM).

Methods: We performed a prospective cross-sectional case-control study of 50 DFM and 50 uncomplicated third-trimester pregnancies matched within 2 gestational weeks. Routine ultrasound growth and well-being parameters as well as MPI were measured.

Fetal myocardial performance index in assessment and management of small-for-gestational-age fetus: a cohort and nested case-control study.

Objective: To assess the clinical utility of the fetal myocardial performance index (MPI) in assessment and management of the small-for-gestational-age (SGA) fetus/growth-restricted fetus (FGR).

Methods: This was a prospective cohort study in metropolitan Australia of patients referred in the period June 2012 to March 2015 to fetal medicine services at 24-38 weeks' gestation for suspected singleton SGA/FGR (estimated fetal weight (EFW) < 10 centile with or without abnormal umbilical artery (UA) Doppler) pregnancy. Patients had MPI assessed in addition to routine measures, and were followed through to birth.

Beat-to-beat variability of fetal myocardial performance index.

Objectives: To determine whether there is beat-to-beat (BTB) variability in the fetal left myocardial performance index (MPI), as evaluated by an automated system, and whether there is a correlation between MPI and fetal heart rate (FHR).

Methods: This was a prospective cross-sectional study of uncomplicated, morphologically normal, singleton pregnancies at 20-38 weeks' gestation. Multiple cineloops for left MPI measurement were acquired during a single examination of each fetus.

The Aortic Isthmus: A Significant yet Underexplored Watershed of the Fetal Circulation.

The aortic isthmus (AoI) is a unique fetal watershed with a waveform reflecting its complex haemodynamic physiology. The systolic component represents left and right ventricular systolic ejection, and the diastolic component represents comparative downstream vascular impedance between the brachiocephalic and subdiaphragmatic fetal circulations. Several indices have been devised to quantify different components of the waveform, including the pulsatility index, resistance index, isthmic flow index, and recently the isthmic systolic index.

Is There a Measurable Difference between the Left and Right Modified Myocardial Performance Indices, and Does This Change to Reflect Unilateral Myocardial Dysfunction in Pathology?

Introduction: Fetal cardiac dysfunction may manifest itself unilaterally as right and left ventricles differing in design, function and load, measurable as differing in myocardial performance indices (MPIs). We wished to define this difference ('delta-MPI' or DMPI), present its normal range and pilot its use in pathological pregnancy.

Material And Methods: Prospective cross-sectional study of 324 normal singleton fetuses (16-38 weeks of gestation).

Frontomaxillary facial angle measurement in trisomy 21 and euploid fetuses: two- and three-dimensional assessment during routine first trimester screening.

Objective: To assess 2D and 3D frontomaxillary facial angle (FMFA) measurements in euploid and trisomy 21 fetuses.

Materials And Methods: Over a 2-year period, women with singleton pregnancies attending a private prenatal screening and diagnosis practice in Sydney, Australia, were invited to participate in this study where 2D images and 3D volumes of the fetal face were collected during routine first trimester screening. In pregnancies where trisomy 21 was confirmed, FMFA measurements were performed in 2D and 3D and compared with those from a euploid cohort.

The FDA Funding Crisis.

The role of the Food and Drug Administration (FDA) is to ensure the safety of prescription and nonprescription drugs, dietary supplements, and the food supply, representing more than 20% of US consumer spending. The increased need to monitor imported drugs, drug products and foods, drug shortages, and compounding pharmacies bring the adequacy of FDA funding into question. Performing even at status quo cannot be accomplished if responsibilities increase without equitable funding increases: both from the federal government and fees imposed on FDA-regulated industries.

The Effect of Ethnicity on 2D and 3D Frontomaxillary Facial Angle Measurement in the First Trimester.

Objectives. To determine the existence and extent of ethnic differences in 2D or 3D fetal frontomaxillary facial angle (FMFA) measurements. Methods.

Frontomaxillary facial angle measurement at 11-14 weeks: assessment of interobserver and intraobserver agreement in 2D and 3D imaging.

Introduction: The primary aim of this study was to assess the interobserver and intraobserver reproducibility of the first-trimester frontomaxillary facial angle (FMFA) measurement using both 2D and 3D ultrasound. Assessment of the relationship between crown-to-rump length (CRL) and FMFA measurement was also reviewed.

Materials And Methods: Two experienced operators imaged the same 30 patients over a 1-month period collecting both 2D static images and 3D volumes during nuchal translucency assessment at 11-14 weeks' gestation.

Comparison of frontomaxillary facial angles using both 2D and 3D ultrasound at 11+0 to 13+6 weeks of gestation.

Introduction: The aim of this study is to (i) directly compare both two-dimensional (2D) and three-dimensional (3D) frontomaxillary facial angle (FMFA) in first trimester, and (ii) to assess the ease with which both may be performed.

Materials And Methods: Both 3D volumes of the fetal head and 2D fetal profiles were collected from 251 consenting patients during routine first-trimester nuchal translucency (NT) screening. The FMFA in 2D was measured at the time of the NT screening.

Fermentable carbohydrate supplementation alters nitrogen excretion in chronic renal failure.

Background: Considerable attention has been given to the impact of nutrition on kidney disease. Most dietary attempts to treat chronic renal failure (CRF) and to decrease uremia use a protein restriction. An alternative dietetic approach based on fermentable carbohydrate (FC) supplementation of the diet could lead to the same urea-lowering effect by increasing urea nitrogen (N) excretion in stool, with a concomitant decrease of the total N quantity excreted in urine.

[Role of dietary fibers in the nutritional management of chronic renal failure].

During the past few decades, considerable attention has been given to the impact of nutrition on kidney disease. Although most dietary attempts to treat chronic renal failure (CRF) and to decrease uremia recommend a protein restriction, another dietetic approach, based on dietary fibers (DF), can lead to the same urea-lowering effect by increasing urea-nitrogen (N) excretion in stool with a concomitant decrease of the total N quantity excreted in urine. In fact, feeding DF results in a greater rate of urea N transfer from blood to large bowel, where it will be hydrolyzed by bacterial ureases before subsequent microflora metabolism and proliferation.

[Proposal of a clinical prediction score for atheromatous renal artery stenosis].

Unlabelled: Renal vascular pathologies are important causes of the chronic renal failure progression. This work aims to define retrospectively a score based on simple clinical and paraclinical helping to select atheromatous renal stenosis affected patients; 67 patients more than 50 years old have been explored by arteriography because of degradation of the renal function or hypertension: 45 of them had one, or many, significant stenosis of the renal arteries. Were analyzed: clinical data: age, weight, sex, blood pressure, previous ateromatous lesions (cardiac, peripheral, aortic), smoking, associated diabetes; biological data: serum cholesterol and creatinine, creatinine variation under angiotensin-coverting enzyme inhibitor or sodium depletion, kaliemia; radiologic data: kidney size through scanning, renal arterial and aortic calcifications on abdominal plain films and profile.

[Use of stress echocardiography in detecting silent myocardial ischemia in hemodialysis patients].

Unlabelled: The chronic renal failure treated by hemodialysis is associated with a high incidence of prematured cardiovascular diseases, which represents the major causes of morbidity and mortality in hemodialysis patients.

Objective Of The Study: To evaluate the interest of stress echocardiography for the detection of silent myocardial ischaemia in the chronic renal failure treated by hemodialysis.

Methods: 24 dobutamine stress echocardiography have been achieved in to patients having an average old of 61 +/- 11 years, 15 men and 3 women, with an average dialysis duration of 55 +/- 27 months.

[Smoking and atheromatous stenosis of the renal arteries].

Unlabelled: Renal vascular pathologies are important causes of the chronic renal failure progression. In these pathologies, the role of smoking in so far as factor of risk was discussed. This work aims to evaluate the effect of smoking exposure on renal arteries of patients with both renal failure and hypertension.

Fermentable carbohydrate and digestive nitrogen excretion.

Background: Interventions that restrict protein intake lower plasma urea concentration and may slow the progression of renal failure. The question arises whether the effect of a dietary protein restriction could be reinforced by enrichment of the diet with fermentable carbohydrate because these carbohydrates may stimulate the extra-renal route of nitrogen (N) excretion through the digestive route.

Methods: The influence of fermentable carbohydrate and moderate protein restriction on N metabolism was investigated in a rat model of renal failure with ablation of 70% of renal mass compared with control rats with intact kidneys.

Deregulated platelet-activating factor levels and acetylhydrolase activity in patients with idiopathic IgA nephropathy.

Background: Platelet-activating factor (PAF) is a phospholipid mediator with potent inflammatory activities. PAF stimulates IgA synthesis by B cells while IgA aggregates enhance PAF production by neutrophils and mesangial cells. These results led us to investigate blood PAF levels and plasma acetylhydrolase (AHA, the PAF catabolic enzyme) activity in patients with idiopathic IgA nephropathy (IgAN).