Sykeserickson3613
Adolescents with beta thalassemia major face various physical and psychosocial challenges. Resilience plays a protective role in coping with the stress resulting from this disease.
This descriptive correlational study was carried out on 134 adolescents (age 11-21 years old) with beta-thalassemia major who were referred at the Thalassemia Centre in southern Iran from October to December 2018 via convenience sampling method. The Jalowiec Coping scale and Connor-Davidson resilience scale were the instruments used in this study. Data analysis was done using Pearson correlation coefficient and linear regression.
Resilience was shown to be correlated with the subscales of confrontive, optimistic, supportant, and evasive coping significantly and positively (p < .001), while in the subscale of emotive coping with resilience, this was not significant. In addition, 38% of variations in the scale of resilience were explained by the five coping subscales.
The findings of this study, indicated the role of courageous coping in promoting resilience and defensive coping as a factor that leads to less resilience than optimal level. Hence, understanding the importance and the role of protective factors and risk factors can help healthcare providers in planning some effective interventions to increase resilience among adolescents with thalassemia.
The findings of this study, indicated the role of courageous coping in promoting resilience and defensive coping as a factor that leads to less resilience than optimal level. Hence, understanding the importance and the role of protective factors and risk factors can help healthcare providers in planning some effective interventions to increase resilience among adolescents with thalassemia.
Our study compared the prospective risks of intrauterine fetal death (IUFD), neonatal death (NND), perinatal death (PND), and neonatal morbidities in monochorionic diamniotic (MCDA) and dichorionic diamniotic (DCDA) twin pregnancies.
This retrospective cohort study included twin pregnancies who had antenatal care and delivery in a public hospital from 2011 to 2018. Exclusion criteria included monoamnionicity, one/both twin miscarriage, twin-twin transfusion syndrome, or lethal congenital abnormalities. All twins were managed in multiple pregnancy clinic with standardized protocols. Gestational age-specific IUFD, NND, PND, and neonatal morbidity rates were compared according to chorionicity.
Three hundred seventy-eight MCDA and 1282 DCDA twins were included. MCDA twins had higher risks of PND (1.9% vs. 0.7% in DCDA twins, p=0.05), composite neonatal morbidity (p=0.01), preterm delivery (p < 0.01), and low birth weight (p < 0.01). The prospective risk of IUFD was 0.6% and 0.4% for MCDA and DCDA twins, respectively after 34 weeks' gestation. No NND occurred among deliveries after 30 weeks. The risk of neonatal morbidity of MCDA twins fell from 22.7% at 34 weeks to 2.7% at 37 weeks (p < 0.01). For DCDA twins, the risk of morbidity fell insignificantly from 36 to 38 weeks (4.0% vs. 3.4%, p=0.60). Logistic regression analysis suggested that the increased risk of perinatal morbidities was related to the higher rate of preterm delivery in MCDA twins rather than chorionicity.
With close fetal monitoring, the risk of late IUFD in twin pregnancies without major complications is low. Perinatal morbidity can be minimized by avoiding late preterm deliveries in twin pregnancies.
With close fetal monitoring, the risk of late IUFD in twin pregnancies without major complications is low. Perinatal morbidity can be minimized by avoiding late preterm deliveries in twin pregnancies.
Previous studies in pregnant women reported a strong correlation between first-trimester ultrasonographic visceral adipose tissue (VAT) measurements and gestational diabetes mellitus (GDM) during the following weeks. In this study, we aimed to evaluate the clinical utility of ultrasonographic subcutaneous and visceral adipose tissue measurements between 11th and 14th weeks of gestation to predict GDM during the 24th to 28th gestational weeks.
This prospective study included a total of 142 pregnant women. Between 11th and 14th gestational weeks, we performed blinded measurements of intraperitoneal, perirenal, and subcutaneous adipose tissue thicknesses using ultrasonography. CDK activity Between 24th and 28th gestational weeks, each participant underwent one-step GDM screening, and the measurement data were assessed for prognostic significance.
Of the 142 women included, 19 (8.8%) were diagnosed with GDM. The mean intraperitoneal and maximum subcutaneous fat thickness were 51.59 ± 22.49 and 19.79 ± 12.52 mm, respectiver, further large-scale studies are needed to confirm these findings.The formation of microbleed and minute tissue necrosis inside adenomyosis after the shedding of endometrial or endometrial-like tissue within the myometrium during menstruation is receiving attention as a new pathological condition of uterine adenomyosis. These formations might greatly affect coagulation and fibrinolysis function. However, these modulations might occur due to indirect effects of massive hemorrhage from the uterus with adenomyosis. We present a case of adenomyosis in which the patient's coagulation system was markedly activated despite the absence of menstruation due to previous microwave endometrial ablation to prevent massive uterine hemorrhage. Although no uterine bleeding was observed at all, the patient's serum levels of thrombin-antithrombin complex and soluble fibrin were abnormally elevated at the time when she complained of lower abdominal pain. As the first such case in the world, the present case is valuable for showing that the coagulation function can be modified by uterine adenomyosis.
The aim of this study was to assess the survival outcomes of head and neck cancer (HNC) by socioeconomic status.
A national retrospective population-based cohort of HNC patients diagnosed in Israel between 2000 and 2017 was conducted. Site of residence and socioeconomic status were correlated with overall survival (OS), controlling for prognostic factors that included tumor site, stage, age, sex, and ethnic group.
Overall, 11 826 patients were identified. Patients from high socioeconomic areas had better overall 5-year survival than patients from low socioeconomic areas (p< 0.005). Patients in stage 3 from a high socioeconomic status had a longer median survival rate of 1.5 years than patients in the low-status group. In a cox proportional hazards analysis, we found age >65 (HR 2.91, 95% confidence interval [CI] 2.75-3.09, p< 0.001) and low socioeconomic group (HR 1.25, 95% CI 1.18-1.33, p< 0.001) to be correlated with inferior OS.
Our findings show that patients with HNC living in low socioeconomic areas had worse OS.
