Arterial hypertension after surgical closure of omphalocele and gastroschisis

Arterial hypertension has been reported as a complication of surgical closure of an abdominal wall defect. No report studying the incidence, the characteristics and the clinical significance of hypertension after surgical correction of an omphalocele or gastroschisis has been published so far. The medical records of all newborns with surgically corrected gastroschisis or omphalocele identified in two centers were retrospectively evaluated. Arterial hypertension was defined as a mean daily systolic and/or diastolic blood pressure value higher than the 95 percentile for age and/or weight, according to literature data. The timing of surgery, weight gain, plasma creatinine and the use of diuretics or vasoactive drugs were compared between the groups with and without hypertension. Seventy-two patients were identified and included in the study, 29 with omphalocele and 43 with gastroschisis. Those with omphalocele were born at a mean age of 37.3±2.6weeks with a mean birth weight of 2,971±715g, and those with gastroschisis were born at 36.1±2.0weeks with a mean birth weight of 2,527±498g. Blood pressure values of 66 patients were available for analysis. Of the omphalocele patients, 46.2% (12/26) developed systolic hypertension, compared to 17.5% (7/40) of the patients with gastroschisis ( P =0.024). Hypertension was always transient, lasting an average of 4 and 1day in the omphalocele and gastroschisis groups, respectively. Two patients with omphalocele were given anti-hypertensive therapy. There was no difference between patients with or without hypertension regarding weight gain, use of vasoactive drugs or diuretics, mean weekly creatinine values or the timing of surgery. Newborns with an abdominal wall defect frequently present with transient arterial hypertension. Hypertension occurs significantly more often, is more severe and lasts longer in patients with omphalocele than in patients with gastroschisis. In both groups, hypertension is transient and rarely requires therapy. The cause of hypertension remains unclea

Long-term outcome of preterm infants treated with nasal continuous positive airway pressure

This study's aim was to assess neurodevelopmental and growth outcome until the age of 4 years of premature infants placed on early nCPAP, in the setting of the neonatal intensive care unit (NICU) and follow-up program of the Division of Neonatology of the Department of Pediatrics of the University Hospital, Lausanne, Switzerland. All consecutive inborn infants weighing <1500g or <32 weeks of gestational age admitted to the NICU during two periods of 12 months—7.1996-6.1997 and 7.1998-6.1999—were compared before and after the systematic application of early nCPAP. Of 172 infants admitted to the NICU, 150 (87%) survived. 126 (84%) were tested at 6 months' corrected age, 121 (81%) at 18 months' corrected age, and 117 (78%) at the age of 4 years. Detailed perinatal data were collected. Follow-up included neurological examination, developmental testing and measurement of growth parameters. Statistical analyses were performed. Early application of nCPAP and avoidance of mechanical ventilation showed no adverse effects on neurodevelopment and growth. A significantly higher developmental quotient was found in the nCPAP group at 18 months' corrected age. Several trends were also noted in the nCPAP group with a decrease of intraventricular hemorrhage and in "abnormal neurodevelopment” at 6 months corrected age, a bigger head circumference at all different tested ages and a greater height at 6 and 18 months corrected ages. In conclusion, our study of developmental outcome documents the absence of any harmful effect of early application of nCPAP to treat respiratory failure in very low birthweight infant

Stroke incidence and 30-day case-fatality in a suburb of Tbilisi: results of the first prospective population-based study in Georgia

BACKGROUND AND PURPOSE: Although stroke is one of the main public health problems worldwide, no study of stroke incidence has been performed in Georgia, and therefore, a population-based registry was established to determine the incidence and case-fatality rates of first-ever stroke. METHODS: We identified all first-ever strokes between November 2000 and July 2003 in a defined population of 51,246 residents in the Sanzona suburb of Tbilisi, the capital of Georgia, using overlapping sources of information and standard diagnostic criteria. RESULTS: A total of 233 first-ever strokes occurred during the study period. The crude annual incidence rate was 165 (95% CI, 145 to 188) per 100,000 residents. The corresponding rate adjusted to the standard "world" population was 103 (95% CI, 89 to 117). In terms of stroke subtype, the crude annual incidence rate per 100,000 inhabitants was 89 (95% CI, 74 to 106) for ischemic stroke, 44 (95% CI, 34 to 57) for intracerebral hemorrhage, 16 (95% CI, 10 to 25) for subarachnoidal hemorrhage, and 16 (95% CI, 10 to 25) for unspecified stroke, and the corresponding case-fatality rates at 1 month were 19.2%, 48.4%, 47.8%, and 69.6%. CONCLUSIONS: The overall stroke incidence rate in an urban population of Georgia is comparable to those reported in developed countries. As for the stroke subtypes, there is an excess of hemorrhagic strokes compared with other registries. Geographical and lifestyle variations may explain these findings, whereas inadequacy of the stroke care system in Georgia might contribute to the high case-fatality. [Authors]]]> Cerebrovascular Accident oai:serval.unil.ch:BIB_31770 2022-05-07T01:14:25Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_31770 La résurrection du Christ dans les apocryphes. Gounelle, R info:eu-repo/semantics/bookPart incollection 2004 Les premiers temps de l'Église. De saint Paul à saint Augustin (Folio Histoire 124), pp. 117-121 Baslez, M-F (ed.) oai:serval.unil.ch:BIB_31771 2022-05-07T01:14:25Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_31771 Le Christ des apocryphes. Gounelle, R info:eu-repo/semantics/bookPart incollection 2004 Les premiers temps de l'Église. De saint Paul à saint Augustin (Folio Histoire 124), pp. 242-245 Baslez, M-F (ed.) oai:serval.unil.ch:BIB_31771256CC87 2022-05-07T01:14:25Z openaire documents urnserval <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_31771256CC87 Cardiovascular disease, chronic kidney disease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010: a comparative risk assessment. info:doi:10.1016/S2213-8587(14)70102-0 info:eu-repo/semantics/altIdentifier/doi/10.1016/S2213-8587(14)70102-0 info:eu-repo/semantics/altIdentifier/pmid/24842598 Global Burden of Metabolic Risk Factors for Chronic Diseases Collaboration Danaei, G. Lu, Y. Singh, G.M. Carnahan, E. Stevens, G.A. Cowan, M.J. Farzadfar, F. Lin, J.K. Finucane, M.M. Rao, M. Khang, Y.H. Riley, L.M. Mozaffarian, D. Lim, S.S. Ezzati, M. Aamodt, G. Abdeen, Z. Abdella, N.A. Rahim, H.F. Addo, J. Aekplakorn, W. Afifi, M.M. Agabiti-Rosei, E. Salinas, C.A. Agyemang, C. Ali, M.K. Ali, M.M. Al-Nsour, M. Al-Nuaim, A.R. Ambady, R. Di Angelantonio, E. Aro, P. Azizi, F. Babu, B.V. Bahalim, A.N. Barbagallo, C.M. Barbieri, M.A. Barceló, A. Barreto, S.M. Barros, H. Bautista, L.E. Benetos, A. Bjerregaard, P. Björkelund, C. Bo, S. Bobak, M. Bonora, E. Botana, M.A. Bovet, P. Breckenkamp, J. Breteler, M.M. Broda, G. Brown, I.J. Bursztyn, M. de León, A.C. Campos, H. Cappuccio, F.P. Capuano, V. Casiglia, E. Castellano, M. Castetbon, K. Cea, L. Chang, C.J. Chaouki, N. Chatterji, S. Chen, C.J. Chen, Z. Choi, J.S. Chua, L. Cífková, R. Cobiac, L.J. Cooper, R.S. Corsi, A.M. Costanza, M.C. Craig, C.L. Dankner, R.S. Dastgiri, S. Delgado, E. Dinc, G. Doi, Y. Dong, G.H. Dorsi, E. Dragano, N. Drewnowski, A. Eggertsen, R. Elliott, P. Engeland, A. Erem, C. Esteghamati, A. Fall, C.H. Fan, J.G. Ferreccio, C. Fezeu, L. Firmo, J.O. Florez, H.J. Fornés, N.S. Fowkes, F.G. Franceschini, G. Frisk, F. Fuchs, F.D. Fuller, E.L. Getz, L. Giampaoli, S. Gómez, L.F. Gomez-Zumaquero, J.M. Graff-Iversen, S. Grant, J.F. Carvajal, R.G. Gulliford, M.C. Gupta, R. Gupta, P.C. Gureje, O. Gutierrez, H.R. Hansen, T.W. Hata, J. He, J. Heim, N. Heinrich, J. Hemmingsson, T. Hennis, A. Herman, W.H. Herrera, V.M. Ho, S. Holdsworth, M. Frisman, G.H. Hopman, W.M. Hussain, A. Husseini, A. Ibrahim, M.M. Ikeda, N. Jacobsen, B.K. Jaddou, H.Y. Jafar, T.H. Janghorbani, M. Jasienska, G. Joffres, M.R. Jonas, J.B. Kadiki, O.A. Kalter-Leibovici, O. Kamadjeu, R.M. Kaptoge, S. Karalis, I. Kastarinen, M.J. Katz, J. Keinan-Boker, L. Kelly, P. Khalilzadeh, O. Kiechl, S. Kim, K.W. Kiyohara, Y. Kobayashi, J. Krause, M.P. Kubínová, R. Kurjata, P. Kusuma, Y.S. Lam, T.H. Langhammer, A. Lawes, C.M. Le, C. Lee, J. Lévy-Marchal, C. Lewington, S. Li, Y. Li, Y. Lim, T.O. Lin, X. Lin, C.C. Lin, H.H. Lind, L. Lissner, L. Liu, X. Lopez-Jaramillo, P. Lorbeer, R. Ma, G. Ma, S. Macià, F. MacLean, D.R. Maggi, S. Magliano, D.J. Makdisse, M. Mancia, G. Mannami, T. Marques-Vidal, P. Mbanya, J.C. McFarlane-Anderson, N. Miccoli, R. Miettola, J. Minh, H.V. Miquel, J.F. Miranda, J.J. Mohamed, M.K. Mohan, V. Mohanna, S. Mokdad, A. Mollentze, W.F. Morales, D.D. Morgan, K. Muiesan, L.M. Muntoni, S. Nabipour, I. Nakagami, T. Nangia, V. Nemesure, B. Neovius, M. Nerhus, K.A. Nervi, F. Neuhauser, H. Nguyen, M. Ninomiya, T. Noale, M. Oh, S.W. Ohkubo, T. Olivieri, O. Önal, A.E. Onat, A. Oróstegui, M. Ouedraogo, H. Pan, W.H. Panagiotakos, D.B. Panza, F. Park, Y. Passos, V.M. Pednekar, M.S. Pelizzari, P.M. Peres, M.A. Pérez, C. Pérez-Fernández, R. Pichardo, R. Phua, H.P. Pistelli, F. Plans, P. Polakowska, M. Poulter, N. Prabhakaran, D. Qiao, Q. Rafiei, M. Raitakari, O.T. Ramos, L.R. Rampal, S. Rampal, L. Rasmussen, F. Reddy, K.K. Redon, J. Revilla, L. Reyes-García, V. Roaeid, R.B. Robinson, C.A. Rodriguez-Artalejo, F. Rojas-Martinez, R. Ronkainen, K. Rosero-Bixby, L. Roth, G.A. Sachdev, H.S. Sánchez, J.R. Sanisoglu, S.Y. Sans, S. Sarraf-Zadegan, N. Scazufca, M. Schaan, B.D. Schapochnik, N. Schelleman, H. Schneider, I.J. Schooling, C.M. Schwarz, B. Sekuri, C. Sereday, M.S. Serra-Majem, L. Shaw, J. Shera, A.S. Shi, Z. Shiri, R. Shu, X.O. Silva, D.A. Silva, E. Simons, L.A. Smith, M. Söderberg, S. Soebardi, S. Solfrizzi, V. Sonestedt, E. Soysal, A. Stattin, P. Stein, A.D. Stergiou, G.S. Stessman, J. Sudo, A. Suka, M. Sundh, V. Sundquist, K. Sundström, J. Swai, A.B. Tai, E.S. Tambs, K. Tesfaye, F. Thomas, G.N. Thorogood, M. Tilvis, R.S. Tobias, M. Torheim, L.E. Trenkwalder, P. Tuomilehto, J.O. Tur, J.A. Tzourio, C. Uhernik, A.I. Ukoli, F.A. Unwin, N. Hoorn, S.V. Vanderpump, M.P. Varo, J.J. Veierød, M.B. Velásquez-Meléndez, G. Verschuren, M. Viet, L. Villalpando, S. Vioque, J. Vollenweider, P. Volpato, S. Wang, N. Wang, Y.X. Ward, M. Waspadji, S. Welin, L.X. Whitlock, G. Wilhelmsen, L. Willeit, J. Woodward, M. Wormser, D. Xavier, A.J. Xu, F. Xu, L. Yamamoto, A. Yang, G. Yang, X. Yeh, L.C. Yoon, J.S. You, Q. Yu, Z. Zhang, J. Zhang, L. Zheng, W. Zhou, M. Ward, M. info:eu-repo/semantics/article article 2014-08</

The Active Recovery Triad monitor:Evaluation of a model fidelity scale for recovery-oriented care in long-term mental health care settings

Objective The Active Recovery Triad (ART) model is a recently developed care model for people who are admitted to an institutional setting for several years and receive 24-h mental health care and support. This study focuses on the ART monitor, a model fidelity scale that measures the degree of compliance with the ART model. Our aim is to evaluate the psychometric properties of the ART monitor and to further improve the instrument. Methods Fifteen teams at the start (n = 7, group 1) or in the process (6 months to three years) of implementing care according to the ART model (n = 8, group 2) were audited using the ART monitor. Auditors were trained care workers, peer workers, and family peer workers. Auditors and team members provided feedback on the instrument. The content validity, construct validity and inter-rater reliability of the ART monitor were investigated. Based on the outcomes of these psychometric properties, the ART monitor was finalized. Results Regarding content validity, auditors and teams indicated that they perceived the ART monitor to be a useful instrument. In terms of construct validity, a significant difference (t(13) = 2.53, p < 0.05) was found between teams at the start of the implementation process (group 1, average score of 2.42 (SD = 0.44)) and teams with a longer duration of implementation (group 2, average score of 2.95 (SD = 0.37)). When allowing for a one-point difference in scores, 88% of the items had an inter-rater agreement over 65%. Items with a relatively low inter-rater reliability, in combination with feedback from auditors and teams regarding content validity, provided direction for further improvement and revision of the instrument. Conclusions We concluded that the revised ART monitor is feasible and useful in mental health care practice. However, further evaluation of its psychometric properties will be needed

Risk for Pneumocystis carinii Transmission among Patients with Pneumonia: a Molecular Epidemiology Study

We report a molecular typing and epidemiologic analysis of Pneumocystis carinii pneumonia (PCP) cases diagnosed in our geographic area from 1990 to 2000. Our analysis suggests that transmission from patients with active PCP to susceptible persons caused only a few, if any, PCP cases in our setting

Opportunities and challenges of self-binding directives: A comparison of empirical research with stakeholders in three European countries

BackgroundSelf-binding directives (SBDs) are psychiatric advance directives that include a clause in which mental health service users consent in advance to involuntary hospital admission and treatment under specified conditions. Medical ethicists and legal scholars identified various potential benefits of SBDs but have also raised ethical concerns. Until recently, little was known about the views of stakeholders on the opportunities and challenges of SBDs.AimsThis article aims to foster an international exchange on SBDs by comparing recent empirical findings on stakeholders’ views on the opportunities and challenges of SBDs from Germany, the Netherlands, and the United Kingdom.MethodComparisons between the empirical findings were drawn using a structured expert consensus process.ResultsFindings converged on many points. Perceived opportunities of SBDs include promotion of autonomy, avoidance of personally defined harms, early intervention, reduction of admission duration, improvement of the therapeutic relationship, involvement of persons of trust, avoidance of involuntary hospital admission, addressing trauma, destigmatization of involuntary treatment, increase of professionals’ confidence, and relief for proxy decision-makers. Perceived challenges include lack of awareness and knowledge, lack of support, undue influence, inaccessibility during crisis, lack of cross-agency coordination, problems of interpretation, difficulties in capacity assessment, restricted therapeutic flexibility, scarce resources, disappointment due to noncompliance, and outdated content. Stakeholders tended to focus on practical challenges and did not often raise fundamental ethical concerns.ConclusionsStakeholders tend to see the implementation of SBDs as ethically desirable, provided that the associated challenges are addressed.<br/

High and Intensive Care in Psychiatry: Validating the HIC Monitor as a Tool for Assessing the Quality of Psychiatric Intensive Care Units

This study aims to validate the HIC monitor as a model-fidelity scale to the High and Intensive Care (HIC) model, a recently developed model for acute psychiatric wards. To assess the psychometric properties of the HIC monitor, 37 audits were held on closed inpatient wards at 20 psychiatric hospitals in the Netherlands. Interrater reliability, construct validity and content validity were examined. Our results suggest that the HIC monitor has good psychometric properties. It can be used as a tool for assessing the implementation of the HIC model on acute psychiatric wards in the Netherlands, and for quality assessment and improvement

A Vaccine against Nicotine for Smoking Cessation: A Randomized Controlled Trial

BACKGROUND: Tobacco dependence is the leading cause of preventable death and disabilities worldwide and nicotine is the main substance responsible for the addiction to tobacco. A vaccine against nicotine was tested in a 6-month randomized, double blind phase II smoking cessation study in 341 smokers with a subsequent 6-month follow-up period. METHODOLOGY/PRINCIPAL FINDINGS: 229 subjects were randomized to receive five intramuscular injections of the nicotine vaccine and 112 to receive placebo at monthly intervals. All subjects received individual behavioral smoking cessation counseling. The vaccine was safe, generally well tolerated and highly immunogenic, inducing a 100% antibody responder rate after the first injection. Point prevalence of abstinence at month 2 showed a statistically significant difference between subjects treated with Nicotine-Qbeta (47.2%) and placebo (35.1%) (P = 0.036), but continuous abstinence between months 2 and 6 was not significantly different. However, in subgroup analysis of the per-protocol population, the third of subjects with highest antibody levels showed higher continuous abstinence from month 2 until month 6 (56.6%) than placebo treated participants (31.3%) (OR 2.9; P = 0.004) while medium and low antibody levels did not increase abstinence rates. After 12 month, the difference in continuous abstinence rate between subjects on placebo and those with high antibody response was maintained (difference 20.2%, P = 0.012). CONCLUSIONS: Whereas Nicotine-Qbeta did not significantly increase continuous abstinence rates in the intention-to-treat population, subgroup analyses of the per-protocol population suggest that such a vaccination against nicotine can significantly increase continuous abstinence rates in smokers when sufficiently high antibody levels are achieved. Immunotherapy might open a new avenue to the treatment of nicotine addiction. TRIAL REGISTRATION: Swiss Medical Registry 2003DR2327; ClinicalTrials.gov NCT00369616