Antenatal findings and early postnatal outcomes in pregnancies with trisomy 21: a 10-year retrospective review at a tertiary centre

Objective To examine the antenatal imaging features, intrapartum findings and early postpartum course of pregnancies with trisomy 21 (T21). Design Ten-year retrospective review Setting A tertiary hospital in the United Kingdom Population Women with a pregnancy affected by T21, who did not have a termination. Methods Women with pregnancies diagnosed with T21 on: antenatal karyotyping; karyotyping of post-mortem tissue and postnatal karyotype samples, from February 2010-2020. Main Outcome Measures Antenatal imaging findings, fetal growth restriction (FGR), birthweight, mode of delivery, and early neonatal outcomes. Results Seventy-six women with a fetus affected by T21 were identified. There were 6 intrauterine deaths, and 70 livebirths. Thirty-eight (50%) had an antenatal diagnosis and twenty-five (33%) had a suspected diagnosis but declined further testing. The diagnosis was unanticipated in 13 (17%). Cardiac anomalies (n=27) were the most common antenatal anomaly. Doppler abnormalities were apparent in 48/73 (68%). Eighteen (25.7%) had ultrasound evidence of FGR. The majority delivered by Caesarean section, and 21.4% of babies weighed below the 3rd percentile at delivery. Fifty-eight (82%) were admitted to the neonatal unit. Forty-three (61%) required respiratory support and fifty-five (78%) either needed naso-gastric feeding or were nil by mouth. Mean PAPP-A values were significantly lower in cases with abnormal Dopplers, FGR, congenital anomalies and with a birthweight below the 10th percentile. Conclusions Fetuses with T21 have high rates of placental insufficiency. FGR and Doppler abnormalities are common. Postnatally, the majority will require respiratory and feeding support. Antenatal counselling and protocols should reflect these risks. Funding None

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Care processes and intermediate outcomes among patients with diabetes mellitus in a tertiary hospital in Southwestern Nigeria: A retrospective review of records

Endocrine Abstracts ◽

10.1530/endoabs.50.p214 ◽

2017 ◽

Author(s):

Oyindamola Awofisoye ◽

Akinola Onasanya ◽

Arinola Esan ◽

Obioma Uchendu

Keyword(s):

Diabetes Mellitus ◽

Retrospective Review ◽

Tertiary Hospital ◽

Southwestern Nigeria ◽

Care Processes ◽

Intermediate Outcomes ◽

Patients With Diabetes

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Causes of delayed exploration of the acute scrotum in a regional tertiary centre

Journal of Clinical Urology ◽

10.1177/2051415820981196 ◽

2020 ◽

pp. 205141582098119

Author(s):

Benjamin Storey ◽

Nathan Shugg ◽

Alison Blatt

Keyword(s):

Retrospective Review ◽

Testicular Torsion ◽

Tertiary Hospital ◽

Adverse Outcomes ◽

Acute Scrotum ◽

Tertiary Institution ◽

Level Of Evidence ◽

Scrotal Pain ◽

Surgical Exploration ◽

Significant Difference

Background: Testicular torsion is an organ-threatening surgical emergency with a limited timeframe for intervention. Objective: To identify the delays to surgical exploration of patients with an acute scrotum in a tertiary hospital to prevent adverse outcomes associated with this time critical emergency. Methods: A retrospective review of medical records for all patients who underwent scrotal exploration for acute scrotal pain in a tertiary hospital in regional New South Wales between January 2008 to December 2018 was performed. Results: Retrospective review identified 242 patients, of whom 161 had testicular torsion and 56 resultant orchidectomies. No statistically significant difference in pre-hospital delays between paediatric or adult populations was found. The average time from presentation to theatre was 4 h 36 min. Patients who were delayed > 6 h from presentation to surgical exploration had significantly increased rates of orchidectomy. Delays that significantly affected rates of orchidectomy were transfer from peripheral sites, late presentation, misdiagnosis and representation after discharge. Conclusion: The most common reason for delay was diagnostic error with the patient later re-presenting to hospital. Patient transfer from the primary hospital to a tertiary institution and subsequent delayed surgical exploration also contributed to significantly higher rates of orchidectomy. Level of Evidence: 3

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Re-assessing the total burden of norovirus circulating in the United Kingdom population

Vaccine ◽

10.1016/j.vaccine.2017.01.009 ◽

2017 ◽

Vol 35 (6) ◽

pp. 853-855 ◽

Cited By ~ 15

Author(s):

John P. Harris ◽

Miren Iturriza-Gomara ◽

Sarah J. O'Brien

Keyword(s):

United Kingdom ◽

United Kingdom Population ◽

The United Kingdom ◽

Total Burden

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Efficacy and Safety of Foley Catheter Balloon for Cervix Priming in Term Pregnancy

Acta Médica Portuguesa ◽

10.20344/amp.8003 ◽

2017 ◽

Vol 30 (4) ◽

pp. 281 ◽

Cited By ~ 2

Author(s):

Catarina Policiano ◽

Mariana Pimenta ◽

Diana Martins ◽

Nuno Clode

Keyword(s):

Foley Catheter ◽

Mode Of Delivery ◽

Tertiary Hospital ◽

Mechanical Effect ◽

Induction Of Labor ◽

Catheter Removal ◽

Bishop Score ◽

Delivery Time ◽

Singleton Pregnancy ◽

Previous Cesarean

Introduction: Foley catheter promotes cervix priming by a direct mechanical effect of distension.Material and Methods: A prospective observational study was conducted at a tertiary hospital, including all cases of induction of labor with Foley catheter between September 1, 2013 and November 30, 2015. Women were eligible if they had a singleton pregnancy with a Bishop score < 6 and a gestational age ≥ 41 weeks or a medical indication for induction of labor. The primary outcome was the Bishop score variation (difference between Bishop score before and after insertion of Foley catheter). Mode of delivery, induction-to-delivery time, uterine tachysystole with fetal decelerations, peripartum fever ≥ 38º C, maternal pain and mortality were also analyzed.Results: Within 201 inductions with Foley catheter, average increase in Bishop score after catheter placement was three (1 - 7), with only 5% (11/201) of unmodified cervix after catheter removal/extrusion. Vaginal delivery rate was 71% (142/201) and in women with a previous cesarean section (n = 40) was 37% (15/40). Average induction-to-delivery time was 38 hours (4 - 120). Uterine infection rate was 3% (6/201). There was only one case of significant vaginal bleeding which required immediate catheter removal. There has been no significative maternal or neonatal morbidity.Discussion/Conclusion: Foley catheter is a safe and effective method of cervical priming for women with an unfavorable cervix, even in the case of a previous cesarean delivery.

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A prospective cohort study on lactation status and breastfeeding challenges in mothers giving birth to preterm infants

International Breastfeeding Journal ◽

10.1186/s13006-021-00447-4 ◽

2022 ◽

Vol 17 (1) ◽

Author(s):

Dingding Dong ◽

Xifang Ru ◽

Xiaofang Huang ◽

Tian Sang ◽

Shan Li ◽

...

Keyword(s):

Logistic Regression ◽

Preterm Infants ◽

Multivariate Logistic Regression Analysis ◽

Tertiary Hospital ◽

Post Discharge ◽

Milk Output ◽

Early Postpartum ◽

Milk Volume ◽

Mothers Of Preterm Infants ◽

Mother’S Own Milk

Abstract Background Mothers of preterm infants face many challenges in breastfeeding, especially regarding lactation. This study aimed to investigate the lactation status and challenges in breastfeeding faced by preterm infants’ mothers. Methods We approached 124 mothers who gave birth to preterm infants between 26 May and 31 October 2018 in a tertiary hospital in China. Lactation status and challenges in breastfeeding on day 7 postpartum, at discharge of infants, 2 weeks post-discharge, and 3 months of corrected age were collected using questionnaires. The area under the receiver operating characteristic (ROC) curve for expressed milk volume on day 7 postpartum for predicting expressed milk volume ≥ 300 mL/d at discharge was calculated. Logistic regression analyses were performed to identify factors associated with delayed lactogenesis II onset and continuation of breastfeeding at 3 months of corrected age. Results Seventy mothers were enrolled, and 51.4% had delayed lactogenesis II. Multivariate logistic regression analysis revealed that older maternal age (aOR = 1.19; 95% CI: 1.01, 1.40) and first live birth (aOR = 4.81; 95% CI 1.43, 16.18) were significant independent predictors of delayed lactogenesis II. Mothers with delayed lactogenesis II had significantly lower expressed milk volume (day 7 postpartum: 160.0 mL vs. 300.0 mL, U = 328.50, p = 0.001; at discharge: 425.0 mL vs. 612.5 mL, U = 372.00, p = 0.005), with a lower proportion of exclusive breastfeeding in their infants (at discharge: 33.3% vs. 69.8%, χ2 = 12.39, df = 1, p < 0.001; 3 months of corrected age: 17.8% vs. 52.8%, χ2 = 11.03, df = 1, p = 0.001). The ROC showed that expressed milk volume > 190 mL/d on day 7 postpartum significantly predicted expressed milk volume ≥ 300 mL/d at discharge. Insufficient human milk was the main reason for breastfeeding discontinuation at 3 months of corrected age. Twins were less likely to continue breastfeeding at 3 months of corrected age (aOR = 0.27; 95% CI 0.09, 0.86). In singleton infants, mother’s own milk ≥50% of total milk uptake at 2 weeks post-discharge (aOR = 32.66; 95% CI 3.00, 355.25) was an independent predictor of continuous breastfeeding at 3 months of corrected age. Feeding complications in infants, poor breastfeeding technique, and low milk output are the main challenges in breastfeeding. Conclusion Interventions to improve early postpartum lactation and breastfeeding techniques may increase breastfeeding adoption in mothers of preterm infants.

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Ten-year experiences with Tetanus at a Tertiary hospital in Northwestern Tanzania: A retrospective review of 102 cases

World Journal of Emergency Surgery ◽

10.1186/1749-7922-6-20 ◽

2011 ◽

Vol 6 (1) ◽

pp. 20 ◽

Cited By ~ 18

Author(s):

Phillipo L Chalya ◽

Joseph B Mabula ◽

Ramesh M Dass ◽

Nkinda Mbelenge ◽

Stephen E Mshana ◽

...

Keyword(s):

Retrospective Review ◽

Tertiary Hospital ◽

Northwestern Tanzania

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Allergy

Oxford Textbook of Medicine ◽

10.1093/med/9780199204854.003.0503 ◽

2010 ◽

pp. 258-266 ◽

Cited By ~ 1

Author(s):

Pamela Ewan

Keyword(s):

United Kingdom ◽

Allergic Disease ◽

Environmental Changes ◽

United Kingdom Population ◽

The United Kingdom ◽

Diagnostic Agents ◽

Allergic Disorders

Allergy is common and becoming commoner: it now affects about one-third of the United Kingdom population. This is being driven by environmental changes, which are also leading to an increase in both the complexity and severity of the condition. In addition to the traditional allergic disorders—asthma, rhinitis, and eczema—multisystem allergic disease and reactivity to several allergens are now common; new allergies have appeared, including those due to foods, drugs, and diagnostic agents; and anaphylaxis is increasing....

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Deepfakes and Disinformation: Exploring the Impact of Synthetic Political Video on Deception, Uncertainty, and Trust in News

Social Media + Society ◽

10.1177/2056305120903408 ◽

2020 ◽

Vol 6 (1) ◽

pp. 205630512090340 ◽

Cited By ~ 11

Author(s):

Cristian Vaccari ◽

Andrew Chadwick

Keyword(s):

Artificial Intelligence ◽

Social Media ◽

Representative Sample ◽

Public Discourse ◽

Civic Culture ◽

United Kingdom Population ◽

The United Kingdom ◽

Experimental Treatments ◽

The Impact ◽

Large Representative

Artificial Intelligence (AI) now enables the mass creation of what have become known as “deepfakes”: synthetic videos that closely resemble real videos. Integrating theories about the power of visual communication and the role played by uncertainty in undermining trust in public discourse, we explain the likely contribution of deepfakes to online disinformation. Administering novel experimental treatments to a large representative sample of the United Kingdom population allowed us to compare people’s evaluations of deepfakes. We find that people are more likely to feel uncertain than to be misled by deepfakes, but this resulting uncertainty, in turn, reduces trust in news on social media. We conclude that deepfakes may contribute toward generalized indeterminacy and cynicism, further intensifying recent challenges to online civic culture in democratic societies.

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