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Connection between contending press structures associated with weight upon antifat preconception, beliefs with regards to bodyweight along with support for obesity-related open public procedures.
© 2020 International Federation for Cell Biology.OBJECTIVE Women's levels of resilience and attitudes towards perineal lacerations vary greatly. Some women see them as part of the birthing process, while others react with anger, depressed mood or even self-harm thoughts. A previous study has reported increased risk of postpartum depressive (PPD) symptoms in women with severe perineal lacerations. The aim of this study was to assess the association between severe obstetric perineal lacerations and PPD. A secondary objective was to assess this association among women with low resilience. DESIGN Nested cohort study. SETTING Uppsala, Sweden. SAMPLE Vaginally delivered women with singleton pregnancies (n = 2,990). METHODS The main exposure was obstetric perineal lacerations. Resilience was assessed in gestational week 32 using the Swedish version of the Sense of Coherence Scale (SOC-29). A digital acyclic graph (DAG) was used to identify possible confounders and mediators. Logistic regression was used to estimate odds ratios and 95% confidence intervals. A sub-analysis was run after excluding women with normal or high resilience. MAIN OUTCOME MEASURES Postpartum depression, assessed with the Depression Self-Reporting Scale (DSRS), completed at six weeks postpartum. RESULTS There was no significant association between severe obstetric perineal lacerations and PPD at six weeks postpartum. However, a significant association was found between severe lacerations and PPD in women with low resilience (OR =4.8 95% CI = 1.2-20), persisting even after adjusting for confounding factors. CONCLUSION Health care professionals might need to identify women with low resilience, as they are at increased risk for PPD after a severe perineal laceration. This article is protected by copyright. All rights reserved.BACKGROUND Alcoholic liver disease (ALD) is a public health concern that is the cause of half of all cirrhosis-related deaths. Early detection of fibrosis, ideally in the precirrhotic stage, is a key strategy for improving ALD outcomes and for preventing progression to cirrhosis. Previous studies identified the blood-borne marker human microfibrillar-associated protein 4 (MFAP4) as a biomarker for detection of hepatitis C virus (HCV)-related fibrosis. AIM To evaluate the diagnostic accuracy of MFAP4 to detect ALD-induced fibrosis. METHOD We performed a prospective, liver biopsy-controlled study involving 266 patients with prior or current alcohol overuse. Patients were split into a training and a validation cohort. RESULTS MFAP4 was present in fibrotic hepatic tissue and serum MFAP4 levels increased with fibrosis grade. The area under the receiver operating characteristic curve (AUROC) for detection of cirrhosis was 0.91 (95% CI 0.85-0.96) in the training cohort and 0.91 (95% CI 0.79-1.00) in the validation cohort. For detection of advanced fibrosis, the AUROC was 0.88 (95% CI 0.81-0.94) in the training cohort and 0.92 (95% CI 0.83-1.00) in the validation cohort. The diagnostic accuracy did not differ between MFAP4 and the enhanced liver fibrosis (ELF) test or transient elastography (TE) in an intention-to-diagnose analysis. MFAP4 did not predict hepatic decompensation in a time-to-decompensation analysis in a subgroup of patients with cirrhosis. CONCLUSION MFAP4 is a novel biomarker that can detect ALD-related fibrosis with high accuracy. © 2020 The Authors. Liver International published by John Wiley & Sons Ltd.BACKGROUND Standard treatment for International Federation of Gynecology and Obstetrics (FIGO) 2018 stage 1B2 cervical cancer (i.e., tumor size between 2 and 4 cm) is a radical hysterectomy (RH) with pelvic lymph node dissection (PLND). We evaluated the oncological and fertility outcomes treatment in patients receiving a fertility-sparing alternative consisting of neoadjuvant chemotherapy (NACT) followed by vaginal radical trachelectomy (VRT). METHODS Patients with stage 1B2 cervical cancer who wished to preserve fertility were included from September 2009 to September 2018. NACT consisted of 6-week cycles of cisplatin or carboplatin with paclitaxel. If tumor size decreased to 2 cm or smaller, NACT was followed by a robot-assisted PLND and VRT. RESULTS Eighteen patients were included. Median follow-up time was 49.7 months (range 11.4-110.8). Median tumor size was 32 mm (range 22-40 mm). Complete remission after NACT occurred in seven women. Four women had a poor response on NACT. Three underwent RH with PLND; of Gynecology and Obstetrics (FIGO) 2018 stage 1B2 cervical cancer (tumor size 2-4 cm) is a radical hysterectomy and pelvic lymph node dissection (PLND). However, many of these women are young and wish to preserve fertility. Data on fertility-sparing treatment options are sparse, but neoadjuvant chemotherapy followed by a vaginal radical trachelectomy and PLND could be an alternative. Since 2009 we performed an observational cohort study in which 18 women opted for this treatment in our center. In 14 women fertility could be preserved. In four patients the tumor recurred. In four women six pregnancies occurred. After careful selection this treatment could be a good fertility-sparing treatment option. © 2020 The Authors. The Oncologist published by Wiley Periodicals, Inc. on behalf of AlphaMed Press.OBJECTIVE To clarify whether preconception paternal smoking has any adverse effects on the offspring. DESIGN Prospective, population-based study. AZD3229 price SETTING Preconception registry data from the National Free Preconception Health Examination Project. POPULATION OR SAMPLE Couples planning pregnancy, with complete information on preconception paternal smoking behavior and pregnancy outcomes. METHODS The effect of questionnaire-based paternal smoking behavior during preconception and pregnancy was assessed via logistic regression. Additionally, we performed a 11 case-control (birth defects vs normal pregnancy) analysis, matched for maternal province, folic acid supplementation, and paternal alcohol consumption. MAIN OUTCOME MEASURES Risk of birth defects in offspring. RESULTS In total, 566,439 couples with complete information on preconception paternal smoking behavior and pregnancy outcomes were enrolled. The preconception paternal smoking rate was 28.7% (162,482) overall; 8.7% (49,303) stopped, 13.3% (75,517) decreased, and 6.
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