Reduction of hospital stay at maternity unit: an evaluation of the impact on maternal and neonatal readmission.

In June 2015, the Belgian federal minister of public health imposed a reduction of 1 day in hospital stay at the maternity unit. This retrospective cohort study evaluated data of all patients who delivered between January 01 2010 and November 30 2015. Neonatal readmissions during the first 28 days postpartum and maternal readmissions during the first 6 weeks postpartum were studied. In total, 6009 births were included. The neonatal readmissions significantly increased (4.8% versus 6.9%, p value = .04) after June 2015. There was no significant difference in maternal readmissions between groups. In conclusion, hospital stay reduction at the maternity unit was linked with an increase of neonatal readmissions in the first 28 days postpartum, but did not have an effect on the maternal readmissions.Impact StatementWhat is already known on this subject? Many studies have evaluated the impact of early discharge on maternal and neonatal morbidity since 1950. Nevertheless, there are still concerns regarding the advantages and inconveniences of this policy. This retrospective cohort study took place in a tertiary referral centre in Belgium (CHU Tivoli) and evaluated data of all patients who delivered between January 01 2010 and November 30 2015.What the results of this study add? The readmissions for icterus increased significantly after the introduction of the reduced stay. There was no significant difference in maternal readmissions between groups.What the implications are of these findings for clinical practice and/or further research? A shorter hospital may be linked with an increase of neonatal readmissions in the first 28 days postpartum, but does not seem to have an effect on the maternal readmissions. Further prospective studies are needed in order to validate this hypothesis and also elucidate the reasons leading to a higher neonatal readmission rate.

Aminophylline reversal of antihypertensive agent toxicity.

Hypotension occurred following a combined beta blocker (atenolol), angiotensin converting enzyme inhibitor (quinapil) and selective serotonin reuptake inhibitor (fluvoxamine) overdose. In another instance heart block and hypotension was noted in association with a diltiazem and atenolol adverse interaction. Crystalloid infusion was ineffective in both cases, but toxicity was rapidly reversed with aminophylline administration. Aminophylline's recognized inotropic and chronotropic properties make it a potentially valuable therapeutic agent in the treatment of antihypertensive medication toxicity.

Digital optical computing with magneto-optic spatial light modulators: a new and efficient multiplication algorithm.

Digital optical computing executed on arrays of binary data can offer parallel processing and multivalued output, which permits more flexibility in algorithm development. The hardware used consists of two computer-controlled magneto-optic spatial-light-modulator arrays in conjunction with a CCD detector array as the computational hardware. Algorithms for binary-processing tasks are presented. We used magneto-optic spatial light modulators for parallel processing in a way that exploits multivalued output. Also, in carrying this evaluation out, we developed a new and efficient multiplication algorithm. Multiplication is an important operation in many digital systems, and the design of fast multipliers is of great interest to computer scientists and engineers. The speed of this computing system is evaluated.

Coronary artery aneurysms in Kawasaki disease: the Puerto Rican experience.

Kawasaki disease is a newly recognized clinical entity of unknown origin that occurs in the pediatric age and is characterized by multisystemic involvement. Pathologically, widespread vasculitis is present and approximately 10 to 20% of affected children have coronary aneurysms. The latter are mostly silent but 1-2% of them progress to coronary artery obstruction and death from myocardial infarction. Such aneurysms can be visualized by echocardiography and 50% of them apparently resolve, although in some cases, residual coronary artery damage persists after resolution of the aneurysm. The local experience with 116 patients of KD is reported. In only 4 of them significant coronary artery involvement was present. They all remained asymptomatic, the affected arteries were slowly recovering and no fatalities were present. The low incidence of coronary aneurysms and the uneventful course of the disease suggests a milder, less virulent course of KD in our environment. Residual changes in the affected coronary arteries are considered a late risk factor for coronary artery disease in man.