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Huang Y, Yang Q. Apert syndrome and obstructive sleep apnea: Timing for midface surgery. Cranio 2024:1-12. [PMID: 39267323 DOI: 10.1080/08869634.2024.2398739] [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: 09/17/2024]
Abstract
OBJECTIVE This study aims to determine the optimal timing for midface surgery in patients with Apert syndrome and Obstructive Sleep Apnea (OSA). METHODS We reviewed relevant articles from Web of Science and PubMed and conducted a bibliometric analysis. RESULTS A review of 74 documents published between 1981 and 2023 revealed that determining the optimal timing for surgery in cases of airway obstruction necessitates consideration of various factors, including the location and severity of airway abnormalities, craniofacial development, potential impact of treatment on future growth, psychological considerations, and overall physiological conditions. Although midface advancement surgery performed around ages 6 to 7 typically yields symptom relief and favorable long-term outcomes, the ideal surgical timing young children with severe OSA remains a contentious issue. CONCLUSION While midface surgery is frequently advocated at ages 6 to 7, there is an urgent need for enhanced cooperation and high-quality research to deepen our understanding.
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Affiliation(s)
- Ying Huang
- Department of Comprehensive Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Qinghua Yang
- Department of Comprehensive Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
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Sallinen RH, Honkila M, Pokka T, Paalanne N, Halt K, Renko M, Kajantie E, Ruuska TS. A Finnish nationwide register-based study shows a further 50% decline in already low child mortality. Acta Paediatr 2024. [PMID: 39166655 DOI: 10.1111/apa.17390] [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: 01/19/2024] [Revised: 05/19/2024] [Accepted: 08/05/2024] [Indexed: 08/23/2024]
Abstract
AIM Child mortality declined significantly in Finland in 1969-2004. We investigated whether the already low mortality rate could still decline from 2005 to 2020. METHODS This was a nationwide register-based study. The subjects were children under 16 years of age who had resided in Finland between 2005 and 2020. The study population was identified from Finland's Population Information System of the Digital and Population Data Services Agency. Causes of death were obtained from Statistics Finland. Changes in annual overall and cause-specific mortality rates were evaluated. RESULTS 3685 children (55% boys) under 16 years of age died in Finland in 2005-2020 from 325 causes. Overall annual child mortality declined by 50% (95% confidence interval 37 to 64%) during the study period, from 0.31/1000 in 2005 to 0.16/1000 in 2020. The mortality rate in children under one year of age declined from 3.1/1000 in 2005 to 1.8/1000 in 2020. The deaths from sudden infant death syndrome fell by 84%, congenital malformations by 62%, infectious diseases by 60%, external causes by 52%, and perinatal disorders by 41%. CONCLUSION Finland's low child mortality further declined over the past two decades. Contributing factors likely include achievements in paediatric research, public health, and clinical practice.
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Affiliation(s)
- Riikka H Sallinen
- Research Unit of Clinical Medicine and Medical Research Centre Oulu, University of Oulu, Oulu, Finland
| | - Minna Honkila
- Research Unit of Clinical Medicine and Medical Research Centre Oulu, University of Oulu, Oulu, Finland
- Department of Paediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland
| | - Tytti Pokka
- Research Unit of Clinical Medicine and Medical Research Centre Oulu, University of Oulu, Oulu, Finland
- Research Service Unit, Oulu University Hospital, Oulu, Finland
| | - Niko Paalanne
- Research Unit of Clinical Medicine and Medical Research Centre Oulu, University of Oulu, Oulu, Finland
- Department of Paediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland
| | - Kimmo Halt
- Research Unit of Clinical Medicine and Medical Research Centre Oulu, University of Oulu, Oulu, Finland
- Department of Paediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland
| | - Marjo Renko
- Department of Paediatrics, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Eero Kajantie
- Research Unit of Clinical Medicine and Medical Research Centre Oulu, University of Oulu, Oulu, Finland
- Department of Paediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Terhi S Ruuska
- Research Unit of Clinical Medicine and Medical Research Centre Oulu, University of Oulu, Oulu, Finland
- Department of Paediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland
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Kember AJ, Anderson JL, Gorazd NE, House SC, Kerr KE, Torres Loza PA, Reuter DG, Hobson SR, Goergen CJ. Maternal posture-physiology interactions in human pregnancy: a narrative review. Front Physiol 2024; 15:1370079. [PMID: 39100275 PMCID: PMC11294255 DOI: 10.3389/fphys.2024.1370079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 07/02/2024] [Indexed: 08/06/2024] Open
Abstract
There are several well-known medical conditions in which posture and gravity interact with natural history, including pregnancy. In this review, we provide a comprehensive overview of interactions between maternal posture and maternal physiology and pathophysiology at rest during pregnancy. We conducted a systematic literature search of the MEDLINE database and identified 644 studies from 1991 through 2021, inclusive, that met our inclusion criteria. We present a narrative review of the resulting literature and highlight discrepancies, research gaps, and potential clinical implications. We organize the results by organ system and, commencing with the neurological system, proceed in our synthesis generally in the craniocaudal direction, concluding with the skin. The circulatory system warranted our greatest and closest consideration-literature concerning the dynamic interplay between physiology (heart rate, stroke volume, cardiac output, blood pressure, and systemic vascular resistance), pathophysiology (e.g., hypertension in pregnancy), and postural changes provide an intricate and fascinating example of the importance of the subject of this review. Other organ systems discussed include respiratory, renal, genitourinary, gastrointestinal, abdominal, and endocrine. In addition to summarizing the existing literature on maternal posture-physiology interactions, we also point out gaps and opportunities for further research and clinical developments in this area. Overall, our review provides both insight into and relevance of maternal posture-physiology interactions vis à vis healthcare's mission to improve health and wellness during pregnancy and beyond.
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Affiliation(s)
- Allan J. Kember
- Temerty Faculty of Medicine, Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON, Canada
- Shiphrah Biomedical Inc., Toronto, ON, Canada
| | - Jennifer L. Anderson
- Larner College of Medicine, University of Vermont, Burlington, VT, United States
| | - Natalyn E. Gorazd
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States
| | - Sarah C. House
- Temerty Faculty of Medicine, Medical Education, University of Toronto, Toronto, ON, Canada
| | - Katherine E. Kerr
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States
| | - Paula A. Torres Loza
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States
| | - David G. Reuter
- Cardiac Innovations, Seattle Children’s, Seattle, WA, United States
| | - Sebastian R. Hobson
- Temerty Faculty of Medicine, Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON, Canada
- Temerty Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Maternal-Fetal Medicine Division, Mount Sinai Hospital, Toronto, ON, Canada
| | - Craig J. Goergen
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States
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Liu T, Xu Y, Gong Y, Zheng J, Chen Z. The global burden of disease attributable to preterm birth and low birth weight in 204 countries and territories from 1990 to 2019: An analysis of the Global Burden of Disease Study. J Glob Health 2024; 14:04109. [PMID: 38991211 PMCID: PMC11239190 DOI: 10.7189/jogh.14.04109] [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: 07/13/2024] Open
Abstract
Background Preterm birth and low birth weight (PBLBW), recognised globally as primary contributors to infant mortality in children under five, have not been sufficiently investigated in terms of their worldwide impact. In this study we aimed to thoroughly evaluate the contemporary trends in disease burden attributable to PBLBW. Methods We analysed data from 204 countries and territories between 1990-2019, as sourced from the 2019 Global Burden of Disease Study. We analysed the global incidence of mortality and disability-adjusted life years (DALYs) associated with PBLBW, stratified by age, gender, year, and geographic location, alongside the socio-demographic index (SDI). We calculated the annual percentage changes to evaluate the dynamic trends over time. We employed a generalised linear model and scrutinised the relationship between the SDI and the disease burden attributed to PBLBW. Results In 2019, the global age-standardised rate of deaths and DALYs related to PBLBW showed significant declines. Over the period 1990-2019, both death and DALY rates displayed substantial downward trends, with similar change trends observed for both females and males. Age-specific ratios revealed a decrease in PBLBW-related deaths and DALYs with increasing age, primarily during the neonatal stages (zero to 27 days). The leading three causes of PBLBW-related DALYs in 2019 were neonatal disorders, lower respiratory infections, and sudden infant death syndrome. Furthermore, the association between SDI and PBLBW-related DALYs indicated that the age-standardised DALY rates in 204 countries and territories worldwide were negatively correlated with SDI in 2019. From 1990 to 2019, the age-standardised DALY rates decreased linearly in most regions, except sub-Saharan Africa. Conclusions The persistent global burden of disease associated with PBLBW is particularly pronounced in neonates aged less than 28 days and in regions with low SDI. In this study, we highlighted the critical need for tailored interventions aimed at mitigating the detrimental effects of PBLBW to attain specific sustainable development goals, particularly those centred on enhancing child survival and overall well-being.
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Affiliation(s)
- Taixiang Liu
- Department of Neonatal Intensive Care Unit, The Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- National Clinical Research Centre for Child Health, Hangzhou, China
| | - Yanping Xu
- Department of Neonatal Intensive Care Unit, The Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- National Clinical Research Centre for Child Health, Hangzhou, China
| | - Yanfeng Gong
- Fudan University School of Public Health, Shanghai, China
| | - Jinxin Zheng
- School of Global Health, Chinese Centre for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- One Health Centre, Shanghai Jiao Tong University/The University of Edinburgh, Shanghai, China
| | - Zheng Chen
- Department of Neonatal Intensive Care Unit, The Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- National Clinical Research Centre for Child Health, Hangzhou, China
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Ames SG, Salvi A, Lin A, Malveau S, Mann NC, Jenkins PC, Hansen M, Papa L, Schmitz S, Sabogal C, Newgard CD. Timing and causes of death to 1 year among children presenting to emergency departments. Acad Emerg Med 2024; 31:555-563. [PMID: 38499441 PMCID: PMC11168880 DOI: 10.1111/acem.14875] [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: 09/11/2023] [Revised: 12/05/2023] [Accepted: 12/31/2023] [Indexed: 03/20/2024]
Abstract
BACKGROUND AND OBJECTIVES A better characterization of deaths in children following emergency care is needed to inform timely interventions. This study aimed to describe the timing, location, and causes of death to 1 year among a cohort of injured and medically ill children. METHODS We conducted a retrospective cohort study of children <18 years requiring emergency care in six states from January 1, 2012, through December 31, 2017, with follow-up through December 31, 2018, for patients who were not discharged from the emergency department (ED). In this cohort, 1-year mortality, time to death within 1 year, and causes of death were assessed from ED, inpatient, and vital status records. RESULTS There were 546,044 children during the 6-year period. The 1-year mortality rate was 2.2% (n = 1356) for injured children and 1.4% (n = 6687) for medically ill children. Matched death certificates were available for 861 (63.5%) of 1356 deaths in the injury cohort and for 4712 (70.5%) of 6687 deaths in the medical cohort. Among deaths in the injury cohort, 1274 (94.0%) occurred in the ED or hospital. The most common causes of death were motor vehicle collisions, firearm injuries, and pedestrian injuries. Among the 6687 deaths in the medical cohort, 5081 (76.0%) children died in the ED or hospital (primarily in the ED) and 1606 (24.0%) occurred after hospital discharge. The most common causes of death were sudden infant death syndrome, suffocation and drowning, and congenital conditions. CONCLUSIONS The 1-year mortality of children presenting to an ED is 2.2% for injured children and 1.4% for medically ill children with most deaths occurring in the ED. Future interventional trials, quality improvement efforts, and health policy focused in the ED could have the potential to improve outcomes of pediatric patients.
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Affiliation(s)
- Stefanie G. Ames
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah
| | - Apoorva Salvi
- Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon
| | - Amber Lin
- Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon
| | - Susan Malveau
- Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon
| | - N. Clay Mann
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah
| | - Peter C. Jenkins
- Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| | - Matthew Hansen
- Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon
| | - Linda Papa
- Department of Emergency Medicine, Orlando Regional Medical Center, Orlando, Florida
| | - Sabrina Schmitz
- Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon
| | - Cesar Sabogal
- Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon
| | - Craig D. Newgard
- Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon
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Fraga A, de Azevedo AC, Veloso J, Ferreira M, Carvalho F, Vale F, de Azevedo AC, Corte-Real AL. Sudden infant death syndrome - a community intervention project. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2024; 42:e2022205. [PMID: 38808866 PMCID: PMC11135904 DOI: 10.1590/1984-0462/2024/42/2022205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 05/14/2023] [Indexed: 05/30/2024]
Abstract
OBJECTIVE To capacitate pregnant women to comply with measures designed to prevent sudden infant death syndrome. METHODS A quasi-experimental study was conducted before and after the intervention that included pregnant women attending the Course of Preparation for Childbirth and Parenthood of Health Centers Cluster. Six training sessions were given in the context of preventing this syndrome. Three questionnaires were applied, one to evaluate the knowledge of pregnant women before classes, other was submitted after the sessions, and another, one month after the birth of the babies, to identify what skills were acquired and which were practiced. RESULTS Among 77 studied pregnant women, 70 answered pre-session questionnaire and the proportion of correct answers varied from from 60.0% to 84.3%. After the intervention, 64 women answered the questionnaire and the proportion of correct answers varied between 79.7% and 100% . Prior to the intervention, the most wrong answers were related to the role of smoking as a risk factor for sudden infant death syndrome and to the use of pacifiers as a protective measure. After the sessions, all women answered correctly to the questions concerning where the baby should sleep and the safest way to lay the baby in the cradle. CONCLUSIONS Health education with the aim of establishing measures may have a significant impact in terms of care delivery and mortality rate caused by sudden infant death syndrome.
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Affiliation(s)
- Ana Fraga
- Hospital de Santo André, Centro Hospitalar de Leiria, Serviço de Pediatria, Leiria, Portugal
| | - Aida Correia de Azevedo
- Hospital São João de Deus, Centro Hospitalar do Médio Ave, Serviço de Pediatria, Vila Nova de Famalicão, Portugal
| | - Joana Veloso
- CeS Ave/Famalicão, USF S. Miguel-O-Anjo, Vila Nova de Famalicão, Portugal
| | - Marta Ferreira
- ACeS Ave/Famalicão, USF Ribeirão, Vila Nova de Famalicão, Portugal
| | - Filipa Carvalho
- CeS Ave/Famalicão, USF S. Miguel-O-Anjo, Vila Nova de Famalicão, Portugal
| | - Filipa Vale
- CeS Ave/Famalicão, USF S. Miguel-O-Anjo, Vila Nova de Famalicão, Portugal
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Cato K, Funkquist EL, Karlsson Rosenblad A. Instrument development and an intervention to increase parents' self-efficacy regarding their infant's sleep. SEXUAL & REPRODUCTIVE HEALTHCARE 2024; 39:100944. [PMID: 38183709 DOI: 10.1016/j.srhc.2023.100944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 12/13/2023] [Accepted: 12/21/2023] [Indexed: 01/08/2024]
Abstract
OBJECTIVE Many Swedish parents experience that their infant has sleeping problems. Parents' self-efficacy regarding their infants' sleep may play an important role in how they perceive these problems. This pilot study aimed to develop an instrument measuring parents' self-efficacy regarding their infant's sleep and to examine if parents' self-efficacy was affected by an intervention focusing on parental education. METHOD Mothers and fathers, at a maternity unit in Sweden, were drawn into either an intervention (n = 46) or a control (n = 42) group. The intervention group received a home visit from a nurse who provided information about infant sleep; the importance of attachment; and advice regarding sleep, breastfeeding and bed sharing, including guidelines for safe bed sharing. Three months later, the participants answered questions on background data, breastfeeding, sleep and self-efficacy. RESULTS The 11-item two-factor Uppsala Parental Self-Efficacy about Infant Sleep Instrument (UPPSEISI) was constructed to measure parents' perceived self-efficacy. In adjusted analyses, being in the intervention group was associated with a higher self-efficacy (P = 0.035), as were being a mother (P = 0.003) and being satisfied with one's own sleep (P = 0.007), while parents' own sleeping problems were associated with a lower self-efficacy (P = 0.015). CONCLUSION Importantly, parental education may increase parents' self-efficacy regarding their infant's sleep.
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Affiliation(s)
- Karin Cato
- Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds väg 14 B, 752 37 Uppsala, Sweden.
| | - Eva-Lotta Funkquist
- Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds väg 14 B, 752 37 Uppsala, Sweden
| | - Andreas Karlsson Rosenblad
- Department of Medical Sciences, Division of Clinical Diabetology and Metabolism, Uppsala University, Uppsala, Sweden; Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Stockholm, Sweden; Department of Statistics, Uppsala University, Uppsala, Sweden
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Okobi OE, Ibanga IU, Egbujo UC, Egbuchua TO, Oranu KP, Oranika US. Trends and Factors Associated With Mortality Rates of Leading Causes of Infant Death: A CDC Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) Database Analysis. Cureus 2023; 15:e45652. [PMID: 37868558 PMCID: PMC10589454 DOI: 10.7759/cureus.45652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2023] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND Infant mortality is a critical indicator of a nation's healthcare system and social well-being. This study explores trends and factors associated with mortality rates for three leading causes of infant death: congenital malformations, deformations, and chromosomal abnormalities; disorders related to short gestation and low birth weight, not elsewhere classified; and sudden infant death syndrome (SIDS). METHODS Utilizing the CDC WONDER (CDC Wide-Ranging Online Data for Epidemiologic Research) database, we conducted a retrospective observational analysis of infant mortality rates and associated factors. Data encompassed multiple years, allowing for trend analysis and exploration of influencing variables. Study variables included demographic, maternal, prenatal, and leading cause as factors. RESULT Trends in infant mortality rates varied across causes. The overall mortality rate was 2.69 per 1,000 (p=0.000) people during 2007-2020. The highest rates were observed in 2007 (3.05), 2008 (3.01), and 2009 (2.93) per 1,000 infants. For congenital malformations, deformations, and chromosomal abnormalities, the rate ranged from 1.35 to 1.12 (2007-2020). Gender-based mortality differences were subtle (male rate 2.88 per 1,000 infants, p=0.000; female infants 2.50 per 1,000 infants, p=0.000). The examination of infant mortality trends also explored maternal variables, including maternal age, education, and delivery method. The analysis revealed disparities across variables. Teenage maternal age correlated with higher mortality rates, while maternal education was associated with lower rates. Vaginal delivery (2.61 per 1,000 infants, p=0.199) showed slightly lower rates compared to cesarean section (2.86 per 1,000 infants, p=0.076). CONCLUSION This study utilizes the CDC WONDER database and offers evidence of changing trends in infant mortality rates for the selected causes. Factors such as maternal age (30-34 years and 35-39 years), race/ethnicity (Black or African-American and White), birthplace (in hospital), and mother's education (master's degree) were identified as influencing mortality rates. These findings contribute to informed policymaking and interventions aimed at mitigating infant mortality and improving the well-being of infants and their families. Further research is needed to fully understand the underlying dynamics of these trends and factors.
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Affiliation(s)
- Okelue E Okobi
- Family Medicine, Larkin Community Hospital Palm Springs Campus, Miami, USA
- Family Medicine, Medficient Health Systems, Laurel, USA
- Family Medicine, Lakeside Medical Center, Belle Glade, USA
| | | | | | - Thelma O Egbuchua
- Pediatrics and Neonatology, Delta State University Teaching Hospital, Oghara, NGA
| | - Kelechukwu P Oranu
- Obstetrics and Gynaecology, Kenechukwu Specialist Hospital and Maternity, Enugu, NGA
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Alanezi SL, Almusalam YA, Afify AA. Awareness of sudden infant death syndrome and its associated risk factors among Saudi mothers attending well-baby clinics at PHC, PSMMC, Riyadh, Saudi Arabia: A cross-sectional study. J Family Med Prim Care 2023; 12:1531-1539. [PMID: 37767455 PMCID: PMC10521861 DOI: 10.4103/jfmpc.jfmpc_1768_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/22/2022] [Accepted: 11/29/2022] [Indexed: 09/29/2023] Open
Abstract
Introduction Sudden infant death syndrome (SIDS) is a leading cause of infant mortality all over the world. Mortality due to SIDS can be averted by educating families and caretakers about safe practices for putting infants to sleep. However, the knowledge, attitude, and practices of mothers while putting the infant to sleep is a gray areas in literature. Aims and Objectives The objectives of the study were to measure the knowledge and awareness about SIDS and its associated risk factors practiced among Saudi mothers attending well-baby clinics in Saudi Arabia to develop appropriate educational program-based interventions for safe practices of infant care. Methods This cross-sectional study was carried out among 385 mothers attending well-baby clinics of primary health care (PHC) and prince sultan military medical city (PSMMC) in Riyadh Saudi Arabia. Information was captured on sociodemographic characteristics, the health status of mothers and infants, knowledge, attitude, and practice followed by mothers while putting infants to sleep. Results From a total number of 385 responses, 350 participants were eventually included in the final sample due to the incompletion of the questionnaire of 350 mothers; only 26% (n = 93) mothers had heard of SIDS. However, 259 mothers were willing to attend the awareness session. Only 94 mothers had knowledge as well as practicing the correct behavior of putting the infant to sleep on the back referred to as "good behavior concordant pairs." Similarly, other good practices include not co-sharing a bed with the infant, removing pillows, blankets, and other wedged objects, using a pacifier, breastfeeding the infant during sleep, not using multiple quilts, not covering the infant's head with a quilt, not using a head cap. The number of good behavior concordant pairs (in green) were 124, 38, 56, 98, 18, 117, and 68 respectively. Conclusions The rate of knowledge and practice for good behavior regarding SIDS was low among Saudi mothers in Riyadh Saudi Arabia. SIDS-related deaths can be averted by improving the understanding of SIDS risk reduction practices among mothers by using health promotion strategies.
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Affiliation(s)
- Saleh L. Alanezi
- Department of Family Medicine, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Yousef A. Almusalam
- Department of Family Medicine, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Aymen A. Afify
- Department of Family Medicine, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
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Polic A, Eutsler KM, Patel SS. Breastfeeding and the patient's perspective. ABDOMINAL RADIOLOGY (NEW YORK) 2023; 48:1629-1636. [PMID: 36625897 DOI: 10.1007/s00261-022-03791-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE The purpose of this article is to summarize available data on breastfeeding in patients with a cancer diagnosis. MATERIALS AND METHODS A review of available literature in the MEDLINE database was performed and the data summarized. In addition, two patient interviews were conducted to gain insight into the patient perspective. RESULTS Breastmilk is the nutritional standard for human infants and understanding the implications of a cancer diagnosis on lactation is important in optimizing maternal and infant outcomes. Though limited, available data suggest that breastfeeding may be a safe and appropriate option for some patients undergoing treatment of a malignancy. CONCLUSIONS Patient experiences with breastfeeding in the setting of a cancer diagnosis vary widely, and depend on the type of malignancy, the timing of the diagnosis, and the indicated treatment. Breastfeeding may be an appropriate option for certain patients after multidisciplinary counseling. Alternatives to breastfeeding exist for patients who are unable to or do not desire to breastfeed.
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Affiliation(s)
- Aleksandra Polic
- Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN, 37232, USA.
| | - Kaitlin M Eutsler
- Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN, 37232, USA
| | - Soha S Patel
- Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN, 37232, USA
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Conformity between Pacifier Design and Palate Shape in Preterm and Term Infants Considering Age-Specific Palate Size, Facial Profile and Lip Thickness. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9060773. [PMID: 35740710 PMCID: PMC9221625 DOI: 10.3390/children9060773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/14/2022] [Accepted: 05/17/2022] [Indexed: 11/17/2022]
Abstract
This retrospective case-control study is the first to examine the spatial conformity between pacifiers and palates in 39 preterm infants (12 females, 27 males) and 34 term infants (19 females, 15 males), taking into account the facial-soft-tissue profile and thickness. The shape of 74 available pacifiers was spatially matched to the palate, and conformity was examined using width, height, and length measurements. In summary, the size concept of pacifiers is highly variable and does not follow a growth pattern, like infant palates do. Pacifiers are too undersized in width, length, and height to physiologically fit the palate structures from 0 to 14 months of age. There are two exceptions, but only for premature palates: the palatal depth index at 9−11 months of age, which has no clinical meaning, and the nipple length at <37 weeks of age, which bears a resemblance to the maternal nipple during non-nutritive sucking. It can be concluded that the age-size concept of the studied pacifiers does not correspond to any natural growth pattern. Physiologically aligned, pacifiers do not achieve the age-specific dimensions of the palate. The effects attributed to the products on oral health in term infants cannot be supposed.
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Affiliation(s)
- Philip O Anderson
- Division of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, California, USA
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Martínez-Valdez L, Richardson V, Bautista-Márquez A, Hernández-Ávila M. Epidemiology of sudden infant death syndrome in Mexico, 2005-2020. Front Pediatr 2022; 10:1001089. [PMID: 36568434 PMCID: PMC9773828 DOI: 10.3389/fped.2022.1001089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/11/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Sudden Infant Death Syndrome (SIDS) constitutes one of the main causes of mortality in children under one year of age in developed countries; it's frequency to varies geographically. In Mexico the real incidence of SIDS is not known. METHODS National databases of deaths in children under one year of age, from 2005 to 2020, were analyzed, due to Sudden Unexpected Infant Death (SUID) [SIDS (R95), accidental suffocation in a sleeping environment (W75), and other ill-defined and unspecified causes of mortality (R99), according to the International Classification of Diseases, tenth revision (ICD 10)]. Mortality rates per year of occurrence due to SUID and their subcategories were calculated. Simple frequencies of SIDS were obtained per year and month of occurrence, state of residence, age, place of death, and access to social security services. RESULTS In the study period 473,545 infant deaths occurred; 7,714 (1.62%) deaths were due to SUID; of these, 6,489 (84%) were due to SIDS, which is among the 10 leading causes of infant death in Mexico. The average mortality rate for SUID was 22.4/100,000 live births, for SIDS was 18.8/100,000 live births. Mortality rates within the states were variable, ranging from 2.4/100,000 to 105.1/100,000 live births. In 81% of SIDS records there was no autopsy; 38% of deaths due to SIDS occurred in infants under one month of age, up to 87% of deaths occurred in families without social security services or it was unknown, and 76.2% of deaths occurred at home. Deaths were more frequent during the last months of autumn and during winter. CONCLUSION In Mexico there is an underregistry of SIDS as cause of death, along with other SUID categories. Health workers need to be trained to improve diagnosis and data registration, including the practice of autopsies; additionally, it is necessary to implement a public health campaign.
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Affiliation(s)
- Libny Martínez-Valdez
- Dirección de Prestaciones Económicas y Sociales, El Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Vesta Richardson
- Dirección de Prestaciones Económicas y Sociales, El Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Aurora Bautista-Márquez
- Dirección de Prestaciones Económicas y Sociales, El Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Mauricio Hernández-Ávila
- Dirección de Prestaciones Económicas y Sociales, El Instituto Mexicano del Seguro Social, Mexico City, Mexico
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Lavezzi AM. Altered Development of Mesencephalic Dopaminergic Neurons in SIDS: New Insights into Understanding Sudden Infant Death Pathogenesis. Biomedicines 2021; 9:biomedicines9111534. [PMID: 34829763 PMCID: PMC8615170 DOI: 10.3390/biomedicines9111534] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 10/20/2021] [Accepted: 10/21/2021] [Indexed: 02/06/2023] Open
Abstract
Sudden infant death syndrome (SIDS) is defined as the unexpected sudden death of an infant under 1 year of age that remains unexplained after a thorough case investigation. The SIDS pathogenesis is still unknown; however, abnormalities in brain centers that control breathing and arousal from sleep, including dramatic changes in neurotransmitter levels, have been supposed in these deaths. This is the first study focusing on mesencephalic dopaminergic neurons, so far extensively studied only in animals and human neurological diseases, in SIDS. Dopaminergic structures in midbrain sections of a large series of sudden infant deaths (36 SIDS and 26 controls) were identified using polyclonal rabbit antibodies against tyrosine hydroxylase, the rate-limiting enzyme in catecholamine biosynthesis, and the dopamine transporter, a membrane protein specifically expressed in dopaminergic cells. Dopamine-immunolabeled neurons were observed concentrated in two specific structures: the pars compacta of the substantia nigra and in the subnucleus medialis of the periaqueductal gray matter. Anatomical and functional degenerations of dopaminergic neurons in these regions were observed in most SIDS cases but never in controls. These results indicate that dopamine depletion, which is already known to be linked especially to Parkinson's disease, is strongly involved even in SIDS pathogenesis.
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Affiliation(s)
- Anna Maria Lavezzi
- "Lino Rossi" Research Center for the Study and Prevention of Unexpected Perinatal Death and SIDS, Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
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Carai S, Weber MW. Primary health care for children - evidence for prevention. BMC Pediatr 2021; 21:328. [PMID: 34496790 PMCID: PMC8424783 DOI: 10.1186/s12887-021-02787-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Susanne Carai
- WHO, Regional office for Europe, Copenhagen, Denmark.
- Witten/Herdecke University, Witten, Germany.
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