Evaluation of prenatal diagnosis of associated congenital heart diseases by fetal ultrasonographic examination in Europe.

Ultrasound scans in the mid trimester of pregnancy are now a routine part of antenatal care in most European countries. With the assistance of Registries of Congenital Anomalies a study was undertaken in Europe. The objective of the study was to evaluate prenatal detection of congenital heart defects (CHD) by routine ultrasonographic examination of the fetus. All congenital malformations suspected prenatally and all congenital malformations, including chromosome anomalies, confirmed at birth were identified from the Congenital Malformation Registers, including 20 registers from the following European countries: Austria, Croatia, Denmark, France, Germany, Italy, Lithuania, Spain, Switzerland, The Netherlands, UK and Ukrainia. These registries follow the same methodology. The study period was 1996-1998, 709 030 births were covered, and 8126 cases with congenital malformations were registered. If more than one cardiac malformation was present the case was coded as complex cardiac malformation. CHD were subdivided into 'isolated' when only a cardiac malformation was present and 'associated' when at least one other major extra cardiac malformation was present. The associated CHD were subdivided into chromosomal, syndromic non-chromosomal and multiple. The study comprised 761 associated CHD including 282 cases with multiple malformations, 375 cases with chromosomal anomalies and 104 cases with non-chromosomal syndromes. The proportion of prenatal diagnosis of associated CHD varied in relation to the ultrasound screening policies from 17.9% in countries without routine screening (The Netherlands and Denmark) to 46.0% in countries with only one routine fetal scan and 55.6% in countries with two or three routine fetal scans. The prenatal detection rate of chromosomal anomalies was 40.3% (151/375 cases). This rate for recognized syndromes and multiply malformed with CHD was 51.9% (54/104 cases) and 48.6% (137/282 cases), respectively; 150/229 Down syndrome (65.8%) were livebirths. Concerning the syndromic cases, the detection rate of deletion 22q11, situs anomalies and VATER association was 44.4%, 64.7% and 46.6%, respectively. In conclusion, the present study shows large regional variations in the prenatal detection rate of CHD with the highest rates in European regions with three screening scans. Prenatal diagnosis of CHD is significantly higher if associated malformations are present. Cardiac defects affecting the size of the ventricles have the highest detection rate. Mean gestational age at discovery was 20-24 weeks for the majority of associated cardiac defects.

Evaluation and comparison of current fetal ultrasound image segmentation methods for biometric measurements: a grand challenge.

This paper presents the evaluation results of the methods submitted to Challenge US: Biometric Measurements from Fetal Ultrasound Images, a segmentation challenge held at the IEEE International Symposium on Biomedical Imaging 2012. The challenge was set to compare and evaluate current fetal ultrasound image segmentation methods. It consisted of automatically segmenting fetal anatomical structures to measure standard obstetric biometric parameters, from 2D fetal ultrasound images taken on fetuses at different gestational ages (21 weeks, 28 weeks, and 33 weeks) and with varying image quality to reflect data encountered in real clinical environments. Four independent sub-challenges were proposed, according to the objects of interest measured in clinical practice: abdomen, head, femur, and whole fetus. Five teams participated in the head sub-challenge and two teams in the femur sub-challenge, including one team who tackled both. Nobody attempted the abdomen and whole fetus sub-challenges. The challenge goals were two-fold and the participants were asked to submit the segmentation results as well as the measurements derived from the segmented objects. Extensive quantitative (region-based, distance-based, and Bland-Altman measurements) and qualitative evaluation was performed to compare the results from a representative selection of current methods submitted to the challenge. Several experts (three for the head sub-challenge and two for the femur sub-challenge), with different degrees of expertise, manually delineated the objects of interest to define the ground truth used within the evaluation framework. For the head sub-challenge, several groups produced results that could be potentially used in clinical settings, with comparable performance to manual delineations. The femur sub-challenge had inferior performance to the head sub-challenge due to the fact that it is a harder segmentation problem and that the techniques presented relied more on the femur's appearance.

21/4/20, anniversaire de la mort de [l'aviateur Jules] Védrines [cimetière de Pantin] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58988

21/4/20, anniversaire de la mort de [l'aviateur Jules] Védrines [cimetière de Pantin] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58989

21/4/20, anniversaire de la mort de [l'aviateur Jules] Védrines [cimetière de Pantin] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58990

21/4/20, anniversaire de la mort de [l'aviateur Jules] Védrines [cimetière de Pantin] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58992

21/4/20, procès Caillaux [Sénat, Haute Cour de Justice] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58994

21/4/20, procès Caillaux [Sénat, Haute Cour de Justice] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58995

21/4/20, procès Caillaux [Sénat, Haute Cour de Justice] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58998

21/4/20, procès Caillaux [Sénat, Haute Cour de Justice] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 59002

Proyecto de una explotación frutal de 21 ha en Albelda (Huesca)

Transformació d´ una explotació mitjançant la plantació de fruiters, la instal•lació d´una infraestructura de reg i la construcció de una nau-magatzem. A l´ actualitat, la finca es dedica al cultiu de extensius. Es situa a la partida de les Unilles, que pertany al terme municipal d´ Albelda (Osca). La finca ocupa una superfície total de 21 ha, de les quals 8,6 ha es dedicaran a la implantació de perer y 10,3 ha a la de poma, a la resta de la superfície s´ hi faran els camins de la finca i la nau magatzem.

Sujetos responsables por los daños derivados del uso de un producto peligroso. Comentario a la STS, 1a, 21.11.2008 (MP:José Antonio Seijas Quintana), RJ 2009\144

La STS, 1a, 21.11.2008, objeto de este comentario, plantea a un tiempo la responsabilidad del consumidor, vendedor, fabricante y Administración pública por los daños materiales causados por la explosión de un producto altamente inflamable que había sido vendido a un particular para la desinfección de su vivienda.