Fetal hydrops associated with tumors

Fetuses with tumors associated with hydrops have a high mortality rate. Relatively few survivors have this potentially fatal combination. This study examined the clinical and pathological findings, pathogenesis, and outcomes of fetuses with tumors and hydrops. One hundred and fifty-eight study cases were collected from the literature and from personal files. Only patients where adequate clinical and pathological data were given and the outcome of pregnancy was described were included in the study. Cardiac tumors were the majority found in association with fetal hydrops. Leukemia and extracardiac teratomas were next in frequency followed by hepatic tumors, neuroblastoma, placental, soft tissue, and renal tumors. The main presenting findings along with hydrops were hydramnios, a tumor mass, placentomegaly, and stillbirth. Most tumors were detected in the third trimester of pregnancy. No fetus with the diagnosis of cardiac rhabdomyoma, neuroblastoma, brain tumor, rhabdoid tumor, or histiocytosis associated with hydrops survived. Those patients with placental chorangioma, pericardial teratoma, and hepatic hemangioma had the best outcome. The overall survival rate was low: 30 of 158 (19%).     

Simply not there: the impact of international migration of nurses and midwives--perspectives from Guyana

The shortage of nurses and midwives across the world and the migratory trends of these scarce professionals--primarily from low-income countries to fill staffing needs in high-income countries--are critical international health care issues. This article reviews some of the demographic, educational, and socioeconomic factors driving this global trend, the impact on health care delivery in low-income countries, and the effect on the implementation of global public health initiatives. Nurses and midwives migrate from low-income nations while concurrently qualified applicants are rejected from educational programs in high-income countries. The impact of migration on the viability of the health care delivery system in Guyana, South America, is presented as an exemplar nation within the broader global context of ethical dilemmas, pressures on educational systems, and the anti- and pro-migration arguments.     

Dysphagia revealing a giant cystic parathyroid adenoma

The aim of this observation was to report a rare case of symptomatic and non-functional cystic parathyroid adenoma in a 52-year-old female, diagnosed with imaging and treated by surgical resection of the gland.     

Fabrication of a graphene-based sensor to detect the humidity and the temperature of a metal body with imprecise data analysis

Graphene is a 2D material with remarkable properties. The present study demonstrates the fabrication of a graphene-based sensor for measuring the temperature and humidity of a metal body. The graphene sensor was fabricated by depositing a thin film of graphene nanoparticles between silver electrodes (separated by ∼50 μm) on a glass substrate. The graphene thin film was characterized by XRD, Raman spectroscopy and UV-vis techniques. The capacitance and resistance for both the relative humidity (in the range of 0–100% RH) and temperature (in the range of 230–310 K) were measured using an LCR meter at 1 kHz in a controlled chamber. The graphene-based sensor expressed high sensitivity with fast response and recovery times for both humidity and temperature with long stability and low hysteresis curves. The sensor was also tested on a metal body, which expressed a good response time. Moreover, the measured data of capacitance and resistance was analyzed with classical and neutrosophic analysis as an application of modern material statistics. It was observed that neutrosophic analysis is more flexible for analyzing the capacitance and resistance of the fabricated sensor.

Graphene is a 2D material with remarkable properties.     

Mozambican Midwives' Views on Barriers to Quality Perinatal Care

Our purpose in this study was to explore the midwives' perception of factors obstructing or facilitating their ability to provide quality perinatal care at a central labor ward in Maputo. In-depth interviews were undertaken with 16 midwives and were analyzed according to grounded theory technique. Barriers to provision of quality perinatal care were identified as follows: (i) the unsupportive environment, (ii) nonempowering and limited interaction with women in labor, (iii) a sense of professional inadequacy and inferiority, and (iv) nonappliance of best caring practices. A model based on the midwives' reflections on barriers to quality perinatal care and responses to these were developed. Actions aimed at overcoming the barriers were improvising and identifying areas in need of change. Identified evading actions were holding others accountable and yielding to dysfunction and structural control. In order to improve perinatal care, the midwives need to see themselves as change agents and not as victims of external and internal causal relationships over which they have no influence. It is moreover essential that the midwives chose actions aiming at overcoming barriers to quality perinatal care instead of choosing evading actions, which might jeopardize the health of the unborn and newborn infant. We suggest that local as well as national education programs need to correspond with existing reality, even if they provide knowledge that surpasses the present possibilities in practice. Quality of intrapartum and the immediate newborn care requires a supportive environment, however, which in the context of this study presented such serious obstacles that they need to be addressed on the national level. Structural and administrative changes are difficult to target as these depend on national organization of maternal health care (MHC) services and national health expenditures.     

Paternal Asthma is a Predictor for Childhood Asthma in the Consanguineous Families from the United Arab Emirates

Consanguinity is known to increase the burden of genetic disorders among offspring. However, the effect of consanguinity on a complex disorder like childhood asthma has not been studied previously. Therefore, we explored this relationship by studying the asthma prevalence in children between 6 and 14 years of age among the local Arab families of the United Arab Emirates (UAE) where consanguinity is known to be highly prevalent. A total of 1136 children from 295 families met our inclusion criteria. The prevalence of childhood asthma was higher among children in consanguineous families (43.3%) compared to non-consanguineous (22.6%, p < 0.001). There was a significant correlation between the degree of consanguinity and the number of asthmatic children per family (p = 0.0002). Girls from consanguineous families had proportionately more asthma (42.9%, p < 0.001) compared to boys (23.1%, p = 0.539).

Paternal asthma in consanguineous families increased asthma risk for both boys and girls (p = 0.021 for boys, p < 0.001 for girls), while maternal asthma had no significant impact on asthma in offspring. Prevalence of childhood asthma was significantly higher in consanguineous families. The significant asthma predictors for girls from the consanguineous families were the degree of consanguinity and paternal asthma. The only predictor for boys was paternal asthma. These interesting observations merit further studies on both larger samples and in other consanguineous communities for confirmation.     

Necrotizing sarcoid granulomatosis in a family of patients with sarcoidosis reinforces the association between both entities

Necrotizing sarcoid granulomatosis (NSG) is a rare entity mainly characterized by a prominent granulomatous vasculitis affecting middle-aged or old individuals and with a favorable prognosis. Although many believe it is a variant of sarcoidosis, the proper classification is still a matter of debate as some of its features are found in sarcoidosis but also in Churg-Strauss syndrome, Wegener's disease and hypersensitivity pneumonitis. In this paper, we described for the first time a case of NSG in a family with several cases of sarcoidosis, reinforcing the relationship between NSG and sarcoidosis. Additional interesting findings were the young age of the patient (15 years old), the symptoms limited to the respiratory tract (uncommon when NSG affects youngsters) and the increase in serologic markers of autoimmune disease. Though complete criteria for autoimmune disease were not present, systemic lupus erythematosus and Sjogren's syndrome are possible candidates. As sarcoidosis is described to be associated with several autoimmune diseases, this finding is an additional suggestion of the relationship between both entities.