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La notion de « droit a l'enfant» est souvent soulevée dans le discours public, bien qu'aucune disposition législative au Québec ne prévoie un tel droit á proprement parler. Notre étude propose une analyse de l'ensemble des développements récents du droit de la famille québécois pour déterminer si un « droit a l'enfant» sous-jacentpeut s'y inférer. De maniere plus particuliere, l'analyse porte sur l'émergencepossible d'un « droit a l'enfant» dans les développements jurisprudentiels et législatifs relatifs á l'adoption, a la procréation assistée et a la gestation pour autrui. Nous tentons de démontrer que la substance du « droit a l'enfant» semble progressivement s 'intégrer par osmose dans le droit de la famille québécois, tant au niveau des développements législatifs que jurisprudentiels, bien que les juristes résistent á le reconnaître comme tel.

Osilodrostat is a novel treatment for adrenocorticotropin-dependent Cushing syndrome; however, its safety during pregnancy has not been reported. This case involves a patient with Cushing disease who became pregnant while on osilodrostat. She was diagnosed at 31 years of age and underwent pituitary tumor removal. After a relapse at 35 years of age, she was initially treated with metyrapone but switched to osilodrostat and hydrocortisone because of nausea, achieving reasonable cortisol control. At 37 years of age, she unknowingly became pregnant despite irregular periods, and the pregnancy was detected at 16 weeks because of ongoing nausea. Osilodrostat was stopped, and she was started on pasireotide and metyrapone. The pregnancy proceeded normally despite elevated urinary free cortisol levels, although she contracted COVID-19 at 25 weeks. At 26 weeks and 1 day, preterm rupture of membranes and breech presentation led to an emergency cesarean section. The newborn had no adrenal insufficiency and developed normally. This case prompts consideration of whether osilodrostat can be used during pregnancy if risks are justified. Pasireotide is rarely used in pregnancy and may have limited effectiveness, but when given, can cause hyperglycemia because of insulin and incretin suppression and should be monitored carefully.

The prepartum rise in cortisol promotes cardiac development and maturation. Here, we investigated the impact of elevated circulating cortisol during mid‐late gestation on cardiac growth and metabolism in fetal sheep. Saline or cortisol (2–3 mg in 4.4 mL/24 h) was infused into the fetal jugular vein from 109 to 116 days gestation (dG, term = 150 dG), and fetal heart tissue was collected at 116 dG. Glucocorticoid concentrations, gene and protein expression were measured in fetal left ventricle (LV) tissue. Intrafetal cortisol infusion increased cardiac cortisol concentration but downregulated the protein abundance of glucocorticoid receptor (GR) isoforms (GRα‐A, GR‐P, GR‐A, GRα‐D2 and GRα‐D3). The gene and protein expression of markers of cardiac hyperplastic growth (IGF1, IGF‐1R, TGFβ and AGT) were downregulated, while a protein marker of DNA replication (proliferating cell nuclear antigen) was upregulated by cortisol infusion. Cardiac protein and/or gene expression of complex I of the electron transport chain, SOD2, GLUT‐4 (gene and protein), and phosphorylated IRS‐1, were upregulated in response to elevated fetal cortisol concentration. Intrafetal cortisol infusion downregulated gene expression of PDK4, which mediates the metabolic switch from glucose to fatty acid metabolism. Cardiac expression of molecular markers involved in cardiovascular protection (SIRT‐1, HO1, LAMP1 and SK1) were also downregulated in the cortisol group. In conclusion, these findings suggest that chronic cortisol exposure in preterm fetuses alters heart development, promoting cardiac maturation and potentially increasing the risk of cardiovascular disease later in life if these changes persist into adulthood. What is the central question of this study? Can elevated fetal cortisol concentration at earlier gestational age impact heart development? What is the main finding and its importance? Excess cortisol exposure in preterm fetuses impacts heart development and may increase the risk of cardiovascular disease later in life if changes persist into adulthood.

Abstract Introduction/Objective Anti Diegoa antibody (DiA) is a rare antibody, associated with severe hemolytic disease of the newborn. It is seen in American Indians and Asians of Mongoloid descent. Only 2.6% of Hispanics and <0.01% of Caucasians and African Americans have this antibody, making it challenging to diagnose. We present a case of a DiA discovered accidentally. Methods/Case Report A 31-year-old G4P3 Hispanic female at 35 weeks 5 days of gestation presented with limited prenatal care and gestation complicated by chronic deep vein thrombosis, on enoxaparin. Her gestational history was significant for Anti-E Antibody (Anti-E) with a gel titer of 1:8 during her second gestation. During her current pregnancy her Anti-E Ab gel titer was 1:32 and an Anti-c Antibody (Anti-c) was also detected. R1R1 panel was used to detect further antibodies since the patient was Anti-E and Anti-c. The initial gel panel could not rule out Duffy Antibody (FyA) and Kidd Antibody (JkB). Two R1R1 panels had already been cross matched and both were compatible. A second gel panel showed Kell antigen (KpA), FyA and JkB, all with a +2 positivity in a R1R1 cell panel (Cell X). Antigen typing labelled the patient as JkB+ and FyA-. One compatible unit was FyB- making FyA- unlikely. One of the cross matched compatible units was FyA+. An additional homozygous R1R1 cell was negative for FyA. Therefore FyA- was ruled out. The positivity on Cell X was then thought to be KpA. A solid phase panel (Cell Y) was conducted and was positive, supporting KpA as the causative factor. A decision was made to repeat our test using the initial patient sample plus a CBC tube. This demonstrated KpA negativity, negating KpA as the causative factor. However the Cell Y positivity in the solid phase panel was still questionable. DiA, a low frequency antibody is also found on this cell. This led to further testing. Another R1R1 cell showed +3 positivity for DiA. Antibody identification confirmed this as DiA with a titer of 2. The patient underwent induction of labor and delivered a healthy neonate. Results (if a Case Study enter NA) N/A Conclusion Since DiA is located in the same panel as KpA, the positive result was presumed to be secondary to KpA. However repeat testing demonstrated KpA negativity and thereby unmasked DiA as the culprit.

OBJECTIVE To look for failed trail of labour after one caesarean section and predicting factors associated with failed labour STUDY DESIGN Comparative Cross-sectional Study SETTING AND DURATION OF STUDY Gynaecology and Obstetrics department Pak Emirates Military Hospital Rawalpindi. From May 2021 to October 2021. METHODS A prospective study was conducted on the women who were booked cases in our department for antenatal checkups and  labour. Those women with history of one caesarean section were recruited for the analysis. They underwent labour in our department and those with failed labour were diagnosed and managed by consultant obstetrician. Relevant clinical factors associated with failed labour among women with one previous caesarean section included in our study. RESULTS A total of 380 women who underwent labour in our hospital with one previous caesarean section were recruited. Mean age of the women included in the study was 34.435±7.361 years. 162 (42.6%) had successful trial of labour while in 218 (57.4%) women trail of labour could not succeed. Statistical analysis revealed that gestation age more than 40 weeks, poor Bishop score (<5) at admission and requirement of labour augmentation (with oxytocin) were found statistically significantly associated with failed trial of labour in our study participants (p-value<0.05). CONCLUSION Failed trial of labour was a common clinical condition in women with one previous caesarean section. Women with gestation age more than 40 weeks, poor bishop score at admission and requiring labour augmentation were more at risk of having failed trial in our study participants.       

Gestational diabetes is defined as hyperglycaemia first detected during pregnancy at glucose concentrations that are less than those of overt diabetes. Around 14% of pregnancies globally are affected by gestational diabetes; its prevalence varies with differences in risk factors and approaches to screening and diagnosis; and it is increasing in parallel with obesity and type 2 diabetes. Gestational diabetes direct costs are US$1·6 billion in the USA alone, largely due to complications including hypertensive disorders, preterm delivery, and neonatal metabolic and respiratory consequences. Between 30% and 70% of gestational diabetes is diagnosed in early pregnancy (ie, early gestational diabetes defined by hyperglycaemia before 20 weeks of gestation). Early gestational diabetes is associated with worse pregnancy outcomes compared with women diagnosed with late gestational diabetes (hyperglycaemia from 24 weeks to 28 weeks of gestation). Randomised controlled trials show benefits of treating gestational diabetes from 24 weeks to 28 weeks of gestation. The WHO 2013 recommendations for diagnosing gestational diabetes (one-step 75 gm 2-h oral glucose tolerance test at 24–28 weeks of gestation) are largely based on the Hyperglycemia and Adverse Pregnancy Outcomes Study, which confirmed the linear association between pregnancy complications and late-pregnancy maternal glycaemia: a phenomenon that has now also been shown in early pregnancy. Recently, the Treatment of Booking Gestational Diabetes Mellitus (TOBOGM) trial showed benefit in diagnosis and treatment of early gestational diabetes for women with risk factors. Given the diabesity epidemic, evidence for gestational diabetes heterogeneity by timing and subtype, and advances in technology, a life course precision medicine approach is urgently needed, using evidence-based prevention, diagnostic, and treatment strategies.

Establishing the gestation period in pregnant dogs is important to minimize neonatal loss and complications. This study aimed to predict the day of parturition using ultrasound to measure the inner chorionic cavity (ICC), biparietal parameter (BP) and crown to rump length (CRL) in 10 pregnant dogs. The measurements were taken once between days 21–34 of gestation. The results were inserted into various formulas to calculate days before parturition (DBP) and compared with actual parturition dates. The ICC measurement, using Luvoni and Grioni’s and Groppetti et al.’s formulas, showed the highest accuracy (94 %). The study enhances methods for predicting parturition in dogs, improving prenatal care and reducing neonatal losses.

We found that the relatively simple microbiota of young infants shifts predictably to a more mature anaerobic microbiota during infancy and the dynamics of this shift are influenced by environmental factors. In this longitudinal study of 75 infants, we demonstrate high interindividual variability within the normal range of birth outcomes, especially in the rate of microbiota progression. Most had acquired a microbiota profile high in Bifidobacterium and Collinsella by 6 months of age, but the time point of this acquisition was later in infants delivered by caesarean section and those born after a shorter duration of gestation. Independently of the delivery mode and gestation duration, infants who acquired a profile high in Bifidobacterium and Collinsella at a later age had lower adiposity at 18 months of age. IMPORTANCE   This study shows that the acquisition of the early microbiota is strongly influenced by environmental factors such as the delivery mode and duration of gestation, even in healthy neonates. The composition of the early microbiota has been linked with long-lasting effects on health and disease. Here we show that the rate of acquisition of certain microbiota predicts adiposity at 18 months of age and so potentially the risk of later obesity. This study shows that the acquisition of the early microbiota is strongly influenced by environmental factors such as the delivery mode and duration of gestation, even in healthy neonates. The composition of the early microbiota has been linked with long-lasting effects on health and disease. Here we show that the rate of acquisition of certain microbiota predicts adiposity at 18 months of age and so potentially the risk of later obesity.

Most good cattle producers will tell you that calving season, whether it be in the spring or fall, should be as close to 60 days long as possible — and certainly no longer than 90 days. Given the gestation period of a cow, I can expect the first calf to be born somewhere around the first day of February, give or take a few days. On Nov. 14 of last year, the first day of deer season, I was in my UTV on the way to my favorite hunting spot.