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Each diet group was then re-randomized to receive diet B [C/L or soy]. ... Objective magnification, 10X (A and B) or 40X (C and D). Figure 3 . 3 Figure 3. Menopause. Author manuscript; available in PMC 2013 September 01. ...doi:10.1097/gme.0b013e31824cfa8f pmid:22617336 pmcid:PMC3427720 fatcat:4gwpbhdimvdmphiwoyqwq6rgg4
The results of other studies have indicated a higher incidence of CHD and hypertension in higher latitudes and lower altitudes suggesting those with lower exposure to ultraviolet-B (UVB) radiation, a major ...doi:10.1016/j.maturitas.2012.03.014 pmid:22542390 pmcid:PMC3458138 fatcat:z5l2ebhzlbajjfiqoivcv24hhy
TMAO concentrations were profiled as part of an analytical panel quantifying B vitamers, the results of which were analyzed separately (under review). ... A total of 1874 parent-child dyads participated in a biomedical assessment, Child Health CheckPoint (CheckPoint), nested between waves 6 and 7 of the B-cohort of the Longitudinal Study of Australian Children ...doi:10.1093/cdn/nzaa103 pmid:32666035 pmcid:PMC7335361 fatcat:x5t67nn4fnfjbai5s7eiusogoy
OBJECTIVE: To compare the maternal and neonatal risks of elective repeat cesarean delivery compared with pregnancy continuation at different gestational ages, starting from 37 weeks. METHODS: We analyzed the composite maternal and neonatal outcomes of repeat cesarean deliveries studied prospectively over 4 years at 19 U.S. centers. Maternal outcome was a composite of pulmonary edema, cesarean hysterectomy, pelvic abscess, thromboembolism, pneumonia, transfusion, or death. Composite neonataldoi:10.1097/aog.0b013e3182822193 pmid:23635619 pmcid:PMC4066022 fatcat:25ainomtvjbijiysrttv5bsula
more »... posite neonatal outcome consisted of respiratory distress, transient tachypnea, necrotizing enterocolitis, sepsis, ventilation, seizure, hypoxic-ischemic encephalopathy, neonatal intensive care unit admission, 5-minute Apgar of 3 or lower, or death. Outcomes after elective repeat cesarean delivery without labor at each specific gestational age were compared with outcomes for all who were delivered later as a result of labor onset, specific obstetric indications, or both. RESULTS: Twenty-three thousand seven hundred ninety-four repeat cesarean deliveries were included. Elective delivery at 37 weeks of gestation had significantly higher risks of adverse maternal outcome (odds ratio [OR] 1.56, 95% confidence interval [CI] 1.06-2.31), whereas elective delivery at 39 weeks of gestation was associated with better maternal outcome when compared with pregnancy continuation (OR 0.51, 95% CI 0.36-0.72). Elective repeat cesarean deliveries at 37 and 38 weeks of gestation had significantly higher risks of adverse neonatal outcome (37 weeks OR 2.02, 95% CI 1.73-2.36; 38 weeks OR 1.39 95% CI 1.24-1.56), whereas delivery at 39 and 40 weeks of gestation presented better neonatal outcome as opposed to pregnancy continuation (39 weeks OR 0.79, 95% CI 0.68-0.92; 40 weeks OR 0.57, 95% CI 0.43-0.75). CONCLUSION: In women with prior cesarean delivery, 39 weeks of gestation is the optimal time for repeat cesarean delivery for both mother and neonate.
A B S T R A C T Purpose Emerging clinical evidence suggests intravenous bisphosphonates may inhibit breast cancer while oral bisphosphonates have received limited evaluation regarding breast cancer influence ... to breast cancer risk, a finding independent of the Gail breast cancer risk score. 11 In addition, a model predictive JOURNAL OF CLINICAL ONCOLOGY O R I G I N A L R E P O R T V O L U M E 2 8 ⅐ N U M B ...doi:10.1200/jco.2010.28.2095 pmid:20567009 pmcid:PMC2917313 fatcat:cyssmwxdxrgojoqavktzgpj7jy
To determine patients' and parents' perceptions regarding the delivery of transition education and perceived barriers to transfer to adult oriented care. A self-report survey was administered to a convenience sample of patients (16-25 years old) with various childhood onset chronic diseases. A similar survey was administered to their parents/guardians. A total of 155 patients and 104 parents participated in the study. The mean age of patients was 18.8 ± 2.3 years; 57% were female. Although mostdoi:10.3233/prm-140269 pmid:24919937 pmcid:PMC5727574 fatcat:mww7ypd3nzf33abe5xrb63mfpi
more »... male. Although most patients and parents reported receiving information and training about their medical condition, significant gaps in other aspects of transition education were identified. These included stated deficiencies in education regarding unprotected intercourse, health of future offspring, birth control, pregnancy, illicit drug use, and future career or vocation counseling. Commonly cited barriers to transfer were emotional attachments and lack of adult medicine specialty providers; however, the majority anticipated being ready to transfer to adult oriented care by age 25 years. There are significant gaps in the delivery of transition education as perceived by patients and their parents. Standardization of transition education may help ensure that patients acquire the knowledge and skills for health care self-management in adulthood and successful transfer to adult oriented care.
Objective-To evaluate whether neonates born to women who had previously received antenatal corticosteroids and then delivered a late-preterm birth neonate had less respiratory morbidity compared with those unexposed to antenatal corticosteroids. Methods-This is a secondary analysis from a multicenter observational study regarding mode of delivery after prior cesarean delivery. We compared women who received one course of antenatal corticosteroids with unexposed parturients, and evaluateddoi:10.1097/aog.0b013e31824758f6 pmid:22353953 pmcid:PMC3338333 fatcat:thvnk6z3uzcpxnh5abzbvs2vmq
more »... nd evaluated various respiratory outcomes among those having a singleton late-preterm birth neonate. We controlled for potential confounders including gestational age at delivery, diabetes, mode of delivery, and maternal race. Results-Five thousand nine hundred twenty-four patients met the inclusion criteria; 550 received steroids, while 5,374 did not. In the univariable model, compared with unexposed women, those who received antenatal corticosteroids appeared more likely to have neonates who required ventilatory support (11.5% v. 8.6%, p=0.022), had respiratory distress syndrome (RDS) (17.1% v. 12.2%, p=0.001), developed transient tachypnea of the newborn (12.9% v. 9.8%, p=0.020), or required resuscitation in the delivery room (55.8% v. 49.7%, p=0.007). After controlling for confounding factors, we found no significant differences among the groups * For a list of other members of the NICHD MFMU, see the Appendix online at regarding all of the above outcomes with an odds ratio for RDS of 0.78 (95% CI 0.60-1.02) and ventilator support of 0.75 (95% CI 0.55-1.03). Conclusion-Exposure to antenatal corticosteroids does not significantly affect respiratory outcomes among those with a subsequent late-preterm birth.
(95% CI) ERCD, elective repeat cesarean; TOL, trial of labor; OR, odds ratio; CI, confidence interval; TTN, transient tachypnea of the newborn; RDS, respiratory distress a P-value from McNemar's test b ... complication 34 (0.9) 17 (0.4) 0.02 2.00 (1.12 -3.58) Operative injury 6 (0.2) 20 (0.5) 0.006 0.30 (0.12 -0.75) Hysterectomy 12 (0.3) 3 (0.1) 0.02 4.00 (1.13 -14.17) Maternal composite b ...doi:10.1016/j.ajog.2012.02.002 pmid:22464069 pmcid:PMC3337034 fatcat:t4ddohjlfjgtrmj5lbxsmpzn4a
OBJECTIVE: Elective repeat cesarean delivery at 37 or 38 weeks compared with 39 completed weeks of gestation is associated with adverse neonatal outcomes. We assessed whether delivery before 39 weeks is justifiable on the basis of decreased adverse maternal outcomes. METHODS: We conducted a cohort study of women with live singleton pregnancies delivered by prelabor elective repeat cesarean delivery from 1999 through 2002 at 19 U.S. academic centers. Gestational age was examined by completeddoi:10.1097/aog.0b013e3182078115 pmid:21252740 pmcid:PMC3127233 fatcat:7eny23clajewnadv4yirr6tiba
more »... ed by completed weeks (eg, 37 completed weeks73؍ 0/7-37 6/7 weeks). Maternal outcomes included a primary composite of death, hysterectomy, uterine rupture or dehiscence, blood transfusion, uterine atony, thromboembolic complications, anesthetic complications, surgical injury or need for arterial ligation, intensive care unit admission, wound complications, or endometritis. RESULTS: Of 13,258 elective repeat cesareans performed at 37 weeks of gestation or later, 11,255 (84.9%) were between 37 0/7 and 39 6/7 weeks (6.3% at 37, 29.5% at 38, and 49.1% at 39 completed weeks), and 15.1% were at 40 0/7 weeks or more. The primary outcome occurred in 7.43% at 37 weeks, 7.47% at 38 weeks and 6.56% at 39 weeks (P for trend test.)90.؍ Delivery before 39 weeks was not associated with a decrease in the primary outcome when compared with delivery at 39 weeks (adjusted odds ratio 1.16; 95% confidence interval 1.00 -1.34). Early delivery was associated with increased maternal hospitalization of 5 days or more [1.96 (1.54, 2.49)] but not with a composite of death or hysterectomy or with individual maternal morbidities. CONCLUSION: Elective repeat cesarean delivery at 37 or 38 weeks is not associated with decreased maternal morbidity.
Objective-Women with a prior myomectomy or prior classical cesarean delivery are often delivered early by cesarean due to concern for uterine rupture. Although theoretically at increased risk for placenta accreta, this risk has not been well quantified. Our objective was to estimate and compare the risks of uterine rupture and placenta accreta in women with prior uterine surgery. Methods-Women with prior myomectomy or prior classical cesarean delivery were compared to women with a prior lowdoi:10.1097/aog.0b013e318273695b pmid:23168757 pmcid:PMC3545277 fatcat:yikguy2o4ncipfacjgzvy5bdcu
more »... ith a prior low transverse cesarean to estimate rates of both uterine rupture and placenta accreta. Results-One hundred seventy-six women with a prior myomectomy, 455 with a prior classical cesarean delivery, and 13,273 women with a prior low transverse cesarean were evaluated. Mean gestational age at delivery differed by group (p<0.001), prior myomectomy (37.3 weeks), prior classical cesarean delivery (35.8 weeks), and low transverse cesarean (38.6 weeks). The frequency of uterine rupture in the prior myomectomy group was 0% (95% CI 0-1.98%). The frequency of uterine rupture in the low transverse cesarean group (0.41%) was not statistically different from the risk in the prior myomectomy group (p>0.99) or in the prior classical cesarean delivery group (0.88%, p=0.13). Placenta accreta occurred in 0% (95% CI 0-1.98%) of prior myomectomy compared with 0.19% in the low transverse cesarean group (p>0.99) and 0.88% in the prior classical cesarean delivery group (p=0.01 relative to low transverse cesarean). The adjusted OR for the prior classical cesarean delivery group (relative to low transverse cesarean) was 3.23 (1.11-9.39) for uterine rupture and 2.09 (0.69-6.33) for accreta. The frequency of accreta for those with previa was 11.1% for the prior classical cesarean delivery and 13.6% for low transverse cesarean groups (p>0.99=1.0). Conclusion-A prior myomectomy is not associated with higher risks of either uterine rupture or placenta accreta. The absolute risks of uterine rupture and accreta after prior myomectomy are low.
Objective-To determine if a model for predicting vaginal birth after cesarean (VBAC) can also predict the probabilty of morbidity associated with a trial of labor (TOL). Study Design-Using a previously published prediction model, we categorized women with one prior cesarean by chance of VBAC. Prevalence of maternal and neonatal morbidity was stratfied by probability of VBAC success and delivery approach. Results-Morbidity became less frequent as the predicted chance of VBAC increased amongdoi:10.1016/j.ajog.2008.06.039 pmid:18822401 pmcid:PMC2743567 fatcat:lswuuiiqyreg7djzsnbys2ftku
more »... ncreased among women who underwent TOL (P<.001), but not elective repeat cesarean section (ERCS) (P >.05). When the predicted chance of VBAC was less than 70%, women undergoing a TOL were more likely to have maternal morbidity (RR 2.2, 95% CI [1.5, 3.1]) than those who underwent an ERCS; when the predicted chance of VBAC was at least 70%, total maternal morbidity was not different between the two groups (RR 0.8, 95% CI [0.5, 1.2]). The results were similar for neonatal morbidity.. Conclusion-A prediction model for VBAC provides information regarding the chance of TOLrelated morbidity, and suggests that maternal morbidity is not greater for those women who undergo TOL than those who undergo ERCS if the chance of VBAC is at least 70%.
Objective-To predict individual-specific risk of uterine rupture during an attempted vaginal birth after cesarean (VBAC). Methods-Women with one prior low-transverse cesarean delivery who underwent a trial of labor with a term singleton were identified in a multi-center concurrently collected database of deliveries occurring during a four-year period. We analyzed different techniques to develop an accurate prediction model for uterine rupture. Results-Of the 11,855 women analyzed, 83 (0.7%) haddoi:10.1016/j.ajog.2008.03.039 pmid:18439555 pmcid:PMC2532505 fatcat:7ag64ubgmfat7f4lpndh53dala
more »... yzed, 83 (0.7%) had a uterine rupture. The optimal model, based on a logistic regression,included: any prior vaginal delivery (OR 0.44, 95% CI 0.27 -0.71) and labor induction(OR 1.73, 95% CI 1.11 -2.69). This model, with a c-statistic of .627, had poor discriminating ability and does not allow the determination of a clinically useful estimate of the probability of uterine rupture for an individual patient. Conclusion-Patient-specific factors cannot be used to accurately predict the relatively small proportion of women who will incur a uterine rupture during an attempted VBAC after 36 weeks of gestatation. Condensation-Factors available before or at admission for delivery cannot be used to accurately predict uterine rupture during an attempted vaginal birth after cesarean.
doi:10.1056/nejmoa0803267 pmid:19129525 pmcid:PMC2811696 fatcat:kplppl54nrh65hvtufdwjaukv4
Further, 2-AAA treatment enhanced insulin secretion from a pancreatic b cell line as well as murine and human islets. ... We calculated Pearson correlations between metabolite concentrations and other biochemical measures of insulin action: fasting insulin, HOMA-IR and HOMA-B (28) . ... age-and sexadjusted partial correlation, r = 0.25; P < 0.001), homeostasis model assessment of insulin resistance (HOMA-IR) (r = 0.24; P < 0.001), homeostasis model assessment of β cell function (HOMA-B) ...doi:10.1172/jci64801 pmid:24091325 pmcid:PMC3784523 fatcat:e4dcwvt635bdxc5wtscpqs3rce
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