Effect of prenatal DHA supplementation on the infant epigenome: results from a randomized controlled trial.

Background: Evidence is accumulating that nutritional exposures in utero can influence health outcomes in later life. Animal studies and human epidemiological studies have implicated epigenetic modifications as playing a key role in this process, but there are limited data from large well-controlled human intervention trials. This study utilized a large double-blind randomized placebo-controlled trial to test whether a defined nutritional exposure in utero, in this case docosahexaenoic acid (DHA), could alter the infant epigenome.

Which Factors Contribute to False-Positive, False-Negative, and Invalid Results in Fetal Fibronectin Testing in Women with Symptoms of Preterm Labor?

 We assessed the influence of external factors on false-positive, false-negative, and invalid fibronectin results in the prediction of spontaneous delivery within 7 days.  We studied symptomatic women between 24 and 34 weeks' gestational age. We performed uni- and multivariable logistic regression to estimate the effect of external factors (vaginal soap, digital examination, transvaginal sonography, sexual intercourse, vaginal bleeding) on the risk of false-positive, false-negative, and invalid results, using spontaneous delivery within 7 days as the outcome.

The Effect of Interpregnancy Interval on the Recurrence Rate of Spontaneous Preterm Birth: A Retrospective Cohort Study.

 We assessed, in women with a previous spontaneous preterm birth, the effect of interpregnancy interval on the subsequent preterm birth rate.  Retrospective cohort study.  A nationwide longitudinal dataset of the the Netherlands Perinatal Registry.

Labour pain with remifentanil patient-controlled analgesia versus epidural analgesia: a randomised equivalence trial.

Objective: To distinguish satisfaction with pain relief using remifentanil patient-controlled analgesia (RPCA) compared with epidural analgesia (EA) in low-risk labouring women.

Design: Randomised controlled equivalence trial.

Setting: Eighteen midwifery practices and six hospitals in the Netherlands.

Does providing written dietary advice improve the ingestion of non-allergic nuts in children with existing nut allergies? - A randomized controlled trial.

Background: Allergy to one or more nuts is common in children and often complete nut avoidance is advised. More recently, introduction of non-allergic nuts into the diet is advised by some allergists.

Objective: This study aims to determine whether the provision of additional written dietary advice increases the ingestion of non-allergic nuts by children with nut allergy.

Does measurement of intrauterine pressure have predictive value during oxytocin-augmented labor?

Objective: In a previous randomized trial that compared monitoring uterine contractions with an intrauterine pressure catheter (IUPC) versus external monitoring, we demonstrated that use of an IUPC did not improve the outcome of labor. To provide insight in the lack of a positive effect, we evaluated level of IUP in Montevideo units (MU) in correlation with dysfunctional labor and adverse neonatal outcome.

Study Design: Here, we present two secondary analyses on the 503 women who had IUP measured in the trial.

Vitamin D and adipose tissue-more than storage.

The pandemic increase in obesity is inversely associated with vitamin D levels. While a higher BMI was causally related to lower 25-hydroxyvitamin D (25(OH)D), no evidence was obtained for a BMI lowering effect by higher 25(OH)D. Some of the physiological functions of 1,25(OH)2D3 (1,25-dihydroxycholecalciferol or calcitriol) via its receptor within the adipose tissue have been investigated such as its effect on energy balance, adipogenesis, adipokine, and cytokine secretion.

Percutaneous renal denervation and the second generation EnligHTN System.

Hypertension remains a major public health burden despite the plethora of therapeutic agents available for this disorder, compelling innovation of alternate therapies including interventional approaches where necessary. The kidney is a major player in the pathophysiology of this disease with increased sympathetic activity being the key factor in the initiation and maintenance of drug resistant hypertension in many patients. Thus renal denervation targeted at decreasing sympathetic drive is becoming the apparent choice in carefully selected patients with resistant hypertension who have exhausted all medical options.

An examination of clinical intuition in risk assessment among acute coronary syndromes patients: observations from a prospective multi-center international observational registry.

Background: As there are limited data evaluating "clinical intuition" in risk prediction among acute coronary syndromes (ACS) patients. We evaluated the relationship between perceived and "scored" risk in ACS patients, and their association with care and outcome.

Methods And Results: Within a prospective multi-center international ACS study from 58 hospitals in Australia, China, India and Russia enrolling patients between May 2009 and February 2011, at least 2 physicians involved in each patient's care estimated the patient's untreated risk, and the change in risk with invasive management.