Meadfrye1501
They found that fludarabine influences the production of C7 in affected cells in RDEB. They describe various mechanisms for this effect. They stress the need to determine how much the increased C7 deposition following haematopoietic stem cell transplantation is because of the engrafted cells, and how much is from the patient's own cells stimulated by drugs such as fludarabine. They caution that drugs may cause deposition of non-functional C7, which could be harmful. Unfortunately, fludarabine is generally too toxic to use in patients with RDEB, but there is the possibility of less toxic analogues that could have the same desirable effect on C7 deposition and have clinical benefit.Infants with acute lymphoblastic leukaemia (ALL) have a high frequency of central nervous system (CNS) involvement. Flow cytometric analysis of cerebrospinal fluid (CSF) was recently demonstrated to be a sensitive method for detecting CNS involvement in childhood ALL. In the present study, CSF from 14 infants was collected at routine lumbar punctures and analysed by multicolour flow cytometry. At initial diagnosis, leukaemic blasts were detected in CSF by flow cytometry in 11 patients (78·6%) compared to seven patients (50%) by cytospin. Larger studies are needed to determine if CSF flow cytometry has prognostic value in infant ALL.
Rising maternal mortality and severe maternal morbidity (SMM) rates have drawn increasing public health attention. We evaluated patterns of SMM across the Washington State Perinatal Regional Network, in which neonatal intensive care unit (NICU) levels correlate with maternal level of care.
Retrospective cohort study using de-identified patient and hospital-level rates of SMM diagnoses and procedures for all women who delivered at 58 hospitals from October 2015 to September 2016. Data were obtained from the Washington State Comprehensive Hospital Abstract Reporting System, which includes inpatient diagnosis with associated Present on Admission flags, procedure, and discharge information derived from hospital billing systems. Deliveries were stratified by having or not having SMM. For each SMM diagnosis, POA rates were tabulated. Hospital SMM rates (all SMM, transfusion only, and SMM excluding transfusion) were grouped according to their NICU level of care (critical access [CA] and 1-4). Odds ratios and 9 · SMM occurs most frequently at highest level of care.. · Higher transfusion rates occur at lower care level hospitals.. · Most SMM POA occurs at higher level of care..
· SMM occurs most frequently at highest level of care.. · Higher transfusion rates occur at lower care level hospitals.. · Most SMM POA occurs at higher level of care..
This study aimed to determine if laboratory inflammatory markers can predict critical disease in symptomatic COVID-19 pregnant women.
Multicenter, retrospective cohort study of all pregnant women presenting to New York City Health + Hospitals emergency departments from March 1 to May 30, 2020. We assessed all symptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive pregnant women with room air oxygen saturation <95% on presentation. Logistic regression modeled the relationship of inflammatory markers to outcomes. Area under receiver operating characteristic (ROC) curve and maximum Youden index determined prognostic ability and optimal predictive cut-off values.
A total of 498 of 5,002 pregnant women were SARS-CoV-2 RT-PCR positive of which 77 presented with hypoxemia. The absolute lymphocyte count (ALC) and neutrophil to lymphocyte ratio (NLR) were highly sensitive for progression to severe illness. ROC curve analysis identified predictive cutoffs ALC < 1.49 × 10
/L (96% sensitivity, 52% specificity, area under the receiver operating characteristic curve [AUC] = 0.80 (95% confidence interval [CI] 0.70-0.90) and NLR >8.1 (100% sensitivity, 70% specificity, AUC = 0.86 (95% CI [0.76-0.96]).
ALC and NLR on presentation are sensitive markers of progression to critical COVID-19 disease in symptomatic pregnant women. This finding provides a practical, rapid method for assessment and can assist clinicians with decision-making regarding triage, level of care, and patient management.
· Few tools exist to gauge risk of severe COVID-19 disease in pregnancy.. Navitoclax nmr · ALC and NLR are sensitive predictive markers of disease progression in symptomatic women.. · Cut-off values for ALC and NLR will help direct patient triage and management..
· Few tools exist to gauge risk of severe COVID-19 disease in pregnancy.. · ALC and NLR are sensitive predictive markers of disease progression in symptomatic women.. · Cut-off values for ALC and NLR will help direct patient triage and management..
The aim of the study is to compare the duration of oxygen therapy by using two methods of weaning from nasal continuous positive airway pressure (nCPAP) in very preterm babies.
Between April 2014 and December 2016, 90 preterm <32 weeks and birthweight >1,000 g who, after at least 7 days on nCPAP, were clinically stable on <6 cm H
O and FiO
<30% were randomly assigned to weaning directly from nCPAP or with nasal high flow therapy (nHFT). In the nCPAP group, pressure was gradually reduced until the infant was stable on 4 cm H
O and then discontinued. In the nHFT group, flow rate was reduced until the infant was stable at 3.l pm and then discontinued.
Eighty-four infants completed the study. There were no differences between the groups for the primary outcome, duration of oxygen therapy (median 33 [14-48] versus 28 [15-37] days;
= 0.17). The incidence of moderate-to-severe bronchopulmonary dysplasia was similar. Weaning time was shorter in the nCPAP group (
= 0.02), but the failure rate was slightly higher although non-significant. In the nHFT group, we observed better perception of patient comfort and a lower incidence of severe nasal injury.
Weaning by nHFT compared with weaning directly off nCPAP does not prolong duration of oxygen therapy. Rather, it is associated with better perceptions of infant comfort among parents and lower rates of severe nasal injury.
· Nasal high-flow therapy is commonly used in most neonatal intensive care unit for nCPAP weaning.. · Weaning by nHFT does not increase the duration of oxygen therapy.. · nHFT use improves the perception of infant comfort among parents..
· Nasal high-flow therapy is commonly used in most neonatal intensive care unit for nCPAP weaning.. · Weaning by nHFT does not increase the duration of oxygen therapy.. · nHFT use improves the perception of infant comfort among parents..
The study aimed to better understand the perceptions of mothers of preterm infants regarding smoking behaviors and environmental tobacco smoke (ETS) exposure using qualitative methodology.
Using a Grounded Theory approach, we conducted in-depth, semi-structured interviews with mothers of preterm infants, both smokers and nonsmokers. Using the Theory of Planned Behavior (TPB) as a conceptual framework for our questions, we conducted and analyzed interviews until theoretical saturation was reached. Analysis included an iterative coding process resulting in theme development.
Our key themes aligned with the TPB domains of attitudes, perceived control, and social norms. Regarding attitudes, mothers expressed that smoking was bad for their infants and that preterm infants were more vulnerable than term infants. Regarding perceived control, mothers commented on their perceived ability to avoid ETS exposure with subthemes including strategies utilized to mitigate ETS exposure risk. Some mothers expressed difficulty avoiding ETS exposure, for example, when residing in high-density housing. Regarding perceived social norms, mothers whose family and friends were nonsmokers expressed ease avoiding ETS, while mothers whose family and friends were smokers expressed more difficulty avoiding ETS.
Mothers used a variety of behaviors within the domains of the TPB to reduce ETS exposures in their preterm infants which can inform future neonatal intensive care unit-based interventional strategies.
· Mothers felt ETS is harmful for preterm infants.. · Mothers reported strategies for ETS avoidance.. · Mothers reported barriers to ETS avoidance.. · TPB can frame mothers' ETS-related behaviors..
· Mothers felt ETS is harmful for preterm infants.. · Mothers reported strategies for ETS avoidance.. · Mothers reported barriers to ETS avoidance.. · TPB can frame mothers' ETS-related behaviors..
Physician attire may influence the parent-provider relationship. Previous studies in adult and outpatient pediatrics showed that formal attire with a white coat was preferred. We aimed to describe parent preferences for physician attire in the neonatal intensive care unit (NICU).
We surveyed 101 parents in a level IV NICU. The survey included photographs of a physician in seven different attires. Attire was scored in five domains and parents selected the most preferred attire in different contexts. All attires were compared with formal attire with white coat. Descriptive statistics, Fisher's exact tests, and one-way analysis of variance were used to compare parent responses.
Scrubs without white coat (40.8 [7.0]) and formal attire without white coat (39.7 [8.0]) had the highest mean (standard deviation) composite preference scores. However, no significant differences between formal attire with white coat (37.1 [9.0]) versus any other attire were observed. When asked to choose a single most preferred uenced by age, setting, and context of care.. · Little is known about physician attire preferences of the parents of neonates.. · Unlike adult patients, NICU parents did not prefer formal attire with a white coat..The aquatic plant Salvinia auriculata has been shown to possess promising properties for the treatment of Staphylococcus aureus bovine mastitis. The disease affects cattle health and compromises dairy cattle productivity, resulting in reduced milk production and higher mortality rates. The aim of this study was to evaluate the antimicrobial activity, antibiofilm activity, and toxicity of S. auriculata root extracts using bovine mammary epithelial cells (MAC-T); determine the chemical composition of the most active extract; and develop an S. auriculata antiseptic solution for pre- and post-milking teat disinfection. Plants were collected during the four seasons of the year. The most active hexane extract was subjected to bioguided fractionation, which resulted in the isolation of six known compounds, stigmast-22-ene-3,6-dione, stigmasterol, friedelinol, β-sitosterol, octadecyl alcohol, and octadecanoic acid. The antimicrobial and antibiofilm activities of the most active extract and isolated compounds were determined against nine S. aureus strains isolated from cows with mastitis. The efficacy of the S. auriculata teat dip formulation was tested using an excised teat model (ex vivo), and promising results were obtained. The S. auriculata extract formulation proved to be as effective as commercial antimicrobials in reducing log counts in excised teats.
Recent advances in hepatitis C virus (HCV) diagnostic testing methods allow for a one-stop simplified 'test and cure' approach. The cost effectiveness of incorporating this simplified approach into HCV screening in Iraq remains uncertain. This study aimed to compare the cost effectiveness of different HCV testing and diagnostic approaches, and screening strategies in Iraq from a health service perspective.
A cost-effectiveness analysis was undertaken using a hybrid model comprising a screening decision tree linked to a lifetime Markov model to estimate outcomes in HCV-infected people. Cost and utility estimates were sourced from the published literature and expert guidance provided by clinicians and policy makers in Iraq. Cost estimates were reported in 2019 USD or 2019 Iraqi Dinar and both costs and benefits were discounted at 3.5% annually.
Strategies using a simplified approach were found to be cost saving in addition to improving patient outcomes when compared with a standard testing and diagnostic approach.
