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A built-in pipe with regard to extensive examination regarding immune system tissues within human brain growth specialized medical trials.
1-3.2], respectively) as did the presence of preexisting medical/obstetric conditions (28.6% of cases, aOR 3.2, 95% CI 2.0-5.3). Problems accessing or complying with care were noted in 25% of medical records and recounted in 50% of interviews. Assessors identified suboptimal factors in 73.2% of deaths and judged 33.9% to be possibly or probably preventable. Care not adapted to risk factors and poor healthcare coordination were frequent suboptimal factors. check details Possibly preventable deaths were higher (P less then .05) for women with gestational diabetes or hypertension (44.6%) than women without (29.0%). CONCLUSIONS Preventive actions to improve healthcare referral and coordination, especially for overweight and obese women and women with medical and obstetrical risk factors, could reduce perinatal mortality in disadvantaged areas. © 2020 Nordic Federation of Societies of Obstetrics and Gynecology.in German Die wissenschaftliche Nutzung von Sekundärdaten, nicht allein von solchen der gesetzlichen Krankenversicherung (GKV), hat sich in den vergangenen Jahren fest in der Versorgungsforschung etabliert. Das zeigen das Memorandum Methoden der Versorgungsforschung 1 und Grundlagenwerke der Sekundärdatenanalyse 2. Gleichwohl entwickelt sich eine hohe Dynamik in diesem Forschungszweig, einerseits durch die zahlreichen durch den Innovationsfonds des Gemeinsamen Bundesausschusses (G-BA) geförderten Projekte mit Nutzung von Sekundärdaten, andererseits durch die rasant zunehmenden wissenschaftlichen Studien mit einem individuellen Datenlinkage von Primär- und Sekundärdaten oder Sekundärdaten unterschiedlicher Dateneigner.INTRODUCTION The objective of this study was the evaluation of utility of plasma level monitoring in the clinical stabilizing efficacy and tolerability of paliperidone palmitate (PP) vs. aripiprazole monohydrate (AM) in bipolar disorder I (BD I) with manic predominance. METHODS Fifty-six outpatients of both sexes, age ranging from 18 to 65 years, affected by BD I with manic predominance, orally treated and stabilized after acute episode for at least 2 weeks with paliperidone or aripiprazole (n=31, paliperidone; n=25, aripiprazole) underwent a prospective observational study of switching to the corresponding long-acting injection (LAI) on the basis of clinical evaluation. The efficacy and tolerability of the 2 treatments were assessed by BPRS, PANSS, HAMD21, and MRS rating scales and a check list every month for 12 months. Drug plasma levels determinations (PLs) were performed at the same times. RESULTS A good clinical stability and tolerability of both drugs were reported. Lower mean PLs of PP showed a positive effect on depressive symptoms. AM PLs variability was associated with greater instability of manic symptoms whereas intermediate PLs seem to have more influence on depressive symptomatology. DISCUSSION PLs drug monitoring has been proven to be useful, and further investigations to identify optimal therapeutic ranges for LAI formulations are needed. © Georg Thieme Verlag KG Stuttgart · New York.in English, German, BACKGROUND We aimed to reduce blood loss in the pediatric critical care unit (PICU) due to blood sampling in neonates and infants. Therefore, an educational program for our staff was established and evaluated. METHODS Patients in a PICU of a tertiary referral center aged 0–12 months who underwent surgery of congenital heart disease on cardiopulmonary bypass were enrolled and divided into a pre- and a post-implementation group. We assessed frequency and types of postoperative blood samples, required blood volume, and amount of blood transfusions in the PICU within 5 days after cardiac surgery. RESULTS Populations were similar prior and after the implementation. Blood drawn for blood gas analysis (0,52 ml±0,16 vs. 0,38 ml±0,12, p less then 0,001) and for complete blood sampling (2,62 ml±0,32 vs. 2,11 ml±0,35, p less then 0,001) could be successfully reduced after implementation of our blood-saving program. The daily diagnostic blood loss per patient was significantly reduced by approximately 35% (1,7 ml/kg/d±1,0 vs. 1,1 ml/kg/d±0,7, p=0,008). DISCUSSION Our quality improvement program is feasible and effective to significantly reduce the blood loss due to blood sampling. Although the incidence of red blood cell transfusions was not significantly reduced, it is certainly beneficial to try to reduce diagnostic blood loss, especially in children with complex diseases requiring long-term intensive care treatment. CONCLUSION We could demonstrate that it is possible to significantly reduce the blood loss due to blood sampling with a simple educational program for PICU staff.Potentilla erecta is a medicinal plant described under its traditional name Tormentil in medieval herbal books and used until today in many European countries. Today monographs for Tormentillae rhizoma in the European pharmacopeia, as well as a monograph of the Herbal Medicinal Product Commission as a drug for traditional use, exist. The present review summarizes published investigations in phytochemistry and pharmacology, together with new findings reflecting the mechanisms of action of ellagitannins as one of the main ingredients of this herbal drug. Taken together all in vitro and in vivo investigations' data support the traditional use for treatment of diarrhea and mucosal inflammation despite a lack of suffcient clinical studies. Georg Thieme Verlag KG Stuttgart · New York.School-based speech-language pathologists (SLPs) can play an important role in the recovery of children who have sustained a mild traumatic brain injury (mTBI). Two types of knowledge barriers are described here that impact the beliefs and ability of SLPs to respond to the needs of these students. Foundational knowledge is relatively stable over time, and encompasses basic definitions and understanding of the injury. In contrast, flexible knowledge addresses clinical management, including assessment and treatment, and should be regularly updated to align with current best practice recommendations. Clinicians are sensitive to this difference, seeking clinically applicable continuing education. However, general poor understanding of pediatric mTBI paired with rapidly advancing research in the field has led to widespread inaccuracies in both foundational and flexible knowledge. Suggestions are provided for educational initiatives and for advocacy of the role of SLPs in the care of students with mTBI. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
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