FANH in children at the EOL is an acceptable form of palliation for some parents and may contribute to a death that is perceived to be peaceful and comfortable. In situations in which FANH may be a reasonable possibility, physicians should be prepared to introduce the option.

Hospitals with access to newborns' inpatient and postdischarge data can use our benchmarking model to compare their management of hyperbilirubinemia with a reference population that received rigorous care.

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There is incomplete overlap between racial identification in medical records versus self-report. Given 1 choice, mothers of multiracial infants overselect black in their newborns' ancestry. Because black race is the lowest risk category for neonatal hyperbilirubinemia, this may lead to underestimating their risk.

The objective of this case is to report the highly unusual occurrence of uterine metastasis from a papillary thyroid cancer (PTC). PTC is rarely associated with distant metastases and typically spreads to bone or pulmonary tissue. In this case a 69-year-old female presented with post menopausal bleeding (PMB). She was otherwise well with no significant medical history or regular medications and reported no family history of thyroid disease. A subsequent endometrial polyp was identified as the cause of her PMB and removed. In addition as part of her clinical examination a goitre was noted and radiological imaging (including an ultrasound, magnetic resonance imaging of the neck and computer tomography of thorax, abdomen and pelvis) was performed and demonstrated a large thyroid mass which extended retrosternally and caused tracheal narrowing. The remainder of the imaging was unremarkable. The endometrial biopsy demonstrated morphological features of PTC. BRAF V600 mutation was not detected. A subsequent core biopsy of the mediastinal mass displayed morphological and immunohistochemical characteristic similar to that of the endometrial polyp. In combination this confirmed a diagnosis of primary papillary thyroid carcinoma. Surgical treatment included a total thyroidectomy, sternotomy and left neck dissection. Lymph node involvement was demonstrated at levels II-VI. Despite radioactive iodine and the use of tyrosine kinase inhibitors this lady died from complications of her disease.

To develop a core outcome set (COS) for randomised controlled trials (RCTs) evaluating the effectiveness of interventions for the treatment of pregnant women with pregestational diabetes mellitus (PGDM). DesignA consensus developmental study. SettingInternational. PopulationTwo hundred and five stakeholders completed the first round. MethodsThe study consisted of three components. 1) A systematic review of the literature to produce a list of outcomes reported in RCTs assessing the effectiveness of interventions for the treatment of pregnant women with PGDM. 2) A three-round, online eDelphi survey to prioritise these outcomes by international stakeholders (including healthcare professionals, researchers and women with PGDM). 3) A consensus meeting where stakeholders from each group decided on the final COS. ResultsWe extracted 131 unique outcomes from 67 records meeting the full inclusion criteria. Of the 205 stakeholders who completed the first round, 174/205 (85%) and 165/174 (95%) completed round 2 and 3, respectively. Participants at the subsequent consensus meeting chose 19 outcomes for inclusion into the COS: trimester specific HbA1c, maternal weight gain during pregnancy, severe maternal hypoglycaemia, diabetic ketoacidosis, miscarriage, pregnancy induced hypertension, pre- Accepted ArticleThis article is protected by copyright. All rights reserved eclampsia, maternal death, birth weight, large for gestational age, small for gestational age, gestational age at birth, preterm birth, mode of birth, shoulder dystocia, neonatal hypoglycaemia, congenital malformations, stillbirth and neonatal death. ConclusionsThis COS will enable better comparison between RCTs to produce robust evidence synthesis, improve trial reporting and optimise research efficiency in studies assessing treatment of pregnant women with PGDM.Tweetable abstract 165 key stakeholders have developed #Treatment #CoreOutcomes in pregnant women with #diabetes existing before pregnancy * Outcome suggested by more than one participant in round 1.

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