A Study on the Correlation between Cord Blood Glucose Level and the Apgar Score.

Science.gov (United States)

Khan, Kalyan; Saha, Ashis Ranjan

2013-02-01

The study of the biochemical parameters of cord blood acts as a mirror, which usually reflects the neonatal status. The widely used system for the evaluation of a neonate is the Apgar score. There is no comprehensive published data which has established the association between the cord blood glucose level and the Apgar score. Similarly, there is also no well accepted reference range of the cord blood glucose level. The main objectives of the present study was to ascertain any adverse effects of an abnormal cord blood glucose level on the neonatal status and to find out a standard reference level of glucose in cord blood. The cord blood glucose estimation was done by using the glucose oxidase peroxidase method and the statistical analysis was performed by using the SPSS, version 16 software. In the present study, the cord blood glucose level was found to have no correlation with the Apgar scores which were calculated at both one minute and five minutes after birth. It was also found that for the foetus to be free from any obvious complication, the cord blood glucose level had to be around 87 mg/dl. The fluctuations in the maternal glucose levels are weakly associated with the glucose level in the cord blood.

Preterm birth and cerebral palsy. Predictive value of pregnancy complications, mode of delivery, and Apgar scores

DEFF Research Database (Denmark)

Topp, Monica Wedell; Langhoff-Roos, J; Uldall, P

1997-01-01

BACKGROUND: Preterm infants are at 8 times higher risk than term infants for pre- and perinatal brain damage, resulting in cerebral palsy. In this paper we have analysed the influence of prenatal and birth-related risk factors on cerebral palsy in preterm infants. METHODS: In a register-based study.......01), and low Apgar scores at 1 minute (45% vs. 36%, p or = 3 (adjusted OR = 1.53 (95% CI 1.00-2.34), p Pregnancy...

Effect of induction-delivery and uterine-delivery on apgar scoring of the newborn.

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Kamat S

1991-07-01

Full Text Available Very short or prolonged induction-delivery interval (i.e. less than 5 minutes or more than 15 minutes and uterine-delivery interval of more than 90 seconds has a definite effect on the apgar scoring of a newborn especially when general anaesthesia is administered as compared to regional anaesthesia for caesarean section.

Surgical apgar score predicts early complication in transfemoral amputees

DEFF Research Database (Denmark)

Wied, Christian; Foss, Nicolai Bang; Kristensen, Morten T

2016-01-01

AIM: To assess whether the surgical apgar score (SAS) is a prognostic tool capable of identifying patients at risk of major complications following lower extremity amputations surgery. METHODS: This was a single-center, retrospective observational cohort study conducted between January 2013...... and April 2015. All patients who had either a primary transtibial amputation (TTA) or transfemoral amputation (TFA) conducted at our institution during the study period were assessed for inclusion. All TTA patients underwent a standardized one-stage operative procedure (ad modum Persson amputation......) performed approximately 10 cm below the knee joint. All TTA procedures were performed with sagittal flaps. TFA procedures were performed in one stage with amputation approximately 10 cm above the knee joint, performed with anterior/posterior flaps. Trained residents or senior consultants performed...

Effects of General and Epidural Anaesthesia in Newborn’s Stres Hormones, Blood Gases, and Apgar Scores in Elective Cesarean Section

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Meral Ezberci

2005-12-01

Full Text Available OBJECTIVE: The aim of this study was to evaluate the effects of general and epidural anaesthesia in newborn’s stres hormones, blood gases, and Apgar scores in elective cesarean section. MATERIALS-METHODS: 50 patients in ASA II (American Society of Anesthesiology class who would undergo elective cesarean section in University of Kahramanmaras Sutcuimam, Department of Anaesthesiology and Reanimation included in the study and randomized into two equal groups (General anaesthesia: Group G and Epidural anaesthesia: Group E. In both groups, newborn stres hormones (TSH, cortisol, and insulin, blood gases, and Apgar scores were studued. All patients received famotidine and granisetron iv 30 min before operations in premedication room. In the general anaesthesia group; aritmal, propofol, and succinylcholine was used for induction and muscle relaxation. Following the induction, positive pressure ventilation of the lungs was started immediately using a 50% N2O + O2 mixture. After delivery of the baby, anaesthesia and muscle relaxation was maintained by 50% N2O +O2, 0,5-1% MAC isoflurane, and cisatracurium. In the epidural anaesthesia group; epidural anaesthesia was performed with 0,375% bupivacaine. The epidural needle inserted through L2-3 or L3-4 interspace. After achieving T4-5 neural blockade, the operation was started. Blood samples for newborn stres hormones and blood gases were taken from umblical vein. The Apgar scores were recorded at 1 min and again at 5 min after the delivery by same person. RESULTS: There were no differences in newborn stress hormones between two groups. In newborn blood gases analyses, only SO2 changes were statistically significant between two groups. There were no differences in newborn Apgar scores between two groups. CONCLUSION: With these results, we concluded that each of the general and epidural anaesthesia techniques have similar effects on newborn blood gases, stress hormones and Apgar scores and can be acceptable

Perinatal outcome in terms of apgar score at 5 minutes after induction of term and post-date pregnancies

International Nuclear Information System (INIS)

Khan, S.R.; Choudry, A.

2013-01-01

Objective: To determine perinatal outcome in terms of Apgar score at 5 minutes after delivery and admission in neonatal intensive care unit (NICU) in induction of term and post-dates pregnancies. Study Design: Descriptive case series. Place and Duration: Gynaecology/Obstetrics Department, Military Hospital, Rawalpindi from 16-02-2009 to 15-08-2009. Subjects and Methods: One hundred and sixty three patients were included in this study. Patients were closely monitored during labour. Perinatal outcome was noted by assessing Apgar score at 5 minutes after delivery and by number of babies admitted to NICU within 1st 24 hours after delivery. Results: Apgar score at 5 minutes was more than > 7 in 67 (94.4%) of term pregnancy and in 85 (92.4%) in post date pregnancy and this difference was insignificant (p=0.618). Only one baby (1.4%) among term group required admission in NICU within first 24 hours of delivery while 3 babies (3.3%) in post date pregnancy had admission in NICU with insignificant difference (p=0.448). Conclusion: Post-term pregnancy, in most cases, probably represents a variant of normal and is associated with good outcome, regardless of form of care givers. In minority of cases there is an increased risk of perinatal death and early neonatal convulsions. (author)

Apgar score is related to development of atopic dermatitis

DEFF Research Database (Denmark)

Naeser, Vibeke; Kahr, Niklas; Stensballe, Lone Graff

2013-01-01

. We cross-linked with data from the Danish National Birth Registry and performed cotwin control analysis in order to test the impact of birth characteristics on the risk of atopic dermatitis. Results. Apgar score, OR (per unit) = 1.23 (1.06-1.44), P = 0.008, and female sex, OR = 1.31 (1.06-1.61), P...... = 0.012, were risk factors for atopic dermatitis in cotwin control analysis, whereas birth anthropometric factors were not significantly related to disease development. Risk estimates in monozygotic and dizygotic twins were not significantly different for the identified risk factors. Conclusions......Aim. To study the impact of birth characteristics on the risk of atopic dermatitis in a twin population. Methods. In a population-based questionnaire study of 10,809 twins, 3-9 years of age, from the Danish Twin Registry, we identified 907 twin pairs discordant for parent-reported atopic dermatitis...

Surgical apgar score in patients undergoing lumbar fusion for degenerative spine diseases.

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Ou, Chien-Yu; Hsu, Shih-Yuan; Huang, Jian-Hao; Huang, Yu-Hua

2017-01-01

Lumbar fusion is a procedure broadly performed for degenerative diseases of spines, but it is not without significant morbidities. Surgical Apgar Score (SAS), based on intraoperative blood loss, blood pressure, and heart rate, was developed for prognostic prediction in general and vascular operations. We aimed to examine whether the application of SAS in patients undergoing fusion procedures for degeneration of lumbar spines predicts in-hospital major complications. One hundred and ninety-nine patients that underwent lumbar fusion operation for spine degeneration were enrolled in this retrospective study. Based on whether major complications were present (N=16) or not (N=183), the patients were subdivided. We identified the intergroup differences in SAS and clinical parameters. The incidence of in-hospital major complications was 8%. The duration of hospital stay for the morbid patents was significantly prolonged (p=0.04). In the analysis of multivariable logistic regression, SAS was an independent predicting factor of the complications after lumbar fusion for degenerative spine diseases [p=0.001; odds ratio (95% confidence interval)=0.35 (0.19-0.64)]. Lower scores were accompanied with higher rates of major complications, and the area was 0.872 under the receiver operating characteristic curve. SAS is an independent predicting factor of major complications in patients after fusion surgery for degenerative diseases of lumbar spines, and provides good risk discrimination. Since the scoring system is relatively simple, objective, and practical, we suggest that SAS be included as an indicator in the guidance for level of care after lumbar fusion surgery. Copyright © 2016 Elsevier B.V. All rights reserved.

Prediction of Outcome After Emergency High-Risk Intra-abdominal Surgery Using the Surgical Apgar Score

DEFF Research Database (Denmark)

Cihoric, Mirjana; Toft Tengberg, Line; Bay-Nielsen, Morten

2016-01-01

BACKGROUND: With current literature quoting mortality rates up to 45%, emergency high-risk abdominal surgery has, compared with elective surgery, a significantly greater risk of death and major complications. The Surgical Apgar Score (SAS) is predictive of outcome in elective surgery, but has nev...... emergency high-risk abdominal surgery. Despite its predictive value, the SAS cannot in its current version be recommended as a standalone prognostic tool in an emergency setting....

Impact of Prenatal Cognitive-Behavioral Stress Management Intervention on Maternal Anxiety and Depression and Newborns’ Apgar Scores

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Mahsa Karamoozian

2015-06-01

Full Text Available Background: Motherhood is a transformative and pleasing experience in a woman’s life. However, given the physical and psychological changes, it can induce a degree of stress and anxiety in mothers. The aim of the present study was to evaluate the effects of cognitive-behavioral stress management (CBSM on maternal anxiety and depression during pregnancy and newborns’ Apgar scores. Methods: This semi-experimental study was performed by applying a pretest-posttest control-group design. Overall, 30 primiparous mothers were selected among women referring to health clinics of Kerman, Iran, using convenience sampling. Subjects were randomly allocated to experimental and control groups. Data were collected, using Pregnancy-Related Anxiety Questionnaire and Edinburgh Postnatal Depression Questionnaire. After completing the pretest, the experimental group was subjected to 12 sessions of CBSM training; posttest data were collected after the intervention. Multivariate analysis of covariance was performed, using SPSS version 16. P-value < 0.05 was considered statistically significant. Results: The obtained results revealed a significant decrement in the average posttest scores of anxiety and depression in the experimental group, compared to pretest scores and the control group. Moreover, differences in 1- and 5-minute Apgar scores between the two groups were statistically significant. These findings indicated the effectiveness of CBSM during pregnancy in reducing maternal anxiety and depression. Conclusion: Pregnant women can benefit from psychological interventions such as CBSM in medical and health care centers.

21 CFR 880.2930 - Apgar timer.

Science.gov (United States)

2010-04-01

... take the Apgar score of a newborn infant. (b) Classification. Class I (general controls). The device is... Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Monitoring Devices § 880.2930...

Serious adverse neonatal outcomes such as 5-minute Apgar score of zero and seizures or severe neurologic dysfunction are increased in planned home births after cesarean delivery.

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Grünebaum, Amos; McCullough, Laurence B; Arabin, Birgit; Chervenak, Frank A

2017-01-01

The United States is with 37,451 home births in 2014 the country with the largest absolute number of home births among all developed countries. The purpose of this study was to examine the occurrence and risks of a 5-minute Apgar score of zero and neonatal seizures or serious neurologic dysfunction in women with a history of prior cesarean delivery for planned home vaginal birth after cesarean (VBAC), compared to hospital VBAC and hospital birth cesarean deliveries for term normal weight infants in the United States from 2007-2014. We report in this study outcomes of women who had one or more prior cesarean deliveries and included women who had a successful vaginal birth after a trial of labor after cesarean (TOLAC) at home and in the hospital, and a repeat cesarean delivery in the hospital. We excluded preterm births (home birth VBAC had an approximately 10-fold and higher increase in adverse neonatal outcomes when compared to hospital VBACS and hospital repeat cesarean deliveries, a significantly higher incidence and risk of a 5-minute Apgar score of 0 of 1 in 890 (11.24/10,000, relative risk 9.04, 95% confidence interval 4-20.39, phome TOLACs and for those desiring a VBAC should strongly recommend a planned TOLAC in the appropriate hospital setting. We emphasize that this stance should be accompanied by effective efforts to make TOLAC available in the appropriate hospital setting.

[Application of Vojta's method for early detection of developmental disturbances in very low birthweight infants with regard to Apgar score and asymmetric body positions].

Science.gov (United States)

Gajewska, Ewa; Samborski, Włodzimierz

2006-01-01

This work focuses on the usefulness of assessment based on seven body positions according to Vojta for early detection of developmental abnormalities of the central nervous system. As additional factors, Apgar score at 1st and 5th minute of life, as well as asymmetry of head or of whole body at the time of investigation (usually third month of life) were analyzed in correlation with subsequent diagnosis of cerebral palsy usually established after the first year of life. The study group consisted of 57 children with birthweight lower than 1500 grams. Seven children were diagnosed with cerebral palsy at the age of one year. The following conclusions were drawn: Vojta's diagnostic method is very sensitive in detecting injury of the central nervous system early in life; high correlation was found between cerebral palsy and asymmetry of the body, but not of the head; low Apgar score at 5th but not at 1st minute is highly predictive for progression to cerebral palsy in infants with very low birthweight.

[Different scoring systems to evaluate the prognosis of Fournier's gangrene: A comparative study].

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Zhu, Xiao-dong; Ding, Fei; Wang, Guo-dong; Shao, Qiang

2015-08-01

To sum up the experience in diagnosis and treatment of Fournier's gangrene and find an optimal evaluation tool for its prognosis by comparing currently used prognostic scoring systems. We retrospectively analyzed 16 cases of Fournier's gangrene diagnosed and surgically treated in our hospital between 2004 and 2012. Using Fournier's Gangrene Severity Index (FGSI), Uludag Fournier's Gangrene Severity Index (UFGSI), Age-Adjusted Charlson Comorbidity Index (ACCI), and Surgical Apgar Score (sAPGAR) , we obtained the prognostic scores of the patients and made comparisons among different scoring systems. FGSI, UFGSI, ACCI, and sAPGAR were all clinically used scoring systems. Statistically significant differences were found in the scores of ACCI and UFGSI but not in those of FGSI and sAPGAR between the death and survival groups, with the maximum area under the ROC curve and minimum standard error for the ACCI score. Both ACCI and UFGSI are useful for evaluating the prognosis of Fournier's gangrene. However, ACCI is even better for its higher sensitivity and specificity and easier clinical collection.

Serious adverse neonatal outcomes such as 5-minute Apgar score of zero and seizures or severe neurologic dysfunction are increased in planned home births after cesarean delivery.

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Amos Grünebaum

Full Text Available The United States is with 37,451 home births in 2014 the country with the largest absolute number of home births among all developed countries. The purpose of this study was to examine the occurrence and risks of a 5-minute Apgar score of zero and neonatal seizures or serious neurologic dysfunction in women with a history of prior cesarean delivery for planned home vaginal birth after cesarean (VBAC, compared to hospital VBAC and hospital birth cesarean deliveries for term normal weight infants in the United States from 2007-2014. We report in this study outcomes of women who had one or more prior cesarean deliveries and included women who had a successful vaginal birth after a trial of labor after cesarean (TOLAC at home and in the hospital, and a repeat cesarean delivery in the hospital. We excluded preterm births (<37 weeks and infants weighing under 2500 g. Hospital VBACS were the reference. Women with a planned home birth VBAC had an approximately 10-fold and higher increase in adverse neonatal outcomes when compared to hospital VBACS and hospital repeat cesarean deliveries, a significantly higher incidence and risk of a 5-minute Apgar score of 0 of 1 in 890 (11.24/10,000, relative risk 9.04, 95% confidence interval 4-20.39, p<.0001 and an incidence of neonatal seizures or severe neurologic dysfunction of 1 in 814 (Incidence: 12.27/10,000, relative risk 11.19, 95% confidence interval 5.13-24.29, p<.0001. Because of the significantly increased neonatal risks, obstetric providers should therefore not offer or perform planned home TOLACs and for those desiring a VBAC should strongly recommend a planned TOLAC in the appropriate hospital setting. We emphasize that this stance should be accompanied by effective efforts to make TOLAC available in the appropriate hospital setting.

The Relationship of Gamma Immunoglobin (IgG) Density and Apgar ...

African Journals Online (AJOL)

The transfer of maternal IgG provides the neonate with humoral immunity during early life. The population of transferred IgG or IgG density (IgGρ) was estimated to find out if it has any relevance to the condition of an infant 1-5 minutes after birth or APGAR score which gives an insight into the state of health of the infant and ...

1 min低Apgar评分超早产儿/超低出生体重儿的远期结局%Long-term outcomes of extremely preterm infants and extremely low birth weight infants with low one-minute Apgar score

Institute of Scientific and Technical Information of China (English)

张慧; 韩彤妍; 朴梅花; 童笑梅; 常艳美; 汤亚南; 刘云峰; 崔蕴璞

2017-01-01

hemorrhage, 22 cases of white matter damage and six cases of retinopathy of prematurity. (3) Outcomes: The survival rate was 48% (24/50) and the mortality rate was 52% (26/50). Among the 26 infants, five died despite treatment and 21 died within 72 hours after their parents giving up treatment. There were no significant differences in the survival rates, mortality rates and rates of abandon treatment between the two groups [43% (16/37) vs 8/13; 11%(4/37) vs 1/13; 46% (17/37) vs 4/13; Fisher exact test, all P>0.05]. (4) Follow-up results: Twenty-one infants were followed-up to at least 18 months of age, among which four were normal, 10 had growth retardation and recurrent respiratory tract infection and seven had motor development retardation. The incidence of motor development retardation in severe group was higher than that in mild group, and the difference between them was statistically significant (5/8 vs 2/13, Fisher exact test, P=0.046). Conclusions EPI or ELBWI with a low one-minute Apgar score have many nosocomial complications, resulting in high mortality and high incidence of motor development retardation.

Serious adverse neonatal outcomes such as 5-minute Apgar score of zero and seizures or severe neurologic dysfunction are increased in planned home births after cesarean delivery

OpenAIRE

Gr?nebaum, Amos; McCullough, Laurence B.; Arabin, Birgit; Chervenak, Frank A.

2017-01-01

The United States is with 37,451 home births in 2014 the country with the largest absolute number of home births among all developed countries. The purpose of this study was to examine the occurrence and risks of a 5-minute Apgar score of zero and neonatal seizures or serious neurologic dysfunction in women with a history of prior cesarean delivery for planned home vaginal birth after cesarean (VBAC), compared to hospital VBAC and hospital birth cesarean deliveries for term normal weight infa...

Low Apgar scores at 5 minutes in a low risk population: maternal and obstetrical factors and postnatal outcome Baixos índices de Apgar no quinto minuto de vida em população de baixo risco: fatores maternos e obstétricos e resultados pós-natais

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Eugenia Maria Assunção Salustiano

2012-10-01

Full Text Available OBJECTIVE: To evaluate the association between Apgar scores of less than seven at five minutes (AS5min 7 at 5 minutes who were randomly selected by a computer program. The main outcomes were neonatal death, newborn respiratory distress, need for orotracheal intubation and neonatal intensive care unit (NICU, and hypoxic-ischemic-encephalopathy. RESULTS: After multiple regression analysis, repeated late decelerations on cardiotocography (OR: 2.4; 95% CI: 1.4-4.1 and prolonged second stage of labor (OR: 3.3; 95% CI: 1.3-8.3 were associated with AS5min 0.05. CONCLUSION: Repeated late decelerations and prolonged second stage of labor in the low-risk population are predictors of AS5min OBJETIVO: Avaliar a associação entre índice de Apgar menor que sete no 5º minuto, os fatores pré-natais e resultados pós-natais. MÉTODOS: Trata-se de estudo retrospectivo com 27.252 recém-nascidos em maternidade escola com população de baixo risco obstétrico, de janeiro de 2003 a dezembro de 2010. Prontuários de todos os casos com índice de Apgar 7 no 5º minuto, escolhidos ao acaso, foram revisados. Os principais desfechos estudados foram: óbito neonatal, insuficiência respiratória neonatal, necessidade de intubação orotraqueal e de unidade terapia intensiva (UTI neonatal e encefalopatia hipóxico-isquêmica. RESULTADOS: Após análise de regressão múltipla, desacelerações tardias (DIP II (OR: 2,4; IC95%: 1,4-4,1 e período expulsivo prolongado (OR: 3,3; IC 95%: 1,3-8,3 se associaram com Apgar < 7 no 5º minuto; assim como com insuficiência respiratória ao nascimento (OR: 3,0; IC 95%: 1,3-6,9, intubação traqueal (OR: 2,5; IC 95%: 1,2-4,8, necessidade de UTI neonatal (OR: 9,5; IC 95%: 6,7-16,8 e encefalopatia hipóxico-isquêmica (OR: 14,1; IC 95%: 3,6-54,7. Nenhuma outra variável prénatal se associou com Apgar < 7 no 5º minuto (p < 0,05. CONCLUSÃO: DIP II e período expulsivo prolongado estão associados com Apgar < 7 no 5º minuto em

Five-minute Apgar score ≤ 5 and Molar Incisor Hypomineralisation (MIH) - a case control study.

Science.gov (United States)

Sidaly, Rivan; Schmalfuss, Andreas; Skaare, Anne B; Sehic, Amer; Stiris, Tom; Espelid, Ivar

2016-07-22

The aetiology of molar incisor hypomineralisation (MIH) is unclear. The asymmetric distribution of MIH in the dentition may indicate that an insult of short duration that affects ameloblasts at a vulnerable stage could be a causative factor. Apgar ≤ 5 at 5 min may indicate asphyxia (hypoxic-ischemic insult) during birth. It was hypnotised that low Apgar score during birth may cause MIH. The present study aimed to examine a possible association between Apgar ≤ 5 at 5 min and the occurrence of MIH. Two study groups were selected for examination. The cases comprised 67 children aged 8-10 years born with Apgar score equal to or below 5 after 5 min. The control group comprised 157 age-matched healthy children. First permanent molars, second primary molars and all permanent incisors were examined in all children. Clinical examination was undertaken by two calibrated examiners and intraoral close-up photographs of the teeth were later evaluated by three calibrated and blinded clinicians. Demarcated opacities, post-eruptive breakdown, atypical restorations and extractions due to MIH, according to the criteria of the European Association of Paediatric Dentistry, were assessed. The prevalence of MIH did not differ between the two groups. A chi-square test failed to confirm any statistically significant relationship between 5-min Apgar scores and MIH occurrence. In addition, there was no statistically significant relationship between the number of affected first permanent molars in cases and controls. There was no association between Apgar ≤ 5 at 5 min and the occurrence of MIH.

Fatores perinatais associados a recém-nascidos de termo com pH<7,1 na artéria umbilical e índice de Apgar <7,0 no 5º minuto Perinatal factors associated with pH<7.1 in umbilical artery and Apgar 5 min <7.0 in term newborn

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Patrícia de Moraes De Zorzi

2012-08-01

Full Text Available OBJETIVO: Avaliar os fatores perinatais associados a recém-nascidos de termo com pHPURPOSE: To assess perinatal factors associated with term newborns with pH<7.1 in the umbilical artery and 5th min Apgar score<7,0. METHODS: Retrospective case-control study carried out after reviewing the medical records of all births from September/1998 to March/2008, that occurred at the General Hospital of Caxias do Sul. The inclusion criterion was term newborns who presented a 5th min Apgar score <7.0 and umbilical artery pH<7.10. In the univariate analysis, we used the Student's t-test and the Mann-Whitney test for continuous variables, the c² test for dichotomous variables and risk estimation by the odds ratio (OR. The level of significance was set at p<0.05. RESULTS: Of a total of 15,495 consecutive births, 25 term neonates (0.16% had pH<7.1 in the umbilical artery and a 5th min Apgar score <7.0. Breech presentation (OR=12.9, p<0.005, cesarean section (OR=3.5, p<0.01 and modified intrapartum cardiotocography (OR=7.8, p<0.02 presented a significant association with the acidosis event. Among the fetal characteristics, need for hospitalization in the neonatal intensive care unit (OR=79.7, p <0.0001, need for resuscitation (OR=12.2, p <0.0001 and base deficit were associated with the event (15.0 versus -4.5, p<0.0001. CONCLUSION: Low Apgar score at the 5th min of life associated with pH<7.1 in the umbilical artery can predict adverse neonatal outcomes.

Beyond the global assessment of functioning: learning from Virginia Apgar.

Science.gov (United States)

Dimsdale, Joel E; Jeste, Dilip V; Patterson, Thomas L

2010-01-01

The Global Assessment of Functioning (GAF) scale is widely used in psychiatry, yet it has certain drawbacks. The authors seek to generate further discussion and research around developing an improved successor to the GAF. The authors used the Apgar scale as a template for constructing a possible successor to the GAF. Consulting with 16 colleagues, they selected 5 domains that were felt to be central to functioning in psychiatric patients. Psychiatrists in diverse clinical settings then completed both a GAF and a Psychiatric Apgar scale on 40 patients. The two scales were found to agree significantly. Use of the Psychiatric Apgar, however, provides clearer guidance about assessing functioning. The GAF was a brilliant addition to psychiatric practice. As we develop the next Diagnostic and Statistical Manual, it is pertinent to ask whether the GAF approach could be optimized even further by applying the lessons of Virginia Apgar.

Low Apgar score, neonatal encephalopathy and epidural analgesia during labour: a Swedish registry-based study.

Science.gov (United States)

Törnell, S; Ekéus, C; Hultin, M; Håkansson, S; Thunberg, J; Högberg, U

2015-04-01

Maternal intrapartum fever (MF) is associated with neonatal sequelae, and women in labour who receive epidural analgesia (EA) are more likely to develop hyperthermia. The aims of this study were to investigate if EA and/or a diagnosis of MF were associated to adverse neonatal outcomes at a population level. Population-based register study with data from the Swedish Birth Register and the Swedish National Patient Register, including all nulliparae (n=294,329) with singleton pregnancies who gave birth at term in Sweden 1999-2008. Neonatal outcomes analysed were Apgar score (AS)neonatal encephalopathy (e.g. convulsions or neonatal cerebral ischaemia). Multivariate logistic regression was used to calculate adjusted odds ratios (AOR) with 95% confidence intervals (CI). EA was used in 44% of the deliveries. Low AS or encephalopathy was found in 1.26% and 0.39% of the children in the EA group compared with 0.80% and 0.29% in the control group. In multivariate analysis, EA was associated with increased risk with low AS, AOR 1.27 (95% CI 1.16-1.39), but not with diagnosis of encephalopathy, 1.11 (0.96-1.29). A diagnosis of MF was associated with increased risk for both low AS, 2.27 (1.71-3.02), and of neonatal encephalopathy, 1.97 (1.19-3.26). Diagnosis of MF was associated with low AS and neonatal encephalopathy, whereas EA was only associated with low AS and not with neonatal encephalopathy. The found associations might be a result of confounding by indication, which is difficult to assess in a registry-based population study. © 2015 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Risk of poor neonatal outcome at term after medically assisted reproduction: a propensity score-matched study.

Science.gov (United States)

Ensing, Sabine; Abu-Hanna, Ameen; Roseboom, Tessa J; Repping, Sjoerd; van der Veen, Fulco; Mol, Ben Willem J; Ravelli, Anita C J

2015-08-01

To study risk of birth asphyxia and related morbidity among term singletons born after medically assisted reproduction (MAR). Population cohort study. Not applicable. A total of 1,953,932 term singleton pregnancies selected from a national registry for 1999-2011. None. Primary outcome Apgar score score score matching analysis was performed with matching on multiple maternal baseline covariates (maternal age, ethnicity, socioeconomic status, parity, year of birth, and preexistent diseases). Each MAR pregnancy was matched to three SC controls. Relative to SC, the MAR singletons had an increased risk of adverse neonatal outcomes including Apgar score score matching, the risk of an Apgar score Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Virginia Apgar y la música de cuerdas

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Leonardo Palacios Sánchez

2011-04-01

Full Text Available Virginia Apgar (1909-1974 is one of the most recognized American doctors, worldwide known by his contribution as the developer of the “Apgar test” a method used for the evaluation of newborns all over the world. She had many interests. She was anesthesiologist, a brilliant teacher and researcher, but she also loved lecture, basketball, fishing, golf, philately, and music. She played violin and cello and she interpreted that instruments in various chamber groups. Being motivated by one of her patients, Carleen Hutchinson, a science and music teacher, she made fourinstruments, viola, violin, cello, and mezzo violin. Nearly twenty years of her death, on October24 1994, on the occasion of the annual meeting of the American Academy of Pediatrics and the issue by American Postal Service of a stamp honoring her, some of the preferred Dr. Apgar musicpieces where performed with the instruments she made. Her life mixed different activities and let invaluable contributions for humanity.

Tentativa de suicidio y apgar familiar modificado

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Bárbara de la C Santos Céspedes

1997-08-01

Full Text Available Se estudian 50 pacientes con tentativa de suicidio durante 1993 en el área de salud del Policlínico "Josué País García" del Centro Urbano "Abel Santamaría" de Santiago de Cuba, mediante el Apgar familiar modificado, instrumento que mide el grado de funcionamiento familiar, adaptado después de estudios pilotos en la misma población. Las categorías adaptación, relación, desarrollo, efecto y convivencia, así como el resultado general del Apgar, demostraron que la dinámica familiar de las personas investigadas fue significativamente desfavorable, hallazgos que se validaron por las técnicas estadísticas convencionales. Este trabajo propone la investigación del fenómeno del suicidio con la perspectiva del enfoque sistémico de la familia y el individuo, modelo que se escapa a la tradición médica, el cual se considera importante como instrumento para los médicos de la familia.50 patients who attempted suicide in 1993 at the health area of the "Josué País García" Polyclinic from the "Abel Santamaría" Urban Center, in Santiago de Cuba, were studied by using the modified family Apgar, a tool that measures the family functioning degree, adaptation, relation, development, effect, and living together categories, as well as the Apgar's general result, showed that the family dynamics of the persons investigated was significantly unfavourable. These findings were validated by the conventional statistical techniques. This paper recommends the investigation of the sucide phenomenon with the perspective of the systemic approach of the family and the individual, a model hat escapes as an important tool for family physicians.

El apgar familiar en ancianos conviventes

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Orlando Díaz Tabares

1998-12-01

Full Text Available Con el objetivo de determinar el comportamiento del Apgar familiar en ancianos conviventes, no institucionalizados y sin alteraciones de la esfera cognoscitiva, pertenecientes a dos consultorios médicos de la familia, ubicados en la comunidad rural del policlínico docente de San Cristóbal, durante el año 1995 se realizó un estudio retrospectivo, longitudinal y descriptivo, mediante la aplicación de un modelo de encuesta a los 70 ancianos que conformaron el universo de estudio. Los resultados fueron procesados estadísticamente utilizando el método Chi cuadrado mediante un sistema computarizado, y se consideró significativo todo valor asociado a una probabilidad menor que 0,05. Resultó estadísticamente notable la percepción de funcionabilidad familiar en los ancianos pertenecientes a familias nucleadas. Existió correspondencia muy significativa entre la evaluación de funcionabilidad que el anciano otorgó a su familia y la detectada por el investigador. No se comprobó relación estadísticamente significativa entre el Apgar familiar y la edad de los ancianos, el vínculo laboral actual y el comportamiento de las funciones asignadas y asumidas por ellosA retrospective, longitudinal and descriptive study was conducted to determine the behavior of family Apgar among noninstitutionalized, living together aged patients who had no alternations of the cognitive sphere and who received medical attention at two family physician’s offices located in the rural community of the Teaching Polyclinic of San Cristóbal, during 1995, 70 elderly patients were surveyed and the results were statistically processed using the Chi square method by a computerized system. Every value associated to a probability under 0.05 was considered as significant. The perception of family functionability in the elderly from nucleated families was statistically remarkable. There was a very important correspondence between the evaluation of functionability granted by

Perbandingan Efek Pemberian Norepinefrin Bolus Intravena dengan Norepinefrin Infus Kontinu dalam Tatalaksana Hipotensi, Laju Nadi, dan Nilai APGAR pada Seksio Sesarea dengan Anestesi Spinal

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Fitri Sepviyanti Sumardi

2015-04-01

Full Text Available Vasopresors are commonly used for the treatment of hypotension in spinal anesthesia for cesarean section. This research aimed to compare intravenous bolus of norepinephrine to continuous infusion of norepinephrine effectiveness in hypotension management in caesarean section patient under spinal anesthesia and their effect on heart rate and APGAR Score, The experimental study was conducted in a double-blind randomized manner to 44 American Society of Anesthesiologist (ASA physical status II pregnant women undergoing cesarean section with spinal anesthesia in Dr. Hasan Sadikin General Hospital Bandung within the period of September to -November 2013. The Study subjects were grouped into two groups, the first group received 4 µg intravenous bolus of norepinephrine group (NB and and the second received 8 µg/minute continuous infusion of norepinephrine group (NK. Data were analyzed by t-test, Mann-Whitney test, chi-square and analysis of variance (ANOVA t-test with p0.05. Conclusion from this study is the administration of norepinephrine in both ways can be used for the treatment of hypotension of spinal anesthesia without affecting the heart rate and APGAR score

Experience with the Management of Congenital Diaphragmatic ...

African Journals Online (AJOL)

Those who did not undergo surgery had lower Apgar scores and higher incidence of associated congenital malformations than the patients who underwent surgical repairs. The differences in the mean of 5 minute Apgar scores among the three groups were not statistically significant (p> 0.05). Age at surgery was higher in ...

Chemotherapy-Induced Fatigue Correlates With Higher Fatigue Scores Before Treatment.

Science.gov (United States)

Araújo, José Klerton Luz; Giglio, Adriana Del; Munhoz, Bruna Antenusse; Fonseca, Fernando Luiz Affonso; Cruz, Felipe Melo; Giglio, Auro Del

2017-06-01

Cancer chemotherapy can induce fatigue in about 20% to 30% of patients. So far, there is very little information as to the predictors of chemotherapy-induced fatigue (CIF). We evaluated potential predictors of CIF in a sample of patients with cancer with several types of solid tumors scheduled to receive chemotherapy according to institutional protocols. Before their first and second chemotherapy cycles, patients answered to the Brief Fatigue Inventory (BFI), Chalder, Mini Nutritional Assessment (MNA), Stress thermometer, and HADS questionnaires as well as provided blood samples for inflammatory markers. We evaluated 52 patients, 37 (71%) were female and mean age was 53 years. The most common tumors were breast cancer 21 (40%) and gastrointestinal tumors 12 (23%). Although 14 (25.2%) patients had an increase in their fatigue BFI scores equal or above 3 points from baseline, we observed no significant overall differences between BFI scores before and after chemotherapy. The only 2 factors associated with an increase of 3 points in the BFI scores after chemotherapy were race and higher baseline BFI levels. By multivariate analysis, overall BFI and Chalder scores after chemotherapy also correlated significantly with their respective baseline scores before treatment. HADS scores before treatment correlated with overall BFI scores postchemotherapy, whereas MNA scores before chemotherapy and female sex correlated with higher Chalder scores after treatment. We conclude that fatigue induced by chemotherapy is common and consistently associated with higher fatigue scores before treatment. Screening for fatigue before chemotherapy may help to identify patients who are prone to develop CIF.

What Is the Apgar Score?

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... Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & Safety Doctors & ... What Else Do I Need to Know? This test was not designed to predict a baby's ... behavior, intelligence, personality, or outcome. It was designed to help ...

Higher Prevalence of Left-Handedness in Twins? Not After Controlling Birth Time Confounders.

Science.gov (United States)

Heikkilä, Kauko; Vuoksimaa, Eero; Saari-Kemppainen, Aulikki; Kaprio, Jaakko; Rose, Richard J; Haukka, Jari; Pitkäniemi, Janne; Iivanainen, Matti

2015-10-01

Pregnancy- and birth-related factors may have an effect on handedness. Compared with singletons, twins have a lower birth weight, shorter gestational age, and are at higher risk for birth complications. We tested whether the prevalence of left-handedness is higher among twins than singletons, and if so, whether that difference is fully explained by pregnancy and birth-related differences between twins and singletons. We analyzed Finnish population-based datasets; included were 8,786 twins and 5,892 singletons with information on birth weight (n = 12,381), Apgar scores (n = 11,129), and gestational age (n = 11,811). Two twin cohorts were involved: FinnTwin12 included twins born during 1983-1987, and FinnTwin16 included twins born during 1974-1979. We had two comparison groups of singletons: 4,101 individuals born during 1986-1988 and enrolled in the Helsinki Ultrasound Trial, and 1,791 individuals who were partners of FinnTwin16 twins. We used logistic regression models with writing hand as the outcome for comparison and evaluating effects of covariates. Left-handedness was more common in twins (9.67%) than in singletons (8.27%; p = .004). However, Apgar scores were associated with handedness, and after controlling for covariates, we found no difference in the prevalence of left-handedness between twins and singletons. Increased left-handedness among twins, often reported by others, was evident in our data, but only among our older twin cohorts, and that association disappeared after removing effects of perinatal covariates.

Outcomes in women attempting vaginal birth after caesarean section ...

African Journals Online (AJOL)

A successful vaginal delivery was associated with lower NICU admissions and higher APGAR scores in the neonate than those delivered by caesarean section but there was no statistically significant difference between the groups for APGAR scores <7. There were 3 cases of uterine rupture discovered at caesarean section ...

Los cincuenta años del puntaje APGAR

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Alfredo Jácome Roca

2003-08-01

Full Text Available

Perfil biográfico de una mujer extraordinaria.

Algún día del año 1949,un grupo de médicos y alumnos se encontraba tomando el desayuno en la cafetería del Hospital Columbia-Presbyterian en NuevaYork, cuando un estudiante (quien rotaba por anestesia comentó que hacía falta desarrollar un sistema de valoración del recién nacido.

La anestesióloga Virginia Apgar, quien se encontraba entre los concurrentes, respondió: “Eso es fácil, se puede hacer de la siguiente manera”; y acto seguido cogió de la mesa un pedazo de papel y escribió los cinco temas de lo que más adelante se convertiría en el famoso puntaje de evaluación del neonato que conocemos como el “Apgar”. Se levantó entonces y se fue al servicio de obstetricia para ensayar de inmediato la escala de valoración que acababa de ocurrírsele.

En 1952, hace cincuenta años, presentaría sus experiencias en un congreso internacional de anestesiología.

Esta anécdota fue contada en 1980 por el médico Richard Patterson, presente en el famoso desayuno; hace parte del material biogràfico de Selma Harrison Calmes, profesora de anestesiología en la Universidad de California en Los Ángeles (UCLA, sobre su colega Ginny Apgar. Calmes es la principal biógrafa de esta sobresaliente, valerosa y peculiar mujer.

Para entender la importancia de lo realizado por Apgar, es necesario ponerse en el contexto de aquella época. Nacida en 1909 en Westfield, Nueva Jersey, tuvo un padre aficionado a la electricidad, las ondas radiales y la astronomía, por lo que ella creció al lado de un telescopio y un laboratorio, instalados en el sótano. Estuvo entonces en temprano contacto con la ciencia y además con la práctica médica, pues un hermano murió a los tres años de tuberculosis y otro visitaba frecuentemente al médico por un eczema crónico, hechos que quizá influyeron en su determinación de seguir la carrera de medicina cuando

Breech at term--mode of delivery? A register-based study

DEFF Research Database (Denmark)

Krebs, L; Langhoff-Roos, J; Weber, Tom

1995-01-01

. Register-based cohort study of all (n = 15718) singleton term breech deliveries of non-malformed infants in Denmark 1982-1990. Process and outcome measures: mode of delivery, gestational age, birth weight, congenital malformations, intrapartum death, Apgar scores and early neonatal death. RESULTS. A total...... of 3247 (20.7%) term infants were delivered vaginally, 7106 (45.3%) by elective and 5356 (34.1%) by emergency cesarean section. Infants delivered vaginally and by emergency cesarean section had significantly higher rates of mortality (intrapartum and early neonatal death) and morbidity (low Apgar scores......) when compared to those delivered by elective cesarean section. In vaginal deliveries, parity was not correlated with outcome, but infants with a birth weight above 4000 grams had significantly higher rates of low Apgar scores. CONCLUSIONS. Register data on singleton term breech deliveries imply...

Risk of poor neonatal outcome at term after medically assisted reproduction: a propensity score-matched study

NARCIS (Netherlands)

Ensing, Sabine; Abu-Hanna, Ameen; Roseboom, Tessa J.; Repping, Sjoerd; van der Veen, Fulco; Mol, Ben Willem J.; Ravelli, Anita C. J.

2015-01-01

To study risk of birth asphyxia and related morbidity among term singletons born after medically assisted reproduction (MAR). Population cohort study. Not applicable. A total of 1,953,932 term singleton pregnancies selected from a national registry for 1999-2011. None. Primary outcome Apgar score

Monitoring of the newborn dog and prediction of neonatal mortality.

Science.gov (United States)

Mila, Hanna; Grellet, Aurélien; Delebarre, Marine; Mariani, Claire; Feugier, Alexandre; Chastant-Maillard, Sylvie

2017-08-01

Despite the high neonatal mortality rate in puppies, pertinent criteria for health evaluation of the newborns are not defined. This study was thus designed to measure and to characterize factors of variation of six health parameters in dog neonates, and to evaluate their value as predictors of neonatal mortality. A total of 347 purebred puppies under identical conditions of housing and management were examined within the first 8h after birth and then at Day 1. The first health evaluation included Apgar score, weight, blood glucose, lactate and β-hydroxybutyrate concentration, rectal temperature and urine specific gravity (SG). The second evaluation at Day 1 included the same parameters, excluding Apgar score and weight. The mortality rate over the first 24h and over 21days of age was recorded. The early predictors of neonatal mortality in the dog were determined with generalized linear mixed models and receiver operating characteristic curves analyses. An Apgar score at or below 6 evaluated within the first 8h after birth was found associated with a higher risk of death during the first 24h. A reduced glucose concentration (≤92mg/dl) at Day 1 was found to be associated with higher mortality between 1 and 21days of age. Low-birth-weight puppies were characterized by both low viability (low Apgar score) and low blood glucose concentration, and thus were found indirectly at higher risk of neonatal mortality. This study promotes two low cost easy-to-use tests for health evaluation in puppies, i.e. Apgar scoring and blood glucose assay. Further investigation is necessary to establish if the strong relationship between blood glucose and neonatal survival reflects high energy requirements or other benefits from colostrum intake. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Adapting the Surgical Apgar Score for Perioperative Outcome Prediction in Liver Transplantation: A Retrospective Study

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Amy C. S. Pearson, MD

2017-11-01

Conclusions. The SAS-LT utilized simple intraoperative metrics to predict early morbidity and mortality after liver transplant with similar accuracy to other scoring systems at an earlier postoperative time point.

Evaluating family function in caring for a geriatric group: Family APGAR applied for older adults by home care nurses.

Science.gov (United States)

Wang, Mei-Wen; Huang, Yi-Yu

2016-06-01

Family function is an essential factor affecting older adults' health. However, there has been no appropriate method to assess the family function of most older adults with fragility or poor health status. The present study aimed to explore the differences and relevance of family function estimated by home care nurses and the older adults, and to determine if nurses could represent older adults to provide the estimation. Study participants were 50 older adults who were aged older 65 years and were taken care of at home by well-trained nurses. The present study used the Family APGAR as the questionnaire. We compared the results evaluated by the older adults and their home care nurses. The results included the level of dysfunction and the total scores of the questionnaire. The paired t-test and McNemar-Bowker test were used for the analysis. Family function could be leveled as "good," "moderate dysfunction" and "severe dysfunction" according to the scores. The family function levels estimated by nurses showed no significant differences to the patients' condition (P = 0.123 > 0.05). Comparing the total scores of the older adults with those of their own home care nurses, the results showed a moderate to nearly high correlation (R = 0.689/P older adults' family problems much earlier and to improve the their health status by enhancing family support. Geriatr Gerontol Int 2015; ●●: ●●-●●. © 2015 Japan Geriatrics Society.

Surgical Apgar Score Predicts Postoperative Complications in ...

African Journals Online (AJOL)

complications were determined during the thirty day post operative period. ... An ideal model to predict postoperative complications ... their SAS for purposes of risk stratification; high risk. (0-4), medium .... surgical audit (9,14). Serial monitoring ...

Using adrenaline during neonatal resuscitation may have an impact on serum cardiac troponin-T levels.

Science.gov (United States)

Helmer, Caroline; Skranes, Janne H; Liestøl, Knut; Fugelseth, Drude

2015-09-01

It has been suggested that serum cardiac troponin-T (cTnT) can predict the severity of neonatal hypoxic-ischaemic encephalopathy. We evaluated whether cTnT was better correlated with adrenaline during cardiopulmonary resuscitation (CPR) than with the severity of the insult itself, based on the Apgar scores. Serum cTnT was analysed in 47 asphyxiated newborn infants treated with hypothermia. Blood samples and resuscitation data were collected from medical records, and multiple linear regressions were used to evaluate the effect of the treatment and the Apgar scores on cTnT levels. The infants were divided into three groups: the no CPR group (n = 29) just received stimulation and ventilation, the CPR minus adrenaline group (n = 9) received cardiac compression and ventilation and the CPR plus adrenaline group (n = 9) received complete CPR, including adrenaline. In the univariate analysis, the five and ten-minute Apgar scores were significantly lower in the CPR plus adrenaline group and the cTnT was significantly higher. Multiple regression analysis showed significantly higher cTnT values in the CPR plus adrenaline group, but no significant relationship between cTnT and the Apgar scores. Although cTnT correlated with the severity of the insult in neonatal hypoxic-ischaemic encephalopathy, the levels may have been affected by adrenaline administered during CPR. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Birth weight and risk of asthma in 3-9-year-old twins

DEFF Research Database (Denmark)

Kindlund, Karin; Thomsen, Simon Francis; Stensballe, Lone Graff

2010-01-01

length and Apgar score, OR 1.31 (95% CI 1.03 to 1.65), p=0.027. The risk tended to be higher in monozygotic co-twins compared with dizygotic co-twins, especially for high birth weight differences. CONCLUSIONS: Low birth weight is a risk factor for asthma independently of gestational age, sex, birth...... length and Apgar score, but this may be due, in part, to residual non-genetic confounding factors. This finding lends support to the "fetal origins hypothesis" suggesting undisclosed prenatal determinants for the risk of asthma....

A danish national cohort study on neonatal outcome in singleton pregnancies with placenta previa

DEFF Research Database (Denmark)

Nørgaard, Lone N; Pinborg, Anja; Lidegaard, Ojvind

2012-01-01

. Main outcome measures. Gestational age, birthweight, Apgar score after 5min, stillbirth, neonatal mortality and admittance to neonatal intensive care unit. Results. The incidence of placenta previa in Denmark was 0.54% in 2006. Neonates born after pregnancies with placenta previa had a higher risk...... of being born at a gestational age below 37 weeks (OR 8.6; 95% CI 7.5-9.9), having Apgar score =7 at 5 min (OR 2.7; 95% CI 2.0-3.7), being transferred to neonatal intensive care unit (OR 4.3; 95% CI 3.8-4.9) and for stillbirth and neonatal mortality combined (OR 1.8; 95% CI 1.1-3.0), compared to neonates...... born in pregnancies without placenta previa. No increased risk of being small-for-gestational age was found (OR 1.0; 95% CI 1.0-1.2). Conclusion. When adjusting for confounders neonates born after pregnancies with placenta previa had a significantly higher risk of being born preterm, having a low Apgar...

Newborns of mothers with intellectual disability have a higher risk of perinatal death and being small for gestational age.

Science.gov (United States)

Höglund, Berit; Lindgren, Peter; Larsson, Margareta

2012-12-01

To study mode of birth, perinatal health and death in children born to mothers with intellectual disability (ID) in Sweden. Population-based register study. National registers; the National Patient Register linked to the Medical Birth Register. Children of first-time mothers with ID (n = 326; classified in the International Classification of Diseases 8-10) were identified and compared with 340 624 children of first-time mothers without ID or any other psychiatric diagnosis between 1999 and 2007. Population-based data were extracted from the National Patient Register and the Medical Birth Register. Mode of birth, preterm birth, small for gestational age, Apgar score, stillbirth and perinatal death. Children born to mothers with ID were more often stillborn (1.2 vs. 0.3%) or died perinatally (1.8 vs. 0.4%) than children born to mothers without ID. They had a higher proportion of cesarean section birth (24.5 vs. 17.7%) and preterm birth (12.2 vs. 6.1%), were small for gestational age (8.4 vs. 3.1%) and had lower Apgar scores (mothers without ID. Logistic regression adjusted for maternal characteristics confirmed an increased risk of small for gestational age (odds ratio 2.25), stillbirth (odds ratio 4.53) and perinatal death (odds ratio 4.25) in children born to mothers with ID. Unborn and newborn children of mothers with ID should be considered a risk group, and their mothers may need better individual-based care and support. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

Adverse perinatal outcomes for advanced maternal age: a cross-sectional study of Brazilian births

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Núbia Karla O. Almeida

2015-10-01

Full Text Available ABSTRACT OBJECTIVES: To investigate the risk of adverse perinatal outcomes in women aged ≥41 years relatively to those aged 21-34. METHODS: Approximately 8.5 million records of singleton births in Brazilian hospitals in the period 2004-2009 were investigated. Odds ratios were estimated for preterm and post-term births, for low Apgar scores at 1 min and at 5 min, for asphyxia, for low birth weight, and for macrosomia. RESULTS: For pregnant women ≥41, increased risks were identified for preterm births, for post-term births (except for primiparous women with schooling ≥12 years, and for low birth weight. When comparing older vs. younger women, higher educational levels ensure similar risks of low Apgar score at 1 min (for primiparous mothers and term births, of low Apgar score at 5 min (for term births, of macrosomia (for non-primiparous women, and of asphyxia. CONCLUSION: As a rule, older mothers are at higher risk of adverse perinatal outcomes, which, however, may be mitigated or eliminated, depending on gestational age, parity, and, especially, on the education level of the pregnant woman.

Replication and validation of higher order models demonstrated that a summary score for the EORTC QLQ-C30 is robust

DEFF Research Database (Denmark)

Giesinger, Johannes M.; Kieffer, Jacobien M.; Fayers, Peter M.

2016-01-01

OBJECTIVE: To further evaluate the higher order measurement structure of the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30), with the aim of generating a summary score. STUDY DESIGN AND SETTING: Using pretreatment QLQ-C30 data (N...... = 3,282), we conducted confirmatory factor analyses to test seven previously evaluated higher order models. We compared the summary score(s) derived from the best performing higher order model with the original QLQ-C30 scale scores, using tumor stage, performance status, and change over time (N = 244......) as grouping variables. RESULTS: Although all models showed acceptable fit, we continued in the interest of parsimony with known-groups validity and responsiveness analyses using a summary score derived from the single higher order factor model. The validity and responsiveness of this QLQ-C30 summary score...

Cesarean Section for the Second Twin

DEFF Research Database (Denmark)

Engelbrechtsen, Line; Nielsen, Elise Hoffmann; Perin, Trine

2013-01-01

deliveries. Data were extracted from medical records, a fetal medicine software program (Astraia), and the National Birth Registry. Short-term poor neonatal outcome was measured as a 5-minute Apgar score ≤ 7, umbilical cord pH ≤ 7.10, and admission to neonatal intensive care unit for more than 3 days....... RESULTS: Vertex-nonvertex fetal presentations were more prevalent in combined deliveries than vaginal deliveries (OR 4.4, 2.5-7.8). Nonvertex second twins born by combined delivery had a higher risk of Apgar score ≤ 7 and umbilical cord pH ≤ 7.10 compared with vaginal delivery, unadjusted OR 6.2 (2...

T-piece resuscitator versus self-inflating bag for preterm resuscitation: an institutional experience.

Science.gov (United States)

Jayaram, Archana; Sima, Adam; Barker, Gail; Thacker, Leroy R

2013-07-01

Manual ventilation in the delivery room is provided with devices such as self-inflating bags (SIBs), flow-inflating bags, and T-piece resuscitators. To compare the effect of type of manual ventilation device on overall response to resuscitation among preterm neonates born at Apgar score. Secondary outcomes were incidence of air leaks, need for chest compressions/epinephrine, need for intubation, and surfactant use. We identified 294 resuscitations requiring ventilation. SIB was used for 135 neonates, and T-piece was used for 159 neonates. There was no significant difference between the 1-min and 5-min Apgar scores between SIB and T-piece (P = .77 and P = .11, respectively), nor were there significant differences in secondary outcomes. The rate of rise of Apgar score was higher, by 0.47, with T-piece, compared to SIB (95% CI 0.08-0.87, P = .02). Although some manikin studies favor T-piece for providing reliable and consistent pressures, our experience did not indicate significant differences in effectiveness of resuscitation between the T-piece and SIB in preterm resuscitations.

"Always Look on the Bright Side of Life!" - Higher Hypomania Scores Are Associated with Higher Mental Toughness, Increased Physical Activity, and Lower Symptoms of Depression and Lower Sleep Complaints.

Science.gov (United States)

Jahangard, Leila; Rahmani, Anahita; Haghighi, Mohammad; Ahmadpanah, Mohammad; Sadeghi Bahmani, Dena; Soltanian, Ali R; Shirzadi, Shahriar; Bajoghli, Hafez; Gerber, Markus; Holsboer-Trachsler, Edith; Brand, Serge

2017-01-01

Background: In the present study, we explored the associations between hypomania, symptoms of depression, sleep complaints, physical activity and mental toughness. The latter construct has gained interest for its association with a broad variety of favorable behavior in both clinical and non-clinical samples. Subjects and Methods: The non-clinical sample consisted of 206 young adults ( M = 21.3 years; age range: 18-24 years; 57.3% males). They completed questionnaires covering hypomania, mental toughness, symptoms of depression, physical activity, and sleep quality. Results: Higher hypomania scores were associated with higher mental toughness, increased physical activity, lower symptoms of depression and lower sleep complaints. No gender differences were observed. Higher hypomania scores were predicted by higher scores of mental toughness subscales of control and challenge, and physical activity. Conclusion: The pattern of results suggests that among a non-clinical sample of young adults, self-rated hypomania scores were associated with higher scores on mental toughness and physical activity, along with lower depression and sleep complaints. The pattern of results further suggests that hypomania traits are associated with a broad range of favorable psychological, behavioral and sleep-related traits, at least among a non-clinical sample of young adults.

Diagnosis and outcome of birth asphyxia in resource constrained health care set up

International Nuclear Information System (INIS)

Zaman, S.; Shah, S.A.; Mehmood, S.; Shahzad, S.; Munir, M.; Mushtaq, A.

2017-01-01

Objective: To determine morbidity and mortality of neonates with low APGAR score in a resource constrained health care set up. Study Design: Prospective descriptive study. Place and Duration of Study: The study was carried out in combined military hospital Attock, from Jan 2013 to Jan 2015. Material and Methods: All term neonates with 37 completed weeks of gestation and APGAR score less than 7 were included in the study. APGAR score was calculated by an attending pediatrician, gynecologist or trained female nurse at 0 and 5 minutes. In Neonatal Intensive Care Unit [NICU] the babies were daily examined by pediatrician. Outcome was documented in term of morbidity i.e. fits and mortality i.e. death of babies. Results: Total number of neonates included in the study were 85 of which 55 (65%) were males and 30 (35%) were females. Of the total neonates 65 (76%) were discharged in satisfactory conditions and 20 (24%) expired during stay in the hospital. The mean APGAR score of newborns was 4.98 +- 0.98 at 5 minutes. During stay in hospital 46 (54%) were diagnosed to have hypoxic ischemic encephalopathy 2 (HIE2), those diagnosed with HIE3 were 5 (6%) and the rest 14 (16%) with HIE1. Conclusion: Low APGAR score is an important cause of admission to NICU. Low APGAR score was found associated with increased risk of fits in neonates and one of the most important cause of mortality in our set up. (author)

Frequency of neonatal complications after premature delivery

Directory of Open Access Journals (Sweden)

Gordana Grgić

2013-04-01

Full Text Available Introduction: Preterm delivery is the delivery before 37 weeks of gestation are completed. The incidence of preterm birth ranges from 5 to 15%. Aims of the study were to determine the average body weight, Apgar score after one and five minutes, and the frequency of the most common complications in preterminfants.Methods: The study involved a total of 631 newborns, of whom 331 were born prematurely Aims of this study were to (24th-37th gestational weeks-experimental group, while 300 infants were born in time (37-42 weeks of gestation-control group.Results: Average body weight of prematurely born infants was 2382 grams, while the average Apgar score in this group after the fi rst minute was 7.32 and 7.79 after the fifth minute. The incidence of respiratory distress syndrome was 50%, intracranial hemorrhage, 28.1% and 4.8% of sepsis. Respiratory distresssyndrome was more common in infants born before 32 weeks of gestation. Mortality of premature infants is present in 9.1% and is higher than that of infants born at term.Conclusions: Birth body weight and Apgar scores was lower in preterm infants. Respiratory distress syndrome is the most common fetal complication of prematurity. Intracranial hemorrhage is the second most common complication of prematurity. Mortality of premature infants is higher than the mortality of infants born at term birth.

Effects of maternal psychotropic drug dosage on birth outcomes

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Michielsen LA

2013-12-01

Full Text Available Laura A Michielsen,1 Frank MMA van der Heijden,1 Paddy KC Janssen,2 Harold JH Kuijpers11Vincent van Gogh Institute for Psychiatry, Venlo, the Netherlands; 2Department of Pharmacy, VieCuri Medical Centre, Venlo, the NetherlandsBackground: The aim of this retrospective study was to explore the relationship between psychotropic medication dosage and birth outcomes.Methods: A total of 136 women were enrolled, who had an active mental disorder, were taking medication to prevent a relapse, or had a history of postpartum depression or psychosis. Medication use was evaluated for the three trimesters and during labor. Based on the defined daily dose, medication use was classified into three groups. Primary outcome variables included the infant gestational age at birth, birth weight, and Apgar scores at one and 5 minutes.Results: Our study showed a significantly higher incidence of Apgar score ≤7 at 5 minutes in women taking psychotropic drugs as compared with the group taking no medication, respectively (16.3% versus 0.0%, P=0.01. There was no significant difference between the two groups in Apgar score at one minute or in gestational age and birth weight. The results showed no significant differences in gestational age, birth weight, or Apgar scores for a low–intermediate or high dose of a selective serotonin reuptake inhibitor and for a low or intermediate dose of an antipsychotic.Conclusion: This study does not indicate a relationship between doses of selective serotonin reuptake inhibitors and antipsychotics and adverse neonatal outcomes.Keywords: pregnancy, psychotropic medication, dosage, birth outcomes

Breech delivery at term in Denmark, 1982-92

DEFF Research Database (Denmark)

Krebs, L; Langhoff-Roos, J

1999-01-01

,476) in Denmark, 1982-92, a review of medical records of all (n = 218) cases with Apgar score controls, was performed. Planned vaginal delivery was associated with a 15 times greater risk of low Apgar score than elective Caesarean section...

Is the Bishop-score significant in predicting the success of labor induction in multiparous women?

Science.gov (United States)

Navve, D; Orenstein, N; Ribak, R; Daykan, Y; Shechter-Maor, G; Biron-Shental, T

2017-05-01

To determine whether the Bishop-score upon admission effects mode of delivery, maternal or neonatal outcomes of labor induction in multiparous women. A retrospective study including 600 multiparous women with a singleton pregnancy, 34 gestational weeks and above who underwent labor induction for maternal, fetal or combined indications. Induction was performed with one of three methods- oxytocin, a slow release vaginal prostaglandin E2 insert (10 mg dinoprostone) or a transcervical double balloon catheter. The women were divided into two groups-Bishop-score manual lysis, uterine revision, perineal tear grade 3-4, need for blood transfusions, relaparotomy, prolonged hospitalization) and neonatal outcomes (Apgar score, cord pH, hospitalization in the neonatal intensive care unit, prolonged hospitalization). Both groups had a high rate of vaginal deliveries-93.7% and 94.9%, respectively. There was no difference between the two groups in terms of maternal or neonatal outcomes. Labor induction in multiparous women is safe and successful regardless of the initial Bishop-score. In multiparous women the Bishop-score is not a good predictor for the success of labor induction, nor is it a predictor for maternal of neonatal adverse outcomes and complications.

Are there any strategies to improve neonatal outcomes associated with epidural analgesia in labor?

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Armani, Marta; Gaggiano, Carla; Dallaglio, Sara; Romanini, Enzo; Sospiri, Carmen; Magnani, Cinzia

2013-09-01

This study was aimed at evaluating the relationship between epidural analgesia and perinatal outcomes and at verifying the advisability of procedural changes in assistance to labor. From January to December 2012, we conducted a retrospective case-control study on 1,963 laboring pregnant women admitted to the Parma University Hospital. We considered two groups: Group 1 received epidural analgesia and Group 2 received no analgesia. Women with elective cesarean sections, multiple pregnancies or deliveries at <34 weeks were excluded. We recorded maternal data (age, type of delivery, obstetric procedures, premature rupture of membranes, screenings for Group-B Streptococcus) and neonatal data (birth weight, gestational age, 1- and 5-minute Apgar scores, diagnosis at discharge). Of the 1,963 laboring women, 287 requested analgesia and 1,676 did not. We found no significant differences between the two groups in the rates of cesarean section, clavicle fracture, and 1-minute Apgar score between 4 and 7. By contrast, we observed a higher rate of instrumental deliveries (p<0.01), fetal occiput posterior position (p<0.05), neonatal cephalohematoma (p=0.01) in Group 1 than in Group 2 . In Group 1 we also found a higher number of newborns with 1-minute Apgar score of 3 or less (p=0.016). In addition, a significantly higher number of women in Group 1 had fever during labor (p=0.003, odds ratio 5.01). Our results suggest that strategies should be activated to overcome or limit the side-effects of analgesia in labor through prospective and multidisciplinary studies. 

“Always Look on the Bright Side of Life!” – Higher Hypomania Scores Are Associated with Higher Mental Toughness, Increased Physical Activity, and Lower Symptoms of Depression and Lower Sleep Complaints

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Leila Jahangard

2017-12-01

Full Text Available Background: In the present study, we explored the associations between hypomania, symptoms of depression, sleep complaints, physical activity and mental toughness. The latter construct has gained interest for its association with a broad variety of favorable behavior in both clinical and non-clinical samples.Subjects and Methods: The non-clinical sample consisted of 206 young adults (M = 21.3 years; age range: 18–24 years; 57.3% males. They completed questionnaires covering hypomania, mental toughness, symptoms of depression, physical activity, and sleep quality.Results: Higher hypomania scores were associated with higher mental toughness, increased physical activity, lower symptoms of depression and lower sleep complaints. No gender differences were observed. Higher hypomania scores were predicted by higher scores of mental toughness subscales of control and challenge, and physical activity.Conclusion: The pattern of results suggests that among a non-clinical sample of young adults, self-rated hypomania scores were associated with higher scores on mental toughness and physical activity, along with lower depression and sleep complaints. The pattern of results further suggests that hypomania traits are associated with a broad range of favorable psychological, behavioral and sleep-related traits, at least among a non-clinical sample of young adults.

umbilical cord parameters in ilorin: correlates and foetal outcome

African Journals Online (AJOL)

2014-08-08

Aug 8, 2014 ... The foetal outcomes were assessed by APGAR scores, birth weight, admission to neonatal intensive ... between the umbilical cord parameters and perinatal events such as Apgar scores and birth weight. .... Suzuki S, Fuse Y. Length of the Umbilical Cord and. Perinatal Outcomes in Japanese Singleton ...

Higher stress scores for female medical students measured by the Kessler Psychological Distress Scale (K10 in Pakistan

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Khadija Qamar

2014-10-01

Full Text Available The aim of this study was to determine the stress level of medical students and the relationship between stress and academic year. A cross-sectional, descriptive study was conducted at an undergraduate medical school with a five-year curriculum, in Pakistan, from January 2014 to April 2014. Medical students in the first four years were included in the study. The Kessler Psychological Distress Scale (K10, a self-administered questionnaire, was distributed to the students. A total of 445 medical students completed the questionnaire. The average stress score was 19.61 (SD = 6.76 with a range from 10 to 43. Stress was experienced by 169 students (41.7%. The scores of female students were higher than scores of males, indicating a higher stress level (P = 0.011. The relationship between stress and academic year was insignificant (P = 0.392.

Higher dietary diversity score is associated with obesity: a case-control study.

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Karimbeiki, R; Pourmasoumi, M; Feizi, A; Abbasi, B; Hadi, A; Rafie, N; Safavi, S M

2018-04-01

The present study was carried out to compare dietary diversity score (DDS) among overweight, obese, and normal-weight adults. This case-control study was conducted with a total of 200 cases (100 participants with obesity and 100 participants with overweight) and 300 controls (normal weight) matched by socio-economic status (SES), older than 18 years. Dietary intakes were assessed using a self-administered Food Frequency Questionnaire. Data regarding physical activity and sociodemographic variables were gathered. DDS was computed based on the scoring of the five food groups emphasized in the United States Department of Agriculture Food Guide Pyramid. Anthropometric measurements were measured, and the body mass index and waist-to-hip ratio were calculated. The mean ± standard deviation of DDS was higher in participants with obesity (5.65 ± 1.32) than that in overweight participants (5.23 ± 1.23), while the lowest score was reported among normal-weight individuals (4.97 ± 1.42) (P obesity increased with each unit increase in DDS (odds ratio [OR]: 1.46; 95% confidence interval [CI]: 1.22, 1.74). However, the association became slightly weaker after adjusting for potential confounding factors (OR: 1.34; 95% CI: 1.07, 1.68). It was concluded that there was a significant positive association between DDS and obesity. However, additional investigations are warranted. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Labor analgesia with ropivacaine added to clonidine: a randomized clinical trial

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Giane Nakamura

Full Text Available CONTEXT AND OBJECTIVE: Previous studies have led to speculation that the association between ropivacaine and clonidine might be more effective than ropivacaine alone. We examined the maternal-fetal effects of two pharmacological approaches: a low dose of ropivacaine or a lower dose of ropivacaine plus clonidine for epidural analgesia during labor. DESIGN AND SETTING: Prospective study at Department of Anesthesiology, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista. METHODS: Thirty-two pregnant women in American Society of Anesthesiologists physical status I and II randomly underwent epidural analgesia using 15 ml of ropivacaine 0.125% (R group or 15 ml of ropivacaine 0.0625% plus 75 µg clonidine (RC group. Pain intensity, sensory block level, latency time, motor block intensity, duration of labor analgesia and duration of epidural analgesia were evaluated. The newborns were evaluated using Apgar scores and the Amiel-Tison method (neurological and adaptive capacity score. RESULTS: There were no statistically significant differences between the groups regarding pain score, sensory block level, duration of epidural analgesia or Apgar score. The latency time, duration of labor analgesia and motor block were R group < RC group. The half-hour and two-hour neurological and adaptive capacity scores were higher in the R group. All of the R group newborns and 75% of the RC group newborns were found to be neurologically healthy at the 24-hour examination. RESULTS: There were no statistically significant differences between the groups regarding pain score, sensory block level, duration of epidural analgesia or Apgar score. The latency time, duration of labor analgesia and motor block were R group < RC group. The half-hour and two-hour neurological and adaptive capacity scores were higher in the R group. All of the R group newborns and 75% of the RC group newborns were found to be neurologically healthy at the 24-hour examination

Epidural analgesia during labor: a retrospective cohort study on its effects on labour, delivery and neonatal outcome.

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Hincz, Piotr; Podciechowskil, Lech; Grzesiak, Mariusz; Horzelski, Wojciech; Wilczyflski, Jan

2014-12-01

to evaluate the impact of epidural analgesia (EA) on labor delivery and neonatal status. retrospective, observational, cohort study comprising 5593 pregnant women who met the inclusion criteria (singleton pregnancy cephalic presentation, 37-42 weeks of gestation). Out of them, 2496 had EA and 3097 constituted the control group. incidence of labor complications and operativd deliveries in women who received EA, neonatal status assessed by Apgar score in 1- and 5-minute, and cord pH values. Labor complications were more frequently observed in the epidural group, with an almost 1.5-fold higher incidence in nulliparous (16.32% vs. 11.29%) and 1.4-fold in multiparous women (9.86% vs. 7.08%). Stepwise logistic regression confirmed that EA is a significant risk factor for labor complications in nulliparous women (OR 1.27, 95% CI 1.03-1.58) and for forceps delivery in multiparous women (5.20, 95% CI 3.31-8.177). Also, EA is an important risk factor for both, low cord arterial pH women, but has no effect on the incidence of cesarean sections, either in nulliparous or multiparous women. EA also increases the risk of labor complications, low 1-minute Apgar score and low umbilical cord pH, but is not associated with low 5-minute Apgar score.

Breech at term--mode of delivery? A register-based study

DEFF Research Database (Denmark)

Krebs, L; Langhoff-Roos, J; Weber, Tom

1995-01-01

) when compared to those delivered by elective cesarean section. In vaginal deliveries, parity was not correlated with outcome, but infants with a birth weight above 4000 grams had significantly higher rates of low Apgar scores. CONCLUSIONS. Register data on singleton term breech deliveries imply......BACKGROUND. The present study was designed to determine neonatal mortality and morbidity in non-malformed singleton term infants delivered in breech presentation and identify a possible correlation between outcome on the one hand and mode of delivery, parity and birth weight on the other. METHODS....... Register-based cohort study of all (n = 15718) singleton term breech deliveries of non-malformed infants in Denmark 1982-1990. Process and outcome measures: mode of delivery, gestational age, birth weight, congenital malformations, intrapartum death, Apgar scores and early neonatal death. RESULTS. A total...

Infections after shoulder arthroplasty are correlated with higher anesthetic risk score: a case-control study in Brazil

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Leonardo Hideto Nagaya

2017-11-01

Conclusion: This study provides evidence suggesting that patient-related known factors such as higher ASA score predisposes to shoulder arthroplasty-associated infection. Furthermore, unusual pathogens associated with PSI were identified.

Permissive hypercapnia and risk for brain injury and developmental impairment.

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Hagen, Erika W; Sadek-Badawi, Mona; Carlton, David P; Palta, Mari

2008-09-01

Permissive hypercapnia is a respiratory-care strategy that is used to reduce the risk for lung injury. The goal of this study was to evaluate whether permissive hypercapnia is associated with higher risk for intraventricular hemorrhage and early childhood behavioral and functional problems than normocapnia among very low birth weight infants. Very low birth weight infants from a statewide cohort were eligible for this study when they were born at <32 weeks' gestational age and survived at least 24 hours. Infants were classified as receiving a permissive hypercapnia, normocapnia, or unclassifiable respiratory strategy during the first 24 hours after birth according to an algorithm based on Pco(2) values and respiratory-treatment decisions that were abstracted from medical charts. Intraventricular hemorrhage diagnosis was also abstracted from the medical chart. Behavioral and functional outcomes were assessed by parent interview at 2 to 3 years. Logistic regression was used to evaluate the relationship between intraventricular hemorrhage and respiratory strategy; ordinary linear regression was used to evaluate differences in behavior and function scores between children by respiratory strategy. Infants who received a permissive hypercapnia strategy were not more likely to have intraventricular hemorrhage than those with normocapnia. There were no differences in any of the behavioral or functional scores among children according to respiratory strategy. There was a significant interaction between care strategy and 1-minute Apgar score, indicating that infants with lower Apgar scores may be at higher risk for intraventricular hemorrhage with permissive hypercapnia. This study suggests that permissive hypercapnia does not increase risk for brain injury and impairment among very low birth weight children. The interaction between respiratory strategy and Apgar score is a potential worrisome exception to this conclusion. Future research should further evaluate the effect

A higher score on the Aging Males' Symptoms scale is associated with insulin resistance in middle-aged men.

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Hamanoue, Nobuya; Tanabe, Makito; Tanaka, Tomoko; Akehi, Yuko; Murakami, Junji; Nomiyama, Takashi; Yanase, Toshihiko

2017-05-30

An age-associated androgen decrease and its pathological conditions are defined as late-onset hypogonadism (LOH). Among the various symptoms associated with LOH, a visceral fat increase is strongly associated with relatively low levels of testosterone. However, few studies have investigated the relationship between the Aging Males' Symptoms (AMS) scores and metabolic abnormalities. Thus, we aimed to clarify this relationship by investigating the relationship between AMS scores and various markers in blood. During routine health examinations in 241 middle-aged males (52.7±7.5 years of age, mean±SD), 150 males (62.2%) displayed higher AMS values than normal. No statistical association was observed between total AMS scores and any testosterone value. All mental, physical and sexual AMS subscales were significantly positively correlated with insulin levels and HOMA-IR. Only sexual subscale scores were significantly inversely associated with free or bioavailable testosterone level. Males with insulin resistance (HOMA-IR≥2.5) demonstrated significantly higher AMS scores than those with normal insulin sensitivity (HOMA-IRinsulin and HOMA-IR values. Interestingly, univariate and multivariate analyses revealed that HOMA-IR≥2.5 was a significant predictor for detection of moderately severe AMS values (AMS≥37), whereas AMS≥37 was not a predictor of metabolic syndrome by International Diabetes Federation (IDF) criterion. In conclusion, almost 60% of healthy male subjects displayed abnormal AMS scores. AMS values were not associated with testosterone values but rather were related to insulin resistance, particularly in subjects with moderately severe AMS values. Insulin resistance-related general unwellness might be reflected by AMS values.

Psychomotor development of preterm babies in the context of biomedical predictors in a Polish sample

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Mariola Bidzan

2014-02-01

Full Text Available Background Preterm birth represents the most frequent complication of pregnancy all over the world. Much research is addressed to psychomotor development of preterm infants during the initial years of their life. Many authors emphasize the role of birth weight, gestational age, and gender in determining the child’s psychomotor development. This study adds to this knowledge as we analyzed the synergistic effect of biomedical predictors such as gestational age, birth weight, Apgar score, time in incubator, type of pregnancy defined based on its outcome, neonatal status immediately after delivery, infant’s gender, and possessing twin sibling. Combined effects of these factors represent an important niche in the studies of the developmental psychology of preterm infants. Participants and procedure The study included 49 preterm infants born in 2008-2009 at the Department of Obstetrics of the Medical University of Gdańsk. The psychomotor development of preterm infants was evaluated according to the Bayley Scales of Infant and Toddler Development®, Third Edition (BSID-III at a mean, non-corrected age of 33.80 months (SD = 5.16. For the purpose of the study we developed a basic model in the form of a pathway diagram, describing the cumulative influence of eight biomedical predictors on the development of the infants during early childhood. Results Our study revealed a synergistic influence of biomedical predictors on the development of preterm infants with regards to cognitive functioning (28% of variance, language skills (10% of variance, motor skills (18% of variance, fine motor skills (16% of variance, and gross motor skills (20% of variance. Moreover, we observed an independent effect of birth weight, child’s gender, and final Apgar score on the psychomotor development of preterm infants. Higher birth weight was associated with higher level of cognitive function and fine motor skills. Male gender of a child was reflected by a higher level of

Preterm birth and cerebral palsy. Predictive value of pregnancy complications, mode of delivery, and Apgar scores

DEFF Research Database (Denmark)

Topp, Monica Wedell; Langhoff-Roos, J; Uldall, P

1997-01-01

BACKGROUND: Preterm infants are at 8 times higher risk than term infants for pre- and perinatal brain damage, resulting in cerebral palsy. In this paper we have analysed the influence of prenatal and birth-related risk factors on cerebral palsy in preterm infants. METHODS: In a register-based stu...

Antenatal clinical pelvimetry in primigravidae and outcome of labour ...

African Journals Online (AJOL)

Method: A retrospective study of clinical pelvimetry and outcome of labour in primigravidae. Results: The total number of primigravidae included in the study was 268 and of these, 74 were adjudged to have adequate pelvis at antenatal clinical pelvimetry. The APGAR scores at one and five minutes were significantly higher ...

Prevalence and predictors of episiotomy among women at first birth ...

African Journals Online (AJOL)

interquartile range (IQR): 2.9-3.5]) was statistically higher than those of women who did not receive episiotomy (median, 3.1 kg [IQR: 2.7-3.4]), (Z = −3.415, P = 0.001). Proportion of newborns with low 1st min Apgar scores in the episiotomy group ...

Birth asphyxia in a mission hospital in Benin City, Nigeria | Onyiriuka ...

African Journals Online (AJOL)

Methods: In this descriptive (cross-sectional) study at St Philomena Catholic Hospital, the one-and-five-minute Apgar scores of 2,208 live-births were recorded. Those with low Apgar scores (6 at one minute) were studied and their data analyzed. Results: Birth asphyxia occurred in 83.8 per 1000 live-births with preterm and ...

Birth characteristics and Wilms tumors in children in the Nordic countries: a register-based case-control study.

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Schüz, Joachim; Schmidt, Lisbeth Samsø; Kogner, Per; Lähteenmäki, Päivi M; Pal, Niklas; Stokland, Tore; Schmiegelow, Kjeld

2011-05-01

Little is known about causes of Wilms tumor. Because of the young age at diagnosis, several studies have looked at various birth characteristics. We conducted a registry-based case-control study involving 690 cases of Wilms tumor aged 0-14 years, occurring in Denmark, Finland, Norway or Sweden during 1985-2006, individually matched to five controls drawn randomly from the Nordic childhood population. Information on birth characteristics was obtained from the population-based medical birth registries. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using conditional logistic regression analysis. We observed a distinct association between Wilms tumor and high birth weight (≥4 kg) for girls (OR 1.97, CI 1.50-2.59) but not for boys (1.04, 0.78-1.38); overall, the OR was 1.43 (1.17-1.74). Among girls, risk increased by 28% (15-42%) per 500 g increase in birth weight. Large-for-gestational age girls also had a higher risk (2.48, 1.51-4.05), whereas no effect was seen for boys (1.12, 0.60-2.07). An association was seen with Apgar score at 5 min birth order. In our large-scale, registry-based study, we confirmed earlier observations of an association between high birth weight and risk of Wilms tumor, but we found an effect only in girls. The higher risk of infants with low Apgar score might reflect hypoxia causing cell damage, adverse side effects of neonatal treatment or reverse causation as low Apgar score might indicate the presence of a tumor. Copyright © 2010 UICC.

[Deeper understanding of fetal acid-base equilibrium].

Science.gov (United States)

Roemer, V M

1993-01-01

Actual pH-measurements, which are used worldwide for quality control in obstetrics, give no information about the extent of metabolic and respiratory pathways involved in the synthesis of H(+)-ions. Therefore we looked for a new method to quantify the de novo-synthesis of H(+)-ions due to both pathways and to correlate them with the clinical condition of the newborn. Using pH-, pCO2 (mmHg)- (and pO2 (mmHg)) measurements in umbilical blood (artery (UA), vein (UV)) of 8882 newborns, which were delivered vaginally in vertex position without cord-entanglements and without major malformations, the pHqu40 (metabolic pathway) and the pHnm (non-metabolic pathway) were computed. Thus both components of fetal acidosis could be determined together with actual pH in one unity i.e. H(+)-ion-concentration (nmol/l). By introduction of a reference-point, which denotes the mean actual pH- (7.373) and the mean pCO2- (36.4 mmHg) value in umbilical venous blood of 599 Apgar 10-babies it is possible to compute the mean de novo-synthesis of H(+)-ions in different clinical neonatal conditions (Apgar-score 1 min). In the case of slightly depressed neonates (Apgar 7-10) the respiratory acidosis dominates the metabolic one. In moderately asphyxiated newborns (Apgar 4-6) both components are equally involved. In severe fetal asphyxia (Apgar 0-3) both components can probably be determined by extrapolation: the metabolic component seems to be dominant. The computed mean actual pH-value in babies scoring Apgar 0 amounts to approximately 7.100 +/- 0.075. The diagnostic range of Apgar-scoring and pH-measurements is not congruent: newborns with actual pH-values in UA-blood between 6,7 and approximately 7,1 do show Apgar-scores (1 min) of 0 or 1 without a possibility to further differentiate the degree of asphyxia by clinical criteria. This means, that actual pH-measurements are of high clinical importance in severely asphyxiated newborns. They should not be abandoned. The intercorrelation of some

Higher blood harmane (1-methyl-9H-pyrido[3,4-b]indole) concentrations correlate with lower olfactory scores in essential tremor.

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Louis, Elan D; Rios, Eileen; Pellegrino, Kathryn M; Jiang, Wendy; Factor-Litvak, Pam; Zheng, Wei

2008-05-01

Harmane (1-methyl-9H-pyrido[3,4-b]indole), a neurotoxin, may be an environmental risk factor for essential tremor (ET). Harmane and related chemicals are toxic to the cerebellum. Whether it is through this mechanism (cerebellar toxicity) that harmane leads to ET is unknown. Impaired olfaction may be a feature of cerebellar disease. To determine whether blood harmane concentrations correlate with olfactory test scores in patients with ET. Blood harmane concentrations were quantified using high performance liquid chromatography. Odor identification testing was performed with the University of Pennsylvania Smell Identification Test (UPSIT). In 83 ET cases, higher log blood harmane concentration was correlated with lower UPSIT score (rho=-0.46, p<0.001). 25/40 (62.5%) cases with high log blood harmane concentration (based on a median split) had low UPSIT scores (based on a median split) vs. 12/43 (27.9%) ET cases with low log blood harmane concentration (adjusted odd ratios (OR) 4.04, 95% confidence intervals (CI) 1.42-11.50, p=0.009). When compared with the low log blood harmane tertile, the odds of olfactory dysfunction were 2.64 times higher in cases in the middle tertile and 10.95 times higher in cases in the high tertile. In 69 control subjects, higher log blood harmane concentration was not correlated with lower UPSIT score (rho=0.12, p=0.32). Blood harmane concentrations were correlated with UPSIT scores in ET cases but not controls. These analyses set the stage for postmortem studies to further explore the role of harmane as a cerebellar toxin in ET.

Pregnancy outcomes in mothers with advanced human ...

African Journals Online (AJOL)

2%, p=0.308) and to have low Apgar scores (28% vs. 12%, Apgar score < 4 at 5 minutes p=0.02). Perinatal sepsis and perinatal deaths were more common in infants born to mothers with advanced HIV disease compared to infants born to HIV negative mothers (8 vs. 3, p=0.003 and 14 vs. 5, p=0.025 respectively). External ...

Epidemiologi ved juvenil systemisk lupus erythematosus

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Odd Vinje

2009-10-01

Full Text Available We have previously described the impact of Apgar scores on later major and minor disabilities. According to these and other studies, children with low Apgar scores have to show symptoms of neonatal encephalopathy in the first week of life to be at risk of developing later disabilities. Information on neonatal encephalopathy has traditionally been less accessible than Apgar scores in The Medical Birth Registry of Norway (MBRN. In the present study the possibility of extracting information on neonatal encephalopathy from the new notification form to the MBRN, which was introduced in late 1998, was investigated. The introduction of specific and generally accepted definitions of neonatal diagnoses combined with more comprehensive reports to MBRN from the neonatal departments may render registry based studies on neonatal encephalopathy possible in the future

Maternal haematocrit and pregnancy outcome in Nigerian women ...

African Journals Online (AJOL)

The higher the packed cell volume in labour, the greater the birth weight, better the Apgar scores but the more the blood loss at delivery. The babies of the patients with a normal packed cell volume had better ... Cependant, ceci n'était pas statisquement important. Il n' y avait aucune mort maternelle. West African Journal of ...

The Zhongshan Score

Science.gov (United States)

Zhou, Lin; Guo, Jianming; Wang, Hang; Wang, Guomin

2015-01-01

Abstract In the zero ischemia era of nephron-sparing surgery (NSS), a new anatomic classification system (ACS) is needed to adjust to these new surgical techniques. We devised a novel and simple ACS, and compared it with the RENAL and PADUA scores to predict the risk of NSS outcomes. We retrospectively evaluated 789 patients who underwent NSS with available imaging between January 2007 and July 2014. Demographic and clinical data were assessed. The Zhongshan (ZS) score consisted of three parameters. RENAL, PADUA, and ZS scores are divided into three groups, that is, high, moderate, and low scores. For operative time (OT), significant differences were seen between any two groups of ZS score and PADUA score (all P RENAL showed no significant difference between moderate and high complexity in OT, WIT, estimated blood loss, and increase in SCr. Compared with patients with a low score of ZS, those with a high or moderate score had 8.1-fold or 3.3-fold higher risk of surgical complications, respectively (all P RENAL score, patients with a high or moderate score had 5.7-fold or 1.9-fold higher risk of surgical complications, respectively (all P RENAL and PADUA scores. ZS score could be used to reflect the surgical complexity and predict the risk of surgical complications in patients undergoing NSS. PMID:25654399

Higher Prostate Weight Is Inversely Associated with Gleason Score Upgrading in Radical Prostatectomy Specimens

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Leonardo Oliveira Reis

2013-01-01

Full Text Available Background. Protective factors against Gleason upgrading and its impact on outcomes after surgery warrant better definition. Patients and Methods. Consecutive 343 patients were categorized at biopsy (BGS and prostatectomy (PGS as Gleason score, ≤6, 7, and ≥8; 94 patients (27.4% had PSA recurrence, mean followup 80.2 months (median 99. Independent predictors of Gleason upgrading (logistic regression and disease-free survival (DFS (Kaplan-Meier, log-rank were determined. Results. Gleason discordance was 45.7% (37.32% upgrading and 8.45% downgrading. Upgrading risk decreased by 2.4% for each 1 g of prostate weight increment, while it increased by 10.2% for every 1 ng/mL of PSA, 72.0% for every 0.1 unity of PSA density and was 21 times higher for those with BGS 7. Gleason upgrading showed increased clinical stage (P=0.019, higher tumor extent (P=0.009, extraprostatic extension (P=0.04, positive surgical margins (P<0.001, seminal vesicle invasion (P=0.003, less “insignificant” tumors (P<0.001, and also worse DFS, χ2=4.28, df=1, P=0.039. However, when setting the final Gleason score (BGS ≤6 to PGS 7 versus BGS 7 to PGS 7, avoiding allocation bias, DFS impact is not confirmed, χ2=0.40, df=1, P=0.530.Conclusions. Gleason upgrading is substantial and confers worse outcomes. Prostate weight is inversely related to upgrading and its protective effect warrants further evaluation.

Perinatal Outcomes in Advanced Age Pregnancies

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Ertuğrul Yılmaz

2016-06-01

Full Text Available Objective: The aim of this study is to evaluate the impact of advanced maternal age on pregnancy outcomes Methods: A retrospective analysis of 951 birth registry records of Zeynep Kamil Hospital, were analyzed between Janu­ary 2003 and December 2007. Study group was made up of women ≥40 years old and control group was made up of women younger than 40 years. Results: Mean maternal age was 41.48 years in the study group and 26.41 years in the control group. Mean gesta­tional age at the time of delivery is 37.73 weeks in study group and 38.10 weeks in the control group. There was no statistical difference in terms of preterm delivery, multiple pregnancy, fetal anomaly, IUGR, superimpose preeclampsia oligohidramnios, presentation anomaly and placenta previa rates between the study and control groups. Incidence of preeclampsia (p=0.041, Chronic hypertension (p=0.001, GDM (p= 0.003,is found to be higher in study group. Cesar­ean birth rate is higher (p<0.05 and hospitalization time is longer in study group (p=0.001. 1st minute and 5th minute APGAR scores of the study group (6.99±2, 8.27±2 was lower than the 1st minute and 5th Minutes APGAR scores of the control group (7.38±1.6, 8.58±1.7. Neonatal intensive care unit administration rate is seen also higher in study group (p<0.01. Conclusion: Advanced maternal age was related to increased pregnancy complications and poor perinatal outcome. Preeclampsia, GDM, chronic hypertension is seen more common in advanced age pregnancies. Neonatal intensive care administration is higher and APGAR scores are lower; cesarean delivery was performed more common, and hospitaliza­tion time was longer in advanced age pregnancies. J Clin Exp Invest 2016; 7 (2: 157-162

Pregnancy in teenagers under 16 years old: perinatal adversities

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José Ricardo Dias Bertagnon

2005-03-01

Full Text Available Objectives: To verify the prevalence of pregnancy among adolescentsunder 16 years of age, the risk of pregnancy-induced hypertensionand neonatal complications in the population attend at the HospitalGeral do Grajaú. Methods: Data related to every delivery performedat the Hospital Geral do Grajaú (HGG from January 1st, 2000 to April30th, 2004 were collected. The sample was divided into two groupsof pregnant women: one consisting of adolescents aged under 16years, and the other comprising all other pregnant women attendedat the Institution. Maternal age, prevalence of pregnancy-inducedhypertension, number of prenatal visits, mode of delivery, gestationalage, birth weight and one-minute Apgar score were analyzed. Forstatistical analysis the t test was used considering p<0.05. Dataregarding pregnant teenagers were compared to those related tothe general patient population of the Obstetrics Clinic of the HGG.These data were obtained from the HGG’s Hospital RecordsDepartment. Results: Two hundred and thirty-one pregnantteenagers under 16 years of age were analyzed. This correspondsto 2.61% of the total obstetric population studied in this Institution.Among them, 53,2% did not attend prenatal care visits adequately,that is, they attended less than 5 visits. The prevalence of pregnancyinducedhypertension among these teenagers was 3.46%. Cesareansection was performed in 22% of the teenagers studied. There were12.1% of low-birth weight newborns and 23.8% preterm infants, ofwhom 6.4% had a one-minute Apgar score = 3, and 17.7% had anApgar score = 7. A statistically significant difference was observedregarding inadequate prenatal care, one-minute Apgar score = 3and prematurity, compared to the data from the total pregnantpopulation of the Institution. Conclusions: A higher risk of pregnancyinducedhypertension among pregnant adolescents aged under 16years compared to the general population of patients of theInstitution was not observed. However, the age

Longitudinal AddiQoL scores may identify higher risk for adrenal crises in Addison's disease.

Science.gov (United States)

Meyer, Gesine; Koch, Maike; Herrmann, Eva; Bojunga, Jörg; Badenhoop, Klaus

2018-05-01

Several studies have shown a reduced quality of life (QoL) in patients with Addison's disease (AD), but investigations of QoL over a long-term course are lacking. Adrenal crises (AC) are life-threatening complications in AD. The purpose of this prospective study was to test whether the repeated use of QoL-questionnaires can detect prodromal periods of an AC. 110 patients with AD were asked to complete the disease specific-QoL questionnaire AddiQoL and a short questionnaire about adverse events once monthly over a period of ten months. AC was defined if at least two of the following symptoms were reported: (a) hypotension, (b) nausea or vomiting, (c) severe fatigue, (d) documented hyponatremia, hyperkalemia, or hypoglycemia, and subsequent parenteral glucocorticoid administration was carried out. Prevalence of AC was 10.9/100 patient years. AddiQoL scores in patients with AC showed a trend (p = 0,08) to a wider fluctuation over time. Subjective precrises not meeting the criteria for AC were reported by 31 patients who had significantly lower AddiQoL scores (p = 0,018). These are the first data showing the course of QoL during a period of ten months in patients with AD. Incidence of AC exceeds previous data. Our data show, that subjective precrises in AD associate with lower QoL. AC, as well as precrises affect intraindividual AddiQol-scores over time with a trend to a stronger fluctuation. Longitudinal AddiQol scores and self-reporting of precrises via patient diaries are additional clinical tools to identify higher risk for critical events.

Transient tachypnea of the newborn and congenital pneumonia: a comparative study.

Science.gov (United States)

Costa, Sandra; Rocha, Gustavo; Leitão, Andreia; Guimarães, Hercília

2012-07-01

Identify perinatal risk factors for transient tachypnea and pneumonia in neonates, and compare the outcome of these clinical conditions during the Neonatal Intensive Care Unit (NICU) stay. Retrospective review of newborns admitted to a level III NICU, comparing patients with transient tachypnea, pneumonia and a control group of healthy neonates. We included 202 patients with transient tachypnea, 29 with pneumonia and 498 controls. Perinatal infectious risk factors were more frequent in patients with pneumonia than in transient tachypnea (p ventilatory support more frequently and for a longer period. Comparing with controls, Apgar score at one and five minutes was higher in controls than in patients with pneumonia (p0.032 and p newborns with transient tachypnea and pneumonia are indistinguishable at presentation but clinical evolution is significantly different. The presence of perinatal infectious risk supports the diagnosis of pneumonia. Low Apgar score at one and five minutes was associated with both diseases, suggesting that etiologic factors may already be present at birth.

Maternal overweight and obesity and risks of severe birth-asphyxia-related complications in term infants: a population-based cohort study in Sweden.

Science.gov (United States)

Persson, Martina; Johansson, Stefan; Villamor, Eduardo; Cnattingius, Sven

2014-05-01

Maternal overweight and obesity increase risks of pregnancy and delivery complications and neonatal mortality, but the mechanisms are unclear. The objective of the study was to investigate associations between maternal body mass index (BMI) in early pregnancy and severe asphyxia-related outcomes in infants delivered at term (≥37 weeks). A nation-wide Swedish cohort study based on data from the Medical Birth Register included all live singleton term births in Sweden between 1992 and 2010. Logistic regression analyses were used to obtain odds ratios (ORs) with 95% CIs for Apgar scores between 0 and 3 at 5 and 10 minutes, meconium aspiration syndrome, and neonatal seizures, adjusted for maternal height, maternal age, parity, mother's smoking habits, education, country of birth, and year of infant birth. Among 1,764,403 term births, 86% had data on early pregnancy BMI and Apgar scores. There were 1,380 infants who had Apgar score 0-3 at 5 minutes (absolute risk  = 0.8 per 1,000) and 894 had Apgar score 0-3 at 10 minutes (absolute risk  = 0.5 per 1,000). Compared with infants of mothers with normal BMI (18.5-24.9), the adjusted ORs (95% CI) for Apgar scores 0-3 at 10 minutes were as follows: BMI 25-29.9: 1.32 (1.10-1.58); BMI 30-34.9: 1.57 (1.20-2.07); BMI 35-39.9: 1.80 (1.15-2.82); and BMI ≥40: 3.41 (1.91-6.09). The ORs for Apgar scores 0-3 at 5 minutes, meconium aspiration, and neonatal seizures increased similarly with maternal BMI. A study limitation was lack of data on effects of obstetric interventions and neonatal resuscitation efforts. Risks of severe asphyxia-related outcomes in term infants increase with maternal overweight and obesity. Given the high prevalence of the exposure and the severity of the outcomes studied, the results are of potential public health relevance and should be confirmed in other populations. Prevention of overweight and obesity in women of reproductive age is important to improve perinatal health.

Congenital esophageal atresia with tracheo-esophageal fistula

International Nuclear Information System (INIS)

Rhee, Chung Sik

1970-01-01

Three cases of esophageal atresia with tracheo-esophageal fistula. 1). Case 1: A female infant birth Wt. 1.95 kg , Apgar Score 10, Skeletal anomalies, was delivered after a pregnancy compeicated by hydroamnious on Aug. 17, 1970. The family history was not contributory. 2) Case 2: A male infant birth Wt. 2.8 kg , Apgar Score 8, was forcep delivered after a pregnancy on Feb. 8, 1970. This infant is twin. The family history was not contributory. 3) Case 3: A female infant birth Wt. 2.22 kg , Apgar Score 10, was C-section after a pregnancy on May, 16. 1970. The family history was not contributory. All cases: After 24 hours 5% glucose solution was given and immediately vomited and some of it regurgitating through the nose and mouth with associated cyanosis and dyspnea. A catheter was inserted through the nose into the esophagus under diagnosis of the esophageal atresia

Obstetric complications and asthma in childhood.

Science.gov (United States)

Xu, B; Pekkanen, J; Järvelin, M R

2000-01-01

Studies have shown that perinatal factors are associated with childhood asthma. The current analyses examined the association between obstetric complications and risk of asthma at the age of 7 years using a prospectively population-based birth cohort in northern Finland. Results indicated that obstetric complications were associated with a higher risk of asthma among children. Those children who were administered special procedures at birth, i.e., cesarean section, vacuum extraction, and other procedures, including use of forceps, manual auxiliary, and extraction breech, had an adjusted odds ratio (OR) for asthma of 1.38 (95% confidence interval [CI] 1.00-1.92), 1.32 (95% CI 0.80-2.19), and 2.14 (95% CI 1.06-4.33), respectively, as compared to children who were delivered normally. Children who had a lower Apgar score at the first and the fifth minute after birth also had a higher risk as compared to those who had an Apgar score of 9-10. The results encourage further evaluation of the association between obstetric complications and risk of asthma among children in other populations, and further exploration of possible mechanisms underlying the association.

Effects of placental infarctions on the fatal outcome in pregnancies complicated by hypertension

International Nuclear Information System (INIS)

Salgado, S.S.; Pathmeswaran, A.

2008-01-01

To determine the frequency of placental infarcts and its effects on the fetal outcome in pregnancies complicated by hypertension. Placentae of 150 normotensive women and 200 hypertensive women were studied to detect the number of placentae with infarctions. Apgar score, birth weight and the head circumference of the newborns were measured and analyzed. The frequency of placental infarcts was significantly higher in hypertensive group (30%) compared to normotensive group (18.7%). An association between placental infarction and low Apgar score of the newborn was seen in the hypertensive group (p<0.001). The difference in the birth weight of the newborns in hypertensive and normotensive groups in relation to placental infarction was statistically significant (2.2 vs. 3.1 kg, p<0.001). A highly significant difference was observed in the head circumference of the newborns of hypertensive group compared to normotensive group in relation to placental infarctions (30.7 cm vs. 32.3 cm, p<0.001). The frequency of placental infarcts was higher in hypertensive women when compared to normotensives. Placental infarctions had an adverse effect on growth and development of the newborns. This information can be useful in planning and management of future pregnancies. (author)

Risks of asphyxia-related neonatal complications in offspring of mothers with type 1 or type 2 diabetes: the impact of maternal overweight and obesity.

Science.gov (United States)

Cnattingius, Sven; Lindam, Anna; Persson, Martina

2017-07-01

We aimed to compare the risks of severe asphyxia-related neonatal complications in the offspring of mothers with type 1 or type 2 diabetes, and to assess the impact of maternal overweight/obesity on these risks. This was a population-based study of 1,343,751 live-born singleton infants in Sweden between 1997 and 2011, including 5941 and 711 infants of mothers with type 1 and type 2 diabetes, respectively. ORs with 95% CIs were calculated for low Apgar score (0-6) at 5 min after birth, hypoxic ischaemic encephalopathy and neonatal seizures. The rates of a low Apgar score were 0.9%, 2.6% and 2.1% in the offspring of mothers without diabetes or with type 1 or type 2 diabetes, respectively. After controlling for maternal confounders (including BMI), the risk of a low Apgar score increased in the offspring of mothers with type 1 diabetes (OR 2.67, 95% CI 2.23, 3.20) but not in the offspring of mothers with type 2 diabetes (OR 1.25, 95% CI 0.66, 2.35). The ORs of hypoxic ischaemic encephalopathy or neonatal seizures were increased in the offspring of mothers with type 1 diabetes (OR 3.41, 95% CI 2.58, 4.49) and type 2 diabetes (OR 2.54, 95% CI 1.13, 5.69). Maternal overweight/obesity was a risk factor for asphyxia-related neonatal complications and low Apgar scores in the offspring of mothers with type 1 diabetes and mothers without diabetes. The risks of a low Apgar score and severe asphyxia-related neonatal complications are increased in the offspring of mothers with type 1 or type 2 diabetes. Maternal overweight/obesity is an important contributing factor.

Maternal and perinatal outcomes in pregnancies with multiple sclerosis: a case-control study.

Science.gov (United States)

Yalcin, Serenat Eris; Yalcin, Yakup; Yavuz, And; Akkurt, Mehmet Ozgur; Sezik, Mekin

2017-05-24

To assess whether maternal multiple sclerosis (MS) is associated with adverse pregnancy outcomes by determining the clinical course of disease during pregnancy and postpartum throughout a 10-year-period in a single tertiary center. We conducted a case-control study that included pregnancies with a definitive diagnosis of MS (n=43), matched with 100 healthy pregnant women with similar characteristics. Maternal and perinatal data were retrieved from hospital files. Groups were compared with the Mann-Whitney and χ2 tests. Logistic regression models were constructed to determine independent effects. Maternal demographic and baseline laboratory data were similar across the groups. Rates of preterm delivery, fetal growth restriction, preeclampsia, gestational diabetes, stillbirth, cesarean delivery, congenital malformation, and 5-min Apgar score were comparable (P>0.05 for all). General anesthesia during cesarean delivery (96% vs. 39%, P=0.002), urinary tract infection (UTI) (12% vs. 3%, P=0.04), low 1-min Apgar score (21% vs. 9%, P=0.04), and nonbreastfeeding (33% vs. 2%, P=0.001) were more frequent in women with MS. The low 1-min Apgar score and breastfeeding rates were independent of general anesthesia and UTI in regression models. MS during pregnancy was not associated with adverse maternal and perinatal outcomes except UTI, low 1-min Apgar scores, and decreased breastfeeding rates.

Etiological aspect of left-handedness in adolescents.

Science.gov (United States)

Dragović, Milan; Milenković, Sanja; Kocijancić, Dusica; Zlatko, Sram

2013-01-01

Lateralization of brain functions such as language and manual dominance (hand preferences and fine motor control) are most likely under genetic control. However, this does not preclude the effect of various environmental factors on functional brain lateralization. A strong association of non-right-handedness (left- and mixed-handedness) with various neurodevelopmental conditions (e.g. schizophrenia, autism, Rett syndrome) implies that in some cases, non-right-handedness may be acquired rather than inherited (i.e., pathologically determined). The aim of the study was: (a) re-investigation of several known risk factors for left-handedness (age of mother and/or father, twin pregnancies, and birth order), and (b) examination of hitherto uninvestigated factors (type of birth, Apgar score, maternal smoking during pregnancy). Putative, causative environmental agents for this shift in manual distributions are explored in a sample of 1031 high school students (404 males and 627 females) from Belgrade. Both pre-existing (age of parents, twin pregnancy, and birth order) and new (Apgar score, maternal smoking, type of birth) putative agents are examined. We found that maternal smoking and low Apgar score (2-6) can significantly increase risk for left-handedness (p=0.046 and p=0.042, respectively).The remaining factors showed no significant association with left-handedness in adolescents. Our study clearly demonstrates that left-handedness may be related to maternal smoking during pregnancy and a low Apgar score on birth.

Nurse Corps Training Importance Survey Report

Science.gov (United States)

1992-06-01

judgment or application of theory. Thorough Knowledge Level NEWBORN 64. Take APGAR readings X 65. Interpret APGAR scores X 66. Administer oxygen to...OCONUS) enough money" is all too popular. Staff Nurse The majority of training is OJT. I would recommend a Navy-wide (OCONUS) manual with a certification

Re-Scoring the Game’s Score

DEFF Research Database (Denmark)

Gasselseder, Hans-Peter

2014-01-01

This study explores immersive presence as well as emotional valence and arousal in the context of dynamic and non-dynamic music scores in the 3rd person action-adventure video game genre while also considering relevant personality traits of the player. 60 subjects answered self-report questionnai......This study explores immersive presence as well as emotional valence and arousal in the context of dynamic and non-dynamic music scores in the 3rd person action-adventure video game genre while also considering relevant personality traits of the player. 60 subjects answered self......-temporal alignment in the resulting emotional congruency of nondiegetic music. Whereas imaginary aspects of immersive presence are systemically affected by the presentation of dynamic music, sensory spatial aspects show higher sensitivity towards the arousal potential of the music score. It is argued...

Evaluation of effective factors on low birth weight neonates' mortality using path analysis

Directory of Open Access Journals (Sweden)

Babaee Gh

2008-06-01

Full Text Available Background: This study have conducted in order to determine of direct or indirect effective factors on mortality of neonates with low birth weight by path analysis.Methods: In this cohort study 445 paired mothers and their neonates were participated in Tehran city. The data were gathered through an answer sheet contain mother age, gestational age, apgar score, pregnancy induced hypertension (PIH and birth weight. Sampling was convenience and neonates of women were included in this study who were referred to 15 government and private hospitals in Tehran city. Live being status of neonates was determined until 24 hours after delivery.Results: The most changes in mortality rate is related to birth weight and its negative score means that increasing in weight leads to increase chance of live being. Second score is related to apgar sore and its negative score means that increasing in apgar score leads to decrease chance of neonate death. Third score is gestational age and its negative score means that increasing in weight leads to increase chance of live being. The less changes in mortality rate is due to hypertensive disorders in pregnancy.Conclusion: The methodology has been used could be adopted in other investigations to distinguish and measuring effect of predictive factors on the risk of an outcome.

Comparative Study of Pregnancy Outcome in Premature Rupture of Membranes With Amniotic Fluid Indices of less and more than 5

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F Tavassoli

2010-03-01

Full Text Available Introduction: Preterm premature rupture of the membranes (PPROM is one of the most important causes of perinatal morbidity and mortality. The aim of this study was to evaluate pregnancy outcome in preterm premature rupture of the membranes with amniotic fluid index less than 5 and more than 5. Methods: This prospective study was performed on 137 pregnant women with gestational age of 28-34 weeks with PPROM from Oct 2006 to Oct 2008. The patients were divided in two groups according to amniotic fluid index: AFI<5 (77 cases, AFI≥5 (60 cases. Chi-square test was used for qualitative variables, while T-student test was used for quantitative test. Results: Both groups were similar with respect to number of pregnancies, gestational age at rupture of the membranes and birth weight. In the group with AFI<5, applied latency was significantly shorter (PV=0.049, rate of cesarean section was higher due to fetal distress (PV=0.008, neonatal Apgar score in first minute was lower during the first week (PV=0.0127 and the rate of neonatal death was higher (PV=0.045 during the first week. Conclusion: An AFI<5 cm after PPROM is associated with earlier delivery, higher rate of cesarean due to fetal distress, higher rate of neonatal death, and lower neonatal Apgar score in first minute during the first week

Research

African Journals Online (AJOL)

abp

29 oct. 2013 ... nouveau-né et l'âge maternelle situé entre 20 et 34 ans, l'âge gestationnel inférieur à 37 SA, et le score d'APGAR<7, mais aussi le rôle d´autres facteurs tels que les .... mères ayant un âge gestationnel supérieur ou égal à 37 SA, il y a ... les nouveau-nés de poids de naissance normal, le score d'APGAR.

[Multicenter clinical study on umbilical cord arterial blood gas parameters for diagnosis of neonatal asphyxia].

Science.gov (United States)

2010-09-01

To obtain the normal range of statistics of umbilical artery blood gas parameters of the newborns for diagnosis of neonatal asphyxia. From March 2008 through September 2009, 17 978 singleton term appropriate for gestational age (AGA) or larger than gestational age (LGA) newborns in six hospitals of five provinces/autonomous regions were consecutively enrolled in this prospective study. The normal ranges of umbilical artery blood gas parameters were obtained from 17 645 newborns with 1 min Apgar score ≥ 8. The correlations between umbilical artery blood pH, BE and prenatal high-risk factors, Apgar scores, and organ damage were analyzed. The diagnostic criteria for asphyxia included the following: (1) Having high-risk factors that might cause asphyxia; (2) 1 min Apgar score ≤ 7 (the respiratory depression must be present); (3) At least one organ showed evidence of hypoxic damage; (4) Other causes of low Apgar score were excluded. The study focused on the distributive characteristics of umbilical artery blood pH (clinically corrected by Eisenberg formula) and BE values of the asphyxiated and non-asphyxiated cases in low Apgar score group, as well as the sensitivity and specificity of different selected pH and BE threshold spots within their distributing ranges. Among the 17 978 singleton term AGA or LGA newborns, the statistically normal range of umbilical artery blood pH, BE for the 17 645 cases with 1 min Apgar scores ≥ 8 were 7.20 ± 0.20 (x(-) ± 1.96 s) and -7.64 ± 10.02 (x(-) ± 1.96 s), respectively. The pH well correlated positively with BE (r = 0.734, P blood pH and BE values correlated positively with the Apgar scores. The umbilical artery blood pH and BE values correlated negatively with organ damage (r = 1, the P values = 0.000 for both). Among the 333 low Apgar score cases, the umbilical artery blood pH corrected values and BE values of the asphyxiated group (163 cases) were 7.011 ± 0.09 (x(-) ± s) and -14.98 ± 2.99 (x(-) ± s), being lower than

Fatores associados à asfixia perinatal Factors associated with perinatal asphyxia

Directory of Open Access Journals (Sweden)

Alfredo de Almeida Cunha

2004-12-01

Full Text Available OBJETIVO: avaliar fatores de risco associados ao índice de Apgar baixo. MÉTODOS: o estudo teve delineamento transversal. A população de estudo foi amostra randômica da população internada em maternidade nível III no ano de 2001. O desfecho foi índice de Apgar baixo, definido como de 1-6 (grupo de estudo comparado a 7-10 (controle no primeiro minuto. A primeira etapa foi avaliar a associação isolada de cada possível fator de risco. A segunda etapa consistiu em análise multivariada com modelagem usando regressão logística (modo passo a passo, reverso. RESULTADOS: houve 39 (14% recém-nascidos (RN deprimidos que foram comparados a 238 (86% não deprimidos. A análise final (multivariada revelou associação do índice de Apgar baixo com os seguintes fatores de risco: antecedente de natimorto (OR=52,6, ameaça de parto prematuro, caracterizada pela existência de contrações uterinas não típicas de trabalho de parto (OR=33,8, baixo peso do RN, inferior a 2.500 g (OR=11,2, antecedente de cesariana (OR=7,4. Funcionaram como fatores de proteção o peso do RN medido em gramas (OR=0,9, sexo feminino do RN (OR=0,1, presença de intercorrência clínica (OR=0,4 e prematuridade, com idade gestacional inferior a 37 semanas (OR=0,1 CONCLUSÃO: o estudo do resultado pode auxiliar na identificação de fetos com risco de asfixia, possibilitando seu encaminhamento dentro do sistema de saúde, bem como o planejamento da assistência em unidades terciárias.PURPOSE: to assess risk factors for low Apgar score. METHODS: this was a cross-sectional study preformed in a random sample of patients admitted to a level III maternity hospital in 2001. The outcome was low Apgar score defined as an Apgar score 1-6 (study group versus Apgar score 7-10 (control group in the first minute of life. The first step was the evaluation of the association of each possible risk factor with low Apgar score. The second step was multivariate analysis with the backward

Raising test scores vs. teaching higher order thinking (HOT): senior science teachers' views on how several concurrent policies affect classroom practices

Science.gov (United States)

Zohar, Anat; Alboher Agmon, Vered

2018-04-01

This study investigates how senior science teachers viewed the effects of a Raising Test Scores policy and its implementation on instruction of higher order thinking (HOT), and on teaching thinking to students with low academic achievements.

Prompt Referral in the Nonoperative Treatment of Obstetrical Brachial Plexus Injuries

Science.gov (United States)

Aubin-Lemay, Camille; Kvann, Julie Chakriya; Retrouvey, Helene; Aldekhayel, Salah; Zadeh, Teanoosh

2017-01-01

Background: Prompt physical and occupational therapy is crucial in managing nonsurgical candidates with obstetrical brachial plexus injuries (OBPI). The objective of our study was to identify newborns suffering from nonoperative OBPI in need of a “fast-track” evaluation by a multidisciplinary team. Methods: This is a retrospective review of patients with OBPI from June 1995 to June 2015. All nonsurgical candidates (Narakas class 1) were included in the study. The Gilbert score and the Medical Research Council grading system were used to measure shoulder and elbow function, respectively. The relationship between shoulder and elbow functional outcomes and time delay to consultation was studied using analysis of variance and Welch’s tests. Various subgroups were studied based on OBPI risk factors: maternal diabetes, birth weight >4 kg, use of forceps, asphyxia, multiple comorbidities, and Apgar score at 1 and 5 minutes. Results: A total of 168 patients were included in this study. Mean follow-up time was 313.8 weeks (minimum: 52; maximum: 1072; SD: 228.1). A total of 19 patients had an Apgar scores <7 at 5 minutes. Time delay between birth and the first consult to our clinic had an impact on shoulder outcome in the subgroup of newborns with Apgar scores <7 at 5 minutes. Conclusions: The subgroup of newborns with an Apgar score <7 at 5 minutes shows improved long-term shoulder function when promptly examined by an OBPI clinic. We recommend a “fast-track” referral for this time-sensitive population. PMID:29632767

Maternal and neonatal complications in term breech delivered vaginally

International Nuclear Information System (INIS)

Jadoon, S.; Jadoon, S.M.K.; Shah, R.

2008-01-01

To evaluate the maternal and neonatal complications in terms of genital tract trauma to mother, perinatal mortality. Apgar score at 5 minutes and neonatal trauma in all singleton term breech cases delivered vaginally. A 100 consecutive patients with singleton breech presentation, whether booked or unbooked, were admitted and delivered vaginally in hospital during the study period. They were studied for maternal and neonatal complications. Maternal complication included any genital tract trauma during delivery while neonatal complications were perinatal mortality, low Apgar score (less than eight at 5 minutes) and birth trauma. There were a total 3977 deliveries during this study period, 145 breech presentation (incidence 3.6%). Out of those, 100 were included in the study. All were unbooked cases, 87% were multigravida while 13% were primigravida. An Apgar score of eight was recorded in 87% babies while 10% had an Apgar score of less than eight after 5 minutes. There were 3 still births and one neonatal death. Aggregated perinatal mortality rate was 40/1000 live births. Only one baby had birth trauma (Erbs paralysis) during vaginal breech delivery. Ninety seven (97%) mothers had no complications while only 3 (3%) had complications. Out of these, one had cervical tear and 2 had vaginal tears. Offering a trial of vaginal breech delivery to strictly selected and well-counselled patients remains an appropriate option without compromising perinatal and maternal outcome. It also decreases the rate of operative delivery for this malpresentation. (author)

Etiological aspect of left-handedness in adolescents

Directory of Open Access Journals (Sweden)

Dragović Milan

2013-01-01

Full Text Available Introduction. Lateralization of brain functions such as language and manual dominance (hand preferences and fine motor control are most likely under genetic control. However, this does not preclude the effect of various environmental factors on functional brain lateralization. A strong association of non-right-handedness (left- and mixed-handedness with various neurodevelopmental conditions (e.g. schizophrenia, autism, Rett syndrome implies that in some cases, non-right-handedness may be acquired rather than inherited (i.e., pathologically determined. Objective. The aim of the study was: (a re-investigation of several known risk factors for left-handedness (age of mother and/or father, twin pregnancies, and birth order, and (b examination of hitherto uninvestigated factors (type of birth, Apgar score, maternal smoking during pregnancy. Methods. Putative, causative environmental agents for this shift in manual distributions are explored in a sample of 1031 high school students (404 males and 627 females from Belgrade. Both pre-existing (age of parents, twin pregnancy, and birth order and new (Apgar score, maternal smoking, type of birth putative agents are examined. Results. We found that maternal smoking and low Apgar score (2-6 can significantly increase risk for left-handedness (p=0.046 and p=0.042, respectively. The remaining factors showed no significant association with left-handedness in adolescents. Conclusion. Our study clearly demonstrates that left-handedness may be related to maternal smoking during pregnancy and a low Apgar score on birth.

Relaxation Therapy on Fetal Outcomes in Complicated Pregnancies Suffering Sleep Disorders: A Randomized Clinical Trial

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azar nematollahi

2016-10-01

Full Text Available Background: Sleep disorders like snoring, mouth breathing, and insomnia are frequent in pregnancy and studies have shown that poor sleep is linked to obstetric complications. Muscle relaxation technique is an effective method used for improving sleep quality. The purpose of this study was to determine the effect of muscle relaxation technique on fetal outcomes in complicated pregnancies with sleep disorders. Methods: This study was performed as a clinical trial on 160 pregnant women who suffered from preeclampsia and gestational diabetes. The participants filled the Pittsburgh Sleep Quality Index (PSQI in order to measure the quality and patterns of their sleep. The participants with the total score of 5 or more were included in the present study. Intervention group were asked to use muscle relaxation technique twice a week at home for 8 weeks alongside the routine care. Study variables included sleep quality, Apgar scores, birth weight, levels of Interleukin- 6 (IL- 6, as well as umbilical cord PH and PO2. Results: The mean score of PSQI before the intervention was 9.28±4.16 and 9.18±3.06 in the intervention and control groups without a significant difference (P=0.6, respectively. However, PSQI global score of the experimental group was smaller than the control group at the end of the study (P<0.001. Also, birth weight (P=0.04, Apgar score (P=0.01, and umbilical cord blood po2 (P=0.03 and PH (P=0.01 were higher, and IL-6 (P=0.04 was smaller in the experimental group compared to the control group. Conclusion: The results of this study showed that muscle relaxation, as a simple, inexpensive and safe method, can improve the fetal outcomes such as birth weight, Apgar score, cord blood po2, and cord blood PH, and also it leads to lower IL-6 in complicated pregnancies.

The relation of breech presentation at term to cerebral palsy

DEFF Research Database (Denmark)

Krebs, L; Topp, M; Langhoff-Roos, J

1999-01-01

OBJECTIVE: To examine the relation between breech delivery and cerebral palsy, considering the influence of intrauterine growth, low Apgar score at birth, and mode of delivery. DESIGN: Register-based, case-control study. POPULATION: A cohort of infants with cerebral palsy born between 1979 and 1986...... in East Denmark, identified by linkage of the cerebral palsy register with the national birth register. Discharge letters from births of breech infants with cerebral palsy were reviewed. MAIN OUTCOME MEASURES: Presentation, mode of delivery, gestational age, birthweight, Apgar score, type of cerebral...

Trends in Overall Mortality, and Timing and Cause of Death among Extremely Preterm Infants near the Limit of Viability

Science.gov (United States)

Sung, Sein; Ahn, So Yoon; Park, Won Soon

2017-01-01

Objective To investigate the trends in mortality, as well as in the timing and cause of death, among extremely preterm infants at the limit of viability, and thus to identify the clinical factors that contribute to decreased mortality. Methods We retrospectively reviewed the medical records of 382 infants born at 23–26 weeks’ gestation; 124 of the infants were born between 2001 and 2005 (period I) and 258 were born between 2006 and 2011 (period II). We stratified the infants into two subgroups–“23–24 weeks” and “25–26 weeks”–and retrospectively analyzed the clinical characteristics and mortality in each group, as well as the timing and cause of death. Univariate and multivariate logistic regression analyses were done to identify the clinical factors associated with mortality. Results The overall mortality rate in period II was 16.7% (43/258), which was significantly lower than that in period I (30.6%; 38/124). For overall cause of death, there were significantly fewer deaths due to sepsis (2.4% [6/258] vs. 8.1% [10/124], respectively) and air-leak syndrome (0.8% [2/258] vs. 4.8% (6/124), respectively) during period II than during period I. Among the clinical factors of time period, 1-and 5-min Apgar score, antenatal steroid identified significant by univariate analyses. 5-min Apgar score and antenatal steroid use were significantly associated with mortality in multivariate analyses. Conclusion Improved mortality rate attributable to fewer deaths due to sepsis and air leak syndrome in the infants with 23–26 weeks’ gestation was associated with higher 5-minute Apgar score and more antenatal steroid use. PMID:28114330

Effects of antenatal corticosteroids on maternal serum indicators of infection in women at risk for preterm delivery: A randomized trial comparing betamethasone and dexamethasone

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Azar Danesh

2012-01-01

Full Text Available Objective: To compare the effect of betamethasone and dexamethasone on maternal white blood cell (WBC and differential count, erythrocyte sedimentation rate (ESR, Apgar score, maternal and fetal plasma glucose and length of admission to delivery, gestational age at delivery in women at risk of preterm labor (PTL. Study Design: Two hundred and forty pregnant women at risk for PTL with intact membranes or preterm premature rupture of the membranes (PPROM were randomly allocated to receive either two intramuscular injections of 12 mg betamethasone at 24-h intervals or 4 injections of 6 mg dexamethasone at 12-h intervals. Blood tests for WBC and differential count, ESR and fasting plasma glucose were drawn before betamethasone or dexamethasone injection and after injection every 24 h for two days. Pregnancy outcome was assessed as Apgar score, fetal plasma glucose and length of gestation. Result : In the preterm delivery group with intact membranes, no significant differences were found between the two groups in the maternal serum indicators of infection. The mean gestational age at delivery, 1- and 5-min Apgar score were higher in the dexamethasone group than in the betamethasone group. In the PPROM group, a significant rise in WBC count was occurred (12.4 cells/mm 3 vs. 10.5 cells/mm 3 , P < 0.001, none of the other maternal serum indicators of infection and outcome variables showed significant differences between the dexamethasone and betamethasone groups. Conclusions : Dexamethasone compared to betamethasone significantly increased WBC count in women with PPROM, but in women at risk of PTL with intact membranes none of the maternal serum indicators of infection showed significant differences.

To press or not to press, and if so, with what? A single question-focused meta-analysis of vasopressor choice during regional anesthesia in obstetrics.

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Biddle, Chuck

2013-08-01

Given the underlying assumption that reasonable maternal hemodynamics can be achieved with either ephedrine or phenylephrine, this focused meta-analysis addresses the impact of vasopressor choice on resultant neonatal Apgar scores during regional anesthesia. The literature was systematically searched for randomized trials of obstetric vasopressor use employing standard search tools. Only the highest quality trials were included. Of 142 studies retrieved, 9 met the defined inclusion criteria. Apgar scores at 1 and 5 minutes in the ephedrine group (served as control) vs the phenylephrine group did not differ at either time epoch; no abnormal values prevailed in either group (relative risk, 0.88; CI, 0.79-1.16). This meta-analysis focused on the most clinically relevant, immediately available information pertinent in the obstetric suite, the Apgar score, and found that ephedrine and phenylephrine did not differ in their effect on this metric. The current meta-analysis provides an updated, evidence-based validation of vasopressor use from the American Society of Anesthesiologists' 2007 "Practice Guidelines for Obstetric Anesthesia".

Similarity between neonatal profile and socioeconomic index: a spatial approach

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d'Orsi Eleonora

2005-01-01

Full Text Available This study aims to compare neonatal characteristics and socioeconomic conditions in Rio de Janeiro city neighborhoods in order to identify priority areas for intervention. The study design was ecological. Two databases were used: the Brazilian Population Census and the Live Birth Information System, aggregated by neighborhoods. Spatial analysis, multivariate cluster classification, and Moran's I statistics for detection of spatial clustering were used. A similarity index was created to compare socioeconomic clusters with the neonatal profile in each neighborhood. The proportions of Apgar score above 8 and cesarean sections showed positive spatial correlation and high similarity with the socioeconomic index. The proportion of low birth weight infants showed a random spatial distribution, indicating that at this scale of analysis, birth weight is not sufficiently sensitive to discriminate subtler differences among population groups. The observed relationship between the neighborhoods' neonatal profile (particularly Apgar score and mode of delivery and socioeconomic conditions shows evidence of a change in infant health profile, where the possibility for intervention shifts to medical services and the Apgar score assumes growing significance as a risk indicator.

Patient Controlled Epidural Analgesia during Labour: Effect of Addition of Background Infusion on Quality of Analgesia & Maternal Satisfaction

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Uma Srivastava

2009-01-01

Full Text Available Patient controlled epidural analgesia (PCEA is a well established technique for pain relief during labor. But the inclusion of continuous background infusion to PCEA is controversial. The aim of this study was to assess whether the use of continuous infusion along with PCEA was beneficial for laboring women with regards to quality of analgesia, maternal satisfaction and neonatal outcome in comparison to PCEA alone. Fifty five parturients received epidural bolus of 10ml solution containing 0.125% bupivacaine +2 ìg.ml-1 of fentanyl. For maintenance of analgesia the patients of Group PCEA self administered 8 ml bolus with lockout interval of 20 minutes of above solution on demand with no basal infusion. While the patients of Group PCEA + CI received continuous epidural infusion at the rate of 10 ml.hr-1 along with self administered boluses of 3 ml with lockout interval of 10 minutes of similar epidural solution. Patients of both groups were given rescue boluses by the anaesthetists for distressing pain. Verbal analogue pain scores, incidence of distressing pain, need of supplementary/rescue boluses, dose of bupivacaine consumed, maternal satisfaction and neonatal Apgar scores were recorded. No significant difference was observed between mean VAS pain scores during labor, maternal satisfaction, mode of delivery or neonatal Apgar scores. But more patients (n=8 required rescue boluses in PCEA group for distressing pain. The total volume consumed of bupivacaine and opioid was slightly more in PCEA + CI group. In both the techniques the highest sensory level, degree of motor block were comparable& prolongation of labor was not seen. It was concluded that both the techniques provided equivalent labor analgesia, maternal satisfaction and neonatal Apgar scores. PCEA along with continuous infusion at the rate of 10 ml/ hr resulted in lesser incidence of distressing pain and need for rescue analgesic. Although this group consumed higher dose of bupivacaine

Neonatal outcomes after preterm birth by mothers’ health insurance status at birth: a retrospective cohort study

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Einarsdóttir Kristjana

2013-02-01

Full Text Available Abstract Background Publicly insured women usually have a different demographic background to privately insured women, which is related to poor neonatal outcomes after birth. Given the difference in nature and risk of preterm versus term births, it would be important to compare adverse neonatal outcomes after preterm birth between these groups of women after eliminating the demographic differences between the groups. Methods The study population included 3085 publicly insured and 3380 privately insured, singleton, preterm deliveries (32–36 weeks gestation from Western Australia during 1998–2008. From the study population, 1016 publicly insured women were matched with 1016 privately insured women according to the propensity score of maternal demographic characteristics and pre-existing medical conditions. Neonatal outcomes were compared in the propensity score matched cohorts using conditional log-binomial regression, adjusted for antenatal risk factors. Outcomes included Apgar scores less than 7 at five minutes after birth, time until establishment of unassisted breathing (>1 minute, neonatal resuscitation (endotracheal intubation or external cardiac massage and admission to a neonatal special care unit. Results Compared with infants of privately insured women, infants of publicly insured women were more likely to receive a low Apgar score (ARR = 2.63, 95% CI = 1.06-6.52 and take longer to establish unassisted breathing (ARR = 1.61, 95% CI = 1.25-2.07, yet, they were less likely to be admitted to a special care unit (ARR = 0.84, 95% CI = 0.80-0.87. No significant differences were evident in neonatal resuscitation between the groups (ARR = 1.20, 95% CI = 0.54-2.67. Conclusions The underlying reasons for the lower rate of special care admissions in infants of publicly insured women compared with privately insured women despite the higher rate of low Apgar scores is yet to be determined. Future research is

Regional 18F-Fluorodeoxyglucose Hypometabolism is Associated with Higher Apathy Scores Over Time in Early Alzheimer Disease.

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Gatchel, Jennifer R; Donovan, Nancy J; Locascio, Joseph J; Becker, J Alex; Rentz, Dorene M; Sperling, Reisa A; Johnson, Keith A; Marshall, Gad A

2017-07-01

Apathy is among the earliest and most pervasive neuropsychiatric symptoms in prodromal and mild Alzheimer disease (AD) dementia that correlates with functional impairment and disease progression. We investigated the association of apathy with regional 18F-fluorodeoxyglucose (FDG) metabolism in cognitively normal, mild cognitive impairment, and AD dementia subjects from the Alzheimer's Disease Neuroimaging Initiative database. Cross-sectional and longitudinal studies. 57 North American research sites. 402 community dwelling elders. Apathy was assessed using the Neuropsychiatric Inventory Questionnaire. Baseline FDG metabolism in five regions implicated in the neurobiology of apathy and AD was investigated in relationship to apathy at baseline (cross-sectional general linear model) and longitudinally (mixed random/fixed effect model). Covariates included age, sex, diagnosis, apolipoprotein E genotype, premorbid intelligence, cognition, and antidepressant use. Cross-sectional analysis revealed that posterior cingulate hypometabolism, diagnosis, male sex, and antidepressant use were associated with higher apathy scores. Longitudinal analysis revealed that the interaction of supramarginal hypometabolism and time, posterior cingulate hypometabolism, and antidepressant use were associated with higher apathy scores across time; only supramarginal hypometabolism was positively related to rate of increase of apathy. Results support an association of apathy with hypometabolism in parietal regions commonly affected in early stages of AD, rather than medial frontal regions implicated in the neurobiology of apathy in later stages. Further work is needed to substantiate whether this localization is specific to apathy rather than to disease stage, and to investigate the potential role of AD proteinopathies in the pathogenesis of apathy. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Maternal and neonatal effects of nalbuphine given immediately before induction of general anesthesia for elective cesarean section

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Sabry M Amin

2011-01-01

Full Text Available Background: Although nalbuphine was studied extensively in labour analgesia and was proved to be acceptable analgesics during delivery, its use as premedication before induction of general anesthesia for cesarean section is not studied. The aim of this study was to evaluate the effect of nalbuphine given before induction of general anesthesia for cesarean section on quality of general anesthesia, maternal stress response, and neonatal outcome. Methods: Sixty full term pregnant women scheduled for elective cesarean section, randomly classified into two equal groups, group N received nalbuphine 0.2 mg/kg diluted in 10 ml of normal saline (n=30, and group C placebo (n=30 received 10 ml of normal saline 1 min before the induction of general anesthesia. Maternal heart rate and blood pressure were measured before, after induction, during surgery, and after recovery. Neonates were assisted by using APGAR0 scores, time to sustained respiration, and umbilical cord blood gas analysis. Result: Maternal heart rate showed significant increase in control group than nalbuphine group after intubation (88.2±4.47 versus 80.1±4.23, P<0.0001 and during surgery till delivery of baby (90.8±2.39 versus 82.6±2.60, P<0.0001 and no significant changes between both groups after delivery. MABP increased in control group than nalbuphine group after intubation (100.55±6.29 versus 88.75±6.09, P<0.0001 and during surgery till delivery of baby (98.50±2.01 versus 90.50±2.01, P<0.0001 and no significant changes between both groups after delivery. APGAR score was significantly low at one minute in nalbuphine group than control group (6.75±2.3, 8.5±0.74, respectively, P=0.0002 (27% of nalbuphine group APGAR score ranged between 4-6, while 7% in control group APGAR score ranged between 4-6 at one minute. All neonates at five minutes showed APGAR score ranged between 9-10. Time to sustained respiration was significantly longer in nalbuphine group than control group (81.8�

Acid-base changes in canine neonates following normal birth or dystocia.

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Lúcio, C F; Silva, L C G; Rodrigues, J A; Veiga, G A L; Vannucchi, C I

2009-07-01

There are limited data concerning blood gas parameters in neonatal dogs. Knowledge of the normal physiology may facilitate effective therapeutic intervention and potentially reduce neonatal mortality. This study examined acid-base parameters in pups born at normal parturition (n = 27) compared with those born after obstetrical assistance or caesarean operation (n = 13) and those born following oxytocin (OXY) administration for treatment of uterine inertia (n = 11). Pups were subjected to an objective scoring method of neonatal health adapted from use in humans (the Apgar score) at birth and again at 5 and 60 min after birth. Venous blood samples were collected at 5 and 60 min after birth for evaluation of blood gas parameters. At birth, all pups had low Apgar scores and a mixed acidosis. The base excess was lowest for pups delivered after OXY administration. The Apgar score improved for all pups after 5 min of birth and there was an improvement in carbon dioxide tension, base excess and venous blood pH at 1 h, although in all pups a metabolic acidosis persisted. These data provide an important insight into neonatal physiology and the variability of blood gas parameters in pups born at normal and abnormal parturition and provide the basis for clinical decision making following dystocia.

Predictive factors for the admission of a newborn in an intensive care unit

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Carla Danielle Ribeiro Lages

2014-04-01

Full Text Available Analytical documentary and retrospective study aiming at determining association between predictive factors for admission of a newborn in a public Intensive Care Unit and maternal features. The study sample had 376 neonates admitted in 2009. Results showed: mothers aged between 19 and 25 years (43.4%, primary education (52.4%, living with a partner (66.2%. Prenatal care was done by 84.8% of them, and 62% presented gestational pathologies. Out of all neonates, 55.1% were male, 85.4% preterm, 83% underweight, 57.2% presented respiratory problems. The bivariate analysis showed a significant association between birth weight and growth (p = 0.04 between maternal age and Apgar in the 1st minute (p = 0.04 and maternal age and Apgar score in the 5th minute (p = 0.01. Maternal age and number of prenatal appointments influence on the admission of the neonates to the Intensive Care Unit because they are related to birth weight and Apgar scores.

In patients suffering from idiopathic central serous chorioretinopathy, anxiety scores are higher than in healthy controls, but do not vary according to sex or repeated central serous chorioretinopathy.

Science.gov (United States)

Bazzazi, Nooshin; Ahmadpanah, Mohammad; Akbarzadeh, Siamak; Seif Rabiei, Mohammad Ali; Holsboer-Trachsler, Edith; Brand, Serge

2015-01-01

Idiopathic central serous chorioretinopathy (CSCR) is a relatively common ophthalmic disorder characterized by the development of a serous detachment of the sensory retina. Psychophysiological factors may trigger or maintain CSCR, though, surprisingly, the association between CSCR and anxiety has yet to be studied. The aims of the present study were threefold: to determine whether 1) Iranian patients with CSCR have higher scores for anxiety, 2) anxiety is lower, if CSCR has been experienced twice, and whether 3) anxiety scores differ between sexes. A total of 30 patients with CSCR and 30 healthy age-and sex-matched controls took part in the study. A brief face-to-face interview was conducted covering demographic variables and history and occurrence of CSCR and assessing anxiety. Compared to healthy controls, anxiety was significantly higher in both first-time and second-time CSCR patients. In CSCR patients, anxiety scores did not differ between sexes. Higher anxiety scores were observed in Iranian patients with CSCR, irrespective of whether this was the first or second occurrence of CSCR. This suggests there is no psychological adaptation in terms of reduced anxiety among patients with repeated CSCR.

birth-weight infants

African Journals Online (AJOL)

including the CRIB (Clinical Risk Index for Babies) score, in a local ... these babies for expensive tertiary care. Subjects. ... patient numbers, the tendency is simply to increase the ... included birth weight, gestational age, 5-minute Apgar score ...

Raising Test Scores vs. Teaching Higher Order Thinking (HOT): Senior Science Teachers' Views on How Several Concurrent Policies Affect Classroom Practices

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Zohar, Anat; Alboher Agmon, Vered

2018-01-01

Purpose: This study investigates how senior science teachers viewed the effects of a Raising Test Scores policy and its implementation on instruction of higher order thinking (HOT), and on teaching thinking to students with low academic achievements. Background: The study was conducted in the context of three concurrent policies advocating: (a)…

Intraplacentaert koriokarcinom

DEFF Research Database (Denmark)

Rørne, Ditte Josefine; Kirschner, Benny

2010-01-01

Choriocarcinoma is found in 1/20,000-40,000 pregnancies. The disease typically presents with symptomatic metastases. We present a case of incidentally discovered intraplacental choriocarcinoma. A gravida 7 at 35 + 4 weeks' gestation presented because of abdominal pain and decreased foetal movemen....... An acute Caesarean was performed with the delivery of a hypotonic, anaemic girl with an Apgar score of 0/1. Choriocarcinoma typically presents as yellow areas, resembling intraplacental infarction. Consequently, the incidence is probably higher than presumed....

Heart valve surgery: EuroSCORE vs. EuroSCORE II vs. Society of Thoracic Surgeons score

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Muhammad Sharoz Rabbani

2014-12-01

Full Text Available Background This is a validation study comparing the European System for Cardiac Operative Risk Evaluation (EuroSCORE II with the previous additive (AES and logistic EuroSCORE (LES and the Society of Thoracic Surgeons’ (STS risk prediction algorithm, for patients undergoing valve replacement with or without bypass in Pakistan. Patients and Methods Clinical data of 576 patients undergoing valve replacement surgery between 2006 and 2013 were retrospectively collected and individual expected risks of death were calculated by all four risk prediction algorithms. Performance of these risk algorithms was evaluated in terms of discrimination and calibration. Results There were 28 deaths (4.8% among 576 patients, which was lower than the predicted mortality of 5.16%, 6.96% and 4.94% by AES, LES and EuroSCORE II but was higher than 2.13% predicted by STS scoring system. For single and double valve replacement procedures, EuroSCORE II was the best predictor of mortality with highest Hosmer and Lemmeshow test (H-L p value (0.346 to 0.689 and area under the receiver operating characteristic (ROC curve (0.637 to 0.898. For valve plus concomitant coronary artery bypass grafting (CABG patients actual mortality was 1.88%. STS calculator came out to be the best predictor of mortality for this subgroup with H-L p value (0.480 to 0.884 and ROC (0.657 to 0.775. Conclusions For Pakistani population EuroSCORE II is an accurate predictor for individual operative risk in patients undergoing isolated valve surgery, whereas STS performs better in the valve plus CABG group.

Among perinatal factors, only the Apgar score is associated with specific language impairment

NARCIS (Netherlands)

Diepeveen, F.B.; de Kroon, M.L.A.; Dusseldorp, E.; Snik, A.F.M.

2013-01-01

Aim: The purpose of this study was to assess the relation of perinatal risk factors with later development of specific language impairment (SLI). Method: In a case-control study, 179 children attending special needs schools for SLI were matched with non-affected children attending mainstream

Among perinatal factors, only the Apgar score is associated with specific language impairment

NARCIS (Netherlands)

Diepeveen, F.B.; Kroon, M.L. De; Dusseldorp, E.; Snik, A.F.M.

2013-01-01

AIM: The purpose of this study was to assess the relation of perinatal risk factors with later development of specific language impairment (SLI). METHOD: In a case-control study, 179 children attending special needs schools for SLI were matched with non-affected children attending mainstream

Among perinatal factors, only the Apgar score is associated with specific language impairment

NARCIS (Netherlands)

Diepeveen, F.B.; Kroon, M.L. de; Dusseldorp, E.; Snik, A.F.

2013-01-01

The purpose of this study was to assess the relation of perinatal risk factors with later development of specific language impairment (SLI). METHOD: In a case-control study, 179 children attending special needs schools for SLI were matched with non-affected children attending mainstream schools.

Prenatal and neonatal adaptations with a focus on the respiratory system.

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Vannucchi, C I; Silva, L C G; Lúcio, C F; Regazzi, F M; Veiga, G A L; Angrimani, D S

2012-12-01

Among the modifications that occur during the neonatal period, pulmonary development is the most critical. The neonate's lungs must be able to perform adequate gas exchange, which was previously accomplished by the placenta. Neonatal respiratory distress syndrome is defined as insufficient surfactant production or pulmonary structural immaturity and is specifically relevant to preterm newborns. Prenatal maternal betamethasone treatment of bitches at 55 days of gestation leads to structural changes in the neonatal lung parenchyma and consequently an improvement in the preterm neonatal respiratory condition, but not to an increase in pulmonary surfactant production. Parturition represents an important challenge to neonatal adaptation, as the uterine and abdominal contractions during labour provoke intermittent hypoxia. Immediately after birth, puppies present venous mixed acidosis (low blood pH and high dioxide carbon saturation) and low but satisfactory Apgar scores. Thus, the combination of physiological hypoxia during birth and the initial effort of filling the pulmonary alveoli with oxygen results in anaerobiosis. As a neonatal adaptation follow-up, the Apgar analysis indicates a tachypnoea response after 1 h of life, which leads to a shift in the blood acid-base status to metabolic acidosis. One hour is sufficient for canine neonates to achieve an ideal Apgar score; however, a haemogasometric imbalance persists. Dystocia promotes a long-lasting bradycardia effect, slows down Apgar score progression and aggravates metabolic acidosis and stress. The latest data reinforce the need to accurately intervene during canine parturition and offer adequate medical treatment to puppies that underwent a pathological labour. © 2012 Blackwell Verlag GmbH.

Right-handers have negligibly higher IQ scores than left-handers: Systematic review and meta-analyses.

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Ntolka, Eleni; Papadatou-Pastou, Marietta

2018-01-01

The relationship between intelligence and handedness remains a matter of debate. The present study is a systematic review of 36 studies (totaling 66,108 individuals), which have measured full IQ scores in different handedness groups. Eighteen of those studies were further included in three sets of meta-analyses (totaling 20,442 individuals), which investigated differences in standardized mean IQ scores in (i) left-handers, (ii) non-right-handers, and (iii) mixed-handers compared to right-handers. The bulk of the studies included in the systematic review reported no differences in IQ scores between left- and right-handers. In the meta-analyses, statistically significant differences in mean IQ scores were detected between right-handers and left-handers, but were marginal in magnitude (d=-0.07); the data sets were found to be homogeneous. Significance was lost when the largest study was excluded. No differences in mean IQ scores were found between right-handers and non-right-handers as well as between right-handers and mixed-handers. No sex differences were found. Overall, the intelligence differences between handedness groups in the general population are negligible. Copyright © 2017 Elsevier Ltd. All rights reserved.

A scoring system for ascertainment of incident stroke; the Risk Index Score (RISc).

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Kass-Hout, T A; Moyé, L A; Smith, M A; Morgenstern, L B

2006-01-01

The main objective of this study was to develop and validate a computer-based statistical algorithm that could be translated into a simple scoring system in order to ascertain incident stroke cases using hospital admission medical records data. The Risk Index Score (RISc) algorithm was developed using data collected prospectively by the Brain Attack Surveillance in Corpus Christi (BASIC) project, 2000. The validity of RISc was evaluated by estimating the concordance of scoring system stroke ascertainment to stroke ascertainment by physician and/or abstractor review of hospital admission records. RISc was developed on 1718 randomly selected patients (training set) and then statistically validated on an independent sample of 858 patients (validation set). A multivariable logistic model was used to develop RISc and subsequently evaluated by goodness-of-fit and receiver operating characteristic (ROC) analyses. The higher the value of RISc, the higher the patient's risk of potential stroke. The study showed RISc was well calibrated and discriminated those who had potential stroke from those that did not on initial screening. In this study we developed and validated a rapid, easy, efficient, and accurate method to ascertain incident stroke cases from routine hospital admission records for epidemiologic investigations. Validation of this scoring system was achieved statistically; however, clinical validation in a community hospital setting is warranted.

Comparison of Bolus Phenylephrine, Ephedrine and Mephentermine for Maintenance of Arterial Pressure during Spinal Anesth

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B Bhattarai

2010-03-01

Full Text Available INTRODUCTION: Hypotension is common following spinal anesthesia. Various vasopressors have been indicated to prevent it. The study compares three such agents namely phenylephrine, ephedrine and mephentermine. METHODS: The study included 90 patients undergoing elective and emergency cesarean section who developed hypotension following subarachnoid blockade. Parturient were randomly divided into three groups each group had 30 patients. Group P received bolus of Phenylephrine 25 microgram, where as group E received Ephedrine 5mg and Group M received Mephentermine 6mg. RESULTS: It was found that rise of blood pressure was significantly higher in case of phenylephrine group in first six minutes, after the bolus, there was significant reduction in the heart rate in phenylephrine group, but there was tachycardia following administration of bolus ephedrine and mephenteramine. Neonatal APGAR score were similar in all three groups. CONCLUSIONS: All three drugs maintained hemodynamics within 20 percent of the baseline values on intravenous administration. Keywords: APGAR, ephedrine, hypotension, mephentermine, phenylephrine, spinal anesthesia.

Fetal cerebro-placental ratio and adverse perinatal outcome: systematic review and meta-analysis of the association and diagnostic performance.

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Nassr, Ahmed Abobakr; Abdelmagied, Ahmed M; Shazly, Sherif A M

2016-03-01

The objective of this meta-analysis is to assess the value of fetal cerebro-placental Doppler ratio (CPR) in predicting adverse perinatal outcome in pregnancies with fetal growth restriction (FGR). Three databases were used: MEDLINE, EMBASE (with online Ovid interface) and SCOPUS and studies from inception to April 2015 were included. Studies that reported perinatal outcomes of fetuses at risk of FGR or sonographically diagnosed FGR that were evaluated with CPR were considered eligible. Perinatal outcomes include cesarean section (CS) for fetal distress, APGAR scores at 5 min, neonatal complications and admission to neonatal intensive care unit (NICU). Pooled data were expressed as odds ratio (OR) and confidence intervals (CI), and the summary receiver operating characteristic (SROC) curve was used to illustrate the diagnostic accuracy of CPR. Seven studies were eligible (1428 fetuses). Fetuses with abnormal CPR were at higher risk of CS for fetal distress (OR=4.49, 95% CI [1.63, 12.42]), lower APGAR scores (OR=4.01, 95% CI [2.65, 6.08]), admission to NICU (OR=9.65, 95% CI [3.02, 30.85]), and neonatal complications (OR=11.00, 95% [3.64, 15.37]) than fetuses who had normal CPR. These risks were higher among studies that included fetuses diagnosed with FGR than fetuses at risk of FGR. Abnormal CPR had higher diagnostic accuracy for adverse perinatal outcomes among "sonographically diagnosed FGR" studies than "at risk of FGR" studies. Abnormal CPR is associated with substantial risk of adverse perinatal outcomes. The test seems to be particularly useful for follow up of fetuses with sonographically diagnosed FGR.

Impact of the Implementation of New WHO Diagnostic Criteria for Gestational Diabetes Mellitus on Prevalence and Perinatal Outcomes: A Population-Based Study

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Katja Erjavec

2016-01-01

Full Text Available Objectives. To determine the impact of the implementation of new WHO diagnostic criteria for gestational diabetes mellitus (GDM on prevalence, predictors, and perinatal outcomes in Croatian population. Methods. A cross-sectional study was performed using data from medical birth certificates collected in 2010 and 2014. Data collected include age, height, and weight before and at the end of pregnancy, while perinatal outcome was assessed by onset of labor, mode of delivery, and Apgar score. Results. A total of 81.748 deliveries and 83.198 newborns were analysed. Prevalence of GDM increased from 2.2% in 2010 to 4.7% in 2014. GDM was a significant predictor of low Apgar score (OR 1.656, labor induction (OR 2.068, and caesarean section (OR 1.567 in 2010, while in 2014 GD was predictive for labor induction (OR 1.715 and caesarean section (OR 1.458 only. Age was predictive for labor induction only in 2014 and for caesarean section in both years, while BMI before pregnancy was predictive for all observed perinatal outcomes in both years. Conclusions. Despite implementation of new guidelines, GDM remains burdened with increased risk of labor induction and caesarean section, but no longer with low Apgar score, while BMI remains an important predictor for all three perinatal outcomes.

Reference Values for the Marx Activity Rating Scale in a Young Athletic Population: History of Knee Ligament Injury Is Associated With Higher Scores.

Science.gov (United States)

Cameron, Kenneth L; Peck, Karen Y; Thompson, Brandon S; Svoboda, Steven J; Owens, Brett D; Marshall, Stephen W

2015-01-01

Activity-related patient-reported outcome measures are an important component of assessment after knee ligament injury in young and physically active patients; however, normative data for most activity scales are limited. To present reference values by sex for the Marx Activity Rating Scale (MARS) within a young and physically active population while accounting for knee ligament injury history and sex. Cross-sectional study. Level 2. All incoming freshman entering a US Service Academy in June of 2011 were recruited to participate in this study. MARS was administered to 1169 incoming freshmen (203 women) who consented to participate within the first week of matriculation. All subjects were deemed healthy and medically fit for military service on admission. Subjects also completed a baseline questionnaire that asked for basic demographic information and injury history. We calculated means with standard deviations, medians with interquartile ranges, and percentiles for ordinal and continuous variables, and frequencies and proportions for dichotomous variables. We also compared median scores by sex and history of knee ligament injury using the Kruskal-Wallis test. MARS was the primary outcome of interest. The median MARS score was significantly higher for men when compared with women (χ(2) = 13.22, df = 1, P MARS scores between men and women (χ(2) = 0.47, df = 1, P = 0.493) who reported a history of injury. Overall, median MARS scores were significantly higher among those who reported a history of knee ligament injury when compared with those who did not (χ(2) = 9.06, df = 1, P = 0.003). Assessing activity as a patient-reported outcome after knee ligament injury is important, and reference values for these instruments need to account for the influence of prior injury and sex. © 2015 The Author(s).

Two-year follow-up study on neurodevelopmental outcomes after term intrapartum asphyxia using age and stages questionnaire.

Science.gov (United States)

Keihani-Doust, Zarrin; Saeedi, Maryam; Esmaeilni, Tahere; Habibi, Massoud; Nazari, Seyed Saeed Hashemi

2013-12-01

Birth asphyxia is one of the multiple causes of neonatal encephalopathy. The objective of this study was to evaluate neurodevelopmental outcomes of newborn term infants with definitive asphyxia. Thirty infants met study criteria for asphyxia. The 5-year incidence of asphyxia was estimated to be 5.5 in 1000. According to the Age and Stage Questionnaire, 10.5% of 6-month-old infants, 14.3% of 12- and 18-month-old infants, and 5.3% of 24-month-old infants had neurodevelopmental delay in gross motor function in the absence of cerebral palsy. In 7.3% of 18-month-old infants, neurodevelopmental delay in problem-solving ability was observed. Higher values of Apgar score and bicarbonate levels were associated with higher Age and Stage Questionnaire total score. Delivery type, maternal age, gravidity of mother, and existence of mother disease during pregnancy were also associated with lower Age and Stage Questionnaire total score in different stages of life.

Planned home and hospital births in South Australia, 1991-2006: differences in outcomes.

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Kennare, Robyn M; Keirse, Marc J N C; Tucker, Graeme R; Chan, Annabelle C

2010-01-18

To examine differences in outcomes between planned home births, occurring at home or in hospital, and planned hospital births. Population-based study using South Australian perinatal data on all births and perinatal deaths during the period 1991-2006. Analysis included logistic regression adjusted for predictor variables and standardised perinatal mortality ratios. Perinatal death, intrapartum death, death attributed to intrapartum asphyxia, Apgar score home births accounted for 0.38% of 300,011 births in South Australia. They had a perinatal mortality rate similar to that for planned hospital births (7.9 v 8.2 per 1000 births), but a sevenfold higher risk of intrapartum death (95% CI, 1.53-35.87) and a 27-fold higher risk of death from intrapartum asphyxia (95% CI, 8.02-88.83). Review of perinatal deaths in the planned home births group identified inappropriate inclusion of women with risk factors for home birth and inadequate fetal surveillance during labour. Low Apgar scores were more frequent among planned home births, and use of specialised neonatal care as well as rates of postpartum haemorrhage and severe perineal tears were lower among planned home births, but these differences were not statistically significant. Planned home births had lower caesarean section and instrumental delivery rates, and a seven times lower episiotomy rate than planned hospital births. Perinatal safety of home births may be improved substantially by better adherence to risk assessment, timely transfer to hospital when needed, and closer fetal surveillance.

The origins of mental toughness – prosocial behavior and low internalizing and externalizing problems at age 5 predict higher mental toughness scores at age 14

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Dena Sadeghi Bahmani

2016-08-01

Full Text Available Background: The concept of mental toughness has gained increasing importance among groups other than elite athletes by virtue of its psychological importance and explanatory power for a broad range of health-related behaviors. However, no study has focused so far on the psychological origins of mental toughness. Therefore, the aims of the present study were: to explore, to what extent the psychological profiles of preschoolers aged five were associated with both 1 mental toughness scores and 2 sleep disturbances at age 14, and 3 to explore possible gender differences.Method: Nine years after their first assessment at age five (preschoolers, a total of 77 adolescents (mean age: 14.35 years; SD = 1.22; 42% females took part in this follow-up study. At baseline, both parents and teachers completed the Strengths and Difficulties Questionnaire (SDQ, covering internalizing and externalizing problems, hyperactivity, negative peer relationships, and prosocial behavior. At follow-up, participants completed a booklet of questionnaires covering socio-demographic data, mental toughness, and sleep disturbances.Results: Higher prosocial behavior, lower negative peer relationships, and lower internalizing and externalizing problems at age five, as rated by parents and teachers, were associated with self-reported higher mental toughness and lower sleep disturbances at age 14. At age 14, and relative to males, females had lower MT scores and reported more sleep disturbances.Results: Higher prosocial behavior, lower negative peer relationships, and lower internalizing and externalizing problems at age five, as rated by parents and teachers, predicted self-reported higher mental toughness and lower sleep disturbances at age 14. At age 14, and relative to males, females had lower MT scores and reported more sleep disturbance.Conclusions: The pattern of results suggests that mental toughness traits during adolescence may have their origins in the pre-school years.

Maternal and neonatal outcomes in birth centers versus hospitals among women with low-risk pregnancies in Japan: A retrospective cohort study.

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Kataoka, Yaeko; Masuzawa, Yuko; Kato, Chiho; Eto, Hiromi

2018-01-01

In order for low-risk pregnant women to base birth decisions on the risks and benefits, they need evidence of birth outcomes from birth centers. The purpose of this study was to describe and compare the maternal and neonatal outcomes of low-risk women who gave birth in birth centers and hospitals in Japan. The participants were 9588 women who had a singleton vaginal birth at 19 birth centers and two hospitals in Tokyo. The data were collected from their medical records, including their age, parity, mode of delivery, maternal position at delivery, duration of labor, intrapartum blood loss, perineal trauma, gestational weeks at birth, birth weight, Apgar score, and stillbirths. For the comparison of birth centers with hospitals, adjusted odds ratios for the birth outcomes were estimated by using a logistic regression analysis. The number of women who had a total blood loss of >1 L was higher in the midwife-led birth centers than in the hospitals but the incidence of perineal lacerations was lower. There were fewer infants who were born at the midwife-led birth centers with Apgar scores of birth centers and hospitals. Additional research, using matched baseline characteristics, could clarify the comparisons for maternal and neonatal outcomes. © 2017 Japan Academy of Nursing Science.

Smoking habit and psychometric scores: a community study.

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Waal-Manning, H J; de Hamel, F A

1978-09-13

During the Milton health survey subjects completed a psychometric inventory consisting of the 48 questions of the Middlesex Hospital questionnaire (MHQ) and 26 from the hostility and direction of hostility questionnaire (HDHQ) designed to examine nine psychological dimensions. The 1209 subjects were classified into smoking categories and the scores for each psychometric trait were calculated. Women scored higher than men and heavy smokers scored higher than "never smokers". The psychometric traits and the scores of the four smoking categories after correcting for age and Quetelet's index showed statistically significant differences by analysis of variance in respect of somatic anxiety and depression for both men and women; and free-floating anxiety, phobic anxiety, hysteria, acting out hostility, self criticism and guilt in women. For somatic anxiety the increase in score almost exactly paralleled the increasing quantity of tobacco consumed.

Sonographic biophysical profile in detection of foetal hypoxia in 100 cases of suspected high risk pregnancy

International Nuclear Information System (INIS)

Ullah, N.; Khan, A.R.; Usman, M.

2010-01-01

Background: The foetus has become increasingly accessible and visible as a patient over the last two decades. Ultrasound imaging has broadened the scope of foetal assessment. Dynamic real time B-Mode ultrasound is used to monitor cluster of biophysical variables, both dynamic and static collectively termed as biophysical profile. The purpose of this study was to determine the effect of sonographic biophysical profile score on perinatal outcome in terms of mortality and morbidity. Methods: This descriptive study was carried on 100 randomly select ed high risk pregnant patients in Radiology Department PGMI, Government Lady Reading Hospital, Peshawar from December 2007 to June 2008. Manning biophysical profile including non-stress was employed for foetal screening, using Toshiba ultrasound machine model Nemio SSA-550A and 7.5 MHZ probe. Results: Out of 100 cases 79 (79%) had a normal biophysical profile in the last scan of 10/10 and had a normal perinatal outcome with 5 minutes Apgar score >7/10. In 13 (13%) cases Apgar score at 5 minute was < 7/10 and babies were shifted to nursery. There were 2 (2%) false positive cases that showed abnormal biophysical profile scores of 6/10 but babies were born with an Apgar score of 8/10 at 5 minutes. There were 2 (2%) neonatal deaths in this study group. The sensitivity of biophysical profile was 79.1%, specificity 92.9%. Predictive value for a positive test was 98.55%; predictive value for a negative test was 41.93%. Conclusion: Biophysical profile is highly accurate and reliable test of diagnosing foetal hypoxia. (author)

Association of Fellowship Training With Otolaryngology Training Examination Scores.

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Akinboyewa, Ibukun; Cabrera-Muffly, Cristina

2016-03-01

No prior studies have evaluated whether residents who pursue fellowship training achieve higher performance on the Otolaryngology Training Examination (OTE) and whether a specific fellowship will demonstrate a correlation with the corresponding specialty-specific OTE score. To determine whether residents pursuing fellowship training achieve higher performance on the OTE and whether fellowship choice is correlated with higher scores on the related subspecialty section of the OTE. This retrospective analysis included 35 residents training in an academic otolaryngology residency program from July 1, 2003, to June 30, 2014. The OTE scores for postgraduate years 2 through 5 and the type of fellowship were collected for all residents meeting inclusion criteria. Data were collected from September 1 to October 15, 2014, and analyzed from October 16 to December 1, 2014. Residents were divided by whether they pursued fellowship training and by the type of fellowship chosen. Outcome measures included comparison of scores between residents who pursued vs those who did not pursue fellowship training and comparison of subspecialty OTE scores between residents who pursued the corresponding fellowship and those who did not. Of the 35 residents who met the inclusion criteria (24 men and 11 women), 17 (49%) pursued fellowship training. The 3 most common fellowship choices were facial plastic and reconstructive surgery, pediatric otolaryngology, and rhinology (4 residents each [24%]). For all residents, mean scores on the OTE improved each subsequent training year, but this difference was only significant between postgraduate years 2 and 3 (from 60.9% to 68.6% correct; P otolaryngology, 72.9% vs 71.3% [P = .79]; and for rhinology, 72.2% vs 71.2% [P = .91]). Residents who pursued fellowship training did not achieve higher scores on the OTE in any examination year compared with residents who did not pursue fellowship training and did not achieve higher scores within the OTE

Birth characteristics and Wilms tumors in children in the Nordic countries

DEFF Research Database (Denmark)

Schüz, Joachim; Schmidt, Lisbeth Samsø; Kogner, Per

2011-01-01

during 1985-2006, individually matched to five controls drawn randomly from the Nordic childhood population. Information on birth characteristics was obtained from the population-based medical birth registries. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using conditional logistic......-based study, we confirmed earlier observations of an association between high birth weight and risk of Wilms tumor, but we found an effect only in girls. The higher risk of infants with low Apgar score might reflect hypoxia causing cell damage, adverse side effects of neonatal treatment or reverse causation...

Profile of newborns undergoing early stimulation in a neonatal intensive care unit

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Karla Camila Lima de Souza

2014-09-01

Full Text Available Objective: To describe the profile of newborns undergoing early stimulation in a neonatal intensive care unit, characterizing the study population according to their neonatal variables and risk factors indicative for the early stimulation treatment. Methods: Cross-sectional and analytical study, held in a reference hospital of Fortaleza, in the period from February to March 2011, with sample consisting of 116 medical records of newborns indicated for the early stimulation treatment. The following variables were analyzed: weight, sex, gestational age, Apgar score, diagnosis of Respiratory Distress Syndrome and Intracranial Hemorrhage, use of mechanical ventilation and continuous positive airway pressure (CPAP. The variables were analyzed using Microsoft Excel™ 2007 software to obtain mean and mode. Results: Among the studied variables, there was a prevalence of low birth weight, prematurity and male newborns. According to the Apgar score, scores of 1st and 5th minutes showed increasing values. Regarding the studied pathologies, the Respiratory Distress Syndrome stands out as the most prevalent, followed by Intracranial Hemorrhage. Concerning the use of mechanical ventilation, CPAP was the most frequently indicated modality, followed by mechanical ventilation. Conclusion: The profile of newborns investigated in this study, which underwent early stimulation in a neonatal intensive care, is represented by male, premature, low weight and high rate of Apgar score at 1st and 5th minutes, with prevalence of respiratory distressand increased use of CPAP. doi:http://dx.doi.org/10.5020/18061230.2013.p523

[Intrapartum amnioinfusion in patients with meconium-stained amniotic fluid].

Science.gov (United States)

Engel, Karina; Samborska, Monika; Bilar, Marek; Sipak-Szmigiel, Olimpia; Ronin-Walknowska, Elzbieta

2008-09-01

The aim of the study was to evaluate the effect of intrapartum amnioinfusion in the presence of meconium stained amniotic fluid. 93 women with meconium-stained amniotic fluid were assigned to receive amnioinfusion or no amnioinfusion (128 women). The trials were evaluated for fetal distress syndrome, route of delivery, fetal acidemia, Apgar score at 1 and 5 min., meconium aspiration syndrome, postpartum endometritis and maternal hospital stays. Amnioinfusion in cases of meconium-stained fluid did not improve the number of fetal distress symptoms during fetal heart rate monitoring. Amnioinfusion was associated with a significant decrease of neonatal acidemia although it did not improve Apgar score. In our study amnioinfusion was not associated with reduction in the incidence of neonatal outcome and puerperial complications.

Survey of Pregnancy Outcome in Preterm Premature Rupture of Membranes with Amniotic Fluid Index <5 and ≥5

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Fatemeh Tavassoli

2010-04-01

Full Text Available Objectives: Preterm premature rupture of membranes (PPROM is among the most important causes of perinatal morbidity and mortality. The aim of this study is to survey the pregnancy outcomes in preterm premature rupture of membranes with an amniotic fluid index of 5.Methods: This prospective cohort study was performed on 137 pregnant women complicated by preterm premature rupture of membranes (PPROM with a gestational age of 28-34 weeks during October 2006 to October 2008. The patients were divided in two groups according to their amniotic fluid index; AFI<5 (77cases, AFI≥5 (60cases. The Chi-squared test for qualitative variables and T-student test for quantitative variables were used to analyze the results.Results: The results showed that there was no significant difference in terms of the number of pregnancies, gestational age at rupture of membranes and birthweight between the two groups. However, the results demonstrated that the patients with AFI<5 exhibited a significantly shorter latency period (p=0.049, a higher rate of cesarean due to fetal distress (p=0.008, a lower neonatal Apgar score in the first minute (p=0.0127 and a higher rate of neonatal death during the first week (p=0.045.Conclusion: Overall, PPROM with oligohydroamnios is associated with shorter latency, higher rate of C/S, higher rate of early neonatal death and lower neonatal Apgar.

Síndrome de aspiração meconial - experiência de um centro terciário

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M.C. Espinheira

2011-03-01

Full Text Available Resumo: Introdução: Aproximadamente 5% dos recém-nascidos com evidência de mecónio no líquido amniótico desenvolvem a síndrome de aspiração meconial (SAM. Objectivos: Conhecer os dados demográficos, a morbilidade e mortalidade na dependência da SAM e identificar possíveis factores de risco. Métodos: : Estudo retrospectivo dos recém-nascidos com SAM nascidos num hospital terciário entre 1 de Janeiro de 1997 e 31 de Dezembro de 2008. Resultados: A SAM foi responsável por 1,4% das admissões na Unidade de Cuidados Intensivos Neonatais (UCIN, verificando-se uma tendência para o decréscimo no número de internamentos ao longo dos anos, principalmente dos casos com líquido amniótico tingido de mecónio. No período de estudo foram analisados 72 recém-nascidos: 55,6% do sexo feminino, 62,5% com parto por cesariana, 93% com idade gestacional > 36 semanas e 91,2% com peso ao nascimento > 2500 g. 69% dos recém-nascidos apresentaram Índice de Apgar 36 weeks of gestational age and 91.2% had a birth weight over 2500 g. Sixty-nine percent had an Apgar score < 7 at 1 minute and 23.6% an Apgar score < 7 at 5 minutes; foetal bradicardia was present in 26.4% of the newborns and tachycardia in 1.4%. The presence of meconium was associated with severe asphyxia and carried a bad prognosis with an increased risk of developing hypoxia (58.3%, need of mechanical ventilatory support (43.1%, respiratory and/or metabolic acidosis (30.6%, pulmonary hypertension (11.1% and hypoxic ischemic encephalopathy (29.2%. The mortality rate was 2.8%. Thick meconium was associated with higher morbidity and mortality rates. Conclusion: The number of admissions for MAS has been decreasing mostly because of a lower admission rate due to thin meconium; the number of cases with thick meconium has remained constant throughout the years. An Apgar score < 7 at 1 minute and signs of foetal distress during labour were associated with MAS. The MAS related morbidity

Tuberous Sclerosis Complex National Database

Science.gov (United States)

2006-10-01

attendees and a live demonstration was conducted. User manuals were also distributed. Simultaneously with DB development, TSA has revised a...Meconium present Low Apgar scores 1-minute score _____ Unknown 5-minute score _____ Unknown Resuscitation: Major Minor...this system manually , even if that data ap- pears in an electronic medical record. No Development of Questionnaire The TSA may choose to use a

Consumption of Low-Calorie Sweeteners among U.S. Adults Is Associated with Higher Healthy Eating Index (HEI 2005 Scores and More Physical Activity

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Adam Drewnowski

2014-10-01

Full Text Available The possibility that low-calorie sweeteners (LCS promote lower quality diets and, therefore, weight gain has been noted as a cause for concern. Data from a representative sample of 22,231 adults were obtained from five cycles of the National Health and Nutrition Examination Survey (1999–2008 NHANES. A single 24-hour recall was used to identify consumers of LCS beverages, foods and tabletop sweeteners. Diet quality was assessed using the Healthy Eating Index 2005 (HEI 2005 and its multiple subscores. Health behaviors of interest were physical activity, smoking and alcohol use. LCS consumers had higher HEI 2005 scores than did non-consumers, largely explained by better SoFAAS subscores (solid fats, added sugar and alcohol. LCS consumers had better HEI subscores for vegetables, whole grains and low-fat dairy, but worse subscores for saturated fat and sodium compared to non-consumers. Similar trends were observed for LCS beverages, tabletop LCS and LCS foods. Consumers of LCS were less likely to smoke and were more likely to engage in recreational physical activity. LCS use was associated with higher HEI 2005 scores, lower consumption of empty calories, less smoking and more physical activity.

Consumption of low-calorie sweeteners among U.S. adults is associated with higher Healthy Eating Index (HEI 2005) scores and more physical activity.

Science.gov (United States)

Drewnowski, Adam; Rehm, Colin D

2014-10-17

The possibility that low-calorie sweeteners (LCS) promote lower quality diets and, therefore, weight gain has been noted as a cause for concern. Data from a representative sample of 22,231 adults were obtained from five cycles of the National Health and Nutrition Examination Survey (1999-2008 NHANES). A single 24-hour recall was used to identify consumers of LCS beverages, foods and tabletop sweeteners. Diet quality was assessed using the Healthy Eating Index 2005 (HEI 2005) and its multiple subscores. Health behaviors of interest were physical activity, smoking and alcohol use. LCS consumers had higher HEI 2005 scores than did non-consumers, largely explained by better SoFAAS subscores (solid fats, added sugar and alcohol). LCS consumers had better HEI subscores for vegetables, whole grains and low-fat dairy, but worse subscores for saturated fat and sodium compared to non-consumers. Similar trends were observed for LCS beverages, tabletop LCS and LCS foods. Consumers of LCS were less likely to smoke and were more likely to engage in recreational physical activity. LCS use was associated with higher HEI 2005 scores, lower consumption of empty calories, less smoking and more physical activity.

Greater Independence in Activities of Daily Living is Associated with Higher Health-Related Quality of Life Scores in Nursing Home Residents with Dementia

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Charice S. Chan

2015-06-01

Full Text Available Health-related quality of life (HRQL for nursing home residents is important, however, the concept of quality of life is broad, encompasses many domains and is difficult to assess in people with dementia. Basic activities of daily living (ADL are measured routinely in nursing homes using the Resident Assessment Instrument-Minimum Data Set Version 2.0 (RAI-MDS and Functional Independence Measure (FIM instrument. We examined the relationship between HRQL and ADL to assess the future possibility of ADL dependency level serving as a surrogate measure of HRQL in residents with dementia. To assess ADL, measures derived from the RAI-MDS and FIM data were gathered for 111 residents at the beginning of our study and at 6-month follow-up. Higher scores for independence in ADL were correlated with higher scores for a disease-specific HRQL measure, the Quality of Life—Alzheimer’s Disease Scale. Preliminary evidence suggests that FIM-assessed ADL is associated with HRQL for these residents. The associations of the dressing and toileting items with HRQL were particularly strong. This finding suggests the importance of ADL function in HRQL. The RAI-MDS ADL scales should be used with caution to evaluate HRQL.

Predicting adverse obstetric outcome after early pregnancy events and complications: a review

DEFF Research Database (Denmark)

van Oppenraaij, R H F; Jauniaux, E; Christiansen, O B

2009-01-01

score after detection of an intrauterine haematoma, the risk of VPTD and intrauterine growth restriction after a crown-rump length discrepancy, the risk of VPTD, LBW and VLBW after a vanishing twin phenomenon and the risk of PTD, LBW and low 5-min Apgar score in a pregnancy complicated by severe...

The effects of epidural/spinal opioids in labour analgesia on neonatal outcomes: a meta-analysis of randomized controlled trials.

Science.gov (United States)

Wang, Kai; Cao, Liang; Deng, Qian; Sun, Li-Qiang; Gu, Tian-Yu; Song, Jie; Qi, Dun-Yi

2014-08-01

Epidural/spinal opioids are increasingly used to relieve parturients' pain in labour. Some studies indicate that opioids can induce side effects in neonates, such as respiratory depression and neurobehavioural changes. This meta-analysis aimed to clarify the effects of opioids in labour analgesia on neonates. PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and EMBASE™ were searched for relevant randomized controlled trials (RCTs). The neonatal data of Apgar scores, Neurological and Adaptive Capacity Scores (NACS), and umbilical cord pH values were extracted. Statistical analyses were carried out using Review Manager 5.2 and Stata(®) 10. Twenty-one trials with 2,859 participants were included in our meta-analysis. No difference in the incidence of Apgar scores analgesia are safe for neonates up to 24 hr after delivery. In future studies, more attention should be paid to the long-term side effects in neonates.

Hepatic Dysfunction in Asphyxiated Neonates: Prospective Case-Controlled Study

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Mukesh Choudhary

2015-01-01

Full Text Available Objective This study was performed to determine the occurrence of hypoxic hepatitis in full-term neonates after perinatal asphyxia and to correlate between the rise in enzymes and severity of asphyxia with Apgar score and hypoxic ischemic encephalopathy (HIE grading of the neonates. Method and Material This prospective case-controlled study was conducted in a tertiary-level hospital in India for a period of 12 months. The study group A comprised 70 newborns suffering from birth asphyxia, while 30 healthy neonates were included in group B (control. All biochemical parameters of liver function, ie, serum alanine transferase (ALT, aspartate transferase (AST, alkaline phosphatase (ALP, lactate dehydrogenase (LDH, total protein, serum albumin, bilirubin (total and direct, and international normalized ratio (INR, were measured on postnatal days 1, 3, and 10 in both study and control groups. Results In group A, 22.8% newborns had severe (Apgar score 0–3, 47.1% had moderate (Apgar score 4–5, and 30% had mild (Apgar score 6–7 birth asphyxia at five minutes. In all, 14.28% babies were in HIE stage I, 25.73% babies were in HIE stage II, and 11.42% babies were in HIE stage III. The rest of the newborns, 48.57%, were normal. The prevalence of liver function impairment was seen in 42.85% of asphyxiated neonates. On day 1, ALT, AST, ALP, LDH, PT, and INR were significantly higher, and total protein and serum albumin were significantly lower in group A than in group B. However, ALT and AST correlated well with increasing severity of HIE score. On day 3, there was a rising trend observed in the concentration of mean LDH as HIE staging of neonates progressed from stage 0 to stage III, and among various HIE stages, the difference in LDH was statistically significant. Conclusion We concluded that AST, ALT at 24 hours, and LDH at 72 hours of animation can be a utilitarian diagnostic tool to differentiate asphyxiated neonates from non-asphyxiated neonates and

Comparing continuous and dichotomous scoring of the balanced inventory of desirable responding.

Science.gov (United States)

Stöber, Joachim; Dette, Dorothea E; Musch, Jochen

2002-04-01

The Balanced Inventory of Desirable Responding (BIDR; Paulhus, 1994) is a widely used instrument to measure the 2 components of social desirability: self-deceptive enhancement and impression management. With respect to scoring of the BIDR, Paulhus (1994) authorized 2 methods, namely continuous scoring (all answers on the continuous answer scale are counted) and dichotomous scoring (only extreme answers are counted). In this article, we report 3 studies with student samples, and continuous and dichotomous scoring of BIDR subscales are compared with respect to reliability, convergent validity, sensitivity to instructional variations, and correlations with personality. Across studies, the scores from continuous scoring (continuous scores) showed higher Cronbach's alphas than those from dichotomous scoring (dichotomous scores). Moreover, continuous scores showed higher convergent correlations with other measures of social desirability and more consistent effects with self-presentation instructions (fake-good vs. fake-bad instructions). Finally, continuous self-deceptive enhancement scores showed higher correlations with those traits of the Five-factor model for which substantial correlations were expected (i.e., Neuroticism, Extraversion, and Conscientiousness). Consequently, these findings indicate that continuous scoring may be preferable to dichotomous scoring when assessing socially desirable responding with the BIDR.

Higher Mobility Scores in Patients with Cystic Fibrosis Are Associated with Better Lung Function

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Aneesha Thobani

2015-01-01

Full Text Available Objective. The purpose of this study was to determine whether mobility and physical activity were associated with lung function in adults with cystic fibrosis (CF. Design. This was a prospective cohort observational study in an urban, academic, specialized care center. Participants were ambulatory, nonhospitalized adults with CF. Main Outcome Measures. Mobility was assessed monthly by the Life-Space Assessment (LSA questionnaire and quarterly by pedometer. Lung function was assessed by spirometry. Results. Twenty-seven subjects participated. Subjects recorded mean pedometer steps of 20,213 ± 11,331 over three days and FEV1% predicted of 77.48% ± 22.60% over one year. The LSA score at enrollment was correlated with initial pedometer steps (r=0.42 and P=0.03, and mean LSA score over one year was correlated with mean number of steps (r=0.51 and P=0.007. LSA mobility and pedometer scores were correlated with FEV1% predicted at enrollment and throughout the study. Conclusions. Mobility and physical activity measured by LSA questionnaire and pedometer are positively associated with lung function in adults with CF. This study confirms the importance of mobility and physical activity and supports the utility of a simple office-based questionnaire as a measure of mobility in adults with CF.

Higher mobility scores in patients with cystic fibrosis are associated with better lung function.

Science.gov (United States)

Thobani, Aneesha; Alvarez, Jessica A; Blair, Shaina; Jackson, Kaila; Gottlieb, Eric R; Walker, Seth; Tangpricha, Vin

2015-01-01

The purpose of this study was to determine whether mobility and physical activity were associated with lung function in adults with cystic fibrosis (CF). This was a prospective cohort observational study in an urban, academic, specialized care center. Participants were ambulatory, nonhospitalized adults with CF. Mobility was assessed monthly by the Life-Space Assessment (LSA) questionnaire and quarterly by pedometer. Lung function was assessed by spirometry. Twenty-seven subjects participated. Subjects recorded mean pedometer steps of 20,213 ± 11,331 over three days and FEV1% predicted of 77.48% ± 22.60% over one year. The LSA score at enrollment was correlated with initial pedometer steps (r = 0.42 and P = 0.03), and mean LSA score over one year was correlated with mean number of steps (r = 0.51 and P = 0.007). LSA mobility and pedometer scores were correlated with FEV1% predicted at enrollment and throughout the study. Mobility and physical activity measured by LSA questionnaire and pedometer are positively associated with lung function in adults with CF. This study confirms the importance of mobility and physical activity and supports the utility of a simple office-based questionnaire as a measure of mobility in adults with CF.

Intelligence Score Profiles of Female Juvenile Offenders

Science.gov (United States)

Werner, Shelby Spare; Hart, Kathleen J.; Ficke, Susan L.

2016-01-01

Previous studies have found that male juvenile offenders typically obtain low scores on measures of intelligence, often with a pattern of higher scores on measures of nonverbal relative to verbal tasks. The research on the intelligence performance of female juvenile offenders is limited. This study explored the Wechsler Intelligence Scale for…

Impact of the mode of delivery on maternal and neonatal outcome in spontaneous-onset breech labor at 32+0-36+6 weeks of gestation: A retrospective cohort study.

Science.gov (United States)

Toivonen, Elli; Palomäki, Outi; Korhonen, Päivi; Huhtala, Heini; Uotila, Jukka

2018-03-30

To compare neonatal and maternal outcomes in spontaneously onset preterm breech deliveries after trial of labor (BTOL) and intended cesarean section (BCS), and between BTOL and vertex control deliveries, in singleton fetuses at 32 +0 -36 +6  weeks of gestation. Retrospective single center cohort study in a Finnish University Hospital including all spontaneous-onset preterm breech deliveries with 32 completed gestational weeks in 2003-2015. The study population comprised a total of 176 preterm breech and 103 vertex control deliveries, matched by gestational age and whether the mother had given birth vaginally before or not. Infants with severe malformations and antepartum fetal distress were excluded. Subgroup analyses were made in two cohorts according to gestational age. Main outcome measures were maternal and neonatal mortality and morbidity, low cord pH and Apgar score. No mortality was observed, and severe morbidity was rare. No difference in incidence of low cord pH or five-minute Apgar score was observed between the groups. Apgar scores at the age of one minute were comparable in the breech groups but more often low in the BTOL group compared to the vertex control group. 16.5% of neonates in the BTOL group, 23.3% in the BCS group and 7.8% in the vertex group needed intensive care. In logistic regression analysis, lower gestational age and being small for gestational age were associated with the need for neonatal intensive care. Being allowed a trial of labor was not associated with the need for neonatal intensive care. Maternal morbidity was similar across the groups, but median blood loss was more pronounced in the BCS group compared to the BTOL group. In breech deliveries at 32 +0 -36 +6 gestational weeks, trial of labor did not increase neonatal morbidity compared to intended cesarean delivery. Infants born after a trial of labor in breech presentation display low one-minute Apgar score and need intensive care more often compared to vertex controls

LABOUR TERMINATION AND PERINATAL OUTCOME IN PREGNANT WOMEN WITH PLACENTA ABRUPTION WITH PPROM AND PROM

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Ranko Kutlesic

2007-10-01

Full Text Available Placenta abruption is an obstetric accident which endangers life and health of both mother and embryo. It is one of the most serious obstetric complications, whose incidence ranges from 4.9-12.9 per 1,000 labours, and according to frequency, it represents the second cause of perinatal death. Retrospective analysis included the interval from 1996 to 2005. Total number of labours was analyzed and it was 32358. In addition, the number of labours complicated by placenta abruption was analyzed, and it was 119 or 0.37%. It analyzed the incidence of placenta abruption according to age of pregnancy and the integrity of embryonic membranes. It is established that there is no statistically significant difference in the incidence of placenta abruption appearing in pregnant women, with and without the disruption of embryonic membranes. The age of pregnant women was also analyzed, and it was found out that the pregnant women with placenta abruption and PPROM were 5 years older than those with placenta abruption without PPROM, and that this difference was very significant. Disruption duration was analyzed as well as the time from the first uterus bleeding to labour. The difference between PPROM and PROM duration was statistically significant, as well as the difference in duration between spontaneous and artificial rupture of embryonic membranes. The way of labour termination was analyzed in pregnant women with verified placenta abruption. In 80% of pregnant women, the labour was terminated by Caesarian section, and only 20% by vaginal labour. Also, the perinatal outcome was analyzed, according to Apgar score in the first and fifth minute. Apgar score showed that out of the total number of abruptions, 7 neonatuses was born dead (11.66%, 13 (21.66% was born in good condition (Apgar score>7, 26 (43.33% was marked with 4-7, while 14 (23.33% was in hard asphyxia (Apgar score 1-5.

Early postpartum eclampsia complicated by subarachnoid ...

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Adele

2,1kg infant was delivered vaginally with an APGAR score of. 10. The patient's blood ... arachnoid haemorrhage (SAH), cerebral oedema and acute hy- drocephalus. ... poorly understood. Intracranial .... hydrocephalus and eclampsia. Can Med ...

Walk Score® and Transit Score® and Walking in the Multi-Ethnic Study of Atherosclerosis

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Hirsch, Jana A.; Moore, Kari A.; Evenson, Kelly R.; Rodriguez, Daniel A; Diez Roux, Ana V.

2013-01-01

Background Walk Score® and Transit Score® are open-source measures of the neighborhood built environment to support walking (“walkability”) and access to transportation. Purpose To investigate associations of Street Smart Walk Score and Transit Score with self-reported transport and leisure walking using data from a large multi-city and diverse population-based sample of adults. Methods Data from a sample of 4552 residents of Baltimore MD; Chicago IL; Forsyth County NC; Los Angeles CA; New York NY; and St. Paul MN from the Multi-Ethnic Study of Atherosclerosis (2010–2012) were linked to Walk Score and Transit Score (collected in 2012). Logistic and linear regression models estimated ORs of not walking and mean differences in minutes walked, respectively, associated with continuous and categoric Walk Score and Transit Score. All analyses were conducted in 2012. Results After adjustment for site, key sociodemographic, and health variables, a higher Walk Score was associated with lower odds of not walking for transport and more minutes/week of transport walking. Compared to those in a “walker’s paradise,” lower categories of Walk Score were associated with a linear increase in odds of not transport walking and a decline in minutes of leisure walking. An increase in Transit Score was associated with lower odds of not transport walking or leisure walking, and additional minutes/week of leisure walking. Conclusions Walk Score and Transit Score appear to be useful as measures of walkability in analyses of neighborhood effects. PMID:23867022

Author Details

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Sultan, SO. Vol 5 (2014) - Articles Assessing birth asphyxia using strictly observational signs, the ARC and AC scores versus Apgar score. Abstract. ISSN: 1821-7613. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and ...

Perinatal outcome of pregnancies complicated by threatened abortion.

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Verma, S K; Premi, H K; Gupta, T V; Thakur, S; Gupta, K B; Randhawa, I

1994-11-01

One hundred and two cases of viable pregnancies with threatened abortion were studied in the department of obstetrics and gynaecology, Kamla Nehru Hospital, IG Medical College, Shimla between November 1987 and February 1989 and their perinatal outcome was evaluated. The pregnancies continued beyond 28 weeks in 61.7% of the cases. The incidence of prematurity was 19.0%. The incidence of low birth weight (LBW) babies was 23.8%. Apgar score was less than 7 in 22.3%. The incidence of neonatal complications was 25.3%. There was no perinatal mortality. In a control group of 50 cases, the incidence of prematurity and LBW was 8% and 4% respectively. Apgar score less than 7 was noted in 4% and neonatal complications were observed only in 4% of newborns.

The effect of routine early amniotomy on spontaneous labor: a meta-analysis.

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Brisson-Carroll, G; Fraser, W; Bréart, G; Krauss, I; Thornton, J

1996-05-01

To obtain estimates of the effects of amniotomy on the risk of cesarean delivery and on other indicators of maternal and neonatal morbidity (Apgar score less than 7 at 5 minutes, admission to neonatal intensive care unit [NICU]). Published studies were identified through manual and computerized searches using Medline and the Cochrane Collaboration Pregnancy and Childbirth Database. Our search identified ten trials, all published in peer-reviewed journals. Trials were assigned a methodological quality score based on a standardized rating system. Three trials were excluded from the analysis for methodological limitations. Data were abstracted by two trained reviewers. Typical odds ratios (OR) were calculated. Amniotomy was associated with a reduction in labor duration varying from 0.8-2.3 hours. There was a nonstatistically significant increase in the risk of cesarean delivery; OR 1.2, 95% confidence interval (CI) 0.9-1.6. The risk of a 5-minute Apgar score less than 7 was reduced in association with early amniotomy (OR 0.5, 95% CI 0.3-0.9). Groups were similar with respect to other indicators of neonatal status (arterial cord pH, NICU admissions). Routine early amniotomy is associated with both benefits and risks. Benefits include a reduction in labor duration and a possible reduction in abnormal 5-minute Apgar scores. This meta-analysis provides no support for the hypothesis that routine early amniotomy reduces the risk of cesarean delivery. An association between early amniotomy and cesarean delivery for fetal distress was noted in one large trial, suggesting that amniotomy should be reserved for patients with abnormal labor progress.

The Effect of Foot Reflexology on Anxiety, Pain, and Outcomes of the Labor in Primigravida Women

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Soheila Moghimi-Hanjani

2015-10-01

Full Text Available Reflexology is a technique used widely as one of non-pharmacological pain managementtechniques. The present study aimed to review and determine the effect of foot reflexology on anxiety, painand outcomes of the labor in primigravida women. This clinical trial study was conducted on 80 primigravidamothers who were divided randomly into an intervention group (Foot reflexology applied for 40 min, n=40and control group (n=40. The pain intensity was scored immediately after the end of intervention and at 30,60 and 120 min after the intervention in both groups, based on McGill Questionnaire for Pain Rating Index(PRI. Spielberger State-Trait Anxiety Inventory (STAI was completed before and after intervention in bothgroups. Duration of labor phases, the type of labor and Apgar scores of the infant at the first and fifth minutewere recorded in both groups. Descriptive and inferential statistics methods (t-test and chi-square test wereapplied in analyzing data. Application of reflexology technique decreased pain intensity (at 30, 60 and 120min after intervention and duration of labor as well as anxiety level significantly (Psignificant difference was observed between two groups in terms of the frequency distribution of the type oflabor and Apgar score (Pduration of labor, anxiety, frequency distribution of natural delivery and increases Apgar scores. Using thisnon-invasive technique, obstetricians can achieve, to some extent, to one of the most important goals ofmidwifery as pain relief and reducing anxiety during labor and encourage the mothers to have a vaginaldelivery.

The Patient Health Questionnaire (PHQ-9) scores and the lifestyles of nursing students.

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Urasaki, Midori; Oshima, Nozomi; Okabayashi, Ayako; Sadatsune, Mai; Shibuya, Aki; Nishiura, Akina; Takao, Toshihiro

2009-08-01

The objective of this investigation was to examine depression in, and the lifestyles of, 260 college students of a nursing school in nonclinical settings. The principal measure of depressive symptoms was the 9-item depression module from the Patient Health Questionnaire (PHQ-9). Additional questions were focused on current stress levels and sleeping, eating, and exercising habits. One hundred and fifty-two college students finally participated. Overall, the average PHQ-9 score was 7.7 +/- 5.1 (SD). The students with PHQ-9 scores of 15 or higher were 9.2%. The average PHQ-9 scores in the 1st school year were significantly higher than those of the 4th school year. The students feeling stressed had significantly higher PHQ-9 scores than those that felt no stress. PHQ-9 scores in the students who had unsatisfactory sleeping habits were significantly higher than those in the students who felt they had satisfactory sleep. The students who slept less than 5 hours and more than 8 hours had significantly higher PHQ-9 scores than those who slept 6-7 hours. PHQ-9 scores in the students who never ate breakfast were higher than those who ate breakfast everyday. Moreover, the students who never ate 3 meals daily had higher PHQ-9 scores than those who did. The results suggest that there is a strong relationship between the severity of depressive symptoms and the lifestyles of college students. This underscores the need to provide effective mental health outreach and treatment, including lifestyle modification, at an early stage in college life.

Comparison of maternal and fetal outcomes among patients undergoing cesarean section under general and spinal anesthesia: a randomized clinical trial

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Anıl İçel Saygı

Full Text Available CONTEXT AND OBJECTIVE: As the rates of cesarean births have increased, the type of cesarean anesthesia has gained importance. Here, we aimed to compare the effects of general and spinal anesthesia on maternal and fetal outcomes in term singleton cases undergoing elective cesarean section.DESIGN AND SETTING: Prospective randomized controlled clinical trial in a tertiary-level public hospital.METHODS: Our study was conducted on 100 patients who underwent cesarean section due to elective indications. The patients were randomly divided into general anesthesia (n = 50 and spinal anesthesia (n = 50 groups. The maternal pre and postoperative hematological results, intra and postoperative hemodynamic parameters and perinatal results were compared between the groups.RESULTS: Mean bowel sounds (P = 0.036 and gas discharge time (P = 0.049 were significantly greater and 24th hour hemoglobin difference values (P = 0.001 were higher in the general anesthesia group. The mean hematocrit and hemoglobin values at the 24th hour (P = 0.004 and P < 0.001, respectively, urine volume at the first postoperative hour (P < 0.001 and median Apgar score at the first minute (P < 0.0005 were significantly higher, and the time that elapsed until the first requirement for analgesia was significantly longer (P = 0.042, in the spinal anesthesia group.CONCLUSION: In elective cases, spinal anesthesia is superior to general anesthesia in terms of postoperative comfort. In pregnancies with a risk of fetal distress, it would be appropriate to prefer spinal anesthesia by taking the first minute Apgar score into account.

Comparison of metaraminol, phenylephrine and ephedrine in prophylaxis and treatment of hypotension in cesarean section under spinal anesthesia

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Fábio Farias de Aragão

2014-09-01

Full Text Available Maternal hypotension is a common complication after spinal anesthesia for cesarean section, with deleterious effects on the fetus and mother. Among the strategies aimed at minimizing the effects of hypotension, vasopressor administration is the most efficient. The aim of this study was to compare the efficacy of phenylephrine, metaraminol, and ephedrine in the prevention and treatment of hypotension after spinal anesthesia for cesarean section. Ninety pregnant women, not in labor, undergoing cesarean section were randomized into three groups to receive a bolus followed by continuous infusion of vasopressor as follows: phenylephrine group (50 μg + 50 μg/min; metaraminol group (0.25 mg + 0.25 mg/min; ephedrine group (4 mg + 4 mg/min. Infusion dose was doubled when systolic blood pressure decreased to 80% of baseline and a bolus was given when systolic blood pressure decreased below 80%. The infusion dose was divided in half when systolic blood pressure increased to 120% and was stopped when it became higher. The incidence of hypotension, nausea and vomiting, reactive hypertension, bradycardia, tachycardia, Apgar scores, and arterial cord blood gases were assessed at the 1st and 5th minutes. There was no difference in the incidence of hypotension, bradycardia, reactive hypertension, infusion discontinuation, atropine administration or Apgar scores. Rescue boluses were higher only in the ephedrine group compared to metaraminol group. The incidence of nausea and vomiting and fetal acidosis were greater in the ephedrine group. The three drugs were effective in preventing hypotension; however, fetal effects were more frequent in the ephedrine group, although transient.

The Effectiveness of Hypnosis Intervention for Labor: An Experimental Study.

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Beevi, Zuhrah; Low, Wah Yun; Hassan, Jamiyah

2017-10-01

Hypnosis has been shown to help pregnant women experience improved labor and postpartum periods. The present study compares the differences between experimental (n = 23) and control groups (n = 22) on specific variables measured both during labor and 24 hr postpartum. The participants in the experimental group received the hypnosis intervention at weeks 16, 20, 28, and 36 of pregnancy, while those in the control group received only routine antenatal care. The data collected at the labor stage describe the length of the labor stage, pain relief used during labor, the method of delivery, and the type of assisted vaginal delivery. Within 24 hr of delivery, data on neonatal birth weight, neonatal Apgar scores, and self-reported pain were obtained. The labor stage results showed no significant differences in the length of the second and third stages of labor. Although the participants in the experimental group reported higher pain levels immediately prior to, during, and immediately after delivery, their use of pethidine during labor was significantly lower than the control group participants. None of the experimental group participants opted for an epidural, and they had a greater number of assisted vaginal deliveries than the control group participants. The 24 hr postpartum results showed that the neonates of the experimental group participants had nonsignificantly higher Apgar scores than those of the women in the control group. Group differences in neonatal weight were not significant. The results of the present study indicate that hypnosis is useful for assisting pregnant women during labor and the postpartum period.

In patients suffering from idiopathic central serous chorioretinopathy, anxiety scores are higher than in healthy controls, but do not vary according to sex or repeated central serous chorioretinopathy

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Bazzazi N

2015-04-01

Full Text Available Nooshin Bazzazi,1 Mohammad Ahmadpanah,2 Siamak Akbarzadeh,1 Mohammad Ali Seif Rabiei,3 Edith Holsboer-Trachsler,4 Serge Brand4,5 1Department of Ophthalmology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran; 2Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical Sciences; Hamadan, Iran; 3Department of Social Medicine, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran; 4Psychiatric Clinics of the University of Basel, Center for Affective, Stress and Sleep Disorders, Basel, Switzerland; 5Department of Sport and Health Science, Sport Science Section, University of Basel, Basel, Switzerland Introduction: Idiopathic central serous chorioretinopathy (CSCR is a relatively common ophthalmic disorder characterized by the development of a serous detachment of the sensory retina. Psychophysiological factors may trigger or maintain CSCR, though, surprisingly, the association between CSCR and anxiety has yet to be studied. The aims of the present study were threefold: to determine whether 1 Iranian patients with CSCR have higher scores for anxiety, 2 anxiety is lower, if CSCR has been experienced twice, and whether 3 anxiety scores differ between sexes.Methods: A total of 30 patients with CSCR and 30 healthy age- and sex-matched controls took part in the study. A brief face-to-face interview was conducted covering demographic variables and history and occurrence of CSCR and assessing anxiety.Results: Compared to healthy controls, anxiety was significantly higher in both first-time and second-time CSCR patients. In CSCR patients, anxiety scores did not differ between sexes.Conclusion: Higher anxiety scores were observed in Iranian patients with CSCR, irrespective of whether this was the first or second occurrence of CSCR. This suggests there is no psychological adaptation in terms of reduced anxiety among patients with repeated CSCR. Keywords: idiopathic central

Sway Area and Velocity Correlated With MobileMat Balance Error Scoring System (BESS) Scores.

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Caccese, Jaclyn B; Buckley, Thomas A; Kaminski, Thomas W

2016-08-01

The Balance Error Scoring System (BESS) is often used for sport-related concussion balance assessment. However, moderate intratester and intertester reliability may cause low initial sensitivity, suggesting that a more objective balance assessment method is needed. The MobileMat BESS was designed for objective BESS scoring, but the outcome measures must be validated with reliable balance measures. Thus, the purpose of this investigation was to compare MobileMat BESS scores to linear and nonlinear measures of balance. Eighty-eight healthy collegiate student-athletes (age: 20.0 ± 1.4 y, height: 177.7 ± 10.7 cm, mass: 74.8 ± 13.7 kg) completed the MobileMat BESS. MobileMat BESS scores were compared with 95% area, sway velocity, approximate entropy, and sample entropy. MobileMat BESS scores were significantly correlated with 95% area for single-leg (r = .332) and tandem firm (r = .474), and double-leg foam (r = .660); and with sway velocity for single-leg (r = .406) and tandem firm (r = .601), and double-leg (r = .575) and single-leg foam (r = .434). MobileMat BESS scores were not correlated with approximate or sample entropy. MobileMat BESS scores were low to moderately correlated with linear measures, suggesting the ability to identify changes in the center of mass-center of pressure relationship, but not higher-order processing associated with nonlinear measures. These results suggest that the MobileMat BESS may be a clinically-useful tool that provides objective linear balance measures.

Perceived social support interacts with prenatal depression to predict birth outcomes.

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Nylen, Kimberly J; O'Hara, Michael W; Engeldinger, Jane

2013-08-01

Prenatal depression has been linked to adverse reproductive outcomes including preterm labor and delivery, and low birth weight. Social support also has been linked to birth outcomes, and may buffer infants from the adverse impact of maternal depression. In this prospective study, 235 pregnant women completed questionnaires about depression and social support. Clinical interviews were administered to assess for DSM-IV axis I disorders. Following delivery, birth outcomes were obtained from medical records. Babies of depressed mothers weighed less, were born earlier and had lower Apgar scores than babies of nondepressed mothers. Depressed women had smaller social support networks and were less satisfied with support from social networks. We found no direct associations between perceived social support and birth weight. However, depressed women who rated their partners as less supportive had babies who were born earlier and had lower Apgar scores than depressed mothers with higher perceived partner support. Women's perception of partner support appears to buffer infants of depressed mothers from potential adverse outcomes. These results are notable in light of the low-risk nature of our sample and point to the need for continued depression screening in pregnant women and a broader view of risk for adverse birth outcomes. The results also suggest a possible means of intervention that may ultimately lead to reductions in adverse birth outcomes.

Do later wake times and increased sleep duration of 12th graders result in more studying, higher grades, and improved SAT/ACT test scores?

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Cole, James S

2016-09-01

The aim of this study was to investigate the relationship between sleep duration, wake time, and hours studying on high school grades and performance on the Scholastic Aptitude Test (SAT)/ American College Testing (ACT) college entrance exams. Data were collected from 13,071 recently graduated high school seniors who were entering college in the fall of 2014. A column proportions z test with a Bonferroni adjustment was used to analyze proportional differences. Analysis of covariance (ANCOVA) was used to examine mean group differences. Students who woke up prior to 6 a.m. and got less than 8 h of sleep (27 %) were significantly more likely to report studying 11 or more hours per week (30 %), almost double the rate compared to students who got more than 8 h of sleep and woke up the latest (16 %). Post hoc results revealed students who woke up at 7 a.m. or later reported significantly higher high school grades than all other groups (p students who woke up between 6:01 a.m. and 7:00 a.m. and got eight or more hours of sleep. The highest reported SAT/ACT scores were from the group that woke up after 7 a.m. but got less than 8 h sleep (M = 1099.5). Their scores were significantly higher than all other groups. This study provides additional evidence that increased sleep and later wake time are associated with increased high school grades. However, this study also found that students who sleep the longest also reported less studying and lower SAT/ACT scores.

Impact of Answer-Switching Behavior on Multiple-Choice Test Scores in Higher Education

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Ramazan BAŞTÜRK

2011-06-01

Full Text Available The multiple- choice format is one of the most popular selected-response item formats used in educational testing. Researchers have shown that Multiple-choice type test is a useful vehicle for student assessment in core university subjects that usually have large student numbers. Even though the educators, test experts and different test recourses maintain the idea that the first answer should be retained, many researchers argued that this argument is not dependent with empirical findings. The main question of this study is to examine how the answer switching behavior affects the multiple-choice test score. Additionally, gender differences and relationship between number of answer switching behavior and item parameters (item difficulty and item discrimination were investigated. The participants in this study consisted of 207 upper-level College of Education students from mid-sized universities. A Midterm exam consisted of 20 multiple-choice questions was used. According to the result of this study, answer switching behavior statistically increase test scores. On the other hand, there is no significant gender difference in answer-switching behavior. Additionally, there is a significant negative relationship between answer switching behavior and item difficulties.

Effect of early amniotomy on the outcome of spontaneous labour: a ...

African Journals Online (AJOL)

Edwin Musinguzi

controlled trial of pregnant women in Enugu, South-east Nigeria ... not vary with respect to cesarean section rate, newborn Apgar scores, and need for new born special care unit admission. ..... The authors declare no conflicts of interest.

Gender Gaps in High School GPA and ACT Scores: High School Grade Point Average and ACT Test Score by Subject and Gender. Information Brief 2014-12

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ACT, Inc., 2014

2014-01-01

Female students who graduated from high school in 2013 averaged higher grades than their male counterparts in all subjects, but male graduates earned higher scores on the math and science sections of the ACT. This information brief looks at high school grade point average and ACT test score by subject and gender

Prompt Referral in the Nonoperative Treatment of Obstetrical Brachial Plexus Injuries

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Alain Joe Azzi, MD

2017-12-01

Conclusions:. The subgroup of newborns with an Apgar score <7 at 5 minutes shows improved long-term shoulder function when promptly examined by an OBPI clinic. We recommend a “fast-track” referral for this time-sensitive population.

Hypertrophic pyloric stenosis, an unusual presentation and rare ...

African Journals Online (AJOL)

matic hernia [7], genitourinary tract abnormalities, and esophageal atresia [4,7]. ... He was born full term with normal Apgar score and weight of. 3.5 kg. The antenatal ... of Pediatric Surgery. Unauthorized reproduction of this article is prohibited.

Does low dose oral ketamine have oxytocic effect? | Okorie ...

African Journals Online (AJOL)

Journal Home > Vol 32, No 1 (2015) > ... duration of labour and APGAR score were determined and all data analyzed using Epi Info. ... for labour analgesia and augmentation and for extended use in repairs of episiotomy and perineal tears.

EAMJ JUNE 09.indb

African Journals Online (AJOL)

2007-12-31

Dec 31, 2007 ... high maternal mortality rates are indicators of the poor state of ... the system and health sector statistics back up this assessment. ... The poor state of health services ... complications, Apgar score of the infants, birth weight.

EPIDURAL LABOUR ANALGESIA IN IZOLA GENERAL HOSPITAL

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Sabina Verem

2018-02-01

Full Text Available Background. The study presents the experience with epidural analgesia (EPA for pain relief in Izola General Hospital from 2003 to 2006, the differences of labour between epidural analgesia and without it and the parturients’ satisfaction. Methods. A retrospective observational study was performed. Data were compared between 214 parturients with EPA matched by 214 parturients without. The control parturient was the equiipara with a term birth and the cephalic presentation of fetus that delivered just before the parturient of the EPA group. Maternal age, labor length, rate of oxitocin use, instrumental deliveries and cesarean sections, Apgar scores and birthweights were compared. The questionnaire was used to estimate the pain in 62 parturients. Results. In GH Izola in 214 parturients (10 % EPA was applied for labour pain relief in the period from July 2003 till December 2006. In the EPA group there was a statistically significance compared with the control group: higher parturients’ mean age (30.5 vs 28.7 y.o.; p < 0.0005, longer labour length (278 vs 222 min; p < 0.0005, higher oxitocin use rate (93.4 % vs 72.9 %; p < 0.0001 and higher instrumental delivery rate (vacuum extraction 14 % vs 1.9 %; p < 0.0001. The cesarean section rates were equal in both groups. Despite the higher instrumental delivery rate and the longer labour length in the EPA group there were no worse perinatal outcomes, neither was statisticaly significant difference in Apgar scores compared with the control group. The mean intensity of pain was highest before the EPA application (VAS 7, lowest during the transition stage (VAS 1.5 and some higher during the second phase (VAS 2.7. Most of parturients in the EPA group were satisfied; 92 % of them evaluated the EPA as good or very good. Conclusions. EPA is a very effective method for pain control during labor. The parturients’ satisfaction with this pain control method is appropriate. Despite the higher instrumental

Successful Delivery in a Woman With Achondroplasia: A Case Report

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Mahbooheh Shirazi

2017-10-01

Full Text Available Achondroplasia is an autosomal dominant disease which is characterized by limb shortening and narrow trunk, and macrocephaly. Women with achondroplasia suffer from infertility, menorrhagia, dysmenorrhoea, leiomyomata and early menopause. Our case was a 26-year-old woman with achondroplasia who had scoliosis and osteoporosis. She referred to our clinic at 9 weeks of gestation and had all screenings completely. She had a single female fetus with no abnormalities. She had an emergent due to rupture of membranes at 37 weeks and 3 days under general anesthesia. The neonate had no complications. The first minute Apgar score was 9 and 5th-minute Apgar score were 10. Umbilical artery Ph was 7.26 and birth weight was 3140. A woman with achondroplasia could have a normal pregnancy and give birth to a healthy term neonate under precise screening.

Successful Delivery in a Woman With Achondroplasia: A Case Report.

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Shirazi, Mahbooheh; Golshahi, Fateme; Teimoory, Nastaran

2017-08-01

Achondroplasia is an autosomal dominant disease which is characterized by limb shortening and narrow trunk, and macrocephaly. Women with achondroplasia suffer from infertility, menorrhagia, dysmenorrhoea, leiomyomata and early menopause. Our case was a 26-year-old woman with achondroplasia who had scoliosis and osteoporosis. She referred to our clinic at 9 weeks of gestation and had all screenings completely. She had a single female fetus with no abnormalities. She had an emergent due to rupture of membranes at 37 weeks and 3 days under general anesthesia. The neonate had no complications. The first minute Apgar score was 9 and 5th-minute Apgar score were 10. Umbilical artery Ph was 7.26 and birth weight was 3140. A woman with achondroplasia could have a normal pregnancy and give birth to a healthy term neonate under precise screening.

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Items 1 - 50 of 159 ... Vol 5, No 2 (2006), A comparison of Apgar Scores of neonates following ... Review Of Laparoscopy At A Dedicated Assisted Reproductive Technology ... As Part Of Clinical Presentation Of Urinary Tract Infection In An Infant.

Intraventricular haemorrhage and periventricular leukomalacia in ...

African Journals Online (AJOL)

Infants with apgar scores < 3 at 5 minutes had a 6-fold increase in IVH and 2-fold ... There was no association with birth weight, gestational age, respiratory ... Improvement in antenatal, labour and delivery, and immediate newborn care; ...

Association between the Osteoporosis Self-Assessment Tool for Asians Score and Mortality in Patients with Isolated Moderate and Severe Traumatic Brain Injury: A Propensity Score-Matched Analysis.

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Rau, Cheng-Shyuan; Kuo, Pao-Jen; Wu, Shao-Chun; Chen, Yi-Chun; Hsieh, Hsiao-Yun; Hsieh, Ching-Hua

2016-12-03

Background: The purpose of this study was to use a propensity score-matched analysis to investigate the association between the Osteoporosis Self-Assessment Tool for Asians (OSTA) scores and clinical outcomes of patients with isolated moderate and severe traumatic brain injury (TBI). Methods: The study population comprised 7855 patients aged ≥40 years who were hospitalized for treatment of isolated moderate and severe TBI (an Abbreviated Injury Scale (AIS) ≥3 points only in the head and not in other regions of the body) between 1 January 2009 and 31 December 2014. Patients were categorized as high-risk (OSTA score -1; n = 5359). Two-sided Pearson's chi-squared, or Fisher's exact tests were used to compare categorical data. Unpaired Student's t -test and Mann-Whitney U test were performed to analyze normally and non-normally distributed continuous data, respectively. Propensity score-matching in a 1:1 ratio was performed using NCSS software, with adjustment for covariates. Results: Compared to low-risk patients, high- and medium-risk patients were significantly older and injured more severely. The high- and medium-risk patients had significantly higher mortality rates, longer hospital length of stay, and a higher proportion of admission to the intensive care unit than low-risk patients. Analysis of propensity score-matched patients with adjusted covariates, including gender, co-morbidity, blood alcohol concentration level, Glasgow Coma Scale score, and Injury Severity Score revealed that high- and medium-risk patients still had a 2.4-fold (odds ratio (OR), 2.4; 95% confidence interval (CI), 1.39-4.15; p = 0.001) and 1.8-fold (OR, 1.8; 95% CI, 1.19-2.86; p = 0.005) higher mortality, respectively, than low-risk patients. However, further addition of age as a covariate for the propensity score-matching demonstrated that there was no significant difference between high-risk and low-risk patients or between medium-risk and low-risk patients, implying that older age

Risk of autism spectrum disorder in children born to mothers with systemic lupus erythematosus and rheumatoid arthritis in Taiwan.

Science.gov (United States)

Tsai, Ping-Han; Yu, Kuang-Hui; Chou, I-Jun; Luo, Shue-Fen; Tseng, Wen-Yi; Huang, Lu-Hsiang; Kuo, Chang-Fu

2017-11-26

To determine whether offspring of Taiwanese mothers with systemic lupus erythematosus or rheumatoid arthritis have a higher risk of autism spectrum disorder. Using the National Health Insurance database and National Birth Registry, we identified a cohort of all live births in Taiwan between 2001 and 2012. Children born to mothers with systemic lupus erythematosus or rheumatoid arthritis were identified and matched with up to 8 controls by maternal age, 1-minute Apgar score, 5-minute Apgar score, mode of delivery, sex of the child, gestational age, birth weight and place of residence. Marginal Cox proportional hazard models were used to estimate relative risk (RR) with 95% confidence intervals (CI) for ASD in offspring. Of 1,893,244 newborns, 0.08% (n=1594) were born to systemic lupus erythematosus mothers, and 0.04% (n=673) were born to rheumatoid arthritis mothers. Overall, 5 of 673 (0.74%) offspring of rheumatoid arthritis mothers, 7 of 1594 (0.44%) offspring of systemic lupus erythematosus mothers and 10,631 of 1,893,244 (0.56%) offspring of all mothers developed autism spectrum disorder. Autism spectrum disorder incidence (per 100,000 person-years) was 140.39 (95% CI, 45.58-327.62) for the rheumatoid arthritis group and 76.19 (95% CI, 30.63-156.97) for the systemic lupus erythematosus group. Autism spectrum disorder risk was not significantly higher for children born to mothers with rheumatoid arthritis (HR, 1.42; 95% CI, 0.60-3.40) or systemic lupus erythematosus (HR, 0.76; 95% CI, 0.36-1.59). Children born to women with systemic lupus erythematosus or rheumatoid arthritis do not have a higher risk of autism spectrum disorder. Copyright © 2017 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

A comparative study on assessment procedures and metric properties of two scoring systems of the Coma Recovery Scale-Revised items: standard and modified scores.

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Sattin, Davide; Lovaglio, Piergiorgio; Brenna, Greta; Covelli, Venusia; Rossi Sebastiano, Davide; Duran, Dunja; Minati, Ludovico; Giovannetti, Ambra Mara; Rosazza, Cristina; Bersano, Anna; Nigri, Anna; Ferraro, Stefania; Leonardi, Matilde

2017-09-01

The study compared the metric characteristics (discriminant capacity and factorial structure) of two different methods for scoring the items of the Coma Recovery Scale-Revised and it analysed scale scores collected using the standard assessment procedure and a new proposed method. Cross sectional design/methodological study. Inpatient, neurological unit. A total of 153 patients with disorders of consciousness were consecutively enrolled between 2011 and 2013. All patients were assessed with the Coma Recovery Scale-Revised using standard (rater 1) and inverted (rater 2) procedures. Coma Recovery Scale-Revised score, number of cognitive and reflex behaviours and diagnosis. Regarding patient assessment, rater 1 using standard and rater 2 using inverted procedures obtained the same best scores for each subscale of the Coma Recovery Scale-Revised for all patients, so no clinical (and statistical) difference was found between the two procedures. In 11 patients (7.7%), rater 2 noted that some Coma Recovery Scale-Revised codified behavioural responses were not found during assessment, although higher response categories were present. A total of 51 (36%) patients presented the same Coma Recovery Scale-Revised scores of 7 or 8 using a standard score, whereas no overlap was found using the modified score. Unidimensionality was confirmed for both score systems. The Coma Recovery Scale Modified Score showed a higher discriminant capacity than the standard score and a monofactorial structure was also supported. The inverted assessment procedure could be a useful evaluation method for the assessment of patients with disorder of consciousness diagnosis.

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African Journals Online (AJOL)

user

system lesions and pleuropulmonary infiltrates 2,4. .... Other drugs that may be used are ... and intra-articular steroid injection. 2,3,6. Long term ... delivery. She gave birth to a female baby whose. Apgar score 8 and weighed 2800grammes. The.

A comparison of perinatal outcomes in singletons and multiples born after in vitro fertilization or intracytoplasmic sperm injection stratified for neonatal risk criteria

NARCIS (Netherlands)

van Heesch, M.M.J.; Evers, J.L.H.; Dumoulin, J.C.M.; van der Hoeven, M.A.H.B.; van Beijsterveldt, C.E.M.; Bonsel, G.J.; Dykgraaf, R.H.M.; van Goudoever, J.B.; Koopman-Esseboom, C.; Nelen, W.L.D.M.; Steiner, K.; Tamminga, P.; Tonch, N.; van Zonneveld, P.; Dirksen, C.D.

2014-01-01

Objective To compare perinatal singleton and multiple outcomes in a large Dutch in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) population and within risk subgroups. Newborns were assigned to a risk category based on gestational age, birthweight, Apgar score and congenital

A comparison of perinatal outcomes in singletons and multiples born after in vitro fertilization or intracytoplasmic sperm injection stratified for neonatal risk criteria

NARCIS (Netherlands)

Heesch, M.M. van; Evers, J.L.H.; Dumoulin, J.C.; Hoeven, M.A. van der; Beijsterveldt, C.E. van; Bonsel, G.J.; Dykgraaf, R.H.; Goudoever, J.B. van; Koopman-Esseboom, C.; Nelen, W.L.D.M.; Steiner, K.; Tamminga, P.; Tonch, N.; Zonneveld, P. van; Dirksen, C.D.

2014-01-01

OBJECTIVE: To compare perinatal singleton and multiple outcomes in a large Dutch in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) population and within risk subgroups. Newborns were assigned to a risk category based on gestational age, birthweight, Apgar score and congenital

A comparison of perinatal outcomes in singletons and multiples born after IVF or ICSI, stratified for neonatal risk criteria

NARCIS (Netherlands)

van Heesch, Mirjam M. J.; Evers, Johannes L. H.; Dumoulin, John C. M.; van der Hoeven, Mark A. H. B. M.; van Beijsterveldt, Catharina E. M.; Bonsel, Gouke J.; Dykgraaf, Ramon H. M.; van Goudoever, Johannes B.; Koopman-Esseboom, Corine; Nelen, Willianne L. D. M.; Steiner, Katerina; Tamminga, Pieter; Tonch, Nino; van Zonneveld, Piet; Dirksen, Carmen D.

2014-01-01

To compare perinatal singleton and multiple outcomes in a large Dutch in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) population and within risk subgroups. Newborns were assigned to a risk category based on gestational age, birthweight, Apgar score and congenital malformation.

Multiple Score Comparison: a network meta-analysis approach to comparison and external validation of prognostic scores

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Sarah R. Haile

2017-12-01

Full Text Available Abstract Background Prediction models and prognostic scores have been increasingly popular in both clinical practice and clinical research settings, for example to aid in risk-based decision making or control for confounding. In many medical fields, a large number of prognostic scores are available, but practitioners may find it difficult to choose between them due to lack of external validation as well as lack of comparisons between them. Methods Borrowing methodology from network meta-analysis, we describe an approach to Multiple Score Comparison meta-analysis (MSC which permits concurrent external validation and comparisons of prognostic scores using individual patient data (IPD arising from a large-scale international collaboration. We describe the challenges in adapting network meta-analysis to the MSC setting, for instance the need to explicitly include correlations between the scores on a cohort level, and how to deal with many multi-score studies. We propose first using IPD to make cohort-level aggregate discrimination or calibration scores, comparing all to a common comparator. Then, standard network meta-analysis techniques can be applied, taking care to consider correlation structures in cohorts with multiple scores. Transitivity, consistency and heterogeneity are also examined. Results We provide a clinical application, comparing prognostic scores for 3-year mortality in patients with chronic obstructive pulmonary disease using data from a large-scale collaborative initiative. We focus on the discriminative properties of the prognostic scores. Our results show clear differences in performance, with ADO and eBODE showing higher discrimination with respect to mortality than other considered scores. The assumptions of transitivity and local and global consistency were not violated. Heterogeneity was small. Conclusions We applied a network meta-analytic methodology to externally validate and concurrently compare the prognostic properties

Neonatal outcome following exposure to organophosphorous pesticides

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Đorđević M.

2010-01-01

Full Text Available The aim of our study was to determine the neonatal outcome in mothers and children exposed to organophosphorous pesticides (OP. We found that 22.4% pregnant women were exposed to organophosphorous pesticides. OP pesticide concentration was higher in breast milk, newborn sera than maternal sera. Newborn parameters such as birth weight, birth length, head circumference, Apgar score and presence of meconium, as well as gestational age of delivery, showed no significant difference between the two groups. However, postpartum weight loss, hospitalization duration, levels of newborn bilirubin and glycaemia differed significantly between the two groups. Morbidity and presence of CNS disorders were six times and more than twelve times higher, respectively, in the OP-exposed than in the OP pesticide non-exposed group.

Higher IELTS Score, Higher Academic Performance?\\ud The Validity of IELTS in Predicting the Academic Performance\\ud of Chinese Students

OpenAIRE

Yen, Dorothy; Kuzma, Joanne

2009-01-01

The International English Language Testing System (IELTS) is widely accepted as a reliable means of assessing whether candidates are ready to study or train in the medium of the English language. It consists of four key parts: reading, speaking, listening and writing. Before enrolling onto any HE programmes at the University of Worcester, international students are required to take the IELTS exam and obtain a\\ud score of 6.0 and above, indicating a satisfactory command of English. However, de...

The Relationship between Rostral Retraction of the Pannus and Outcomes at Cesarean Section.

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Turan, Ozhan M; Rosenbloom, Joshua; Galey, Jessica L; Kahntroff, Stephanie L; Bharadwaj, Shobana; Turner, Shafonya M; Malinow, Andrew M

2016-08-01

Objective Maternal obesity presents several challenges at cesarean section. In an effort to routinely employ a transverse suprapubic skin incision, we often retract the pannus in a rostral direction using adhesive tape placed after induction of anesthesia and before surgical preparation of the skin. We sought to understand the association between taping and neonatal cord blood gases, Apgar scores, and time from skin incision to delivery of the neonate. Study Design This is a retrospective study, performed using prospectively collected anesthesiology records with data supplemented from the patients' medical records. Singleton pregnancies with morbid obesity (body mass index [BMI] > 40 kg/m(2)) between 37 and 42 weeks of gestation who delivered via nonurgent, scheduled cesarean delivery under regional (spinal, combined spinal-epidural, or epidural) anesthesia between March 2007 and March 2013 were identified. Maternal demographics including BMI, comorbidities, type of anesthesia, time intervals during the surgery, cord gas results, and Apgar scores were collected. The relationship between taping and blood acid-base status, Apgar scores, and interval from skin incision to delivery was investigated using appropriate statistical tests. Results There were 2,525 (27.5%) cesarean deliveries out of 9,189 total deliveries. Applying the described inclusion/exclusion criteria, 141 patients were identified (33 taped and 108 nontaped). There was no significant difference in BMI between the taped (51.9 kg/m(2)) and nontaped groups (47.4 kg/m(2)), p > 0.05. There was no difference in type of anesthesia (p > 0.05). The only significant difference between the taped and not-taped groups was the presence of chronic hypertension in the taped group (p = 0.03). There were no significant differences in cord blood gas values, Apgar scores, or skin incision to delivery interval (p > 0.05 for all outcomes). Conclusions Taping of the pannus at cesarean section is a

Placental IGF-1 and IGFBP-3 expression correlate with umbilical cord blood PAH and PBDE levels from prenatal exposure to electronic waste

International Nuclear Information System (INIS)

Xu, Xijin; Yekeen, Taofeek Akangbe; Xiao, Qiongna; Wang, Yuangping; Lu, Fangfang; Huo, Xia

2013-01-01

Electronic waste recycling produces Polycyclic Aromatic Hydrocarbons (PAHs) and Polybrominated Diphenyl Ethers (PBDEs) which may affect fetal growth and development by altering the insulin-like-growth factor (IGF) system. Questionnaires were administered to pregnant women (Guiyu, an e-waste site, n = 101; control, n = 53), and umbilical cord blood (UCB) and placentas were collected upon delivery. PBDEs and PAHs in UCB and placental IGF-1 and IGFBP-3 mRNA levels were analyzed using GC–MS and real-time PCR, respectively. Infant birth length and Apgar scores were lower in Guiyu. All PAHs (except Fl, Chr, IP, BbF and BP), total 16-PAHs, total/individual PBDEs, placental IGF-1 (median 0.23 vs 0.19; P < 0.05) and IGFBP-3 (median 1.91 vs 0.68; P < 0.001) levels were significantly higher in Guiyu. Spearman correlation showed that BDE-154, BDE-209 and ∑5ring-PAHs positively correlate with IGF-1 while PBDEs, 4 rings and total PAHs correlate with IGFBP-3 expression. Increased placental IGF-1 level might indirectly affect fetal growth and development. -- Highlights: •PAHs and PBDEs from e-waste may affect fetal growth via alteration of IGF system. •Infant birth length and Apgar scores were lower in Guiyu compared to Chaoan. •Most PAHs, all PBDEs, IGF-1 and IGFBP-3 levels were significantly higher in Guiyu. •IGF-1 positively correlates with BDE-154, BDE-209 and ∑5ring-PAHs. •The observed increase in IGF-1 might indirectly affect fetal growth and development. -- The correlation between POPs and placental IGF-1 and IGFBP-3 assessed provides more information on the human health risk associated with electronic waste

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Mr Olusoji

Early detection. close survcillance and timcl y delivery are necessary to reduce complications associated with the condition. ... Keywords: Pree<:iampsia, Malcrnal morbidit y, perinalal oUlcome, early dCleclion and managemcnl ... hypertension, renal diseases. thrombophilia, outcome, Apgar scores and birth weight. These.

Is routine caesarean section necessary for breech-breech and ...

African Journals Online (AJOL)

Subjects: Twin gestations with breech-breech and breech-transverse presentations. Main outcome measures: Birth weights, 5-minute Apgar scores and neonatal mortality rates among 41 women who underwent vaginal delivery were compared with those of 27 who underwent transverse lower-segment caesarean sections.

Pregnancy outcome in the elderly gravida in Addis Ababa | Marai ...

African Journals Online (AJOL)

1998-08-30

... to August 30, 1998 in the above setting fulfilling inclusion criteria were cases and controls respectively. Main outcome measures: Included current obstetric problems, labour induction, operative delivery, low birthweight, apgar scores, prenatal death, neonatal intensive care admission rates and mean foetal birthweight.

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Mr Olusoji

Keywords: Social Class. Binh Before Arrival. (BBA), Apgar Score, Perineal tear, Early neonatal deaths (ENND), Fresh still binhs and Intmpanum eclampsia, Primary Postpanum Hcamorrhagc. Correspondence: Dr. Olalekan .0, Awolola,. Depanment of Obstetrics and Gynaecology, State. SjlC{:ialist Hospital, Asubiaro, Osogbo ...

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Mr Olusoji

Thus proper education during tlte antenatal clinic visits will make managing these patients easicr. Keywords: Social Class, Traditional Binh Allendants (TBA). Induction of labour (lOL), Elective. Caesarean Section (ELCS), Emergency Caesarean Seclion (EMCS), Apgar Score (AS), Prolonged. Pregnancy and Spontaneous ...

An Objective Fluctuation Score for Parkinson's Disease

Science.gov (United States)

Horne, Malcolm K.; McGregor, Sarah; Bergquist, Filip

2015-01-01

Introduction Establishing the presence and severity of fluctuations is important in managing Parkinson’s Disease yet there is no reliable, objective means of doing this. In this study we have evaluated a Fluctuation Score derived from variations in dyskinesia and bradykinesia scores produced by an accelerometry based system. Methods The Fluctuation Score was produced by summing the interquartile range of bradykinesia scores and dyskinesia scores produced every 2 minutes between 0900-1800 for at least 6 days by the accelerometry based system and expressing it as an algorithm. Results This Score could distinguish between fluctuating and non-fluctuating patients with high sensitivity and selectivity and was significant lower following activation of deep brain stimulators. The scores following deep brain stimulation lay in a band just above the score separating fluctuators from non-fluctuators, suggesting a range representing adequate motor control. When compared with control subjects the score of newly diagnosed patients show a loss of fluctuation with onset of PD. The score was calculated in subjects whose duration of disease was known and this showed that newly diagnosed patients soon develop higher scores which either fall under or within the range representing adequate motor control or instead go on to develop more severe fluctuations. Conclusion The Fluctuation Score described here promises to be a useful tool for identifying patients whose fluctuations are progressing and may require therapeutic changes. It also shows promise as a useful research tool. Further studies are required to more accurately identify therapeutic targets and ranges. PMID:25928634

HIGHER ORDER THINKING IN TEACHING GRAMMAR

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Citra Dewi

2017-04-01

Full Text Available The aim of this paper discussed about how to enhance students’ higher order thinking that should be done by teacher in teaching grammar. Usually teaching grammar was boring and has the same way to learn like change the pattern of sentence into positive, negative and introgative while the students’ need more various way to develop their thinking. The outcome of students’ competence in grammar sometimes not sufficient enough when the students’ occured some test international standart like Test of English Foreign Language, International English Language Testing. Whereas in TOEFL test it needed higher order thinking answer, so teacher should develop students’ higher order thingking in daily teaching grammar in order to make the students’ enhance their thinking are higher. The method was used in this paper by using field study based on the experience of teaching grammar. It can be shown by students’ toefl score was less in stucture and written expression. The result of this paper was after teacher gave some treatments to enhance students’ higher order thinking in teaching grammar, the students’ toefl scores are sufficient enough as a part of stucture and written expression. It can concluded that it needed some strategies to enhancce students higher order thinking by teaching grammar it can make students’ higher toefl score. Teachers should be creative and inovative to teach the students’ started from giving the students’ question or test in teaching grammar.

Mediterranean diet score and left ventricular structure and function: the Multi-Ethnic Study of Atherosclerosis.

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Levitan, Emily B; Ahmed, Ali; Arnett, Donna K; Polak, Joseph F; Hundley, W Gregory; Bluemke, David A; Heckbert, Susan R; Jacobs, David R; Nettleton, Jennifer A

2016-09-01

Data are limited on the relation between dietary patterns and left ventricular (LV) structure and function. We examined cross-sectional associations of a diet-score assessment of a Mediterranean dietary pattern with LV mass, volume, mass-to-volume ratio, stroke volume, and ejection fraction. We measured LV variables with the use of cardiac MRI in 4497 participants in the Multi-Ethnic Study of Atherosclerosis study who were aged 45-84 y and without clinical cardiovascular disease. We calculated a Mediterranean diet score from intakes of fruit, vegetables, nuts, legumes, whole grains, fish, red meat, the monounsaturated fat:saturated fat ratio, and alcohol that were self-reported with the use of a food-frequency questionnaire. We used linear regression with adjustment for body size, physical activity, and cardiovascular disease risk factors to model associations and assess the shape of these associations (linear or quadratic). The Mediterranean diet score had a slight U-shaped association with LV mass (adjusted means: 146, 145, 146, and 147 g across quartiles of diet score, respectively; P-quadratic trend = 0.04). The score was linearly associated with LV volume, stroke volume, and ejection fraction: for each +1-U difference in score, LV volume was 0.4 mL higher (95% CI: 0.0, 0.8 mL higher), the stroke volume was 0.5 mL higher (95% CI: 0.2, 0.8 mL higher), and the ejection fraction was 0.2 percentage points higher (95% CI: 0.1, 0.3 percentage points higher). The score was not associated with the mass-to-volume ratio. A higher Mediterranean diet score is cross-sectionally associated with a higher LV mass, which is balanced by a higher LV volume as well as a higher ejection fraction and stroke volume. Participants in this healthy, multiethnic sample whose dietary patterns most closely conformed to a Mediterranean-type pattern had a modestly better LV structure and function than did participants with less-Mediterranean-like dietary patterns. This trial was registered at

Effect of psychoprophylaxis (Lamaze preparation) on labor and delivery in primiparas.

Science.gov (United States)

Scott, J R; Rose, N B

1976-05-27

To investigate whether "prepared-childbirth" courses offer measurable physical advantages, we compared the labor and delivery characteristics of 129 primiparas who had completed ante-partum Lamaze-training psychoprophylaxis classes with an equal number of matched controls who had not. The former were given narcotics less frequently during labor (P less than 0.001), received conduction anesthesia less often (P less than 0.001), and had a higher frequency of spontaneous vaginal deliveries (P less than 0.001) than the control patients. However, these differences had no apparent effects on the length of labor, number or type of maternal complications, frequency of fetal distress, mean Apgar scored, or neonatal problems.

Comparison of the effect of aromatherapy with Jasminum officinale and Salvia officinale on pain severity and labor outcome in nulliparous women

Science.gov (United States)

Kaviani, Maasumeh; Maghbool, Shahla; Azima, Sara; Tabaei, Mohammad Hosein

2014-01-01

Background: Using non-pharmacological pain relief methods for reducing labor pain has always been one of the major concerns in obstetrics and gynecology. Objective: Comparing the effects of aromatherapy with jasmine and salvia on pain severity and labor outcome in nulliparous women. Materials and Methods: In this randomized clinical trial, 156 nulliparous women in labor were randomly selected and divided into salvia, jasmine, and control groups (52 in each group). The study duration was 6 months (from October 2009 to March 2010). Each group underwent aromatherapy using an incense mask for 15 min (distilled water for the control group). Pain severity was measured before and 30 and 60 min after the incense aromatherapy. Also, duration of the first and second stages of labor, first- and fifth-minute APGAR scores of the baby, and the frequency of labor type were measured and recorded in each group. Results: In comparison to the other groups, pain severity and duration of the first and second stages of labor were significantly lower in the aromatherapy group of salvia 30 min after the intervention (P = 0.001). However, no significant difference was found among the three groups regarding pain severity 60 min after the aromatherapy, first- and fifth-minute APGAR scores of the baby, and the frequency of labor type. Conclusions: The results of the present study indicated that aromatherapy with saliva had beneficial effects on pain relief, shortened the labor stages, and had no negative impact on the baby's APGAR score. PMID:25558267

Differences of wells scores accuracy, caprini scores and padua scores in deep vein thrombosis diagnosis

Science.gov (United States)

Gatot, D.; Mardia, A. I.

2018-03-01

Deep Vein Thrombosis (DVT) is the venous thrombus in lower limbs. Diagnosis is by using venography or ultrasound compression. However, these examinations are not available yet in some health facilities. Therefore many scoring systems are developed for the diagnosis of DVT. The scoring method is practical and safe to use in addition to efficacy, and effectiveness in terms of treatment and costs. The existing scoring systems are wells, caprini and padua score. There have been many studies comparing the accuracy of this score but not in Medan. Therefore, we are interested in comparative research of wells, capriniand padua score in Medan.An observational, analytical, case-control study was conducted to perform diagnostic tests on the wells, caprini and padua score to predict the risk of DVT. The study was at H. Adam Malik Hospital in Medan.From a total of 72 subjects, 39 people (54.2%) are men and the mean age are 53.14 years. Wells score, caprini score and padua score has a sensitivity of 80.6%; 61.1%, 50% respectively; specificity of 80.65; 66.7%; 75% respectively, and accuracy of 87.5%; 64.3%; 65.7% respectively.Wells score has better sensitivity, specificity and accuracy than caprini and padua score in diagnosing DVT.

External validation of the NOBLADS score, a risk scoring system for severe acute lower gastrointestinal bleeding.

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Tomonori Aoki

Full Text Available We aimed to evaluate the generalizability of NOBLADS, a severe lower gastrointestinal bleeding (LGIB prediction model which we had previously derived when working at a different institution, using an external validation cohort. NOBLADS comprises the following factors: non-steroidal anti-inflammatory drug use, no diarrhea, no abdominal tenderness, blood pressure ≤ 100 mmHg, antiplatelet drug use, albumin < 3.0 g/dL, disease score ≥ 2, and syncope.We retrospectively analyzed 511 patients emergently hospitalized for acute LGIB at the University of Tokyo Hospital, from January 2009 to August 2016. The areas under the receiver operating characteristic curves (ROCs-AUCs for severe bleeding (continuous and/or recurrent bleeding were compared between the original derivation cohort and the external validation cohort.Severe LGIB occurred in 44% of patients. Several clinical factors were significantly different between the external and derivation cohorts (p < 0.05, including background, laboratory data, NOBLADS scores, and diagnosis. The NOBLADS score predicted the severity of LGIB with an AUC value of 0.74 in the external validation cohort and one of 0.77 in the derivation cohort. In the external validation cohort, the score predicted the risk for blood transfusion need (AUC, 0.71, but was not adequate for predicting intervention need (AUC, 0.54. The in-hospital mortality rate was higher in patients with a score ≥ 5 than in those with a score < 5 (AUC, 0.83.Although the external validation cohort clinically differed from the derivation cohort in many ways, we confirmed the moderately high generalizability of NOBLADS, a clinical risk score for severe LGIB. Appropriate triage using this score may support early decision-making in various hospitals.

The effects of umbilical cord entanglement upon labor management and fetal health: retrospective case control study.

Science.gov (United States)

Buyukkayaci Duman, Nuriye; Topuz, Senay; Bostanci, Mehmet Omer; Gorkem, Umit; Yuksel Kocak, Derya; Togrul, Cihan; Gungor, Tayfun

2018-03-01

This retrospective study aimed at determining prognostic factors that paved the way for umbilical cord entanglement (UCE) and the effects of UCE upon labor management and fetal health. Sixty women who gave term birth with head presentation and received UCE diagnosis following birth composed the case group while another 60 women with the same characteristics who were selected with randomized sampling method and who did not develop UCE comprised the control group. The data obtained were processed with SPSS 22.0 statistical program. T test was used for comparing demographic and obstetric data and mean birth weight of babies in the case group and control group. For comparing data on active labor management and fetal health, numbers, percentages and chi-square test were used. Also for comparing values case: 58.3.0%; control: 21.7%), vacuum assisted vaginal delivery (case: 20.0%; control: 3.3%), forceps assisted vaginal delivery (case: 8.3%; control: 1.7%), fetal distress (case: 60.0%; control: 25.0%), amniotic fluid meconium (case: 58.3%; control: 21.7%), APGAR score less than 7 at the 1st minute (case: 58.3%; control: 21.7%) and APGAR score less than 7 at the 5th minute were higher in the women in the case group than the women in the control group (p < 0.05). UCE increased rates of interventional birth, emergent cesarean delivery, vacuum assisted vaginal delivery, forceps assisted vaginal delivery, amniotic fluid meconium and fetal distress.

Formation of borrower’s bank credit scoring integrated model

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O.V. Lysenok

2017-03-01

Full Text Available The article proposes the borrower’s bank credit scoring model that is of particular relevance in an unstable world and Ukrainian financial markets. The essence of this integrated model is the consistent definition of indicators, which analyze the financial and economic situation and development of scoring that allows to calculate overall index, that is, the integral factor of credit scoring level of the bank to calculate which one uses the formed set of factors characterizing riskiness, profitability and liquidity of the banking institution. The author determines the factors according to their functional purpose; the former ones are divided into four groups: capital adequacy, loan portfolio quality, profitability and liquidity. Each group consists of four indicators; each indicator is assigned thresholds to determine the appropriate credit scoring level of the bank for one or another direction. The higher is the value of the integral factor, the more efficient and less risky is the financial and economic activity of banks and the higher is their credit scoring level. The study concludes that the proposed model for bank credit scoring differs with its transparency and clarity due to use in its implementation only public information. The disadvantages include the presence of the subjective factor in assigning a certain number of points based on expert and normative methods.

Stress-Induced Hyperglycemia, but Not Diabetic Hyperglycemia, Is Associated with Higher Mortality in Patients with Isolated Moderate and Severe Traumatic Brain Injury: Analysis of a Propensity Score-Matched Population.

Science.gov (United States)

Rau, Cheng-Shyuan; Wu, Shao-Chun; Chen, Yi-Chun; Chien, Peng-Chen; Hsieh, Hsiao-Yun; Kuo, Pao-Jen; Hsieh, Ching-Hua

2017-11-03

Background : Admission hyperglycemia is associated with higher morbidity and mortality in patients with traumatic brain injury (TBI). Stress-induced hyperglycemia (SIH), a form of hyperglycemia induced by the stress response, is associated with increased patient mortality following TBI. However, admission hyperglycemia occurs not only in SIH but also in patients with diabetic hyperglycemia (DH). Current information regarding whether trauma patients with SIH represent a distinct group with differential outcomes compared to those with DH remains limited. Methods : Serum glucose concentration ≥200 mg/dL upon arrival at the emergency department was defined as hyperglycemia. Presence of diabetes mellitus (DM) was determined by patient history and/or admission glycated hemoglobin (HbA1c) level ≥6.5%. In the present study, the patient cohort included those with moderate and severe TBI, as defined by an Abbreviated Injury Scale (AIS) score ≥3 points in the head, and excluded those who had additional AIS scores ≥3 points in any other region of the body. A total of 1798 adult patients with isolated moderate to severe TBI were allocated into four groups: SIH ( n = 140), DH ( n = 187), diabetic normoglycemia (DN, n = 186), and non-diabetic normoglycemia (NDN, n = 1285). Detailed patient information was retrieved from the Trauma Registry System at a level I trauma center between 1 January 2009, and 31 December 2015. Unpaired Student's t - and Mann-Whitney U -tests were used to analyze normally and non-normally distributed continuous data, respectively. Categorical data were compared using the Pearson chi-square or two-sided Fisher's exact tests. Matched patient populations were allocated in a 1:1 ratio according to propensity scores calculated by NCSS software. Logistic regression was used to evaluate the effect of SIH and DH on the adjusted mortality outcome. Results : In patients with isolated moderate to severe TBI, the presence of SIH and DH led to 9.1-fold and 2

Perinatal mortality and morbidity up to 28 days after birth among 743 070 low-risk planned home and hospital births: a cohort study based on three merged national perinatal databases

NARCIS (Netherlands)

de jonge, A.; Geerts, C. C.; van der Goes, B. Y.; Mol, B. W.; Buitendijk, S. E.; Nijhuis, J. G.

2015-01-01

To compare rates of adverse perinatal outcomes between planned home births versus planned hospital births. A nationwide cohort study. The Netherlands. Low-risk women in midwife-led care at the onset of labour. Analysis of national registration data. Intrapartum and neonatal death, Apgar scores, and

NBME subject examination in surgery scores correlate with surgery clerkship clinical experience.

Science.gov (United States)

Myers, Jonathan A; Vigneswaran, Yalini; Gabryszak, Beth; Fogg, Louis F; Francescatti, Amanda B; Golner, Christine; Bines, Steven D

2014-01-01

Most medical schools in the United States use the National Board of Medical Examiners Subject Examinations as a method of at least partial assessment of student performance, yet there is still uncertainty of how well these examination scores correlate with clinical proficiency. Thus, we investigated which factors in a surgery clerkship curriculum have a positive effect on academic achievement on the National Board of Medical Examiners Subject Examination in Surgery. A retrospective analysis of 83 third-year medical students at our institution with 4 unique clinical experiences on the general surgery clerkship for the 2007-2008 academic year was conducted. Records of the United States Medical Licensing Examination Step 1 scores, National Board of Medical Examiners Subject Examination in Surgery scores, and essay examination scores for the groups were compared using 1-way analysis of variance testing. Rush University Medical Center, Chicago IL, an academic institution and tertiary care center. Our data demonstrated National Board of Medical Examiners Subject Examination in Surgery scores from the group with the heavier clinical loads and least time for self-study were statistically higher than the group with lighter clinical services and higher rated self-study time (p = 0.036). However, there was no statistical difference of National Board of Medical Examiners Subject Examination in Surgery scores between the groups with equal clinical loads (p = 0.751). Students experiencing higher clinical volumes on surgical services, but less self-study time demonstrated statistically higher academic performance on objective evaluation, suggesting clinical experience may be of higher value than self-study and reading. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Effects of obstetric gel on the process and duration of labour in pregnant women: Randomised controlled trial.

Science.gov (United States)

Seval, Mehmet Murat; Yüce, Tuncay; Yakıştıran, Betül; Şükür, Yavuz Emre; Özmen, Batuhan; Atabekoğlu, Cem; Koç, Acar; Söylemez, Feride

2017-08-01

The present study investigated maternal and neonatal outcomes in pregnant women who used obstetric lubricant gels during active labour. This prospective randomised controlled study included 180 pregnant women. Women were randomly assigned to two groups during the first-stage of labour. Pregnant women in the obstetric gel group received standard antepartum care plus vaginal application of obstetric gel. Women in the control group received standard antepartum care without obstetric gel. Mean duration of the second stage of labour was significantly shorter in the obstetric gel group than control group (45 ± 34 min vs. 58 ± 31 min, respectively; p = .005). Mean APGAR values at 5 min were significantly higher in the obstetric gel group (9.5 ± 0.6 vs. 9.2 ± 0.7; p = .0014). Among nulliparous women, mean duration of the second stage of labour was significantly shorter in the gel group than control group (53 ± 52 min vs. 83 ± 45 min, respectively; p = .003). Using obstetric gel at the beginning of the first stage decreases the length of the second stage of labour, particularly in nulliparous women, and may be associated with an improved APGAR score at 5 min. Impact statement A limited number of studies in the literature have demonstrated that obstetric gels shorten the second stage of labour and are protective for the pelvic floor. The results of this study show that using obstetric gel shortens the second stage of labour in only nulliparous, but not multiparous women. In addition, a significant improvement in the 5 min APGAR score was seen in the neonates of women who used obstetric gel. The application of obstetric gels during the labour of nulliparous women may be a useful clinical practice and may have a widespread use in the future.

Propensity score method for analyzing the effect of labor induction in prolonged pregnancy.

Science.gov (United States)

Pyykönen, Aura; Tapper, Anna-Maija; Gissler, Mika; Haukka, Jari; Petäjä, Jari; Lehtonen, Lasse

2018-04-01

There is an ongoing debate on the optimal time of labor induction to reduce the risks associated with prolonged pregnancy. Registry-based study of 212 716 term, singleton cephalic deliveries between 2006 and 2012 in Finland comparing the outcomes of labor induction with those of expectant management in five, three-day gestational age periods between 40 and 42 weeks (group 1: 40 +0 -40 +2 ; group 2: 40 +3 -40 +5 ; group 3: 40 +6 -41 +1 ; group 4: 41 +2 -41 +4 ; group 5: 41 +5 -42 +0 ). Using Poisson regression, induced deliveries in each of the gestational age periods were compared with all ongoing pregnancies. Propensity score matching was applied to reduce confounding by indication. In the gestational age groups 1 and 2, labor induction significantly decreased the risk of meconium aspiration syndrome [relative risk (RR) 0.40, 95% confidence interval (CI) 0.18-0.91 (group 1), RR 0.44, 95% CI 0.21-0.91 (group 2)] but increased the risk for prolonged hospitalization of a neonate [RR 1.30, 95% CI 1.10-1.54 (group 1) and RR 1.23, 95% CI 1.03-1.47 (group 2)]. In groups 3 and 4, labor induction significantly increased the risk for emergency cesarean section [RR 1.17, 95% CI 1.06-1.28 (group 3) and RR 1.19, 95% CI 1.09-1.29 (group 4)] but still reduced the risk for meconium aspiration syndrome. In group 5, labor induction did not affect the risk for any of the studied outcomes (operative delivery, obstetric trauma, neonatal mortality, respirator treatment, Apgar <7). Propensity score matching is a novel approach to studying the effect of labor induction. It highlighted the conflicting maternal and neonatal risks and benefits of the intervention, and supported expectant management as a valid option, at least until close to 42 weeks. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

Association between sleep stages and hunger scores in 36 children.

Science.gov (United States)

Arun, R; Pina, P; Rubin, D; Erichsen, D

2016-10-01

Childhood obesity is a growing health challenge. Recent studies show that children with late bedtime and late awakening are more obese independent of total sleep time. In adolescents and adults, a delayed sleep phase has been associated with higher caloric intake. Furthermore, an adult study showed a positive correlation between REM sleep and energy balance. This relationship has not been demonstrated in children. However, it may be important as a delayed sleep phase would increase the proportion of REM sleep. This study investigated the relationship between hunger score and sleep physiology in a paediatric population. Thirty-six patients referred for a polysomnogram for suspected obstructive sleep apnoea were enrolled in the study. Sleep stages were recorded as part of the polysomnogram. Hunger scores were obtained using a visual analogue scale. Mean age was 9.6 ± 3.5 years. Mean hunger scores were 2.07 ± 2.78. Hunger scores were positively correlated with percentage of total rapid eye movement (REM) sleep (r = 0.438, P hunger score (r = -0.360, P hunger scores. These findings suggest that delayed bedtime, which increases the proportion of REM sleep and decreases the proportion of SWS, results in higher hunger levels in children. © 2015 World Obesity.

The power and robustness of maximum LOD score statistics.

Science.gov (United States)

Yoo, Y J; Mendell, N R

2008-07-01

The maximum LOD score statistic is extremely powerful for gene mapping when calculated using the correct genetic parameter value. When the mode of genetic transmission is unknown, the maximum of the LOD scores obtained using several genetic parameter values is reported. This latter statistic requires higher critical value than the maximum LOD score statistic calculated from a single genetic parameter value. In this paper, we compare the power of maximum LOD scores based on three fixed sets of genetic parameter values with the power of the LOD score obtained after maximizing over the entire range of genetic parameter values. We simulate family data under nine generating models. For generating models with non-zero phenocopy rates, LOD scores maximized over the entire range of genetic parameters yielded greater power than maximum LOD scores for fixed sets of parameter values with zero phenocopy rates. No maximum LOD score was consistently more powerful than the others for generating models with a zero phenocopy rate. The power loss of the LOD score maximized over the entire range of genetic parameters, relative to the maximum LOD score calculated using the correct genetic parameter value, appeared to be robust to the generating models.

Observation On The Rates, Benefits And Complications Of ...

African Journals Online (AJOL)

Outcome measures were 2nd stage duration, birth weight, Apgar score, perineal tear, perineal pain, dyspareunia and incontinence in the pueperium. There were 1,404 vaginal deliveries and 34.5% of them had episiotomy. Episiotomy was more frequent in nulliparous (65.7%) than multiparous (17.4%) women.

Limitations in the Activity of Mobility at Age 6 Years After Difficult Birth at Term : A Prospective Cohort Study

NARCIS (Netherlands)

van Iersel, Patricia A. M.; Algra, Annechien M.; Bakker, Saskia C. M.; Jonker, Arnold J. H.; Hadders-Algra, Mijna

Background. A difficult birth at term (DBAT) may manifest as fetal acidosis and low Apgar scores and is often referred to as "perinatal asphyxia," especially when infants show signs of neonatal encephalopathy (NE). In contrast to DBAT resulting in moderate-to-severe NE, which is associated with

SOS score: an optimized score to screen acute stroke patients for obstructive sleep apnea.

Science.gov (United States)

Camilo, Millene R; Sander, Heidi H; Eckeli, Alan L; Fernandes, Regina M F; Dos Santos-Pontelli, Taiza E G; Leite, Joao P; Pontes-Neto, Octavio M

2014-09-01

Obstructive sleep apnea (OSA) is frequent in acute stroke patients, and has been associated with higher mortality and worse prognosis. Polysomnography (PSG) is the gold standard diagnostic method for OSA, but it is impracticable as a routine for all acute stroke patients. We evaluated the accuracy of two OSA screening tools, the Berlin Questionnaire (BQ), and the Epworth Sleepiness Scale (ESS) when administered to relatives of acute stroke patients; we also compared these tools against a combined screening score (SOS score). Ischemic stroke patients were submitted to a full PSG at the first night after onset of symptoms. OSA severity was measured by apnea-hypopnea index (AHI). BQ and ESS were administered to relatives of stroke patients before the PSG and compared to SOS score for accuracy and C-statistics. We prospectively studied 39 patients. OSA (AHI ≥10/h) was present in 76.9%. The SOS score [area under the curve (AUC): 0.812; P = 0.005] and ESS (AUC: 0.789; P = 0.009) had good predictive value for OSA. The SOS score was the only tool with significant predictive value (AUC: 0.686; P = 0.048) for severe OSA (AHI ≥30/h), when compared to ESS (P = 0.119) and BQ (P = 0.191). The threshold of SOS ≤10 showed high sensitivity (90%) and negative predictive value (96.2%) for OSA; SOS ≥20 showed high specificity (100%) and positive predictive value (92.5%) for severe OSA. The SOS score administered to relatives of stroke patients is a useful tool to screen for OSA and may decrease the need for PSG in acute stroke setting. Copyright © 2014 Elsevier B.V. All rights reserved.

Effects of labor analgesia on maternal and neonatal outcome by epidural low concentration of bupivacaine combined with anisodamine

Institute of Scientific and Technical Information of China (English)

Yang Xiaoli; Zhou Chunqin; Li Xiaogang; Shen Xiaodong; Zou Yuliang

2008-01-01

Objective To observe the effects of labor analgesia on maternal and neonatal outcome by epidural application of 0.125% bupivacaine combined with anisodamine on the labor stage, and modes of delivery and neonatal Apgar's score. Methods A total of 220 primiparaes with full-term pregnancy, monocyesis and fetal head presentation without any obstetrical or systematic complications were chosen and divided into analgesic group and control group (110 in each group). The mixture of bupivaeaine and anisodamine was injected into the epidural space of the parturients in the analgesic group while those patients in the control group did not receive any analgesics. Results The analgesic effect was satisfactory (91.8 %), and no side effects occurred in the second stage of labor. The instrument delivery rate was lower in the analgesic group, and there was no significant difference between the two groups in neonatal Apgar's score. Conclusion The method is feasible in clinic for labor pain relief without increasing the rate of dystocla and complications of delivery.

Maternal Body Mass Index Does Not Affect Neonatal Umbilical Artery Blood Gas Parameters

Directory of Open Access Journals (Sweden)

Salam E. Chalouhi

2013-01-01

Full Text Available This study was undertaken to assess the impact of obesity on fetal well-being in glucose-tolerant and nonhypertensive women. Medical charts of all patients admitted to the labor and delivery department at our institution between January, 2011 and July, 2011 were retrospectively reviewed. Patients with diabetes/impaired glucose tolerance or hypertension were excluded. A total of 100 women, 50 lean and 50 obese, were included. Umbilical artery blood gas parameters (BGPs were compared in lean (<25 kg/m2 and obese (≥30 kg/m2 women. Obese and lean women were comparable with respect to all baseline characteristics. There was no difference in any of the BGP or Apgar scores between obese and lean patients. Pearson’s correlation coefficient found no significant correlation between BMI and BGP/Apgar scores. Maternal obesity does not seem to affect BGP and fetal well-being in glucose-tolerant and nonhypertensive women.

Maternal and newborn morbidity by birth facility among selected United States 2006 low-risk births.

Science.gov (United States)

Wax, Joseph R; Pinette, Michael G; Cartin, Angelina; Blackstone, Jacquelyn

2010-02-01

We sought to evaluate perinatal morbidity by delivery location (hospital, freestanding birth center, and home). Selected 2006 US birth certificate data were accessed online from the Centers for Disease Control and Prevention. Low-risk maternal and newborn outcomes were tabulated and compared by birth facility. A total of 745,690 deliveries were included, of which 733,143 (97.0%) occurred in hospital, 4661 (0.6%) at birth centers, and 7427 (0.9%) at home. Compared with hospital deliveries, home and birthing center deliveries were associated with more frequent prolonged and precipitous labors. Home births experienced more frequent 5-minute Apgar scores home and birthing center deliveries were associated with less frequent chorioamnionitis, fetal intolerance of labor, meconium staining, assisted ventilation, neonatal intensive care unit admission, and birthweight Home births are associated with a number of less frequent adverse perinatal outcomes at the expense of more frequent abnormal labors and low 5-minute Apgar scores. Copyright 2010 Mosby, Inc. All rights reserved.

RANDOMISED CONTROLLED STUDY COMPARING A 0.75% ROPIVACAINE TO A CONVENTIONAL DOSE OF HYPERBARIC BUPIVACAINE FOR CESARIAN SECTION BY EPIDURAL ANALGESIA

Directory of Open Access Journals (Sweden)

Porika

2015-09-01

Full Text Available Central neuraxial blocked is one of the safest and efficacious methods of anaesthesia and analgesia. It has the added advantage of prolonged pain relief into the postoperative period. Epidural analgesia has increased steadily in popularity when compared to spinal anaesthes ia due to its neurological consequences and improved post - operative analgesia with epidural Opioids and as a consequence decreased side effects and prolonged the duration of analgesia. Present study is undertaken to compare hemodynamic and analgesic charac teristics using a 0.75% ropivacaine to a conventional dose of 0.5% bupivacaine for cesarean section under epidural anaesthesia. This study was conducted in ASA Grade I 50 singleton parturient to compare hemodynamics, APGAR scores and analgesic characterist ics of ropivacaine and bupivacaine. We have observed that the onset of sensory blockade was slower with ropivacaine and the duration of sensory blockade was also less. Whereas there was no significant change in haemodynamics and APGAR scores with both the drugs.

Comparison between visual and computerized cardiotocography in low risk pregnancy

International Nuclear Information System (INIS)

Mirghani, Hisham M.; Khair, Howaida

2005-01-01

To compare between visual and computerized cardiotocography (cCTG) in low-risk pregnant women in predicting pregnancy outcome. One hundred and fifty-three consecutive computerized fetal heart tracings were recorded from non-laboring pregnant women at >/- 30 weeks gestation. All traces were reviewed by 2 experienced obstetricians. The study was carried out at Al-Ain Medical District, United Arab Emirates, between August 2004 and December 2004. Of the 153 pregnant women, 11 (7.2%) were delivered by cesarean section. The interobserver agreement was 0.60. The observers cCTG agreement were 0.48 and 0.45. The difference in cesarean section rate was not statistically significant. Observers interpretation and cCTG did not correlate well with Apgar score at 5 minutes and admission to special care baby unit. Computerized CTG has little advantage over conventional CTG in the prediction of Apgar score and need for neonatal intensive care unit admission in a low-risk population. (author)

Differences in distribution of T-scores and Z-scores among bone densitometry tests in postmenopausal women (a comparative study)

International Nuclear Information System (INIS)

Wendlova, J.

2002-01-01

To determine the character of T-score and Z-score value distribution in individually selected methods of bone densitometry and to compare them using statistical analysis. We examined 56 postmenopausal women with an age between 43 and 68 years with osteopenia or osteoporosis according to the WHO classification. The following measurements were made in each patient: T-score and Z-score for: 1) Stiffness index (S) of the left heel bone, USM (index). 2) Bone mineral density of the left heel bone (BMDh), DEXA (g of Ca hydroxyapatite per cm 2 ). 3) Bone mineral density of trabecular bone of the L1 vertebra (BMDL1). QCT (mg of Ca hydroxyapatite per cm 3 ). The densitometers used in the study were: ultrasonometer to measure heel bone, Achilles plus LUNAR, USA: DEXA to measure heel bone, PIXl, LUNAR, USA: QCT to measure the L1 vertebra, CT, SOMATOM Plus, Siemens, Germany. Statistical analysis: differences between measured values of T-scores (Z-scores) were evaluated by parametric or non-parametric methods of determining the 95 % confidence intervals (C.I.). Differences between Z-score and T-score values for compared measurements were statistically significant; however, these differences were lower for Z-scores. Largest differences in 95 % C.I., characterizing individual measurements of T-score values (in comparison with Z-scores), were found for those densitometers whose age range of the reference groups of young adults differed the most, and conversely, the smallest differences in T-score values were found when the differences between the age ranges of reference groups were smallest. The higher variation in T-score values in comparison to Z-scores is also caused by a non-standard selection of the reference groups of young adults for the QCT, PIXI and Achilles Plus densitometers used in the study. Age characteristics of the reference group for T-scores should be standardized for all types of densitometers. (author)

Pain Scores Are Not Predictive of Pain Medication Utilization

Directory of Open Access Journals (Sweden)

Suzanne Galloway

2011-01-01

Full Text Available Objective. To compare Visual Analogue Scale (VAS scores with overall postoperative pain medication requirements including cumulative dose and patterns of medication utilization and to determine whether VAS scores predict pain medication utilization. Methods. VAS scores and pain medication data were collected from participants in a randomized trial of the utility of phenazopyridine for improved pain control following gynecologic surgery. Results. The mean age of the 219 participants was 54 (range19 to 94. We did not detect any association between VAS and pain medication utilization for patient-controlled anesthesia (PCA or RN administered (intravenous or oral medications. We also did not detect any association between the number of VAS scores recorded and mean pain scores. Conclusion. Postoperative VAS scores do not predict pain medication use in catheterized women inpatients following gynecologic surgery. Increased pain severity, as reflected by higher VAS scores, is not associated with an increase in pain assessment. Our findings suggest that VAS scores are of limited utility for optimal pain control. Alternative or complimentary methods may improve pain management.

Is there a relation between priapism occurring after penile doppler ultrasonography and international erectile function index score and erection hardness score levels?

Science.gov (United States)

Sönmez, Mehmet Giray; Öztürk, Ahmet

2017-12-01

The relation between Erection Hardness Score (EHS) and The International Erectile Function Index (IIEF) Questionnaire- Erectile Function Domain Score (IIEF-EF score) used in erectile dysfunction (ED) evaluation and the prevalence of priapism after penile Doppler ultrasonography (PDU) was examined in this study. A total of 62 patients who had PDU were included in the study. Patients were divided into two groups; there were 33 patients in IIEF-EF score ≤10, EHS 10, EHS ≥2 group (Group 2). The two groups separated according to their scores were compared for age, body mass index (BMI), prevalence of priapism, vascular comorbidities and duration of erection. When compared to Group 2, median age, rate of vascular comorbidities rate and BMI were detected to be higher in Group 1 with IIEF-EF score ≤10 and EHS 10 and EHS ≥2 (p<0.001, p=0.027, p=0.049 respectively). High IIEF-EF and EHS scores, younger ages and lower rates of vascular comorbidities in patients from whom PDU was demanded increase the prevalence of priapism.

The Sinonasal Outcome Test 22 score in persons without chronic rhinosinusitis

DEFF Research Database (Denmark)

Lange, Bibi; Thilsing, T; Baelum, J

2016-01-01

-67 with a mean score of 10.5 (CI: 9.1 - 11.9) and the median score was 7. Persons with allergic rhinitis and blue collar workers had a significant higher score. CONCLUSION: The median value of 7 is taken as the normal SNOT 22 score in persons without CRS and can be used as a reference in clinical settings...... and research. Allergic rhinitis and occupation affects SNOT 22 in persons without CRS. This article is protected by copyright. All rights reserved....

Marital status and optimism score among breast cancer survivors.

Science.gov (United States)

Croft, Lindsay; Sorkin, John; Gallicchio, Lisa

2014-11-01

There are an increasing number of breast cancer survivors, but their psychosocial and supportive care needs are not well-understood. Recent work has found marital status, social support, and optimism to be associated with quality of life, but little research has been conducted to understand how these factors relate to one another. Survey data from 722 breast cancer survivors were analyzed to estimate the association between marital status and optimism score, as measured using the Life Orientation Test-Revised. Linear regression was used to estimate the relationship of marital status and optimism, controlling for potential confounding variables and assessing effect modification. The results showed that the association between marital status and optimism was modified by time since breast cancer diagnosis. Specifically, in those most recently diagnosed (within 5 years), married breast cancer survivors had a 1.50 higher mean optimism score than unmarried survivors (95 % confidence interval (CI) 0.37, 2.62; p = 0.009). The difference in optimism score by marital status was not present more than 5 years from breast cancer diagnosis. Findings suggest that among breast cancer survivors within 5 years since diagnosis, those who are married have higher optimism scores than their unmarried counterparts; this association was not observed among longer-term breast cancer survivors. Future research should examine whether the difference in optimism score among this subgroup of breast cancer survivors is clinically relevant.

Prediction of Length of Postoperative Ventilation in CDH Survivors ...

African Journals Online (AJOL)

Materials & Methods: This is a retrospective study of cases of CDH survivors managed by the authors over the period from January 2003 till February 2010. The preoperative variables included gestational age, gender, birth weight, Apgar score, the time of intubation, the ventilation strategy, the presence of a significant PDA ...

Predictors of bronchopulmonary dysplasia and pulmonary hypertension in newborn children

DEFF Research Database (Denmark)

Ali, Zarqa; Peter, Schmidt; Dodd, James Keith

2013-01-01

%. Infants with BPD differed significantly from infants without BPD with regard to the following characteristics: Infants with BPD more frequently had a lower gestational age and BW, intubation at birth, mechanical ventilation within 24 hours of birth, a lower ­Apgar score at one minute and five minutes...

Forløsningsmåde ved underkropspraesentation. Selektion ved røntgenologisk baekkenmåling

DEFF Research Database (Denmark)

Krebs, L; Nilas, L; Langhoff-Roos, J

1997-01-01

, pelvimetry was performed in 74 women, where pelvic dimensions too small for recommendation of vaginal breech delivery were found in 30 cases. The overall rate of caesarean section was 78%, among diagnosed patients it was 84% and 64% among undiagnosed breech presentations. Rates of morbidity (low Apgar score...

Asphyxia Neonatorum-Incidence In Cape Town

African Journals Online (AJOL)

task of all concerned with the process of human repro- duction. In order to achieve this, a study of the incidence and risk factors of asphyxia neonatorum was undertaken in the Groote Schuur Maternity Hospital. TABLE I. INCIDENCE OF ASPHYXIA NEONATORUM. Source of. Hospital. Apgar score 0 - 3% information.

Materno-foetal outcome of labour in obese women in Yaounde ...

African Journals Online (AJOL)

The objectives of the study were to determine the socio-demographic characteristics of pregnant women with obesity and morbid obesity determine the mean birth weight, foetal length and Apgar score of the babies as well as associated maternal complications. This was a descriptive cross sectional prospective study ...

effects of Vitamin D deficiency on pregnancy outcomes.

African Journals Online (AJOL)

ternal vitamin D deficiency and adverse maternal and fetal outcomes including gestational diabetes, preec- ... ed complications, birth weight, Apgar scores, neonatal gender and presence of congenital anomalies were ..... draui P, González-Salmerón MD,Pérez-López FR;. Spanish Vitamin D and Women's Health Research.

Top of the basilar artery embolic stroke and neonatal myoclonus

NARCIS (Netherlands)

Govaert, Paul; Dudink, Jeroen; Visser, Gerhard; Breukhoven, Petra; Vanhatalo, Sampsa; Lequin, Maarten

Cerebellar stroke has been virtually unreported in the living newborn infant. A term newborn male weighing 3380g at birth suffered myoclonic seizures within 24 hours of birth by spontaneous vaginal delivery. Apgar scores were 3 and 4 at 1 and 5 minutes. Myoclonus persisted for 9 days, responding

Mode of delivery has an independent impact on neonatal condition at birth.

Science.gov (United States)

Prior, Tomas; Kumar, Sailesh

2014-10-01

Current intra-partum monitoring techniques are often criticized for their poor specificity, with their performance frequently evaluated using measures of the neonatal condition at birth as a surrogate marker for intra-partum fetal compromise. However, these measures may potentially be influenced by a multitude of other factors, including the mode of delivery itself. This study aimed to investigate the impact of mode of delivery on neonatal condition at birth. This prospective observational study, undertaken at a tertiary referral maternity unit in London, UK, included 604 'low risk' women recruited prior to delivery. Commonly assessed neonatal outcome variables (Apgar score at 1 and 5min, umbilical artery pH and base excess, neonatal unit admission, and a composite neonatal outcome score) were used to compare the condition at birth between babies born by different modes of delivery, using one-way ANOVA and chi-squared testing. Infants born by instrumental delivery for presumed fetal compromise had the poorest condition at birth (mean composite score=1.20), whereas those born by Cesarean section for presumed fetal compromise had a better condition at birth (mean composite score=0.64) (p=surrogate marker of intra-partum fetal compromise. When evaluating the efficacy of intra-partum monitoring techniques, the isolated use of Apgar scores, umbilical artery acidosis and neonatal unit admission should be discouraged. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Characteristics of Youth Food Preparation in Low-Income, African American Homes: Associations with Healthy Eating Index Scores.

Science.gov (United States)

Sattler, Melissa; Hopkins, Laura; Anderson Steeves, Elizabeth; Cristello, Angelica; Mccloskey, Morgan; Gittelsohn, Joel; Hurley, Kristen

2015-01-01

This study explores food preparation behaviors, including types of food prepared, methods of preparation, and frequency of preparation of low-income urban African American youth ages 9-15 in Baltimore City (n = 289) and analyzes a potential association to diet quality as measured through Healthy Eating Index 2010 (HEI) scores. Overall, the youth prepared their own food 6.7 ± 0.33 times per week without significant differences between age groups or genders as measured through pairwise comparison of means. Cereal, noodles, and sandwiches were amongst the foods prepared most frequently. Linear regression analysis found youth food preparation frequency was not significantly associated with total HEI (p = 0.59), sodium (p = 0.58), empty calories (p = 0.96), or dairy scores (p = 0.12). Younger age was associated with higher total HEI scores (p = 0.012) and higher dairy scores (p = 0.01) and female gender was associated with higher total HEI scores (p = 0.03), higher sodium scores (p = 0.03), and lower dairy scores (p = 0.008).

Accuracy of the Auto Scoring by the S9 CPAP in Patients with Obstructive Sleep Apnea

Directory of Open Access Journals (Sweden)

Joon Hyun Baek

2016-06-01

Full Text Available Background and Objective Several continuous positive airway pressure (CPAP devices currently in use automatically estimate and provide information of the residual respiratory events such as apnea-hypopnea index (AHI, apnea index (AI, and hypopnea index (HI. To compare the auto scoring of the residual respiratory events using the S9 CPAP device with simultaneous manual scoring and identify factors that are associated with difference between auto scoring and manual scoring in patients with OSA. Methods Patients with moderate to severe OSA titrated manually using S9 CPAP device were included. The correlation between auto scoring and manual scoring was assessed during an overnight standard in-hospital CPAP titration. Results Eighty-six patients with moderate to severe OSA were included. There was a strong correlation between auto scoring and manual scoring on AHI (r = 0.74, p < 0.001, with a stronger correlation on the AI (r = 0.86, p < 0.001, and a weaker correlation on HI (r = 0.56, p < 0.001. Overall, S9 auto scoring tended to underestimate the AHI (mean AHI difference: −1.30 owing to the strong underestimation on HI. Higher BMI, higher AHI from diagnostic polysomnography, higher leakage and lower oxygen saturation were independent factors for greater difference between auto scoring and manual scoring. Conclusions Auto scoring showed strong correlation with manual scoring. However, auto scoring of S9 CPAP tended to underestimate the AHI, as compared to manual scoring. Characteristic features of severe OSA were associated factors for difference between auto scoring and manual scoring.

Mediterranean diet score and left ventricular structure and function: the Multi-Ethnic Study of Atherosclerosis12

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Levitan, Emily B; Ahmed, Ali; Arnett, Donna K; Polak, Joseph F; Hundley, W Gregory; Bluemke, David A; Heckbert, Susan R; Jacobs, David R; Nettleton, Jennifer A

2016-01-01

Background: Data are limited on the relation between dietary patterns and left ventricular (LV) structure and function. Objective: We examined cross-sectional associations of a diet-score assessment of a Mediterranean dietary pattern with LV mass, volume, mass-to-volume ratio, stroke volume, and ejection fraction. Design: We measured LV variables with the use of cardiac MRI in 4497 participants in the Multi-Ethnic Study of Atherosclerosis study who were aged 45–84 y and without clinical cardiovascular disease. We calculated a Mediterranean diet score from intakes of fruit, vegetables, nuts, legumes, whole grains, fish, red meat, the monounsaturated fat:saturated fat ratio, and alcohol that were self-reported with the use of a food-frequency questionnaire. We used linear regression with adjustment for body size, physical activity, and cardiovascular disease risk factors to model associations and assess the shape of these associations (linear or quadratic). Results: The Mediterranean diet score had a slight U-shaped association with LV mass (adjusted means: 146, 145, 146, and 147 g across quartiles of diet score, respectively; P-quadratic trend = 0.04). The score was linearly associated with LV volume, stroke volume, and ejection fraction: for each +1-U difference in score, LV volume was 0.4 mL higher (95% CI: 0.0, 0.8 mL higher), the stroke volume was 0.5 mL higher (95% CI: 0.2, 0.8 mL higher), and the ejection fraction was 0.2 percentage points higher (95% CI: 0.1, 0.3 percentage points higher). The score was not associated with the mass-to-volume ratio. Conclusions: A higher Mediterranean diet score is cross-sectionally associated with a higher LV mass, which is balanced by a higher LV volume as well as a higher ejection fraction and stroke volume. Participants in this healthy, multiethnic sample whose dietary patterns most closely conformed to a Mediterranean-type pattern had a modestly better LV structure and function than did participants with less�

Greater Equality: The Hidden Key to Better Health and Higher Scores

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Wilkinson, Richard; Pickett, Kate

2011-01-01

There are now many studies of income inequality and health that compare countries, American states, or other large regions, and the majority of these studies show that more egalitarian societies tend to be healthier. Inequality is associated with lower life expectancy, higher rates of infant mortality, shorter height, poor self-reported health,…

Relationships among personality traits, metabolic syndrome, and metabolic syndrome scores: The Kakegawa cohort study.

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Ohseto, Hisashi; Ishikuro, Mami; Kikuya, Masahiro; Obara, Taku; Igarashi, Yuko; Takahashi, Satomi; Kikuchi, Daisuke; Shigihara, Michiko; Yamanaka, Chizuru; Miyashita, Masako; Mizuno, Satoshi; Nagai, Masato; Matsubara, Hiroko; Sato, Yuki; Metoki, Hirohito; Tachibana, Hirofumi; Maeda-Yamamoto, Mari; Kuriyama, Shinichi

2018-04-01

Metabolic syndrome and the presence of metabolic syndrome components are risk factors for cardiovascular disease (CVD). However, the association between personality traits and metabolic syndrome remains controversial, and few studies have been conducted in East Asian populations. We measured personality traits using the Japanese version of the Eysenck Personality Questionnaire (Revised Short Form) and five metabolic syndrome components-elevated waist circumference, elevated triglycerides, reduced high-density lipoprotein cholesterol, elevated blood pressure, and elevated fasting glucose-in 1322 participants aged 51.1±12.7years old from Kakegawa city, Japan. Metabolic syndrome score (MS score) was defined as the number of metabolic syndrome components present, and metabolic syndrome as having the MS score of 3 or higher. We performed multiple logistic regression analyses to examine the relationship between personality traits and metabolic syndrome components and multiple regression analyses to examine the relationship between personality traits and MS scores adjusted for age, sex, education, income, smoking status, alcohol use, and family history of CVD and diabetes mellitus. We also examine the relationship between personality traits and metabolic syndrome presence by multiple logistic regression analyses. "Extraversion" scores were higher in those with metabolic syndrome components (elevated waist circumference: P=0.001; elevated triglycerides: P=0.01; elevated blood pressure: P=0.004; elevated fasting glucose: P=0.002). "Extraversion" was associated with the MS score (coefficient=0.12, P=0.0003). No personality trait was significantly associated with the presence of metabolic syndrome. Higher "extraversion" scores were related to higher MS scores, but no personality trait was significantly associated with the presence of metabolic syndrome. Copyright © 2018 Elsevier Inc. All rights reserved.

The Use of Tests in Admissions to Higher Education.

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Fruen, Mary

1978-01-01

There are both strengths and weaknesses of using standardized test scores as a criterion for admission to institutions of higher education. The relative importance of scores is dependent on the institution's degree of selectivity. In general, decision processes and admissions criteria are not well defined. Advantages of test scores include: use of…

Low birthweight and mortality

DEFF Research Database (Denmark)

Bakketeig, Leiv S.; Jacobsen, Geir; Skjærven, Rolv

2006-01-01

. The analysis considered 7 803 of these births, as 8 were excluded due to insufficient information. 30% of these second order LBW children had an older sibling who was also LBW. Early neonatal mortality of a “repeat” LBW birth was about 13% lower than among “non-repeat” LBW births (p..., the infant mortality was significantly higher among non-repeat LBW births (78.4 vs 60.8 per 1000, RR 1.30, CI 1.06, 1.56). Both after 1 and 5 minutes a significantly greater proportion of LBW repeat births had Apgar scores of 7 or above. Repeat second order LBW births weighed on average 68 grams more than...... non-repeat LBW births (pvs 2...

Spontaneous rupture of the middle colic artery resulting in delayed ...

African Journals Online (AJOL)

mission for three days after delivery due to raised blood pressure which was controlled using antihypertensives. The baby weighed 3.8 kg with good Apgar score. ... Osamu C, Hiroshi K, Makoto S, Soichiro Y, Hiroyuki. K, Yasumasa K, Hiroyasu M. Spontaneous rupture of. Dissecting Aneurysm of the Middle colic Artery. Tokai.

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2003 were the subjects of this study. The mothers were identified from the labour ward register. Their case notes were retrieved and analyzed to obtain information on details of maternal demography, complications during pregnancy, labour and delivery, babies' birth weight and apgar score at one minute. Data analysis was ...

Out-of-hospital births, U.S., 1978: birth weight and Apgar scores as measures of outcome.

OpenAIRE

Declercq, E R

1984-01-01

An examination of 1978 natality data for the United States disclosed that low birth weight was less common among 30,819 infants born out of hospital than among 3,294,101 infants born in hospital in that year. When controls were applied for birth attendant, infants' race, and mothers' education, age, nativity, and parity, the data revealed that white, well-educated women between 25 and 39 years of age, who were having their second babies and were attended by midwives out of hospital, were at l...

Long-term outcome in term breech infants with low Apgar score--a population-based follow-up

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Krebs, L; Langhoff-Roos, J; Thorngren-Jerneck, K

2001-01-01

and 218 controls. RESULTS: Four cases (4.6%) and one control (0.5%) had cerebral palsy. In infants without cerebral palsy, speech/language problems were more frequent than controls (10.6 versus 3.2%) (P=0.02). There were no differences in rates of deficits in attention, motor control and perception (DAMP...

D-score: a search engine independent MD-score.

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Vaudel, Marc; Breiter, Daniela; Beck, Florian; Rahnenführer, Jörg; Martens, Lennart; Zahedi, René P

2013-03-01

While peptides carrying PTMs are routinely identified in gel-free MS, the localization of the PTMs onto the peptide sequences remains challenging. Search engine scores of secondary peptide matches have been used in different approaches in order to infer the quality of site inference, by penalizing the localization whenever the search engine similarly scored two candidate peptides with different site assignments. In the present work, we show how the estimation of posterior error probabilities for peptide candidates allows the estimation of a PTM score called the D-score, for multiple search engine studies. We demonstrate the applicability of this score to three popular search engines: Mascot, OMSSA, and X!Tandem, and evaluate its performance using an already published high resolution data set of synthetic phosphopeptides. For those peptides with phosphorylation site inference uncertainty, the number of spectrum matches with correctly localized phosphorylation increased by up to 25.7% when compared to using Mascot alone, although the actual increase depended on the fragmentation method used. Since this method relies only on search engine scores, it can be readily applied to the scoring of the localization of virtually any modification at no additional experimental or in silico cost. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Inter-expert and intra-expert reliability in sleep spindle scoring

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Wendt, Sabrina Lyngbye; Welinder, Peter; Sørensen, Helge Bjarup Dissing

2015-01-01

Objectives To measure the inter-expert and intra-expert agreement in sleep spindle scoring, and to quantify how many experts are needed to build a reliable dataset of sleep spindle scorings. Methods The EEG dataset was comprised of 400 randomly selected 115 s segments of stage 2 sleep from 110...... with higher reliability than the estimation of spindle duration. Reliability of sleep spindle scoring can be improved by using qualitative confidence scores, rather than a dichotomous yes/no scoring system. Conclusions We estimate that 2–3 experts are needed to build a spindle scoring dataset...... with ‘substantial’ reliability (κ: 0.61–0.8), and 4 or more experts are needed to build a dataset with ‘almost perfect’ reliability (κ: 0.81–1). Significance Spindle scoring is a critical part of sleep staging, and spindles are believed to play an important role in development, aging, and diseases of the nervous...

Poor performances of EuroSCORE and CARE score for prediction of perioperative mortality in octogenarians undergoing aortic valve replacement for aortic stenosis.

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Chhor, Vibol; Merceron, Sybille; Ricome, Sylvie; Baron, Gabriel; Daoud, Omar; Dilly, Marie-Pierre; Aubier, Benjamin; Provenchere, Sophie; Philip, Ivan

2010-08-01

Although results of cardiac surgery are improving, octogenarians have a higher procedure-related mortality and more complications with increased length of stay in ICU. Consequently, careful evaluation of perioperative risk seems necessary. The aims of our study were to assess and compare the performances of EuroSCORE and CARE score in the prediction of perioperative mortality among octogenarians undergoing aortic valve replacement for aortic stenosis and to compare these predictive performances with those obtained in younger patients. This retrospective study included all consecutive patients undergoing cardiac surgery in our institution between November 2005 and December 2007. For each patient, risk assessment for mortality was performed using logistic EuroSCORE, additive EuroSCORE and CARE score. The main outcome measure was early postoperative mortality. Predictive performances of these scores were assessed by calibration and discrimination using goodness-of-fit test and area under the receiver operating characteristic curve, respectively. During this 2-year period, we studied 2117 patients, among whom 134/211 octogenarians and 335/1906 nonoctogenarians underwent an aortic valve replacement for aortic stenosis. When considering patients with aortic stenosis, discrimination was poor in octogenarians and the difference from nonoctogenarians was significant for each score (0.58, 0.59 and 0.56 vs. 0.82, 0.81 and 0.77 for additive EuroSCORE, logistic EuroSCORE and CARE score in octogenarians and nonoctogenarians, respectively, P performances of these scores are poor in octogenarians undergoing cardiac surgery, especially aortic valve replacement. Risk assessment and therapeutic decisions in octogenarians should not be made with these scoring systems alone.

Increased discordance between HeartScore and coronary artery calcification score after introduction of the new ESC prevention guidelines

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Diederichsen, Axel C P; Mahabadi, Amir-Abbas; Gerke, Oke

2015-01-01

-contrast Cardiac-CT scan was performed to detect coronary artery calcification (CAC). RESULTS: Agreement of HeartScore risk groups with CAC groups was poor, but higher when applying the algorithm for the low-risk compared to the high-risk country model (agreement rate: 77% versus 63%, and weighted Kappa: 0...

The effects of labor and delivery on maternal and neonatal outcomes in term twins: a retrospective cohort study.

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Wenckus, D J; Gao, W; Kominiarek, M A; Wilkins, I

2014-08-01

To compare maternal and neonatal outcomes in twins undergoing a trial of labor versus pre-labor caesarean. Retrospective cohort study. 19 US hospitals from the Consortium on Safe Labor. Of 2225 twin sets ≥36 weeks' gestation. Maternal (abruption, estimated blood loss, postpartum haemorrhage, transfusion, chorioamnionitis, hysterectomy, ICU admission, death) and neonatal outcomes (birth injury, 5-minute Apgar <7, NICU admission, RDS, TTN, sepsis, asphyxia, NICU length of stay, death) were compared between the trial of labour and pre-labour caesarean groups with univariate and multivariate logistic and linear regression analyses. Similar analyses were performed for actual delivery modes. Maternal and neonatal outcomes. Among the 2225 twin sets, 1078 had a trial of labour, and 65.9% of those delivered vaginally. There was an increased risk for postpartum haemorrhage [OR 2.5, 95% confidence interval (CI) 1.4-4.5] and blood transfusion (OR 1.9, 95%CI 1.2-3.2) for the trial of labour compared with pre-labour caesarean groups. Birth injury only occurred in the trial of labour group, 1% Twin A, 0.4% Twin B. Both twins had a higher risk of 5-minute Apgar <7 with trial of labour compared to pre-labour caesarean (A: OR 3.9, 95%CI 1.05-14.5; B: OR 3.9, 95%CI 1.3-12.3). Term twins undergoing a trial of labour have increased maternal haemorrhage and transfusions along with neonatal birth trauma and lower Apgar scores, but these absolute neonatal occurrences were rare. Trial of labour in twins remains a safe and reasonable option in appropriately selected cases. © 2014 Royal College of Obstetricians and Gynaecologists.

Evaluasi Misfit-Score Strategi Pemanufakturan dengan Strategi Bisnis Serta Dampaknya pada Kinerja Operasional

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Titik Kusmantini

2009-03-01

Full Text Available This research was established based on organizational kesesuaian hubungan theory, where in the formulation of strategic decision in manufacturing strategic must be alingment with business strategy. The higher congcruence can create higher performance. The hypothesis was tested with multiple regression models and the degree of fit (misfit-score to computing with euclidean distance as regression coeficient.Keyword: Manufacturing, Business, Performance, Misfit-Score.

Quality of life in family caregivers of schizophrenia patients in Spain: caregiver characteristics, caregiving burden, family functioning, and social and professional support.

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Ribé, José M; Salamero, Manel; Pérez-Testor, Carles; Mercadal, Josep; Aguilera, Concepción; Cleris, Margarida

2018-03-01

Caregivers experience physical and mental stress that ends up lowering their quality of life (QoL). Our goal was to research (a) the level of caregivers QoL; (b) the relationships between the demographic characteristics of the caregivers, their caregiving burden, their family functioning, their social and professional support and their QoL and (c) the best predictors of caregivers QoL. 100 key caregivers (70% parents, 8% spouses, 17% siblings and 5% children) were studied using the world health organization quality of life-Bref (WHOQOL-BREF) to research their QoL, the Zarit Scale to assess their perception of their caregiving burden, the Social Network Questionnaire to examine their social support, the Family APGAR to assess the satisfaction with social support from the family and a professional support scale (Escala de Apoyo Profesional) to determine the professional support received by caregivers was performed. Scores on the WHOQOL-BREF in the Physical, Psychological, Social and Environment domains were 15.0 (SD = 3.7), 13.3 (SD = 4.2), 11.0 (SD = 4.7) and 13.5 (SD = 3.1), respectively. Through bivariate analysis, the dimensions that showed a positive significant association with QoL were being a young male caregiver who was a working father with a high educational level and help from other family members. Caregivers of patients who were older and had a later onset of the illness, a lower score on the Zarit Scale and a high score on the Social Network Questionnaire, Family APGAR and Escala de Apoyo Profesional showed higher QoL. Many of these variables made a unique contribution in the multivariate analysis. There is a significant association between the caregiver's burden and their QoL. Regression analysis showed that the best predictors of QoL were caregiving burden, social support and professional support.

Nursing Activities Score and Acute Kidney Injury

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Filipe Utuari de Andrade Coelho

Full Text Available ABSTRACT Objective: to evaluate the nursing workload in intensive care patients with acute kidney injury (AKI. Method: A quantitative study, conducted in an intensive care unit, from April to August of 2015. The Nursing Activities Score (NAS and Kidney Disease Improving Global Outcomes (KDIGO were used to measure nursing workload and to classify the stage of AKI, respectively. Results: A total of 190 patients were included. Patients who developed AKI (44.2% had higher NAS when compared to those without AKI (43.7% vs 40.7%, p <0.001. Patients with stage 1, 2 and 3 AKI showed higher NAS than those without AKI. A relationship was identified between stage 2 and 3 with those without AKI (p = 0.002 and p <0.001. Conclusion: The NAS was associated with the presence of AKI, the score increased with the progression of the stages, and it was associated with AKI, stage 2 and 3.

Combined spinal-epidural analgesia in labour: its effects on delivery outcome

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Suneet Kaur Sra Charanjit Singh

2016-06-01

Full Text Available ABSTRACT BACKGROUND AND OBJECTIVES: Combined spinal-epidural (CSE has become an increasingly popular alternative to traditional labour epidural due to its rapid onset and reliable analgesia provided. This was a prospective, convenient sampling study to determine the effects of CSE analgesia on labour outcome. METHODS: One hundred and ten healthy primigravida parturients with a singleton pregnancy of ≥37 weeks gestation and in the active phase of labour were studied. They were enrolled to the CSE (n = 55 or Non-CSE (n = 55 group based on whether they consented to CSE analgesia. Non-CSE parturients were offered other methods of labour analgesia. The duration of the first and second stage of labour, rate of instrumental vaginal delivery and emergency cesarean section, and Apgar scores were compared. RESULTS: The mean duration of the first and second stage of labour was not significantly different between both groups. Instrumental delivery rates between the groups were not significantly different (CSE group, 11% versus Non-CSE group, 16%. The slightly higher incidence of cesarean section in the CSE group (16% versus 15% in the Non-CSE group was not statistically significant. Neonatal outcome in terms of Apgar score of less than 7 at 1 and 5 min was similar in both groups. CONCLUSION: There were no significant differences in the duration of labour, rate of instrumental vaginal delivery and emergency cesarean section, and neonatal outcome in parturients who received compared to those who did not receive CSE for labour analgesia.

Epidural analgesia during labor vs no analgesia: A comparative study

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Wesam Farid Mousa

2012-01-01

Full Text Available Background: Epidural analgesia is claimed to result in prolonged labor. Previous studies have assessed epidural analgesia vs systemic opioids rather than to parturients receiving no analgesia. This study aimed to evaluate the effect of epidural analgesia on labor duration compared with parturients devoid of analgesia. Methods: One hundred sixty nulliparous women in spontaneous labor at full term with a singleton vertex presentation were assigned to the study. Parturients who request epidural analgesia were allocated in the epidural group, whereas those not enthusiastic to labor analgesia were allocated in the control group. Epidural analgesia was provided with 20 mL bolus 0.5% epidural lidocaine plus fentanyl and maintained at 10 mL for 1 h. Duration of the first and second stages of labor, number of parturients receiving oxytocin, maximal oxytocin dose required for each parturient, numbers of instrumental vaginal, vacuum-assisted, and cesarean deliveries and neonatal Apgar score were recorded. Results: There was no statistical difference in the duration of the active-first and the second stages of labor, instrumental delivery, vacuum-assisted or cesarean delivery rates, the number of newborns with 1-min and 5-min Apgar scores less than 7 between both groups and number of parturients receiving oxytocin, however, the maximal oxytocin dose was significantly higher in the epidural group. Conclusion: Epidural analgesia by lidocaine (0.5% and fentanyl does not prolong labor compared with parturients without analgesia; however, significant oxytocin augmentation is required during the epidural analgesia to keep up the aforementioned average labor duration.

The Role of Relaxation Training to Pregnant Mothers on Health Index of Infants

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SA Mosaviasl

2009-07-01

Full Text Available ABSTRACT: Introduction & Objective: Investigations have shown that the emotional stress during the pregnancy period could have sustainable effects on the embryo. Different factors such as family members, spouse, supporting friends could relive these effects, but coping skills especially relaxation could be more effective on stress. This study was conducted to investigate the effect of relaxation training to pregnant mothers on health index such as Apgar index, weight, height, and cowlick grade in infants. Materials & Methods: This is a clinical trail in which 100 pregnant women who referred to health center of Yasuj (2006-2008 were selected using simple sampling method and assigned randomly to case and control groups. The relaxation was taught to the case group whereas nothing was taught to control groups. At the time of delivery the above mentioned indices were assessed. The gathered data was analyzed using SPSS software. Results: The results showed a significant difference between two groups in weight, height, cephalic index, and colic grade (with better situation in case group. There was no significant difference between two groups in Apgar scores. Conclusion: Considering the results of this study, it seems that teaching of relaxation to pregnant women could be effective in health index of children especially in the time of delivery. Therefore attention should be paid to different methods for reducing the stress in this group of mothers. Keywords: relaxation, pregnant women, infants, Apgar scores

Polygenic Risk Score Identifies Subgroup With Higher Burden of Atherosclerosis and Greater Relative Benefit From Statin Therapy in the Primary Prevention Setting.

Science.gov (United States)

Natarajan, Pradeep; Young, Robin; Stitziel, Nathan O; Padmanabhan, Sandosh; Baber, Usman; Mehran, Roxana; Sartori, Samantha; Fuster, Valentin; Reilly, Dermot F; Butterworth, Adam; Rader, Daniel J; Ford, Ian; Sattar, Naveed; Kathiresan, Sekar

2017-05-30

Relative risk reduction with statin therapy has been consistent across nearly all subgroups studied to date. However, in analyses of 2 randomized controlled primary prevention trials (ASCOT [Anglo-Scandinavian Cardiac Outcomes Trial-Lipid-Lowering Arm] and JUPITER [Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin]), statin therapy led to a greater relative risk reduction among a subgroup at high genetic risk. Here, we aimed to confirm this observation in a third primary prevention randomized controlled trial. In addition, we assessed whether those at high genetic risk had a greater burden of subclinical coronary atherosclerosis. We studied participants from a randomized controlled trial of primary prevention with statin therapy (WOSCOPS [West of Scotland Coronary Prevention Study]; n=4910) and 2 observational cohort studies (CARDIA [Coronary Artery Risk Development in Young Adults] and BioImage; n=1154 and 4392, respectively). For each participant, we calculated a polygenic risk score derived from up to 57 common DNA sequence variants previously associated with coronary heart disease. We compared the relative efficacy of statin therapy in those at high genetic risk (top quintile of polygenic risk score) versus all others (WOSCOPS), as well as the association between the polygenic risk score and coronary artery calcification (CARDIA) and carotid artery plaque burden (BioImage). Among WOSCOPS trial participants at high genetic risk, statin therapy was associated with a relative risk reduction of 44% (95% confidence interval [CI], 22-60; P statin therapy was 3.6% (95% CI, 2.0-5.1) among those in the high genetic risk group and 1.3% (95% CI, 0.6-1.9) in all others. Each 1-SD increase in the polygenic risk score was associated with 1.32-fold (95% CI, 1.04-1.68) greater likelihood of having coronary artery calcification and 9.7% higher (95% CI, 2.2-17.8) burden of carotid plaque. Those at high genetic risk have a greater

Extension of the lod score: the mod score.

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Clerget-Darpoux, F

2001-01-01

In 1955 Morton proposed the lod score method both for testing linkage between loci and for estimating the recombination fraction between them. If a disease is controlled by a gene at one of these loci, the lod score computation requires the prior specification of an underlying model that assigns the probabilities of genotypes from the observed phenotypes. To address the case of linkage studies for diseases with unknown mode of inheritance, we suggested (Clerget-Darpoux et al., 1986) extending the lod score function to a so-called mod score function. In this function, the variables are both the recombination fraction and the disease model parameters. Maximizing the mod score function over all these parameters amounts to maximizing the probability of marker data conditional on the disease status. Under the absence of linkage, the mod score conforms to a chi-square distribution, with extra degrees of freedom in comparison to the lod score function (MacLean et al., 1993). The mod score is asymptotically maximum for the true disease model (Clerget-Darpoux and Bonaïti-Pellié, 1992; Hodge and Elston, 1994). Consequently, the power to detect linkage through mod score will be highest when the space of models where the maximization is performed includes the true model. On the other hand, one must avoid overparametrization of the model space. For example, when the approach is applied to affected sibpairs, only two constrained disease model parameters should be used (Knapp et al., 1994) for the mod score maximization. It is also important to emphasize the existence of a strong correlation between the disease gene location and the disease model. Consequently, there is poor resolution of the location of the susceptibility locus when the disease model at this locus is unknown. Of course, this is true regardless of the statistics used. The mod score may also be applied in a candidate gene strategy to model the potential effect of this gene in the disease. Since, however, it

Parental and infant characteristics and childhood leukemia in Minnesota

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Ross Julie A

2008-02-01

Full Text Available Abstract Background Leukemia is the most common childhood cancer. With the exception of Down syndrome, prenatal radiation exposure, and higher birth weight, particularly for acute lymphoid leukemia (ALL, few risk factors have been firmly established. Translocations present in neonatal blood spots and the young age peak of diagnosis suggest that early-life factors are involved in childhood leukemia etiology. Methods We investigated the association between birth characteristics and childhood leukemia through linkage of the Minnesota birth and cancer registries using a case-cohort study design. Cases included 560 children with ALL and 87 with acute myeloid leukemia (AML diagnoses from 28 days to 14 years. The comparison group was comprised of 8,750 individuals selected through random sampling of the birth cohort from 1976–2004. Cox proportional hazards regression specific for case-cohort studies was used to compute hazard ratios (HR and 95% confidence intervals (CIs. Results Male sex (HR = 1.41, 95% CI 1.16–1.70, white race (HR = 2.32, 95% CI 1.13–4.76, and maternal birth interval ≥ 3 years (HR = 1.31, 95% CI 1.01–1.70 increased ALL risk, while maternal age increased AML risk (HR = 1.21/5 year age increase, 95% CI 1.0–1.47. Higher birth weights (>3798 grams (HRALL = 1.46, 1.08–1.98; HRAML = 1.97, 95% CI 1.07–3.65, and one minute Apgar scores ≤ 7 (HRALL = 1.30, 95% CI 1.05–1.61; HRAML = 1.62, 95% CI 1.01–2.60 increased risk for both types of leukemia. Sex was not a significant modifier of the association between ALL and other covariates, with the exception of maternal education. Conclusion We confirmed known risk factors for ALL: male sex, high birth weight, and white race. We have also provided data that supports an increased risk for AML following higher birth weights, and demonstrated an association with low Apgar scores.

Umbilical blood flow ultrasound characteristics of perioperative fetal intrauterine hypoxia and their relationship with maternal and fetal oxidative stress injury

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Yu-Mei He

2017-05-01

Full Text Available Objective: To study the relationship between umbilical blood flow ultrasound characteristics of perioperative fetal intrauterine hypoxia and maternal as well as fetal oxidative stress injury. Methods: 108 puerperae giving birth in our hospital between May 2014 and October 2016 were selected and divided into normal pregnancy group with neonatal Apgar score >7 points and intrauterine hypoxia group with neonatal Apgar score ≤7 points, color Doppler diasonograph was used to determine umbilical blood flow ultrasound parameters, umbilical cord blood was collected to determine the levels of oxidative stress products, and the placenta was collected to determine the levels of oxidative stress products and related apoptosis molecules. Results: During 24–30 weeks, 31–36 weeks and 37–41 weeks of pregnancy, umbilical blood flow resistance index (RI, pulsatility index (PI and diastolic velocity/systolic velocity (S/D of intrauterine hypoxia group were significantly higher than those of normal pregnancy group (P<0.05; malondialdehyde (MDA, oxidized low-density lipoprotein (ox- LDL, 8-isoprostanes (8-iso, and heat shock protein 70 (HSP-70 levels in umbilical cord blood of intrauterine hypoxia group were significantly higher than those of normal pregnancy group (P<0.05, MDA, oxLDL, 8-ios, HSP-70, Fas, FasL and Bax levels in placenta tissue were significantly higher than those of normal pregnancy group (P<0.05, and Bcl-2 and XIAP levels were significantly lower than those of normal pregnancy group (P<0.05; RI, PI and S/ D were positively correlated with MDA, oxLDL, 8-ios and HSP-70 levels in umbilical cord blood and placenta tissue, positively correlated with Fas, FasL and Bax levels in placenta tissue, and negatively correlated with Bcl-2 and XIAP levels in placental tissue. Conclusions: The increased umbilical blood flow resistance and decreased flow volume of fetal intrauterine hypoxia are closely related to maternal, fetal and placental oxidative

OUR EXPERIENCE WITH EPIDURAL LABOUR ANALGESIA

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Uršula Reš Muravec

2003-12-01

Full Text Available Background. To evaluate the effects of regional labour analgesia used at the Hospital for Gynecology and Obstetrics in Postojna, Slovenia, in the year 2002.Patients and methods. In this retrospective study we enrolled 294 parturients who delivered in the year 2002 in the Postojna Maternity Hospital: in group 1 there were 147 parturients in whom three different regional analgesic techniques (study group were used at labour; in group 2 there were 147 parturients in whom regional analgesia was not used (control group. In the first step the two groups were compared in terms of maternal demographic data, duration and outcome of labour and 1' and 5' Apgar scores. In the second step the three regional analgesic groups were compared in terms of the course and outcome of labour, fetal condition, side and adverse effects of regional analgesic techniques, and patient satisfaction with a particular analgesic technique.Results. Regional labour analgesia was used in 147 (14% of the 1048 women who delivered in 2002: epidural analgesia (EPI was performed in 51.0%, combined spinal-epidural (CSE in 42.2% and spinal analgesia (SA in 6.8% of cases. The women in the regional analgesia group were significantly older, more educated, more often nulliparous and accompanied by their partner at labour than the women in the control group. Further, the duration of labour was significantly longer, oxytocin more frequently administered than in the control group. In terms of labour outcome there were no differences in the Cesarean section rates and 1- and 5-min Apgar scores minutes, but and the vacuum extraction rate was significantly higher in the regional analgesia group. Among the three regional analgesia techniques used, there were no statistically significant differences observed in terms of labour duration and outcome, and Apgar scores. The patient satisfaction was greatest with CSE. Adverse side effects such as weak muscles, reduced motion abilities, itching, nausea

Neonatal tetanus associated with skin infection

African Journals Online (AJOL)

delivery had been vaginal, the infant weighing 3 440 g and with. Apgar scores of 9 and 10 at 1 and ... infection and a chest infection, but the other systems were normal. CASE REPORT ... Intrathecal and intramuscular immunoglobulin were given, and the wound was treated. ... Standard doses of the above drugs were used.

Assessment of partogram use during labour in Rujumbura Health ...

African Journals Online (AJOL)

Objectives: To establish extent of use of a partogram, health facility and health workers' factors that affected its use during labour plus the relationship between foetal Apgar score and its use. Materials and Methods: A cross-sectional study involving observations, record reviews and interviewing of staff in 8 health facilities (4 ...

Maternal and Fetal Acid-Base Chemistry: A Major Determinant of ...

African Journals Online (AJOL)

Very small changes in pH may significantly affect the function of various fetal organ systems, such as the central nervous system, and the cardiovascular system with associated fetal distress and poor Apgar score. Review of existing data on maternal-fetal acid-base balance in pregnancy highlight the factors that are ...

Predicting Infant Maltreatment in Low-Income Families: The Interactive Effects of Maternal Attributions and Child Status at Birth

Science.gov (United States)

Bugental, Daphne Blunt; Happaney, Keith

2004-01-01

Maternal attributions and child neonatal status at birth were assessed as predictors of infant maltreatment (harsh parenting and safety neglect). The population included low-income, low-education families who were primarily Hispanic. Child maltreatment during the 1st year of life (N = 73) was predicted by neonatal status (low Apgar scores, preterm…

Neonatal screening for absolute lymphopenia | El-Sayed | Egyptian ...

African Journals Online (AJOL)

Three neonates had congenital anomalies, one only experienced dysmorphic features and 8 (1.6%) had family history of unexplained death but these data could not be linked to the presence of lymphopenia in the studied sample. APGAR scores at 1 and 5 minutes were significantly lower in neonates with lymphopenia (p ...

Smart Kote Glove for Assessment of Scoring Parameters of Dan and Kyu Grade Kendokas

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Kwangyul Jeong

2018-02-01

Full Text Available Kendo is one of the most ancient swordsmanship arts in Japan. The aims of this study are to develop and test an innovative smart Kote glove for assisting the Kendoka to distinguish scoring from non-scoring Kote (wrist strikes. An in-house developed pressure sensing platform was utilized to develop the smart Kote glove. Ten kendo practitioners, comprising of five Dan (black belts equivalent and five Kyu (lower level/ungraded of both genders, participated in this study. The results showed significant differences between Dan and Kyu participants in both accuracy and sharpness of the strikes. Dan grade participants showed higher percentage of hitting the target comparing to Kyu grade (92% and 75% respectively. The percentage of scoring was also significantly higher in Dan (78% than in Kyu (37% grades. The average impact force of scoring by Dan grade (1159 ± 379 N was higher than by Kyu grade (852 ± 429 N.

Motivational effects of coronary artery calcium scores on statin adherence and weight loss.

Science.gov (United States)

Kalia, Nove K; Cespedes, Lucas; Youssef, George; Li, Dong; Budoff, Matthew J

2015-05-01

The aim of this study was to assess the effect on adherence to statin therapy and assess the effect of beneficial changes in behavior that resulted in weight loss in patients who underwent coronary artery calcium (CAC) scoring with cardiac computed tomography. Despite convincing data demonstrating the benefits of HmGCoA inhibitors for both primary and secondary prevention of coronary heart disease, they remain underused. Also, despite convincing data demonstrating the benefits of weight loss for both primary and secondary prevention of coronary heart disease, it remains difficult to motivate behavioral changes resulting in weight loss. In this study, we assess whether higher CAC scores are associated with increased compliance with statin medication and whether higher CAC scores are associated with beneficial lifestyle behaviors resulting in weight loss. We retrospectively analyzed patients that had undergone baseline CAC testing and returned for a follow-up scan. All patients had weight documented and were administered a questionnaire regarding compliance to medications. The primary endpoint was measurable weight loss between visit one and visit two and the self-reported compliance to statin use. The study population with data regarding statin compliance consisted of 2608 individuals (72% men, mean age 58±8 years) who were followed for a mean of 4.1±3.2 years after an initial CAC scan. Overall, statin compliance was lowest (27.4%) among those with CAC=0, and gradually increased with higher CAC scores (1-99, 39.2%; 100-399, 53.6%; ≥400, 58.8%; Ptool, a higher rate of adherences with statin therapy was observed in patients with higher CAC scores.

COMPARISON BETWEEN FENTANYL 2 μG/mL VERSUS DEXMEDETOMIDINE 1.5 μG/mL AS ADJUVANTS WITH ISOBARIC BUPIVACAINE 0.0625% IN EPIDURAL LABOUR ANALGESIA

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Karuna Harsoor

2016-11-01

Full Text Available BACKGROUND Low-dose bupivacaine with opioids like fentanyl have been used traditionally as an adjunct for epidural labour analgesia, but has side effects like pruritus, urinary retention, nausea, vomiting, etc. Dexmedetomidine, an α-2 adrenergic agonist with a high placental retention, decreased sympathetic outflow and norepinephrine release thereby causing sedation, anxiolysis, analgesia, sympatholysis and maternal haemodynamic stability. Hence, this study was carried out to compare dexmedetomidine and fentanyl as adjuvants in epidural labour analgesia. MATERIALS AND METHODS A prospective randomised, double-blind study was conducted in 60 term parturients in active labour of ASA I and II physical status. They were randomised into 2 groups with 30 parturients in each and received 15 mL of 0.0625% Inj. Bupivacaine plus either 1.5 μg/mL Inj. Dexmedetomidine (BD group or 2 μg/mL Inj. Fentanyl (BF group. VAS, sedation scores, modified four grade Bromage scale, haemodynamics, peripheral oxygen saturation were recorded at baseline and regular intervals. When VAS was ≥4, subsequent doses of 5 mL of the respective group drug was administered. Parturients were ambulated when Bromage scale was 0 with no postural hypotension. Duration of analgesia, labour outcome, neonatal Apgar scores and side effects were noted. RESULTS Demography and haemodynamic stability were similar and comparable. Duration of analgesia was significantly longer in BD group (131.83±45.760 than BF group (85.33±22.512 (p<0.0001. More no. of top-ups was needed in BF group (1.80±1.518 than BD group (0.17±0.461 (p<0.0001. Significantly reduced VAS scores was observed in BD group than BF group. Mean sedation scores (p<0.05 and maximum Bromage scores (p=0.004 were significantly higher in BD group than BF group. Ambulation was less in BD group (3 parturients than BF group (26 parturients. Side effects were significantly more in BF group than BD group (p=0.007. The labour outcomes

Direct concurrent comparison of multiple pediatric acute asthma scoring instruments.

Science.gov (United States)

Johnson, Michael D; Nkoy, Flory L; Sheng, Xiaoming; Greene, Tom; Stone, Bryan L; Garvin, Jennifer

2017-09-01

Appropriate delivery of Emergency Department (ED) treatment to children with acute asthma requires clinician assessment of acute asthma severity. Various clinical scoring instruments exist to standardize assessment of acute asthma severity in the ED, but their selection remains arbitrary due to few published direct comparisons of their properties. Our objective was to test the feasibility of directly comparing properties of multiple scoring instruments in a pediatric ED. Using a novel approach supported by a composite data collection form, clinicians categorized elements of five scoring instruments before and after initial treatment for 48 patients 2-18 years of age with acute asthma seen at the ED of a tertiary care pediatric hospital ED from August to December 2014. Scoring instruments were compared for inter-rater reliability between clinician types and their ability to predict hospitalization. Inter-rater reliability between clinician types was not different between instruments at any point and was lower (weighted kappa range 0.21-0.55) than values reported elsewhere. Predictive ability of most instruments for hospitalization was higher after treatment than before treatment (p < 0.05) and may vary between instruments after treatment (p = 0.054). We demonstrate the feasibility of comparing multiple clinical scoring instruments simultaneously in ED clinical practice. Scoring instruments had higher predictive ability for hospitalization after treatment than before treatment and may differ in their predictive ability after initial treatment. Definitive conclusions about the best instrument or meaningful comparison between instruments will require a study with a larger sample size.

The fracture risk assessment tool (FRAX® score in subclinical hyperthyroidism

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Polovina Snežana

2015-01-01

Full Text Available Background/Aim. The Fracture Risk Assessment Tool (FRAX® score is the 10-year estimated risk calculation tool for bone fracture that includes clinical data and hip bone mineral density measured by dual-energy x-ray absorptiometry (DXA. The aim of this cross-sectional study was to elucidate the ability of the FRAX® score in discriminating between bone fracture positive and negative pre- and post-menopausal women with subclinical hyperthyroidism. Methods. The bone mineral density (by DXA, thyroid stimulating hormone (TSH level, free thyroxine (fT4 level, thyroid peroxidase antibodies (TPOAb titre, osteocalcin and beta-cross-laps were measured in 27 pre- and post-menopausal women with newly discovered subclinical hyperthyroidism [age 58.85 ± 7.83 years, body mass index (BMI 27.89 ± 3.46 kg/m2, menopause onset in 46.88 ± 10.21 years] and 51 matched euthyroid controls (age 59.69 ± 5.72 years, BMI 27.68 ± 4.66 kg/m2, menopause onset in 48.53 ± 4.58 years. The etiology of subclinical hyperthyroisims was autoimmune thyroid disease or toxic goiter. FRAX® score calculation was performed in both groups. Results. In the group with subclinical hyperthyroidism the main FRAX® score was significantly higher than in the controls (6.50 ± 1.58 vs 4.35 ± 1.56 respectively; p = 0.015. The FRAX® score for hip was also higher in the evaluated group than in the controls (1.33 ± 3.92 vs 0.50 ± 0.46 respectively; p = 0.022. There was no correlations between low TSH and fracture risk (p > 0.05. The ability of the FRAX® score in discriminating between bone fracture positive and negative pre- and postmenopausal female subjects (p < 0.001 is presented by the area under the curve (AUC plotted via ROC analysis. The determined FRAX score cut-off value by this analysis was 6%, with estimated sensitivity and specificity of 95% and 75.9%, respectively. Conclusion. Pre- and postmenopausal women with subclinical hyperthyroidism have higher FRAX® scores and thus

The Vocational Preference Inventory Scores and Environmental Preferences

Science.gov (United States)

Kunce, Joseph T.; Kappes, Bruno Maurice

1976-01-01

This study investigated the relationship between vocational interest measured by the Vocational Preference Inventory (VPI) and preferences of 175 undergraduates for structured or unstructured environments. Males having clear-cut preferences for structured situations had significantly higher Realistic-Conventional scores than those without…

College Math Assessment: SAT Scores vs. College Math Placement Scores

Science.gov (United States)

Foley-Peres, Kathleen; Poirier, Dawn

2008-01-01

Many colleges and university's use SAT math scores or math placement tests to place students in the appropriate math course. This study compares the use of math placement scores and SAT scores for 188 freshman students. The student's grades and faculty observations were analyzed to determine if the SAT scores and/or college math assessment scores…

Dose Uniformity of Scored and Unscored Tablets: Application of the FDA Tablet Scoring Guidance for Industry.

Science.gov (United States)

Ciavarella, Anthony B; Khan, Mansoor A; Gupta, Abhay; Faustino, Patrick J

This U.S. Food and Drug Administration (FDA) laboratory study examines the impact of tablet splitting, the effect of tablet splitters, and the presence of a tablet score on the dose uniformity of two model drugs. Whole tablets were purchased from five manufacturers for amlodipine and six for gabapentin. Two splitters were used for each drug product, and the gabapentin tablets were also split by hand. Whole and split amlodipine tablets were tested for content uniformity following the general chapter of the United States Pharmacopeia (USP) Uniformity of Dosage Units , which is a requirement of the new FDA Guidance for Industry on tablet scoring. The USP weight variation method was used for gabapentin split tablets based on the recommendation of the guidance. All whole tablets met the USP acceptance criteria for the Uniformity of Dosage Units. Variation in whole tablet content ranged from 0.5 to 2.1 standard deviation (SD) of the percent label claim. Splitting the unscored amlodipine tablets resulted in a significant increase in dose variability of 6.5-25.4 SD when compared to whole tablets. Split tablets from all amlodipine drug products did not meet the USP acceptance criteria for content uniformity. Variation in the weight for gabapentin split tablets was greater than the whole tablets, ranging from 1.3 to 9.3 SD. All fully scored gabapentin products met the USP acceptance criteria for weight variation. Size, shape, and the presence or absence of a tablet score can affect the content uniformity and weight variation of amlodipine and gabapentin tablets. Tablet splitting produced higher variability. Differences in dose variability and fragmentation were observed between tablet splitters and hand splitting. These results are consistent with the FDA's concerns that tablet splitting can have an effect on the amount of drug present in a split tablet and available for absorption. Tablet splitting has become a very common practice in the United States and throughout the

A score for measuring health risk perception in environmental surveys.

Science.gov (United States)

Marcon, Alessandro; Nguyen, Giang; Rava, Marta; Braggion, Marco; Grassi, Mario; Zanolin, Maria Elisabetta

2015-09-15

In environmental surveys, risk perception may be a source of bias when information on health outcomes is reported using questionnaires. Using the data from a survey carried out in the largest chipboard industrial district in Italy (Viadana, Mantova), we devised a score of health risk perception and described its determinants in an adult population. In 2006, 3697 parents of children were administered a questionnaire that included ratings on 7 environmental issues. Items dimensionality was studied by factor analysis. After testing equidistance across response options by homogeneity analysis, a risk perception score was devised by summing up item ratings. Factor analysis identified one latent factor, which we interpreted as health risk perception, that explained 65.4% of the variance of five items retained after scaling. The scale (range 0-10, mean ± SD 9.3 ± 1.9) had a good internal consistency (Cronbach's alpha 0.87). Most subjects (80.6%) expressed maximum risk perception (score = 10). Italian mothers showed significantly higher risk perception than foreign fathers. Risk perception was higher for parents of young children, and for older parents with a higher education, than for their counterparts. Actual distance to major roads was not associated with the score, while self-reported intense traffic and frequent air refreshing at home predicted higher risk perception. When investigating health effects of environmental hazards using questionnaires, care should be taken to reduce the possibility of awareness bias at the stage of study planning and data analysis. Including appropriate items in study questionnaires can be useful to derive a measure of health risk perception, which can help to identify confounding of association estimates by risk perception. Copyright © 2015 Elsevier B.V. All rights reserved.

Serum Uric Acid as a Predictor of Perinatal Outcome in Women with Pre-Eclampsia

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Jwan Muhammad Zangana

2018-03-01

Full Text Available Background and objectives: Pre-eclampsia is one of the medical complication of pregnancy and contributes significantly to maternal and perinatal morbidity and mortality. Hyperuricemia is often associated with preeclampsia. The objective of this study was to assess serum uric acid in group of women with pre-eclampsia and to evaluate its diagnostic effect on perinatal outcome. Patients and methods: This is a hospital-based cross-sectional study conducted in Maternity Teaching Hospital in Erbil city, Iraq. Convenient sample size of 200 participants preeclamptic pregnant women with ≥ 34 weeks of gestation in different level of hypertension were included. After getting informed consent from participant who were diagnosed with pre-eclampsia (hypertension and proteinuria, all sociodemographic information was collected from 1st June 2017 to 19th January 2018. Blood samples were obtained to assess serum uric acid besides other investigation routinely done and fetal outcome (birth weight, gestational age, intrauterine death, Apgar score, admission to neonatal care unit, intrauterine growth restriction and early neonatal death was evaluated. Results: Serum uric acid was ≥ 6 mg/dL in 127 (63.5% among all pre-eclamptic women. There was positive significant association between means of serum uric acid at different levels of hypertension with p=0.000 in ANOVA and x2 test. This study revealed significant association between increased level of serum uric acid and bad fetal outcome (birth weight, gestational age, intrauterine death, Apgar score, admission to neonatal care unit, intrauterine growth restriction and early neonatal death and Apgar score in 1st minute. Conclusion: This study revealed significant raised level of serum uric acid among pre-eclamptic women and significant effect on fetal outcome and perinatal morbidity and mortality.

Inflammatory Bowel Disease and Risk of Adverse Pregnancy Outcomes

Science.gov (United States)

Boyd, Heather A.; Basit, Saima; Harpsøe, Maria C.; Wohlfahrt, Jan; Jess, Tine

2015-01-01

Background and Objectives Existing data on pregnancy complications in inflammatory bowel disease (IBD) are inconsistent. To address these inconsistencies, we investigated potential associations between IBD, IBD-related medication use during pregnancy, and pregnancy loss, pre-eclampsia, preterm delivery, Apgar score, and congenital abnormalities. Methods We conducted a cohort study in >85,000 Danish National Birth Cohort women who were pregnant in the period 1996-2002 and had information on IBD, IBD-related medication use (systemic or local corticosteroids, 5-aminosalicylates), pregnancy outcomes and potential confounders. We evaluated associations between IBD and adverse pregnancy/birth outcomes using Cox regression and log-linear binomial regression. Results IBD was strongly and significantly associated with severe pre-eclampsia, preterm premature rupture of membranes and medically indicated preterm delivery in women using systemic corticosteroids during pregnancy (hazard ratios [HRs] >7). IBD was also associated with premature preterm rupture of membranes in women using local corticosteroid medications (HR 3.30, 95% confidence interval [CI] 1.33-8.20) and with medically indicated preterm delivery (HR 1.91, 95% CI 0.99-3.68) in non-medicated women. Furthermore, IBD was associated with low 5-minute Apgar score in term infants (risk ratio [RR] 2.19, 95% CI 1.03-4.66). Finally, Crohn’s disease (but not ulcerative colitis) was associated with major congenital abnormalities in the offspring (RR 1.85, 95% CI 1.06-3.21). No child with a congenital abnormality born to a woman with IBD was exposed to systemic corticosteroids in utero. Conclusion Women with IBD are at increased risk of severe pre-eclampsia, medically indicated preterm delivery, preterm premature rupture of membranes, and delivering infants with low Apgar score and major congenital malformations. These associations are only partly explained by severe disease as reflected by systemic corticosteroid use

Perinatal mortality and morbidity up to 28 days after birth among 743 070 low-risk planned home and hospital births: a cohort study based on three merged national perinatal databases.

Science.gov (United States)

de Jonge, A; Geerts, C C; van der Goes, B Y; Mol, B W; Buitendijk, S E; Nijhuis, J G

2015-04-01

To compare rates of adverse perinatal outcomes between planned home births versus planned hospital births. A nationwide cohort study. The Netherlands. Low-risk women in midwife-led care at the onset of labour. Analysis of national registration data. Intrapartum and neonatal death, Apgar scores, and admission to a neonatal intensive care unit (NICU) within 28 days of birth. Of the total of 814 979 women, 466 112 had a planned home birth and 276 958 had a planned hospital birth. For 71 909 women, their planned place of birth was unknown. The combined intrapartum and neonatal death rates up to 28 days after birth, including cases with discrepancies in the registration of the moment of death, were: for nulliparous women, 1.02‰ for planned home births versus 1.09‰ for planned hospital births, adjusted odds ratio (aOR) 0.99, 95% confidence interval (95% CI) 0.79-1.24; and for parous women, 0.59‰ versus 0.58‰, aOR 1.16, 95% CI 0.87-1.55. The rates of NICU admissions and low Apgar scores did not significantly differ among nulliparous women (NICU admissions up to 28 days, 3.41‰ versus 3.61‰, aOR 1.05, 95% CI 0.92-1.18). Among parous women the rates of Apgar scores below seven and NICU admissions were significantly lower among planned home births (NICU admissions up to 28 days, 1.36 versus 1.95‰, aOR 0.79, 95% CI 0.66-0.93). We found no increased risk of adverse perinatal outcomes for planned home births among low-risk women. Our results may only apply to regions where home births are well integrated into the maternity care system. © 2014 Royal College of Obstetricians and Gynaecologists.

Clinical scoring and instrumental analysis to evaluate skin types.

Science.gov (United States)

Mercurio, D G; Segura, J H; Demets, M B A; Maia Campos, P M B G

2013-04-01

The biology of the skin is very complex, and there are a number of methods used to classify the different skin types. It is possible to measure or quantify the characteristics of the specific skin types, using a variety of techniques that can objectively evaluate the properties of the skin in a noninvasive manner. To clinically characterize different skin types by dermatological evaluation and biophysical and skin imaging techniques, and to evaluate the relationship between the different characteristics. The study recruited 26 volunteers. Clinical scoring was performed by a dermatologist who classified the volunteers' skin as normal or dry (group 1) and combination or oily (group 2). Objective measurements included skin microrelief, pH, oiliness, water content of the stratum corneum and transepidermal water loss (TEWL). Positive correlations were found between the level of skin oiliness and skin texture obtained from both instrumental analysis and clinical scoring. The combination and oily skin types had higher clinical scores for shine intensity, oiliness and tendency to pigmentation, and also had higher objective scores for sebum secretion, TEWL and roughness. Biophysical and skin imaging techniques are effective tools to help characterize skin type and assist in clinical dermatology. We found that different skin types had different characteristics related to skin microrelief, oiliness and TEWL, and therefore require specific dermatological treatments. © The Author(s) CED © 2013 British Association of Dermatologists.

NAPLAN Scores as Predictors of Access to Higher Education in Victoria

OpenAIRE

Brendan Houng; Moshe Justman

2014-01-01

This paper examines the extent to which year-9 performance on the National Assessment Program—Language Arts and Numeracy (NAPLAN) predicts access to higher education as determined by subsequent achievement on year-12 Victoria Certificate of Education (VCE) exams. VCE performance is measured via three binary indicators: achieving an Australian tertiary admission rank (ATAR) above 50 ("ATAR50"), above 70 ("ATAR70"), and above 90 ("ATAR90"); and two continuous indicators: ATAR and the Tertiary E...

abdominal pregnancy with a full term live fetus:case report

African Journals Online (AJOL)

Emmanuel Ameh

A. Y. Isah, Y. Ahmed, E. I. Nwobodo and B. A. Ekele. Department of Obstetrics and Gynaecology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria ... and two units of blood were transfused intra operatively. The fetus weighed 3.20kg with Apgar scores of 7 and 8 in the 1st and 5th minutes respectively.

Fetal goiter and bilateral ovarian cysts

DEFF Research Database (Denmark)

Lassen, Pernille; Sundberg, Karin; Juul, Anders

2008-01-01

by each injection and followed by a gradual reduction of fetal goiter as well as the left ovarian cyst. The right cyst ruptured spontaneously. At 36 weeks + 4 days, the patient underwent elective caesarean section and gave birth to a female, weighing 2,880 g with 1- and 5-min Apgar scores of 10...

The Long-term Risk of Epilepsy after Febrile Seizures in susceptible subgroups

DEFF Research Database (Denmark)

Vestergaard, Mogens; Pedersen, Carsten Bøcker; Sidenius, Per Christian

2007-01-01

A family history of seizures, preexisting brain damage, or birth complications may modify the long-term risk of epilepsy after febrile seizures. The authors evaluated the association between febrile seizures and epilepsy in a population-based cohort of 1.54 million persons born in Denmark (1978-2......, or low Apgar scores at 5 minutes....

Comparison between the outcome of trial of labour and elective ...

African Journals Online (AJOL)

Foetal outcome was assessed based on APGAR score at five minutes, need for admission to the new born unit and the occurrence of early neonatal death. Results: A total of 142 participants were recruited of which 71 had undergone TOL and 71 had undergone ERCS. Clinical pelvimetry was the most common criteria used ...

Exploratory Study of the Potential Effects of Exposure to Sonic Boom on Human Health. Volume 2. Epidemiological Study.

Science.gov (United States)

1986-06-01

were retained from the original source. The undesired data lines in both shortened population files were then manually deleted through full-screen...Prenatal Visits 00-99 00-blank 88-not on certificate 99-unknown Apgar Score: 161-162 1 min. 00-10, 88, 99 99-entry >10 88-not on record 00=blank 163

Perinatal asphyxia in a specialist hospital in Port Harcourt, Nigeria ...

African Journals Online (AJOL)

For outborn babies with no Apgar score recording, a history of poor cry from birth with either poor colour, respiratory distress, floppiness or loss of primitive reflexes were used. Results: One hundred and fifty seven of 630 babies admitted had perinatal asphyxia giving a prevalence of 29.4%. Mean gestational age of affected ...

Team-based learning on a third-year pediatric clerkship improves NBME subject exam blood disorder scores

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Kris Saudek

2015-10-01

Full Text Available Purpose: At our institution, speculation amongst medical students and faculty exists as to whether team-based learning (TBL can improve scores on high-stakes examinations over traditional didactic lectures. Faculty with experience using TBL developed and piloted a required TBL blood disorders (BD module for third-year medical students on their pediatric clerkship. The purpose of this study is to analyze the BD scores from the NBME subject exams before and after the introduction of the module. Methods: We analyzed institutional and national item difficulties for BD items from the NBME pediatrics content area item analysis reports from 2011 to 2014 before (pre and after (post the pilot (October 2012. Total scores of 590 NBME subject examination students from examinee performance profiles were analyzed pre/post. t-Tests and Cohen's d effect sizes were used to analyze item difficulties for institutional versus national scores and pre/post comparisons of item difficulties and total scores. Results: BD scores for our institution were 0.65 (±0.19 compared to 0.62 (±0.15 nationally (P=0.346; Cohen's d=0.15. The average of post-consecutive BD scores for our students was 0.70(±0.21 compared to examinees nationally [0.64 (±0.15] with a significant mean difference (P=0.031; Cohen's d=0.43. The difference in our institutions pre [0.65 (±0.19] and post [0.70 (±0.21] BD scores trended higher (P=0.391; Cohen's d=0.27. Institutional BD scores were higher than national BD scores for both pre and post, with an effect size that tripled from pre to post scores. Institutional BD scores increased after the use of the TBL module, while overall exam scores remained steadily above national norms. Conclusions: Institutional BD scores were higher than national BD scores for both pre and post, with an effect size that tripled from pre to post scores. Institutional BD scores increased after the use of the TBL module, while overall exam scores remained steadily above

A Comparative Study between the Conventional MCQ Scores and MCQ with the CBA Scores at the Standardized Clinical Knowledge Exam for Clinical Medical Students

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Mahmood Ghadermarzi

2015-06-01

Full Text Available Background and purpose: Partial knowledge is one of the main factors to be considered when dealing with the improvement of the administration of Multiple Choice Questions (MCQ in testing. Various strategies have been proposed for this factor in the traditional testing environment. Therefore, this study proposed a Confidence Based Assessment (CBA as a pertinent solution and aims at comparing the effect of the CBA Scoring system with that of the conventional scoring systems (with and without negative score estimation as penalty on the students’ scores and estimating their partial knowledge on clinical studies.Methods: This comparative study was conducted using a standardized clinical knowledge exam for 117 clinical students. After two-step training, both the conventional MCQ and CBA examination was given in a single session simultaneously. The exam included 100 questions and the volunteers were requested to complete a questionnaire regarding their attitude and satisfaction on their first experience of the CBA after exam. A new confidence based marking system was selected for the scoring, which was a hybrid of the UCL and MUK2010 systems. The MCQ-Assistant, SPSS and Microsoft office Excel software were used for scoring and data analysis.Results: The mean age of the volunteers was 27.3±5.47, of whom 43.6% were men and 69.2% were senior medical students. Exam reliability was 0.977. The fit line of the MCQ scores without penalty estimation was R2=0.9816 and Intercept=18.125 or approximately.2 deviation in the low scores. The MCQ scoring with penalty had a fit line approximately parallel to the 45-degree line but on or above it and the CBA scoring fit line was nearer to the 45-degree line, parallel to it and a little below it. These two sets of scores had a significant p value0.037. The response percentage to the CBA is higher (p value=0.0001. The discrimination power of the MCQ and the CBA for the upper and lower 1/3 of the students was not

Sex and STEM Occupation Predict Autism-Spectrum Quotient (AQ Scores in Half a Million People.

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Emily Ruzich

Full Text Available This study assesses Autism-Spectrum Quotient (AQ scores in a 'big data' sample collected through the UK Channel 4 television website, following the broadcasting of a medical education program. We examine correlations between the AQ and age, sex, occupation, and UK geographic region in 450,394 individuals. We predicted that age and geography would not be correlated with AQ, whilst sex and occupation would have a correlation. Mean AQ for the total sample score was m = 19.83 (SD = 8.71, slightly higher than a previous systematic review of 6,900 individuals in a non-clinical sample (mean of means = 16.94 This likely reflects that this big-data sample includes individuals with autism who in the systematic review score much higher (mean of means = 35.19. As predicted, sex and occupation differences were observed: on average, males (m = 21.55, SD = 8.82 scored higher than females (m = 18.95; SD = 8.52, and individuals working in a STEM career (m = 21.92, SD = 8.92 scored higher than individuals non-STEM careers (m = 18.92, SD = 8.48. Also as predicted, age and geographic region were not meaningfully correlated with AQ. These results support previous findings relating to sex and STEM careers in the largest set of individuals for which AQ scores have been reported and suggest the AQ is a useful self-report measure of autistic traits.

External Validation of the Emergency Trauma Score for Early Prediction of Mortality in Trauma Patients

NARCIS (Netherlands)

Joosse, Pieter; de Jong, Willem-Jan J.; Wendt, Klaus W.; Schep, Niels W.; Goslings, J. Carel; Reitsma, J.

Objectives: The Emergency Trauma Score has been developed for early estimation of mortality risk in adult trauma patients with an Injury Severity Score of 16 or higher. Emergency Trauma Score combines four early predictors available at the trauma resuscitation room: age, Glasgow Coma Scale, base

Comparison of an expert system with other clinical scores for the evaluation of severity of asthma.

Science.gov (United States)

Gautier, V; Rédier, H; Pujol, J L; Bousquet, J; Proudhon, H; Michel, C; Daurès, J P; Michel, F B; Godard, P

1996-01-01

"Asthmaexpert" was produced at the special request of several clinicians in order to obtain a better understanding of the medical decisions taken by clinical experts in the management of asthmatic patients. In order to assess the severity of asthma, a new score called Artificial Intelligence score (AI score), produced by Asthmaexpert, was compared with three other scores (Aas, Hargreave and Brooks). One hundred patients were enrolled prospectively in the study during their first consultation in the out-patient clinic. Distribution of severity level according to the different scores was studied, and the reliability between AI and other scores was evaluated by Kappa and MacNemar tests. Correlations with functional parameters were performed. The AI score assessed higher levels of severity than the other scores (Kappa = 18, 28 and 10% for Aas, Hargreave and Brooks, respectively) with significant MacNemar test in all cases. There was a significant correlation between AI score and forced expiratory volume in one second (FEV1) (r = 0.73). These data indicate that the AI score is a severity score which defines higher levels of severity than the chosen scores. Correlations for functional parameters are good. This score appears easy to use for the first consultation of an asthmatic patient.

Association Between Low IQ Scores and Early Mortality in Men and Women: Evidence From a Population-Based Cohort Study.

Science.gov (United States)

Maenner, Matthew J; Greenberg, Jan S; Mailick, Marsha R

2015-05-01

Lower (versus higher) IQ scores have been shown to increase the risk of early mortality, however, the underlying mechanisms are poorly understood and previous studies underrepresent individuals with intellectual disability (ID) and women. This study followed one third of all senior-year students (approximately aged 17) attending public high school in Wisconsin, U.S. in 1957 (n  =  10,317) until 2011. Men and women with the lowest IQ test scores (i.e., IQ scores ≤ 85) had increased rates of mortality compared to people with the highest IQ test scores, particularly for cardiovascular disease. Importantly, when educational attainment was held constant, people with lower IQ test scores did not have higher mortality by age 70 than people with higher IQ test scores. Individuals with lower IQ test scores likely experience multiple disadvantages throughout life that contribute to increased risk of early mortality.

Exploring a Source of Uneven Score Equity across the Test Score Range

Science.gov (United States)

Huggins-Manley, Anne Corinne; Qiu, Yuxi; Penfield, Randall D.

2018-01-01

Score equity assessment (SEA) refers to an examination of population invariance of equating across two or more subpopulations of test examinees. Previous SEA studies have shown that score equity may be present for examinees scoring at particular test score ranges but absent for examinees scoring at other score ranges. No studies to date have…

Correlation between parity and concentration of immunoglobulins A, G and M in human colostrum

Directory of Open Access Journals (Sweden)

Gabriel André João Striker

2003-06-01

Full Text Available Objective: To study the relationship between parity andimmunoglobulin concentrations in human colostrum. Methods:82 puerperas aged 21-41 years were selected, with gestationalage ≥ 37 weeks, up to the fourth parity, good nutritional status andno gestational or puerperal diseases. The inclusion criteria for thenewborn were: weight > 2,500 g, Apgar score > 7 in the firstminute and exclusive maternal breastfeeding until discharge fromthe nursery. The mothers were divided into 2 groups: A -primiparous, B - multiparous. Colostrum was collected manuallyfrom 48 to 72 hours after delivery and the immunoglobulins weremeasured by ELISA technique. Results: No differences wereobserved regarding timing to collect colostrum; the earliercolostrum was collected, the higher the concentration of immunoglobulinA; primiparous women showed higher concentrations of IgA andIgM in their colostrum than multiparous women; there were nodifferences regarding IgG concentrations in the two groups.Conclusion: Primiparous women presented higher concentrationsof IgA and IgM in their colostrum than multiparous women.

Exploring relationships between hospital patient safety culture and Consumer Reports safety scores.

Science.gov (United States)

Smith, Scott Alan; Yount, Naomi; Sorra, Joann

2017-02-16

A number of private and public companies calculate and publish proprietary hospital patient safety scores based on publicly available quality measures initially reported by the U.S. federal government. This study examines whether patient safety culture perceptions of U.S. hospital staff in a large national survey are related to publicly reported patient safety ratings of hospitals. The Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture (Hospital SOPS) assesses provider and staff perceptions of hospital patient safety culture. Consumer Reports (CR), a U.S. based non-profit organization, calculates and shares with its subscribers a Hospital Safety Score calculated annually from patient experience survey data and outcomes data gathered from federal databases. Linking data collected during similar time periods, we analyzed relationships between staff perceptions of patient safety culture composites and the CR Hospital Safety Score and its five components using multiple multivariate linear regressions. We analyzed data from 164 hospitals, with patient safety culture survey responses from 140,316 providers and staff, with an average of 856 completed surveys per hospital and an average response rate per hospital of 56%. Higher overall Hospital SOPS composite average scores were significantly associated with higher overall CR Hospital Safety Scores (β = 0.24, p Consumer Reports Hospital Safety Score, which is a composite of patient experience and outcomes data from federal databases. As hospital managers allocate resources to improve patient safety culture within their organizations, their efforts may also indirectly improve consumer-focused, publicly reported hospital rating scores like the Consumer Reports Hospital Safety Score.

External validation of scoring systems in risk stratification of upper gastrointestinal bleeding.

Science.gov (United States)

Anchu, Anna Cherian; Mohsina, Subair; Sureshkumar, Sathasivam; Mahalakshmy, T; Kate, Vikram

2017-03-01

The aim of this study was to externally validate the four commonly used scoring systems in the risk stratification of patients with upper gastrointestinal bleed (UGIB). Patients of UGIB who underwent endoscopy within 24 h of presentation were stratified prospectively using the pre-endoscopy Rockall score (PRS) >0, complete Rockall score (CRS) >2, Glasgow Blatchford bleeding scores (GBS) >3, and modified GBS (m-GBS) >3 scores. Patients were followed up to 30 days. Prognostic accuracy of the scores was done by comparing areas under curve (AUC) in terms of overall risk stratification, re-bleeding, mortality, need for intervention, and length of hospitalization. One hundred and seventy-five patients were studied. All four scores performed better in the overall risk stratification on AUC [PRS = 0.566 (CI: 0.481-0.651; p-0.043)/CRS = 0.712 (CI: 0.634-0.790); p0.001); m-GBS = 0.802 (CI: 0.734-0.871; pbleed [AUC-0.679 (CI: 0.579-0.780; p = 0.003)]. All the scoring systems except PRS were found to be significantly better in detecting 30-day mortality with a high AUC (CRS = 0.798; p-0.042)/GBS = 0.833; p-0.023); m-GBS = 0.816; p-0.031). All four scores demonstrated significant accuracy in the risk stratification of non-variceal patients; however, only GBS and m-GBS were significant in variceal etiology. Higher cutoff scores achieved better sensitivity/specificity [RS > 0 (50/60.8), CRS > 1 (87.5/50.6), GBS > 7 (88.5/63.3), m-GBS > 7(82.3/72.6)] in the risk stratification. GBS and m-GBS appear to be more valid in risk stratification of UGIB patients in this region. Higher cutoff values achieved better predictive accuracy.

Severity assessment scores to guide empirical use of antibiotics in community acquired pneumonia.

Science.gov (United States)

Singanayagam, Aran; Chalmers, James D

2013-10-01

Severity assessment scores were first developed to predict the 30 day mortality in community acquired pneumonia; however, several guidelines have extended their use to guide empirical antibiotic prescription decisions. This approach has theoretical advantages because a decrease in broad-spectrum antibiotic treatment in low-risk patients might reduce antibiotic-related side-effects, and to give broad-spectrum therapy to patients at higher risk of death is intuitive. However, evidence in support of this approach is not clear. In particular, the British Thoracic Society guidelines suggest withholding a macrolide from patients with low CURB 65 scores, despite evidence that these patients have a higher frequency of atypical pathogens than do those with a higher severity of pneumonia. Severity scores do not perform well in some groups and might overestimate disease severity in elderly people, leading to inappropriate broad-spectrum treatment to those at high risk of complications such as Clostridium difficile infection. In this Review, we discuss the evidence for antibiotic prescribing guided by severity score and suggest that more evidence of effect and implementation is needed before this approach can be universally adopted. Copyright © 2013 Elsevier Ltd. All rights reserved.

Prognostic significance of Gleason score 7 (3+4 and Gleason score 7 (4+3 in prostatic adenocarcinoma in relation to clinical stage, androgen tissue status and degree of neuroendocrine differentiation

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Mijović M.

2014-01-01

Full Text Available Prognosis and choice of treatment of adenocarcinoma of the prostate (ADCP directly depend on the numerous of predictive factors, among which the most important are summary histological tumor grade (Gleason score, which is the sum of the first and second dominant histological grade and clinical stage. According to recent research these factors include androgen tissue status and degree of neuroendocrine differentiation. The importance of the first and second dominant histological grade becomes particularly important in ADCP Gleason score 7. Tumors with worse prognosis considered to be ADCP of higher Gleason score, the advanced clinical stage, androgen independent tumors and tumors that show a higher degree of neuroendocrine differentiation. The aim of the study was to determine the predictive significance of ADCP Gleason score 7 (3+4 and ADCP Gleason score 7 (4+3 in relation to clinical stage, androgen tissue status and degree of focal neuroendocrine differentiation. The study included 33 ADCP of Gleason score 7,26 (78.79% ADCP 7 (3+4 and 7 (21.21% ADCP 7 (4+3. All tumors are most often diagnosed with stage D2, when there are already distant metastases. ADCP of Gleason score 7 (4+3 were diagnosed more often at this stage, among them there are more androgen independent tumors and they show a greater degree of focal neuroendocrine differentiation. All the results are in accordance with data from the literature suggesting that ADCP of Gleason score 7 (4+3 have a worse prognosis than ADCP of Gleason score 7 (3 +4.

Higher emotional intelligence is related to lower test anxiety among students

Science.gov (United States)

Ahmadpanah, Mohammad; Keshavarz, Mohammadreza; Haghighi, Mohammad; Jahangard, Leila; Bajoghli, Hafez; Sadeghi Bahmani, Dena; Holsboer-Trachsler, Edith; Brand, Serge

2016-01-01

Background For students attending university courses, experiencing test anxiety (TA) dramatically impairs cognitive performance and success at exams. Whereas TA is a specific case of social phobia, emotional intelligence (EI) is an umbrella term covering interpersonal and intrapersonal skills, along with positive stress management, adaptability, and mood. In the present study, we tested the hypothesis that higher EI and lower TA are associated. Further, sex differences were explored. Method During an exam week, a total of 200 university students completed questionnaires covering sociodemographic information, TA, and EI. Results Higher scores on EI traits were associated with lower TA scores. Relative to male participants, female participants reported higher TA scores, but not EI scores. Intrapersonal and interpersonal skills and mood predicted low TA, while sex, stress management, and adaptability were excluded from the equation. Conclusion The pattern of results suggests that efforts to improve intrapersonal and interpersonal skills, and mood might benefit students with high TA. Specifically, social commitment might counteract TA. PMID:26834474

Evaluation of revised trauma score in poly- traumatized patients

International Nuclear Information System (INIS)

Ahmad, H.N.

2004-01-01

Objective: To determine the prognostic value and reliability of revised trauma score (RTS) in polytraumatized patients. Subjects and Methods: Thirty adult patients of road traffic accidents sustaining multisystem injuries due to high energy blunt trauma were managed according to the protocols of advanced trauma life support (ATLS) and from their first set of data RTS was calculated. Score of each patient was compared with his final outcome at the time of discharge from the hospital. Results: The revised trauma score was found to be a reliable predictor of prognosis of polytraumatized patients but a potentially weak predictor for those patients having severe injury involving a single anatomical region. The higher the RTS the better the prognosis of polytrauma patient and vice versa. Revised trauma score <8 turned out to be an indicator of severe injury with high mortality and morbidity and overall mortality in polytraumatized patients was 26.66%. However, RTS-6 was associated with 50% mortality. Conclusion: The revised trauma score is a reliable indicator of prognosis of polytraumatized patients. Therefore, it can be used for field and emergency room triage. (author)

External validation of the Emergency Trauma Score for early prediction of mortality in trauma patients

NARCIS (Netherlands)

Joosse, Pieter; de Jong, Willem-Jan J.; Reitsma, Johannes B.; Wendt, Klaus W.; Schep, Niels W.; Goslings, J. Carel

2014-01-01

The Emergency Trauma Score has been developed for early estimation of mortality risk in adult trauma patients with an Injury Severity Score of 16 or higher. Emergency Trauma Score combines four early predictors available at the trauma resuscitation room: age, Glasgow Coma Scale, base excess, and

Higher Dietary Cost Is Associated with Higher Diet Quality: A Cross-Sectional Study among Selected Malaysian Adults

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Ibnteesam Pondor

2017-09-01

Full Text Available Food price is a determining factor of food choices; however its relationship with diet quality is unclear in Malaysia. This study aimed to examine socio-economic characteristics and daily dietary cost (DDC in relation to diet quality in the state of Selangor, Malaysia. Dietary intake was assessed using a Food Frequency Questionnaire (FFQ and diet quality was estimated using a Malaysian Healthy Eating Index (M-HEI. DDC in Malaysian Ringgit (RM was calculated from dietary intake and national food prices. Linear regression models were fitted to determine associations between DDC and M-HEI scores and predictors of diet quality. The mean M-HEI score of respondents was 61.31 ± 10.88 and energy adjusted DDC was RM10.71/2000 kcal (USD 2.49. The highest quintile of adjusted DDC had higher M-HEI scores for all respondents (Q1: 57.14 ± 10.07 versus Q5: 63.26 ± 11.54, p = 0.001. There were also positive associations between DDC and M-HEI scores for fruits (p < 0.001 and vegetables (p = 0.017 for all respondents. Predictors of diet quality included carbohydrate (β = 0290; p < 0.001 and fat intakes (β = −0.242; p < 0.001 and energy adjusted DDC (β = 0.196; p < 0.001. Higher dietary cost is associated with healthy eating among Malaysian adults.

Diet Quality Scores of Australian Adults Who Have Completed the Healthy Eating Quiz.

Science.gov (United States)

Williams, Rebecca L; Rollo, Megan E; Schumacher, Tracy; Collins, Clare E

2017-08-15

Higher scores obtained using diet quality and variety indices are indicators of more optimal food and nutrient intakes and lower chronic disease risk. The aim of this paper is to describe the overall diet quality and variety in a sample of Australian adults who completed an online diet quality self-assessment tool, the Healthy Eating Quiz. The Healthy Eating Quiz takes approximately five minutes to complete online and computes user responses into a total diet quality score (out of a maximum of 73 points) and then categorizes them into the following groups: 'needs work' (Healthy eating quiz scores were higher in those aged 45-75 years compared to 16-44 years ( p Healthy Eating Quiz data indicates that individuals receiving feedback on how to improve their score can improve their diet quality, there is a need for further nutrition promotion interventions in Australian adults.

Is facility based neonatal care in low resource setting keeping pace ...

African Journals Online (AJOL)

Many com- munity based interventions designed to address neonatal mortality ... ties, local data is very crucial but still very scanty7. ... The nurses work in 8 hour shifts and on average each shift has .... In-born. Home. Total (%). Low APGAR Score. 7 (3.9). 173 (96.1). 0 (0.0). 180(15.1) ..... entry, literature search and write up.

Low Incidence Of Extensor Plantar Reflex In Newborns In An ...

African Journals Online (AJOL)

Healthy term newborns with Apgar score of 8 and above at one minute were recruited into the study consecutively in a maternity hospital in Ibadan, Nigeria. The plantar reflex was elicited by stroking the lateral side of the sole with firm pressure, between 24 - 48 hours after delivery. Results Of 461 newborns, the plantar reflex ...

Prediction of antigenic epitopes on protein surfaces by consensus scoring

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Zhang Chi

2009-09-01

Full Text Available Abstract Background Prediction of antigenic epitopes on protein surfaces is important for vaccine design. Most existing epitope prediction methods focus on protein sequences to predict continuous epitopes linear in sequence. Only a few structure-based epitope prediction algorithms are available and they have not yet shown satisfying performance. Results We present a new antigen Epitope Prediction method, which uses ConsEnsus Scoring (EPCES from six different scoring functions - residue epitope propensity, conservation score, side-chain energy score, contact number, surface planarity score, and secondary structure composition. Applied to unbounded antigen structures from an independent test set, EPCES was able to predict antigenic eptitopes with 47.8% sensitivity, 69.5% specificity and an AUC value of 0.632. The performance of the method is statistically similar to other published methods. The AUC value of EPCES is slightly higher compared to the best results of existing algorithms by about 0.034. Conclusion Our work shows consensus scoring of multiple features has a better performance than any single term. The successful prediction is also due to the new score of residue epitope propensity based on atomic solvent accessibility.

[Is the socioeconomic deprivation EPICES score useful in obstetrics?].

Science.gov (United States)

Convers, M; Langeron, A; Sass, C; Moulin, J-J; Augier, A; Varlet, M-N; Seffert, P; Chêne, G

2012-04-01

To describe a validated and multifactorial deprivation score to study the relationship between socioeconomic deprivation and perinatal risks. The index of deprivation EPICES (Evaluation of Precarity and Inequalities in Health Examination Centers) was used to characterize the deprivation status of 234 women in post-partum in comparison with perinatal morbidity. The cutoff value of 30.7 was the threshold to define deprivation. Two hundred and eight patients were included in this retrospective study from whom 48 (23%) had a score of deprivation higher than 30.7. Maternofetal morbidity was more severe in deprived patients. The current results show that the EPICES score could be a useful obstetrical tool for the identification of deprived women during pregnancy. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Designing Social Media into Higher Education Courses

OpenAIRE

Thapanee Seechaliao

2015-01-01

This research paper presents guiding on how to design social media into higher education courses. The research methodology used a survey approach. The research instrument was a questionnaire about guiding on how to design social media into higher education courses. Thirty-one lecturers completed the questionnaire. The data were scored by frequency and percentage. The research results were the lecturers' opinions concerning the designing social media into higher education ...

Correlation between CHA2DS2-VASc Score and Glaucoma Treatment and Prognosis.

Science.gov (United States)

Pikkel, Yoav Y; Krebs, Daniel; Igal, Vadim; Sharabi-Nov, Adi; Epstein, Irena; Pikkel, Joseph

2018-01-01

To find if CHA 2 DS 2 -VASc scale can accurately predict the treatment, prognosis, and outcome for primary open-angle glaucoma (POAG). A survey of 250,000 patient years was taken, using the records of the Ophthalmology Department at Ziv Medical Center. Data was collected regarding the retinal nerve fiber layer (RNFL), visual field (VF), line of treatment (LOT) of glaucoma, and all the data needed to accurately calculate CHA 2 DS 2 -VASc score for each patient. Sixty-seven patients were included in the statistical analysis. The mean age was 72.5 years. The mean CHA 2 DS 2 -VASc score was 3.27 + -1.7. Positive Pearson's correlation coefficients were found for LOT and CHA 2 DS 2 -VASc score, 0.35, and for RNFL grade and CHA2DS2-VASc score, 0.37. The correlation was negative for RNFL width and CHA2DS2-VASc score, -0.35. CHA 2 DS 2 -VASc score was shown to be correlated with glaucoma. This correlation was manifested positively by the LOT needed to stop glaucoma progression, with higher CHA 2 DS 2 -VASc scores correlated with more aggressive treatment. Since glaucoma is a disease with a progressing nature, it is important to treat patients aggressively on one hand, while offering the most benign treatment as possible on the other hand. Modification of the CHA 2 DS 2 -VASc score could achieve an even higher correlation.

Psychosocial and demographic factors influencing pain scores of patients with knee osteoarthritis.

Science.gov (United States)

Eberly, Lauren; Richter, Dustin; Comerci, George; Ocksrider, Justin; Mercer, Deana; Mlady, Gary; Wascher, Daniel; Schenck, Robert

2018-01-01

Pain levels in patients with osteoarthritis (OA) of the knee are commonly assessed by using a numeric scoring system, but results may be influenced by factors other than the patient's actual physical discomfort or disease severity, including psychosocial and demographic variables. We examined the possible relation between knee-pain scores and several psychosocial, sociodemographic, disease, and treatment variables in 355 patients with knee OA. The pain-evaluation instrument was a 0- to 10-point rating scale. Data obtained retrospectively from the patients' medical records were demographic characteristics, body mass index (BMI), concomitant disorders, illicit and prescription drug use, alcohol use, smoking, knee OA treatment, and severity of knee OA indicated by Kellgren-Lawrence (KL) radiographic grade. Univariate and multivariate analyses were performed to determine whether these variables correlated with reported pain scores. On univariate analysis, higher pain scores were significantly associated with Native American or Hispanic ethnicity; a higher BMI; current prescription for an opioid, antidepressant, or gabapentinoid medication; depression; diabetes mellitus; fibromyalgia; illicit drug use; lack of health insurance; smoking; previous knee injection; and recommendation by the clinician that the patient undergo knee surgery. Neither the patient's sex nor the KL grade showed a correlation. On multivariate analysis, depression, current opioid prescription, and Native American or Hispanic ethnicity retained a significant association with higher pain scores. Our results in a large, ethnically diverse group of patients with knee OA suggest that psychosocial and sociodemographic factors may be important determinants of pain levels reported by patients with knee OA.

[Optimum approach to delivery for control of premature birth (author's transl)].

Science.gov (United States)

Nieder, J; Lattorff, E

1980-01-01

Foetal condition and neonatal mortality of 637 prematurely born children with birth weights below 2,501 g were analysed, depending on modes of delivery, such as spontaneous birth, speculum delivery, use of forceps, manual support, and caesarean section. The clinical condition of the newborn, assessed five minutes from parturition by Apgar score 1, was found to depend primarily on birth weight rather than on the mode of delivery. The average Apgar values were lower for less mature newborns. While Apgar scores were worst for newborns after caesarean section delivery, the differences between approaches to delivery could not be statistically secured. Neonatal mortality went up, according to expectation, along with dropping birth weight. The mortality rate of premature births below 1,501 g was not affected by delivery modes. Prophylactic use of Shute forceps and speculum delivery appeared to be superior to spontaneous birth in the medium weight class, between 1,501 g and 2,000 g. Yet, not even here were the differences between clear postnatal mortality rates statistically secured. -Lowest mortality figures were recorded from spontaneous birth in the weight class between 2,001 g and 2,500 g, but significant differences were established only to speculum delivery. Premature newborns after caesarean section had poorer prospects than all variants of vaginal birth, but among the latter premature births from breech presentation were more endangered than others. Decisions as to vaginal, abdominal, spontaneous proprophylactically surgical approaches to premature deliveries should be taken for every individual case and due consideration of many factors.

A new evaluation score that uses salpingoscopy to reflect fallopian tube function in infertile women.

Science.gov (United States)

Nakagawa, Koji; Inoue, Masato; Nishi, Yayoi; Sugiyama, Rie; Motoyama, Koji; Kuribayashi, Yasushi; Akira, Shigeo; Sugiyama, Rikikazu

2010-12-01

To build an evaluation scoring system using the results of salpingoscopy, and to evaluate the relationship between this scoring system and the outcome of pregnancy. Retrospective study. Sugiyama Clinic. Using salpingoscopy, we observed the tubal lumen, paying attention to the following six results: adhesions, loss of mucosal folds, rounded edges of mucosal folds, debris, foreign bodies, and abnormal vessels. From April 2008 through June 2009, 104 women in whom unexplained infertility had been diagnosed underwent salpingoscopy. The F scores were evaluated related with various clinical results or pregnancy rates. The F score expressed the sum of the abnormal results, and one abnormal result was given a 1-point F score. Approximately 60% of the patients showed an F score of 0, and the percentages of patients who showed 1, 2, 3, and ≥4 points were 19.2%, 11.5%, 4.5%, and 4.5%, respectively. After evaluation, 23 patients achieved pregnancy within a year. The pregnancy rates for patients with F scores of 0 and 1 point were 30.6% and 20.0%, respectively, and the rate of patients with an F score of 0 was significantly higher than the rate of patients with high F scores (F score ≥2; 9.1%). The patients showing a lower F score (0 or 1) showed higher fecundity than those showing an F score of ≥2. Copyright © 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Description and validation of a scoring system for tomosynthesis in pulmonary cystic fibrosis

Energy Technology Data Exchange (ETDEWEB)

Vult von Steyern, Kristina; Bjoerkman-Burtscher, Isabella M.; Bozovic, Gracijela; Wiklund, Marie; Geijer, Mats [Skaane University Hospital, Lund University, Centre for Medical Imaging and Physiology, Lund (Sweden); Hoeglund, Peter [Skaane University Hospital, Competence Centre for Clinical Research, Lund (Sweden)

2012-12-15

To design and validate a scoring system for tomosynthesis (digital tomography) in pulmonary cystic fibrosis. A scoring system dedicated to tomosynthesis in pulmonary cystic fibrosis was designed. Three radiologists independently scored 88 pairs of radiographs and tomosynthesis examinations of the chest in 60 patients with cystic fibrosis and 7 oncology patients. Radiographs were scored according to the Brasfield scoring system and tomosynthesis examinations were scored using the new scoring system. Observer agreements for the tomosynthesis score were almost perfect for the total score with square-weighted kappa >0.90, and generally substantial to almost perfect for subscores. Correlation between the tomosynthesis score and the Brasfield score was good for the three observers (Kendall's rank correlation tau 0.68, 0.77 and 0.78). Tomosynthesis was generally scored higher as a percentage of the maximum score. Observer agreements for the total score for Brasfield score were almost perfect (square-weighted kappa 0.80, 0.81 and 0.85). The tomosynthesis scoring system seems robust and correlates well with the Brasfield score. Compared with radiography, tomosynthesis is more sensitive to cystic fibrosis changes, especially bronchiectasis and mucus plugging, and the new tomosynthesis scoring system offers the possibility of more detailed and accurate scoring of disease severity. (orig.)

Description and validation of a scoring system for tomosynthesis in pulmonary cystic fibrosis

International Nuclear Information System (INIS)

Vult von Steyern, Kristina; Bjoerkman-Burtscher, Isabella M.; Bozovic, Gracijela; Wiklund, Marie; Geijer, Mats; Hoeglund, Peter

2012-01-01

To design and validate a scoring system for tomosynthesis (digital tomography) in pulmonary cystic fibrosis. A scoring system dedicated to tomosynthesis in pulmonary cystic fibrosis was designed. Three radiologists independently scored 88 pairs of radiographs and tomosynthesis examinations of the chest in 60 patients with cystic fibrosis and 7 oncology patients. Radiographs were scored according to the Brasfield scoring system and tomosynthesis examinations were scored using the new scoring system. Observer agreements for the tomosynthesis score were almost perfect for the total score with square-weighted kappa >0.90, and generally substantial to almost perfect for subscores. Correlation between the tomosynthesis score and the Brasfield score was good for the three observers (Kendall's rank correlation tau 0.68, 0.77 and 0.78). Tomosynthesis was generally scored higher as a percentage of the maximum score. Observer agreements for the total score for Brasfield score were almost perfect (square-weighted kappa 0.80, 0.81 and 0.85). The tomosynthesis scoring system seems robust and correlates well with the Brasfield score. Compared with radiography, tomosynthesis is more sensitive to cystic fibrosis changes, especially bronchiectasis and mucus plugging, and the new tomosynthesis scoring system offers the possibility of more detailed and accurate scoring of disease severity. (orig.)

Is Multilingualism Linked to a Higher Tolerance of Ambiguity?

Science.gov (United States)

DeWaele, Jean-Marc; Wei, Li

2013-01-01

The present study investigates the link between multilingualism and the personality trait Tolerance of Ambiguity (TA) among 2158 mono-, bi- and multilinguals. Monolinguals and bilinguals scored significantly lower on TA compared to multilinguals. A high level of global proficiency of various languages was linked to higher TA scores. A stay abroad…

ASTRAL, DRAGON and SEDAN scores predict stroke outcome more accurately than physicians.

Science.gov (United States)

Ntaios, G; Gioulekas, F; Papavasileiou, V; Strbian, D; Michel, P

2016-11-01

ASTRAL, SEDAN and DRAGON scores are three well-validated scores for stroke outcome prediction. Whether these scores predict stroke outcome more accurately compared with physicians interested in stroke was investigated. Physicians interested in stroke were invited to an online anonymous survey to provide outcome estimates in randomly allocated structured scenarios of recent real-life stroke patients. Their estimates were compared to scores' predictions in the same scenarios. An estimate was considered accurate if it was within 95% confidence intervals of actual outcome. In all, 244 participants from 32 different countries responded assessing 720 real scenarios and 2636 outcomes. The majority of physicians' estimates were inaccurate (1422/2636, 53.9%). 400 (56.8%) of physicians' estimates about the percentage probability of 3-month modified Rankin score (mRS) > 2 were accurate compared with 609 (86.5%) of ASTRAL score estimates (P DRAGON score estimates (P DRAGON score estimates (P DRAGON and SEDAN scores predict outcome of acute ischaemic stroke patients with higher accuracy compared to physicians interested in stroke. © 2016 EAN.

Assessment of PANC3 score in predicting severity of acute pancreatitis

Directory of Open Access Journals (Sweden)

Avreen Singh Shah

2017-01-01

Full Text Available Introduction: Acute pancreatitis is inflammatory process of the pancreas associated with local and systemic complications. At present, there are lots of scores (such as Ransons, APACHE II, bedside index for severity in acute pancreatitis that help us in predicting severity at the time of admission but these are time consuming or require complex calculation and are costly. Material and Methods: PANC3 Scoring System is one of the better systems because the three criteria used (hematocrit, body mass index, and pleural effusion are simple, easy to assess, readily available, and economic. In this prospective study, 100 cases were evaluated to see the prospects of PANC3 scoring in predicting the severity of acute pancreatitis as decided by modified Marshals score. Results: The results showed that PANC3 score had a 96.43% specificity, 75% sensitivity, 80% positive predictive value, and 95.29% negative predictive value. Conclusion: Hence, the PANC3 score is a cost-effective, promising score that helps in predicting the severity of acute pancreatitis leading to prompt treatment and early referral to higher center.

Biomarkers of brain injury in neonatal encephalopathy treated with hypothermia.

Science.gov (United States)

Massaro, An N; Chang, Taeun; Kadom, Nadja; Tsuchida, Tammy; Scafidi, Joseph; Glass, Penny; McCarter, Robert; Baumgart, Stephen; Vezina, Gilbert; Nelson, Karin B

2012-09-01

To determine if early serum S100B and neuron-specific enolase (NSE) levels are associated with neuroradiographic and clinical evidence of brain injury in newborns with encephalopathy. Patients who received therapeutic whole-body hypothermia were prospectively enrolled in this observational study. Serum specimens were collected at 0, 12, 24, and 72 hours of cooling. S100B and NSE levels were measured by enzyme linked immunosorbent assay. Magnetic resonance imaging was performed in surviving infants at 7-10 days of life. Standardized neurologic examination was performed by a child neurologist at 14 days of life. Multiple linear regression analyses were performed to evaluate the association between S100B and NSE levels and unfavorable outcome (death or severe magnetic resonance imaging injury/significant neurologic deficit). Cutoff values were determined by receiver operating curve analysis. Newborns with moderate to severe encephalopathy were enrolled (n = 75). Median pH at presentation was 6.9 (range, 6.5-7.35), and median Apgar scores of 1 at 1 minute, 3 at 5 minutes, and 5 at 10 minutes. NSE and S100B levels were higher in patients with unfavorable outcomes across all time points. These results remained statistically significant after controlling for covariables, including encephalopathy grade at presentation, Apgar score at 5 minutes of life, initial pH, and clinical seizures. Elevated serum S100B and NSE levels measured during hypothermia were associated with neuroradiographic and clinical evidence of brain injury in encephalopathic newborns. These brain-specific proteins may be useful immediate biomarkers of cerebral injury severity. Copyright © 2012 Mosby, Inc. All rights reserved.

Investigating the debate of home birth safety: A critical review of cohort studies focusing on selected infant outcomes.

Science.gov (United States)

Elder, Heather R; Alio, Amina P; Fisher, Susan G

2016-07-01

There is a debate within the medical community regarding the safety of planned home births. The presumption of increased risk of maternal and infant morbidity and mortality at home due to limited access to life-saving interventions is not clearly supported by research. The aim of the present study was to assess strengths and limitations of the methodological approaches of cohort studies that compare home births with hospital births by focusing on selected infant outcomes. Studies were identified that assess the risk for at least one of three infant outcomes (mortality, Apgar score, and admission to the neonatal intensive care unit [NICU]) of home births compared with hospital births. Fifteen cohort studies were included. Two studies of low-risk births and two including higher risk births found home births to be at an increased risk of neonatal mortality. However, mortality is rare in developed nations and may not be the best measure of safety. When studies focused on low-risk pregnancies, planned birth location, and well-trained birth attendants, there was no difference in neonatal morbidity (Apgar score and NICU admission). Many methodological challenges were identified among these studies. This review contributes to the home birth published work by identifying key strengths and limitations that need to be accounted for in the interpretation of study findings and the development of future studies. Based on this review, the key variables that would strengthen future studies are birth attendant identification, documented planned birth location, and specification of the birth risk level. Uniformity of data collection and minimizing missing data are also critical. © 2016 Japan Academy of Nursing Science.

[School performance of former premature infants in the first four years of school].

Science.gov (United States)

Frenzel, J; Paalhorn, U

1992-12-01

School achievement during the first four grades was analysed by means of subject marks in 203 prematurely born and in 140 maturely born children. In subjects referring to behaviour in the classroom, no statistically significant differences in average marks could be found between prematurely born children and the control group. The average marks in performance subjects were slightly higher in the subgroup of very prematurely born children. However, statistically significant lower marks were observed in the subject of sports only, and for formerly immature children also in the subject of manual training. The higher the educational level of the mothers, the better the average marks without sports. No relationships between school performance and manifestation of postnatal risk factor like Apgar score, blood gas values and duration of oxygen dependency could be seen. These results demonstrate that school performance of former premature infants lies within the normal variance of their grade.

Detecting determinism with improved sensitivity in time series: rank-based nonlinear predictability score.

Science.gov (United States)

Naro, Daniel; Rummel, Christian; Schindler, Kaspar; Andrzejak, Ralph G

2014-09-01

The rank-based nonlinear predictability score was recently introduced as a test for determinism in point processes. We here adapt this measure to time series sampled from time-continuous flows. We use noisy Lorenz signals to compare this approach against a classical amplitude-based nonlinear prediction error. Both measures show an almost identical robustness against Gaussian white noise. In contrast, when the amplitude distribution of the noise has a narrower central peak and heavier tails than the normal distribution, the rank-based nonlinear predictability score outperforms the amplitude-based nonlinear prediction error. For this type of noise, the nonlinear predictability score has a higher sensitivity for deterministic structure in noisy signals. It also yields a higher statistical power in a surrogate test of the null hypothesis of linear stochastic correlated signals. We show the high relevance of this improved performance in an application to electroencephalographic (EEG) recordings from epilepsy patients. Here the nonlinear predictability score again appears of higher sensitivity to nonrandomness. Importantly, it yields an improved contrast between signals recorded from brain areas where the first ictal EEG signal changes were detected (focal EEG signals) versus signals recorded from brain areas that were not involved at seizure onset (nonfocal EEG signals).

WebScore: An Effective Page Scoring Approach for Uncertain Web Social Networks

Directory of Open Access Journals (Sweden)

Shaojie Qiao

2011-10-01

Full Text Available To effectively score pages with uncertainty in web social networks, we first proposed a new concept called transition probability matrix and formally defined the uncertainty in web social networks. Second, we proposed a hybrid page scoring algorithm, called WebScore, based on the PageRank algorithm and three centrality measures including degree, betweenness, and closeness. Particularly,WebScore takes into a full consideration of the uncertainty of web social networks by computing the transition probability from one page to another. The basic idea ofWebScore is to: (1 integrate uncertainty into PageRank in order to accurately rank pages, and (2 apply the centrality measures to calculate the importance of pages in web social networks. In order to verify the performance of WebScore, we developed a web social network analysis system which can partition web pages into distinct groups and score them in an effective fashion. Finally, we conducted extensive experiments on real data and the results show that WebScore is effective at scoring uncertain pages with less time deficiency than PageRank and centrality measures based page scoring algorithms.

Evaluation of acute myocardial infarction by 201Tl single-photon emission computed tomography using scoring system

International Nuclear Information System (INIS)

Setsuta, Koichi

1991-01-01

In 36 patients with acute myocardial infarction (AMI) 201 Tl single photon emission computed tomography (SPECT) examinations were performed in a relatively early phase of AMI. The short and long axis views of the left ventricle (LV) were divided into 6 segments. Images of each segment were assigned scores (segmental scores) based on a visual evaluation of the extent of 201 Tl accumulations. SPECT scores were compared with max GOT, max LDT, max CPK and max CK-MB, Killip classification and Forrester hemodynamic subset on admission, and LV ejection fraction (LVEF). Segmental scores were compared with LV wall motion evaluated by left ventriculography. The results are as follows: There were significant correlations between SPECT scores and max GOT, max LDH, max CPK and max CK-MB. SPECT scores in patients with Killip group III were significantly higher than in patients with Killip group I+II. However, no significant differences in max GOT, max LDH, max CPK and max CK-MB were observed between patients with Killip group III and those with Killip group I+II. SPECT scores were significantly higher in patients with Forrester group III+IV than in patients with Forrester group I+II. Segmental scores in segments evaluated as akinesis, dyskinesis and aneurysm by left ventriculography were significantly higher than those evaluated as hypokinesis or normal. Segmental scores in segments evaluated as hypokinesis were significantly high in comparison with normal segments. Significant correlations were observed between LVEF and SPECT scores. However, LVEF correlated poorly with max GOT, max LDH and max CPK, and no significant correlation was observed between LVEF and max CK-MB. SPECT examinations were performed in 11 patients in both the acute and chronic phase of AMI. SPECT scores in the chronic phase did not change in 4 patients, decreased in 5, increased in 2. These results suggest that SPECT scores and segmental scores can be useful indices in the evaluation of AMI. (J.P.N.)

A comparison of the scorings of real and standardized patients on physician communication skills.

Science.gov (United States)

Rezaei, Rita; Mehrabani, G

2014-05-01

To compare the scorings of real and standardized patients on physician communication skills. Patient scoring (n=183) on physicians' communication skills was determined by 93 real and 90 standardized patients. Eighty physicians (42 specialists and 38 general physicians) in private practice were enrolled. Data were analyzed using self administered questionnaires and checklists including 16 close ended questions. Twelve percent of patients were not satisfied with the physician communication skills. Poor communication skills were more reported by male patients and those with a higher educational level. The physician communication skill received a higher score with increase of age of patients. A good physician's communication skill was reported more by married patients. A good physician's communication skill was significantly more in female doctors, in general physicians and in doctors wearing a White Coat. Real patients scored physician's communication skills higher than standardized patients. It is important that physicians try to learn the principles of a good physician-patient communication skill. Therefore, providing medical educational programs on the role of a good doctor and patient relationship at all levels for the doctors and applying them in their clinical practice seem necessary to improve the physician communication skills.

Longitudinal associations between physical activity and depression scores in Swedish women followed 32 years.

Science.gov (United States)

Gudmundsson, P; Lindwall, M; Gustafson, D R; Östling, S; Hällström, T; Waern, M; Skoog, I

2015-12-01

Physical activity is negatively associated with depressive symptoms. However, few studies consider dynamic associations of changes in physical activity and reciprocal relationships. This study aimed to perform comprehensive evaluations of relationships between physical activity and depression scores in women followed from mid- to late life. The Prospective Population Study of Women in Gothenburg, Sweden, provided repeated measures of self-reported physical activity and depressive symptoms between 1974 and 2005 (baseline N = 676, 84.5% response rate). Depressive symptoms were assessed using the Montgomery-Åsberg Depression Rating Scale, and physical activity was evaluated by the Saltin-Grimby Physical Activity Level Scale. Latent growth curve analyses were used to evaluate associations of change, and cross-lagged models were used to study the reciprocal relationship between physical activity and depression scores. At baseline, lower levels of physical activity were related to higher depression scores. Individuals with decreasing physical activity over time evidenced higher depression scores at 32-year follow-up. Higher average baseline depression score was related to declining levels of physical activity at subsequent examinations. Reduced physical activity may be a long-term consequence of depression. It is important to address individual changes in physical activity and not merely absolute levels of physical activity in relationship to depression. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Peer-instructed seminar attendance is associated with improved preparation, deeper learning and higher exam scores : A survey study

NARCIS (Netherlands)

Bouwmeester, Rianne A M; De Kleijn, Renske A M; Van Rijen, Harold V M

2016-01-01

Background: Active engagement in education improves learning outcomes. To enhance active participation in seminars, a student-centered course design was implemented and evaluated in terms of self-reported preparation, student motivation and exam scores. We hypothesized that small group learning with

A quality score for coronary artery tree extraction results

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Cao, Qing; Broersen, Alexander; Kitslaar, Pieter H.; Lelieveldt, Boudewijn P. F.; Dijkstra, Jouke

2018-02-01

Coronary artery trees (CATs) are often extracted to aid the fully automatic analysis of coronary artery disease on coronary computed tomography angiography (CCTA) images. Automatically extracted CATs often miss some arteries or include wrong extractions which require manual corrections before performing successive steps. For analyzing a large number of datasets, a manual quality check of the extraction results is time-consuming. This paper presents a method to automatically calculate quality scores for extracted CATs in terms of clinical significance of the extracted arteries and the completeness of the extracted CAT. Both right dominant (RD) and left dominant (LD) anatomical statistical models are generated and exploited in developing the quality score. To automatically determine which model should be used, a dominance type detection method is also designed. Experiments are performed on the automatically extracted and manually refined CATs from 42 datasets to evaluate the proposed quality score. In 39 (92.9%) cases, the proposed method is able to measure the quality of the manually refined CATs with higher scores than the automatically extracted CATs. In a 100-point scale system, the average scores for automatically and manually refined CATs are 82.0 (+/-15.8) and 88.9 (+/-5.4) respectively. The proposed quality score will assist the automatic processing of the CAT extractions for large cohorts which contain both RD and LD cases. To the best of our knowledge, this is the first time that a general quality score for an extracted CAT is presented.

The PER (Preoperative Esophagectomy Risk) Score: A Simple Risk Score to Predict Short-Term and Long-Term Outcome in Patients with Surgically Treated Esophageal Cancer.

Science.gov (United States)

Reeh, Matthias; Metze, Johannes; Uzunoglu, Faik G; Nentwich, Michael; Ghadban, Tarik; Wellner, Ullrich; Bockhorn, Maximilian; Kluge, Stefan; Izbicki, Jakob R; Vashist, Yogesh K

2016-02-01

Esophageal resection in patients with esophageal cancer (EC) is still associated with high mortality and morbidity rates. We aimed to develop a simple preoperative risk score for the prediction of short-term and long-term outcomes for patients with EC treated by esophageal resection. In total, 498 patients suffering from esophageal carcinoma, who underwent esophageal resection, were included in this retrospective cohort study. Three preoperative esophagectomy risk (PER) groups were defined based on preoperative functional evaluation of different organ systems by validated tools (revised cardiac risk index, model for end-stage liver disease score, and pulmonary function test). Clinicopathological parameters, morbidity, and mortality as well as disease-free survival (DFS) and overall survival (OS) were correlated to the PER score. The PER score significantly predicted the short-term outcome of patients with EC who underwent esophageal resection. PER 2 and PER 3 patients had at least double the risk of morbidity and mortality compared to PER 1 patients. Furthermore, a higher PER score was associated with shorter DFS (P PER score was identified as an independent predictor of tumor recurrence (hazard ratio [HR] 2.1; P PER score allows preoperative objective allocation of patients with EC into different risk categories for morbidity, mortality, and long-term outcomes. Thus, multicenter studies are needed for independent validation of the PER score.

Untitled

African Journals Online (AJOL)

mortality rates, congenital malformation rates and Apgar score of less than 7 at 5 minutes in babies born by ... entre l994 et décembre 2000 constitue la base de cet etude. ll y a l66 patientes soit 28,9% qui ont eu accouchement ..... Eur J Obsteet Gynecol Reprod Biol Oct 2001;. 98(2): 186 ~ 92. Hannah ME, Hannah WJ, ...

Predictive values of D-dimer assay, GRACE scores and TIMI scores for adverse outcome in patients with non-ST-segment elevation myocardial infarction

Science.gov (United States)

Satilmisoglu, Muhammet Hulusi; Ozyilmaz, Sinem Ozbay; Gul, Mehmet; Ak Yildirim, Hayriye; Kayapinar, Osman; Gokturk, Kadir; Aksu, Huseyin; Erkanli, Korhan; Eksik, Abdurrahman

2017-01-01

Purpose To determine the predictive values of D-dimer assay, Global Registry of Acute Coronary Events (GRACE) and Thrombolysis in Myocardial Infarction (TIMI) risk scores for adverse outcome in patients with non-ST-segment elevation myocardial infarction (NSTEMI). Patients and methods A total of 234 patients (mean age: 57.2±11.7 years, 75.2% were males) hospitalized with NSTEMI were included. Data on D-dimer assay, GRACE and TIMI risk scores were recorded. Logistic regression analysis was conducted to determine the risk factors predicting increased mortality. Results Median D-dimer levels were 349.5 (48.0–7,210.0) ng/mL, the average TIMI score was 3.2±1.2 and the GRACE score was 90.4±27.6 with high GRACE scores (>118) in 17.5% of patients. The GRACE score was correlated positively with both the D-dimer assay (r=0.215, P=0.01) and TIMI scores (r=0.504, P=0.000). Multivariate logistic regression analysis revealed that higher creatinine levels (odds ratio =18.465, 95% confidence interval: 1.059–322.084, P=0.046) constituted the only significant predictor of increased mortality risk with no predictive values for age, D-dimer assay, ejection fraction, glucose, hemoglobin A1c, sodium, albumin or total cholesterol levels for mortality. Conclusion Serum creatinine levels constituted the sole independent determinant of mortality risk, with no significant values for D-dimer assay, GRACE or TIMI scores for predicting the risk of mortality in NSTEMI patients. PMID:28408834

A Comparison of Two Scoring Methods for an Automated Speech Scoring System

Science.gov (United States)

Xi, Xiaoming; Higgins, Derrick; Zechner, Klaus; Williamson, David

2012-01-01

This paper compares two alternative scoring methods--multiple regression and classification trees--for an automated speech scoring system used in a practice environment. The two methods were evaluated on two criteria: construct representation and empirical performance in predicting human scores. The empirical performance of the two scoring models…

Circadian variability of the initial Glasgow Coma Scale score in traumatic brain injury patients

Directory of Open Access Journals (Sweden)

John K. Yue

2017-01-01

Conclusions: Nighttime TBI patients present with decreased GCS scores and are admitted to ICU at higher rates, yet have fewer prior comorbidities and similar systemic injuries. The interaction between nighttime hours and decreased GCS score on ICU admissions has important implications for clinical assessment/triage.

Clinical Course Score (CCS): a new clinical score to evaluate efficacy of neurotrauma treatment in traumatic brain injury and subarachnoid hemorrhage.

Science.gov (United States)

Brandner, Sebastian; Kellermann, Isabel; Hore, Nirjhar; Bozhkov, Yavor; Buchfelder, Michael

2015-01-01

Neurotrauma continues to represent a challenging public health issue requiring continual improvement in therapeutic approaches. As no such current system exists, we present in this study the Clinical Course Score (CCS) as a new clinical score to evaluate the efficacy of neurotrauma treatment. The CCS was calculated in neurotrauma patients to be the difference between the grade of the Glasgow Outcome Scale 6 months after discharge from our department and the grade of a 1 to 5 point reduced Glasgow Coma Scale on admission. We assessed the CCS in a total of 248 patients (196 traumatic brain injury [TBI] patients and 52 subarachnoid hemorrhage [SAH] patients) who were treated in our Department of Neurosurgery between January 2011 and December 2012. We found negative CCS grades both in mild TBI and in mild SAH patients. In patients with severe TBI or SAH, we found positive CCS grades. In SAH patients, we found higher CCS scores in younger patients compared with elderly subjects in both mild and severe cases. The CCS can be useful in evaluating different therapeutic approaches during neurotrauma therapy. This new score might improve assessment of beneficial effects of therapeutic procedures.

A Study of the Correlation of the Improvement of Teaching Evaluation Scores Based on Student Performance Grades

Science.gov (United States)

Chen, Chi Yuan; Wang, Shu-Yin; Yang, Yi-Fang

2017-01-01

The purpose of the study is to explore the influence of teaching evaluations on teachers in that they might try to please their students by giving higher grades in order to get higher teaching evaluation scores. To achieve this purpose, the study analyzed the correlations between teaching evaluation scores, student's final grades and course fail…

NCACO-score: An effective main-chain dependent scoring function for structure modeling

Directory of Open Access Journals (Sweden)

Dong Xiaoxi

2011-05-01

Full Text Available Abstract Background Development of effective scoring functions is a critical component to the success of protein structure modeling. Previously, many efforts have been dedicated to the development of scoring functions. Despite these efforts, development of an effective scoring function that can achieve both good accuracy and fast speed still presents a grand challenge. Results Based on a coarse-grained representation of a protein structure by using only four main-chain atoms: N, Cα, C and O, we develop a knowledge-based scoring function, called NCACO-score, that integrates different structural information to rapidly model protein structure from sequence. In testing on the Decoys'R'Us sets, we found that NCACO-score can effectively recognize native conformers from their decoys. Furthermore, we demonstrate that NCACO-score can effectively guide fragment assembly for protein structure prediction, which has achieved a good performance in building the structure models for hard targets from CASP8 in terms of both accuracy and speed. Conclusions Although NCACO-score is developed based on a coarse-grained model, it is able to discriminate native conformers from decoy conformers with high accuracy. NCACO is a very effective scoring function for structure modeling.

Increased correlation coefficient between the written test score and tutors’ performance test scores after training of tutors for assessment of medical students during problem-based learning course in Malaysia

Directory of Open Access Journals (Sweden)

Heethal Jaiprakash

2016-03-01

Full Text Available This paper is aimed at finding if there was a change of correlation between the written test score and tutors’ performance test scores in the assessment of medical students during a problem-based learning (PBL course in Malaysia. This is a cross-sectional observational study, conducted among 264 medical students in two groups from November 2010 to November 2012. The first group’s tutors did not receive tutor training; while the second group’s tutors were trained in the PBL process. Each group was divided into high, middle and low achievers based on their end-of-semester exam scores. PBL scores were taken which included written test scores and tutors’ performance test scores. Pearson correlation coefficient was calculated between the two kinds of scores in each group. The correlation coefficient between the written scores and tutors’ scores in group 1 was 0.099 (p<0.001 and for group 2 was 0.305 (p<0.001. The higher correlation coefficient in the group where tutors received the PBL training reinforces the importance of tutor training before their participation in the PBL course.

Neighbourhood socioeconomic status and maternal factors at birth as moderators of the association between birth characteristics and school attainment: a population study of children attending government schools in Western Australia.

Science.gov (United States)

Malacova, E; Li, J; Blair, E; Mattes, E; de Klerk, N; Stanley, F

2009-10-01

This article investigates whether reading and writing skills among children of equivalent perinatal characteristics differ by neighbourhood socioeconomic status and maternal factors. Notifications of births for all non-Aboriginal singletons born in 1990-7 in Western Australia subsequently attending government primary schools were linked to the State literacy tests in grade three and with information on socioeconomic status of the school and the residential area. Using multilevel modelling, the associations between birth characteristics (gestational age, intrauterine growth, birth order and Apgar score at 5 minutes) and literacy attainment in grade three were examined in models that included socioeconomic and demographic factors of the child, mother and community. Higher percentages of optimal head circumference and birth length and term birth were positively and independently associated with literacy scores. A higher percentage of optimal birth weight was associated with higher reading scores especially for children born to mothers residing in educationally advantaged areas. First birth was positively associated with reading and writing attainment: this association was stronger for children born to single mothers and additional advantage in writing was also associated with first birth in children living in disadvantaged areas. These findings suggest that having suboptimal growth in utero or an older sibling at birth increases vulnerability to poor literacy attainment especially among children born to single mothers or those in disadvantaged neighbourhoods. These data provide evidence for advocating lifestyles compatible with optimum fetal growth and socioeconomic conditions conducive to healthy lifestyles, particularly during pregnancy.

Various scoring systems for predicting mortality in Intensive Care Unit

African Journals Online (AJOL)

2015-12-07

Dec 7, 2015 ... Mortality rate was higher in patients admitted from wards other than surgery ... evaluate the predictability of various severity of illness scores, and ..... Livingston BM, MacKirdy FN, Howie JC, Jones R, Norrie JD. Assessment of.

Description and validation of a scoring system for tomosynthesis in pulmonary cystic fibrosis.

Science.gov (United States)

Vult von Steyern, Kristina; Björkman-Burtscher, Isabella M; Höglund, Peter; Bozovic, Gracijela; Wiklund, Marie; Geijer, Mats

2012-12-01

To design and validate a scoring system for tomosynthesis (digital tomography) in pulmonary cystic fibrosis. A scoring system dedicated to tomosynthesis in pulmonary cystic fibrosis was designed. Three radiologists independently scored 88 pairs of radiographs and tomosynthesis examinations of the chest in 60 patients with cystic fibrosis and 7 oncology patients. Radiographs were scored according to the Brasfield scoring system and tomosynthesis examinations were scored using the new scoring system. Observer agreements for the tomosynthesis score were almost perfect for the total score with square-weighted kappa >0.90, and generally substantial to almost perfect for subscores. Correlation between the tomosynthesis score and the Brasfield score was good for the three observers (Kendall's rank correlation tau 0.68, 0.77 and 0.78). Tomosynthesis was generally scored higher as a percentage of the maximum score. Observer agreements for the total score for Brasfield score were almost perfect (square-weighted kappa 0.80, 0.81 and 0.85). The tomosynthesis scoring system seems robust and correlates well with the Brasfield score. Compared with radiography, tomosynthesis is more sensitive to cystic fibrosis changes, especially bronchiectasis and mucus plugging, and the new tomosynthesis scoring system offers the possibility of more detailed and accurate scoring of disease severity. Tomosynthesis is more sensitive than conventional radiography for pulmonary cystic fibrosis changes. The radiation dose from chest tomosynthesis is low compared with computed tomography. Tomosynthesis may become useful in the regular follow-up of patients with cystic fibrosis.

Ethics Requirement Score: new tool for evaluating ethics in publications

Science.gov (United States)

dos Santos, Lígia Gabrielle; Fonseca, Ana Carolina da Costa e; Bica, Claudia Giuliano

2014-01-01

Objective To analyze ethical standards considered by health-related scientific journals, and to prepare the Ethics Requirement Score, a bibliometric index to be applied to scientific healthcare journals in order to evaluate criteria for ethics in scientific publication. Methods Journals related to healthcare selected by the Journal of Citation Reports™ 2010 database were considered as experimental units. Parameters related to publication ethics were analyzed for each journal. These parameters were acquired by analyzing the author’s guidelines or instructions in each journal website. The parameters considered were approval by an Internal Review Board, Declaration of Helsinki or Resolution 196/96, recommendations on plagiarism, need for application of Informed Consent Forms with the volunteers, declaration of confidentiality of patients, record in the database for clinical trials (if applicable), conflict of interest disclosure, and funding sources statement. Each item was analyzed considering their presence or absence. Result The foreign journals had a significantly higher Impact Factor than the Brazilian journals, however, no significant results were observed in relation to the Ethics Requirement Score. There was no correlation between the Ethics Requirement Score and the Impact Factor. Conclusion Although the Impact Factor of foreigner journals was considerably higher than that of the Brazilian publications, the results showed that the Impact Factor has no correlation with the proposed score. This allows us to state that the ethical requirements for publication in biomedical journals are not related to the comprehensiveness or scope of the journal. PMID:25628189

Ethics Requirement Score: new tool for evaluating ethics in publications.

Science.gov (United States)

Santos, Lígia Gabrielle dos; Costa e Fonseca, Ana Carolina da; Bica, Claudia Giuliano

2014-01-01

To analyze ethical standards considered by health-related scientific journals, and to prepare the Ethics Requirement Score, a bibliometric index to be applied to scientific healthcare journals in order to evaluate criteria for ethics in scientific publication. Journals related to healthcare selected by the Journal of Citation Reports™ 2010 database were considered as experimental units. Parameters related to publication ethics were analyzed for each journal. These parameters were acquired by analyzing the author's guidelines or instructions in each journal website. The parameters considered were approval by an Internal Review Board, Declaration of Helsinki or Resolution 196/96, recommendations on plagiarism, need for application of Informed Consent Forms with the volunteers, declaration of confidentiality of patients, record in the database for clinical trials (if applicable), conflict of interest disclosure, and funding sources statement. Each item was analyzed considering their presence or absence. The foreign journals had a significantly higher Impact Factor than the Brazilian journals, however, no significant results were observed in relation to the Ethics Requirement Score. There was no correlation between the Ethics Requirement Score and the Impact Factor. Although the Impact Factor of foreigner journals was considerably higher than that of the Brazilian publications, the results showed that the Impact Factor has no correlation with the proposed score. This allows us to state that the ethical requirements for publication in biomedical journals are not related to the comprehensiveness or scope of the journal.

Risk factors associated with neonatal deaths: a matched case-control study in Indonesia.

Science.gov (United States)

Abdullah, Asnawi; Hort, Krishna; Butu, Yuli; Simpson, Louise

2016-01-01

Similar to global trends, neonatal mortality has fallen only slightly in Indonesia over the period 1990-2010, with a high proportion of deaths in the first week of life. This study aimed to identify risk factors associated with neonatal deaths of low and normal birthweight infants that were amenable to health service intervention at a community level in a relatively poor province of Indonesia. A matched case-control study of neonatal deaths reported from selected community health centres (puskesmas) was conducted over 10 months in 2013. Cases were singleton births, born by vaginal delivery, at home or in a health facility, matched with two controls satisfying the same criteria. Potential variables related to maternal and neonatal risk factors were collected from puskesmas medical records and through home visit interviews. A conditional logistic regression was performed to calculate odds ratios using the clogit procedure in Stata 11. Combining all significant variables related to maternal, neonatal, and delivery factors into a single multivariate model, six factors were found to be significantly associated with a higher risk of neonatal death. The factors identified were as follows: neonatal complications during birth; mother noting a health problem during the first 28 days; maternal lack of knowledge of danger signs for neonates; low Apgar score; delivery at home; and history of complications during pregnancy. Three risk factors (neonatal complication at delivery; neonatal health problem noted by mother; and low Apgar score) were significantly associated with early neonatal death at age 0-7 days. For normal birthweight neonates, three factors (complications during delivery; lack of early initiation of breastfeeding; and lack of maternal knowledge of neonatal danger signs) were found to be associated with a higher risk of neonatal death. The study identified a number of factors amenable to health service intervention associated with neonatal deaths in normal and low

Reliable scar scoring system to assess photographs of burn patients.

Science.gov (United States)

Mecott, Gabriel A; Finnerty, Celeste C; Herndon, David N; Al-Mousawi, Ahmed M; Branski, Ludwik K; Hegde, Sachin; Kraft, Robert; Williams, Felicia N; Maldonado, Susana A; Rivero, Haidy G; Rodriguez-Escobar, Noe; Jeschke, Marc G

2015-12-01

Several scar-scoring scales exist to clinically monitor burn scar development and maturation. Although scoring scars through direct clinical examination is ideal, scars must sometimes be scored from photographs. No scar scale currently exists for the latter purpose. We modified a previously described scar scale (Yeong et al., J Burn Care Rehabil 1997) and tested the reliability of this new scale in assessing burn scars from photographs. The new scale consisted of three parameters as follows: scar height, surface appearance, and color mismatch. Each parameter was assigned a score of 1 (best) to 4 (worst), generating a total score of 3-12. Five physicians with burns training scored 120 representative photographs using the original and modified scales. Reliability was analyzed using coefficient of agreement, Cronbach alpha, intraclass correlation coefficient, variance, and coefficient of variance. Analysis of variance was performed using the Kruskal-Wallis test. Color mismatch and scar height scores were validated by analyzing actual height and color differences. The intraclass correlation coefficient, the coefficient of agreement, and Cronbach alpha were higher for the modified scale than those of the original scale. The original scale produced more variance than that in the modified scale. Subanalysis demonstrated that, for all categories, the modified scale had greater correlation and reliability than the original scale. The correlation between color mismatch scores and actual color differences was 0.84 and between scar height scores and actual height was 0.81. The modified scar scale is a simple, reliable, and useful scale for evaluating photographs of burn patients. Copyright © 2015 Elsevier Inc. All rights reserved.

A comprehensive scoring system in correlation with perioperative airway management for neonatal Pierre Robin Sequence.

Directory of Open Access Journals (Sweden)

Ning Yin

Full Text Available To evaluate a comprehensive scoring system which combines clinical manifestations of Pierre Robin Sequence (PRS including severity of breathing difficulties, body weight and preoperative Cormack-Lehane grade, for its correlation with perioperative PRS airway management decision.Forty PRS children were retrospectively recruited after surgery. Specialists examined all subjects and scored for clinical manifestations (1´ - 4´, weight gain (1´- 4´, dyspnea scores (1´- 4´, and Cormack-Lehane grade (1´- 4´. The correlation of the integrated scores and the necessity of endotracheal intubation or laryngeal mask application were analyzed. In addition, the score correlation with postoperative dyspnea and/or low pulse oxygen saturation (SPO2 levels after extubation was determined.In our study every individual patient had a score from 0´ to 16´, while the higher in the numbers represented higher risk of breathing difficulty. All patients with comprehensive scores 13 points required a laryngeal mask assisted airway management and were considered to have difficult airways. Dyspnea after extubation and postoperative low SPO2 occurred among patients who scored over 10 points.In PRS patients, preoperative weight gaining status and severity of dyspnea in combination with Cormack-Lehane classification provide a scoring system that could help to optimize airway management decisions such as endotracheal intubation or laryngeal mask airway placement and has the potential to predict postoperative dyspnea or low SPO2 levels.

People reporting experiences of mediumship have higher dissociation symptom scores than non-mediums, but below thresholds for pathological dissociation [version 3; referees: 2 approved, 1 not approved

Directory of Open Access Journals (Sweden)

Helané Wahbeh

2018-01-01

Full Text Available Background: Dissociative states exist on a continuum from nonpathological forms, such as highway hypnosis and day-dreaming, to pathological states of derealization and depersonalization. Claims of communication with deceased individuals, known as mediumship, were once regarded as a pathological form of dissociation, but current definitions recognize the continuum and include distress and functional disability as symptoms of pathology. This study examined the relationship between dissociative symptoms and mediumship in a large convenience sample. Methods: Secondary analyses of cross-sectional survey data were conducted. The survey included demographics, the Dissociation Experience Scale Taxon (DES-T, score range 0-100, as well as questions about instances of mediumship experiences. Summary statistics and linear and logistic regressions explored the relationship between dissociative symptoms and mediumship endorsement. Results: 3,023 participants were included and were mostly middle-aged (51 years ± 16; range 17-96, female (70%, Caucasian (85%, college educated (88%, had an annual income over $50,000 (55%, and were raised Christian (71% but were presently described as Spiritual but not Religious (60%. Mediumship experiences were endorsed by 42% of participants, the experiences usually began in childhood (81%, and 53% had family members who reported similar experiences. The mean DES-T score across all participants was 14.4 ± 17.3, with a mean of 18.2 ± 19.3 for those claiming mediumship experiences and 11.8 ± 15.2 for those who did not (t = -10.3, p < 0.0005. The DES-T threshold score for pathological dissociation is 30. Conclusions: On average, individuals claiming mediumship experiences had higher dissociation scores than non-claimants, but neither group exceeded the DES-T threshold for pathology. Future studies exploring dissociative differences between these groups may benefit from using more comprehensive measures of dissociative symptoms

On individual differences in person perception: raters' personality traits relate to their psychopathy checklist-revised scoring tendencies.

Science.gov (United States)

Miller, Audrey K; Rufino, Katrina A; Boccaccini, Marcus T; Jackson, Rebecca L; Murrie, Daniel C

2011-06-01

This study investigated raters' personality traits in relation to scores they assigned to offenders using the Psychopathy Checklist-Revised (PCL-R). A total of 22 participants, including graduate students and faculty members in clinical psychology programs, completed a PCL-R training session, independently scored four criminal offenders using the PCL-R, and completed a comprehensive measure of their own personality traits. A priori hypotheses specified that raters' personality traits, and their similarity to psychopathy characteristics, would relate to raters' PCL-R scoring tendencies. As hypothesized, some raters assigned consistently higher scores on the PCL-R than others, especially on PCL-R Facets 1 and 2. Also as hypothesized, raters' scoring tendencies related to their own personality traits (e.g., higher rater Agreeableness was associated with lower PCL-R Interpersonal facet scoring). Overall, findings underscore the need for future research to examine the role of evaluator characteristics on evaluation results and the need for clinical training to address evaluators' personality influences on their ostensibly objective evaluations.

Seropositivity of Dengue Antibodies during Pregnancy

Directory of Open Access Journals (Sweden)

Nor Azlin Mohamed Ismail

2014-01-01

Full Text Available Purpose. Malaysia a dengue endemic country with dengue infections in pregnancy on the rise. The present study was aimed at determining dengue seroprevalence (IgG or IgM during pregnancy and its neonatal transmission in dengue seropositive women. Methods. Maternal with paired cord blood samples were tested for dengue antibodies (IgG and IgM using an enzyme-linked immunosorbent assay (ELISA. Maternal age, parity, occupation, ethnic group, and gestational age were recorded. Data on neonatal Apgar score and admissions to the Neonatal Intensive Care Unit (NICU were analyzed. Results. Out of 358 women recruited, about 128 (35.8% patients were seropositive. Twelve patients (3.4% had recent infections (IgM positive and another 116 women (32.4% were with past infections (IgG positive. All babies born to seropositive mothers had positive IgG paired cord blood; however, no IgM seropositivity was observed. All neonates had good Apgar scores and did not require NICU admission. Conclusion. In this study, 35.8% pregnant women were found to be dengue seropositive. However, transplacental transfer of IgG antibodies had no detrimental effect on the neonatal outcomes.

Intrapartum FHR monitoring and neonatal CT brain scan

International Nuclear Information System (INIS)

Takahashi, Yoshiki; Ukita, Masahiko; Nakada, Eizo

1982-01-01

The effect of fetal distress on the neonatal brain was investigated by neonatal CT brain scan, FHR monitoring and mode of delivery. This study involved 11 cases of full term vertex delivery in which FHR was recorded by fetal direct ECG during the second stage labor. All infants weighed 2,500 g or more. FHR monitoring was evaluated by Hon's classification. Neonatal brain edema was evaluated by cranial CT histgraphic analysis (Nakada's method). 1) Subdural hemorrhage was noted in 6 of 7 infants delivered by vacuum extraction or fundal pressure (Kristeller's method). 2) Intracranial hemorrhage was demonstrated in all of 3 infants with 5-min. Apgar score 7 or less. 3) Two cases with prolonged bradycardia and no variability had intraventricular or intracerebral hemorrhage which resulted in severe central nervous system damage. 4) The degree of neonatal brain edema correlated with 5-min. Apgar score. 5) One case with prolonged bradycardia and no variability resulted in severe neonatal brain edema. Four cases with variable deceleration and increased variability resulted in mild neonatal brain edema. Two cases with late deceleration and decreased variability resulted in no neonatal brain edema. (author)

Obstetric outcomes in women with polycystic ovary syndrome and isolated polycystic ovaries undergoing in vitro fertilization: a retrospective cohort analysis.

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Wan, Hei Lok Tiffany; Hui, Pui Wah; Li, Hang Wun Raymond; Ng, Ernest Hung Yu

2015-03-01

This retrospective cohort study evaluated the obstetric outcomes in women with polycystic ovary syndrome (PCOS) and isolated polycystic ovaries (PCO) undergoing in vitro fertilization (IVF) treatment. We studied 104 women with PCOS, 184 with PCO and 576 age-matched controls undergoing the first IVF treatment cycle between 2002 and 2009. Obstetric outcomes and complications including gestational diabetes (GDM), gestational hypertension (GHT), gestational proteinuric hypertension (PET), intrauterine growth restriction (IUGR), gestation at delivery, baby's Apgar scores and admission to the neonatal intensive care unit (NICU) were reviewed. Among the 864 patients undergoing IVF treatment, there were 253 live births in total (25 live births in the PCOS group, 54 in the PCO group and 174 in the control group). The prevalence of obstetric complications (GDM, GHT, PET and IUGR) and the obstetric outcomes (gestation at delivery, birth weight, Apgar scores and NICU admissions) were comparable among the three groups. Adjustments for age and multiple pregnancies were made using multiple logistic regression and we found no statistically significant difference among the three groups. Patients with PCO ± PCOS do not have more adverse obstetric outcomes when compared with non-PCO patients undergoing IVF treatment.

Relationship between Maternal General and Specific-Pregnancy Stress, Anxiety, and Depression Symptoms and Pregnancy Outcome.

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Hasanjanzadeh, Parvin; Faramarzi, Mahbobeh

2017-04-01

Despite scientific advances in the field of physical problems during pregnancy, the effect of mental problems on the health of pregnant women is still an important issue that needs further research. To determine the association of symptoms of stress, anxiety and depression during pregnancy and there effect on the pregnancy outcome. This was a descriptive correlational study. The population included 200 pregnant women of the urban and rural health centers affiliated with Babol University of Medical Sciences. There were 100 each in second and third trimester. Convenience multi stage cluster sampling was performed. Data collection was received through the Hospital Anxiety Depression Scale (HADS), Pregnancy Distress Questionnaire (PDQ), and Perceived Stress Scale (PSS-14) questionnaires. The correlation results showed a significant difference between variables of depression, stress, and anxiety with birth weight, birth height and head circumference and infants' APGAR score (prelationships on prediction of infant weight (B=-0.324), anxiety on prediction of infant height (B=-0.197), stress on prediction of head circumference (B=-0.350) and depression on prediction of APGAR score (B=-0.323) are effective (pdepression, anxiety and stress in pregnancy, and scheduling to avoid adverse consequences of the pregnancy outcome.

Exploring Content Validity of Shore Handwriting Screening and Newly Developed Score Sheet With Pre-Kindergarten Students

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Denise K. Donica

2015-07-01

Full Text Available Background: Limited tools exist to measure handwriting readiness skills of pre-kindergarten students. This study was a preliminary exploration of content validity of the Shore Handwriting Screening (SHS and the newly developed Score Sheet with the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2 in 4- and 5-year-old pre-kindergarten students. Because socioeconomic status (SES is known to impact handwriting skills, data from two different socioeconomic groups were collected. Method: Students from a Lower SES group (n = 36 and a Higher SES group (n = 14 completed the SHS and fine motor composite of the BOT-2. Pearson’s correlation was used to compare scores on the two assessments within the two groups. Results: SHS overall percentage scores were compared to standard scores and composite scores of the BOT-2. SHS scores displayed moderate to high correlation with fine manual control portions of the BOT-2 for the Lower SES group and low to moderate correlation for the same portion in the Higher SES group. Conclusion: SHS and the Score Sheet correlate to fine and visual-motor skill subtests on the fine manual control portions of the BOT-2, which supports the need for further research on the reliability and validity of the Score Sheet for use in practice.

APLIKASI Z-SCORE METHOD DALAM PEMBENTUKAN PORTOFOLIO

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Deannes Isynuwardhana

2017-03-01

Full Text Available The problem that often occurs in forming portfolio was regarding the selection and weighting the stock wichhad to be included in portfolio. This study attempted to solve the problem by using a simple model, which wasexpected to be applied easily by investors. This was a descriptive research with quantitative approach, andused stocks that was categorized as “blue chip” in Indonesia’s stock exchange as a sample. Stock selectionprocess used Z-score method with 6 criteria. There were, price earning ratio, price to book value, debt to equityratio, gross profit margin, return on equity, and stock’s historical price. The weighting of each stock inportfolio was then calculated by were used Bodie, Kane, and Markus (2011 approach. The coefficient ofvariation, risk and return of the market used as benchmark to measure portfolio performance. The result showedthat portfolio which formed by Z-score method give higher return than the market. Although the portfolioprovided greater risk, but it was not comparable with the marker return that gave negative results in return.The result suggested that portfolio which was created using the Z-score method could be applied by investorsin Indonesia’s stock exchange.

Soetomo score: score model in early identification of acute haemorrhagic stroke

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Moh Hasan Machfoed

2016-06-01

Full Text Available Aim of the study: On financial or facility constraints of brain imaging, score model is used to predict the occurrence of acute haemorrhagic stroke. Accordingly, this study attempts to develop a new score model, called Soetomo score. Material and methods: The researchers performed a cross-sectional study of 176 acute stroke patients with onset of ≤24 hours who visited emergency unit of Dr. Soetomo Hospital from July 14th to December 14th, 2014. The diagnosis of haemorrhagic stroke was confirmed by head computed tomography scan. There were seven predictors of haemorrhagic stroke which were analysed by using bivariate and multivariate analyses. Furthermore, a multiple discriminant analysis resulted in an equation of Soetomo score model. The receiver operating characteristic procedure resulted in the values of area under curve and intersection point identifying haemorrhagic stroke. Afterward, the diagnostic test value was determined. Results: The equation of Soetomo score model was (3 × loss of consciousness + (3.5 × headache + (4 × vomiting − 4.5. Area under curve value of this score was 88.5% (95% confidence interval = 83.3–93.7%. In the Soetomo score model value of ≥−0.75, the score reached the sensitivity of 82.9%, specificity of 83%, positive predictive value of 78.8%, negative predictive value of 86.5%, positive likelihood ratio of 4.88, negative likelihood ratio of 0.21, false negative of 17.1%, false positive of 17%, and accuracy of 83%. Conclusions: The Soetomo score model value of ≥−0.75 can identify acute haemorrhagic stroke properly on the financial or facility constrains of brain imaging.

Development of a severity score for CRPS.

Science.gov (United States)

Harden, R Norman; Bruehl, Stephen; Perez, Roberto S G M; Birklein, Frank; Marinus, Johan; Maihofner, Christian; Lubenow, Timothy; Buvanendran, Asokumar; Mackey, Sean; Graciosa, Joseph; Mogilevski, Mila; Ramsden, Christopher; Schlereth, Tanja; Chont, Melissa; Vatine, Jean-Jacques

2010-12-01

The clinical diagnosis of Complex Regional Pain Syndrome (CRPS) is a dichotomous (yes/no) categorization necessary for clinical decision-making. However, such dichotomous diagnostic categories do not convey an individual's subtle and temporal gradations in severity of the condition, and have poor statistical power when used as an outcome measure in research. This study evaluated the validity and potential utility of a continuous type score to index severity of CRPS. Psychometric and medical evaluations were conducted in 114 CRPS patients and 41 non-CRPS neuropathic pain patients. Based on the presence/absence of 17 clinically-assessed signs and symptoms of CRPS, an overall CRPS Severity Score (CSS) was derived. The CSS discriminated well between CRPS and non-CRPS patients (pCRPS diagnoses using both IASP diagnostic criteria (Eta=0.69) and proposed revised criteria (Eta=0.77-0.88). Higher CSS was associated with significantly higher clinical pain intensity, distress, and functional impairments, as well as greater bilateral temperature asymmetry and thermal perception abnormalities (p'sCRPS, and support its validity as an index of CRPS severity. Its utility as an outcome measure in research studies is also suggested, with potential statistical advantages over dichotomous diagnostic criteria. Copyright © 2010. Published by Elsevier B.V.

Labour analgesia and the baby: good news is no news.

Science.gov (United States)

Reynolds, Felicity

2011-01-01

When investigating different methods of maternal pain relief in labour, neonatal outcome has not always been at the forefront, or else maternal changes, such as haemodynamics, fever, length of labour, need for oxytocin or type of delivery, are taken as surrogates for neonatal outcome. It is essential to examine the actual baby and to appreciate that labour pain itself has adverse consequences for the baby. For systemic analgesia, pethidine has been most extensively studied and compared with neuraxial analgesia. It depresses fetal muscular activity, aortic blood flow, short-term heart rate variability and oxygen saturation. In the newborn it exacerbates acidosis, depresses Apgar scores, respiration, neurobehavioural score, muscle tone and suckling. Alternatives have few advantages, remifentanil being the most promising. Neuraxial analgesia is associated with better Apgar scores and variable neurobehavioural changes. Neonatal acid-base status is not only better with epidural than with systemic opioid analgesia, it is also better than with no analgesia. The effect on breast feeding has yet to be established, though it is certainly no worse than that of systemic opioid analgesia. Variations in neuraxial technique have little impact on the newborn. Widespread ignorance of the benefit to the newborn of neuraxial labour analgesia in the UK among non-anaesthetists needs to be combated. Copyright © 2010 Elsevier Ltd. All rights reserved.

Higher Dietary Cost Is Associated with Higher Diet Quality: A Cross-Sectional Study among Selected Malaysian Adults.

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Pondor, Ibnteesam; Gan, Wan Ying; Appannah, Geeta

2017-09-16

Food price is a determining factor of food choices; however its relationship with diet quality is unclear in Malaysia. This study aimed to examine socio-economic characteristics and daily dietary cost (DDC) in relation to diet quality in the state of Selangor, Malaysia. Dietary intake was assessed using a Food Frequency Questionnaire (FFQ) and diet quality was estimated using a Malaysian Healthy Eating Index (M-HEI). DDC in Malaysian Ringgit (RM) was calculated from dietary intake and national food prices. Linear regression models were fitted to determine associations between DDC and M-HEI scores and predictors of diet quality. The mean M-HEI score of respondents was 61.31 ± 10.88 and energy adjusted DDC was RM10.71/2000 kcal (USD 2.49). The highest quintile of adjusted DDC had higher M-HEI scores for all respondents (Q1: 57.14 ± 10.07 versus Q5: 63.26 ± 11.54, p = 0.001). There were also positive associations between DDC and M-HEI scores for fruits ( p diet quality included carbohydrate (β = 0290; p healthy eating among Malaysian adults.

Birth characteristics and Wilms tumors in children in the Nordic countries

DEFF Research Database (Denmark)

Schüz, Joachim; Schmidt, Lisbeth Samsø; Kogner, Per

2011-01-01

Little is known about causes of Wilms tumor. Because of the young age at diagnosis, several studies have looked at various birth characteristics. We conducted a registry-based case-control study involving 690 cases of Wilms tumor aged 0-14 years, occurring in Denmark, Finland, Norway or Sweden...... during 1985-2006, individually matched to five controls drawn randomly from the Nordic childhood population. Information on birth characteristics was obtained from the population-based medical birth registries. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using conditional logistic......-for-gestational age girls also had a higher risk (2.48, 1.51-4.05), whereas no effect was seen for boys (1.12, 0.60-2.07). An association was seen with Apgar score at 5 min birth order. In our large-scale, registry...

Higher Mortality in registrants with sudden model for end-stage liver disease increase: Disadvantaged by the current allocation policy.

Science.gov (United States)

Massie, Allan B; Luo, Xun; Alejo, Jennifer L; Poon, Anna K; Cameron, Andrew M; Segev, Dorry L

2015-05-01

Liver allocation is based on current Model for End-Stage Liver Disease (MELD) scores, with priority in the case of a tie being given to those waiting the longest with a given MELD score. We hypothesized that this priority might not reflect risk: registrants whose MELD score has recently increased receive lower priority but might have higher wait-list mortality. We studied wait-list and posttransplant mortality in 69,643 adult registrants from 2002 to 2013. By likelihood maximization, we empirically defined a MELD spike as a MELD increase ≥ 30% over the previous 7 days. At any given time, only 0.6% of wait-list patients experienced a spike; however, these patients accounted for 25% of all wait-list deaths. Registrants who reached a given MELD score after a spike had higher wait-list mortality in the ensuing 7 days than those with the same resulting MELD score who did not spike, but they had no difference in posttransplant mortality. The spike-associated wait-list mortality increase was highest for registrants with medium MELD scores: specifically, 2.3-fold higher (spike versus no spike) for a MELD score of 10, 4.0-fold higher for a MELD score of 20, and 2.5-fold higher for a MELD score of 30. A model incorporating the MELD score and spikes predicted wait-list mortality risk much better than a model incorporating only the MELD score. Registrants with a sudden MELD increase have a higher risk of short-term wait-list mortality than is indicated by their current MELD score but have no increased risk of posttransplant mortality; allocation policy should be adjusted accordingly. © 2015 American Association for the Study of Liver Diseases.

Effects of honours programme participation in higher education : A propensity score matching approach

NARCIS (Netherlands)

Kool, Ada; Mainhard, Tim; Jaarsma, Debbie; van Beukelen, Peter; Brekelmans, Mieke

2017-01-01

Honours programmes have become part of higher education systems around the globe, and an increasing number of students are enrolled in such programmes. So far, effects of these programmes are largely under-researched. Two gaps in previous research on the effects of such programmes were addressed:

Algorithm improvement program nuclide identification algorithm scoring criteria and scoring application.

Energy Technology Data Exchange (ETDEWEB)

Enghauser, Michael [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2016-02-01

The goal of the Domestic Nuclear Detection Office (DNDO) Algorithm Improvement Program (AIP) is to facilitate gamma-radiation detector nuclide identification algorithm development, improvement, and validation. Accordingly, scoring criteria have been developed to objectively assess the performance of nuclide identification algorithms. In addition, a Microsoft Excel spreadsheet application for automated nuclide identification scoring has been developed. This report provides an overview of the equations, nuclide weighting factors, nuclide equivalencies, and configuration weighting factors used by the application for scoring nuclide identification algorithm performance. Furthermore, this report presents a general overview of the nuclide identification algorithm scoring application including illustrative examples.

The relationship between a model of end stage liver disease score (MELD score) and the occurrence of spontaneous bacterial peritonitis in liver cirrhotic patients.

Science.gov (United States)

Gayatri, A A Ayu Yuli; Suryadharma, I G A; Purwadi, N; Wibawa, I D N

2007-01-01

To determine relationship between MELD score and the occurrence of SBP, prevalence of SBP, pattern of bacterial culture and antibiotic susceptibility of causative bacteria of liver cirrhotic patients at Sanglah Hospital. Study design was a cross-sectional analytic study. The population in this study consists of liver cirrhotic patients admitted at Sanglah Hospital Denpasar from June 2005 to February 2006. This result confirmed that the MELD score is a reliable index of disease severity and that higher MELD scores had a significantly more frequent SBP prevalence in patients with a MELD score of 18 or more compared with that in patients with a MELD score of 17 or less (p=0.01; 95% CI = 1.379-15.537). Prevalence of SBP was 30.6%. Thirteen patients (68.4%) had monomicrobial positive culture of Aerob bacteria, consisting of Gram negative bacterias in 10 (77%), with Escherichia coli and Acinettobacter baumanii being the most frequent, and 3 (23%) had Gram positive bacteria. High sensitivity to Cefoperazone, Cefotaxim, Ceftazidime, Cefpirome, Ciprofloxacin, Fosfomicin, Meropenem, Streptomycin, Gentamycin, Trimethoprim/Sulphamethoxazole, were shown. Based on this study we concluded that severe liver cirrhosis with MELD score > or = 18 was associated with an increase risk of SBP, with a prevalence of 30.6%. Common causes of SBP mostly were Escherichia coli and Acinettobacter baumanii, which were sensitive to antibiotic treatment of Cefoperazone, Cefotaxime and Ciprofloxacin.

Automated essay scoring and the future of educational assessment in medical education.

Science.gov (United States)

Gierl, Mark J; Latifi, Syed; Lai, Hollis; Boulais, André-Philippe; De Champlain, André

2014-10-01

Constructed-response tasks, which range from short-answer tests to essay questions, are included in assessments of medical knowledge because they allow educators to measure students' ability to think, reason, solve complex problems, communicate and collaborate through their use of writing. However, constructed-response tasks are also costly to administer and challenging to score because they rely on human raters. One alternative to the manual scoring process is to integrate computer technology with writing assessment. The process of scoring written responses using computer programs is known as 'automated essay scoring' (AES). An AES system uses a computer program that builds a scoring model by extracting linguistic features from a constructed-response prompt that has been pre-scored by human raters and then, using machine learning algorithms, maps the linguistic features to the human scores so that the computer can be used to classify (i.e. score or grade) the responses of a new group of students. The accuracy of the score classification can be evaluated using different measures of agreement. Automated essay scoring provides a method for scoring constructed-response tests that complements the current use of selected-response testing in medical education. The method can serve medical educators by providing the summative scores required for high-stakes testing. It can also serve medical students by providing them with detailed feedback as part of a formative assessment process. Automated essay scoring systems yield scores that consistently agree with those of human raters at a level as high, if not higher, as the level of agreement among human raters themselves. The system offers medical educators many benefits for scoring constructed-response tasks, such as improving the consistency of scoring, reducing the time required for scoring and reporting, minimising the costs of scoring, and providing students with immediate feedback on constructed-response tasks. © 2014

Dutch validation of the low anterior resection syndrome score.

Science.gov (United States)

Hupkens, B J P; Breukink, S O; Olde Reuver Of Briel, C; Tanis, P J; de Noo, M E; van Duijvendijk, P; van Westreenen, H L; Dekker, J W T; Chen, T Y T; Juul, T

2018-04-21

The aim of this study was to validate the Dutch translation of the low anterior resection syndrome (LARS) score in a population of Dutch rectal cancer patients. Patients who underwent surgery for rectal cancer received the LARS score questionnaire, a single quality of life (QoL) category question and the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire. A subgroup of patients received the LARS score twice to assess the test-retest reliability. A total of 165 patients were included in the analysis, identified in six Dutch centres. The response rate was 62.0%. The percentage of patients who reported 'major LARS' was 59.4%. There was a high proportion of patients with a perfect or moderate fit between the QoL category question and the LARS score, showing a good convergent validity. The LARS score was able to discriminate between patients with or without neoadjuvant radiotherapy (P = 0.003), between total and partial mesorectal excision (P = 0.008) and between age groups (P = 0.039). There was a statistically significant association between a higher LARS score and an impaired function on the global QoL subscale and the physical, role, emotional and social functioning subscales of the EORTC QLQ-C30 questionnaire. The test-retest reliability of the LARS score was good, with an interclass correlation coefficient of 0.79. The good psychometric properties of the Dutch version of the LARS score are comparable overall to the earlier validations in other countries. Therefore, the Dutch translation can be considered to be a valid tool for assessing LARS in Dutch rectal cancer patients. Colorectal Disease © 2018 The Association of Coloproctology of Great Britain and Ireland.

River Discharge and Local Scale Habitat Influence LIFE Score Macroinvertebrate LIFE Scores

DEFF Research Database (Denmark)

Dunbar, Michael J.; Pedersen, Morten Lauge; Cadman, Dan

2010-01-01

Midlands of the U.K., we describe how local-scale habitat features (indexed through River Habitat Survey or Danish Habitat Quality Survey) and changing river flow (discharge) influence the response of a macroinvertebrate community index. The approach has broad applicability in developing regional flow...... Invertebrate index for Flow Evaluation (LIFE), an average of abundance-weighted flow groups which indicate the microhabitat preferences of each taxon for higher velocities and clean gravel/cobble substrata or slow/still velocities and finer substrata. 3. For the Danish fauna, the LIFE score responded to three...... of the channel (negative). In both cases, LIFE responded negatively to features associated with historical channel modification. We suggest that there are several mechanisms for these relationships, including the narrower tolerances of taxa preferring high velocity habitat; these taxa are also continually...

Direct power comparisons between simple LOD scores and NPL scores for linkage analysis in complex diseases.

Science.gov (United States)

Abreu, P C; Greenberg, D A; Hodge, S E

1999-09-01

Several methods have been proposed for linkage analysis of complex traits with unknown mode of inheritance. These methods include the LOD score maximized over disease models (MMLS) and the "nonparametric" linkage (NPL) statistic. In previous work, we evaluated the increase of type I error when maximizing over two or more genetic models, and we compared the power of MMLS to detect linkage, in a number of complex modes of inheritance, with analysis assuming the true model. In the present study, we compare MMLS and NPL directly. We simulated 100 data sets with 20 families each, using 26 generating models: (1) 4 intermediate models (penetrance of heterozygote between that of the two homozygotes); (2) 6 two-locus additive models; and (3) 16 two-locus heterogeneity models (admixture alpha = 1.0,.7,.5, and.3; alpha = 1.0 replicates simple Mendelian models). For LOD scores, we assumed dominant and recessive inheritance with 50% penetrance. We took the higher of the two maximum LOD scores and subtracted 0.3 to correct for multiple tests (MMLS-C). We compared expected maximum LOD scores and power, using MMLS-C and NPL as well as the true model. Since NPL uses only the affected family members, we also performed an affecteds-only analysis using MMLS-C. The MMLS-C was both uniformly more powerful than NPL for most cases we examined, except when linkage information was low, and close to the results for the true model under locus heterogeneity. We still found better power for the MMLS-C compared with NPL in affecteds-only analysis. The results show that use of two simple modes of inheritance at a fixed penetrance can have more power than NPL when the trait mode of inheritance is complex and when there is heterogeneity in the data set.

Posterior Urethroplasty Complexity and Prognosis Can be Described by a Novel Method: Posterior Urethral Stenosis Score.

Science.gov (United States)

Wang, Lin; Lv, Xiangguo; Jin, Chongrui; Guo, Hailin; Shu, Huiquan; Fu, Qiang; Sa, Yinglong

2018-02-01

To develop a standardized PU-score (posterior urethral stenosis score), with the goal of using this scoring system as a preliminary predictor of surgical complexity and prognosis of posterior urethral stenosis. We retrospectively reviewed records of all patients who underwent posterior urethral surgery at our institution from 2013 to 2015. The PU-score is based on 5 components, namely etiology (1 or 2 points), location (1-3 points), length (1-3 points), urethral fistula (1 or 2 points), and posterior urethral false passage (1 point). We calculated the score of all patients and analyzed its association with surgical complexity, stenosis recurrence, intraoperative blood loss, erectile dysfunction, and urinary incontinence. There were 144 patients who underwent low complexity urethral surgery (direct vision internal urethrotomy, anastomosis with or without crural separation) with a mean score of 5.1 points, whereas 143 underwent high complexity urethroplasty (anastomosis with inferior pubectomy or urethrorectal fistula repair, perineal or scrotum skin flap urethroplasty, bladder flap urethroplasty) with a mean score of 6.9 points. The increase of PU-score was predictive of higher surgical complexity (P = .000), higher recurrence (P = .002), more intraoperative blood loss (P = .000), and decrease of preoperative (P = .037) or postoperative erectile function (P = .047). However, no association was observed between PU-score and urinary incontinence (P = .213). The PU-score is a novel and meaningful scoring system that describes the essential factors in determining the complexity and prognosis for posterior urethral stenosis. Copyright © 2017. Published by Elsevier Inc.

Skin autofluorescence as proxy of tissue AGE accumulation is dissociated from SCORE cardiovascular risk score, and remains so after 3 years.

Science.gov (United States)

Tiessen, Ans H; Jager, Willemein; ter Bogt, Nancy C W; Beltman, Frank W; van der Meer, Klaas; Broer, Jan; Smit, Andries J

2014-01-01

Skin autofluorescence (SAF), as a proxy of AGE accumulation, is predictive of cardiovascular (CVD) complications in i.a. type 2 diabetes mellitus and renal failure, independently of most conventional CVD risk factors. The present exploratory substudy of the Groningen Overweight and Lifestyle (GOAL)-project addresses whether SAF is related to Systematic COronary Risk Evaluation (SCORE) risk estimation (% 10-year CVD-mortality risk) in overweight/obese persons in primary care, without diabetes/renal disease, and if after 3-year treatment of risk factors (change in, Δ) SAF is related to ΔSCORE. In a sample of 65 participants from the GOAL study, with a body mass index (BMI) >25-40 kg/m2, hypertension and/or dyslipidemia, but without diabetes/renal disease, SAF and CVD risk factors were measured at baseline, and after 3 years of lifestyle and pharmaceutical treatment. At baseline, the mean SCORE risk estimation was 3.1±2.6%, mean SAF 2.04±0.5AU. In multivariate analysis SAF was strongly related to age, but not to other risk factors/SCORE. After 3 years ΔSAF was 0.34±0.45 AU (phistory of CVD compared to 54 persons without CVD (p=0.002). Baseline and 3-year-Δ SAF are not related to (Δ)SCORE, or its components, except age, in the studied population. ΔSAF was negatively related to Δweight. As 3-year SAF was higher in persons with CVD, these results support a larger study on SAF to assess its contribution to conventional risk factors/SCORE in predicting CVD in overweight persons with low-intermediate cardiovascular risk.

Correlation between the umbilical artery flow ultrasound parameters of intrauterine fetal distress and fetal ischemic hypoxic damage

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Hai-Ying Gu

2017-08-01

Full Text Available Objective: To study the correlation between the umbilical artery flow ultrasound parameters of intrauterine fetal distress and fetal ischemic hypoxic damage. Methods: A total of 158 puerperae who gave birth in our hospital between July 2016 and June 2017 were selected and divided into the intrauterine distress group (Apgar<7 points and normal pregnancy group (Apgar≥7 points according to the neonatal Apgar score, the umbilical artery flow ultrasound parameters at 24-30 weeks, 31-36 weeks and 37-41 weeks of gestation were determined, and the umbilical arterial blood gas parameters and oxidative stress molecule levels were determined. Results: At 24-30 weeks, 31-36 weeks and 37-41 weeks of gestation, umbilical arterial RI, PI and S/D of intrauterine distress group were significantly higher than those of normal pregnancy group; umbilical arterial pH and PaO2 of intrauterine distress group were significantly lower than those of normal pregnancy group and negatively correlated with RI, PI and S/D while PaCO2 and lactic acid levels were significantly higher than those of normal pregnancy group and positively correlated with RI, PI and S/D; SOD, GSH-px and CAT levels in umbilical artery of intrauterine distress group were significantly lower than those of normal pregnancy group and negatively correlated with RI, PI and S/D while MDA and 8-OHdG levels were significantly higher than those of normal pregnancy group and positively correlated with RI, PI and S/D. Conclusion: Umbilical artery flow ultrasound characteristics of intrauterine fetal distress are characterized by the increased resistance and decreased blood flow and are correlated with the degree of fetal hypoxia and oxidative stress.

Support vector regression scoring of receptor-ligand complexes for rank-ordering and virtual screening of chemical libraries.

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Li, Liwei; Wang, Bo; Meroueh, Samy O

2011-09-26

The community structure-activity resource (CSAR) data sets are used to develop and test a support vector machine-based scoring function in regression mode (SVR). Two scoring functions (SVR-KB and SVR-EP) are derived with the objective of reproducing the trend of the experimental binding affinities provided within the two CSAR data sets. The features used to train SVR-KB are knowledge-based pairwise potentials, while SVR-EP is based on physicochemical properties. SVR-KB and SVR-EP were compared to seven other widely used scoring functions, including Glide, X-score, GoldScore, ChemScore, Vina, Dock, and PMF. Results showed that SVR-KB trained with features obtained from three-dimensional complexes of the PDBbind data set outperformed all other scoring functions, including best performing X-score, by nearly 0.1 using three correlation coefficients, namely Pearson, Spearman, and Kendall. It was interesting that higher performance in rank ordering did not translate into greater enrichment in virtual screening assessed using the 40 targets of the Directory of Useful Decoys (DUD). To remedy this situation, a variant of SVR-KB (SVR-KBD) was developed by following a target-specific tailoring strategy that we had previously employed to derive SVM-SP. SVR-KBD showed a much higher enrichment, outperforming all other scoring functions tested, and was comparable in performance to our previously derived scoring function SVM-SP.

Non-laboratory-based self-assessment screening score for non-alcoholic fatty liver disease: development, validation and comparison with other scores.

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Yong-ho Lee

Full Text Available Non-alcoholic fatty liver disease (NAFLD is a prevalent and rapidly increasing disease worldwide; however, no widely accepted screening models to assess the risk of NAFLD are available. Therefore, we aimed to develop and validate a self-assessment score for NAFLD in the general population using two independent cohorts.The development cohort comprised 15676 subjects (8313 males and 7363 females who visited the National Health Insurance Service Ilsan Hospital in Korea in 2008-2010. Anthropometric, clinical, and laboratory data were examined during regular health check-ups and fatty liver diagnosed by abdominal ultrasound. Logistic regression analysis was conducted to determine predictors of prevalent NAFLD and to derive risk scores/models. We validated our models and compared them with other existing methods using an external cohort (N = 66868.The simple self-assessment score consists of age, sex, waist circumference, body mass index, history of diabetes and dyslipidemia, alcohol intake, physical activity and menopause status, which are independently associated with NAFLD, and has a value of 0-15. A cut-off point of ≥ 8 defined 58% of males and 36% of females as being at high-risk of NAFLD, and yielded a sensitivity of 80% in men (77% in women, a specificity of 67% (81%, a positive predictive value of 72% (63%, a negative predictive value of 76% (89% and an AUC of 0.82 (0.88. Comparable results were obtained using the validation dataset. The comprehensive NAFLD score, which includes additional laboratory parameters, has enhanced discrimination ability, with an AUC of 0.86 for males and 0.91 for females. Both simple and comprehensive NAFLD scores were significantly increased in subjects with higher fatty liver grades or severity of liver conditions (e.g., simple steatosis, steatohepatitis.The new non-laboratory-based self-assessment score may be useful for identifying individuals at high-risk of NAFLD. Further studies are warranted to evaluate

The Zhongshan score: a novel and simple anatomic classification system to predict perioperative outcomes of nephron-sparing surgery.

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Zhou, Lin; Guo, Jianming; Wang, Hang; Wang, Guomin

2015-02-01

In the zero ischemia era of nephron-sparing surgery (NSS), a new anatomic classification system (ACS) is needed to adjust to these new surgical techniques. We devised a novel and simple ACS, and compared it with the RENAL and PADUA scores to predict the risk of NSS outcomes. We retrospectively evaluated 789 patients who underwent NSS with available imaging between January 2007 and July 2014. Demographic and clinical data were assessed. The Zhongshan (ZS) score consisted of three parameters. RENAL, PADUA, and ZS scores are divided into three groups, that is, high, moderate, and low scores. For operative time (OT), significant differences were seen between any two groups of ZS score and PADUA score (all P RENAL showed no significant difference between moderate and high complexity in OT, WIT, estimated blood loss, and increase in SCr. Compared with patients with a low score of ZS, those with a high or moderate score had 8.1-fold or 3.3-fold higher risk of surgical complications, respectively (all P RENAL score, patients with a high or moderate score had 5.7-fold or 1.9-fold higher risk of surgical complications, respectively (all P RENAL and PADUA scores. ZS score could be used to reflect the surgical complexity and predict the risk of surgical complications in patients undergoing NSS.

Management of Labor and Delivery After Fetoscopic Repair of an Open Neural Tube Defect.

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Kohn, Jaden R; Rao, Vibha; Sellner, Allison A; Sharhan, Dina; Espinoza, Jimmy; Shamshirsaz, Alireza A; Whitehead, William E; Belfort, Michael A; Sanz Cortes, Magdalena

2018-06-01

To report labor, delivery, and neonatal outcomes in a cohort of women delivering neonates who had undergone fetoscopic neural tube defect repair. We conducted a retrospective cohort study from April 2014 to January 2018. All patients met Management of Myelomeningocele Study eligibility criteria. We included patients with completed second-trimester fetoscopic neural tube defect repair (laparotomy, uterine exteriorization, and minimally invasive access through two or three uterine ports) followed by standardized management of labor and delivery at our institution. Outcomes included rates of vaginal delivery, term delivery, and intrapartum cesarean delivery as well as obstetric and neonatal outcomes after oxytocin. Complications of interest included preterm prelabor rupture of membranes, chorioamnionitis, uterine dehiscence or rupture, 5-minute Apgar score less than 7, and neonatal acidosis (umbilical artery pH less than 7.15). Thirty-four patients had fetoscopic repair, followed by 17 vaginal deliveries (50%, 95% CI 32-68%). Median gestational age was 38 1/7 weeks at vaginal delivery (range 26 0/7-40 2/7 weeks of gestation) and 37 1/7 weeks of gestation at cesarean delivery (range 25 5/7-40 5/7 weeks of gestation); 62% of deliveries occurred at term. Eight patients had prelabor cesarean delivery: three nonurgent and five urgent (for nonreassuring fetal heart tracings). Twenty-six patients labored; six were induced and 20 labored spontaneously. Of the latter, five were augmented. Of 26 laboring patients, 17 delivered vaginally and nine underwent urgent cesarean delivery (35%, 95% CI 17-56%; seven nonreassuring fetal heart tracings and two breech). There were no cases of uterine rupture or dehiscence. Most (94%, 95% CI 80-99%) had normal 5-minute Apgar scores; one neonate (3%, 95% CI 0-15%) had acidosis but normal Apgar scores. Our data regarding trial of labor, use of low-dose oxytocin, and vaginal delivery after prenatal fetoscopic neural tube defect repair are

Spontaneous regression of retinopathy of prematurity:incidence and predictive factors

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Rui-Hong Ju

2013-08-01

Full Text Available AIM:To evaluate the incidence of spontaneous regression of changes in the retina and vitreous in active stage of retinopathy of prematurity(ROP and identify the possible relative factors during the regression.METHODS: This was a retrospective, hospital-based study. The study consisted of 39 premature infants with mild ROP showed spontaneous regression (Group A and 17 with severe ROP who had been treated before naturally involuting (Group B from August 2008 through May 2011. Data on gender, single or multiple pregnancy, gestational age, birth weight, weight gain from birth to the sixth week of life, use of oxygen in mechanical ventilation, total duration of oxygen inhalation, surfactant given or not, need for and times of blood transfusion, 1,5,10-min Apgar score, presence of bacterial or fungal or combined infection, hyaline membrane disease (HMD, patent ductus arteriosus (PDA, duration of stay in the neonatal intensive care unit (NICU and duration of ROP were recorded.RESULTS: The incidence of spontaneous regression of ROP with stage 1 was 86.7%, and with stage 2, stage 3 was 57.1%, 5.9%, respectively. With changes in zone Ⅲ regression was detected 100%, in zoneⅡ 46.2% and in zoneⅠ 0%. The mean duration of ROP in spontaneous regression group was 5.65±3.14 weeks, lower than that of the treated ROP group (7.34±4.33 weeks, but this difference was not statistically significant (P=0.201. GA, 1min Apgar score, 5min Apgar score, duration of NICU stay, postnatal age of initial screening and oxygen therapy longer than 10 days were significant predictive factors for the spontaneous regression of ROP (P＜0.05. Retinal hemorrhage was the only independent predictive factor the spontaneous regression of ROP (OR 0.030, 95%CI 0.001-0.775, P=0.035.CONCLUSION:This study showed most stage 1 and 2 ROP and changes in zone Ⅲ can spontaneously regression in the end. Retinal hemorrhage is weakly inversely associated with the spontaneous regression.

An antenatal prediction model for adverse birth outcomes in an urban population: The contribution of medical and non-medical risks.

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Posthumus, A G; Birnie, E; van Veen, M J; Steegers, E A P; Bonsel, G J

2016-07-01

in the Netherlands the perinatal mortality rate is high compared to other European countries. Around eighty percent of perinatal mortality cases is preceded by being small for gestational age (SGA), preterm birth and/or having a low Apgar-score at 5 minutes after birth. Current risk detection in pregnancy focusses primarily on medical risks. However, non-medical risk factors may be relevant too. Both non-medical and medical risk factors are incorporated in the Rotterdam Reproductive Risk Reduction (R4U) scorecard. We investigated the associations between R4U risk factors and preterm birth, SGA and a low Apgar score. a prospective cohort study under routine practice conditions. six midwifery practices and two hospitals in Rotterdam, the Netherlands. 836 pregnant women. the R4U scorecard was filled out at the booking visit. after birth, the follow-up data on pregnancy outcomes were collected. Multivariate logistic regression was used to fit models for the prediction of any adverse outcome (preterm birth, SGA and/or a low Apgar score), stratified for ethnicity and socio-economic status (SES). factors predicting any adverse outcome for Western women were smoking during the first trimester and over-the-counter medication. For non-Western women risk factors were teenage pregnancy, advanced maternal age and an obstetric history of SGA. Risk factors for high SES women were low family income, no daily intake of vegetables and a history of preterm birth. For low SES women risk factors appeared to be low family income, non-Western ethnicity, smoking during the first trimester and a history of SGA. the presence of both medical and non-medical risk factors early in pregnancy predict the occurrence of adverse outcomes at birth. Furthermore the risk profiles for adverse outcomes differed according to SES and ethnicity. to optimise effective risk selection, both medical and non-medical risk factors should be taken into account in midwifery and obstetric care at the booking visit

Frequency of hepatitis C in pregnancy and pregnancy outcome

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Jaffery, T.; Tariq, N.; Ayub, R.; Yawar, A.

2005-01-01

Objective: To determine the frequency of HCV infections in pregnant women, to find out the risk factors of HCV infection in pregnant women and to compare pregnancy outcome of the sero-positive women with sero-negative women. Design: Case-control study. Place and Duration of Study: Shifa International Hospital, Islamabad, from June 2001 to May 2002. Patients and Methods: Study was conducted on 947 booked pregnant women who were screened for HCV antibodies during antenatal consultation and were admitted for delivery in labor room. At the time of admission in labor ward, medical records of all patients were reviewed for anti HCV antibody testing and the presence of risk factors for HCV infection. Previous vaginal deliveries with episiotomy, previous surgeries, blood transfusions, and D and C for abortion or dysfunctional uterine bleeding were taken as independent variables. The obstetric outcome variables studied were: completed weeks of gestation by mother, birth weight and apgar score of newborns. The risk factors under study and the outcome variables were compared among HCV positive and negative women through a case-control study and measures of association calculated. Results: The proportion of HCV sero-positively among pregnant woman in our study was 3.27%. Among all the risk factors under study, previous surgery was found to have a significant association with HCV positive status of women (p=0.001). Other variables did not have significant association with HCV positive status in our study. There was no statistical difference in the mean birth weight of newborns (p=0.94), mean Apgar score of newborns (p=0.73) and mean gestational period among HCV positive cases and controls (p=0.47). Conclusion: Prevalence of hepatitis C in pregnant women was 3.27%. Past history of surgical procedures was the most important factor for transmission of hepatitis C virus infection. No adverse effect on pregnancy outcome was observed in terms of gestational age, Apgar score and baby

Scoring Mental Health Quality of Life With the SF-36 in Patients With and Without Diabetes Foot Complications.

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Ahn, Junho; Del Core, Michael A; Wukich, Dane K; Liu, George T; Lalli, Trapper; VanPelt, Michael D; La Fontaine, Javier; Lavery, Lawrence A; Raspovic, Katherine M

2018-03-01

The aim of this study was to examine if using orthogonal and oblique factor analysis detect changes in health-related quality of life differently in diabetic patients on the Short Form-36 (SF-36) survey. A total of 155 patients had diabetic foot complications (DFC), and 145 patients had no DFCs. The SF-36 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores were calculated using scoring coefficients determined by orthogonal and oblique rotation principle component analyses of the subscales. The DFC group had lower orthogonal ( P < .00001) and oblique PCS scores ( P < .00001). However, despite lower Mental Health subscale scores in the patients with DFCs, orthogonal MCS scores ( P = .156) did not differ. In contrast, the oblique MCS scores reflected the difference in the Mental Health subscale ( P = .0005). Orthogonal and oblique PCS scores did not differ significantly. However, orthogonal MCS scores were significantly higher than oblique MCS scores in those with DFCs ( P = .0004) and without DFCs ( P = .005). The shorter, 12-item SF-12 survey demonstrated similar results. Poorer physical function leads to higher orthogonal MCS scores than if determined by oblique scoring coefficients since Physical Function, Bodily Pain, and General Health are weighted more negatively in orthogonal coefficients when calculating the MCS score. Oblique scoring coefficients may address this issue, but further study is necessary to confirm whether oblique MCS scores accurately represent the mental health of patients with diabetic foot disease.

Predictive power of the ESUR scoring system for prostate cancer diagnosis verified with targeted MR-guided in-bore biopsy

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Schimmöller, L.; Quentin, M.; Arsov, C.; Hiester, A.; Kröpil, P.; Rabenalt, R.; Albers, P.; Antoch, G.; Blondin, D.

2014-01-01

Highlights: • The PI-RADS summed score (PS sum ) demonstrated very good diagnostic values, especially for higher grade PCa. • Lesions with PS sum ≥13 represented prostate cancer in 88% and higher grade prostate cancer in 42%. • Sensitivity and NPV was nearly 100% for higher grade PCa detection using a cut-off limit of PS sum 10. • Peripheral zone lesions demonstrated better diagnostic value with the PS sum compared to transitional zone lesions. • Further improvement of the PI-RADS score is required to prevent unnecessary overdiagnosis. - Abstract: Purpose: This study evaluates the diagnostic value of the ESUR scoring system (PI-RADS) regarding prostate cancer detection using MR-guided in-bore biopsies (IB-GB) as the reference standard. Methods: 566 lesions in 235 consecutive patients (65.7 ± 7.9 years, PSA 9.9 ± 8.5 ng/ml) with a multiparametric (mp)-MRI (T2WI, DWI, DCE) of the prostate at 3 T were scored using the PI-RADS scoring system. PI-RADS single (PS single ), summed (PS sum ), and overall (PS overall ) scores were determined. All lesions were histologically verified by IB-GB. Results: Lesions with a PS sum below 9 contained no prostate cancer (PCa) with Gleason score (GS) ≥ 4 + 3 = 7. A PS sum of 13–15 (PS overall V) resulted in 87.8% (n = 108) in PCa and in 42.3% (n = 52) in GS ≥ 4 + 3 = 7. Transition zone (TZ) lesions with a PS sum of 13–15 (PS overall V) resulted in 76.3% (n = 36) in PCa and in 26.3% (n = 10) in GS ≥ 4 + 3 = 7, whereas for peripheral zone (PZ) lesions cancer detection rate at this score was 92.9% (n = 79) and 49.4% (n = 42) for GS ≥ 4 + 3 = 7. Using a threshold of PS sum ≥ 10, sensitivity was 86.0%, and negative predictive value (NPV) was 86.2%. For higher grade PCa sensitivity was 98.6%, and NPV was 99.5%. Conclusion: A PS sum below 9 excluded a higher grade PCa, whereas lesions with a PS sum ≥ 13 (PS overall V) represented in 88% PCa, and in 42% higher grade PCa. The PS sum or PS overall demonstrated a

Evaluating the Validity and Applicability of Automated Essay Scoring in Two Massive Open Online Courses

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Erin Dawna Reilly

2014-11-01

Full Text Available The use of massive open online courses (MOOCs to expand students’ access to higher education has raised questions regarding the extent to which this course model can provide and assess authentic, higher level student learning. In response to this need, MOOC platforms have begun utilizing automated essay scoring (AES systems that allow students to engage in critical writing and free-response activities. However, there is a lack of research investigating the validity of such systems in MOOCs. This research examined the effectiveness of an AES tool to score writing assignments in two MOOCs. Results indicated that some significant differences existed between Instructor grading, AES-Holistic scores, and AES-Rubric Total scores within two MOOC courses. However, use of the AES system may still be useful given instructors’ assessment needs and intent. Findings from this research have implications for instructional technology administrators, educational designers, and instructors implementing AES learning activities in MOOC courses.

Effect of playing tactics on goal scoring in Norwegian professional soccer.

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Tenga, Albin; Holme, Ingar; Ronglan, Lars Tore; Bahr, Roald

2010-02-01

Methods that include an assessment of opponent interactions are thought to provide a more valid analysis of team match performance. The purpose of this study was to examine the effect of playing tactics on goal scoring by assessing opponent interactions in Norwegian elite soccer. The sample included 203 team possessions leading to goals (cases) and 1688 random team possessions (control group) from 163 of 182 (90%) matches played in the men's professional league during the 2004 season. Multidimensional qualitative data using ten ordered categorical variables were obtained to characterize each team possession. The proportion of goals scored during counterattacks (52%) was higher than during elaborate attacks (48%), while for the control group the proportion using elaborate attacks (59%) was higher than when using counterattacks (41%) (P = 0.002). Multiple logistic regression analyses showed that, for the main variable "team possession type", counterattacks were more effective than elaborate attacks when playing against an imbalanced defence (OR = 1.64; 95% confidence interval: 1.03 to 2.61; P = 0.038). Assessment of opponent interactions is critical to evaluate the effectiveness of offensive playing tactics on the probability of scoring goals, and improves the validity of team match-performance analysis in soccer.

SIRS score on admission and initial concentration of IL-6 as severe acute pancreatitis outcome predictors.

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Gregoric, Pavle; Pavle, Gregoric; Sijacki, Ana; Ana, Sijacki; Stankovic, Sanja; Sanja, Stankovic; Radenkovic, Dejan; Dejan, Radenkovic; Ivancevic, Nenad; Nenad, Ivancevic; Karamarkovic, Aleksandar; Aleksandar, Karamarkovic; Popovic, Nada; Nada, Popovic; Karadzic, Borivoje; Borivoje, Karadzic; Stijak, Lazar; Stefanovic, Branislav; Branislav, Stefanovic; Milosevic, Zoran; Zoran, Milosević; Bajec, Djordje; Djordje, Bajec

2010-01-01

Early recognition of severe form of acute pancreatitis is important because these patients need more agressive diagnostic and therapeutical approach an can develope systemic complications such as: sepsis, coagulopathy, Acute Lung Injury (ALI), Acute Respiratory Distress Syndrome (ARDS), Multiple Organ Dysfunction Syndrome (MODS), Multiple Organ Failure (MOF). To determine role of the combination of Systemic Inflammatory Response Syndrome (SIRS) score and serum Interleukin-6 (IL-6) level on admission as predictor of illness severity and outcome of Severe Acute Pancreatitis (SAP). We evaluated 234 patients with first onset of SAP appears in last twenty four hours. A total of 77 (33%) patients died. SIRS score and serum IL-6 concentration were measured in first hour after admission. In 105 patients with SIRS score 3 and higher, initial measured IL-6 levels were significantly higher than in the group of remaining 129 patients (72 +/- 67 pg/mL, vs 18 +/- 15 pg/mL). All nonsurvivals were in the first group, with SIRS score 3 and 4 and initial IL-6 concentration 113 +/- 27 pg/mL. The values of C-reactive Protein (CRP) measured after 48h, Acute Physiology and Chronic Health Evaluation (APACHE II) score on admission and Ranson score showed the similar correlation, but serum amylase level did not correlate significantly with Ranson score, IL-6 concentration and APACHE II score. The combination of SIRS score on admission and IL-6 serum concentration can be early, predictor of illness severity and outcome in SAP.

GalaxyDock BP2 score: a hybrid scoring function for accurate protein-ligand docking

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Baek, Minkyung; Shin, Woong-Hee; Chung, Hwan Won; Seok, Chaok

2017-07-01

Protein-ligand docking is a useful tool for providing atomic-level understanding of protein functions in nature and design principles for artificial ligands or proteins with desired properties. The ability to identify the true binding pose of a ligand to a target protein among numerous possible candidate poses is an essential requirement for successful protein-ligand docking. Many previously developed docking scoring functions were trained to reproduce experimental binding affinities and were also used for scoring binding poses. However, in this study, we developed a new docking scoring function, called GalaxyDock BP2 Score, by directly training the scoring power of binding poses. This function is a hybrid of physics-based, empirical, and knowledge-based score terms that are balanced to strengthen the advantages of each component. The performance of the new scoring function exhibits significant improvement over existing scoring functions in decoy pose discrimination tests. In addition, when the score is used with the GalaxyDock2 protein-ligand docking program, it outperformed other state-of-the-art docking programs in docking tests on the Astex diverse set, the Cross2009 benchmark set, and the Astex non-native set. GalaxyDock BP2 Score and GalaxyDock2 with this score are freely available at http://galaxy.seoklab.org/softwares/galaxydock.html.

Neonatal facial coding system scores and spectral characteristics of infant crying during newborn circumcision.

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Lehr, Victoria Tutag; Zeskind, Philip Sanford; Ofenstein, John P; Cepeda, Eugene; Warrier, Indulekha; Aranda, J V

2007-06-01

To determine the relations between Neonatal Facial Coding System (NFCS) scores and measures of infant crying during newborn circumcision. Video and audio recordings were made of infant facial activity and cry sounds, respectively, during the lysis phase of circumcisions of 44 healthy term males (analgesia before circumcision. NFCS scores were determined by blinded assistant from video recordings of facial activity. Measures of infant crying were determined via spectrum analysis of audio recordings by a blinded, independent researcher. Pearson product-moment correlations were used to examine relationship between NFCS scores and measures of crying. Principal component factor analysis detected dimensions underlying related measures of crying. Factor scores from a factor analysis were used in stepwise linear regression to predict NFCS scores. Higher NFCS scores correlated with lower peak fundamental frequency of crying (P<0.01) and with higher amplitudes of crying at peak fundamental frequency and dominant frequency and in overall cry sample (P<0.01). The factor analysis showed 3 significant orthogonal dimensions underlying measures of crying: Power and Velocity (amplitude and rapidity), Pitch of Crying (frequency characteristics), and Infant Arousal (turbulence and intensity) accounting for 42.3%, 17.8%, and 14.6% of variance, respectively. A regression analysis showed all 3 factor scores accounted for significant and separate portions of variance (P<0.001). The best predictor of NFCS score was Power and Velocity (P<0.002), followed by Infant Arousal (P<0.002), and Pitch of Crying (P<0.007). These data provide some of the first known evidence linking specific measures of infant crying with an independent, validated measure of pain.

Mother's education and the risk of several neonatal outcomes: an evidence from an Italian population-based study.

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Cantarutti, Anna; Franchi, Matteo; Monzio Compagnoni, Matteo; Merlino, Luca; Corrao, Giovanni

2017-07-12

Maternal socioeconomic disparities strongly affect child health, particularly in low and middle income countries. We assessed whether neonatal outcomes varied by maternal education in a setting where healthcare system provides universal coverage of health services to all women, irrespective of their socioeconomic status. A population-based study was performed on 383,103 singleton live births occurring from 2005 to 2010 in Lombardy, an Italian region with approximately 10 million inhabitants. The association between maternal education, birthplace and selected neonatal outcomes (preterm birth, low birth weight, small-for-gestational age, low 5-min Apgar score, severe congenital anomalies, cerebral distress and respiratory distress) was estimated by fitting logistic regression models. Model adjustments were applied for sociodemographic, reproductive and medical maternal traits. Compared with low-level educated mothers, those with high education had reduced odds of preterm birth (Odds Ratio; OR = 0.81, 95% CI 0.77-0.85), low birth weight (OR = 0.78, 95% CI 0.70-0.81), small for gestational age (OR = 0.82, 95% CI 0.79-0.85), and respiratory distress (OR = 0.84, 95% CI 0.80-0.88). Mothers born in a foreign country had higher odds of preterm birth (OR = 1.16, 95% CI 1.11-1.20), low Apgar score (OR = 1.18, 95% CI 1.07-1.30) and respiratory distress (OR = 1.19, 95% CI 1.15-1.24) than Italian-born mothers. The influence of maternal education on neonatal outcomes was confirmed among both, Italian-born and foreign-born mothers. Low levels of education and maternal birthplace are important factors associated with adverse neonatal outcomes in Italy. Future studies are encouraged to investigate factors mediating the effects of socioeconomic inequality for identifying the main target groups for interventions.

Pre-existing diabetes mellitus and adverse pregnancy outcomes

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Wahabi Hayfaa A

2012-09-01

Full Text Available Abstract Background Pregnancies complicated by pre-existing diabetes mellitus (PDM are associated with a high rate of adverse outcomes, including an increased miscarriage rate, preterm delivery, preeclampsia, perinatal mortality and congenital malformations; compared to the background population. The objectives of this study are to determine the prevalence of PDM and to investigate the maternal and the neonatal outcomes of women with PDM. Methods This is a retrospective cohort study for women who delivered in King Khalid University Hospital (KKUH during the period of January 1st to the 31st of December 2008. The pregnancy outcomes of the women with PDM were compared to the outcomes of all non-diabetic women who delivered during the same study period. Results A total of 3157 deliveries met the inclusion criteria. Out of the study population 116 (3.7% women had PDM. There were 66 (57% women with type 1 diabetes mellitus (T1DM and 50 (43% women with type 2 diabetes mellitus (T2DM. Compared to non-diabetic women those with PDM were significantly older, of higher parity, and they had more previous miscarriages. Women with PDM were more likely to be delivered by emergency cesarean section (C/S, OR 2.67, 95% confidence intervals (CI (1.63-4.32, P P P P = 0.002. They more frequently have APGAR scores P 0.057 and more likely to be delivered at P 0.003. The stillbirth rate was 2.6 times more among the women with PDM; however the difference did not reach statistical significance, P 0.084. Conclusion PDM is associated with increased risk for C/S delivery, macrosomia, stillbirth, preterm delivery and low APGAR scores at 5 min.

Study of the Effects of Intravenous Injection of Hyoscine on Parturition (Labor

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H Bekhradi Nasab

2006-01-01

Full Text Available Introduction: Despite wide use of hyoscine by midwives and doctors as an adjunct to labor, the obstetrics literature contains few references to the effect of this drug. This study was a double blinded, randomized controlled trial of primigravidas in Iran to determine the effects of hyoscine intravenous injection on parturition (labor. Methods:One hundred primigravidas in uncomplicated spontaneous labor with cervical dilation less than 4 cm and cervical effacement < 50% were randomly assigned into two groups; the experimental group ( N = 50 receiving 20 mg hyoscine and the control group ( N = 50 receiving placebo, with predetermined codes injected at the beginning of the active phase of labor. The groups were compared for labor progress, fetal tachycardia and bradycardia after 0.5 and 1h of injection, Apgar score and birth weight. Statistical methods for normally distributed variables included 2- tailed student T test and chi- square analysis. The accepted level of significance was p < 0.05. Results:The two groups were similar in respect to maternal age, gestational age , initial cervical effacement & dilation and mean birth weight. The mean change in the cervical effacement and dilation after 1 & 2 h of injection was significantly higher in those receiving hyoscine (p< 0.0001. There was a significant difference in the duration of active phase and second stage of labor in the two groups ( p < 0.0001 . Fetal tachycardia and bradycardia occurred more frequently in patients in the hyoscine group as compared to the control group but the difference was not significant. The difference between the mean first and fifth- minute Apgar score was not significant, too. Conclusion: This small study suggests the benefits of a single dose of hyoscine for labor progress and represents the first attempt to evaluate this medication. However, larger randomized studies are needed to establish the efficacy, safety, and optimal dose of hyoscine .

Neonatal nucleated red blood cells in infants of overweight and obese mothers.

Science.gov (United States)

Sheffer-Mimouni, Galit; Mimouni, Francis B; Dollberg, Shaul; Mandel, Dror; Deutsch, Varda; Littner, Yoav

2007-06-01

The perinatal outcome of the infant of obese mother is adversely affected and in theory, may involve fetal hypoxia. We hypothesized that an index of fetal hypoxia, the neonatal nucleated red blood cell (NRBC) count, is elevated in infants of overweight and obese mothers. Absolute NRBC counts taken during the first 12 hours of life in 41 infants of overweight and obese mothers were compared to 28 controls. Maternal body mass index and infant birthweight were significantly higher in the overweight and obese group (P cell and lymphocyte counts did not differ between groups. The absolute NRBC count was higher (P = 0.01), and the platelet count lower (P = 0.05) in infants of overweight and obese mothers than in controls. In stepwise regression analysis, the absolute NRBC count in infants of overweight and obese mothers remained significantly higher even after taking into account birthweight or gestational age and Apgar scores (P mothers have increased nucleated red blood cells at birth compared with controls. We speculate that even apparently healthy fetuses of overweight and obese mothers are exposed to a subtle hypoxemic environment.

Allegheny County Walk Scores

Data.gov (United States)

Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Walk Score measures the walkability of any address using a patented system developed by the Walk Score company. For each 2010 Census Tract centroid, Walk Score...

Comparison of efficacy of bupivacaine and fentanyl with bupivacaine and sufentanil for epidural labor analgesia

Directory of Open Access Journals (Sweden)

Kalra Sumit

2010-01-01

Full Text Available Objectives: A study to compare the efficacy between fentanyl and sufentanil combined with low concentration (0.0625% of bupivacaine for epidural labor analgesia in laboring women. Materials and Methods: Fifty full term parturients received an initial bolus dose of a 10 ml solution containing 0.125% bupivacaine. The patients were randomly divided into two: group F received 0.0625% bupivacaine with 2.5 mcg/ml fentanyl and group S received 0.0625% bupivacaine with 0.25 mcg/ml sufentanil. Verbal analogue pain scores, need of supplementary/rescue boluses dose of bupivacaine consumed, mode of delivery, maternal satisfaction, and neonatal Apgar scores were recorded. No significant difference was observed between both groups. Results: Both the groups provided equivalent labor analgesia and maternal satisfaction. The chances of cesarean delivery were also not increased in any group. No difference in the cephalad extent of sensory analgesia, motor block or neonatal Apgar score were observed. Although mean pain scores throughout the labor and delivery were similar in both groups, more patients in fentanyl group required supplementary boluses though not statistically significant. Conclusion: We conclude that both 0.0625% bupivacaine-fentanyl (2.5 μg/ml and 0.0625% bupivacaine-sufentanil (0.25 μg/ml were equally effective by continuous epidural infusion in providing labor analgesia with hemodynamic stability achieving equivalent maternal satisfaction without serious maternal or fetal side effects. We found that sufentanil was 10 times more potent than fentanyl as an analgesic for continuous epidural labor analgesia.

Emotional Intelligence in Medical Students is Inversely Correlated with USMLE Step 1 Score: Is there a Better Way to Screen Applicants?

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Allison Lee Boden

2018-03-01

Full Text Available Background: The primary aim of this study was to investigate whether USMLE board scores correlate with the emotional intelligence of medical students. We hypothesized that higher Step 1 scores would be associated with lower emotional intelligence.Methods: This prospective study included medical students who self-reported their USMLE Step 1 score and completed a survey designed to measure their emotional intelligence. The survey was composed of a Grit Scale, a Hardiness-Resilience quiz, and the “Reading the Mind in the Eyes” quiz. For participants who completed all three instruments, a composite score was equal to the sum of the three scoresThis study was performed at Emory University School of Medicine in Atlanta, Georgia. Of the 85 medical students who were recruited to participate, 72 completed all aspects of this study (85% completion rate.Results: Pearson correlation analyses showed that grit (r=-0.105, P=0.34, hardiness-resilience (r=-0.230, P=0.04, the eye quiz (r=-0.033, P=0.79, and the composite score (r=-0.187, P=0.12 wereinversely correlated with USMLE scores. Participants who scored higher than the national average had a lower mean hardiness score compared to those who scored lower than the national average (P=0.03. Those who scored at least one standard deviation above the national average had a lowermean hardiness score (P=0.05 and a lower composite score (P=0.04.Conclusion: Higher USMLE Step 1 scores are associated with lower emotional intelligence, namely hardiness, in medical students.Keywords: EMOTIONAL INTELLIGENCE, USMLE STEP 1, HARDINESS, GRIT, RESIDENCY SELECTION

Calcium scoring in unenhanced and enhanced CT data of the aorta-iliacal arteries: impact of image acquisition, reconstruction, and analysis parameter settings

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Komen, N. (Dept. of Surgery, Univ. Medical Center Rotterdam, Erasmus MC, Rotterdam (Netherlands); Dept. of Surgery, Univ. Hospital Antwerp, Edegem (Belgium)), email: nielskomen@hotmail.com; Klitsie, P.; Jeekel, J.; Lange, J.F. (Dept. of Surgery, Univ. Medical Center Rotterdam, Erasmus MC, Rotterdam (Netherlands)); Hermans, J.J.; Niessen, W.J. (Dept. of Radiology, Univ. Medical Center Rotterdam, Erasmus MC, Rotterdam (Netherlands)); Kleinrensink, G.J. (Dept. of Neurosciences and Anatomy, Univ. Medical Center Rotterdam, Erasmus MC, Rotterdam (Netherlands))

2011-11-15

Background. Several studies have been published on the matter of abdominal aortic and iliac calcifications and the association to clinical entities such as diabetes mellitus and renal failure. However, comparing of these studies is questionable since quantification methods for atherosclerosis differ. Purpose. To evaluate the effect of image acquisition settings, reconstruction parameters, and analysis methods on calcium quantification in the abdominal aorta. Material and Methods. Calcium scores were retrospectively determined on standardized abdominal CT scans of 15 patients. Two researchers obtained calcium scores with 10 different lower thresholds (LT) (130, 145, 160, 175, 200, 300, 400, 500, 600, 1000) in CT scans with and without contrast enhancement, with slice thicknesses (ST) varying between 2.0-5.0 mm for the non-contrast-enhanced series and between 1.0-5.0 mm for the contrast-enhanced series. In addition calcium scores obtained with two convolution kernels (B10f, B20f) were compared. Inter-observer variability was calculated. Results. Calcium scoring at higher STs is overestimated compared to smaller STs and this effect was more pronounced with increasing calcium loads. Concerning the convolution kernel, scores obtained with kernel B10f were overestimated compared to kernel B20f. Increase of LT resulted in a decrease of the calcium score and scoring in contrast-enhanced series resulted in higher scores compared to non-contrast-enhanced series. These effects are more apparent in patients with higher calcium loads. Calcium scoring reproducibility with the reference standard is limited for the aorta-iliac trajectory, whereas scoring with the remaining settings is reproducible. Conclusion. Scores obtained with different settings cannot be compared. The inter-observer reproducibility was limited using the reference standard and practical difficulties were substantial. Scoring with higher LT, ST, and contrast enhancement is faster and has less practical

Association between Diet-Quality Scores, Adiposity, Total Cholesterol and Markers of Nutritional Status in European Adults: Findings from the Food4Me Study

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Rosalind Fallaize

2018-01-01

Full Text Available Diet-quality scores (DQS, which are developed across the globe, are used to define adherence to specific eating patterns and have been associated with risk of coronary heart disease and type-II diabetes. We explored the association between five diet-quality scores (Healthy Eating Index, HEI; Alternate Healthy Eating Index, AHEI; MedDietScore, MDS; PREDIMED Mediterranean Diet Score, P-MDS; Dutch Healthy Diet-Index, DHDI and markers of metabolic health (anthropometry, objective physical activity levels (PAL, and dried blood spot total cholesterol (TC, total carotenoids, and omega-3 index in the Food4Me cohort, using regression analysis. Dietary intake was assessed using a validated Food Frequency Questionnaire. Participants (n = 1480 were adults recruited from seven European Union (EU countries. Overall, women had higher HEI and AHEI than men (p < 0.05, and scores varied significantly between countries. For all DQS, higher scores were associated with lower body mass index, lower waist-to-height ratio and waist circumference, and higher total carotenoids and omega-3-index (p trends < 0.05. Higher HEI, AHEI, DHDI, and P-MDS scores were associated with increased daily PAL, moderate and vigorous activity, and reduced sedentary behaviour (p trend < 0.05. We observed no association between DQS and TC. To conclude, higher DQS, which reflect better dietary patterns, were associated with markers of better nutritional status and metabolic health.

Functional Movement Screen: Pain versus composite score and injury risk.

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Alemany, Joseph A; Bushman, Timothy T; Grier, Tyson; Anderson, Morgan K; Canham-Chervak, Michelle; North, William J; Jones, Bruce H

2017-11-01

The Functional Movement Screen (FMS™) has been used as a screening tool to determine musculoskeletal injury risk using composite scores based on movement quality and/or pain. However, no direct comparisons between movement quality and pain have been quantified. Retrospective injury data analysis. Male Soldiers (n=2154, 25.0±1.3years; 26.2±.7kg/m 2 ) completed the FMS (scored from 0 points (pain) to 3 points (no pain and perfect movement quality)) with injury data over the following six months. The FMS is seven movements. Injury data were collected six months after FMS completion. Sensitivity, specificity, receiver operator characteristics and positive and negative predictive values were calculated for pain occurrence and low (≤14 points) composite score. Risk, risk ratios (RR) and 95% confidence intervals were calculated for injury risk. Pain was associated with slightly higher injury risk (RR=1.62) than a composite score of ≤14 points (RR=1.58). When comparing injury risk between those who scored a 1, 2 or 3 on each individual movement, no differences were found (except deep squat). However, Soldiers who experienced pain on any movement had a greater injury risk than those who scored 3 points for that movement (pmovements in which pain occurrence increased, so did injury risk (p<0.01). Pain occurrence may be a stronger indicator of injury risk than a low composite score and provides a simpler method of evaluating injury risk compared to the full FMS. Published by Elsevier Ltd.

A measurement model of perinatal stressors: identifying risk for postnatal emotional distress in mothers of high-risk infants.

Science.gov (United States)

DeMier, R L; Hynan, M T; Hatfield, R F; Varner, M W; Harris, H B; Manniello, R L

2000-01-01

A measurement model of perinatal stressors was first evaluated for reliability and then used to identify risk factors for postnatal emotional distress in high-risk mothers. In Study 1, six measures (gestational age of the baby, birthweight, length of the baby's hospitalization, a postnatal complications rating for the infant, and Apgar scores at 1 and 5 min) were obtained from chart reviews of preterm births at two different hospitals. Confirmatory factor analyses revealed that the six measures could be accounted for by three factors: (a) Infant Maturity, (b) Apgar Ratings, and (c) Complications. In Study 2, a modified measurement model indicated that Infant Maturity and Complications were significant predictors of postnatal emotional distress in an additional sample of mothers. This measurement model may also be useful in predicting (a) other measures of psychological distress in parents, and (b) measures of cognitive and motor development in infants.

A comparison between modified Alvarado score and RIPASA score in the diagnosis of acute appendicitis.

Science.gov (United States)

Singla, Anand; Singla, Satpaul; Singh, Mohinder; Singla, Deeksha

2016-12-01

Acute appendicitis is a common but elusive surgical condition and remains a diagnostic dilemma. It has many clinical mimickers and diagnosis is primarily made on clinical grounds, leading to the evolution of clinical scoring systems for pin pointing the right diagnosis. The modified Alvarado and RIPASA scoring systems are two important scoring systems, for diagnosis of acute appendicitis. We prospectively compared the two scoring systems for diagnosing acute appendicitis in 50 patients presenting with right iliac fossa pain. The RIPASA score correctly classified 88 % of patients with histologically confirmed acute appendicitis compared with 48.0 % with modified Alvarado score, indicating that RIPASA score is more superior to Modified Alvarado score in our clinical settings.

Predictive values of D-dimer assay, GRACE scores and TIMI scores for adverse outcome in patients with non-ST-segment elevation myocardial infarction

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Satilmisoglu MH

2017-03-01

Full Text Available Muhammet Hulusi Satilmisoglu,1 Sinem Ozbay Ozyilmaz,1 Mehmet Gul,1 Hayriye Ak Yildirim,2 Osman Kayapinar,3 Kadir Gokturk,4 Huseyin Aksu,1 Korhan Erkanli,5 Abdurrahman Eksik1 1Department of Cardiology, 2Department of Biochemistry, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, 3Department of Cardiology, Duzce University Faculty of Medicine, Duzce, 4Department of Infectious Diseases, 5Department of Thoracic and Cardiovascular Surgery, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey Purpose: To determine the predictive values of D-dimer assay, Global Registry of Acute Coronary Events (GRACE and Thrombolysis in Myocardial Infarction (TIMI risk scores for adverse outcome in patients with non-ST-segment elevation myocardial infarction (NSTEMI.Patients and methods: A total of 234 patients (mean age: 57.2±11.7 years, 75.2% were males hospitalized with NSTEMI were included. Data on D-dimer assay, GRACE and TIMI risk scores were recorded. Logistic regression analysis was conducted to determine the risk factors predicting increased mortality.Results: Median D-dimer levels were 349.5 (48.0–7,210.0 ng/mL, the average TIMI score was 3.2±1.2 and the GRACE score was 90.4±27.6 with high GRACE scores (>118 in 17.5% of patients. The GRACE score was correlated positively with both the D-dimer assay (r=0.215, P=0.01 and TIMI scores (r=0.504, P=0.000. Multivariate logistic regression analysis revealed that higher creatinine levels (odds ratio =18.465, 95% confidence interval: 1.059–322.084, P=0.046 constituted the only significant predictor of increased mortality risk with no predictive values for age, D-dimer assay, ejection fraction, glucose, hemoglobin A1c, sodium, albumin or total cholesterol levels for mortality.Conclusion: Serum creatinine levels constituted the sole independent determinant of mortality risk, with no significant values for D

Flexible and efficient genome tiling design with penalized uniqueness score

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Du Yang

2012-12-01

Full Text Available Abstract Background As a powerful tool in whole genome analysis, tiling array has been widely used in the answering of many genomic questions. Now it could also serve as a capture device for the library preparation in the popular high throughput sequencing experiments. Thus, a flexible and efficient tiling array design approach is still needed and could assist in various types and scales of transcriptomic experiment. Results In this paper, we address issues and challenges in designing probes suitable for tiling array applications and targeted sequencing. In particular, we define the penalized uniqueness score, which serves as a controlling criterion to eliminate potential cross-hybridization, and a flexible tiling array design pipeline. Unlike BLAST or simple suffix array based methods, computing and using our uniqueness measurement can be more efficient for large scale design and require less memory. The parameters provided could assist in various types of genomic tiling task. In addition, using both commercial array data and experiment data we show, unlike previously claimed, that palindromic sequence exhibiting relatively lower uniqueness. Conclusions Our proposed penalized uniqueness score could serve as a better indicator for cross hybridization with higher sensitivity and specificity, giving more control of expected array quality. The flexible tiling design algorithm incorporating the penalized uniqueness score was shown to give higher coverage and resolution. The package to calculate the penalized uniqueness score and the described probe selection algorithm are implemented as a Perl program, which is freely available at http://www1.fbn-dummerstorf.de/en/forschung/fbs/fb3/paper/2012-yang-1/OTAD.v1.1.tar.gz.

Predictive power of the ESUR scoring system for prostate cancer diagnosis verified with targeted MR-guided in-bore biopsy

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Schimmöller, L., E-mail: Lars.Schimmoeller@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Quentin, M., E-mail: Michael.Quentin@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Arsov, C., E-mail: Cristian.Arsov@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Urology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Hiester, A., E-mail: Andreas.Hiester@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Urology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Kröpil, P., E-mail: Patric.Kroepil@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Rabenalt, R., E-mail: Robert.Rabenalt@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Urology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Albers, P., E-mail: urologie@uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Urology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Antoch, G., E-mail: Antoch@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Blondin, D., E-mail: Dirk.Blondin@sk-mg.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany)

2014-12-15

Highlights: • The PI-RADS summed score (PS{sub sum}) demonstrated very good diagnostic values, especially for higher grade PCa. • Lesions with PS{sub sum} ≥13 represented prostate cancer in 88% and higher grade prostate cancer in 42%. • Sensitivity and NPV was nearly 100% for higher grade PCa detection using a cut-off limit of PS{sub sum} 10. • Peripheral zone lesions demonstrated better diagnostic value with the PS{sub sum} compared to transitional zone lesions. • Further improvement of the PI-RADS score is required to prevent unnecessary overdiagnosis. - Abstract: Purpose: This study evaluates the diagnostic value of the ESUR scoring system (PI-RADS) regarding prostate cancer detection using MR-guided in-bore biopsies (IB-GB) as the reference standard. Methods: 566 lesions in 235 consecutive patients (65.7 ± 7.9 years, PSA 9.9 ± 8.5 ng/ml) with a multiparametric (mp)-MRI (T2WI, DWI, DCE) of the prostate at 3 T were scored using the PI-RADS scoring system. PI-RADS single (PS{sub single}), summed (PS{sub sum}), and overall (PS{sub overall}) scores were determined. All lesions were histologically verified by IB-GB. Results: Lesions with a PS{sub sum} below 9 contained no prostate cancer (PCa) with Gleason score (GS) ≥ 4 + 3 = 7. A PS{sub sum} of 13–15 (PS{sub overall} V) resulted in 87.8% (n = 108) in PCa and in 42.3% (n = 52) in GS ≥ 4 + 3 = 7. Transition zone (TZ) lesions with a PS{sub sum} of 13–15 (PS{sub overall} V) resulted in 76.3% (n = 36) in PCa and in 26.3% (n = 10) in GS ≥ 4 + 3 = 7, whereas for peripheral zone (PZ) lesions cancer detection rate at this score was 92.9% (n = 79) and 49.4% (n = 42) for GS ≥ 4 + 3 = 7. Using a threshold of PS{sub sum} ≥ 10, sensitivity was 86.0%, and negative predictive value (NPV) was 86.2%. For higher grade PCa sensitivity was 98.6%, and NPV was 99.5%. Conclusion: A PS{sub sum} below 9 excluded a higher grade PCa, whereas lesions with a PS{sub sum} ≥ 13 (PS{sub overall} V) represented in 88

More than meets the eye: infant presenting with hypoxic ischaemic encephalopathy.

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Sen, Kuntal; Agarwal, Rajkumar

2018-04-05

We report a newborn infant who presented with poor Apgar scores and umbilical artery acidosis leading to the diagnosis of hypoxic ischaemic encephalopathy. During the course of the infant's hospitalisation, subsequent workup revealed an underlying genetic cause that masqueraded as hypoxic ischaemic encephalopathy. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Effect of hyoscine butylbromide first stage of labour in multiparus ...

African Journals Online (AJOL)

The effects of hyoscine in shortening labor time; and neonatal Apgar score was compared. Results: Duration of the first (mean± SD: 186.8 ± 125.6 minutes vs. 260.4 ± 120.9 minutes, p= 0.00 1) and second stage of labor (mean± SD: 20.0 ± 8.1minutes vs. 25.8 ± 9.4 minutes, p= 0.03) was shorter in hyoscine group.

Síndrome convulsivo neonatal: Enfoque diagnóstico a propósito de un caso de epilepsia focal sintomática

OpenAIRE

Joaquín Saavedra D.; María José Sierralta S.; Felipe Pinto S.; Cristian Saavedra D.; Francisco Cerda C.

2012-01-01

INTRODUCTION: Neonatal seizures are a hypersynchronic depolarizationof a finite set of cortical neurons. The symptomsthat manifest are motor, sensory, autonomic, or mixed. The etiologymust be studied from the beginning. CASE REPORT: Termnewborn, female, 38 weeks gestation, born of vaginal deliverywith Apgar score 9-9. Mother of 24 years, no history or backgroundmorbid during pregnancy. It presents two episodes ofsudden cyanosis boxes discarded at the time of hypoglycemia,hypokalemia, or infec...

Clinical and echocardiographic characteristics associated with the evolution of the ductus arteriosus in the neonate with birth weight lower than 1,500g

OpenAIRE

Visconti, Luiza Fortunato; Morhy, Samira Saady; Deutsch, Alice D'Agostini; Tavares, Gl?ucia Maria Penha; Wilberg, Tatiana Jardim Mussi; Rossi, Felipe de Souza

2013-01-01

ABSTRACT Objective: To identify clinical and echocardiographic parameters associated with the evolution of the ductus arteriosus in neonates with birth weight lower than 1,500g. Methods: Retrospective study of 119 neonates in which clinical parameters (Prenatal: maternal age, risk of infection and chorioamnionitis, use of corticosteroid, mode of delivery and gestational age. Perinatal: weight, Apgar score, gender and birth weight/gestational age classification; Postnatal: use of surfactant, s...

Primary Carnitine Deficiency

DEFF Research Database (Denmark)

Rasmussen, Jan; Hougaard, David M; Sandhu, Noreen

2017-01-01

Primary carnitine deficiency (PCD) causes low levels of carnitine in patients potentially leading to metabolic and cardiac symptoms. Newborn screening for PCD is now routine in many countries by measuring carnitine levels in infants. In this study we report Apgar scores, length and weight...... scores, length and weight compared to controls. Newborns with PCD and newborns born to mothers with PCD had significantly lower levels of free carnitine (fC0) than controls. Screening algorithms focusing only on fC0 had a high rate of detection of newborns with PCD. Sample collection 4-9 days after birth...

Lecturers' Experience of Using Social Media in Higher Education Courses

Science.gov (United States)

Seechaliao, Thapanee

2015-01-01

This research paper presents lecturers' experience of using social media in higher education courses. The research methodology used a survey approach. The research instrument was a questionnaire about lecturers' experience of using social media in higher education courses. Thirty-one lecturers completed the questionnaire. The data were scored by…

Ethnic differences in maternal dietary patterns are largely explained by socio-economic score and integration score: a population-based study.

Science.gov (United States)

Sommer, Christine; Sletner, Line; Jenum, Anne K; Mørkrid, Kjersti; Andersen, Lene F; Birkeland, Kåre I; Mosdøl, Annhild

2013-01-01

The impact of socio-economic position and integration level on the observed ethnic differences in dietary habits has received little attention. To identify and describe dietary patterns in a multi-ethnic population of pregnant women, to explore ethnic differences in odds ratio (OR) for belonging to a dietary pattern, when adjusted for socio-economic status and integration level and to examine whether the dietary patterns were reflected in levels of biomarkers related to obesity and hyperglycaemia. This cross-sectional study was a part of the STORK Groruddalen study. In total, 757 pregnant women, of whom 59% were of a non-Western origin, completed a food frequency questionnaire in gestational week 28±2. Dietary patterns were extracted through cluster analysis using Ward's method. Four robust clusters were identified where cluster 4 was considered the healthier dietary pattern and cluster 1 the least healthy. All non-European women as compared to Europeans had higher OR for belonging to the unhealthier dietary patterns 1-3 vs. cluster 4. Women from the Middle East and Africa had the highest OR, 21.5 (95% CI 10.6-43.7), of falling into cluster 1 vs. 4 as compared to Europeans. The ORs decreased substantially after adjusting for socio-economic score and integration score. A non-European ethnic origin, low socio-economic and integration scores, conduced higher OR for belonging to clusters 1, 2, and 3 as compared to cluster 4. Significant differences in fasting and 2-h glucose, fasting insulin, glycosylated haemoglobin (HbA1c), insulin resistance (HOMA-IR), and total cholesterol were observed across the dietary patterns. After adjusting for ethnicity, differences in fasting insulin (p=0.015) and HOMA-IR (p=0.040) across clusters remained significant, despite low power. The results indicate that socio-economic and integration level may explain a large proportion of the ethnic differences in dietary patterns.

Modified PADSS (Post Anaesthetic Discharge Scoring System) for monitoring outpatients discharge.

Science.gov (United States)

Palumbo, Piergaspare; Tellan, Guglielmo; Perotti, Bruno; Pacilè, Maria Antonietta; Vietri, Francesco; Illuminati, Giulio

2013-01-01

The decision to discharge a patient undergoing day surgery is a major step in the hospitalization pathway, because it must be achieved without compromising the quality of care, thus ensuring the same assistance and wellbeing as for a long-term stay. Therefore, the use of an objective assessment for the management of a fair and safe discharge is essential. The authors propose the Post Anaesthetic Discharge Scoring System (PADSS), which considers six criteria: vital signs, ambulation, nausea/vomiting, pain, bleeding and voiding. Each criterion is given a score ranging from 0 to 2. Only patients who achieve a score of 9 or more are considered ready for discharge. Furthermore, PADSS has been modified to ensure a higher level of safety, thus the "vital signs" criteria must never score lower than 2, and none of the other five criteria must ever be equal to 0, even if the total score reaches 9. The effectiveness of PADSS was analyzed on 2432 patients, by recording the incidence of postoperative complications and the readmission to hospital. So far PADDS has proved to be an efficient system that guarantees safe discharge.

A muscle ultrasound score in the diagnosis of amyotrophic lateral sclerosis.

Science.gov (United States)

Tsuji, Yukiko; Noto, Yu-Ichi; Shiga, Kensuke; Teramukai, Satoshi; Nakagawa, Masanori; Mizuno, Toshiki

2017-06-01

The aims of this study are to elucidate the frequencies and distribution of fasciculations using muscle ultrasound in patients with amyotrophic lateral sclerosis (ALS) and those with other conditions mimicking ALS, and subsequently to develop a novel fasciculation score for the diagnosis of ALS. Ultrasound of 21 muscles was performed to detect fasciculations in 36 consecutive patients suspected of having ALS. We developed a fasciculation ultrasound score that indicated the number of muscles with fasciculations in statistically selected muscles. A total of 525 muscles in 25 ALS patients and 231 in 11 non-ALS patients were analysed. Using relative operating characteristic and multivariate logistic regression analysis, we selected the trapezius, deltoid, biceps brachii, abductor pollicis brevis, abdominal, vastus lateralis, vastus medialis, biceps femoris, and gastrocnemius muscles for the fasciculation ultrasound score. The mean scores were higher in the ALS group than those in the non-ALS group (5.3±0.5vs. 0.3±0.7) (mean±SD); pdifferentiating ALS patients from non-ALS patients. The fasciculation ultrasound score can be a simple and useful diagnostic marker of ALS. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

Ripasa score: a new diagnostic score for diagnosis of acute appendicitis

International Nuclear Information System (INIS)

Butt, M.Q.

2014-01-01

Objective: To determine the usefulness of RIPASA score for the diagnosis of acute appendicitis using histopathology as a gold standard. Study Design: Cross-sectional study. Place and Duration of Study: Department of General Surgery, Combined Military Hospital, Kohat, from September 2011 to March 2012. Methodology: A total of 267 patients were included in this study. RIPASA score was assessed. The diagnosis of appendicitis was made clinically aided by routine sonography of abdomen. After appendicectomies, resected appendices were sent for histopathological examination. The 15 parameters and the scores generated were age (less than 40 years = 1 point; greater than 40 years = 0.5 point), gender (male = 1 point; female = 0.5 point), Right Iliac Fossa (RIF) pain (0.5 point), migration of pain to RIF (0.5 point), nausea and vomiting (1 point), anorexia (1 point), duration of symptoms (less than 48 hours = 1 point; more than 48 hours = 0.5 point), RIF tenderness (1 point), guarding (2 points), rebound tenderness (1 point), Rovsing's sign (2 points), fever (1 point), raised white cell count (1 point), negative urinalysis (1 point) and foreign national registration identity card (1 point). The optimal cut-off threshold score from the ROC was 7.5. Sensitivity analysis was done. Results: Out of 267 patients, 156 (58.4%) were male while remaining 111 patients (41.6%) were female with mean age of 23.5 +- 9.1 years. Sensitivity of RIPASA score was 96.7%, specificity 93.0%, diagnostic accuracy was 95.1%, positive predictive value was 94.8% and negative predictive value was 95.54%. Conclusion: RIPASA score at a cut-off total score of 7.5 was a useful tool to diagnose appendicitis, in equivocal cases of pain. (author)

QRS Score at Presentation Electrocardiogram Is Correlated With Infarct Size and Mortality in ST-Segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention.

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Shiomi, Hiroki; Kosuge, Masami; Morimoto, Takeshi; Watanabe, Hiroki; Taniguchi, Tomohiko; Nakatsuma, Kenji; Toyota, Toshiaki; Yamamoto, Erika; Shizuta, Satoshi; Tada, Tomohisa; Furukawa, Yutaka; Nakagawa, Yoshihisa; Ando, Kenji; Kadota, Kazushige; Kimura, Kazuo; Kimura, Takeshi

2017-07-25

In ST-segment elevation myocardial infarction (STEMI), QRS score at presentation ECG may reflect the progression of infarction and facilitate prediction of the degree of myocardial salvage achieved by reperfusion therapy.Methods and Results:Admission electrocardiogram (ECG) was studied in 2,607 patients with STEMI undergoing primary percutaneous coronary intervention (PCI) within 24 h of symptom onset. Patients were classified into 3 groups according to QRS score: low (0-3, n=1,227), intermediate (4-7, n=810), and high (≥8, n=570). An increase of infarct size estimated by median peak creatine phosphokinase was observed as QRS score increased (low score, 1,836 IU/L; inter-quartile range (IQR), 979-3,190 IU/L; intermediate score, 2,488 IU/L; IQR, 1,126-4,640 IU/L; high score, 3,454 IU/L; IQR, 1,759-5,639 IU/L; P<0.001). Higher QRS score was associated with higher long-term mortality (low, intermediate, and high score, 15.6%, 19.7%, and 23.7% at 5 years, respectively; log-rank P<0.001). The positive relationship of QRS score with mortality was consistently seen when stratified by infarct location. The association of high QRS score with increased mortality was most remarkably seen in patients with early (≤2 h) presentation (low, intermediate, and high score: 16.7%, 16.6%, and 28.1% at 5 years, respectively; log-rank P<0.001). Higher QRS score at presentation ECG was associated with larger infarct size, and higher long-term mortality in patients with STEMI undergoing primary PCI. QRS score appears to be important in the early risk stratification for STEMI.

Reliability of a visual scoring system with fluorescent tracers to assess dermal pesticide exposure.

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Aragon, Aurora; Blanco, Luis; Lopez, Lylliam; Liden, Carola; Nise, Gun; Wesseling, Catharina

2004-10-01

We modified Fenske's semi-quantitative 'visual scoring system' of fluorescent tracer deposited on the skin of pesticide applicators and evaluated its reproducibility in the Nicaraguan setting. The body surface of 33 farmers, divided into 31 segments, was videotaped in the field after spraying with a pesticide solution containing a fluorescent tracer. A portable UV lamp was used for illumination in a foldaway dark room. The videos of five farmers were randomly selected. The scoring was based on a matrix with extension of fluorescent patterns (scale 0-5) on the ordinate and intensity (scale 0-5) on the abscissa, with the product of these two ranks as the final score for each body segment (0-25). Five medical students rated and evaluated the quality of 155 video images having undergone 4 h of training. Cronbach alpha coefficients and two-way random effects intraclass correlation coefficients (ICC) with absolute agreement were computed to assess inter-rater reliability. Consistency was high (Cronbach alpha = 0.96), but the scores differed substantially between raters. The overall ICC was satisfactory [0.75; 95% confidence interval (CI) = 0.62-0.83], but it was lower for intensity (0.54; 95% CI = 0.40-0.66) and higher for extension (0.80; 95% CI = 0.71-0.86). ICCs were lowest for images with low scores and evaluated as low quality, and highest for images with high scores and high quality. Inter-rater reliability coefficients indicate repeatability of the scoring system. However, field conditions for recording fluorescence should be improved to achieve higher quality images, and training should emphasize a better mechanism for the reading of body areas with low contamination.

Comparison of Risk Scores for Prediction of Complications following Aortic Valve Replacement.

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Wang, Tom Kai Ming; Choi, David Hyun-Min; Haydock, David; Gamble, Greg; Stewart, Ralph; Ruygrok, Peter

2015-06-01

Risk models play an important role in stratification of patients for cardiac surgery, but their prognostic utilities for post-operative complications are rarely studied. We compared the EuroSCORE, EuroSCORE II, Society of Thoracic Surgeon's (STS) Score and an Australasian model (Aus-AVR Score) for predicting morbidities after aortic valve replacement (AVR), and also evaluated seven STS complications models in this context. We retrospectively calculated risk scores for 620 consecutive patients undergoing isolated AVR at Auckland City Hospital during 2005-2012, assessing their discrimination and calibration for post-operative complications. Amongst mortality scores, the EuroSCORE was the best at discriminating stroke (c-statistic 0.845); the EuroSCORE II at deep sternal wound infection (c=0.748); and the STS Score at composite morbidity or mortality (c=0.666), renal failure (c=0.634), ventilation>24 hours (c=0.732), return to theatre (c=0.577) and prolonged hospital stay >14 days post-operatively (c=0.707). The individual STS complications models had a marginally higher c-statistic (c=0.634-0.846) for all complications except mediastinitis, and had good calibration (Hosmer-Lemeshow test P-value 0.123-0.915) for all complications. The STS Score was best overall at discriminating post-operative complications and their composite for AVR. All STS complications models except for deep sternal wound infection had good discrimination and calibration for post-operative complications. Copyright © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

The International Bleeding Risk Score

DEFF Research Database (Denmark)

Laursen, Stig Borbjerg; Laine, L.; Dalton, H.

2017-01-01

The International Bleeding Risk Score: A New Risk Score that can Accurately Predict Mortality in Patients with Upper GI-Bleeding.......The International Bleeding Risk Score: A New Risk Score that can Accurately Predict Mortality in Patients with Upper GI-Bleeding....

The Importance of Rockall Scoring System for Upper Gastrointestinal Bleeding in Long-Term Follow-Up.

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Bozkurt, Mehmet Abdussamet; Peker, Kıvanç Derya; Unsal, Mustafa Gökhan; Yırgın, Hakan; Kahraman, İzzettin; Alış, Halil

2017-06-01

The aim of the study is to examine the importance of Rockall scoring system in long-term setting to estimate re-bleeding and mortality rate due to upper gastrointestinal bleeding. A total of 321 patients who had been treated for upper gastrointestinal bleeding were recruited to the study. Patients' demographic and clinical data, the amount of blood transfusion, endoscopy results, and Rockall scores were retrieved from patients' charts. The re-bleeding, morbidity, and mortality rates were noted after 3 years of follow-up with telephone. Re-bleeding rate was statistically significantly higher in Rockall 4 group compared to Rockall 0 group. Mortality rate was also statistically significantly higher in Rockall 4 group. Rockall risk scoring system is a valuable tool to predict re-bleeding and mortality rates for patients with upper gastrointestinal bleeding in long-term setting.

Higher body mass index associated with severe early childhood caries.

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Davidson, Katherine; Schroth, Robert J; Levi, Jeremy A; Yaffe, Aaron B; Mittermuller, Betty-Anne; Sellers, Elizabeth A C

2016-08-20

Severe Early Childhood Caries (S-ECC) is an aggressive form of tooth decay in preschool children affecting quality of life and nutritional status. The purpose was to determine whether there is an association between Body Mass Index (BMI) and S-ECC. Children with S-ECC were recruited on the day of their slated dental surgery under general anesthesia. Age-matched, caries-free controls were recruited from the community. All children were participating in a larger study on nutrition and S-ECC. Analysis was restricted to children ≥ 24 months of age. Parents completed a questionnaire and heights and weights were recorded. BMI scores and age and gender adjusted BMI z-scores and percentiles were calculated. A p-value ≤ 0.05 was significant. Two hundred thirty-five children were included (141 with S-ECC and 94 caries-free). The mean age was 43.3 ± 12.8 months and 50.2 % were male. Overall, 34.4 % of participants were overweight or obese. Significantly more children with S-ECC were classified as overweight or obese when compared to caries-free children (p = 0.038) and had significantly higher mean BMI z-scores than caries-free children (0.78 ± 1.26 vs. 0.22 ± 1.36, p = 0.002). Those with S-ECC also had significantly higher BMI percentiles (69.0 % ± 29.2 vs. 56.8 % ± 31.7, p = 0.003). Multiple linear regression analyses revealed that BMI z-scores were significantly and independently associated with S-ECC and annual household income as were BMI percentiles. Children with S-ECC in our sample had significantly higher BMI z-scores than caries-free peers.

Intravenous remifentanil versus epidural ropivacaine with sufentanil for labour analgesia: a retrospective study.

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Rong Lin

Full Text Available Remifentanil with appropriate pharmacological properties seems to be an ideal alternative to epidural analgesia during labour. A retrospective cohort study was undertaken to assess the efficacy and safety of remifentanil intravenous patient-controlled analgesia (IVPCA compared with epidural analgesia. Medical records of 370 primiparas who received remifentanil IVPCA or epidural analgesia were reviewed. Pain and sedation scores, overall satisfaction, the extent of pain control, maternal side effects and neonatal outcome as primary observational indicators were collected. There was a significant decline of pain scores in both groups. Pain reduction was greater in the epidural group throughout the whole study period (0 ∼ 180 min (P < 0.0001, and pain scores in the remifentanil group showed an increasing trend one hour later. The remifentanil group had a lower SpO2 (P < 0.0001 and a higher sedation score (P < 0.0001 within 30 min after treatment. The epidural group had a higher overall satisfaction score (3.8 ± 0.4 vs. 3.7 ± 0.6, P = 0.007 and pain relief score (2.9 ± 0.3 vs. 2.8 ± 0.4, P < 0.0001 compared with the remifentanil group. There was no significant difference on side effects between the two groups, except that a higher rate of dizziness (1% vs. 21.8%, P < 0.0001 was observed during remifentanil analgesia. And logistic regression analysis demonstrated that nausea, vomiting were associated with oxytocin usage and instrumental delivery, and dizziness was associated to the type and duration of analgesia. Neonatal outcomes such as Apgar scores and umbilical-cord blood gas analysis were within the normal range, but umbilical pH and base excess of neonatus in the remifentanil group were significantly lower. Remifentanil IVPCA provides poorer efficacy on labor analgesia than epidural analgesia, with more sedation on parturients and a trend of newborn acidosis. Despite these adverse effects, remifentanil IVPCA can still be an alternative

Drawing causal inferences using propensity scores: a practical guide for community psychologists.

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Lanza, Stephanie T; Moore, Julia E; Butera, Nicole M

2013-12-01

Confounding present in observational data impede community psychologists' ability to draw causal inferences. This paper describes propensity score methods as a conceptually straightforward approach to drawing causal inferences from observational data. A step-by-step demonstration of three propensity score methods-weighting, matching, and subclassification-is presented in the context of an empirical examination of the causal effect of preschool experiences (Head Start vs. parental care) on reading development in kindergarten. Although the unadjusted population estimate indicated that children with parental care had substantially higher reading scores than children who attended Head Start, all propensity score adjustments reduce the size of this overall causal effect by more than half. The causal effect was also defined and estimated among children who attended Head Start. Results provide no evidence for improved reading if those children had instead received parental care. We carefully define different causal effects and discuss their respective policy implications, summarize advantages and limitations of each propensity score method, and provide SAS and R syntax so that community psychologists may conduct causal inference in their own research.

Score-driven exponentially weighted moving averages and Value-at-Risk forecasting

NARCIS (Netherlands)

Lucas, A.; Zhang, X.

2016-01-01

We present a simple methodology for modeling the time variation in volatilities and other higher-order moments using a recursive updating scheme that is similar to the familiar RiskMetrics approach. The parameters are updated using the score of the forecasting distribution, which allows the

A summary risk score for the prediction of Alzheimer disease in elderly persons.

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Reitz, Christiane; Tang, Ming-Xin; Schupf, Nicole; Manly, Jennifer J; Mayeux, Richard; Luchsinger, José A

2010-07-01

To develop a simple summary risk score for the prediction of Alzheimer disease in elderly persons based on their vascular risk profiles. A longitudinal, community-based study. New York, New York. Patients One thousand fifty-one Medicare recipients aged 65 years or older and residing in New York who were free of dementia or cognitive impairment at baseline. We separately explored the associations of several vascular risk factors with late-onset Alzheimer disease (LOAD) using Cox proportional hazards models to identify factors that would contribute to the risk score. Then we estimated the score values of each factor based on their beta coefficients and created the LOAD vascular risk score by summing these individual scores. Risk factors contributing to the risk score were age, sex, education, ethnicity, APOE epsilon4 genotype, history of diabetes, hypertension or smoking, high-density lipoprotein levels, and waist to hip ratio. The resulting risk score predicted dementia well. According to the vascular risk score quintiles, the risk to develop probable LOAD was 1.0 for persons with a score of 0 to 14 and increased 3.7-fold for persons with a score of 15 to 18, 3.6-fold for persons with a score of 19 to 22, 12.6-fold for persons with a score of 23 to 28, and 20.5-fold for persons with a score higher than 28. While additional studies in other populations are needed to validate and further develop the score, our study suggests that this vascular risk score could be a valuable tool to identify elderly individuals who might be at risk of LOAD. This risk score could be used to identify persons at risk of LOAD, but can also be used to adjust for confounders in epidemiologic studies.

Non-alcoholic fatty liver disease - histological scoring systems: a large cohort single-center, evaluation study.

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Rastogi, Archana; Shasthry, Saggere Muralikrishna; Agarwal, Ayushi; Bihari, Chhagan; Jain, Priyanka; Jindal, Ankur; Sarin, Shiv

2017-11-01

Non-alcoholic fatty liver disease (NAFLD) is an increasingly common cause of chronic liver disease. Till date, liver biopsy remains the gold standard for identification and quantification of the wide histological spectra of NAFLD. Histological scorings are very useful and widely applied for the diagnosis and management in clinical trials and follow-up studies of non-alcoholic steatohepatitis (NASH). However, in view of scarce published literature, there is a need to evaluate them in large cohort of NAFLD. This study was aimed to evaluate the two histological scoring systems (NAS-CRN, SAF) in the diagnosis of NAFLD and to assess the role of histological characteristics as injury markers in NAFLD. Retrospective histological study of liver biopsies of 1000 patients diagnosed as NAFLD, between 2010 and 2016, was conducted. Histopathologic evaluation and semiquantiative scoring based on NAS-CRN and SAF algorithm and their correlation with serum aminotransferase and fibrosis were performed. Liver biopsies were classified according to the NAS-CRN scoring, as NAS <3 (not NASH) in 72 (7.2%), NAS 3-4 (borderline NASH) in 310 (31%), and NAS ≥5 (definite NASH) in 618 (61.8%), and SAF classified 117 (11.7%) not NASH and 883 (88.3%) definite NASH. There was excellent concordance for definite NASH and not NASH; however, 88.06% of borderline NASH was classified as NASH by SAF. 76.39% by NAS and 78.63% by SAF algorithm who were diagnosed as not NASH showed the presence of fibrosis; however, higher stages of fibrosis were significantly more prevalent in definite NASH, excluding burnt-out cirrhosis. Serum ALT was significantly associated with increasing stages of fibrosis (p < 0.001) and the three categories (not NASH, borderline NASH, and definite NASH) when classified as with/without fibrosis (p < 0.001). Steatosis of higher grades, more ballooned cells, and more foci of Lobular Inflammation were found in significantly higher proportion of patients with NASH (p < 0

The CSIRO Healthy Diet Score: An Online Survey to Estimate Compliance with the Australian Dietary Guidelines.

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Hendrie, Gilly A; Baird, Danielle; Golley, Rebecca K; Noakes, Manny

2017-01-09

There are few dietary assessment tools that are scientifically developed and freely available online. The Commonwealth Scientific and Industrial Research Organisation (CSIRO) Healthy Diet Score survey asks questions about the quantity, quality, and variety of foods consumed. On completion, individuals receive a personalised Diet Score-reflecting their overall compliance with the Australian Dietary Guidelines. Over 145,000 Australians have completed the survey since it was launched in May 2015. The average Diet Score was 58.8 out of a possible 100 (SD = 12.9). Women scored higher than men; older adults higher than younger adults; and normal weight adults higher than obese adults. It was most common to receive feedback about discretionary foods (73.8% of the sample), followed by dairy foods (55.5%) and healthy fats (47.0%). Results suggest that Australians' diets are not consistent with the recommendations in the guidelines. The combination of using technology and providing the tool free of charge has attracted a lot of traffic to the website, providing valuable insights into what Australians' report to be eating. The use of technology has also enhanced the user experience, with individuals receiving immediate and personalised feedback. This survey tool will be useful to monitor population diet quality and understand the degree to Australians' diets comply with dietary guidelines.

Using the Bologna Score to assess normal delivery healthcare

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Isaiane da Silva Carvalho

Full Text Available Abstract OBJECTIVE Describing the obstetric care provided in public maternity hospitals during normal labour using the Bologna Score in the city of Natal, Northeastern Brazil. METHOD A quantitative cross-sectional study conducted with 314 puerperal women. Data collection was carried out consecutively during the months of March to July 2014. RESULTS Prenatal care was provided to 95.9% of the mothers, beginning around the 1st trimester of pregnancy (72.3% and having seven or more consultations (51%. Spontaneous vaginal delivery was planned for 88.2% women. All laboring women were assisted by a health professional, mostly by a physician (80.6%, and none of them obtained 5 points on the Bologna Score due to the small percentage of births in non-supine position (0.3% and absence of a partogram (2.2%. A higher number of episiotomies were observed among primiparous women (75.5%. CONCLUSION The score obtained using the Bologna Index was low. Thus, it is necessary to improve and readjust the existing obstetrical model.

The Changes of Students’ Toefl Score After One Year Learning

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Ienneke Indra Dewi

2015-10-01

Full Text Available BINUS students are supposed to increase their English competence indicated by their TOEFL scores. This paper aims to observe the differences between studens TOEFL scores obtained when they entered BINUS and the scores after they joined TOEFL courses at BINUS for one year. The participants were 121 students. The data for the entrance test were taken from the BINUS data center and the final test data were taken from their final test at English class. The data were analysed using statistics especially the descriptive statistics, comparing means, and correlation. To support the quantative data, a set of questionnaires was distributed to those 121 students. The results show that the students’ TOEFL scores have increased significantly in the final test compared to those in the entrance test. The low achiever students showed a better performance than the higher ones. Students’ motivation and background support their English study. Students proved to have the most problem in listening. The results of the research are expected to be the input for English lecturers to improve their teaching especially the existence of SALLC (Self Access Language Learning Center.