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Ceska Gynekologie 2020To informed about international surveillance network severe maternal morbidity and mortality - INOSS. (Review)
Review
OBJECTIVE
To informed about international surveillance network severe maternal morbidity and mortality - INOSS.
DESIGN
Literature review.
SETTINGS
1st Department of Gynaecology and Obstetrics Faculty of Medicine, Comenius University and University Hospital, Bratislava, Slovak Republic.
METHODS
Literate review of articles published till august 2019.
RESULTS
The International Network of Obstetric Survey Systems (INOSS) is an international network that connects countries with the same or similar system of surveillance of acute severe maternal morbidity and mortality. The INOSS was established in year 2010 by twelve countries. Nowadays 19 countries are involved in the INOSS. The cooperation between member countries is focused on the acquisition of relevant data about rare severe acute maternal morbidities. INOSS in 2017 year unified definitions of 8 severe acute maternal morbidities according Delphi method: eclampsia, amniotic fluid embolism, peripartum hysterectomy, severe primary postpartum haemorrhage, uterine rupture, abnormally invasive placenta, spontaneous hemoperitoneum in pregnancy, and cardiac arrest in pregnancy.
CONCLUSION
The international cooperation allows the acquisition of relevant epidemiologic data and the optimalization of the treatment according the evidence-based medicine.
Topics: Data Collection; Evidence-Based Medicine; Female; Humans; International Cooperation; Maternal Mortality; Morbidity; Obstetric Labor Complications; Population Surveillance; Pregnancy; Pregnancy Complications; Registries; Slovakia; Surveys and Questionnaires
PubMed: 32527109
DOI: No ID Found -
Obstetrics and Gynecology Clinics of... Sep 2020Post-traumatic stress disorder (PTSD) accompanies miscarriage, intrauterine fetal demise, and preterm birth. Levels of PTSD may be higher for women who experience acute,... (Review)
Review
Post-traumatic stress disorder (PTSD) accompanies miscarriage, intrauterine fetal demise, and preterm birth. Levels of PTSD may be higher for women who experience acute, life-threatening events during labor and delivery. Severe maternal morbidities or near misses for maternal death disproportionately impact African American, Hispanic, American Indian, and women in rural communities. Expanding research demonstrates association between severe maternal morbidity or near-miss events and PTSD. Multiple preceding conditions and intrapartum and postpartum events place women at higher risk for PTSD. Postpartum evaluation provides an opportunity for PTSD screening. Untreated perinatal PTSD impacts long-term maternal and child health and contributes to health disparities.
Topics: Abortion, Spontaneous; Adult; Delivery, Obstetric; Ethnicity; Female; Fetal Death; Healthcare Disparities; Humans; Labor, Obstetric; Maternal Mortality; Morbidity; Parturition; Postpartum Period; Pregnancy; Pregnancy Complications; Premature Birth; Prevalence; Rural Population; Stress Disorders, Post-Traumatic
PubMed: 32762930
DOI: 10.1016/j.ogc.2020.04.004 -
International Journal of Rheumatic... Feb 2021
Topics: Arthritis, Psoriatic; Comorbidity; Female; Fibromyalgia; Global Health; Humans; Male; Morbidity
PubMed: 33523565
DOI: 10.1111/1756-185X.14029 -
Current Opinion in Pediatrics Dec 2023The purpose is to describe the latest research on epidemiology, causes, and morbidities of stroke in neonates and children. (Review)
Review
PURPOSE OF REVIEW
The purpose is to describe the latest research on epidemiology, causes, and morbidities of stroke in neonates and children.
RECENT FINDINGS
The global incidence of childhood stroke is approximately 2 per 100 000 person-years, which is significantly lower compared to neonates (20-40 per 100 000 live births) and adults (80-90 per 100 000 person-years). Placental abnormalities are a risk factor for perinatal stroke, although cause is usually multifactorial. In children, nonatherosclerotic arteriopathies and arteriovenous malformations are major causes of ischemic and hemorrhagic strokes, respectively. The perinatal period confers a high risk of stroke and can lead to long-term disability, including motor delay, cognitive or speech impairment, and epilepsy. Recent studies suggest that at least 50% of survivors of perinatal stroke have abnormal neurodevelopmental scores in long-term follow up. Childhood stroke is associated with significant morbidity, including epilepsy, motor impairments, and behavioral disability. Recent studies have also identified an association between pediatric stroke and behavioral disorders, such as attention deficit hyperactivity disorder and autism.
SUMMARY
Perinatal and childhood strokes are important causes of neurological morbidity. Given the low incidence of childhood stroke, prospective research studies on epidemiology, causes, and outcomes remain limited, highlighting the need for continued multisite collaborations.
Topics: Child; Female; Humans; Infant, Newborn; Pregnancy; Epilepsy; Incidence; Placenta; Prospective Studies; Stroke
PubMed: 37779483
DOI: 10.1097/MOP.0000000000001294 -
Current Obesity Reports Jun 2021In this review, we summarize the role of obesity in carcinogenesis, providing details on specific cancer sites. Special emphasis is given to gender differences in... (Review)
Review
PURPOSE OF REVIEW
In this review, we summarize the role of obesity in carcinogenesis, providing details on specific cancer sites. Special emphasis is given to gender differences in obesity-related cancers and on the effect of bariatric surgery on cancer risk.
RECENT FINDINGS
Accumulating evidence has highlighted the detrimental role of overweight/obesity in cancer, with almost 55% of cancers diagnosed in women and 24% diagnosed in men considered overweight- and obesity-related cancers. Sufficient data have shown that higher BMI is associated with risk of gynecologic malignancies (mainly breast and endometrial cancers) as well as cancers in sites such as the esophagus (adenocarcinoma), gastric cardia, colon, rectum, liver, gallbladder, pancreas, kidney, thyroid gland, and multiple myeloma. The main mechanisms underlying this relationship include the insulin/IGF1 system, the effect of sex hormones, and adipocytokines. Marked differences may be seen in specific cancer sites when comparing men to women. There is a higher overall incidence of obesity-related cancers among females (endometrial, ovarian, and postmenopausal female breast cancers), whereas cancers that concern both sexes show a higher incidence in males, particularly esophageal adenocarcinoma (male to female ratio: 9: 1 in the USA). Additionally, bariatric surgery has provided evidence of lowering overall cancer risk in patients with morbid obesity. Interestingly, bariatric surgery may lower overall cancer risk in women within the first 5 years after surgery due to the reduced risk of breast and endometrial cancer, and non-Hodgkin lymphoma. Obesity constitutes the base for marked metabolic, hormonal, and inflammatory alterations, including increased cancer risk in both men and women. Implementation of early obesity prevention strategies could ameliorate the continuously increasing incidence of cancer attributed to obesity.
Topics: Bariatric Surgery; Female; Humans; Incidence; Male; Neoplasms; Obesity; Obesity, Morbid; Overweight; Prevalence; Sex Characteristics
PubMed: 33523397
DOI: 10.1007/s13679-021-00426-0 -
Puerto Rico Health Sciences Journal Mar 2023The analysis of morbidity and mortality is fundamental for improving the quality of patient care. The objective of this study was to evaluate the combined medical and...
OBJECTIVE
The analysis of morbidity and mortality is fundamental for improving the quality of patient care. The objective of this study was to evaluate the combined medical and surgical morbidity and mortality of neurosurgical patients.
METHODS
We performed a daily prospective compilation of morbidities and mortalities during a consecutive 4-month period in all the patients who were 18 years of age or older and had been admitted to the neurosurgery service at the Puerto Rico Medical Center. For each patient, any surgical or medical complication, adverse event, or death within 30 days was included. The patients' comorbidities were analyzed for their influence on mortality.
RESULTS
Fifty-seven percent of the patients presented at least 1 complication. The most frequent complications were hypertensive episodes, mechanical ventilation for more than 48 hours, sodium disturbances, and bronchopneumonia. Twenty-one patients died, for an overall 30-day mortality of 8.2%. Mechanical ventilation for more than 48 hours, sodium disturbances, bronchopneumonia, unplanned intubation, acute kidney injury, blood transfusion, shock, urinary tract infection, cardiac arrest, arrhythmia, bacteremia, ventriculitis, sepsis, elevated intracranial pressure, vasospasm, stroke, and hydrocephalus were significant factors for mortality. None of the analyzed patients' comorbidities were significant for mortality or longer length of stay. The type of surgical procedure did not influence the length of stay.
CONCLUSION
The mortality and morbidity analysis provided valuable neurosurgical information that may influence future treatment management and corrective recommendations. Indication and judgment errors were significantly associated with mortality. In our study, the patients' comorbidities were not significant for mortality or increased length of stay.
Topics: Patient Care; Prospective Studies; Neurosurgical Procedures; Postoperative Complications; Hospital Mortality; Comorbidity; Morbidity; Puerto Rico
PubMed: 36941096
DOI: No ID Found -
Internal Medicine Journal Aug 2021Heart failure is a common healthcare problem associated with high morbidity and mortality. The burden of heart failure is changing; increases secondary to an ageing... (Review)
Review
Heart failure is a common healthcare problem associated with high morbidity and mortality. The burden of heart failure is changing; increases secondary to an ageing population may be offset by improved primary cardiovascular prevention and advances in heart failure therapies. In this review, we evaluate recent international trends in heart failure incidence, morbidity and mortality. Although the age-standardised incidence of heart failure has been decreasing since 2000, the incidence in those age groups <55 years is increasing with patients being diagnosed at younger ages. Despite improvements in therapies for heart failure, prognosis still remains poor with up to one-third of patients not surviving beyond 1 year following diagnosis and no improvements in mortality over the past 10 years. The case-mix of heart failure patients is changing with a greater proportion having non-ischaemic aetiology and preserved ejection fraction, and a higher prevalence of non-cardiovascular comorbidity and mortality.
Topics: Comorbidity; Heart Failure; Humans; Incidence; Middle Aged; Prevalence; Stroke Volume
PubMed: 33650267
DOI: 10.1111/imj.15253 -
The American Journal of Cardiology Feb 2020
Topics: Disruptive, Impulse Control, and Conduct Disorders; Gambling; Humans; Morbidity; Prognosis; United States
PubMed: 31785771
DOI: 10.1016/j.amjcard.2019.08.053 -
American Journal of Obstetrics &... Aug 2019Labor dystocia has been identified as a contributor to the rising cesarean delivery rate in the United States. Allowing more time for vaginal delivery, while being...
BACKGROUND
Labor dystocia has been identified as a contributor to the rising cesarean delivery rate in the United States. Allowing more time for vaginal delivery, while being cognizant of maternal and neonatal outcomes, has been identified as a possible strategy to lower cesarean delivery rates.
OBJECTIVE
This study aimed to characterize the relationship between the duration of active phase and second-stage labor and maternal and neonatal morbidity.
STUDY DESIGN
We present a secondary analysis of the Consortium on Safe Labor project. From labors of 66,940 nonanomalous nulliparous term singleton vertex gestations, we excluded labors for which active phase (≥6 cm dilation) or second stage durations could not be calculated and from sites that did not report determinants of morbidity. For each duration of active phase or second stage labor (grouped in 1-hour increments), the adjusted maternal and neonatal composite morbidity was estimated by and compared with the morbidity associated with a duration <1 hour total and a duration of 1 hour shorter.
RESULTS
After exclusions, 48,144 deliveries remained. In adjusted models, compared with labor durations <1 hour total, maternal composite morbidity was significantly higher across active phase and second stage durations (both P<.001); neonatal composite morbidity was higher across the second stage (P<.001), but not active phase (P=.07) duration. These relationships appear linear with no apparent inflection point, and morbidity increases more rapidly. When compared with labor durations 1 hour shorter, significant differences persisted in maternal and neonatal composite morbidity in second stage labor only through 4 and 3 hours, respectively.
CONCLUSION
Maternal and neonatal composite morbidity is greater with longer durations of active and second stage labor; however, no clear cutoff point was determined to suggest truncation of either stage of labor for reasons of morbidity. In addition, incrementally higher morbidities that were noted vs duration <1 hour total were obscured when comparison was made with labors 1 hour shorter, which suggests that focusing on short differences in duration of labor may mask important underlying trends.
Topics: Cesarean Section; Delivery, Obstetric; Dystocia; Female; Humans; Labor Stage, Second; Morbidity; Pregnancy; United States
PubMed: 33345796
DOI: 10.1016/j.ajogmf.2019.100032 -
Journal of Epidemiology and Community... Nov 2023
Topics: Humans; Dementia; Alzheimer Disease; Morbidity; Cluster Analysis; Risk Factors
PubMed: 37286347
DOI: 10.1136/jech-2023-220779