scholarly journals Administration of Antenatal Corticosteroids: Current State of Knowledge

2022 ◽  
Author(s):  
Richard Berger ◽  
Ioannis Kyvernitakis ◽  
Holger Maul
Keyword(s):  
Standard Procedure ◽  
Obstetric Care ◽  
Time Frame ◽  
Psychomotor Development ◽  
Antenatal Corticosteroids ◽  
Current State ◽  
Term Adverse Effect ◽  
Repeat Administration ◽  
Term Benefit

AbstractThe administration of a single course of corticosteroids before week 34 + 0 of gestation in cases with impending preterm birth is now standard procedure in obstetric care and firmly established in the guidelines of different countries. But despite the apparently convincing data, numerous aspects of this intervention have not yet been properly studied. It is still not clear which corticosteroid achieves the best results. There are very few studies on what constitutes an appropriate dose, circadian rhythms, the time frame in which corticosteroids are effective, and the balance between the risks and benefits of repeat administration. As the existing studies have rarely included patients before week 24 + 0 of gestation, we have very little information on the possible benefits of administering corticosteroids before this timepoint. If corticosteroids are administered antenatally after week 34 + 0 of gestation, the short-term benefit may be offset by the long-term adverse effect on psychomotor development. This present study summarizes the current state of knowledge regarding these issues.

Autonomy in Maternal Accounts of Birth after Cesarean

2012 ◽  
Vol 16 (1) ◽  
pp. 62-70 ◽  
Author(s):  
Elizabeth Soliday ◽  
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Scientific Knowledge ◽  
Practice Patterns ◽  
Obstetric Care ◽  
Ethical Guidelines ◽  
Current State ◽  
Short And Long Term ◽  
Maternal Autonomy

Following decades of maltreatment of women in obstetric care, professional respect for maternal autonomy in obstetric decision making and care have become codified in global and national professional ethical guidelines. Yet, using the example of birth after cesarean, identifiable threats to maternal autonomy in obstetrics continue. This paper focuses on how current scientific knowledge and obstetric practice patterns factor into restricted maternal autonomy as evidenced in three representative maternal accounts obtained prior and subsequent to birth after cesarean. Short- and long-term remedies to improve the current state of restricted maternal autonomy in clinical practice surrounding decision making on birth after cesarean are provided.

First Things First: The Pressing Danger of Crisis Instability in U.S.-China Relations

2013 ◽  
Vol 37 (4) ◽  
pp. 49-89 ◽  
Author(s):  
Avery Goldstein
Keyword(s):  
United States ◽  
Cold War ◽  
The United States ◽  
Time Frame ◽  
Military Conflict ◽  
Current State ◽  
Near Term ◽  
Key Aspects ◽  
The Cold War

Since the mid-1990s, much has been written about the potentially disruptive impact of China if it emerges as a peer competitor challenging the United States. Not enough attention has been paid, however, to a more immediate danger—that the United States and a weaker China will find themselves locked in a crisis that could escalate to open military conflict. The long-term prospect for a new great power rivalry ultimately rests on uncertain forecasts about big shifts in national capabilities and debatable claims about the motivations of the two countries. By contrast, the danger of crisis instability involving these two nuclear-armed states is a tangible near-term concern. An analysis that examines the current state of U.S.-China relations and compares it with key aspects of U.S.-Soviet relations during the Cold War indicates that a serious Sino-American crisis may be more likely and more dangerous than expected. The capabilities each side possesses, and specific features of the most likely scenarios for U.S.-China crises, suggest reasons to worry that escalation pressures will exist and that they will be highest early in a crisis, compressing the time frame for diplomacy to avert military conflict.

751 Long-term benefit of a hospital based heart failure programme: downgrading the risk of class IV patients

2003 ◽  
Vol 2 (1) ◽  
pp. 161
Author(s):  
E RYAN ◽  
C OLOUGHLIN ◽  
M LEDWIDGE ◽  
B TRAVERS ◽  
M RYDER ◽  
...  
Keyword(s):  
Heart Failure ◽  
Term Benefit ◽  
Class Iv

CURRENT STATE AND DEVELOPMENT PERSPECTIVES OF THE CASPIAN SPRAT FISHERIES

2018 ◽  
pp. 69-75
Author(s):  
Tatiana Vasilievna Pomogaeva ◽  
Aliya Ahmetovna Aseinova ◽  
Yuriy Aleksandrovich Paritskiy ◽  
Vjacheslav Petrovich Razinkov
Keyword(s):  
Food Item ◽  
Growth Potential ◽  
North West ◽  
Marine Fishery ◽  
The North ◽  
Current State ◽  
West Part ◽  
Eggs And Larvae ◽  
Intensive Growth

The article presents annual statistical data of the Caspian Research Institute of Fishery. There has been kept track of the long term dynamics of the stocks of three species of Caspian sprat (anchovy, big-eyed kilka, sprat) and investigated a process of substituting a food item of sprats Eurytemora grimmi to a small-celled copepod species Acartia tonsa Dana. According to the research results, there has been determined growth potential of stocks of each species. Ctenophoran-Mnemiopsis has an adverse effect on sprat population by eating fish eggs and larvae. Ctenophoram - Mnemiopsis is a nutritional competitor to the full-grown fishes. The article gives recommendations on reclamation of stocks of the most perspective species - common sprat, whose biological characteristics helped not to suffer during Ctenophoram outburst and to increase its population during change of the main food item. Hydroacoustic survey data prove the intensive growth of common sprat biomass in the north-west part of the Middle Caspian. According to the results of the research it may be concluded that to realize the volumes of recommended sprat catch it is necessary to organize the marine fishery of common sprat at the Russian Middle Caspian shelf.

Challenges in Antenatal Corticosteroid Prescribing: A Retrospective Study

2020 ◽  
Vol 16 (4) ◽  
pp. 327-333
Author(s):  
Shannon Armstrong-Kempter ◽  
Lucinda Beech ◽  
Sarah J. Melov ◽  
Adrienne Kirby ◽  
Roshini Nayyar
Keyword(s):  
Retrospective Study ◽  
Obstetric Care ◽  
Patient Characteristics ◽  
Tertiary Hospital ◽  
Optimal Timing ◽  
Prescribing Practices ◽  
Antenatal Corticosteroids ◽  
Term Infants ◽  
Preterm Premature Rupture ◽  
To Receive

Background: The discovery of the benefits of antenatal corticosteroids (ACS) for preterm infants was one of the most significant developments in obstetric care. However, due to the difficulty in predicting preterm delivery, optimal use of ACS, is challenging. Objective: To describe prescribing practices for antenatal corticosteroids (ACS) at a tertiary hospital over five years to determine whether ACS were received at optimal timing; to determine patient characteristics of women receiving ACS at optimal timing; to determine patient characteristics of those who did not receive ACS as indicated and to examine the trend in ACS prescribing over the study period. Methods: We performed a retrospective study of all deliveries from January 2011 to December 2015. The rates of ACS prescription for each group of women (preterm, late preterm, and term) were recorded and analysed. Results: A total of 65% of women who delivered before 34 weeks’ gestation received ACS. Of these women, 63% delivered within 7 days of receiving ACS. Women most likely to receive ACS with optimal timing were primiparous (relative risk [RR], 1.25 [CI, 1.08-1.45]), or women diagnosed with pre-eclampsia (RR, 1.34 [CI 1.10-1.63]), preterm premature rupture of membranes (RR, 1.33 [CI, 1.15-1.54]) or threatened preterm labour (RR, 1.42 [CI, 1.22-1.65]). Conclusion: A significant number of women and babies are exposed to ACS without commensurate benefit, and a significant number who deliver preterm do not receive ACS. The percentage of preterm and term infants receiving ACS should be determined to optimise service delivery.

scholarly journals Depression following traumatic brain injury: a comprehensive overview

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Marc Fakhoury ◽  
Zaynab Shakkour ◽  
Firas Kobeissy ◽  
Nada Lawand
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Health Concern ◽  
First Year ◽  
Comprehensive Overview ◽  
Symptoms Of Depression ◽  
Current State ◽  
Post Traumatic ◽  
Brain Changes

Abstract Traumatic brain injury (TBI) represents a major health concern affecting the neuropsychological health; TBI is accompanied by drastic long-term adverse complications that can influence many aspects of the life of affected individuals. A substantial number of studies have shown that mood disorders, particularly depression, are the most frequent complications encountered in individuals with TBI. Post-traumatic depression (P-TD) is present in approximately 30% of individuals with TBI, with the majority of individuals experiencing symptoms of depression during the first year following head injury. To date, the mechanisms of P-TD are far from being fully understood, and effective treatments that completely halt this condition are still lacking. The aim of this review is to outline the current state of knowledge on the prevalence and risk factors of P-TD, to discuss the accompanying brain changes at the anatomical, molecular and functional levels, and to discuss current approaches used for the treatment of P-TD.

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