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Sidar SS, Skuthan A. Occupational Therapy Practitioners' Perceptions of Providing Services for the Acute Postpartum Population. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2024:15394492241234846. [PMID: 38436257 DOI: 10.1177/15394492241234846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Occupational therapy practitioners' (OTP's) perceptions of their role in working on the acute postpartum hospital unit are unknown. The objective of this research was to determine the perspectives of OTP's enrolled in a continuing education course to gain competency in providing services to acute postpartum patients. Investigators engaged in a phenomenology consisting of semi-structured interviews with six OTP's working in acute care hospitals preparing to work on the postpartum unit. Three themes emerged from transcripts: (a) Its' Not THAT Different; (b) Willing To Try; and (c) Shifting Focus To Mom. OTPs working in hospitals identified existing skills applicable to working with acute postpartum patients, a need for additional learning to enhance competence, and a desire to focus support for the birthing person to improve maternal outcomes. Hospital onboarding and/or entry-level OTP programs should consider including education on the postpartum population. Future research should focus on program implementation on acute postpartum hospital units.
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Xiao L, Xiao H, Zhong Y, Luo Y, Luo H, Wang M. Association between functional constipation and vaginal wind in women at 6 weeks postpartum. Int Urogynecol J 2023; 34:2925-2932. [PMID: 37578617 PMCID: PMC10756862 DOI: 10.1007/s00192-023-05619-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/05/2023] [Indexed: 08/15/2023]
Abstract
INTRODUCTION AND HYPOTHESIS The pathogenesis of vaginal wind remains unclear. This study was aimed at assessing the association between functional constipation and vaginal wind in women at 6 weeks postpartum. METHODS This is a multicenter cross-sectional study. We collected data, such as baseline demographic, clinical characteristics, pelvic organ prolapse quantification score. and surface electromyography parameters of pelvic floor muscles, of women at 6 weeks postpartum who visited the postpartum rehabilitation clinic between May 2022 and September 2022. The cohort data were from women who visited the postpartum rehabilitation clinic of the First Affiliated Hospital of Gannan Medical University and the Women and Children's Health Care Hospital of Yudu County. Follow-up for the control and study cohorts was conducted until 6 weeks postpartum. RESULTS Among the 377 women, 101 (26.79%) reported vaginal wind. Multivariate regression analysis showed that postpartum women with functional constipation were at a higher risk for vaginal wind than women without functional constipation (odds ratio [OR], 2.41). The results remained stable across the propensity score analyses (OR, 1.86-2.30). In addition, we found age, body mass index, mode of delivery, changes in the anatomical location of Bp points, urinary incontinence, pelvic floor muscle strength, and birth weight of the neonate were not associated with increased odds of vaginal wind in women at 6 weeks postpartum. CONCLUSIONS Vaginal wind is common among women at 6 weeks postpartum and is associated with functional constipation. Functional constipation may serve as a reference for the pathogenesis, prevention, and treatment of vaginal wind.
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Affiliation(s)
- Li Xiao
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Gannan Medical University, No.128 Jinling Road, Zhanggong District, Ganzhou City, 341000, Jiangxi Province, China
- Ganzhou Key Laboratory of Rehabilitation Medicine, Ganzhou City, Jiangxi Province, China
- Ganzhou Intelligent Rehabilitation Technology Innovation Center, Ganzhou City, Jiangxi Province, China
| | - Huilian Xiao
- Department of Pelvic Floor and Postpartum Rehabilitation, Maternal and Child Health Hospital of Yudu County, Ganzhou City, Jiangxi Province, China
| | - Yanbiao Zhong
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Gannan Medical University, No.128 Jinling Road, Zhanggong District, Ganzhou City, 341000, Jiangxi Province, China
- Ganzhou Key Laboratory of Rehabilitation Medicine, Ganzhou City, Jiangxi Province, China
- Ganzhou Intelligent Rehabilitation Technology Innovation Center, Ganzhou City, Jiangxi Province, China
| | - Yun Luo
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Gannan Medical University, No.128 Jinling Road, Zhanggong District, Ganzhou City, 341000, Jiangxi Province, China
- Ganzhou Key Laboratory of Rehabilitation Medicine, Ganzhou City, Jiangxi Province, China
- Ganzhou Intelligent Rehabilitation Technology Innovation Center, Ganzhou City, Jiangxi Province, China
| | - Huachao Luo
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Gannan Medical University, No.128 Jinling Road, Zhanggong District, Ganzhou City, 341000, Jiangxi Province, China
- Ganzhou Key Laboratory of Rehabilitation Medicine, Ganzhou City, Jiangxi Province, China
- Ganzhou Intelligent Rehabilitation Technology Innovation Center, Ganzhou City, Jiangxi Province, China
| | - Maoyuan Wang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Gannan Medical University, No.128 Jinling Road, Zhanggong District, Ganzhou City, 341000, Jiangxi Province, China.
- Ganzhou Key Laboratory of Rehabilitation Medicine, Ganzhou City, Jiangxi Province, China.
- Ganzhou Intelligent Rehabilitation Technology Innovation Center, Ganzhou City, Jiangxi Province, China.
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Yin Y, Zhang Y, Qian C. Association of delivery mode and number of pregnancies with anorectal manometry data in patients with postpartum constipation. BMC Pregnancy Childbirth 2023; 23:160. [PMID: 36899308 PMCID: PMC10007787 DOI: 10.1186/s12884-023-05480-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 03/01/2023] [Indexed: 03/12/2023] Open
Abstract
OBJECTIVE To explore the association of delivery mode and the number of pregnancies with anorectal manometry data in patients with postpartum constipation. METHODS This retrospective study included women with postpartum constipation treated at the pelvic floor rehabilitation department of Huzhou Maternity & Child Health Care Hospital between January 2018 and December 2019. RESULTS Among 127 patients included, 55 (43.3%) had one pregnancy, 72 (56.7%) had two pregnancies, 96 (75.6%) delivered spontaneously, 25 (16.7%) underwent Cesarean section, and six (4.7%) needed a Cesarean section despite spontaneous labor. The median duration of constipation was 12 months (range, 6-12). There were no differences between the two groups for any manometry parameters (all P > 0.05). The patients with a spontaneous delivery had a lower change in maximal contracting sphincter pressure compared with those with Cesarean section (14.3 (4.5-25.0) vs. 19.6 (13.4-40.0), P = 0.023). Only the delivery mode (Cesarean vs. spontaneous) independently affected the changes in contracting sphincter pressure (B = 10.32, 95%CI: 2.95-17.69, P = 0.006); age (P = 0.201), number of pregnancies (P = 0.190), and constipation duration (P = 0.161) were not associated. CONCLUSION The patients with a spontaneous delivery had a lower change in maximal contracting sphincter pressure compared with those with a Cesarean section, suggesting that patients with Cesarean may retain a better "push" function during defecation.
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Affiliation(s)
- Yan Yin
- General surgery department, Huzhou Maternity and Child Health Care Hospital, 313000, Huzhou, China.
| | - Yumin Zhang
- General surgery department, Huzhou Maternity and Child Health Care Hospital, 313000, Huzhou, China
| | - Cheng Qian
- General surgery department, Huzhou Maternity and Child Health Care Hospital, 313000, Huzhou, China
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Li Y, Han M, Song J, Liu S, Wang Y, Su X, Wei K, Xu Z, Li H, Wang Z. The prebiotic effects of soluble dietary fiber mixture on renal anemia and the gut microbiota in end-stage renal disease patients on maintenance hemodialysis: a prospective, randomized, placebo-controlled study. J Transl Med 2022; 20:599. [PMID: 36517799 PMCID: PMC9753397 DOI: 10.1186/s12967-022-03812-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Renal anemia is caused by end-stage renal disease (ESRD) but has a complex etiology. The application of dietary fiber (DF) to regulate the gut microbiota has shown effective therapeutic effects in some diseases, but its role in renal anemia is not clear. The aim of this study was to explore the effect of DF on renal anemia by regulating the gut microbiota and its metabolite, short-chain fatty acids (SCFAs). METHODS A total of 162 ESRD patients were enrolled and randomly distributed into a DF or a control group (received oral DF or potato starch, 10 g/day for 8 weeks). Hemoglobin (Hb), serum iron (Fe2+), serum ferritin (SF), soluble transferrin receptor (sTfR), hepcidin and the dosage of recombinant human erythropoietin (rhEPO) before and after intervention in patients were analyzed. The gut microbiota and SCFAs in both groups were analyzed by 16S rDNA sequencing and gas chromatography-mass spectrometry, respectively. Spearman's correlation test was used to analyze the correlation between the gut microbiota, SCFAs and the hematological indicators. RESULTS Compared with the control group, (1) the patients in the DF group had higher Hb [117.0 (12.5) g/L vs. 94.0 (14.5) g/L, p < 0.001], Fe2+ [13.23 (4.83) μmol/L vs. 10.26 (5.55) μmol/L, p < 0.001], and SF levels [54.15 (86.66) ng/ml vs. 41.48 (36.60) ng/ml, p = 0.003]. (2) The rhEPO dosage in the DF group was not significantly decreased (p = 0.12). (3) Bifidobacterium adolescentis, Lactobacillus and Lactobacillaceae were increased in the DF group, and Lactobacillus and Lactobacillaceae were positively correlated with Hb (r = 0.44, p < 0.001; r = 0.44, p < 0.001) and Fe2+ levels (r = 0.26, p = 0.016; r = 0.26, p = 0.016) and negatively correlated with rhEPO dosage (r = - 0.45, p < 0.001; r = - 0.45, p < 0.001). (4) Patients in the DF group had elevated serum butyric acid (BA) levels [0.80 (1.65) vs. 0.05 (0.04), p < 0.001] and BA levels were positively correlated with Hb (r = 0.26, p = 0.019) and Fe2+ (r = 0.31, p = 0.005) and negatively correlated with rhEPO dosage (r = - 0.36, p = 0.001). Lactobacillus and Lactobacillaceae were positively correlated with BA levels (r = 0.78, p < 0.001; r = 0.78, p < 0.001). CONCLUSION DF may improve renal anemia in ESRD patients by regulating the gut microbiota and SCFAs. Trial registration This study was registered in the China Clinical Trial Registry ( www.chictr.org.cn ) on December 20, 2018 ( ChiCTR1800020232 ).
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Affiliation(s)
- Yang Li
- grid.410638.80000 0000 8910 6733Department of Nephrology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Nephrology, No. 16766 Jingshi Road, Jinan, 250014 Shandong China
| | - Min Han
- grid.410638.80000 0000 8910 6733Department of Nephrology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Nephrology, No. 16766 Jingshi Road, Jinan, 250014 Shandong China
| | - Jia Song
- grid.410638.80000 0000 8910 6733Department of Nephrology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Nephrology, No. 16766 Jingshi Road, Jinan, 250014 Shandong China ,grid.410638.80000 0000 8910 6733Shandong First Medical University, No. 6699 Qingdao Street, Jinan, 250117 Shandong China
| | - Shijin Liu
- grid.410638.80000 0000 8910 6733Department of Nephrology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Nephrology, No. 16766 Jingshi Road, Jinan, 250014 Shandong China ,grid.268079.20000 0004 1790 6079Weifang Medical University, No. 7166 Baotong West Street, Weifang, 261053 Shandong China
| | - Yongjun Wang
- grid.452422.70000 0004 0604 7301Department of Clinical Nutrition, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, No. 16766 Jingshi Road, Jinan, 250014 Shandong China
| | - Xinhuan Su
- grid.460018.b0000 0004 1769 9639Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021 Shandong China
| | - Kai Wei
- grid.410638.80000 0000 8910 6733Department of Nephrology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Nephrology, No. 16766 Jingshi Road, Jinan, 250014 Shandong China
| | - Zhen Xu
- Department of Nephrology, Yuncheng Chengxin Hospital, West of Jiangmiaodeng Tower, Yunzhou Street, Heze, 274700 Shandong China
| | - Hui Li
- Department of Nephrology, People’s Hospital of Lingcheng, No. 245 Zhongxing Road, Dezhou, 253599 Shandong China
| | - Zunsong Wang
- grid.410638.80000 0000 8910 6733Department of Nephrology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Nephrology, No. 16766 Jingshi Road, Jinan, 250014 Shandong China
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Analysis of the Outcome of Treatment of Brain Metastases from Malignant Trophoblastic Tumours and Risk Factors for Prognosis during Pregnancy. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:3932460. [PMID: 36017013 PMCID: PMC9388270 DOI: 10.1155/2022/3932460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/30/2022] [Accepted: 07/02/2022] [Indexed: 11/28/2022]
Abstract
Temozolomide combined with whole-brain radiotherapy has good near-term efficacy and safety in the treatment of brain metastases from nonsmall cell lung cancer. In this study, we analyzed the risk factors for treatment and prognosis of brain metastases in gestational trophoblastic neoplasm (GTN) during pregnancy. Thirty-one patients with brain metastases were included in the study. All patients had a pathological diagnosis of primary lesions, including 23 adenocarcinomas, 7 squamous carcinomas, and 1 adenosquamous carcinoma, and had ≥3 intracranial metastases, controlled primary lesions (including resected primary lesions or unresectable primary lesions in partial remission (PR)/complete remission (CR) for ≥2 months) by cranial enhancement MRI and no extracranial metastases. Presence or control of extracranial metastases was for ≥2 months. The common adverse toxic effects were nausea, vomiting, neutropenia, and thrombocytopenia, but most patients tolerated them with symptomatic management.
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