Miracle-dz/UniFAR-FTUs huggingface dataset:
Obstetric and Neonatal Outcomes After Antipsychotic Medication Exposure in Pregnancy

OBJECTIVE: Antipsychotic medications are used by increasing numbers of women of reproductive age. The safety of these medications during pregnancy has not been well described. We undertook a systematic review and meta-analysis of the adverse obstetric and neonatal outcomes associated with exposure to antipsychotics during pregnancy. DATA SOURCES: PubMed, Reprotox, and ClinicalTrials.gov were searched to identify potential studies for inclusion. METHODS OF STUDY SELECTION: Case–control or cohort studies estimating adverse birth outcomes associated with antipsychotic exposure during pregnancy were included. Pooled odds ratios (ORs) were used for dichotomous outcomes and weighted mean differences were used for neonatal birth weight and gestational age. Thirteen cohort studies, including 6,289 antipsychotic-exposed and 1,618,039 unexposed pregnancies, were included. TABULATION, INTEGRATION, AND RESULTS: Antipsychotic exposure was associated with an increased risk of major malformations (absolute risk difference [ARD] 0.03, 95% confidence interval [CI] 0.00–0.05, P=.04, Z=2.06), heart defects (ARD 0.01, 95% CI 0.00–0.01, P<.001, Z=3.44), preterm delivery (ARD 0.05, 95% CI 0.03–0.08, P<.001, Z=4.10), small-for-gestational-age births (ARD 0.05, 95% CI 0.02–0.09, P=.006, Z=2.74), elective termination (ARD 0.09, 95% CI 0.05–0.13, P<.001, Z=4.69), and decreased birth weight (weighted mean difference −57.89 g, 95% CI −103.69 to −12.10 g, P=.01). There was no significant difference in the risk of major malformations (test for subgroup differences: &khgr;²=0.07, degrees of freedom=1, P=.79) between typical (OR 1.55, 95% CI 1.21–1.99, P=.006) and atypical (OR 1.39, 95% CI 0.66–2.93, P=.38) antipsychotic medications. Antipsychotic exposure was not associated with risk of large-for-gestational-age births, stillbirth, and spontaneous abortion. Although antipsychotic exposure during pregnancy was associated with increased risk of adverse obstetric and neonatal outcomes, this association does not necessarily imply causation. This analysis was limited by the small number of included studies and limited adjustment in studies for possible confounders. CONCLUSION: Women requiring antipsychotic treatment during pregnancy appear at higher risk of adverse birth outcomes, regardless of causation, and may benefit from close monitoring and minimization of other potential risk factors during pregnancy.
Guide to the Mental Health Act

My own experience with " lomudase " (i.e., combined isoprenaline and chymotrypsin therapy) conforms to that of Dr. D. Tilley (Jourinal, December 26, p. 1484) in that all but one of 12 patients have experienced a subjective improvement reflected in their increased ability to get about and, in some cases, go to work, and that, after all, is the object of the exercise. My ,only conclusion is that further treatment along these lines is justified, and my only object in writing is to persuade others to keep an open mind until more detailed results are available. -I am, etc.,
Pro‐inflammatory cytokines are raised in extrahepatic portal venous obstruction, with minimal hepatic encephalopathy

Background and Aims: Minimal hepatic encephalopathy (MHE) and hyperammonemia are seen in patients with extrahepatic portal venous obstruction (EHPVO). Inflammation has been shown to play an important role in the pathogenesis of hepatic encephalopathy in cirrhotics. This study assessed serum pro‐inflammatory cytokines and their correlation with hyperammonemia, 1H‐magnetic resonance (MR) spectroscopy‐derived brain glutamine, and diffusion tensor imaging (DTI)‐derived metrics in patients with EPHVO, with and without MHE.
Increased Golgi protein 73 expression in hepatocellular carcinoma tissue correlates with tumor aggression but not survival

Background and Aim: Serum Golgi protein 73 (sGP73) is a novel and promising biomarker for hepatocellular carcinoma (HCC). However, there are few reports on the pattern of GP73 expression in HCC and the relationship of this expression to clinicopathologic features of patients. This study aimed to investigate the expression of GP73 and it correlation with clinical parameters.
Effects of cigarette smoking on lung function in four population samples in the People's Republic of China

As part of an ongoing study of cardiopulmonary risk factors in the People's Republic of China, we conducted lung function tests and obtained information about smoking habits on 6,765 Chinese men and women 35 to 56 yr of age residing in or around Beijing in the north and in or around Guangzhou in the south. Within each region, separate urban and rural populations were recruited. This study examined the relationship between tobacco consumption (both manufactured cigarettes and leaf tobacco) and lung function in a subset of current smokers and never smokers who had acceptable lung function data. All methods were strictly standardized. Overall, tobacco smoking was associated with a statistically significant mean difference in FEV1 among men (-89 ml) and women (-52 ml) relative to never smokers after adjusting for age, height, and residence. Differences between smokers of cigarettes and smokers of leaf tobacco were not significant. Among the subset of smokers who smoked only cigarettes, this decrement increase.
Stripping the long saphenous vein

Sir I write to describe a hitherto unreported complication of suction drainage whereby the small bowel was traumatized in a manner which could have resulted in perforation. At emergency laparotomy, a nulliparous woman was found to have an ectopic pregnancy aborting from the fimbrial end of her only remaining fallopian tube. Hoping to save her fertility, the pregnancy was ‘milked‘ out of the tube and apparent haemostasis achieved with the diathermy. The abdomen was closed with a 6 mm Redi-vac drain in the pouch of Douglas. After 2 days, however, she was still bleeding copiously from the drain and salpingectomy had to be performed. An incidental finding was that part of the small bowel which had fallen into the pouch of Douglas bore a series of punctate haematomas each surrounded by a small halo of indented serosa (Fig. I). These can only have been caused by the holes in the drain. Thereafter the patient made an uncomplicated recovery.
Exposure to high static or pulsed magnetic fields does not affect cellular processes in the yeast Saccharomyces cerevisiae

We report results of a study of the effects of strong static (up to 16 T for 8 h) and pulsed (up to 55 T single‐shot and 4 × 20 T repeated shots) magnetic fields on Saccharomyces cerevisiae cultures in the exponential phase of growth. In contrast to previous reports restricted to only a limited number of cellular parameters, we have examined a wide variety of cellular processes: genome‐scale gene expression, proteome profile, cell viability, morphology, and growth, metabolic and fermentation activity after magnetic field exposure. None of these cellular activities were impaired in response to static or pulsed magnetic field exposure. Our results confirm and extend previous reports on the absence of magnetic field effects on yeast and support the hypothesis that magnetic fields have no impact on the transcriptional machinery and on the integrity of unicellular biological systems. Bioelectromagnetics 31:28–38, 2010. © 2009 Wiley‐Liss, Inc.
Acceleration of germination and early growth of wheat and bean seedlings grown under various magnetic field and osmotic conditions

Magnetic field (MF) can have different effects on plant metabolism depending on its application style, intensity, and environmental conditions. This study reports the effects of different intensities of static MF (4 or 7 mT) on seed germination and seedling growth of bean or wheat seeds in different media having 0, 2, 6, and 10 atmosphere (atm) osmotic pressure prepared with sucrose or salt. The germination percentages of the treated seeds were compared with untreated seeds germinated in different osmotic pressure during 7 days of incubation. The application of both MFs promoted the germination ratios of bean and wheat seeds, regardless of increasing osmotic pressure of sucrose or salt. Growth data measured on the 7th day showed that the treated plants grew faster than control. After 7 days of incubation, the mean length of treated seedlings was statistically higher than control plants in all the media. The greatest germination and growth rates in both plants were from the test groups exposed to 7 mT MF. Strikingly, effects of static MF on germination and growth increased positively with increasing osmotic pressure or salt stress compared to their respective controls. On the other hand, MF application caused an increase in dry biomass accumulation of root and shoots of both seedlings; however, this effect was found statistically important in all the conditions for wheat but not for bean, in general. Bioelectromagnetics 31:120–129, 2010. © 2009 Wiley‐Liss, Inc.
Effect of PUVA on plasma and skin immunoreactive α‐melanocyte stimulating hormone concentrations

Plasma α‐melanocyte stimulating hormone (α‐MSH) concentrations were measured in patients receiving PUVA therapy as treatment for mycosis fungoides, and PUVA or UVB as treatment for psoriasis. Skin immunoreactive α‐MSH was also measured in those patients who received PUVA. The mean plasma and skin α‐MSH concentrations after 2–3 weeks of PUVA were not significantly different from pre‐treatment values and showed no relationship either to skin type or to the degree of tanning that occurred in response to PUVA. Plasma α‐MSH concentrations were also unchanged after UVB. There was also no short term change in plasma α‐MSH concentrations in patients after receiving their first treatment with PUVA. It would appear that circulating and skin α‐MSH levels are unaffected by UV and show no causal relationship to PUVA induced pigmentation.
Extent types of and the factors related to malnutrition among children under three years of age in Botswana

Malnutrition affects physical growth, morbidity, mortality, cognitive development, reproduction, and physical work capacity, and it consequently impacts on human performance, health and survival. It is an underlying factor in many diseases for both children and adults, and is particularly prevalent in developing countries, where it affects one out of every 3 preschool-age children. A well-nourished child is one whose weight and height measurements compare very well with the standard normal distribution of heights and weights of healthy children of the same age and sex. Factors that contribute to malnutrition are many and varied. The objective of the present study is to evaluate the level of malnutrition and the impact of some socio-economic and demographic factors of households on the nutritional status of children under 3 years of age in Botswana. Factors included: the number of children under 3 years of age in the family, occupation of the parents, marital status, family income, parental education, maternal nutritional knowledge, residence location (urban or rural), gender, and breastfeeding practices. The study was a cross-sectional descriptive survey using a structured questionnaire and measurements of weight and height. Four hundred households and mothers of children under three, representing the 23 Health Regions of Botswana, participated in the study. Reference standards used were those of the National Center for Health Statistics (NCHS). EPI Info software (version 5) was used for data entry and analysis. The results show that the level of wasting, stunting, and underweight in children under three years of age was 5.5 %, 38.7 %, and 15.6 % respectively. Malnutrition was significantly (p Keywords : child malnutrition, socio-economic factors, breastfeeding, Botswana, pre-school children African Journal of Food, Agriculture, Nutrition and Development Vol. 6(1) 2006
Maternal and Neonatal Outcomes by Attempted Mode of Operative Delivery From a Low Station in the Second Stage of Labor

OBJECTIVE: To evaluate maternal and neonatal outcomes by attempted mode of operative delivery from a low station in the second stage of labor. METHODS: Retrospective study of 2,518 women carrying singleton fetuses at 37 weeks of gestation or greater who underwent attempted forceps-assisted delivery, attempted vacuum-assisted vaginal delivery, or cesarean delivery from a low station in the second stage of labor. Primary outcomes were stratified by parity and included a maternal adverse outcome composite (postpartum hemorrhage, transfusion, endometritis, peripartum hysterectomy, or intensive care unit admission) and a neonatal adverse outcome composite (5-minute Apgar score less than 4, respiratory morbidity, neonatal intensive care unit admission, shoulder dystocia, birth trauma, or sepsis). RESULTS: In nulliparous patients, the maternal adverse composite was not significantly different between women who underwent attempted forceps (12.1% compared with 10.8%, adjusted odds ratio [OR] 0.77, 95% confidence interval [CI] 0.40–1.34) or vacuum (8.3% compared with 10.8%, adjusted OR 0.68, 95% CI 0.40–1.16) delivery compared with cesarean delivery. Among parous women, the maternal adverse composite was not significantly different with attempted forceps (10.7% compared with 12.5%, adjusted OR 0.40, 95% CI 0.09–1.71) or vacuum (11.3% compared with 12.5%, adjusted OR 0.44, 95% CI 0.11–1.72) compared with cesarean delivery. Compared with neonates delivered by cesarean, the neonatal adverse composite was significantly lower among neonates born to nulliparous women who underwent attempted forceps (9.4% compared with 16.7%, adjusted OR 0.44, 95% CI 0.27–0.72) but not among those who underwent vacuum delivery (11.9% compared with 16.7%, adjusted OR 0.68, 95% CI 0.44–1.04). Among parous women, the neonatal adverse composite was not significantly different after attempted forceps (4.1% compared with 12.5%, adjusted OR 0.28, 95% CI 0.06–1.35) or vacuum (12.5% compared with 12.5%, adjusted OR 1.03, 95% CI 0.28–3.87) compared with cesarean delivery. CONCLUSION: A trial of forceps delivery from a low station compared with cesarean delivery was associated with decreased neonatal morbidity among neonates born to nulliparous women. LEVEL OF EVIDENCE: II
Macrolides to Prevent COPD Exacerbations

Chronic obstructive pulmonary disease (COPD) is one of the major health problems in the world. Long-term treatment with macrolide antibiotics is a recent development that has been reported to have beneficial effects on exacerbation frequency. These effects are not only attributed to the antimicrobial effect but also to the immune modulatory effect. Six randomized trials and 1 retrospective study have been performed to investigate the efficacy of macrolides in the prevention of acute exacerbations of COPD. Besides the beneficial effects on the occurrence of exacerbations of COPD, this treatment also seems to improve quality of life and is well tolerated. Antimicrobial resistance is one of the future issues to consider before implementing this therapy.
Maternal Immunization to Prevent Neonatal Group B Streptococcal Disease: New Progress and Promise.

Neonatal sepsis remains among the top 10 causes of young child death worldwide. The bacteria group B streptococci (GBS) is the leading cause of neonatal sepsis in the Americas, Europe, Australia, and subSaharan Africa. Shortly after GBS emerged, clinical trials demonstrated that intrapartum ampicillin for mothers colonized with GBS or presenting with other obstetric risk factors was effective at preventing neonatal group B streptococcal disease in the first week of life (early onset). Several resource-rich countries have implemented intrapartum antibiotic prophylaxis guidelines with great effects. Despite this success, a residual early-onset disease burden remains, and intrapartum prophylaxis is not effective at reducing late-onset group B streptococcal disease (onset on day 7–89 of life), illnesses where meningitis and long-term sequelae predominate. Moreover, intrapartum prophylaxis has always been viewed as an interim strategy with potential risks, including evolving antibiotic resistance among GBS or other neonatal pathogens and unintended consequences of antibiotic exposure for the mother or newborn. The article by Donders et al in this issue of Obstetrics & Gynecology (see page 213) signals new progress in maternal group B streptococcal vaccine evaluation, raising the hope that vaccine may offer a future avenue for the prevention of neonatal group B streptococcal disease. The first U.S. consensus GBS prevention guidelines in 1996 included a discussion of maternal immunization as a potential GBS prevention strategy. At that time, polysaccharide formulations had already undergone limited testing and data were accumulating from phase I studies of conjugate formulations. The trial discussed by Donders et al reports the first results from a family of phase II trials in pregnant women (www.clinicaltrials.gov) evaluating a multivalent (GBS serotype Ia, Ib, III) capsular polysaccharide vaccine conjugated to a CRM197 carrier. Although the sample size of the trial (86 pregnant women from Belgium and Canada) was small, the results are promising and signal renewed momentum for group B streptococcal vaccine development. Among the vaccinated participants (n551), the vaccine had an acceptable reactogenicity and safety profile. Safety is critical for all vaccines, but the concern is paramount for a maternal immunization strategy where the product may affect both mother and child. Accumulating more data, particularly on maternal and newborn serious adverse events, will be critical for a fuller assessment of safety. Efficacy assessments also will require large-scale phase III evaluation. The trial by Donders et al documents a significant rise in serotypespecific GBS antibodies postvaccination among mothers and a transfer ratio of 68–81%, depending on serotype, to the newborn. However, immune correlates of protection have not yet been established, although Stephanie J. Schrag, DPhil
Cervical Dilation on Admission in Term Spontaneous Labor and Maternal and Newborn Outcomes

OBJECTIVE: To examine associations between cervical dilation on admission and maternal and newborn outcomes in term spontaneous labor. METHODS: This is a retrospective cohort study of 11,368 singleton, term (37–43 6/7 weeks of gestation) spontaneously laboring women delivering in 14 hospitals in Washington State between 2012 and 2014 using chart abstracted data from the Obstetrics Clinical Outcomes Assessment Program. Women with prior cesarean delivery or ruptured membranes on admission were excluded. Pregnancy history, cervical dilation on admission, and outcomes were analyzed. Associations between early (less than 4 cm cervical dilation) and late (4 cm or greater cervical dilation) admission and outcomes were examined using general linear models with a log-link stratifying by parity. Results were reported as adjusted relative risks (RRs) with 95% confidence intervals (CIs). RESULTS: Early admission compared with late admission was associated with increased epidural use of 84.8% compared with 71.8% in nulliparous women and 66.3% compared with 53.1% in multiparous women (nulliparous RR 1.18, 95% CI 1.13–1.24; multiparous RR 1.25, 95% CI 1.18–1.32); oxytocin augmentation in 58.5% compared with 36.6% in nulliparous women and 45.9% compared with 20.7% in multiparous women (nulliparous RR 1.56, 95% CI 1.50–1.63; multiparous RR 2.14, 95% CI 1.87–2.44); and cesarean delivery of 21.8% compared with 14.5% in nulliparous women and 3.7% compared with 1.9% in multiparous women (nulliparous RR 1.50, 95% CI 1.32–1.70; multiparous women RR 1.95, 95% CI 1.47–2.57). Early admission was associated with increased neonatal intensive care unit admission for newborns of nulliparous women only (RR 1.38, 95% CI 1.01–1.89). Between 2012 and 2014, late admission increased 14.6% for nulliparous patients and 10.1% for multiparous patients, and the cesarean delivery rate decreased from 10.5% to 7.9% (P<.001) for all. CONCLUSION: Early admission (less than 4 cm cervical dilation) is a risk factor for increased medical intervention and cesarean delivery.
Chorioamnionitis and Neurocognitive Development at Age 2 Years

OBJECTIVE: To evaluate whether chorioamnionitis is associated with decreased Bayley II scores at age 2 years. METHODS: We conducted an observational cohort study of women and their offspring enrolled in the Eunice Kennedy Shriver National Institute of Child Health and Development's Maternal-Fetal Medicine Units Network multicenter, randomized controlled trial of magnesium for cerebral palsy prevention in pregnancies at high risk for early preterm delivery. We included nonanomalous singleton gestations and excluded pregnancies missing outcome or exposure data. Our primary exposure was chorioamnionitis, defined by the clinical diagnosis of chorioamnionitis and a maternal fever greater than 100°F. Our primary outcome was a Bayley II Mental Developmental Index score less than 70 or Psychomotor Developmental Index score less than 70 assessed at age 2 years. We also assessed Mental Developmental Index or Psychomotor Developmental Index score less than 85. We conducted bivariate analyses and fit a log-linear regression model, adjusting for related to Mental Developmental Index or Psychomotor Developmental Index score less than 70 or less than 85 with a detectable effect size estimated at a relative risk of 1.5 or greater. RESULTS: Of 1,574 patients in our analysis, 194 (12%) had chorioamnionitis and 1,366 (87%) had preterm premature rupture of membranes. The mean gestational age at delivery was 29 3/7 weeks. There were no significant differences in Mental Developmental Index score less than 70 (37 [19.1%] compared with 233 [17%], P=.45) or Psychomotor Developmental Index score less than 70 (29 [15%] compared with 195 [14%] P=.76) for children born to mothers with or without chorioamnionitis, respectively. After adjusting for confounders, there remained no difference in the proportion of abnormal scores in either group. However, neonates diagnosed with sepsis were found to have significantly decreased Mental Developmental Index scores. CONCLUSION: Exposure to chorioamnionitis was not associated with neurocognitive defects as measured by abnormal Bayley II scores.