scholarly journals Twinning rate in a sample from a Brazilian hospital with a high standard of reproductive care

2001 ◽  
Vol 119 (6) ◽  
pp. 216-219 ◽  
Author(s):  
Gloria Maria Duccini Dal Colletto ◽  
Conceição Aparecida de Mattos Segre ◽  
Bernardo Beiguelman
Keyword(s):  
High Frequency ◽  
Maternal Age ◽  
Private Hospital ◽  
High Standard ◽  
Southeastern Brazil ◽  
Increased Risk ◽  
The Mean ◽  
Very High ◽  
Assisted Fertilization

CONTEXT: Epidemiological studies on twin births have been motivated mostly by the positive correlation between twinning rate and human fertility, prematurity, low birth weight, increased risk of infant death and long term risk for morbidity. OBJECTIVE: This paper intends to estimate the incidence of multiple births in a private hospital in Brazil with a high standard of reproductive care, and to evaluate the effects of maternal age, gestation order and assisted fertilization on twinning rate. DESIGN: Retrospective analysis. SETTING: First-class tertiary private hospital, São Paulo, Brazil. PARTICIPANTS: The multiple birth rate was investigated among 7,997 deliveries from 1995 to 1998, including 7,786 singletons, 193 twins, 17 triplets and one quadruplet. RESULTS: The rates per 1,000 dizygotic and monozygotic pairs and for triplets were estimated as 19.51, 4.50 and 2.13, respectively. The dizygotic and triplet rates were the highest observed in Brazil up to the present day. The twinning rate among primigravidae older than 30 years was very high (45.02 per 1,000) and was due to a disproportionately high frequency of dizygotic pairs. The triplet rate was also very high among the mothers of this age group (5.71 per 1,000). These facts are strong indicators that these women were the ones most frequently submitted to assisted reproductive techniques. The mean maternal age of the studied population was about six years higher than that estimated for mothers in the general population of southeastern Brazil. Primigravidae aged under 30 years as well as multigravidae showed similar twinning rates, which were almost 20 per 1,000. Among the deliveries of multigravidae older than 30 years, an unusually high frequency of monozygotic twins was observed (7.04 per 1,000), probably as a consequence of the residual effect of long-term use of oral contraceptives. CONCLUSIONS: The dizygotic twinning rate increased from 13.51 to 28.98 per 1,000 over the four years studied, with the twinning rate for primigravidae over 30 years old in 1998 being twice that observed in 1995. The mean maternal age was also high during this period, but the extremely high increase in twinning rate observed cannot be attributed solely to this variable. Assisted fertilization seems to be the most probable cause of this unusually high twinning rate.

scholarly journals Neurological Development and Iron Supplementation in Healthy Late-Preterm Neonates: A Randomized Double-Blind Controlled Trial

2021 ◽  
Author(s):  
Rita Luciano ◽  
Domenico Marco Romeo ◽  
Giuseppina Mancini ◽  
Serena Sivo ◽  
Carolina Dolci ◽  
...  
Keyword(s):  
Placebo Group ◽  
Iron Supplementation ◽  
Controlled Trial ◽  
Preterm Neonates ◽  
Neurological Development ◽  
Double Blind ◽  
Neurological Outcomes ◽  
Increased Risk ◽  
The Mean

Abstract ObjectiveLate-preterm infants (LPT) are at increased risk for long-term neurodevelopmental sequelaeand iron deficiency. Aim of the study is to assess the positive effect of iron supplementation on neurological development in healthy LPT.DesignWe designed a perspective, randomized placebo-controlled double-blind trial. The newborns were randomized in two groups: thirty-three patients received martial prophylaxis, thirty-three placebo. Every patient was assessed using the Griffith Mental Development Scales (GMDS)-II edition at 12 months of post-conceptional age.SettingThe study was performed at the Neonatology Unit of Fondazione Policlinico Gemelli IRCCS.PatientsSixty-six healthy LPT infants born between 340⁄7 and 366⁄7 weeks of Gestational Age were enrolled in the study.InterventionsOne group received martial prophylaxis from the third week of life to six months of post-conceptional age (2 mg/kg/day of iron pidolate), the other received placebo.Main outcome measuresFifty-two of the enrolled infants were assessed using the GMDS at 12-month of post-conceptional age. Statistical analysis of the mean scores of the Griffith subscales was performed.ResultsThere was a difference in the mean Developmental Quotient (DQ) (p<0.01) between the two groups: Iron Group mean DQ 121.45+10.53 vs Placebo Group mean DQ 113.25+9.70. Moreover, mean scores of the Griffith subscales A, B and D showed significant differences between the two Groups (scale A p<0.05, scale B p<0.02, scale D p<0.01 respectively).ConclusionsOur data show that newborns who received iron supplementation during the first six months of life achieved significantly better neurological outcomes at GMDS than Placebo group.

Prevalence of Musculoskeletal Disorders in Professional Symphony Orchestra Musicians in Greece: A Pilot Study Concerning Age, Gender, and Instrument-Specific Results

2013 ◽  
Vol 28 (2) ◽  
pp. 91-95 ◽  
Author(s):  
Dimosthenis G Fotiadis ◽  
Eleni G Fotiadou ◽  
Dimitrios G Kokaridas ◽  
Argyrios C Mylonas
Keyword(s):  
Pilot Study ◽  
Musculoskeletal Disorders ◽  
High Frequency ◽  
Musculoskeletal Disorder ◽  
Symphony Orchestra ◽  
Prevention Programs ◽  
Previous Experience ◽  
Professional Career ◽  
The Mean ◽  
Very High

This study was designed to investigate the frequency of musculoskeletal disorders among musicians in a professional-level symphony orchestra in Greece. The sample consisted of 147 musicians (97 men, 50 women) of the Athens and Thessaloniki State Symphony Orchestra. The mean age of the musicians was 38.97 years (range 24 to 67, SD 9.68), while the years of experience in the orchestra ranged from 1 to 35 (mean 14.2, SD 8.47). The data were collected with the Standardized Nordic Questionnaire, which records the frequency of musculoskeletal disorders. Our results showed a very high percentage (81.6%) of the musicians had suffered at least once, during their professional career, some kind of musculoskeletal disorder that was associated with pain or discomfort and was directly related to their profession. More than two-thirds of the musicians had also suffered a problem in the hand and neck areas during the last 12 months. Musculoskeletal disorders appeared to be related to gender, age, kind of instrument played, and duration of rehearsing/performing, along with previous experience. In summary, there is a high frequency of injury among professional-level musicians in Greece reported in our study, highlighting the obvious need to develop prevention programs.

Calciphylaxis: The Beginning of the End?

2008 ◽  
Vol 28 (3) ◽  
pp. 268-270 ◽  
Author(s):  
Adrian Fine ◽  
Bunny Fontaine
Keyword(s):  
High Frequency ◽  
Response To Therapy ◽  
Ionized Calcium ◽  
Calcium Salts ◽  
Early Improvement ◽  
Time Period ◽  
High Incidence ◽  
Yearly Incidence ◽  
The Mean ◽  
Very High

Background We previously reported a very high incidence of calciphylaxis, mainly in peritoneal dialysis (PD) patients. Although we identified several risk factors for the condition, including PD, we were unable to identify why our particular unit had such a high frequency of the condition and a reliable treatment. Objectives To assess the apparent changing frequency of the condition and the response to therapy, and to attempt to determine putative factors that might explain our uniquely high incidence of calciphylaxis. Methods A prospective clinical record was kept on all patients that developed calciphylaxis in our center [both PD and hemodialysis (HD) units] between 1998 and 2006. Results Of the 59 patients that developed calciphylaxis, 54 were on PD, 4 were on HD, and 1 was in predialysis. In the PD population, the mean yearly incidence from 1998 to 2003 was 4.5/100 patient-years, falling to 1.3/100 patient-years in 2004 – 2006. The percent of patients not taking calcium salts fell during this time period. Conversion to HD led to marked early improvement. A marked discrepancy between the levels of ionized calcium (routinely used in our center) and corrected serum calcium was found, with most cases of hypercalcemia (corrected) being missed by using ionized values. Conclusions The incidence of calciphylaxis is falling dramatically. This may be related partially to reduction in usage of calcium salts. Conversion to HD is beneficial. Our uniquely high incidence of calciphylaxis may be related to our use of ionized calcium levels to monitor these patients.

Advanced maternal age and the impact on maternal and offspring cardiovascular health

2019 ◽  
Vol 317 (2) ◽  
pp. H387-H394 ◽  
Author(s):  
Christy-Lynn M. Cooke ◽  
Sandra T. Davidge
Keyword(s):  
Cardiovascular Disease ◽  
Maternal Age ◽  
Cardiovascular Health ◽  
Advanced Maternal Age ◽  
Limited Information ◽  
In Utero Environment ◽  
Increased Risk ◽  
Health And Disease ◽  
The Impact

Delaying pregnancy, which is on the rise, may increase the risk of cardiovascular disease in both women and their children. The physiological mechanisms that lead to these effects are not fully understood but may involve inadequate adaptations of the maternal cardiovascular system to pregnancy. Indeed, there is abundant evidence in the literature that a fetus developing in a suboptimal in utero environment (such as in pregnancies complicated by fetal growth restriction, preterm birth, and/or preeclampsia) is at an increased risk of cardiovascular disease in adulthood, the developmental origins of health and disease theory. Although women of advanced age are at a significantly increased risk of pregnancy complications, there is limited information as to whether advanced maternal age constitutes an added stressor on the prenatal environment of the fetus, and whether or not this is secondary to impaired cardiovascular function during pregnancy. This review summarizes the current literature available on the impact of advanced maternal age on cardiovascular adaptations to pregnancy and the role of maternal age on long-term health risks for both the mother and offspring.

scholarly journals Risks of Skin, Hair, and Nail Supplements

2020 ◽  
pp. e2020089
Author(s):  
Emily K. Burns ◽  
Ariadna Perez-Sanchez ◽  
Rajani Katta
Keyword(s):  
Allergic Reactions ◽  
Post Marketing Surveillance ◽  
Increased Risk ◽  
Surveillance Programs ◽  
Post Marketing ◽  
Potential Risks ◽  
High Doses ◽  
Risk Of Cancer ◽  
Very High

Skin, hair, and nail supplements, sometimes referred to as “beauty supplements” or “ingestible skin care”, are a large and growing industry. These products may contain vitamins and minerals, sometimes in very high doses. They may also contain herbs, hormones, microbes, or animal derivatives such as fish oils and collagen powders. Dietary supplements are regulated as foods, not drugs, by the U.S. Food and Drug Administration. Therefore, manufacturers do not need to provide any proof of safety, efficacy, or quality prior to sale. This is of serious concern, as many adverse effects due to supplement components have been reported. The potential risks cover multiple categories. These include acute toxicities such as choking, as well as chronic toxicities, such as increased risk of diabetes. Teratogenicity and interaction with drugs and laboratory testing have been documented in research studies. Other risks include potentially increased risk of cancer with long-term use, allergic reactions, and others. It is vital that physicians educate their patients on these risks. As no post-marketing surveillance programs are required for supplements, our understanding of supplement risks is incomplete. Physicians should be wary of these risks and encourage further research and regulation.

scholarly journals Safety of Construction Components in a Very High Number of Load Cycles

2020 ◽  
Vol 2 (1) ◽  
pp. 199-206
Author(s):  
František Nový ◽  
Juraj Belan ◽  
Otakar Bokůvka
Keyword(s):  
Fatigue Resistance ◽  
High Frequency ◽  
Asymmetry Parameter ◽  
High Strength ◽  
Cyclic Stress ◽  
Average Value ◽  
Safety And Reliability ◽  
Important Position ◽  
Very High

AbstractProgressive, high-strength materials have an important position in the transport industry. In this industry, components are subject to high safety and reliability requirements because they often operate under long-term cyclic stress regimes. The paper presents results of fatigue resistance of high-strength materials such DOMEX 700MC, HARDOX 400, HARDOX 450, and INCONEL 718 (UTS from 850 to 1560 MPa) measured at high-frequency cyclic loading (f = 20 kHz, T = 20 ± 5 ° C, push-pull loading, cycle asymmetry parameter of R = -1) in the area from N = 2x106 to N = 2x108 cycles. Fatigue resistance showed a continuous decrease about average value Sa 2x108/Sa 2x106 = 19.1%.

Long-term effects on renal function and blood pressure of treatment with cisplatin, vinblastine, and bleomycin in patients with germ cell cancer.

1988 ◽  
Vol 6 (11) ◽  
pp. 1728-1731 ◽  
Author(s):  
S W Hansen ◽  
S Groth ◽  
G Daugaard ◽  
N Rossing ◽  
M Rørth
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Germ Cell ◽  
Cell Cancer ◽  
Germ Cell Cancer ◽  
Long Term Effects ◽  
Increased Risk ◽  
The Mean

Long-term effects of cisplatin on renal function were investigated in 34 patients with germ cell cancer observed for a median of 65 months (range, 43 to 97 months). All patients achieved a complete remission after treatment with cisplatin (median dose 583 mg/m2), vinblastine, and bleomycin. None of the patients relapsed during follow-up. During treatment the glomerular filtration rate (GFR) decreased by 18% (P less than .05). During follow-up kidney function recovered in ten patients and partly improved in eight patients. Changes in plasma creatinine did not consistently correspond to alterations in GFR. The mean increase in systolic blood pressure during follow-up did not differ from the increase seen in a group of age-matched healthy men. The mean increase in diastolic pressure, however, was significant (P less than .05), but was entirely due to hypertension observed in six patients. Renography of these patients was normal. We conclude that the decrease in GFR observed during treatment with cisplatin is partly reversible. Cisplatin-treated patients have an increased risk of developing hypertension years after treatment.

Retethering risk in pediatric spinal lipoma of the conus medullaris

2021 ◽  
pp. 1-8
Author(s):  
Toshiaki Hayashi ◽  
Tomomi Kimiwada ◽  
Reizo Shirane ◽  
Teiji Tominaga
Keyword(s):  
Risk Factors ◽  
Growth Rate ◽  
Pediatric Patients ◽  
Conus Medullaris ◽  
Increased Risk ◽  
Long Term Follow Up ◽  
The Mean ◽  
Untethering Surgery

OBJECTIVE Lipoma of the conus medullaris (LCM) causes neurological symptoms known as tethered cord syndrome (TCS). The symptoms can be seen at diagnosis and during long-term follow-up. In this report, pediatric patients with LCMs who underwent untethering surgery, under the policy of performing surgery if diagnosed regardless of symptoms, were retrospectively reviewed to evaluate long-term surgical outcomes. Possible risk factors for retethered cord syndrome (ReTCS) were evaluated in the long-term follow-up period. METHODS A total of 51 consecutive pediatric patients with LCMs who underwent a first untethering surgery and were followed for > 100 months were retrospectively analyzed. The surgery was performed with the partial removal technique. Pre- and postoperative clinical and radiological data were reviewed to analyze the outcomes of surgery and identify potential risk factors for ReTCS. RESULTS During follow-up, 12 patients experienced neurological deterioration due to ReTCS. The overall 10-year and 15-year progression-free survival rates were 82.3% and 75.1%, respectively. On univariate analysis, a lipoma type of lipomyelomeningocele (OR 11, 95% CI 2.50–48.4; p = 0.0014), patient age at the time of surgery (OR 0.41, 95% CI 0.14–1.18; p = 0.0070), and the mean patient growth rate after surgery (OR 2.00, 95% CI 1.12–3.41; p = 0.0040) were significant factors associated with ReTCS. Cox proportional hazard models showed that a lipoma type of lipomyelomeningocele (HR 5.16, 95% CI 1.54–20.1; p = 0.010) and the mean growth rate after surgery (HR 1.88, 95% CI 1.00–3.50; p = 0.040) were significantly associated with the occurrence of ReTCS. CONCLUSIONS More complex lesions and a high patient growth rate after surgery seemed to indicate increased risk of ReTCS. Larger prospective studies and registries are needed to define the risks of ReTCS more adequately.

scholarly journals Can We Predict Preterm Delivery Based on the Previous Pregnancy?

2021 ◽  
Vol 10 (7) ◽  
pp. 1517
Author(s):  
Tamar Wainstock ◽  
Ruslan Sergienko ◽  
Eyal Sheiner
Keyword(s):  
Risk Factors ◽  
Pregnancy Complications ◽  
Maternal Age ◽  
Population Based ◽  
Subsequent Pregnancy ◽  
Interpregnancy Interval ◽  
Multivariable Logistic Regression Model ◽  
Increased Risk ◽  
Nested Case Control

(1) Background: Preterm deliveries (PTD, <37 gestational weeks) which occur in 5–18% of deliveries across the world, are associated with immediate and long-term offspring morbidity, as well as high costs to health systems. Our aim was to identify risk factors during the first pregnancy ending at term for PTD in the subsequent pregnancy. (2) Methods: A retrospective population- based nested case−control study was conducted, including all women with two first singleton consecutive deliveries. Women with PTD in the first pregnancy were excluded. Characteristics and complications of the first pregnancy were compared among cases, defined as women with PTD in their second pregnancy, and the controls, defined as women delivering at term in their second pregnancy. A multivariable logistic regression model was used to study the association between pregnancy complications (in the first pregnancy) and PTD (in the subsequent pregnancy), while adjusting for maternal age and the interpregnancy interval. (3) Results: A total of 39,780 women were included in the study, 5.2% (n = 2088) had PTD in their second pregnancy. Women with PTD, as compared to controls (i.e., delivered at term in second pregnancy), were more likely to have the following complications in their first pregnancy: perinatal mortality (0.4% vs. 1.0%), small for gestational age (12.4% vs. 8.1%), and preeclampsia (7.6% vs. 5.7%). In the multivariable model, after adjusting for maternal age, interpregnancy interval and co-morbidities, having any one of these first pregnancy complications was independently associated with an increased risk for PTD (adjusted OR = 1.44; 95%CI 1.28–1.62), and the risk was greater if two or more complications were diagnosed (adjusted OR = 2.09; 95%CI 1.47–3.00). These complications were also risk factors for early PTD (<34 gestational weeks), PTD with a systematic infectious disease in the background, and possibly with spontaneous PTD. (4) Conclusions: First pregnancy complications are associated with an increased risk for PTD in the subsequent pregnancy. First pregnancy, although ending at term, may serve as a window of opportunity to identify women at risk for future PTD.

Effects of Very High Free-Stream Turbulence on the Jet–Mainstream Interaction in a Film Cooling Flow

1998 ◽  
Vol 120 (4) ◽  
pp. 785-790 ◽  
Author(s):  
A. Kohli ◽  
D. G. Bogard
Keyword(s):  
High Frequency ◽  
Film Cooling ◽  
Thermal Field ◽  
Free Stream ◽  
Complex Interaction ◽  
Free Stream Turbulence ◽  
High Frequency Response ◽  
Cooling Flow ◽  
The Mean ◽  
Very High

Dispersion of coolant jets in a film cooling flow field is the result of a highly complex interaction between the film cooling jets and the mainstream. Understanding this complex interaction, particularly near the injection location, is critical for improving the predictive capabilities of existing film cooling models, especially when very high free-stream turbulence levels exist. This study uses a high-Frequency-response temperature sensor to investigate the mean and fluctuating thermal field of a film cooling flow for two vastly different free-stream turbulence levels (0.5 and 20 percent). The high-frequency-response temperature sensor provides new information about the film cooling flow in terms of actual rms levels (Θ′), probability density functions (pdf’s), and frequency spectra of the thermal field. Results are presented for both free-stream conditions using round hosed inclined at 35 deg, at a momentum flux ration of I = 0.156 and density ratio of DR = 1.05. The mean thermal field results show severe degradation of the film cooling jet occurs with very high free-stream turbulence levels. Temperature rms results indicate levels as high as Θ′ = 0.25 exist at the jet-mainstream interface. More information is provided by the temperature pdf’s, which are able to identify differences in the jet-mainstream interaction for the two free stream conditions. With small free-stream turbulence, strong intermittent flow structures generated at the jet-mainstream interface disperse the jet by moving hot main stream fluid into the coolant core, and ejecting coolant fluid into the mainstream. When the free stream has large scales and very high turbulence levels, the jet-mainstream interface is obliterated by large-scale turbulent structures originating from the free stream, which completely penetrate the coolant jet, causing very rapid dispersion of the film cooling jet.

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