Hasil untuk "Medicine (General)"

Rui-Fang Lu, Chao-Yin She, Dan-Ni He et al.

Abstract Hepatocellular carcinoma (HCC) ultrasound screening encounters challenges related to accuracy and the workload of radiologists. This retrospective, multicenter study assessed four artificial intelligence (AI) enhanced strategies using 21,934 liver ultrasound images from 11,960 patients to improve HCC ultrasound screening accuracy and reduce radiologist workload. UniMatch was used for lesion detection and LivNet for classification, trained on 17,913 images. Among the strategies tested, Strategy 4, which combined AI for initial detection and radiologist evaluation of negative cases in both detection and classification phases, outperformed others. It not only matched the high sensitivity of original algorithm (0.956 vs. 0.991) but also improved specificity (0.787 vs. 0.698), reduced radiologist workload by 54.5%, and decreased both recall and false positive rates. This approach demonstrates a successful model of human-AI collaboration, not only enhancing clinical outcomes but also mitigating unnecessary patient anxiety and system burden by minimizing recalls and false positives.

Benjamin M. Moy, Hanna K. Bertucci, Betelehem Lemma et al.

ABSTRACT Regadenoson, a selective adenosine A2A receptor agonist, is widely used as a stress agent for myocardial perfusion imaging. A2A receptor activation has been implicated in migraines due to its pro‐nociceptive effects within trigeminal pain pathways. This case report discusses a 67‐year‐old female with headache, sudden onset unilateral weakness, and paresthesias after undergoing a PET‐CT for ischemic evaluation. Subsequent lab and imaging studies were unconcerning for acute stroke or seizure, raising suspicion for hemiplegic migraine given her extensive neurologic history and rapid onset of symptoms. Regadenoson may be associated with hemodynamic instability and lowering of the seizure threshold. Patients should be screened for neurologic risk factors prior to receiving regadenoson to determine if alternate modalities for ischemic evaluation are more suitable.

Levent Gülüm, Süheyla Esin Köksal, Emrah Güler et al.

The objective of this study was to evaluate the physicochemical, bioactive, and technological properties of pasta made from durum wheat semolina that was partially replaced with Acorn flour at levels of 10%, 20%, and 30%. The incorporation of Acorn flour had a substantial impact on the nutritional composition of the pasta, resulting in increases in total phenolic content (TPC), total flavonoid content (TFC), and antioxidant capacity in comparison with the control sample. The highest values for TPC and TFC were found in the samples containing 20% and 30% Acorn flour (p<0.05), demonstrating the functional potential of this formulation. However, an increase in the quantity of Acorn flour used in the pasta production process resulted in a noticeable darkening of the pasta's colour. This observation is consistent with the findings of previous research conducted on the use of non-traditional flours. While the increased amounts of Acorn flour resulted in enhanced nutritional and antioxidant profiles, the darker appearance and alterations in texture may have implications for sensory and visual acceptability. The present findings are corroborated by extant literature, which demonstrates that functional flours such as buckwheat, chickpea, lentil, chia, and sorghum have exhibited analogous trends in enhancing bioactive compounds and altering technological properties. Incorporation of Acorn flour at levels ranging from 10% to 20% optimises the health benefits of pasta while maintaining its desirable sensory and structural characteristics. Presented research contributes to the valorization of non-wood forest product (NWFP) resources and the development of innovative functional pasta products using sustainable ingredients.

Usamah Usamah, Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo Regional General Hospital, Surabaya, Indonesia, Christrijogo Sumartono et al.

Mulata Haile Nega, Derbew Fikadu Berhe, Vera Ribeiro

Abstract Background Statin-induced myopathy is reported to be associated with the solute carrier organic anion transporter family member 1B1 gene single nucleotide polymorphism, c.521 T > C. There is no epidemiologic data on this gene polymorphism in several countries. Therefore, this study aimed at assessing the genotype and allele frequencies of the gene variant in three countries. Methods This study involved healthy individuals from Colombia, Mozambique, and Portugal. Genomic DNA was isolated from blood samples using the Qiamp DNA Extraction Kit (Qiagen). The isolated DNA was genotyped using novel Polymerase Chain Reaction—Restriction Fragment Length Polymorphism. Microstat and GraphPad QuickCal software were used for the Chi-square test and the evaluation of Hardy–Weinberg equilibrium respectively. Results A total of 181 individuals’ blood samples were analyzed. Overall, the TT (74.0%) genotype was the highest and the CC (7.8%) was the lowest. Country wise genotypic frequencies were Colombia 47(70.2%) TT, 12(17.9%) TC and 8(11.9%) CC; Mozambique 47(88.7%) TT, 5(9.4%) TC, and 1(1.9%) CC; and Portugal 40(65.6%) TT, 16(26.2%) TC, and 5(8.2%) CC. The reference (T) allele was highest among Mozambicans (93.4%) compared to Colombians (79.1%) and Portuguese (78.7%). Mozambicans showed statistically significant genotypic and allelic frequency differences compared to Colombians (p < 0.01) and Portuguese (p < 0.01). Conclusions Overall and country-wise, CC genotype was less frequent and it is relatively high for Colombians and Portuguese populations. This finding may imply statins risk–benefit variability associated with CC genotype among these populations that needs further understanding.

Hasan Pasalari, Angila Ataei-Pirkooh, Mitra Gholami et al.

The surveillance of wastewater treatment plant (WWTP) as the end point of SARS-CoV-2 shed from infected people arise a speculation on transmission of this virus of concern from WWTP in epidemic period. To this end, the present study was developed to comprehensively investigate the presence of SARS-CoV-2 in raw wastewater, effluent and air inhaled by workers and employee in the largest WWTP in Tehran for one-year study period. The monthly raw wastewater, effluent and air samples of WWTP were taken and the SARS-CoV-2 RNA were detected using QIAamp Viral RNA Mini Kit and real-time RT-PCR assay. According to results, the speculation on the presence of SARS-CoV-2 was proved in WWTP by detection this virus in raw wastewater. However, no SARS-CoV-2 was found in both effluent and air of WWTP; this presents the low or no infection for workers and employee in WWTP. Furthermore, further research are needed for detection the SARS-CoV-2 in solid and biomass produced from WWTP processes due to flaks formation, followed by sedimentation in order to better understand the wastewater-based epidemiology and preventive measurement for other epidemics probably encountered in the future.

Hendrik Schawe, Mariano G. Beiró, J. Ignacio Alvarez-Hamelin et al.

Abstract We study the dynamics of interactions between a traditional medium, the New York Times journal, and its followers in Twitter, using a massive dataset. It consists of the metadata of the articles published by the journal during the first year of the COVID-19 pandemic, and the posts published in Twitter by a large set of followers of the @nytimes account along with those published by a set of followers of several other media of different kind. The dynamics of discussions held in Twitter by exclusive followers of a medium show a strong dependence on the medium they follow: the followers of @FoxNews show the highest similarity to each other and a strong differentiation of interests with the general group. Our results also reveal the difference in the attention payed to U.S. presidential elections by the journal and by its followers, and show that the topic related to the “Black Lives Matter” movement started in Twitter, and was addressed later by the journal.

Sung-Un Park, Hyunkyun Ahn, Wi-Young So

The coronavirus disease 2019 (COVID-19) pandemic has prompted the implementation of social distancing policies worldwide, limiting participation in exercise and substantially impacting health behaviors. In accordance with the theory of planned behavior (TPB), the present study aimed to develop a model for predicting the intent to participate in exercise and engage in health behaviors among Korean men using the perception of COVID-19 risk as an exogenous variable. We analyzed data obtained from 374 Korean men who had completed a 32-item, online questionnaire. Structural equation modeling was performed to evaluate the effect of attitudes, subjective norms, and perceived behavioral control (PBC) on the intention to participate in exercise and health behaviors using COVID-19 risk perception as an antecedent variable. COVID-19 risk perception exerted significant negative effects on the attitude toward exercise participation (β = −0.857, p < 0.001), subjective norms associated with exercise participation (β = −0.862, p < 0.001), and PBC related to exercise (β = −0.738, p < 0.001). In addition, both attitude (β = 0.213, p < 0.001) and subjective norms (β = 0.168, p = 0.001) exerted significant effects on the intention to participate in exercise. PBC also exerted significant effects on the intention to participate in exercise (β = 0.580, p < 0.001) and health behaviors (β = 0.461, p < 0.001). Lastly, the intention to participate in exercise exerted a significant effect on health behaviors (β = 0.400, p < 0.001). The data indicated that, among TPB variables, PBC exerted the greatest influence on the intention to participate in exercise and had a significant effect on engagement in health behaviors. The current findings support TPB as an important theoretical model for predicting the intention to participate in exercise and patterns of health behavior among Korean men during the COVID-19 pandemic. Our study also highlights the importance of addressing PBC when designing interventions to promote exercise participation and health behaviors among Korean men.

Said Abdirahman Ahmed, MD, Mesut Karataş, MD, Lütfi Öcal, MD et al.

Spontaneous coronary artery dissection is described as the intramural bleeding that separates the layers of an epicardial coronary artery wall, either with or without an intimal tear. Atherosclerosis, iatrogenic damage, or trauma are not linked to this syndrome. Here we present a 28-year-old male with 1 month history stroke but no any chronic disease as well family history of heart disease who presented with 2 days' duration of typical cardiac chest pain. Based on an emergency electrocardiogram that showed biphasic T-wave inversion with ST-elevation myocardial infarction, the patient was taken to the a  catheterization laboratory(cath-lab), with the result of spontaneous coronary artery dissection of the left anterior dissenting artery with thrombolysis in myocardial infarction flow grade 0 and normal of other vessels. Then we successfully did angioplasty, and the patient was discharged with aspirin 100 mg 1 × 1, clopidogrel 75 mg 1 × 1, and rivaroxaban 20 mg 1 × 1.

Samantha Halman, Laura Marcotte, Michelle Elizov et al.

Defining General Internal Medicine (GIM) has been difficult due to the tension between ensuring flexibility for varied environments and the need for national standards. With the launch of competency-based medical education, the Royal College of Physicians and Surgeons of Canada Specialty Committee in GIM (SCGIM) (national standard-setting body) had the opportunity to explicitly define the discipline via elaboration of the GIM competencies and Entrustable Professional Activities (EPAs). Defining the EPAs is the essence of defining the tasks of the discipline. We describe our SCGIM approach to the continuous review of the theoretical written documentation around EPAs in the “real world environment” in order to continuously refine the EPAs and ensure they are facilitating skill attainment. Major lessons learned (1) centralized feedback with simple reporting and multiple input is best; (2) there is tension between theory (perfect EPAs) and practical implementation; (3) it takes time to see how the EPAs are performing.

Qian YANG, Yifan ZHANG, Zhichao HAN et al.

BackgroundEnvironmental pollutants can affect N6-methyladenosine (m6A) level in the body, but the change of m6A level in kidney after being exposed to cadmium (Cd) and the molecular mechanism of renal injury need to be further studied. ObjectiveTo analyze the associations of m6A modification and methyltransferases/demethylases with microRNA-21 (miR-21) and transforming growth factor- β1 (TGF - β1) in kidney of rats exposed to Cd. MethodsTwenty-four SPF male SD rats were divided into 4 groups, with 6 rats in each group, and were exposed to Cd by subcutaneous injection of 2.0, 1.0, and 0.5 mg·kg−1 cadmium chloride (CdCl2) and equal volume of normal saline for 2 weeks, 7 d a week, respectively. The levels of N-acetyl-β-D-glucosidase (UNAG) and albumin (UALB) in urine, and the levels of m6A methylation and TGF-β1 in kidney were detected by enzyme-linked immunosorbent assay (ELISA). The level of blood urea nitrogen (BUN) was measured by urease method. The levels of renal oxidative stress indicators such as malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) were detected by total bile acid method, water-soluble tetrazolium asssay, and colorimetric method respectively. The relative levels of TGF-β1, methyltransferases, and demethylases in kidney were measured by reverse transcription-polymerase chain reaction. The expression of miR-21 in kidney was detected by fluorescent quantitative polymerase chain reaction. ResultsAfter 2 weeks of exposure to Cd, the body weights of rats in the 2.0 and 1.0 mg·kg−1 cadmium chloride groups decreased, and the ratio of kidney/body weight and the levels of BUN, UNAG, and TGF-β1 mRNA and protein increased in the 2.0 mg·kg−1 cadmium chloride group (P<0.05). The expression levels of m6A modification, methyltransferases METTL3, METTL14, Wilms’ tumor 1-associated protein (WTAP), and miR-21 were increased both in the 2.0 and 1.0 mg·kg−1 cadmium chloride groups, with significant differences compared with the control group (P<0.05). The results of correlation analysis showed that the m6A modification level was negatively correlated with SOD (r=−0.4489, P<0.05) and GSH-Px (r=−0.4874, P<0.05), METTL3 was negatively correlated with MDA (r=−0.5158, P<0.05), while there was a positive correlation between FTO and GSH-Px (r=0.4802, P<0.05). In addition, miR-21 was positively correlated with METTL3 (r=0.7491), METTL14 (r=0.6157), and WTAP (r=0.6660) (P<0.05), TGF-β1 was positively correlated with METTL3 (r=0.5025, P<0.05) but negatively correlated with FTO (r=−0.5634, P<0.05) . ConclusionCd can induce m6A methylation and up-regulation of METTL3, METTL14, WTAP, and miR-21 expression levels in rat kidney tissues, indicating that m6A and miR-21 may be associated with Cd-induced renal fibrosis.

Zihan Chang, Fen Xie, Hualing Li et al.

ObjectiveThis study intended to investigate whether retinal nerve fiber layer (RNFL) thickness could become a potential marker in patients with Parkinson’s disease with cognitive impairment (PD-CI).MethodsFifty-seven PD patients and 45 age-matched healthy controls (HCs) were recruited in our cross-sectional study and completed optical coherence tomography (OCT) evaluations. PD with normal cognition (PD-NC) and cognitive impairment (PD-CI) patients were divided following the 2015 Movement Disorder Society criteria. RNFL thickness was quantified in subfields of the 3.0-mm circle surrounding the optic disk; while a battery of neuropsychiatric assessments was conducted to estimate the Parkinsonism severity. General linear models and one-way ANOVA were adopted to assess RNFL thickness between subgroups with different cognitive statuses; logistic regression analyses were applied to determine the relation between RNFL and PD-CI cases.ResultsCompared with HCs, more thinning of the RNFL was observed in the inferior and temporal sectors in PD patients, especially in the PD-CI group. Inferior RNFL thickness was reduced in PD-CI compared with PD-NC patients. Logistic regression analysis found that inferior RNFL thickness was independently associated with PD-CI cases (odds ratio = 0.923, p = 0.014). Receiver operating characteristic analysis showed that the RNFL-involved combined model provided a high accuracy in screening cognitive deficiency in PD cases (area under the curve = 0.85, p &lt; 0.001).ConclusionReduced RNFL thickness especially in the inferior sector is independently associated with PD-CI patients. Our study present new perspectives into verifying possible indicators for neuropathological processes or disease severity in Parkinsonians with cognitive dysfunction.

Ian A Clark, Siawoosh Mohammadi, Martina F Callaghan et al.

Conduction velocity is the speed at which electrical signals travel along axons and is a crucial determinant of neural communication. Inferences about conduction velocity can now be made in vivo in humans using a measure called the magnetic resonance (MR) g-ratio. This is the ratio of the inner axon diameter relative to that of the axon plus the myelin sheath that encases it. Here, in the first application to cognition, we found that variations in MR g-ratio, and by inference conduction velocity, of the parahippocampal cingulum bundle were associated with autobiographical memory recall ability in 217 healthy adults. This tract connects the hippocampus with a range of other brain areas. We further observed that the association seemed to be with inner axon diameter rather than myelin content. The extent to which neurites were coherently organised within the parahippocampal cingulum bundle was also linked with autobiographical memory recall ability. Moreover, these findings were specific to autobiographical memory recall and were not apparent for laboratory-based memory tests. Our results offer a new perspective on individual differences in autobiographical memory recall ability, highlighting the possible influence of specific white matter microstructure features on conduction velocity when recalling detailed memories of real-life past experiences.

Zahra Abdelmalek, M. Zubair Akbar Qureshi, S. Bilal et al.

The consolidation power of different nanomaterials such as metallic nanoparticles and metallic-oxides nanoparticles in a new-fangled and energetic hybrid material should give rise to fascinating properties that combine the advantages of each of the nanocomponents. In this paper, developed an MHD-hybrid model for the thermal energy system with seven different types of nanoparticles. For this purpose, we simulate the thermal conductivity and viscosity hybridized nanocomponents modeled based on the shape and size factor of each nanoparticle. The effect of morphology for Metallic and non-Metallic nanoparticles on flow and heat transfer rate has been investigated through hybrid nanofluids flow. Mathematical modeling of the concerning problem is done in the form of the partial differential structure under the boundary layer theory. The intrinsic features of capitalized induced particles along with base fluid are presented by empirical relations and utilized during the formulation of work. These hybrid nanofluids flow passing through the two orthogonal moving up/down porous disks. Thermal enhancement performance is analyzed through variation of shape and size of the nanoparticles with convective conditions. A stable system of nonlinear differential equations is obtained by applying suitable transformation on governing partial differential equations. Consequences of pertinent parameters on axial velocity, radial velocity, tangential velocity, and temperature distribution are elaborated. Important results of non-dimensional parameters with different types of hybrid nanofluids are examined through porous orthogonal disks. We achieved that the carbon nanomaterial has significant results on thermal performance. Novel results are obtained on thermal conductivity and viscosity associated with the shape/size of the nanoparticles. Shear stress increases with the increase of values of MHD. For the injection case, the Nusselt number shows significant results. If we increase the size of the nanoparticles then Skin friction also increases. This research set a strong foundation in the field of nano-biomedical devices, and engineering nanotechnology oriented electronic computers.

Münevver Yılmaz, Ayse Berna Anil, Murat Anil et al.

Objective: The aim of this study is to determine the clinical signs of traumatic brain injury and its long-term effects on prognosis by evaluating the clinical and radiological findings of the patients admitted to the pediatric emergency department due to blunt head trauma. Method: The cases who applied to the pediatric emergency department due to head trauma were examined prospectively. Glaskow Coma (GCS) and Pediatric Trauma Scores (PTS) were calculated. The patients were evaluated neurologically 6 months after they were discharged. Results: A total of 707 pediatric patients [mean age: 59.8 +- 42.6 months; range: 1 month to 13 years; 263 (37.2%) girls] were evaluated prospectively. Pathology was detected in 101 cases (45.9%) [(epidural hematoma, 14; subdural hematoma, 11; brain edema, 36; intracerebral hematoma, 6; subarachnoid hemorrhage, 8; cerebral contusion, 22. Seventy-two (10.1%) patients had skull fractures.] Seventeen cases (2.4%) were operated, and 7 (1.4%) cases were lost. In children aged &lt; 2 years vomiting, tachypnea, focal neurological findings, multitrauma, GCS &lt;15 and low PTS were more common with traumatic brain injury (p &lt;0.05). Vomiting, GCS &lt;15 and low PTS were more common in children &gt;2 years old and with traumatic brain injury (p &lt;0.05). Neurological sequelae were not detected in patients aged &lt;2 years with mild trauma. Loss of consciousness, pulse rate, respiratory and blood pressure abnormalities, focal neurological findings, low GCS and PTS were more common in children aged &gt;2 years and with neurological sequelae (p &lt;0.05). Conclusion: Physical examination findings, GCS, and PTS levels are useful tools in predicting the short- and long-term consequences of the injury.

Gonzalo R. Tortella, Amedea B. Seabra, Jorge Padrão et al.

The COVID-19 pandemic has had a negative impact on education. The restrictions imposed have undoubtedly led to impairment of the psychological well-being of both teachers and students, and of the way they experience interpersonal relationships. As reported previously in the literature, adverse effects such as loneliness, anxiety, and stress have resulted in a decrease in the cognitive performance of school and higher education students. Therefore, the objective of this work is to present a general overview of the reported adverse effects of the COVID-19 pandemic which may potentially influence the learning performance of students. Some neuroscientific findings related to memory and cognition, such as neuroplasticity and long-term potentiation, are also shown. We also discuss the positive effects of the practice of mindfulness, as well as other simple recommendations based on neuroscientific findings such as restful sleep, physical activity, and nutrition, which can act on memory and cognition. Finally, we propose some practical recommendations on how to achieve more effective student learning in the context of the pandemic. The aim of this review is to provide some assistance in this changing and uncertain situation in which we all find ourselves, and we hope that some of the information could serve as a starting point for hypotheses to be tested in educational research and their association with neuroscience.

Andrew Moses, Willy Weng, Ani Orchanian-Cheff et al.

Point-of-care ultrasound (POCUS) is an important tool for diagnosis and management across medical specialties. This scoping review consolidates POCUS education literature, examining how curricula are developed, implemented, and assessed. We identify literature gaps, explore directions for further research, and provide recommendations for curriculum development, implementation, and improvement. Methods We conducted a scoping review per the framework outlined by Arksey & O’Malley. A systematic search of the MEDLINE, EMBASE, Cochrane, ERIC, Web of Science, and Scopus databases was conducted to identify published, English language literature, on POCUS education in undergraduate or graduate medical training. Results Of 6,164 articles identified, 421 were analyzed in depth. Curricular content included diverse diagnostic and therapeutic applications, varying significantly by specialty. Teaching modalities included in-person didactics (74%), human models (58%), simulation (33%), and web-based didactics (18%). Several studies showed better outcomes for structured vs. apprenticeship curricula, hands-on teaching vs. didactic lectures, and human models vs. simulators. Web-based didactics were as effective as in-person didactics and conveyed benefits in reusability, cost, and instructor time. Dedicated electives and boot-camps were identified as effective. Few curricula assessed knowledge retention (5%), clinical decision making (3%), learner behavior (12%), or patient outcomes (6%). Conclusion Scholarly POCUS education literature is expanding. Curricular content varies and should be tailored to specialty needs. Structured curricula utilizing hands-on learning, electives, and bootcamps can enhance educational outcomes. Higher-level outcomes such as knowledge retention, clinical decision making, learner behavior, and patient outcomes, are lacking and should be a focus of further research

Inka Toman, Pamela Mathura, Narmin Kassam

Background The American and Canadian Choosing Wisely campaigns recommend against routine complete blood count (CBC) and chemistry testing in the face of clinical stability in the inpatient internal medicine setting. Problem Patients on internal medicine units commonly have daily lab tests ordered at admission and lab testing is often bundled. Four ‘core’ lab tests (CBC, electrolytes, creatinine, and urea) account for more than half of all lab tests performed. Methods The Model for Improvement and the Donabedian framework was used to define the problem, evaluate the baseline state, and generate targeted improvements. A quality improvement (QI) initiative consisting of education and process change was implemented on one general internal medicine unit and multiple plan-do-study-act cycles were carried out. The outcome measure was the total number of core labs performed, and the process measure was the proportion of patients with tests ordered on a repeating daily basis. Results The initiative led to an 18.9% decrease in the total number of core labs ordered and an 18.2% absolute decrease in repeating daily lab orders. Conclusions A multifaceted QI initiative aimed at reducing unnecessary lab testing was successful at reducing the number of lab tests ordered and changing lab ordering process.

Olufemi Opeyemi Ogundiran, Elvis Agbonlahor, Kayode Israel Oke et al.

BACKGROUND: Work-related musculoskeletal pain (WMSP) is a common symptom associated with work-related musculoskeletal disorders. It is aggravated by poor lifting techniques, inappropriate ergonomics, repetitive movements and awkward posture during the course of performing one’s duties. Variables such as age, marital status, work experience, alcohol, smoking and exercise habits have been found to play major roles in WMSP prevalence among different categories of workers. OBJECTIVES: This study focused on the lifetime, 12-month and point prevalence of WMSP in association with the socio-demographics, lifestyle and work-related characteristics of brewery workers in Osun state, Southwest, Nigeria. METHOD: A descriptive research design was utilized, and a total of eighty-nine (89) participants were recruited with strict adherence to the inclusion criteria. A 28-item questionnaire was developed to obtain specific information on the prevalence and pattern of WMSP, while anthropometric measurements (weight and height) of each participant were measured. Collected data were organized and analyzed using descriptive statistics and Chi square test. RESULTS: The lifetime, 12-month and point prevalence of WMSP among the participants were 96.6%, 93.3%, and 57.3% respectively. The low back was the mostly affected body region. Significant associations exist between each of the lifetime, 12-month and point prevalence of WMSP and participants' marital status. Furthermore, a significant association exists between the point prevalence of WMSP and participants’ age. CONCLUSION: It was concluded that there was a high prevalence of WMSP among brewery workers in Osun state, Southwest, Nigeria.

Wen-Wei Hsu, Chia-Jung Hsieh, Chien-Nan Lee et al.

Purpose: To assess the complication rates following chorionic villus sampling (CVS) and midtrimester amniocentesis in Taiwan. Methods: This is a national registry-based cohort study from Taiwan. We included all women with singleton pregnancies who received either CVS (n = 1409) or midtrimester amniocentesis (n = 250,566) during 2006–2012. We assessed preterm premature rupture of membranes (PPROM), intrauterine fetal demise (IUFD), infection and spontaneous abortion (SA) that occurred within fourteen days after the procedures. We also assessed the risks of preterm delivery and miscarriage before 24 gestational weeks after amniocentesis. These complications were collected from the Genetic Disease Database of the Ministry of Health and Welfare, Taiwan National Birth Certificate Registry, and the Taiwan National Health Insurance Database. Pearson χ2 tests were used to compare the distributions between groups. Results: For patients who underwent midtrimester amniocentesis, the rates of PPROM, IUFD, infection and SA within fourteen days were 0.24%, 0.11%, 0.05%, and 0.05%, respectively. Women with a normal fetal karyotype had a preterm birth rate (<37 gestational weeks) of 9.38%. The miscarriage rate (<24 gestational weeks) was 0.68%, which was 0.22% higher than those who did not receive the invasive procedures (p < 0.0001). After CVS, the IUFD rate was 1.68%, and the SA rate within fourteen days was 0.77%. Conclusion: The use of our large cohort demonstrated that the procedure-related complication rates were comparable to recent review or meta-analysis. This dataset might facilitate counselling in women who consider invasive genetic diagnostic procedures. Keywords: Amniocentesis, Chorionic villus sampling, Infection, Miscarriage, Preterm premature rupture of membranes