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1.
Adv Mater ; 33(39): e2103000, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34397123

RESUMO

The competing and non-equilibrium phase transitions, involving dynamic tunability of cooperative electronic and magnetic states in strongly correlated materials, show great promise in quantum sensing and information technology. To date, the stabilization of transient states is still in the preliminary stage, particularly with respect to molecular electronic solids. Here, a dynamic and cooperative phase in potassium-7,7,8,8-tetracyanoquinodimethane (K-TCNQ) with the control of pulsed electromagnetic excitation is demonstrated. Simultaneous dynamic and coherent lattice perturbation with 8 ns pulsed laser (532 nm, 15 MW cm-2 , 10 Hz) in such a molecular electronic crystal initiates a stable long-lived (over 400 days) conducting paramagnetic state (≈42 Ωcm), showing the charge-spin bistability over a broad temperature range from 2 to 360 K. Comprehensive noise spectroscopy, in situ high-pressure measurements, electron spin resonance (ESR), theoretical model, and scanning tunneling microscopy/spectroscopy (STM/STS) studies provide further evidence that such a transition is cooperative, requiring a dedicated charge-spin-lattice decoupling to activate and subsequently stabilize nonequilibrium phase. The cooperativity triggered by ultrahigh-strain-rate (above 106 s- 1 ) pulsed excitation offers a collective control toward the generation and stabilization of strongly correlated electronic and magnetic orders in molecular electronic solids and offers unique electro-magnetic phases with technological promises.

2.
Pediatr Neurol ; 121: 40-44, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34153813

RESUMO

BACKGROUND: The proportion of children with recurrent signs and symptoms of intracranial hypertension after medication wean has been reported to be between 18% and 50%. Few studies have reported intracranial hypertension recurrence risk in children while adjusting for each individual's observed follow-up time after medication wean. In addition, the role of intracranial hypertension etiology on the risk of disease recurrence has not been widely studied. METHODS: The medical charts of patients with intracranial hypertension treated with intracranial pressure-lowering medication were analyzed retrospectively for disease recurrence. Baseline characteristics from diagnosis were recorded in addition to information regarding duration of therapy, medication wean, and recurrence. Survival analyses as well as Poisson regression models with time under observation as an offset were performed. RESULTS: One hundred and thirty-three patients were included in the study. The cumulative risk of intracranial hypertension recurrence increased rapidly within the first six months after medication wean and was 1.5% at one month, 9.5% at three months, and 20% at six months. This risk leveled off near 12 to 18 months. CONCLUSIONS: While the cumulative risk of intracranial hypertension recurrence increases most dramatically within the first six months after medication wean, it does not appear to taper until 12 to 18 months. Given the possibility of delayed or asymptomatic recurrences, long-term follow-up is ideal, although patients can likely be seen less frequently after the first 12 to 18 months after medication wean.

3.
J Pain Palliat Care Pharmacother ; 35(2): 91-99, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34010103

RESUMO

Oncology and Palliative Medicine lack guidance on routine opioid risk screening and compliance monitoring. This study explored relationships among risk screening and aberrant medication related behaviors in patients with advanced lung cancer receiving embedded palliative care. This was a single center, prospective study and data was collected from December 2018 to March 2020. At the initial palliative visit, patients provided a baseline urine drug screen (UDS) test and completed the Screener and Opioid Assessment for Patients with Pain - Revised (SOAPP-R) self-assessment. Clinical pharmacists provided comprehensive review and interpretation of UDS results. Among 39 patients, 12 (30.8%) scored positive for risk of aberrant medication behaviors on the SOAPP-R. Only 34 of 39 patients provided a baseline UDS test and were included in further analysis. Prior to pharmacist review, 11/11 (100%) baseline UDS results in the positive-risk group and 13/23 (56.5%) in the negative-risk group appeared unexpected (p = 0.01). After pharmacist review, aberrant baseline UDS results were confirmed for 5/11 (45.5%) positive-risk and 4/23 (17.4%) negative-risk patients (p = 0.11). Overall, the SOAPP-R alone may be inadequate in this population and clinical pharmacists play an important role in comprehensive UDS result interpretation. Future studies are needed to validate this risk-screening tool in palliative cancer populations.

4.
Nano Lett ; 2021 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-33886320

RESUMO

Magnetoelectrics are witnessing an ever-growing success toward the voltage-controlled magnetism derived from inorganic materials. However, these inorganic materials have predominantly focused on the ferroelectromagnetism at solid-to-solid interfaces and suffered several drawbacks, including the interface-sensitive coupling mediators, high-power electric field, and limited chemical tunability. Here, we report a promising design strategy to shift the paradigm of next-generation molecular magnetoelectrics, which relies on the integration between molecular magnetism and electric conductivity though an in situ cross-linking strategy. Following this approach, we demonstrate a versatile and efficient synthesis of flexible molecular-based magnetoelectronics by cross-linking of magnetic coordination networks that incorporate conducting chain building blocks. The as-grown compounds feature an improved critical temperature up to 337 K and a room-temperature magnetism control of low-power electric field. It is envisaged that the cross-linking of molecular interfaces is a feasible method to couple and modulate magnetism and electron conducting systems.

5.
Anticancer Res ; 41(3): 1439-1444, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33788735

RESUMO

BACKGROUND/AIM: Chemopreventative therapeutics may be helpful in familial adenomatous polyposis (FAP) management; however, prospective chemopreventative studies are complicated by potential ototoxicity and pre-existing hearing loss. The aim of this study was to establish and compare baseline hearing status of children and adolescents with FAP and their unaffected siblings. PATIENTS AND METHODS: Twenty FAP pediatric patients with documented mutation of the adenomatous polyposis coli (APC) gene and nine unaffected sibling controls underwent baseline hearing evaluation, including audiometry, speech perception testing, and middle and inner ear physiologic measures. Results of the FAP cohort were compared to the unaffected sibling cohort. RESULTS: Two (5%) children with FAP presented with baseline hearing loss of unknown etiology, likely unrelated to their FAP diagnosis. No significant differences were found in any of the hearing measures between groups. CONCLUSION: Mutation of the APC gene is not necessarily indicative of higher risk for baseline hearing loss in the pediatric population.


Assuntos
Proteína da Polipose Adenomatosa do Colo/genética , Polipose Adenomatosa do Colo/genética , Perda Auditiva/genética , Audição/genética , Mutação , Polipose Adenomatosa do Colo/fisiopatologia , Adolescente , Audiometria/métodos , Criança , Estudos de Coortes , Feminino , Testes Auditivos , Humanos , Masculino , Fatores de Risco , Irmãos
6.
Artigo em Inglês | MEDLINE | ID: mdl-33471249

RESUMO

OBJECTIVES: We evaluated the effectiveness of Moms2B, a community-based group pregnancy and parenting program, in an effort to assess whether the program improved pregnancy and infant outcomes. METHODS: We conducted a retrospective matched exposure cohort study comparing women exposed to the Moms2B program during pregnancy (two or more prenatal visits) who delivered a singleton live birth or stillbirth (≥ 20 weeks gestation) from 2011-2017 to a closely matched group of women not exposed to the program. Primary outcomes were preterm birth and low birth weight. Propensity score methods were used to provide strong control for confounders. RESULTS: The final analytic file comprised 675 exposed pregnancies and a propensity score-matched group of 1336 unexposed pregnancies. Most of the women were non-Hispanic Black. We found evidence of better outcomes among pregnancies exposed to Moms2B versus unexposed pregnancies, particularly for the primary outcome of low birth weight [9.45% versus 12.00%, respectively, risk difference (RD) = -2.55, 95% confidence interval (CI) = (-5.44, 0.34)]. Point estimates for all adverse pregnancy outcomes uniformly favored exposure to Moms2B. CONCLUSIONS FOR PRACTICE: Our findings suggest that participation in the Moms2B program improves pregnancy and infant outcomes. The program offers an innovative group model of pregnancy and parenting support for women, especially in non-Hispanic Black women with high-risk pregnancies.

7.
J Vet Intern Med ; 34(6): 2497-2506, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33128421

RESUMO

BACKGROUND: Chronic kidney disease-mineral and bone disorder (CKD-MBD) in dogs is associated with hypovitaminosis D, increased parathyroid hormone (PTH), and increased fibroblast growth factor-23 (FGF-23) concentrations. Best practice for vitamin D metabolite supplementation in CKD-MBD remains unknown. OBJECTIVE: To provide an extended-release calcifediol supplement to dogs with CKD and to measure its effects on variables indicative of CKD-MBD. ANIMALS: Ten dogs with International Renal Interest Society stages 2 and 3 CKD. METHODS: In a prospective study, dogs received a calcifediol supplement for 84 days. Serum 25-hydroxyvitamin D (25[OH]D), 1,25-dihydroxyvitamin D (1,25[OH]2 D), 24,25-dihydroxyvitamin D (24,25[OH]2 D), creatinine, calcium, phosphorus, PTH, plasma FGF-23 concentrations, and urine profiles were measured monthly during supplementation. Urine calcium to creatinine (UCa/Cr) ratios and fractional excretion of calcium, phosphorus, and sodium were determined. RESULTS: All serum vitamin D metabolite concentrations increased significantly by day 84 (P < .001): [25(OH)D (median 249.9 ng/mL; range, 149.7-469.9 ng/mL) compared to baseline (median 50.2 ng/mL; range, 31.3-66.0 ng/mL); 1,25(OH)2 D (median 66.1 pg/mL; range, 56.9-88.1 pg/mL) compared to baseline (median 37.3 pg/mL; range, 29.3-56.7 pg/mL); 24,25(OH)2 D (median 81.4 ng/mL; range, 22.1-151.7 ng/mL) compared to baseline (median 15.4 ng/mL; range, 6.9-40.6 ng/mL)]. There were no significant differences in calcium, phosphorus, PTH concentrations, UCa/Cr or fractional excretion of calcium. No dog developed ionized hypercalcemia. Plasma FGF-23 concentrations increased by day 84 (median 1219 pg/mL; range, 229-8824 pg/mL) compared to baseline (median 798 pg/mL; range, 103-4.145 pg/mL) (P < .01). CONCLUSIONS AND CLINICAL IMPORTANCE: Calcifediol supplementation for 84 days was well-tolerated in dogs with IRIS stages 2 and 3 CKD. It remains to be determined how long-term supplementation would affect CKD progression and QOL.


Assuntos
Distúrbio Mineral e Ósseo na Doença Renal Crônica , Doenças do Cão , Insuficiência Renal Crônica , Animais , Calcifediol , Cálcio , Distúrbio Mineral e Ósseo na Doença Renal Crônica/veterinária , Suplementos Nutricionais , Doenças do Cão/tratamento farmacológico , Cães , Hormônio Paratireóideo , Estudos Prospectivos , Qualidade de Vida , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/tratamento farmacológico , Insuficiência Renal Crônica/veterinária , Vitamina D
8.
Am J Perinatol ; 2020 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-32829479

RESUMO

OBJECTIVE: The objective of this study was to create three point-of-care predictive models for very preterm birth using variables available at three different time points: prior to pregnancy, at the end of the first trimester, and mid-pregnancy. STUDY DESIGN: This is a retrospective cohort study of 359,396 Ohio Medicaid mothers from 2008 to 2015. The last baby for each mother was included in the final dataset. Births prior to 22 weeks were excluded. Multivariable logistic regression was used to create three models. These models were validated on a cohort that was set aside and not part of the model development. The main outcome measure was birth prior to 32 weeks. RESULTS: The final dataset contained 359,396 live births with 6,516 (1.81%) very preterm births. All models had excellent calibration. Goodness-of-fit tests suggested strong agreement between the probabilities estimated by the model and the actual outcome experience in the data. The mid-pregnancy model had acceptable discrimination with an area under the receiver operator characteristic curve of approximately 0.75 in both the developmental and validation datasets. CONCLUSION: Using data from a large Ohio Medicaid cohort we developed point-of-care predictive models that could be used before pregnancy, after the first trimester, and in mid-pregnancy to estimate the probability of very preterm birth. Future work is needed to determine how the calculator could be used to target interventions to prevent very preterm birth. KEY POINTS: · We developed predictive models for very preterm birth.. · All models showed excellent calibration.. · The models were integrated into a risk calculator..

9.
Struct Dyn ; 7(3): 034305, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32637460

RESUMO

Understanding guest exchange processes in metal-organic frameworks is an important step toward the rational design of functional materials with tailor-made properties. The dehydration of the flexible metal-organic framework [Co(AIP)(bpy)0.5(H2O)]•2H2O was studied by novel in situ dynamic x-ray diffraction techniques. The complex mechanism of dehydration, along with the as-yet unreported metastable structures, was determined. The structural information obtained by the application of these techniques helps to elucidate the important guest-host interactions involved in shaping the structural landscape of the framework lattice and to highlight the importance of utilizing this technique in the characterization of functional framework materials.

10.
Clin Transplant ; 34(3): e13822, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32037573

RESUMO

BACKGROUND: Hospital readmission (HR) after surgery is considered a quality metric. METHODS: Data on 2371 first-time adult kidney transplant (KT) recipients were collected to analyze the "early" (≤30 days) and "late" (31-365 days) HR patterns after KT at a single center over a 12-year time span (2002-2013). RESULTS: 30-day, 90-day, and 1-year HR were 31%, 41%, and 53%, respectively. Risk factors for HR included age >50, female sex, black race, BMI >30, transplant LOS >5 days, and pre-transplant time on dialysis >765 days. Indications for early (n = 749) and late (n = 508) HR were similar. Early HR (OR: 3.80, P = .007) and black race (OR: 2.38, P = .009) were associated with higher odds of 1-year graft failure while frequency (1-2, 3-4, 5+) of HR (ORs: 4.68, 8.36, 9.44, P < .001) and age > 50 (OR: 2.11, P = .007) were associated with higher odds of 1-year mortality. Transplant LOS > 5 days increased both odds of 1-year graft failure (OR: 3.51, P = .001) and mortality (OR: 2.05, P = .006). One-year graft and recipient survival were 96.7% and 94.8%, respectively. CONCLUSIONS: Hospital readmission was associated with reduced graft and patient survival; however, despite a relatively high and consistent HR rate after KT, overall 1-year graft and patient survival was high.


Assuntos
Transplante de Rim , Adulto , Feminino , Sobrevivência de Enxerto , Humanos , Readmissão do Paciente , Diálise Renal , Fatores de Risco , Transplantados
11.
EMBO Mol Med ; 12(2): e9910, 2020 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-31930715

RESUMO

No approved therapy exists for cancer-associated cachexia. The colon-26 mouse model of cancer cachexia mimics recent late-stage clinical failures of anabolic anti-cachexia therapy and was unresponsive to anabolic doses of diverse androgens, including the selective androgen receptor modulator (SARM) GTx-024. The histone deacetylase inhibitor (HDACi) AR-42 exhibited anti-cachectic activity in this model. We explored combined SARM/AR-42 therapy as an improved anti-cachectic treatment paradigm. A reduced dose of AR-42 provided limited anti-cachectic benefits, but, in combination with GTx-024, significantly improved body weight, hindlimb muscle mass, and grip strength versus controls. AR-42 suppressed the IL-6/GP130/STAT3 signaling axis in muscle without impacting circulating cytokines. GTx-024-mediated ß-catenin target gene regulation was apparent in cachectic mice only when combined with AR-42. Our data suggest cachectic signaling in this model involves catabolic signaling insensitive to anabolic GTx-024 therapy and a blockade of GTx-024-mediated anabolic signaling. AR-42 mitigates catabolic gene activation and restores anabolic responsiveness to GTx-024. Combining GTx-024, a clinically established anabolic therapy, with AR-42, a clinically evaluated HDACi, represents a promising approach to improve anabolic response in cachectic patients.

12.
Am J Obstet Gynecol ; 222(1): 60.e1-60.e7, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31401259

RESUMO

BACKGROUND: Endometrial intraepithelial neoplasia, also known as complex atypical hyperplasia, is a precancerous lesion of the endometrium associated with a 40% risk of concurrent endometrial cancer at the time of hysterectomy. Although a majority of endometrial cancers diagnosed at the time of hysterectomy for endometrial intraepithelial neoplasia are low risk and low stage, approximately 10% of patients ultimately diagnosed with endometrial cancers will have high-risk disease that would warrant lymph node assessment to guide adjuvant therapy decisions. Given these risks, some physicians choose to refer patients to a gynecologic oncologist for definitive management. Currently, few data exist regarding preoperative factors that can predict the presence of concurrent endometrial cancer in patients with endometrial intraepithelial neoplasia. Identification of these factors may assist in the preoperative triaging of patients to general gynecology or gynecologic oncology. OBJECTIVE: To determine whether preoperative factors can predict the presence of concurrent endometrial cancer at the time of hysterectomy in patients with endometrial intraepithelial neoplasia; and to describe the ability of preoperative characteristics to predict which patients may be at a higher risk for lymph node involvement requiring lymph node assessment at the time of hysterectomy. MATERIALS AND METHODS: We conducted a retrospective cohort study of women undergoing hysterectomy for pathologically confirmed endometrial intraepithelial neoplasia from January 2004 to December 2015. Patient demographics, imaging, pathology, and outcomes were recorded. The "Mayo criteria" were used to determine patients requiring lymphadenectomy. Unadjusted associations between covariates and progression to endometrial cancer were estimated by 2-sample t-tests for continuous covariates and by logistic regression for categorical covariates. A multivariable model for endometrial cancer at the time of hysterectomy was developed using logistic regression with 5-fold cross-validation. RESULTS: Of the 1055 charts reviewed, 169 patients were eligible and included. Of these patients, 87 (51.5%) had a final diagnosis of endometrial intraepithelial neoplasia/other benign disease, whereas 82 (48.5%) were ultimately diagnosed with endometrial cancer. No medical comorbidities were found to be strongly associated with concurrent endometrial cancer. Patients with endometrial cancer had a thicker average endometrial stripe compared to the patients with no endometrial cancer at the time of hysterectomy (15.7 mm; standard deviation, 9.5) versus 12.5 mm; standard deviation, 6.4; P = .01). An endometrial stripe of ≥2 cm was associated with 4.0 times the odds of concurrent endometrial cancer (95% confidence interval, 1.5-10.0), controlling for age. In all, 87% of endometrial cancer cases were stage T1a (Nx or N0). Approximately 44% of patients diagnosed with endometrial cancer and an endometrial stripe of ≥2 cm met the "Mayo criteria" for indicated lymphadenectomy compared to 22% of endometrial cancer patients with an endometrial stripe of <2 cm. CONCLUSION: Endometrial stripe thickness and age were the strongest predictors of concurrent endometrial cancer at time of hysterectomy for endometrial intraepithelial neoplasia. Referral to a gynecologic oncologist may be especially warranted in endometrial intraepithelial neoplasia patients with an endometrial stripe of ≥2 cm given the increased rate of concurrent cancer and potential need for lymph node assessment.


Assuntos
Carcinoma in Situ/cirurgia , Carcinoma Endometrioide/epidemiologia , Hiperplasia Endometrial/cirurgia , Neoplasias do Endométrio/cirurgia , Lesões Pré-Cancerosas/cirurgia , Fatores Etários , Idoso , Carcinoma in Situ/diagnóstico por imagem , Carcinoma in Situ/patologia , Carcinoma Endometrioide/patologia , Estudos de Coortes , Hiperplasia Endometrial/diagnóstico por imagem , Hiperplasia Endometrial/patologia , Neoplasias do Endométrio/diagnóstico por imagem , Neoplasias do Endométrio/epidemiologia , Neoplasias do Endométrio/patologia , Feminino , Humanos , Excisão de Linfonodo , Pessoa de Meia-Idade , Gradação de Tumores , Estadiamento de Neoplasias , Lesões Pré-Cancerosas/diagnóstico por imagem , Lesões Pré-Cancerosas/patologia , Estudos Retrospectivos , Medição de Risco , Ultrassonografia
13.
Am J Med Genet A ; 182(1): 104-114, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31639281

RESUMO

Research about Alzheimer's disease (AD) in individuals with Down syndrome (DS) has predominantly focused on the underlying genetics and neuropathology. Few studies have addressed how AD risk impacts caregivers of adults with DS. This study aimed to explore the perceived impact of AD development in adults with DS on caregivers by assessing caregiver knowledge, concerns, effect on personal life, and resource utilization via a 40-question (maximum) online survey. Survey distribution by four DS organizations and two DS clinics resulted in 89 caregiver respondents. Only 28 caregivers correctly answered all three AD knowledge questions. Caregivers gave an average AD concern rating of 5.30 (moderately concerned) and an average impact of possible diagnosis rating of 6.28 (very strong impact), which had a significant negative correlation with the age of the adult with DS (p = .009). Only 33% of caregivers reported utilization of resources to gain more information about the AD and DS association, with low levels of perceived usefulness. Our data reveal caregivers' misconceptions about AD development in DS, underutilization of available resources, and substantial concerns and perceived impacts surrounding a possible AD diagnosis. This study lays the foundation for how the medical community can better serve caregivers of aging adults with DS.


Assuntos
Envelhecimento/patologia , Doença de Alzheimer/epidemiologia , Cuidadores/psicologia , Síndrome de Down/epidemiologia , Adulto , Envelhecimento/genética , Doença de Alzheimer/complicações , Doença de Alzheimer/genética , Doença de Alzheimer/patologia , Progressão da Doença , Síndrome de Down/complicações , Síndrome de Down/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Inquéritos e Questionários
14.
Acta Crystallogr E Crystallogr Commun ; 75(Pt 6): 728-731, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31391954

RESUMO

In the title 1:2 co-crystal, C10H9N2 +·(C6H7.75O6·C6H7.25O6)-, l-ascorbic acid (LAA) and 4,4'-bi-pyridine (BPy) co-crystallize in the chiral space group P21 with two mol-ecules of LAA, and one mol-ecule of bpy in the asymmetric unit. The structure was modeled in two parts due to possible proton transfer from LAA to the corresponding side of the bpy mol-ecule having an occupancy of approximately 0.25 and part 2 with an occupancy of approximately 0.75. In this structure, LAA forms hydrogen bonds with neighboring LAA mol-ecules, forming extended sheets of LAA mol-ecules which are bridged by bpy mol-ecules. A comparison to a related and previously published co-crystal of LAA and 3-bromo-4-pyridone is presented.

16.
Adv Mater ; 31(11): e1807178, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30680821

RESUMO

In the continuously growing field of correlated electronic molecular crystals, there is significant interest in addressing alkali-metal-intercalated aromatic hydrocarbons, in which the possibility of high-temperature superconductivity emerges. However, searching for superconducting aromatic molecular crystals remains elusive due to their small shielding fraction volume. To exploit this potential, a design principle for percolation networks of technologically important film geometry is indispensable. Here the effect of potassium-intercalation is shown on the percolation network in self-assembled aromatic molecular crystals. It is demonstrated that one-dimensional (1D) dipole pairs, induced by dipole interaction, regulate the conductivity, as well as the electronic and optical transitions, in alkali-metal-intercalated molecular electronic crystals. A solid-solution growth methodology of aromatic molecular films with a broad range of stability is developed to uncover electronic and optical transitions of technological importance. The light-induced electron interactions enhance the charge-carrier itinerancy, leading to a switchable metal-to-insulator transition. This discovery opens a route for the development of aromatic molecular electronic solids and long-term modulation of electronic efficacy in nanotechnologically important thin films.

17.
Female Pelvic Med Reconstr Surg ; 25(4): 323-327, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29489553

RESUMO

OBJECTIVE: Bothersome urinary symptoms are often present postpartum. The objective of this study was to examine the association between bothersome urinary symptoms and screening positive for postpartum depression. METHODS: Women presenting at the routine 6-week postpartum visit were screened for risk of depression with the Edinburgh Postnatal Depression Scale. A questionnaire comprising delivery characteristics and demographics, 20-item Postpartum Symptom Inventory (PSI), Urinary Distress Inventory (UDI) short form, Incontinence Impact Questionnaire (IIQ) short form, and history of depression and antidepressant use was completed. Scores were then compared. RESULTS: Data from 104 women were analyzed, with 89% reporting excellent or good health; 73% delivered vaginally; 22% reported a history of depression, and 7% were taking an antidepressant. Twelve percent were classified as at risk of depression. Median UDI score was 5.6 (range, 0-44.4). Median IIQ score was 0 (range, 0-85.7). There was no statistically significant association between bothersome urinary symptoms and the odds of screening positive for depression using either the UDI (adjusted odds ratio [OR], 2.9; 95% confidence interval [CI], 0.7-12.5) or the IIQ (adjusted OR, 0.5; 95% CI, 0.1-2.9). The UDI score was associated with elevated PSI scores as PSI scores increased by 5.4 points if a woman had a UDI score that was greater than zero versus a UDI score of zero, controlling for education level, age, and whether the patient had a cesarean delivery (95% CI, 2.2-8.6; P = 0.001). The UDI score was not associated with antidepressant use (OR, 2.4; 95% CI, 0.5-13.2). The IIQ score had no associations with PSI score (adjusted difference in means, 2.9; 95% CI, -0.9 to 6.8; P = 0.13) or antidepressant use (OR, 1.9; 95% CI, 0.4-9.3). CONCLUSIONS: No statistically significant association between bothersome urinary symptoms and the odds of screening positive for increased risk of postpartum depression was found. Future work in this area is needed.


Assuntos
Depressão Pós-Parto/epidemiologia , Incontinência Urinária/epidemiologia , Adolescente , Adulto , Antidepressivos/uso terapêutico , Estudos Transversais , Depressão Pós-Parto/diagnóstico , Feminino , Humanos , Pessoa de Meia-Idade , Ohio/epidemiologia , Período Pós-Parto , Escalas de Graduação Psiquiátrica , Inquéritos e Questionários , Avaliação de Sintomas , Adulto Jovem
18.
Public Health Nurs ; 35(6): 551-557, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30264408

RESUMO

OBJECTIVES: The Ohio Infant Mortality Reduction Initiative (OIMRI) is a home-visiting program that aims to reduce infant mortality among infants of high-risk black women. This study examined birth outcomes among OIMRI participants and compared program participants to matched non-OIMRI women. DESIGN: Program data were linked to birth records, death records, and Medicaid claims data. Propensity score matching was used to match program participants with like women in Ohio. SAMPLE: The sample consisted of 2,837 black mothers from 14 counties in Ohio. MEASUREMENTS: Infant mortality, causes of death, and birth weight were examined. RESULTS: There were 25 deaths among 2,837 OIMRI participants from 2010 to 2015, for an infant mortality rate of 8.8 deaths per 1,000 live births (95% CI 5.4-12.2). Among those women who participated in OIMRI, three fewer deaths per 1,000 births within the first year of life were estimated compared to those not in OIMRI; however, this was not statistically significant. CONCLUSIONS: The number of infant deaths among women enrolled in the OIMRI program was not significantly different from those who did not participate in OIMRI. Programs like OIMRI cannot singlehandedly address the infant mortality disparity but may help prevent some infant mortality risks.


Assuntos
Afro-Americanos/estatística & dados numéricos , Visita Domiciliar , Mortalidade Infantil , Gravidez de Alto Risco , Adulto , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Medicaid/estatística & dados numéricos , Ohio , Gravidez , Risco , Fatores de Risco , Estados Unidos
19.
J Psychosom Res ; 107: 33-37, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29502761

RESUMO

OBJECTIVE: Postpartum depression may be associated with higher levels of postpartum pain, but the association with discomfort in general is unclear. We sought to describe an association between postpartum mood disturbances and quantitatively measured physical symptoms at the time of the routine postpartum encounter. METHODS: We designed a novel quantitative measurement of postpartum symptoms, the Postpartum Symptom Inventory (PSI), to allow comparison to scores of postpartum mood. Women presenting for a routine postpartum visit were asked to complete a brief questionnaire about their delivery, the 20-item PSI, and an Edinburgh Postnatal Depression Scale (EPDS). Depression scores were compared with symptom inventory scores and demographic data. RESULTS: Two hundred six women responded, of whom 77% had a vaginal delivery. The most common physical symptoms experienced to a bothersome degree were fatigue (35.3%), back/hip pain (22.4%), and headache (13.2%). Twenty-nine women (14.3%) had an EPDS score of 10 or more, thereby screening positive for possible depression. Women screening positive had significantly greater total PSI scores than women who did not screen positive (20.2 vs 12.2, p < 0.001). After adjustment for history of depression and age, the odds of screening positive for depression were 3.6 times higher in women with PSI scores over 10 compared to women with lower scores [95% CI: (1.1, 11.4); p = 0.03]. CONCLUSION: Data suggest that a high level of physical symptomatology as measured by a PSI score >10 at six weeks post-delivery is associated with increased odds of screening positive for postpartum depression.


Assuntos
Afeto , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/psicologia , Programas de Rastreamento , Adulto , Feminino , Humanos , Escalas de Graduação Psiquiátrica , Inquéritos e Questionários
20.
Dalton Trans ; 47(3): 916-924, 2018 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-29260180

RESUMO

Several complexes of Co(ii) or Fe(ii) with 1,4,7,10-tetraazacyclododecane (CYCLEN) appended with 1,7-(6-methyl)2-picolyl groups are studied as 1H NMR paraSHIFT agents (paramagnetic shift agents) for the registration of temperature. Two of the complexes, [Co(BMPC)]2+ and [Fe(BMPC)]2+, contain methyl groups only on the methyl picolyl pendents. Two other complexes, [Co(2MPC)]2+ and [Fe(2MPC)]2+, contain picolyl groups and also methyl groups on the macrocyclic amines. All macrocyclic complexes are in high spin form as shown by solution magnetic moments in the range of 5.0-5.9µBM and 5.3-5.8µBM for Co(ii) and Fe(ii) complexes, respectively. The 1H NMR spectra of both of the Fe(ii) complexes and one of the Co(ii) complexes are consistent with a predominant diastereomeric form in deuterium oxide solutions. The highly shifted methyl proton resonances for [Co(2MPC)]2+ appear at 164 and -113 ppm for macrocycle and pendent picolyl methyls and show temperature coefficients of -0.58 ppm °C-1 and 0.49 ppm °C-1, respectively. Fe(ii) complexes have less shifted methyl proton resonances and smaller temperature coefficients. The 1H resonances of [Fe(2MPC)]2+ appear at 105 ppm and -46 ppm with corresponding temperature coefficients (CT) of -0.29 ppm °C-1 and 0.22 ppm °C-1, respectively. The relatively narrow linewidths of [Fe(2MPC)]2+, however, produce superior CT/FWHM values of 0.44 and 0.31 °C-1 for the N-methyl and picolyl proton resonances where FWHM is the full width at half maximum of the 1H resonance. The crystal structure of [Co(BMPC)]Cl2 shows a six-coordinate Co(ii) bound to the macrocyclic amines and two pendent picolyl groups. The distorted trigonal prismatic geometry of the complex resembles that of an analogous complex containing four 6-methyl-2-picolyl groups, in which only two picolyl pendents are coordinated.

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