Relationship between Breastfeeding, Birth History, and Acute Pyelonephritis in Infants

BACKGROUND: Although the clinical importance of the immunological benefits of breastfeeding has been emphasized for decades, their direct relationship with acute pyelonephritis (APN) is still not clear. Our goal was to determine whether breastfeeding truly provides protection against APNs, while investigating the effects of other factors such as sex, age, mode of delivery, and birth weight on APN.METHODS: A total of 62 infants under 6 months of age who had both microbiologically and radiologically-confirmed APN were enrolled in the case group. Healthy infants (n = 178) who visited the hospital for scheduled vaccinations were enrolled in the control group. The following participant characteristics were compared between the case and control groups: age, sex, birth order among siblings, feeding methods, weight percentile by month, birth weight percentile by gestational age, gestational age at birth, and mode of delivery.RESULTS: Babies exclusively fed with manufactured infant formulae before 6 months of age had significantly higher risk for APN than breastfed or mixed-fed infants (odds ratio [OR], 3.4; 95% confidence interval [CI], 1.687–7.031; P = 0.001). Firstborn babies had lower risk for APN than 2nd- or 3rd-born babies (OR, 0.43; 95% CI, 0.210–0.919). Other factors that increased the risk for APN were low birth weight percentiles (OR, 8.33; 95% CI, 2.300–30.166) and birth via caesarean section (OR, 2.32; 95% CI, 1.097–4.887). There were more preterm births in the case group (10.9% vs. 1.7%; P = 0.002), but this did not increase the risk for APN (OR, 4.47; P = 0.063).CONCLUSION: Feeding exclusively with formula before 6 months of age was related to higher risk for APN, which demonstrates that breastfeeding has a protective effect against APN. The other risk factors for APN were birth order (≥ 2nd-born), low birth weight, and birth via caesarean section.

Uptake of antenatal care services among women of reproductive age in Mandera County, Kenya

Background: Antenatal care is an opportunity for prevention and management of existing and potential causes of maternal and newborn mortality and morbidity. The new WHO antenatal care model, stipulates that, the first antenatal care visit takes place within the first trimester (gestational age of <12 weeks) and then, additional seven visits. Only 37% of women in Mandera County had utilized the recommended minimum four ANC visits. Objectives: There was need to assess the critical factors influencing the uptake of ANC in Mandera County Kenya, in order to enlighten stakeholders on the development of appropriate ANC Service Provision Program. This study took the intiative of bridging the gap. Methodology: The study adopted cross-sectional design using both quantitative and qualitative methods. Stratified and Sample random sampling were used to get a quantity of 348 respondents. Data was collected using questionnaire, FGDs and KIIs guides and Pearson's Chi-square test. Multivariate analysis using logistic regression was summarized to establish the strengths of the association. Odds Ratio (OR) and 95% Confidence Interval (CI) were used and threshold for statistical significance was set at p<0.05. Qualitative data was transcribed and analyzed thematically. Results: The proportion of women who utilized ANC was 83.0% and only 60.3% had attended recommended visits. Individual factors that influenced ANC uptake were; age, level of education, monthly income, gravida, parity and complications during pregnancy. Contextual factors that influenced ANC were; time taken to reach health facilities, source of maternal information and local discouragements. There was no significant relationship between Religion, marital status, age at first pregnancy with ANC uptake. Conclusion: The negative perception can change by; improving culturally sensitive ANC services accessibility by; increasing the number of female skilled health workers and reducing traveling time to the health facilities by conducting regular outreach services targeting villages with no close facility to pastoral communities. It will be important to strengthen CHVs' capacity to emphasize primary health care and accelerate progress towards UHC in the County. Provide health education and promotion targeting older mothers with high parity, women inclined to harmful cultural practices and their partners. In spite of a wide range of literature on ANC topics in most parts of Kenya, it was limited pertaining Mandera County. Recomandations: Meticulous understanding of local barriers and facilitating factors of ANC utilization is prerequisite for designing and implementing interventions that aim to improve ANC uptake. Well developed infrastructure is a basic need that falls in the category of basic wants for Mandera County

Combined estrogen-progestin pill is a safe and effective option for endometrial hyperplasia without atypia: a three-year single center experience / 부인종양

OBJECTIVE: To evaluate the effectiveness of oral contraceptive pill (OCP) as therapy for endometrial hyperplasia (EH) without atypia in reproductive-aged women compared with oral progestin. METHODS: A retrospective cohort study was carried out in our reproductive center. Consecutive patients diagnosed with infertility and non-atypical EH identified through electronic database who met inclusion criteria (n=309). Patients were assigned to two treatment groups: OCP (n=216) and oral progestin (n=93); clinical and reproductive outcomes were recorded. RESULTS: Reversal of EH to normal endometrium, clinical pregnancy, live birth and miscarriage rate. Women in OCP group were younger, had higher prevalence of Polycystic Ovary Syndrome and other uterine pathology and longer duration of infertility than women in progestin group. Reversal of EH was observed in 93.52% women on OCP and in 86.02% women on progestin (p=0.032; adjusted odds ratio [aOR]= 2.35; 95% confidence interval [CI]=1.06-5.21) after the initial course of treatment for 2 to 6 months. Cyclic OCP (n=184) resulted in better response to treatment compared to continuous OCP (n=32) (95.11% vs. 84.38%; p=0.039; aOR =3.60; 95% CI =1.12-11.55). Clinical pregnancy rate in OCP group was marginally higher than progestin group (87/208, 41.83% vs. 27/90, 30.00%; p=0.054). Miscarriage (25.29% vs. 29.63%; p=0.654) and live birth rate (31.25% vs. 21.11%; p=0.074) were comparable between the groups. CONCLUSION: For the first time we demonstrate that OCP is an effective therapy for non-atypical EH and is associated with higher remission rate compared with oral progestin. Reproductive outcomes are reassuring and comparable between the two groups.

Blood Pressure Trajectories from Childhood to Adolescence in Pediatric Hypertension

It has been known for a long time that elevated blood pressure (BP) in the young may persist and progress into adult hypertension (HTN). Multiple studies have revealed the predicted BP trajectory lines starting from childhood and related them to later cardiovascular (CV) risks in adulthood. As a small baby grows into a tall adult, BP will also naturally increase. Among early-life predictors of adult HTN, birth history, such as prematurity, and low birth weight have been popular subjects in research on pediatric HTN, because body size at birth has been reported to be inversely related to the risk of adulthood HTN. The hypothesis of HTN in prematurely born adolescents has been postulated as a physiological predisposition to postnatal excessive weight gain. Current body weight is a well-known independent predictor of HTN in children, and some studies showed that children demonstrating upward crossing of their weight percentiles while growing into adolescents have significantly increased risk for elevated BP later in life. Recently, reports focused on the adverse effect of excessive catch-up growth in this population are gradually drawing attention. Accordingly, children born prematurely or with intrauterine growth restriction who show rapid changes in their weight percentile should be under surveillance with BP monitoring. Prevention of childhood obesity, along with special care for premature infants or infants small for their gestational age, by providing healthy nutritional guidelines should be cardinal strategies for the prevention of adult HTN and CV risks later in life.

Sexual Function and Factors Affecting Menopause: A Systematic Review

The purpose of this review study is to evaluate sexual function and its effective factors in menopause. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The key words of “menopause,” “postmenopause,” “postmenopausal,” “premenopause,” “pre-menopausal period,” “sexual function,” “sexual health,” “sexuality,” “sexual and gender disorders,” “sexual development,” “sexual dysfunction,” “sexual disorders,” “sexual behavior and “sexual activity” were used in combination with the Boolean operators OR and AND. After reviewing the selected articles, 27 papers were selected based on the criteria for entering the study and the goals set. The results of the reviewed articles showed that, in the physical domain, the factors affecting sexual function can be mentioned, age, hormonal changes, medical problems and reproductive history. Sexual disorders in menopause can be affected by some of the individual and social characteristics and psychological problems. Considering the fact that many psychological and social injuries occur in this period following sexual disorders; therefore, policies and programs for improving the quality of life of women in menopause should be aimed at eliminating sexual dysfunction, correcting attitudes and negative emotions and help to women for more comfortable in menopause.

Interaction Effect Between Breast Density and Reproductive Factors on Breast Cancer Risk in Korean Population

BACKGROUND: This study was conducted to explore the effect of known risk factors, focusing on risk factors including age at menarche, age at menopause, number of children, family history of breast cancer, and age at first birth according to breast density, in consideration of interaction among East-Asian women. METHODS: Case-control study with 2,123 cases and 2,121 controls with mammographic density was conducted. Using the mammographic film, breast density was measured using Breast Imaging-Reporting and Data System. To identify the association of selected reproductive factors including age at menarche, age at menopause, number of children, family history of breast cancer, and age at first birth according to breast density, stratified analysis was conducted according to breast density groups and interaction effects was assessed. The results were presented with adjusted OR and 95% CIs. RESULTS: Significant interaction effect between age at first birth and breast density on breast cancer (P = 0.048) was observed. Women with age at first birth ≥ 28 years old showed increased breast cancer risk in extremely dense breast group (≥ 75%) (OR = 1.627, 95% CI = 1.190–2.226). However, women with fatty breast (< 50%) and heterogeneously dense breast (50%–75%) did not show an increased association. Age at menarche, age at menopause, number of children, and family history of breast cancer did not show significant interaction with breast cancer and similar risk patterns were observed. CONCLUSIONS: Age at first birth showed significant interaction with breast density on breast cancer risk. Further studies considering biologically plausable model between exposure, intermediate outcomes and breast cancer risk with prospective design need to be undertaken in East Asian women.

Television Viewing Time and Breast Cancer Incidence for Japanese Premenopausal and Postmenopausal Women: The JACC Study / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The evidence on effects of TV viewing time among premenopausal and postmenopausal women for breast cancer risk remains controversial and limited. MATERIALS AND METHODS: A prospective study encompassing 33,276 (17,568 premenopausal, and 15,708 postmenopausal) women aged 40-79 years in whom TV viewing time, menstrual, and reproductive histories were determined by a self-administered questionnaire. The follow-up was from 1988 to 2009 and hazard ratios (HRs) with 95% confidence intervals (CIs) of breast cancer incidence were calculated for longer TV viewing time in reference to shorter TV viewing time by Cox proportional hazard models. RESULTS: During 16.8-year median follow-up, we found positive associations between TV viewing time and breast cancer incidence with a borderline significant trend among total women and a significant trend among postmenopausal women. Among total women, the multivariable HRs (95% CIs) for risk of breast cancer in reference to < 1.5 hr/day of TV viewing time were 0.89 (0.59-1.34) for 1.5 to < 3.0 hr/day, 1.19 (0.82-1.74) for 3.0 to < 4.5 hr/day, and 1.45 (0.91-2.32) for ≥ 4.5 hr/day (p for trend=0.053) and among postmenopausal women, the corresponding risk estimates were 1.10 (0.42-2.88), 2.54 (1.11-5.80), and 2.37 (0.92-6.10) (p for trend=0.009), respectively. CONCLUSION: Prolonged TV viewing time was associated with increased risk of breast cancer, especially among postmenopausal women.

Korean reference for full-term birth length by sex: data from the 4th Korean National Health and Nutrition Examination Survey (KNHANES-IV; 2007–2009)

PURPOSE: The purpose of this study was to construct reference data for birth length of full-term and preterm Korean infants by sex and to define a sex-specific birth length cut-off to identify small for gestational age (SGA).METHODS: Data were collected from the 4th Korean National Health and Nutrition Examination Survey (2007–2009), comprising 843 children with birth length data and birth history.RESULTS: References for the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles of birth length and weight were created using singleton neonates of gestational age (GA) 36–37 weeks and 38–41 weeks by sex. The birth length cutoff value for SGA (<10th percentile) was 48 cm in both male and female neonates, and the ≤3rd percentile cutoff was 47 cm in males and 46 cm in females born at a GA of 38–41 weeks.CONCLUSION: New Korean reference data were created for birth length and differed from those of other ethnicities. Further research on short-term and long-term health outcomes of SGA infants based on the new reference data is needed.

Baseline characteristics of postmenopausal women with osteoporosis treated with teriparatide in a real-world setting in Latin America: a subregional analysis from the Asia and Latin America Fracture Observational Study (ALAFOS)

Abstract Background: Osteoporosis is a major healthcare concern in Latin America. Factors such as changing demographics, fragmented healthcare systems, and financial considerations may result in a huge increase in the burden of osteoporosis in this region. The aim of this article is to describe the baseline clinical characteristics and fracture history of patients who are prescribed teriparatide in normal clinical practice in Latin America. Methods: We conducted a prospective, multinational, observational study (the Asia and Latin America Fracture Observational Study [ALAFOS]) in 20 countries worldwide to assess the incidence of fractures in postmenopausal women with osteoporosis receiving teriparatide as a part of routine clinical practice in a real-world setting. In this subregional analysis of the ALAFOS study, we report the clinical characteristics, fracture history, risk factors for osteoporosis, comorbidities, previous osteoporosis therapies and health-related quality of life measures at baseline for patients from the four participant Latin American countries: Argentina, Brazil, Colombia, and Mexico. Results: The Latin America subregional cohort included 546 postmenopausal women (mean [SD] age: 71.0 [10.1] years; range: 40-94 years), constituting 18% of the ALAFOS total population. The baseline mean (SD) bone mineral density T-scores were - 3.02 (1.23) at the lumbar spine and - 2.31 (0.96) at the femoral neck; 62.8% of patients had a history of low trauma fracture after the age of 40 years and 39.7% of patients had experienced ≥1 fall in the past year. Osteoporosis medications were used by 70.9% of patients before initiating teriparatide. The median (Q1, Q3) EQ-5D-5 L Visual Analog Scale (VAS) scores for perceived health status at baseline was 70 (50, 80). The mean (SD) worst back pain numeric rating scale score for the overall Latin American cohort was 4.3 (3.4) at baseline. Conclusions: This baseline analysis of the Latin America subregion of the ALAFOS study indicates that patients who are prescribed teriparatide in the four participant countries had severe osteoporosis and high prevalence of fractures. They also had back pain and poor health-related quality of life. The proportions of patients with severe or extreme problems on the EQ-5D-5 L individual domains were lower than those in the overall ALAFOS study population.

Factors associated with postpartum health problems among married women of reproductive age in the Democratic Republic of the Congo: a cross-sectional study in Kenge City

Maternal mortality is attracting attention worldwide, but maternal health problems after delivery have received less attention. Most studies focus on prenatal maternal health problems. We aimed to identify factors associated with postpartum health problems among married women of reproductive age in Democratic Republic of the Congo. We employed a cross-sectional study design and randomly enrolled 700 married women of reproductive age in Kenge city. Data collection instrument was developed using the UNICEF Multiple Indicator Cluster Survey. T-test, chi-square test, and binary logistic regression analysis were performed using the SPSS version 24.0. Significant risk factors associated with postpartum health problems were initial postnatal care period; within 24 hours (Odds Ratio [OR]=2.197, 95% confidence interval [CI]: [1.156­4.174], p=.016); within 7 days (OR=1.972, 95% CI: [1.102­3.528, p=.022]; within 14 days (OR=2.124, 95% CI: [1.082­4.172], p=.029) among reproductive health and health service utilization characteristics. Health education by RECO (Relais Cmunataure) was associated with postpartum health problems including PCIME (Prise en Charge Integree des Maladies de l'Enfant; OR=1.845, 95% CI: [1.038­3.282], p=.037); hand washing (OR=1.897, 95% CI: [1.060­3.396], p=.031); malaria (OR=2.003, 95% CI: [1.192­3.366], p=.009) among Maternal and Child Health intervention characteristics. In conclusion, it is necessary to develop and promote health policies and educational programs focusing on PNC service within 24 hours, PNC services within 7 days, PCIME, hand washing, prevention of malaria

Multi-drug resistant bacteria and associated factors among reproductive age women with significant bacteriuria

Background: Urinary tract infection (UTI), an infection that disproportionately affects women, is commonly caused by bacteria. Emergence of multi-drug resistant urinary tract infections is a serious health issue with significant maternal morbidity and mortality. Objective: The aim of this study was to assess the prevalence of multi-drug resistant bacteria and associated factors among reproductive age women with significant bacteriuria. Methods: Cross-sectional study was conducted from April to August 2016 on 424 study subjects in Jimma University Specialized Hospital. Data were collected using pretested questionnaire. Morning midstream urine samples were collected and processed following standard operating procedures. Antimicrobial susceptibility testing was done following Clinical Laboratory Standards Institute 2014 guidelines. Samples were tested for cell surface hydrophobicity, biofilm production, extended spectrum betalactamases and carbapenemases production. Results: The prevalence of UTI among suspected reproductive age women was 22.9%. E. coli was the most frequent isolate with a rate of 57% among isolated bacteria followed by Klebsiella species (24.7%). Over 90% of the isolates were multi-drug resistant. Resistance pattern for ampicillin was 100% followed by ticarcillin (92.4%) and colistin (86%) while less resistance rate was found for imipenem(13%). Multivariate analysis revealed that risk factors such as previous history of hospitalization, extended spectrum betalactamase production and strong biofilm production were significantly associated with multidrug resistance (p <0.05). Conclusion: The prevalence of multi-drug resistance (MDR) among isolates of UTI in the study was high and this correlates with the prevalence of virulence phenotypes. Gram-negative organisms were the most common causes of UTIs

Covert contraceptive use among women of reproductive age in Ibadan, Nigeria

BACKGROUND: This study assessed the prevalence and determinants of covert contraceptive use among women of reproductive age in Ibadan, Nigeria. METHODS: A cross sectional study among women attending a family planning clinic in a maternity teaching hospital in Ibadan, Nigeria was conducted. Data was collected on sociodemographic characteristics, contraceptive use and partner awareness of use. The socio-demographic predictors of covert contraceptive use were explored using logistic regressions. RESULTS: Twenty-five (6.8%) of the 365 respondents were practicing covert contraception. Their mean age was 34.7+6.67 years, 98.6% were married and with modal parity of 3 (29.6%). A logistic regression analysis showed that participants' age (p = 0.555), occupation (p = 0.679), education (p = 0.642), parity (p = 0.385) and husbands' education (p = 0.926) were not statistically associated with covert contraceptive use while husbands' financial supports (p = 0.000) and approval for family planning use (p = 0.000) were associated with reduction in the likelihood covert contraceptive use. CONCLUSION: Covert contraceptive use exist among our women. Poor financial support and disapproval by the husbands were the strongest predictors of the practice. Greater male involvement in contraceptive service provision will help address these negative factors promoting covert contraceptive practices

Aspectos sociodemográficos, história sexual reprodutiva e conhecimento contraceptivo de puérperas adolescentes e adultas / Características sociodemográficas, historia reproductiva sexual y el conocimiento de anticonceptivos de adolescentes y adultos / Socio-demographic aspects, sexual reproductive history and contraceptive knowledge of puerperal teenagers and adults

OBJETIVO: descrever e comparar os aspectos sociodemográficos, a história sexual e reprodutiva e o conhecimento contraceptivo de puérperas adolescentes e adultas que tiveram seus partos numa maternidade de referência para a macrorregião de saúde. MÉTODOS: foi realizada entrevista individual com um instrumento semi estruturado contendo questões relativas aos aspectos estudados. RESULTADOS: a média de idade das puérperas foi de 26,74 anos. Dentre os métodos contraceptivos, a pílula foi apontada como mais conhecido. Houve associação estatisticamente significante entre o período fértil e a idade da puérpera e a renda. A mediana de idade em que as puérperas tiveram sua primeira relação sexual foi de 17 anos. A associação idade da puérpera e idade da primeira relação sexual (p<0,001) identificou início mais cedo da atividade sexual entre as adolescentes. CONCLUSÃO: as puérperas, em geral, possuem conhecimento inadequado do período fértil, além do conhecimento limitado acercados métodos contraceptivos. Há necessidade de maior atenção à assistência e ao planejamento familiar.

OBJECTIVE: to describe and to compare the sociodemographic aspects, the sexual and reproductive history and contraceptiveknowledge of postpartum teenagers and adults who had their births in a reference maternity for the health macro-region.METHODS: we used individual interview with a semi-structured instrument containing questions related to the previously studiedaspects. RESULTS: the average of the mothers’ age was 26.74 years old. Among the methods of contraception, the pill was the mostknown by the mothers. There was a statistically significant association between the fertile phase, the age of puerperal woman andincome. The median age at which the mothers had their first sexual intercourse was 17 years old. The association of postpartumage and her first sexual intercourse age (p <0.001) identified earlier onset of sexual activity among adolescents. CONCLUSION: ingeneral, they have inadequate knowledge of the fertile period, in addition to limited knowledge about contraceptive methods.There is a need for greater attention to family planning and care.

OBJETIVO: describir y comparar los aspectos socio-demográficos, la historia sexual y reproductiva y el conocimiento anticonceptivode las madres adolescentes y adultos que tenían sus entregas en una maternidad de referencia en la macro-región de salud. MÉTODOS: fueron realizadas entrevistas individuales con instrumentos semi-estructurados con las cuestiones relativas a losaspectos estudiados. RESULTADOS: La edad media de las madres fue de 26,74 años. Entre los métodos anticonceptivos, la píldora hasido nombrado el más conocido. Se observó una asociación estadísticamente significativa entre el período fértil y la edad puerperaly los ingresos. La edad media a la que las madres tuvieron su primera relación sexual fue a los 17 años. La asociación edadpuerperal y la edad de la primera relación sexual (p <0,001) identificó inicio más temprano de la actividad sexual entre losadolescentes. CONCLUSIÓN: las madres, generalmente, tienen un conocimiento inadecuado del período fértil, además de unconocimiento limitado acerca de los métodos anticonceptivos. Existe la necesidad de una mayor atención a la ayuda y a laplanificación familiar.

Predictive Factors for Severe Thrombocytopenia and Classification of Causes of Thrombocytopenia in Premature Infants

PURPOSE: This study investigated predictive factors for severe neonatal thrombocytopenia, which greatly increases the need for intensive care and is associated with a high mortality rate in premature infants. Factors adopted for prompt identification of at-risk newborns include blood test results and birth history. This study analyzed the relationship between the presence of severe neonatal thrombocytopenia and the mortality rate. The causes of thrombocytopenia in premature infants were also examined. METHODS: This retrospective study evaluated 625 premature infants admitted to the neonatal intensive care unit (NICU) at Chung-Ang University Medical Center. The neonates were classified into 3 groups according to the severity of thrombocytopenia: mild (100×10⁹/L≤platelet < 150×10⁹/L), moderate (50×10⁹/L≤platelet < 100×10⁹/L), or severe (platelet < 50×10⁹/L). Analysis of blood samples obtained at the onset of thrombocytopenia included platelet count, white blood cell (WBC) count, hemoglobin level, hematocrit level, absolute neutrophil count, and high-sensitivity C-reactive protein level. RESULTS: Of the 625 premature infants admitted to our NICU, 214 were detected with thrombocytopenia. The mortality rate in thrombocytopenic neonates was 18.2% (39/214), whereas a mortality rate of only 1.0% was observed in non-thrombocytopenic neonates. The major causes of thrombocytopenia were perinatal insufficiency and sepsis in premature infants. Severe thrombocytopenia was noted more frequently in premature infants with higher WBC counts and in those with a younger gestational age. CONCLUSION: Platelet count, WBC count, and gestational age are reliable predictors for severe neonatal thrombocytopenia. The major causes of thrombocytopenia were perinatal insufficiency and sepsis in premature infants.

Effect of Childbirth Age on Bone Mineral Density in Postmenopausal Women

BACKGROUND: In postmenopausal women, there is rapid bone loss due to estrogen depletion. In women, reproductive factors such as age at menarche, breastfeeding, and parity are considered risk factors of osteoporosis. Many reports suggest that obesity is associated with a reduced risk of osteoporosis. This nationwide, population-based study aims to identify the association between maternal age and osteoporosis risk in postmenopausal women of different obesity classifications. METHODS: We assessed data from the Korean National Health and Nutrition Examination Survey 2010–2012. The study included 1,328 postmenopausal women, after excluding women with missing data for reproductive history among 4,546 postmenopausal women in the survey. Multivariate regression was used to identify the association between childbirth age and postmenopausal bone mineral density after adjustments for confounding factors. RESULTS: The prevalence of postmenopausal osteoporosis was 35.24% (n = 468). After dividing the subjects into obese and non-obese groups based on body mass index (BMI) and waist circumference, there were significant differences between non-osteoporosis and osteoporosis groups with regard to age at first childbirth, age at last childbirth, and parity in the BMI-based general obesity group. The prevalence of osteoporosis was highest in women older than 35 years old at last childbirth. The prevalence of osteoporosis was also greater in women with parity ≥ 4 compared to those with lower parity levels. CONCLUSION: Postmenopausal women of older age at last childbirth and higher parity were at increased risk of osteoporosis in the BMI-based non-general obesity group.

Preterm Labor and Birth: Definition, Assessment, and Management

No abstract available.

Clinical characteristics of lower respiratory tract infection in low birth weight children

PURPOSE: Lower respiratory tract infection (LRTI) is one of the most common causes of hospitalization in the pediatric population. In this study, we investigated the clinical characteristics of LRTI, particularly in low birth weight children. METHODS: We reviewed medical records of children at ages 0–6 years with LRTI in Korea University Anam Hospital between January and December of 2014. Clinical data including age, sex, birth history, viral pathogens, blood test results, and clinical courses were collected. RESULTS: In the 828 eligible cases, 617 (74.5%) were pneumonia and followed by bronchiolitis 180 (21.7%) and bronchitis 31 (3.7%). The median age of the subjects was 17 months (interquartile range [IQR], 7–28 months), the median gestational age was 39.0 weeks (IQR, 38.0–40.0 weeks) and the median birth weight was 3,200 g (IQR, 2,900–3,480 g). Sixty-four children (7.7%) were low birth weight (< 2,500 g) and their median gestational age and birth weight were 33.0 weeks (IQR, 30.0–36.0 weeks) and 2,045 g (IQR, 1,565–2,300 g), respectively. The rates of oxygen supplement (17.2% vs. 4.6%, P < 0.001) and systemic steroid use (20.3% vs. 4.7%, P < 0.001) were significantly higher in low birth weight children than normal birth weight children. Respiratory viruses were identified in 82.6% (519 of 628 subjects); RSV was detected in 240 subjects (38.2%), followed by rhinovirus 168 (26.8%) and adenoviruses 75 (11.9%). The distribution of respiratory viruses was not different between normal birth weight children and low birth weight children. CONCLUSION: Low birth weight children show more severe clinical manifestations than normal birth weight children during hospitalization for LRTI, although respiratory viral pathogens were not different. Clinicians should be aware that the severity may be increased when low birth weight children were hospitalized due to low respiratory tract infection.

Scorpions and life-history strategies: from evolutionary dynamics toward the scorpionism problem

This work aims to contribute to the general information on scorpion reproductive patterns in general including species that can be noxious to humans. Scorpions are unusual among terrestrial arthropods in several of their life-history traits since in many aspects their reproductive strategies are more similar to those of superior vertebrates than to those of arthropods in general. This communication focuses mainly on the aspects concerning embryonic and post-embryonic developments since these are quite peculiar in scorpions and can be directly connected to the scorpionism problem. As in previous similar contributions, the content of this communication is addressed mainly to non-specialists whose research embraces scorpions in several fields such as venom toxins and public health. A precise knowledge of reproductive strategies presented by several scorpion groups and, in particular, those of dangerous species may prove to be a useful tool in the interpretation of results dealing with scorpionism, and also lead to a better treatment of the problems caused by infamous scorpions.(AU)

Prevalence of functioning difficulties and disability in Mexican adolescent women and their populational characteristics / Prevalencia de dificultades de funcionamiento y discapacidad en adolescentes mexicanas y sus características poblacionales

Abstract: Objective: Report prevalence of functioning difficulties and disabilities among Mexican adolescent women 15-17 years old and identify differences in characteristics of those with and without a functioning difficulty or disability Materials and methods: Using data from the National Survey of Boys, Girls and Women in Mexico 2015 we estimated prevalence of functioning difficulties and disability and used chi square tests for independence and logistic regression to explore associations between this condition and various characteristics. Results: Of Mexican adolescent women 15-17 years old, 11.1% had a functioning difficulty or disability. The group of domains of functioning difficulty and disability with by far the highest prevalence was socio-emotional and behavioral functioning difficulties or disability with 8.6%. Being employed, rural residence and self-reported depression symptoms were associated with having functioning difficulties or disability. Conclusions: This survey constitutes an important initial step in collecting data on functioning difficulty and disability in Mexico although larger samples should be studied.

Resumen: Objetivo: Reportar la prevalencia de dificultades de funcionamiento y discapacidad entre mujeres adolescentes mexicanas de 15-17 años e identificar diferencias en características entre las que tienen tal condición y las que no. Material y métodos: Basado en la Encuesta Nacional de Niños, Niñas y Mujeres 2015, se estimaron prevalencias de problemas de funcionamiento y discapacidad y se exploró la relación con varias características con ji cuadrada y regresión logística. Resultados: El 11.1% de las mujeres adolescentes mexicanas de 15-17 años tuvieron dificultades de funcionamiento o discapacidad. El grupo de ámbitos de dificultades de funcionamiento y discapacidad con la mayor prevalencia fue socioemocional y comportamiento con 8.6%. Tener empleo, residencia rural y síntomas de depresión autoreportadas están asociadas con tener dificultades de funcionamiento y discapacidad. Conclusiones: Esta encuesta constituye un primer paso importante en la generación de datos sobre dificultades de funcionamiento y discapacidad en México, aunque se requiere estudiar el tema en muestras mayores.

Application of single nucleotide polymorphism array for the identification of pathogenic copy number variations in fetuses with malformations and women with an adverse reproductive history / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To apply single nucleotide polymorphism microarray (SNP array) for the detection of genome-wide copy number variations(CNVs) in fetuses with malformations and women with an adverse reproductive history, and to explore the correlation of rare CNVs with the clinical manifestations.</p><p><b>METHODS</b>Amniotic fluid and umbilical cord blood samples were collected from 314 women with singleton pregnancy. SNP array was performed on samples where chromosomal abnormalities were excluded after G-banding analysis.</p><p><b>RESULTS</b>Pathological CNVs were detected in 8.91% (28/314) of all samples, which included 11 duplications, 9 deletions, 4 loss of heterozygosity (LOH), and 4 conjoined deletions and duplications. The sizes of duplications and deletions were between 0.47 Mb and 16.7 Mb, and between 0.16 Mb and 13.3 Mb, respectively. Fifteen CNVs were mapped to the regions of microdeletion or microduplication syndromes or regions associated with clinical manifestations, while the remainder 13 were considered benign or variant of uncertain significance.</p><p><b>CONCLUSION</b>A proportion of fetuses with malformations and women with an adverse reproductive history may be attributed to CNVs, half of which are mapped with to the regions of well known syndromes. SNP array may facilitate discovery of new syndromes and provide a basis for genetic counseling and prenatal diagnosis.</p>