Effects of a pre-visit online information tool about genetic counselling for ovarian cancer patients, a randomized controlled trial.

OBJECTIVE: In the Netherlands, patients with ovarian cancer are offered genetic testing. Pre-test preparation may help counseling patients. The aim of this study was to determine if use of a web-based intervention, leads to more effective genetic counseling of ovarian cancer patients. METHODS: Between 2016 and 2018, 127 ovarian cancer patients referred for genetic counseling in our hospital participated in this trial. 104 Patients were analyzed. All patients filled out questionnaires pre- and post-counseling. The intervention group also completed a questionnaire after visiting an online tool. Length of consultation, patients' satisfaction, knowledge, anxiety, depression and distress were compared before and after counselling. RESULTS: The intervention group had the same level of knowledge compared to the counseling group, but at an earlier point in time. They were satisfied with the intervention (86%) and better prepared for counseling (66%). The intervention did not lead to shorter consultations. No differences in levels of anxiety, depression, distress and satisfaction were observed. CONCLUSION: Although consultation length was unaffected, the improvements in knowledge after online education and patients satisfaction indicates that this tool can be an effective addition to genetic counseling. PRACTICE IMPLICATIONS: Use of an educational tool may lead to a more effective, personalized way of genetic counselling and enables shared decision making.

Bowel habits in the first 24 months of life: preterm- versus term-born infants.

BACKGROUND AND AIM: New prospective studies concerning feeding and bowel habits of term and preterm infants from birth to 24 months of life are needed. The aim of the present study was to describe and compare feeding and bowel habits between term- and preterm-born infants starting from birth up to the age of 24 months. PATIENTS AND METHODS: Between August and November 2006 all of the infants admitted to an academic and nonacademic neonatal care unit with gestational age 25 to 42 weeks participated in the study. Bowel diaries were recorded 1 and 2 weeks, and 3, 6, 12, and 24 months after birth. Infants with gastrointestinal surgery, neurological diseases, metabolic diseases, or congenital abnormalities were excluded. RESULTS: A total of 199 (126 preterm) infants were eligible; 153 gave consent for participation. Although feeding frequency was higher in the first 3 months in the preterm born, overall feeding frequency decreased between the first 3 follow-up periods (P < 0.001) in both groups. In the first and second week, breast-fed infants had 2.41 more episodes of defecation per week compared with the formula-fed infants (P = 0.017 and P = 0.021, respectively). Higher median (10th percentile-90th percentile) defecation frequency was only found in week 1 in the term compared with the preterm group (24 [9.4-31.6] versus 16 [6.5-31]; P = 0.002). The overall median defecation frequency was 16 (7-30) per week from birth up to the age of 24 months over the total group of participating infants. CONCLUSIONS: Term and preterm infants have a comparable defecation frequency from the second week of life up to the age of 24 months.

Duration of meconium passage in preterm and term infants.

BACKGROUND: First passage of stool after birth, meconium, is delayed in preterm infants compared to term infants. The difference in duration of meconium passage until transition to normal stools has however never been assessed in preterm and term infants. HYPOTHESIS: Preterm infants have prolonged duration of passage of meconium (PoM) compared to term infants. METHODS: Between August and November 2006, all infants born in an academic and non-academic hospital with gestational age (GA) 25-42 weeks and without metabolical, congenital diseases or gastrointestinal disorders, were included. Infants were divided into four groups: (A) GA < or =30 weeks; (B) GA between 31 and 34 weeks; (C) GA between 35 and 36 weeks; (D) GA > or = 37 weeks (term born). RESULTS: A total of 198 infants (102 males); 32, 62, 33 and 71 infants in groups A, B, C and D, respectively, were included. With decreasing gestation a trend was found for delayed first PoM (p<0.001). Compared to term infants 79% (56/71), less preterm infants passed their first stool within 24 h after birth--group A: 44% (14/32); group B: 68% (42/62); and group C: 73% (24/33). With decreasing gestation a trend for prolonged PoM was found (p<0.001). The mean (SD) PoM duration was prolonged in group A: 7.8 days (2.5); group B: 4.3 days (2.4); and group C: 2.9 days (1.3) compared to term infants. Furthermore, PoM was associated with birth weights < or =2500 g (p = 0.03) and morphine therapy (p = 0.03). Duration of PoM was not associated with type of feeding, small for gestational age, large for gestational age or need for respiratory support. CONCLUSION: PoM was not only delayed but also prolonged in preterm infants. Duration of PoM was associated with GA, birth weight and morphine therapy.