Exposure to thioguanine during 117 pregnancies in women with inflammatory bowel disease

Background: Safety of thioguanine in pregnant patients with inflammatory bowel disease [IBD] is sparsely recorded. This study was aimed to document the safety of thioguanine during pregnancy and birth. Methods: In this multicentre case series, IBD patients treated with thioguanine during pregnancy were included. Data regarding disease and medication history, pregnancy course, obstetric complications, and neonatal outcomes were collected. Results: Data on 117 thioguanine-exposed pregnancies in 99 women were collected. Most [78%] had Crohn's disease and the mean age at delivery was 31 years. In 18 pregnancies [15%], IBD flared. Obstetric and infectious complications were seen in 15% [n = 17] and 7% [n = 8] of pregnancies, respectively. Ten pregnancies [8.5%] resulted in a first trimester miscarriage, one in a stillbirth at 22 weeks of gestational age and one in an induced abortion due to trisomy 21. In total, 109 neonates were born from 101 singleton pregnancies and four twin pregnancies. One child was born with a congenital abnormality [cleft palate]. In the singleton pregnancies, 10 children were born prematurely and 10 were born small for gestational age. Screening for myelosuppresion was performed in 16 neonates [14.7%]; two had anaemia in umbilical cord blood. All outcomes were comparable to either the general Dutch population or to data from three Dutch cohort studies on the use of conventional thiopurines in pregnant IBD patients. Conclusion: In this large case series, the use of thioguanine during pregnancy is not associated in excess with adverse maternal or neonatal outcomes.Cellular mechanisms in basic and clinical gastroenterology and hepatolog

No association between glucocorticoid receptor polymorphisms and long-term respiratory outcome after very preterm birth

Developmen

Gender differences in respiratory symptoms in 19-year-old adults born preterm

Objective: To study the prevalence of respiratory and atopic symptoms in (young) adults born prematurely, differences between those who did and did not develop Bronchopulmonary Disease (BPD) at neonatal age and differences in respiratory health between males and females. Methods: Design: Prospective cohort study. Setting: Nation wide follow-up study, the Netherlands. Participants: 690 adults (19 year old) born with a gestational age below 32 completed weeks and/or with a birth weight less than 1500g. Controls were Dutch participants of the European Community Respiratory Health Survey (ECRHS). Main outcome measures: Presence of wheeze, shortness of breath, asthma, hay fever and eczema using the ECRHS-questionnaire

Reasons for contacting the consultation service of a Dutch assault centre

A telephone and e-mail helpline known as the Consultation Service, open to all the public, was launched at a Dutch Centre for Sexual Violence to deal with non-acute sexual violence. The aim of this study was to gain insight into case characteristics, reasons for contacting the Consultation Service and whether these reasons differed for victims, their relatives and professionals. Using a mixed methods design, the study included all consultations handled at the Consultation Service in 2018 and 2019. Descriptive statistics described quantitatively the case characteristics, the themes and differences between victims, relatives and professionals. The themes of the reasons for contact were established from the qualitative analysis, using the method of content analysis. Cases were characterised by complexity. Three themes emerged: case complexity, decision-making on care options and reporting to the police, which differed for victims, relatives and professionals. The differences in reasons for contacting the helpline imply that approaches should be adapted and fitted to different clients. Specialised care is needed to guide clients through cases that are challenging and often complex. There is a widespread lack of knowledge of options in addition to the complex multifaceted aspects to decision making about actions post-assault. Assault centres should implement a Consultation Service in which integrated care is offered not only to the victims, but also to their relatives and professionals

Precision and accuracy in measuring absence from work as a basis for calculating productivity costs in The Netherlands

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An introduction in the ecology of spatio-temporal affordances in airspace

Aerospace Engineerin