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Kilpatrick R, Davis JM, Aranda JV. Caffeine: how early is too early? Pediatr Res 2024:10.1038/s41390-024-03199-z. [PMID: 38643263 DOI: 10.1038/s41390-024-03199-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 03/23/2024] [Indexed: 04/22/2024]
Affiliation(s)
- Ryan Kilpatrick
- Department of Pediatrics, Tufts Medical Center, Boston, MA, USA
| | - Jonathan M Davis
- Department of Pediatrics, Tufts Medical Center, Boston, MA, USA.
- Tufts Clinical and Translational Research Institute, Tufts University School of Medicine, Boston, MA, USA.
| | - Jacob V Aranda
- Division of Neonatology and the Neonatal Clinical and Translational Pharmacology Research Laboratory, State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
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2
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Li Y, Wen H, Yang Y, Zhao Z, Gao H, Li H, Huang M. Potential prognostic markers of retained placenta in dairy cows identified by plasma metabolomics coupled with clinical laboratory indicators. Vet Q 2022; 42:199-212. [DOI: 10.1080/01652176.2022.2145619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Yuqiong Li
- Laboratory Institute of Animal Science, Ningxia Academy of Agricultural and Forestry Sciences, Yinchuan, Ningxia 750002, China
| | - Huiyu Wen
- Laboratory Institute of Animal Science, Ningxia Academy of Agricultural and Forestry Sciences, Yinchuan, Ningxia 750002, China
| | - Yuwei Yang
- Laboratory Institute of Animal Science, Ningxia Academy of Agricultural and Forestry Sciences, Yinchuan, Ningxia 750002, China
| | - Zhengwei Zhao
- Laboratory Institute of Animal Science, Ningxia Academy of Agricultural and Forestry Sciences, Yinchuan, Ningxia 750002, China
| | | | | | - Meizhou Huang
- Academician (Expert) Workstation of Sichuan Province, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
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Zhang Y, Zhao J, Qin Y, Wang Y, Yu Z, Ning X, Sun S. Specific alterations of gut microbiota in patients with membranous nephropathy: A systematic review and meta-analysis. Front Physiol 2022; 13:909491. [PMID: 36388089 PMCID: PMC9664147 DOI: 10.3389/fphys.2022.909491] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 10/03/2022] [Indexed: 02/12/2024] Open
Abstract
Background: The pathogenesis of idiopathic membranous nephropathy (IMN) has not yet been thoroughly clarified, and gut dysbiosis may be a contributor to IMN. However, the characterization of gut microbiota in patients with IMN remains uncertain. Methods: Cochrane Library, PubMed, China National Knowledge Internet, Web of Science, and Embase were used to search for studies through 18 May 2022. A meta-analysis based on the standardized mean difference (SMD) with 95% confidence interval (CI) was conducted on the alpha diversity index. The between-group comparison of the relative abundance of gut microbiota taxa and the beta diversity were extracted and qualitatively analyzed. Results: Five studies were included involving 290 patients with IMN, 100 healthy controls (HCs), and 129 patients with diabetic kidney disease (DKD). The quantitative combination of alpha diversity indices indicated that although bacterial richness was impaired [ACE, SMD = 0.12, (-0.28, 0.52), p = 0.55, I 2 = 0%; Chao1, SMD = -0.34, (-0.62, -0.06), p < 0.05, I 2 = 36%], overall diversity was preserved [Shannon, SMD = -0.16, (-0.64, 0.31), p = 0.50, I 2 = 53%; Simpson, SMD = 0.27, (-0.08, 0.61), p = 0.13, I 2 = 0%]. The beta diversity was significantly varied compared to HCs or DKD patients. Compared to HCs, the abundance of Proteobacteria increased, while that of Firmicutes decreased at the phylum level. Furthermore, the abundance of Lachnospira were depleted, while those of Streptococcus were enriched at the genus level. Proteobacteria and Streptococcus were also increased compared to DKD patients. Conclusions: The expansion of Proteobacteria and depletion of Lachnospira may be critical features of the altered gut microbiota in patients with IMN. This condition may play an important role in the pathogenesis of IMN and could provide bacterial targets for diagnosis and therapy.
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Affiliation(s)
- Yumeng Zhang
- Department of Postgraduate Student, Xi’an Medical University, Xi’an, China
- Department of Nephrology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Jin Zhao
- Department of Nephrology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Yunlong Qin
- Department of Nephrology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
- Department of Nephrology, 980th Hospital of People’s Liberation Army Joint Logistic Support Force (Bethune International Peace Hospital), Shijiazhuang, Hebei, China
| | - Yuwei Wang
- Department of Postgraduate Student, Xi’an Medical University, Xi’an, China
- Department of Nephrology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Zixian Yu
- Department of Nephrology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Xiaoxuan Ning
- Department of Geriatric, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Shiren Sun
- Department of Nephrology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
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Gulzar Ahmad S, Iqbal T, Javaid A, Ullah Munir E, Kirn N, Ullah Jan S, Ramzan N. Sensing and Artificial Intelligent Maternal-Infant Health Care Systems: A Review. SENSORS 2022; 22:s22124362. [PMID: 35746144 PMCID: PMC9228894 DOI: 10.3390/s22124362] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/20/2022] [Accepted: 05/23/2022] [Indexed: 02/01/2023]
Abstract
Currently, information and communication technology (ICT) allows health institutions to reach disadvantaged groups in rural areas using sensing and artificial intelligence (AI) technologies. Applications of these technologies are even more essential for maternal and infant health, since maternal and infant health is vital for a healthy society. Over the last few years, researchers have delved into sensing and artificially intelligent healthcare systems for maternal and infant health. Sensors are exploited to gauge health parameters, and machine learning techniques are investigated to predict the health conditions of patients to assist medical practitioners. Since these healthcare systems deal with large amounts of data, significant development is also noted in the computing platforms. The relevant literature reports the potential impact of ICT-enabled systems for improving maternal and infant health. This article reviews wearable sensors and AI algorithms based on existing systems designed to predict the risk factors during and after pregnancy for both mothers and infants. This review covers sensors and AI algorithms used in these systems and analyzes each approach with its features, outcomes, and novel aspects in chronological order. It also includes discussion on datasets used and extends challenges as well as future work directions for researchers.
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Affiliation(s)
- Saima Gulzar Ahmad
- Department of Computer Science, Wah Campus, COMSATS University Islamabad, Islamabad 45040, Pakistan; (S.G.A.); (T.I.); (A.J.)
| | - Tassawar Iqbal
- Department of Computer Science, Wah Campus, COMSATS University Islamabad, Islamabad 45040, Pakistan; (S.G.A.); (T.I.); (A.J.)
| | - Anam Javaid
- Department of Computer Science, Wah Campus, COMSATS University Islamabad, Islamabad 45040, Pakistan; (S.G.A.); (T.I.); (A.J.)
| | - Ehsan Ullah Munir
- Department of Computer Science, Wah Campus, COMSATS University Islamabad, Islamabad 45040, Pakistan; (S.G.A.); (T.I.); (A.J.)
- Correspondence:
| | - Nasira Kirn
- School of Computing, Engineering and Physical Sciences, University of the West of Scotland, Glasgow G72 0LH, UK;
| | - Sana Ullah Jan
- School of Computing, Edinburgh Napier University, Edinburgh EH10 5DT, UK; (S.U.J.); (N.R.)
| | - Naeem Ramzan
- School of Computing, Edinburgh Napier University, Edinburgh EH10 5DT, UK; (S.U.J.); (N.R.)
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Farah E, Barger MK, Klima C, Rossman B, Hershberger P. Impaired Lactation: Review of Delayed Lactogenesis and Insufficient Lactation. J Midwifery Womens Health 2021; 66:631-640. [PMID: 34596953 DOI: 10.1111/jmwh.13274] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 05/08/2021] [Accepted: 06/04/2021] [Indexed: 12/29/2022]
Abstract
It is estimated that as many as 1 in 20 women worldwide are unable to successfully breastfeed or provide adequate nutrition for their infants through their breast milk alone. Compromised nutrition in the early stages of life places the infant at risk for insufficient growth as well as serious and potentially disabling or life-threatening complications. This review summarizes risk factors associated with impaired lactation that may result in either delayed lactogenesis or insufficient lactation. The risk factors for insufficient lactation are categorized into preglandular, glandular, and postglandular causes. Impaired lactation can occur despite maternal motivation, knowledge, support, and appropriate breastfeeding technique. Although there is no clear way to predict who will experience impaired lactation, knowledge about the risk factors can enable health care professionals to better identify at-risk mother-infant dyads. Early intervention may help prevent infant complications associated with inadequate nutritional intake.
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Affiliation(s)
- Erin Farah
- Department of Human Development Nursing Science, University of Illinois at Chicago, Chicago, Illinois
| | - Mary K Barger
- Hahn School of Nursing and Health Sciences, University of San Diego, San Diego, California
| | - Carrie Klima
- Department of Human Development Nursing Science, University of Illinois at Chicago, Chicago, Illinois
| | - Beverly Rossman
- Department of Women, Children, and Family Nursing, Rush University Medical Center, Chicago, Illinois
| | - Patricia Hershberger
- Department of Health Systems Science, University of Illinois at Chicago, Chicago, Illinois
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Abstract
BACKGROUND Retained placenta is a common complication of pregnancy affecting 1% to 6% of all births. If a retained placenta is left untreated, spontaneous delivery of the placenta may occur, but there is a high risk of bleeding and infection. Manual removal of the placenta (MROP) in an operating theatre under anaesthetic is the usual treatment, but is invasive and may have complications. An effective non-surgical alternative for retained placenta would potentially reduce the physical and psychological trauma of the procedure, and costs. It could also be lifesaving by providing a therapy for settings without easy access to modern operating theatres or anaesthetics. Injection of uterotonics into the uterus via the umbilical vein and placenta is an attractive low-cost option for this. This is an update of a review last published in 2011. OBJECTIVES To assess the use of umbilical vein injection (UVI) of saline solution with or without uterotonics compared to either expectant management or with an alternative solution or other uterotonic agent for retained placenta. SEARCH METHODS For this update, we searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (14 June 2020), and reference lists of retrieved studies. SELECTION CRITERIA Randomised controlled trials (RCTs) comparing UVI of saline or other fluids (with or without uterotonics), either with expectant management or with an alternative solution or other uterotonic agent, in the management of retained placenta. We considered quasi-randomised, cluster-randomised, and trials reported only in abstract form. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trials for inclusion and risk of bias, extracted data, and checked them for accuracy. We assessed the certainty of the evidence using the GRADE approach. We calculated pooled risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs), and presented results using 'Summary of findings' tables. MAIN RESULTS We included 24 trials (n = 2348). All included trials were RCTs, one was quasi-randomised, and none were cluster-randomised. Risk of bias was variable across the included studies. We assessed certainty of evidence for four comparisons: saline versus expectant management, oxytocin versus expectant management, oxytocin versus saline, and oxytocin versus plasma expander. Evidence was moderate to very-low certainty and downgraded for risk of bias of included studies, imprecision, and inconsistency of effect estimates. Saline solution versus expectant management There is probably little or no difference in the incidence of MROP between saline and expectant management (RR 0.93, 95% CI 0.80 to 1.10; 5 studies, n = 445; moderate-certainty evidence). Evidence for the following remaining primary outcomes was very-low certainty: severe postpartum haemorrhage 1000 mL or greater, blood transfusion, and infection. There were no events reported for maternal mortality or postpartum anaemia (24 to 48 hours postnatal). No studies reported addition of therapeutic uterotonics. Oxytocin solution versus expectant management UVI of oxytocin solution might slightly reduce in the need for manual removal compared with expectant management (mean RR 0.73, 95% CI 0.56 to 0.95; 7 studies, n = 546; low-certainty evidence). There may be little to no difference between the incidence of blood transfusion between groups (RR 0.81, 95% CI 0.47 to 1.38; 4 studies, n = 339; low-certainty evidence). There were no maternal deaths reported (2 studies, n = 93). Evidence for severe postpartum haemorrhage of 1000 mL or greater, additional uterotonics, and infection was very-low certainty. There were no events for postpartum anaemia (24 to 48 hours postnatal). Oxytocin solution versus saline solution UVI of oxytocin solution may reduce the use of MROP compared with saline solution, but there was high heterogeneity (RR 0.82, 95% CI 0.69 to 0.97; 14 studies, n = 1370; I² = 54%; low-certainty evidence). There were no differences between subgroups according to risk of bias or oxytocin dose for the outcome MROP. There may be little to no difference between groups in severe postpartum haemorrhage of 1000 mL or greater, blood transfusion, use of additional therapeutic uterotonics, and antibiotic use. There were no events for postpartum anaemia (24 to 48 hours postnatal) (very low-certainty evidence) and there was only one event for maternal mortality (low-certainty evidence). Oxytocin solution versus plasma expander One small study reported UVI of oxytocin compared with plasma expander (n = 109). The evidence was very unclear about any effect on MROP or blood transfusion between the two groups (very low-certainty evidence). No other primary outcomes were reported. For other comparisons there were little to no differences for most outcomes examined. However, there was some evidence to suggest that there may be a reduction in MROP with prostaglandins in comparison to oxytocin (4 studies, n = 173) and ergometrine (1 study, n = 52), although further large-scale studies are needed to confirm these findings. AUTHORS' CONCLUSIONS UVI of oxytocin solution is an inexpensive and simple intervention that can be performed when placental delivery is delayed. This review identified low-certainty evidence that oxytocin solution may slightly reduce the need for manual removal. However, there are little or no differences for other outcomes. Small studies examining injection of prostaglandin (such as dissolved misoprostol) into the umbilical vein show promise and deserve to be studied further.
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Affiliation(s)
- Nimisha Kumar
- Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Shayesteh Jahanfar
- MPH Program, Department of Public Health and Community Medicine, Tufts University School of Medicine, Michigan, USA
| | - David M Haas
- Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Andrew D Weeks
- Department of Women's and Children's Health, The University of Liverpool, Liverpool, UK
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Atiq F, Wuijster E, de Maat MP, Kruip MJ, Cnossen MH, Leebeek FW. Criteria for low von Willebrand factor diagnosis and risk score to predict future bleeding. J Thromb Haemost 2021; 19:719-731. [PMID: 33370487 PMCID: PMC7986755 DOI: 10.1111/jth.15227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/01/2020] [Accepted: 12/18/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Important diagnostic and clinical aspects of moderately reduced von Willebrand factor (VWF) levels are still unknown. There is no clear evidence which cutoff value (0.50 vs 0.60 IU/ml) should be used to diagnose "low VWF." Also, the incidence of bleeding after the diagnosis has been made, and risk factors for bleeding are unknown yet. OBJECTIVES To investigate the incidence of postsurgical bleeding, postpartum hemorrhage (PPH), and traumatic and spontaneous bleeding after low VWF diagnosis, and to develop a risk score to predict future bleeding. METHODS We performed a cohort study in patients with historically lowest VWF levels of 0.31 to 0.60 IU/ml. Clinical data of patients were retrospectively collected. RESULTS We included 439 patients with low VWF. During a follow-up of 6.3 ± 3.7 years, 259 surgical procedures, 81 deliveries, and 109 spontaneous and traumatic bleeding episodes were reported. The incidence of postsurgical bleeding was 2.7%, whereas 10% of deliveries was complicated by PPH. Overall, 65 patients (14.8%) had bleeding requiring treatment, which was not different between patients with historically lowest VWF levels of 0.31-0.50 and 0.51-0.60 IU/ml (p = .154). Age <18 years, abnormal bleeding score at diagnosis, and being referred for bleeding symptoms at the time of diagnosis were independent risk factors for bleeding during follow-up, and therefore included in the risk score. CONCLUSIONS The cutoff value of low VWF diagnosis should be set at 0.60 IU/ml. Furthermore, a risk score is developed to identify individuals with a high risk for bleeding after low VWF diagnosis.
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Affiliation(s)
- Ferdows Atiq
- Department of HematologyErasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Esmee Wuijster
- Department of HematologyErasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Moniek P.M. de Maat
- Department of HematologyErasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Marieke J.H.A. Kruip
- Department of HematologyErasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Marjon H. Cnossen
- Department of Pediatric HematologyErasmus MC‐Sophia Children’s HospitalUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Frank W.G. Leebeek
- Department of HematologyErasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
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Bovbjerg ML. Current Resources for Evidence-Based Practice, March 2021. J Obstet Gynecol Neonatal Nurs 2021; 50:225-236. [PMID: 33607061 DOI: 10.1016/j.jogn.2021.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
An extensive review of new resources to support the provision of evidence-based care for women and infants. The current column includes a discussion of men's experiences of pregnancy loss and commentaries on reviews focused on the effects of perineal massage on perineal trauma and air pollution and heat exposure on birth outcomes.
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Khamidullina Z, Myrzabekova A, Syzdykova A. UTEROTONIC DRUGS IN THE PREVENTION OF POSTPARTUM HEMORRHAGES. REPRODUCTIVE MEDICINE 2020. [DOI: 10.37800/rm2020-1-37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
In the world practice, hemorrhages in obstetrics take leading positions within the causes of maternal morbidity and mortal ity. 800 women die every day due to childbirth complications under the data of the World Health Organization. The majority of maternal deaths occur during the perinatal period, usually within 24 hours postpartum. It is possible to prevent most of them. Lack of adequate pre-conceptional training, uncompensated extragenital diseases increase the percentage of pathological births. Consequently, practicing obstetricians-gynecologists have to face such childbirth complications as postpartum hemorrhage with increasing frequency. Uterine atonia is the main cause of postpartum hemorrhages. Uterotonic drugs administration enables to re- duce the risk of postpartum atonic hemorrhages. Particular attention should be paid to postpartum hemorrhage prevention, i.e. the use of uterotonic drugs as an integral part of the active management during the third period in natural labor and caesarean section.
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Plazentalösungsstörung nach Spontangeburt: Welches Uterotonikum hilft am besten? Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/a-1265-7886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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