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Each theme was necessarily discussed separately.
The results of the study show that coronavirus pandemic has a significant potential for creating anxiety, adversity and fear, which has a negative emotional effect on pregnant people. It will be useful to provide awareness for midwives and nurses not only about the physical health of pregnant women, but also their mental health, and to cooperate with mental health experts if necessary.
The results of the study show that coronavirus pandemic has a significant potential for creating anxiety, adversity and fear, which has a negative emotional effect on pregnant people. It will be useful to provide awareness for midwives and nurses not only about the physical health of pregnant women, but also their mental health, and to cooperate with mental health experts if necessary.
Obesity is a major public health problem and is rising in prevalence in child-bearing women. The complications of pregnancy in women with obesity are well documented. Pregnant women with obesity require different maternity care considerations to normal weight women. How women respond to the care of health professionals, determines how likely they will be to engage with it, and thus research into the current care experiences of women with obesity is valuable.
The purpose of this scoping review was to examine the evidence of the antenatal maternity care experiences of women with obesity (BMI≥30kg/m
).
A systematic literature search was conducted for English language publications 2008-2018 using Medline, Scopus, PsycINFO and CINAHL. Following critical appraisal, and a search of the reference lists of primary articles, 17 articles resulted for this review. A thematic synthesis process was used to collate the findings.
Four major themes were identified 1) inconsistent or absent information regarding weight management, 2) the stigma and stereotyping associated with their obesity, 3) medicalisation and depersonalisation of pregnant women with obesity, and 4) a desire for information and need for change.
The findings suggested that based on women's experiences there is a need for improved education and communication for health care professionals when caring for pregnant women with obesity. Some conflicting information from women in the studies highlight the need for further research in the area, and the implementation of individualised care and continuity of care for pregnant women with obesity.
The findings suggested that based on women's experiences there is a need for improved education and communication for health care professionals when caring for pregnant women with obesity. Some conflicting information from women in the studies highlight the need for further research in the area, and the implementation of individualised care and continuity of care for pregnant women with obesity.The microbiota-gut-liver-lung axis plays a bidirectional role in the pathophysiology of a number of infectious diseases. During the course of severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1) and 2 (SARS-CoV-2) infection, this pathway is unbalanced due to intestinal involvement and systemic inflammatory response. Moreover, there is convincing preliminary evidence linking microbiota-gut-liver axis perturbations, proinflammatory status, and endothelial damage in noncommunicable preventable diseases with coronavirus disease 2019 (Covid-19) severity. Intestinal damage due to SARS-CoV-2 infection, systemic inflammation-induced dysfunction, and IL-6-mediated diffuse vascular damage may increase intestinal permeability and precipitate bacterial translocation. The systemic release of damage- and pathogen-associated molecular patterns (e.g. lipopolysaccharides) and consequent immune-activation may in turn auto-fuel vicious cycles of systemic inflammation and tissue damage. Thus, intestinal bacterial translocation may play an additive/synergistic role in the cytokine release syndrome in Covid-19. This review provides evidence on gut-liver axis involvement in Covid-19 as well as insights into the hypothesis that intestinal endotheliitis and permeability changes with bacterial translocation are key pathophysiologic events modulating systemic inflammatory response. #link# Moreover, it presents an overview of readily applicable measures for the modulation of the gut-liver axis and microbiota in clinical practice.
In read more , the average player body mass has increased by approximately 25% since 1955. Visceral adipose tissue (VAT) is associated with low grade inflammation, and chronic diseases, such as cardiovascular diseases. The purpose of this study was to investigate changes in VAT in relation to other indices of body composition, across 1 season in professional rugby.
One hundred and sixteen male rugby union players' (age 26.2 ± 4.6 y, BMI 29.40 ± 3.22 kg.m
) total body composition dual energy X-ray absorptiometry scans from 4 time points across the season (baseline, preseason, midseason, and postseason) were analyzed. Players were grouped by playing position, forwards (n = 65) and backs (n = 51). Players followed individually tailored diet plans.
Mean baseline VAT was 404.67 ± 229.43 g (forwards 469.36 ± 263.16 g, backs 311.40 ± 121.15 g). Total mass, lean mass, body fat percentage (%BF), and VAT were greater in forwards than backs at all 4 timepoints. Meaningful increases in VAT across the season, were obsertween VAT and cardiometabolic risk.
Despite regular high-intensive exercise and individually tailored dietary control across a professional rugby season, players from both playing positions demonstrated increases in VAT, although the cause remains unknown. Our findings indicate the importance of monitoring VAT in athletes alongside standard measures of body composition. Additionally, our findings suggest there may be an upper threshold of body mass beyond which lean mass may not increase further and instead %BF and VAT are more likely to accumulate. Further research is required to identify how increasing player size may impact long-term cardiometabolic health given the known links between VAT and cardiometabolic risk.
We aimed to assess differences in breast cancer risk across benign breast disease diagnosed at prevalent or incident screens.
We conducted a retrospective cohort study with data from 629,087 women participating in a long-standing population-based breast cancer screening program in Spain. Each benign breast disease was classified as non-proliferative, proliferative without atypia, or proliferative with atypia, and whether it was diagnosed in a prevalent or incident screen. link2 We used partly conditional Cox hazard regression to estimate the adjusted hazard ratios of the risk of breast cancer.
Compared with women without benign breast disease, the risk of breast cancer was significantly higher (p-value=0.005) in women with benign breast disease diagnosed in an incident screen (aHR, 2.67; 95%CI 2.24-3.19) than in those with benign breast disease diagnosed in a prevalent screen (aHR, 1.87; 95%CI 1.57-2.24). The highest risk was found in women with a proliferative benign breast disease with atypia (aHR, 4.35; 95%CI 2.09-9.08, and 3.35; 95%CI 1.51-7.40 for those diagnosed at incident and prevalent screens, respectively), while the lowest was found in women with non-proliferative benign breast disease (aHR, 2.39; 95%CI 1.95-2.93, and 1.63; 95%CI 1.32-2.02 for those diagnosed at incident and prevalent screens, respectively).
Our study showed that the risk of breast cancer conferred by a benign breast disease differed according to type of screen (prevalent or incident). To our knowledge, this is the first study to analyse the impact of the screening type on benign breast disease prognosis.
Our study showed that the risk of breast cancer conferred by a benign breast disease differed according to type of screen (prevalent or incident). To our knowledge, this is the first study to analyse the impact of the screening type on benign breast disease prognosis.
Various difficulty scoring systems (DSS) have been formulated to grade the complexity of laparoscopic hepatectomies (LH). This study aims to externally validate and compare 4 contemporary DSS including the Iwate, Institut Mutualiste Montsouris (IMM), Southampton and Hasegawa DSS in predicting the intraoperative technical difficulty and postoperative outcomes after LH.
Retrospective review of 548 consecutive patients who underwent LH of which 455 met the study inclusion criteria. Outcomes measures of technical difficulty included operation time, Pringles maneuver, blood loss and blood transfusion rate. Postoperative outcomes measured included morbidity, major morbidity and postoperative hospital stay.
There was a statistically significant progressive increase in blood loss, blood transfusion rate, operation time and postoperative stay associated with all 4 DSS. There was also good calibration with respect to blood loss, operation time, Pringles maneuver, open conversion rate, postoperative morbidity, postoperative major morbidity and postoperative stay for all 4 DSS. The Southampton score demonstrated the poorest calibration in terms of operation time and discrimination in terms of application of Pringles maneuver and major morbidity amongst all 4 systems.
All 4 DSS significantly correlated with outcome measures associated with intraoperative technical difficulty and postoperative outcomes. link3 The Southampton DSS was the poorest system in our cohort of patients.
All 4 DSS significantly correlated with outcome measures associated with intraoperative technical difficulty and postoperative outcomes. The Southampton DSS was the poorest system in our cohort of patients.
The BALAD score and BALAD-2 class derived from bilirubin, albumin, AFP, AFP-L3, and des-gamma-carboxyprothrombin (DCP) are effective in predicting mortality in HCC, but have not been validated in North America.
148 HCC patients from 2000 to 2015 who had all five biomarkers tested at diagnosis were included. Hazard ratios (HR) were calculated.
75 patients died during a median follow-up of 21.9 months. 1-and 3-year survival rates were 70.8% and 47.6%. 114 (77%) had cirrhosis. The HR (95%CI) for death were 1.24 (0.42-3.67), 1.79 (0.61-5.26), 2.83 (0.95-8.38), and 7.19 (2.26-22.91) for BALAD scores 1, 2, 3, and 4 vs. BALAD 0. The HR (95%CI) for death were 1.25 (0.65-2.40), 1.75 (0.94-3.23), and 6.20 (3.29-11.68) for BALAD-2 classes 2, 3, and 4 vs. BALAD-2 class 1. A multivariate model incorporating maximal tumor diameter, tumor number, neutrophil-lymphocyte ratio, and BALAD had HR of 1.43 (1.14-1.81) per increase of 1 BALAD score. A similar model with BALAD-2 had HR of 1.50 (1.18-1.90) per increase of 1 BALAD-2 class.
BALAD models at diagnosis can predict the survival of HCC patients in North America. AFP, AFP-L3, and DCP reflect tumor progression and metastasis of HCC and distinguish the BALAD model from other predictive models.
BALAD models at diagnosis can predict the survival of HCC patients in North America. AFP, AFP-L3, and DCP reflect tumor progression and metastasis of HCC and distinguish the BALAD model from other predictive models.
This study set out to illustrate the trajectories of myopia control in time sequence and explore orthokeratology compliance for parents with myopic children in the first fitting within one year. Profiling these results is crucial to improving myopia control and orthokeratology care.
To obtain a better understanding of myopia control and orthokeratology care that could promote compliance with orthokeratology (ortho-K) lenses for parents with myopic children.
We conducted semi-structured qualitative interviews and pre-interview questionnaire surveys of the parent who is mainly responsible for complying to ortho-K lens care for their myopic children aged 7-12 years, including 16 mothers and 4 fathers. A framework analytical approach that involved gaining familiarity with the data to identify a thematic framework was used for data analysis. It was written in line with the COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist.
Five themes and twelve subthemes depicted the parents' trajectory during myopia diagnosis, treatment, and compliance with ortho- K for their children in the first fitting within one year.
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