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https://www.readbyqxmd.com/read/28504574/gut-dysbiosis-following-c-section-instigates-higher-colonisation-of-toxigenic-clostridium-perfringens-in-infants
#1
R Nagpal, H Tsuji, T Takahashi, K Nomoto, K Kawashima, S Nagata, Y Yamashiro
Herein we investigated the intestinal carriage of α-toxigenic and enterotoxigenic Clostridium perfringens during infancy, focusing on its association with other gut microbes and mode of delivery and feeding. Faecal samples from 89 healthy term infants were collected at age 7 days, 1 month, 3 months, 6 months and 3 years. C. perfringens was quantified by qPCR; other gut bacteria were quantified by reverse-transcription-qPCR. Alpha-toxigenic C. perfringens was detected in 3.4% infants at day 7 but was present in 35-40% infants at subsequent time-points, with counts ranging from 10(3)-10(7) cells/g faeces...
May 15, 2017: Beneficial Microbes
https://www.readbyqxmd.com/read/28490355/regional-inequity-in-complete-antenatal-services-and-public-emergency-obstetric-care-is-associated-with-greater-burden-of-maternal-deaths-analysis-from-consecutive-district-level-facility-survey-of-karnataka-india
#2
M Himanshu, Carina Källestål
BACKGROUND: This equity focused evaluation analyses change in inter-district inequity of maternal health services (MHS) in Karnataka state between 2006-07 & 2012-13, alongside association of MHS inequity with distribution of maternal deaths. METHODS: Repeated cross-sectional analysis of inequity and decomposition was done on nine district level MHS indicators using Theil's T index. Data was obtained from population linked district level facility surveys and health information systems...
May 11, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28481770/elective-cesarean-section-for-women-living-with-hiv-a-systematic-review-of-risks-and-benefits
#3
Caitlin E Kennedy, Ping Teresa Yeh, Shristi Pandey, Ana Pilar Betran, Manjulaa Narasimhan
OBJECTIVE AND DESIGN: To inform World Health Organization guidelines, we conducted a systematic review and meta-analysis to assess maternal and perinatal outcomes comparing cesarean section before labor and rupture of membranes (elective c-section/ECS) with other modes of delivery for women living with HIV. METHODS: We searched PUBMED, CINAHL, Embase, CENTRAL, and previous reviews to identify published trials and observational studies through October 2015. Results were synthesized using random-effects meta-analysis, stratifying for combination antiretroviral therapy (cART), CD4/viral load (VL), delivery at term, and low-/middle-income countries (LMICs)...
May 5, 2017: AIDS
https://www.readbyqxmd.com/read/28481167/impact-of-a-mobile-health-application-on-user-engagement-and-pregnancy-outcomes-among-wyoming-medicaid-members
#4
James Bush, Dilek E Barlow, Jennie Echols, Jasmine Wilkerson, Katherine Bellevin
BACKGROUND: Pregnancy and birth outcomes are a critical area of healthcare, yet negative outcomes like C-sections and preterm births remain widespread. Studies show that early and ongoing prenatal care can improve outcomes; however, in-person care is difficult to deliver in rural areas. This article examines the impact of mobile health technology on user engagement and birth outcomes in a Wyoming pilot study. The pilot did face some limitations; namely, the small app user group size and scant demographic information collected from users...
May 8, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28477295/do-tort-reforms-impact-the-incidence-of-birth-by-cesarean-section-a-reassessment
#5
Javier Cano-Urbina, Daniel Montanera
Investigations into the existence and impact of defensive medicine in obstetrics have produced mixed and often conflicting implications. The most widely-cited and accepted results in this literature find that less severe malpractice environments cause an increase in the use of cesarean section. This has been interpreted as "offensive medicine"; taking advantage of lenient malpractice environments by providing unnecessary services in order to raise revenue. In this article we show that an assumption concerning births with an unknown method of delivery, which is not explicitly stated in the literature, is pivotal in obtaining these results...
March 2017: International Journal of Health Economics and Management
https://www.readbyqxmd.com/read/28471912/effect-of-synbiotic-on-the-gut-microbiota-of-caesarean-delivered-infants-a-randomized-double-blind-multicenter-study
#6
Mei Chien Chua, Kaouther Ben-Amor, Christophe Lay, Anne Goh Eng Neo, Wen Chin Chiang, Rajeshwar Rao, Charmaine Chew, Surasith Chaithongwongwatthana, Nipon Khemapech, Jan Knol, Voranush Chongsrisawat
We determined the effect of short-chain galacto-oligosaccharides (scGOS), long-chain fructo-oligosaccharides (lcFOS) and Bifidobacterium breve M-16 V on the gut microbiota of caesarean born infants. Infants were randomized to receive a standard formula (control), the same with scGOS/lcFOS and B. breve M-16 V (synbiotic), or with scGOS/lcFOS (prebiotic) from birth until week 16, 30 subjects born vaginally were included as a reference group. Synbiotic supplementation resulted in a higher bifidobacteria proportion from day 3/5 (p < 0...
May 3, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28463391/nya-nationella-riktlinjer-f%C3%A3-r-extremt-f%C3%A3-r-tidigt-f%C3%A3-dda-ett-viktigt-steg-fram%C3%A3-t-f%C3%A3-r-b%C3%A3-ttre-v%C3%A3-rd
#7
Mikael Norman
New Swedish guideline on periviable births A new national guideline on management of periviable births has been issued by the Swedish Neonatal and Obstetric Societies. The guideline focuses on management of deliveries at 22 to 25 weeks of gestation and five interventions are pin-pointed: centralization of care, use of antenatal corticosteroids, mode of delivery (use of C-section), neonatologist present in the delivery room and start of neonatal resuscitation. For each gestational week, a statement is made on whether or not the specific intervention is recommended...
April 25, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28463211/-pregnancy-and-postpartum-control-in-hiv-infected-women
#8
Eduardo M Warley, Silvina Tavella, Alejandra Rosas
Pregnancy and postpartum control in HIV infected women. We present data from a retrospective observational descriptive study with the objective of evaluating characteristics of HIV-infected pregnant women, analyze the level of control of pregnancy and assess adherence to treatment and loss of follow up after delivery. We analyzed reported data of 104 pregnancies, 32.7% of them under 25 years old. The diagnosis was performed as part of pregnancy control in 36.5% of women. TARV started before 24 weeks of pregnancy in 70% of them and a regimen with 2 nucleos(t)ides and 1 ritonavir potenciated protease inhibitor (PIr) was prescribed in 84...
2017: Medicina
https://www.readbyqxmd.com/read/28407769/geographic-variation-within-the-military-health-system
#9
Linda Kimsey, Samuel Olaiya, Chad Smith, Andrew Hoburg, Stuart R Lipsitz, Tracey Koehlmoos, Louis L Nguyen, Joel S Weissman
BACKGROUND: This study seeks to quantify variation in healthcare utilization and per capita costs using system-defined geographic regions based on enrollee residence within the Military Health System (MHS). METHODS: Data for fiscal years 2007 - 2010 were obtained from the Military Health System under a data sharing agreement with the Defense Health Agency (DHA). DHA manages all aspects of the Department of Defense Military Health System, including TRICARE. Adjusted rates were calculated for per capita costs and for two procedures with high interest to the MHS- back surgery and Cesarean sections for TRICARE Prime and Plus enrollees...
April 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28367489/clear-cell-carcinoma-arising-from-abdominal-wall-endometriosis-brief-report-and-review-of-the-literature
#10
Cecília Marques, Teresa S Silva, Margarida F Dias
•Endometriosis-associated abdominal wall cancer is a rare entity with poor prognosis.•Personal history of C-section is extremely relevant.•The treatment consists in a wide local excision with adjuvant chemotherapy.•Proper treatment of abdominal endometriosis could prevent these situations.
May 2017: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/28358578/breastfeeding-initiation-in-mothers-with-repeat-cesarean-section-the-impact-of-marital-status
#11
Jordyn T Wallenborn, Whitney C Graves, Saba W Masho
BACKGROUND: Approximately 90% of mothers with a primary C-section have a subsequent C-section. To date, research has demonstrated that primary C-sections are associated with breastfeeding noninitiation. However, it is unknown if this association persists after the primary C-section. Furthermore, literature has shown a differing relationship between breastfeeding initiations by marital status. Due to the high proportion of women who give birth while unmarried, investigating differences by marital status will add a significant contribution to breastfeeding literature...
May 2017: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
https://www.readbyqxmd.com/read/28353357/-the-scarlet-c-exploring-caesarean-section-stigma
#12
Emily T Cripe
In this article, I explore my own journey with delivering my first child via Caesarean section. I discuss the discourse in society surrounding childbirth and the stigma associated with giving birth via C-section, as well as the impacts that this discourse has for women whose births don't go according to plan and who end up requiring medical intervention.
March 29, 2017: Health Communication
https://www.readbyqxmd.com/read/28350150/-burn-out-commitment-personality-and-experiences-during-work-and-training-survey-among-psychiatry-residents
#13
R Krebs, A L Ewalds, P T van der Heijden, E J M Penterman, K P Grootens
BACKGROUND: In the last few years international studies have reported on increase in burn-out and depressive symptoms among psychiatry residents. In the field of research, however, commitment and dedication are now being mentioned more frequently as positive factors that counterbalance burn-out. AIM: To find out how a group of Dutch psychiatry residents feel about their work, to discover their degree of burn-out and commitment and to clarify the various factors involved...
2017: Tijdschrift Voor Psychiatrie
https://www.readbyqxmd.com/read/28346935/dysbiosis-in-the-neonatal-period-role-of-cesarean-section
#14
Josef Neu
From epidemiological studies and studies done evaluating microbiomes in infants, there is a strong signal that the infants born by elective cesarean section (C-section) develop microbiota that differs from those babies born by vaginal delivery. Epidemiological studies show increased odds ratios for the development of immunological disorders such as type 1 diabetes, celiac disease, asthma, allergic diseases as well as metabolic diseases such as obesity in babies born by C-section. These are interesting associations, and if supported by additional studies that rigorously control for confounding factors, they will have major public health implications...
2017: Nestlé Nutrition Institute Workshop Series
https://www.readbyqxmd.com/read/28335004/barriers-and-facilitators-for-institutional-delivery-among-poor-mesoamerican-women-a-cross-sectional-study
#15
Bernardo Hernandez, Danny V Colombara, Marielle C Gagnier, Sima S Desai, Annie Haakenstad, Casey Johanns, Claire R McNellan, Jennifer Nelson, Erin B Palmisano, Diego Ríos-Zertuche, Alexandra Schaefer, Paola Zúñiga-Brenes, Emma Iriarte, Ali H Mokdad
Professional skilled care has shown to be one of the most promising strategies to reduce maternal mortality, and in-facility deliveries are a cost-effective way to ensure safe births. Countries in Mesoamerica have emphasized in-facility delivery care by professionally skilled attendants, but access to good-quality delivery care is still lacking for many women. We examined the characteristics of women who had a delivery in a health facility and determinants of the decision to bypass a closer facility and travel to a distant one...
March 15, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28301885/geburtshilfe-kombinierte-spinal-epidural-analgesie-cse
#16
Jan Wallenborn, Thorsten Artmann, Peter Kranke
Due to intrathecal application, CSE combines rapid response with adequate analgesia with the possibility of providing unlimited neuraxial obstetrical pain relief via the indwelling epidural catheter. The superiority of CSE over EDA lies above all in its rapid action, excellent analgesia, lack of motor blockade after a single intrathecal opioid administration, lower rate of unilateral blockages and less need for subsequent epidural injections. The most common side effect is pruritus, which is harmless and usually does not require any therapeutic intervention...
March 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28293312/platelet-count-in-first-trimester-of-pregnancy-as-a-predictor-of-perinatal-outcome
#17
Santiago Garcia-Tizon Larroca, Juan Arevalo-Serrano, Virginia Ortega Abad, Pilar Pintado Recarte, Alejandro Garcia Carreras, Gonzalo Nozaleda Pastor, Cesar Rodriguez Hernandez, Ricardo Perez Fernandez Pacheco, Juan De Leon Luis
AIM: To rule out maternal and pregnancy factors that may contribute to platelet count (PLT) changes in the first trimester of gestation and examine if there is any association between its levels and adverse perinatal outcome. METHODS: The study population included all patients from the first-trimester visit between 2013-2015 with pregnancy results. Linear multiple regression was constructed to rule out variables that may have a significant contribution to PLT. For each adverse outcome at birth, multiple logistic regression analysis was implemented to estimate the PLT effect...
March 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28292470/sexual-dimorphism-in-the-effect-of-maternal-obesity-on-antioxidant-defense-mechanisms-in-the-human-placenta
#18
LaShauna Evans, Leslie Myatt
INTRODUCTION: Maternal obesity creates an adverse intrauterine environment, negatively impacts placental respiration, is associated with a higher incidence of pregnancy complications and programs the offspring for disease in adult life in a sexually dimorphic manner. We defined the effect of maternal obesity and fetal sex on pro- and anti-oxidant status in placenta and placental mitochondria. METHODS: Placental villous tissue was collected at term via c-section prior to labor from four groups of patients based on fetal sex and prepregnancy/1st trimester body mass index: lean - BMI 22...
March 2017: Placenta
https://www.readbyqxmd.com/read/28292278/caesarean-section-and-adiposity-at-6-18-and-30%C3%A2-years-of-age-results-from-three-pelotas-brazil-birth-cohorts
#19
Aluisio J D Barros, Leonardo Pozza Santos, Fernando Wehrmeister, Janaina Vieira Dos Santos Motta, Alicia Matijasevich, Ina S Santos, Ana M B Menezes, Helen Gonçalves, Maria Cecília Formoso Assunção, Bernardo L Horta, Fernando C Barros
BACKGROUND: Association between caesarian section (C-section) and obesity is controversial and mostly based on body mass index (BMI), which has inherent limitations. Using direct estimates of body fat mass, we aimed to assess the association between C-section and adiposity using fat mass index and BMI z-score in three birth cohort studies from Pelotas, Brazil. METHODS: We measured weight, height and fat mass (using dual X-ray absorptiometry (DXA)) at ages 6, 18 and 30 years among participants in the 2004, 1993 and 1982 population-based Pelotas Birth Cohort Studies, respectively...
March 14, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28231830/the-distribution-of-maternity-services-across-rural-and-remote-australia-does-it-reflect-population-need
#20
Margaret I Rolfe, Deborah Anne Donoghue, Jo M Longman, Jennifer Pilcher, Sue Kildea, Sue Kruske, Jude Kornelsen, Stefan Grzybowski, Lesley Barclay, Geoffrey Gerard Morgan
BACKGROUND: Australia has a universal health care system and a comprehensive safety net. Despite this, outcomes for Australians living in rural and remote areas are worse than those living in cities. This study will examine the current state of equity of access to birthing services for women living in small communities in rural and remote Australia from a population perspective and investigates whether services are distributed according to need. METHODS: Health facilities in Australia were identified and a service catchment was determined around each using a one-hour road travel time from that facility...
February 23, 2017: BMC Health Services Research
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