scholarly journals Microbiome and Gestational Diabetes: Interactions with Pregnancy Outcome and Long-Term Infant Health

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Caterina Neri ◽  
Erika Serafino ◽  
Maddalena Morlando ◽  
Alessandra Familiari
Keyword(s):  
Gestational Diabetes ◽  
Infant Health ◽  
Term Infant ◽  
Adverse Outcomes ◽  
Health Concern ◽  
Microbiota Composition ◽  
Long Term Outcomes ◽  
Microbial Composition ◽  
Maternal And Neonatal Outcomes

Microbiota composition is progressively being connected to different physiologic effects, such as glucose metabolism, and also to different pathologies, such as gestational diabetes mellitus (GDM). GDM is a public health concern that affects an important percentage of pregnancies and is correlated with many adverse maternal and neonatal outcomes. An increasing number of studies are showing some connections between specific microbial composition of the gut microbiota and development of GDM and adverse outcomes in mothers and neonates. The aim of this review is to analyze the available data on microbial changes that characterize healthy pregnancies and pregnancies complicated by GDM and to understand the correlation of these changes with adverse maternal outcomes; this review will also discuss the consequences of these maternal gut microbiome alterations on neonatal microbiota composition and neonatal long-term outcomes.

Short- and long-term outcomes of preterm spontaneous twin anemia-polycythemia sequence

2020 ◽  
Vol 48 (4) ◽  
pp. 329-334
Author(s):  
Soo Jin Han ◽  
Seung Mi Lee ◽  
Sohee Oh ◽  
Subeen Hong ◽  
Jeong Won Oh ◽  
...  
Keyword(s):  
Cord Blood ◽  
Neonatal Morbidity ◽  
Adverse Outcomes ◽  
Control Group ◽  
Long Term Outcomes ◽  
Neurodevelopmental Outcomes ◽  
Monochorionic Twin ◽  
Increased Risk ◽  
Study Population

AbstractBackgroundIn monochorionic twin pregnancy, placental anastomosis and inter-twin blood transfusion can result in specific complications, such as twin-twin transfusion syndrome (TTTS) and twin anemia-polycythemia sequence (TAPS). It is well established that adverse outcomes are increased in TTTS, but reports on the neonatal and long-term outcomes of TAPS are lacking. The objective of this study was to evaluate the neonatal and neurodevelopmental outcomes in spontaneous TAPS.MethodsThe study population consisted of monochorionic twin pregnancies with preterm birth (24–37 weeks of gestation) between November 2003 and December 2016 and in which cord blood was taken at the time of delivery. According to the result of hemoglobin in cord blood, the study population was divided into two groups: a spontaneous TAPS group and a control group. Neonatal and neurodevelopmental outcomes were compared between the two groups.ResultsDuring the study period, 11 cases were diagnosed as spontaneous TAPS (6.4%). The TAPS group had lower gestational age at delivery and had a higher risk for cesarean delivery. However, neonates with TAPS were not at an increased risk for neonatal mortality and significant neonatal morbidity. In addition, the frequency of severe cerebral lesion during the neonatal period and the risk of cerebral palsy at 2 years of age were not different between the two groups.ConclusionThe spontaneous TAPS diagnosed by postnatal diagnostic criteria was not associated with the increased risk of adverse neonatal and neurodevelopmental outcomes. Further studies are needed to evaluate the morbidity of antenatally diagnosed TAPS.

scholarly journals Abnormal Liver Function Tests and Long-Term Outcomes in Patients Discharged after Acute Heart Failure

2021 ◽  
Vol 10 (8) ◽  
pp. 1730
Author(s):  
Hiroshi Miyama ◽  
Yasuyuki Shiraishi ◽  
Shun Kohsaka ◽  
Ayumi Goda ◽  
Yosuke Nishihata ◽  
...  
Keyword(s):  
Heart Failure ◽  
Liver Function ◽  
Liver Function Tests ◽  
Abnormal Liver Function ◽  
Adverse Outcomes ◽  
Long Term Outcomes ◽  
Function Tests ◽  
Parameter Values

Abnormal liver function tests (LFTs) are known to be associated with impaired clinical outcomes in heart failure (HF) patients. However, this implication varies with each single LFT panel. We aim to evaluate the long-term outcomes of acute HF (AHF) patients by assessing multiple LFT panels in combination. From a prospective multicenter registry in Japan, 1158 AHF patients who were successfully discharged were analyzed (mean age, 73.9 ± 13.5 years; men, 58%). LFTs (i.e., total bilirubin, aspartate aminotransferase or alanine aminotransferase, and alkaline phosphatase) at discharge were assessed; borderline and abnormal LFTs were defined as 1 and ≥2 parameter values above the normal range, respectively. The primary endpoint was composite of all-cause death or HF readmission. At the time of discharge, 28.7% and 8.6% of patients showed borderline and abnormal LFTs, respectively. There were 196 (16.9%) deaths and 298 (25.7%) HF readmissions during a median 12.4-month follow-up period. The abnormal LFTs group had a significantly higher risk of experiencing the composite outcome (adjusted hazard ratio: 1.51, 95% confidence interval: 1.08–2.12, p = 0.017), whereas the borderline LFTs group was not associated with higher risk of adverse events when referenced to the normal LFTs group. Among AHF patients, the combined elevation of ≥2 LFT panels at discharge was associated with long-term adverse outcomes.

Infant Health Care and Long-Term Outcomes

2019 ◽  
Vol 101 (2) ◽  
pp. 341-354 ◽  
Author(s):  
Aline Bütikofer ◽  
Katrine V. Løken ◽  
Kjell G. Salvanes
Keyword(s):  
Health Care ◽  
Infant Health ◽  
Long Term Outcomes

scholarly journals Case of ventricular septal rupture following acute myocardial infarction

Ultrasound ◽  
2020 ◽  
Vol 28 (3) ◽  
pp. 196-201
Author(s):  
Natasha M Amorosi ◽  
Alison White
Keyword(s):  
Myocardial Infarction ◽  
Point Of Care ◽  
Initial Point ◽  
Signs And Symptoms ◽  
Adverse Outcomes ◽  
Point Of Care Ultrasound ◽  
Ventricular Septal Rupture ◽  
Long Term Outcomes

Ventricular septal rupture is a rare and potentially fatal complication of transmural myocardial infarction. Early identification utilising transthoracic echocardiography significantly improves long term outcomes in these patients. We report on a case of a 77-year-old male who presented with signs and symptoms of cardiac failure and a loud systolic murmur. The patient underwent an initial point-of-care ultrasound which revealed evidence of a transmural myocardial infarction and a high suspicion of an apical ventricular septal rupture. A complete transthoracic echocardiogram confirmed the septal rupture diagnosis and the patient subsequently underwent surgical repair of the ventricular rupture. This case highlights the role of echocardiography in decreasing adverse outcomes in patients with ventricular septal rupture.

Feeding of Low Birth Weight Neonates

2020 ◽  
Vol 34 (1-2) ◽  
pp. 28-51
Author(s):  
Nishanth Banait ◽  
Sriparna Basu ◽  
Prakash Desai ◽  
Sourabh Dutta ◽  
Ashok Kumar ◽  
...  
Keyword(s):  
Guideline Development ◽  
Adverse Outcomes ◽  
World Health ◽  
Long Term Outcomes ◽  
Infancy And Childhood ◽  
Recommendations For Practice ◽  
Health Organization ◽  
Practice Questions ◽  
Development Group

Nutrition in this critical period is essential for immediate outcomes such as changes in anthropometry (weight, length, and head circumference) as well as adverse effects like necrotizing enterocolitis. Nutrition also affects long-term adverse outcomes such as developmental delay, diplegic cerebral palsy, and death during infancy and childhood. This review has looked for the effects of nutrition in these areas. Further long-term outcomes like risk of adult onset diseases like myocardial infarction and stroke may also be related to the nutrition of the LBW neonate but have not been included in this review. The guideline has been developed using standard methods adapted by National Neonatology Forum in accordance with the process described in the World Health Organization handbook for guideline development. The detailed methods are described elsewhere in this compilation of guidelines. Table 1 summarizes the recommendations for practice questions prioritized by the guideline development group in consultation with a wider group of National Neonatology Forum members. The recommendations made by this group are summarized in Table 1 .

scholarly journals Postoperative atrial fibrillation: Target for stroke prevention?

2017 ◽  
Vol 2 (3) ◽  
pp. 222-228 ◽  
Author(s):  
Vincent Thijs ◽  
Robin Lemmens ◽  
Omar Farouque ◽  
Geoffrey Donnan ◽  
Hein Heidbuchel
Keyword(s):  
Atrial Fibrillation ◽  
Lifestyle Changes ◽  
Adverse Outcomes ◽  
Postoperative Atrial Fibrillation ◽  
Long Term Outcomes ◽  
Number Of Patients ◽  
History Of ◽  
Long Term Mortality

Purpose A substantial number of patients without a history of atrial fibrillation who undergo surgery develop one or more episodes of atrial fibrillation in the first few days after the operation. We studied whether postoperative transient atrial fibrillation is a risk factor for future atrial fibrillation, stroke and death. Method We performed a narrative review of the literature on epidemiology, mechanisms, risk of atrial fibrillation, stroke and death after postoperative atrial fibrillation. We reviewed antithrombotic guidelines on this topic and identified gaps in current management. Findings Patients with postoperative atrial fibrillation are at high risk of developing atrial fibrillation in the long term. Mortality is also increased. Most, but not all observational studies report a higher risk of stroke. The optimal antithrombotic regimen for patients with postoperative atrial fibrillation has not been defined. The role of lifestyle changes and of surgical occlusion of the left atrial appendage in preventing adverse outcomes after postoperative atrial fibrillation is not established. Conclusion Further studies are warranted to establish the optimal strategy to prevent adverse long-term outcomes after transient, postoperative atrial fibrillation.

scholarly journals Prevalence of Gestational Diabetes Mellitus, Maternal and Neonatal outcomes in a Peripheral Hospital in North India

2017 ◽  
Vol 5 (6) ◽  
pp. 2343 ◽  
Author(s):  
Naiyma Choudhary ◽  
Mohd Rasheed ◽  
Vivek Aggarwal
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Gestational Hypertension ◽  
Adverse Outcomes ◽  
Neonatal Outcomes ◽  
North India ◽  
Peripheral Hospital ◽  
Medical Entity ◽  
Maternal And Neonatal Outcomes

Background: Gestational diabetes mellitus (GDM) is a well-known medical entity which should be diagnosed at the earliest to prevent adverse maternal and neonatal outcomes due to hyperglycemia.Methods: This study was done in patients attending antenatal OPD in a peripheral hospital in North India. A total of 569 patients diagnosed as GDM were included in the study out of 6321 who attended the antenatal clinic.Results: The prevalence of gestational diabetes mellitus was found to be 9%. Gestational hypertension was seen in 29.35% of patients. The percent of babies who were admitted to NICU was 29.35%.Conclusions: These results stress the need for early detection and treatment of GDM to prevent adverse outcomes.

scholarly journals LO58: Long-term outcomes among emergency department syncope patients: a systematic review

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S27-S27
Author(s):  
C. Leafloor ◽  
P. Jiho Hong ◽  
L. Sikora ◽  
J. Elliot ◽  
M. Mukarram ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Phase 1 ◽  
Adverse Outcomes ◽  
Cochrane Central Register ◽  
Phase 2 ◽  
Long Term Outcomes ◽  
One Year

Introduction: Approximately 50% of patients discharged from the Emergency Department (ED) after syncope have no cause found. Long-term outcomes among syncope patients are not well studied, to guide physicians regarding outpatient testing and follow-up. The objective of this study was to conduct a systematic review for long-term (one year) outcomes among ED patients with syncope. We aim to use the results of this review to guide us in prospective analysis of one year outcomes with our large database of syncope patients. Methods: We searched Cochrane Central Register of Controlled Trials, Medline and Medline in Process, PubMed, Embase, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) from the inception to June, 2017. We included studies that reported long-term outcomes among adult ED patients (16 years or older) with syncope. We excluded studies on pediatric patients, and studies that included syncope mimickers: pre-syncope, seizure, intoxication, loss of consciousness after head trauma. We also excluded case reports, letters to the editor and review articles. Outcomes included death, syncope recurrence requiring hospitalization, arrhythmias and procedural interventions for arrhythmias. We selected articles based on title and abstract review during phase-1 and conducted full article review during phase-2. Meta-analysis was performed by pooling the outcomes using random effects model (RevMan v.5.3; Cochrane Collaboration). Results: Initial literature search generated 2094 articles after duplicate removal. 50 articles remained after phase-1 (=0.85) and 16 articles were included in the systematic review after phase-2 (=0.86). The 16 included studies enrolled a total of 44,755 patients. Pooled analysis at 1-year follow-up showed the following outcomes: 7% mortality; 14% recurrence of syncope requiring hospitalization; one study reported that 0.6% of patients had a pacemaker inserted; and two studies reported 0.8 11.5% of patients suffered new arrhythmias. Conclusion: An important proportion of ED patients with syncope suffer outcomes at 1-year. Appropriate follow-up is needed to prevent long-term adverse outcomes. Further prospective research to identify patients at risk for long-term important cardiac outcomes and death is needed.

scholarly journals Diabetes in Pregnancy and MicroRNAs: Promises and Limitations in Their Clinical Application

2018 ◽  
Vol 4 (4) ◽  
pp. 32 ◽  
Author(s):  
Adriana Ibarra ◽  
Begoña Vega-Guedes ◽  
Yeray Brito-Casillas ◽  
Ana Wägner
Keyword(s):  
Gestational Diabetes ◽  
Maternal Diabetes ◽  
Long Term Outcomes ◽  
Pregnant Rats ◽  
Diagnostic Biomarkers ◽  
Obesity And Diabetes ◽  
Increased Risk ◽  
Short And Long Term

Maternal diabetes is associated with an increased risk of complications for the mother and her offspring. The latter have an increased risk of foetal macrosomia, hypoglycaemia, respiratory distress syndrome, preterm delivery, malformations and mortality but also of life-long development of obesity and diabetes. Epigenetics have been proposed as an explanation for this long-term risk, and microRNAs (miRNAs) may play a role, both in short- and long-term outcomes. Gestation is associated with increasing maternal insulin resistance, as well as β-cell expansion, to account for the increased insulin needs and studies performed in pregnant rats support a role of miRNAs in this expansion. Furthermore, several miRNAs are involved in pancreatic embryonic development. On the other hand, maternal diabetes is associated with changes in miRNA both in maternal and in foetal tissues. This review aims to summarise the existing knowledge on miRNAs in gestational and pre-gestational diabetes, both as diagnostic biomarkers and as mechanistic players, in the development of gestational diabetes itself and also of short- and long-term complications for the mother and her offspring.

BIOCHEMICAL PREDICTORS OF EARLY AND LONG-TERM OUTCOMES OF TRAUMATIC BRAIN INJURY IN CHILDREN

2021 ◽  
Author(s):  
Elena Sorokina ◽  
◽  
Zhanna Semenova ◽  
Valery Ivanovich Lukianov ◽  
Olga Karaseva ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Blood Serum ◽  
Glutamate Receptors ◽  
Severe Traumatic Brain Injury ◽  
Adverse Outcomes ◽  
Long Term Outcomes ◽  
Damage Repair

In children with mild and severe traumatic brain injury (TBI), the role of various damage/repair neuromarkers in the outcomes of trauma was studied. It has been shown that in the first days after TBI with adverse outcomes, there was a significant increase in NSE, S100b, NO products and a decrease in the content of BDNF and autoantibodies to NMDA (NR2) glutamate receptors (Glu) in the blood serum. After 6 months with unfavorable outcomes, there was an increase in aAb to S100b and a decrease in BDNF.

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