Detecting single-trial EEG evoked potential using a wavelet domain linear mixed model: application to error potentials classification.

Objective: The main goal of this work is to develop a model for multisensor signals, such as magnetoencephalography or electroencephalography (EEG) signals that account for inter-trial variability, suitable for corresponding binary classification problems. An important constraint is that the model be simple enough to handle small size and unbalanced datasets, as often encountered in BCI-type experiments.

Approach: The method involves the linear mixed effects statistical model, wavelet transform, and spatial filtering, and aims at the characterization of localized discriminant features in multisensor signals.

First Berlin heart EXCOR pediatric VAD interhospital transports of nonambulatory patients with the Ikus stationary driver.

Ventricular assist devices (VADs) are increasingly being used in pediatric patients to support cardiac failure. As more centers adopt this technology, there may be a need to transport these patients over long distances to facilitate patient care and organ transplantation. Food and Drug Administration indications for use state only that the patient must be a candidate for transplantation and does not place restrictions on the transplant capabilities of the implanting medical center.

Abnormal placentation: evidence-based diagnosis and management of placenta previa, placenta accreta, and vasa previa.

Placenta previa, placenta accreta, and vasa previa cause significant maternal and perinatal morbidity and mortality. With the increasing incidence of both cesarean delivery and pregnancies using assisted reproductive technology, these 3 conditions are becoming more common. Advances in grayscale and Doppler ultrasound have facilitated prenatal diagnosis of abnormal placentation to allow the development of multidisciplinary management plans to achieve the best outcomes for mother and baby.

The impact of prior preeclampsia on the risk of superimposed preeclampsia and other adverse pregnancy outcomes in patients with chronic hypertension.

Objective: We sought to compare the rates of superimposed preeclampsia and adverse outcomes in women with chronic hypertension with or without prior preeclampsia.

Study Design: We conducted secondary analysis of 369 women with chronic hypertension (104 with prior preeclampsia) enrolled at 12-19 weeks as part of a multisite trial of antioxidants to prevent preeclampsia (no reduction was found). Outcome measures were rates of superimposed preeclampsia and other adverse perinatal outcomes.

Antioxidant supplementation and premature rupture of the membranes: a planned secondary analysis.

Objective: The purpose of this study was to determine if antioxidant supplementation during pregnancy reduces the incidence of premature rupture of the membranes (PROM).

Study Design: A placebo-controlled, double-blind trial was conducted. PROM and preterm PROM (PPROM) were planned secondary outcomes of the trial.

Serum inhibin A and angiogenic factor levels in pregnancies with previous preeclampsia and/or chronic hypertension: are they useful markers for prediction of subsequent preeclampsia?

Objective: Our objective was to determine whether measurement of placenta growth factor (PLGF), inhibin A, or soluble fms-like tyrosine kinase-1 (sFlt-1) at 2 times during pregnancy would usefully predict subsequent preeclampsia (PE) in women at high risk.

Study Design: We analyzed serum obtained at enrollment (12(0/7) to 19(6/7) weeks) and follow-up (24-28 weeks) from 704 patients with previous PE and/or chronic hypertension (CHTN) enrolled in a randomized trial for the prevention of PE. Logistic regression analysis assessed the association of log-transformed markers with subsequent PE; receiver operating characteristic analysis assessed predictive value.

Antioxidant therapy to prevent preeclampsia: a randomized controlled trial.

Objective: To study whether antioxidant supplementation will reduce the incidence of preeclampsia among patients at increased risk.

Methods: A randomized, placebo-controlled, double-blind clinical trial was conducted at four Brazilian sites. Women between 12 0/7 weeks and 19 6/7 weeks of gestation and diagnosed to have chronic hypertension or a prior history of preeclampsia were randomly assigned to daily treatment with both vitamin C (1,000 mg) and vitamin E (400 International Units) or placebo.

Metabolism, tissue distribution, and pharmacokinetics of N-methyl-N-2,4,6-tetranitroaniline (tetryl).

Tetryl (N-methyl-N,2,4,6-tetranitroaniline) is a booster explosive that was used in the production of detonators and blasting caps. It is an environmental contaminant that is found in detectable levels in areas associated with its production, use, storage, and disposal. Preliminary microsomal assays showed that one major metabolite was formed under anaerobic and aerobic conditions with both NADH and NADPH as cofactors.

Tissue distribution and elimination of N-methyl-N-2,4,6-tetranitroaniline (tetryl) in rats.

The elimination of tetryl was studied using ring-labeled 14C-tetryl. Tetryl was given subcutaneously to male Sprague-Dawley rats at doses of 25, 100, and 300 mg kg(-1), and urine and feces were collected 24 h post-injection. Percent urinary elimination was observed to be 10.

New therapies in the prevention of preeclampsia.

Purpose Of Review: The review summarizes the results of recent randomized clinical trials whose primary purpose was to prevent preeclampsia and explores safety concerns that have been raised by these trials. Preeclampsia remains one the most common causes of perinatal and maternal mortality, particularly in resource-poor developing countries where its impact on morbidity and mortality is 20 to 100-fold greater than that in developed countries. The potential benefit of antioxidant vitamins and calcium continue to be explored, and are the subject of this review.

Tocolysis in women with preterm labor between 32 0/7 and 34 6/7 weeks of gestation: a randomized controlled pilot study.

Objective: The purpose of this study was to determine whether intravenous magnesium sulfate (MgSO4) followed by oral nifidepine tocolysis in women with preterm labor between 32 0/7 and 34 6/7 weeks' gestation reduces neonatal hospital stay.

Study Design: Fifty-four women between 32 0/7 and 34 6/7 weeks with preterm labor were randomized to receive either MgSO4 and oral nifidepine (n = 24) or no tocolysis (n = 30). All women received betamethasone and prophylactic antibiotics.

Prevention and management of RhD isoimmunization.

An Rh-negative woman is at risk for developing Rh isoimmunization upon exposure to RhD antigens from her Rh-positive baby through fetal-maternal hemorrhage. The incidence of Rh isoimmunization and fetal hemolytic disease has decreased substantially since Rh immune globulin was introduced in 1968. When RhD sensitization does occur, careful follow-up of these mothers and judicious intervention can result in good outcomes for most pregnancies.

The pattern of change in the lecithin/sphingomyelin ratio in patients with preterm premature rupture of membranes between 24 and 34 weeks' gestation.

Objective: To report the pattern of change in the lecithin/sphingomyelin (L/S) ratio in patients with preterm premature rupture of membranes (PPROM) between 24 and 34 weeks' gestation.

Study Design: L/S was determined prospectively using transvaginally and transabdominally collected amniotic fluid from patients with PPROM between 24 and 34 weeks' gestation. Samples were collected prospectively on admission and every 48 to 96 hours until L/S was > or =2.

Maturity testing with preterm premature rupture of the membranes.

The presence or absence of fetal pulmonary maturity as assessed by amniotic fluid analysis and the role of fetal maturity tests in the management of premature rupture of the membranes are addressed. The hazards of the high falsely immature test are carefully explored. A management scheme based on the results of amniotic fluid analysis is also described.

Does the combined antenatal use of corticosteroids and antibiotics increase late-onset neonatal sepsis in the very low birth weight infant?

Objective: The purpose of this study was to determine whether the combined use of maternal antenatal corticosteroids and antibiotic therapy is associated with an increased risk of late-onset neonatal sepsis among very low birth weight infants.

Study Design: The outcomes of infants admitted to the 3 Cincinnati neonatal intensive care units between May 1991 and May 2000 were retrospectively evaluated. Late-onset neonatal sepsis was defined either as the occurrence of a positive blood culture obtained after 72 hours of life with clinical signs of sepsis or as the need for >5 consecutive days of antibiotic therapy for presumed sepsis that initiated after 72 hours of life.

A comparison of various routes and dosages of misoprostol for cervical ripening and the induction of labor.

Objective: The purpose of this study was to compare the efficacy of different routes of misoprostol administration for cervical ripening and the induction of labor.

Study Design: Three hundred thirty women at > or = 32 weeks gestation with a Bishop score < or = 6 and an indication for induction were randomized to 1 of 3 double-blinded groups: (1) 25 microg orally administered misoprostol plus 25 microg vaginally administered misoprostol, (2) orally administered placebo plus 25 microg vaginally administered misoprostol, or (3) 25 microg orally administered misoprostol plus vaginally administered placebo. Doses were repeated every 4 hours until onset of labor or a maximum of 12 doses were given.

Antibiotic prophylaxis at Cesarean delivery.

Objective: Our aim was to compare the efficacy of ampicillin, cefotetan, and ampicillin/sulbactam in the prevention of post-Cesarean endomyometritis.

Methods: Consenting patients undergoing Cesarean delivery at the University of Louisville Hospital were enrolled in a prospective, double-blinded randomization to receive either ampicillin/sulbactam (Group 1), cefotetan (Group 2), or ampicillin (Group 3) single dose antibiotic prophylaxis following umbilical cord clamping. The primary outcome variable was the frequency of endomyometritis in the respective groups.

A multicenter, placebo-controlled pilot study of intravenous immune globulin treatment of antiphospholipid syndrome during pregnancy. The Pregnancy Loss Study Group.

Objective: Treatment with heparin and low-dose aspirin improves fetal survival among women with antiphospholipid syndrome. Despite treatment, however, these pregnancies are frequently complicated by preeclampsia, fetal growth restriction, and placental insufficiency, often with the result of preterm birth. Small case series suggest that intravenous immune globulin may reduce the rates of these obstetric complications, but the efficacy of this treatment remains unproven.

Human chorionic gonadotropin exhibits potent inhibition of preterm delivery in a small animal model.

Objective: The purpose of this study was to test the capability of human chorionic gonadotropin to inhibit prostaglandin-induced preterm delivery in a murine model.

Study Design: A preterm delivery model was developed by using intraperitoneal injection of 20 microgram of prostaglandin F(2)(alpha) to induce preterm labor in C3H/HeN inbred mice. Mice were then pretreated with human chorionic gonadotropin 4 hours before administration of prostaglandin F(2)(alpha), and time to delivery of the first pup was recorded.

Maintenance oral nifedipine for preterm labor: a randomized clinical trial.

Objective: This study was undertaken to evaluate the efficacy of maintenance oral nifedipine in patients initially treated with intravenous magnesium sulfate for preterm labor.

Study Design: Patients with a diagnosis of preterm labor between 24 and 33.9 weeks' gestation were randomly assigned to receive either maintenance tocolytic therapy with oral nifedipine (20 mg every 4-6 hours) or no treatment (control) after discontinuation of magnesium tocolysis.