ABSTRACT
Fetal growth restriction includes all those fetuses that do not reach their own growth potential due to placental insufficiency and therefore at higher risk of adverse perinatal outcomes. Identification and follow-up of these fetuses is essential to decrease this additional risk. Although estimated fetal weight under the 3rd centile and pathological cerebroplacental ratio are the most accepted predictive criteria, some evidence suggests that abnormal uterine artery Doppler may be a useful prognostic parameter in late-onset growth restriction fetuses at the moment of diagnosis. However, its prediction capacity as a standalone parameter is limited. In that context, integrated models of biometric and hemodynamic ultrasound parameters including uterine Doppler have been proposed as an effective approach to stratify the risk and improve perinatal outcomes. Moreover, an association of abnormal uterine artery Doppler and histological findings of placental underperfusion due to vascular obstruction has been described. Finally, it has also been suggested that the evaluation of uterine artery Doppler at third trimester in appropriate-for-gestational-age fetuses could identify cases of subclinical placental insufficiency, but further evidence is needed to define such predictive strategies.
Subject(s)
Placental Insufficiency , Pregnancy , Female , Humans , Pregnancy Trimester, Third , Placental Insufficiency/diagnostic imaging , Placental Insufficiency/pathology , Placenta/diagnostic imaging , Uterine Artery/diagnostic imaging , Middle Cerebral Artery/diagnostic imaging , Ultrasonography, Prenatal , Prospective Studies , FetusABSTRACT
OBJECTIVE: Non-motor symptoms (NMS) have been identified in some focal adult-onset dystonia. In the present study we aimed to evaluate the presence of NMS in patients with spasmodic dysphonia (SD), a focal action-induced dystonia that affects intrinsic laryngeal muscle control. METHODS: Seventeen SD patients and 17 control subjects not significantly different in age and sex were evaluated for the presence of NMS. Additionally, voice handicap index (VHI-10), reflux symptom index, neuropsychiatric symptoms and QoL were assessed by validated scales and questionnaires. RESULTS: Patients' group significantly differed from control group in mild depressive symptoms (4.35 ± 3.9 vs. 1.47 ± 2; p=0.01), insomnia (35.3% vs. 14.7%; p=0.016), smell and taste loss (11.8% vs. 0%; p=0.033), swallowing difficulties (17.6% vs. 0%; p=0.007) and throat pain (17.6% vs. 0%; p=0.007). In the group of SD, there was no correlation between voice perception evaluated by VHI-10, number of NMS or QoL. CONCLUSION: Patients with SD have a greater burden of depressive, smell, taste, and sleep NMS than control subjects.
Subject(s)
Dysphonia/complications , Aged , Aged, 80 and over , Case-Control Studies , Depression/complications , Disorders of Excessive Somnolence/complications , Dysphonia/physiopathology , Dysphonia/psychology , Female , Humans , Male , Middle Aged , Quality of Life , Sensation Disorders/complications , Sleep Initiation and Maintenance Disorders/complications , Surveys and QuestionnairesSubject(s)
COVID-19/therapy , Hospitals, Public/organization & administration , Hospitals, Teaching/organization & administration , Hospitals, Urban/organization & administration , Patient Transfer , Aged , Female , Hospital Bed Capacity , Humans , Male , Middle Aged , Quarantine , SARS-CoV-2 , Severity of Illness Index , SpainABSTRACT
Alternatives to conventional hospitalization are needed to increase health systems resilience in the face of COVID-19 pandemic. Herein, we describe the characteristics and outcomes of 63 patients admitted to a single HaH during the peak of COVID-19 in Barcelona. Our results suggest that HaH seems to be a safe and efficacious alternative to conventional hospitalization for accurately selected patients with COVID-19.
