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Yao J, Roth H, Anderson D, Lu H, Rong H, Baird K. Comparison of Spontaneous Pushing and Directed Pushing During the Second Stage of Labor Among Chinese Women Without Epidural Analgesia: Protocol for a Noninferior Feasibility Study. JMIR Res Protoc 2024; 13:e55701. [PMID: 38530330 PMCID: PMC11005428 DOI: 10.2196/55701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/18/2024] [Accepted: 02/26/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Maternal pushing during the second stage of labor could influence labor progress and maternal-neonatal outcomes. Although the image of health care providers directing the laboring women to push during the second stage of labor could be commonly observed globally, this practice is not sufficiently researched and is questioned regarding its effectiveness and outcomes on the mother and baby. Meanwhile, a strategy referred to as "spontaneous pushing," which supports women to push by following their bodily urges, has been evaluated in several trials. However, in China, spontaneous pushing is not common practice. Notwithstanding the evaluation of spontaneous pushing, there is a lack of high-quality evidence to support either strategies of directed pushing or spontaneous pushing. OBJECTIVE This study aims to test the feasibility of a future randomized controlled trial to compare the effects of spontaneous pushing and directed pushing during the second stage of labor for maternal and neonatal outcomes in China. METHODS A nonrandomized, single-group, noninferiority feasibility study will be conducted in a public hospital in Hebei Province, China. In total, 105 women meeting the selection criteria will be recruited to receive the intervention (spontaneous pushing), while 105 sets of medical notes from women who received routine care (directed pushing) will be identified and reviewed to compare outcomes for both cohorts. A mixed methods approach will be used to assess primary outcomes (feasibility and acceptability) and secondary outcomes (effectiveness). RESULTS Data collection took place between May and October 2023. A total of 110 women were invited to participate in the intervention of spontaneous pushing. Midwives' interviews were conducted and will be transcribed for analysis in March 2024. The data analysis is planned to be completed by May 2024. CONCLUSIONS This feasibility study will provide important information by conducting a full-scale clinical trial in the future as well as the potential facilitators and barriers of it. A future randomized controlled trial is likely to have considerable policy and funding impacts regarding pushing management during the second stage of labor and improvement in women's childbirth experience. TRIAL REGISTRATION Chinese Clinical Trial Register ChiCTR2300071178; https://tinyurl.com/mudtnbft. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/55701.
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Affiliation(s)
- Jiasi Yao
- School of Nursing, Hebei Medical University, Shijiazhuang, China
- Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Heike Roth
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney, Australia
- Collective for Midwifery, Child and Family Health, School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Debra Anderson
- Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Hong Lu
- School of Nursing, Peking University, Beijing, China
| | - Huijuan Rong
- Department of Nursing, The Fourth Hospital of Shijiazhuang, Shijiazhuang, China
| | - Kathleen Baird
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney, Australia
- Collective for Midwifery, Child and Family Health, School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney, Australia
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Mellado-García E, Díaz-Rodríguez L, Cortés-Martín J, Sánchez-García JC, Piqueras-Sola B, Higuero Macías JC, Rodríguez-Blanque R. Systematic Reviews and Synthesis without Meta-Analysis on Hydrotherapy for Pain Control in Labor. Healthcare (Basel) 2024; 12:373. [PMID: 38338258 PMCID: PMC10855539 DOI: 10.3390/healthcare12030373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 01/15/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Although there is scientific evidence regarding the use of water immersion during labor, this evidence is primarily focused on the first stage of labor. There is limited scientific evidence on water immersion during the second stage of labor. OBJECTIVE The objective of this study was to conduct a comprehensive systematic review and synthesis of contemporary evidence related to water birth, with a specific focus on the second stage of labor. METHODS A systematic review of the scientific literature published between January 2018 and October 2023 was carried out. A synthesis of the results was conducted following the Synthesis without Meta-Analysis (SWiM) guidelines. PubMed, Scopus, and the Cochrane Library were utilized as information sources. The search strategy was designed using the keywords "immersion" and "parturition", along with their relevant synonyms. Inclusion criteria encompassed studies employing randomized controlled trials (RCTs), systematic reviews, and quantitative and qualitative approaches focusing on pregnant women undergoing water immersion at any stage of the labor process. RESULTS Eleven articles were selected: two systematic reviews (one quantitative and one qualitative), five cohort studies, one case-control study, one cross-sectional observational study, and two qualitative studies. A thorough assessment of the methodology was performed using several specific tools: the Cochrane RoB 2 (Risk of Bias 2) tool for systematic reviews, JBI Critical Appraisal Checklist for Qualitative Research for qualitative studies, STROBE for observational descriptive studies, and CASPe for qualitative studies. The results provided fundamental insights that will contribute to conceptual standardization regarding the effects of water birth on maternal and fetal health. Additionally, a synthesis of the results was performed concerning types of delivery, analgesia use, pain perception, and maternal satisfaction with the water birth experience. CONCLUSIONS In this study, we conclude that the results regarding delivery types, labor durations, and analgesia use found in the literature, along with statistically significant maternal/fetal effects, are crucial for making recommendations regarding the use of water during labor in any of its stages if the woman desires it safely.
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Affiliation(s)
- Elena Mellado-García
- Research Group CTS-1068, Andalusia Research Plan, Junta de Andalucía, 18014 Granada, Spain; (E.M.-G.); (L.D.-R.); (J.C.-M.); (B.P.-S.); (R.R.-B.)
- Costa del Sol Health District, Servicio Andaluz de Salud, Junta de Andalucía, 29640 Fuengirola, Spain
| | - Lourdes Díaz-Rodríguez
- Research Group CTS-1068, Andalusia Research Plan, Junta de Andalucía, 18014 Granada, Spain; (E.M.-G.); (L.D.-R.); (J.C.-M.); (B.P.-S.); (R.R.-B.)
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
| | - Jonathan Cortés-Martín
- Research Group CTS-1068, Andalusia Research Plan, Junta de Andalucía, 18014 Granada, Spain; (E.M.-G.); (L.D.-R.); (J.C.-M.); (B.P.-S.); (R.R.-B.)
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
| | - Juan Carlos Sánchez-García
- Research Group CTS-1068, Andalusia Research Plan, Junta de Andalucía, 18014 Granada, Spain; (E.M.-G.); (L.D.-R.); (J.C.-M.); (B.P.-S.); (R.R.-B.)
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
| | - Beatriz Piqueras-Sola
- Research Group CTS-1068, Andalusia Research Plan, Junta de Andalucía, 18014 Granada, Spain; (E.M.-G.); (L.D.-R.); (J.C.-M.); (B.P.-S.); (R.R.-B.)
- Virgen de las Nieves University Hospital, Servicio Andaluz de Salud, Junta de Andalucía, 18014 Granada, Spain
| | | | - Raquel Rodríguez-Blanque
- Research Group CTS-1068, Andalusia Research Plan, Junta de Andalucía, 18014 Granada, Spain; (E.M.-G.); (L.D.-R.); (J.C.-M.); (B.P.-S.); (R.R.-B.)
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
- San Cecilio University Hospital, Servicio Andaluz de Salud, Junta de Andalucía, 18016 Granada, Spain
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Fung DK, Trinquier AE, Wang JD. Crosstalk between (p)ppGpp and other nucleotide second messengers. Curr Opin Microbiol 2023; 76:102398. [PMID: 37866203 PMCID: PMC10842992 DOI: 10.1016/j.mib.2023.102398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/25/2023] [Accepted: 09/27/2023] [Indexed: 10/24/2023]
Abstract
In response to environmental cues, bacteria produce intracellular nucleotide messengers to regulate a wide variety of cellular processes and physiology. Studies on individual nucleotide messengers, such as (p)ppGpp or cyclic (di)nucleotides, have established their respective regulatory themes. As research on nucleotide signaling networks expands, recent studies have begun to uncover various crosstalk mechanisms between (p)ppGpp and other nucleotide messengers, including signal conversion, allosteric regulation, and target competition. The multiple layers of crosstalk implicate that (p)ppGpp is intricately linked to different nucleotide signaling pathways. From a physiological perspective, (p)ppGpp crosstalk enables fine-tuning and feedback regulation with other nucleotide messengers to achieve optimal adaptation.
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Affiliation(s)
- Danny K Fung
- Department of Bacteriology, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Aude E Trinquier
- Department of Bacteriology, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Jue D Wang
- Department of Bacteriology, University of Wisconsin-Madison, Madison, WI 53706, USA.
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Zang Y, Hu Y, Lu H. Effects of different techniques during the second stage of labour on reducing perineal laceration: An overview of systematic reviews. J Clin Nurs 2023; 32:996-1013. [PMID: 35253295 DOI: 10.1111/jocn.16276] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/25/2022] [Accepted: 02/21/2022] [Indexed: 12/28/2022]
Abstract
AIM AND OBJECTIVE To summarize the evidence on the effects of different techniques during the second stage of labour on reducing perineal laceration depending on available systematic reviews to provide optimal evidence for decision-making. BACKGROUND Preventing perineal laceration has been considered an important part of improving women's health. Various techniques have been used to prevent perineal laceration during the second stage of labour. However, systematic reviews evaluating the effects of different techniques on reducing perineal laceration show inconsistent results. DESIGN Overview of systematic reviews. METHODS Five English and four Chinese databases were systematically searched for relevant systematic reviews and meta-analyses published between 1 January 2016 and 31 August 2021. The quality of the included reviews was assessed by the AMSTAR 2 tool. A narrative synthesis was conducted to report the results of moderate-to-high quality systematic reviews. The overview was reported according to the PRISMA statement. RESULTS Eighteen reviews were included, of which four reviews had moderate-to-high methodological quality. Perineal massage and warm compresses significantly decreased the incidence of third- or fourth-degree perineal laceration (moderate-quality evidence). Hands-off technique had no impact on perineal laceration (low-to-moderate quality evidence). Ritgen's manoeuvre could reduce the incidence of first-degree perineal laceration but increase the incidence of second-degree perineal laceration (very low-quality evidence). Spontaneous pushing (low-quality evidence) and delayed pushing (moderate-quality evidence) had no impact on the incidence of third- or fourth-degree perineal laceration. Upright positions did not increase the risk of third- or fourth-degree perineal laceration (very low- to low-quality evidence) but increased the risk of second-degree perineal laceration for women without epidural analgesia (low-quality evidence). CONCLUSIONS Perineal massage and warm compresses could be the better choice for preventing perineal laceration in the second stage of labour. RELEVANCE TO CLINICAL PRACTICE Midwives and obstetricians could use perineal massage and warm compresses to prevent perineal laceration and should consider women's preferences and experience with perineal techniques.
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Affiliation(s)
- Yu Zang
- School of Nursing, Hebei Medical University, Shijiazhuang, China
| | - Yinchu Hu
- School of Nursing, Peking University, Beijing, China
| | - Hong Lu
- School of Nursing, Peking University, Beijing, China
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Whiting R, Paterson H, Hudspith A, Caldwell C. Willing but not able: A survey of New Zealand health practitioners' interests in providing second trimester abortion care and the obstacles they face. Aust N Z J Obstet Gynaecol 2022; 62:779-785. [PMID: 35906725 DOI: 10.1111/ajo.13602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 07/17/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND In 2020, abortion was removed from the Crimes Act. Abortions under 20 weeks gestation no longer require an indication and criteria for abortion above 20 weeks gestation has broadened. Prior to law reform, all abortions were provided on licensed premises and the responsible health practitioner was a doctor. Subsequently, any health practitioner with abortion in their scope of practice can provide abortion care. AIMS To describe the characteristics of health practitioners who expressed an interest in participating in second trimester abortion care, and to identify and describe the barriers to providing an optimal second trimester abortion service. MATERIALS AND METHODS This was an exponential non-discriminating snowball email survey using tick boxes and open comments. Quantitative data were analysed using descriptive statistics and free-text components were analysed using a general inductive approach. RESULTS The 113 respondents included: 38 hospital-based obstetrics and gynaecology doctors, 22 primary care doctors, 13 midwives and 14 nurses/nurse practitioners. Thirty-three (29.2%) and 62 (54.9%) respondents reported interest in providing second trimester surgical and medical abortion care respectively. The most commonly identified barrier to both surgical and medical second trimester abortion provision was lack of trained staff, followed by an unsupportive work environment. Thematic analysis aligned with these findings and commonly featured difficulty in accessing feticide. CONCLUSIONS We need to actively recruit and train all health practitioners interested in providing second trimester abortion care to strengthen the workforce. This requires an organisation to oversee an inclusive national framework for abortion training, including feticide, and provide professional supervision.
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Affiliation(s)
- Rosie Whiting
- RANZCOG Core Trainee, Women's Health Service, Capital and Coast DHB, Wellington, New Zealand
| | - Helen Paterson
- Head of Section/Senior Lecturer, Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Anna Hudspith
- RANZCOG Advanced Trainee, Women's Health Service, Capital and Coast DHB, Wellington, New Zealand
| | - Coleen Caldwell
- Clinical Lecturer, Department of Obstetrics and Gynaecology, Christchurch School of Medicine, University of Otago, Christchurch, New Zealand
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Pouryousef S, Jahromi MK, Yeganeh S, Rouhandeh R, Paki S, Jokar M. The Effect of an educational Intervention on Anxiety of Pregnant Women: A Quasi-Experimental Study. Invest Educ Enferm 2022; 40:e05. [PMID: 36264693 PMCID: PMC9714979 DOI: 10.17533/udea.iee.v40n2e05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 06/06/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES The aim of study is the effect of educational intervention on anxiety of pregnant women. METHODS This quasi-experimental study is done on the pregnant women referring to family physicians offices in Gerash City, Iran. 62 women were selected and divided into 2 groups (control and intervention). In intervention group the anxiety reduction training classes were held as a group discussion in 4 weekly 90-minute sessions. Control group received routine care. The anxiety assessment completed by two groups before and after the educational intervention. The measurement instruments included a demographic information questionnaire and the short form of the Pregnancy Related Anxiety Questionnaire (PRAQ-17). RESULTS Comparison of the mean scores of different dimensions of pregnancy anxiety in the pre-intervention and post-intervention stages in the intervention group using paired t-test indicated a statistically significant difference in the dimensions Fear of childbirth, Fear of giving birth to a physically or mentally disabled child, Fear of mood swings and Fear of changes in marital relations (p < 0.05) in comparison with control group. CONCLUSIONS Holding pregnancy-training classes using group discussion method is a good strategy to reduce anxiety in pregnant women. Therefore, it is recommended that this educational strategy classes be used with mothers from the second trimester of pregnancy in urban family physician centers or those referred to a nearby clinic.
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Affiliation(s)
- Sajad Pouryousef
- School of Nursing, Gerash University of Medical Sciences, Gerash, Iran,
| | - Marzieh Kargar Jahromi
- Student Research Committee,School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran,
| | - Sedigheh Yeganeh
- School of Nursing, Gerash University of Medical Sciences, Gerash, Iran,
| | | | - Somayeh Paki
- Social Security Organization, Isfahan University of Medical Sciences, Isfahan, Iran,
| | - Mozhgan Jokar
- Student Research Committee,School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
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Mahjoub H, Loya A, Ayaz T, Weng CY. Second Primary Malignancies following a Diagnosis of Conjunctival Melanoma. Curr Eye Res 2022; 47:634-641. [PMID: 34898336 DOI: 10.1080/02713683.2021.2018465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 10/20/2021] [Accepted: 12/06/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND Although incidence of second primary malignancies (SPMs) has been investigated in patients with cutaneous melanoma and uveal melanoma, limited studies have investigated their occurrence subsequent to conjunctival melanoma (CM). We conducted a retrospective observational study to assess incidence of SPMs in patients with primary CM and to identify associated risk factors. METHODS Cases of first primary CM diagnosed from 2000 to 2018 were extracted from the national cancer database Surveillance, Epidemiology, and End Results Program. Standardized incidence ratios (SIR) and excess absolute risk (EAR) of SPMs were calculated compared to a matched cohort from the general population with similar sex, race, age group, and calendar year. EAR was per 10,000 individuals, and a P-value of <0.05 was considered significant. RESULTS A total of 471 patients met inclusion criteria, 57 (12.1%) of whom developed second primary malignancies (excluding eye and orbit melanomas) over an average (±SD) follow-up period of 6.8 (±5.0) years. Average age at diagnosis for the overall cohort was 60.2 (±18.6) years. Patients with CM demonstrated a significantly increased risk for overall SPMs relative to the general population, even after excluding eye and orbit melanomas (SIR 1.52; 95% confidence interval [CI], 1.15-1.97; EAR 67.58). Specific sites and malignancy types with increased risk were cutaneous melanoma (SIR 7.95; 95% CI, 4.45-13.12; EAR 45.34), ophthalmic non-melanoma malignancies (SIR 80.92; 95% CI, 2.05-450.84; EAR 3.41), and non-intrahepatic biliary malignancies (SIR 11.72; 95% CI, 1.42-42.32; EAR 6.32). Risk of overall SPMs (excluding eye and orbit melanomas) was significantly increased 5-10 years from diagnosis date. CONCLUSIONS Patients with CM had an increased incidence of SPMs compared to the general population. Specifically, these patients developed more cutaneous, ophthalmic non-melanoma, and non-intrahepatic biliary malignancies. These second neoplasms could be due to shared pathophysiology or mutual risk factors. Patients with CM may benefit from surveillance for SPMs, such as annual age-appropriate screenings in the first 10 years after diagnosis.
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Affiliation(s)
- Heba Mahjoub
- School of Medicine Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Asad Loya
- School of Medicine Baylor College of Medicine, Houston, Texas, USA
| | - Talha Ayaz
- School of Medicine University of Texas Medical Branch at Galveston, Texas, USA
| | - Christina Y Weng
- School of Medicine Baylor College of Medicine, Houston, Texas, USA
- Department of Ophthalmology Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA
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Jiang L, Peng L, Rong M, Liu X, Pang Q, Li H, Wang Y, Liu Z. Nomogram Incorporating Multimodal Transvaginal Ultrasound Assessment at 20 to 24 Weeks' Gestation for Predicting Spontaneous Preterm Delivery in Low-Risk Women. Int J Womens Health 2022; 14:323-331. [PMID: 35264886 PMCID: PMC8901232 DOI: 10.2147/ijwh.s356167] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 02/17/2022] [Indexed: 01/09/2023] Open
Abstract
Background The majority of women who experience spontaneous preterm delivery (SPTD) have low-risk, asymptomatic pregnancies with a cervical length (CL) ≥25mm and no clear risk factors. Despite the fact that cervical elastography is a potential tool for predicting SPTD, there is currently no feasible solution to make a reliable prediction for preventing SPTD. Objective The aim of this study was to construct a nomogram including multimodal transvaginal ultrasound parameters during the second trimester to predict SPTD in low-risk women. Methods This multi-center study enrolled 1260 women with singleton pregnancies between 20 and 24 weeks’ gestation. CL and cervical elastography data were obtained when they were undergoing the second-trimester anomaly scan. Univariate and multivariate Logistic regression were utilized to screen predictors independently related to SPTD from the maternal characteristics and multimodal ultrasound data. Then construct a nomogram to determine the likelihood of SPTD in pregnant women. Results A total of 66 pregnancies in the training cohort (7.8%, 66/842) and 37 pregnancies (8.9%, 37/418) in the validation cohort ended in SPTD. Age, uterine curettage, CL, and strain in the anterior lip of internal os were the independent predictors of SPTD (P < 0.001, < 0.001, = 0.007, and < 0.001, respectively). These predictors constituted a nomogram to predict the probability of SPTD for a pregnant woman in her second trimester. It showed good discrimination (C-index = 0.898 and 0.839), calibration (P = 0.258 and 0.115), and yielded net benefits both in the training and validation cohorts. Conclusion The nomogram including data of multimodal transvaginal ultrasound at 20 to 24 weeks’ gestation is expected to identify women with SPTD in the low-risk, asymptomatic population.
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Affiliation(s)
- Lingli Jiang
- Department of Obstetrics and Gynecology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, People's Republic of China
| | - Lei Peng
- Department of Obstetrics and Gynecology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, People's Republic of China
| | - Miaoling Rong
- Department of Obstetrics and Gynecology, First Maternity and Infant Hospital Affiliated to Tongji University, Shanghai, People's Republic of China
| | - Xiaozhi Liu
- Department of Ultrasound, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, People's Republic of China
| | - Qinxia Pang
- Department of Obstetrics and Gynecology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, People's Republic of China
| | - Huaping Li
- Department of Obstetrics and Gynecology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, People's Republic of China
| | - Ying Wang
- Department of Obstetrics and Gynecology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, People's Republic of China
| | - Zhou Liu
- Department of Obstetrics and Gynecology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, People's Republic of China
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Renner R, Ennis M, Guilbert E, Roy G, Barrett J. Second- and Third-Trimester Medical Abortion Providers and Services in 2019: Results from the Canadian Abortion Provider Survey. J Obstet Gynaecol Can 2022; 44:690-699. [PMID: 35183788 DOI: 10.1016/j.jogc.2022.01.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Mifepristone became available in Canada in 2017. Updated national guidelines recommend its off-label use for second/third-trimester medical abortion (STMA/TTMA) by labour induction. The objective of this study was to explore STMA/TTMA provision in Canada and the role of mifepristone. METHODS We conducted a national, cross-sectional, web-based, self-administered, anonymized survey, available in English and French. The survey was distributed through health professional organizations and recruited physicians who provided abortion care in 2019. We used a modified Dillman technique to maximize participation. The survey included sections on workforce and clinical care, including mifepristone use. We used R statistical software to produce descriptive statistics. RESULTS Four hundred sixty-five clinicians responded to the survey, of whom 112 reported providing STMA and 63, TTMA, for a total of 115 respondents providing at least 1 of the 2 services. Two-thirds of respondents were general obstetrician-gynaecologists or family physicians and the remainder were maternal-fetal medicine subspecialists. The majority (64.7%) provided STMA/TTMA in an academic hospital, and 59.4% performed fewer than 5 STMAs (maximum 50) and 76.1%, fewer than 5 TTMA (maximum 15) in 2019. Fifty-nine percent of respondents reported having used mifepristone/misoprostol for STMA. Among mifepristone users, 48.6% used it for TTMA. Most required an indication beyond patient request to provide STMA/TTMA (82.1%/95.5%). CONCLUSIONS STMA/TTMA care is provided by multiple (sub-) specialties, and mifepristone has not yet been universally implemented. Our results will inform knowledge translation activities aimed at facilitating collaboration between STMA/TTMA providers and health policy and service delivery leaders and will further increase mifepristone use for STMA/TTMA in Canada.
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Affiliation(s)
- Regina Renner
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada; Contraception Abortion Research Team, Women's Health Research Institute, BC Women's Hospital and Health Centre, Vancouver, BC, Canada; 3rd Floor David Strangway Building, 5950 University Boulevard, Vancouver, British Columbia, V6T 1Z3, Canada.
| | - Madeleine Ennis
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada; Contraception Abortion Research Team, Women's Health Research Institute, BC Women's Hospital and Health Centre, Vancouver, BC, Canada; 3rd Floor David Strangway Building, 5950 University Boulevard, Vancouver, British Columbia, V6T 1Z3, Canada
| | - Edith Guilbert
- Contraception Abortion Research Team, Women's Health Research Institute, BC Women's Hospital and Health Centre, Vancouver, BC, Canada; Department of Obstetrics, Gynecology and Reproduction, Laval University, Quebec City, Quebec, Canada; 945, avenue Wolfe, Québec, Québec, G1V 5B3, Canada
| | - Geneviève Roy
- Contraception Abortion Research Team, Women's Health Research Institute, BC Women's Hospital and Health Centre, Vancouver, BC, Canada; Department of Obstetrics and Gynaecology, University of Montreal, Montreal,Quebec, Canada; Centre Hospitalier de l'Université de Montréal (CHUM)1000 St-Denis, Montréal, Québec H2X 0C1
| | - Jon Barrett
- Contraception Abortion Research Team, Women's Health Research Institute, BC Women's Hospital and Health Centre, Vancouver, BC, Canada; Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada; Health Sciences Centre, Room 2F391280 Main Street WestHamilton, ON L8S 4K1
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Hudspith A, Paterson H, Caldwell C, Whiting R. Leaps ahead in law but not in practice: Why we need to train in second trimester abortion care. Aust N Z J Obstet Gynaecol 2021; 62:140-146. [PMID: 34751956 DOI: 10.1111/ajo.13454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Abortion care has always been controversial, with health professionals worldwide continually working to offer well-rounded safe services. Key improvements in New Zealand since abortion law reform include the ability to self-refer, no formal certification under 20 weeks gestation, and change to the indications for abortion after 20 weeks. Nationally, we know that the second trimester abortion incidence is stable, and will therefore require an ongoing workforce to sustain the service. AIMS To document the current second trimester workforce for medical and surgical abortion in New Zealand, and examine their training and practice. MATERIALS AND METHODS Anonymous non-discriminatory snowball survey covering the domains of demographics, barriers to abortion care, abortion training, abortion provision and procedure specifics using Qualtrics software. RESULTS Eleven practitioners currently perform dilation and evacuation, and 33 wish to. Current providers have between zero and three other colleagues to assist them in service provision. Most learned by an informal apprenticeship model and operate relatively infrequently. There is variance in the cervical preparation and evacuation procedure as well as skillset and/or willingness for later gestations. Fifty-nine practitioners' units currently provide medical abortion, and 62 wish to. There is more coherence in the regime of medical abortion, although the availability of this is affected by gestation and location. CONCLUSION For most women requesting second trimester abortions, additional time, cost and stress is still very much the status quo. District Health Boards need to prioritise training and workforce planning to ensure the availability of this essential service.
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Affiliation(s)
- Anna Hudspith
- RANZCOG Advanced Trainee, Women's Health Service, Capital and Coast DHB, Wellington, New Zealand
| | - Helen Paterson
- Head of Section/Senior Lecturer, Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Coleen Caldwell
- Clinical Lecturer, Department of Obstetrics and Gynaecology, Christchurch School of Medicine, University of Otago, Christchurch, New Zealand
| | - Rosie Whiting
- RANZCOG Core Trainee, Women's Health Service, Capital and Coast DHB, Wellington, New Zealand
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Araújo AE, Delgado A, Maia JN, Lima Campos S, Wanderley Souto Ferreira C, Lemos A. Efficacy of spontaneous pushing with pursed lips breathing compared with directed pushing in maternal and neonatal outcomes. J OBSTET GYNAECOL 2021; 42:854-860. [PMID: 34581237 DOI: 10.1080/01443615.2021.1945016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This is a quasi-randomised clinical trial, with 62 low-risk pregnant women in the second stage of labour. They were randomly allocated in control (CG) (n = 31) and intervention (IG) (n = 31) groups. The IG performed spontaneous pushing with pursed lips breathing while the CG was oriented to perform directed pushing associated with Valsalva Manoeuvre (VM). There was no difference between the groups regarding the occurrence of episiotomy (RR 1,1; 95%IC 1,0 to 1,2). However, there was a decrease in the duration of the maternal pushing by 3.2 min (MD 3,2; 95%CI 1,4 to 5,1) and a difference in maternal anxiety (Md (IQR) IG 46 (35-52), CG 51 (44-56) p:0,049), both favouring the IG. Spontaneous pushing was effective in reducing the duration of the pushing and showed a difference in maternal anxiety but did not decrease the maternal and neonatal outcomes. Brazilian Clinical Trials Registry (ReBEC) under the identifier: RBR-556d22IMPACT STATEMENTWhat is already known on the subject? Spontaneous pushing reduces the duration of pushing time when compared to directed pushing with VM but has no effect on other maternal and neonatal outcomes, based on a low quality of evidence.What do the results of this study add? No subject has been published on the subject. Our results suggest that the use spontaneous pushing with pursed lips breathing reduces the duration of the pushing by 3.2 min, also showing a difference in maternal anxiety. This result may indicate its use for emotional control when compared to the directed pushing.What are the implications of these findings for clinical practice and/or further research? These findings may signal an attitude in decision-making about guiding the breathing pattern in the expulsive stage.
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Affiliation(s)
- Ana Eulina Araújo
- Post-Gratuate Program of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Brazil
| | - Alexandre Delgado
- Post-Gratuate Program of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Brazil.,Post-Graduate Program on Integral Medicine, Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Brazil
| | - Juliana Netto Maia
- Post-Gratuate Program of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Brazil
| | - Shirley Lima Campos
- Post-Gratuate Program of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Brazil
| | | | - Andrea Lemos
- Post-Gratuate Program of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Brazil
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Galligan D, Williamson S, Myers J, Silbermann R, Medvedova E, Nagle S, Schachter L, Chen A, Scott E, Maziarz R. Second Autologous Stem Cell Transplant as Salvage in Multiple Myeloma - The Oregon Health and Science University Experience. Clin Lymphoma Myeloma Leuk 2021; 22:105-112. [PMID: 34686447 DOI: 10.1016/j.clml.2021.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/10/2021] [Accepted: 08/24/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Second autologous transplants (SAT) are routinely performed in the setting of myeloma relapse, though data on outcomes are lacking. We conducted a single-center review of all multiple myeloma patients at OHSU who received SAT (excluding tandems) with responses assessed by International Myeloma Working Group (IMWG) criteria. RESULTS Sixty-eight patients received SAT between 1999 and 2019. Risk by IMWG was available for 50 patients (10 high-risk). Median age at SAT was 61 (45-74). Median time between 1st and 2nd Autologous stem cell transplantation (ASCT) was 5.5 years (1.1 - 15.2). Median progression-free survival (PFS) after 1st ASCT (available for 53 pts) was 2.5 years (0.3 - 10). The average # of lines of therapy prior to SAT was 2.8 (1-14). SAT prep regimens (available for 67 pts) were: Fifty-one (87%) melphalan 200 mg/m2, 6 (9%) melphalan 140 mg/m2, 1 (2%) BEAM, 1 (2%) melphalan 200 mg/m2 and bortezomib. All used PBSC mobilization. Median overall survival (OS) after SAT was 4.68 years, and median PFS was 1.72 years. By treatment era (1999-2009 vs. 2010-2019), median OS was 1.97 vs. 5.52 years (P = .15). When analyzed by IMWG group (standard/low vs. high risk) median PFS and OS were not significantly different (1.87 vs. 1.61 years and 3.58 vs. 5.91 years, respectively). Treatment-Related Mortality (TRM) occurred in 1 patient (2%). CONCLUSION Our experience with SAT for multiple myeloma (MM) shows that it has low TRM and is effective, with median OS >4.5 years, though with a shorter PFS than after 1st ASCT.
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Affiliation(s)
- Derek Galligan
- Oregon Health & Science University, Knight Cancer Institute, Portland, Oregon.
| | - Staci Williamson
- Oregon Health & Science University, Knight Cancer Institute, Portland, Oregon
| | - Jessie Myers
- Oregon Health & Science University, Knight Cancer Institute, Portland, Oregon
| | - Rebecca Silbermann
- Oregon Health & Science University, Knight Cancer Institute, Portland, Oregon
| | - Eva Medvedova
- Oregon Health & Science University, Knight Cancer Institute, Portland, Oregon
| | - Sarah Nagle
- Oregon Health & Science University, Knight Cancer Institute, Portland, Oregon
| | - Levanto Schachter
- Oregon Health & Science University, Knight Cancer Institute, Portland, Oregon
| | - Andy Chen
- Oregon Health & Science University, Knight Cancer Institute, Portland, Oregon
| | - Emma Scott
- Oregon Health & Science University, Knight Cancer Institute, Portland, Oregon
| | - Richard Maziarz
- Oregon Health & Science University, Knight Cancer Institute, Portland, Oregon
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13
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Loya A, Ramachandran V, Ayaz T, Weng CY. Second primary malignancies after ocular adnexal lymphoma diagnosis. BMC Ophthalmol 2021; 21:162. [PMID: 33827494 PMCID: PMC8028208 DOI: 10.1186/s12886-021-01921-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 03/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although studies have investigated the risk of second primary malignancies (SPMs) associated with lymphoma of various sites, limited studies have investigated this risk in patients with lymphoma originating within the ocular adnexa. We conducted a retrospective study to assess incidence of secondary malignancies in patients with a prior diagnosis of ocular adnexal lymphoma (OAL) and to determine latency periods and age-groups at increased risk for SPM occurrence. METHODS Retrospective analysis was performed on data obtained from Surveillance, Epidemiology, and End Results (SEER) 9 database. Patients with an initial primary malignancy diagnosis of OAL between 1973 and 2015 were included in the study. Standardized incidence ratios (SIR) and excess absolute risks (EAR) compared to a SEER reference population with similar sex, race, age, and calendar year were computed for SPMs. Excess absolute risk is per 10,000 individuals; alpha of 0.05 was used. RESULTS Of 1834 patients with primary ocular adnexal lymphoma, 279 developed a secondary malignancy during average follow-up of 110.03 months (+/- 88.46), denoting higher incidence than expected (SIR 1.20; 95% CI, 1.07 to 1.35; EAR 30.56). Amongst the primary lymphoma cohort, 98.7% (1810/1834) of patients had non-Hodgkin's lymphoma and amongst those that developed secondary malignancies, 99.6% (278/279) had non-Hodgkin's lymphoma. Patients exhibited increased incidence of lymphohematopoietic and non-lymphohematopoietic second malignancies and no secondary malignancies of the eye or orbit. Patients had increased incidence of secondary malignancies in the first year (SIR 2.07; 95% CI, 1.49 to 2.79; EAR 150.37) and 1-5 years following lymphoma diagnosis (SIR 1.24; 95% CI, 1.01 to 1.51; EAR 34.89). Patients with various OAL subtypes demonstrated differing patterns of site-specific and overall SPM risk. CONCLUSIONS Patients with prior diagnosis of ocular adnexal lymphoma possess increased risk of hematologic and non-hematologic secondary malignancies. Risk of secondary malignancy could vary by lymphoma subtype. Patients with ocular adnexal lymphoma may benefit from regular surveillance to promote early detection of second primary malignancies.
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Affiliation(s)
- Asad Loya
- Baylor College of Medicine, School of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA
| | - Vignesh Ramachandran
- Baylor College of Medicine, School of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA
| | - Talha Ayaz
- University of Texas Medical Branch at Galveston, School of Medicine, 301 University Blvd., Galveston, TX, 77555, USA
| | - Christina Y Weng
- Baylor College of Medicine, Department of Ophthalmology-Cullen Eye Institute, 1977 Butler Boulevard, Houston, TX, 77030, USA.
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14
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Infante-Torres N, Molina-Alarcón M, Arias-Arias A, Rodríguez-Almagro J, Hernández-Martínez A. Relationship Between Prolonged Second Stage of Labor and Short-Term Neonatal Morbidity: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health 2020; 17:E7762. [PMID: 33114127 PMCID: PMC7660349 DOI: 10.3390/ijerph17217762] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/14/2020] [Accepted: 10/21/2020] [Indexed: 12/02/2022]
Abstract
To evaluate the association between prolonged second stage of labor and the risk of adverse neonatal outcomes with a systematic review and meta-analysis. PubMed, Scopus and EMBASE were searched using the search strategy "Labor Stage, Second" AND (length OR duration OR prolonged OR abnormal OR excessive). Observational studies that examine the relationship between prolonged second stage of labor and neonatal outcomes were selected. Prolonged second stage of labor was defined as 4 h or more in nulliparous women and 3 h or more in multiparous women. The main neonatal outcomes were 5 min Apgar score <7, admission to the Neonatal Intensive Care Unit, neonatal sepsis and neonatal death. Data collection and quality assessment were carried out independently by the three reviewers. Twelve studies were selected including 266,479 women. In nulliparous women, a second stage duration greater than 4 h increased the risk of 5 min Apgar score <7, admission to the Neonatal Intensive Care Unit and neonatal sepsis and intubation. In multiparous women, a second stage of labor greater than 3 h was related to 5 min Apgar score <7, admission to the Neonatal Intensive Care Unit, meconium staining and composite neonatal morbidity. Prolonged second stage of labor increased the risk of 5 min Apgar score <7 and admission to the Neonatal Intensive Care Unit in nulliparous and multiparous women, without increasing the risk of neonatal death. This review demonstrates that prolonged second stage of labor increases the risk of neonatal complications in nulliparous and multiparous women.
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Affiliation(s)
- Nuria Infante-Torres
- Mancha Centro Hospital, Av. Constitución, 3, Alcázar de San Juan, 13600 Ciudad Real, Spain; (N.I.-T.); (A.A.-A.)
| | - Milagros Molina-Alarcón
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing, University of Castilla-La Mancha, Av. de España, s/n, 02001 Albacete, Spain;
| | - Angel Arias-Arias
- Mancha Centro Hospital, Av. Constitución, 3, Alcázar de San Juan, 13600 Ciudad Real, Spain; (N.I.-T.); (A.A.-A.)
| | - Julián Rodríguez-Almagro
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing, University of Castilla-La Mancha, Camilo José Cela, 14, 13071 Ciudad Real, Spain;
| | - Antonio Hernández-Martínez
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing, University of Castilla-La Mancha, Camilo José Cela, 14, 13071 Ciudad Real, Spain;
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15
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Bernasconi A, De Franco C, Iorio P, Smeraglia F, Rizzo M, Balato G. Use of synthetic cartilage implant (Cartiva®) for degeneration of the first and second metatarsophalangeal joint: what is the current evidence? J BIOL REG HOMEOS AG 2020; 34:15-21. ADVANCES IN MUSCULOSKELETAL DISEASES AND INFECTIONS-SOTIMI 2019. [PMID: 32856435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Polyvinyl alcohol hydrogel implants (also known as Synthetic Cartilage Implant or Cartiva® have been described in the treatment of degeneration of the first and second metatarsophalangeal joint (MTPJ). We reviewed literature to report characteristics of devices on the market and investigate their efficacy and safety. Following the PRISMA checklist, the Medline and Scopus databases were searched, including studies reporting use of Cartiva® for treating joint degeneration of the first and second MPTJ. Studies were searched for surgical technique, postoperative protocol, clinical scores, complications and reoperations. We found that, although some studies suggest that the use of Synthetic Cartilage Implant (Cartiva® is effective in the treatment of hallux rigidus in providing symptoms relief without sacrifice of joint motion, the redundancy of cohorts reported in studies and the frequency of conflict of interest reported by authors weaken the strength of evidence available and warrant further studies. Regarding the treatment of the second MTPJ ailments, no recommendation can be formulated to date due to the lack of primary studies.
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Affiliation(s)
- A Bernasconi
- Orthopaedic Division, Department of Public Health, University of Naples Federico II, Naples, Italy
| | - C De Franco
- Orthopaedic Division, Department of Public Health, University of Naples Federico II, Naples, Italy
| | - P Iorio
- Orthopaedic Division, Department of Public Health, University of Naples Federico II, Naples, Italy
| | - F Smeraglia
- Orthopaedic Division, Department of Public Health, University of Naples Federico II, Naples, Italy
| | - M Rizzo
- Orthopaedic Division, Department of Public Health, University of Naples Federico II, Naples, Italy
| | - G Balato
- Orthopaedic Division, Department of Public Health, University of Naples Federico II, Naples, Italy
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16
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Clement ND, Merrie KL, Weir DJ, Holland JP, Deehan DJ. Asynchronous Bilateral Total Knee Arthroplasty: Predictors of the Functional Outcome and Patient Satisfaction for the Second Knee Replacement. J Arthroplasty 2019; 34:2950-2956. [PMID: 31331702 DOI: 10.1016/j.arth.2019.06.056] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 06/19/2019] [Accepted: 06/26/2019] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The primary aim of this study is to identify independent preoperative predictors of outcome and patient satisfaction for the second total knee arthroplasty (TKA). METHODS A retrospective cohort of 454 patients undergoing an asynchronous (6 weeks or more apart) bilateral primary TKA were identified from an arthroplasty database. Patient demographics, comorbidities, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Short Form-12 scores were collected preoperatively and 1 year postoperatively. Overall patient satisfaction was assessed at 1 year. RESULTS The 1 year WOMAC pain score (P = .01), and improvement in WOMAC pain (P < .001) and functional (P = .002) scores were significantly lower for the second TKA. Worse preoperative WOMAC pain, function, and stiffness scores were demonstrated to be independent predictors of improvement in the WOMAC pain, function, and stiffness scores, respectively, for both the first and second TKA. The overall rate of satisfaction with the first TKA was 94.0% and 94.7% for the second TKA (P = .67). The rate of satisfaction for the second TKA was 77.8% for patients that were dissatisfied with their first TKA, which was an independent predictor of dissatisfaction (P = .02). CONCLUSION Improvement in pain and function is less with the second TKA, but the satisfaction rate remains similar. There are common independent predictors for change in the WOMAC score for the first and second TKA; however, the predictors of satisfaction were different with no common factors. Patients that were dissatisfied with their first TKA were more likely to be dissatisfied with their second TKA. LEVEL OF EVIDENCE II Prognostic retrospective cohort study.
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Affiliation(s)
- Nicholas D Clement
- Department of Orthopedics, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Katie L Merrie
- Department of Orthopedics, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - David J Weir
- Department of Orthopedics, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - James P Holland
- Department of Orthopedics, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - David J Deehan
- Department of Orthopedics, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
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Ren Y, Xu Z, Wu F, Ejima Y, Yang J, Takahashi S, Wu Q, Wu J. Does Temporal Expectation Driven by Rhythmic Cues Differ From That Driven by Symbolic Cues Across the Milli second and Second Range? Perception 2019; 48:515-529. [PMID: 31046568 DOI: 10.1177/0301006619847579] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Temporal expectation relies on different predictive information, such as regular rhythms and symbolic cues, to direct attention to a future moment in time to optimize behaviour. However, whether differences exist between temporal expectations driven by regular rhythms and symbolic cues has not been clearly established. In this study, 20 participants performed two temporal expectation tasks in which a rhythmic cue or a symbolic cue indicated (70% expected) that the target would appear after an interval of 500 ms (short), 1,500 ms (medium), or 2,500 ms (long). We found larger cueing effects for the rhythmic cued task than for the symbolic cued task during the short interval, indicating that rhythmic cues were more effective in improving performance. Furthermore, no significant difference was found during the longer interval, reflect that the behavioural differences between the two forms of temporal expectations were likely to diminish as the time interval increased. Thus, we speculate that the temporal expectation driven by rhythmic cues differs from that driven by symbolic cues only in the limited time range; however, the mechanisms underlying the two forms of temporal expectations trend to become more similar over increasing temporal scales.
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Affiliation(s)
- Yanna Ren
- Department of Psychology, Medical Humanities College, Guizhou University of Traditional Chinese Medicine, Guiyang, China; Cognitive Neuroscience Laboratory, Graduate School of Natural Science and Technology, Okayama University, Japan
| | - Zhihan Xu
- Cognitive Neuroscience Laboratory, Graduate School of Natural Science and Technology, Okayama University, Japan
| | - Fengxia Wu
- Cognitive Neuroscience Laboratory, Graduate School of Natural Science and Technology, Okayama University, Japan
| | - Yoshimichi Ejima
- Cognitive Neuroscience Laboratory, Graduate School of Natural Science and Technology, Okayama University, Japan
| | - Jiajia Yang
- Cognitive Neuroscience Laboratory, Graduate School of Natural Science and Technology, Okayama University, Japan
| | - Satoshi Takahashi
- Cognitive Neuroscience Laboratory, Graduate School of Natural Science and Technology, Okayama University, Japan
| | - Qiong Wu
- Cognitive Neuroscience Laboratory, Graduate School of Natural Science and Technology, Okayama University, Japan
| | - Jinglong Wu
- Cognitive Neuroscience Laboratory, Graduate School of Natural Science and Technology, Okayama University, Japan; Shanghai University of Traditional Chinese Medicine, China
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18
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Kazemi K, Adibi A, Hovsepian S. Reference values of nuchal fold thickness in an Iranian population sample. J Res Med Sci 2018; 23:94. [PMID: 30505332 PMCID: PMC6225456 DOI: 10.4103/jrms.jrms_357_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 06/13/2018] [Accepted: 07/25/2018] [Indexed: 12/30/2022]
Abstract
Background: Considering that ethnicity and gestational age (GA) could affect the value of nuchal fold thickness (NFT) in mid-trimester, we aimed to determine the reference intervals of NFT values for each gestational week from 16 to 24 weeks of pregnancy among a group of Iranian pregnant women. Materials and Methods: In this cross-sectional study, medical files of pregnant women who underwent fetal anomaly scanning at 16–24 weeks of gestation were reviewed and the following data were extracted: GA, value of NFT, value of nuchal translucency (NT) in their previous ultrasound study, if available, and head circumference (HC). The 5th, 25th, 50th, 75th, and 95th percentiles of NFT for each gestational week were determined. The association between NFT and HC, GA, and NT were also determined. Results: Medical files of 882 pregnant women were studied. The expected 95th percentile value of NFT between 16th and 24th weeks of gestation ranged from 4 mm to 5.9 mm. The mean (standard deviation) of NFT increased with GA from 2.67 (0.90) mm at 16th weeks to 4.69 (0.71) mm at 24th weeks. There was a significant positive association between NFT and GA (β = 1.11, p < 0.001), HC (β = 0.21, p < 0.001), and NT (β = 0.351, p < 0.001). Conclusion: The findings of this study revealed that before the 20th week of gestation, the appropriate cutoff value of NFT is 5 mm, and for 21st to 24th weeks, the proper cutoff is 6 mm. However, for providing more conclusive results, further studies with larger sample size and considering the impact of other influencing variables are recommended.
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Affiliation(s)
- Kimia Kazemi
- Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Atoosa Adibi
- Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Silva Hovsepian
- Emam Hossein Children's Hospital, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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Matthew J, Malamateniou C, Knight CL, Baruteau KP, Fletcher T, Davidson A, McCabe L, Pasupathy D, Rutherford M. A comparison of ultrasound with magnetic resonance imaging in the assessment of fetal biometry and weight in the second trimester of pregnancy: An observer agreement and variability study. Ultrasound 2018; 26:229-244. [PMID: 30479638 DOI: 10.1177/1742271x17753738] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 12/21/2017] [Indexed: 11/16/2022]
Abstract
Objective To compare the intra and interobserver variability of ultrasound and magnetic resonance imaging in the assessment of common fetal biometry and estimated fetal weight in the second trimester. Methods Retrospective measurements on preselected image planes were performed independently by two pairs of observers for contemporaneous ultrasound and magnetic resonance imaging studies of the same fetus. Four common fetal measurements (biparietal diameter, head circumference, abdominal circumference and femur length) and an estimated fetal weight were analysed for 44 'low risk' cases. Comparisons included, intra-class correlation coefficients, systematic error in the mean differences and the random error. Results The ultrasound inter- and intraobserver agreements for ultrasound were good, except intraobserver abdominal circumference (intra-class correlation coefficient = 0.880, poor), significant increases in error was seen with larger abdominal circumference sizes. Magnetic resonance imaging produced good/excellent intraobserver agreement with higher intra-class correlation coefficients than ultrasound. Good interobserver agreement was found for both modalities except for the biparietal diameter (magnetic resonance imaging intra-class correlation coefficient = 0.942, moderate). Systematic errors between modalities were seen for the biparietal diameter, femur length and estimated fetal weight (mean percentage error = +2.5%, -5.4% and -8.7%, respectively, p < 0.05). Random error was above 5% for ultrasound intraobserver abdominal circumference, femur length and estimated fetal weight and magnetic resonance imaging interobserver biparietal diameter, abdominal circumference, femur length and estimated fetal weight (magnetic resonance imaging estimated fetal weight error >10%). Conclusion Ultrasound remains the modality of choice when estimating fetal weight, however with increasing application of fetal magnetic resonance imaging a method of assessing fetal weight is desirable. Both methods are subject to random error and operator dependence. Assessment of calliper placement variations may be an objective method detecting larger than expected errors in fetal measurements.
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Affiliation(s)
- Jacqueline Matthew
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St Thomas' Hospital, London, UK.,NIHR Biomedical Research Centre, Guy's and St Thomas' NHS Hospital Foundation Trust, London, UK
| | - Christina Malamateniou
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St Thomas' Hospital, London, UK.,Department of Family Care and Mental Health, Faculty of Education and Health, University of Greenwich, London, UK
| | - Caroline L Knight
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St Thomas' Hospital, London, UK.,Department of Women and Children's Health, King's College London, King's Health Partners, St. Thomas' Hospital, London, UK
| | - Kelly P Baruteau
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St Thomas' Hospital, London, UK.,Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
| | - Tara Fletcher
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St Thomas' Hospital, London, UK.,Radiology Department, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
| | - Alice Davidson
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St Thomas' Hospital, London, UK
| | - Laura McCabe
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St Thomas' Hospital, London, UK
| | - Dharmintra Pasupathy
- Department of Family Care and Mental Health, Faculty of Education and Health, University of Greenwich, London, UK
| | - Mary Rutherford
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St Thomas' Hospital, London, UK
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20
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Abstract
BACKGROUND An increasing number of reports describe the delayed second twin delivery for days, or weeks with good results in the majority of the cases, and different survival rate between centers, without reported randomized controlled trials (RCTs). OBJECTIVES This study was designed to evaluate the suggested management of the delayed second twin delivery in the Sabah Maternity Hospital regarding its outcome, possible risks, and benefits. PATIENTS AND METHODS Forty-seven twin pregnancies with preterm labor (PTL) of the first fetus between 20-30 weeks, and delayed delivery of the second twin were included in this study. Studied women signed informed consent about the possible risks of keeping the live fetus in the hostile intrauterine environment, and benefits of the prolonged gestation for the second twin. Throughout the conservative treatment of the second twin, the studied women were hospitalized with regular follow up for infections, consumptive coagulopathy parameters, and wellbeing of the second twin. RESULTS There was significant difference in the gestational age at delivery between the first and second twin (22.6 ± 3.4 versus 34.3 ± 2.5 weeks; respectively, p = .01). There was significant difference in the birth weight between the first and second twin (435 ± 91.2 versus 1472 ± 61.5 g; respectively, p = .004). The rate of the cesarean delivery was significantly high during delivery of the second twin compared with the first twin (23.4% (11/47) versus 0% (0/47); respectively, p = .0001) with high survival rate for the second twin (85.1% (40/47)) after the delayed second twin delivery. CONCLUSIONS The birth weight, the gestational age, and the survival rate of the studied second twin significantly increased after the suggested management of the delayed second twin delivery.
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Affiliation(s)
- Mohamed Farghali
- a Department of Obstetrics and Gynecology , Faculty of Medicine, Ain Shams University , Cairo , Egypt
| | - Ibrahim Abdelazim
- a Department of Obstetrics and Gynecology , Faculty of Medicine, Ain Shams University , Cairo , Egypt
| | - Khaled Abdelrazek
- a Department of Obstetrics and Gynecology , Faculty of Medicine, Ain Shams University , Cairo , Egypt
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Lombardi MA. A Historical Review of U.S. Contributions to the Atomic Redefinition of the SI Second in 1967. J Res Natl Inst Stand Technol 2017; 122:1-17. [PMID: 34877115 PMCID: PMC7339784 DOI: 10.6028/jres.122.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/25/2017] [Indexed: 06/13/2023]
Abstract
This paper was written to commemorate the 50th anniversary of the atomic redefinition of the second in the International System (SI) in 1967. It focuses on the work of individuals and organizations in the United States who made significant contributions to the redefinition of the SI second and helped to establish the era of atomic timekeeping.
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22
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Akhlaghi NM, Abbas FM, Mohammadi M, Shamloo MRK, Radmehr O, Kaviani R, Rakhshan V. Radicular anatomy of permanent mandibular second molars in an Iranian population: A preliminary study. Dent Res J (Isfahan) 2016; 13:362-6. [PMID: 27605995 PMCID: PMC4993065 DOI: 10.4103/1735-3327.187883] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Root morphology is of utmost importance to endodontic sciences. Since there are a few studies on the morphology of mandibular second molars' roots, and some anatomical variables are not evaluated before, the aim of this study was to investigate thoroughly radicular anatomy of this tooth. Materials and Methods: This ex vivo study was performed on 150 intact mandibular second molars. After access cavity preparation and ensuring canal patency, Indian ink was injected into root canals from the orifices. The teeth became transparent using methyl salicylate storage. Then, they were inspected by an endodontist under a ×10 stereomicroscope regarding numerous root morphological variables. Data were analyzed using chi-square test and analysis of variance (α = 0.05). Results: About 86.7% of teeth had two roots and 13.3% were single-rooted (P = 0.0001), of which, 50% were C-shaped (6.7% of all teeth, P = 0.0001). 86.7% of mesial roots were double canalled, whereas 75.3% of distal roots were single canalled (P = 0.0001). 71.45% and 95.3% of the mesial and distal roots had one apical foramen, respectively (P = 0.0001). Apical foramens were mostly central followed by lingual in most cases. Distances between apical foramen and apical constriction ranged between 0.27 and 0.40 mm (P = 0.0545). Distances between apical foramen and root apices ranged between 0.30 and 0.47 mm (P = 0.0001). Vertucci classifications of mesial canals were Type II in 62.6% and Type IV in 37.4%. 86.2% of single-canal distal roots were Type I. 66.7% of double-canal distal roots were Type II and 33.3% were Type IV (P = 0.0001). The mean root lengths from cervical to apex of mesial, distal, and single roots were 14.02 ± 0.85 (95% confidence interval [CI] = 13.87–14.17), 13.35 ± 0.91 (95% CI = 13.19–13.50), and 14.25 ± 0.72 mm (95% CI = 13.91–14.58), respectively. The extents of canal curvatures varied between 20° and 31° buccolingually (P = 0.0000), and between 19° and 27° mesiodistally (P = 0.0000). Conclusion: There was a considerable rate of eccentric apical foramen in mandibular second molars.
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Affiliation(s)
- Nahid M Akhlaghi
- Department of Endodontics, Dental Branch, Islamic Azad University, Tehran, Iran
| | - Fatemeh Mashadi Abbas
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | | | - Orkideh Radmehr
- Department of Dental Anatomy and Morphology, Dental Branch, Islamic Azad University, Tehran, Iran
| | - Ramin Kaviani
- Department of Dental Anatomy and Morphology, Dental Branch, Islamic Azad University, Tehran, Iran
| | - Vahid Rakhshan
- Department of Dental Anatomy and Morphology, Dental Branch, Islamic Azad University, Tehran, Iran
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Abstract
The purpose of this study was to determine predictors of return to the same practice with a second idiopathic trigger digit. A total of 2234 patients with Quinnell grade 2 or greater (objective triggering) of one or more digits were retrospectively analysed. A total of 490 of 2234 (22%) patients returned to the same practice with a second trigger digit, with an average follow-up time of 2.1 years (range, 7 days to 10 years). Predictors of return with a second trigger digit included carpal tunnel syndrome, Type 1 diabetes mellitus and duration of follow-up in years. Patients diagnosed with idiopathic trigger digit can be advised that about one in five will return to the same practice with another trigger digit, with approximately double the risk in patients that have carpal tunnel syndrome or Type 1 diabetes.
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Affiliation(s)
- S Ferree
- Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA, USA
| | - V Neuhaus
- Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA, USA
| | - S J E Becker
- Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA, USA
| | - J B Jupiter
- Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA, USA
| | - C S Mudgal
- Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA, USA
| | - D C Ring
- Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA, USA
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Li M, Gao Z, Wang Y, Wang H, Zhang S. Identification, expression and bioactivity of hexokinase in amphioxus: insights into evolution of vertebrate hexokinase genes. Gene 2014; 535:318-26. [PMID: 24262936 DOI: 10.1016/j.gene.2013.10.068] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 10/11/2013] [Accepted: 10/27/2013] [Indexed: 11/23/2022]
Abstract
Hexokinase family includes hexokinases I, II, III and IV, that catalyze the phosphorylation of glucose to produce glucose 6-phosphate. Hexokinase IV, also known as glucokinase, is only half size of the other types of hexokinases that contain two hexokinase domains. Despite the enormous progress in the study of hexokinases, the evolutionary relationship between glucokinase and other hexokinases is still uncertain, and the molecular processes leading to the emergence of hexokinases in vertebrates remain controversial. Here we clearly demonstrated the presence of a single hexokinase-like gene in the amphioxus Branchiostoma japonicum, Bjhk, which shows a tissue-specific expression pattern, with the most abundant expression in the hepatic caecum, testis and ovary. The phylogenetic and synteny analyses both reveal that BjHK is the archetype of vertebrate hexokinases IV, i.e. glucokinases. We also found for the first time that recombinant BjHK showed functional enzyme activity resembling vertebrate hexokinases I, II, III and IV. In addition, a native glucokinase activity was detected in the hepatic caecum. Finally, glucokinase activity in the hepatic caecum was markedly reduced by fasting, whereas it was considerably increased by feeding. Altogether, these suggest that Bjhk represents the archetype of glucokinases, from which vertebrate hexokinase gene family was evolved by gene duplication, and that the hepatic caecum plays a role in the control of glucose homeostasis in amphioxus, in favor of the notion that the hepatic caecum is a tissue homologous to liver.
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Poon LM, Bassett R, Rondon G, Hamdi A, Qazilbash M, Hosing C, Jones RB, Shpall EJ, Popat UR, Nieto Y, Worth LL, Cooper L, De Lima M, Champlin RE, Kebriaei P. Outcomes of second allogeneic hematopoietic stem cell transplantation for patients with acute lymphoblastic leukemia. Bone Marrow Transplant 2013; 48:666-70. [PMID: 23085830 PMCID: PMC10426811 DOI: 10.1038/bmt.2012.195] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Revised: 08/20/2012] [Accepted: 08/30/2012] [Indexed: 11/09/2022]
Abstract
For patients with ALL who relapse following allo-SCT, only a second SCT provides a realistic chance for long-term disease remission. We retrospectively analyzed the outcomes of 31 patients with relapsed ALL after a prior allo-SCT, who received a second SCT (SCT2) at our center. With a median follow-up of 3 years, 1- and 3-year PFS was 23 and 11% and 1- and 3 year OS rates were 23 and 11%. Twelve patients (39%) were transplanted with active disease, of whom 75% attained a CR. We found a significant relationship between the time to treatment failure following first allograft (SCT1) and PFS following SCT2 (P=0.02, hazard ratio=0.93/month). In summary, a second transplant remains a potential treatment option for achieving response in a highly refractory patient population. While long-term survival is limited, a significant proportion of patients remains disease-free for up to 1 year following SCT2, providing a window of time to administer preventive interventions. Notably, our four long-term survivors received novel therapies with their second transplant underscoring the need for a fundamental change in the methods for SCT2 to improve outcome.
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Affiliation(s)
- LM Poon
- Departments of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Roland Bassett
- Biostatistics, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Gabriela Rondon
- Departments of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Amir Hamdi
- Departments of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Muzaffar Qazilbash
- Departments of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Chitra Hosing
- Departments of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Roy B Jones
- Departments of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Elizabeth J Shpall
- Departments of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Uday R. Popat
- Departments of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Yago Nieto
- Departments of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Laura L Worth
- Pediatrics, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Laurence Cooper
- Pediatrics, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Marcos De Lima
- Departments of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Richard E. Champlin
- Departments of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Partow Kebriaei
- Departments of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas
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Park SH, Hwang J, Choi YK, Kang CB. Effect of Postpartum Outcomes in Mother's Upright Position During the Second Stage of Labor: Systematic Review. Korean J Women Health Nurs 2012; 18:209-222. [PMID: 37697513 DOI: 10.4069/kjwhn.2012.18.3.209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023] Open
Abstract
PURPOSE The purpose of this study was to determine whether upright position is effective in labor through systematic review in randomized controlled trials. METHODS We established the PICO (Patient-Intervention-Comparator-Outcome) strategy, and reviewed 282 literatures from national and international electronic databases, and finally selected 9 references based on inclusion and exclusion criteria. We evaluated the quality of references and carried out a meta-analysis. RESULTS The maternal outcomes showed that the duration of their second-stage labor was 2.29 minutes shorter than that of the women in the recumbent position, and were less likely to have episiotomy. The other outcomes, including the mode of delivery, blood loss, hemoglobin level, use of oxytocin, use of analgesics, and perineal laceration, did not differ between the groups. The fetal heart rate abnormality occurred less than in the control group. The Apgar scores of the groups did not differ. CONCLUSION There is evidence that an upright position in the second stage of labor reduces the duration of the second stage of labor, the incidence of episiotomy, and an abnormal fetal heart rate.
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Affiliation(s)
- Seong Hi Park
- School of Nursing, Hanzhong University, Donghae, Korea
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27
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Park YW, Lim JC, Kim YH, Kwon HS. Uterine artery Doppler velocimetry during mid- second trimester to predict complications of pregnancy based on unilateral or bilateral abnormalities. Yonsei Med J 2005; 46:652-7. [PMID: 16259063 PMCID: PMC2810571 DOI: 10.3349/ymj.2005.46.5.652] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
We performed this study to evaluate uterine artery Doppler velocimetry (UADV) measurement of unilateral or bilateral abnormalities as a predictor of complications in pregnancy during the mid-second trimester (20-24 weeks). We enrolled 1,090 pregnant women who had undergone UADV twice: once between the 20th and 24th week (1st stage) and again between the 28th and 32nd week (2nd stage) of pregnancy, and then delivered at Yonsei Medical Center. UADV was performed bilaterally. Follow-up UADV was performed between the 28th and 32nd week, and the frequencies of pregnancy-induced hypertension (PIH), fetal growth restriction (FGR), and preterm delivery (before 34 weeks of gestation) were determined. Chi-squared and t-tests were used where appropriate, with p < .05 considered significant. According to the results of UADV performed between 20-24 weeks of gestation, 825 women (75.7%) were included in the normal group, 196 (18.0%) in the unilateral abnormality group, and 69 (6.3%) in the bilateral abnormality group. The incidences of FGR were 8.0%, 10.2%, and 26.1%, and the incidences of PIH were 0.1%, 3.6%, and 14.5%, respectively. The incidence of PIH was significantly lower in the normal group. The incidences of preterm delivery were 2.2%, 5.6%, and 8.7%, respectively. PIH developed in 46.7% of patients with bilateral abnormal findings in both the 1st and 2nd stage tests, and developed in none of the patients with normal findings in both tests. Abnormal results found by UADV performed between the 20-24th weeks of pregnancy, such as high S/D ratios regardless of placental location and the presence of an early diastolic notch, were associated with significant increases in the incidences of intrauterine growth restriction (IUGR) and PIH. This was true for both bilateral and unilateral abnormalities. Abnormal findings in bilateral UADV during the second trimester especially warrant close follow up for the detection of subsequent development of pregnancy complications.
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Affiliation(s)
- Yong Won Park
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Chul Lim
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Korea
| | - Young Han Kim
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Korea
| | - Han Sung Kwon
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Korea
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