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Katarzyna W, Małgorzata P, Agata W(P, Wioletta M, Jan M, Katarzyna R, Maciej W. Blood-Stained Colostrum: A Rare Phenomenon at an Early Lactation Stage. CHILDREN 2022; 9:children9020213. [PMID: 35204933 PMCID: PMC8870239 DOI: 10.3390/children9020213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 01/28/2022] [Accepted: 02/01/2022] [Indexed: 11/20/2022]
Abstract
The phenomenon described in the literature as rusty pipe syndrome is a rare condition (the estimated incidence is 0.1% in the population of breastfeeding women) where the prenatal milk and the colostrum are rust- or blood-colored. Due to the rare occurrence of this phenomenon and the related nature of the baby’s regurgitated discharge—green, brown or blood-stained, there is a general fear of latching a newborn or continuing to breastfeed if the regurgitation persists. In this care report, a patient’s milk was tested to determine its microbiological and morphological content. No significant abnormalities were noted in these tests. The nutritional profile of the blood-stained colostrum was normal. Breast milk has an indisputably invaluable impact on the newborn’s further development and there is no connection between rusty pipe syndrome, as described in the literature, and any clinical complications. This is crucial to encourage mothers to keep breastfeeding even if they observe blood-stained colostrum.
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Affiliation(s)
- Wszołek Katarzyna
- Gynecological and Obstetrics Hospital, Poznan University of Medical Sciences, 61-701 Poznań, Poland; (P.M.); (M.W.); (M.J.); (R.K.); (W.M.)
- Department of Maternal and Child Health, Poznan University of Medical Sciences, 60-535 Poznań, Poland
- Correspondence:
| | - Pięt Małgorzata
- Gynecological and Obstetrics Hospital, Poznan University of Medical Sciences, 61-701 Poznań, Poland; (P.M.); (M.W.); (M.J.); (R.K.); (W.M.)
- Department of Midwifery, Poznan University of Medical Sciences, 60-535 Poznań, Poland
| | | | - Meissner Wioletta
- Gynecological and Obstetrics Hospital, Poznan University of Medical Sciences, 61-701 Poznań, Poland; (P.M.); (M.W.); (M.J.); (R.K.); (W.M.)
| | - Mazela Jan
- Gynecological and Obstetrics Hospital, Poznan University of Medical Sciences, 61-701 Poznań, Poland; (P.M.); (M.W.); (M.J.); (R.K.); (W.M.)
- Neonatal Infection Clinic, Gynecological and Obstetrics Hospital, Poznan University of Medical Sciences, 60-535 Poznań, Poland
| | - Rybicka Katarzyna
- Gynecological and Obstetrics Hospital, Poznan University of Medical Sciences, 61-701 Poznań, Poland; (P.M.); (M.W.); (M.J.); (R.K.); (W.M.)
| | - Wilczak Maciej
- Gynecological and Obstetrics Hospital, Poznan University of Medical Sciences, 61-701 Poznań, Poland; (P.M.); (M.W.); (M.J.); (R.K.); (W.M.)
- Department of Maternal and Child Health, Poznan University of Medical Sciences, 60-535 Poznań, Poland
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Siziba LP, Mank M, Stahl B, Kurz D, Gonsalves J, Blijenberg B, Rothenbacher D, Genuneit J. Human milk oligosaccharide profiles and child atopic dermatitis up to 2 years of age: The Ulm SPATZ Health Study. Pediatr Allergy Immunol 2022; 33:e13740. [PMID: 35212042 DOI: 10.1111/pai.13740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 01/17/2022] [Accepted: 01/24/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Human milk oligosaccharides (HMOs) have several biological functions. Yet, very few studies have investigated the effect of HMOs on the development of allergies and even fewer on their specific associations with atopic dermatitis (AD) during early childhood. OBJECTIVE This study investigated whether individual HMO concentrations, measured at two time points of lactation, were associated with reported diagnosis of AD in children up to two years of age. METHOD Outcome data were available for HMOs measured in human milk samples collected at 6 weeks (n = 534) and 6 months (n = 356) of lactation. Associations of HMOs with AD, ascertained from parents and pediatricians at ages one and two years, were assessed in crude and adjusted logistic regression models. RESULTS Few associations were statistically significant at the conventional level (p < .05), for example, 6-week Lacto-N-neotetraose with 2-year AD [OR 95%CI: 0.82 (0.66, 1.00)] and 6-month 3'-sialyllactose among non-secretor mothers with 1-year AD [2.59 (1.53, 6.81)]. Importantly, accounting for multiple testing, these and all further associations were not statistically significant (all p > .0031, which is the threshold for statistical significance after correction for multiple testing). CONCLUSION Our findings suggest that the intake of different levels (or even absence) of the individual HMOs measured at 6 weeks and 6 months of lactation, in the current study, is not significantly associated with the development of AD in early childhood. Given the exploratory nature of our study and the limited sample size, these results should be interpreted with caution. The specific HMOs for which we show plausible associations at conventional level may warrant further research and investigation.
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Affiliation(s)
- Linda P Siziba
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Marko Mank
- Danone Nutricia Research, Utrecht, The Netherlands
| | - Bernd Stahl
- Danone Nutricia Research, Utrecht, The Netherlands.,Department of Chemical Biology & Drug Discovery, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Deborah Kurz
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | | | | | | | - Jon Genuneit
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany.,Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
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Siziba LP, Mank M, Stahl B, Kurz D, Gonsalves J, Blijenberg B, Rothenbacher D, Genuneit J. Associations of Human Milk Oligosaccharides With Otitis Media and Lower and Upper Respiratory Tract Infections up to 2 Years: The Ulm SPATZ Health Study. Front Nutr 2021; 8:761129. [PMID: 34760912 PMCID: PMC8572796 DOI: 10.3389/fnut.2021.761129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 09/28/2021] [Indexed: 12/23/2022] Open
Abstract
Background: Human milk oligosaccharides (HMOs) support and concurrently shape the neonatal immune system through various mechanisms. Thereby, they may contribute to lower incidence of infections in infants. However, there is limited evidence on the role of individual HMOs in the risk of otitis media (OM), as well as lower and upper respiratory tract infections (LRTI and URTI, respectively) in children up to 2 years. Objective: To investigate whether individual HMO concentrations measured at 6 weeks of lactation were associated with risk of OM, LRTI or URTI up to 2 years in breastfed infants. Associations with OM, LRTI and URTI were determined for the most prominent human milk oligosaccharides including 13 neutral, partly isomeric structures (trioses up to hexaoses), two acidic trioses, and lactose. Design: HMO measurements and physician reported data on infections were available from human milk samples collected at 6 weeks postpartum (n = 667). Associations of HMOs with infections were assessed in crude and adjusted models using modified Poisson regression. Results: Absolute concentrations (median [min, max], in g/L) of 2′-fucosyllactose (2′-FL) tended (p = 0.04) to be lower, while lacto-N-tetraose (LNT) was higher in the milk for infants with OM in the 1st year of life (p = 0.0046). In the milk of secretor mothers, LNT was significantly higher in the milk for infants with OM (RR [95% CI]: 0.98 [0.15, 2.60]) compared to infants without OM (RR [95% CI]: 0.76 [0.14, 2.90]) at 1 year (p = 0.0019). No statistically significant milk group differences and associations were observed for OM, LRTI, and URTI (p > 0.0031). Conclusion: Our findings suggest that neither prominent neutral individual HMOs (ranging from 2′-FL to LNDFHs) nor acidic human milk sialyllactoses or lactose are significantly associated with a reduced or increased risk of infections in infants up to 2 years of age. Further research is needed to determine whether specific HMOs could potentially reduce the incidence or alleviate the course of distinct infections in early life.
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Affiliation(s)
- Linda P Siziba
- Department of Pediatrics, Pediatric Epidemiology, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Marko Mank
- Danone Nutricia Research, Utrecht, Netherlands
| | - Bernd Stahl
- Danone Nutricia Research, Utrecht, Netherlands.,Department of Chemical Biology & Drug Discovery, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
| | - Deborah Kurz
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | | | | | | | - Jon Genuneit
- Department of Pediatrics, Pediatric Epidemiology, Medical Faculty, Leipzig University, Leipzig, Germany.,Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
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Siziba LP, Brenner H, Amitay EL, Koenig W, Rothenbacher D, Genuneit J. Potential sex differences in human milk leptin and their association with asthma and wheeze phenotypes: Results of the Ulm Birth Cohorts. Pediatr Allergy Immunol 2021; 32:1663-1672. [PMID: 34173262 DOI: 10.1111/pai.13586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 06/21/2021] [Accepted: 06/23/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND The hormone leptin has been suggested to play a role in the respiratory and immune systems. Evidence on sex-specific concentrations of leptin in human milk and sex-specific associations with the development of asthma and wheeze has been put forward but is still scarce. OBJECTIVE To investigate whether male and female infants receive different levels of leptin through human milk and whether leptin is implicated in the development of asthma and wheeze in a sex-dependent manner using data from the two Ulm Birth Cohort studies. METHODS Leptin data were available from human milk samples collected at 6 weeks (Ulm Birth Cohort Study [UBCS, n = 678; Ulm SPATZ Health Study, n = 587]), and, in SPATZ only, at 6 months (n = 377) and 12 months (n = 66) of lactation. Sex-specific associations with doctor-diagnosed asthma and wheeze phenotypes were assessed in crude and adjusted models using logistic regression. Adjustments were made for maternal allergy, exclusive breastfeeding, infant age at the time of milk sampling, and child BMI z-score. RESULTS At 6 weeks, leptin levels (median [min, max], in ng/L) were higher in the milk for girls (197 [0.100, 4120]) than in milk for boys (159 [1.02, 3280], p = .045) in UBCS. No significant sex differences were observed in SPATZ (p = .152). There were no significant associations of leptin with asthma or wheeze in both studies, even in a sex-dependent manner (p > .05). CONCLUSION It remains unclear whether male and female infants receive different levels of leptin through human milk. However, leptin in human milk may not be associated with history and development of asthma and wheeze in a sex-specific manner.
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Affiliation(s)
- Linda P Siziba
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Efrat L Amitay
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Wolfgang Koenig
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | | | - Jon Genuneit
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany.,Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
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Jiang S, Pan J, Li Y, Ju M, Zhang W, Lu J, Lv J, Li K. Comprehensive Human Milk Patterns Are Related to Infant Growth and Allergy in the CHMP Study. Mol Nutr Food Res 2021; 65:e2100011. [PMID: 34227225 DOI: 10.1002/mnfr.202100011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 06/10/2021] [Indexed: 12/26/2022]
Abstract
SCOPE The aim of the present study is to identify human milk pattern using multi-omics datasets and to explore association between patterns, infant growth, and allergy using data from the Chinese Human Milk Project (CHMP) study. METHODS AND RESULTS Three patterns are identified from integrative analysis of proteome, lipidome, and glycome profiles of 143 mature human milk samples. Factor 1 is positively associated with 128 proteins, phospholipids, and human milk oligosaccharides (HMOs) including lacto N-neohexaose (LNnH) and lacto-N-difucohexaose II (LNDFH II); factor 2 is negatively associated with as1 -casein, phospholipids while positively associates with HMOs including LNnH, lactosialyl tetrasaccharide c (LSTc), and 2'-fucosyllactose (2'FL); factor 3 is positively associated with lysophospholipids while negatively associates with 27 proteins, triglycerides with two saturated fatty acids, 6'-sialyllactose (6'SL) and 2'FL. In general, factor 1 and factor 2 are associated with slower while factor 3 is associated with faster growth rate (p < 0.044). One unit higher in loadings of factor 2 is associated with 34% lower risk of allergies (p ≤ 0.017). Associations are not significant after adjustment for city except for factor 1. CONCLUSIONS Three possible human milk patterns with varying degree of stability are identified. Future work is needed to understand these patterns in terms of generalization, biologic mechanisms, and genotype influences.
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Affiliation(s)
- Shilong Jiang
- Nutrition and Metabolism Research Division, Innovation Center, Heilongjiang Feihe Dairy Co., Ltd., Beijing, 100015, China.,PKUHSC-China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, Xueyuan Road 38, Haidian, Beijing, 100083, China
| | - Jiancun Pan
- Nutrition and Metabolism Research Division, Innovation Center, Heilongjiang Feihe Dairy Co., Ltd., Beijing, 100015, China.,PKUHSC-China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, Xueyuan Road 38, Haidian, Beijing, 100083, China
| | - Yuanyuan Li
- Nutrition and Metabolism Research Division, Innovation Center, Heilongjiang Feihe Dairy Co., Ltd., Beijing, 100015, China.,PKUHSC-China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, Xueyuan Road 38, Haidian, Beijing, 100083, China
| | - Mengnan Ju
- Nutrition and Metabolism Research Division, Innovation Center, Heilongjiang Feihe Dairy Co., Ltd., Beijing, 100015, China.,PKUHSC-China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, Xueyuan Road 38, Haidian, Beijing, 100083, China
| | - Wei Zhang
- Nutrition and Metabolism Research Division, Innovation Center, Heilongjiang Feihe Dairy Co., Ltd., Beijing, 100015, China.,PKUHSC-China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, Xueyuan Road 38, Haidian, Beijing, 100083, China
| | - Jing Lu
- Key Laboratory of Agro-Food Processing and Quality Control, Institute of Food Science and Technology, Chinese Academy of Agricultural Sciences, Beijing, China.,School of Food and Health, Beijing Technology and Business University, Fucheng Road 11, Haidian, Beijing, 100048, China
| | - Jiaping Lv
- Key Laboratory of Agro-Food Processing and Quality Control, Institute of Food Science and Technology, Chinese Academy of Agricultural Sciences, Beijing, China
| | - Kaifeng Li
- Nutrition and Metabolism Research Division, Innovation Center, Heilongjiang Feihe Dairy Co., Ltd., Beijing, 100015, China.,PKUHSC-China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, Xueyuan Road 38, Haidian, Beijing, 100083, China
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Pollutants in Breast Milk: A Public Health Perspective - A Commentary of the Nutrition Committee of the French Society of Pediatrics. J Pediatr Gastroenterol Nutr 2021; 72:343-346. [PMID: 32868668 DOI: 10.1097/mpg.0000000000002928] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Pregnant and lactating women are continuously and ubiquitously exposed to numerous environmental pollutants from various sources including air, food, water, and occupational and household environments. The available evidence shows that pollutants are present in human milk and one of the emerging questions is what happens when the nursing infant is involuntarily exposed to contaminants through breastfeeding.The available literature does not currently provide a conclusive evidence of any consistent or clinically relevant health consequences in infants exposed to environment chemicals through breast milk. The available data strongly suggest that the benefits of breastfeeding outweigh the potential harmful effects of pollutants contained in human milk. The committee of nutrition of the French Pediatric Society strongly supports breastfeeding but also calls for public health actions to reduce the overall contamination level in the environment, to continue promoting breastfeeding, and to support research in this area.
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Ramiro-Cortijo D, Singh P, Liu Y, Medina-Morales E, Yakah W, Freedman SD, Martin CR. Breast Milk Lipids and Fatty Acids in Regulating Neonatal Intestinal Development and Protecting against Intestinal Injury. Nutrients 2020; 12:E534. [PMID: 32092925 PMCID: PMC7071444 DOI: 10.3390/nu12020534] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 02/14/2020] [Accepted: 02/16/2020] [Indexed: 12/13/2022] Open
Abstract
Human breast milk is the optimal source of nutrition for infant growth and development. Breast milk fats and their downstream derivatives of fatty acids and fatty acid-derived terminal mediators not only provide an energy source but also are important regulators of development, immune function, and metabolism. The composition of the lipids and fatty acids determines the nutritional and physicochemical properties of human milk fat. Essential fatty acids, including long-chain polyunsaturated fatty acids (LCPUFAs) and specialized pro-resolving mediators, are critical for growth, organogenesis, and regulation of inflammation. Combined data including in vitro, in vivo, and human cohort studies support the beneficial effects of human breast milk in intestinal development and in reducing the risk of intestinal injury. Human milk has been shown to reduce the occurrence of necrotizing enterocolitis (NEC), a common gastrointestinal disease in preterm infants. Preterm infants fed human breast milk are less likely to develop NEC compared to preterm infants receiving infant formula. Intestinal development and its physiological functions are highly adaptive to changes in nutritional status influencing the susceptibility towards intestinal injury in response to pathological challenges. In this review, we focus on lipids and fatty acids present in breast milk and their impact on neonatal gut development and the risk of disease.
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Affiliation(s)
- David Ramiro-Cortijo
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA; (D.R.-C.); (P.S.); (Y.L.); (E.M.-M.); (S.D.F.)
| | - Pratibha Singh
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA; (D.R.-C.); (P.S.); (Y.L.); (E.M.-M.); (S.D.F.)
| | - Yan Liu
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA; (D.R.-C.); (P.S.); (Y.L.); (E.M.-M.); (S.D.F.)
| | - Esli Medina-Morales
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA; (D.R.-C.); (P.S.); (Y.L.); (E.M.-M.); (S.D.F.)
| | - William Yakah
- Department of Neonatology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA;
| | - Steven D. Freedman
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA; (D.R.-C.); (P.S.); (Y.L.); (E.M.-M.); (S.D.F.)
- Division of Translational Research, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA
| | - Camilia R. Martin
- Department of Neonatology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA;
- Division of Translational Research, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA
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Saeed OB, Haile ZT, Chertok IA. Association Between Exclusive Breastfeeding and Infant Health Outcomes in Pakistan. J Pediatr Nurs 2020; 50:e62-e68. [PMID: 31862130 DOI: 10.1016/j.pedn.2019.12.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 12/09/2019] [Accepted: 12/09/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE The infant mortality rate in Pakistan is one of the highest in the world with most cases attributed to diarrheal or respiratory diseases. Exclusive breastfeeding for the first 6 months of life is recommended by the World Health Organization to achieve optimal growth and health, however, in Pakistan the rate of exclusive breastfeeding by mothers is <40%. The aim of this study was to investigate the relationship of exclusive breastfeeding, diarrhea, acute respiratory infections and fever among infants under the age of 6 months. DESIGN AND METHODS The cross-sectional study analyzed secondary data from the 2017-18 Pakistan Demographic and Health-Survey. The sampling frame for the current study consisted of last-born children who were under the age of 6 months. The study sample consisted of 1033 infants under the age of 6 months. RESULTS The prevalence of exclusive breastfeeding was 53.6%. Compared to infants who were not breastfed exclusively, infants who were had lower odds of diarrhea, acute respiratory infection, and fever. The observed association was independent of potential confounders. CONCLUSIONS Exclusive breastfeeding reduces the odds of childhood illnesses. Plausible explanations for the observed association may be related to human milk's contents including necessary nutrients to fulfill an infant's needs within first months of life. Additionally, continued exposure to breastfeeding also reduces exposure to other contaminated foods to ensure adequate nutrition for the infant. PRACTICE IMPLICATIONS The findings have important implications for educating families and healthcare providers about the benefits of exclusive breastfeeding for optimal child health outcomes.
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Affiliation(s)
- Omar Babar Saeed
- Ohio University Heritage College of Osteopathic Medicine, Athens, OH, United States of America.
| | - Zelalem T Haile
- Department of Social Medicine, Heritage College of Osteopathic Medicine, Ohio University, Dublin, OH, United States of America.
| | - Ilana Azulay Chertok
- School of Nursing, College of Health Sciences and Professions, Ohio University, Athens, OH, United States of America.
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