Dowlingbateman6662

the study phases. The prevalence of exclusive breastfeeding (EBF) was 51.7 % at baseline, 77.1 % at discharge, and 21.6 % after sixth months; and that of BF, 87.1 % at the beginning, 48.4 % at month six, and 20.6 % at one year. The facilitating factors of EBF were at the beginning, not using a nest or breast pump; 15 days of satisfaction with LM and not using a pacifier or breast pump; 4 months of satisfaction with LM; 6 months attending Lactation Support Groups (GAL) and not introducing complementary feeding (CA); and those of LM at 1 year, attending GAL. The main reasons for abandonment were own initiative, incorporation to work, and little weight gain by the NB. Conclusions one in 5 newborns received EBF up to 6 months and BF up to one year. It would be necessary to promote strategies that favor breastfeeding, such as eliminating the nest, advising against breast pumps and pacifiers at the beginning, starting CA from the sixth month, and organizing GALs during the first year.

Background gestational weight gain (GWG) is one of the most commonly used indicators in prenatal care, and probably the most influential factor in perinatal outcomes. Objective to determine the extent to which the GWG of pregnant women from the Ribera Health Department (Valencia) meets GWG international standards as recommended by the U.S. Institute of Medicine (IOM). Methods a retrospective observational study of a sample of 4,361 women who gave birth at Hospital Universitario de la Ribera between January 1, 2010 and December 31, 2015. Pregnant women were classified according to GWG international recommendations adequate weight gain, above and below. Results a higher GWG increases the risk of cesarean delivery or instrumental delivery (OR = 1.454, p < 0.001; OR = 1.442, p < 0.001, respectively), and of having a macrosomic or larger newborn for gestational age (OR = 3.851, p = 0.008; OR = 1.749, p < 0.001, respectively) as compared to an appropriate GWG. GWG is related to birth weight (p < 0.001ons adequate weight gain, above and below. Results a higher GWG increases the risk of cesarean delivery or instrumental delivery (OR = 1.454, p less then 0.001; OR = 1.442, p less then 0.001, respectively), and of having a macrosomic or larger newborn for gestational age (OR = 3.851, p = 0.008; OR = 1.749, p less then 0.001, respectively) as compared to an appropriate GWG. GWG is related to birth weight (p less then 0.001). Conclusions the GPG recommendations issued by the IOM are generally well adapted to pregnant women in our environment. It has been found that a GPG other than these recommendations increases the probability of obtaining poor perinatal outcomes. Nevertheless, a more personalized approach is needed, adapting international recommendations to prenatal control for each of the pre-pregnancy BMI categories.Introduction We find a rising number of patients receiving antiplatelet and anticoagulation therapy who require endoscopic retrograde cholangiopancreatography (ERCP), probably due to a higher incidence of the increased morbidity of older patients. Considering the increasingly spreading use of direct oral anticoagulants (DOACs), we want to study about the influence of these factors on the possibility of hemorrhage after ERCP in our center.

We collected data from all the examinations carried out in the years 2017 and 2018, which included 797 examinations on 588 patients. Collected data included personal history of the patients, results of the test and follow-up.

In our study, the percentage of post-ERCP bleeding was 4.6% (n=37). With regard to the severity, in 21.6% (n=8) of the cases the bleeding was mild, it was moderate in 59.5% (n=22), and severe in 18.9% (n=7). Previous cardiopathy, antiplatelet therapy, anticoagulation therapy, treatment with DOACs, having a pancreatic stent, and lithiasis removal double the risk of bleeding after ERCP. Having a sphincterotomy represents an over five-fold increase of the risk.

In the multivariate analysis, we observed a statistically significant increase of bleeding among patients treated with DOACs, compared to patients who receive anticoagulation with acenocoumarol or low-molecular-weight heparins (LMWH).

In the multivariate analysis, we observed a statistically significant increase of bleeding among patients treated with DOACs, compared to patients who receive anticoagulation with acenocoumarol or low-molecular-weight heparins (LMWH).Introduction Different endoscopic procedures have been proposed for the management of surgical leaks. Endoscopic internal drainage using trans-fistulary double-pigtail plastic stents has emerged as an alternative, especially in fistulae presenting after laparoscopic gastric sleeve. Methods Retrospective case series conducted at a single tertiary care center including all upper gastrointestinal post-surgical leaks primarily managed with endoscopic trans-fistulary insertion of double-pigtail plastic stents. Clinical success was defined as the absence of extravasation of oral radiographic contrast and radiological resolution of the collection with adequate oral intake Results Nine patients were included, 6 (66.6%) females, median age 52.6 years (IQR 47-60). Five cases presented after laparoscopic gastric sleeves, 2 cases after distal esophagectomies, one after a Roux-en-Y gastric bypass and another one after a pancreaticoduodenectomy. Fistulae measured less then 10 mm in 5 patients (55.6%) and 10-20 mm in 4 patients (44.4%). read more Six were early leaks. Technical and clinical success was achieved in 9 (100%) and 7 (77.8%) cases, respectively. Seven (77.8%) patients required ≤3 endoscopic procedures. Median hospital stay after the first endoscopic procedure was 12 days (IQR 6.5-17.5 days), while overall median time until leak healing was 118.5 days (IQR 84.5-170). One patient presenting a post-esophagectomy intrathoracic leak developed an esophageal-tracheal fistula 37 days after stent deployment. Conclusions Our results support the use of endoscopic internal drainage in postsurgical abdominal leaks, regardless of the type of surgery, although only two patients with intrathoracic dehiscence were included.