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1.
Sarah Averbach Othman Kakaire Rachel McDiehl Christine Dehlendorf Felicia Lester Jody Steinauer 《Contraception》2019,99(2):87-93
Objective
This study assessed whether immediate postpartum insertion of levonorgestrel contraceptive implants is associated with a difference in infant growth from birth to 6 months, onset of lactogenesis, or breastfeeding continuation at 3 and 6 months postpartum compared to delayed insertion at 6 to 8 weeks postpartum.Study design
We conducted a randomized trial of women in Uganda who desired contraceptive implants postpartum. We randomly assigned participants to receive either immediate (within 5 days of delivery) or delayed (6 to 8 weeks postpartum) insertion of a two-rod levonorgestrel contraceptive implant system. This is a prespecified secondary analysis evaluating breastfeeding outcomes. The primary outcome of this secondary analysis was change in infant weight; infants were weighed and measured at birth and 6 months. We used a validated questionnaire to assess onset of lactogenesis daily in person while participants were in the hospital, and then daily by phone after they left the hospital, until lactogenesis was documented. We used interviewer-administered questionnaires to assess breastfeeding continuation and concerns at 3 months and 6 months postpartum.Results
Among the 96 women randomized to the immediate group and the 87 women to the delayed group, the mean change in infant weight from birth to 6 months was similar between groups: 4632?g in the immediate group and 4407?g in the delayed group (p=.26). Among the 97 women who had not experienced lactogenesis prior to randomization, the median time to onset of lactogenesis did not differ significantly between the immediate and delayed groups (65?h versus 63?h; p=.84). Similar proportions of women in the immediate and delayed groups reported exclusive breastfeeding at 3 months (74% versus 71%; p=.74) and 6 months (48% versus 52%; p=.58).Conclusion
We found no association between the timing of postpartum initiation of levonorgestrel contraceptive implants and change in infant growth from birth to 6 months, onset of lactogenesis, or breastfeeding continuation at 3 or 6 months postpartum.Implications
This study provides evidence that immediate postpartum initiation of contraception implants does not have a deleterious effect on infant growth or initiation or continuation of breastfeeding. 相似文献2.
Timothy J Halligan Nathan G Russell William J Dunn Steven J Caldroney Timothy B Skelton 《Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics》2005,100(6):688-692
Scurvy is a nondiscriminatory disease process resulting from a nutritional deficiency of ascorbic acid (vitamin C). The severe vitamin deficiency produces a breakdown in the cellular structure of the body. This case report describes a middle-age woman with a history of edema, bruising of the lower extremities, anemia, and severe periodontal disease. Her presentation and medical history are classic for the signs of scurvy. Scurvy is now only uncommonly seen in developed countries, but there are still vulnerable populations whose nutritional status can lead to scurvy. The aim of this report is to help the clinician identify and treat scurvy, a disease that was once feared for its high mortality but is now easily treatable, even in cases that have progressed to multiple organ dysfunction and failure. 相似文献
3.
Stent fracture: an unusual cause of late restenosis after sirolimus-eluting stent placement. 总被引:1,自引:0,他引:1
Anderson Mehrle Thomas Skelton Alexandra Almonacid 《Catheterization and cardiovascular interventions》2007,69(7):988-991
Stent fracture is uncommon but may have consequences including restenosis. To date, stent fractures reported have been related to aggressive post dilation. We describe a case that involves fracture of a stent deployed to nominal pressure. Unlike most stent fractures reported that involve stent struts only our case demonstrated circumferential disruption with complete separation of the stent segments. 相似文献
4.
The goals of the present study were twofold: first, to assess the renal excretory and hormonal responses to chronic water restriction in dogs whose sodium retaining mechanisms had been stimulated through dietary sodium (Na+) deprivation; second, to determine the mediator(s) of the natriuresis which was observed with water restriction in these sodium deprived dogs. Three groups of dogs maintained on a low Na+ diet (5 mEq/day) for two weeks underwent a three day period of water restriction. In normal, intact dogs Group 1 (N = 5), water restriction resulted in a significant increase in Na+ excretion with a net cumulative loss of 26.3 +/- 2.6 mEq over three days. The natriuresis was associated with a significant increase in plasma vasopressin (PAVP) (1.7 to 10.2 pg/mliter) and a significant fall in plasma aldosterone (PALDO) from the levels observed with Na+ restriction alone (24.9 to 12.4 ng/dliter). The natriuresis could not be explained by decreases in food intake as determined by control studies in four dogs. Group 2 (N = 6) dogs had a decrease in PALDO with water restriction that was prevented by means of continuous i.v. aldosterone infusion (6.0 micrograms/kg/day). Dogs in this group failed to demonstrate a natriuresis during three days of water restriction, despite the fact that PAVP rose from 3.3 +/- 0.8 to a peak level of 14.95 +/- 1.9 pg/mliter. Group 3 (N = 6) dogs underwent selective neurohypophysectomy, thus preventing the rise in PAVP during three days of water restriction. In this group, PALDO also remained unchanged from the Na+ deprived level during water restriction, and no natriuresis was observed. We conclude: 1) that the natriuresis which occurs with water restriction is a potent physiological response that occurs even in the Na+ restricted state; and 2) this natriuresis can be explained by a fall in PALDO and not the rise in PAVP. 相似文献
5.
Giangennaro Coppola Francesca Felicia Operto Gianfranca Auricchio Alessandra D'Amico Delia Fortunato Antonio Pascotto 《Epileptic Disord》2007,9(2):145-148
A child had the characteristic clinical and EEG pattern of migrating partial seizures in infancy with left temporal lobe atrophy, hippocampal sclerosis and cortical-subcortical blurring.Seizures were drug-resistant, with recurring episodes of status epilepticus. The child developed microcephaly with arrest of psychomotor development. Focal brain lesions, in the context of migrating partial seizures, have not been previously reported.[Published with video sequences]. 相似文献
6.
It is argued that the prevalence of AIDS is substantially under-represented in existing national AIDS data. Thus although official statistics demonstrate significant recent shifts in transmission routes for HIV, health educators are faced with a problem because it is difficult to develop preventive strategies against a syndrome whose prevalence can only be estimated. Problems of the true extent of the prevalence of HIV are compounded when there is a lack of knowledge about the specifics of heterosexual behaviour. It is unwise to assume that the protective strategies developed by gay men in the face of HIV are routinely available for adoption by heterosexuals, who are characterised by social divisions of age, gender and relative amounts of social power. These concerns represent a problem for health educators. To date, sociological work may not have made the most effective contribution in its support of intervention strategies against HIV/AIDS. Examination of the empirical literature on lay concepts of health and illness reveals a pessimistic stance on the part of some researchers about the ability of individuals to modify behaviour. More positive readings of their own data are possible. The traditional concerns to emphasise the socio-economic determinants of health and behaviour, now also shared by some health educators, should not obscure a concern for the fate of individuals. The most effective contribution that health promotion may be able to make to the control of HIV in the heterosexual population is to assist in the development of strategies of empowerment and 'horizontal intervention'. 相似文献
7.
General practitioner perceptions of low back pain patients 总被引:2,自引:0,他引:2
8.
Robert K. McNamara R. Duncan Kirkby Gregory E. dePape Ronald W. Skelton Michael E. Corcoran 《Hippocampus》1993,3(2):149-152
There is some controversy about the role of long-term potentiation (LTP) in spatial learning. The authors have found that triggering generalized kindled seizures with stimulation of the perforant path disrupts spatial learning in the Morris water maze but that kindling per se does not affect spatial learning. It is suggested that abnormal electrical activity induced by high-frequency stimulation of the perforant path may have been responsible for the disruption of spatial learning previously attributed to LTP saturation. 相似文献
9.
James L Onambele G Woledge R Skelton D Woods D Eleftheriou K Hawe E Humphries SE Haddad F Montgomery H 《European journal of applied physiology》2004,92(1-2):227-230
A reduction in interleukin-6 (IL-6) activity may contribute to the beneficial effects of hormone replacement therapy (HRT) on the menopausal decline in bone mineral density (BMD). We have examined this hypothesis using a genetic strategy. The –174C (rather than G) IL-6 gene variant is associated with lower IL-6 expression. As such, we might anticipate the C allele to be associated with a greater response to HRT. We have tested this hypothesis. Mean three-site [spine (L1-L4), neck of femur, and Wards triangle] BMD was measured in 65 women in a 1-year randomised controlled trial of HRT with 0.625 mg oestrogen/day and 0.15 mg norgestrel (n=30). Baseline BMD was genotype-independent for both the control and HRT group. In the control group, the percentage change in BMD after 1 year was similar between genotypes (P=0.45). In contrast, in the HRT group, the rise was genotype-dependent. Those homozygous for the G allele showed a 3.62 (2.14)% increase in BMD compared with 10.44 (4.68)% for the C-homozygous group. Heterozygotes had an intermediate BMD increase of 5.6 (2.82)% [P=0.006 (P value for interaction between HRT and genotype was 0.04)] Although the study was limited by its small sample size, these are the first data to demonstrate the importance of IL-6 genotype in determining response to oestrogen therapy, rather than its physiological withdrawal. 相似文献
10.
CD1a and antitumour immune response 总被引:3,自引:0,他引:3
Primary immune response is based on the capacity of local professional antigen-presenting cells (whose prototype is represented by dendritic cells, DCs) to take up and present antigens to selected clones of T cells, but also to non-specific effector cells such as macrophages or natural killer cells. The four CD1 proteins, all of which share a limited homology to class I MHC proteins, are differently expressed in various cell types, of both mesenchymal and, as recently described, epithelial lineage. Regarding the role of CD1 molecules in the anti-tumour response, it has been reported that CD1+ dendritic cells are involved in the first steps of the primary immune response in a number of malignancies. Moreover, the presence of a high number of DCs in the tumoral or peritumoral area, as well as in the draining lymph nodes, has been shown to correlate with a better prognosis. A recent report on the presence of CD1a in metaplastic epithelial cells of Barrett esophagus introduced new questions about CD1a expression patterns. Moreover, the strong correlation between the lack of CD1a+ cells and the malignant evolution of the lesion may indicate a possible role of non-professional APCs in mediating and/or potentiating immune responses to tumours. 相似文献