Bildeli3469
Previous research indicated that diabetes during pregnancy results in a more permeable placenta. Based on this data, we hypothesized that women with maternal diabetes were more likely to have infants who developed neonatal abstinence syndrome (NAS).
The purpose of the study was to examine the association between maternal diabetes and NAS in a cohort of women reporting substance use during pregnancy.
This study used data from a population-based cohort of all newborns born in 2017 and 2018 (N = 36,974) in the state of West Virginia and restricted the analysis to those infants with intrauterine substance exposure (14%, n = 5188). Multiple logistic regression was performed to analyze the adjusted relationship between maternal diabetes and NAS while controlling for maternal and infant covariates.
Just over 28% of women with diabetes had an infant who developed NAS, whereas 34.8% of women without diabetes had an infant who developed NAS. The adjusted odds ratio of infants developing NAS born to women with diabetes was 0.70 (95% confidence interval 0.51, 0.94) compared with those born to mothers without diabetes after controlling for covariates. Contrary to our hypothesis, the study suggests that maternal diabetes during pregnancy is associated with a decreased risk of an infant developing NAS.
Future research generating from this hypothesis may lead to potential implications for practice for infants born to mothers with substance use during pregnancy and diabetes.
More research should be conducted to investigate the relationship between glucose metabolism and NAS.
More research should be conducted to investigate the relationship between glucose metabolism and NAS.
A mesenchymal hamartoma is a rare benign tumor of the chest wall seen prenatally or at birth. Typically arising from one or more ribs, this tumor will have a rapid growth between weeks 28 and 36 of gestation, followed by a plateau and a spontaneous regression, usually within the first year of life.
A 37-week 2-day, 3.48-kg female infant was admitted to the neonatal intensive care unit with a prenatally diagnosed left chest mass with a large pleural effusion and respiratory failure.
The infant was referred to our institution with multiple chest masses on the left side, resulting in the thorax's marked deformity. Imaging studies confirmed the presence of a multifocal mesenchymal hamartoma.
At laparotomy, 3 mesenchymal hamartomas were found. The lateral mass, encompassing ribs 5 and 6, resulted in an en bloc resection. The ribs cephalad and caudal were bowed and displaced but not involved in the mesenchymal hamartoma. Complete excision of the lateral mass was done, and histopathological examination confirmed the diagnosis of mesenchymal hamartoma.
After resection of the largest mass, the left lung reinflated appropriately, and within a few weeks, the infant was discharged home without supplemental oxygen support.
Symptomatic patients with cardiorespiratory compromise are best treated with surgical resection. In asymptomatic patients, it is best to proceed with serial imaging and conservative management with watchful waiting. Due to the rarity of the condition, data on long-term follow-up and outcomes are needed.
Symptomatic patients with cardiorespiratory compromise are best treated with surgical resection. GSK2245840 research buy In asymptomatic patients, it is best to proceed with serial imaging and conservative management with watchful waiting. Due to the rarity of the condition, data on long-term follow-up and outcomes are needed.
The purpose of this trial was to determine whether anterior cruciate ligament reconstruction (ACLR) with anterolateral structure augmentation (ALSA) would result in better clinical outcomes in patients with a high risk of clinical failure.
From February 2017 to June 2018, 120 young, active adults with chronic anterior cruciate ligament injury and high risk of clinical failure were randomized. The patients were followed for >2 years, with 5 being lost to follow-up and 1 being withdrawn from the study. Clinical characteristics, operative findings, and postoperative clinical outcomes were analyzed.
The analysis included data from 114 patients, including 95 men and 19 women with a mean age (and standard deviation) of 30.1 ± 6.7 years in the ACLR group and 30.1 ± 6.4 years in the ALSA group. The rate of clinical failure was 20.4% (11 of 54 patients) and 3.3% (2 of 60 patients) in the ACLR and ALSA groups, respectively (difference, 17.1%; 95% confidence interval [CI], 5.3% to 29.8%; p = 0.007). Significantly higher rates of return to the preinjury level of sports (48.3% versus 27.8%; difference, 20.5%; 95% CI, 2.7% to 36.6%; p = 0.024) and to a competitive level of play (63.3% versus 42.6%; difference, 22.3%; 95% CI, 4.1% to 38.8%; p = 0.027) was found in the ALSA group.
Compared with isolated ACLR, combined ACLR and ALSA resulted in a reduction in persistent rotatory laxity and higher rates of return to preinjury and competitive levels of play at 2 years of follow-up in the population studied. Our study suggests that patients with high risk of clinical failure appear to be candidates for the ALSA approach.
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
The American Cancer Society (ACS) released updated cervical cancer screening guidelines in 2020 that endorse a shift in practice to primary human papillomavirus (HPV) screening in people with a cervix, beginning at ages of 25-65 years. When access to US Food and Drug Administration-approved primary HPV testing is not available, the ACS offers cotesting or cytology as acceptable alternative strategies but suggests that these testing modalities may be excluded from future iterations of the guidelines. The ASCCP recognizes the benefits and risks of primary HPV cervical cancer screening while acknowledging the barriers to widespread adoption, including implementation issues, the impact of limited HPV vaccination in the United States, and inclusion of populations who may not be well represented on primary HPV screening trials, such as underrepresented minorities. The ASCCP endorses the 2018 US Preventive Services Task Force Recommendation Statement and supports the ACS cervical cancer screening guidelines. Most importantly, the ASCCP endorses any cervical cancer screening for secondary prevention of cervical cancer and recommends interventions that improve screening for those who are underscreened or unscreened.
