The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) in December 2019 form Wuhan, China leads to coronavirus disease 2019 (COVID-19) pandemic. While the common cold symptoms are observed in mild cases, COVID-19 is accompanied by multiorgan failure in severe patients. The involvement of different organs in severe patients results in lengthening the hospitalization duration and increasing the mortality rate. In this review, we aimed to investigate the involvement of different organs in COVID-19 patients, particularly in severe cases. Also, we tried to define the potential underlying mechanisms of SARS-CoV2 induced multiorgan failure. The multi-organ dysfunction is characterized by acute lung failure, acute liver failure, acute kidney injury, cardiovascular disease, and as well as a wide spectrum of hematological abnormalities and neurological disorders. The most important mechanisms are related to the direct and indirect pathogenic features of SARS-CoV2. Although the presence of angiotensin-converting enzyme 2, a receptor of SARS-CoV2 in the lung, heart, kidney, testis, liver, lymphocytes, and nervous system was confirmed, there are controversial findings to about the observation of SARS-CoV2 RNA in these organs. Moreover, the organ failure may be induced by the cytokine storm, a result of increased levels of inflammatory mediators, endothelial dysfunction, coagulation abnormalities, and infiltration of inflammatory cells into the organs. Therefore, further investigations are needed to detect the exact mechanisms of pathogenesis. Since the involvement of several organs in COVID-19 patients is important for clinicians, increasing their knowledge may help to improve the outcomes and decrease the rate of mortality and morbidity.

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Enteric duplication cysts are rare congenital malformations that are most commonly diagnosed in children. Enteric duplications associated with the pancreas are especially uncommon, and may present with specific clinical findings such as severe pancreatitis. These cysts often pose unique surgical challenges. In addition, the diagnosis of pancreatic duplication cysts is often difficult, and may be confused with pancreatic pseudocysts or neoplasms. Herein we report two cases of pancreatic duplication cysts, and present a complete tabulation of all case reports of pancreatic-associated duplication cysts reported in the English literature. We conclude that pancreatic duplication cysts are a rare entity, most commonly found to occur in infants and children. We further find that although severe complications may arise as a result of their presentation and treatment, the rate of post-operative complications in patients between 3 and 21 years of age is extremely low, with the highest complication rate occurring in a bimodal distribution (\3-years and [21-years of age). Despite complications in the youngest and older patient populations, surgical excision remains the mainstay of therapy for pancreatic duplication cysts in all age groups.

Objective: Exposure to maternal obesity in utero predisposes offspring to obesity and metabolic disease. This study investigated whether maternal obesity is associated with alterations in expression of fetal microRNA (miRNA). Study Design: A cohort study of women with body mass index (BMI) !35 kg/m 2 (n ¼ 16) versus those with normal BMI 20 to 24.9 (n ¼ 20) was performed. All participants had normal glucose tolerance (1-hour glucose challenge test <130) and normally grown neonates (2700-3500 g). Umbilical cord samples were collected immediately after delivery. Expression of miRNA was assessed using Affymetrix GeneChip miRNA 3.0 Arrays. Differential miRNA expression was determined using Student t tests with Benjamini-Hocherg correction. Results: For 1733 human mature miRNAs, the expression levels were not statistically different in umbilical cord blood samples from pregnancies of obese women compared to controls. Conclusion: Expression of fetal miRNA is not altered in umbilical cord blood in response to in utero exposure to obesity. Alternate mechanisms underlying the fetal effects of maternal obesity should be explored.

BACKGROUND: Despite considerate debate, the best method of diagnosing gestational diabetes mellitus remains unknown. A commonly used method of gestational diabetes mellitus screening in the United States is the 2-step method, which includes screening with a 50-gram, 1hour glucose challenge followed by a 100-gram, 3-hour diagnostic oral glucose tolerance test. The International Association of Diabetes and Pregnancy Study Group has recommended the 1-step method using a 75gram, 2-hour oral glucose tolerance test. The International Association of Diabetes and Pregnancy Study Group thresholds have been predicted to increase the rates of gestational diabetes mellitus, yet little is known about the effect on pregnancy outcomes, especially in the United States. OBJECTIVE: This study aimed to determine whether adoption of the 1step method of gestational diabetes mellitus screening leads to improved obstetrical outcomes at a single academic institution. STUDY DESIGN: This is a retrospective cohort study of patients who delivered before and after a switch from the 2-step method to the 1-step International Association of Diabetes and Pregnancy Study Group method in July 2015. Women with a due date of January 1, 2012 through October 1, 2015 were diagnosed with gestational diabetes mellitus using the 2step method with Carpenter and Coustan criteria. After a 6-month transition period, outcomes from women with a due date of May 1, 2016 through February 1, 2018, when the 1-step International Association of Diabetes and Pregnancy Study Group criteria were used to diagnose gestational diabetes mellitus, were evaluated. Women with gestational diabetes mellitus were managed similarly throughout the study period. The primary outcome was the incidence of primary cesarean delivery. Maternal and neonatal outcomes were compared using chi-square and t tests, and multivariable logistic regression was used to control for changes in the population. RESULTS: With the adoption of the International Association of Diabetes and Pregnancy Study Group method, the rates of gestational diabetes mellitus more than doubled, to 23.3% from 9.2% (P<.001). The rates of primary cesarean delivery increased with the International Association of Diabetes and Pregnancy Study Group criteria (22.2% vs 19.4%, P¼.001), and the incidence of shoulder dystocia was not significantly different (1.1% vs 0.8%, P¼.07). The rate of preeclampsia decreased during the time the 1-step method was in use (8.2% vs 10.9%, P<.001). The rate of macrosomia was not different using a definition of !4500 g (0.99% vs 0.86%, P¼.5) but was reduced when using a definition of !4000 g (8.0% vs 6.0%, P<.001). The rate of neonatal intensive care unit admission did not change significantly. Controlling for maternal age, body mass index, race or ethnicity, chronic hypertension, and parity, the adjusted odds of a diagnosis of gestational diabetes mellitus increased 3-fold (adjusted odds ratio, 3.3; 95% confidence interval, 2.90e3.66) with 1-step testing, the adjusted odds of a shoulder dystocia incr...

Multiparous women are less likely to accept this strategy of PTB prevention. A standardized counseling approach may improve patient acceptance and mitigate variability in acceptance rates observed amongst sonographers.

Objectives: The purpose of this study is investigating curcumin role in mood alterations in male rats after spinal cord injury through focusing on the involvement of NLRP3 inflammasome. Methods: Fourteen  adualt male Wistar rats (220–250 g) were divided to five animal groups (n = 8 per group): Control: healthy animals which  received normal saline for 14 days; spinal cord injury: spinal cord injury-induced animals which received normal saline for 14 days; spinal cord injury + curcumin (20, 40, and 80 mg/kg/ i.p): spinal cord injury-induced animals treated with 3 doses of curcumin for 14 days. To assess the mood of animals, the elevated plus maze test, forced swimming test, tail suspension test, and open field test were performed. Graph-pad prism software was used for data analysis. Statistical analysis was done by one-way ANOVA with Tukey’s post hoc test. P < 0.05 was statistically significant. Results: Treatment with curcumin with two doses of 40 and 80 mg/kg increased open arm time and decreased close arm time as compared to the spinal cord injury group. The administration of curcumin (40 mg/kg and 80 mg/kg) enhanced the altered behaviors. Spinal cord injury caused an increase in the protein levels NLRP3, ASC and Casp1 in the hippocampus of animals as compared to the sham group. Curcumin regulated the protein levels of NLRP3, ASC and Casp1 in the hippocampus of animals. Conclusion: Depression is prevalent in person with spinal cord injury and our findings indicated that curcumin appears to constitute a suitable agent to reduce neuroinflammation and through it, relieve a depressive-like state.

Providers were 5.9 times more likely to order the recommended testing for GDM women who attended the postpartum visit in the post-DMC period. GDM women who receive prenatal care in a specialized diabetes in pregnancy program are more likely to complete the 2HrOGTT in the postpartum period.