The correlation of corneal SBN density with total neuropathy score suggests that reduced corneal nerve density reflects peripheral neuropathy in diabetes. Corneal SBN changes precede other clinical and electrophysiology tests of neuropathy supporting a possible role for corneal IVCM and corneal sensitivity testing as surrogate markers in the assessment of diabetic peripheral and cardiac autonomic neuropathy.

BackgroundThe importance of maternal sleep and its contribution to maternal and fetal health during pregnancy is increasingly being recognised. However, the ability to accurately recall sleep practices during pregnancy has been questioned. The aim of this study is to test the accuracy of recall of normal sleep practices in late pregnancy.MethodsThirty healthy women between 35 and 38 weeks of gestation underwent level III respiratory polysomnography (PSG) with infrared digital video recordings in their own homes. Data regarding sleep positions, number of times getting out of bed during the night and respiratory measures were collected. A sleep questionnaire was administered the morning after the recorded sleep. Continuous data were assessed using Spearman’s Rho and Bland-Altman. Cohen’s Kappa was used to assess recall in the categorical variables.ResultsTwo-thirds of participants went to sleep on their left side. There was good agreement in sleep onset position between video and questionnaire data (Kappa 0.52), however the there was poor agreement on position on wakening (Kappa 0.24). The number of times getting out of bed during the night was accurately recalled (Kappa 0.65). Twenty five out of 30 participants snored as recorded by PSG. Questionnaire data was inaccurate for this measure. Bland-Altman plots demonstrated acceptable agreement between video and questionnaire data for estimated sleep duration, but not the time taken to fall asleep (sleep latency). One participant had mild obstructive sleep apnoea and another probable high upper airways resistance.ConclusionsSleep onset position, sleep duration and the number of times getting out of bed during the night were accurately recalled, but sleep latency and sleep position on waking were not. This study identifies the sleep variables that can be accurately obtained by questionnaire and those that cannot.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-016-0905-0) contains supplementary material, which is available to authorized users.

Surfactant deficiency in premature neonates is a major factor in the development of respiratory distress syndrome (RDS), which is still a significant cause of mortality and morbidity. The aim of this study was to test a noninvasive method of administering surfactant as treatment for RDS. The animal model used was the premature neonatal rabbit of 27-d gestation (full-term being 31 d) primed with an initial oropharyngeal dose of surfactant. The animals were divided into three groups that received either no supplemental surfactant (n = 20), undried nebulized surfactant (n = 21), or dried nebulized surfactant (n = 24). Drying of the surfactant solution was undertaken to create a hygroscopic aerosol that would facilitate surfactant deposition in the lower respiratory tract. The group treated with dried surfactant aerosol showed superior survival (66.7%) and less evidence of RDS. The control and undried aerosol groups each had similar low survival rates (23.8 and 45.0%, respectively). The results indicate that a dried, hygroscopic aerosol is an effective means of administration of surfactant to spontaneously breathing premature rabbit neonates.

BackgroundAssessment of stroke volume (SV) is often necessary in clinical and research settings. The clinically established method for SV assessment in pregnancy is echocardiography, but given its limitations, it is not always an appropriate measurement tool. Thoracic impedance cardiography (ICG) allows continuous, non-invasive SV assessment. However, SV determination relies on assumptions regarding the thoracic shape that may mean the algorithm is not valid in pregnancy. The available data regarding the validity of ICG against an established reference standard using modern SV algorithms are both limited and conflicting. We aimed to test the validity of ICG in a clinically realistic setting in late pregnancy using echocardiography.MethodsTwenty-nine women in late pregnancy underwent standard echocardiography assessments with simultaneous ICG measurement. Agreement between devices was tested using Bland-Altman analysis.ResultsBland-Altman analysis of the relationship between ICG and echocardiography demonstrated that the 95% limits of agreement exceeded acceptable or expected ranges. Measures of maternal and fetal anthropometry do not account for the lack of agreement.ConclusionsAbsolute values of SV as determined by ICG are not valid in pregnancy. Further work is required to examine the ability of ICG to assess relative changes in maternal haemodynamics in late pregnancy.