Infant male sex as a risk factor for shoulder dystocia but not for cephalopelvic disproportion: An independent or confounded effect?

Background: Shoulder dystocia (ShD) and cephalopelvic disproportion (CPD) share some common risk factors. Whether infant male sex is an independent risk factor for ShD, or if the risk is confounded by other known factors, is uncertain.Objective: The aim of this study was to explore the unconfounded effect of infant male sex on the risk for ShD and its interaction with other risk factors compared with CPD.Methods: A retrospective data analysis was conducted of deliveries in Lamphun Hospital, Lamphun, Thailand. All vaginal deliveries complicated by ShD were collected as ShD cases. All labors terminated by cesarean delivery (CD) due to CPD were collected as CD/CPD cases. Vaginal deliveries that took place immediately before or after the index ShD cases were collected as controls. Multivariable adjusted odds ratios (AORs) for infant male sex and its 95% CI in cases of ShD and CD/CPD were computed by multichotomous logistic regression controlling for other obstetric risks. The effects of maternal height, gestational age, and birth weight on the risk for ShD or CD/CPD among male or female infants was also explored. Stability of the effect of the risk between male and female infants was tested with Chow tests.Results: Thirty-five ShD cases and 199 CD/CPD cases were collected, as were 586 controls. Infant male sex was a significant independent risk factor for ShD (AOR = 5.00; 95% CI, 1.83-13.61; P = 0.002), but not for CD/CPD (AOR = 1.09; 95% CI, 0.75-1.59; P = NS). For CD/CPD, the effects of maternal height, gestational age, and birth weight were similar for male and female infants, but the corresponding effect on ShD was more pronounced in male than in female infants (P < 0.001 for all comparisons).Conclusions: Infant male sex is a risk factor for ShD independent of other known risks. Male sex also amplified the existing effects of short maternal height, extended gestational age, and greater birth weight. If infant sex is known to be male before delivery, the obstetrician may consider avoiding vaginal delivery in mothers who have other strong risks for ShD.     

Dynamics of telomere length in captive Siamese cobra (Naja kaouthia) related to age and sex

Telomeres comprise tandem repeated DNA sequences that protect the ends of chromosomes from deterioration or fusion with neighboring chromosomes, and their lengths might vary with sex and age. Here, age‐ and sex‐related telomere lengths in male and female captive Siamese cobras (Naja kaouthia) were investigated using quantitative real‐time polymerase chain reaction based on cross‐sectional data. A negative correlation was shown between telomere length and body size in males but not in females. Age‐related sex differences were also recorded. Juvenile female snakes have shorter telomeres relative to males at up to 5 years of age, while body size also rapidly increases during this period. This suggests that an accelerated increase in telomere length of female cobra results from sex hormone stimulation to telomerase activity, reflecting sexually dimorphic phenotypic traits. This might also result from amplification of telomeric repeats on sex chromosomes. By contrast, female Siamese cobras older than 5 years had longer telomeres than males. Diverse sex hormone levels and oxidative stress parameters between sexes may affect telomere length.     

Impact of pericardial adhesions on diastolic function as assessed by vortex formation time, a parameter of transmitral flow efficiency

Acute pulmonary embolism (PE) is a common disease which frequently results in life-threatening right ventricular (RV) failure. High-risk PE, presenting with hypotension, shock, RV dysfunction or right heart thrombus is associated with a high mortality, particularly during the first few hours. Accordingly, it is important to commence effective therapy as soon as possible. In the case described in this report, a 49-year-old woman with myotonic dystrophy type 1 presented with acute respiratory failure and hypotension. Transthoracic echocardiography showed signs of right heart failure and a mobile right heart mass highly suspicious of a thrombus. Based on echocardiographic findings, acute thrombolysis was performed resulting in hemodynamic stabilization of the patient and complete resolution of the right heart thrombus. This case underscores the important role of transthoracic echocardiography for the diagnosis, management and monitoring of PE and underlines the efficacy and safety of thrombolysis in the treatment of PE associated with right heart thrombus.     

A novel method of caenophidian snake sex identification using molecular markers based on two gametologous genes

Sex identification provides important information for ecological and evolutionary studies, as well as benefiting snake conservation management. Traditional methods such as cloacal probing or cloacal popping are counterproductive for sex identification concerning very small species, resulting in difficulties in the management of their breeding programs. In this study, the nucleotide sequences of gametologous genes (CTNNB1 and WAC genes) were used for the development of molecular sexing markers in caenophidian snakes. Two candidate markers were developed with the two primer sets, and successfully amplified by a single band on the agarose gel in male (ZZ) and two bands, differing in fragment sizes, in female (ZW) of 16 caenophidian snakes for CTNNB1 and 12 caenophidian snakes for WAC. Another candidate marker was developed with the primer set to amplify the specific sequence for CTNNB1W homolog, and the PCR products were successfully obtained in a female‐specific 250‐bp DNA bands. The three candidate PCR sexing markers provide a simple sex identification method based on the amplification of gametologous genes, and they can be used to facilitate effective caenophidian snake conservation and management programs.