Dermoscopic findings were consistent with a melanocytic lesion and a scoop shave biopsy revealed a 2.7 mm thick nodular melanoma.

Melanoma is the most lethal skin cancer in the United States. The likelihood of metastatic spread to lymph nodes statistically increases beyond a probability of 5% when patients have primary lesions thicker than 0.8 mm.¹ Thus, for patients with tumors thicker than 0.8 mm, or some other high-risk features such as high mitotic index, a sentinel lymph node biopsy (SLNB) is recommended. This patient underwent wide local excision and reconstruction of his ear. An SLNB was also performed and the results were negative.

The patient returned for a complete skin exam every 3 months. Ten months after the excision, he presented with episodes of headache and confusion. Magnetic resonance imaging revealed metastasis to the brain; a biopsy confirmed that it was melanoma. Two months later, after attempts at resection of the brain metastasis, the patient died.

This case demonstrates that patients with thick melanoma are at continued risk for recurrence and poor outcomes; they benefit from close surveillance and work-up of unusual symptoms that might suggest metastases. Phase 3 trials are currently underway to consider the use of adjuvant therapy in patients with advanced stage II melanoma who, on average, have worse outcomes than patients with early-stage III disease.²

‌

Text courtesy of Jonathan Karnes, MD, medical director, MDFMR Dermatology Services, Augusta, ME. Photos courtesy of Jonathan Karnes, MD (copyright retained).

Dermoscopic findings were consistent with a melanocytic lesion and a scoop shave biopsy revealed a 2.7 mm thick nodular melanoma.

Melanoma is the most lethal skin cancer in the United States. The likelihood of metastatic spread to lymph nodes statistically increases beyond a probability of 5% when patients have primary lesions thicker than 0.8 mm.¹ Thus, for patients with tumors thicker than 0.8 mm, or some other high-risk features such as high mitotic index, a sentinel lymph node biopsy (SLNB) is recommended. This patient underwent wide local excision and reconstruction of his ear. An SLNB was also performed and the results were negative.

The patient returned for a complete skin exam every 3 months. Ten months after the excision, he presented with episodes of headache and confusion. Magnetic resonance imaging revealed metastasis to the brain; a biopsy confirmed that it was melanoma. Two months later, after attempts at resection of the brain metastasis, the patient died.

This case demonstrates that patients with thick melanoma are at continued risk for recurrence and poor outcomes; they benefit from close surveillance and work-up of unusual symptoms that might suggest metastases. Phase 3 trials are currently underway to consider the use of adjuvant therapy in patients with advanced stage II melanoma who, on average, have worse outcomes than patients with early-stage III disease.²

‌

Text courtesy of Jonathan Karnes, MD, medical director, MDFMR Dermatology Services, Augusta, ME. Photos courtesy of Jonathan Karnes, MD (copyright retained).

Dermoscopic findings were consistent with a melanocytic lesion and a scoop shave biopsy revealed a 2.7 mm thick nodular melanoma.

Melanoma is the most lethal skin cancer in the United States. The likelihood of metastatic spread to lymph nodes statistically increases beyond a probability of 5% when patients have primary lesions thicker than 0.8 mm.¹ Thus, for patients with tumors thicker than 0.8 mm, or some other high-risk features such as high mitotic index, a sentinel lymph node biopsy (SLNB) is recommended. This patient underwent wide local excision and reconstruction of his ear. An SLNB was also performed and the results were negative.

The patient returned for a complete skin exam every 3 months. Ten months after the excision, he presented with episodes of headache and confusion. Magnetic resonance imaging revealed metastasis to the brain; a biopsy confirmed that it was melanoma. Two months later, after attempts at resection of the brain metastasis, the patient died.

This case demonstrates that patients with thick melanoma are at continued risk for recurrence and poor outcomes; they benefit from close surveillance and work-up of unusual symptoms that might suggest metastases. Phase 3 trials are currently underway to consider the use of adjuvant therapy in patients with advanced stage II melanoma who, on average, have worse outcomes than patients with early-stage III disease.²

‌

Text courtesy of Jonathan Karnes, MD, medical director, MDFMR Dermatology Services, Augusta, ME. Photos courtesy of Jonathan Karnes, MD (copyright retained).

Real-World Experience With Automated Insulin Pumps

Continuous Blood Glucose Monitoring for T2DM

Statin-Induced Adverse Effects

Long QT and Cardiac Arrest After Pulmonary Edema

And more online

• Clinical Impact of U-500 Insulin Initiation

• Diabetes Self-Management Education

• SGLT2 Inhibitors, T2DM, and Heart Failure

• Alirocumab Use in Statin-Intolerant Veterans

• K Pneumoniae-Induced Aortitis

Read now 

Real-World Experience With Automated Insulin Pumps

Continuous Blood Glucose Monitoring for T2DM

Statin-Induced Adverse Effects

Long QT and Cardiac Arrest After Pulmonary Edema

And more online

• Clinical Impact of U-500 Insulin Initiation

• Diabetes Self-Management Education

• SGLT2 Inhibitors, T2DM, and Heart Failure

• Alirocumab Use in Statin-Intolerant Veterans

• K Pneumoniae-Induced Aortitis

Read now 

Real-World Experience With Automated Insulin Pumps

Continuous Blood Glucose Monitoring for T2DM

Statin-Induced Adverse Effects

Long QT and Cardiac Arrest After Pulmonary Edema

And more online

• Clinical Impact of U-500 Insulin Initiation

• Diabetes Self-Management Education

• SGLT2 Inhibitors, T2DM, and Heart Failure

• Alirocumab Use in Statin-Intolerant Veterans

• K Pneumoniae-Induced Aortitis

Read now 

This supplement will teach you about the 6 pillars of Lifestyle Medicine, looks at the future of Lifestyle Medicine, demonstrates the power of Lifestyle Medicine as evidence-based treatment of chronic disease, and describes how you can incorporate Lifestyle Medicine into your practice.

Click here to access this content now 

This supplement will teach you about the 6 pillars of Lifestyle Medicine, looks at the future of Lifestyle Medicine, demonstrates the power of Lifestyle Medicine as evidence-based treatment of chronic disease, and describes how you can incorporate Lifestyle Medicine into your practice.

Click here to access this content now 

This supplement will teach you about the 6 pillars of Lifestyle Medicine, looks at the future of Lifestyle Medicine, demonstrates the power of Lifestyle Medicine as evidence-based treatment of chronic disease, and describes how you can incorporate Lifestyle Medicine into your practice.

Click here to access this content now 

One of the unexpected consequences of the pandemic is that many people are rethinking their priorities and lifestyles, and physicians are no exception.

This year’s Medscape Physician Lifestyle and Happiness Report surveyed more than 10,000 physicians in 29 specialties about how they are prioritizing wellness, work-life balance, and their family lives during this challenging time.

Pets, prayer, and partners

The pandemic has taken a toll on physicians outside of work as well as on the job. Eight in 10 physicians (82% of men and 80% of women) said they were “somewhat” or “very” happy outside of work before the pandemic. This is almost exactly the same result as in last year’s survey.

However, when asked how happy they are outside of work currently, only 6 in 10 (59%) reported being “somewhat” or “very” happy. While the pandemic has made life difficult for everyone, health care professionals face particular stresses even outside of work. Wayne M. Sotile, PhD, founder of the Center for Physician Resilience, says he has counseled doctors who witnessed COVID-related suffering and death at work, then came home to a partner who didn’t believe that the pandemic was real.

Still, physicians reported that spending time with people they love and engaging in favorite activities helps them stay happy. “Spending time with pets” and “religious practice/prayer” were frequent “other” responses to the question, “What do you do to maintain happiness and mental health?” Seven in 10 physicians reported having some kind of religious or spiritual beliefs.

The majority of physicians (83%) are either married or living with a partner, with male physicians edging out their female peers (89% vs. 75%). Among married physicians, 8 in 10 physicians reported that their union is “good” or “very good.” The pandemic may have helped in this respect. Dr. Sotile says he’s heard physicians say that they’ve connected more with their families in the past 18 months. Specialists with the highest rates of happy marriages were otolaryngologists and immunologists (both 91%), followed closely by dermatologists, rheumatologists, and nephrologists (all 90%).

Among physicians balancing a medical career and parenthood, female physicians reported feeling conflicted more often than males (48% vs. 29%). Nicole A. Sparks, MD, an ob.gyn. and a health and lifestyle blogger, cites not being there for her kids as a source of stress. She notes that her two young children notice when she’s not there to help with homework, read bedtime stories, or make their dinner. “Mom guilt can definitely set in if I have to miss important events,” she says.

Work-life balance is an important, if elusive, goal for physicians, and not just females. Sixty percent of female doctors and 53% of male doctors said they would be willing to take a cut in pay if it meant more free time and a better work-life balance. Many doctors do manage to get away from work occasionally, with one-fifth of all physicians taking 5 or more weeks of vacation each year.

Seeking a ‘balanced life’

Alexis Polles, MD, medical director for the Professionals Resource Network, points out the importance of taking time for personal health and wellness. “When we work with professionals who have problems with mental health or substance abuse, they often don’t have a balanced life,” she says. “They are usually in a workaholic mindset and disregard their own needs.”

Few physicians seem to prioritize self-care, with a third indicating they “always” or “most of the time” spend enough time on their own health and wellness. But of those who do, males (38%) are more likely than females (27%) to spend enough time on their own health and wellness. Dr. Polles adds that exercising after a shift can help physicians better make the transition from professional to personal life. Though they did not report when they exercised, about a third of physicians reported doing so four or more times per week. Controlling weight is an issue as well, with 49% of male and 55% of female physicians saying they are currently trying to lose weight.

Of physicians who drink alcohol, about a third have three or more drinks per week. (The CDC defines “heavy drinking” as consuming 15 drinks or more per week for men and eight drinks or more per week for women.)

Of those surveyed, 92% say they do not regularly use cannabidiol or cannabis, and a mere 4% of respondents said they would use at least one of these substances if they were to become legal in their state.

A version of this article first appeared on Medscape.com.

One of the unexpected consequences of the pandemic is that many people are rethinking their priorities and lifestyles, and physicians are no exception.

This year’s Medscape Physician Lifestyle and Happiness Report surveyed more than 10,000 physicians in 29 specialties about how they are prioritizing wellness, work-life balance, and their family lives during this challenging time.

Pets, prayer, and partners

The pandemic has taken a toll on physicians outside of work as well as on the job. Eight in 10 physicians (82% of men and 80% of women) said they were “somewhat” or “very” happy outside of work before the pandemic. This is almost exactly the same result as in last year’s survey.

However, when asked how happy they are outside of work currently, only 6 in 10 (59%) reported being “somewhat” or “very” happy. While the pandemic has made life difficult for everyone, health care professionals face particular stresses even outside of work. Wayne M. Sotile, PhD, founder of the Center for Physician Resilience, says he has counseled doctors who witnessed COVID-related suffering and death at work, then came home to a partner who didn’t believe that the pandemic was real.

Still, physicians reported that spending time with people they love and engaging in favorite activities helps them stay happy. “Spending time with pets” and “religious practice/prayer” were frequent “other” responses to the question, “What do you do to maintain happiness and mental health?” Seven in 10 physicians reported having some kind of religious or spiritual beliefs.

The majority of physicians (83%) are either married or living with a partner, with male physicians edging out their female peers (89% vs. 75%). Among married physicians, 8 in 10 physicians reported that their union is “good” or “very good.” The pandemic may have helped in this respect. Dr. Sotile says he’s heard physicians say that they’ve connected more with their families in the past 18 months. Specialists with the highest rates of happy marriages were otolaryngologists and immunologists (both 91%), followed closely by dermatologists, rheumatologists, and nephrologists (all 90%).

Among physicians balancing a medical career and parenthood, female physicians reported feeling conflicted more often than males (48% vs. 29%). Nicole A. Sparks, MD, an ob.gyn. and a health and lifestyle blogger, cites not being there for her kids as a source of stress. She notes that her two young children notice when she’s not there to help with homework, read bedtime stories, or make their dinner. “Mom guilt can definitely set in if I have to miss important events,” she says.

Work-life balance is an important, if elusive, goal for physicians, and not just females. Sixty percent of female doctors and 53% of male doctors said they would be willing to take a cut in pay if it meant more free time and a better work-life balance. Many doctors do manage to get away from work occasionally, with one-fifth of all physicians taking 5 or more weeks of vacation each year.

Seeking a ‘balanced life’

Alexis Polles, MD, medical director for the Professionals Resource Network, points out the importance of taking time for personal health and wellness. “When we work with professionals who have problems with mental health or substance abuse, they often don’t have a balanced life,” she says. “They are usually in a workaholic mindset and disregard their own needs.”

Few physicians seem to prioritize self-care, with a third indicating they “always” or “most of the time” spend enough time on their own health and wellness. But of those who do, males (38%) are more likely than females (27%) to spend enough time on their own health and wellness. Dr. Polles adds that exercising after a shift can help physicians better make the transition from professional to personal life. Though they did not report when they exercised, about a third of physicians reported doing so four or more times per week. Controlling weight is an issue as well, with 49% of male and 55% of female physicians saying they are currently trying to lose weight.

Of physicians who drink alcohol, about a third have three or more drinks per week. (The CDC defines “heavy drinking” as consuming 15 drinks or more per week for men and eight drinks or more per week for women.)

Of those surveyed, 92% say they do not regularly use cannabidiol or cannabis, and a mere 4% of respondents said they would use at least one of these substances if they were to become legal in their state.

A version of this article first appeared on Medscape.com.

One of the unexpected consequences of the pandemic is that many people are rethinking their priorities and lifestyles, and physicians are no exception.

This year’s Medscape Physician Lifestyle and Happiness Report surveyed more than 10,000 physicians in 29 specialties about how they are prioritizing wellness, work-life balance, and their family lives during this challenging time.

Pets, prayer, and partners

The pandemic has taken a toll on physicians outside of work as well as on the job. Eight in 10 physicians (82% of men and 80% of women) said they were “somewhat” or “very” happy outside of work before the pandemic. This is almost exactly the same result as in last year’s survey.

However, when asked how happy they are outside of work currently, only 6 in 10 (59%) reported being “somewhat” or “very” happy. While the pandemic has made life difficult for everyone, health care professionals face particular stresses even outside of work. Wayne M. Sotile, PhD, founder of the Center for Physician Resilience, says he has counseled doctors who witnessed COVID-related suffering and death at work, then came home to a partner who didn’t believe that the pandemic was real.

Still, physicians reported that spending time with people they love and engaging in favorite activities helps them stay happy. “Spending time with pets” and “religious practice/prayer” were frequent “other” responses to the question, “What do you do to maintain happiness and mental health?” Seven in 10 physicians reported having some kind of religious or spiritual beliefs.

The majority of physicians (83%) are either married or living with a partner, with male physicians edging out their female peers (89% vs. 75%). Among married physicians, 8 in 10 physicians reported that their union is “good” or “very good.” The pandemic may have helped in this respect. Dr. Sotile says he’s heard physicians say that they’ve connected more with their families in the past 18 months. Specialists with the highest rates of happy marriages were otolaryngologists and immunologists (both 91%), followed closely by dermatologists, rheumatologists, and nephrologists (all 90%).

Among physicians balancing a medical career and parenthood, female physicians reported feeling conflicted more often than males (48% vs. 29%). Nicole A. Sparks, MD, an ob.gyn. and a health and lifestyle blogger, cites not being there for her kids as a source of stress. She notes that her two young children notice when she’s not there to help with homework, read bedtime stories, or make their dinner. “Mom guilt can definitely set in if I have to miss important events,” she says.

Work-life balance is an important, if elusive, goal for physicians, and not just females. Sixty percent of female doctors and 53% of male doctors said they would be willing to take a cut in pay if it meant more free time and a better work-life balance. Many doctors do manage to get away from work occasionally, with one-fifth of all physicians taking 5 or more weeks of vacation each year.

Seeking a ‘balanced life’

Alexis Polles, MD, medical director for the Professionals Resource Network, points out the importance of taking time for personal health and wellness. “When we work with professionals who have problems with mental health or substance abuse, they often don’t have a balanced life,” she says. “They are usually in a workaholic mindset and disregard their own needs.”

Few physicians seem to prioritize self-care, with a third indicating they “always” or “most of the time” spend enough time on their own health and wellness. But of those who do, males (38%) are more likely than females (27%) to spend enough time on their own health and wellness. Dr. Polles adds that exercising after a shift can help physicians better make the transition from professional to personal life. Though they did not report when they exercised, about a third of physicians reported doing so four or more times per week. Controlling weight is an issue as well, with 49% of male and 55% of female physicians saying they are currently trying to lose weight.

Of physicians who drink alcohol, about a third have three or more drinks per week. (The CDC defines “heavy drinking” as consuming 15 drinks or more per week for men and eight drinks or more per week for women.)

Of those surveyed, 92% say they do not regularly use cannabidiol or cannabis, and a mere 4% of respondents said they would use at least one of these substances if they were to become legal in their state.

A version of this article first appeared on Medscape.com.

Key clinical point: A pregnancy-specific questionnaire to perform risk factor-based screening for elevated lead levels during pregnancy identified parturients with elevated blood lead levels with good sensitivity but poor specificity.

Major finding: Almost 78% of participants reported at least 1 risk factor for lead, with the questionnaire showing high sensitivity (100%) but low specificity (22%) for identifying detectable maternal lead levels. The blood lead level was clinically reportable in 2.2% of participants, with 1 of them having a blood lead level above 5 μg/dL.

Study details: Findings are from an analysis of 92 parturients with a singleton pregnancy ≥34 weeks’ gestation who had data recorded for blood lead levels and completed a lead risk factor survey modified for pregnancy.

Disclosures: This work was supported by the Harvard Catalyst, Harvard Clinical and Translational Science Center, Harvard University, and others. The authors declared no conflict of interests.

Source: Johnson KM et al. Matern Child Health J. 2022 Jan 12. doi: 10.1007/s10995-021-03325-x.

Key clinical point: A pregnancy-specific questionnaire to perform risk factor-based screening for elevated lead levels during pregnancy identified parturients with elevated blood lead levels with good sensitivity but poor specificity.

Major finding: Almost 78% of participants reported at least 1 risk factor for lead, with the questionnaire showing high sensitivity (100%) but low specificity (22%) for identifying detectable maternal lead levels. The blood lead level was clinically reportable in 2.2% of participants, with 1 of them having a blood lead level above 5 μg/dL.

Study details: Findings are from an analysis of 92 parturients with a singleton pregnancy ≥34 weeks’ gestation who had data recorded for blood lead levels and completed a lead risk factor survey modified for pregnancy.

Disclosures: This work was supported by the Harvard Catalyst, Harvard Clinical and Translational Science Center, Harvard University, and others. The authors declared no conflict of interests.

Source: Johnson KM et al. Matern Child Health J. 2022 Jan 12. doi: 10.1007/s10995-021-03325-x.

Key clinical point: A pregnancy-specific questionnaire to perform risk factor-based screening for elevated lead levels during pregnancy identified parturients with elevated blood lead levels with good sensitivity but poor specificity.

Major finding: Almost 78% of participants reported at least 1 risk factor for lead, with the questionnaire showing high sensitivity (100%) but low specificity (22%) for identifying detectable maternal lead levels. The blood lead level was clinically reportable in 2.2% of participants, with 1 of them having a blood lead level above 5 μg/dL.

Study details: Findings are from an analysis of 92 parturients with a singleton pregnancy ≥34 weeks’ gestation who had data recorded for blood lead levels and completed a lead risk factor survey modified for pregnancy.

Disclosures: This work was supported by the Harvard Catalyst, Harvard Clinical and Translational Science Center, Harvard University, and others. The authors declared no conflict of interests.

Source: Johnson KM et al. Matern Child Health J. 2022 Jan 12. doi: 10.1007/s10995-021-03325-x.

Key clinical point: Singleton exome sequencing (sES) could be a valuable prenatal diagnostic tool that offers the opportunity to obtain reliable and rapid prenatal results that reveal novel disease-causing variants in fetuses with ultrasound anomalies.

Major finding: The overall diagnostic yield for detection of pathogenic or likely pathogenic variants was 34.4%, with the diagnostic rate being highest for multiple anomalies (56%), followed by skeletal or renal abnormalities (50%). Furthermore, 20 novel disease-causing variants in different known disease-associated genes were identified.

Study details: Findings are from a retrospective analysis of 90 fetuses with a normal rapid aneuploidy detection but abnormal ultrasound findings, who were further investigated with sES or multigene panel analysis of 6,713 genes.

Disclosures: The study did not receive funds, grants, or other support. The authors declared no competing interests.

Source: Smogavec M et al. Eur J Hum Genet. 2022 Jan 1. doi: 10.1038/s41431-021-01012-7.

Key clinical point: Singleton exome sequencing (sES) could be a valuable prenatal diagnostic tool that offers the opportunity to obtain reliable and rapid prenatal results that reveal novel disease-causing variants in fetuses with ultrasound anomalies.

Major finding: The overall diagnostic yield for detection of pathogenic or likely pathogenic variants was 34.4%, with the diagnostic rate being highest for multiple anomalies (56%), followed by skeletal or renal abnormalities (50%). Furthermore, 20 novel disease-causing variants in different known disease-associated genes were identified.

Study details: Findings are from a retrospective analysis of 90 fetuses with a normal rapid aneuploidy detection but abnormal ultrasound findings, who were further investigated with sES or multigene panel analysis of 6,713 genes.

Disclosures: The study did not receive funds, grants, or other support. The authors declared no competing interests.

Source: Smogavec M et al. Eur J Hum Genet. 2022 Jan 1. doi: 10.1038/s41431-021-01012-7.

Key clinical point: Singleton exome sequencing (sES) could be a valuable prenatal diagnostic tool that offers the opportunity to obtain reliable and rapid prenatal results that reveal novel disease-causing variants in fetuses with ultrasound anomalies.

Major finding: The overall diagnostic yield for detection of pathogenic or likely pathogenic variants was 34.4%, with the diagnostic rate being highest for multiple anomalies (56%), followed by skeletal or renal abnormalities (50%). Furthermore, 20 novel disease-causing variants in different known disease-associated genes were identified.

Study details: Findings are from a retrospective analysis of 90 fetuses with a normal rapid aneuploidy detection but abnormal ultrasound findings, who were further investigated with sES or multigene panel analysis of 6,713 genes.

Disclosures: The study did not receive funds, grants, or other support. The authors declared no competing interests.

Source: Smogavec M et al. Eur J Hum Genet. 2022 Jan 1. doi: 10.1038/s41431-021-01012-7.

Key clinical point: Prenatal detection of fetal growth restriction (FGR) combined with polyhydramnios should indicate presence of different etiological groups with different prenatal and postnatal outcomes, necessitating long-term follow-up.

Major finding: The highest proportion of etiology identified was chromosomal abnormalities (41.8%), followed by complex malformation syndromes (24.1%), isolated malformations (15.7%), musculoskeletal disorders (9.2%), and parentally nonanomalous fetuses (9.2%). Overall, the mortality rate in the population was 64.7%.

Study details: Findings are from a single-center, retrospective analysis of 153 cases with FGR and polyhydramnios diagnosed by prenatal ultrasound, identified over 17 years.

Disclosures: No other funding sources were declared, except for open access funding by Projekt DEAL. The authors declared no competing interests.

Source: Walter A et al. Sci Rep. 2022 Jan 10. doi: 10.1038/s41598-021-04371-9.

Key clinical point: Prenatal detection of fetal growth restriction (FGR) combined with polyhydramnios should indicate presence of different etiological groups with different prenatal and postnatal outcomes, necessitating long-term follow-up.

Major finding: The highest proportion of etiology identified was chromosomal abnormalities (41.8%), followed by complex malformation syndromes (24.1%), isolated malformations (15.7%), musculoskeletal disorders (9.2%), and parentally nonanomalous fetuses (9.2%). Overall, the mortality rate in the population was 64.7%.

Study details: Findings are from a single-center, retrospective analysis of 153 cases with FGR and polyhydramnios diagnosed by prenatal ultrasound, identified over 17 years.

Disclosures: No other funding sources were declared, except for open access funding by Projekt DEAL. The authors declared no competing interests.

Source: Walter A et al. Sci Rep. 2022 Jan 10. doi: 10.1038/s41598-021-04371-9.

Key clinical point: Prenatal detection of fetal growth restriction (FGR) combined with polyhydramnios should indicate presence of different etiological groups with different prenatal and postnatal outcomes, necessitating long-term follow-up.

Major finding: The highest proportion of etiology identified was chromosomal abnormalities (41.8%), followed by complex malformation syndromes (24.1%), isolated malformations (15.7%), musculoskeletal disorders (9.2%), and parentally nonanomalous fetuses (9.2%). Overall, the mortality rate in the population was 64.7%.

Study details: Findings are from a single-center, retrospective analysis of 153 cases with FGR and polyhydramnios diagnosed by prenatal ultrasound, identified over 17 years.

Disclosures: No other funding sources were declared, except for open access funding by Projekt DEAL. The authors declared no competing interests.

Source: Walter A et al. Sci Rep. 2022 Jan 10. doi: 10.1038/s41598-021-04371-9.

Key clinical point: A short femur (SF) as an isolated symptom in prenatal diagnosis may not require additional surveillance, but intensified pregnancy monitoring may be required if SF is a part of small for gestational age (SGA) baby, an intrauterine growth retardation, or a suspected late growth retardation.

Major finding: Overall, 49.9% of fetuses presented with an isolated SF and 50.1% had additional abnormalities, 42.6% being SGA babies and 57.4% having ≥1 severe malformation. Children with isolated SF vs those with SF and additional abnormalities had a higher live birth rate (97.8% vs 78.9%) and a lower rate of perinatal death (0.1% vs 3.9%), abortions (0.3% vs 9.6%), or spontaneous miscarriages/intrauterine demises (1.8% vs 7.6%).

Study details: Findings are from a retrospective analysis of 1,373 singleton pregnancies with a fetal femoral length of <5^th percentile, detected during the second trimester screening.

Disclosures: The open access funding was enabled and organized by Projekt DEAL. The authors declared no conflict of interests.

Source: Friebe‐Hoffmann U et al. Arch Gynecol Obstet. 2022 Jan 11. doi: 10.1007/s00404-021-06394-z.

Key clinical point: A short femur (SF) as an isolated symptom in prenatal diagnosis may not require additional surveillance, but intensified pregnancy monitoring may be required if SF is a part of small for gestational age (SGA) baby, an intrauterine growth retardation, or a suspected late growth retardation.

Major finding: Overall, 49.9% of fetuses presented with an isolated SF and 50.1% had additional abnormalities, 42.6% being SGA babies and 57.4% having ≥1 severe malformation. Children with isolated SF vs those with SF and additional abnormalities had a higher live birth rate (97.8% vs 78.9%) and a lower rate of perinatal death (0.1% vs 3.9%), abortions (0.3% vs 9.6%), or spontaneous miscarriages/intrauterine demises (1.8% vs 7.6%).

Study details: Findings are from a retrospective analysis of 1,373 singleton pregnancies with a fetal femoral length of <5^th percentile, detected during the second trimester screening.

Disclosures: The open access funding was enabled and organized by Projekt DEAL. The authors declared no conflict of interests.

Source: Friebe‐Hoffmann U et al. Arch Gynecol Obstet. 2022 Jan 11. doi: 10.1007/s00404-021-06394-z.

Key clinical point: A short femur (SF) as an isolated symptom in prenatal diagnosis may not require additional surveillance, but intensified pregnancy monitoring may be required if SF is a part of small for gestational age (SGA) baby, an intrauterine growth retardation, or a suspected late growth retardation.

Major finding: Overall, 49.9% of fetuses presented with an isolated SF and 50.1% had additional abnormalities, 42.6% being SGA babies and 57.4% having ≥1 severe malformation. Children with isolated SF vs those with SF and additional abnormalities had a higher live birth rate (97.8% vs 78.9%) and a lower rate of perinatal death (0.1% vs 3.9%), abortions (0.3% vs 9.6%), or spontaneous miscarriages/intrauterine demises (1.8% vs 7.6%).

Study details: Findings are from a retrospective analysis of 1,373 singleton pregnancies with a fetal femoral length of <5^th percentile, detected during the second trimester screening.

Disclosures: The open access funding was enabled and organized by Projekt DEAL. The authors declared no conflict of interests.

Source: Friebe‐Hoffmann U et al. Arch Gynecol Obstet. 2022 Jan 11. doi: 10.1007/s00404-021-06394-z.

Key clinical point: Performing a first-trimester ultrasound examination along with noninvasive prenatal testing (NIPT) led to a higher positive predictive value (PPV) for trisomy 18, which could help alleviate stress caused by a false-positive NIPT result in cases where the ultrasound is normal.

Major finding: The PPV of NIPT was 100%, 84.6%, and 100% for trisomy 21, trisomy 18, and trisomy 13, respectively. The use of ultrasound in pregnancies with positive NIPT results detected abnormalities in 80% of trisomy 13 and 100% of true-positive trisomy 18 cases.

Study details: This was a retrospective analysis of 41 women with positive NIPT results for trisomy 21, trisomy 18, and trisomy 13 who underwent a first-trimester ultrasound scan.

Disclosures: The study did not receive any funding. The authors did not have any conflict of interests.

Source: Saito M et al. J Obstet Gynaecol Res. 2021 Dec 16. doi: 10.1111/jog.15115.

Key clinical point: Performing a first-trimester ultrasound examination along with noninvasive prenatal testing (NIPT) led to a higher positive predictive value (PPV) for trisomy 18, which could help alleviate stress caused by a false-positive NIPT result in cases where the ultrasound is normal.

Major finding: The PPV of NIPT was 100%, 84.6%, and 100% for trisomy 21, trisomy 18, and trisomy 13, respectively. The use of ultrasound in pregnancies with positive NIPT results detected abnormalities in 80% of trisomy 13 and 100% of true-positive trisomy 18 cases.

Study details: This was a retrospective analysis of 41 women with positive NIPT results for trisomy 21, trisomy 18, and trisomy 13 who underwent a first-trimester ultrasound scan.

Disclosures: The study did not receive any funding. The authors did not have any conflict of interests.

Source: Saito M et al. J Obstet Gynaecol Res. 2021 Dec 16. doi: 10.1111/jog.15115.

Key clinical point: Performing a first-trimester ultrasound examination along with noninvasive prenatal testing (NIPT) led to a higher positive predictive value (PPV) for trisomy 18, which could help alleviate stress caused by a false-positive NIPT result in cases where the ultrasound is normal.

Major finding: The PPV of NIPT was 100%, 84.6%, and 100% for trisomy 21, trisomy 18, and trisomy 13, respectively. The use of ultrasound in pregnancies with positive NIPT results detected abnormalities in 80% of trisomy 13 and 100% of true-positive trisomy 18 cases.

Study details: This was a retrospective analysis of 41 women with positive NIPT results for trisomy 21, trisomy 18, and trisomy 13 who underwent a first-trimester ultrasound scan.

Disclosures: The study did not receive any funding. The authors did not have any conflict of interests.

Source: Saito M et al. J Obstet Gynaecol Res. 2021 Dec 16. doi: 10.1111/jog.15115.