Schaeferblevins9085

Background The work productivity and activity impairment (WPAI) questionnaire is a fine linguistic validated tool to measure work productivity and activity impairment. Considering its capability, this study aimed to evaluate the validity of the Persian version of WPAI-AQ in asthmatics.Methods The standard forward-backward process was used to translate the English version of WPAI-AQ into Persian. The convergent validity and responsiveness were evaluated by analyzing the correlations between the Persian WPAI-AQ and the health outcomes, and its longitudinal change score with the change in SGRQ score, respectively. Additionally, the stability was estimated according to test-retest scores.Results There was a significant correlation between the Persian WPAI-AQ related outcomes and symptoms, activities, and impacts of disease (r = 0.41-0.89, p less then  0.04). Desirable stability was observed by the test-retest analysis; 0.90 (95%CI 0.89-0.95) for overall impairment, 0.90 (95%CI 0.86-0.93) for work time missed, 0.72 (95%CI 0.54-0.83) for activity impairment; 0.79 (95%CI 0.71-0.86) for student class time missed, and 0.76 (95%CI 0.66-0.81) for school impairment. Response to the change scores strongly supported the longitudinal responsiveness of the Persian WPAI-AQ (r = 0.37 to 0.63, p less then  0.05).Conclusion The Persian WPAI-AQ is a feasible valid tool to estimate work productivity and activity impairment in Persian-speaking asthmatic patients.Purpose To evaluate the outcome of pregnancies among women affected by sickle cell disease (SCD).Material and methods This retrospective comparative cohort study was carried out between 1 January 2014 and 31 December 2018. The files of pregnant women with and without SCD were analyzed. The main variables recorded included parity, diseases that occurred during pregnancy, maternal and gestational ages at delivery, mode of delivery, birthweight and Apgar score. Data were analyzed using SPSS 21.0. Fisher exact test and the t-test was used for comparison. p  less then  .05 was considered statistically significant.Results Our frequency of delivery of women with SCD was 0.1% (35/34,895). Significant complications associated with SCD were maternal anemia (RR = 17.00, 95%CI = 5.35-53.99), intra-uterine fetal demise (RR = 12.00, 95%CI = 1.39-103.22), low birthweight (RR = 2.52, 95%CI = 1.50-4.25), neonatal asphyxia (RR = 7.70, 95%CI = 2.57-22.99), transfer of newborn to the neonatal intensive care unit (RR = 3.42, 95%CI = 1.94-6.03), early neonatal death (RR = 4.56, 95%CI = 1.09-19.10), and maternal postpartum severe anemia (RR = 4.50, 95%CI = 1.36-14.87).Conclusions Pregnancies amongst women with SCD are still associated with increased risk of maternal anemia as well as perinatal morbidity and mortality despite frequent blood transfusion. Therefore, new strategies should be explored to improve such pregnancies.Background Cardiotocography (CTG) is a widely used method for assessing fetal wellbeing during labor. It is well-known that CTG has high sensitivity but low specificity. To avoid unnecessary operative interventions, adjunctive methods such as fetal blood sampling (FBS) are used. Few studies have looked into whether FBS can be used during second stage of labor, and in that case, which of the methods (lactate or pH) are preferred.Objective To evaluate clinical effectiveness of measuring lactate versus pH in preventing birth acidemia when FBS was performed during second stage of labor.Methods Secondary analysis of a randomized controlled trial . Thousand three hundred and thirty-eight women with a singleton pregnancy, cephalic presentation, gestational age ≥34 weeks, and indication for FBS during second stage of labor were included.Main outcome measures Metabolic acidemia (pH 12 mmol/l) or pH less then 7.00 in cord arterial blood at birth.Secondary outcomes A composite outcome (metabolic acidemia, pH less then 7 or Apgar score less then 4), and rates of operative deliveries.Results Metabolic acidemia occurred in 4.1% in the lactate versus 5.1% in the pH group (relative risk (RR) 0.80; 95% confidence interval (CI) 0.48-1.35) and pH less then 7 in 1.4% versus 2.8% (RR 0.51, 95% CI 0.23-1.13). Composite outcome was found in 3.8 versus 4.9%, respectively (RR 0.76; 95% CI 0.46-1.26). No difference in total operative interventions was found. More cesarean deliveries were performed in the lactate group (16.5 vs. ONO-7475 12.4%; RR 1.33; 95% CI 1.02-1.74).Conclusion When analyzing lactate or pH in fetal scalp blood during second stage of labor neonatal outcomes were comparable. The frequency of total operative interventions was similar but more cesarean deliveries were performed in the lactate group.Purpose Hyperhomocysteinemia is closely related to, but is not a confirmed risk factor of, cerebral small vessel disease (CSVD). This study aimed to determine whether hyperhomo-cysteinemia is correlated significantly with CSVD.Materials and methods This cross-sectional study compared the homocysteine (Hcy) levels of patients with and without CSVD. High-sensitivity C-reactive protein (hs-CRP) levels were compared according to white matter lesion (WML) severity, which was classified using the Fazekas system. Risk factors for ischemic CSVD were analyzed through multivariate unconditional logistic regression analysis.Results Hcy levels were significantly higher in patients with lacunar infarction (LI) than in controls (p=.0438), in patients with Fazekas 2-3 than in patients with Fazekas 0-1 WMLs (p=.0192), in patients with Fazekas 4-6 than in patients with Fazekas 2-3 WMLs (p=.0207), and in patients with LI than in patients without LI (p=.0043). hs-CRP levels were significantly higher in patients with LI than in patients without LI (p=.0068) and in patients with Fazekas 4-6 than in patients with Fazekas 0-1 WMLs (p=.0031). Three multivariate unconditional logistic regression analyses showed that hyperhomocysteinemia is a risk factor for LI (p=.006; odds ratio [OR], 27.668), severe WML (p=.028; OR, 1.984), and high hs-CRP level (p=.016; OR, 3.956).Conclusions The assessment of Hcy levels is important for ischemic CSVD. Hyperhomocysteinemia is a risk factor for LI and severe WML. Further, hyperhomocysteinemia is associated with high hs-CRP levels, and this may involve an inflammatory mechanism; however, further studies are needed in this regard.