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Dejan Krušič, Drago Brilej, Colin Currie, Radko Komadina
BACKGROUND: The aim was to describe an audit of hip fracture patient care and outcomes in a Slovenian healthcare setting prior to the implementation of the Geriatric Fracture Center (GFC) model of care. METHODS: The Fragility Fracture Network (FFN) hip fracture audit database was used to collect data on hip fracture care in elderly patients. Epidemiological data were submitted as well as fracture type, prefracture residence and mobility prior to the fracture. The timeline of events and acute care data were also collected...
November 28, 2016: Wiener Klinische Wochenschrift
Emmanuel Amabebe, Steven Reynolds, Victoria Stern, Graham Stafford, Martyn Paley, Dilly O C Anumba
Changes in vaginal microbiota that is associated with preterm birth (PTB) leave specific metabolite fingerprints that can be detected in the cervicovaginal fluid (CVF) using metabolomics techniques. In this study, we characterize and validate the CVF metabolite profile of pregnant women presenting with symptoms of threatened preterm labor (PTL) by both (1)H-nuclear magnetic resonance spectroscopy (NMR) and enzyme-based spectrophotometry. We also determine their predictive capacity for PTB, singly, and in combination, with current clinical screening tools - cervicovaginal fetal fibronectin (FFN) and ultrasound cervical length (CL)...
2016: Frontiers in Medicine
Merel M C Bruijn, Jolande Y Vis, Femke F Wilms, Martijn A Oudijk, Anneke Kwee, Martina M Porath, Guid Oei, Hubertina C J Scheepers, Marc E A Spaanderman, Kitty W M Bloemenkamp, Monique C Haak, Antoinette C Bolte, Frank P H A Vandenbussche, Mallory D Woiski, Caroline J Bax, Jérôme M J Cornette, Johannes J Duvekot, Bas W A Nij Bijvank, Jim van Eyck, Maureen T M Franssen, Krystyna M Sollie, Joris A M van der Post, Patrick M M Bossuyt, Brent C Opmeer, M Kok, Ben W J Mol, Gert-Jan van Baaren
OBJECTIVE: To compare the accuracy of the Actim Partus test and fetal fibronectin (fFN) test in the prediction of spontaneous preterm delivery within seven days in symptomatic women undergoing cervical length measurement. STUDY DESIGN: We performed a post-hoc analysis on frozen samples of a nationwide cohort study in all 10 perinatal centres in the Netherlands. We selected samples from women with signs of preterm labour between 24 and 34 weeks of gestational age and a cervical length below 30mm...
November 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Anderson W Chuck, Nguyen X Thanh, Radha S Chari, Robert Douglas Wilson, Selikke Janes-Kelley, James C Wesenberg
OBJECTIVES: In 2006, the Alberta Ministry of Health issued a policy to implement fetal fibronectin (fFN) testing as a publicly funded service for pregnant women. The goals were to reduce maternity health care utilization and unnecessary treatment, which would result in cost-savings for the health system by more accurately diagnosing false preterm labour. We conducted a post-policy implementation review to determine whether the policy implementation achieved its goals. METHODS: We assessed the impacts of fFN testing on clinical decision-making for ambulance transfer, hospital admission, and length of hospital stay by comparing these variables between the tested and untested patients...
July 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Suzanne M Dyer, Maria Crotty, Nicola Fairhall, Jay Magaziner, Lauren A Beaupre, Ian D Cameron, Catherine Sherrington
BACKGROUND: Hip fractures are an increasingly common consequence of falls in older people that are associated with a high risk of death and reduced function. This review aims to quantify the impact of hip fracture on older people's abilities and quality of life over the long term. METHODS: Studies were identified through PubMed and Scopus searches and contact with experts. Cohort studies of hip fracture patients reporting outcomes 3 months post-fracture or longer were included for review...
2016: BMC Geriatrics
Yansong Chua, Abigail Morrison
The role of dendritic spiking mechanisms in neural processing is so far poorly understood. To investigate the role of calcium spikes in the functional properties of the single neuron and recurrent networks, we investigated a three compartment neuron model of the layer 5 pyramidal neuron with calcium dynamics in the distal compartment. By performing single neuron simulations with noisy synaptic input and occasional large coincident input at either just the distal compartment or at both somatic and distal compartments, we show that the presence of calcium spikes confers a substantial advantage for coincidence detection in the former case and a lesser advantage in the latter...
2016: Frontiers in Computational Neuroscience
Merel M C Bruijn, Frederik J R Hermans, Jolande Y Vis, Femke F Wilms, Martijn A Oudijk, Anneke Kwee, Martina M Porath, Guid Oei, Hubertina C J Scheepers, Marc E A Spaanderman, Kitty W M Bloemenkamp, Monique C Haak, Antoinette C Bolte, Frank P H A Vandenbussche, Mallory D Woiski, Caroline J Bax, Jérôme M J Cornette, Johannes J Duvekot, Bas W A N I J Bijvank, Jim van Eyck, Maureen T M Franssen, Krystyna M Sollie, Joris A M van der Post, Patrick M M Bossuyt, Marjolein Kok, Ben W J Mol, Gert-Jan van Baaren
Objective 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. Methods 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...
July 21, 2016: American Journal of Perinatology
Jessica Spiegelman, Whitney Booker, Simi Gupta, Jennifer Lam-Rochlin, Andrei Rebarber, Daniel H Saltzman, Ana Monteagudo, Nathan S Fox
Objective To estimate the independent association of a short cervical length (CL), positive fetal fibronectin (fFN), amniotic fluid (AF) sludge, and cervical funneling with spontaneous preterm birth in twin pregnancies. Methods Retrospective cohort study of twin pregnancies managed by a single maternal-fetal medicine practice from June 2005 to February 2014. All patients underwent transvaginal sonographic CL and fFN testing. We reviewed all images from the first CL at 22(0/7) to 25(6/7) weeks for the presence of (1) a short CL, which is defined as ≤25 mm, (2) AF sludge, and (3) cervical funneling, and also recorded (4) the fFN result from that time...
October 2016: American Journal of Perinatology
Reva Tripathi, Shakun Tyagi, Yedla M Mala, Nilanchali Singh, Nalini B Pandey, Preeti Yadav
OBJECTIVE: To compare the accuracy of rapid bedside tests for phosphorylated insulin-like growth factor-binding protein 1 (phIGFBP-1) and fetal fibronectin (fFN) to predict preterm delivery among women with threatened preterm labor. METHODS: A prospective observational study was conducted among women with a singleton pregnancy of 28-36 weeks, intact membranes, and symptoms suggestive of preterm labor who attended a center in New Delhi, India, between April 1, 2011, and March 31, 2014...
October 2016: International Journal of Gynaecology and Obstetrics
H Blain, T Masud, P Dargent-Molina, F C Martin, E Rosendahl, N van der Velde, J Bousquet, A Benetos, C Cooper, J A Kanis, J Y Reginster, R Rizzoli, B Cortet, M Barbagallo, K E Dreinhöfer, B Vellas, S Maggi, T Strandberg
Prevention of fragility fractures in older people has become a public health priority, although the most appropriate and cost-effective strategy remains unclear. In the present statement, the Interest Group on Falls and Fracture Prevention of the European Union Geriatric Medicine Society, in collaboration with the International Association of Gerontology and Geriatrics for the European Region, the European Union of Medical Specialists, and the International Osteoporosis Foundation-European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, outlines its views on the main points in the current debate in relation to the primary and secondary prevention of falls, the diagnosis and treatment of bone fragility, and the place of combined falls and fracture liaison services for fracture prevention in older people...
August 2016: Aging Clinical and Experimental Research
Francesco Fiorini, Alexander Isted, Natasha L Hezelgrave, Andrew H Shennan
OBJECTIVE: To assess the predictive value of quantitative fetal fibronectin (fFN) concentration in cervicovaginal fluid for spontaneous preterm birth in women with bulging fetal membranes. STUDY DESIGN: This was a prospective observational study from five UK tertiary centres of a cohort of women with singleton pregnancy and bulging fetal membranes presenting between 18 and 32 weeks of gestation (n=62), in the period 2010-2014. fFN concentrations in cervicovaginal fluid were measured both quantitatively and qualitatively at presentation in all women...
August 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Maryam Parisaei, Jane Currie, Neil O'Gorman, Stephen Morris, Anna L David
Foetal fibronectin testing (fFN) has a high negative predictive value for preterm delivery, but it has a cost implication. This two-stage prospective study evaluated the real patient costs and clinical impact of introducing the fFN test in women presenting acutely with threatened preterm labour in a tertiary UK obstetric hospital. Introduction of the fFN test for women with threatened preterm labour reduced antenatal admissions and in utero transfers, and reduced steroid treatment and tocolysis, even at 1 year after implementation...
May 5, 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Vincenzo Berghella, Gabriele Saccone
OBJECTIVE DATA: Fetal fibronectin is an extracellular matrix glycoprotein that is produced by amniocytes and cytotrophoblasts and has been shown to predict spontaneous preterm birth. STUDY: The aim of this systematic review and metaanalysis of randomized clinical trials was to evaluate the effect of the use of fetal fibronectin in the prevention of preterm birth in singleton pregnancies with threatened preterm labor. STUDY APPRAISAL AND SYNTHESIS METHODS: The research was conducted with the use of MEDLINE, EMBASE, Web of Sciences, Scopus, ClinicalTrial...
October 2016: American Journal of Obstetrics and Gynecology
Michaela Golic, Jan-Peter Siedentopf, Franziska Pauly, Larry Hinkson, Wolfgang Henrich, Elisabeth Tucher
OBJECTIVE: The most important parameter in prediction of preterm birth is the cervical length measured by transvaginal ultrasound. In cases with mid-range cervical length (10-30 mm), prediction of preterm birth is difficult. In these cases, testing for cervicovaginal fluid fetal fibronectin (fFN) can improve prediction. However, it is unclear whether transvaginal ultrasound itself influences the fFN result. The purpose of this study was to evaluate this issue independent of gestational age and cervical length...
April 23, 2016: Journal of Perinatal Medicine
Elena Magro-Malosso, Viola Seravalli, Mauro Cozzolino, Marina Spitaleri, Tommaso Susini, Mariarosaria Di Tommaso
OBJECTIVE: to evaluate the diagnostic accuracy of cervicovaginal fetal fibronectin (fFN) in predicting preterm delivery (PTD) in symptomatic and asymptomatic women with cervical length (CL) ≤ 20 mm. METHODS: A retrospective cohort study on pregnant singleton women admitted for CL ≤ 20 mm, with or without uterine contractions, between 22 and 34 weeks. For each group, symptomatic and asymptomatic, the following outcomes were evaluated: PTD before 37 and 34 weeks, delivery within 48 h, 7, 14 and 21 days after fibronectin sampling...
April 7, 2016: Journal of Maternal-fetal & Neonatal Medicine
Michela Centra, Giuliana Coata, Elena Picchiassi, Luisa Alfonsi, Samanta Meniconi, Vittorio Bini, Maria Rosaria Di Tommaso, Mauro Cozzolino, Fabio Facchinetti, Francesca Ferrari, Maria Teresa Gervasi, Silvia Rusconi, Tullia Todros, Valentina Frisina, Nicola Rizzo, Maria Bisulli, Gian Carlo Di Renzo
OBJECTIVE: To evaluate diagnostic accuracy of quantitative fetal fibronectin (qfFN) test in predicting preterm birth (PTB) risk <34 weeks' gestation or within 14 days from testing. We explored the predictive potential of the test in five-predefined PTB risk categories based on predefined qfFN thresholds (<10, 10-49, 50-199, 200-499 and ≥500 ng/mL). METHODS: Measurement of cervicovaginal qfFN with Rapid fFN 10Q System (Hologic) in 126 women with singleton pregnancy (23-33 weeks' gestation) reporting signs and symptoms indicative of preterm labour (PTL)...
April 6, 2016: Journal of Perinatal Medicine
M Hadži-Legal, A Daneva Markova, M Stefanovic, M Tanturovski
The pathophysiology of preterm delivery (PTD) is complex and multifactorial.It occurs in 8-12% of all deliveries, and the rate of PTD has increased during the past years in spite of intensive efforts towards early detection and prompt treatment. Fifty-eight pregnant women were eligible to join the study if they attended the University Clinic for Gynecology and Obstetrics, Skopje and were admitted to Department of High Risk pregnancy Unit with symptoms of preterm labor (PTL) (symptoms of uterine activity judged by the assessing physician to be indicative of PTL) at 24...
2016: Clinical and Experimental Obstetrics & Gynecology
J Min, H A Watson, N L Hezelgrave, P T Seed, A H Shennan
OBJECTIVE: To identify whether preterm surveillance clinics (PSCs) risk-stratify high-risk women accurately by comparing outcomes of those admitted to hospital on the basis of asymptomatic testing with those not admitted. METHODS: We performed a subanalysis from a larger prospective cohort study on sonographic cervical length, quantitative fetal fibronectin (qfFN) and risk of spontaneous preterm birth. We identified 1130 asymptomatic singleton pregnancies at high risk of preterm birth, screened between 23 and 28 weeks of gestation at a PSC in a tertiary hospital in London, UK...
July 2016: Ultrasound in Obstetrics & Gynecology
Dilek Uygur, A Seval Ozgu-Erdinc, Ruya Deveer, Hakan Aytan, M Tamer Mungan
OBJECTIVE: To compare fetal fibronectin (fFN) assessment, ultrasound parameters, and Bishop score in the prediction of successful induction of labor at term when cervix is unfavorable. MATERIALS AND METHODS: Seventy-three nulliparous women undergoing labor induction at term with Bishop score less than 5 were enrolled in this study. Successful labor induction was defined as vaginal delivery occurring within 24 hours of initiation of induction. fFN obtained from vaginal secretion was measured by immunoassay...
February 2016: Taiwanese Journal of Obstetrics & Gynecology
Amy L Turitz, Christina M Ackerman, Denise L Johnson, Tracy C Bank, Jimmy K Duong, Shing M Lee, Cynthia Gyamfi-Bannerman
BACKGROUND: Fetal fibronectin (fFN) is used as a biomarker for preterm delivery. Currently, its use is discouraged if there has been vaginal manipulation in the previous 24 hours. OBJECTIVE: Our objective is to determine if there are differences between fFN results before and after vaginal manipulation in the form of sterile vaginal exam or transvaginal ultrasound. STUDY DESIGN: This was a prospective observational cohort study at a single center of women between 22-33 6/7 weeks at risk for preterm delivery due to: (1) a history of preterm delivery, short cervix, or multifetal gestation; or (2) symptoms of preterm labor...
May 2016: American Journal of Obstetrics and Gynecology
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