Characterization of Babies Discharged from Cabell Huntington Hospital During the Calendar Year 2005 with the Diagnoses of Neonatal Abstinence Syndrome

Recent concern regarding the impact of maternal drug abuse on neonatal well-being was the impetus for this retrospective cohort study of newborns diagnosed with neonatal abstinence syndrome that were discharged from Cabell Huntington Hospital during the calendar year 2005. Medical records of the neonates and their mothers were analyzed for a variety of health related outcomes and healthcare cost. Forty-eight neonates were diagnosed with Neonatal Abstinence Syndrome in 2005, forty of which required NICU assistance. The average maternal age at delivery was 26; gravity was 3.1 and most were single, separated or divorced. The majority had poor or inconsistent prenatal care. Twenty-one delivered by cesarean section most often for fetal distress. Most delivered prematurely with an average gestation of 35.9 weeks. Half of the mothers went into preterm labor with half of those having premature ruptured membranes. Opiates were the most common maternal substance found, while neonates most often tested positive for methadone. Nearly 90% of the mothers smoked. Thirty-four of the mothers were found to continue illicit drug abuse while pregnant, while another eight were seen in a methadone clinic for a history of abuse. Most of the neonates required weaning with methadone. The majority of our study cases were funded by Medicaid, mostly by West Virginia with total hospital costs exceeding 1.7 million dollars. Direct cost attributed to detoxification was in excess of $180,000. The number of neonates diagnosed with Neonatal Abstinence Syndrome has nearly tripled from 2003 to 2007. The problem of maternal drug abuse and addiction during pregnancy has dramatic effects on both their unborn children and our local healthcare system. Increased awareness of this growing problem is needed so that earlier interventions can be implemented. It is our opinion that all obstetrical patients at risk should be screened early and often so that those affected individuals can be managed more aggressively to improve neonatal outcomes

Modulation of Cellular Stemness for Enhanced Fat Grafting

Summary:. Low volumetric retention limits the utility of fat grafting. Although inclusion of stem cells and platelet-rich plasma have been proposed to enhance graft retention, accumulating evidence has failed to show a clear benefit. Here, we propose a strategy to pharmacologically enhance stemness of stem and progenitor cell populations in fat grafts to promote increased volume retention and tissue health. We also propose how to integrate stemness-promoting and differentiation-promoting therapies such as platelet-rich plasma, and viability promoting therapies within the common fat grafting workflow to achieve optimal fat grafting results

Snow precipitation on Mars driven by cloud-induced night-time convection

International audienceAlthough it contains less water vapour than Earth’s atmosphere, the Martian atmosphere hosts clouds. These clouds, composed of water-ice particles, influence the global transport of water vapour and the seasonal variations of ice deposits. However, the influence of water-ice clouds on local weather is unclear: it is thought that Martian clouds are devoid of moist convective motions, and snow precipitation occurs only by the slow sedimentation of individual particles. Here we present numerical simulations of the meteorology in Martian cloudy regions that demonstrate that localized convective snowstorms can occur on Mars. We show that such snowstorms—or ice microbursts—can explain deep night-time mixing layers detected from orbit and precipitation signatures detected below water-ice clouds by the Phoenix lander. In our simulations, convective snowstorms occur only during the Martian night, and result from atmospheric instability due to radiative cooling of water-ice cloud particles. This triggers strong convective plumes within and below clouds, with fast snow precipitation resulting from the vigorous descending currents. Night-time convection in Martian water-ice clouds and the associated snow precipitation lead to transport of water both above and below the mixing layers, and thus would affect Mars’ water cycle past and present, especially under the high-obliquity conditions associated with a more intense water cycle