Fetal pH and postnatal adaptation in preterm vaginal deliveries

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Body mass index and outcome in renal transplant recipients: a systematic review and meta-analysis

BACKGROUND: Whether overweight or obese end stage renal disease (ESRD) patients are suitable for renal transplantation (RT) is often debated. The objective of this review and meta-analysis was to systematically investigate the outcome of low versus high BMI recipients after RT. METHODS: Comprehensive searches were conducted in MEDLINE OvidSP, Web of Science, Google Scholar, Embase, and CENTRAL (the Cochrane Library 2014, issue 8). We reviewed four major guidelines that are available regarding (potential) RT recipients. The methodology was in accordance with the Cochrane Handbook for Systematic Reviews of Interventions and written based on the PRISMA statement. The quality assessment of studies was performed by using the GRADE tool. A meta-analysis was performed using Review Manager 5.3. Random-effects models were used. RESULTS: After identifying 5,526 studies addressing this topic, 56 studies were included. We extracted data for 37 outcome measures (including data of more than 209,000 RT recipients), of which 26 could be meta-analysed. The following outcome measures demonstrated significant differences in favour of low BMI (<30) recipients: mortality (RR = 1.52), delayed graft function (RR = 1.52), acute rejection (RR = 1.17), 1-, 2-, and 3-year graft survival (RR = 0.97, 0.95, and 0.97), 1-, 2-, and 3-year patient survival (RR = 0.99, 0.99, and 0.99), wound infection and dehiscence (RR = 3.13 and 4.85), NODAT (RR = 2.24), length of hospital stay (2.31 days), operation duration (0.77 hours), hypertension (RR = 1.35), and incisional hernia (RR = 2.72). However, patient survival expressed in hazard ratios was in significant favour of high BMI recipients. Differences in other outcome parameters were not significant. CONCLUSIONS: Several of the pooled outcome measurements show significant benefits for ‘low’ BMI (<30) recipients. Therefore, we postulate that ESRD patients with a BMI >30 preferably should lose weight prior to RT. If this cannot be achieved with common measures, in morbidly obese RT candidates, bariatric surgery could be considered. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12916-015-0340-5) contains supplementary material, which is available to authorized users

Direct monitoring of arterial blood pressure in depressed and normal newborn infants during the first hour of life.

Direct systolic, diastolic, and mean arterial blood pressure was continuously recorded during the first 64 min of life in 150 newborn infants. The data were analyzed at 4, 8, 16, 32, and 64 min. The highest blood pressure values were noted during the first few minutes of life in all newborn infants, with a rapid drop within 4 to 8 min. Decline in blood pressure was more gradual throughout the remainder of the observation period. Blood pressures of depressed newborn infants at birth (Apgar scores 6 or less at 1 and 5 min) were compared to those of normal newborn infants (Apgar scores 7 or greater at 1 and 5 min). The former demonstrated generally higher systolic pressures during the first 16 min and diastolic pressures at 4 min when infants were compared by their 1 min Apgar scores and higher diastolic pressures at 4 min when the infants were compared by their 5 min Apgar scores

Effectiveness of neonatal transport systems

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