Paediatric cataracts are one of the more common ocular abnormalities that occur in approximately 6 in 10,000 infants and are a major cause of childhood blindness. A suggested pathological mechanism for congenital cataract formation is the abnormal arrangement of lens fibres during embryogenesis. While toxins, chromosomal abnormalities, infections and metabolic disorders account for the majority of the cases, up to 87% of unilateral cataracts remain idiopathic, making disease prevention an ongoing challenge. Early diagnosis and timely referral to ensure effective genetic counselling and postnatal follow‐up is paramount to prevent long‐term visual consequences. We describe three cases of congenital cataracts with incongruence in antenatal ultrasound findings and postnatal results. Improvement over time in the diagnostic sensitivity of ultrasound allows for early diagnosis of congenital cataracts, yet there is little published evidence regarding the sensitivity and specificity of ultrasound as a diagnostic modality. As congenital cataracts have significant long‐term implications if left untreated, such as loss of visual capacity and amblyopia, a targeted ultrasound survey should be performed at morphology scans, with a special focus on the orbital region. This should be extended to those with a significant family history of fetal eye abnormalities and severe malformations. Given the high proportion of idiopathic congenital cataracts, the scope of developing other preventative strategies is limited. Early and accurate diagnosis in the antenatal period may be feasible, by thorough examination of the eyes to detect ocular anomalies, especially in high‐risk individuals.
ObjectiveTo evaluate the role of multiparametric magnetic resonance imaging (mpMRI) and Gallium‐68 (68Ga)‐prostate‐specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) in guiding salvage therapy for patients with biochemical recurrence (BCR) post‐radical prostatectomy.Patients and MethodsPatients were evaluated with paired mpMRI and 68Ga‐PSMA PET/CT scans for BCR (prostate‐specific antigen [PSA] >0.2 ng/mL). Patient, tumour, PSA and imaging characteristics were analysed with descriptive statistics.ResultsA total of 117 patients underwent paired scans to investigate BCR, of whom 53.0% (62/117) had detectable lesions on initial scans and 47.0% (55/117) did not. Of those without detectable lesions, 8/55 patients proceeded to immediate salvage radiotherapy (sRT) and 47/55 were observed. Of patients with negative imaging who were initially observed, 46.8% (22/47) did not reach threshold for repeat imaging, while 53.2% were rescanned due to rising PSA levels. Of these rescanned patients, 31.9% (15/47) were spared sRT due to proven distant disease, or due to absence of disease on repeat imaging. Of the original 117 patients, 53 (45.3%) were spared early sRT due to absence of disease on imaging or presence of distant disease, while those undergoing delayed sRT still maintained good PSA responses. Of note, patients with high‐risk features who underwent sRT despite negative imaging demonstrated satisfactory PSA responses to sRT. Study limitations include the observational design and absence of cause‐specific or overall survival data.ConclusionOur findings support the use of mpMRI and 68Ga‐PSMA PET/CT in guiding timing and necessity of salvage therapy tailored to detected lesions, with potential to reduce unnecessary sRT‐related morbidity. Larger or randomized trials are warranted to validate this.
Virtual poster abstracts Objectives: Maternal hemodynamics, in particular cardiac output (CO), are assuming importance in the management and investigation of women with fetal growth restriction (FGR) and pre-eclampsia (PET). However, there are many different techniques. We compared two different methods (gas rebreathing and bio-impedance) in this study of maternal hemodynamics during study of women undergoing in vitro fertilisation (IVF) treatment. Methods: This was an observational, prospective longitudinal study. 74 women were recruited from those registered to commence IVF treatment at The Wolfson Fertility Centre, Hammersmith Hospital, between August 2018 and December 2019. Inclusion criteria were women aged 18-44yrs, with no pre-existing cardiac morbidity or any chronic conditions who were having either a fresh or frozen IVF cycle. Four time points during IVF treatment were selected to measure CO. The Innocor ® , is an inert gas re-breathing device and the NICaS ® uses whole body bio-impedance as a method of measuring CO. Neither have been validated in women undergoing IVF. CO measurements taken from both devices at the single time points were compared using the Bland-Altman analysis. Longitudinal changes in CO using both devices were compared using a 4-quadrant plot. Results: A total of 113 measurements of CO from 44 recruits were suitable for Bland-Altman analysis. The mean CO for Innocor ® was 4.6L/min and for NICaS ® was 5.05L/min. The bias was 0.44 L/min, with a percentage error of 76% and the intraclass correlation coefficient (ICC) was 0.135 (95%CI-0.43 to 0.306). 61 measurements of CO from 28 participants were suitable for longitudinal analysis of the comparability of the two devices using a 4-quadrant plot. Longitudinal concordance was found to 59%. Conclusions: These outcomes do not support the interchangeable use of the NICaS ® and Innocor ® when measuring CO. Though this study was peformed in women undergoing IVF, its results are likely to be generalisable in women undergoing pregnancy. VP64.16 Effect of two-dimensional ultrasound and colour Doppler of endometrium on pregnancy outcome in IUI cycle
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