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https://www.readbyqxmd.com/read/28708899/the-cost-effectiveness-of-a-quality-improvement-program-to-reduce-maternal-and-fetal-mortality-in-a-regional-referral-hospital-in-accra-ghana
#1
David M Goodman, Rohit Ramaswamy, Marc Jeuland, Emmanuel K Srofenyoh, Cyril M Engmann, Adeyemi J Olufolabi, Medge D Owen
OBJECTIVE: To evaluate the cost-effectiveness of a quality improvement intervention aimed at reducing maternal and fetal mortality in Accra, Ghana. DESIGN: Quasi-experimental, time-sequence intervention, retrospective cost-effectiveness analysis. METHODS: Data were collected on the cost and outcomes of a 5-year Kybele-Ghana Health Service Quality Improvement (QI) intervention conducted at Ridge Regional Hospital, a tertiary referral center in Accra, Ghana, focused on systems, personnel, and communication...
2017: PloS One
https://www.readbyqxmd.com/read/28699402/the-management-of-episiotomy-technique-and-its-effect-on-pelvic-floor-muscles-during-a-malposition-childbirth
#2
Dulce A Oliveira, Marco P L Parente, Begoña Calvo, Teresa Mascarenhas, Renato M Natal Jorge
Vaginal childbirth is the leading cause of pelvic floor muscles injury, which contributes to pelvic floor dysfunction, being enhanced by fetal malposition. Therefore, the aim of the present study is to verify the influence of mediolateral episiotomies in the mechanics of the pelvic floor with the fetus in occiput posterior position when compared to the occiput anterior position. Numerical simulations of vaginal deliveries, with and without episiotomy, are performed based on the Finite Element Method. The biomechanical model includes the pelvic floor muscles, a surface to delimit the anterior region of the birth canal and a fetus...
August 2017: Computer Methods in Biomechanics and Biomedical Engineering
https://www.readbyqxmd.com/read/28696961/current-body-composition-measurement-techniques
#3
Thaisa Lemos, Dympna Gallagher
PURPOSE OF REVIEW: The current article reviews the most innovative and precise, available methods for quantification of in-vivo human body composition. RECENT FINDINGS: Body composition measurement methods are continuously being perfected. Ongoing efforts involve multisegmental and multifrequency bioelectrical impedance analysis, quantitative magnetic resonance for total body water, fat, and lean tissue measurements, imaging to further define ectopic fat depots...
July 10, 2017: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/28696507/the-impact-of-epigenomic-next-generation-sequencing-approaches-on-our-understanding-of-neuropsychiatric-disorders
#4
REVIEW
Anne-Laure Schang, Délara Sabéran-Djoneidi, Valérie Mezger
Patients suffering from psychiatric disorders have a life span burden, which represents an enormous human, family, social, and economical cost. Several concepts have revolutionized our way of appraising neuropsychiatric disorders (NPDs). They result from a combination of genetic factors and environmental insults, and their etiology finds roots in the neurodevelopmental period. As epigenetic mechanisms tightly control brain development, exposure to adverse conditions disturbing the epigenetic landscape of the fetal brain increases the risk of developing NPDs, due to the persistence of abnormal epigenetic signatures, at distance from the initial stimulus...
July 11, 2017: Clinical Genetics
https://www.readbyqxmd.com/read/28695637/antenatal-management-of-fetal-intrapericardial-teratoma-a-systematic-review
#5
REVIEW
Ahmed A Nassr, Sherif A Shazly, Shaine A Morris, Nancy Ayres, Jimmy Espinoza, Hadi Erfani, Olutoyin A Olutoye, Sara K Sexson, Oluyinka O Olutoye, Charles D Fraser, Michael A Belfort, Alireza A Shamshirsaz
OBJECTIVES: The purpose of this systematic review is to provide a comprehensive overview on the clinical course, perinatal outcome and effectiveness of antenatal management options for pericardial teratoma. METHODS: A comprehensive search including Ovid MEDLINE, Ovid EMBASE, and Scopus was conducted from inception to September 2016. All studies that reported the antenatal course of pericardial teratoma in singleton or twin gestations were considered eligible Standardized forms were used for data abstraction by two independent reviewers...
July 10, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28695618/quality-predictors-of-parental-satisfaction-after-birth-of-infants-with-life-limiting-conditions
#6
Charlotte Wool, Victoria J Kain, Joana Mendes, Brian S Carter
AIM: This study examines parental satisfaction with care received in the context of a life-limiting fetal diagnosis and subsequent birth. METHODS: Survey methods were utilized to embed the Quality Indicators (QI) and Parental Satisfaction of Perinatal Palliative Care Instrument in a survey: "The Voice of Parents". RESULTS: The web-based survey had a final sample of N=405 parent responders. Overall, parents reported satisfaction with care (80...
July 11, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28694387/inhibition-of-autophagy-limits-vertical-transmission-of-zika-virus-in-pregnant-mice
#7
Bin Cao, Lindsay A Parnell, Michael S Diamond, Indira U Mysorekar
Zika virus (ZIKV) infection during pregnancy leads to devastating fetal outcomes, including intrauterine growth restriction and microcephaly. Greater understanding of mechanisms underlying ZIKV maternal-fetal transmission is needed to develop new therapeutic interventions. Here, we define an important role for the autophagy pathway in ZIKV vertical transmission. ZIKV infection induced autophagic activity in human trophoblasts and pharmacological inhibition limited ZIKV infectivity. Furthermore, deficiency in an essential autophagy gene, Atg16l1, in mice limited ZIKV vertical transmission and placental and fetal damage and overall improved placental and fetal outcomes...
July 10, 2017: Journal of Experimental Medicine
https://www.readbyqxmd.com/read/28693354/perinatal-outcomes-of-congenital-heart-disease-after-emergent-neonatal-cardiac-procedures
#8
Aline Wolter, Helene Holtmann, Andreea Kawecki, Jan Degenhardt, Christian Enzensberger, Oliver Graupner, Hakan Akintürk, Can Yerebakan, Markus Khalil, Dietmar Schranz, Roland Axt-Fliedner
PURPOSE: We compared outcome of neonates with prenatal and postnatal diagnosis of congenital heart disease presenting in our paediatric heart centre between 2005-05/2015 who underwent an emergent intervention within 48 hours postpartum. MATERIALS AND METHODS: In 52/111 (46.8%) with emergent intervention, congenital heart disease was diagnosed prenatally, in 59/111 (53.2%) with no specialized fetal echocardiography, diagnosis was made postnatally. In 98/111 (88...
July 10, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28686845/metabolomics-and-fetal-alcohol-spectrum-disorder-a-mini-review
#9
Erin Goldberg, Michel Aliani
Fetal alcohol spectrum disorder (FASD) is a major public health issue that encompasses an array of physical, neurological and behavioral effects due to alcohol consumption during pregnancy. Classical biomarkers of FASD that are currently used lack sensitivity and specificity, and as such there is an opportunity through the use of novel metabolomics analysis to identify novel biomarkers to identify those at risk for FASD, which could more effectively aid in early intervention. The focus of this mini-review is to identify current work that has been done in the field of metabolomics in FASD in utero, and to highlight promising metabolites that could act as biomarkers in the future...
July 7, 2017: Biochemistry and Cell Biology, Biochimie et Biologie Cellulaire
https://www.readbyqxmd.com/read/28685553/application-of-oxaliplatin-in-combination-with-epirubicin-in-transcatheter-arterial-chemoembolization-in-the-treatment-of-primary-liver-carcinoma
#10
G Chang, L L Xie, W Y Li, F F Xia, P C Huang, Q R Liu, C D Zhang, T J Zhang, H F Li
Many cases of liver carcinoma miss the opportunity of surgical treatment because of hidden onset and delayed diagnosis. In recent years, interventional treatment has gradually become a non-surgical method for treating liver carcinoma. To discuss the effects of oxaliplatin in combination with epirubicin in the treatment and its influence on prognosis, this study randomly selected 218 advanced primary liver carcinoma patients from Binzhou People’s Hospital, Binzhou, China and divided them into a control group (n=109) and an observation group (n=109)...
April 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28685270/tolerance-and-immunity-to-pathogens-in-early-life-insights-from-hbv-infection
#11
REVIEW
Michelle Hong, Antonio Bertoletti
Immunity is not static but varies with age. The immune system of a newborn infant is not "defective" or "immature." Rather, there are distinct features of innate and adaptive immunity from fetal life to adulthood, which may alter the susceptibility of newborn infants to infections compared to adults. Increased protection to certain infectious diseases during early life may benefit from a dampened immune response as a result of decreased immune pathology. This concept may offer an alternative interpretation of the different pathological manifestations clinically observed in hepatitis B virus (HBV)-infected patients during the natural history of infection...
July 6, 2017: Seminars in Immunopathology
https://www.readbyqxmd.com/read/28685004/a-newborn-with-an-alternative-porto-caval-shunt
#12
Çağrı Damar, Ayşe Gül Alımlı, Betül Emine Derinkuyu, Kudret Ebru Özcan, Asburçe Olgaç, Ali Murat Koç
BACKGROUND: Absent ductus venosus (ADV) is a rare condition, but it should be known that this embryonic anomaly may be detected by fetal echocardiographic or newborn ultrasound examinations. CASE REPORT: We present a baby with an ADV and an accompanying alternative porto-caval shunt between the right portal vein and inferior vena cava detected on postnatal ultrasound examination. CONCLUSIONS: Variations in the fetal umbilical or porto-systemic circulations should be detected by fetal or newborn ultrasound examinations and kept in mind before common interventions such as UV catheterizations...
2017: Polish Journal of Radiology
https://www.readbyqxmd.com/read/28681500/continuous-support-for-women-during-childbirth
#13
REVIEW
Meghan A Bohren, G Justus Hofmeyr, Carol Sakala, Rieko K Fukuzawa, Anna Cuthbert
BACKGROUND: Historically, women have generally been attended and supported by other women during labour. However, in hospitals worldwide, continuous support during labour has often become the exception rather than the routine. OBJECTIVES: The primary objective was to assess the effects, on women and their babies, of continuous, one-to-one intrapartum support compared with usual care, in any setting. Secondary objectives were to determine whether the effects of continuous support are influenced by:1...
July 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28680565/oxidative-injury-of-the-pulmonary-circulation-in-the-perinatal-period-short-and-long-term-consequences-for-the-human-cardiopulmonary-system
#14
Daphne P de Wijs-Meijler, Dirk J Duncker, Dick Tibboel, Ralph T Schermuly, Norbert Weissmann, Daphne Merkus, Irwin K M Reiss
Development of the pulmonary circulation is a complex process with a spatial pattern that is tightly controlled. This process is vulnerable for disruption by various events in the prenatal and early postnatal periods. Disruption of normal pulmonary vascular development leads to abnormal structure and function of the lung vasculature, causing neonatal pulmonary vascular diseases. Premature babies are especially at risk of the development of these diseases, including persistent pulmonary hypertension and bronchopulmonary dysplasia...
March 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28678849/community-health-promotion-and-medical-provision-for-neonatal-health-champion-cluster-randomised-trial-in-nagarkurnool-district-telangana-formerly-andhra-pradesh-india
#15
RANDOMIZED CONTROLLED TRIAL
Peter Boone, Alex Eble, Diana Elbourne, Chris Frost, Chitra Jayanty, Rashmi Lakshminarayana, Vera Mann, Rohini Mukherjee, Gilda Piaggio, Padmanabh Reddy
BACKGROUND: In the mid-2000s, neonatal mortality accounted for almost 40% of deaths of children under 5 years worldwide, and constituted 65% of infant deaths in India. The neonatal mortality rate in Andhra Pradesh was 44 per 1,000 live births, and was higher in the rural areas and tribal regions, such as the Nagarkurnool division of Mahabubnagar district (which became Nagarkurnool district in Telangana in 2014). The aim of the CHAMPION trial was to investigate whether a package of interventions comprising community health promotion and provision of health services (including outreach and facility-based care) could lead to a reduction of the order of 25% in neonatal mortality...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28670938/the-effect-of-low-dose-aspirin-on-fetal-weight-of-idiopathic-asymmetrically-intrauterine-growth-restricted-fetuses-with-abnormal-umbilical-artery-doppler-indices-a-randomized-clinical-trial
#16
Mohammed K Ali, Ahmed M Abbas, Ali H Yosef, Mostafa Bahloul
OBJECTIVE: To investigate the effect of aspirin on fetal weight in fetuses with idiopathic asymmetrical intrauterine growth restriction (IUGR) complicated by abnormal umbilical artery Doppler indices. MATERIAL AND METHODS: The study was a randomized controlled trial conducted at Woman's Health Hospital, Assiut, Egypt, between June 2016 and the January 2017 included 60 pregnant women (28-30 weeks) with idiopathic asymmetrical IUGR associated with abnormal umbilical artery Doppler indices...
July 2, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28668289/foley-catheterisation-versus-oral-misoprostol-for-induction-of-labour-in-hypertensive-women-in-india-inform-a-multicentre-open-label-randomised-controlled-trial
#17
Shuchita Mundle, Hillary Bracken, Vaishali Khedikar, Jayashree Mulik, Brian Faragher, Thomas Easterling, Simon Leigh, Paul Granby, Alan Haycox, Mark A Turner, Zarko Alfirevic, Beverly Winikoff, Andrew D Weeks
BACKGROUND: Between 62 000 and 77 000 women die annually from pre-eclampsia and eclampsia. Prompt delivery, preferably by the vaginal route, is vital for good maternal and neonatal outcomes. Two low-cost interventions-low-dose oral misoprostol tablets and transcervical Foley catheterisation-are already used in low-resource settings. We aimed to compare the relative risks and benefits of these interventions. METHODS: We undertook this multicentre, open-label, randomised controlled trial in two public hospitals in Nagpur, India...
June 28, 2017: Lancet
https://www.readbyqxmd.com/read/28665803/methylation-differences-reveal-heterogeneity-in-preterm-pathophysiology-results-from-bipartite-network-analyses
#18
Suresh K Bhavnani, Bryant Dang, Varun Kilaru, Maria Caro, Shyam Visweswaran, George Saade, Alicia K Smith, Ramkumar Menon
BACKGROUND: Recent studies have shown that epigenetic differences can increase the risk of spontaneous preterm birth (PTB). However, little is known about heterogeneity underlying such epigenetic differences, which could lead to hypotheses for biological pathways in specific patient subgroups, and corresponding targeted interventions critical for precision medicine. Using bipartite network analysis of fetal DNA methylation data we demonstrate a novel method for classification of PTB. METHODS: The data consisted of DNA methylation across the genome (HumanMethylation450 BeadChip) in cord blood from 50 African-American subjects consisting of 22 cases of early spontaneous PTB (24-34 weeks of gestation) and 28 controls (>39 weeks of gestation)...
June 30, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28661576/physiological-alterations-associated-with-intrauterine-growth-restriction-in-fetal-pigs-causes-and-insights-for-nutritional-optimization
#19
REVIEW
Junjun Wang, Cuiping Feng, Ting Liu, Meng Shi, Guoyao Wu, Fuller W Bazer
Intrauterine growth restriction (IUGR) remains a major problem in swine production since the associated low birth weight leads to high rates of pre-weaning morbidity and mortality plus permanent retardation of growth and development. Complex biological events-including genetics, epigenetics, maternal maturity, maternal nutrition, placenta efficiency, uterine capacity, and other environmental factors-can affect fetal growth and development during late gestation, as well as maturity of oocytes, duration of estrus, and both implantation and placentation of conceptuses in uteri of sows...
June 29, 2017: Molecular Reproduction and Development
https://www.readbyqxmd.com/read/28661549/hepatitis-c-in-pregnancy-review-of-current-knowledge-and-updated-recommendations-for-management
#20
Charlotte M Page, Brenna L Hughes, Eleanor H J Rhee, Jeffrey A Kuller
Importance: An estimated 1% to 2.5% of pregnant women in the United States are infected with hepatitis C virus (HCV), which carries approximately a 6% risk of mother-to-infant transmission. Objectives: The aims of this article are to review the current evidence on HCV in pregnancy and to provide updated recommendations for management. Evidence Acquisition: Original research articles, review articles, and guidelines on HCV in general and specifically in pregnancy were reviewed, as were drug safety profiles from the Food and Drug Administration...
June 2017: Obstetrical & Gynecological Survey
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