Search

Objectives: This study aimed to investigate dyssynchronous heart failure in fetuses of mothers with diabetes mellitus (FDM) and fetal controls (FC) using two-dimensional speckle tracking echocardiography (2D-STE) and novel M-mode prototype software (PS)., Methods: In this cohort study 174 fetuses were analyzed, 87 in the FDM-cohort and 87 gestational age-matched fetuses in the FC-cohort. A subgroup of 38 fetuses formed the final case group, with a high median frame rate of approximately 160 frames/s. Using 2D Cardiac Performance Analysis software (TOMTEC, Unterschleissheim, Germany) we measured global longitudinal strain (GLS). TOMTEC PS detected annular displacement by assessing an artificial M-mode on the previously generated tracking. Dyssynchrony (DYS) was calculated as the inter- and intraventricular difference in time to peak GLS or annular displacement., Results: Greater DYS was observed in all basal myocardial measurement sites and software between FDM-cohort compared to FC-cohort and no significant correlation was found between DYS measurements and gestational age. Intraventricular DYS between the basal segments was statistically significant (all p ≤ 0.036, Wald test of univariate regression models). The PS performed best in DYS measurements identifying right ventricular DYS as potentially predicting FDM (FDM: median, 18.5 (interquartile range [IQR], 13.9-25.0) ms vs. FC: median, 2.7 [IQR, 1.5-3.5] ms; p < 0.001)., Conclusion: Increased intraventricular DYS demonstrated an impact of maternal diabetes mellitus on fetal hearts independent of gestational age. The prototype M-mode method identified cardiac dysfunction with higher accuracy than the conventional analysis. High-quality echocardiographic image acquisition is imperative for clinical application of 2D-STE and related advanced technologies., Competing Interests: Conflict of interest Authors and participating institutions have no competing interests., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: The coronavirus disease 2019 (COVID-19) emergency has represented a profound upheaval in the dynamics of infectious diseases transmission worldwide. This phenomenon has been at least in part driven by the introduction of non-pharmaceutical interventions (NPIs), implemented to counteract viral transmission. Our study aimed to assess the magnitude and the features of the impact of the COVID-19 pandemic on the incidence of notifiable infectious diseases (NIDs) in the Lazio region, Italy., Methods: Data on NIDs in the Lazio Region with symptom onset date included in the time interval from 1 January 2017 to 31 December 2023 were collected from different surveillance system databases available at SERESMI/Lazio Region Unit and classified into five categories based on the main transmission route of the disease. Descriptive statistics were performed and interrupted time series (ITS) analysis was used to assess the effect of the COVID-19 pandemic and subsequent recovery period on monthly NIDs cases., Results: Immediately after the start of the COVID-19 pandemic, a significant, sharp and immediate reduction in monthly cases was recorded for all NIDs (-86.73%), regardless of the transmission route. The decrease was particularly significant for vector-borne, food-borne and respiratory-transmitted diseases (RDs), and in general in females. During the COVID-19 recovery phase, monthly cases of all NIDs showed a significant positive level change, particularly significant for sexually transmitted/blood-borne diseases, contact diseases and RDs., Discussion: The COVID-19 pandemic has been responsible for the disruption of all NIDs transmission patterns, while the magnitude and dynamics of its effects varied depending on the transmission route; furthermore, the impact of the pandemic wave was still noticeable during the post-COVID-19 era and the incidence trajectories of NIDs in this phase were peculiar for each disease category., Competing Interests: Declarations. Ethics approval and consent to participate: For studies of this type, approval from an Ethical Committee and formal consent are not required because patients’ information, which are pseudonymized, come from Regional surveillance systems for infectious diseases, all deriving from regulatory provision. For the same reason, the absence of informed consent (and an evaluation by an Ethics Committee) is legitimated by: Regulation (EU) 2016/679; Protection of Personal Data, Authorization 15 December 2016 n. 9/2016; Legislative Decree 10 August 2018, n. 101.” Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Objectives: The aim of this study was to compare the adrenal gland size of fetuses with congenital heart diseases (CHD) and normal fetuses., Methods: In this cross-sectional prospective study we measured the fetal adrenal gland size (total width, cortex width, medulla width, adrenal gland ratio of total width divided by medulla width) in 62 fetuses with CHD and 62 gestational-age-matched controls between 20 + 0 and 39 + 3 weeks of gestation. First, we clustered three CHD subgroups: CHD group&#95;1 with a normal outflow tract (n=7), CHD group&#95;2 with an altered outflow tract and anterograde flow in the ascending aorta (n=39) and CHD group&#95;3 with an altered outflow tract and retrograde flow in the ascending aorta (n=16). In a second step, we summed up all CHD cases with outflow tract anomalies to CHD group&#95;2 + 3 (n=55). Each group was compared to their matched controls., Results: Prenatally, fetuses affected by CHD with outflow tract alterations show an elevated adrenal gland ratio (total width/medulla width) compared to normal fetuses (p<0.001). This finding applies to both subgroups of outflow tract alterations with anterograde (p<0.001) and retrograde perfusion of the ascending aorta (p<0.001)., Conclusions: Fetuses affected by CHD with an altered outflow tract show a relatively larger cortex of the adrenal gland compared to normal fetuses. The results of this study suggest that haemodynamic changes during fetal maturation cause an elevated metabolic stress level that may be responsible for an enlarged adrenal gland ratio., (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)