ISUOG Practice Guidelines: role of ultrasound in screening for and follow-up of pre-eclampsia.

Hypertensive disease of pregnancy affects up to 10% of pregnant women1 and the pooled global incidence of pre-eclampsia (PE) is approximately 3%2. Significant variations between developed and developing countries can be attributed to true differences or differences arising from data acquisition. PE and its complications are a major contributor to maternal and perinatal morbidity and mortality worldwide1, 3. Given that timely and effective care can improve the outcome of PE3, the development of effective prediction and prevention strategies has been a major objective of prenatal care and of research.Full Tex

Diagnosis and treatment of synthetic mid-urethral sling complications

\ua9 2025 The AuthorsBackground and Objective: Synthetic Mid-Urethral Slings (SMUS) have been widely used with benefit to many women. Complications arise in a small proportion, occurring acutely in the perioperative stage, post-operatively and in a delayed fashion many years after implantation. Clinical trials provide data on selected patients who are as homogeneous as possible. Real world studies rarely provide detail on the denominator population from which the sample originates. Mature clinical quality registries (CQR) provide long term data on a non selected population who have undergone a procedure for a given condition. Near complete case ascertainment is the goal and there are many examples in other clinical areas. Due to the serious and potentially life changing nature of some of the complications that may arise following SMUS, health agencies instigated action on behalf of patients to promote improvements in care. Methods and Limitations: The International Continence Society (ICS) assembled a multidisciplinary working group to forge this guidance. The working group includes 2 consumer advocates and relevant medical expertise. The management of complications following SMUS placement is discussed and algorithms are provided for each of the common complications of SMUS. The recommendations are based on an expert consensus derived from experience and limited data from a multiple narrative and systematic reviews of the literature. Due to a retrospective design, low cohort numbers, short follow-up and inconsistent definitions, all the studies were at high risk of bias (Figure 1). Key Findings and Conclusions: This overview of SMUS complications commissioned by the ICS aims to provide background literature and algorithms for management of common problems that may present, though it is not exhaustive. Problems such as recurrent urine infection and overactive bladder may have their root cause in an obstructive SMUS. The temporal link between sling implantation and onset of symptoms is not always evident and patients are not always aware that an SMUS was implanted as part of a pelvic floor procedure. Clinicians need to be assiduous in their history taking and physical examination to determine the likely root cause using imaging or other tests judiciously. Multi-disciplinary teams (MDT) are required particularly where chronic pain has develope

O-RADS US risk stratification and management system: A consensus guideline from the ACR ovarian-adnexal reporting and data system committee.

The Ovarian-Adnexal Reporting and Data System (O-RADS) US risk stratification and management system is designed to provide consistent interpretations, to decrease or eliminate ambiguity in US reports resulting in a higher probability of accuracy in assigning risk of malignancy to ovarian and other adnexal masses, and to provide a management recommendation for each risk category. It was developed by an international multidisciplinary committee sponsored by the American College of Radiology and applies the standardized reporting tool for US based on the 2018 published lexicon of the O-RADS US working group. For risk stratification, the O-RADS US system recommends six categories (O-RADS 0-5), incorporating the range of normal to high risk of malignancy. This unique system represents a collaboration between the pattern-based approach commonly used in North America and the widely used, European-based, algorithmic-style International Ovarian Tumor Analysis (IOTA) Assessment of Different Neoplasias in the Adnexa model system, a risk prediction model that has undergone successful prospective and external validation. The pattern approach relies on a subgroup of the most predictive descriptors in the lexicon based on a retrospective review of evidence prospectively obtained in the IOTA phase 1-3 prospective studies and other supporting studies that assist in differentiating management schemes in a variety of almost certainly benign lesions. With O-RADS US working group consensus, guidelines for management in the different risk categories are proposed. Both systems have been stratified to reach the same risk categories and management strategies regardless of which is initially used. At this time, O-RADS US is the only lexicon and classification system that encompasses all risk categories with their associated management schemes

An investigation into the effect of fabrication parameter variation on the characteristics of screen printed thick film silver/silver chloride reference electrodes

Purpose – the purpose of this paper is to show how the fabrication parameters of screen-printed thick-film reference electrodes have been experimentally varied and their effect on device characteristics investigated.Design/methodology/approach – the tested devices were fabricated as screen-printed planar structures consisting of a silver back contact, a silver/silver chloride interfacial layer and a final salt reservoir layer containing potassium chloride. The fabrication parameters varied included deposition method and thickness, salt concentration and binder type used for the final salt reservoir layer. Characterisation was achieved by monitoring the electrode potentials as a function of time following initial immersion in test fluids in order to ascertain initial hydration times, subsequent electrode drift rates and useful lifetime of the electrodes. Additionally, the effect of fabrication parameter variation on electrode stability and their response time in various test media was also investigated.Findings – results indicate that, although a trade-off exists between hydration times and drift rate that is dependent on device thickness, the initial salt concentration levels and binder type also have a significant bearing on the practical useful lifetime. Generally speaking, thicker devices take longer to hydrate but have longer useful lifetimes in a given range of chloride environments. However, the electrode stability and response time is also influenced by the type of binder material employed for the final salt reservoir layer.Originality/value – the reported results help to explain better the behaviour of thick-film reference electrodes and contribute towards the optimisation of their design and fabrication for use in solid-state chemical senso