CDC Division of Reproductive Health's Emergency Preparedness Resources and Activities for Radiation Emergencies: Public Health Considerations for Women's Reproductive Health.

Pregnant, postpartum, and lactating people, and infants have unique needs during public health emergencies, including nuclear and radiological incidents. This report provides information on the CDC Division of Reproductive Health's emergency preparedness and response activities to address the needs of women of reproductive age (aged 15-49 years), people who are pregnant, postpartum, or lactating, and infants during a radiation emergency. Highlighted preparedness activities include: (1) development of a quick reference guide to inform key questions about pregnant, postpartum, and lactating people, and infants during radiation emergencies; and (2) exercising the role of reproductive health experts during nuclear and radiological incident preparedness activities.

Emergency Preparedness and Response: Highlights from the Division of Reproductive Health, 2011-2021.

This report provides historical context and rationale for coordinated, systematic, and evidence-based public health emergency preparedness and response (EPR) activities to address the needs of women of reproductive age. Needs of pregnant and postpartum women, and infants-before, during, and after public health emergencies-are highlighted. Four focus areas and related activities are described: (1) public health science; (2) clinical guidance; (3) partnerships, communication, and outreach; and (4) workforce development. Finally, the report summarizes major activities of the Division of Reproductive Health's EPR Team at the Centers for Disease Control and Prevention.

Severe Coronavirus Infections in Pregnancy: A Systematic Review.

OBJECTIVE: To inform the current coronavirus disease 2019 (COVID-19) outbreak, we conducted a systematic literature review of case reports of Middle East respiratory syndrome coronavirus (MERS-CoV), severe acute respiratory syndrome coronavirus (SARS-CoV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, during pregnancy and summarized clinical presentation, course of illness, and pregnancy and neonatal outcomes. DATA SOURCES: We searched MEDLINE and ClinicalTrials.gov from inception to April 23, 2020. METHODS OF STUDY SELECTION: We included articles reporting case-level data on MERS-CoV, SARS-CoV, and SARS-CoV-2 infection in pregnant women. Course of illness, indicators of severe illness, maternal health outcomes, and pregnancy outcomes were abstracted from included articles. TABULATION, INTEGRATION, AND RESULTS: We identified 1,328 unique articles, and 1,253 articles were excluded by title and abstract review. We completed full-text review on 75, and 29 articles were excluded by full-text review. Among 46 publications reporting case-level data, eight described 12 cases of MERS-CoV infection, seven described 17 cases of SARS-CoV infection, and 31 described 98 cases of SARS-CoV-2 infection. Clinical presentation and course of illness ranged from asymptomatic to severe fatal disease, similar to the general population of patients. Severe morbidity and mortality among women with MERS-CoV, SARS-CoV, or SARS-CoV-2 infection in pregnancy and adverse pregnancy outcomes, including pregnancy loss, preterm delivery, and laboratory evidence of vertical transmission, were reported. CONCLUSION: Understanding whether pregnant women may be at risk for adverse maternal and neonatal outcomes from severe coronavirus infections is imperative. Data from case reports of SARS-CoV, MERS-CoV, and SAR-CoV-2 infections during pregnancy are limited, but they may guide early public health actions and clinical decision-making for COVID-19 until more rigorous and systematically collected data are available. The capture of critical data is needed to better define how this infection affects pregnant women and neonates. This review was not registered with PROSPERO.

Addressing Maternal Health During CDC's Ebola Response in the United States.

Previous outbreaks suggest that pregnant women with Ebola virus disease (EVD) are at increased risk for severe disease and death. Healthcare workers who treat pregnant women with EVD are at increased risk of body fluid exposure. Despite the absence of pregnant women with EVD in the United States, CDC activated the Maternal Health Team (MHT), a functional unit dedicated to emergency preparedness and response issues, on October 18, 2014. We describe major activities of the MHT. A high-priority MHT activity was to publish guiding principles early in the response. The MHT also prepared guidance documents, provided guidance and technical support for hospital preparedness, and addressed inquiries. We analyzed maternal health inquiries received through CDC-INFO, MHT, and CDC's Medical Investigations Team from August 2014 to December 2015. Internal call logs used to capture, monitor, and track inquiries for the three data sources were merged. Inquiries not related to maternal health issues and duplicates were removed. Each inquiry was categorized by route (email/phone), inquirer type, and topic. In total, 201 inquiries were received from clinicians, public health professionals, and the public. The predominant topic was related to infection control for high-risk situations such as labor and delivery. During the Ebola response, most inquiries were received via email rather than telephone, a notable shift compared to the H1N1 emergency response. Lessons learned during the H1N1 and Ebola responses are currently informing CDC's Zika Response, an unprecedented emergency response primarily focused on reproductive health issues.

CDC Online Course: Reproductive Health in Emergency Preparedness and Response.

In an emergency, the needs of women of reproductive age, particularly pregnant and postpartum women, introduce unique challenges for public health and clinical care. Incorporating reproductive health issues and considerations into emergency preparedness and response is a relatively new field. In recent years, several resources and tools specific to reproductive health have been developed. However, there is still a need for training about the effects of emergencies on women of reproductive age. In an effort to train medical and public health professionals about these topics, the CDC Division of Reproductive Health developed Reproductive Health in Emergency Preparedness and Response, an online course that is available across the United States.

Retención, efectividad, cobertura y reacción sensitiva al tratamiento restaurativo atraumático modificado, utilizando dos marcas de Ionómero de vidrio. (En niños de 7-8 años del centro escolar Cantón San Antonio del Municipio de Ciudad Victoria, Carolina # 2 y Filos de Palacios del Municipio de Jutiapa en el Departamento de Cabañas) / Retention, effectiveness, coverage and sensitive reaction to the modified atraumatic restorative treatment, using two brands of Glass Ionomer. (In children 7-8 years old from the Cantón San Antonio school in the Municipality of Ciudad Victoria, Carolina # 2 and Filos de Palacios in the Municipality of Jutiapa in the Department of Cabañas)

Objetivo: Determinar la Retención, Efectividad, Cobertura y Reacción sensitiva al Tratamiento Restaurativo Atraumático Modificado, utilizando Ketac™ Molar 3MM ESPE y Fuji IX. Metodología: El diseño corresponde a un Ensayo Clínico Aleatorizado, triple ciego. La muestra fueron 49 escolares de 7 a 8 años del área rural de los Municipios de Jutiapa y Ciudad Victoria en el departamento de Cabañas; se conformaron dos grupos A (n24) empleando Ketac Molar y B (n25) utilizando Fuji IX. Los diferentes datos se procesaron en una hoja diseñada en el programa Excel, se resumieron con estadísticos descriptivos, se analizaron con test de significación e inferencia estadística empleando el software SPSS v.18. Resultados: No existe diferencia significativa en los tiempos promedios de cada tratamiento según marca de cemento de Ionómero de Vidrio utilizada, (P ="0.093") además que existe diferencia significativa en lo referente a retención y efectividad entre las marcas de cemento de ionómero de vidrio posterior a 3 y 6 meses de realizados, (3 meses P ="0.000"), (6 meses P ="0.006"). Conclusiones: El TRAM produce mínima ansiedad y reacción sensitiva durante y posterior al tratamiento.

Objective: To determine the Retention, Effectiveness, Coverage and Sensitive Reaction to the Modified Atraumatic Restorative Treatment, using Ketac ™ Molar 3MM ESPE and Fuji IX. Methodology: The design corresponds to a Randomized Clinical Trial, triple blind. The sample consisted of 49 schoolchildren aged 7 to 8 from the rural area of ​​the Municipalities of Jutiapa and Ciudad Victoria in the department of Cabañas; two groups A (n24) were formed using Ketac Molar and B (n25) using Fuji IX. The different data were processed in a sheet designed in the Excel program, they were summarized with descriptive statistics, they were analyzed with a significance test and statistical inference using the SPSS v.18 software. Results: There is no significant difference in the average times of each treatment according to the Glass Ionomer cement brand used, (P = "0.093"), in addition there is a significant difference in terms of retention and effectiveness between the glass ionomer cement brands. glass after 3 and 6 months after being made, (3 months P = "0.000"), (6 months P = "0.006"). Conclusions: TRAM produces minimal anxiety and sensitive reaction during and after treatment.

The Centers for Disease Control and Prevention's maternal health response to 2009 H1N1 influenza.

We describe the efforts of the Maternal Health Team, which was formed to address the needs of pregnant and breastfeeding women during the Centers for Disease Control and Prevention's (CDC's) 2009 pandemic influenza A (2009 H1N1) emergency response. We examined the team's activities, constructed a timeline of key pandemic events, and analyzed the Maternal Health 2009 H1N1 inquiry database. During the pandemic response, 9 guidance documents that addressed the needs of pregnant and breastfeeding women and their providers were developed by the Maternal Health Team. The Team received 4661 maternal health-related inquiries that came primarily from the public (75.5%) and were vaccine related (69.3%). Peak inquiry volume coincided with peak hospitalizations (October-November 2009). The Maternal Health 2009 H1N1 inquiry database proved useful to identify information needs of the public and health care providers during the pandemic.

Prior contraceptive use among women who gave birth in the US-Mexico border region, 2005: the Brownsville-Matamoros Sister City Project for Women's Health.

INTRODUCTION: Dramatic population growth in the US-Mexico border region suggests more effective family planning services are needed, yet binational data are scarce. The Brownsville-Matamoros Sister City Project for Women's Health collected binational, standardized data from 947 postpartum women in Cameron County (Texas) and Matamoros (Tamaulipas, Mexico) hospitals from August through November 2005. METHODS: We analyzed these data to estimate the proportion of women with unintended pregnancy and the proportion of these women who reported contraceptive use, and to identify associated factors. RESULTS: The current pregnancy was unintended for 48% of women overall. Almost half of these women reportedly used birth control at conception, but many used low-efficacy methods. Among women with unintended pregnancy who did not use contraception, 34.1% of Mexico residents believed they could not become pregnant and 28.4% of US residents reported no reason for nonuse. Overall, contraceptive use to prevent pregnancy was less common among younger than older women and among women who had not graduated high school compared with those who had. Among Mexico residents, those who had a source of routine health care were more likely than those who did not to have used contraception. CONCLUSION: More effective contraceptive practices are needed in this population, especially among younger and less-educated women. A cooperative binational approach that integrates reproductive and family planning services may be most effective.

Andrographolide inhibits IFN-gamma and IL-2 cytokine production and protects against cell apoptosis.

Andrographolide is the main labdane diterpene present in Andrographis paniculata. Two lines of evidence report immunostimulant and anti-inflammatory properties for andrographolide in different models. Using murine T-cells in vitro we demonstrated that andrographolide and to a lesser extent, 14-deoxyandrographolide (14-DAP), reduced significantly, in a dose-dependent manner, the IFN-gamma production induced by concanavaline A (CON-A), with an IC50 of 1.7 +/- 0.07 microM and 35.8 +/- 0.50 microM, respectively. Andrographolide, but not 14-DAP, inhibited partially the IL-2 production induced by CON-A. Andrographolide at doses of 5 and 10 microM reduced the extracellular-signal-regulated protein kinase (ERK1/2) phosphorylation induced by CON-A, whereas 14-DAP only reduced ERK1 and partially the ERK2 phosphorylation. The inhibition of ERK1/2 phosphorylation was associated to a decrease in the IFN-gamma production, due that UO126, a specific ERK1/2 inhibitor, also reduced the IFN-gamma production in murine T-cells induced by CON-A. Additionally, andrographolide and to a lesser extent 14-DAP, at doses of 50 microM and 100 microM, respectively, reduced the apoptosis induced by hydrocortisone and PMA in thymocytes, which was associated to a decrease in caspase-3 like activity. We conclude that both diterpenic labdanes isolated from A. paniculata can exert potent immunosuppressant effects without affecting the viability of the cells.

Depresión en adolescentes. Relaciones con el desempeño académico / Depression in adolescents. Relationships with academic achievement

El objetivo de este trabajo fue, por un lado, explorar los indicadores de depresión en escolares adolescentes, de acuerdo al sexo, la edad y el tipo de escula a la concurren y, por otro lado, determinar su relación con el desempeño académico en las áreas de lengua y matemática. Los instrumentos empleados para el relevamiento de datos fueron un Cuestionario de Depresión para niños y pruebas de logro utilizadas en operativos provinciales de evaluación de calidad educativa. Se trabajó con una muestra de 888 alumnos del 7ª y 9ª año de EGB., de ambos sexos, asistentes a escuelas públicas y privadas. Los resultados globales indicaron correlaciones negativas estadísticamente significativas entre los indicadores de depresión y el rendimiento escolar en ambas áreas. Sin embargo, un análisis pormenorizado de acuerdo al sexo, la edad y el tipo de escuela, indicó que esa asociación depende de estas variables y que los efectos se observan en las mujeres y en los alumnos de las escuelas públicas(AU)

Depresión en adolescentes. Relaciones con el desempeño académico / Depression in adolescents. Relationships with academic achievement

El objetivo de este trabajo fue, por un lado, explorar los indicadores de depresión en escolares adolescentes, de acuerdo al sexo, la edad y el tipo de escula a la concurren y, por otro lado, determinar su relación con el desempeño académico en las áreas de lengua y matemática. Los instrumentos empleados para el relevamiento de datos fueron un Cuestionario de Depresión para niños y pruebas de logro utilizadas en operativos provinciales de evaluación de calidad educativa. Se trabajó con una muestra de 888 alumnos del 7ª y 9ª año de EGB., de ambos sexos, asistentes a escuelas públicas y privadas. Los resultados globales indicaron correlaciones negativas estadísticamente significativas entre los indicadores de depresión y el rendimiento escolar en ambas áreas. Sin embargo, un análisis pormenorizado de acuerdo al sexo, la edad y el tipo de escuela, indicó que esa asociación depende de estas variables y que los efectos se observan en las mujeres y en los alumnos de las escuelas públicas

Principales causas de ceguera en la provincia Sancti Spíritus / Main causes of blindness in Sancti Spiritus Province

Se estudian 226 pacientes ciegos de la provincia Sancti Spíritus. Se analizan varios parámetros como edad, sexo y estado laboral. La causa más frecuente fue el glaucoma, fundamentalmente el crónico simple. La morbilidad de la provincia fue de 54,4 por cada 10 000 habitantes