Hospital Infant Formula Discharge PackagesDo They Affect the Duration of Breast-feeding?

Objective: To determine whether the duration of breastfeeding is affected by the contents of the hospital discharge package. Design: A randomized clinical trial with 2 experimental interventions (a discharge package containing a manual breast pump only and a discharge package containing a commercially prepared infant formula and a manual breast pump) and a control group who received a commercially prepared infant formula discharge package only. Sociodemographic characteristics and information concerning prior births (including feeding methods) were obtained from each mother within 48 hours of her infant\u27s birth. Sources of influence on the mother\u27s feeding decision, maternal attitudes concerning breastfeeding, and maternal feeding preferences were also assessed. Participants: The sample consisted of 763 women who had given birth who were admitted to the maternal-fetal unit of a midwestern community hospital. Main Outcome Measures: Information concerning current method of infant feeding was obtained from telephone interviews conducted at 2-week intervals until the infant was 16 weeks old. The data were analyzed using descriptive statistics, multivariate analysis of variance, logistic regression analysis, and survival analysis. Results: The content of the hospital discharge package did not affect whether the mother engaged in exclusive or partial breast-feeding during the 16-week follow-up interval. However, there was some evidence that providing formula samples at discharge from the hospital increased the duration of exclusive breast-feeding compared with providing a manual breast pump. Conclusion: This study does not support the assumption that inclusion of infant formula in hospital discharge packages decreases the duration of breastfeedin

Specific heat and non-linear susceptibility in spin glasses with random fields

We study magnetic properties of spin glass SG systems under a random field (RF), beased on the suggestion that RFs can be induced by a weak transverse field in the compound LiHo$_x$Y$_{1-x}$F$_4$. We consider a cluster spin model that allows long-range disordered interactions among clusters and short-range interactions inside the clusters, besides a local RF for each spin following a Gaussian distribution with standard deviation $\Delta$. We adopt the one-step replica symmetry breaking (RSB) approach to get an exactly solvable single-cluster problem. We discuss the behavior of order parameters, specific heat $C_{m}$, nonlinear susceptibility $\chi_3$ and phase diagrams for different disorder configurations. In the absence of RF, the $\chi_3$ exhibits a divergence at $T_f$, while the $C_{m}$ shows a broad maximum at a temperature $T^{**}$ around 30$\%$ above $T_f$, as expected for conventional SG systems. The presence of RF changes this scenario. The $C_{m}$ still shows the maximum at $T^{**}$ that is weakly dependent on $\Delta$. However, the $T_f$ is displaced to lower temperatures, enhancing considerable the ration $T^{**}/T_f$. Furthermore, the divergence in $\chi_3$ is replaced by a rounded maximum at a temperature $T^{*}$, which becomes increasingly higher than $T_f$ as $\Delta$ enhances. As a consequence, the paramagnetic phase is unfolded in three regions: (i) a conventional paramagnetism ($T>T^{**}$; (ii) a region with formation of short-range order with frozen spins ($T^{*}<T<T^{**}$); (iii) a region with slow growth of free-energy barriers slowing down the spin dynamics before the SG transition ($T_f<T<T^{*}$) suggesting an intermediate Griffiths phase before the SG state. Our results reproduce qualitatively some findings of LiHo$_x$Y$_{1-x}$F$_4$ as the rounded maximum of $\chi_3$ behavior triggered by RF.Comment: 9 pages, 6 figure

Análise de segregação complexa de 1.792 famílias com fenda lábio-palatina na América do Sul: 1967-1997

Although several studies have demonstrated familial aggregation of nonsyndromic cleft lip with or without cleft palate (CL/P), its model of inheritance remains uncertain. We report the results of complex segregation analysis performed in South American families with a newborn affected with CL/P. Families of 1,792 consecutive newborns affected with CL/P and registered during the period 1967 to 1997 were studied. A model that did not include a major locus was the best-fitting model for CL/P families. This result is in agreement with previous studies which showed a significant association of several putative susceptibility loci and CL/P, indicating that the genes involved in CL/P are likely to have only a very modest impact on disease risk.Os estudos sobre fendas lábio-palatinas (FL/P) demonstram existir uma maior incidência do defeito nas famílias de afetados, mas seu modo de herança permanece indefinido. Esse trabalho apresenta os resultados de uma análise de segregação complexa realizada em 1.792 famílias sul-americanas que possuíam um recém-nascido com FL/P. Essas crianças foram registradas entre 1967 e 1997 e os nascimentos foram consecutivos. Um modelo sem um locus principal foi o que melhor se adequou às famílias de FL/P estudadas. Esse resultado está de acordo com estudos anteriores que mostraram uma significativa associação entre vários loci de suscetibilidade e FL/P, indicando que os genes relacionados com FL/P, isoladamente, contribuem pouco para o risco desse defeito

Complex segregation analysis of 1,792 cleft lip and palate families in South America: 1967-1997

Os estudos sobre fendas lábio-palatinas (FL/P) demonstram existir uma maior incidência do defeito nas famílias de afetados, mas seu modo de herança permanece indefinido. Esse trabalho apresenta os resultados de uma análise de segregação complexa realizada em 1.792 famílias sul-americanas que possuíam um recém-nascido com FL/P. Essas crianças foram registradas entre 1967 e 1997 e os nascimentos foram consecutivos. Um modelo sem um locus principal foi o que melhor se adequou às famílias de FL/P estudadas. Esse resultado está de acordo com estudos anteriores que mostraram uma significativa associação entre vários loci de suscetibilidade e FL/P, indicando que os genes relacionados com FL/P, isoladamente, contribuem pouco para o risco desse defeito.Although several studies have demonstrated familial aggregation of nonsyndromic cleft lip with or without cleft palate (CL/P), its model of inheritance remains uncertain. We report the results of complex segregation analysis performed in South American families with a newborn affected with CL/P. Families of 1,792 consecutive newborns affected with CL/P and registered during the period 1967 to 1997 were studied. A model that did not include a major locus was the best-fitting model for CL/P families. This result is in agreement with previous studies which showed a significant association of several putative susceptibility loci and CL/P, indicating that the genes involved in CL/P are likely to have only a very modest impact on disease risk

Hyperlactatemia during cardiopulmonary bypass: determinants and impact on postoperative outcome

INTRODUCTION: Hyperlactatemia during cardiopulmonary bypass is relatively frequent and is associated with an increased postoperative morbidity. The aim of this study was to determine which perfusion-related factors may be responsible for hyperlactatemia, with specific respect to hemodilution and oxygen delivery, and to verify the clinical impact of hyperlactatemia during cardiopulmonary bypass in terms of postoperative morbidity and mortality rate. METHODS: Five hundred consecutive patients undergoing cardiac surgery with cardiopulmonary bypass were admitted to this prospective observational study. During cardiopulmonary bypass, serial arterial blood gas analyses with blood lactate and glucose determinations were obtained. Hyperlactatemia was defined as a peak arterial blood lactate concentration exceeding 3 mmol/l. Pre- and intraoperative factors were tested for independent association with the peak arterial lactate concentration and hyperlactatemia. The postoperative outcome of patients with or without hyperlactatemia was compared. RESULTS: Factors independently associated with hyperlactatemia were the preoperative serum creatinine value, the presence of active endocarditis, the cardiopulmonary bypass duration, the lowest oxygen delivery during cardiopulmonary bypass, and the peak blood glucose level. Once corrected for other explanatory variables, hyperlactatemia during cardiopulmonary bypass remained significantly associated with an increased morbidity, related mainly to a postoperative low cardiac output syndrome, but not to mortality. CONCLUSION: Hyperlactatemia during cardiopulmonary bypass appears to be related mainly to a condition of insufficient oxygen delivery (type A hyperlactatemia). During cardiopulmonary bypass, a careful coupling of pump flow and arterial oxygen content therefore seems mandatory to guarantee a sufficient oxygen supply to the peripheral tissues

Association between PCOS and autoimmune thyroid disease : systematic review and meta-analysis

Polycystic ovary syndrome (PCOS) is the most prevalent endocrine disorder affecting women of reproductive age. PCOS has been associated with distinct metabolic and cardiovascular diseases and with autoimmune conditions, predominantly autoimmune thyroid disease (AITD). AITD has been reported in 18–40% of PCOS women, depending on PCOS diagnostic criteria and ethnicity. The aim of this systematic review and metaanalysis was to summarize the available evidence regarding the likelihood of women with PCOS also having AITD in comparison to a reference group of non-PCOS women. We systematically searched EMBASE and MEDLINE for non-interventional case control, cross-sectional or cohort studies published until August 2017. The Ottawa–Newcastle Scale was used to assess the methodological quality of studies. Statistical meta-analysis was performed with R. Thirteen studies were selected for the present analysis, including 1210 women diagnosed with PCOS and 987 healthy controls. AITD was observed in 26.03 and 9.72% of PCOS and control groups respectively. A significant association was detected between PCOS and chance of AITD (OR = 3.27, 95% CI 2.32–4.63). Notably, after geographical stratification, the higher risk of AITD in PCOS women persisted for Asians (OR = 4.56, 95% CI 2.47–8.43), Europeans (OR = 3.27, 95% CI 2.07–5.15) and South Americans (OR = 1.86, 95% CI 1.05–3.29). AIDT is a frequent condition in PCOS patients and might affect thyroid function. Thus, screening for thyroid function and thyroidspecific autoantibodies should be considered in patients with PCOS even in the absence of overt symptoms. This systematic review and meta-analysis is registered in PROSPERO under number CRD42017079676