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Neonatal and General paediatric Surgery
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
The presence of blood in the stool is an alarming symptom, which is promptly brought to the attention of the doctor. It is important to determine the nature and quantity of blood loss and to search for additional physical signs such as hypovolaemic shock, anaemia or bilious vomiting. Swallowed maternal blood may lead to the appearance of blood in the vomitus or in the stool. To differentiate between maternal and fetal blood, the Apt test is used. Mixing the material with sodium hydroxide will colour adult haemoglobin brown while fetal haemoglobin remains pink.
Placental Disorders
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Daniele Di Mascio, Francesco D’Antonio
TVU with color Doppler is the standard for the diagnosis of vasa previa (Figure 29.6). Women with risk factors that are judged to increase their risk of vasa previa (low-lying placenta, or previa, velamentous cord insertion, succenturiate or bilobed placenta, and multiple gestations) should be screened with TVU for this condition, usually at the time of the 20-week anatomy ultrasound or in general when these ultrasound diagnoses are made (Table 29.5). Vasa previa is diagnosed if a vessel is visualized over the cervix with color Doppler demonstrating a rhythm consistent with the fetal heart rate. The American Institute of Ultrasound in Medicine (AIUM) and ACOG recommend that the placental cord insertion site be documented whenever technically possible [69]. A recent systematic review showed a high accuracy of TVU color Doppler (median detection rate of 93% and specificity of 99%), but also noted that the quality of the available studies was relatively poor [70]. Thus, not all vasa previa will be detected prenatally, even by adequate examinations and experienced operators using color Doppler. Women whose vasa previa has been diagnosed prenatally have been reported to have lower perinatal mortality than those with vasa previas that are undiagnosed (3% versus 56%) [71]. The Apt test may be used to distinguish between fetal and maternal sources of vaginal bleeding, although this test may be of little use in many clinical situations with bleeding from a vasa previa, as bleeding can lead to rapid deterioration of the fetal status and require urgent delivery before an Apt test can be completed.
Effects of total sleep deprivation on execution lapses during vigilance tasks
Published in Chronobiology International, 2022
Jingqiang Li, Yanru Zhou, Xining Zhang, Qingfu Wang, Lu Zhang
Each experiment was conducted with 5–8 participants at a time, and a total of 28 hours for each subject were conducted. The experiment was completed over seven sessions, during which participants were forbidden to engage in activities that could interfere with their arousal state, such as having intense conversation, playing games, sports, and so on. They were allowed to read the books provided to them, complete their assignments, and do simple puzzles during intervals per hour of testing. The laboratory’s ambient temperature was controlled at 24 ± 1°C, and the illumination level was set to 70–100 Lux (Roenneberg and Foster 1997; Tosini et al. 2010). Participants were provided with water and food such as fruit juices, skimmed milk, whole-wheat bread, chicken breasts, and beef patties. The basal metabolic rate and resting energy expenditure were calculated according to the FAO/WHO/UNU formula, the Mifflin formula, and their sex, age, height, and weight (Alfonzo-González et al. 2004; Amatruda et al. 1993; Buchanan et al. 2001). They were used as the standard to guide participants in the amount of food during the experiment. All volunteers experienced TSD of 30 hours (7:00 to +12:00), with testing being conducted from 8:00 to +11:00. Note that the hour value with a “+” sign means the next day. The participants completed the KSS and AD-ACL once an hour; the APT test was administered next, on the hour every hour, and lasted approximately 25 minutes. There were two volunteers in each experiment who wore the fNIRS hood every two hours (starting at 9:00, 14 times each person). fNIRS was continuously monitored during the resting state (five minutes before the task) and the APT. This study was approved by the Ethics Review Committee of the Safety Science and Engineering College of the Civil Aviation University of China (CAUC-PSY-2021-012).
Clinical feasibility of auditory processing tests in Japanese older adults: a pilot study
Published in Acta Oto-Laryngologica, 2019
Shohei Fujimoto, Yukihide Maeda, Chie Obuchi, Yasue Uchida, Tsuneo Harashima, Kazunori Nishizaki
The present study showed that it is feasible to administer Japanese APT tests to older adults in otolaryngology clinics. Of our Japanese APT test battery, FST may be one auditory test that is suitable for administration in large-scale clinical studies in the future.