Gestational age specific values of amniotic fluid index should be used and the 5th and 95th percentiles taken as lower and upper limits of normal, respectively.

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BackgroundNecrotizing enterocolitis (NEC) is a severe inflammatory bowel disease that may lead to perforation, causing high morbidity and mortality in preterm infants. Abdominal ultrasound (AUS) has been shown to provide benefits in diagnosing and managing NEC in recent years.ObjectiveThis study focused on the utility of AUS in the diagnosis and evaluation of surgical NEC.Patients and methodsIn this retrospective study, available data of the patients diagnosed from January 2019 to June 2022 were reviewed. The sensitivity and specificity of AUS in diagnosing a perforation were analyzed. Typical cases for the application of AUS in monitoring and evaluating the progression, complications, and sequela of NEC were described.ResultsThere were 69 neonates diagnosed with NEC and examined by AUS, of whom eight patients developed a perforation. AUS was used for diagnosing a perforation in eight patients with key features of pneumoperitoneum and/or complex ascites, allowing us to find four locations of perforation, with a sensitivity and specificity of 100%.ConclusionAUS plays an important role in diagnosing and evaluating surgical NEC in newborn infants, with good sensitivity and specificity.

Background: For patients with breast cancer undergoing neoadjuvant systemic treatment (NST) the optimal timing of sentinel node biopsy (SLNB) is unclear. While adequate axillary staging prior to NST could allow for a-priori tailoring of systemic treatment, SLNB after NST could spare those patients from complete axillary dissection (AD), who are free of metastases in the axilla or convert from a positive (Npos) to a negative (Nneg) axillary status following NST. For these patients, however, the reliability of SLNB to predict the axillary status remains yet to be prospectively confirmed.Material and Methods: The German SENTINA protocol, as a substudy of the German Geparquinto neoadjuvant trial of the AGO and the German Breast Group (GBG), is a 4-arm prospective multicenter case control study designed to examine the role of SLN in patients undergoing NST.Study design:Arm A before NST: clinically Nneg + negative SLN --> no add. Axillary surgery Arm B before NST: clinically Nneg + positive SLN --> sentinel-node-guided AD after NST Arm C before NST: clinically Npos, after NST: clinically Nneg --> sentinel-node-guided AD after NST Arm D before NST: clinically Npos, after NST: clinically Npos --> ADStudy objectives:1. to compare the detection rate of SLNB before and after NST2. to evaluate the number of patients with involved nodes despite being clinically Nneg before NST3. to determine the number of patients who convert from clinically Npos to histologically Nneg after NST4. to evaluate the false-negative rate of SNB for patients who convert from clinically Npos to histologically SNneg after NST5. to determine lymphatic pathway configuration, detection rate and false-negative rate of SLNB after prior SLNB6. to determine the false negative rate of intraoperative frozen section before and after NSTResults: Until now 366 patients from 30 institutions have been enrolled in this trial. 230 patients have completed primary systemic and surgical treatment. A total of 1508 patients were calculated as adequate to have the one-sided confidence interval of 95 % for the false negative rate of SLNB in the arms B and C not exceeding 10% (196 pts each). 82 pts entered arm A. Fifty-eight, 76 and 24 pts were recruited for the arms B, C and D respectively.Conclusion: To our knowledge the SENTINA trial is the first prospective multicenter study to evaluate the role of SLNB in the neoadjuvant setting. The SENTINA protocol will allow for a direct comparison of the feasibility and reproducibility of a standardized SLNB-procedure before and after NST. The study will provide reliable data on the predictive value of SLNB before and after NST in patients converting from a clinically positive to a negative axillary status and offer insights into the biology of axillary response to NST. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1008.