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Sample records for 4-6 weeks postpartum

  1. Emotion Reactivity Is Increased 4-6 Weeks Postpartum in Healthy Women: A Longitudinal fMRI Study

    PubMed Central

    Gingnell, Malin; Bannbers, Elin; Moes, Harmen; Engman, Jonas; Sylvén, Sara; Skalkidou, Alkistis; Kask, Kristiina; Wikström, Johan; Sundström-Poromaa, Inger

    2015-01-01

    Marked endocrine alterations occur after delivery. Most women cope well with these changes, but the postpartum period is associated with an increased risk of depressive episodes. Previous studies of emotion processing have focused on maternal–infant bonding or postpartum depression (PPD), and longitudinal studies of the neural correlates of emotion processing throughout the postpartum period in healthy women are lacking. In this study, 13 women, without signs of post partum depression, underwent fMRI with an emotional face matching task and completed the MADRS-S, STAI-S, and EPDS within 48 h (early postpartum) and 4–6 weeks after delivery (late postpartum). Also, data from a previous study including 15 naturally cycling controls assessed in the luteal and follicular phase of the menstrual cycle was used. Women had lower reactivity in insula, middle frontal gyrus (MFG), and inferior frontal gyrus (IFG) in the early as compared to the late postpartum assessment. Insular reactivity was positively correlated with anxiety in the early postpartum period and with depressive symptoms late postpartum. Reactivity in insula and IFG were greater in postpartum women than in non-pregnant control subjects. Brain reactivity was not correlated with serum estradiol or progesterone levels. Increased reactivity in the insula, IFG, and MFG may reflect normal postpartum adaptation, but correlation with self-rated symptoms of depression and anxiety in these otherwise healthy postpartum women, may also suggest that these changes place susceptible women at increased risk of PPD. These findings contribute to our understanding of the neurobiological aspects of the postpartum period, which might shed light on the mechanisms underlying affective puerperal disorders, such as PPD. PMID:26061879

  2. Changes in the lipids of human milk from 2 to 16 weeks postpartum.

    PubMed

    Clark, R M; Ferris, A M; Fey, M; Brown, P B; Hundrieser, K E; Jensen, R G

    1982-01-01

    Changes in total lipid, fatty acids, total cholesterol, free cholesterol, and lipid phosphorus in mature milk with time were investigated. Milk samples were collected from 10 mothers at 2, 6, 12, and 16 weeks postpartum. During 1 day, each mother donated two complete breast expressions. Expressions were taken using an electric breast pump 1 h after the previous a.m. and p.m. nursing. For each mother, the a.m. and p.m. samples were pooled for analysis. It was observed that the amount of total lipid increased significantly (p less than 0.05) from 3.9 g/100 ml at 2 weeks to 5.2 g/100 at 16 weeks postpartum. The total fatty acid composition remained uniform during the investigation. Average total cholesterol and free cholesterol in the milk were 10.3 mg/100 ml and 8.3 mg/100 ml, respectively. These concentrations did not change significantly with time postpartum. Average lipid phosphorus was 3.9 mg/100 ml and also remained constant throughout. We conclude that the fatty acid pattern, lipid phosphorus, total cholesterol, and free cholesterol of mature milk to 16 weeks postpartum remains relatively constant while total lipid concentration increases.

  3. Macronutrients in human milk at 2, 12, and 16 weeks postpartum.

    PubMed

    Ferris, A M; Dotts, M A; Clark, R M; Ezrin, M; Jensen, R G

    1988-06-01

    This study evaluated changes in human milk composition from 2 to 16 weeks postpartum. Milk from 12 mothers was analyzed for lipid (utilizing a modified Folch), lactose (enzymatic hydrolysis), and nitrogen (semi-micro Kjeldahl). Energy was calculated by fractional analysis and bomb calorimetry. All samples were from well-defined subjects, and uniform collection procedures were used. Milk lipid, total nitrogen, and energy content differed significantly from one woman to another. Lipid and energy content increased from 3.98 +/- 1.0 to 5.50 +/- 1.1 gm/100 ml and 68.5 +/- 9.8 to 83.0 +/- 11.1 kcal/100 ml, respectively, and nitrogen content decreased significantly from 0.24 +/- 0.05 to 0.16 +/- 0.02 gm/100 ml from 2 to 16 weeks postpartum. Lactose remained statistically stable, increasing from 6.3 +/- 0.7 to 7.0 +/- 0.7 gm/100 ml. Estimates of energy from fractional analysis of macronutrients produced lower caloric estimates, especially at 2 weeks postpartum. Statistical differences over time and between and among mothers were found at all periods studied; therefore, on the basis of these data, we caution against reliance on single sample values as representative of mature milk either for individuals or for groups.

  4. Development of the Childbirth Perception Scale (CPS): perception of delivery and the first postpartum week.

    PubMed

    Truijens, Sophie E M; Wijnen, Hennie A; Pommer, Antoinette M; Oei, S Guid; Pop, Victor J M

    2014-10-01

    Some caregivers suggest a more positive experience of childbirth when giving birth at home. Since properly developed instruments that assess women's perception of delivery and the early postpartum are missing, the aim of the current study is to develop a Childbirth Perception Scale (CPS). Three focus groups with caregivers, pregnant women, and women who recently gave birth were conducted. Psychometric properties of 23 candidate items derived from the interviews were tested with explorative factor analysis (EFA) (N = 495). Confirmatory factor analysis (CFA) was performed in another sample of women (N = 483) and confirmed a 12-item CPS. The EFA in sample I suggested a two-component solution: a subscale 'perception of delivery' (six items) and a subscale 'perception of the first postpartum week' (six items). The CFA in sample II confirmed an adequate model fit and a good internal consistency (α = .82). Multivariate linear regression showed a positive effect of home delivery on perception of delivery in multiparous but not in primiparous women. The 12-item CPS with two dimensions (perception of delivery and perception of first postpartum week) has adequate psychometric properties. In multiparous women, home delivery showed to be independently related to more positive perception of delivery.

  5. Factors related to breastfeeding discontinuation between hospital discharge and 2 weeks postpartum.

    PubMed

    Brand, Elizabeth; Kothari, Catherine; Stark, Mary Ann

    2011-01-01

    Although breastfeeding is known to be beneficial to both mother and infant, many women encounter barriers to breastfeeding, even after successful breastfeeding initiation, which may put them at greater risk for early cessation of breastfeeding. The objectives of this study were to conduct a secondary analysis of data from a longitudinal study of postpartum depression to (a) examine factors related to very early discontinuation of breastfeeding (at 2 weeks postpartum) following hospital discharge and (b) identify women's reasons for very early cessation of breastfeeding. The results of this study support findings from previous research. Having a perceived support system, whether it is personal or professional, may have an effect on both the initiation and duration of breastfeeding. Educating expectant and new mothers, especially women who encounter multiple barriers and are at risk for very early cessation of breastfeeding, of the benefits of breastfeeding and supporting them in developing efficient techniques and problem-solving skills can help increase the duration of breastfeeding.

  6. Nipple Pain, Damage, and Vasospasm in the First 8 Weeks Postpartum

    PubMed Central

    Amir, Lisa H.; Cullinane, Meabh; Donath, Susan M.

    2014-01-01

    Abstract Background: Nipple pain and damage are common in the early postpartum period and are associated with early cessation of breastfeeding and comorbidities such as depression, anxiety, and mastitis. The incidence of nipple vasospasm has not been reported previously. This article describes nipple pain and damage prospectively in first-time mothers and explores the relationship between method of birth and nipple pain and/or damage. Subjects and Methods: A prospective cohort of 360 primiparous women was recruited in Melbourne, Australia, in the interval 2009–2011, and after birth participants were followed up six times. The women completed a questionnaire about breastfeeding practices and problems at each time point. Pain scores were graphically represented using spaghetti plots to display each woman's experience of pain over the 8 weeks of the study. Results: After birth, before they were discharged home from hospital, 79% (250/317) of the women in this study reported nipple pain. Over the 8 weeks of the study 58% (198/336) of women reported nipple damage, and 23% (73/323) reported vasospasm. At 8 weeks postpartum 8% (27/340) of women continued to report nipple damage, and 20% (68/340) were still experiencing nipple pain. Ninety-four percent (320/340) of the women were breastfeeding at the end of the study, and there was no correlation between method of birth and nipple pain and/or damage. Conclusions: Nipple pain is a common problem for new mothers in Australia and often persists for several weeks. Further studies are needed to establish the most effective means of preventing and treating breastfeeding problems in the postnatal period. PMID:24380583

  7. Six-Week Postpartum Maternal Self-Criticism and Dependency and 4-Month Mother-Infant Self- and Interactive Contingencies

    ERIC Educational Resources Information Center

    Beebe, Beatrice; Jaffe, Joseph; Buck, Karen; Chen, Henian; Cohen, Patricia; Blatt, Sidney; Kaminer, Tammy; Feldstein, Stanley; Andrews, Howard

    2007-01-01

    Associations of 6-week postpartum maternal self-criticism and dependency with 4-month mother-infant self- and interactive contingencies during face-to-face play were investigated in 126 dyads. Infant and mother face, gaze, touch, and vocal quality were coded second by second from split-screen videotape. Self- and interactive contingencies were…

  8. Impact of risk factors on the timing of first postpartum venous thromboembolism: a population-based cohort study from England.

    PubMed

    Abdul Sultan, Alyshah; Grainge, Matthew J; West, Joe; Fleming, Kate M; Nelson-Piercy, Catherine; Tata, Laila J

    2014-10-30

    Impact on the timing of first postpartum venous thromboembolism (VTE) for women with specific risk factors is of crucial importance when planning the duration of thromboprophylaxis regimen. We observed this using a large linked primary and secondary care database containing 222 334 pregnancies resulting in live and stillbirth births between 1997 and 2010. We assessed the impact of risk factors on the timing of postpartum VTE in term of absolute rates (ARs) and incidence rate ratios (IRRs) using a Poisson regression model. Women with preeclampsia/eclampsia and postpartum acute systemic infection had the highest risk of VTE during the first 3 weeks postpartum (ARs ≥2263/100 000 person-years; IRR ≥2.5) and at 4-6 weeks postpartum (AR ≥1360; IRR ≥3.5). Women with body mass index (BMI) >30 kg/m(2) or those having cesarean delivery also had elevated rates up to 6 weeks (AR ≥1425 at 1-3 weeks and ≥722 at 4-6 weeks). Women with postpartum hemorrhage or preterm birth, had significantly increased VTE rates only in the first 3 weeks (AR ≥1736; IRR ≥2). Our findings suggest that the duration of the increased VTE risk after childbirth varies based on the type of risk factors and can extend up to the first 3 to 6 weeks postpartum.

  9. Impact of risk factors on the timing of first postpartum venous thromboembolism: a population-based cohort study from England

    PubMed Central

    Grainge, Matthew J.; West, Joe; Fleming, Kate M.; Nelson-Piercy, Catherine; Tata, Laila J.

    2014-01-01

    Impact on the timing of first postpartum venous thromboembolism (VTE) for women with specific risk factors is of crucial importance when planning the duration of thromboprophylaxis regimen. We observed this using a large linked primary and secondary care database containing 222 334 pregnancies resulting in live and stillbirth births between 1997 and 2010. We assessed the impact of risk factors on the timing of postpartum VTE in term of absolute rates (ARs) and incidence rate ratios (IRRs) using a Poisson regression model. Women with preeclampsia/eclampsia and postpartum acute systemic infection had the highest risk of VTE during the first 3 weeks postpartum (ARs ≥2263/100 000 person-years; IRR ≥2.5) and at 4-6 weeks postpartum (AR ≥1360; IRR ≥3.5). Women with body mass index (BMI) >30 kg/m2 or those having cesarean delivery also had elevated rates up to 6 weeks (AR ≥1425 at 1-3 weeks and ≥722 at 4-6 weeks). Women with postpartum hemorrhage or preterm birth, had significantly increased VTE rates only in the first 3 weeks (AR ≥1736; IRR ≥2). Our findings suggest that the duration of the increased VTE risk after childbirth varies based on the type of risk factors and can extend up to the first 3 to 6 weeks postpartum. PMID:25157182

  10. Postpartum depression

    MedlinePlus

    Depression - postpartum; Postnatal depression; Postpartum psychological reactions ... The exact causes of postpartum depression are unknown. Changes in hormone levels during and after pregnancy may affect a woman's mood. Many non-hormonal factors may also ...

  11. An investigation of the microbiota in uterine flush samples and endometrial biopsies from dairy cows during the first 7 weeks postpartum.

    PubMed

    Knudsen, Lif Rødtness Vesterby; Karstrup, Cecilia Christensen; Pedersen, Hanne Gervi; Angen, Øystein; Agerholm, Jørgen Steen; Rasmussen, Eva Láadal; Jensen, Tim Kåre; Klitgaard, Kirstine

    2016-07-15

    Metritis and endometritis commonly occur in dairy cows after calving. Although numerous studies have been performed to identify the causative pathogens, a complete overview has not been done. Metagenomic studies have analyzed the bacterial populations of uterine flush samples from postpartum (pp) dairy cows, but the microbiota in the uterine luminal fluid may differ from the microbiota of the endometrium itself, and important putative pathogens may have been overlooked. In the present study, we compared the microbiota of the uterine lumen and the endometrium of healthy, metritic, and endometritic cows. Samples were collected from 68 Holstein dairy cows at 1, 4, and 7 weeks pp, and the data were analyzed by deep sequencing of the V1 and V2 hypervariable regions of the 16S ribosomal RNA gene. The results showed that Porphyromonadaceae, Fusobacteriaceae, Leptotrichiaceae, and Mycoplasmataceae may be associated with uterine disease. The microbiota of the uterine flush samples and the endometrial biopsies were correlated, but the microbiota of the biopsies was more diverse. Fusobacteriaceae and Leptotrichiaceae were not observed in the biopsies at week 7, whereas they accounted for 20% and 13%, respectively, of the bacterial populations in the flush samples. The Mycoplasmataceae family was observed in much higher quantity in the flush samples than in the biopsies of the endometritis groups at weeks 4 and 7. Our findings support the observations of previous metagenomic studies and illustrate the importance of including endometrial biopsies to obtain more detailed knowledge of the pp uterine microbiota. PMID:27039075

  12. Incidence of postpartum infection after vaginal delivery in Viet Nam.

    PubMed

    Ngoc, Nguyen T N; Sloan, Nancy L; Thach, Tran S; Liem, Le K B; Winikoff, Beverly

    2005-06-01

    This study assessed the incidence of postpartum infection which is rarely clinically evaluated and is probably underestimated in developing countries. This prospective study identified infection after vaginal delivery by clinical and laboratory examinations prior to discharge from hospital and again at six weeks postpartum in Ho Chi Minh City, Viet Nam. Textbook definitions, physicians' diagnoses, symptomatic and verbal autopsy definitions were used for classifying infection. Logistic regression was used for determining associations of postpartum infection with socioeconomic and reproductive characteristics. In total, 978 consecutive, eligible consenting women were followed up at 42+/-7 (range 2-45) days postpartum (not associated with incidence). Ninety-eight percent took 'prophylactic' antibiotics. The most conservative estimate of the incidence of postpartum infection was 1.7%. The incidence of serious infection was 0.5%, but increased to 4.6% when verbal autopsy and symptomatic definitions were used. Postpartum infection, particularly serious infection, is greatly underestimated. Just preventing or treating infection could have a substantial impact on reducing maternal mortality in developing countries. PMID:16117363

  13. Longitudinal Changes in Serum Proinflammatory Markers across Pregnancy and Postpartum: Effects of Maternal Body Mass Index

    PubMed Central

    Christian, Lisa M.; Porter, Kyle

    2014-01-01

    Background The maternal immune system undergoes substantial changes to support healthy pregnancy. Although obesity is a primary driver of inflammation and predictive of perinatal complications, additive effects of pregnancy and obesity on changes in inflammatory processes are not well delineated. Methods This study examined serum proinflammatory markers interleukin(IL)-6, IL-8, tumor necrosis factor(TNF)-α, IL-1β, and C-reactive protein(CRP) during each trimester of pregnancy and 4-6 weeks postpartum among 57 women. Results Overall, IL-6 showed an increasing trend across pregnancy and significant increase at postpartum. Similarly, TNF-α increased significantly across gestation, with a further increase at postpartum. Both IL-8 and IL-1β showed a U-shaped curve, decreasing from early to later pregnancy, and increasing at postpartum. Finally, serum CRP decreased significantly across pregnancy, with further decreases at postpartum. Maternal obesity predicted higher IL-6 at each study visit. Obese women showed a trend toward elevated serum CRP during pregnancy, and significantly higher levels at postpartum. Discussion The course of pregnancy and postpartum is characterized by significant changes in serum proinflammatory mediators. Obese women show elevations in serum proinflammatory markers relative to normal weight women during pregnancy and postpartum. Further research is needed to determine the extent to which obesity-induced inflammation affects maternal and fetal health. PMID:25082648

  14. Prevalence of episiotomy in primiparas, related conditions, and effects of episiotomy on suture materials used, perineal pain, wound healing 3 weeks postpartum, in Turkey: A prospective follow-up study

    PubMed Central

    Karaçam, Zekiye; Ekmen, Hatice; Çalişır, Hüsniye; Şeker, Sibel

    2013-01-01

    Background: Despite current recommendations against routine use of episiotomy, its incidence is still high in Turkey. The study aimed to identify the prevalence of episiotomy in primiparas, related conditions, and effects of episiotomy on suture materials used, perineal pain, and wound healing 3 weeks postpartum. Materials and Methods: This study was designed as a prospective follow-up study. Data were collected via a questionnaire form between March 2007 and February 2009 in Aydın Government Hospital, Turkey. Three hundred ninety-six primiparas were included in the study by convenience sampling. Results: It was determined that 56.3% of the women had episiotomies. The results of the study revealed that the probability of receiving an episiotomy was decreased in women with lack of legal marriage and unplanned pregnancies, and increased in women who had ineffective pushing efforts approximately four times, miscellaneous two times and baby's head circumference 1.27 times. Moreover, the results of the study demonstrated that an episiotomy increased the number of the suture materials used by approximately five-fold, as well as the prevalence of pain on the first postpartum day. On the third postpartum week evaluation, it was determined that the probability of problems with wound healing and experiencing pain was approximately two times higher among women who received episiotomies than those who did not receive episiotomies. Conclusion: The study revealed that episiotomies in primiparas increased the number of suture materials used and the probability of having perineal pain on the first postpartum day, as well as perineal pain and wound-healing problems during the third postpartum week. PMID:23983762

  15. Postpartum Thyroiditis

    MedlinePlus

    ... high thyroid hormone levels in the blood) and hypothyroidism (low thyroid hormone levels in the blood). In postpartum thyroiditis, thyrotoxicosis occurs first followed by hypothyroidism. What causes postpartum thyroiditis? The exact cause is ...

  16. Postpartum Depression

    MedlinePlus

    ... do not need treatment. The symptoms of postpartum depression last longer and are more severe. You may ... treatment right away, often in the hospital. Postpartum depression can begin anytime within the first year after ...

  17. Postpartum Blood Clots

    MedlinePlus

    ... Breast Infection Postpartum Blood Clots Postpartum Thyroid Disorders Postpartum Depression The risk of developing blood clots (thrombophlebitis) is ... Breast Infection Postpartum Blood Clots Postpartum Thyroid Disorders Postpartum Depression NOTE: This is the Consumer Version. CONSUMERS: Click ...

  18. Postpartum Infections

    MedlinePlus

    ... Drug Interactions Pill Identifier Commonly searched drugs Aspirin Metformin Warfarin Tramadol Lactulose Ranitidine News & Commentary Recent News ... Muscle Disorders Brain, Spinal Cord, and Nerve Disorders Cancer Children's Health Issues ... Bladder and Kidney Infections Breast Infection Postpartum Blood Clots Postpartum Thyroid Disorders Postpartum ...

  19. Anhedonia in postpartum rats.

    PubMed

    Navarre, Brittany M; Laggart, Jillian D; Craft, Rebecca M

    2010-01-12

    Postpartum depression (PPD) is a debilitating illness, yet little is known about its causes. The purpose of this study was to examine a major symptom of depression during the postpartum period, anhedonia, by comparing sucrose preference in female rats that had undergone actual pregnancy or hormone-simulated pregnancy (HSP) to their respective controls. Whereas HSP rats showed significantly less preference than vehicle control rats for 1% sucrose solution during the first three weeks of the "postpartum" period, previously pregnant females showed only slightly depressed sucrose preference for the first 1-2 days postpartum, compared to non-pregnant controls. Habituation to 1% sucrose during the pregnancy period, which increased preference upon later testing in previously pregnant rats tested on postpartum day 2, did not significantly increase preference in HSP rats, suggesting that depressed preference in the latter group was not due to neophobia. Pre-treatment with desipramine did not prevent suppressed sucrose preference in HSP rats, and preference was even further suppressed following chronic sertraline treatment. These results suggest that estradiol withdrawal following HSP may cause anhedonia during the early "postpartum" period. In contrast, females that have undergone actual pregnancy are less likely to show this effect, suggesting that postpartum hormonal changes other than the dramatic decline in estradiol may buffer its negative mood effects.

  20. Postpartum contraception.

    PubMed

    Sober, Stephanie; Schreiber, Courtney A

    2014-12-01

    As birth spacing has demonstrated health benefits for a woman and her children, contraception after childbirth is recognized as an important health issue. The potential risk of pregnancy soon after delivery underscores the importance of initiating postpartum contraception in a timely manner. The contraceptive method initiated in the postpartum period depends upon a number of factors including medical history, anatomic and hormonal factors, patient preference, and whether or not the woman is breastfeeding. When electing a contraceptive method, informed choice is paramount. The availability of long-acting reversible contraceptive methods immediately postpartum provides a strategy to achieve reductions in unintended pregnancy. PMID:25264698

  1. Elective Delivery Before 39 Weeks

    MedlinePlus

    ... Delivery, and Postpartum Care Elective Delivery Before 39 Weeks • What is a “medically indicated” delivery? • What is ... the baby grow and develop during the last weeks of pregnancy? • What are the risks for babies ...

  2. 2,4,6-Trichlorophenol

    Integrated Risk Information System (IRIS)

    2,4,6 - Trichlorophenol ; CASRN 88 - 06 - 2 Human health assessment information on a chemical substance is included in the IRIS database only after a comprehensive review of toxicity data , as outlined in the IRIS assessment development process . Sections I ( Health Hazard Assessments for Noncarcino

  3. An Intervention To Reduce Postpartum Depressive Symptoms: A Randomized Controlled Trial

    PubMed Central

    Howell, Elizabeth A; Bodnar-Deren, Susan; Balbierz, Amy; Loudon, Holly; Mora, Pablo A.; Zlotnick, Caron; Wang, Jason; Leventhal, Howard

    2013-01-01

    Depressive symptoms and depression are a common complication of childbirth and a growing body of literature suggests that there are modifiable factors associated with their occurrence. We developed a behavioral educational intervention targeting these factors and successfully reduced postpartum depressive symptoms in a randomized trial among low-income black and Latina women. We now report results of 540 predominantly white, high income mothers in a second randomized trial. Mothers in the intervention arm received a 2-step intervention that prepared and educated mothers about modifiable factors associated with postpartum depressive symptoms (e.g., physical symptoms, low self-efficacy), bolstered social support, and enhanced management skills. The control arm received enhanced usual care. Participants were surveyed prior to randomization, 3-weeks, 3-months, and 6-months postpartum. Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS of 10 or greater). Prevalence of depressive symptoms postpartum were unexpectedly low precluding detection of difference in rates of depressive symptoms among intervention vs. enhanced usual care post hospitalization: 3-weeks (6.0 % vs. 5.6%, p=.83), 3-months (5.1% vs. 6.5%, p=.53) and 6-months (3.6% vs. 4.6%, p=.53). PMID:24019052

  4. Postpartum thyroiditis.

    PubMed

    Argatska, Antoaneta B; Nonchev, Boyan I

    2014-01-01

    Postpartum thyroiditis (PPT) is a syndrome of transient or permanent thyroid dysfunction occurring in the first year after delivery or abortion. It is the most common thyroid disease in the postpartum period with incidence between 5 and 9%. In essence, it is an autoimmune inflammation of the thyroid, caused by changes in humoral and cell-mediated immune response. It has a characteristic biphasic course with an episode of transient thyrotoxicosis followed by transient or permanent hypothyroidism. Of all predisposing factors positive titers of thyroid peroxidase antibodies have the greatest importance. In some of the affected patients the disease course is marked by expressed hormonal disorders causing significant subjective symptoms. This underlines the need for early identification of risk groups aimed at prophylaxis and adequate treatment of thyroid dysfunction in the postpartum period. The frequency of PPT varies between analyses and studies on risk factors do not establish reliable predictive models for progression of the disease. This is due to the different methodology of research and the involvement of a number of genetic and non-genetic factors in different geographic regions. That is why implementation of mass screening programs is now controversial. The discrepancy in the opinions of researchers makes it necessary to have studies of the problem in performed in every clinical center in which the possible risk specific to the region and the population covered might be defined prognostically. The results of these studies can be used to introduce targeted and cost-effective screening for early detection of risk patients and prevention of morbidity and complications of PPT. PMID:25434070

  5. Postpartum thyroiditis.

    PubMed

    Argatska, Antoaneta B; Nonchev, Boyan I

    2014-01-01

    Postpartum thyroiditis (PPT) is a syndrome of transient or permanent thyroid dysfunction occurring in the first year after delivery or abortion. It is the most common thyroid disease in the postpartum period with incidence between 5 and 9%. In essence, it is an autoimmune inflammation of the thyroid, caused by changes in humoral and cell-mediated immune response. It has a characteristic biphasic course with an episode of transient thyrotoxicosis followed by transient or permanent hypothyroidism. Of all predisposing factors positive titers of thyroid peroxidase antibodies have the greatest importance. In some of the affected patients the disease course is marked by expressed hormonal disorders causing significant subjective symptoms. This underlines the need for early identification of risk groups aimed at prophylaxis and adequate treatment of thyroid dysfunction in the postpartum period. The frequency of PPT varies between analyses and studies on risk factors do not establish reliable predictive models for progression of the disease. This is due to the different methodology of research and the involvement of a number of genetic and non-genetic factors in different geographic regions. That is why implementation of mass screening programs is now controversial. The discrepancy in the opinions of researchers makes it necessary to have studies of the problem in performed in every clinical center in which the possible risk specific to the region and the population covered might be defined prognostically. The results of these studies can be used to introduce targeted and cost-effective screening for early detection of risk patients and prevention of morbidity and complications of PPT. PMID:25507668

  6. Postpartum hemorrhage.

    PubMed

    Su, Cindy W

    2012-03-01

    Postpartum hemorrhage (PPH) is a very common obstetric emergency with high morbidity and mortality rates worldwide. Understanding its etiology is fundamental to effectively managing PPH in an acute setting. Active management of the third stage of labor is also a key component in its prevention. Management strategies include conservative measures (medications, uterine tamponade, and arterial embolization) as well as surgical interventions (arterial ligations, compression sutures, and hysterectomy). Creating a standardized PPH protocol and running simulation-based drills with a multidisciplinary team may also help decrease maternal morbidity and improve perinatal outcomes, although further studies are needed. PMID:22309588

  7. The Identification of Postpartum Depression

    PubMed Central

    Sit, Dorothy K.; Wisner, Katherine L.

    2009-01-01

    Postpartum depression (PPD) is the most common medical complication of childbearing. Universal screening maximizes the likelihood of prompt identification of PPD. Obstetrician-gynecologists routinely evaluate postpartum women for a general health examination and review of family planning options at approximately 6 weeks after birth; therefore, they are well-positioned to identify PPD. In this paper, we review the diagnostic criteria for postpartum depressive disorders and clinical risk factors predictive of PPD. We examine depression screening tools, appropriate cut-points associated with positive screens, the optimal timing for screening and the acceptability of depression screening in obstetrical settings. Lastly, we explore how to manage patients who screen positive for depression and treatment options for women with PPD. PMID:19661761

  8. Postpartum depression

    PubMed Central

    Pearlstein, Teri; Howard, Margaret; Salisbury, Amy; Zlotnick, Caron

    2014-01-01

    Postpartum depression (PPD) affects up to 15% of mothers. Recent research has identified several psychosocial and biologic risk factors for PPD. The negative short-term and long-term effects on child development are well-established. PPD is under recognized and under treated. The obstetrician and pediatrician can serve important roles in screening for and treating PPD. Treatment options include psychotherapy and antidepressant medication. Obstacles to compliance with treatment recommendations include access to psychotherapists and concerns of breastfeeding mothers about exposure of the infant to antidepressant medication. Further research is needed to examine systematically the short-term and long-term effect of medication exposure through breastmilk on infant and child development. PMID:19318144

  9. Depression in Pregnancy and Postpartum Period

    PubMed Central

    Sood, Mamta; Sood, A.K.

    2003-01-01

    This prospective study was carried out in a service hospital, with the aim to study the prevalence and incidence of depression in pregnancy and postpartum period. Eighty Four consecutive patients attending the antenatal outpatient in the Obstetrics & Gynaecology department in their last trimester of pregnancy were recruited for the study. They were assessed on Beck Depression Inventory thrice viz. during third trimester of pregnancy, within 3 days of delivery (early postpartum period) & within 4-8 weeks of delivery (late postpartum period).The prevalence of depression was 8.3%, 20% and 12.8% respectively at three ratings. The incidence was 16% and 10% in the early & late postpartum period respectively. Further analysis revealed that depression in pregnancy correlated significantly with depression in early postpartum period, but not with late postpartum period. Depression in early postpartum period correlated with depression in late postpartum period.These findings have implications for early detection and care of women at risk for developing depression. PMID:21206814

  10. Is the Predictability of New-Onset Postpartum Depression Better During Pregnancy or in the Early Postpartum Period? A Prospective Study in Croatian Women.

    PubMed

    Nakić Radoš, Sandra; Herman, Radoslav; Tadinac, Meri

    2016-01-01

    The researchers' aim was to examine whether it was better to predict new-onset postpartum depression (PPD) during pregnancy or immediately after childbirth. A prospective study conducted in Croatia followed women (N = 272) from the third trimester of pregnancy through the early postpartum period (within the first 3 postpartum days), to 6 weeks postpartum. Questionnaires on depression, anxiety, stress, coping, self-esteem, and social support were administered. Through regression analyses we showed that PPD symptoms could be equally predicted by variables from pregnancy (30.3%) and the early postpartum period (34.0%), with a small advantage of PPD prediction in the early postpartum period.

  11. Is the Predictability of New-Onset Postpartum Depression Better During Pregnancy or in the Early Postpartum Period? A Prospective Study in Croatian Women.

    PubMed

    Nakić Radoš, Sandra; Herman, Radoslav; Tadinac, Meri

    2016-01-01

    The researchers' aim was to examine whether it was better to predict new-onset postpartum depression (PPD) during pregnancy or immediately after childbirth. A prospective study conducted in Croatia followed women (N = 272) from the third trimester of pregnancy through the early postpartum period (within the first 3 postpartum days), to 6 weeks postpartum. Questionnaires on depression, anxiety, stress, coping, self-esteem, and social support were administered. Through regression analyses we showed that PPD symptoms could be equally predicted by variables from pregnancy (30.3%) and the early postpartum period (34.0%), with a small advantage of PPD prediction in the early postpartum period. PMID:25558954

  12. Cryptogenic postpartum stroke.

    PubMed

    Bereczki, Dániel; Szegedi, Norbert; Szakács, Zoltán; Gubucz, István; May, Zsolt

    2016-01-01

    An estimated 25-40% of ischemic strokes are classified as cryptogenic, which means the cause of the cerebral infarction remains unidentified. One of the potential pathomechanisms - especially among young patients with no cardiovascular risk factors - is paradoxical embolism through a patent foramen ovale. Pregnancy, cesarean delivery and the postpartum period are associated with an increased risk of cerebrovascular events. Factors that may contribute to ischemic strokes during gestation and puerperium include classic cardiovascular risk factors, changes in hemostaseology/hemodynamics, and pregnancy-specific disorders such as pre-eclampsia, eclampsia, postpartum cerebral angiopathy or peripartum cardiomyopathy. In this case report, we present a 36-year-old thrombolysis candidate undergoing mechanical thrombectomy 3 weeks after a cesarean section due to HELLP-syndrome. After evaluation of anamnestic and diagnostic parameters, closure of the patent foramen ovale has been performed. In the absence of specific guidelines, diagnostic work-up for cryptogenic stroke should be oriented after the suspected pathomechanism based on patient history and clinical picture. As long as definite evidences emerge, management of cryptogenic stroke patients with pathogenic right-to-left shunt remains individual based on the mutual decision of the patient and the multidisciplinary medical team. PMID:27591063

  13. Postpartum Depression Action Plan

    MedlinePlus

    MENU Return to Web version Postpartum Depression | Postpartum Depression Action Plan Patient __________________________ Physician/NP/PA __________________ Clinic ____________________________ Phone Number ____________________ Choose one area and add other areas as you begin to ...

  14. A Counselor's Primer on Postpartum Depression.

    ERIC Educational Resources Information Center

    Pfost, Karen S.; And Others

    1990-01-01

    Notes that women are particularly vulnerable to depression during the postpartum period. Distinguishes postpartum depression from normal postpartum adjustment, postpartum blues, and postpartum psychosis. Describes biological, psychodynamic, and diathesis-stress perspectives on postpartum depression. Encourages counselors to fashion individualized…

  15. A Review of Postpartum Depression

    PubMed Central

    Andrews-Fike, Christa

    1999-01-01

    Postpartum depression (PPD) is an irritable, severely depressed mood that occurs within 4 weeks of giving birth and possibly as late as 30 weeks postpartum. Manifestations include crying spells, insomnia, depressed mood, fatigue, anxiety, and poor concentration. Patients may experience mild, moderate, or severe symptoms. Many psychosocial stressors may have an impact on the development of PPD. Recent studies conclude that the majority of factors are largely social in nature. The greatest risk is in women with a history of depression or other affective illness and in those who have experienced depression during past pregnancies. Women with significant risk factors should be followed closely in the postpartum period. The severity of symptoms and degree of impairment guide the approach to treatment. Treatment should begin with psychotherapy and advance to pharmacotherapy if needed; however, many patients benefit from concomitant treatment with both psychotherapy and medication. Common forms of psychotherapy include interpersonal therapy and short-term cognitive-behavioral therapy. Postpartum depression demands the same pharmacologic treatment as major depression does, with similar doses as those given to patients with nonpuerperal depression. It is essential to use an adequate dose of antidepressants in a duration sufficient to ensure complete recovery. Mothers should continue medication for 6 to 12 months postpartum to ensure a complete recovery. Inadequate treatment of depression puts women at risk for the sequelae of untreated affective illness, and the depression may become chronic, recurrent, and/or refractory. Family physicians are key players in the detection and treatment of PPD owing to the nature of the disease and the tendency for new mothers to negate their feelings as something other than a treatable psychiatric illness. PMID:15014700

  16. Predictors of postpartum depression: prospective study of 264 women followed during pregnancy and postpartum.

    PubMed

    Gaillard, Adeline; Le Strat, Yann; Mandelbrot, Laurent; Keïta, Hawa; Dubertret, Caroline

    2014-02-28

    The prevalence of postpartum depression is approximately 13%. Postpartum depression is associated with a higher maternal morbidity and mortality, and also with pervasive effects on the emotional, cognitive and behavioral development of the child. The aim of our study was to identify socio-demographic, psychosocial and obstetrical risk factors of postpartum depression in a middle class community sample, using a prospective design. We enrolled consecutively 312 pregnant outpatients in a single maternity unit. The first assessment was conducted between 32 and 41 weeks gestation, and a second time between 6 and 8 weeks after delivery. Depressive symptoms were measured using the French version of the Edinburgh Postnatal Depression Scale (EPDS). A cut-off score of 12/30 or above was considered as indicative of Major Depression. Of the initial sample of 312 women, 264 (84.6%) were followed-up between 6 and 8 weeks after delivery and considered for analysis. Depression during pregnancy, migrant status, and physical abuse by the partner were independently associated with postpartum depression when considered together, whereas physical complications were significantly associated with postpartum depression only when adjusting for antenatal depression. Depression during pregnancy, history of physical abuse, migrant status and postpartum physical complications are four major risk factors for postpartum depression. PMID:24370337

  17. Oxytocin course over pregnancy and postpartum period and the association with postpartum depressive symptoms.

    PubMed

    Jobst, Andrea; Krause, Daniela; Maiwald, Carina; Härtl, Kristin; Myint, Aye-Mu; Kästner, Ralph; Obermeier, Michael; Padberg, Frank; Brücklmeier, Benedikt; Weidinger, Elif; Kieper, Susann; Schwarz, Markus; Zill, Peter; Müller, Norbert

    2016-08-01

    During the postpartum period, women are at higher risk of developing a mental disorder such as postpartum depression (PPD), a disorder that associates with mother-infant bonding and child development. Oxytocin is considered to play a key role in mother-infant bonding and social interactions and altered oxytocin plasma concentrations were found to be associated with PPD. In the present study, we evaluated oxytocin plasma levels and depressive symptoms during pregnancy and the postpartum period in healthy women. We evaluated 100 women twice during pregnancy (weeks 35 and 38) and three times in the postpartum period (within 2 days and 7 weeks and 6 months after delivery) by measuring oxytocin plasma levels with enzyme-linked immunosorbent assay (ELISA) and assessing depressive symptoms with the Montgomery-Asberg Depression Rating Scale. Oxytocin plasma levels significantly increased from the 35th week of gestation to 6 months postpartum in all women. However, levels decreased from the 38th week of gestation to 2 days after delivery in participants with postpartum depressive symptoms, whereas they continuously increased in the group without postpartum depressive symptoms; the difference between the course of oxytocin levels in the two groups was significant (Δt2-t3: t = 2.14; p = 0.036*). Previous depressive episodes and breastfeeding problems predicted postpartum depressive symptoms. Our results indicate that alterations in the oxytocin system during pregnancy might be specific for women who develop postpartum depressive symptoms. Future studies should investigate whether oxytocin plasma levels might have predictive value in women at high risk for PPD. PMID:27320943

  18. Postpartum Depression: An Overview.

    ERIC Educational Resources Information Center

    Albright, Angela

    1993-01-01

    Occurring in about 12 percent of postpartum women, postpartum depression has been focus of considerable research. Variables that have been correlated with postpartum depression range from biological causes, to lack of social support, to relationship with husband, to attributional styles, to psychodynamic explanations. There is need for more…

  19. Postpartum thyroid dysfunction.

    PubMed

    Browne-Martin, K; Emerson, C H

    1997-03-01

    Four disorders of the postpartum period are associated with thyroid dysfunction. The most common is PPT. Although recovery from thyroid dysfunction often occurs in PPT, many patients eventually develop permanent hypothyroidism. Postpartum Graves' Disease is less common than PPT, but it is not unusual. Whereas antithyroid drugs are indicated for postpartum Graves' Disease, they are not useful in PPT. Although they are rare, lymphocytic hypophysitis and postpartum pituitary infarction are important entities because they cause deficiencies of many critical hormones. The autoimmune nature of PPT, postpartum Graves' disease, and lymphocytic hypophysitis highlights the unique effects of pregnancy on the immune system.

  20. Long-Term Efficacy of Postpartum Intravenous Iron Therapy

    PubMed Central

    Zimmermann, Roland

    2014-01-01

    Background. The potential benefits of administering a dose of intravenous iron in patients with moderate postpartum anaemia rather than oral iron alone remains unproven. Aims. To determine whether a single injection of intravenous iron followed by a 6-week course of oral iron is as effective over 6 months in restoring normal haemoglobin levels and replenishing iron stores in women with moderate postpartum anaemia as a course of oral iron alone in women with mild postpartum anaemia. Materials and Methods. Retrospective two-arm cohort study in women with mild postpartum anaemia (haemoglobin 9.6–10.5 g/dL) prescribed iron daily for 6 weeks (N = 150) and women with moderate postpartum anaemia (haemoglobin 8.5–9.5 g/dL), given a single 500 mg injection of intravenous iron followed by iron daily for 6 weeks (N = 75). Haemoglobin and ferritin were measured 6 months postpartum. Results. Haemoglobin returned to similar mean levels in both groups. Ferritin levels were statistically significantly higher in the intravenous + oral group (57.7 ± 49.3 μg/L versus 32.9 ± 20.1 μg/L). Conclusions. Despite lower baseline haemoglobin, intravenous iron carboxymaltose was superior to oral iron alone in replenishing iron stores in moderate postpartum anaemia and may prove similarly beneficial in mild postpartum anaemia. PMID:25431768

  1. A Review of Postpartum Psychosis

    PubMed Central

    SIT, DOROTHY; ROTHSCHILD, ANTHONY J.; WISNER, KATHERINE L.

    2011-01-01

    Objective The objective is to provide an overview of the clinical features, prognosis, differential diagnosis, evaluation, and treatment of postpartum psychosis. Methods The authors searched Medline (1966–2005), PsycInfo (1974–2005), Toxnet, and PubMed databases using the key words postpartum psychosis, depression, bipolar disorder, schizophrenia, organic psychosis, pharmacotherapy, psychotherapy, and electroconvulsive therapy. A clinical case is used to facilitate the discussion. Results The onset of puerperal psychosis occurs in the first 1–4 weeks after childbirth. The data suggest that postpartum psychosis is an overt presentation of bipolar disorder that is timed to coincide with tremendous hormonal shifts after delivery. The patient develops frank psychosis, cognitive impairment, and grossly disorganized behavior that represent a complete change from previous functioning. These perturbations, in combination with lapsed insight into her illness and symptoms, can lead to devastating consequences in which the safety and well-being of the affected mother and her offspring are jeopardized. Therefore, careful and repeated assessment of the mothers’ symptoms, safety, and functional capacity is imperative. Treatment is dictated by the underlying diagnosis, bipolar disorder, and guided by the symptom acuity, patient’s response to past treatments, drug tolerability, and breastfeeding preference. The somatic therapies include antimanic agents, atypical antipsychotic medications, and ECT. Estrogen prophylaxis remains purely investigational. Conclusions The rapid and accurate diagnosis of postpartum psychosis is essential to expedite appropriate treatment and to allow for quick, full recovery, prevention of future episodes, and reduction of risk to the mother and her children and family. PMID:16724884

  2. The postpartum triathlete.

    PubMed

    Thein-Nissenbaum, Jill

    2016-09-01

    The postpartum period in a woman's life is filled with numerous changes, including physical changes, changes in sleep habits, and learning how to best care for a newborn. A common goal among postpartum women is to either begin or resume an active lifestyle, which often includes physical activity such as running, biking and swimming. The postpartum athlete may discover barriers that prevent her from returning to or beginning an exercise routine. These obstacles include muscle weakness, fatigue, depression and physical changes that require exercise modification. The physical therapist is well-suited to properly assess, treat and manage the care of the postpartum athlete. Postpartum athletes wishing to begin or resume training for triathlons require special consideration, as the triathlete must balance training to compete in three different sports. The purpose of the paper is to identify the unique physical and physiological changes that occur to the female during the postpartum period. In addition, injuries that are more commonly seen during the postpartum period will be discussed. Recommendations for beginning or resuming an exercise program will be reviewed. Lastly, sport-specific training for the postpartum triathlete, including challenges presented with each triathlon component, will be discussed. PMID:27497835

  3. Postpartum Depression and Child Development.

    ERIC Educational Resources Information Center

    Murray, Lynne, Ed.; Cooper, Peter J., Ed.

    Only recently has the research on postpartum depression dealt with the disorder's effects on child development. This book explores the impact of postpartum depression on mother-infant interaction and child development, its treatment, and postpartum psychosis. The chapters are: (1) "The Nature of Postpartum Depressive Disorders" (Michael O'Hara);…

  4. Kawasaki disease in a postpartum patient.

    PubMed Central

    Fason, Janet T.; Fry, Yvonne W.; Smith, Dominique

    2004-01-01

    Kawasaki disease, also known as mucocutaneous lymph node syndrome, is a multisystem disease. It usually affects children below the age of five, but it occasionally affects adults. There are less than 50 English-reported adult cases in the literature, and only five reported cases of Kawasaki disease and pregnancy, as of 2003. The cases associated with pregnancy involved patients who had a history of Kawasaki disease during childhood and addressed how the complications of the illness (i.e,. coronary artery aneurysms) were managed during pregnancy and delivery. There are no reported cases of Kawasaki disease in postpartum patients. This article presents a case of Kawasaki disease in a 21-year-old, four-week postpartum patient who initially responded to intravenous (IV) antibiotic therapy. This paper will review the diagnosis and treatment of Kawasaki disease as well as the multiple outside variables that impact the management of adult postpartum patients with Kawasaki disease. PMID:15586654

  5. Postpartum renal vein thrombosis.

    PubMed

    Rubens, D; Sterns, R H; Segal, A J

    1985-01-01

    Renal vein thrombosis in adults is usually a complication of the nephrotic syndrome. Rarely, it has been reported in nonnephrotic women postpartum. The thrombosis may be a complication of the hypercoagulable state associated with both the nephrotic syndrome and pregnancy. Two postpartum patients with renal vein thrombosis and no prior history of renal disease are reported here. Neither patient had heavy proteinuria. In both cases, pyelonephritis was suspected clinically and the diagnosis of renal vein thrombosis was first suggested and confirmed by radiologic examination. Renal vein thrombosis should be considered in women presenting postpartum with flank pain.

  6. Postpartum Support International

    MedlinePlus

    ... 4773 1.800.944.4773 You are not alone Learn More Essential info about perinatal mood & anxiety ... women suffer from postpartum depression You are not alone You are not to blame With help, you ...

  7. Postpartum affective disorders: incidence and treatment.

    PubMed

    Ugarriza, D N

    1992-05-01

    1. Postpartum depression is a culture-bound syndrome found in Western societies. The lack of supportive rites and rituals for postpartum women shape depressive symptoms. 2. Postpartum depression is a term used for three distinct syndromes: postpartum "blues," postpartum psychosis, and postpartum depression. 3. Treatment issues surrounding each postpartum affective disorder are different and require education and support of family members as well as postpartum women.

  8. Placental Corticotropin-Releasing Hormone Mediates the Association Between Prenatal Social Support and Postpartum Depression

    PubMed Central

    Hahn-Holbrook, Jennifer; Schetter, Christine Dunkel; Arora, Chander; Hobel, Calvin J.

    2013-01-01

    Three decades of research point to both biological and psychological risk factors for postpartum depression, but very little research integrates the two. This study bridged this gap by testing whether prenatal social support predicted depressive symptoms at 8 weeks postpartum in a multiethnic sample of 210 women and whether the stress hormone placental corticotropin-releasing hormone (pCRH), measured at 19, 29, and 37 weeks’ gestation, mediated this relationship. We found that prenatal family support predicted significantly fewer depressive symptoms postpartum and more gradual increases in pCRH from 29 to 37 weeks’ gestation. Furthermore, steeper increases in pCRH during this same period predicted more depressive symptoms postpartum. Finally, these changes in pCRH in late pregnancy mediated the relationship between prenatal family support and postpartum depressive symptoms. These results suggest that social and biological risk factors for postpartum depressive symptoms are intertwined and move us closer to an integrated biopsychosocial understanding of postpartum depression. PMID:23997996

  9. 2,4,6-Trinitrotoluene (TNT)

    Integrated Risk Information System (IRIS)

    2,4,6 - Trinitrotoluene ( TNT ) ; CASRN 118 - 96 - 7 Human health assessment information on a chemical substance is included in the IRIS database only after a comprehensive review of toxicity data , as outlined in the IRIS assessment development process . Sections I ( Health Hazard Assessments for N

  10. 2,3,4,6-Tetrachlorophenol

    Integrated Risk Information System (IRIS)

    2,3,4,6 - Tetrachlorophenol ; CASRN 58 - 90 - 2 Human health assessment information on a chemical substance is included in the IRIS database only after a comprehensive review of toxicity data , as outlined in the IRIS assessment development process . Sections I ( Health Hazard Assessments for Noncar

  11. A Dogrib History. Grade 4-6.

    ERIC Educational Resources Information Center

    Fraser, Tara

    A publication on the history and traditional lifestyle of the Dogrib Tribe of Canada's Northwest Territories is intended for use in grades 4-6. The text is illustrated with numerous drawings. Sections describe the caribou, spruce tree, muskox, fox, ducks and geese and their usefulness to Dogrib people. Activities covered are trading at the trading…

  12. Career Education: Grades 4-6.

    ERIC Educational Resources Information Center

    Cortland-Madison Board of Cooperative Educational Services, Cortland, NY.

    The third of a series of nine career education guides includes four social studies units for grades 4-6. Part one, famous Americans from Plymouth Rock to Tranquility Base, includes goals, objectives, skills to be taught or reviewed, lists of famous Americans in the fields of science and medicine, inventions, sports, religion, politics, literature,…

  13. 4-6 Computer Awareness. Interim Guide.

    ERIC Educational Resources Information Center

    Manitoba Dept. of Education, Winnipeg. Computer Services Branch.

    This guide was developed to assist teachers in achieving goals related to the development of computer awareness in students in grades 4-6 in the Canadian province of Manitoba. An overview of the program describes a set of basic concepts, skills, and attitudes relating to computer technology, and provides information on activities that can be used…

  14. Maternal Postpartum Role Collapse as a Theory of Postpartum Depression

    ERIC Educational Resources Information Center

    Amankwaa, Linda Clark

    2005-01-01

    The purpose of this paper is to discuss the development of a theory of maternal postpartum role collapse. The influences of traditional role theory and symbolic interactionism are presented. The development of the maternal postpartum role collapse theory emerged from the study of postpartum depression among African-American women (Amankwaa, 2000).…

  15. Cost-utility analysis of a one-time supervisor telephone contact at 6-weeks post-partum to prevent extended sick leave following maternity leave in The Netherlands: results of an economic evaluation alongside a randomized controlled trial

    PubMed Central

    2011-01-01

    Background Working women of childbearing age are a vital part of the population. Following childbirth, this group of women can experience a myriad of physical and mental health problems that can interfere with their ability to work. Currently, there is little known about cost-effective post-partum interventions to prevent work disability. The purpose of the study was to evaluate whether supervisor telephone contact (STC) during maternity leave is cost-effective from a societal perspective in reducing sick leave and improving quality-adjusted life years (QALYs) compared to common practice (CP). Methods We conducted an economic evaluation alongside a randomized controlled trial. QALYs were measured by the EuroQol 5-D, and sick leave and presenteeism by the Health and work Performance Questionnaire. Resource use was collected by questionnaires. Data were analysed according to intention-to-treat. Missing data were imputed via multiple imputation. Uncertainty was estimated by 95% confidence intervals, cost-utility planes and curves, and sensitivity analyses. Results 541 working women from 15 companies participated. Response rates were above 85% at each measurement moment. At the end of the follow-up, no statistically significant between-group differences in QALYs, mean hours of sick leave or presenteeism or costs were observed. STC was found to be less effective and more costly. For willingness-to-pay levels from €0 through €50,000, the probability that STC was cost-effective compared to CP was 0.2. Overall resource use was low. Mean total costs were €3678 (95% CI: 3386; 3951). Productivity loss costs represented 37% of the total costs and of these costs, 48% was attributable to sick leave and 52% to work presenteeism. The cost analysis from a company's perspective indicated that there was a net cost associated with the STC intervention. Conclusions STC was not cost-effective compared to common practice for a healthy population of working mothers; therefore

  16. [Postpartum psychiatric disorders].

    PubMed

    Mazaira, Silvina

    2014-01-01

    The postpartum period represents a very particular time in women's life, the beginning of a new bond, the maternity. As many times, beginnings are such turbulent, intense. In this period the women suffers deep changes in their hormonal status, with its body and changes and affective oscillations. Women are often so labile at this time, ranging from happiness to deep sadness. The vast majority suffers the blues, a benign form of mild depressive state. On the other hand, 20% may have a major depressive episode, and a much less percentage will suffer the most disruptive postpartum syndrome, the postpartum psychosis. In this paper it will be described the symptomatology of such cases, the most important treatment approaches and will focus on the clinical dilemma of using psychotropic medications during breastfeeding. PMID:25545081

  17. Eating disorder symptoms pre- and postpartum.

    PubMed

    Pettersson, Cecilia Brundin; Zandian, Modjtaba; Clinton, David

    2016-08-01

    The study aimed to investigate symptoms of disordered eating pre- and postpartum using a standardised and widely used measure of eating disorder (ED) psychopathology. A consecutive series of women attending either prenatal (N = 426) or postnatal (N = 345) clinics in metropolitan Stockholm were assessed using the Eating Disorder Examination Questionnaire (EDE-Q). Assessments were conducted at either the first visit to prenatal clinics (10-12 weeks of pregnancy) or 6 to 8 months postpartum. An optimised shortened version of the EDE-Q was best suited for studying eating disorders pre- and postpartum. Using the optimised version of the instrument with 14 items and a cut-off score of ≥2.8, it was estimated that 5.3 % of prepartum and 12.8 % of postpartum mothers were suffering from clinical eating disorders. Seriously disordered eating behaviour during, and especially after, pregnancy may be more common than previously thought. It is imperative that health services focus increased attention on these problems by raising awareness, developing and extending specialist services, as well as through implementing educational programmes and training directed toward frontline healthcare services.

  18. Eating disorder symptoms pre- and postpartum.

    PubMed

    Pettersson, Cecilia Brundin; Zandian, Modjtaba; Clinton, David

    2016-08-01

    The study aimed to investigate symptoms of disordered eating pre- and postpartum using a standardised and widely used measure of eating disorder (ED) psychopathology. A consecutive series of women attending either prenatal (N = 426) or postnatal (N = 345) clinics in metropolitan Stockholm were assessed using the Eating Disorder Examination Questionnaire (EDE-Q). Assessments were conducted at either the first visit to prenatal clinics (10-12 weeks of pregnancy) or 6 to 8 months postpartum. An optimised shortened version of the EDE-Q was best suited for studying eating disorders pre- and postpartum. Using the optimised version of the instrument with 14 items and a cut-off score of ≥2.8, it was estimated that 5.3 % of prepartum and 12.8 % of postpartum mothers were suffering from clinical eating disorders. Seriously disordered eating behaviour during, and especially after, pregnancy may be more common than previously thought. It is imperative that health services focus increased attention on these problems by raising awareness, developing and extending specialist services, as well as through implementing educational programmes and training directed toward frontline healthcare services. PMID:26961005

  19. Dynamics of postpartum endometrial cytology and bacteriology and their relationship to fertility in dairy cows.

    PubMed

    Gilbert, Robert O; Santos, Natalia R

    2016-05-01

    Endometrial samples were obtained from 56 consecutively calving dairy cows examined for endometrial cytology and for aerobic and anaerobic bacterial growth. Changes over time, correlations between different cell types and between cell and bacterial populations and with fertility measures were calculated. The proportion of neutrophils in cytologic preparations decreased with time postpartum. Other cell types did not change significantly with time. The proportion of neutrophils early (Day 0 and 7) postpartum was negatively correlated with neutrophil proportion at 5 or 7 weeks postpartum and positively correlated with fertility. Cows with high proportion of neutrophils at 7 days postpartum (>40%) were significantly more likely to become pregnant than those with lower proportions of neutrophils. Escherichia coli were the bacteria most frequently isolated at 0 or 7 days postpartum but were uncommon after that. Trueperella pyogenes were most prevalent at 3 weeks postpartum and were more likely to infect cows that had previously been infected with E coli. The presence of T pyogenes at 3 weeks postpartum increased the risk of concomitant or later infection with gram-negative anaerobes. The presence of T pyogenes at 3 weeks postpartum significantly reduced the risk of pregnancy at 150 days in milk. The presence of alpha-hemolytic Streptoccus spp. at 7 days postpartum was associated with improved reproductive performance. The proportion of neutrophils at 5 and 7 weeks postpartum was related to concomitant bacterial infection. These findings suggest that rapid mobilization of neutrophils to the postpartum uterus is a beneficial response for uterine health in dairy cows. PMID:26944540

  20. Reproducibility and validity of a food frequency questionnaire in assessing dietary intakes of low-income Caucasian postpartum women living in Sheffield, United Kingdom.

    PubMed

    Mouratidou, Theodora; Ford, Fiona A; Fraser, Robert B

    2011-04-01

    The aim of this study was to examine the reproducibility and validity of a semi-quantitative food frequency questionnaire (FFQ) for assessing dietary intakes of low-income, Caucasian, English-speaking, postpartum women living in Sheffield, United Kingdom. Data was obtained from a cross-sectional sample of the 'Healthy Start' study; a population-based survey of mothers and infants. Participants completed two FFQs at 4 and 8 weeks postpartum. Measures from 24-hour dietary recalls (24HDRs) were collected at 4, 6, 8 and 12 weeks postpartum. In the reproducibility study, crude Pearson's correlation coefficients ranged from 0.40 (riboflavin) to 0.73 (thiamine), mean value 0.54. In the validation study, crude Pearson correlation coefficients between the FFQ and the measures from the 24HDRs ranged from 0.10 (B12) to 0.55 (manganese), mean value 0.34. Energy-adjustments and corrections for attenuation had no significant effect on the strength of the correlation both observed in the reproducibility and validity study. On average, 68% of the participants were classified correctly, and 3% were misclassified into the extreme opposite quintile of the distribution. The authors conclude that the questionnaire performed well for the majority of nutrients examined and that is a valid tool for ranking individuals according to nutrient distribution.

  1. Impact of childhood trauma on postpartum depression: a prospective study.

    PubMed

    De Venter, Maud; Smets, Jorien; Raes, Filip; Wouters, Kristien; Franck, Erik; Hanssens, Myriam; Jacquemyn, Yves; Sabbe, Bernard G C; Van Den Eede, Filip

    2016-04-01

    Studies on the impact of childhood trauma on postpartum depression show inconsistencies and methodological limitations. The present study examines the effect of childhood trauma on depression 12 and 24 weeks after childbirth, while controlling for history of depression, depression symptoms during pregnancy and type D personality. During the third trimester of pregnancy, 210 women completed self-report questionnaires assessing depression (current and/or past episodes), childhood trauma and type D personality, of whom 187 participated in the postpartum follow-up, with depression symptoms being reassessed at 12 and 24 weeks after delivery with three depression outcome measures. Eventually, 183 participants were retained for analysis. Results indicated no predictive value of childhood trauma on postpartum depression in the univariate analyses, nor after controlling for previous depression, depression symptoms during pregnancy and type D personality. However, past depression and depression symptoms during pregnancy did independently and convincingly predict postpartum depression, especially at 12 weeks and to a lesser extent at 24 weeks following childbirth. Overall, we found no significant association between childhood trauma and postpartum depression. Past depression and depression symptoms during pregnancy are more relevant factors to assess before childbirth.

  2. Impact of childhood trauma on postpartum depression: a prospective study.

    PubMed

    De Venter, Maud; Smets, Jorien; Raes, Filip; Wouters, Kristien; Franck, Erik; Hanssens, Myriam; Jacquemyn, Yves; Sabbe, Bernard G C; Van Den Eede, Filip

    2016-04-01

    Studies on the impact of childhood trauma on postpartum depression show inconsistencies and methodological limitations. The present study examines the effect of childhood trauma on depression 12 and 24 weeks after childbirth, while controlling for history of depression, depression symptoms during pregnancy and type D personality. During the third trimester of pregnancy, 210 women completed self-report questionnaires assessing depression (current and/or past episodes), childhood trauma and type D personality, of whom 187 participated in the postpartum follow-up, with depression symptoms being reassessed at 12 and 24 weeks after delivery with three depression outcome measures. Eventually, 183 participants were retained for analysis. Results indicated no predictive value of childhood trauma on postpartum depression in the univariate analyses, nor after controlling for previous depression, depression symptoms during pregnancy and type D personality. However, past depression and depression symptoms during pregnancy did independently and convincingly predict postpartum depression, especially at 12 weeks and to a lesser extent at 24 weeks following childbirth. Overall, we found no significant association between childhood trauma and postpartum depression. Past depression and depression symptoms during pregnancy are more relevant factors to assess before childbirth. PMID:26189446

  3. Heterogeneity of postpartum depression: a latent class analysis

    PubMed Central

    2016-01-01

    Summary Background Maternal depression in the postpartum period confers substantial morbidity and mortality, but the definition of postpartum depression remains controversial. We investigated the heterogeneity of symptoms with the aim of identifying clinical subtypes of postpartum depression. Methods Data were aggregated from the international perinatal psychiatry consortium Postpartum Depression: Action Towards Causes and Treatment, which represents 19 institutions in seven countries. 17 912 unique subject records with phenotypic data were submitted. We applied latent class analyses in a two-tiered approach to assess the validity of empirically defined subtypes of postpartum depression. Tier one assessed heterogeneity in women with complete data on the Edinburgh postnatal depression scale (EPDS) and tier two in those with postpartum depression case status. Findings 6556 individuals were assessed in tier one and 4245 in tier two. A final model with three latent classes was optimum for both tiers. The most striking characteristics associated with postpartum depression were severity, timing of onset, comorbid anxiety, and suicidal ideation. Women in class 1 had the least severe symptoms (mean EPDS score 10·5), followed by those in class 2 (mean EPDS score 14·8) and those in class 3 (mean EPDS score 20·1). The most severe symptoms of postpartum depression were significantly associated with poor mood (mean EPDS score 20·1), increased anxiety, onset of symptoms during pregnancy, obstetric complications, and suicidal ideation. In class 2, most women (62%) reported symptom onset within 4 weeks postpartum and had more pregnancy complications than in other two classes (69% vs 67% in class 1 and 29% in class 3). Interpretation PPD seems to have several distinct phenotypes. Further assessment of PPD heterogeneity to identify more precise phenotypes will be important for future biological and genetic investigations. Funding Sources of funding are listed at the end of the

  4. Effectiveness of a combined prenatal and postpartum smoking cessation program.

    PubMed

    Gadomski, Anne; Adams, Laurie; Tallman, Nancy; Krupa, Nicole; Jenkins, Paul

    2011-02-01

    Women frequently quit smoking during pregnancy but then relapse postpartum. The BABY & ME-Tobacco Free program combines prenatal and postpartum smoking cessation counseling and biomarker feedback with monthly postpartum incentives. The settings included 22 sites (WIC offices and prenatal clinics) in upstate New York. A quasi-experimental design was used to evaluate this intervention, that included four face-to-face prenatal sessions with a counselor who did smoking cessation counseling, carbon monoxide testing and random saliva cotinine testing. For 1 year postpartum, mothers were biochemically tested every 3-4 weeks and, if negative, were issued a voucher for diapers. Three implementation models were studied: multi-tasking counselors at fixed sites (Models 1 and 2) versus itinerant smoking cessation specialists (Model 3). Outcomes included biochemically validated abstinence rates during pregnancy and postpartum. Logistic regression was used to identify predictors of postpartum abstinence and program dropout. Proportional hazards regression was used to compare implementation models. Of the 777 pregnant women who enrolled in the program, 588 were eligible for the postpartum program. The intention to treat pregnancy quit rate was 60%. Postpartum, Model 3 showed consistently better quit outcomes than the other models. Predictors of abstinence at 6 months postpartum are: older age (OR = 1.07, 95% C.I. 1.02-1.12), lower baseline carbon monoxide level (OR = 0.69, 95% C.I. 0.49-0.97), Model 3 (OR = 4.60, 95% C.I. 2.80-7.57) and attending more prenatal sessions (OR = 3.52; 95% C.I. 2.19-5.65). The BABY & ME-Tobacco Free program is an effective smoking cessation program for pregnant and parenting women.

  5. Predictors of the Longitudinal Course of Postpartum Depression Following Interpersonal Psychotherapy

    ERIC Educational Resources Information Center

    Nylen, Kimberly J.; O'Hara, Michael W.; Brock, Rebecca; Moel, Joy; Gorman, Laura; Stuart, Scott

    2010-01-01

    Objective: We examined the course and predictors of postpartum depression in the 18 months following interpersonal psychotherapy (IPT). Method: We enrolled 120 community women with major depression in a 12-week randomized trial of individual IPT during the postpartum period (O'Hara, Stuart, Gorman, & Wenzel, 2000). At 6, 12, and 18 months…

  6. The relationship between depression and body dissatisfaction across pregnancy and the postpartum: a prospective study.

    PubMed

    Clark, Abigail; Skouteris, Helen; Wertheim, Eleanor H; Paxton, Susan J; Milgrom, Jeannette

    2009-01-01

    The overall aim of this study was to examine the relationship between depression and body dissatisfaction across pregnancy and the first 12 months postpartum. During pregnancy, women's (N = 116) perceived attractiveness and strength/fitness remained stable, while feeling fat and salience of weight/shape decreased in late pregnancy. During the postpartum, feeling fat and salience of weight/shape increased. Depression and body dissatisfaction scores were correlated with each other concurrently and across multiple time points. However, in baseline-controlled prospective analyses, only a model of greater depression late in pregnancy predicting body dissatisfaction at six weeks postpartum and feeling fat throughout the postpartum was supported. PMID:19129334

  7. Changes in Depressive Symptoms over 0–9 Months Postpartum

    PubMed Central

    Crow, Scott; McGovern, Patricia; Miner, Michael; Center, Bruce

    2011-01-01

    Abstract Objective To investigate mothers' changes in prevalence of postpartum depression (PPD) symptoms over 0–9 months postpartum and determine which symptoms best distinguish depressed from nondepressed women. Methods This was a prospective study of English-literate mothers of newborns, recruited from four family medicine clinics and three pediatric clinics. Mothers completed surveys at 0–1, 2, 4, 6, and 9 months postpartum, and surveys included demographic characteristics, a two-question depression screen, the 9-Item Patient Health Questionnaire (PHQ-9), and other health and work characteristics. Results There were 506 participants (33% response rate), and 112 (22.1%) had a positive PHQ-9 (score ≥10) at some time within the first 9 months after delivery. The proportion of women with a positive PHQ-9 was greatest at 0–1 month (12.5%), then fell to between 5.0% and 7.1% at 2–6 months, and rose again to 10.2% at 9 months postpartum. Most of the PHQ-9 symptoms differentiated well between depressed and nondepressed women; items that were less discriminating were abnormal sleep, abnormal appetite/eating, and fatigue. Assessment of possible predictors of a change from negative to positive PHQ-9 between 6 and 9 months postpartum revealed only one significant predictor: prior history of depression. Conclusions Depressive symptoms in this sample were most frequent at 0–1 month and 9 months postpartum. Most PHQ-9 items differentiated well between depressed and nondepressed mothers; these findings support the use of the PHQ-9 for PPD screening. Future research is needed to confirm our observed secondary peak in depressive symptoms at 9 months postpartum and to investigate possible causes. PMID:21351876

  8. [Postpartum thyroiditis. A review].

    PubMed

    Hurtado-Hernández, Z; Segura-Domínguez, A

    2013-01-01

    Postpartum thyroiditis (PPT) is a transient thyroid dysfunction of autoimmune origin that can occur in the first year postpartum in women who have not been previously diagnosed with thyroid disease. It may start with clinical thyrotoxicosis followed by hypothyroidism and the subsequent recovery of thyroid function, or may just appear as isolated thyrotoxicosis or hypothyroidism. PPT recurs in high percentage of patients after subsequent pregnancies. Many women develop permanent hypothyroidism sometime during the 3 to 10 year period after an episode of PPT. It is important for family physicians to be familiar with this disease, due to its high prevalence in order to make a correct diagnosis and therapeutic intervention. Family doctors also play a crucial role in the monitoring of these patients, given the negative implications of established hypothyroidism on reproduction in the female population during their reproductive years. This article reviews the principle characteristics of PPT along with its diagnosis and treatment. PMID:23834978

  9. Assessing postpartum family functioning.

    PubMed

    Midmer, D; Talbot, Y

    1988-09-01

    The birth of a child requires adaptation and reorganization within the family system in order to accommodate the new family member and to allow the family to continue in its psychosocial development. Knowledge of the normative and transitional changes required at this stage of family life will enhance family practitioners' understanding of some of the common concerns and complaints related to them by various family members during the postpartum period. The Family FIRO model represents a helpful conceptual framework to increase the family physician's understanding of the issues of inclusion, control, and intimacy that are highlighted during the transition to parenthood. The authors briefly present this model and discuss its application to postpartum adjustment and its implications for health-care professionals.

  10. Assessing Postpartum Family Functioning

    PubMed Central

    Midmer, Deana; Talbot, Yves

    1988-01-01

    The birth of a child requires adaptation and reorganization within the family system in order to accommodate the new family member and to allow the family to continue in its psychosocial development. Knowledge of the normative and transitional changes required at this stage of family life will enhance family practitioners' understanding of some of the common concerns and complaints related to them by various family members during the postpartum period. The Family FIRO model represents a helpful conceptual framework to increase the family physician's understanding of the issues of inclusion, control, and intimacy that are highlighted during the transition to parenthood. The authors briefly present this model and discuss its application to postpartum adjustment and its implications for health-care professionals. PMID:21253238

  11. Short term post-partum heat stress in dairy cows

    NASA Astrophysics Data System (ADS)

    Fuquay, J. W.; Chapin, L. T.; Brown, W. H.

    1980-06-01

    Since many dairy cows calve during late summer, the objective was to determine if heat stress immediately post-partum would (1) alter metabolism, thus, increasing susceptibility to metabolic disorders, (2) affect lactation and/or (3) affect reproduction. Forty four cows, calving during late summer, were paired with one member of each pair stressed (HS) for the first 10 post-partum days in a hot barn. Controls (CC) were kept in a cooled section of the barn. Plasma drawn weekly for 7 weeks was analyzed in an autoanalyzer for calcium, inor. phosphorus, protein, glucose and cholesterol and by radioimmunoassay for cortisol and progesterone. Ovaries and uteri were palpated weekly. Rectal temperatures were significant higher for HS during the first 10 post-partum days. No significant effects on plasma constituents were observed during the 10-day treatment period. For the 7-week period, glucose and cholesterol were lower in HS, as were cyclic peaks of progesterone and cortisol. Both calcium and inorganic phosphorus remained clinically low for the 7 weeks, but no treatment effects were seen. Uteri of HS involuted more rapidly than the CC. Treatment did not affect reproductive efficiency. Lactation milk yields did not differ, but milk fat percent was lower in HS. Heat stress immediately post-partum altered lipid metabolism, but the animal's compensatory mechanisms prevented reduction in milk production or reproductive efficiency.

  12. Management of postpartum haemorrhage

    PubMed Central

    Bonnet, Marie Pierre; Benhamou, Dan

    2016-01-01

    Postpartum Haemorrhage (PPH) is a major cause of maternal morbidity and mortality. Treatment of acquired coagulopathy observed in severe PPH is an important part of PPH management, but is mainly based on literature in trauma patients, and data thus should be interpreted with caution. This review describes recent advances in transfusion strategy and in the use of tranexamic acid and fibrinogen concentrates in women with PPH. PMID:27408694

  13. Management of postpartum haemorrhage.

    PubMed

    Bonnet, Marie Pierre; Benhamou, Dan

    2016-01-01

    Postpartum Haemorrhage (PPH) is a major cause of maternal morbidity and mortality. Treatment of acquired coagulopathy observed in severe PPH is an important part of PPH management, but is mainly based on literature in trauma patients, and data thus should be interpreted with caution. This review describes recent advances in transfusion strategy and in the use of tranexamic acid and fibrinogen concentrates in women with PPH. PMID:27408694

  14. Interpersonal Psychotherapy for Postpartum Depression

    PubMed Central

    Stuart, Scott

    2014-01-01

    Perinatal depression is prevalent and has a great impact on both mother and infant. There are empirically validated treatments for both postpartum depression and depression during pregnancy. Primary among these is interpersonal psychotherapy, which has been shown to be effective for postpartum women across the spectrum from mild to severe depression. At present, interpersonal psychotherapy is the best validated treatment for postpartum depression and should be considered first-line treatment, especially for depressed breastfeeding women. PMID:22473762

  15. Determinants of changes in vitamin D status postpartum in Swedish women.

    PubMed

    Brembeck, Petra; Winkvist, Anna; Bååth, Mari; Bärebring, Linnea; Augustin, Hanna

    2016-02-14

    Low vitamin D status has been associated with unfavourable health outcomes. Postpartum, it is speculated that maternal vitamin D status decreases due to transfer of vitamin D from mother to child through breast milk. A few studies have investigated changes in maternal vitamin D postpartum and possible determinants. Thus, the aims of the present study were to determine changes in serum concentrations of 25-hydroxyvitamin D (25(OH)D) between 2 weeks and 12 months postpartum in Swedish women and to evaluate lactation and other determinants for changes in 25(OH)D concentration postpartum. In total, seventy-eight women were studied at 2 weeks, 4 months and 12 months postpartum. Data collection included measurements of weight and height as well as information about lactation, sun exposure, use of oestrogen contraceptives and physical activity level. Blood samples were collected and serum 25(OH)D levels were analysed using liquid chromatography-tandem MS. Dietary intake of vitamin D was recorded using 4-d food diaries. For all the women studied, mean serum 25(OH)D did not change between 2 weeks and 12 months postpartum (67 (SD 23) v. 67 (SD 19) nmol/l). No association was found between lactation and changes in serum 25(OH)D concentration postpartum. Significant determinants for postpartum changes in 25(OH)D concentration were use of vitamin D supplements (P=0·003), use of oestrogen contraceptives (P=0·013) and season (P=0·005). In conclusion, no changes were observed in 25(OH)D concentrations during the 1st year postpartum in these women and no association was found between lactation and changes in 25(OH)D concentration postpartum. The main determinants for the variation in changes in 25(OH)D concentrations postpartum were use of vitamin D supplements, use of oestrogen contraceptives and season. PMID:26586446

  16. Prenatal predictors of postpartum depression and postpartum depressive symptoms in Mexican mothers: a longitudinal study.

    PubMed

    Lara, María Asunción; Navarrete, Laura; Nieto, Lourdes

    2016-10-01

    Prospective studies on the predictors of postpartum depression (PPD) in Latin America are scarce, which is a matter of importance, since the significance of PPD risk factors may vary according to the level of development of a country, the types of measurement and the time periods assessed. This study identifies the prenatal predictors for PPD (diagnostic interview) and postpartum depressive symptoms (PPDS) (self-report scale) in Mexican mothers at 6 weeks and 6 months postpartum. Two hundred and ten women were interviewed using the Structured Clinical Interview (SCID-I), Patient Health Questionnaire (PHQ-9) and various risk factor scales. Univariate logistic regressions showed that social support, marital satisfaction, life events, a history of psychopathology, anxiety symptoms, depressive symptoms, the traditional female role, previous miscarriages/termination of pregnancy and unplanned/unwanted pregnancy were significant predictors for both PPD and PPDS at both assessment times in the postpartum. Education, age, marital status, income, occupation, parity, C-section and resilience were significant for only one of the measurements and/or at just one assessment time. General findings replicate a high- and low-income country observed psychosocial risk profile and confirm a sociodemographic and obstetric profile of vulnerability that is more prevalent in resource-constrained countries. PPD constitutes a high burden for new mothers, particularly for those living in low-middle-income countries who face social disadvantages (such as low educational attainment and income).

  17. Anger after Childbirth: An Overlooked Reaction to Postpartum Stressors

    ERIC Educational Resources Information Center

    Graham, Jennifer E.; Lobel, Marci; DeLuca, Robyn Stein

    2002-01-01

    Other than postpartum depression, little is known about women's emotional responses to childbirth and subsequent stressors. Anger was explored on the basis of theory and evidence that it is a likely emotional response in this context. During their third trimester of pregnancy and approximately six weeks after delivery, 163 participants completed…

  18. Thyroid function 48h after delivery as a marker for subsequent postpartum depression.

    PubMed

    Albacar, Glòria; Sans, Teresa; Martín-Santos, Rocío; García-Esteve, Lluïsa; Guillamat, Roser; Sanjuan, Julio; Cañellas, Francesca; Carot, José Miguel; Gratacòs, Mònica; Bosch, Joan; Gaviria, Ana; Labad, Antonio; Zotes, Alfonso Gutiérrez; Vilella, Elisabet

    2010-06-01

    Physiological changes during gestation and after delivery are associated with postpartum thyroid dysfunction, which is due to thyroid autoimmunity in some cases. Postpartum thyroid dysfunction, in turn, has been associated with postpartum depression (PPD). The aim of the present study was to evaluate whether thyroid function immediately after delivery can predict postpartum depression at 8 weeks and 32 weeks after delivery. This study examined 1053 postpartum Spanish women without a previous history of depression. We evaluated depressive symptoms at 48h, 8 weeks and 32 weeks postpartum and used a diagnostic interview to confirm major depression for all probable cases. Free thyroxin (fT4), thyroid-stimulating hormone (TSH), thyroid peroxidase antibodies (TPOAb) and C-reactive protein (CRP) were assayed at 48h postpartum. Binary and multivariate logistic regression analyses were performed to determine independent risk factors for PPD. Although 152 women (14.4%) had high TPOAb (>27IU/mL) and slightly elevated TSH concentrations with normal fT4, we did not find any association between thyroid function and PPD. This thyroid dysfunction was not associated with CRP concentrations that were outside of the normal range (>3mg/L). We conclude that thyroid function at 48h after delivery does not predict PPD susceptibility. PMID:19939574

  19. Effects of antenatal, postpartum and post-weaning melatonin supplementation on blood pressure and renal antioxidant enzyme activities in spontaneously hypertensive rats.

    PubMed

    Lee, S K; Sirajudeen, K N S; Sundaram, Arunkumar; Zakaria, Rahimah; Singh, H J

    2011-06-01

    Although melatonin lowers blood pressure in spontaneously hypertensive rats (SHR), its effect following antenatal and postpartum supplementation on the subsequent development of hypertension in SHR pups remains unknown. To investigate this, SHR dams were given melatonin in drinking water (10 mg/kg body weight/day) from day 1 of pregnancy until day 21 postpartum. After weaning, a group of male pups continued to receive melatonin till the age of 16 weeks (Mel-SHR), while no further melatonin was given to another group of male pups (Maternal-Mel-SHR). Controls received plain drinking water. Systolic blood pressure (SBP) was measured at 4, 6, 8, 12 and 16 weeks of age, after which the kidneys were collected for analysis of antioxidant enzyme profiles. SBP was significantly lower till the age of 8 weeks in Maternal-Mel-SHR and Mel-SHR than that in the controls, after which no significant difference was evident in SBP between the controls and Maternal-Mel-SHR. SBP in Mel-SHR was lower than that in controls and Maternal-Mel-SHR at 12 and 16 weeks of age. Renal glutathione peroxidase (GPx) and glutathione s-transferase (GST) activities, levels of total glutathione and relative GPx-1 protein were significantly higher in Mel-SHR. GPx protein was however significantly higher in Mel-SHR. No significant differences were evident between the three groups in the activities of superoxide dismutase, catalase and glutathione reductase. In conclusion, it appears that while antenatal and postpartum melatonin supplementation decreases the rate of rise in blood pressure in SHR offspring, it however does not alter the tendency of offspring of SHR to develop hypertension.

  20. Demographic, maternal, and infant health correlates of post-partum depression in Jordan.

    PubMed

    Safadi, Reema R; Abushaikha, Lubna A; Ahmad, Muayyad M

    2016-09-01

    This cross-sectional correlational study examined post-partum depression and its relationship with demographic, maternal, and infant health problems in urban Jordanian women. Participants (n = 315) were selected from five maternal child healthcare centers and one major hospital in Amman, Jordan. Patient Health Questionnaire-9 was used to measure post-partum depression within 12 weeks of birth. A number of socio-demographic and health problems were examined for an association with post-partum depression. Results showed that 25% of post-partum women suffered moderate to severe depression and 50% of the sample had mild depression. None of the socio-demographic variables (age, education, employment, income) were significantly related to post-partum depression; however, two obstetric/infant variables (mode of birth and breastfeeding), were significantly associated with post-partum depression. There was a significant association between post-partum depression and 15 health problems of obstetric, gynecologic (i.e. episiotomy pain, infection), and general health conditions (i.e. fatigue, headache). Nurses and midwives need to emphasize post-partum depression screening, follow-up, and proper management of maternal and infant health factors predisposing to post-partum depression rather than merely focusing on women's inherent demographic factors.

  1. Prenatal and Postpartum Evening Salivary Cortisol Levels in Association with Peripartum Depressive Symptoms

    PubMed Central

    Iliadis, Stavros I.; Comasco, Erika; Sylvén, Sara; Hellgren, Charlotte; Sundström Poromaa, Inger; Skalkidou, Alkistis

    2015-01-01

    Background The biology of peripartum depression remains unclear, with altered stress and the Hypothalamus-Pituitary-Adrenal axis response having been implicated in its pathophysiology. Methods The current study was undertaken as a part of the BASIC project (Biology, Affect, Stress, Imaging, Cognition), a population-based longitudinal study of psychological wellbeing during pregnancy and the postpartum period in Uppsala County, Sweden, in order to assess the association between evening salivary cortisol levels and depressive symptoms in the peripartum period. Three hundred and sixty-five pregnant women from the BASIC cohort were recruited at pregnancy week 18 and instructed to complete a Swedish validated version of the Edinburgh Postnatal Depression Scale at the 36th week of pregnancy as well as the sixth week after delivery. At both times, they were also asked to provide evening salivary samples for cortisol analysis. A comprehensive review of the relevant literature is also provided. Results Women with postpartum EPDS score ≥ 10 had higher salivary evening cortisol at six weeks postpartum compared to healthy controls (median cortisol 1.19 vs 0.89 nmol/L). A logistic regression model showed a positive association between cortisol levels and depressive symptoms postpartum (OR = 4.1; 95% CI 1.7–9.7). This association remained significant even after controlling for history of depression, use of tobacco, partner support, breastfeeding, stressful life events, and sleep problems, as possible confounders (aOR = 4.5; 95% CI 1.5–14.1). Additionally, women with postpartum depressive symptoms had higher postpartum cortisol levels compared to both women with depressive symptoms antenatally and controls (p = 0.019 and p = 0.004, respectively). Conclusions Women with depressive symptoms postpartum had higher postpartum cortisol levels, indicating an altered response of the HPA-axis in postpartum depression. PMID:26322643

  2. Influence of hepatic load from far-off dry period to early postpartum period on the first postpartum ovulation and accompanying subsequent fertility in dairy cows

    PubMed Central

    KAWASHIMA, Chiho; ITO, Nozomi; NAGASHIMA, Shuntarou; MATSUI, Motozumi; SAWADA, Kumiko; SCHWEIGERT, Florian J.; MIYAMOTO, Akio; KIDA, Katsuya

    2016-01-01

    The aim of the present study was to investigate nutritional and metabolic parameters during the dry and early postpartum periods of ovulatory and anovulatory cows, as well as their postpartum reproductive performance. Blood samples from 20 multiparous Holstein cows were collected once a week from the far-off dry period to 3 weeks postpartum. Early postpartum (0–3 weeks) ovulation was confirmed using plasma progesterone concentration profiles, and cows were considered ovulatory if they had resumed luteal activity by this point (n = 9), whereas cows that had not were considered anovulatory (n = 11). Data from the ovulatory and anovulatory cows were analyzed separately for the far-off dry period (7–4 weeks prepartum), the close-up dry period (3–1 weeks prepartum), and the early postpartum period (0–3 weeks). Serum gamma-glutamyl transpeptidase activity (far-off, P = 0.065; close-up, P = 0.051; and early postpartum, P = 0.030) and aspartate aminotransferase (close-up, P = 0.050 and early postpartum, P = 0.087) activities were higher in anovulatory than in ovulatory cows. The days open period was longer (P = 0.019) in anovulatory than in ovulatory cows, and the number of artificial inseminations per conception (P = 0.025) was greater. In conclusion, we found that continuously high gamma-glutamyl transpeptidase activities in serum, which may be induced by liver disorders, prevent subsequent ovulation and affect subsequent fertility, even if cows obtain sufficient ovulation-related energy and β-carotene. PMID:26935323

  3. Postpartum Depression: Is Mode of Delivery a Risk Factor?

    PubMed Central

    Goker, Asli; Yanikkerem, Emre; Demet, M. Murat; Dikayak, Serife; Yildirim, Yasemin; Koyuncu, Faik M.

    2012-01-01

    There are various factors related to postpartum depression. In this study we have aimed to determine the effect of mode of delivery on the risk of postpartum depression. A total of 318 women who applied for delivery were included in the study. Previously diagnosed fetal anomalies, preterm deliveries, stillbirths, and patients with need of intensive care unit were excluded from the study. Data about the patients were obtained during hospital stay. During the postpartum sixth week visit Edinburgh postnatal depression scale (EPDS) was applied. There was no significant difference between EPDS scores when compared according to age, education, gravidity, wanting the pregnancy, fear about birth, gender, family type, and income level (P > 0.05). Those who had experienced emesis during their pregnancy, had a history of depression, and were housewives had significantly higher EPDS scores (P < 0.05). Delivering by spontaneous vaginal birth, elective Cesarean section, or emergency Cesarean section had no effect on EPDS scores. In conclusion healthcare providers should be aware of postpartum depression risk in nonworking women with a history of emesis and depression and apply the EPDS to them for early detection of postpartum depression. PMID:23304542

  4. 16 CFR 4.6 - Cooperation with other agencies.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Cooperation with other agencies. 4.6 Section 4.6 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE MISCELLANEOUS RULES § 4.6 Cooperation with other agencies. It is the policy of the Commission to cooperate...

  5. 37 CFR 4.6 - Attorneys and Agents.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2011-07-01 2011-07-01 false Attorneys and Agents. 4.6 Section 4.6 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE GENERAL COMPLAINTS REGARDING INVENTION PROMOTERS § 4.6 Attorneys and Agents. Complaints...

  6. Postabortal and postpartum contraception.

    PubMed

    Cameron, Sharon

    2014-08-01

    Healthcare providers often underestimate a woman' need for immediate effective contraception after an abortion or childbirth. Yet, these are times when women may be highly motivated to avoid or delay another pregnancy. In addition, starting the most effective long-acting reversible methods (i.e. the intrauterine device, intrauterine system or implants) at these times, is safe, with low risk of complications. Good evidence shows that women choosing long-acting reversible contraceptives at the time of an abortion are at significantly lower risk of another abortion, compared with counterparts choosing other methods. Uptake of long-acting reversible methods postpartum can also prevent short inter-pregnancy intervals, which have negative consequences for maternal and child health. It is important, therefore, that providers of abortion and maternity care are trained and funded to be able to provide these methods for women immediately after an abortion or childbirth.

  7. Management of Postpartum Depression

    PubMed Central

    Guille, Constance; Newman, Roger; Fryml, Leah D.; Lifton, Clay K.; Epperson, C. Neill

    2013-01-01

    Postpartum depression, now termed peripartum depression by the DSM-V, is one of the most common complications in the postpartum period and has potentially significant negative consequences for mothers and their families. This article highlights common clinical challenges in the treatment of peripartum depression and reviews the evidence for currently available treatment options. Psychotherapy is the first-line treatment options for women with mild-to-moderate peripartum depression. Antidepressant medication in combination with therapy is recommended for women with moderate-to-severe depression. While pooled case reports and small controlled studies have demonstrated undetectable infant serum levels and no short-term adverse events in infants of mothers breastfeeding while taking sertraline (Zoloft) and paroxetine (Paxil), further research is needed including larger samples and long-term follow-up of infants exposed to antidepressants via breastfeeding with control for maternal depression. Pharmacological treatment recommendations in women who are lactating must include discussion with the patient regarding the benefits of breastfeeding, risks of antidepressant use during lactation and risks of untreated illness. There is a growing evidence base for non-pharmacological interventions including repetitive Transcranial Magnetic Stimulation (rTMS) which may offer an attractive option for women who wish to continue to breastfeed and are concerned about exposure of medication to their infant. Among severe cases of peripartum depression with psychosis referral to a psychiatrist or psychiatric APRN is warranted. Suicidal or homicidal ideation with a desire, intent or plan to harm oneself or anyone one else, including the infant, is a psychiatric emergency, and an evaluation by a mental health professional should be conducted immediately. Peripartum depression treatment research is limited by small samples sizes and few controlled studies. Much work is still needed to better

  8. Postpartum Rh immunoprophylaxis.

    PubMed

    Sandler, S Gerald; Gottschall, Jerome L

    2012-12-01

    The postpartum dose of Rh immune globulin varies according to an individual laboratory estimation of fetal red blood cells in each mother's peripheral blood. In the United States, a four-step procedure determines the postpartum dose (number of vials of 300 micrograms; 1,500 international units) of Rh immune globulin (anti-D) for each RhD-negative mother who has delivered an RhD-positive newborn and has not already formed anti-D. The first step is a rosette fetal red blood cell screen to determine whether an excessive (greater than 30 mL fetal whole blood) fetomaternal hemorrhage occurred. If the rosette screen is negative, the mother receives one vial of Rh immune globulin for Rh immunoprophylaxis. If the rosette screen is positive, the blood sample is retested by a quantitative method, typically an acid-elution (Kleihauer-Betke) assay. The result of the acid-elution assay is converted to an estimation of the volume of the fetomaternal hemorrhage, which is the basis for calculating the dose of Rh immune globulin. The acid-elution assay is subjective, imprecise, and poorly reproducible. As a result, the formula for calculating the dose includes a precautionary adjustment, adding an extra vial in borderline situations to prevent underdosing. Flow cytometry is a more precise method for quantifying a fetomaternal hemorrhage. However, few hospitals use flow cytometry, because it is not cost-effective to maintain an expensive, high-technology laboratory service for the relatively few occasions when a precise quantitative determination of fetomaternal hemorrhage is required.

  9. Internet confessions of postpartum depression.

    PubMed

    Kantrowitz-Gordon, Ira

    2013-12-01

    Women with postpartum depression may suffer in silence due to the stigma of depression and failed motherhood. It is important to consider how mothers are able to talk about postpartum depression and what strategies they use. Foucault's idea that confession is a widespread technique for producing truth in Western societies was tested through discourse analysis of posts on an Internet forum for women with postpartum depression. The Internet forum showed women's use of confessionary language and self-judgments as well as their sense of disconnected mothering, shame, and disembodiment. Discourses of depression included the good mother, biomedical illness, and social dysfunction. Findings have implications for creating safe spaces for helping mothers with postpartum depression. PMID:24274243

  10. Psychobiology of postpartum mood disorders.

    PubMed

    Wisner, K L; Stowe, Z N

    1997-02-01

    Postpartum mood disorders are common. The clustering of mood-disorder episodes after birth compels a search for factors particularly potent during childbearing. In this article, the complex relationships between the dynamic postbirth physiological environment and mood disorder are discussed. Available studies show a lack of evidence that serum levels of gonadal hormones account for mood disturbance in women. However, substantial amounts of data demonstrate their ability to modulate other neuroendocrine systems. Alterations in hypothalamic-pituitary-adrenal (HPA) axis function attributable to childbearing show remarkable similarity to those observed in depressed women. Postpartum women are also at increased risk for hypothalamic-pituitary-thyroidal (HPT) axis dysfunction that may increase affective-disorder vulnerability. A decreased rate of postpartum recovery of HPA- and HPT-axis function may play a more central role than cross-sectional measures. Understanding the etiology of postpartum mood disorders will require integration of multiple psychosocial and biological risk factors. Further research is critically needed.

  11. Postpartum management of diabetes pregnancy.

    PubMed

    Hossain, Nazli

    2016-09-01

    Diabetes mellitus has assumed the role of an epidemic. Previously considered a disease of affluent developed countries, it has become more common in developing countries. Pakistan is included among the countries with a high prevalence of diabetes. In this scenario, postpartum management of a woman with diabetes mellitus becomes more important as in this period counseling and educating a woman is essential. Counselling includes life style modifications to prevent future risks involving all the systems of the body. This review article discusses management of diabetes mellitus in postpartum period, guidelines for postpartum screening of women with gestational diabetes mellitus, risks involved in future life and stresses upon the need of local population based studies. Primary care providers and gynaecologists must realize the importance of postpartum screening for diabetes mellitus and provide relevant information to women as well. PMID:27582163

  12. Postpartum Depression: An Interactional View.

    ERIC Educational Resources Information Center

    Kraus, Mary Ann; Redman, E. Scott

    1986-01-01

    Postpartum depression is conceptualized as a predictable developmental, family crisis, which occurs when the natural difficulties of childbirth are benignly mishandled. Tactics are illustrated for interdicting maladaptive interpersonal spirals, including normalizing conflicting complaints; reframing depression as positive but costly; regulating…

  13. Antibody responses to Plasmodium falciparum and Plasmodium vivax blood-stage and sporozoite antigens in the postpartum period

    PubMed Central

    McLean, Alistair R. D.; Boel, Machteld E.; McGready, Rose; Ataide, Ricardo; Drew, Damien; Tsuboi, Takafumi; Beeson, James G.; Nosten, François; Simpson, Julie A.; Fowkes, Freya J. I.

    2016-01-01

    During pregnancy a variety of immunological changes occur to accommodate the fetus. It is unknown whether these changes continue to affect humoral immunity postpartum or how quickly they resolve. IgG levels were measured to P. falciparum and P. vivax antigens in 201 postpartum and 201 controls over 12 weeks. Linear mixed-effects models assessed antibody maintenance over time and the effect of microscopically confirmed Plasmodium spp. infection on antibody levels, and whether this was different in postpartum women compared with control women. Postpartum women had reduced Plasmodium spp. antibody levels compared to controls at baseline. Over 12 weeks, mean antibody levels in postpartum women increased to levels observed in control women. Microscopically confirmed P. falciparum and P. vivax infections during follow-up were associated with an increase in species-specific antibodies with similar magnitudes of boosting observed in postpartum and control women. Antibodies specific for pregnancy-associated, VAR2CSA-expressing parasites did not rapidly decline postpartum and did not boost in response to infection in either postpartum or control women. After pregnancy, levels of malaria-specific antibodies were reduced, but recovered to levels seen in control women. There was no evidence of an impaired ability to mount a boosting response in postpartum women. PMID:27558000

  14. Antibody responses to Plasmodium falciparum and Plasmodium vivax blood-stage and sporozoite antigens in the postpartum period.

    PubMed

    McLean, Alistair R D; Boel, Machteld E; McGready, Rose; Ataide, Ricardo; Drew, Damien; Tsuboi, Takafumi; Beeson, James G; Nosten, François; Simpson, Julie A; Fowkes, Freya J I

    2016-01-01

    During pregnancy a variety of immunological changes occur to accommodate the fetus. It is unknown whether these changes continue to affect humoral immunity postpartum or how quickly they resolve. IgG levels were measured to P. falciparum and P. vivax antigens in 201 postpartum and 201 controls over 12 weeks. Linear mixed-effects models assessed antibody maintenance over time and the effect of microscopically confirmed Plasmodium spp. infection on antibody levels, and whether this was different in postpartum women compared with control women. Postpartum women had reduced Plasmodium spp. antibody levels compared to controls at baseline. Over 12 weeks, mean antibody levels in postpartum women increased to levels observed in control women. Microscopically confirmed P. falciparum and P. vivax infections during follow-up were associated with an increase in species-specific antibodies with similar magnitudes of boosting observed in postpartum and control women. Antibodies specific for pregnancy-associated, VAR2CSA-expressing parasites did not rapidly decline postpartum and did not boost in response to infection in either postpartum or control women. After pregnancy, levels of malaria-specific antibodies were reduced, but recovered to levels seen in control women. There was no evidence of an impaired ability to mount a boosting response in postpartum women. PMID:27558000

  15. Neutrophil functions and cytokines expression profile in buffaloes with impending postpartum reproductive disorders.

    PubMed

    Patra, Manas Kumar; Kumar, Harendra; Nandi, Sukdeb

    2013-10-01

    The study was conducted to correlate the periparturient immune status in terms of neutrophil functions and cytokine expression in peripheral blood mononuclear cell culture with impending postpartum reproductive disorders in buffaloes. Forty pregnant buffaloes were observed for occurrence of postpartum reproductive disorders (PRD), i.e., metritis, endometritis and delayed uterine involution etc., during one week prepartum to four weeks postpartum period. A representative number (n = 6) of buffaloes that did not develop any PRD were included in group I (healthy, control), while the animals which experienced PRD were assigned into group II (PRD, n = 8). The blood samples were collected at weekly interval from one week prepartum to four weeks postpartum period considering the day of calving as 'd 0'. Differential leucocytes counts, superoxide and hydrogen peroxide production activity in isolated neutrophils and the mRNA expression profile of cytokines i.e., IL-2, IL-4 and IFN-γ in PBMC culture were studied in all the samples. A higher total leucocytes, neutrophil and band cells count along with impaired neutrophil functions i.e., lowered level of production of superoxide and hydrogen peroxide before parturition and during early postpartum period were observed in buffaloes developing PRD. Further, a lower expression of IL-2, IFN-γ and IL-4 mRNA in PBMC culture was observed at calving in buffaloes that subsequently developed PRD at later postpartum. Thus, suppression in neutrophil function and cytokine expression at prepartum to early postpartum period predisposes the buffaloes to develop postpartum reproductive disorders. Hence, monitoring of neutrophils function and cytokine expression profile would be effective to predict certain reproductive disorders at late pregnancy or immediately after parturition in buffaloes. In future, this may be a novel approach for determining suitable management and therapeutic decisions for prevention of commonly occurring reproductive

  16. Longitudinal Change in Sleep and Daytime Sleepiness in Postpartum Women

    PubMed Central

    Filtness, Ashleigh J.; MacKenzie, Janelle; Armstrong, Kerry

    2014-01-01

    Sleep disruption strongly influences daytime functioning; resultant sleepiness is recognised as a contributing risk-factor for individuals performing critical and dangerous tasks. While the relationship between sleep and sleepiness has been heavily investigated in the vulnerable sub-populations of shift workers and patients with sleep disorders, postpartum women have been comparatively overlooked. Thirty-three healthy, postpartum women recorded every episode of sleep and wake each day during postpartum weeks 6, 12 and 18. Although repeated measures analysis revealed there was no significant difference in the amount of nocturnal sleep and frequency of night-time wakings, there was a significant reduction in sleep disruption, due to fewer minutes of wake after sleep onset. Subjective sleepiness was measured each day using the Karolinska Sleepiness Scale; at the two earlier time points this was significantly correlated with sleep quality but not to sleep quantity. Epworth Sleepiness Scores significantly reduced over time; however, during week 18 over 50% of participants were still experiencing excessive daytime sleepiness (Epworth Sleepiness Score ≥12). Results have implications for health care providers and policy makers. Health care providers designing interventions to address sleepiness in new mothers should take into account the dynamic changes to sleep and sleepiness during this initial postpartum period. Policy makers developing regulations for parental leave entitlements should take into consideration the high prevalence of excessive daytime sleepiness experienced by new mothers, ensuring enough opportunity for daytime sleepiness to diminish to a manageable level prior to reengagement in the workforce. PMID:25078950

  17. Functional Status Outcomes in Mothers with and without Postpartum Depression

    PubMed Central

    Posmontier, Barbara

    2008-01-01

    Objective To compare functional status between women with and without postpartum depression (PPD). Methods A two-group cross-sectional design compared functional status between 23 women with and 23 women without PPD. Participants were 6 to 26 weeks postpartum, and from obstetric practices in the Northeastern United States. Structured clinical interviews were used to establish diagnoses of PPD. Participants were matched on type of delivery, weeks postpartum, and parity. Participants compared current functioning to pre-pregnancy functioning utilizing the Inventory of Functional Status After Childbirth. The Postpartum Depression Screening Scale was used to measure PPD severity. Hierarchical multiple and logistic regression models were used to analyze data. Results Controlling for infant gender, number of nighttime infant awakenings, and income, PPD predicted lower personal (P<0.001), household (P<0.05), and social functioning (P<0.001), but no difference in infant care. Women with PPD were 12 times less likely to achieve pre-pregnancy functional levels. Conclusions Interventions are needed to address household, social, and personal functioning in women with PPD. Clinicians may find functional assessment is a useful adjunct and a less threatening way to screen and monitor treatment for PPD. PMID:18586183

  18. Toxics in My Home? You Bet! Curriculum on Household Toxics for Grades 4-6.

    ERIC Educational Resources Information Center

    Purin, Gina; And Others

    This curriculum consists of a one-week course of study designed to introduce students in grades 4-6 to (or increase their awareness of) toxic substances commonly found in the home. It includes an introduction/conceptual framework, four lessons, a unit evaluation, and appendices. Each lesson consists of a statement of purpose, objectives,…

  19. Predictors of body image during the first year postpartum:a prospective study.

    PubMed

    Rallis, Sofia; Skouteris, Helen; Wertheim, Eleanor H; Paxton, Susan J

    2007-01-01

    This longitudinal study investigated body image changes and possible predictors of multiple dimensions of body image in the first year postpartum. Women (N = 79) who had been followed up since early pregnancy (including reporting retrospectively about pre-pregnancy and concurrently about late pregnancy) completed questionnaires at 6 weeks, 6 months, and 12 months postpartum that focussed on body image measures of feeling fat, attractiveness, salience of shape and weight, and strength and fitness. Women experienced greater body dissatisfaction in the postpartum in comparison to pre-pregnancy and late pregnancy, with 6 months postpartum being the time of most body concern. In ratings of perceived current and ideal figure size, women decreased their current size ratings over the postpartum period; however, ratings of ideal figure remained stable over the three time points. The findings also revealed that higher frequency of physical comparison tendencies at 6 weeks postpartum, and depressive symptoms and dieting behaviours at 6 months postpartum were predictors of body image of different types at 12 months post birth.

  20. Predictors of body image during the first year postpartum:a prospective study.

    PubMed

    Rallis, Sofia; Skouteris, Helen; Wertheim, Eleanor H; Paxton, Susan J

    2007-01-01

    This longitudinal study investigated body image changes and possible predictors of multiple dimensions of body image in the first year postpartum. Women (N = 79) who had been followed up since early pregnancy (including reporting retrospectively about pre-pregnancy and concurrently about late pregnancy) completed questionnaires at 6 weeks, 6 months, and 12 months postpartum that focussed on body image measures of feeling fat, attractiveness, salience of shape and weight, and strength and fitness. Women experienced greater body dissatisfaction in the postpartum in comparison to pre-pregnancy and late pregnancy, with 6 months postpartum being the time of most body concern. In ratings of perceived current and ideal figure size, women decreased their current size ratings over the postpartum period; however, ratings of ideal figure remained stable over the three time points. The findings also revealed that higher frequency of physical comparison tendencies at 6 weeks postpartum, and depressive symptoms and dieting behaviours at 6 months postpartum were predictors of body image of different types at 12 months post birth. PMID:17613464

  1. Group therapy and its barriers for women suffering from postpartum depression.

    PubMed

    Ugarriza, Doris Noel

    2004-04-01

    Data were collected to pilot-test the feasibility and the effects of the "Gruen" Postpartum Depression Group Therapy as an intervention for depression for a small treatment and control group of postpartum depressed mothers. Treatment was a ten-week group therapy consisting of four interacting aspects: (1) education and information, (2) stress reduction techniques,(3) development of support systems, and (4) cognitive restructuring. Beck Depression Inventory II scores were significantly lower post treatment in the treatment group. Women stated psychoeducation was the greatest help to them. One of the problems associated with treating postpartum women was their inability to get to therapy because of childcare responsibilities.

  2. Management of postpartum depression.

    PubMed

    Guille, Constance; Newman, Roger; Fryml, Leah D; Lifton, Clay K; Epperson, C Neill

    2013-01-01

    The mainstays of treatment for peripartum depression are psychotherapy and antidepressant medications. More research is needed to understand which treatments are safe, preferable, and effective. Postpartum depression, now termed peripartum depression by the DSM-V, is one of the most common complications in the postpartum period and has potentially significant negative consequences for mothers and their families. This article highlights common clinical challenges in the treatment of peripartum depression and reviews the evidence for currently available treatment options. Psychotherapy is the first-line treatment option for women with mild to moderate peripartum depression. Antidepressant medication in combination with therapy is recommended for women with moderate to severe depression. Although pooled case reports and small controlled studies have demonstrated undetectable infant serum levels and no short-term adverse events in infants of mothers breastfeeding while taking sertraline (Zoloft) and paroxetine (Paxil), further research is needed including larger samples and long-term follow-up of infants exposed to antidepressants via breastfeeding controlling for maternal depression. Pharmacologic treatment recommendations for women who are lactating must include discussion with the patient regarding the benefits of breastfeeding, risks of antidepressant use during lactation, and risks of untreated illness. There is a growing evidence base for nonpharmacologic interventions including repetitive transcranial magnetic stimulation, which may offer an attractive option for women who wish to continue to breastfeed and are concerned about their infants being exposed to medication. Among severe cases of peripartum depression with psychosis, referral to a psychiatrist or psychiatric advanced practice registered nurse is warranted. Suicidal or homicidal ideation with a desire, intent, or plan to harm oneself or anyone else, including the infant, is a psychiatric emergency, and

  3. 2,4,6-Triphenylphosphinine and 2,4,6-triphenylposphabarrelene revisited: synthesis, reactivity and coordination chemistry.

    PubMed

    Rigo, M; Sklorz, J A W; Hatje, N; Noack, F; Weber, M; Wiecko, J; Müller, C

    2016-02-01

    The synthesis of 2,4,6-triphenylphosphinine has been revisited and a general protocol for the preparation of such low-coordinate phosphorus compounds in good to excellent yields could be established. This allows to investigate several aspects of the chemistry of 2,4,6-triarylphosphinine, such as the reaction with in situ generated benzyne to give 2,4,6-triphenylphosphabarrelene. The corresponding 2,4,6-triphenylphosphabarrelene-selenide could be characterized crystallographically for the first time and the structural and electronic properties of this cage-compound in comparison to classical triarylphosphines could be evaluated. Moreover, [(L)W(CO)5)] complexes of both 2,4,6-triphenylphosphinine and 2,4,6-triphenylphosphabarrelene were prepared and characterized by means of X-ray crystallography. This allowed for the first time a direct structural comparison of these related phosphorus compounds, coordinated to the same metal fragment.

  4. The Heritability of Postpartum Depression

    PubMed Central

    Corwin, Elizabeth J.; Kohen, Ruth; Jarrett, Monica; Stafford, Brian

    2012-01-01

    Postpartum depression (PPD) is a serious mood disorder that may carry life-long consequences for a woman and her family. Multiple risk factors for PPD have been identified, including psychosocial, situational, and biological stimuli, several of which are experienced by most, if not all, postpartum women. Given the commonality of these risk factors, it is unclear why fewer than 20% of postpartum women actually develop PPD. In this review, we suggest that different susceptibility to PPD among postpartum women may be explained by the presence or absence of genetic variants that confer increased risk. We review three categories of genes known to code for proteins associated with depression in the general population or proteins known to be affected by childbirth for their possible association with PPD, including genes related to central nervous system monoamine availability, proinflammatory cytokines, and brain neuropeptides. Only two studies are available in the literature to date specifically looking at polymorphisms in postpartum women as related to PPD; both are concerned with monoamine availability. These are discussed in further depth. Conclusions regarding the contribution of genetic polymorphisms to the development of PPD are mixed. Ultimately, the complexity of the disorder and the interrelationships among different genes thought to contribute to depression suggest that much more research is required to understand the heritability of PPD. The complexity of the disorder also suggests that epigenetic influences must be considered as well when discussing susceptibility. PMID:20453020

  5. 11 CFR 4.6 - Discretionary release of exempt records.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... the public interest and that the rights of third parties would not be prejudiced. ... 11 Federal Elections 1 2010-01-01 2010-01-01 false Discretionary release of exempt records. 4.6 Section 4.6 Federal Elections FEDERAL ELECTION COMMISSION PUBLIC RECORDS AND THE FREEDOM OF...

  6. Toxicological profile for 2,4,6-trinitrotoluene

    SciTech Connect

    1995-11-01

    This Statement was prepared to give you information about 2,4,6-trinitrotoluene and to emphasize the human health effects that may result from exposure to it. The Environmental Protection Agency (EPA) has identified 1,397 sites on its National Priorities List (NPL). 2,4,6-Trinitrotoluene has been found in at least 20 of these sites.

  7. Postpartum Post-Traumatic Stress Disorder

    MedlinePlus

    ... 944.4773 Learn More Pregnancy & Postpartum Mental Health Social Support Online Training Depression During Pregnancy & Postpartum Anxiety During ... this illness is caused by a real or perceived trauma during delivery or postpartum. ... and/or lack of support and reassurance during the delivery Women who have ...

  8. Postpartum Coronary Vasospasm with Literature Review

    PubMed Central

    Koneru, Jayanth; Alattar, Fadi; Alqaqa, Ashraf; Virk, Hirtaj; Shamoon, Fayez; Bikkina, Mahesh

    2014-01-01

    Acute myocardial infarction during pregnancy or the postpartum period is rare. We report a case of a 39-year-old postpartum woman who developed non-ST-elevation myocardial infarction due to severe diffuse coronary vasospasm. To our knowledge, this is the first case of angiographically evidenced coronary vasospasm, in a postpartum woman, with resistance to intracoronary nitroglycerin. PMID:25105029

  9. Pseudomonas sp. CL7 from Sludge Removed 2,3,4,6-Tetrachlorophenol in Vivo and in Vitro Condition.

    PubMed

    Karn, Santosh Kumar; Reddy, M Sudhakara; Chakrabarti, Swapan Kumar

    2016-04-01

    The present research focused on 2,3,4,6-Tetrachlorophenol (2,3,4,6-TeCP) mineralizing bacterium from the sludge of pulp and paper industry and identified as Pseudomonas sp. CL7 by 16s rRNA gene sequences analysis. This isolate degraded 2,3,4,6-TeCP as indicated by stoichiometric release of chloride and biomass formation. High pressure liquid chromatography (HPLC) analysis showed that Pseudomonas sp. (CL7) was able to mineralize a higher concentration of 2,3,4,6-TeCP (600 mg/l or 2.5 mM) than any previously reported 2,3,4,6-TeCP degrading bacteria. As the concentration of 2,3,4,6-TeCP increased from 50 (0.21 mM) to 600 mg/l (2.5 mM), the reduction in the cell growth was observed and the 2,3,4,6-TeCP degradation was more than 85% in all the concentrations in the present study. CL7 was able to remove 100% of 2,3,4,6-TeCP from the sludge (in Vitro condition) when supplemented with 100 mg/l (0.42 mM) of 2,3,4,6-TeCP and grown for two weeks. This study showed that CL7 can be used for bioremediation of 2,3,4,6-TeCP. PMID:27131053

  10. Postpartum Tuberculosis: A Diagnostic and Therapeutic Challenge

    PubMed Central

    Gudeta, Alemeshet; Zerihun, Aklilu; Lewis, Odene; Ahmed, Sohail; Gajjala, Jhansi; Thomas, Alicia

    2016-01-01

    Tuberculosis (TB) infection in pregnant women and newborn babies is always challenging. Appropriate treatment is pivotal to curtail morbidity and mortality. TB diagnosis or exposure to active TB can be emotionally distressing to the mother. Circumstances can become more challenging for the physician if the mother's TB status is unclear. Effective management of TB during pregnancy and the postpartum period requires a multidisciplinary approach including pulmonologist, obstetrician, neonatologist, infectious disease specialist, and TB public health department. Current guidelines recommend primary Isoniazid prophylaxis in TB exposed pregnant women who are immune-suppressed and have chronic medical conditions or obstetric risk factors and close and sustained contact with a patient with infectious TB. Treatment during pregnancy is the same as for the general adult population. Infants born to mothers with active TB at delivery should undergo a complete diagnostic evaluation. Primary Isoniazid prophylaxis for at least twelve weeks is recommended for those with negative diagnostic tests and no evidence of disease. Repeated negative diagnostic tests are mandatory before interrupting prophylaxis. Separation of mother and infant is only necessary when the mother has received treatment for less than 2 weeks, is sputum smear-positive, or has drug-resistant TB. This case highlights important aspects for management of TB during the postpartum period which has a higher morbidity. We present a case of a young mother migrating from a developing nation to the USA, who was found to have a positive quantiFERON test associated with multiple cavitary lung lesions and gave birth to a healthy baby. PMID:27610260

  11. Postpartum Tuberculosis: A Diagnostic and Therapeutic Challenge.

    PubMed

    Kodadhala, Vijay; Gudeta, Alemeshet; Zerihun, Aklilu; Lewis, Odene; Ahmed, Sohail; Gajjala, Jhansi; Thomas, Alicia

    2016-01-01

    Tuberculosis (TB) infection in pregnant women and newborn babies is always challenging. Appropriate treatment is pivotal to curtail morbidity and mortality. TB diagnosis or exposure to active TB can be emotionally distressing to the mother. Circumstances can become more challenging for the physician if the mother's TB status is unclear. Effective management of TB during pregnancy and the postpartum period requires a multidisciplinary approach including pulmonologist, obstetrician, neonatologist, infectious disease specialist, and TB public health department. Current guidelines recommend primary Isoniazid prophylaxis in TB exposed pregnant women who are immune-suppressed and have chronic medical conditions or obstetric risk factors and close and sustained contact with a patient with infectious TB. Treatment during pregnancy is the same as for the general adult population. Infants born to mothers with active TB at delivery should undergo a complete diagnostic evaluation. Primary Isoniazid prophylaxis for at least twelve weeks is recommended for those with negative diagnostic tests and no evidence of disease. Repeated negative diagnostic tests are mandatory before interrupting prophylaxis. Separation of mother and infant is only necessary when the mother has received treatment for less than 2 weeks, is sputum smear-positive, or has drug-resistant TB. This case highlights important aspects for management of TB during the postpartum period which has a higher morbidity. We present a case of a young mother migrating from a developing nation to the USA, who was found to have a positive quantiFERON test associated with multiple cavitary lung lesions and gave birth to a healthy baby. PMID:27610260

  12. Postpartum Tuberculosis: A Diagnostic and Therapeutic Challenge

    PubMed Central

    Gudeta, Alemeshet; Zerihun, Aklilu; Lewis, Odene; Ahmed, Sohail; Gajjala, Jhansi; Thomas, Alicia

    2016-01-01

    Tuberculosis (TB) infection in pregnant women and newborn babies is always challenging. Appropriate treatment is pivotal to curtail morbidity and mortality. TB diagnosis or exposure to active TB can be emotionally distressing to the mother. Circumstances can become more challenging for the physician if the mother's TB status is unclear. Effective management of TB during pregnancy and the postpartum period requires a multidisciplinary approach including pulmonologist, obstetrician, neonatologist, infectious disease specialist, and TB public health department. Current guidelines recommend primary Isoniazid prophylaxis in TB exposed pregnant women who are immune-suppressed and have chronic medical conditions or obstetric risk factors and close and sustained contact with a patient with infectious TB. Treatment during pregnancy is the same as for the general adult population. Infants born to mothers with active TB at delivery should undergo a complete diagnostic evaluation. Primary Isoniazid prophylaxis for at least twelve weeks is recommended for those with negative diagnostic tests and no evidence of disease. Repeated negative diagnostic tests are mandatory before interrupting prophylaxis. Separation of mother and infant is only necessary when the mother has received treatment for less than 2 weeks, is sputum smear-positive, or has drug-resistant TB. This case highlights important aspects for management of TB during the postpartum period which has a higher morbidity. We present a case of a young mother migrating from a developing nation to the USA, who was found to have a positive quantiFERON test associated with multiple cavitary lung lesions and gave birth to a healthy baby.

  13. The association between physical activity and maternal sleep during the postpartum period

    PubMed Central

    Vladutiu, Catherine J.; Evenson, Kelly R.; Borodulin, Katja; Deng, Yu; Dole, Nancy

    2014-01-01

    Background Physical activity is associated with improved sleep quality and duration in the general population, but its effect on sleep in postpartum women is unknown. Methods We examined cross-sectional and longitudinal associations between hours/week of self-reported domain-specific and overall moderate to vigorous physical activity (MVPA) and sleep quality and duration at 3- and 12-months postpartum among a cohort of 530 women in the Pregnancy, Infection, and Nutrition Postpartum Study. Results MVPA was not associated with sleep quality or duration at 3-months postpartum. At 12-months postpartum, a one hour/week increase in recreational MVPA was associated with higher odds of good (vs. poor) sleep quality (odds ratio, OR=1.14; 95% confidence interval, CI, 1.03–1.27) and a one hour/week increase in child/adult care MVPA was associated with lower odds of good (vs. poor) sleep quality (OR=0.93; 95% CI=0.88–0.99). A one hour/week increase in child/adult care MVPA (OR=1.08, 95% CI=1.00–1.16) was associated with higher odds of long sleep duration and one hour/week increases in indoor household (OR=1.09, 95% CI=1.01–1.18) and overall MVPA (OR=1.04, 95% CI=1.01–1.07) were associated with higher odds of short (vs. normal) sleep duration. Comparing 3-months postpartum to 12-months postpartum, increased work MVPA was associated with good sleep quality (OR=2.40, 95% CI=1.12–5.15) and increased indoor household MVPA was associated with short sleep duration (OR=1.85, 95% CI=1.05–3.27) as measured at 12-months postpartum. Conclusions Selected domains of MVPA and their longitudinal increases were associated with sleep quality and duration at 12-months postpartum. Additional research is needed to elucidate whether physical activity can improve postpartum sleep. PMID:24577601

  14. Postpartum Pyomyoma, a Rare Complication of Sepsis Associated with Chorioamnionitis and Massive Postpartum Haemorrhage Treated with an Intrauterine Balloon

    PubMed Central

    Kaler, Mandeep; Gailer, Ruth; Iskaros, Joseph; David, Anna L.

    2015-01-01

    We report the successful treatment of a postpartum pyomyoma, a rare but serious complication of uterine leiomyomata in a 28-year-old primigravida. The patient was treated for an Escherichia Coli (E. Coli) urinary tract infection (UTI) at 16 weeks of gestation. She had asymptomatic short cervical length on ultrasound scan at 20 weeks that was managed conservatively due to the presence of further UTI and received antibiotics. She was known to have a left sided intramural leiomyoma. She presented with abdominal pain and vaginal bleeding at 23+1 weeks of gestation and the next day she had spontaneous vaginal delivery and collapsed with E. Coli septic shock, massive postpartum haemorrhage, and disseminated intravascular coagulation and was successfully treated with oxytocic drugs, a Rusch intrauterine balloon, and intravenous antibiotics. Eleven days postnatally she re-presented with systemic sepsis and was treated for retained products of conception. Sepsis persisted and investigations showed a postpartum pyomyoma that was initially managed with intravenous antibiotics to avoid surgery. Ultimately she required laparotomy, drainage of pyomyoma, and myomectomy. Postoperative recovery was good and the patient had a successful pregnancy two years later. PMID:26199774

  15. Economic stress and cortisol among postpartum low-income Mexican American women: buffering influence of family support

    PubMed Central

    Jewell, Shannon L.; Luecken, Linda J.; Gress-Smith, Jenna; Crnic, Keith A.; Gonzales, Nancy A.

    2016-01-01

    Low-income Mexican American women experience significant health disparities during the postpartum period. Contextual stressors, such as economic stress, are theorized to affect health via dysregulated cortisol output. However, cultural protective factors including strong family support may buffer the impact of stress. In a sample of 322 low-income Mexican American women (mother age 18–42; 84% Spanish-speaking; modal family income $10,000–$15,000), we examined the interactive influence of economic stress and family support at 6 weeks postpartum on maternal cortisol output (AUCg) during a mildly challenging mother-infant interaction task at 12 weeks postpartum, controlling for 6 week maternal cortisol and depressive symptoms. The interaction significantly predicted cortisol output such that higher economic stress predicted higher cortisol only among women reporting low family support. These results suggest that family support is an important protective resource for postpartum Mexican American women experiencing elevated economic stress. PMID:26332931

  16. Towards an Understanding of Change in Physical Activity from Pregnancy Through Postpartum

    PubMed Central

    Evenson, Kelly R.

    2010-01-01

    Objective The purpose of this paper was to describe the rationale, data collection, and proposed analyses for examination of mediators of change in physical activity from pregnancy to postpartum among a cohort of pregnant women. Method The Pregnancy Infection and Nutrition 3 (PIN3) Study enrolled 2006 pregnant women into the cohort from 2001 to 2005. All women lived in central North Carolina upon enrollment. Physical activity was assessed using a self-reported one week recall, measured twice during pregnancy and once each at 3- and 12-months postpartum. On a subset of women, one-week accelerometer measures were also collected during the two postpartum time periods. Potential mediators (intrapersonal, interpersonal, community) were collected during pregnancy and postpartum through interviews and take home questionnaires. Results To assess mediation of physical activity among our cohort, we will first describe change in physical activity and the mediators, as well as their associations, through pregnancy into the postpartum period. Following this, the product of coefficients approach will be applied to examine whether each measure had indirect effects on change in physical activity. Each individual level mediator will be examined one at a time and across the time points in which it was available. The Sobel standard error approximation formula will be used to test for significance of the mediation effect. Conclusions This study will provide evidence to develop appropriate interventions targeted at physical activity and will help focus efforts on the appropriate time periods between pregnancy and postpartum. PMID:21278835

  17. The effects of Pilates exercise on sleep quality in postpartum women.

    PubMed

    Ashrafinia, Farzaneh; Mirmohammadali, Mandana; Rajabi, Hamid; Kazemnejad, Anooshirvan; Sadeghniiathaghighi, Khosro; Amelvalizadeh, Mehrnoosh; Chen, Hui

    2014-04-01

    Prolonged poor sleeping quality can decrease women's ability to perform their maternal and family duties after delivery. The aim of this study was to investigate the effects of a Pilates training program on sleep quality in primigravida postpartum women in a randomized clinical trial. Eighty postpartum women were randomly divided into intervention and control groups (n = 40). Home-based 30-min Pilates exercises were started 72 h after the delivery and performed five times per week for consecutive 8 weeks. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI) prior to the intervention and 4th and 8th weeks afterwards. The intervention group showed a significant improvement in subjective sleep quality, sleep latency, daytime dysfunction and global PSQI score (P < 0.001); however, there was no difference in sleep duration, habitual sleep efficiency and sleep disturbance between the groups. In conclusion, Pilates exercises appeared to improve sleep quality in primigravida postpartum women. PMID:24725785

  18. A Systematic Review of Early Postpartum Medroxyprogesterone Receipt and Early Breastfeeding Cessation: Evaluating the Methodological Rigor of the Evidence

    PubMed Central

    Fernandez, I. Diana; Howard, Cynthia R.; Fisher, Susan G.; Ternullo, Sharon R.; Buckley, Ryan J.J.; Dozier, Ann M.

    2012-01-01

    Abstract Background Breastfeeding has numerous maternal and infant benefits. Progesterone contraception after birth is frequently recommended, but because a decrease in progesterone is required to initiate lactation, early postpartum progesterone contraception use could inhibit lactation. The purpose of this article is to critically evaluate the scientific basis for conflicting clinical recommendations related to postpartum medroxyprogesterone use among breastfeeding women. Methods Relevant peer-reviewed literature was identified through a comprehensive search of PubMed through December 2010. The search was restricted to clinical trials, randomized clinical trials, or comparative studies written in English and conducted among humans. The studies included in this review addressed the effect of medroxyprogesterone administration at <6 weeks postpartum on breastfeeding exclusivity and/or duration and measured breastfeeding outcomes at ≥6 weeks postpartum. Results Of the 20 articles identified, only three studies satisfied the inclusion criteria. However, all three studies were of low-quality methodological rigor, and none accounted for potential confounders. Conclusion Current evidence is methodologically weak and provides an inadequate basis for inference about a possible causal relationship between early postpartum medroxyprogesterone use and poor breastfeeding outcomes. However, given the presence of a strong biological model describing the potential deleterious effect of postpartum medroxyprogesterone use on lactation, further research that improves on current literature is warranted. Meanwhile, we recommend that potential breastfeeding risks associated with early (<6 weeks) postpartum medroxyprogesterone use be disclosed to allow for a fully informed consent and decision-making process. PMID:22085201

  19. Racial and Ethnic Differences in Factors Associated With Early Postpartum Depressive Symptoms

    PubMed Central

    Howell, Elizabeth A.; Mora, Pablo A.; Horowitz, Carol R.; Leventhal, Howard

    2015-01-01

    OBJECTIVE To explore racial differences in reporting of early postpartum depressive symptoms. To explore whether racial differences in early postpartum experience (such as mother’s health status and social context) might account for racial differences in reported postpartum depressive symptoms. METHODS This was a telephone survey of 655 white, African-American, and Hispanic mothers between 2 and 6 weeks postpartum. Mothers reported on demographic factors, physical symptoms, daily function, infant behaviors, social support, skills in managing infant and household, access, and trust in the medical system. We explored racial differences in report of early postpartum depressive symptoms using bivariate and multivariate statistics. RESULTS African-American and Hispanic women more commonly reported postpartum depressive symptoms (43.9% and 46.8%, respectively) than white women (31.3%, P < .001). Similar factors (physical symptom burden, lack of social support, and lack of self-efficacy) were associated with early postpartum depressive symptoms in white, African-American, and Hispanic mothers. In a comprehensive model including other demographic factors, history of depression, physical symptoms, daily function, infant behavior, social support, skills in managing infant and household, access, and trust, the adjusted odds ratio for reported postpartum depressive symptoms remained elevated for African-American women at 2.16 (95% confidence interval 1.26–3.70) and Hispanic women at 1.89 (95% confidence interval 1.19–3.01) as compared with white women. CONCLUSION African-American and Hispanic mothers are at higher risk for reporting early postpartum depressive symptoms as compared with white mothers. Factors associated with these symptoms are similar among African-American, Hispanic, and white mothers. PMID:15932842

  20. Postpartum Adjustment in Primiparous Parents.

    ERIC Educational Resources Information Center

    Atkinson, A. Kathleen; Rickel, Annette U.

    Within the framework of the social stress and behavioral theories of depression, this study investigated the hypothesis that postpartum depression is a function of disruption of parents' prepartum functioning by the subsequent demands of infant caretaking. Seventy-eight primiparous married couples (N=156, 78 men and 78 women) volunteered to…

  1. Adolescent Motherhood and Postpartum Depression

    ERIC Educational Resources Information Center

    Birkeland, Robyn; Thompson, J. Kevin; Phares, Vicky

    2005-01-01

    Adolescent mothers undergo unique personal and social challenges that may contribute to postpartum functioning. In this exploratory investigation completed within a risk and resilience framework, 149 adolescent mothers, ages 15 to 19, who participated in school-based teen parents' programs, completed measures of parental stress (social isolation…

  2. 17 CFR 275.206(4)-6 - Proxy voting.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 17 Commodity and Securities Exchanges 3 2011-04-01 2011-04-01 false Proxy voting. 275.206(4)-6...) RULES AND REGULATIONS, INVESTMENT ADVISERS ACT OF 1940 § 275.206(4)-6 Proxy voting. If you are an... section 206(4) of the Act (15 U.S.C. 80b-6(4)), for you to exercise voting authority with respect...

  3. 17 CFR 275.206(4)-6 - Proxy voting.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Proxy voting. 275.206(4)-6...) RULES AND REGULATIONS, INVESTMENT ADVISERS ACT OF 1940 § 275.206(4)-6 Proxy voting. If you are an... section 206(4) of the Act (15 U.S.C. 80b-6(4)), for you to exercise voting authority with respect...

  4. A PI 4. 6 peroxidase that specifically crosslinks extensin precursors

    SciTech Connect

    Upham, B.L; Alizadeh, H.; Ryan, K.J.; Lamport, D.T.A. )

    1991-05-01

    The primary cell wall is a microcomposite of cellulose, pectin, hemicellulose and protein. The warp-weft model of the primary cell wall hypothesize that extensin monomers are intermolecularly crosslinked orthogonal to the cellulose microfibril thus mechanically coupling the major load-bearing polymer: cellulose. Media of tomato cell cultures contains heat labile, peroxide dependent crosslinking activity, as determined by the rate of decrease in monomer concentration analyzed via Superose-6. Isoelectric focusing of tomato cell culture media indicated crosslinking was predominantly in the acidic peroxidase fraction (pI4.6). This peroxidase was partially purified by ultracentrifugation, DEAE-Trisacryl and HPLC-DEAE chromatography techniques resulting in a 90 fold purification and 45% yield. A second acidic peroxidase eluted from the HPLC-DEAE column had 25% of the crosslinking activity of the pI 4.6 peroxidase. Purified basic peroxidase had only 0.7% of the activity of the pI 4.6 peroxidase. The specific activity of the pI 4.6 peroxidase was 5,473 mg extensin crosslinked/min/mg peroxidase. The pI 4.6 peroxidase crosslinked the following extensins: tomato I and II, carrot, Ginkgo II and did not crosslink Ginkgo I, Douglas Fir, Maize, Asparagus I and II, and sugarbeet extensins as well as bovine serum albumin. Comparison of motifs common to extensins that are crosslinked by the pI 4.6 peroxidase may help identify the crosslink domain(s) of extension.

  5. Prevention of postpartum smoking relapse in mothers of infants in the neonatal intensive care unit

    PubMed Central

    Phillips, R M; Merritt, T A; Goldstein, M R; Deming, D D; Slater, L E; Angeles, D M

    2012-01-01

    Objective: Approximately 40% of women who smoke tobacco quit smoking during pregnancy, yet up to 85% relapse after delivery. Those who resume smoking often do so by 2 to 8 weeks postpartum. Smoking mothers are more than twice as likely to quit breastfeeding by 10 weeks postpartum. The hospitalization of a newborn, while stressful, is an opportunity to emphasize the importance of a smoke-free environment for babies. Supporting maternal-infant bonding may reduce maternal stress and motivate mothers to remain smoke free and continue breastfeeding. The objective of this study was to reduce postpartum smoking relapse and prolong breastfeeding duration during the first 8 weeks postpartum in mothers who quit smoking just before or during pregnancy and have newborns admitted to the Neonatal Intensive Care Unit (NICU). Study Design: This study was an Institutional Review Board-approved prospective randomized clinical trial. After informed consent, mothers of newborns admitted to the NICU were randomized to a control or intervention group. Both groups received weekly encouragement to remain smoke free and routine breastfeeding support. Mothers in the intervention group were also given enhanced support for maternal-infant bonding including information about newborn behaviors, and were encouraged to frequently hold their babies skin-to-skin. Result: More mothers were smoke free (81 vs 46%, P<0.001) and breastfeeding (86 vs 21%, P<0.001) in the intervention than in the control group at 8 weeks postpartum. Conclusion: Interventions to support mother–infant bonding during a newborn's hospitalization in the NICU are associated with reduced rates of smoking relapse and prolonged duration of breastfeeding during the first 8 weeks postpartum. PMID:21836549

  6. Effects of post-partum administration of ketoprofen on sow health and piglet growth.

    PubMed

    Viitasaari, Elina; Hänninen, Laura; Heinonen, Mari; Raekallio, Marja; Orro, Toomas; Peltoniemi, Olli; Valros, Anna

    2013-10-01

    The effect of the non-steroidal anti-inflammatory drug ketoprofen on the post farrowing phase of sows was studied in a randomized, blinded, placebo-controlled trial. Ketoprofen (3mg/kg) was administered intramuscularly to 20 healthy sows for 3 days post-partum (p.p.). The control group (n=20) received a saline placebo. Backfat, number of days of constipation and days before feed refusal were measured. Body condition (BCS) and shoulder sores were scored for 1 week p.p. Changes in BCS, backfat and shoulder sore scores were analysed with ANOVA. Blood was collected on days -1, 0, 5 and 14 with respect to medication. Aspartate aminotransferase (AST), creatinine kinase (CK), haptoglobin and serum amyloid A (SAA) were quantified and analysed with a Mann-Whitney U test. BCS and backfat decreased less following ketoprofen administration than with the placebo (-0.08 ± 0.2 vs. -0.8 ± 0.2, 1.0 ± 0.8mm vs. -2.0 ± 0.9 mm, respectively; P<0.05 for both) during the first 2 weeks of lactation. The shoulder sore score deterioration was milder during days 4-6 p.p. with ketoprofen than placebo (P<0.05). Duration of constipation was shorter with ketoprofen than placebo (5.5 ± 0.3 vs. 6.4 ± 0.3 days p.p.; P<0.05). Incidences of feed refusal occurred later in the ketoprofen group than in the placebos (9.6 ± 0.9 vs. 3.8 ± 0.8 days p.p.; P<0.05). AST and SAA values were higher after ketoprofen administration than placebo on day 5 p.p. (P<0.05). It was concluded that ketoprofen appeared to benefit sows during the first 2 weeks post farrowing, but caused some tissue irritation.

  7. Blastomycosis and Pregnancy: An Unusual Postpartum Disease Course.

    PubMed

    Surprenant, David; Kaniszewska, Monika; Hutchens, Kelli; Go, Christine; O'Keefe, Paul; Swan, James; Tung, Rebecca

    2015-01-01

    Blastomyces dermatitidis is responsible for systemic mycoses. It is predominantly caused by inhalation of spores and often manifests as pneumonia, which can potentially disseminate; however, direct cutaneous inoculation may also occur. Blastomycosis in the perigravid period is exceedingly rare. The partial immunosuppressive state induced by pregnancy can engender more severe infections and is associated with a risk of vertical transmission. Published cases describe postpartum symptomatic improvement accompanying immune reconstitution, even in the absence of treatment. We present a 31-year-old gravid female with multifocal cutaneous blastomycosis. After delivering a healthy full-term infant with no evidence of congenital infection, the patient's cutaneous lesions continued to worsen. At 6 weeks postpartum she was treated with oral itraconazole and demonstrated clinical improvement after 5 months of therapy. This case highlights the importance of prompt disease recognition, understanding of risk factors and initiation of appropriate antifungal therapy of blastomycotic infection occurring in the unique setting of pregnancy. PMID:26120305

  8. Association of postpartum maternal morbidities with children's mental, psychomotor and language development in rural Bangladesh.

    PubMed

    Hamadani, J D; Tofail, F; Hilaly, A; Mehrin, F; Shiraji, S; Banu, S; Huda, S N

    2012-06-01

    Little is known from developing countries about the effects of maternal morbidities diagnosed in the postpartum period on children's development. The study aimed to document the relationships of such morbidities with care-giving practices by mothers, children's developmental milestones and their language, mental and psychomotor development. Maternal morbidities were identified through physical examination at 6-9 weeks postpartum (n=488). Maternal care-giving practices and postnatal depression were assessed also at 6-9 weeks postpartum. Children's milestones of development were measured at six months, and their mental (MDI) and psychomotor (PDI) development, language comprehension and expression, and quality of psychosocial stimulation at home were assessed at 12 months. Several approaches were used for identifying the relationships among different maternal morbidities, diagnosed by physicians, with children's development. After controlling for the potential confounders, maternal anaemia diagnosed postpartum showed a small but significantly negative effect on children's language expression while the effects on language comprehension did not reach the significance level (p=0.085). Children's development at 12 months was related to psychosocial stimulation at home, nutritional status, education of parents, socioeconomic status, and care-giving practices of mothers at six weeks of age. Only a few mothers experienced each specific morbidity, and with the exception of anaemia, the sample-size was insufficient to make a conclusion regarding each specific morbidity. Further research with a sufficient sample-size of individual morbidities is required to determine the association of postpartum maternal morbidities with children's development.

  9. Bio-psycho-socio-demographic and Obstetric Predictors of Postpartum Depression in Pregnancy: A prospective Cohort Study

    PubMed Central

    Abdollahi, Fatemeh; Rohani, Samad; Sazlina, Ghazali Shariff; Zarghami, Mehran; Azhar, Md Zain; Lye, Munn Sann; Rezaiee Abhari, Farideh; Majidi, Zohreh; Mozafari, Soghra

    2014-01-01

    Objective: There are various attempts to confirm variables that could predict postpartum depression in advance. This study determined antenatal risk factors for postpartum depression in women at risk of developing this disorder. Methods: A prospective cohort study was conducted with 2279 eligible women who attended at Mazandaran province’ primary health centers from 32-42 weeks of pregnancy to eighth postpartum weeks. The women were screened for symptoms of depression using the Iranian version of Edinburgh Postnatal Depression Scale. An Edinburgh Postnatal Depression Scale score of > 12 indicated possible postpartum depression. Univariate and multiple logistic regression models were used for data analysis. Results: A total of 2083women during 32-42 weeks of gestation participated in this study and were followed up to 8-week postpartum. Four hundred and three (19.4%) mothers yielded scores above the threshold of 12. Depression and general health state in pregnancy based on Edinburgh Postnatal Depression Scale (OR = 1.35, CI = 1.3-1.4) and General Health Questionnaire-28 (OR = 1.03, CI = 1.01-1.04), respectively were significant independent antenatal risk factors of depression symptoms at 8-week postpartum. Mothers who lived in nuclear families (OR = 1.38, CI = 1.04-1.84), whose husbands had lower educational status (OR = 0.95, CI = 0.91-0.99), and with delayed prenatal care (OR = 1.01, CI = 1.001-1.03) were more susceptible to postpartum depression. Conclusion: A comprehensive antenatal assessment focused on psychiatric problems, environmental and obstetric factors would benefit pregnant women in the prevention of postpartum depression. PMID:25053953

  10. Admission to psychiatric hospital in the early and late postpartum periods: Scottish national linkage study

    PubMed Central

    Langan Martin, Julie; McLean, Gary; Cantwell, Roch; Smith, Daniel J

    2016-01-01

    Objective To describe weekly admission rates for affective and non-affective psychosis, major depression and other psychiatric disorders in the early and late postpartum periods. To assess the impact of socioeconomic status, age and parity on admission rates. Methods Scottish maternity records were linked to psychiatric hospital admissions. 3290 pregnancy-related psychiatric admissions were assessed. Weekly admission rates were calculated for the pregnancy period, early postpartum period (6 weeks after birth) and late postpartum period (up to 2 years after birth), and compared with pre-pregnancy rates (up to 2 years before pregnancy). Admission rates were generated by calculating the total number of admissions for each time period divided by the number of weeks in the period. Incidence rate ratios (IRRs) were generated for each time period, using deprivation, age, parity and record of previous psychiatric hospital care-adjusted Poisson regression models. Results Women from more deprived social quintiles accounted for the largest proportion of admissions across all time periods. Compared with pre-pregnancy period, admission rates fell during pregnancy, increased markedly during the early postpartum period, and remained elevated for 2 years after childbirth. Within the most affluent quintile, admission IRRs were higher in the early postpartum period (IRR=1.29, 95% CI 1.02 to 1.59) than in the late postpartum period (IRR=0.87, 95% CI 0.74 to 0.98). For the late postpartum period, there was a positive association between higher maternal age and admission IRRs (ages 20–35 years, IRR=1.35, 95% CI 1.16 to 1.54 and age>40 years IRR=1.72, 95% CI 1.41 to 2.09). Conclusions Rates of psychiatric admission fell during pregnancy and increased in the early postpartum period (particularly during the first 2 weeks after birth), and remained elevated above baseline during the 2-year late postpartum period. An understanding of how social deprivation, age and parity

  11. Hematobiochemical profile in Surti goats during post-partum period

    PubMed Central

    Manat, Tanvi D.; Chaudhary, Sandhya S.; Singh, Virendra Kumar; Patel, Sanjay B.; Puri, Gopal

    2016-01-01

    concentration decreased up to 14th day post-partum and then started increasing from 21st day onward. Conclusion: Hematobiochemical parameters are indicative of health status of animals. Significantly low values of Hb, PCV, and TLC during first 2 weeks post-partum are indicative of stress. Catabolism of protein occurred during 2 weeks post-partum, as observed from increase in urea concentration. Decrease TGs and high level of NEFA during the transition period are suggestive of utilization of lipids for the supply of energy. High glucose level on 0 day indicates that the animals were in positive energy status. PMID:27051179

  12. The Postpartum Telogen Effluvium Fallacy

    PubMed Central

    Mirallas, Oriol; Grimalt, Ramon

    2016-01-01

    Introduction Postpartum telogen effluvium (PPTE) is a commonly described entity, but few studies deal with the real incidence and pathogenesis of this claimed common disease. Objective To analyze the objective data published and to define the real incidence of the so-called PPTE. Method A retrospective review of the published data was conducted. Results No statistically significant data were found in any of the papers reviewed, which could support the conclusion that the amount of hair shedding between pregnant and postpartum women is different. Conclusion PPTE is not a well-defined entity, and the exact incidence is unknown. From our literature review, we could state that the frequency of PPTE is so low and undefined that we dare say that PPTE does not exist. PMID:27386466

  13. [Management of major postpartum hemorrhage].

    PubMed

    Nebout, Sophie; Merbai, Nadia; Faitot, Valentina; Keita, Hawa

    2014-02-01

    Postpartum hemorrhage (PPH) is defined by loss of greater than 500 mL of blood following vaginal delivery or 1,000 mL of blood following cesarean section, in the first 24 hours postpartum. Its incidence is up to 5% and the severe forms represent 1% of births. PPH is the first cause of obstetrical maternal mortality in France and 90% of these deaths are considered as preventable. Its management is multidisciplinary (obstetricians, anesthetists, midwives, biologists and interventional radiologists), based on treatment protocols where time is a major prognosis factor. In case of failure of the initial measures (oxytocin, manual placenta removal, uterus and birth canal examination), the management of severe forms includes active resuscitation (intravenous fluids, blood transfusion, vasoactive drugs), haemostatic interventions (sulprostone, tamponnade and haemostatic suture, surgical procedures and arterial embolization) and the correction of any potential coagulopathy (administration of blood products and haemostatic agents). PMID:24373716

  14. Plasma progesterone and blood metabolite profiles in post-partum small east African zebu cows.

    PubMed

    Tegegne, A; Entwistle, K W; Mukasa-Mugerwa, E

    1993-05-01

    Plasma progesterone profiles were used to monitor post-partum reproductive activity in 12 Small East African zebu (Bos indicus) cows allocated to either supplementary or no supplementary feeding (control) with continuous or restricted (twice daily) suckling regimes. Intact bulls were used for breeding. Blood samples were collected 3 times a week for 33 weeks to determine plasma progesterone levels. Weekly blood samples were also used to determine blood metabolite concentrations. Plasma progesterone levels remained below 1 ng/ml in all cows until week 12 post-partum. Only 5 cows showed ovarian activity over the 33 week period. Cows that cycled expressed irregular and short-lived progesterone rises (> 1 ng/ml) lasting 8 to 12 days prior to establishment of normal patterns of progesterone secretion where progesterone levels ranged from 8 to 10 ng/ml in cows with normal cycles. Plasma total protein, albumin, globulin, blood urea nitrogen and glucose levels varied over time without consistent trends, and were not influenced by either supplementary feeding of suckling regimes, nor differed between cyclic and acyclic cows. It was concluded that extended post-partum anoestrus, conception failure and early embryonic mortality were responsible for lowered reproductive efficiency in zebu cows. Blood metabolite concentrations were not good indicators of nutritional status and were not related to post-partum ovarian activity. PMID:8236477

  15. An Integrated Intervention in Pregnant African Americans Reduces Postpartum Risk: A Randomized Trial

    PubMed Central

    El-Mohandes, Ayman A.E.; Kiely, Michele; Joseph, Jill G.; Subramanian, Siva; Johnson, Allan A.; Blake, Susn M.; Gantz, Marie G.; El-Khorazaty, M. Nabil

    2010-01-01

    Objective To evaluate the efficacy of an integrated multiple risk intervention delivered mainly during pregnancy, in reducing such risks (smoking, environmental tobacco smoke exposure, depression and intimate partner violence) postpartum. Design Data from this randomized controlled trial were collected prenatally and on average 10 weeks postpartum in six prenatal care sites in the District of Columbia. African Americans were screened, recruited and randomly assigned to the behavioral intervention or usual care. Clinic-based, individually tailored counseling was delivered to intervention women. The outcome measures were number of reisks reported postpartum and reduction of these risks between baseline and postpartum. Results The intervention was effective in significantly reducing the number of risks reported in the postpartum period. In Bivariate analyses, the intervention group was more successful in resolving all risks (47% compared with 35%, p=0.007), number needed to treat=9, 95% confidence interval [CI] 5-31) and in resolving some risks (63% compared with 54%, p=0.009), number needed to treat=11, 95% CI 7-43) as compared with the usual care group. In logistical regression analyses, women in the intervention group were more likely to resolve all risks (OR=1.86, 95% CI: 1.25-2.75) and in resolving at least one risk (OR=1.6, 95% CI: 1.15-2.22). Conclusions An integrated multiple risk factor intervention addressing psychosocial and behavioral risks delivered mainly during pregnancy can have beneficial effects in risk reduction postpartum. PMID:18757660

  16. Postpartum IUDS: keys for success.

    PubMed

    O'Hanley, K; Huber, D H

    1992-04-01

    Intrauterine device (IUD) insertion is convenient and efficient in the postplacental and immediate postpartum periods. Insertion at these times is demonstrably safe, having a low incidence of infection, few bleeding problems, and low perforation rates. IUD expulsion rates can vary widely, and are a function of timing of insertion, type of IUD, and insertion technique. When a copper T device is inserted postplacentally or immediately postpartum by an experienced and trained clinician, expulsion rates of about 7-15 per 100 users at six months can be expected. Women must be told how to detect expulsions and instructed to return for reinsertion or for another method. Most investigators emphasize that high fundal IUD placement will reduce the expulsion rate. Unplanned pregnancy rates for postplacental IUD insertion range from 2.0-2.8 per 100 users at 24 months when using modern copper IUDs, correct insertion technique, careful postinsertion instructions and good follow-up. Postplacental insertions are performed manually or with a ring forceps. Immediate postpartum insertions (10 minutes to 48 hours after delivery) are performed with the ring forceps.

  17. Forgiveness Week.

    ERIC Educational Resources Information Center

    Milner, Art

    1984-01-01

    Carefully orchestrated public relations and publicity campaign at Free Library of Philadelphia motivated an estimated 35,000 patrons to return almost 160,000 overdues during "no fines" week. Coverage by radio stations, newspapers, and television aided recovery of materials including rare 1910 score of a Rachmaninoff symphony which was 31 years…

  18. 11. DETAILS: CONCRETE SHEET PILING, CORNERS #4 & #6, DWG. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    11. DETAILS: CONCRETE SHEET PILING, CORNERS #4 & #6, DWG. NO. 11, 1-1/2" = 1 FT., FEB. 12, 1908, MADE BY E.C.L., APPROVED BY O.F. LACKEY - Baltimore Inner Harbor, Pier 5, South of Pratt Street between Market Place & Concord Street, Baltimore, Independent City, MD

  19. Health Promotion Activity Book for Grades 4-6.

    ERIC Educational Resources Information Center

    Ohio State Dept. of Health, Columbus.

    This book of activities is designed to supplement health lessons for students in grades 4-6. Some of the activities are quite simple and require very little instruction and direction, while others are more difficult and require careful explanation prior to completion. The level of difficulty of the activities is varied in order to create both…

  20. 2,4,6-TRINITROTOLUENE TRANSFORMATION IN PLANTED, SOIL COLUMNS

    EPA Science Inventory

    2,4,6-Trinitrotoluene (TNT), has been used extensively by the United States military to manufacture explosive devices. Since the conclusion of World War 11, many of these military installations have also been involved in the disposal of surplus and outdated explosives. Both the c...

  1. 41 CFR 60-4.6 - Goals and timetables.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., in the Notice required by 41 CFR 60-4.2. Covered construction contractors performing construction... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Goals and timetables. 60... 4-CONSTRUCTION CONTRACTORS-AFFIRMATIVE ACTION REQUIREMENTS § 60-4.6 Goals and timetables....

  2. 4,6-Dinitro-o-cyclohexyl phenol

    Integrated Risk Information System (IRIS)

    4,6 - Dinitro - o - cyclohexyl phenol ; CASRN 131 - 89 - 5 Human health assessment information on a chemical substance is included in the IRIS database only after a comprehensive review of toxicity data , as outlined in the IRIS assessment development process . Sections I ( Health Hazard Assessments

  3. 4.6 Doses to Patients in Therapy

    NASA Astrophysics Data System (ADS)

    Noßke, D.; Mattsson, S.; Johansson, L.

    This document is part of Subvolume A 'Fundamentals and Data in Radiobiology, Radiation Biophysics, Dosimetry and Medical Radiological Protection' of Volume 7 'Medical Radiological Physics' of Landolt-Börnstein - Group VIII 'Advanced Materials and Technologies'. It contains the Section '4.6 Doses to Patients in Therapy' of the Chapter '4 Dosimetry in Nuclear Medicine Diagnosis and Therapy' with the contents:

  4. Learn about Seabirds. Teaching Packet, Grades 4-6.

    ERIC Educational Resources Information Center

    Fish and Wildlife Service (Dept. of Interior), Anchorage, AK.

    This teaching packet is designed to teach Alaskan students in grades 4-6 about Alaska's seabird populations, the worldwide significance of seabirds, and the environmental conditions to which seabirds are sensitive. The packet includes a curriculum guide (containing a teacher's background story and 12 teaching activities), a separately published…

  5. Science 4-6. Kentucky's Environmental Education Program.

    ERIC Educational Resources Information Center

    Kentucky State Dept. of Education, Frankfort. Div. of Program Development.

    This unit of instruction for grades 4-6 is one of a series of curriculum units referred to as the Interdisciplinary Unit. Its purpose is to allow the individual teacher to expose the students to many experiences, ideas, and applications based on their environment (Kentucky). Each lesson is built on two basic concepts, each to balance the other.…

  6. Council Minutes, February 4-6, 2011: Santa Monica, California

    ERIC Educational Resources Information Center

    Educational Researcher, 2011

    2011-01-01

    This article presents minutes of the American Educational Research Association's meetings held in Santa Monica, California, on February 4-6, 2011. President Kris D. Gutierrez led a discussion of the meeting dates for the summer Executive Board and Council meetings. It was agreed that members of Council will be polled to determine the best dates…

  7. Creating Sacred Places for Children in Grades 4-6.

    ERIC Educational Resources Information Center

    Fox, Sandra J.

    This guide attempts to help teachers of American Indian children in grades 4-6 provide a culturally relevant education that takes place in the regular classroom, includes content related to Indian students' lives, makes students proud, expands to other experiences, and enhances learning. Creating sacred places means responding appropriately to…

  8. A systematic review of interventions to improve postpartum retention of women in PMTCT and ART care

    PubMed Central

    Geldsetzer, Pascal; Yapa, H Manisha N; Vaikath, Maria; Ogbuoji, Osondu; Fox, Matthew P; Essajee, Shaffiq M; Negussie, Eyerusalem K; Bärnighausen, Till

    2016-01-01

    Introduction The World Health Organization recommends lifelong antiretroviral therapy (ART) for all pregnant and breastfeeding women living with HIV. Effective transitioning from maternal and child health to ART services, and long-term retention in ART care postpartum is crucial to the successful implementation of lifelong ART for pregnant women. This systematic review aims to determine which interventions improve (1) retention within prevention of mother-to-child HIV transmission (PMTCT) programmes after birth, (2) transitioning from PMTCT to general ART programmes in the postpartum period, and (3) retention of postpartum women in general ART programmes. Methods We searched Medline, Embase, ISI Web of Knowledge, the regional World Health Organization databases and conference abstracts for data published between 2002 and 2015. The quality of all included studies was assessed using the GRADE criteria. Results and Discussion After screening 8324 records, we identified ten studies for inclusion in this review, all of which were from sub-Saharan Africa except for one from the United Kingdom. Two randomized trials found that phone calls and/or text messages improved early (six to ten weeks) postpartum retention in PMTCT. One cluster-randomized trial and three cohort studies found an inconsistent impact of different levels of integration between antenatal care/PMTCT and ART care on postpartum retention. The inconsistent results of the four identified studies on care integration are likely due to low study quality, and heterogeneity in intervention design and outcome measures. Several randomized trials on postpartum retention in HIV care are currently under way. Conclusions Overall, the evidence base for interventions to improve postpartum retention in HIV care is weak. Nevertheless, there is some evidence that phone-based interventions can improve retention in PMTCT in the first one to three months postpartum. PMID:27118443

  9. Factors associated with breastfeeding duration and exclusivity in mothers returning to paid employment postpartum.

    PubMed

    Bai, Dorothy Li; Fong, Daniel Yee Tak; Tarrant, Marie

    2015-05-01

    Mothers who are employed postpartum are less likely to continue breastfeeding than mothers who are not formally employed. However, as postpartum employment is increasingly necessary for the majority of new mothers, it is important to investigate factors that influence the continuation of breastfeeding in employed mothers. A sample of 1,738 mothers who returned to paid employment postpartum were recruited from the obstetric units of four public hospitals in Hong Kong, and prospectively followed for 12 months or until their infant was weaned. More than 85 % of participants returned to formal employment within 10 weeks postpartum, with over 90 % of these employed full-time. About one-third of the participants (32 %) were able to combine breastfeeding and employment, with breastfeeding defined as continuing for more than 2 weeks after returning to work postpartum. Later return to work and higher maternal education were associated with new mothers being able to combine breastfeeding and employment. Later return to work, shorter working hours, parental childcare, and higher maternal education were also associated with less likelihood of weaning from any or exclusive breastfeeding. Improvements in employment-related conditions for mothers and additional support for lower educated mothers may be effective strategies to enable employed women to continue breastfeeding after their return to work.

  10. Sleep Quality in Women with and without Postpartum Depression

    PubMed Central

    Posmontier, Bobbie

    2008-01-01

    Objective To compare and measure the effects of sleep quality on women with and without postpartum depression (PPD). Design A case-control repeated measures matched pairs design. Setting Home and obstetric office. Participants Forty-six women who were 6 to 26 weeks postpartum. Two participants were dropped from the final analysis because they were outliers. Methods Participants underwent wrist actigraphy at home for 7 consecutive days to measure sleep quality (sleep latency, wake after sleep onset, sleep efficiency, wake episodes). The Postpartum Depression Screening Scale measured depression severity. Psychosocial variables were collected during a screening interview. A structured clinical interview was used to diagnose PPD. Correlations, t-tests, and hierarchical multiple regressions were run to analyze data. Results With the exception of wake episodes, sleep latency (B = 1.80, S.E. = 0.73, P<0.05), wake after sleep onset (B = 6.85, S.E. = 2.85, P<0.05), and thus sleep efficiency (B = −6.31, S.E. = 3.13, P<0.05) predicted PPD symptom severity. Conclusions Women with PPD experienced poorer sleep quality than women without PPD, and sleep quality worsened with increasing PPD symptom severity. Clinicians need to address measures to improve sleep quality in depressed mothers to decrease symptom severity, and researchers need to develop interventions to facilitate better sleep quality in women with PPD. PMID:19012723

  11. Prevalence and clinical significance of postpartum endometritis and wound infection.

    PubMed Central

    Chaim, W; Bashiri, A; Bar-David, J; Shoham-Vardi, I; Mazor, M

    2000-01-01

    OBJECTIVE: To correlate clinical variables (gestational age, severe pregnancy-induced hypertension, gestational diabetes mellitus, history of previous cesarean sections, fetal distress, perinatal mortality, postpartum anemia, Apgar score < or = 3 at 1 minute and < or = 7 at 5 minutes, and instrumental delivery) with postpartum endometritis (PPE) and wound infection. METHODS: Descriptive cross-sectional study of the outcome of 75,947 term and preterm singleton deliveries; vaginally and by cesarean section from 1989-1997. RESULTS: The prevalence of PPE after vaginal deliveries was 0.17% (120/68,273). Gestational age of less than 37 weeks, severe pregnancy-induced hypertension, fetal distress, instrumental deliveries, neonatal mortality, postpartum anemia, and Apgar scores of < 7 after 5 minutes were significantly associated with PPE. Gestational diabetes and an Apgar score of < 3 after 1 minute showed similar frequency with and without PPE. The prevalence of PPE after cesarean section was 2.63% (202/7,677). Preterm cesarean sections, history of previous cesarean sections, anemia, and low Apgar scores were seen more frequently with PPE than without. The incidence of cesarean delivery with gestational diabetes mellitus, fetal distress, and perinatal mortality was similar in presence and absence of PPE. The rate of wound infection after cesarean section was 3.97% (318/7,995). Gestational diabetes mellitus, history of previous cesarean deliveries, and low Apgar scores were significantly more frequent with than without wound infection. Gestational age, severe pregnancy-induced hypertension, fetal distress, perinatal mortality, and postpartum anemia were not associated with wound infection. CONCLUSIONS: Awareness of the aforementioned associations may prevent and shorten hospital stay by early diagnosis and appropriate treatment. PMID:10805361

  12. Postpartum hemorrhage: use of hemostatic combat gauze.

    PubMed

    Schmid, Bernd C; Rezniczek, Günther A; Rolf, Norbert; Maul, Holger

    2012-01-01

    Cheap and simple interventions that are intended to minimize postpartum hemorrhage are of major public health concern. We report a case of postpartum hemorrhage in which conservative interventions had failed. The use of a chitosan-covered gauze that originally was developed for combat trauma allowed us to achieve hemostasis, and a seemingly inevitable hysterectomy was avoided. PMID:22011588

  13. Use of postpartum care: predictors and barriers.

    PubMed

    DiBari, Jessica N; Yu, Stella M; Chao, Shin M; Lu, Michael C

    2014-01-01

    This study aimed to identify actual and perceived barriers to postpartum care among a probability sample of women who gave birth in Los Angeles County, California in 2007. Survey data from the 2007 Los Angeles Mommy and Baby (LAMB) study (N = 4,075) were used to identify predictors and barriers to postpartum care use. The LAMB study was a cross-sectional, population-based study that examined maternal and child health outcomes during the preconception, prenatal, and postpartum periods. Multivariable analyses identified low income, being separated/divorced and never married, trying hard to get pregnant or trying to prevent pregnancy, Medi-Cal insurance holders, and lack of prenatal care to be risk factors of postpartum care nonuse, while Hispanic ethnicity was protective. The most commonly reported barriers to postpartum care use were feeling fine, being too busy with the baby, having other things going on, and a lack of need. Findings from this study can inform the development of interventions targeting subgroups at risk for not obtaining postpartum care. Community education and improved access to care can further increase the acceptability of postpartum visits and contribute to improvements in women's health. Postpartum care can serve as a gateway to engage underserved populations in the continuum of women's health care. PMID:24693433

  14. Associations of prepartum body condition score with occurrence of clinical endometritis and resumption of postpartum ovarian activity in dairy cattle.

    PubMed

    Kadivar, Ali; Ahmadi, Mohammad Rahim; Vatankhah, Mahmood

    2014-01-01

    This study was performed to investigate the effect of periparturient body condition score on the occurrence of clinical endometritis and postpartum resumption of ovarian activity in dairy cows. Eighty-seven lactating Holstein cows, fed with a total mixed ration diet, were included into the study. Body condition scoring (using a 5-point scale with quarter-point divisions) was performed by the same investigator using the visual technique every 2 weeks, from 2 weeks before until 6 weeks after calving. Palpation of the reproductive tract and ultrasonographic assessment of ovaries for detection of corpus luteum using a rectal linear probe was also performed at 2, 4, and 6 weeks after calving. Cows with clinical endometritis had significantly lower body condition score (BCS) than normal cows at all weeks pre- and postcalving, and cows that did not ovulate until 45 days after calving had a significantly lower BCS pre- and postpartum. Cows that did not ovulate until 45 days after calving also lost more BCS from 2 weeks before to 4 weeks after calving. Besides, first ovulation after calving take occurred later in cows with clinical endometritis compared to normal cows (P < 0.05). In conclusion, low BCS is a risk factor for postpartum endometritis and delayed cyclicity in dairy cows. BCS loss from dry-off to early lactation and occurrence of clinical endometritis can significantly affect postpartum ovarian activity.

  15. Postpartum ovarian follicular dynamics in primiparous and pluriparous Mediterranean Italian buffaloes (Bubalus bubalis).

    PubMed

    Presicce, Giorgio Antonio; Bella, Antonino; Terzano, Giuseppina Maria; De Santis, Giuseppe; Senatore, Elena Maria

    2005-03-15

    The objective of this study was to monitor ovarian function in postpartum primiparous and pluriparous Mediterranean Italian buffaloes (Bubalus bubalis) during months of increasing daylength. Ovarian ultrasound monitoring was carried out for a total of 60 days from calving in 10 primiparous and 10 pluriparous buffaloes. Progesterone was determined from calving until a week after first postpartum ovulation. The study was undertaken during months of increasing day length. Time required for complete postpartum uterine involution was 31 +/- 1.0 and 33 +/- 1.3 days in primiparous and pluriparous buffaloes respectively (P = 0.1). The first postpartum ovulation was recorded on 4 primiparous and 8 pluriparous buffaloes (P = 0.16). Time for first postpartum ovulation to occur was 25.5 +/- 6.9 and 15.5 +/- 1.3 days in primiparous and pluriparous buffaloes, respectively (P = 0.07). Overall, 8 of the 12 first postpartum ovulations (66.6%) occurred in the ovary contra-lateral to the one bearing the gravidic CL, one out of 4 in primiparous and 3 out of 8 in pluriparous buffaloes (P = 1.0). Following a first postpartum ovulation, 3 primiparous and 4 pluriparous buffaloes displayed a complete wave of follicular development leading to a new ovulation. Ovulation following parturition was not recorded in 6 primiparous and two pluriparous buffaloes for the 60 days of ultrasound monitoring. Growth rate (mm/d) and largest size (mm) of first postpartum ovulating follicle was 0.95 +/- 0.18 and 1.07 +/- 0.07 (P = 0.4), and 13.5 +/- 0.8 and 14.1 +/- 0.4 (P = 0.4) in primiparous and pluriparous buffaloes, respectively. Following calving, the total number of available antral follicles (> or =2 mm) declined gradually towards the end of the study period. Follicles greater or equal to 3 mm in diameter on the contrary showed a prominent increase in the first 2 weeks from calving. The number of follicles greater or equal to 3 mm in diameter was significantly higher in the ovary contra-lateral to

  16. Postpartum ovarian follicular dynamics in primiparous and pluriparous Mediterranean Italian buffaloes (Bubalus bubalis).

    PubMed

    Presicce, Giorgio Antonio; Bella, Antonino; Terzano, Giuseppina Maria; De Santis, Giuseppe; Senatore, Elena Maria

    2005-03-15

    The objective of this study was to monitor ovarian function in postpartum primiparous and pluriparous Mediterranean Italian buffaloes (Bubalus bubalis) during months of increasing daylength. Ovarian ultrasound monitoring was carried out for a total of 60 days from calving in 10 primiparous and 10 pluriparous buffaloes. Progesterone was determined from calving until a week after first postpartum ovulation. The study was undertaken during months of increasing day length. Time required for complete postpartum uterine involution was 31 +/- 1.0 and 33 +/- 1.3 days in primiparous and pluriparous buffaloes respectively (P = 0.1). The first postpartum ovulation was recorded on 4 primiparous and 8 pluriparous buffaloes (P = 0.16). Time for first postpartum ovulation to occur was 25.5 +/- 6.9 and 15.5 +/- 1.3 days in primiparous and pluriparous buffaloes, respectively (P = 0.07). Overall, 8 of the 12 first postpartum ovulations (66.6%) occurred in the ovary contra-lateral to the one bearing the gravidic CL, one out of 4 in primiparous and 3 out of 8 in pluriparous buffaloes (P = 1.0). Following a first postpartum ovulation, 3 primiparous and 4 pluriparous buffaloes displayed a complete wave of follicular development leading to a new ovulation. Ovulation following parturition was not recorded in 6 primiparous and two pluriparous buffaloes for the 60 days of ultrasound monitoring. Growth rate (mm/d) and largest size (mm) of first postpartum ovulating follicle was 0.95 +/- 0.18 and 1.07 +/- 0.07 (P = 0.4), and 13.5 +/- 0.8 and 14.1 +/- 0.4 (P = 0.4) in primiparous and pluriparous buffaloes, respectively. Following calving, the total number of available antral follicles (> or =2 mm) declined gradually towards the end of the study period. Follicles greater or equal to 3 mm in diameter on the contrary showed a prominent increase in the first 2 weeks from calving. The number of follicles greater or equal to 3 mm in diameter was significantly higher in the ovary contra-lateral to

  17. Low Omega-3 Index in Pregnancy Is a Possible Biological Risk Factor for Postpartum Depression

    PubMed Central

    Markhus, Maria Wik; Skotheim, Siv; Graff, Ingvild Eide; Frøyland, Livar; Braarud, Hanne Cecilie; Stormark, Kjell Morten; Malde, Marian Kjellevold

    2013-01-01

    Background Depression is a common disorder affecting 10–15% women in the postpartum period. Postpartum depression can disrupt early mother-infant interaction, and constitutes a risk factor for early child development. Recently, attention has been drawn to the hypothesis that a low intake of seafood in pregnancy can be a risk factor for postpartum depression. Seafood is a unique dietary source of the marine omega-3 fatty acids and is a natural part of a healthy balanced diet that is especially important during pregnancy. Methods In a community based prospective cohort in a municipality in Western Norway, we investigated both nutritional and psychological risk factors for postpartum depression. The source population was all women who were pregnant within the period November 2009 - June 2011. The fatty acid status in red blood cells was assessed in the 28th gestation week and participants were screened for postpartum depression using the Edinburgh Postnatal Depression Scale (EPDS) three months after delivery. The aim of the present study was to investigate if a low omega-3 index in pregnancy is a possible risk factor for postpartum depression. Results In a simple regression model, the omega-3 index was associated with the EPDS score in a nonlinear inverse manner with an R square of 19. Thus, the low omega-3 index explained 19% of the variance in the EPDS score. The DPA content, DHA content, omega-3 index, omega-3/omega-6 ratio, total HUFA score, and the omega-3 HUFA score were all inversely correlated with the EPDS score. The EPDS scores of participants in the lowest omega-3 index quartile were significantly different to the three other omega-3 index quartiles. Conclusion In this study population, a low omega-3 index in late pregnancy was associated with higher depression score three months postpartum. PMID:23844041

  18. A natural model of behavioral depression in postpartum adult female cynomolgus monkeys (Macaca fascicularis)

    PubMed Central

    CHU, Xun-Xun; Rizak, Joshua Dominic; YANG, Shang-Chuan; WANG, Jian-Hong; MA, Yuan-Ye; HU, Xin-Tian

    2014-01-01

    Postpartum depression (PPD) is a modified form of major depressive disorders (MDD) that can exert profound negative effects on both mothers and infants than MDD. Within the postpartum period, both mothers and infants are susceptible; but because PPD typically occurs for short durations and has moderate symptoms, there exists challenges in exploring and addressing the underlying cause of the depression. This fact highlights the need for relevant animal models. In the present study, postpartum adult female cynomolgus monkeys (Macaca fascicularis) living in breeding groups were observed for typical depressive behavior. The huddle posture behavior was utilized as an indicator of behavioral depression postpartum (BDP) as it has been established as the core depressive-like behavior in primates. Monkeys were divided into two groups: A BDP group (n=6), which were found to spend more time huddling over the first two weeks postpartum than other individuals that formed a non-depression control group (n=4). The two groups were then further analyzed for locomotive activity, stressful events, hair cortisol levels and for maternal interactive behaviors. No differences were found between the BDP and control groups in locomotive activity, in the frequencies of stressful events experienced and in hair cortisol levels. These findings suggested that the postpartum depression witnessed in the monkeys was not related to external factors other than puerperium period. Interestingly, the BDP monkeys displayed an abnormal maternal relationship consisting of increased infant grooming. Taken together, these findings suggest that the adult female cynomolgus monkeys provide a natural model of behavioral postpartum depression that holds a number of advantages over commonly used rodent systems in PPD modeling. The cynomolgus monkeys have a highly-organized social hierarchy and reproductive characteristics without seasonal restriction—similar to humans—as well as much greater homology to

  19. A natural model of behavioral depression in postpartum adult female cynomolgus monkeys (Macaca fascicularis).

    PubMed

    Chu, Xun-Xun; Dominic Rizak, Joshua; Yang, Shang-Chuan; Wang, Jian-Hong; Ma, Yuan-Ye; Hu, Xin-Tian

    2014-05-01

    Postpartum depression (PPD) is a modified form of major depressive disorders (MDD) that can exert profound negative effects on both mothers and infants than MDD. Within the postpartum period, both mothers and infants are susceptible; but because PPD typically occurs for short durations and has moderate symptoms, there exists challenges in exploring and addressing the underlying cause of the depression. This fact highlights the need for relevant animal models. In the present study, postpartum adult female cynomolgus monkeys (Macaca fascicularis) living in breeding groups were observed for typical depressive behavior. The huddle posture behavior was utilized as an indicator of behavioral depression postpartum (BDP) as it has been established as the core depressive-like behavior in primates. Monkeys were divided into two groups: A BDP group (n=6), which were found to spend more time huddling over the first two weeks postpartum than other individuals that formed a non-depression control group (n=4). The two groups were then further analyzed for locomotive activity, stressful events, hair cortisol levels and for maternal interactive behaviors. No differences were found between the BDP and control groups in locomotive activity, in the frequencies of stressful events experienced and in hair cortisol levels. These findings suggested that the postpartum depression witnessed in the monkeys was not related to external factors other than puerperium period. Interestingly, the BDP monkeys displayed an abnormal maternal relationship consisting of increased infant grooming. Taken together, these findings suggest that the adult female cynomolgus monkeys provide a natural model of behavioral postpartum depression that holds a number of advantages over commonly used rodent systems in PPD modeling. The cynomolgus monkeys have a highly-organized social hierarchy and reproductive characteristics without seasonal restriction-similar to humans-as well as much greater homology to humans

  20. [The impact of thyroid function in women of reproductive age: infertility, pregnancy and the postpartum period].

    PubMed

    Speer, Gábor

    2013-12-22

    This article reviews the management and diagnosis of thyroid dysfunction during pregnancy and postpartum, which was published by any of the endocrine societies in 2012. The author presents human data based on these clinical practice guidelines, however, there are also many unresolved questions. Especially, there are inconsistencies about screening using plasma TSH measurement. In pregnancy the main causes of hyperthyroidism are Graves's disease and gestational transient thyrotoxicosis. Generally, gestational transient thyrotoxicosis does not require medication, whereas Graves's disease needs antithyroid drug therapy. Postpartum thyroiditis occurs more frequently in antithyroid peroxidase-positive women, who should be screened using serum thyrotropin measurements at 6 to 12 gestation weeks and at 3 and 6 months postpartum. Because overt maternal hypothyroidism, due to autoimmune pathophysioloical mechanisms, negatively affects the fetus, timely recognition and treatment are important. The subclinical form of maternal hypothyroidism should also be treated. A link between thyroid dysfunction and infertility has been warranted. PMID:24334133

  1. Two-stage biotransformation of 2,4,6-trinitrotoluene

    SciTech Connect

    VanderLoop, S.L.; Suidan, M.T.; Moteleb, M.A.; Maloney, S.W.

    1995-12-31

    TNT is the explosive most widely used by the military, but current technologies for treating munitions production wastewater are costly and produce a secondary waste, spent GAC. Bioremediation holds promise as a more effective and less costly treatment strategy. An anaerobic fluidized-bed granular activated carbon (GAC) bioreactor in series with an activated sludge reactor was used to treat 2,4,6-trinitrotoluene (TNT). A wastewater solution of 100 mg/L 2,4,6-TNT, as well as carbonate buffer and nutrient solutions, were fed to the anaerobic reactor. Ethanol and ammonia were supplied for microbial growth at 540 mg/L and 20 mg/L, respectively. The mixed anaerobic culture completely transformed the TNT to unknown products. Attempts to detect these products by gas chromatography (GC) and high-performance liquid chromatography (HPLC) were unsuccessful. The effluent from this reactor was treated further in an activated sludge system. The TNT transformation products were partially oxidized in the aerobic stage, resulting in recovery of 91% of the total influent nitrogen as ammonia, nitrate, and biomass. This corresponds to recovery of 82% of influent TNT nitrogen.

  2. Maternal Stress Predicts Postpartum Weight Retention

    PubMed Central

    Whitaker, Kara; Vernon, Marlo; Wilcox, Sara

    2014-01-01

    Postpartum weight retention (PPWR) is a significant contributor to the development of overweight and obesity in women of childbearing age. Stress may be a key mechanism making it more difficult for mothers to lose weight in the year following delivery. The aim of this study was to assess whether specific aspects of parenting stress and life stress influence postpartum weight retention in new mothers. Women in late pregnancy or up to 2 months postpartum (n = 123) were enrolled in the study and followed through the first year postpartum. Linear regression models evaluated the associations of parenting stress (isolation, attachment and depressive symptoms) as well as overall life stress at 2, 6, and 12 months postpartum with PPWR at 6 and 12 months. During the first year postpartum, higher depression and life stress were significantly associated with greater PPWR. As the effect of depression diminished, the effect of life stress became significant. Contrary to hypothesized relationships, fewer problems with attachment and less social isolation were significantly associated with greater PPWR. Higher gestational weight gain and African American race were also significantly associated with greater PPWR at both 6 and 12 months. Different types of stress predict weight retention in first time mothers during the first year postpartum. Understanding the relationships between parenting stress, concurrent life stress and PPWR can enhance the development of future interventions that specifically target self-identified stressors, leading to improved weight related outcomes. PMID:24760321

  3. Nutrition and postpartum rebreeding in cattle.

    PubMed

    Randel, R D

    1990-03-01

    Body weight and condition score, although perhaps imprecise or subjective, are functional indicators of energy status and rebreeding performance after calving. Inadequate precalving and(or) postcalving energy or protein nutrition lowers pregnancy rates as well as first-service conception rates and extends postpartum intervals in suckled postpartum beef females. Normal nutritional regimens for dairy cows that are fed for maximal lactation do not exhibit long postpartum intervals or reduced fertility. Yet excessive protein intake may depress postpartum rebreeding performance, especially in older dairy cows. Feeding of ionophores, with increased ruminal propionate levels in the rumen, results in an earlier return to estrus postpartum. Underfeeding of the postpartum cow extends the period of ovarian inactivity. The underfed postpartum cow's lack of ovarian activity appears to be due to a suppression of the pulsatile release of LH from the anterior pituitary gland, which in turn is controlled by release of GnRH from the hypothalamus. Some metabolic compound(s) presumably act on the hypothalamic-pituitary-ovarian axis as the nutritional state of the animal is altered.

  4. POSTPARTUM DOULAS: MOTIVATIONS AND PERCEPTIONS OF PRACTICE

    PubMed Central

    McComish, Judith Fry; Visger, Joan M.; Rowland, Carolynn A.; Kelleher, Jacqueline

    2010-01-01

    Objective To describe the perceptions of a United States cohort of experienced birth doulas who were among the first in the country to be trained to provide postpartum support. Design A qualitative, longitudinal study using ethnographic methods; participant observation and semi-structured interviews. Setting Midwestern, urban, US; postpartum homecare over three months Participants Four postpartum doulas; 13 families Measurements Participant observation during six postpartum home visits per family; thirteen semi-structured interviews with doulas at the completion of each family’s care; four summative interviews with doulas at the end of the study. Findings When describing their postpartum practice, four themes emerged: supporting women, taking the mother’s perspective, empowering women, and empowering families. When speaking of the motivations three themes emerged: being “called” to practice, interest in preventing negative experiences, and career development. Key conclusions and implications for practice In the US, new mothers see midwives and physicians sporadically after discharge from the hospital. Postpartum doulas fill this gap in continuity of care by providing support for families as they transition to life with their new infant. Understanding the beliefs, values, and practices of these important paraprofessionals will help midwives effectively integrate postpartum doula care into the care of women and infants. PMID:21055853

  5. Prospective Evaluation of Hot Flashes during Pregnancy and Postpartum

    PubMed Central

    Thurston, Rebecca C.; Luther, James F.; Wisniewski, Stephen R.; Eng, Heather; Wisner, Katherine L.

    2014-01-01

    Objective To determine the prevalence, course, and risk factors for hot flashes during pregnancy and postpartum. Study Design Women (N=429) were assessed prospectively during pregnancy (weeks 20, 30, 36) and up to a year after delivery (weeks 2, 12, 26, 52). A clinical interview, physical measurements, and questionnaires were administered at each visit. Results Thirty-five percent of women reported hot flashes during pregnancy and 29% reported hot flashes after delivery. In multivariable binomial mixed effects models, women who were younger (per year: OR(95%CI): 0.94(0.88–0.99)), had a higher pre-pregnancy body mass index (BMI; per unit increase: OR(95%CI): 1.05(1.01–1.10)), and had less than a college education (OR(95%CI): 2.58(1.19–5.60); vs. college) were more likely to report hot flashes during pregnancy. Higher depressive symptoms were associated with hot flashes during pregnancy (per unit increase: OR(95%CI): 1.08(1.04–1.13)) and after birth (OR(95%CI): 1.19(1.14–1.25), multivariable models). Conclusion Hot flashes, typically considered a menopausal symptom, were reported by over a third of women during pregnancy and/or postpartum. Predictors of hot flashes during this reproductive transition, including depressive symptoms, low education, and higher BMI are similar to those experienced during menopause. Future work should investigate the role of hormonal and affective factors in hot flashes during pregnancy and postpartum. PMID:24035604

  6. Relationship between Fathers' Depression and Perceived Social Support and Stress in Postpartum Period

    PubMed Central

    Kamalifard, Mahin; Hasanpoor, Shirin; Babapour Kheiroddin, Jalil; Panahi, Samira; Bayati Payan, Somayeh

    2014-01-01

    Introduction: The evidence suggests that some men experience depression after the childbirth of their wife, and this real and unknown phenomenon will adversely affect them as well as their families. Regarding the lack of understanding about the paternal depression and its complex and multifaceted etiology, the present study was done to assess the paternal postpartum depression and its relationship with perceived stress and social support components. Methods: In this descriptive study, 205 new fathers were assessed from 6th to 12th week postpartum in seven health centers, affiliated to Shahid Beheshti University. Collected data with the Edinburgh Postnatal Depression Scale, Perceived Stress Scale, and the Perceived Social Support Scale were analyzed by descriptive statistics, correlation tests and linear regression analysis. Results: 11.7% of the fathers scored 12 or above in the Edinburgh scale, which indicated depression symptom. The postnatal depression scores had a significant positive correlation with the perceived stress scores and a significant negative correlation with the perceived social support components scores. Perceived stress was key predictor of paternal postpartum depression. Perceived social support components cannot significantly predict the paternal postpartum depression. Conclusion: Assessment of paternal postpartum depression and its risk factors is recommended. Healthcare providers should pay more attention to the increasing public awareness, stress management and communication skills training, and support of fathers during the postnatal period. PMID:25276749

  7. Postpartum Care and Contraception in Obese Women.

    PubMed

    Maclean, Courtney C; Thompson, Ivana S

    2016-03-01

    Postpartum obese women have an increased risk of breastfeeding difficulties and depression. Retaining the pregnancy weight at 6 months postpartum predicts long-term obesity. Risks for weight retention include excessive gestational weight gain, ethnicity, socioeconomic status, diet, exercise, depression, and duration of breastfeeding. Exercise and reducing total caloric intake promote postpartum weight loss. Intrauterine devices and contraceptive implants are the most effective contraceptives for obese women. Contraceptive pills, patches, and vaginal rings are effective options; however, obese women should be made aware of a potential increased risk of venous thromboembolism. Vasectomy and hysteroscopic sterilization carry the least surgical risk for obese women. PMID:26694498

  8. Hantavirus pulmonary syndrome in a postpartum woman

    PubMed Central

    Murthy, Pooja R.; Ucchil, Rajesh; Shah, Unmil; Chaudhari, Dipak

    2016-01-01

    Hantavirus infection, a rare disease diagnosed in India and carries a very high mortality. There are no reports of this infection in association with pregnancy or postpartum period in our country. We present a case of a 30-year-old female diagnosed to have hantavirus pulmonary syndrome in the postpartum period. We intend to create awareness about this infection and consider it in the differential diagnosis of patients presenting with acute respiratory distress syndrome and multiorgan dysfunction in association with pregnancy and postpartum period. PMID:27688634

  9. Hantavirus pulmonary syndrome in a postpartum woman.

    PubMed

    Murthy, Pooja R; Ucchil, Rajesh; Shah, Unmil; Chaudhari, Dipak

    2016-09-01

    Hantavirus infection, a rare disease diagnosed in India and carries a very high mortality. There are no reports of this infection in association with pregnancy or postpartum period in our country. We present a case of a 30-year-old female diagnosed to have hantavirus pulmonary syndrome in the postpartum period. We intend to create awareness about this infection and consider it in the differential diagnosis of patients presenting with acute respiratory distress syndrome and multiorgan dysfunction in association with pregnancy and postpartum period. PMID:27688634

  10. Hantavirus pulmonary syndrome in a postpartum woman

    PubMed Central

    Murthy, Pooja R.; Ucchil, Rajesh; Shah, Unmil; Chaudhari, Dipak

    2016-01-01

    Hantavirus infection, a rare disease diagnosed in India and carries a very high mortality. There are no reports of this infection in association with pregnancy or postpartum period in our country. We present a case of a 30-year-old female diagnosed to have hantavirus pulmonary syndrome in the postpartum period. We intend to create awareness about this infection and consider it in the differential diagnosis of patients presenting with acute respiratory distress syndrome and multiorgan dysfunction in association with pregnancy and postpartum period.

  11. Mother-infant bonding impairment across the first 6 months postpartum: the primacy of psychopathology in women with childhood abuse and neglect histories.

    PubMed

    Muzik, Maria; Bocknek, Erika London; Broderick, Amanda; Richardson, Patricia; Rosenblum, Katherine L; Thelen, Kelsie; Seng, Julia S

    2013-02-01

    Our goal was to examine the trajectory of bonding impairment across the first 6 months postpartum in the context of maternal risk, including maternal history of childhood abuse and neglect and postpartum psychopathology, and to test the association between self-reported bonding impairment and observed positive parenting behaviors. In a sample of women with childhood abuse and neglect histories (CA+, n = 97) and a healthy control comparison group (CA-, n = 53), participants completed questionnaires related to bonding with their infants at 6 weeks, 4 months, and 6 months postpartum and psychopathology at 6 months postpartum. In addition, during a 6-month postpartum home visit, mothers and infants participated in a dyadic play interaction subsequently coded for positive parenting behaviors by blinded coders. We found that all women, independent of risk status, increased in bonding with their infant over the first 6 months postpartum; however, women with postpartum psychopathology (depression and posttraumatic stress disorder [PTSD]) showed consistently greater bonding impairment scores at all timepoints. Moreover, we found that, at the 6-month assessment, bonding impairment and observed parenting behaviors were significantly associated. These results highlight the adverse effects of maternal postpartum depression and PTSD on mother-infant bonding in early postpartum in women with child abuse and neglect histories. These findings also shed light on the critical need for early detection and effective treatment of postpartum mental illness in order to prevent problematic parenting and the development of disturbed mother-infant relationships. Results support the use of the Postpartum Bonding Questionnaire as a tool to assess parenting quality by its demonstrated association with observed parenting behaviors. PMID:23064898

  12. Aerobic biotransformation and mineralization of 2,4,6-trinitrotoluene

    SciTech Connect

    Bae, B.H.; Autenrieth, R.L.; Bonner, J.S.

    1995-12-31

    Respirometric mineralization studies of 2,4,6-trinitrotoluene (TNT) were conducted with microorganisms isolated from a site contaminated with munitions waste in Illinois. Nine aerobic bacterial species were isolated under a carbon- and nitrogen-limited condition and tentatively identified as: one Pseudomonas species; one Enterobacter species; and seven Alcaligenes species. Experiments were performed using each of the nine organisms individually and with a consortium of all nine bacterial species. The aerobic microorganisms were cultured in a sterile nutrient solution with glucose and 20 mg/L TNT. Mineralization was determined using uniformly ring-labeled {sup 14}C-TNT in a respirometer that trapped the evolved CO{sub 2}. Biodegradation behavior was characterized based on oxygen consumption, distribution of {sup 14}C activity, and high-performance liquid chromatography (HPLC) analysis of TNT and its transformation products.

  13. Screening for fungi intensively mineralizing 2,4,6-trinitrotoluene.

    PubMed

    Scheibner, K; Hofrichter, M; Herre, A; Michels, J; Fritsche, W

    1997-04-01

    Within a screening program, 91 fungal strains belonging to 32 genera of different ecological and taxonomic groups (wood- and litter-decaying basidiomycetes, saprophytic micromycetes) were tested for their ability to metabolize and mineralize 2,4,6-trinitrotoluene (TNT). All these strains metabolized TNT rapidly by forming monoaminodinitrotoluenes (AmDNT). Micromycetes produced higher amounts of AmDNT than did wood- and litter-decaying basidiomycetes. A significant mineralization of [14C]TNT was only observed for certain wood- and litter-decaying basidiomycetes. The most active strains, Clitocybula dusenii TMb12 and Stropharia rugosa-annulata DSM11372 mineralized 42% and 36% respectively of the initial added [14C]TNT (100 microM corresponding to 4.75 microCi/l) to 14CO2 within 64 days. Micromycetes (deuteromycetes, ascomycetes, zygomycetes) proved to be unable to mineralize [14C]TNT significantly.

  14. Postpartum blues: relationship between not-protein bound steroid hormones in plasma and postpartum mood changes.

    PubMed

    Heidrich, A; Schleyer, M; Spingler, H; Albert, P; Knoche, M; Fritze, J; Lanczik, M

    1994-02-01

    The relationship between non-bound steroid hormone levels in plasma and the occurrence of postpartum mood changes was investigated in 26 newly delivered mothers throughout the first 5 days postpartum. Studies with saliva samples had reported higher concentrations of 17 beta-estradiol and progesterone on the days of symptoms in women experiencing postpartum blues. As there had been a controversy as to how far saliva concentrations reflect free hormone levels in plasma, free hormone levels of 17 beta-estradiol and progesterone were determined in plasma using ultrafiltration. No significant difference concerning free hormone levels could be found between women with and without postpartum blues. PMID:8201129

  15. Destruction of 2,4,6-trinitrotoluene by Fenton oxidation

    SciTech Connect

    Li, Z.M.; Comfort, S.D.; Shea, P.J.

    1997-03-01

    Past disposal practices at munitions production facilities have generated numerous acres of 2,4,6-trinitrotoluene (TNT)-contaminated soil. We determined the potential of the Fenton reagent (Fe{sup 2+} and H{sub 2}O{sub 2}) to remediate TNT contamination in water, aqueous extracts of contaminated soil, and soil-water slurries. The effects of H{sub 2}O{sub 2} and Fe{sup 2+} concentrations, solution pH, temperature, and initial TNT concentration on transformation and mineralization rates were evaluated. Treating an aqueous TNT solution (70 mg TNT L{sup -1}) with Fenton reagent (1% H{sub 2}O{sub 2}, 80 mg Fe{sup 2+} L{sup -1}) in the dark resulted in 100% destruction of TNT within 24 h. This coincided with 40% mineralization. Subsequent exposure to light resulted in >90% mineralization. We observed generation of 2,4,6-trinitrobenzoic acid and 1,3,5-trinitrobenzene within 15 min following Fenton oxidation of TNT. This indicates that initial TNT destruction likely occurs by methyl group oxidation and decarboxylation. Subsequent transformations involve nitro moiety removal with ring hydroxylation and cleavage, as evidenced by the stoichiometric recovery of TNT-nitrogen as NO{sub 3}{sup -} and production of oxalic acid as the primary C-containing end product. Upon exposure to light, Fe(II) was regenerated and the oxalate produced from 14C-TNT oxidation disappeared; this coincided with a decrease in solution {sup 14}C activity. Similar observations were made when {sup 14}C-oxalic acid was the starting substrate. Fenton oxidation was also effective in destroying TNT in aqueous extracts of contaminated soil and soil-water slurries. Experimental data provide evidence that the Fenton reagent can effectively remediate TNT-contaminated water and soil. 39 refs., 8 figs., 1 tab.

  16. Maternal and infant sleep postpartum.

    PubMed

    McGuire, Elizabeth

    2013-07-01

    New parents should be aware that infants' sleep is unlike that of adults and that meeting their infant's needs is likely to disrupt their own sleep. They will need to adjust their routine to manage their own sleep needs. Parental sleep patterns in the postpartum period are tied to the infant's development of a circadian sleep-wake rhythm, and the infant's feeds. Close contact with the mother and exposure to light/dark cues appear to assist in the development of the infant's circadian rhythm. The composition of breastmilk varies over the course of 24 hours and some components produced at night are likely to contribute to the infant's day/night entrainment. There is no clear evidence that using artificial feeds improves maternal sleep. Most infants need night feeds but requirements for nighttime feeds vary with the individual.

  17. Reversible posterior encephalopathy syndrome associated with late onset postpartum eclampsia: A case report

    PubMed Central

    Bo, Qi-Yu; Zhao, Xiu-He; Yang, Xue; Wang, Sheng-Jun

    2016-01-01

    Late onset postpartum eclampsia (LPE) is defined by its onset at >48 h after delivery. Reversible posterior encephalopathy syndrome (RPES) associated with LPE is uncommon, with the majority of RPES cases having a late postpartum onset within 4 weeks after childbirth. The present study reported the case of a 15-year old female presenting with convulsions that began 5 weeks after delivery. A magnetic resonance imaging scan of the brain revealed multiple lesions in the cortex, subcortical region and deep white matter of the bilateral cerebellum, and occipital, frontal and parietal lobes. The clinical manifestations and radiological abnormalities were readily resolved subsequent to antihypertension and anticonvulsion treatment. In conclusion, the present rare case indicates that LPE should be considered as a potential diagnosis even at 4 weeks after delivery. Furthermore, clinicians should familiarize with the reversible radioimaging features of RPES, since early recognition and adequate treatment are important to the outcome of patients. PMID:27602098

  18. Reversible posterior encephalopathy syndrome associated with late onset postpartum eclampsia: A case report

    PubMed Central

    Bo, Qi-Yu; Zhao, Xiu-He; Yang, Xue; Wang, Sheng-Jun

    2016-01-01

    Late onset postpartum eclampsia (LPE) is defined by its onset at >48 h after delivery. Reversible posterior encephalopathy syndrome (RPES) associated with LPE is uncommon, with the majority of RPES cases having a late postpartum onset within 4 weeks after childbirth. The present study reported the case of a 15-year old female presenting with convulsions that began 5 weeks after delivery. A magnetic resonance imaging scan of the brain revealed multiple lesions in the cortex, subcortical region and deep white matter of the bilateral cerebellum, and occipital, frontal and parietal lobes. The clinical manifestations and radiological abnormalities were readily resolved subsequent to antihypertension and anticonvulsion treatment. In conclusion, the present rare case indicates that LPE should be considered as a potential diagnosis even at 4 weeks after delivery. Furthermore, clinicians should familiarize with the reversible radioimaging features of RPES, since early recognition and adequate treatment are important to the outcome of patients.

  19. Carry-over effects of periparturient endocrine changes on postpartum reproductive function of Holstein heifers bred to genetically different service sires.

    PubMed

    Guilbault, L A; Thatcher, W W; Collier, R J; Wilcox, C J; Drost, M

    1985-12-01

    Effects of fetal sire on postpartum reproductive changes of the dam were studied in 21 Holstein heifers whose pregnancy had been initiated by either Angus (n = 7), Holstein (n = 7) or Brahman (n = 7) bulls. After parturition, all heifers were managed uniformly. Heifers in each service-sire-breed group were bled via jugular venipuncture thrice weekly from d 160 to 265 of pregnancy, daily thereafter until 15 d postpartum, and three times per week until d 60 postpartum. Ability of heifers to release prolactin (PRL) and luteinizing hormone (LH) was evaluated on d 10 postpartum after a simultaneous injection of thyrotropin releasing hormone (TRH; 100 micrograms) and gonadotropin releasing hormone (GnRH; 100 micrograms). Between d 5 and 60 postpartum, the reproductive tract of each heifer was examined rectally thrice weekly after collection of blood samples. Basal concentrations of LH from d 1 to 10 postpartum, as well as ability of the pituitary gland to release LH and PRL after the GnRH-TRH challenge, did not differ between service-sire-breed groups (P greater than .1). Means and profiles of progesterone concentrations during the first 60 d postpartum did not differ between service-sire-breed groups (P greater than .1). However, increases in progesterone concentrations following the GnRH-TRH challenge were synchronized more precisely in Angus (P less than .02) than in Holstein- and Brahman-service-sire groups. Daily rates of reduction in cervical and uterine horn diameters were higher (P less than .01) in Holstein- and Brahman- than in Angus-service-sire groups and were associated with higher profiles of postpartum 15-keto-13,14-dihydro-prostaglandin F2 alpha (PGFM) concentrations. Within-cow PGFM concentrations were correlated positively with cervical (r = .36) and uterine horn (r = .32) diameters. Postpartum ovarian responsiveness and uterine involution in Holstein heifers may be affected by genotypes of the conceptus they bore during pregnancy. PMID:4086401

  20. Coping strategies for postpartum depression: a multi-centric study of 1626 women.

    PubMed

    Gutiérrez-Zotes, Alfonso; Labad, Javier; Martín-Santos, Rocío; García-Esteve, Luisa; Gelabert, Estel; Jover, Manuel; Guillamat, Roser; Mayoral, Fermín; Gornemann, Isolde; Canellas, Francesca; Gratacós, Mónica; Guitart, Montserrat; Roca, Miguel; Costas, Javier; Ivorra, Jose Luis; Navinés, Ricard; de Diego-Otero, Yolanda; Vilella, Elisabet; Sanjuan, Julio

    2016-06-01

    The transition to motherhood is stressful as it requires several important changes in family dynamics, finances, and working life, along with physical and psychological adjustments. This study aimed at determining whether some forms of coping might predict postpartum depressive symptomatology. A total of 1626 pregnant women participated in a multi-centric longitudinal study. Different evaluations were performed 8 and 32 weeks after delivery. Depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS) and the structured Diagnostic Interview for Genetic Studies (DIGS). The brief Coping Orientation for Problem Experiences (COPE) scale was used to measure coping strategies 2-3 days postpartum. Some coping strategies differentiate between women with and without postpartum depression. A logistic regression analysis was used to explore the relationships between the predictors of coping strategies and major depression (according to DSM-IV criteria). In this model, the predictor variables during the first 32 weeks were self-distraction (OR 1.18, 95 % CI 1.04-1.33), substance use (OR 0.58, 95 % CI 0.35-0.97), and self-blame (OR 1.18, 95 % CI 1.04-1.34). In healthy women with no psychiatric history, some passive coping strategies, both cognitive and behavioral, are predictors of depressive symptoms and postpartum depression and help differentiate between patients with and without depression.

  1. Delivery method and self-reported postpartum general health status among primiparous women.

    PubMed

    Lydon-Rochelle, M T; Holt, V L; Martin, D P

    2001-07-01

    Despite nearly four million deliveries in the United States each year, minimal information exists on unintended health consequences following childbirth, particularly in relation to delivery method. The purpose of this study was to assess the association between method of delivery and the general health status, sexual, bowel and urinary functioning of primiparous women as measured at 7 weeks postpartum. Data from the Statewide Obstetrical Review of Quality System (StORQS) Survey of Maternity Care in Washington State were analysed. Participants included all primiparous women with a delivery of a singleton infant discharged alive between August and December 1991 from 10 non-federal short-stay hospitals who responded to the StORQS Survey of Maternity Care (n = 971). The main outcome measures included the modified Medical Outcomes Study 36-Item Short-Form Health Survey and self-reported sexual, bowel and urinary functioning. At 7 weeks postpartum, women who had caesarean or assisted vaginal deliveries reported significantly lower postpartum general health status scores than women with unassisted vaginal delivery. Additionally, women with assisted vaginal delivery reported significantly worse sexual, bowel and urinary functioning. Our results suggest that more careful attention to the postpartum general health and sexual functioning of women with caesarean and assisted vaginal delivery may be merited.

  2. Effect of propylene glycol on adipose tissue mobilization in postpartum over-conditioned Holstein cows.

    PubMed

    Bjerre-Harpøth, V; Storm, A C; Eslamizad, M; Kuhla, B; Larsen, M

    2015-12-01

    Our objective was to investigate the quantitative and qualitative effects of propylene glycol (PG) allocation on postpartum adipose tissue mobilization in over-conditioned Holstein cows. Nine ruminally cannulated and arterially catheterized cows were, at parturition, randomly assigned to a ruminal pulse dose of either 500g of tap water (n=4) or 500g of PG (n=5) once a day. The PG was given with the morning feeding for 4 wk postpartum (treatment period), followed by a 4-wk follow-up period. All cows were fed the same prepartum and postpartum diets. At -16 (±3), 4 (±0), 15 (±1) and 29 (±2) days in milk (DIM), body composition was determined using the deuterium oxide dilution technique, liver and subcutaneous adipose tissue biopsies were collected, and mammary gland nutrient uptake was measured. Weekly blood samples were obtained during the experiment and daily blood samples were taken from -7 to 7 DIM. Postpartum feed intake and milk yield was not affected by PG allocation. The body content of lipid was not affected by treatment, but tended to decrease from 4 to 29 DIM with both treatments. Except for the first week postpartum, no difference in plasma nonesterified fatty acids concentration was noted between treatments in the treatment period. Yet, PG allocation resulted in decreased plasma concentrations of β-hydroxybutyrate (BHB) and increased plasma concentrations of glucose. In the follow-up period, plasma concentrations of nonesterified fatty acids, glucose, and BHB did not differ between treatments. Additionally, the change in abundance of proteins in adipose tissue biopsies from prepartum to 4 DIM was not affected by treatment. In conclusion, the different variables to assess body fat mobilization were concurrent and showed that a 4-wk postpartum PG allocation had limited effect on adipose tissue mobilization. The main effect was an enhanced glucogenic status with PG. No carry-over effect of PG allocation was recorded for production or plasma metabolites

  3. Incident HIV during Pregnancy and Postpartum and Risk of Mother-to-Child HIV Transmission: A Systematic Review and Meta-Analysis

    PubMed Central

    Drake, Alison L.; Wagner, Anjuli; Richardson, Barbra; John-Stewart, Grace

    2014-01-01

    Background Women may have persistent risk of HIV acquisition during pregnancy and postpartum. Estimating risk of HIV during these periods is important to inform optimal prevention approaches. We performed a systematic review and meta-analysis to estimate maternal HIV incidence during pregnancy/postpartum and to compare mother-to-child HIV transmission (MTCT) risk among women with incident versus chronic infection. Methods and Findings We searched PubMed, Embase, and AIDS-related conference abstracts between January 1, 1980, and October 31, 2013, for articles and abstracts describing HIV acquisition during pregnancy/postpartum. The inclusion criterion was studies with data on recent HIV during pregnancy/postpartum. Random effects models were constructed to pool HIV incidence rates, cumulative HIV incidence, hazard ratios (HRs), or odds ratios (ORs) summarizing the association between pregnancy/postpartum status and HIV incidence, and MTCT risk and rates. Overall, 1,176 studies met the search criteria, of which 78 met the inclusion criterion, and 47 contributed data. Using data from 19 cohorts representing 22,803 total person-years, the pooled HIV incidence rate during pregnancy/postpartum was 3.8/100 person-years (95% CI 3.0–4.6): 4.7/100 person-years during pregnancy and 2.9/100 person-years postpartum (p = 0.18). Pooled cumulative HIV incidence was significantly higher in African than non-African countries (3.6% versus 0.3%, respectively; p<0.001). Risk of HIV was not significantly higher among pregnant (HR 1.3, 95% CI 0.5–2.1) or postpartum women (HR 1.1, 95% CI 0.6–1.6) than among non-pregnant/non-postpartum women in five studies with available data. In African cohorts, MTCT risk was significantly higher among women with incident versus chronic HIV infection in the postpartum period (OR 2.9, 95% CI 2.2–3.9) or in pregnancy/postpartum periods combined (OR 2.3, 95% CI 1.2–4.4). However, the small number of studies limited power to detect associations

  4. Water quality criteria for 2,4,6-trinitrotoluene.

    PubMed

    Ryon, M G; Ross, R H

    1990-04-01

    The occurrence of the munitions compound 2,4,6-trinitrotoluene (TNT) in groundwater and surface water surrounding U.S. Army ammunition plants may result in contamination of local drinking water supplies. TNT exerts its primary toxic effect in humans on the hematologic system and liver, but it is also known to cause gastrointestinal effects and cataracts. Health effects data were analyzed for TNT and although no controlled human studies exist concerning the acute or chronic toxic effects of exposure to TNT, sufficient animal toxicity data are available to derive an ambient water quality criterion for the protection of human health. This paper summarizes the available literature on metabolism and toxicity of TNT in humans and animals. Based on noncarcinogenic mammalian toxicity data, and following the methodologies of the U.S. Environmental Protection Agency, an ambient water quality criterion for the protection of human health of 135 micrograms/liter is proposed when consumption of both contaminated water and fish is anticipated. For drinking water alone, the proposed criterion is 140 micrograms/liter.

  5. Solubility of 2,4,6-trinitrotoluene (TNT) in water

    SciTech Connect

    Ro, K.S.; Venugopal, A.; Adrian, D.D.; Constant, D.; Valsaraj, K.T.; Thibodeaux, L.J.; Qaisi, K.; Roy, D.

    1996-07-01

    Current literature values of 2,4,6-trinitrotoluene (TNT) solubility in water vary widely from 100 to 200 mg/L at room temperature. The authors investigated the effects of temperature and pH on the solubility of both reference TNT and field neat TNT obtained from the Alabama Army Ammunition Plant (AAAP), Childersburg, AL. The TNT solubility determined from this study was significantly lower than that of Taylor and Rinkenbach, which was cited by several reference chemical handbooks and articles. However, the values reported by the Merck Index and the Lange`s Handbook of Chemistry compared well with the authors` values. TNT solubility dropped rapidly as the pH increased. Three unknown HPLC peaks were observed at high pH, indicating a possibility of forming unknown transformation products. Both reference and field neat TNT solubility agreed well. A semiempirical solubility correlation was developed to predict the solubility of TNT at a temperature range from 6 C to 42 C.

  6. Resilience after Hurricane Katrina among pregnant and postpartum women

    PubMed Central

    Harville, Emily W.; Xiong, Xu; Buekens, Pierre; Pridjian, Gabriella; Elkind-Hirsch, Karen

    2010-01-01

    Background Although disaster causes distress, many disaster victims do not develop long-term psychopathology. Others report benefits after traumatic experiences (post-traumatic growth). The objective of this study was to examine demographic and hurricane-related predictors of resilience and post-traumatic growth. Methods 222 pregnant southern Louisiana women were interviewed, and 292 postpartum women completed interviews at delivery and eight weeks later. Resilience was measured by scores lower than a non-affected population, using the Edinburgh Depression Scale and the Post-Traumatic Stress Checklist (PCL). Post-traumatic growth was measured by questions about perceived benefits of the storm. Women were asked about their experience of the hurricane, addressing danger, illness/injury, and damage. Chi-square tests and log-Poisson models were used to calculate associations and relative risks (RR) for demographics, hurricane experience, and mental health resilience and perceived benefit. Findings 35% of pregnant and 34% of the postpartum women were resilient from depression, while 56% and 49% were resilient from post-traumatic stress disorder. Resilience was most likely among white women, older women, and women who had a partner. A greater experience of the storm, particularly injury/illness or danger, was associated with lower resilience. Experiencing damage due to the storm was associated with increased report of some perceived benefits. Conclusions Many pregnant and postpartum women are resilient from the mental health consequences of disaster, and perceive benefits after a traumatic experience. Certain aspects of experiencing disaster reduce resilience, but may increase perceived benefit. PMID:20123173

  7. Uterine involution and progesterone level during the postpartum period in Barbary ewes in north Libya.

    PubMed

    Medan, M S; El-Daek, T

    2015-01-01

    The objectives of the present study were to determine the time of uterine involution and ovarian activity using ultrasound examination and progesterone assay. Weekly progesterone levels were measured starting one week postpartum until two weeks after the 1(st) postpartum estrus in Barbary ewes lambed during winter in AL-Bayda city, north of Libya. A total of 15 Barbary ewes were used in the present study distributed in three groups according to the month of lambing as group 1 (lambed in January), group 2 (lambed in February) and group 3 (lambed in March). Ewes were examined weekly by trans-rectal ultrasound to check involution of the uterus starting one week after lambing until complete uterine involution. Blood samples were collected from the jugular vein, and serum was separated and stored at -20 °C until measuring progesterone using ELISA. Results showed that uterine involution completed at day 35 postpartum in groups 1 and 2, while it occurred at day 28 in group 3. The mean progesterone level was basal (less than 1 ng/ml) for a long period and started to increase at days 119, 99 and 77 postpartum in group 1, 2 and 3, respectively. One ewe did not show estrus at all during the period of study in group 2 and there were no growing follicles on their ovaries. The obtained results indicate that, uterine involution as determined by ultrasound completed earlier in ewes lambed in March than those lambed in February or January. Also, progesterone level and ultrasound examination showed that there was no ovarian activity for a longtime after parturition indicating that reproduction in Barbary ewes tends to be seasonal in AL-Bayda city, north Libya.

  8. Uterine involution and progesterone level during the postpartum period in Barbary ewes in north Libya

    PubMed Central

    Medan, M.S.; EL-Daek, T.

    2015-01-01

    The objectives of the present study were to determine the time of uterine involution and ovarian activity using ultrasound examination and progesterone assay. Weekly progesterone levels were measured starting one week postpartum until two weeks after the 1st postpartum estrus in Barbary ewes lambed during winter in AL-Bayda city, north of Libya. A total of 15 Barbary ewes were used in the present study distributed in three groups according to the month of lambing as group 1 (lambed in January), group 2 (lambed in February) and group 3 (lambed in March). Ewes were examined weekly by trans-rectal ultrasound to check involution of the uterus starting one week after lambing until complete uterine involution. Blood samples were collected from the jugular vein, and serum was separated and stored at -20 °C until measuring progesterone using ELISA. Results showed that uterine involution completed at day 35 postpartum in groups 1 and 2, while it occurred at day 28 in group 3. The mean progesterone level was basal (less than 1 ng/ml) for a long period and started to increase at days 119, 99 and 77 postpartum in group 1, 2 and 3, respectively. One ewe did not show estrus at all during the period of study in group 2 and there were no growing follicles on their ovaries. The obtained results indicate that, uterine involution as determined by ultrasound completed earlier in ewes lambed in March than those lambed in February or January. Also, progesterone level and ultrasound examination showed that there was no ovarian activity for a longtime after parturition indicating that reproduction in Barbary ewes tends to be seasonal in AL-Bayda city, north Libya. PMID:26623357

  9. Postpartum Teens’ Breakfast Consumption is Associated with Snack and Beverage Intake and Body Mass Index

    PubMed Central

    Schwarz, Cynthia; Budd, Elizabeth L; Yount, Byron W; Lapka, Christina

    2010-01-01

    Addressing high risk dietary patterns among postpartum teens may help reduce weight retention and prevent intergenerational obesity. The objective of this study was to describe the relationship between breakfast consumption and outcomes of snack and beverage intake and body mass index (BMI) among postpartum teens. During 2007–2009, 1,330 postpartum teens across 27 states participated in a cross-sectional, baseline assessment of a group-randomized, nested cohort study. Participants were enrolled in the Parents as Teachers Teen Program and completed a seven-day recall of breakfast, snack and beverage consumption. BMI was calculated from heights and weights obtained by on-site staff. Sample descriptives were compared across breakfast consumption frequency groupings by one-way analysis of variance tests or chi-square tests. General Linear Models assessed relationships between breakfast consumption and measures of snack and sweetened beverage intake, water consumption, and BMI-for-age percentile. Almost half (42%) of the sample consumed breakfast fewer than two days per week. Those who ate breakfast six to seven days per week consumed 1,197 fewer calories per week from sweet and salty snacks, 1,337 fewer calories per week from sweetened drinks, and had a lower BMI compared to those who ate breakfast fewer than two days per week (p<.05). Consumption of fruit, vegetables, milk, water and cereal as a snack were higher among regular breakfast consumers (p<.05). While breakfast consumption among postpartum teens is low, those who regularly consume breakfast had healthier snacking behaviors and weight. Interventions are needed to encourage breakfast consumption among teen mothers. PMID:21185974

  10. The Effects of Bromocriptine on Preventing Postpartum Flare in Systemic Lupus Erythematosus Patients from South China

    PubMed Central

    Qian, Qiu; Liuqin, Liang; Hao, Li; Shiwen, Yuan; Zhongping, Zhan; Dongying, Chen; Fan, Lian; Hanshi, Xu; Xiuyan, Yang; Yujin, Ye

    2015-01-01

    Objective. Prolactin plays an important role on the disease flare of postpartum SLE patients. 76 pregnant SLE patients were enrolled in this study to evaluate the efficacy of bromocriptine (an inhibitor of prolactin secretion) on preventing the postpartum disease relapse. Methods. Patients were randomly divided into the treatment group (bromocriptine, 2.5 mg oral, twice a day for 14 days after delivery) and the control group. All the patients were followed up for 12 months. Clinical features were recorded every 4 weeks. Serum prolactin and estradiol levels were measured at the second week and the second month after delivery. The endpoint of the study was disease relapse and defined when SLEDAI score increased by ≥3 points from the antenatal baseline. Results. (1) Serum levels of prolactin and estradiol decreased significantly in bromocriptine treatment group at the second week (P < 0.001) and second month (P < 0.05) after delivery compared to control group. (2) The relapse rate of the treatment group was lower than the control group (χ2 = 4.68, P = 0.0305). Conclusions. Two weeks of oral bromocriptine treatment in postpartum SLE patients may relieve the disease from hyperprolactinemia and hyperestrogenemia and may be beneficial in preventing the patients from disease relapse. PMID:25973434

  11. Postpartum Vascular Dysfunction in the Reduced Uteroplacental Perfusion Model of Preeclampsia

    PubMed Central

    Quon, Anita; Davidge, Sandra T.

    2016-01-01

    Preeclampsia is a disorder affecting 2–8% of all pregnancies, characterized by gestational hypertension (≥ 140/90 mmHg) and proteinuria (≥300 mg over 24 hours) diagnosed following the 20th week of pregnancy, and for which there is currently no available treatment. While the precise cause of preeclampsia is unknown, placental ischemia/hypoxia resulting from abnormal trophoblast invasion and maternal endothelial dysfunction are central characteristics. Preeclampsia is a major cause of both maternal and fetal morbidity and mortality in the perinatal period. In addition, women who have experienced preeclampsia are more likely to suffer cardiovascular disease later in life. The cause of this elevation in cardiovascular risk postpartum, however, is unknown. We hypothesize that there may be lasting vascular dysfunction following exposure to reduced uteroplacental perfusion during pregnancy that may contribute to increased cardiovascular risk postpartum. Using the rat reduced utero-placental perfusion pressure (RUPP) model of preeclampsia, blood pressure was assessed in dams at gestational day 20, one and three months postpartum. Mesenteric artery and aortic function were assessed using wire myography. We demonstrated hypertension and increased mesenteric artery responses to phenylephrine at gestational day 20, with the latter due to a decreased contribution of nitric oxide without any change in methylcholine-induced relaxation. At one month postpartum, we demonstrated a small but significant vasoconstrictive phenotype that was due to an underlying loss of basal nitric oxide contribution. At three months postpartum, endothelium-dependent relaxation of the aorta demonstrated sensitivity to oxLDL and mesenteric arteries demonstrated decreased nitric oxide bioavailability with impaired methylcholine-induced relaxation; indicative of an early development of endothelial dysfunction. In summary, we have demonstrated impaired vascular function following exposure to a RUPP

  12. Prepartum and Postpartum Rumen Fluid Microbiomes: Characterization and Correlation with Production Traits in Dairy Cows

    PubMed Central

    Lima, Fabio S.; Oikonomou, Georgios; Lima, Svetlana F.; Bicalho, Marcela L. S.; Ganda, Erika K.; de Oliveira Filho, Jose C.; Lorenzo, Gustavo; Trojacanec, Plamen

    2014-01-01

    Microbes present in the rumen of dairy cows are essential for degradation of cellulosic and nonstructural carbohydrates of plant origin. The prepartum and postpartum diets of high-producing dairy cows are substantially different, but in what ways the rumen microbiome changes in response and how those changes may influence production traits are not well elucidated. Here, we sequenced the 16S and 18S rRNA genes using the MiSeq platform to characterize the prepartum and postpartum rumen fluid microbiomes in 115 high-producing dairy cows, including both primiparous and multiparous animals. Discriminant analysis identified differences between the microbiomes of prepartum and postpartum samples and between primiparous and multiparous cows. 18S rRNA sequencing revealed an overwhelming dominance of the protozoan class Litostomatea, with over 90% of the eukaryotic microbial population belonging to that group. Additionally, fungi were relatively more prevalent and Litostomatea relatively less prevalent in prepartum samples than in postpartum ones. The core rumen microbiome (common to all samples) consisted of 64 bacterial taxa, of which members of the genus Prevotella were the most prevalent. The Chao1 richness index was greater for prepartum multiparous cows than for postpartum multiparous cows. Multivariable models identified bacterial taxa associated with increased or reduced milk production, and general linear models revealed that a metagenomically based prediction of productivity is highly associated with production of actual milk and milk components. In conclusion, the structure of the rumen fluid microbiome shifts between the prepartum and first-week postpartum periods, and its profile within the context of this study could be used to accurately predict production traits. PMID:25501481

  13. Structural study of 2,4,6-triisopropylbenzenesulfonyl chloride

    SciTech Connect

    Laba, V. I. Sviridova, A. V.; Nesterov, V. N.

    2009-01-15

    The structure of 2,4,6-triisopropylbenzenesulfonyl chloride (TPSCl) (I) was studied by X-ray diffraction. Compound I is a highly selective condensing agent first suggested by Khorana for the formation of the C3'-C5' interribonucleotide linkage in the oligo- and polyribonucleotide synthesis. I crystals are orthorhombic. At -120 deg. C, the unit-cell parameters are a = 14.184(4) A, b = 11.344(5) A, c = 19.883(6) A, V = 3199(2) A{sup 3}, d{sub calc} = 1.257 g/cm{sup 3}, Z = 8, sp. gr. Pbca. Molecule I adopts a strongly flattened boat conformation with the carbon atoms C-SO{sub 2}Cl (C{sub 1}) and C-i-Pr (C4) of the benzene ring deviating from the bottom of the boat by 0.065(1) and 0.032(1) A, respectively. Molecule I is sterically overcrowded, resulting in an increase in the bond lengths and bond-angle distortions in the fragment containing the SO{sub 2}Cl group and two ortho-i-Pr groups. Nonbonded contacts that are present in the molecule can be considered weak intramolecular hydrogen bonds (for example, the (CH{sub 3}){sub 2}C-H-O=S bond). There is no rotation of the SO{sub 2}Cl, ortho-i-Pr, and CH{sub 3} groups. The above-mentioned facts are, apparently, responsible for the specific selectivity of TPSCl. New readily available sterically hindered arenesulfonyl chlorides were designed.

  14. Relationships between insulin-like growth factor-I, milk yield, body condition score, and postpartum luteal activity in high-producing dairy cows.

    PubMed

    Tamadon, Amin; Kafi, Mojtaba; Saeb, Mehdi; Mirzaei, Abdolah; Saeb, Saedeh

    2011-01-01

    The relations between body condition score (BCS), milk yield, serum insulin-like growth factor-I (IGF-I) profile, and luteal activity were investigated in postpartum dairy cows. Seventy-one healthy high-producing multiparous Holstein cows were subjected to transrectal ultrasound scanning twice weekly from the first to the eighth week postpartum. Blood samples were collected twice weekly to measure serum progesterone (P4) and every 2 weeks to detect serum IGF-I concentrations. BCS was monitored weekly after calving. Cows with serum P4 concentrations ≥1 ng/ml on at least two consecutive samplings were considered to have commenced luteal activity. Commencement of luteal activity (C-LA) was observed earlier than 45 days postpartum in 71.8% of cows while 28.2% showed C-LA later than 45 days. Prolonged luteal phase was the most common abnormal pattern of luteal activity observed. Cows with a C-LA earlier than 45 days postpartum had higher (P ≤ 0.05) mean serum concentrations of IGF-I than those with later C-LA. In addition, cows which showed C-LA earlier than 45 days postpartum had more optimal productive indices including shorter calving to conception interval and calving to first service interval (P ≤ 0.05), and fewer services per conception (P = 0.07). C-LA was significantly later in cows that lost more than 0.5 BCS units within 3 weeks postpartum than in those that lost less than 0.5 units BCS during the same interval (P = 0.02). We conclude that high-producing dairy cows with higher postpartum serum IGF-I concentrations have earlier commencement and normal luteal activity, and better reproductive performance. Severity and duration of BCS loss adversely affect commencement of luteal activity.

  15. Investigation of the effect of religious doctrines on religious knowledge and attitude and postpartum blues in primiparous women

    PubMed Central

    Akbarzadeh, Marzieh; Mokhtaryan, Tahereh; Amooee, Sedigheh; Moshfeghy, Zeinab; Zare, Najaf

    2015-01-01

    Background: Postpartum blues is a transient change of moods occurring in the first few days after delivery. The present study aimed to investigate the effect of religious doctrines on postpartum blues in primiparous women. Materials and Methods: In this randomized controlled tria1, 84 primiparous women who had average or weak religious attitude were randomly divided into intervention and control groups. In the intervention group, religious doctrines were instructed from 20th to 28th weeks of gestation through 6 weekly sessions of 60–90 min each. The control group, however, just received the routine care. Spielberger's anxiety scale and the questionnaires assessing religious knowledge and attitude were completed by both groups before, immediately after, and 1–2 months after the intervention. Also, postpartum blues were evaluated by Edinburg Postnatal Depression Scale (EPDS) 10 days after delivery. Then, the data were analyzed using Chi-square, paired t-test, independent t-test, analysis of variance (ANOVA), and Pearson correlation coefficient. Results: The results showed postpartum blues in 59.5% of the study participants. Besides, the results of independent t-test revealed a statistically significant difference between the two groups regarding the mean score of postpartum blues (P = 0.036). Although the intervention group's knowledge and attitude scores were higher than those of the control group, no significant difference was found between the two groups regarding the correlation coefficient between postpartum blues and religious knowledge (P = 0.088) and religious attitude (P = 0.7). Conclusions: The results of the study show that instruction of religious doctrines was effective in increasing the religious knowledge and attitudes and reducing the postpartum blues. PMID:26457094

  16. Factors associated with depressive symptoms in the early postpartum period among women with recent gestational diabetes mellitus.

    PubMed

    Nicklas, Jacinda M; Miller, Laura J; Zera, Chloe A; Davis, Roger B; Levkoff, Sue E; Seely, Ellen W

    2013-11-01

    Women with gestational diabetes mellitus (GDM) have a substantial risk of subsequently developing type 2 diabetes. This risk may be mitigated by engaging in healthy eating, physical activity, and weight loss when indicated. Since postpartum depressive symptoms may impair a woman's ability to engage in lifestyle changes, we sought to identify factors associated with depressive symptoms in the early postpartum period among women with recent GDM. The participants are part of the baseline cohort of the TEAM GDM (Taking Early Action for Mothers with Gestational Diabetes Mellitus) study, a one-year randomized trial of a lifestyle intervention program for women with a recent history of GDM, conducted in Boston, Massachusetts between June 2010 and September 2012. We administered the Edinburgh Postnatal Depression Scale (EPDS) at 4-15 weeks postpartum to women whose most recent pregnancy was complicated by GDM (confirmed by laboratory data or medical record review). An EPDS score ≥9 indicated depressive symptoms. We measured height and thyroid stimulating hormone, and administered a questionnaire to collect demographic data and information about breastfeeding and sleep. We calculated body mass index (BMI) using self-reported pre-pregnancy weight and measured height. We reviewed medical records to obtain data about medical history, including history of depression, mode of delivery, and insulin use during pregnancy. We conducted bivariable analyses to identify correlates of postpartum depressive symptoms, and then modeled the odds of postpartum depressive symptoms using multivariable logistic regression. Our study included 71 women (mean age 33 years ± 5; 59 % White, 28 % African-American, 13 % Asian, with 21 % identifying as Hispanic; mean pre-pregnancy BMI 30 kg/m(2) ± 6). Thirty-four percent of the women scored ≥9 on the EPDS at the postpartum visit. In the best fit model, factors associated with depressive symptoms at 6 weeks postpartum included cesarean

  17. Factors associated with depressive symptoms in the early postpartum period among women with recent gestational diabetes mellitus

    PubMed Central

    Nicklas, Jacinda M; Miller, Laura J; Zera, Chloe A; Davis, Roger B.; Levkoff, Sue E; Seely, Ellen W

    2012-01-01

    Objectives Women with gestational diabetes mellitus (GDM) have a substantial risk of subsequently developing type 2 diabetes. This risk may be mitigated by engaging in healthy eating, physical activity, and weight loss when indicated. Since postpartum depressive symptoms may impair a woman's ability to engage in lifestyle changes, we sought to identify factors associated with depressive symptoms in the early postpartum period among women with recent GDM. Methods The participants are part of the baseline cohort of the TEAM GDM (Taking Early Action for Mothers with Gestational Diabetes Mellitus) study, a one-year randomized trial of a lifestyle intervention program for women with a recent history of GDM, conducted in Boston, Massachusetts between June 2010 and September 2012. We administered the Edinburgh Postnatal Depression Scale (EPDS) at 4-15 weeks postpartum to women whose most recent pregnancy was complicated by GDM (confirmed by laboratory data or medical record review). An EPDS score ≥9 indicated depressive symptoms. We measured height and thyroid stimulating hormone, and administered a questionnaire to collect demographic data and information about breastfeeding and sleep. We calculated body mass index (BMI) using self-reported pre-pregnancy weight and measured height. We reviewed medical records to obtain data about medical history, including history of depression, mode of delivery, and insulin use during pregnancy. We conducted bivariable analyses to identify correlates of postpartum depressive symptoms, and then modeled the odds of postpartum depressive symptoms using multivariable logistic regression. Results Our study included 71 women (mean age 33 years ±5; 59% White, 28% African-American, 13% Asian, with 21% identifying as Hispanic; mean pre-pregnancy BMI 30 kg/m2±6). Thirty-four percent of the women scored ≥9 on the EPDS at the postpartum visit. In the best fit model, factors associated with depressive symptoms at 6 weeks postpartum included

  18. Factors associated with depressive symptoms in the early postpartum period among women with recent gestational diabetes mellitus.

    PubMed

    Nicklas, Jacinda M; Miller, Laura J; Zera, Chloe A; Davis, Roger B; Levkoff, Sue E; Seely, Ellen W

    2013-11-01

    Women with gestational diabetes mellitus (GDM) have a substantial risk of subsequently developing type 2 diabetes. This risk may be mitigated by engaging in healthy eating, physical activity, and weight loss when indicated. Since postpartum depressive symptoms may impair a woman's ability to engage in lifestyle changes, we sought to identify factors associated with depressive symptoms in the early postpartum period among women with recent GDM. The participants are part of the baseline cohort of the TEAM GDM (Taking Early Action for Mothers with Gestational Diabetes Mellitus) study, a one-year randomized trial of a lifestyle intervention program for women with a recent history of GDM, conducted in Boston, Massachusetts between June 2010 and September 2012. We administered the Edinburgh Postnatal Depression Scale (EPDS) at 4-15 weeks postpartum to women whose most recent pregnancy was complicated by GDM (confirmed by laboratory data or medical record review). An EPDS score ≥9 indicated depressive symptoms. We measured height and thyroid stimulating hormone, and administered a questionnaire to collect demographic data and information about breastfeeding and sleep. We calculated body mass index (BMI) using self-reported pre-pregnancy weight and measured height. We reviewed medical records to obtain data about medical history, including history of depression, mode of delivery, and insulin use during pregnancy. We conducted bivariable analyses to identify correlates of postpartum depressive symptoms, and then modeled the odds of postpartum depressive symptoms using multivariable logistic regression. Our study included 71 women (mean age 33 years ± 5; 59 % White, 28 % African-American, 13 % Asian, with 21 % identifying as Hispanic; mean pre-pregnancy BMI 30 kg/m(2) ± 6). Thirty-four percent of the women scored ≥9 on the EPDS at the postpartum visit. In the best fit model, factors associated with depressive symptoms at 6 weeks postpartum included cesarean

  19. Sleep and Sleepiness among First-Time Postpartum Parents: A Field- and Laboratory-Based Multimethod Assessment

    PubMed Central

    Insana, Salvatore P.; Montgomery-Downs, Hawley E.

    2012-01-01

    The study aim was to compare sleep, sleepiness, fatigue, and neurobehavioral performance among first-time mothers and fathers during their early postpartum period. Participants were 21 first-time postpartum mother-father dyads (N=42) and seven childless control dyads (N=14). Within their natural environment, participants completed one week of wrist actigraphy monitoring, along with multi-day self-administered sleepiness, fatigue, and neurobehavioral performance measures. The assessment week was followed by an objective laboratory based test of sleepiness. Mothers obtained more sleep compared to fathers, but mothers’ sleep was more disturbed by awakenings. Fathers had greater objectively measured sleepiness than mothers. Mothers and fathers did not differ on subjectively measured sleep quality, sleepiness, or fatigue; however, mothers had worse neurobehavioral performance than fathers. Compared to control dyads, postpartum parents experienced greater sleep disturbance, sleepiness, and sleepiness associated impairments. Study results inform social policy, postpartum sleep interventions, and research on postpartum family systems and mechanisms that propagate sleepiness. PMID:22553114

  20. Chiropractic management of postpartum pubic symphysis diastasis: A case report.

    PubMed

    Henry, Lucian

    2015-03-01

    This case report describes the chiropractic management of a 30-year-old female patient with severe postpartum pelvic pain secondary to pubic symphysis diastasis. No literature was found on the chiropractic management of postpartum symphysis pubis diastasis. The existing literature concerning chiropractic care for symphysis pubis dysfunction during pregnancy is limited and indicates a potential benefit. Separation of the pubic symphysis may include ligamentous injury to the sacroiliac joints and may lead to chronic pain. Pubic symphysis separation of 17 millimeters was present on digital radiograph. Management consisted of chiropractic adjustments, trigger point release, electrical stimulation, moist heat, sacroiliac belt, and specific stabilizing exercises. The patient's pain improved immediately following treatment on the initial visit. Pain was reduced from 8/10 VAS at the first visit to 2/10 at the fourth visit. She was able to resume normal activities and reached a final pain level of 1/10. The diastasis was reduced by 7 millimeters at 14-weeks post radiograph for a final separation of just under 10 millimeters. Collaboration between obstetricians, midwives and chiropractors may be warranted.

  1. Chiropractic management of postpartum pubic symphysis diastasis: A case report

    PubMed Central

    Henry, Lucian

    2015-01-01

    This case report describes the chiropractic management of a 30-year-old female patient with severe postpartum pelvic pain secondary to pubic symphysis diastasis. No literature was found on the chiropractic management of postpartum symphysis pubis diastasis. The existing literature concerning chiropractic care for symphysis pubis dysfunction during pregnancy is limited and indicates a potential benefit. Separation of the pubic symphysis may include ligamentous injury to the sacroiliac joints and may lead to chronic pain. Pubic symphysis separation of 17 millimeters was present on digital radiograph. Management consisted of chiropractic adjustments, trigger point release, electrical stimulation, moist heat, sacroiliac belt, and specific stabilizing exercises. The patient’s pain improved immediately following treatment on the initial visit. Pain was reduced from 8/10 VAS at the first visit to 2/10 at the fourth visit. She was able to resume normal activities and reached a final pain level of 1/10. The diastasis was reduced by 7 millimeters at 14-weeks post radiograph for a final separation of just under 10 millimeters. Collaboration between obstetricians, midwives and chiropractors may be warranted. PMID:25729083

  2. A long-term follow-up of postpartum thyroiditis.

    PubMed

    Othman, S; Phillips, D I; Parkes, A B; Richards, C J; Harris, B; Fung, H; Darke, C; John, R; Hall, R; Lazarus, J H

    1990-05-01

    To investigate the long-term outcome of postpartum thyroiditis (PPT), 43 patients with PPT and 171 control women were evaluated 3.5 (range 2-4) years postpartum. Ten (23%) PPT patients were hypothyroid compared to none of the controls (P less than 0.001). Factors associated with the development of hypothyroidism were high antimicrosomal antibody titre measured at 16 weeks gestation (P less than 0.01), severity of hypothyroid phase of PPT, multiparity, and a previous history of spontaneous abortion. The presence of microsomal antibody but no PPT in one pregnancy did not prevent the occurrence of PPT in the next pregnancy in two patients and a further five patients had PPT in two successive pregnancies. There was no association between HLA haplotype, family history of thyroid disease, smoking or frequency of oral contraception, and the development of long-term hypothyroidism after PPT. It is concluded that permanent hypothyroidism is an important sequel to PPT and patients with PPT should be followed up appropriately.

  3. Safety and trough concentrations of nevirapine prophylaxis given daily, twice weekly, or weekly in breast-feeding infants from birth to 6 months.

    PubMed

    Shetty, Avinash K; Coovadia, Hoosen M; Mirochnick, Mark M; Maldonado, Yvonne; Mofenson, Lynne M; Eshleman, Susan H; Fleming, Thomas; Emel, Lynda; George, Kathy; Katzenstein, David A; Wells, Jennifer; Maponga, Charles C; Mwatha, Anthony; Jones, Samuel Adeniyi; Abdool Karim, Salim S; Bassett, Mary T

    2003-12-15

    Despite the success of antiretroviral prophylaxis in reducing mother-to-child HIV-1 transmission, postpartum transmission through breast milk remains a problem. Antiretroviral administration to the infant during the period of breast-feeding could protect against postnatal transmission. An open-label phase 1/2 study was designed to assess the safety and trough concentrations of nevirapine (NVP) given once weekly (OW), twice weekly (TW), or once daily (OD) to HIV-exposed breast-feeding infants for 24 weeks. Following maternal dosing with 200 mg NVP orally at onset of labor, breast-feeding infants were randomized within 48 hours of birth to 1 of 3 regimens: arm 1, NVP given OW (4 mg/kg from birth to 14 days, upward arrow to 8 mg/kg from 15 days to 24 weeks), arm 2, NVP given TW (4 mg/kg from birth to 14 days, upward arrow to 8 mg/kg from 15 days to 24 weeks), and arm 3, NVP given OD (2 mg/kg from birth to 14 days, upward arrow to 4 mg/kg from 15 days to 24 weeks). Trough NVP concentrations and clinical and laboratory abnormalities were monitored. Of the 75 infants randomized (26 to OW, 25 to TW, and 24 to OD dosing), 63 completed the 32-week follow-up visit. No severe skin, hepatic, or renal toxicity related to NVP was observed. Neutropenia occurred in 8 infants. Trough NVP levels were lower than the therapeutic target (100 ng/mL) in 48 of 75 (64.0%) samples from infants in the OW arm, 3 of 65 (4.6%) samples in the TW arm, and 0 of 72 samples in the OD arm. Median (range) trough NVP concentrations were 64 ng/mL (range: <25-1519 ng/mL) with OW dosing; 459 (range: <25-1386 ng/mL) with TW dosing; and 1348 (range: 108-4843 ng/ml) with OD dosing. Our data indicate that NVP prophylaxis for 6 months was safe and well tolerated in infants. OD NVP dosing resulted in all infants with trough concentration greater than the therapeutic target and maintenance of high drug concentrations. A phase 3 study is planned to assess the efficacy of OD infant NVP regimen to prevent breast

  4. Biological Degradation of 2,4,6-Trinitrotoluene

    PubMed Central

    Esteve-Núñez, Abraham; Caballero, Antonio; Ramos, Juan L.

    2001-01-01

    Nitroaromatic compounds are xenobiotics that have found multiple applications in the synthesis of foams, pharmaceuticals, pesticides, and explosives. These compounds are toxic and recalcitrant and are degraded relatively slowly in the environment by microorganisms. 2,4,6-Trinitrotoluene (TNT) is the most widely used nitroaromatic compound. Certain strains of Pseudomonas and fungi can use TNT as a nitrogen source through the removal of nitrogen as nitrite from TNT under aerobic conditions and the further reduction of the released nitrite to ammonium, which is incorporated into carbon skeletons. Phanerochaete chrysosporium and other fungi mineralize TNT under ligninolytic conditions by converting it into reduced TNT intermediates, which are excreted to the external milieu, where they are substrates for ligninolytic enzymes. Most if not all aerobic microorganisms reduce TNT to the corresponding amino derivatives via the formation of nitroso and hydroxylamine intermediates. Condensation of the latter compounds yields highly recalcitrant azoxytetranitrotoluenes. Anaerobic microorganisms can also degrade TNT through different pathways. One pathway, found in Desulfovibrio and Clostridium, involves reduction of TNT to triaminotoluene; subsequent steps are still not known. Some Clostridium species may reduce TNT to hydroxylaminodinitrotoluenes, which are then further metabolized. Another pathway has been described in Pseudomonas sp. strain JLR11 and involves nitrite release and further reduction to ammonium, with almost 85% of the N-TNT incorporated as organic N in the cells. It was recently reported that in this strain TNT can serve as a final electron acceptor in respiratory chains and that the reduction of TNT is coupled to ATP synthesis. In this review we also discuss a number of biotechnological applications of bacteria and fungi, including slurry reactors, composting, and land farming, to remove TNT from polluted soils. These treatments have been designed to achieve

  5. Biological degradation of 2,4,6-trinitrotoluene.

    PubMed

    Esteve-Núñez, A; Caballero, A; Ramos, J L

    2001-09-01

    Nitroaromatic compounds are xenobiotics that have found multiple applications in the synthesis of foams, pharmaceuticals, pesticides, and explosives. These compounds are toxic and recalcitrant and are degraded relatively slowly in the environment by microorganisms. 2,4,6-Trinitrotoluene (TNT) is the most widely used nitroaromatic compound. Certain strains of Pseudomonas and fungi can use TNT as a nitrogen source through the removal of nitrogen as nitrite from TNT under aerobic conditions and the further reduction of the released nitrite to ammonium, which is incorporated into carbon skeletons. Phanerochaete chrysosporium and other fungi mineralize TNT under ligninolytic conditions by converting it into reduced TNT intermediates, which are excreted to the external milieu, where they are substrates for ligninolytic enzymes. Most if not all aerobic microorganisms reduce TNT to the corresponding amino derivatives via the formation of nitroso and hydroxylamine intermediates. Condensation of the latter compounds yields highly recalcitrant azoxytetranitrotoluenes. Anaerobic microorganisms can also degrade TNT through different pathways. One pathway, found in Desulfovibrio and Clostridium, involves reduction of TNT to triaminotoluene; subsequent steps are still not known. Some Clostridium species may reduce TNT to hydroxylaminodinitrotoluenes, which are then further metabolized. Another pathway has been described in Pseudomonas sp. strain JLR11 and involves nitrite release and further reduction to ammonium, with almost 85% of the N-TNT incorporated as organic N in the cells. It was recently reported that in this strain TNT can serve as a final electron acceptor in respiratory chains and that the reduction of TNT is coupled to ATP synthesis. In this review we also discuss a number of biotechnological applications of bacteria and fungi, including slurry reactors, composting, and land farming, to remove TNT from polluted soils. These treatments have been designed to achieve

  6. Lying behavior and postpartum health status in grazing dairy cows.

    PubMed

    Sepúlveda-Varas, P; Weary, D M; von Keyserlingk, M A G

    2014-10-01

    Many cows have difficulty making the transition from pregnancy to lactation, as evidenced by the high incidence of disease that occurs in the weeks after calving. Changes in lying behavior can be used as an indicator of illness, yet no work to date has evaluated this relationship in dairy cows on pasture. The objectives of this study were to describe the lying behavior of grazing dairy cows during the first 3 wk after calving and determine the relationships between transition diseases and lying behavior. Our convenience sample included 227 multiparous and 47 primiparous Holstein cows from 6 commercial farms. Cows were recruited as they calved during the spring calving period. Electronic data loggers (Hobo Pendant G Acceleration, Onset Computer Corp., Pocasset, MA) recorded lying behavior at 1-min intervals. Diseases were recorded up to 21 d in milk, and cows were subsequently categorized into 3 health categories: (1) healthy, not lame and had no other signs of clinical (retained placenta, milk fever, metritis, mastitis) or subclinical (ketosis, hypocalcemia) postpartum diseases; (2) lame, identified as being clinically or severely lame with no other signs of clinical or subclinical postpartum disease; and (3) sick, diagnosed as having one or more clinical postpartum diseases (with or without a subclinical disease) but not lame. This last group was further divided into 2 groups: those that were diagnosed with a single clinical health event and those diagnosed with more than one clinical event. Lying behavior differed between primiparous and multiparous cows; primiparous cows divided their lying time into more bouts than did multiparous cows (9.7 ± 0.54 vs. 8.4 ± 0.26 bouts/d) and spent less time lying down than multiparous cows (7.5 ± 0.38 h/d vs. 8.5 ± 0.19 h/d). Lying behavior was also affected by illness; primiparous cows that developed more than one clinical disease, excluding lameness, spent more time lying, and tended to have longer lying bouts in the days

  7. Postpartum IUCD: Rediscovering a Languishing Innovation.

    PubMed

    Balsarkar, Geetha Dharmesh; Nayak, Arun

    2015-07-01

    The National Family Planning Programme of India, since its inception in 1951, has been able to successfully achieve significant reductions in maternal mortality and fertility. Over the past decade, the need for contraception has changed dramatically in India. Couples no longer desire sterilization, but prefer modern reversible long-term methods of contraception. The ideal time to discuss contraception is in the antenatal period when there is a good rapport between the doctor and the patient. The window period when the patient is admitted in the hospital during delivery can be used effectively to offer postpartum contraception. It has been found that the highest chance of unwanted pregnancy is in the first year after delivery, when women do not report to the doctor if this window period is missed. Postpartum intrauterine contraceptive devices are ideal for a country like India and it can be used to cover the unmet need of contraception if inserted immediately after delivery. There are two types of insertion: post placental, within 10 min of delivery of placenta and postpartum, within 48 h of delivery. Although there is a greater chance of expulsion in the postpartum insertions, it can be significantly reduced with proper training and user experience. Postpartum IUCD should be routinely offered to all patients delivering in institutions to provide complete care to a parturient and to achieve safe motherhood. PMID:26243985

  8. Case Report: Postpartum Cough and Dyspnea.

    PubMed

    Czerwinski, Eileen M

    2016-01-01

    Peripartum/postpartum cardiomyopathy (PPCM) is a rare condition associated with pregnancy in which there is left ventricular (LV) dysfunction resulting in symptoms of heart failure (). This occurs in previously healthy women and is seen in the last month of pregnancy or during the first 5 months postpartum (). Incidence ranges from 1 in 1,300 to 1 in 15,000 pregnancies in the United States (). A case study is presented of a patient with severe impairment of LV function seen in the emergency department (ED). The ED is a common location for initial presentation; therefore, the ED provider should be cognizant of key features of PPCM. The differential diagnosis and medical management of PPCM are discussed. Emergency department management should focus on 3 key elements: an increase in inotropy and a reduction in preload and afterload. Differences between postpartum and peripartum states are outlined. PMID:27482991

  9. Antenatal Cognitive-behavioral Therapy for Prevention of Postpartum Depression: A Pilot Study

    PubMed Central

    Kwon, Jung Hye; Lee, Jeong Jae

    2008-01-01

    Purpose To examine the efficacy of cognitive-behavioral therapy (CBT) for the prevention of postpartum depression (PPD) in "at risk" women. Materials and Methods We recruited 927 pregnant women in 6 obstetric and gynecology clinics and screened them using Beck Depression Inventory (BDI). Ninety-nine of the screened women who had significantly high scores in BDI (a score above 16) were selected for the study. They were contacted through by telephone, and 27 who had consented to participate in the study were interviewed via SCID-IV-I. Twenty-seven eligible women were randomly assigned to the CBT intervention (n = 15) and control condition (n = 12). All participants were required to complete written questionnaires, assessing demographic characteristics, depressive symptoms, negative thoughts, dyadic communication satisfaction, and global marital satisfaction prior to treatment and approximately 1 month postpartum. The 15 women in the CBT condition received 9 bi-weekly 1-hour individual CBT sessions, targeting and modifying negative patterns of thinking and behaviors occurring in the context of the dyadic relationship. Results The analysis of covariance (ANCOVA) showed that there were significant differences in all postpartum measures between the 2 groups, indicating that our antenatal intervention with CBT was effective in reducing depressive symptoms and improving marital satisfaction, which lasted until the postpartum period. Conclusion Our pilot study has provided preliminary empirical evidence that antenatal CBT intervention can be an effective preventive treatment for PPD. Further study in this direction was suggested. PMID:18729297

  10. Post-partum hemorrhage in women with rare bleeding disorders.

    PubMed

    Peyvandi, Flora; Menegatti, Marzia; Siboni, Simona Maria

    2011-02-01

    Post-partum hemorrhage (PPH) accounts for a substantial fraction of maternal deaths in the general population. Among all women, however, those affected with rare bleeding disorders (RBDs) represent a particular group since to usual bleeding symptoms, they are likely to experience bleedings associated to obstetrical and gynaecological problems. Pregnancy and childbirth, two important stages in the life of a woman, pose a special clinical challenge in women with RBDs, since information about these issues are really scarce and limited to few case reports. These data show that all women with RBDs, except for FXI deficiency, have to be considered potentially at risk for developing PPH, therefore they should be monitored carefully during and immediately after pregnancy. The implication is that women with bleeding disorders may require prophylaxis and/or close observation for several weeks and should be followed by a multidisciplinary team including expertises such as laboratory haematologist, obstetrician-gynaecologist, anaesthesiologist, family physician, and laboratory technician.

  11. A Randomized Controlled Trial of Innovative Postpartum Care Model for Mother-Baby Dyads

    PubMed Central

    Laliberté, Corinne; Dunn, Sandra; Pound, Catherine; Sourial, Nadia; Yasseen, Abdool S.; Millar, David; Rennicks White, Ruth; Walker, Mark; Lacaze-Masmonteil, Thierry

    2016-01-01

    Objective To evaluate the efficacy, safety, and maternal satisfaction of a newly established integrative postpartum community-based clinic providing comprehensive support for mothers during the first month after discharge from the hospital. Our primary interests were breastfeeding rates, readmission and patient satisfaction. Methods A randomized controlled trial was conducted in Ottawa, Canada, where 472 mothers were randomized via a 1:2 ratio to either receive standard of care (n = 157) or to attend the postpartum breastfeeding clinic (n = 315). Outcome data were captured through questionnaires completed by the participants at 2, 4, 12 and 24 weeks postpartum. Unadjusted and adjusted logistic regression models were conducted to determine the effect of the intervention on exclusive breastfeeding at 12 weeks (primary outcome). Secondary outcomes included breastfeeding rate at 2, 4 and 24 weeks, breastfeeding self-efficacy scale, readmission rate, and satisfaction score. Results More mothers in the intervention group (n = 195, 66.1%) were exclusively breastfeeding at 12 weeks compared to mothers in the control group (n = 81, 60.5%), however no statistically significant difference was observed (OR = 1.28; 95% CI:0.84–1.95)). The rate of emergency room visits at 2 weeks for the intervention group was 11.4% compared to the standard of care group (15.2%) (OR = 0.69; 95% CI: 0.39–1.23). The intervention group was significantly more satisfied with the overall care they received for breastfeeding compared to the control group (OR = 1.96; 95% CI: 3.50–6.88)). Conclusion This new model of care did not significantly increase exclusive breastfeeding at 12 weeks. However, there were clinically meaningful improvements in the rate of postnatal problems and satisfaction that support this new service delivery model for postpartum care. A community-based multidisciplinary postpartum clinic is feasible to implement and can provide appropriate and highly satisfactory care to

  12. Behavioral and Pharmacological Investigation of Anxiety and Maternal Responsiveness of Postpartum Female Rats in a Pup Elevated Plus Maze

    PubMed Central

    Yang, Yu; Qin, Jingxue; Chen, Weihai; Sui, Nan; Chen, Hong; Li, Ming

    2015-01-01

    The present study investigated the validity of a novel pup-based repeated elevated plus maze task to detect reduced anxiety and increased maternal responsiveness in postpartum female rats and explored the roles of dopamine D2, serotonin transporter and GABA/benzodiazepine receptors in the mediation of these processes. Sprague-Dawley postpartum or nulliparous female rats were tested 4 times every other day on postpartum days 4, 6 and 8 in an elevated plus maze with 4 pups or 4 pup-size erasers placed on each end of the two open arms. When tested with erasers, untreated postpartum mother rats entered the open arms proportionally more than nulliparous rats. They also tended to spend more time in the open arms, indicating reduced anxiety. When tested with pups, postpartum rats retrieved pups into the closed arms, entered the open arms and closed arms more and had a higher moving speed than nulliparous rats, indicating increased maternal responsiveness. Both haloperidol (0.1 or 0.2 mg/kg, sc) and fluoxetine (5 or 10 mg/kg, ip) dose- and time-dependently decreased the percentage of time spent in the open arms and speed, but did not affect the percentage of open arm entries. Diazepam (1.0 or 2.0 mg/kg, ip) did not affect pup retrieval, open arm time/entry in lactating rats. Thus, the percentage of open arm entries appears to be the most sensitive measure of anxiety in postpartum female rats, while speed could be used to index maternal responsiveness to pups, which are likely mediated by the dopamine D2 and serotonin transporter systems. PMID:26159828

  13. Thyroid peroxidase antibodies in early pregnancy: utility for prediction of postpartum thyroid dysfunction and implications for screening.

    PubMed

    Premawardhana, L D K E; Parkes, A B; John, R; Harris, B; Lazarus, J H

    2004-08-01

    Thyroid peroxidase antibodies (TPOAb) in pregnancy are a marker for postpartum (PPTD) and long-term thyroid dysfunction, with variable sensitivity and specificity in PPTD prediction. To test its utility in prediction, we recruited 308 TPOAb-positive (147 developed PPTD (PPTD group) and 161 remained euthyroid [PPTE group]) and 102 TPOAb-negative women (none developed PPTD), in early pregnancy (median, 18; range, 9-19 weeks' gestation). TPOAb levels were higher in the PPTD group (median) (125.2 kIU/L; p < 0.001), and in its hypothyroid (162.4 kIU.; p < 0.0001), hyperthyroid (114.2 kIU/L; p < 0.007), and biphasic (105.1 kIU/L; p < 0.02) variants, compared to the PPTE group (66.7 kIU/L) The incidence of PPTD was significantly higher with TPOAb levels above 58.2 kIU/L (early pregnancy versus postpartum; relative risk, 1.37 [95% confidence interval [CI] 1.17-1.61] versus 0.78 [95% CI 0.5-1.2]) compared to levels below. The integrated postpartum TPOAb response was higher in the PPTD group (median) (159 kIU/L per week) and its variants (hypothyroid; 199 kIU/L per week; biphasic, 180 kIU/L per week; hyperthyroid, 120 kIU/L per week), compared to the PPTE group (86 kIU/L per week p < 0.004). Median early pregnancy TPOAb levels in the PPTD and PPTE groups correlated well with the postpartum antibody response (r = 0.58, p < 0.001). The sensitivity of TPOAb in PPTD prediction was 100% (early pregnancy and postpartum), specificity 62% (early pregnancy) versus 41% (postpartum) and positive predictive value 48% (early pregnancy and postpartum). The timing of TPOAb testing, the sensitive assay used and the absence of PPTD in TPOAb-negative subjects contributed to this high sensitivity. We recommend TPOAb in early pregnancy as a useful predictor of PPTD, particularly in populations where PPTD does not occur in TPOAb-negative women.

  14. Reducing Postpartum Depressive Symptoms Among Black and Latina Mothers: A Randomized Controlled Trial

    PubMed Central

    Howell, Elizabeth A; Balbierz, Amy; Wang, Jason; Parides, Michael; Zlotnick, Caron; Leventhal, Howard

    2012-01-01

    OBJECTIVE To estimate the effectiveness of a behavioral educational intervention to reduce postpartum depressive symptoms among minority mothers. METHODS We recruited 540 self-identified black or African American and Latina or Hispanic mothers during their postpartum hospital stay and randomized them to receive a behavioral educational intervention or enhanced usual care. The intervention arm received a two-step behavioral educational intervention that prepares and educates mothers about modifiable factors associated with symptoms of postpartum depression (physical symptoms, low social support, low self-efficacy, and infant factors), bolsters social support, enhances management skills, and increases participants’ access to resources. Enhanced usual care participants received a list of community resources and received a 2-week control call. Participants were surveyed prior to randomization, 3-weeks, 3-months, and 6-months later to assess depressive symptoms. The primary outcome, depression, was assessed using the Edinburgh Postnatal Depression Scale (score of 10 or greater). RESULTS Positive depression screens were less common among intervention vs. enhanced usual care post-hospitalization: 3-weeks (8.8% vs. 15.3%, p=.03), 3-months (8.4% vs. 13.24%, p=.09) and 6-months (8.9% vs.13.7%, p=.11). An intention-to-treat repeated measures analysis for up to 6 months of follow-up demonstrated that mothers in the intervention group were less likely to screen positive for depression versus enhanced usual care (odds ratio of 0.67; 95% confidence interval [CI] 0.47–0.97; number needed to treat, 16; 95% CI: 9–112) CONCLUSION An action oriented behavioral educational intervention reduced positive depression screens among black and Latina postpartum mothers. PMID:22488220

  15. Uterine artery embolization for primary postpartum hemorrhage

    PubMed Central

    Kim, Tae-Hee; Lee, Hae-Hyeog; Kim, Jun-Mo; Ryu, Ae-Li; Chung, Soo-Ho; Seok Lee, Woo

    2013-01-01

    Background: Postpartum hemorrhage is the leading cause of severe maternal morbidity and death. A prompt management of uterine artery embolization (UAE) is important for a good outcome. UAE is generally accepted to be a safe and reliable procedure. Objective: To estimate critical patient characteristics influencing the success of UAE for the treatment of emergent primary postpartum hemorrhage. Materials and Methods: This was a cross sectional study that reviewed 121 patients who were diagnosed primary postpartum hemorrhage between February 2002 and December 2009 at a tertiary treatment center among 4,022 deliveries. We evaluated patient clinical characteristics associated with a successful surgical outcome of UAE. Results: The success rate for UAE was 96%. For two cases, UAE complication was associated with fever (>38.5oC). Five patients had problems that required admission to the intensive care unit (ICU). Conclusion: To increase the surgical success rate and lower the number of ICU admissions, the decision to treat primary postpartum hemorrhage using UAE should be based on individual patient clinical findings under the direction of obstetrics staff and an interventional radiologist. PMID:24639786

  16. Postpartum depression among women with unintended pregnancy

    PubMed Central

    Brito, Cynthia Nunes de Oliveira; Alves, Sandra Valongueiro; Ludermir, Ana Bernarda; de Araújo, Thália Velho Barreto

    2015-01-01

    OBJECTIVE To analyze the association between unintended pregnancy and postpartum depression. METHODS This is a prospective cohort study conducted with 1,121 pregnant aged 18 to 49 years, who attended the prenatal program devised by the Brazilian Family Health Strategy, Recife, PE, Northeastern Brazil, between July 2005 and December 2006. We interviewed 1,121 women during pregnancy and 1,057 after childbirth. Unintended pregnancy was evaluated during the first interview and postpartum depression symptoms were assessed using the Edinburgh Postnatal Depression Screening Scale. The crude and adjusted odds ratios for the studied association were estimated using logistic regression analysis. RESULTS The frequency for unintended pregnancy was 60.2%; 25.9% presented postpartum depression symptoms. Those who had unintended pregnancies had a higher likelihood of presenting this symptoms, even after adjusting for confounding variables (OR = 1.48; 95%CI 1.09;2.01). When the Self Reporting Questionnaire (SRQ-20) variable was included, the association decreased, however, remained statistically significant (OR = 1.42; 95%CI 1.03;1.97). CONCLUSIONS Unintended pregnancy showed association with subsequent postpartum depressive symptoms. This suggests that high values in Edinburgh Postnatal Depression Screening Scale may result from unintended pregnancy. PMID:26083941

  17. Barriers to completion of desired postpartum sterilization.

    PubMed

    Boardman, Lori A; DeSimone, Michael; Allen, Rebecca H

    2013-02-01

    Tubal sterilization is a highly effective, permanent, and safe method of contraception. Many women who desire postpartum sterilization do not obtain the procedure due to barriers. We performed a retrospective cohort study examining patients from a single obstetrics practice who delivered between 1/1/07 and 6/30/07 at Women and Infants Hospital in Providence, RI. During the study period, 626 women in the practice delivered. Of these subjects, 87 (14%) desired postpartum sterilization. Of these 87, 45 (51.7%) underwent sterilization as planned. In multivariable analysis controlling for age, BMI, delivery mode and marital status, older age (OR 2.15, 95% CI 1.12, 4.12, p=0.02) and cesarean delivery (OR 19.65, 95% CI 3.75, 103.1, p < 0.001) were associated with completion of postpartum sterilization and being married (OR 0.10, 95% CI 0.02, 0.56, p=0.009) and having a higher BMI (OR 0.60, 95% CI 0.39, 0.91, p=0.02) were associated with incompletion. Only half of women who request postpartum sterilization antenatally end up obtaining the procedure.

  18. Exercise prescription for overweight and obese women: pregnancy and postpartum.

    PubMed

    Mottola, Michelle F

    2009-06-01

    Once a low-risk pregnancy has been established, walking in combination with nutritional control may be effective in preventing excessive weight gain in overweight and obese women. Maternal exercise prescription should use the Frequency, Intensity, Time spent and Type of exercise principle, with a frequency of three to four sessions per week as ideal. Intensity based on a target heart-rate zone of 110 to 131 beats per minute for women 20 to 29 years of age and 108 to 127 beats per minute for women 30 to 39 years of age, coupled with use of the rating of perceived exertion scale and the "Talk Test" is suggested. Dieting and exercise together are most effective in reducing weight retention after childbirth and compliance may be improved by incorporating child-care and children into the exercise routine. After medical consultation, postpartum women should begin exercise slowly, starting from 15 minutes, and building to at least 150 minutes of aerobic activity per week, with this activity spread throughout the week.

  19. Relationships between thyroid hormones and serum energy metabolites with different patterns of postpartum luteal activity in high-producing dairy cows.

    PubMed

    Kafi, M; Tamadon, A; Saeb, M; Mirzaei, A; Ansari-Lari, M

    2012-08-01

    This study investigated the relationships of thyroid hormones, serum energy metabolites, reproductive parameters, milk yield and body condition score with the different patterns of postpartum luteal activity in the postpartum period. A total of 75 multiparous healthy (free of detectable reproductive disorders) Holstein dairy cows (mean peak milk yield = 56.5 ± 7.0 kg/day) were used in this study. Transrectal ultrasound scanning and blood sample collection were performed twice weekly. Serum concentrations of progesterone (P4) were measured twice weekly and beta-hydroxybutyrate (BHBA), non-esterified fatty acids, thyroxine (T4), 3,30,5-tri-iodothyronine (T3), free thyroxine (fT4) and free 3,30,5-tri-iodothyronine (fT3) were measured every 2 weeks from the 1st to the 8th week postpartum. On the basis of the serum P4 profile of the cows, 25 (33.4%) had normal luteal activity (NLA), whereas 30 (40%), 10 (13.3%), 6 (8%) and 4 (5.3%) had prolonged luteal phase (PLP), delayed first ovulation (DOV), anovulation (AOV) and short luteal phase, respectively. Serum T4 concentrations in PLP cows were higher than that in NLA cows at the 3rd week postpartum and did not change during the period of study, whereas in the NLA cows the concentrations increased (P < 0.05). Further, the least square (LS) mean of serum fT4 concentrations in the DOV and AOV cows were significantly lower than in the NLA cows during the study period (P < 0.05). In addition, the AOV cows had higher LS mean serum BHBA and T4 concentrations than the NLA cows in early weeks postpartum (P < 0.05). In conclusion, the serum thyroid hormones' profile differs in high-producing dairy cows showing PLP, AOV and DOV in comparison with the postpartum NLA cows.

  20. The Postpartum Depressive State in Relation to Perceived Rearing: A Prospective Cohort Study

    PubMed Central

    Okada, Takashi; Murase, Satomi; Aleksic, Branko; Furumura, Kaori; Shiino, Tomoko; Nakamura, Yukako; Tamaji, Ai; Ishikawa, Naoko; Ohoka, Harue; Usui, Hinako; Banno, Naomi; Morita, Tokiko; Goto, Setsuko; Kanai, Atsuko; Masuda, Tomoko; Ozaki, Norio

    2012-01-01

    Background The relationship between perceived rearing and the postpartum depressive state remains unclear. We aimed to examine whether perceived rearing is a risk factor for postpartum depression as measured by the Edinburgh Postnatal Depression Scale (EPDS), and whether the score of perceived rearing is affected by depressive mood (the state dependency of perceived rearing). Methods Pregnant women (n = 448, mean age 31.8±4.2 years) completed the EPDS as a measure of depressive state in early pregnancy (T1), late pregnancy (around 36 weeks), and at 1 month postpartum (T2), and the Parental Bonding Instrument (PBI) at T1 as a measure of perceived rearing. Changes in the EPDS and the PBI scores from T1 to T2 were compared between the non depressive (ND) group and the postpartum depressive (PD) group. Results There were no significant differences in any PBI category for perceived rearing between the ND and PD groups at T1. EPDS scores did not change significantly from T1 to T2 in the ND group but increased significantly in the PD group. The PBI maternal care score increased significantly in the ND group (p<0.01), while decreasing in the PD group (p<0.05). Additionally, in both the ND and PD groups, significant negative correlation was observed regarding change in the EPDS and PBI maternal care scores from T1 to T2 (r = −0.28, p = 0.013). Conclusions The present study suggests that perceived rearing is not a strong risk factor for postpartum depression as measured by the EPDS. Furthermore, the results indicated the state dependency of the PBI maternal care score. PMID:23185582

  1. Pharmacokinetics of Tenofovir During Pregnancy and Postpartum

    PubMed Central

    Best, Brookie M.; Burchett, Sandra; Li, Hong; Stek, Alice; Hu, Chengcheng; Wang, Jiajia; Hawkins, Elizabeth; Byroads, Mark; Watts, D. Heather; Smith, Elizabeth; Fletcher, Courtney V.; Capparelli, Edmund V.; Mirochnick, Mark

    2016-01-01

    Objectives Tenofovir disoproxol fumarate (TDF) is increasingly used in HAART regimens of pregnant women, but limited data exist on pregnancy pharmacokinetics of chronically-dosed TDF. This study described tenofovir pharmacokinetics during pregnancy and postpartum. Methods IMPAACT P1026s is a prospective, non-blinded pharmacokinetic study of HIV-infected pregnant women that included a cohort receiving 300 mg TDF once daily. Steady-state 24-hour pharmacokinetic profiles were measured at 2nd and 3rd trimester and postpartum, with maternal and umbilical cord samples at delivery. Tenofovir was measured by LC-MS. The target AUC was ≥ 1.99 mcg•hr/mL (non-pregnant historical control 10th percentile). Results Median tenofovir AUC was decreased during the 2nd (1.9 mcg•hr/mL) and 3rd (2.4 mcg•hr/mL, p=0.005) trimesters versus postpartum (3.0 mcg•hr/mL). Tenofovir AUC exceeded the target for 2/4 (50%) 2nd trimester; 27/37 (73%; 95% CI: 56%, 86%) 3rd trimester; and 27/32 (84%; 95% CI: 67%, 95%) postpartum women (p>0.05). Median 2nd/3rd trimester troughs were lower (39/54 ng/mL) than postpartum (61 ng/mL). Median 3rd trimester weight was heavier for subjects below target AUC versus those above target (97.9 vs. 74.2 kg, p = 0.006). Median ratio of cord blood to maternal concentrations was 0.88. No infants were HIV infected. Conclusions This study found lower tenofovir AUC and troughs during pregnancy. Transplacental passage with chronic TDF use during pregnancy was high. Standard TDF doses appear appropriate for most HIV-infected pregnant women but therapeutic drug monitoring with dose adjustment should be considered in pregnant women with high weight (> 90kg) or inadequate HIV RNA response. PMID:25959631

  2. Postpartum von Willebrand factor levels in women with and without von Willebrand disease and implications for prophylaxis.

    PubMed

    James, A H; Konkle, B A; Kouides, P; Ragni, M V; Thames, B; Gupta, S; Sood, S; Fletcher, S K; Philipp, C S

    2015-01-01

    The aim of this study was to elucidate the fall in von Willebrand factor (VWF) and factor VIII activity (FVIII) after childbirth in women with and without von Willebrand disease (VWD). VWF:RCo, VWF:Ag, and FVIII were obtained in the third trimester of pregnancy, on admission for childbirth, and 10 times postpartum. Specimens were processed within 4 h and analysed centrally. Means were calculated at each time point. Forty women (40 pregnancies) without VWD and 32 women (35 pregnancies) with VWD were enrolled. 15/32 with VWD were treated (30% of those with type 1 and all of those with type 2) in 17 pregnancies. Treatments prior to delivery consisted of desmopressin (2/17), VWF concentrate (15/17) and after delivery VWF concentrate (16/17). Duration of treatment was 0-21 days (median 6). VWF levels peaked at 250% of baseline--4 h postpartum in women with VWD and 12 h postpartum in women without VWD. Thereafter, VWF levels fell rapidly, approached baseline at 1 week and reached baseline at 3 weeks. Except immediately postpartum, when the levels among treated cases were higher, levels among women with VWD appeared to parallel, but were lower than those among women without VWD. Levels were lowest among those who received treatment. VWF levels fall rapidly after childbirth. Except immediately postpartum, current treatment strategies do not raise VWF levels to the levels of women without VWD or even to the levels of women with milder, untreated VWD. Consequently, women with VWD may be at risk of postpartum haemorrhage despite treatment.

  3. The Prevalence and Risk Factors of Paternal Depression from the Antenatal to the Postpartum Period and the Relationships between Antenatal and Postpartum Depression among Fathers in Hong Kong

    PubMed Central

    Koh, Y. W.; Chui, C. Y.; Tang, C. S. K.; Lee, A. M.

    2014-01-01

    Introduction. Despite the fact that maternal perinatal mental health problems have been extensively studied and addressed to be a significant health problem, the literature on paternal perinatal mental health problems is relatively scarce. The present study aims at determining the prevalence of paternal perinatal depression and identifying the risk factors and the relationship between antenatal and postpartum depression. Methodology. 622 expectant fathers were recruited from regional maternal clinics. The expectant fathers were assessed using standardized and validated psychological instruments on 3 time points including early pregnancy, late pregnancy, and six weeks postpartum. Results. Results showed that a significant proportion of expectant fathers manifested depressive symptoms during the perinatal period. Paternal antenatal depression could significantly predict higher level of paternal postpartum depression. Psychosocial risk factors were consistently associated with paternal depression in different time points. Conclusions. The present study points to the need for greater research and clinical attention to paternal depression given that it is a highly prevalent problem and could be detrimental to their spouse and children development. The present findings contribute to theoretical basis of the prevalence and risk factors of paternal perinatal depression and have implications of the design of effective identification, prevention, and interventions of these clinical problems. PMID:24600517

  4. Factors related to prediabetes among postpartum Thai women with a history of gestational diabetes mellitus.

    PubMed

    Youngwanichsetha, Sununta; Phumdoung, Sasitorn

    2013-12-01

    Women with a history of gestational diabetes mellitus are at risk of developing prediabetes. Using a cross-sectional analytic design, the factors related to prediabetes among Thai women (n = 210) with a history of gestational diabetes mellitus were investigated. The main outcomes measured were two-hour plasma glucose after taking a 75 g oral glucose tolerance test at a six week postpartum visit. Data were analyzed using descriptive statistics and Pearson's correlation. The study showed that the incidence of prediabetes among postpartum Thai women was 26.67%. Factors associated with prediabetes were: (i) being over 35 years of age; (ii) three or more pregnancies; (iii) recurrent gestational diabetes mellitus; (iv) high plasma glucose before taking a 100 g glucose tolerance test and high postprandial plasma glucose during pregnancy; and (v) being overweight or obese at six weeks' postpartum. The results showed that nursing interventions need to be implemented to reduce plasma glucose and body mass index in order to prevent or reverse prediabetes.

  5. Psychiatric Morbidity and Correlates in Postpartum Women in a Tertiary Care Hospital

    PubMed Central

    Kumar, Narendra; Nagaraj, Anil Kumar Mysore; Koudike, Umashree; Majgi, Sumanth Mallikarjuna

    2016-01-01

    Background: A range of psychological disorders occur in women in the postpartum period apart from the traditional blues, postpartum depression and psychosis. These include obsession of infanticide, PTSD, morbid preoccupations regarding child birth and disorders of mother-infant relationships, though they are under emphasized. Methods: it is a cross-sectional study conducted in the tertiary maternity care hospital. A total of 152 study subjects were interviewed on MINI (Mini International Neuropsychiatric Inventory) and GAF (Global Assessment of Functioning) within 2 weeks after delivery. Results: The psychiatric morbidity was seen in 67 (44%) of the study subjects. About 26% of subjects had Depressive disorder NOS. Obsessive harm to the child, Panic disorder, Social phobia were the other disorders identified. There were no cases of Mania, Bipolar disorder, psychosis, post traumatic stress disorder or substance use disorder diagnosed across the sample. The Global Assessment of Functioning (GAF) score averaged 87.8. Statistically significant association was seen to be present between psychiatric illness and number of previous still births and dead children before this delivery (P = 0.045). Conclusions: The study reveals that psychiatric co-morbidity is very common in the postpartum period and can be detected as early as first week after delivery. Social phobia identified as a common association is a new finding and needs further replication. It needs a larger sample with a prospective assessment to generalize the findings of our study. PMID:27570341

  6. Effects of repetitive transcranial magnetic stimulation on clinical, social, and cognitive performance in postpartum depression

    PubMed Central

    Myczkowski, Martin Luiz; Dias, Álvaro Machado; Luvisotto, Tatiana; Arnaut, Debora; Bellini, Bianca Boura; Mansur, Carlos Gustavo; Rennó, Joel; Tortella, Gabriel; Ribeiro, Philip Leite; Marcolin, Marco Antônio

    2012-01-01

    Background: This randomized, placebo-controlled, double-blind pilot study evaluated the impact of repetitive transcranial magnetic stimulation (rTMS) on clinical, cognitive, and social performance in women suffering with postpartum depression. Methods: Fourteen patients were randomized to receive 20 sessions of sham rTMS or active 5 Hz rTMS over the left dorsolateral prefrontal cortex. Psychiatric clinical scales and a neuropsychological battery were applied at baseline (pretreatment), week 4 (end of treatment), and week 6 (follow-up, posttreatment week 2). Results: The active rTMS group showed significant improvement 2 weeks after the end of rTMS treatment (week 6) in Hamilton Depression Rating Scale (P = 0.020), Global Assessment Scale (P = 0.037), Clinical Global Impression (P = 0.047), and Social Adjustment Scale-Self Report-Work at Home (P = 0.020). Conclusion: This study suggests that rTMS has the potential to improve the clinical condition in postpartum depression, while producing marginal gains in social and cognitive function. PMID:23118543

  7. Early postpartum gastric band slippage after bariatric surgery in an adolescent obese girl

    PubMed Central

    Schmitt, Françoise; Topart, Philippe; Salle, Agnès; Sentilhes, Loïc; Bouhours-Nouet, Natacha; Coutant, Régis; Weil, Dominique; Podevin, Guillaume

    2016-01-01

    We report here a case of a rarely described complication of laparoscopic adjustable gastric banding (LAGB), slippage during the postpartum period, after LAGB had been performed in an adolescent obese girl. The LAGB had been placed after one year of clinical survey initiated at the age of 16. Maximal pre-operative body mass index (BMI) was 48.5 kg.m−2 and obesity was associated with insulin resistance. Before pregnancy, there was a loss of 17 Kg (final BMI = 41.5 kg.m−2) and a resolution of insulin resistance. The patient became pregnant 21 months after LAGB, and whole pregnancy and delivery were uneventful for both mother and fetus. Six weeks after delivery, the patient suddenly complained for total food intolerance, due to a band slippage, leading to removal of the band. Slippage is now a rare complication of LAGB, but can happen during pregnancy and the postpartum period as well. PMID:27619323

  8. Early postpartum gastric band slippage after bariatric surgery in an adolescent obese girl.

    PubMed

    Schmitt, Françoise; Topart, Philippe; Salle, Agnès; Sentilhes, Loïc; Bouhours-Nouet, Natacha; Coutant, Régis; Weil, Dominique; Podevin, Guillaume

    2016-09-12

    We report here a case of a rarely described complication of laparoscopic adjustable gastric banding (LAGB), slippage during the postpartum period, after LAGB had been performed in an adolescent obese girl. The LAGB had been placed after one year of clinical survey initiated at the age of 16. Maximal pre-operative body mass index (BMI) was 48.5 kg.m(-2) and obesity was associated with insulin resistance. Before pregnancy, there was a loss of 17 Kg (final BMI = 41.5 kg.m(-2)) and a resolution of insulin resistance. The patient became pregnant 21 months after LAGB, and whole pregnancy and delivery were uneventful for both mother and fetus. Six weeks after delivery, the patient suddenly complained for total food intolerance, due to a band slippage, leading to removal of the band. Slippage is now a rare complication of LAGB, but can happen during pregnancy and the postpartum period as well.

  9. Early postpartum gastric band slippage after bariatric surgery in an adolescent obese girl

    PubMed Central

    Schmitt, Françoise; Topart, Philippe; Salle, Agnès; Sentilhes, Loïc; Bouhours-Nouet, Natacha; Coutant, Régis; Weil, Dominique; Podevin, Guillaume

    2016-01-01

    We report here a case of a rarely described complication of laparoscopic adjustable gastric banding (LAGB), slippage during the postpartum period, after LAGB had been performed in an adolescent obese girl. The LAGB had been placed after one year of clinical survey initiated at the age of 16. Maximal pre-operative body mass index (BMI) was 48.5 kg.m−2 and obesity was associated with insulin resistance. Before pregnancy, there was a loss of 17 Kg (final BMI = 41.5 kg.m−2) and a resolution of insulin resistance. The patient became pregnant 21 months after LAGB, and whole pregnancy and delivery were uneventful for both mother and fetus. Six weeks after delivery, the patient suddenly complained for total food intolerance, due to a band slippage, leading to removal of the band. Slippage is now a rare complication of LAGB, but can happen during pregnancy and the postpartum period as well.

  10. Early postpartum gastric band slippage after bariatric surgery in an adolescent obese girl.

    PubMed

    Schmitt, Françoise; Topart, Philippe; Salle, Agnès; Sentilhes, Loïc; Bouhours-Nouet, Natacha; Coutant, Régis; Weil, Dominique; Podevin, Guillaume

    2016-01-01

    We report here a case of a rarely described complication of laparoscopic adjustable gastric banding (LAGB), slippage during the postpartum period, after LAGB had been performed in an adolescent obese girl. The LAGB had been placed after one year of clinical survey initiated at the age of 16. Maximal pre-operative body mass index (BMI) was 48.5 kg.m(-2) and obesity was associated with insulin resistance. Before pregnancy, there was a loss of 17 Kg (final BMI = 41.5 kg.m(-2)) and a resolution of insulin resistance. The patient became pregnant 21 months after LAGB, and whole pregnancy and delivery were uneventful for both mother and fetus. Six weeks after delivery, the patient suddenly complained for total food intolerance, due to a band slippage, leading to removal of the band. Slippage is now a rare complication of LAGB, but can happen during pregnancy and the postpartum period as well. PMID:27619323

  11. Prenatal depression predicts postpartum maternal attachment in low-income Latina mothers with infants.

    PubMed

    Perry, Deborah F; Ettinger, Anna K; Mendelson, Tamar; Le, Huynh-Nhu

    2011-04-01

    Although maternal attachment is an important predictor of infant attachment security and other developmental outcomes, little is known about the formation of maternal attachment in the first few months of the infant's life, particularly among ethnic minority mothers. The current study examined the predictors of postpartum maternal attachment in a sample of 217 Latina women enrolled in a perinatal depression prevention trial. Mothers' attachment to their infants was measured at 6-8 weeks postpartum using the Maternal Postnatal Attachment Scale. A variety of predictors of early attachment were explored including: depressive symptoms during pregnancy, pregnancy intention, feelings about the pregnancy, and the quality of the partner relationship. The strongest predictor of lower maternal attachment was depressive symptoms late in pregnancy; pregnancy intention was marginally predictive of attachment, with lower scores being associated with unwanted pregnancies. The study fills a critical gap in our understanding of the role of depressive symptoms during pregnancy in shaping mothers' early attachment to their infants. PMID:21402409

  12. Non-invasive endocrine monitoring of ovarian and adrenal activity in chinchilla (Chinchilla lanigera) females during pregnancy, parturition and early post-partum period.

    PubMed

    Mastromonaco, Gabriela F; Cantarelli, Verónica I; Galeano, María G; Bourguignon, Nadia S; Gilman, Christine; Ponzio, Marina F

    2015-03-01

    The chinchilla is a rodent that bears one of the finest and most valuable pelts in the world. The wild counterpart is, however, almost extinct because of a drastic past and ongoing population decline. The present work was developed to increase our knowledge of the reproductive physiology of pregnancy and post-partum estrus in the chinchilla, characterizing the endocrine patterns of urinary progesterone, estradiol, LH and cortisol metabolites throughout gestation and post-partum estrus and estimating the ovulation timing at post-partum estrus. Longitudinal urine samples were collected once per week throughout pregnancy and analyzed for creatinine, cortisol, LH, estrogen and progesterone metabolite concentrations. To indirectly determine the ovulation timing at post-partum estrus, a second experiment was performed using pregnant females subjected to a post-partum in vivo fertilization scheme. Urinary progestagen metabolites increased above baseline levels in early pregnancy between weeks-8 and -11 respectively to parturition, and slightly declined at parturition time. Urinary estrogens showed rising levels throughout mid- and late pregnancy (weeks-9 to -6 and a further increase at week-5 to parturition) and decreased in a stepwise manner after parturition, returning to baseline levels two weeks thereafter. Cortisol metabolite levels were relatively constant throughout pregnancy with a tendency for higher levels in the last third of gestation and after the pups' birth. Parturition was associated with dramatic reductions in urinary concentrations of sex steroids (especially progestagens). Observations in breeding farms indicated that the females that resulted in a second pregnancy after mating, did so on the second day after parturition. These data were in agreement with an LH peak detected 24h after parturition. Urinary steroid hormone patterns of estrogen and progestagen metabolites provided valuable information on endocrine events during pregnancy and after

  13. Non-invasive endocrine monitoring of ovarian and adrenal activity in chinchilla (Chinchilla lanigera) females during pregnancy, parturition and early post-partum period.

    PubMed

    Mastromonaco, Gabriela F; Cantarelli, Verónica I; Galeano, María G; Bourguignon, Nadia S; Gilman, Christine; Ponzio, Marina F

    2015-03-01

    The chinchilla is a rodent that bears one of the finest and most valuable pelts in the world. The wild counterpart is, however, almost extinct because of a drastic past and ongoing population decline. The present work was developed to increase our knowledge of the reproductive physiology of pregnancy and post-partum estrus in the chinchilla, characterizing the endocrine patterns of urinary progesterone, estradiol, LH and cortisol metabolites throughout gestation and post-partum estrus and estimating the ovulation timing at post-partum estrus. Longitudinal urine samples were collected once per week throughout pregnancy and analyzed for creatinine, cortisol, LH, estrogen and progesterone metabolite concentrations. To indirectly determine the ovulation timing at post-partum estrus, a second experiment was performed using pregnant females subjected to a post-partum in vivo fertilization scheme. Urinary progestagen metabolites increased above baseline levels in early pregnancy between weeks-8 and -11 respectively to parturition, and slightly declined at parturition time. Urinary estrogens showed rising levels throughout mid- and late pregnancy (weeks-9 to -6 and a further increase at week-5 to parturition) and decreased in a stepwise manner after parturition, returning to baseline levels two weeks thereafter. Cortisol metabolite levels were relatively constant throughout pregnancy with a tendency for higher levels in the last third of gestation and after the pups' birth. Parturition was associated with dramatic reductions in urinary concentrations of sex steroids (especially progestagens). Observations in breeding farms indicated that the females that resulted in a second pregnancy after mating, did so on the second day after parturition. These data were in agreement with an LH peak detected 24h after parturition. Urinary steroid hormone patterns of estrogen and progestagen metabolites provided valuable information on endocrine events during pregnancy and after

  14. Transdermal Estradiol Treatment for Postpartum Depression: A Pilot Randomized Trial

    PubMed Central

    Wisner, Katherine L.; Sit, Dorothy K.Y.; Moses-Kolko, Eydie L.; Driscoll, Kara E.; Prairie, Beth; Stika, Catherine S.; Eng, Heather F.; Dills, John L; Luther, James F.; Wisniewski, Stephen R.

    2015-01-01

    Postpartum depression occurs in 14.5% of women in the first three months after birth. This study was an 8 week acute phase randomized trial with three cells (transdermal estradiol (E2), sertraline, and placebo) for the treatment of postpartum major depressive disorder. However, the study was stopped after batch analysis revealed that the E2 serum concentrations were lower than pre-study projections. This paper explores our experiences that will inform future investigations of therapeutic E2 use. Explanations for the low E2 concentrations were: 1) Study patch non-adhesion, which did not explain the low concentrations across the entire sample. 2) Ineffective transdermal patch preparations, although two different patch preparations were used and no significant main effect of patch type on E2 concentrations was found. 3) Obesity, at study entry, E2-treated women had mean ± SD BMI=32.9 ±7.4. No pharmacokinetic data comparing E2 concentrations from transdermal patches in obese women vs. normal weight controls are available. 4) Induction of Cytochrome P450 (CYP450) 3A4 and other E2 elimination pathways in pregnancy. CYP4503A4 is induced in pregnancy and is a pathway for the metabolism of E2. Conversion to estrone and Phase II metabolism via glucuronidation and sulfation, which also increase in pregnancy, are routes of E2 elimination. The time required for these pathways to normalize after delivery has not been elucidated. The observation that transdermal E2 doses greater than 100 mcg/day did not increase serum concentrations was unexpected. Another hypothesis consistent with this observation is suppression of endogenous E2 secretion with increasing exogenous E2 dosing. PMID:26061609

  15. Transdermal Estradiol Treatment for Postpartum Depression: A Pilot, Randomized Trial.

    PubMed

    Wisner, Katherine L; Sit, Dorothy K Y; Moses-Kolko, Eydie L; Driscoll, Kara E; Prairie, Beth A; Stika, Catherine S; Eng, Heather F; Dills, John L; Luther, James F; Wisniewski, Stephen R

    2015-08-01

    Postpartum depression occurs in 14.5% of women in the first 3 months after birth. This study was an 8-week acute phase randomized trial with 3 cells (transdermal estradiol [E2], sertraline [SERT], and placebo [PL]) for the treatment of postpartum major depressive disorder. However, the study was stopped after batch analysis revealed that the E2 serum concentrations were lower than prestudy projections. This paper explores our experiences that will inform future investigations of therapeutic E2 use. Explanations for the low E2 concentrations were as follows: (1) study patch nonadhesion, which did not explain the low concentrations across the entire sample. (2) Ineffective transdermal patch preparations, although 2 different patch preparations were used and no significant main effect of patch type on E2 concentrations was found. (3) Obesity, at study entry, E2-treated women had body mass index of 32.9 (7.4) (mean [SD]). No pharmacokinetic data comparing E2 concentrations from transdermal patches in obese women versus normal weight controls are available. (4) Induction of cytochrome P450 (CYP450) 3A4 and other E2 elimination pathways in pregnancy. CYP4503A4 is induced in pregnancy and is a pathway for the metabolism of E2. Conversion to estrone and phase II metabolism via glucuronidation and sulfation, which also increase in pregnancy, are routes of E2 elimination. The time required for these pathways to normalize after delivery has not been elucidated. The observation that transdermal E2 doses greater than 100 μg/d did not increase serum concentrations was unexpected. Another hypothesis consistent with this observation is suppression of endogenous E2 secretion with increasing exogenous E2 dosing. PMID:26061609

  16. Hemostatic profile during late pregnancy and early postpartum period in mares.

    PubMed

    Bazzano, M; Giannetto, C; Fazio, F; Marafioti, S; Giudice, E; Piccione, G

    2014-03-01

    Hemostasis is a physiological process that prevents excessive blood loss and represents a protective mechanism at the time of delivery. Peripartum hemorrhage is a recurring hazardous condition to mare's health; therefore, we aimed to study mares' hemostatic profile to investigate whether physiological adjustments occur during late pregnancy and early postpartum. Fifteen pregnant mares have been monitored from the 34th week of pregnancy until the third week after foaling. Fifteen nonpregnant mares were used as control group. Jugular blood samples were analyzed for platelet count (Plt), prothrombin time (PT), activated partial thromboplastin time (aPTT), and fibrinogen (Fb). Platelet count showed significant changes at foaling (P < 0.05) and a negative correlation (r = -0.968; P = 0.032) with postpartum. Prothrombin time changed (P < 0.05) showing a significant correlation (r = 0.675; P = 0.016) with late pregnancy. Fibrinogen concentrations changed throughout the experimental period (P < 0.0001). The linear regression model revealed a positive correlation (r = 0.9210; P < 0.0001) between Fb and late pregnancy and a negative correlation (r = -0.9583; P = 0.042) between Fb and early postpartum. The shortening in PT recorded in the imminence of parturition along with the increase in Plt and Fb at foaling might reflect a physiological hypercoagulable state that constrains excessive bleeding, enhancing mares' odds of surviving. Our research improves the knowledge about blood coagulation in periparturient mares providing specific information on routine coagulation tests that may support in monitoring mare's hemostatic profile during late pregnancy and early postpartum.

  17. Success Providing Postpartum Intrauterine Devices in Private-Sector Health Care Facilities in Nigeria: Factors Associated With Uptake

    PubMed Central

    Eluwa, George IE; Atamewalen, Ronke; Odogwu, Kingsley; Ahonsi, Babatunde

    2016-01-01

    ABSTRACT Background: Use of modern contraceptive methods in Nigeria remained at 10% between 2008 and 2013 despite substantive investments in family planning services. Many women in their first postpartum year, in particular, have an unmet need for family planning. We evaluated use of postpartum intrauterine device (IUD) insertion and determined factors associated with its uptake in Nigeria. Methods: Data were collected between May 2014 and February 2015 from 11 private health care facilities in 6 southern Nigerian states. Women attending antenatal care in participating facilities were counseled on all available contraceptive methods including the postpartum IUD. Data were abstracted from participating facility records and evaluated using a cross-sectional analysis. Categorical variables were calculated as proportions while continuous variables were calculated as medians with the associated interquartile range (IQR). Multivariate logistic regression analysis was used to identify factors associated with uptake of the postpartum IUD while controlling for potential confounding factors, including age, educational attainment, marital status, parity, number of living children, and previous use of contraception. Results: During the study period, 728 women delivered in the 11 facilities. The median age was 28 years, and most women were educated (73% had completed at least the secondary level). The majority (96%) of the women reported they were married, and the median number of living children was 3 (IQR, 2–4). Uptake of the postpartum IUD was 41% (n = 300), with 8% (n = 25) of the acceptors experiencing expulsion of the IUD within 6 weeks post-insertion. After controlling for potential confounding factors, several characteristics were associated with greater likelihood of choosing the postpartum IUD, including lower education, having a higher number of living children, and being single. Women who had used contraceptives previously were less likely to choose the

  18. Effect of feeding calcareous marine algae to Holstein cows prepartum or postpartum on serum metabolites and performance.

    PubMed

    Wu, Z; Bernard, J K; Taylor, S J

    2015-07-01

    Thirty-six multiparous Holstein cows and 12 springing heifers were used in a 9-wk randomized design trial to determine the response of cows fed calcareous marine algae (CMA) beginning 3wk prepartum or after parturition through 6wk postpartum on dry matter intake (DMI), blood and urine metabolites, and milk yield and composition. Within parity and expected calving date, cows were assigned randomly to 1 of 4 treatments with a 2×2 factorial arrangement. Prepartum diets were supplemented with calcium carbonate (CON) or 50g/d of CMA with a resulting dietary cation-anion difference of -5.17 and -3.99mEq/100g, respectively. Postpartum diets were formulated to provide either 317g/d of sodium bicarbonate and calcium carbonate (NBC) or 100g/d of CMA, providing a dietary cation-anion difference of 35.58 and 15.64mEq/100g, based on 25kg/d of DMI, respectively. No differences were observed in prepartum DMI or postpartum DMI, milk yield, percentage of milk fat, protein, lactose, and solids-not fat among treatments. Milk protein yield was higher for cows fed CMA prepartum compared with CON. Interactions of prepartum treatment and week were observed for yield of milk fat and energy-corrected milk because of higher yields for cows fed CMA during wk 2 and 6 compared with CON. Serum Na concentrations were greater for cows fed CON prepartum or NBC postpartum compared with CMA. Postpartum urinary concentrations of Na exhibited an interaction among treatments and were higher for CON-NBC and CMA-NBC compared with CON-CMA and CMA-CMA. Similar interactions of treatments were also observed for serum urea N and creatinine postpartum. Postpartum urinary K concentrations were higher for cows fed CMA postpartum compared with NBC. Results of this trial indicate that feeding cows CMA prepartum does not affect DMI or serum metabolites prepartum, but does support higher milk protein yield. Performance and serum metabolite concentrations of cows fed CMA postpartum were comparable with that of cows

  19. Effect of lead on the sorption of 2,4,6-trichlorophenol on soil and peat.

    PubMed

    Pei, Zhi-Guo; Shan, Xiao-Quan; Liu, Tao; Xie, Ya-Ning; Wen, Bei; Zhang, Shuzhen; Khan, Shahamat U

    2007-06-01

    The effect of lead on the sorption of 2,4,6-trichlorophenol (2,4,6-TCP) on soil and peat was investigated using a batch equilibration method. Lead markedly diminished the sorption of 2,4,6-TCP, and 2,4,6-TCP had little effect on lead sorption. Peat was a more effective adsorbent for 2,4,6-TCP than soil. The desorption hysteresis of 2,4,6-TCP verified the presence of high-energy sorption sites. Mechanisms of lead suppression effect on the 2,4,6-TCP sorption included the following: Firstly, lead accelerated the aggregation of colloids, the aggregates covered the surface in part and shrunk the pore sizes of the adsorbents, hence decreased the sorption of 2,4,6-TCP. Secondly, X-ray absorption and Fourier transform infrared spectroscopy study suggested that lead competed with 2,4,6-TCP for carboxylic, phenolic and Si-OH groups of organic matter and clay minerals. Such competition was partly responsible for the overall suppression effect of lead on the sorption of 2,4,6-TCP.

  20. Fordyce happiness program and postpartum depression

    PubMed Central

    Rabiei, Leili; Mazaheri, Maryam Amidi; Masoudi, Reza; Hasheminia, Sayed Ali Mohammad

    2014-01-01

    Background: Postpartum depression is endangering the health of mothers and has negative impacts on the evolution of social communication and newborns evolution. This study was conducted to determine the effects of Fordyce Happiness program on the postpartum depression. Materials and Methods: This quasi-experimental intervention carried out on postpartum mothers that referred to 4 health centers in Isfahan. A total of 133 mothers were selected by convenient sampling and then randomly allocated in two groups (63 and 70 mothers for intervention and control respectively). Maternal depression 3 times before, immediate and 1 months after intervention in both groups was evaluated with Beck Depression Inventory-II-Persian standardized questionnaires. Educational sessions based on the Fordyce happiness program were conducted for intervention group. Data was analyzed in SPSS17 (SPSS Inc, Chicago, Illinois) descriptive and analytic statistical tests at significance level of 0.05. Results: No significant differences in demographic variables between the two groups (P ≥ 0.05). No significant differences in depression scores in the two groups before training. However after 2 months a significant difference in depression score was observed between two groups (control group: 19.38 ± 3.94; intervention group: 16.24 ± 4.8; P < 0.001). Furthermore in intervention group showed significant differences in depression scores before and after intervention (19.15 ± 3.41 and 16.24 ± 4.83; P < 0.001). However in the control group had not any significant change. Conclusion: Fordyce happiness program was effective in reducing postpartum depression in our study. With attention to the effectiveness and low cost of this program, it is recommended that this program might be considered for all mothers after childbirth in health centers or other community-based settings. PMID:24949034

  1. Relationships between fertility and postpartum changes in body condition and body weight in lactating dairy cows.

    PubMed

    Carvalho, P D; Souza, A H; Amundson, M C; Hackbart, K S; Fuenzalida, M J; Herlihy, M M; Ayres, H; Dresch, A R; Vieira, L M; Guenther, J N; Grummer, R R; Fricke, P M; Shaver, R D; Wiltbank, M C

    2014-01-01

    The relationship between energy status and fertility in dairy cattle was retrospectively analyzed by comparing fertility with body condition score (BCS) near artificial insemination (AI; experiment 1), early postpartum changes in BCS (experiment 2), and postpartum changes in body weight (BW; experiment 3). To reduce the effect of cyclicity status, all cows were synchronized with Double-Ovsynch protocol before timed AI. In experiment 1, BCS of lactating dairy cows (n = 1,103) was evaluated near AI. Most cows (93%) were cycling at initiation of the breeding Ovsynch protocol (first GnRH injection). A lower percentage pregnant to AI (P/AI) was found in cows with lower (≤ 2.50) versus higher (≥ 2.75) BCS (40.4 vs. 49.2%). In experiment 2, lactating dairy cows on 2 commercial dairies (n = 1,887) were divided by BCS change from calving until the third week postpartum. Overall, P/AI at 70-d pregnancy diagnosis differed dramatically by BCS change and was least for cows that lost BCS, intermediate for cows that maintained BCS, and greatest for cows that gained BCS [22.8% (180/789), 36.0% (243/675), and 78.3% (331/423), respectively]. Surprisingly, a difference existed between farms with BCS change dramatically affecting P/AI on one farm and no effect on the other farm. In experiment 3, lactating dairy cows (n = 71) had BW measured weekly from the first to ninth week postpartum and then had superovulation induced using a modified Double-Ovsynch protocol. Cows were divided into quartiles (Q) by percentage of BW change (Q1 = least change; Q4 = most change) from calving until the third week postpartum. No effect was detected of quartile on number of ovulations, total embryos collected, or percentage of oocytes that were fertilized; however, the percentage of fertilized oocytes that were transferable embryos was greater for cows in Q1, Q2, and Q3 than Q4 (83.8, 75.2, 82.6, and 53.2%, respectively). In addition, percentage of degenerated embryos was least for cows in Q1, Q2

  2. Women with postpartum depression: "my husband" stories

    PubMed Central

    Montgomery, Phyllis; Bailey, Pat; Purdon, Sheri Johnson; Snelling, Susan J; Kauppi, Carol

    2009-01-01

    Background The research on Postpartum Depression (PPD) to date suggests that there is a knowledge gap regarding women's perception of their partners' role as carer and care activities they perform. Therefore, the purpose of this study was to describe women's understanding of their partners' or husbands' involvement in the midst of PPD. Methods This study used interview data from a larger study of northern and rural Ontario women's stories of help-seeking for PPD. The interpretive description approach was used to illustrate the complexity of women's spousal connections in PPD. Data from a purposive community sample of 27 women who self-identified as having been diagnosed with PPD was used. From the verbatim transcribed interviews a number of data excerpts were identified and labeled as "my husband" stories. Narrative analysis was employed to examine these stories. Results During this time of vulnerability, the husbands' physical, emotional and cognitive availability positively contributed to the women's functioning and self-appraisals as wife and mother. Their representations of their husbands' 'doing for' and/or 'being with' promoted their well-being and ultimately protected the family. Conclusion Given that husbands are perceived to be central in mitigating women's suffering with PPD, the consistent implementation of a triad orientation, that includes woman, child and partner rather than a more traditional and convenient dyadic orientation, is warranted in comprehensive postpartum care. Finally, this study contributes a theoretical understanding of responsive as well as reactive connections between women and family members during the postpartum period. PMID:19732461

  3. Biotransformation of 2,4,6-trinitrotoluene with Phanaerochaete chrysosporium in agitated cultures at pH 4. 5

    SciTech Connect

    Hawari, J.; Halasz, A.; Beaudet, S.; Paquet, L. . Biotechnology Research Inst.); Ampleman, G.; Thiboutot, S. . Defence Research Establishment Valcartier)

    1999-07-01

    The biotransformation of 2,4,6-trinitrotoluene (TNT) by Phanerochaete chrysosporium with molasses and citric acid at pH 4.5 was studied. In less than 2 weeks, TNT disappeared completely, but mineralization did not exceed 1%. A time study revealed the presence of several intermediates, marked by the initial formation of two monohydroxylaminodinitrotoluenes (2- and 4-HADNT) followed by their successive transformation to several other products, including monoaminodinitrotoluenes (ADNT). A group of nine acylated intermediates were also detected. They included 2-N-acetylamido-4,6-dinitrotoluene and its p isomer, 2-formylamido-4,6-dinitrotoluene and its p isomer (as acylated ADNT), 4-N-acetylamino-2-amino-6-nitrotoluene and 4-N-formylamido-2-amino-6-nitrotoluene (as acetylated DANT), 4-N-acetylhydroxy-2,6-dinitrotoluene and 4-N-acetoxy-2,6-dinitrotoluene (as acetylated HADNT), and finally 4-N-acetylamido-2-hydroxylamino-6-nitrotoluene. Furthermore, a fraction of HADNTs were found to rearrange to their corresponding phenolamines, while another group dimerized to azoxytoluenes which in turn transformed to azo compounds and eventually to the corresponding hydrazo derivatives. After 30 days, all of these metabolites, except traces of 4-ADNT and the hydrazo derivatives, disappeared, but mineralization did not exceed 10% even after the incubation period was increased to 120 days.

  4. Effect of lavender scent inhalation on prevention of stress, anxiety and depression in the postpartum period

    PubMed Central

    Kianpour, Maryam; Mansouri, Akram; Mehrabi, Tayebeh; Asghari, Gholamreza

    2016-01-01

    Background: Stress, anxiety, and postpartum depression are the most common problems among women in their childbearing age. Research has shown that aromatherapy administered during labor reduces anxiety in mothers. With regard to the specific biological conditions in postpartum period and the subsequent drop in hormone levels, this study investigated the effect of lavender on prevention of stress, anxiety, and postpartum depression in women. Materials and Methods: In a clinical trial, 140 women admitted to the obstetric and gynecological unit were randomly divided into aromatherapy and non-aromatherapy groups immediately after delivery. Intervention with aromatherapy consisted of inhaling three drops of lavender essential oil every 8 h with for 4 weeks. The control group received routine care after discharge and was followed up by telephone only. After 2 weeks, 1 and 3 months of delivery, women were assessed by the 21-item Depression, Anxiety, and Stress Scale and the Edinburgh stress, anxiety, and depression scale in the two groups. Data analysis was performed by Mann-Whitney, analysis of variance (ANOVA), and post hoc tests. Level of significance was set as 0.05 for all tests. Results: The results showed that the mean stress, anxiety, and depression at time point of 2 weeks (P = 0.012, P < 0.0001, and P = 0.003, respectively) and stress, anxiety, and depression scores at time points of 1 month (P < 0.0001) and 3 months after delivery (P < 0.0001) were significantly lower in the study group compared with the control group. Conclusions: Inhaling the scent of lavender for 4 weeks can prevent stress, anxiety, and depression after childbirth. PMID:27095995

  5. Evaluation of the oral subchronic toxicity of HHCB (1,3,4,6,7,8-hexahydro-4,6,6,7,8,8-hexamethylcyclopenta-gamma-2 -benzopyran) in the rat.

    PubMed

    Api, A M; Ford, R A

    1999-12-20

    1,3,4,6,7,8-Hexahydro-4,6,6,7,8,8-hexamethylcyclopenta-gamma-2-ben zopyran (HHCB) is used in a wide variety of fragrances in consumer products. Because of the widespread exposure to this material, a 90-day oral feeding study in accordance with OECD guidelines No. 408, with 4-week recovery periods for selected rats, was conducted. HHCB was added to the diet of rats at levels calculated to result in mean daily doses of 5, 15, 50 or 150 mg HHCB/kg. On completion of the treatment period, three males and three females from the high dose and control groups were maintained for a treatment free period of 4 weeks. No adverse effects were revealed from clinical examination or following extensive histopathological examinations. There were no significant findings at any dose level; a NOAEL of 150 mg/kg per day was concluded. As a supplement to the main study, histopathological examination of the prostate, seminal vesicles, mammary gland and testes of males and ovaries, mammary gland, uterus and vagina of females was undertaken on all animals in all test groups. This examination did not reveal any evidence of hormonal effects.

  6. Preventing postpartum depression: A meta-analytic review

    PubMed Central

    Sockol, Laura E.; Epperson, C. Neill; Barber, Jacques P.

    2014-01-01

    This meta-analysis assessed the efficacy of a wide range of preventive interventions designed to reduce the severity of postpartum depressive symptoms or decrease the prevalence of postpartum depressive episodes. A systematic review identified 37 randomized or quasi-randomized controlled trials in which an intervention was compared to a control condition. Differences between treatment and control conditions in the level of depressive symptoms and prevalence of depressive episodes by 6 months postpartum were assessed in separate analyses. Depressive symptoms were significantly lower at post-treatment in intervention conditions, with an overall effect size in the small range after exclusion of outliers (Hedges' g = 0.18). There was a 27% reduction in the prevalence of depressive episodes in intervention conditions by 6 months postpartum after removal of outliers and correction for publication bias. Later timing of the postpartum assessment was associated with smaller differences between intervention and control conditions in both analyses. Among studies that assessed depressive symptoms using the EPDS, higher levels of depressive symptoms at pre-treatment were associated with smaller differences in depressive symptoms by 6 months postpartum. These findings suggest that interventions designed to prevent postpartum depression effectively reduce levels of postpartum depressive symptoms and decrease risk for postpartum depressive episodes. PMID:24211712

  7. Relationship between serum insulin-like growth factor-I and genotype during the postpartum interval in beef cows.

    PubMed

    Spicer, L J; Chase, C C; Rutter, L M

    2002-03-01

    The objective of this study was to determine the effect of genotype and week postpartum on serum concentrations of IGF-I, body condition score (BCS), BW, and ovarian function in beef cows. Cows from the following genotypes were utilized in two consecutive years: Angus (A x A; n = 9), Brahman (B x B; n = 10), Charolais (C x C; n = 12), Angus x Brahman (A x B; n = 22), Brahman x Charolais (B x C; n = 19) and Angus x Charolais (A x C; n = 24). Serum concentrations of IGF-I, BCS, and BW were determined between wk 2 and 9 postpartum. Rectal ultrasound was used to determine days postpartum to first medium (6 to 9 mm) and first large (> or = 10 mm) follicle. Averaged across genotype, BCS decreased (P < 0.05) from 5.0 +/- 0.1 on wk 3 to 4.8 +/- 0.1 on wk 6 postpartum, and BW decreased (P < 0.05) between wk 2 and 3 and again between wk 4 and 9 postpartum. Averaged over year and week postpartum, serum IGF-I concentrations were greatest (P < 0.05) in B x B cows (46 +/- 5 ng/mL) compared with all other genotypes; lowest in A x A (12 +/- 4 ng/mL), C x C (13 +/- 4 ng/mL), and A x C cows (18 +/- 3 ng/mL); and intermediate (P < 0.05) in A x B (28 +/- 3 ng/mL) and B x C (26 +/- 3 ng/mL) cows compared with all other genotypes. Serum IGF-I concentrations did not change (P > 0.10) with week postpartum in C x C, A x A, and A x C cows, but increased (P < 0.05) between wk 2 and 7 postpartum in B x C, A x B, and B x B cows. Average interval to first medium (16 +/- 2 d) and first large (35 +/- 2 d) follicle did not differ (P > 0.10) among genotypes. Serum IGF-I concentrations correlated with BCS (r = 0.53 to 0.72, P < 0.001) but not with days to first large follicle (r = -0.19 to -0.22, P > 0.10). Averaged across genotypes, cows that lost BCS postpartum had lower (P < 0.01) serum IGF-I concentrations. Cows that calved with adequate BCS (i.e., > or = 5) had greater (P < 0.01) serum IGF-I concentrations postpartum than cows that calved with inadequate BCS (i.e., < 5) but days to first large

  8. Relationship between serum insulin-like growth factor-I and genotype during the postpartum interval in beef cows.

    PubMed

    Spicer, L J; Chase, C C; Rutter, L M

    2002-03-01

    The objective of this study was to determine the effect of genotype and week postpartum on serum concentrations of IGF-I, body condition score (BCS), BW, and ovarian function in beef cows. Cows from the following genotypes were utilized in two consecutive years: Angus (A x A; n = 9), Brahman (B x B; n = 10), Charolais (C x C; n = 12), Angus x Brahman (A x B; n = 22), Brahman x Charolais (B x C; n = 19) and Angus x Charolais (A x C; n = 24). Serum concentrations of IGF-I, BCS, and BW were determined between wk 2 and 9 postpartum. Rectal ultrasound was used to determine days postpartum to first medium (6 to 9 mm) and first large (> or = 10 mm) follicle. Averaged across genotype, BCS decreased (P < 0.05) from 5.0 +/- 0.1 on wk 3 to 4.8 +/- 0.1 on wk 6 postpartum, and BW decreased (P < 0.05) between wk 2 and 3 and again between wk 4 and 9 postpartum. Averaged over year and week postpartum, serum IGF-I concentrations were greatest (P < 0.05) in B x B cows (46 +/- 5 ng/mL) compared with all other genotypes; lowest in A x A (12 +/- 4 ng/mL), C x C (13 +/- 4 ng/mL), and A x C cows (18 +/- 3 ng/mL); and intermediate (P < 0.05) in A x B (28 +/- 3 ng/mL) and B x C (26 +/- 3 ng/mL) cows compared with all other genotypes. Serum IGF-I concentrations did not change (P > 0.10) with week postpartum in C x C, A x A, and A x C cows, but increased (P < 0.05) between wk 2 and 7 postpartum in B x C, A x B, and B x B cows. Average interval to first medium (16 +/- 2 d) and first large (35 +/- 2 d) follicle did not differ (P > 0.10) among genotypes. Serum IGF-I concentrations correlated with BCS (r = 0.53 to 0.72, P < 0.001) but not with days to first large follicle (r = -0.19 to -0.22, P > 0.10). Averaged across genotypes, cows that lost BCS postpartum had lower (P < 0.01) serum IGF-I concentrations. Cows that calved with adequate BCS (i.e., > or = 5) had greater (P < 0.01) serum IGF-I concentrations postpartum than cows that calved with inadequate BCS (i.e., < 5) but days to first large

  9. The effect of urinary incontinence status during pregnancy and delivery mode on incontinence postpartum. A cohort study*

    PubMed Central

    Wesnes, SL; Hunskaar, S; Bo, K; Rortveit, G

    2009-01-01

    Objective The objectives of this study were to investigate prevalence of urinary incontinence at 6 months postpartum and to study how continence status during pregnancy and mode of delivery influence urinary incontinence at 6 months postpartum in primiparous women. Design Cohort study. Setting Pregnant women attending routine ultrasound examination were recruited to the Norwegian Mother and Child Cohort Study (MoBa). Population A total of 12 679 primigravidas who were continent before pregnancy. Methods Data are from MoBa, conducted by the Norwegian Institute of Public Health. Data are based on questionnaires answered at week 15 and 30 of pregnancy and 6 months postpartum. Main outcome measures Urinary incontinence 6 months postpartum is presented as proportions, odds ratios and relative risks (RRs). Results Urinary incontinence was reported by 31% of the women 6 months after delivery. Compared with women who were continent during pregnancy, incontinence was more prevalent 6 months after delivery among women who experienced incontinence during pregnancy (adjusted RR 2.3, 95% CI 2.2–2.4). Adjusted RR for incontinence after spontaneous vaginal delivery compared with elective caesarean section was 3.2 (95% CI 2.2–4.7) among women who were continent and 2.9 (95% CI 2.3–3.4) among women who were incontinent in pregnancy. Conclusion Urinary incontinence was prevalent 6 months postpartum. The association between incontinence postpartum and mode of delivery was not substantially influenced by incontinence status in pregnancy. Prediction of a group with high risk of incontinence according to mode of delivery cannot be based on continence status in pregnancy. PMID:19220234

  10. Postpartum deaths: piglet, placental, and umbilical characteristics.

    PubMed

    Rootwelt, V; Reksen, O; Farstad, W; Framstad, T

    2013-06-01

    The fetal growth of the piglet is highly dependent on its placenta, and the newborn piglet birth weight is highly associated with postpartum death. However, there is little information available in the literature on the assessment of the placenta in relation to postpartum death in piglets. The aim of this study was to evaluate the impact of the placental area and placental weight, status of the umbilical cord, and piglet birth characteristics, such as blood parameters, vitality score, and birth weight on postpartum death. All live born piglets in litters from 26 Landrace-Yorkshire sows were monitored during farrowing and the status of each was recorded, including placental area and placental weight and blood variables obtained from the piglets and umbilical veins. Out of the 386 live-born piglets, 16.8% died before weaning at 5 wk. Among these, 78.5% died within the first 3 d of life. Mean blood concentration of lactate was increased in piglets that did not survive to weaning (P = 0.003). Concentrations of hemoglobin and hematocrit were decreased (P < 0.001) compared with survivors. Piglets born with a broken umbilical cord had a reduced vitality score vs. piglets born with an intact umbilical cord (P = 0.021), and they had an increased probability of dying before weaning (P = 0.050). Mean birth weight, body mass index, placental area (P < 0.001), and placental weight (P = 0.020) were reduced in piglets that died before weaning vs. those that survived. Birth weight and placental area were furthermore negatively associated with live litter size. Blood concentrations of IgG and albumin recorded at d 1 were decreased in piglets that died before weaning (P < 0.01), and blood concentration of albumin was positively associated with placental area (P < 0.001). We conclude that placental area and placental weight, status of the umbilical cord, birth weight, body mass index, blood concentrations of lactate, hemoglobin, and hematocrit recorded at birth, and blood

  11. Persistence of uterine bacterial infection, and its associations with endometritis and ovarian function in postpartum dairy cows

    PubMed Central

    GHANEM, Mohamed Elshabrawy; TEZUKA, Erisa; DEVKOTA, Bhuminand; IZAIKE, Yoshiaki; OSAWA, Takeshi

    2014-01-01

    We investigated the relationship between the persistence of uterine bacterial infections with cytologically determined endometritis and ovarian function in 65 postpartum Holstein cows. Vaginal mucus discharges were collected, and endometrial smear samples (n = 130) were collected for cytological and bacteriological examinations from the cows at weeks 5 and 7 postpartum (pp). Blood samples were collected at weeks 3, 5 and 7 pp to determine plasma progesterone concentrations to monitor ovarian activity. According to the bacteriological examination, cows were classified into four groups. The first group (n = 32; 49%) comprised cows negative for bacteria at weeks 5 and 7 pp. The second group (n = 11; 17%) comprised cows with bacterial infections at week 5 pp but that were clear of infection at week 7 pp. The third group (n = 12; 19%) comprised cows without bacteria at week 5 pp but that acquired an infection by week 7 pp. The fourth group (n = 10; 15%) comprised cows with bacterial infections at weeks 5 and 7 pp (persistence of infection). A positive correlation (P < 0.001) was noted between the severity of cytologically determined endometritis, purulent vaginal discharge and the persistence of infection. Cows with persistent infections had a significantly (P < 0.01) prolonged luteal phase compared with cows without infection. In conclusion, the prevalence of cytologically determined endometritis and prolonged luteal phase were significantly increased in cows with persistent infections. PMID:25482111

  12. Persistence of uterine bacterial infection, and its associations with endometritis and ovarian function in postpartum dairy cows.

    PubMed

    Ghanem, Mohamed Elshabrawy; Tezuka, Erisa; Devkota, Bhuminand; Izaike, Yoshiaki; Osawa, Takeshi

    2015-01-01

    We investigated the relationship between the persistence of uterine bacterial infections with cytologically determined endometritis and ovarian function in 65 postpartum Holstein cows. Vaginal mucus discharges were collected, and endometrial smear samples (n = 130) were collected for cytological and bacteriological examinations from the cows at weeks 5 and 7 postpartum (pp). Blood samples were collected at weeks 3, 5 and 7 pp to determine plasma progesterone concentrations to monitor ovarian activity. According to the bacteriological examination, cows were classified into four groups. The first group (n = 32; 49%) comprised cows negative for bacteria at weeks 5 and 7 pp. The second group (n = 11; 17%) comprised cows with bacterial infections at week 5 pp but that were clear of infection at week 7 pp. The third group (n = 12; 19%) comprised cows without bacteria at week 5 pp but that acquired an infection by week 7 pp. The fourth group (n = 10; 15%) comprised cows with bacterial infections at weeks 5 and 7 pp (persistence of infection). A positive correlation (P < 0.001) was noted between the severity of cytologically determined endometritis, purulent vaginal discharge and the persistence of infection. Cows with persistent infections had a significantly (P < 0.01) prolonged luteal phase compared with cows without infection. In conclusion, the prevalence of cytologically determined endometritis and prolonged luteal phase were significantly increased in cows with persistent infections. PMID:25482111

  13. Lavender Fragrance Essential Oil and the Quality of Sleep in Postpartum Women

    PubMed Central

    Keshavarz Afshar, Mahnaz; Behboodi Moghadam, Zahra; Taghizadeh, Ziba; Bekhradi, Reza; Montazeri, Ali; Mokhtari, Pouran

    2015-01-01

    Background: Labor and delivery is a stressful stage for mothers. During these periods, sleep-related disorders have been reported. The problems of inadequate sleep include decrease in concentration, judgment, difficulty in performing daily activities, and an increase in irritability. Even the effects of moderate sleep loss on life and health quality can be similar to sleep deprivation. some research aggravated by aromatherapy on sleep quality in different periods of life so might be useful for the improve of sleep quality in postpartum women. Objectives: This study aimed to determine the effect of aromatherapy on the quality of sleep in postpartum women. The sample was recruited from medical health centers of Zanjan University of Medical Sciences. Patients and Methods: This study was a randomized clinical trial with the control group. A total of 158 mothers in postpartum period (with certain inclusion criteria) were enrolled in the study and assigned randomly to two groups of control and intervention. Lavender fragrance (made by Barij Essence Pharmaceutical Co.) was used by participants in the intervention group nightly before sleeping. The fragrance was dropped on cotton balls, which were placed on a cylindrical container at mothers’ disposal. Keeping the container at a projected distance of 20 cm, the participants inhaled 10 deep breaths and then the container was placed beside their pillow until morning. This procedure was done 4 times a week for 8 weeks. For the control group, the same intervention was done with the placebo. The instrument for collecting data was Pittsburgh sleep quality index, which was completed at the baseline, fourth, and eighth weeks after the intervention. Data were analyzed using independent t test and repeated measures analysis of variance calculated by SPSS16. Results: Before the intervention, there were no significant differences between mothers in two groups (P > 0.05). After 8 weeks follow up, a significant improvement appeared in

  14. A cow-level association of ruminal pH on body condition score, serum beta-hydroxybutyrate and postpartum disorders in Thai dairy cattle.

    PubMed

    Chaidate, Inchaisri; Somchai, Chanpongsang; Jos, Noordhuizen; Henk, Hogeveen

    2014-09-01

    Subacute ruminal acidosis in dairy cows occurs when ruminal pH is below about 5.5. However, the exact threshold level of ruminal pH affecting cow health is still in debate. This investigation was carried out in 505 cows within 31 farms. The postpartum disorders, including dystocia, retained placenta, anestrus, cystic ovary, metritis, clinical mastitis and lameness, were analyzed. Ruminal pH, serum beta-hydroxy butyrate (SBHB), serum urea nitrogen and body condition score (BCS) were measured once during the 3 to 6 weeks postpartum, while BCS was determined once more at 1 week before calving. Ruminal pH was determined by ruminocentesis technique. The ruminal pH was evaluated to study the association with BCS, SBHB and postpartum disorders using linear regression in a generalized linear mixed model with farm as a random effect. The results show that low ruminal pH was associated with dystocia, metritis and lameness. Moreover, a low ruminal pH can be found in cows with a high loss of BCS after calving and also in cows with low SBHB postpartum. These findings confirmed the feasibility of the ruminocentesis technique and the association of low ruminal pH on various postpartum disorders at the individual cow level. However, the consequences of low ruminal pH on dairy cow health still needs more exploration for a better understanding of the physiological mechanisms.

  15. Considering a Relational Model for Depression in Women with Postpartum Depression

    PubMed Central

    Williams, Reg A.; Seng, Julia S.

    2015-01-01

    Purpose To extend testing of a relational theory that a low sense of belonging, delayed or impaired bonding, and loneliness are salient risk factors for postpartum depression (PPD) in women. Methods Data for this theory-testing analysis came from a larger prospective longitudinal cohort study and included women who were retained to the end of the study at the 6 week postpartum interview (n=564). Structural equation modeling was used to test the “fit” of the model and determine significance of direct and indirect paths. Results The model explained 35% of the variance in postpartum depression with impaired bonding and loneliness as the strongest indicators. Lower sense of belonging, less perceived social support from a healthcare practitioner and a partner, and lower parenting sense of competence were additional predictors. Conclusion Study findings challenge current thinking about the relationship between impaired bonding and PPD as this study raises the possibility that impaired bonding is a risk for PPD as opposed to the reverse relationship. The study provided evidence of the importance of healthcare practitioners’ alliance with patients. This paper contributes to advancing the science of women’s mental health in relation to depression by considering additional predictors which might be amenable to intervention. PMID:25705566

  16. Seasonal Effects on Depression Risk and Suicidal Symptoms in Postpartum Women

    PubMed Central

    Sit, Dorothy; Seltman, Howard; Wisner, Katherine L.

    2011-01-01

    Background Postpartum depression (PPD) is the most common complication of childbirth. Suicide is a leading cause of maternal death in the first postpartum year. Depressed mothers often have suicidal ideation (SI). Depression and suicidality may vary across the seasons. Previous studies of seasonality and PPD were relatively small or encumbered by study design constraints. We examined the possible relationship between seasonality, depression, and SI in 9,339 new mothers. Methods From 2006 to 2010, the investigators screened women within 4–6 weeks postpartum with the Edinburgh Postnatal Depression Scale (EPDS). We used spectral analysis to explore seasonal variation in risk for depression and suicidality. Results The study team screened 9,339 new mothers, of whom 1,316 (14%) women had positive depression scores (EPDS ≥ 10) which suggest PPD risk; 294 (3%) women had SI (item 10 ≥ 1). A positive EPDS was associated significantly with SI. PPD risk varied significantly across 12-months—risk was highest in December. We detected no seasonal variation in SI. Conclusions Effects of seasonal light variation may contribute to increased risk for depressive symptoms. Suicidality could be related to maternal depression but not seasonal variation. PMID:21381158

  17. What are postpartum women doing while the rest of the world is asleep?

    PubMed

    McBean, Amanda L; Montgomery-Downs, Hawley E

    2015-06-01

    Large individual differences characterize maternal postpartum sleep and adjustment. Our goal was to explore aspects of mothers' nocturnal environments and behaviours that may explain differences in postpartum adjustment. A total of 201 mothers of infants aged 0-6 months completed an online survey with demographics, number and duration of nocturnal awakenings, caretaking behaviours, environment and nocturnal activities during 'one typical night during the past week'. Mothers reported 2.9 [standard deviation (SD) ± 1.7] nocturnal awakenings, each lasting 33.9 (SD ± 22.5) min. Infant age was related inversely to duration but unrelated to number of awakenings. Falling asleep while feeding was less frequent among exclusively formula-feeders. Among the entire sample, mothers used a cellphone (59%), backlit tablet (25%), TV (20%) and computer (16%) during nocturnal awakenings. Watching TV and using a computer were each associated with longer nocturnal awakenings. Eighty-nine per cent of women used ≥1 extra light source during nocturnal awakenings: night light (35%), light from a cracked door (28%), desk lamp (25%), electronic device (19%) or room light (14%). Light source(s) was unrelated to number or duration of nocturnal awakenings. These data suggest that, although supplemental light sources were not associated with awakenings, TV and computer use accounted for longer awakenings. Feeding method and technology use may help to explain individual differences in postpartum adjustments and may be targets for more effective interventions. PMID:25431167

  18. Treatment-resistant, five-year long, postpartum-onset Capgras episode resolving after electroconvulsive therapy.

    PubMed

    Rapinesi, Chiara; Kotzalidis, Georgios D; Del Casale, Antonio; Ferri, Vittoria Rachele; Di Pietro, Simone; Scatena, Paola; Serata, Daniele; Danese, Emanuela; Sani, Gabriele; Koukopoulos, Alexia E; Angeletti, Gloria; Girardi, Paolo

    2015-01-01

    Postpartum psychosis, which rarely presents with Capgras syndrome (delusional misidentification), requires rapid symptom resolution. First-line drugs have important drawbacks, such as delayed onset of clinical response and secretion in breast milk. In this report, we report successful treatment of a treatment-resistant woman presenting with treatment-resistant Capgras syndrome, with onset during postpartum. A 36-year-old woman had presented with Capgras syndrome during postpartum. For more than five years, she believed her son and other family members were substituted by impostors. All adequately administrated treatments were unsuccessful. We suggested electroconvulsive therapy to overcome treatment resistance. After six electroconvulsive therapy sessions, delusions of doubles subsided and other symptoms improved. She was discharged two weeks later with a mood stabilizer and low-dose atypical antipychotic combination and is well at the one-and-a-half-year follow-up. Electroconvulsive therapy followed by a mood stabilizer-antipsychotic drug combination showed rapid, permanent, and effective control of long-standing Capgras syndrome in a young woman.

  19. 45 CFR 4.6 - Materials related to petitions under the National Vaccine Injury Compensation Program.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Vaccine Injury Compensation Program. 4.6 Section 4.6 Public Welfare DEPARTMENT OF HEALTH AND HUMAN... Vaccine Injury Compensation Program. Notwithstanding the provisions of §§ 4.1, 4.2, and 4.3, service of..., shall be served upon the Director, Division of Vaccine Injury Compensation, Office of Special...

  20. 45 CFR 4.6 - Materials related to petitions under the National Vaccine Injury Compensation Program.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Vaccine Injury Compensation Program. 4.6 Section 4.6 Public Welfare Department of Health and Human... Vaccine Injury Compensation Program. Notwithstanding the provisions of §§ 4.1, 4.2, and 4.3, service of..., shall be served upon the Director, Division of Vaccine Injury Compensation, Office of Special...

  1. 45 CFR 4.6 - Materials related to petitions under the National Vaccine Injury Compensation Program.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Vaccine Injury Compensation Program. 4.6 Section 4.6 Public Welfare DEPARTMENT OF HEALTH AND HUMAN... Vaccine Injury Compensation Program. Notwithstanding the provisions of §§ 4.1, 4.2, and 4.3, service of..., shall be served upon the Director, Division of Vaccine Injury Compensation, Office of Special...

  2. 45 CFR 4.6 - Materials related to petitions under the National Vaccine Injury Compensation Program.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Vaccine Injury Compensation Program. 4.6 Section 4.6 Public Welfare DEPARTMENT OF HEALTH AND HUMAN... Vaccine Injury Compensation Program. Notwithstanding the provisions of §§ 4.1, 4.2, and 4.3, service of..., shall be served upon the Director, Division of Vaccine Injury Compensation, Office of Special...

  3. 45 CFR 4.6 - Materials related to petitions under the National Vaccine Injury Compensation Program.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Vaccine Injury Compensation Program. 4.6 Section 4.6 Public Welfare DEPARTMENT OF HEALTH AND HUMAN... Vaccine Injury Compensation Program. Notwithstanding the provisions of §§ 4.1, 4.2, and 4.3, service of..., shall be served upon the Director, Division of Vaccine Injury Compensation, Office of Special...

  4. Prenatal β-Endorphin as an Early Predictor of Postpartum Depressive Symptoms in Euthymic Women

    PubMed Central

    Yim, Ilona S.; Glynn, Laura M.; Schetter, Christine Dunkel; Hobel, Calvin J.; Chicz-DeMet, Aleksandra; Sandman, Curt A.

    2010-01-01

    Background After delivery, many women experience symptoms of postpartum depression (PPD), and early identification of women at risk is therefore important. The opioid peptide β-endorphin has been implicated in non-puerperal depression but its role in the development of PPD is unknown. Methods Three hundred and seven women with a singleton, full-term (>37.0 weeks’ GA) pregnancy were recruited early in pregnancy and followed up into the postpartum period. Blood samples were obtained at 15, 19, 25, 31 and 37 weeks’ gestational age (GA) and at 9 weeks postpartum for assessment of β-endorphin. Depressive symptoms were assessed with the Center for Epidemiological Studies – Depression scale at the last four pregnancy visits and with the Edinburgh Postnatal Depression Scale postpartum. Results Among women who were euthymic at 25 weeks’ GA, those who proceeded to develop PPD symptoms had higher levels of β-endorphin throughout pregnancy compared to women without PPD symptoms (all t > 2.11, p < .05). At each assessment, women above the cut-off score for β-endorphin were at more than three-fold risk for PPD symptoms (odds ratios 3.19 – 4.68) compared to women below the cut-off score. Limitations Self-report of depressive symptoms, no mental health history. Conclusions β-Endorphin may be a useful early predictor of PPD symptoms in women who do not report depressive symptoms in midpregnancy. If replicated, these findings have clinical implications for the identification and treatment of this at risk group and further suggest that some of the pathways leading to this complex disorder may be specific to subgroups of women. PMID:20051292

  5. Suicidal Ideation in Depressed Postpartum Women: Associations with Childhood Trauma, Sleep Disturbance and Anxiety

    PubMed Central

    Sit, Dorothy; Luther, James; Buysse, Daniel; Dills, John L.; Eng, Heather; Okun, Michele; Wisniewski, Stephen; Wisner, Katherine L

    2015-01-01

    Background Suicide is one of the leading causes of death in postpartum women. Identifying modifiable factors related to suicide risk in mothers after delivery is a public health priority. Our study aim was to examine associations between suicidal ideation (SI) and plausible risk factors (experience of abuse in childhood or as an adult, sleep disturbance, and anxiety symptoms) in depressed postpartum women. Methods This secondary analysis included 628 depressed mothers at 4–6 weeks postpartum. Diagnosis was confirmed with the Structured Clinical Interview for DSM-IV. We examined SI from responses to the Edinburgh Postnatal Depression Scale-EPDS item 10; depression levels on the Structured Interview Guide for the Hamilton Depression Rating Scale, Atypical Depression Symptoms (SIGH-ADS); plus sleep disturbance and anxiety levels with subscales from the EPDS and SIGH-ADS items on sleep and anxiety symptoms.. Results Of the depressed mothers, 496 (79%) ‘never’ had thoughts of self-harm; 98 (15.6%) ‘hardly ever’; and 34 (5.4%) ‘sometimes’ or ‘quite often’. Logistic regression models indicated that having frequent thoughts of self-harm was related to childhood physical abuse (odds ratio-OR=1.68, 95% CI=1.00, 2.81); in mothers without childhood physical abuse, having frequent self-harm thoughts was related to sleep disturbance (OR=1.15, 95%CI=1.02, 1.29) and anxiety symptoms (OR=1.11, 95%CI=1.01, 1.23). Discussion Because women with postpartum depression can present with frequent thoughts of self-harm and a high level of clinical complexity, conducting a detailed safety assessment, that includes evaluation of childhood abuse history and current symptoms of sleep disturbance and anxiety, is a key component in the management of depressed mothers. PMID:26001587

  6. Effects of prepartum ingestion of Ipomoea carnea on postpartum maternal and neonate behavior in goats.

    PubMed

    Gotardo, Andre T; Pfister, James A; Ferreira, Marcos Barbosa; Górniak, Silvana Lima

    2011-04-01

    Ipomoea carnea is a toxic plant that grows in tropical areas, and is readily consumed by grazing goats. The plant contains the alkaloids swainsonine and calystegines, which inhibit cellular enzymes and cause systematic cell death. This study evaluated the behavioral effects on dams and kids of prenatal ingestion of this plant. Freshly harvested leaves of I. carnea (10 g/kg body weight) were fed daily to nine pregnant goats from the fifth to the 16th week of gestation; five pregnant goats were controls. Dam and kid behavior were evaluated during 2-hr postpartum. Further evaluation of the offspring was performed using various tests after birth: (1) reaching and discriminating their dam from an alien doe (two tests at 12-hr postpartum), and (2) navigating a progressive maze (2, 4, and 6 days postpartum). Postnatal (n = 2) and fetal (n = 2) mortality were observed in the treated group. Intoxicated kids had difficulty in standing at birth, and only one was able to suckle within 2 hr of birth. Treated kids were slower than controls to arrive at their dam in the discrimination test; treated kids often (seven of nine completed tests) incorrectly chose the alien dam (controls: 0/10 tests). During some runs on days 2, 4, and 6 postpartum, treated kids were slower to leave the starting point of the maze, and were slower to arrive at the dam on all test days. This study suggests that the offspring of pregnant goats given I. carnea during gestation have significant behavioral alterations and developmental delays.

  7. Perinatal Dyadic Psychotherapy for postpartum depression: a randomized controlled pilot trial.

    PubMed

    Goodman, Janice H; Prager, Joanna; Goldstein, Richard; Freeman, Marlene

    2015-06-01

    An integrated approach addressing maternal depression and associated mother-infant relationship dysfunction may improve outcomes. This study tested Perinatal Dyadic Psychotherapy (PDP), a dual-focused mother-infant intervention to prevent/decrease maternal postpartum depression and improve aspects of the mother-infant relationship related to child development. Women recruited from hospital postpartum units were screened using a three-stage process. Forty-two depressed first-time mothers and their 6-week-old infants were enrolled and randomized to receive the PDP intervention or usual care plus depression monitoring by phone. The intervention consisted of eight home-based, nurse-delivered mother-infant sessions consisting of (a) supportive, relationship-based, mother-infant psychotherapy, and (b) a developmentally based infant-oriented component focused on promoting positive mother-infant interactions. Data collected at baseline, post-intervention, and three-month follow-up included measures of maternal depression, anxiety, maternal self-esteem, parenting stress, and mother-infant interaction. Depression and anxiety symptoms and diagnoses decreased significantly, and maternal self-esteem increased significantly across the study time frame with no between-group differences. There were no significant differences between groups on parenting stress or mother-infant interaction at post-intervention and follow-up. No participants developed onset of postpartum depression during the course of the study. PDP holds potential for treating depression in the context of the mother-infant relationship; however, usual care plus depression monitoring showed equal benefit. Further research is needed to explore using low-intensity interventions as a first step in a stepped care approach and to determine what subset of at-risk or depressed postpartum mothers might benefit most from the PDP intervention. PMID:25522664

  8. Vitamin D Status during Pregnancy: A Longitudinal Study in Swedish Women from Early Pregnancy to Seven Months Postpartum.

    PubMed

    Lundqvist, Anette; Sandström, Herbert; Stenlund, Hans; Johansson, Ingegerd; Hultdin, Johan

    2016-01-01

    Low vitamin D levels during pregnancy may have negative consequences for the health of both the mother and child. Cross-sectional studies in childbearing women suggest that vitamin D levels are low during pregnancy, but few studies have followed the same women during pregnancy and postpartum. The aims of this study were to longitudinally assess vitamin D status during pregnancy and postpartum and identify the factors associated with vitamin D status in pregnant women in northern Sweden. Between September 2006 and March 2009, 184 women were consecutively recruited at five antenatal primary care clinics. Blood was sampled, and dietary intake was estimated using a food frequency questionnaire with 66 food items/food aggregates and questions on the intake of vitamin supplements at gestational weeks 12, 21, and 35, as well as at 12 and 29 weeks after birth. Plasma 25(OH) vitamin D levels were analyzed using liquid chromatography tandem-mass spectrometry. At least one-third of the women had 25(OH) vitamin D levels <50 nmol/L on at least one sampling occasion. Plasma levels increased slightly over the gestation period and peaked in late pregnancy. The levels reverted to the baseline levels after birth. Multivariate analysis showed that gestational and postpartum week, season, dietary intake of vitamin D, and vitamin supplementation were significantly related to plasma levels. There was also an influence of season on the longitudinal concentration patterns. In conclusion, more than one-third of the women studied had low 25(OH) vitamin D levels, and gestational and postpartum week was related to 25(OH) vitamin D levels after adjustment for season and vitamin D intake.

  9. Overcoming functional impairment in postpartum depressed or anxious women: a pilot trial of desvenlafaxine with flexible dosing

    PubMed Central

    Misri, Shaila; Swift, Elena; Abizadeh, Jasmin; Shankar, Radhika

    2016-01-01

    Objectives: Antidepressants are the first line treatment for moderate to severe major depressive disorder (MDD) in perinatal and general populations. However, there appears to be paucity of evidence around antidepressant use in women with postpartum depression or anxiety. Selection of an appropriate antidepressant is crucial in promoting efficacy, optimizing tolerability, and managing comorbid anxiety or depression. Our aim was to investigate the treatment effect and tolerability profile of desvenlafaxine, and to examine the functionality of women with postpartum depression or anxiety after desvenlafaxine treatment. Methods: Fifteen postpartum women with depression or anxiety completed this 12-week prospective pilot study with a flexible dose of desvenlafaxine (50–100 mg). Participants were recruited at a tertiary care level program. Measures of depression (Montgomery–Åsberg Depression Rating Scale, MADRS), anxiety (Hamilton Anxiety Rating Scale, HAM-A), worry (Penn State Worry Questionnaire, PSWQ) and functional impairment (Sheehan Disability Scale, SDS) were completed at baseline, 8 weeks, and 12 weeks. Results: In the intention-to-treat analysis (n = 17), the majority of women responded to medication (88.2%, n = 15), and reached remission of depressive (82.4%, n = 14) and anxiety symptoms (82.4%, n = 14). Remission of depression was achieved in a mean of 6.9 weeks [standard deviation (SD) = 3.01] at a mean dose of 71 mg/day (SD = 25.7). Significant decreases were observed on PSWQ worry scores (p < 0.0001) and SDS scores for social (p < 0.0001) and family life impairment (p < 0.0001). The medication was generally well tolerated. Conclusion: The results of our prospective pilot study suggest that treatment with desvenlafaxine of postpartum mothers with depression or anxiety can lead to symptom remission and restoration of functionality. PMID:27536346

  10. Vitamin D Status during Pregnancy: A Longitudinal Study in Swedish Women from Early Pregnancy to Seven Months Postpartum

    PubMed Central

    Lundqvist, Anette; Sandström, Herbert; Stenlund, Hans; Johansson, Ingegerd; Hultdin, Johan

    2016-01-01

    Low vitamin D levels during pregnancy may have negative consequences for the health of both the mother and child. Cross-sectional studies in childbearing women suggest that vitamin D levels are low during pregnancy, but few studies have followed the same women during pregnancy and postpartum. The aims of this study were to longitudinally assess vitamin D status during pregnancy and postpartum and identify the factors associated with vitamin D status in pregnant women in northern Sweden. Between September 2006 and March 2009, 184 women were consecutively recruited at five antenatal primary care clinics. Blood was sampled, and dietary intake was estimated using a food frequency questionnaire with 66 food items/food aggregates and questions on the intake of vitamin supplements at gestational weeks 12, 21, and 35, as well as at 12 and 29 weeks after birth. Plasma 25(OH) vitamin D levels were analyzed using liquid chromatography tandem-mass spectrometry. At least one-third of the women had 25(OH) vitamin D levels <50 nmol/L on at least one sampling occasion. Plasma levels increased slightly over the gestation period and peaked in late pregnancy. The levels reverted to the baseline levels after birth. Multivariate analysis showed that gestational and postpartum week, season, dietary intake of vitamin D, and vitamin supplementation were significantly related to plasma levels. There was also an influence of season on the longitudinal concentration patterns. In conclusion, more than one-third of the women studied had low 25(OH) vitamin D levels, and gestational and postpartum week was related to 25(OH) vitamin D levels after adjustment for season and vitamin D intake. PMID:26938997

  11. Adherence to extended postpartum antiretrovirals is associated with decreased breastmilk HIV-1 transmission: Results of the BAN study

    PubMed Central

    DAVIS, Nicole L.; MILLER, William C.; HUDGENS, Michael G.; CHASELA, Charles S.; SICHALI, Dorothy; KAYIRA, Dumbani; NELSON, Julie A. E.; STRINGER, Jeffrey S. A.; ELLINGTON, Sascha R.; KOURTIS, Athena P.; JAMIESON, Denise J; VAN DER HORST, Charles

    2015-01-01

    Objective Estimate association between postpartum antiretroviral adherence and breastmilk HIV-1 transmission Design Prospective cohort study Methods Mother-infant pairs were randomized after delivery to immediately begin receiving 28 weeks of either triple maternal antiretrovirals (zidovudine, lamivudine, and either nevirapine, nelfinavir, or lopinavir-ritonavir) or daily infant nevirapine as part of the Breastfeeding, Antiretrovirals, and Nutrition study. Associations between postpartum antiretroviral adherence and rate of breastmilk HIV-1 transmission were estimated using Cox models. We measured adherence over four postpartum time intervals using pill count, suspension bottle weight, and maternal self-report. Adherence was categorized and lagged by one interval. Missing adherence measures were multiply imputed. Infant HIV-1 infection was determined by DNA PCR every 2-6 weeks. The primary endpoint was infant HIV-1 infection by 38 weeks of age among infants alive and uninfected at 5 weeks. Results Analyses included 1479 mother-infant pairs and 45 transmission events. Using pill count and bottle weight information, 22-40% of mother-infant pairs at any given interval were <90% adherent. Having ≥90% adherence was associated with a 52% (95% CI 3-76%) relative reduction in the rate of breastmilk HIV-1 transmission, compared with having <90% adherence when controlling for study arm, breastfeeding status, and maternal characteristics. Complete case analysis rendered similar results (n=501; relative reduction 59%, 95% CI 6-82%). Conclusion Non-adherence to extended postpartum ART regimens in ‘real world’ settings is likely to be higher than that seen in BAN. Identifying mothers with difficulty adhering to antiretrovirals, and developing effective adherence interventions, will help maximize benefits of ARV provision throughout breastfeeding. PMID:25493600

  12. Prehypertension During Normotensive Pregnancy and Postpartum Clustering of Cardiometabolic Risk Factors: A Prospective Cohort Study.

    PubMed

    Lei, Qiong; Zhou, Xin; Zhou, Yu-Heng; Mai, Cai-Yuan; Hou, Ming-Min; Lv, Li-Juan; Duan, Dong-Mei; Wen, Ji-Ying; Lin, Xiao-Hong; Wang, Peizhong P; Ling, Xuefeng B; Li, Yu-Ming; Niu, Jian-Min

    2016-08-01

    The nonstratification of blood pressure (BP) levels may underestimate future cardiovascular risk in pregnant women who present with BP levels in the range of prehypertension (120-139/80-89 mm Hg). We prospectively evaluated the relationship between multiple antepartum BP measurements (from 11(+0) to 13(+6) weeks' gestation to term) and the occurrence of postpartum metabolic syndrome in 507 normotensive pregnant women after a live birth. By using latent class growth modeling, we identified the following 3 distinctive diastolic BP (DBP) trajectory groups: the low-J-shaped group (34.2%; DBP from 62.5±5.8 to 65.0±6.8 mm Hg), the moderate-U-shaped group (52.6%; DBP from 71.0±5.9 to 69.8±6.2 mm Hg), and the elevated-J-shaped group (13.2%; DBP from 76.2±6.7 to 81.8±4.8 mm Hg). Notably, the elevated-J-shaped trajectory group had mean DBP and systolic BP levels within the range of prehypertension from 37(+0) and 26(+0) weeks of pregnancy, respectively. Among the 309 women who completed the ≈1.6 years of postpartum follow-up, the women in the elevated-J-shaped group had greater odds of developing postpartum metabolic syndrome (adjusted odds ratio, 6.55; 95% confidence interval, 1.79-23.92; P=0.004) than the low-J-shaped group. Moreover, a parsimonious model incorporating DBP (membership in the elevated-J-shaped group but not in the DBP prehypertension group as identified by a single measurement) and elevated levels of fasting glucose (>4.99 mmol/L) and triglycerides (>3.14 mmol/L) at term was developed, with good discrimination and calibration for postpartum metabolic syndrome (c-statistic, 0.764; 95% confidence interval, 0.674-0.855; P<0.001). Therefore, prehypertension identified by DBP trajectories throughout pregnancy is an independent risk factor for predicting postpartum metabolic syndrome in normotensive pregnant women. PMID:27354425

  13. Prevalence and risk factors for postpartum depressive symptoms in Argentina: a cross-sectional study

    PubMed Central

    Mathisen, Siv Elin; Glavin, Kari; Lien, Lars; Lagerløv, Per

    2013-01-01

    Introduction Postpartum depression is a prevalent disorder with negative consequences for women, infants, and the family as a whole. Most studies of this disorder have been conducted in Western countries, and studies from developing countries are few. In this paper, we report the first – as far as we are aware – study of the prevalence and risk factors associated with postpartum depressive symptoms in Argentina. Materials and methods The study participants were 86 women attending 6 week checkups, (range 4–12 weeks) postpartum at a private health care center in the metropolitan area of Buenos Aires. The women completed the Edinburgh Postnatal Depression Scale (EPDS) and a questionnaire collecting demographic and obstetric data. Data were described as proportions (percentages). Differences between proportions were assessed with chi-squared tests. To control for possible confounders, we fitted bivariate logistic regression models in which the dependent variable was an EPDS sum score of <10 versus a score of ≥10. Results We found a high prevalence of depressive symptoms. A total of 32 women (37.2%) had an EPDS score of ≥10, 16 (18.6%) had a score between 10 and 12, and 16 (18.6%) had a score of ≥13. In our sample, an EPDS score of ≥10 was significantly associated with multiparity (odds ratio [OR] =3.58; 95% confidence interval [CI]: 1.13–11.30; P=0.030), pregnancy complications (OR =3.40; 95% CI: 1.03–11.26; P=0.045), labor complications (OR =11.43; 95% CI: 1.71–76.61; P=0.012), cesarean section (OR =4.19; 95% CI: 1.10–16.01; P=0.036), and incomplete breast-feeding (OR =5.00; 95% CI: 1.42–17.54; P=0.012). Conclusion Our results indicate that postpartum depression may be prevalent in Argentina, and may be associated with incomplete breast-feeding, cesarean section, perinatal complications and multiparity. The prevalence and risk factors for postpartum depression has not been described previously and is a considerable health-related problem among

  14. Women's Experiences with Postpartum Anxiety: Expectations, Relationships, and Sociocultural Influences

    ERIC Educational Resources Information Center

    Wardrop, Andrea A.; Popadiuk, Natalee E.

    2013-01-01

    Evidence about anxiety in the postpartum is sparse and contradictory. Our research expands this knowledge by using a qualitative methodology, the Feminist Biographical Method, to explore first time mothers' experiences of postpartum anxiety. Data collection included 1.5 to 2.0 hour interviews with six women about their experiences of anxiety in…

  15. Committee opinion no. 530: access to postpartum sterilization.

    PubMed

    2012-07-01

    Postpartum tubal sterilization is one of the safest and most effective methods of contraception. Women who desire this type of sterilization typically undergo thorough counseling and informed consent during prenatal care and reiterate their desire for postpartum sterilization at the time of their hospital admission. Not all women who desire postpartum sterilization actually undergo the surgical procedure, and women with unfulfilled requests for postpartum sterilization have a high rate of repeat pregnancy (approaching 50%) within the following year. Potentially correctable barriers to obtaining postpartum sterilization include patient and health care provider factors, as well as hospital and health care system issues. Given the consequences of a missed procedure and the limited time frame in which it may be performed, postpartum sterilization should be considered an urgent surgical procedure. In addition, women with government insurance face barriers to sterilization procedures based on cumbersome consent requirements. The differences in the requirements surrounding consent for sterilization procedures based on the type of insurance a patient has must be addressed in order to establish fair and equitable access to sterilization procedures for all women. Policies and procedures that remove barriers to and increase efficiency in performing postpartum sterilization could reduce cancellations of the procedure. Improving consistency in accomplishing desired postpartum sterilization is an important strategy to reduce high rates of unintended pregnancy in the United States.

  16. Factors Influencing Physical Activity among Postpartum Iranian Women

    ERIC Educational Resources Information Center

    Roozbahani, Nasrin; Ghofranipour, Fazlollah; Eftekhar Ardabili, Hassan; Hajizadeh, Ebrahim

    2014-01-01

    Background: Postpartum women are a population at risk for sedentary living. Physical activity (PA) prior to pregnancy may be effective in predicting similar behaviour in the postpartum period. Objective: To test a composite version of the extended transtheoretical model (TTM) by adding "past behaviour" in order to predict PA behaviour…

  17. Cluster Subtypes Appropriate for Preventing Postpartum Smoking Relapse

    PubMed Central

    Simonelli, Mary Colleen; Velicer, Wayne F

    2011-01-01

    Objective While the majority of women quit smoking either before or during pregnancy, 60 to 80% relapse in the postpartum period. The objective of this research was to examine postpartum women who quit smoking during their pregnancies and to determine the predictive factors for relapse in the postpartum period by identifying different subgroups that predict risk of relapse. Method One hundred forty four postpartum women who were abstinent at the time of delivery were recruited. Data regarding the Acquisition Stage of Change, Decisional Balance and Situational Temptations to Smoke were assessed in the immediate postpartum period. Based on their intention to remain abstinent, 121 women identified in the acquisition-Precontemplation (aPC) group comprised the study sample. Smoking status was assessed again at 2-months postpartum Results A cluster analysis was performed to idenitfy subgroups of the acquisition-Precontemplation (aPC) group. Four subgroups were identified and were labeled Most Protected, Ambivalent, Risk Denial, and High Risk. Logistic regression was performed to establish external validity of the clusters. The clusters and exclusive breastfeeding were the only statistically significant variables associated with relapse at 2-months postpartum. Conclusions The results confirmed the clusters identified in previous prevention research with both adolescents and postpartum women, The cluster profiles can serve to guide the development of a tailored intervention program. PMID:22136873

  18. Challenges in Diagnosing and Treating Postpartum Blues, Depression and Psychosis

    ERIC Educational Resources Information Center

    Lewis, Carol A.; Byers, Alison Daly; Malard, Sarah Deann; Dawson, Gregory A.

    2010-01-01

    With recent media attention and a growing awareness in popular culture, the appropriate treatment for postpartum depression has taken center stage as a prevalent women's health issue. There is little agreement on the definition, existence and treatment of postpartum depression. Contributing to this factor is the lack of research that exists to…

  19. Severe Maternal Pre- and Postpartum Intra-Abdominal Bleeding due to Deciduosis

    PubMed Central

    Lüdders, D. W.; Henke, R.-P.; Saba, M.; Raddatz, L.; Soliman, A.; Malik, E.

    2015-01-01

    The term “deciduosis” is used to describe the severe pregnancy-associated occurrence of ectopic decidua with a usually asymptomatic course. We report on two cases of massive maternal intra-abdominal bleeding due to such symptomatic changes. The complications arose at different time points for the two cases: prepartum (26th week of pregnancy) or, respectively, – reported here for the first time – seven days postpartum. As well as differential diagnostic aspects we describe the management of the disease and its possible effects on subsequent pregnancies. PMID:25914420

  20. Obesity-Related Dietary Behaviors among Racially and Ethnically Diverse Pregnant and Postpartum Women

    PubMed Central

    Harris, Ashley; Chilukuri, Nymisha; West, Meredith; Henderson, Janice; Lawson, Shari; Polk, Sarah; Levine, David; Bennett, Wendy L.

    2016-01-01

    Introduction. Obesity is common among reproductive age women and disproportionately impacts racial/ethnic minorities. Our objective was to assess racial/ethnic differences in obesity-related dietary behaviors among pregnant and postpartum women, to inform peripartum weight management interventions that target diverse populations. Methods. We conducted a cross-sectional survey of 212 Black (44%), Hispanic (31%), and White (25%) women, aged ≥ 18, pregnant or within one year postpartum, in hospital-based clinics in Baltimore, Maryland, in 2013. Outcomes were fast food or sugar-sweetened beverage intake once or more weekly. We used logistic regression to evaluate the association between race/ethnicity and obesity-related dietary behaviors, adjusting for sociodemographic factors. Results. In adjusted analyses, Black women had 2.4 increased odds of fast food intake once or more weekly compared to White women (CI = 1.08, 5.23). There were no racial/ethnic differences in the odds of sugar-sweetened beverage intake. Discussion. Compared with White or Hispanic women, Black women had 2-fold higher odds of fast food intake once or more weekly. Black women might benefit from targeted counseling and intervention to reduce fast food intake during and after pregnancy. PMID:27298738

  1. Postpartum Mood Disorders Screening in the NICU.

    PubMed

    Scheans, Patricia; Mischel, Rebecca; Munson, Margi; Bulaevskaya, Katya

    2016-01-01

    Maternal depression is increasingly recognized as the leading complication of childbearing. A mother's mental health impacts the well-being and long-term outcomes of her children. This column will discuss a systematic approach to screening for maternal postpartum mood disorders (PPMDs) and referring women to resources according to an established algorithm. This work was undertaken in a tertiary referral NICU and performed by dedicated NICU personnel with the goals of optimizing NICU infants' outcomes and supporting maternal and family health and well-being. PMID:27461203

  2. Modern use of extracorporeal life support in pregnancy and postpartum.

    PubMed

    Sharma, Nirmal S; Wille, Keith M; Bellot, Scott C; Diaz-Guzman, Enrique

    2015-01-01

    Extracorporeal membrane oxygenation (ECMO) use during pregnancy and the postpartum period are thought to be associated with an increased risk for maternal or fetal bleeding complications. We present our recent institutional experience in managing pregnant and postpartum patients with ECMO. We also performed a literature review of modern use of ECMO in pregnant and postpartum patients utilizing Pubmed and Embase databases. ECMO was used for severe cardiopulmonary failure due to multiple conditions. Based on published reports, overall maternal and fetal survival on ECMO were 80% and 70%, respectively. Mild-to-moderate vaginal bleeding was reported in a few cases, with rare occurrences of catastrophic postpartum hemorrhage. There was no consensus on an optimal anticoagulation strategy in these patients, though most preferred to keep anticoagulation at lower therapeutic levels. We conclude that ECMO, in well-selected pregnant and postpartum patients, appears to be safe and associated with low risk of maternal and fetal complications.

  3. Postpartum and Post-Abortion Contraception: From Research to Programs.

    PubMed

    Shah, Iqbal H; Santhya, K G; Cleland, John

    2015-12-01

    Contraception following delivery or an induced abortion reduces the risk of an early unintended pregnancy and its associated adverse health consequences. Unmet need for contraception during the postpartum period and contraceptive counseling and services following abortion have been the focus of efforts for the last several decades. This article provides an introduction to the more focused contributions that follow in this special issue. We discuss the validity and measurement of the concept of unmet need for family planning during the postpartum period. We then present key findings on postpartum contraceptive protection, use dynamics, and method mix, followed by an assessment of interventions to improve postpartum family planning. The evidence on postabortion contraceptive uptake and continuation of use remains thin, although encouraging results are noted for implementation of comprehensive abortion care and for the impact of post-abortion contraceptive counseling and services. Drawing on these studies, we outline policy and program implications for improving postpartum and post-abortion contraceptive use.

  4. Perspective of Postpartum Depression Theories: A Narrative Literature Review

    PubMed Central

    Abdollahi, Fatemeh; Lye, Munn-Sann; Zarghami, Mehran

    2016-01-01

    Postpartum depression is the most prevalent emotional problem during a women's lifespan. Untreated postpartum depression may lead to several consequences such as child, infant, fetal, and maternal effects. The main purpose of this article is to briefly describe different theoretical perspectives of postpartum depression. A literature search was conducted in Psych Info, PubMed, and Science Direct between 1950 and 2015. Additional articles and book chapters were referenced from these sources. Different theories were suggested for developing postpartum depression. Three theories, namely, biological, psychosocial, and evolutionary were discussed. One theory or combinations of psychosocial, biological, and evolutionary theories were considered for postpartum depression. The most important factor that makes clinicians’ choice of intervention is their theoretical perspectives. Healthcare providers and physicians should help women to make informed choices regarding their treatment based on related theories. PMID:27500126

  5. Perspective of Postpartum Depression Theories: A Narrative Literature Review.

    PubMed

    Abdollahi, Fatemeh; Lye, Munn-Sann; Zarghami, Mehran

    2016-06-01

    Postpartum depression is the most prevalent emotional problem during a women's lifespan. Untreated postpartum depression may lead to several consequences such as child, infant, fetal, and maternal effects. The main purpose of this article is to briefly describe different theoretical perspectives of postpartum depression. A literature search was conducted in Psych Info, PubMed, and Science Direct between 1950 and 2015. Additional articles and book chapters were referenced from these sources. Different theories were suggested for developing postpartum depression. Three theories, namely, biological, psychosocial, and evolutionary were discussed. One theory or combinations of psychosocial, biological, and evolutionary theories were considered for postpartum depression. The most important factor that makes clinicians' choice of intervention is their theoretical perspectives. Healthcare providers and physicians should help women to make informed choices regarding their treatment based on related theories.

  6. [Postpartum depression: we know the risks, can it be prevented?].

    PubMed

    Zinga, Dawn; Phillips, Shauna Dae; Born, Leslie

    2005-10-01

    In the past 20 years, there has been increasing recognition that for some women, pregnancy may be burdened with mood problems, in particular depression, that may impact both mother and child. With identification of risk factors for postpartum depression and a growing knowledge about a biologic vulnerability for mood change following delivery, research has accumulated on attempts to prevent postpartum depression using various psychosocial, psychopharmacologic, and hormonal strategies. The majority of psychosocial and hormonal strategies have shown little effect on postpartum depression. Notwithstanding, results from preliminary trials of interpersonal therapy, cognitive-behavioural therapy, and antidepressants indicate that these strategies may be of benefit. Information on prevention of postpartum depression using dietary supplements is sparse and the available evidence is inconclusive. Although a few studies show promising results, more rigorous trials are required. The abounding negative evidence in the literature indicates that postpartum depression cannot be easily prevented, yet.

  7. The relationship between restrictive state abortion laws and postpartum depression.

    PubMed

    Medoff, Marshall H

    2014-01-01

    Is there a relationship between restrictive state abortion laws and postpartum depression? Do states with restrictive abortion laws have higher rates of postpartum depression? If there is a relationship, does it differ by the type of restrictive state abortion law? Using the Centers for Disease Control's 2008 Pregnancy Risk Assessment Monitoring System state survey of the percentage of women who gave birth and suffered from postpartum depression, states with and without restrictive abortion laws were compared. The empirical results found that there were no significant differences in the incidence of postpartum depression between states with parental involvement laws, mandatory counseling laws, waiting period laws, two-visit laws, and states without these restrictive abortion laws. States that prohibit the Medicaid funding of abortions have significantly higher rates of postpartum depression than in those states that fund Medicaid abortions. PMID:25068613

  8. Perspective of Postpartum Depression Theories: A Narrative Literature Review.

    PubMed

    Abdollahi, Fatemeh; Lye, Munn-Sann; Zarghami, Mehran

    2016-06-01

    Postpartum depression is the most prevalent emotional problem during a women's lifespan. Untreated postpartum depression may lead to several consequences such as child, infant, fetal, and maternal effects. The main purpose of this article is to briefly describe different theoretical perspectives of postpartum depression. A literature search was conducted in Psych Info, PubMed, and Science Direct between 1950 and 2015. Additional articles and book chapters were referenced from these sources. Different theories were suggested for developing postpartum depression. Three theories, namely, biological, psychosocial, and evolutionary were discussed. One theory or combinations of psychosocial, biological, and evolutionary theories were considered for postpartum depression. The most important factor that makes clinicians' choice of intervention is their theoretical perspectives. Healthcare providers and physicians should help women to make informed choices regarding their treatment based on related theories. PMID:27500126

  9. Penta- and 2,4,6-tri-chlorophenol biodegradation during municipal solid waste anaerobic digestion.

    PubMed

    Limam, Intissar; Limam, Rim Driss; Mezni, Mohamed; Guenne, Angéline; Madigou, Céline; Driss, Mohamed Ridha; Bouchez, Théodore; Mazeas, Laurent

    2016-08-01

    In this study isotopic tracing using (13)C labelled pentachlorophenol (PCP) and 2,4,6-trichlorophenol (2,4,6-TCP) is proposed as a tool to distinguish the loss of PCP and 2,4,6-TCP due to biodegradation from other physical processes. This isotopic approach was applied to accurately assess in situ PCP and 2,4,6-TCP degradation under methanogenic conditions in several microcosms made up of household waste. These microcosms were incubated in anaerobic conditions at 35°C (mesophilic) and 55°C (thermophilic) without agitation. The volume of biogas produced (CH4 and CO2), was followed for a period of 130 days. At this stage of stable methanogenesis, (13)C6-PCP and (13)C6-2,4,6-TCP were introduced anaerobically in microcosms and its monitoring at mesophilic and thermophilic conditions was performed in parallel by gas chromatography mass spectrometry (GC-MS) and gas chromatography isotope-ratio mass spectrometry (GC-IRMS). This study proved the almost total dechlorination of bioavailable PCP and 2,4,6-TCP into 4-CP at 35°C. Nevertheless, high rate adsorption in particular materials of the two compounds was observed. Furthermore, Carbon-13 Nuclear Magnetic Resonance ((13)C-NMR) Spectroscopy analysis of (13)C labelled 2,4,6-TCP mesophilic incubations showed the partial mineralization of 4-CP at 35°C to acetate and then to HCO(3-). Consequently, NMR results confirm the biogas isotopic results indicating the mineralization of (13)C labelled 2,4,6-TCP into (13)C (CH4 and CO2). Concerning (13)C labelled PCP mesophilic incubations, the isotopic composition of the biogas still natural until the day 262. In contrast, no dechlorination was observed at 55°C. Thus PCP and 2,4,6-TCP were persistent in thermophilic conditions.

  10. On the common modulus attack into the LUC4,6 cryptosystem

    NASA Astrophysics Data System (ADS)

    Wong, Tze Jin; Said, Mohd Rushdan Md; Othman, Mohamed; Koo, Lee Feng

    2015-05-01

    The LUC4,6 cryptosystem is a system analogy with RSA cryptosystem and extended from LUC and LUC3 cryptosystems. The process of encryption and decryption are derived from the fourth order linear recurrence sequence and based on Lucas function. This paper reports an investigation into the common modulus attack on the LUC4,6 cryptosystem. In general, the common modulus attack will be succeeded if the sender sends the plaintext to two users used same RSA-modulus and both of encryption keys of them are relatively prime to each other. However, based on the characteristics of high order Lucas sequence, the LUC4,6 cryptosystem is unattackable

  11. Antepartum to postpartum changes in transcapillary fluid balance.

    PubMed

    Bungum, L; Tollan, A; Oian, P

    1990-09-01

    During the puerperium significant changes occur in the body volume homeostasis. In the present study the transcapillary fluid balance was examined antepartum in nine healthy women. The interstitial colloid osmotic pressure was measured by the 'wick' method, and interstitial hydrostatic pressure by the 'wick-in-needle' method in subcutaneous tissue on the thorax and at the ankle. From antepartum (gestational week 37-40) to postpartum (5th day), the following changes were observed: A significant increase in the colloid osmotic pressure both in plasma (mean 1.8 mmHg, P = 0.027) and in the interstitial fluid at the ankle (mean 2.9 mmHg, P = 0.008). Neither colloid osmotic pressure gradient (plasma-interstitium), interstitial hydrostatic pressure, nor haemoglobin and haematocrit changed. The observed rise in the interstitial colloid osmotic pressure must be caused by mobilization of fluid from the interstitium, probably due to a reduced capillary hydrostatic pressure. The increase in plasma colloid osmotic pressure is most likely caused by an increased albumin synthesis and/or transport of interstitial proteins back to the vascular compartment.

  12. Emotional memory in pregnant women at risk for postpartum depression.

    PubMed

    Williams, Marissa E; Becker, Suzanna; McKinnon, Margaret C; Wong, Queenie; Cudney, Lauren E; Steiner, Meir; Frey, Benicio N

    2015-10-30

    Postpartum depression (PPD) is associated with debilitating effects on mothers and their infants. A previous history of depression is considered the strongest risk factor for PPD. Depressed individuals recall more negative than positive content and higher levels of stress hormones released during encoding are associated with enhanced recall of emotional stimuli. This study examined the impact of a previous history of major depressive disorder (MDD) and pregnancy on emotional memory. Seventy-seven participants completed the study [44 pregnant women in the second trimester of pregnancy with and without a lifetime history of MDD and 33 non-pregnant women with and without a lifetime history of MDD]. All completed an encoding task and provided salivary cortisol (sCORT) and alpha-amylase (sAA) samples. Participants returned one week later for a surprise incidental recognition memory task. Women with a history of MDD had worse recognition than women without a history of MDD for negative, but not positive images; this effect was independent of sCORT and sAA levels. Pregnancy did not affect emotional memory. Considering that several previous studies found enhanced memory bias for negative content during depressive states, our results suggest that clinical remission may be associated with an opposite cognitive processing of negative emotional content. PMID:26272023

  13. Postpartum depression and help-seeking behavior.

    PubMed

    McGarry, Joanne; Kim, Han; Sheng, Xiaoming; Egger, Marlene; Baksh, Laurie

    2009-01-01

    The objective of this analysis was to investigate the demographic differences between women who report postpartum depression symptoms (PPDS) and seek help versus those who report symptoms but who do not seek help, using data from the Utah Pregnancy Risk Assessment Monitoring System (PRAMS) 2004 dataset. Overall, 14.7% of Utah women reported experiencing PPDS in 2004. Sixty percent of the women who reported having PPDS did not seek help. Seeking help for depression during pregnancy was associated with help-seeking behavior postpartum (adjusted odds ratio [aOR] = 0.1; 95% confidence interval [CI], 0.04-0.2). Other factors associated with seeking help included having an infant admitted to the intensive care unit (aOR = 0.4; 95% CI, 0.2-0.9) and rural residency (aOR = 0.3; 95% CI, 0.2-0.7). Nonwhite women were 12.1 times (95% CI, 3.0-48.5) more likely to not seek help for depression compared to white women. Further, Hispanic women (aOR = 3.2; 95% CI, 1.3-8.1) and women who experienced emotional abuse had increased odds of not seeking help (aOR = 2.9; 95% CI, 1.3-6.2). Nearly 15% of Utah women in this study reported PPDS, yet fewer than half sought help. Target populations, such as nonwhite, Hispanic, emotionally abused, and urban women, have been identified for public health interventions.

  14. The Effects of SPARK Physical Education Program on Fundamental Motor Skills in 4-6 Year-Old Children

    PubMed Central

    Mostafavi, Reza; Ziaee, Vahid; Akbari, Hakimeh; Haji-Hosseini, Samaneh

    2013-01-01

    Objective The purpose of this study was to investigate the effect of SPARK Physical Education (PE) program on fundamental motor skills in 4-6 year children. SPARK (Sports, Play, and Active Recreation for Kids) is an evidence based PE program designed in order to promote the lifelong wellbeing. Methods In total, 90 children aged 4 to 6 years were selected randomly. The children were allocated into 3 groups with separate PE programs: 1-SPARK, 2-Gymnastics and 3-Routine activity. Using the Test of Gross Motor Development (TGMD-2), a pretest was done in all groups. Afterwards, SPARK and Gym PE programs were performed for 8 weeks and 3 sessions each week. The third group used to do the routine physical education program in their daycare. After 8 weeks (24 sessions), the post tests were done for all groups with the same scoring system as the pretest. Findings The results showed that the SPARK program had a higher efficacy on the promotion of the fundamental motor skills comparing to the routine physical education programs or gymnastics PE group. Conclusion SPARK can be used as an appropriate alternative in order to promote the children's motor skills. PMID:23724186

  15. Financial Incentives for Smoking Cessation Among Depression-Prone Pregnant and Newly Postpartum Women: Effects on Smoking Abstinence and Depression Ratings

    PubMed Central

    Lopez, Alexa A.; Skelly, Joan M.

    2015-01-01

    Introduction: We examined whether pregnant and newly postpartum smokers at risk for postpartum depression respond to an incentive-based smoking-cessation treatment and how the intervention impacts depression ratings. Methods: This study is a secondary data analysis. Participants (N = 289; data collected 2001–2013) were smokers at the start of prenatal care who participated in 4 controlled clinical trials on the efficacy of financial incentives for smoking cessation. Women were assigned either to an intervention wherein they earned vouchers exchangeable for retail items contingent on abstaining from smoking or to a control condition wherein they received vouchers of comparable value independent of smoking status. Treatments were provided antepartum through 12-weeks postpartum. Depression ratings (Beck Depression Inventory [BDI]-1A) were examined across 7 antepartum/postpartum assessments. Women who reported a history of prior depression or who had BDI scores ≥ 17 at the start of prenatal care were categorized as depression-prone (Dep+), while those meeting neither criterion were categorized as depression-negative (Dep−). Results: The intervention increased smoking abstinence independent of depression status (p < .001), and it decreased mean postpartum BDI ratings as well as the proportion of women scoring in the clinical range (≥17 and >21) compared with the control treatment (ps ≤ .05). Treatment effects on depression ratings were attributable to changes in Dep+ women. Conclusions: These results demonstrate that depression-prone pregnant and newly postpartum women respond well to this incentive-based smoking-cessation intervention in terms of achieving abstinence, and the intervention also reduces the severity of postpartum depression ratings in this at-risk population. PMID:25762756

  16. Seminar on the Associated Schools: N'Djamena, Chad, 4-6 May 1982.

    ERIC Educational Resources Information Center

    International Understanding at School, 1982

    1982-01-01

    Recommendations of a seminar held in N'Djamena, Chad, from May 4-6, 1982, to support the activities of the Associated Schools project intended to promote international understanding and peace are described. (RM)

  17. COMPARISON OF BIOMARKERS IN WORKERS EXPOSED TO 2,4,6-TRINITROTOLUENE

    EPA Science Inventory

    2,4,6-Trinitrotoluene (TNT) is an important occupational and environmental pollutant. In TNT-exposed humans, the notable toxic manifestations have included aplastic anemia, toxic hepatitis, cataracts, hepatomegaly, and liver cancer. Therefore, we developed methods to biomonitor w...

  18. Desulfurization of 2,4,6,8-tetraethyl dibenzothiophene by recombinant Mycobacterium sp. strain MR65.

    PubMed

    Watanabe, Kimiko; Noda, Ken-ichi; Konishi, Jin; Maruhashi, Kenji

    2003-09-01

    Recombinant Mycobacterium sp. strain MR65 harboring dszABCD genes was used to desulfurize alkyl dibenzothiophenes (Cx-DBTs) in n-hexadecane. The specific desulfurization activity for 2,4,6,8-tetraethyl DBT (C8-DBT) by DszC enzyme was about twice that for 4,6-dipropyl DBT (C6-DBT). However, the degradation rate of 2,4,6,8-tetraethyl DBT in n-hexadecane by resting cells of strain MR65 was only about 40% of that of 4,6-dipropyl DBT. These results indicated that the desulfurization ability for Cx-DBTs by resting cells depends on carbon number substituted at positions 4 and 6 and that the rate-limiting step in the desulfurization reaction of highly alkylated Cx-DBTs is the transfer process from the oil phase into the cell.

  19. The Specific Role of Relationship Life Events in the Onset of Depression during Pregnancy and the Postpartum

    PubMed Central

    Wright, Nicola; Hill, Jonathan; Pickles, Andrew; Sharp, Helen

    2015-01-01

    Background The precipitating role of life events in the onset of depression is well-established. The present study sought to examine whether life events hypothesised to be personally salient would be more strongly associated with depression than other life events. In a sample of women making the first transition to parenthood, we hypothesised that negative events related to the partner relationship would be particularly salient and thus more strongly predictive of depression than other events. Methods A community-based sample of 316 first-time mothers stratified by psychosocial risk completed interviews at 32 weeks gestation and 29 weeks postpartum to assess dated occurrence of life events and depression onsets from conception to 29 weeks postpartum. Complete data was available from 273 (86.4%). Cox proportional hazards regression was used to examine risk for onset of depression in the 6 months following a relationship event versus other events, after accounting for past history of depression and other potential confounders. Results 52 women (19.0%) experienced an onset of depression between conception and 6 months postpartum. Both relationship events (Hazard Ratio = 2.1, p = .001) and other life events (Hazard Ratio = 1.3, p = .020) were associated with increased risk for depression onset; however, relationship events showed a significantly greater risk for depression than did other life events (p = .044). Conclusions The results are consistent with the hypothesis that personally salient events are more predictive of depression onset than other events. Further, they indicate the clinical significance of events related to the partner relationship during pregnancy and the postpartum. PMID:26645963

  20. Spiro[2.4]hepta-4,6-dienes: synthesis and application in organic synthesis

    NASA Astrophysics Data System (ADS)

    Menchikov, L. G.; Nefedov, O. M.

    2016-03-01

    This review integrates and describes systematically the data in the field of spiro[2.4]hepta-4,6-dienes published in the past 15 years. The changes in the development of studies that took place during this period are noted. The methods for the synthesis, the reactivity details and key chemical transformations of spiro[2.4]hepta-4,6-dienes are considered, with the emphasis on applications of these compounds in organic synthesis. The bibliography includes 207 references.

  1. Inhibitory activities against rice pathogens of 8-hydroxy-2,4,6-octatriynamide from Agrocybe sp.

    PubMed

    Zheng, Yongbiao; Xu, Xiaoping; Wu, Yabin

    2016-03-01

    8-Hydroxy-2,4,6-octatriynamide, a natural polyacetylene with inhibitory activities against rice pathogens, was isolated from the liquid fermentation broth of strain Agrocybe sp. YB2005 during screening for new natural chemical agents to control rice pathogens. 8-hydroxy-2,4,6-octatriynamide was purified by consecutive chromatography over a Cl8 reversed phase silica gel, sephadex LH-20 and silica gel. The chemical structure of 8-hydroxy-2,4,6-octatriynamide was elucidated through spectroscopic analyses, including 1D- and 2D-NMR, ESI mass spectrometry and X-ray single crystal diffraction. Bioassays showed that 8-hydroxy-2,4,6-octatriynamide could significantly inhibit growth of Xanthomonas oryzae with an MIC of 53.1 μM in a 96-well plate and the growth of Rhizoctonia solani at 1.02 mM in a 24-well plate. When rice leaves were inoculated with Magnaporthe grisea and cultured in artificial nutrition liquid containing 0.34 mM 8-hydroxy-2,4,6-octatriynamide, no rice blast was observed. The present study implied that 8-hydroxy-2,4,6-octatriynamide could be a candidate agent against rice pathogens. PMID:26861586

  2. Evaluation of the clinical effect of an on-line course for community nurses on post-partum emotional distress: a community-based longitudinal time-series quasi-experiment.

    PubMed

    Thome, Marga; Orlygsdottir, Brynja; Elvarsson, Bjarki Thor

    2012-09-01

    About 14% of Icelandic women suffer post-partum from frequent depressive symptoms, and of those, 12% also report a high degree of parenting stress. Education of nurses and midwives on post-partum distress is crucial in reducing its degree. The purpose of the study is to evaluate the clinical effect of an on-line course for community nurses on post-partum emotional distress. A community-based, longitudinal, time-series quasi-experiment was conducted in four stages from 2001 to 2005. Mothers attending 16 health centres throughout Iceland and scoring ≥ 12 on the Edinburgh Postnatal Depression Scale (EPDS) at the 9th week post-partum were eligible to participate. Health centres were divided into experimental (EHC) and control centres (CHC), and control centres were crossed over to experimental centres the following year and new control centres recruited. Nurses at EHC attended an on-line course on post-partum emotional distress. Participating mothers answered the EPDS; the Parenting Stress Index/Short form and the Fatigue Scale. Nursing diagnoses and interventions were recorded at all study centres. Of the women who were eligible (n = 163), 57% (n = 93) participated. At baseline, 9 weeks post-partum, there were no significant differences between groups of women in the rate of depressive symptoms, fatigue or parenting stress. Women in all groups improved on all distress indicators over time; however, those from the EHC improved statistically and clinically significantly more on depressive symptoms than those from the CHC. Documentation of particular nursing diagnoses and interventions was significantly more frequent at the EHC, but referrals to specialists were significantly less frequent. On-line education for nurses on post-partum emotional distress is feasible and is related to improvement in post-partum depressive symptoms.

  3. Elevated Corticotropin-Releasing Hormone in Human Pregnancy Increases the Risk of Postpartum Depressive Symptoms

    PubMed Central

    Yim, Ilona S.; Glynn, Laura M.; Schetter, Christine Dunkel; Hobel, Calvin J.; Chicz-DeMet, Aleksandra; Sandman, Curt A.

    2009-01-01

    Context Postpartum depression (PPD) is common and has serious implications for the mother and her newborn. A possible link between placental corticotropin-releasing hormone (pCRH) and PPD incidence has been discussed, but there is a lack of empirical evidence. Objective To determine whether accelerated pCRH increases throughout pregnancy are associated with PPD symptoms. Design Pregnant women were recruited into this longitudinal cohort study. Blood samples were obtained at 15, 19, 25, 31 and 37 weeks gestational age (GA) for assessment of pCRH, cortisol and ACTH. Depressive symptoms were assessed with a standardized questionnaire at the last four pregnancy visits and postpartum. Setting Subjects were recruited from two Southern California Medical Centers, and visits were conducted in university research laboratories. Participants 100 adult women with a singleton pregnancy. Main Outcome Measure PPD symptoms were assessed 8.7 weeks (SD = 2.94 wks) after delivery with the Edinburgh Postnatal Depression Scale. Results Sixteen women developed PPD symptoms. At 25 weeks GA, pCRH was a strong predictor of PPD symptoms (R2 = .21, β = .46, p < .001), an effect that remained significant after controlling for prenatal depressive symptoms. No significant associations were found for cortisol and ACTH. Receiver Operating Characteristic curve analyses revealed that pCRH at 25 weeks GA is a useful diagnostic test (area under the curve = .78, p = .001). Sensitivity (.75) and specificity (.74) at the ideal cut-off point (56.86 pg/ml pCRH) were high. Growth curve analyses indicated that pCRH trajectories in women with PPD symptoms are significantly accelerated between 23 and 26 weeks GA. Conclusion There is a critical period in mid-pregnancy during which pCRH is a sensitive and specific early diagnostic test for PPD symptoms. If replicated, these results have implications for identification and treatment of pregnant women at risk of PPD. PMID:19188538

  4. Evaluation of home testing to improve follow up after gestational diabetes (Fingerstick Assessments of Sugar Two-months postpartum or FAST)

    PubMed Central

    Lewis, Beth G; Pagan, Elvis R; Evers, Martin

    2013-01-01

    Objective Historically the rates of postpartum glucose tolerance testing for women with gestational diabetes (GDM) average a suboptimal 33%. Barriers include the need for new mothers to miss work and/or arrange for childcare in order to engage in a two-hour test at a commercial lab. This pilot study was initiated to test the theory that a home testing regimen would be accepted by patients and increase the rate of postpartum glucose assessments relative to published rates, without requiring additional health-care staff or resources to achieve this goal. Study design Six weeks postpartum, women with GDM from an academic private practice were asked to check fingerstick blood glucose (FAST Protocol) four times a day for two days, and then obtain an oral glucose tolerance test (OGTT). The physician consultants saw the women each month during pregnancy and arranged the postpartum testing. Results Two of 69 refused to be consented. Twelve of the remaining 67(18%) women completed both the FAST regimen and the OGTT, three completed only the OGTT and five completed only the FAST regimen for a final follow-up rate of 20/67 (30%). The demands of caring for a newborn, or the annoyance of fingersticks, were barriers to compliance. Conclusions In spite of intense physician involvement, this home testing regimen was not associated with an increase in the rates of women participating in postpartum glucose assessments.

  5. Feasibility and Perception of Using Text Messages as an Adjunct Therapy for Low-Income, Minority Mothers With Postpartum Depression

    PubMed Central

    Ladley, Amy S; Rhyne, Elizabeth A; Halloran, Donna R

    2015-01-01

    Background Postpartum depression (PPD) is the most common medical problem among new mothers that can have a negative impact on infant health. Traditional treatments are often difficult for low-income mothers to complete, particularly given the numerous barriers families face. Objective Among low-income, primarily racial, and ethnic minority mothers with postpartum depression, our aim was to evaluate (1) the feasibility of sending supportive text messages, and (2) the perception of receiving private, supportive text messages for postpartum depression. Methods Mothers found to be at risk for postpartum depression received supportive text messages four times weekly for 6 months in addition to receiving access to traditional counseling services based within an academic pediatric office. Feasibility was evaluated along with cellular and text messaging use, access, and perception of the message protocol. Perception of the message protocol was evaluated at study completion via a Likert scale questionnaire and open-ended qualitative survey. Results In total, 4158/4790 (86.81%) text messages were successfully delivered to 54 mothers over a 6-month period at a low cost (US $777.60). Among the 96 scripted messages, 37 unique messages (38.54%) allowed for a response. Of all sent messages that allowed for responses, 7.30% (118/1616) were responded to, and 66.1% of those responses requested a call back; 46% (25/54) of mothers responded at least once to a text message. Mothers felt that messages were easily received and read (25/28, 89%) and relevant to them personally (23/28, 82%). Most shared texts with others (21/28, 75%). Conclusions Text messaging is feasible, well-accepted, and may serve as a simple, inexpensive adjunct therapy well-suited to cross socioeconomic boundaries and provide private support for at-risk mothers suffering from postpartum depression. PMID:26543910

  6. Postpartum uterine diseases and their impacts on conception and days open in dairy herds in Italy.

    PubMed

    Toni, F; Vincenti, L; Ricci, A; Schukken, Y H

    2015-10-15

    The objective of this study was to describe the incidence and the impact of postpartum uterine diseases in postpartum cows on future uterine status and reproductive performance in large Italian dairy herds. This study provides an important quantitative estimate of uterine and postpartum diseases incidence that afflict high-producing Italian dairy cows. The total number of cows included in the study was 1498 on three farms; all cows were followed from the dry period until 300 days postpartum. All farms used high-quality data collection systems and standard operating procedures: weekly herd health visits, monthly Dairy Herd Improvement Association visits, and, due to cheese-making milk quality requirements, a supplementary milk sample collected at 7 ± 3 days postpartum evaluated for milk components. Clinical metritis in primiparous cows did not change the time to the first artificial insemination (AI) or days open; conversely, clinical metritis in multiparous cows had impact on the time to first AI (hazard ratio: 0.66, P < 0.01) and resulted in a lower conception rate at first insemination and a increase in days open (odds ratio: 0.64, P < 0.05). Clinical endometritis had a strong deleterious effect on first AI conception rate (odds ratio: 0.34, P < 0.05) and days open across all lactations (hazard ratio: 0.68, P < 0.05). Persistent metritis, defined as the presence of both clinical metritis and clinical endometritis in the same animal in the same lactation, caused low conception rate both in the first-lactation and in older cows and had a strong negative effect on the proportion of pregnant cows at 300 days (P < 0.05). In conclusion, the impact of endometritis on fertility was true across lactation groups. A good management and precocious diagnosis of the pathologies is not resolutive to restore good fertility parameters, and understanding the immune response in first-lactation cows may be of value for developing alternative intervention protocols for older

  7. Relationship of monoamine oxidase-A distribution volume to postpartum depression and postpartum crying.

    PubMed

    Sacher, Julia; Rekkas, P Vivien; Wilson, Alan A; Houle, Sylvain; Romano, Leslie; Hamidi, Jinous; Rusjan, Pablo; Fan, Ian; Stewart, Donna E; Meyer, Jeffrey H

    2015-01-01

    Postpartum depression (PPD) has a prevalence rate of 13% and a similarly high proportion of women report a subclinical state of one or more major depressive episode symptoms. The aim was to investigate whether monoamine oxidase-A (MAO-A) VT, an index of MAO-A density, is increased in the prefrontal and anterior cingulate cortex (PFC and ACC), during PPD or when a PPD spectrum symptom, greater predisposition to crying, is present. MAO-A is an enzyme that increases in density after estrogen decline, and has several functions including creating oxidative stress, influencing apoptosis and monoamine metabolism. Fifty-seven women were recruited including 15 first-onset, antidepressant naive, PPD subjects, 12 postpartum healthy who cry due to sad mood, 15 asymptomatic postpartum healthy women, and 15 healthy women not recently pregnant. Each underwent [(11)C]-harmine positron emission tomography scanning to measure MAO-A VT. Both PPD and greater predisposition to crying were associated with greater MAO-A VT in the PFC and ACC (multivariate analysis of variance (MANOVA), group effect, F21,135=1.856; p=0.019; mean combined region elevation 21% and 14% in PPD and crying groups, respectively, relative to postpartum asymptomatic). Greater MAO-A VT in the PFC and ACC represents a new biomarker in PPD, and the PPD symptom of predisposition to crying. Novel strategies for preventing PPD (and some PPD symptoms) may be possible by avoiding environmental conditions that elevate MAO-A level and enhancing conditions that normalize MAO-A level. These findings also argue for clinical trials in PPD with the newer, well-tolerated MAO-A inhibitor antidepressants.

  8. Prenatal and postpartum care of women with substance use disorders.

    PubMed

    Gopman, Sarah

    2014-06-01

    The incidence of substance abuse in pregnancy is substantial and affects pregnancy health and outcomes. Multiple challenges exist in the identification of women with substance abuse disorders in pregnancy and the provision of care. A multidisciplinary approach has been shown to be most successful in providing comprehensive and effective care. This article outlines key aspects of prenatal and postpartum care, with a brief overview provided of intrapartum care. Issues covered include screening, opioid replacement therapy, comorbid medical and psychiatric conditions, environmental stressors, parenting preparation, pain management in labor and postpartum, breastfeeding guidance, prevention of relapse, and assistance with postpartum transition to primary care.

  9. Pregnancy and postpartum bowel changes: constipation and fecal incontinence.

    PubMed

    Shin, Grace Hewon; Toto, Erin Lucinda; Schey, Ron

    2015-04-01

    Pregnancy and the postpartum period are often associated with many gastrointestinal complaints, including nausea, vomiting, and heartburn; however, the most troublesome complaints in some women are defecatory disorders such as constipation and fecal incontinence, especially postpartum. These disorders are often multifactorial in etiology, and many studies have looked to see what risk factors lead to these complications. This review discusses the current knowledge of pelvic floor and anorectal physiology, especially during pregnancy, and reviews the current literature on causes and treatments of postpartum bowel symptoms of constipation and fecal incontinence.

  10. Triple Negative Breast Cancer in Pregnancy and Postpartum: Two Case Reports in Hispanic Women

    PubMed Central

    Upadhyay, Ruchi; Butt, Qurat-Ul-Ain; Hamaoui, Abraham; Henderson, Cassandra; McCalla, Sydney; Gilak, Hamid

    2015-01-01

    Objective. Despite studies suggesting that triple negative breast cancer is more often seen in women of African ancestry, we report here two cases of pregnancy associated triple negative breast cancer in Hispanic women. Cases. Case one is a 37-year-old female para 2-0-0-2, who presented with a left breast mass, at 19 weeks of gestation, the biopsy of which reported an invasive ductal carcinoma, found to be triple receptor negative. The patient underwent chemotherapy during the pregnancy and was delivered with a cesarean at 37 weeks for obstetric indication. After delivery, the patient completed her chemotherapy that was followed by radical mastectomy and radiotherapy. Case two is a 28-year-old female para 6-0-1-5, who presented while breast-feeding with signs and symptoms of mastitis, and an engorged and tender right breast, five months postpartum. However, the sonogram revealed a fluid filled cavity. Aspiration and cytology did not reflect an infection and were negative for malignancy. High suspicion and lack of improvement led to biopsy that identified an invasive ductal carcinoma, found to be triple negative. The patient underwent chemotherapy followed by modified radical mastectomy. Conclusions. Triple negative breast cancer, during pregnancy or postpartum, poses a unique challenge and requires a multidisciplinary team to optimize treatment for these women. PMID:26448887

  11. Seeking help for postpartum depression in the Israeli Jewish orthodox community: factors associated with use of professional and informal help.

    PubMed

    Bina, Rena

    2014-01-01

    Postpartum depression (PPD) has potentially devastating personal and familial consequences. However, very few women receive treatment, either professional or informal. Use patterns and factors associated with both professional and informal help for PPD have not yet been investigated. This study examined factors associated with use of professional and informal help for PPD in an Israeli sample that included women from secular, traditional, orthodox, and ultra-orthodox Jewish religious groups. One to two days postpartum, 1,059 women were recruited from a large hospital in Jerusalem, Israel, and completed an initial survey; 805 women (76%) participated at the 6-week follow-up; 94 women (12%) screened positive for PPD symptoms at the 6-week follow-up and were referred for help; and 88 women completed the 6-month postpartum follow-up interview. Of the women referred for help, 69% used some sort of help, with 24% using professional help and 45% using informal help. Confidence in mental health professionals and higher levels of PPD symptomatology were associated with use of professional help. Recognition of personal need for professional psychological help was negatively associated with use of informal help. Findings from this study highlight the importance of routine screening for PPD and culturally sensitive referrals using informal sources of help. PMID:24791859

  12. [Investigations on the influence of Rh immunoglobulin prophylaxis on the immune response to postpartum rubella vaccination (author's transl)].

    PubMed

    Maroni, E; Kunz, J; Rösli, A; Munzinger, J

    1975-11-01

    A preliminary investigation showed that patients with rubella HHT antibody titres of 1:8 or greater did not show a significant rise in the antibody titre following rubella vaccination. The rubella antibody titre was determined in 651 obstetric patients. Of these, 43 (6.6%) had no significant antibodies to rubella (HHT less than 1:8) and were included in the present investigation. Patients in Group A received 0.5 ml. of the rubella vaccine Meruvax on the fifth postpartum day. Patients of Group B(Rh negative and Rh positive) received 250 mug anti-D in a 16% gammaglobulin solution intra-muscularly 48 hours postpartum and the rubella vaccination 3 days later. Three weeks following the rubella vaccination the mean geometric rubella antibody titre had risen +/- 1 Standard deviation to 19.6 +/- 7.7 in Group A (17 patients) and to 18.0 +/- 6.3 in Group B (12 patients). Six weeks following the rubella vaccinations Group A (19 patients) showed titres of 61.7 +/- 2.9 and Group B (14 patients) showed titres of 70.0 +/- 2.6. There was no statistically significant difference (greater than 0.5). The conversion rate in both groups was 100%. Patients can therefore be vaccinated against rubella in the postpartum period even though they will receive a concomitant prophylaxis with Rh immunoglobulin.

  13. Seeking help for postpartum depression in the Israeli Jewish orthodox community: factors associated with use of professional and informal help.

    PubMed

    Bina, Rena

    2014-01-01

    Postpartum depression (PPD) has potentially devastating personal and familial consequences. However, very few women receive treatment, either professional or informal. Use patterns and factors associated with both professional and informal help for PPD have not yet been investigated. This study examined factors associated with use of professional and informal help for PPD in an Israeli sample that included women from secular, traditional, orthodox, and ultra-orthodox Jewish religious groups. One to two days postpartum, 1,059 women were recruited from a large hospital in Jerusalem, Israel, and completed an initial survey; 805 women (76%) participated at the 6-week follow-up; 94 women (12%) screened positive for PPD symptoms at the 6-week follow-up and were referred for help; and 88 women completed the 6-month postpartum follow-up interview. Of the women referred for help, 69% used some sort of help, with 24% using professional help and 45% using informal help. Confidence in mental health professionals and higher levels of PPD symptomatology were associated with use of professional help. Recognition of personal need for professional psychological help was negatively associated with use of informal help. Findings from this study highlight the importance of routine screening for PPD and culturally sensitive referrals using informal sources of help.

  14. Postpartum depression in a military sample.

    PubMed

    Appolonio, Kathryn Kanzler; Fingerhut, Randy

    2008-11-01

    Postpartum depression (PPD) affects nearly 1 in 8 mothers and has many negative implications. Studies show particular risk factors are linked with PPD. There are nearly 200,000 women serving in the U.S. Armed Forces, but little is known regarding PPD and active duty (AD) mothers. This study examined rates and risk factors for AD mothers and found that 19.5% were positive for PPD symptoms. Ten significant psychosocial factors were associated with PPD, including low self-esteem, prenatal anxiety, prenatal depression, history of previous depression, social support, poor marital satisfaction, life stress, child care stress, difficult infant temperament, and maternity blues. This study has implications for prevention, identification, and treatment of AD military women with PPD.

  15. Rapunzel Syndrome: A Rare Postpartum Case

    PubMed Central

    Tegene, Teshome; Foda, Yahia; Hussain, Omar; Manikonda, Geeta

    2013-01-01

    The Rapunzel syndrome describes a disorder in which a significant amount of hair is swallowed, forming a trichobezoar that extends past the stomach into the small intestines. Given the indigestible nature of hair, it subsequently leads to obstruction within the gastrointestinal system. Clinically, patients may present with symptoms of gastrointestinal obstruction, including abdominal complaints such as pain, nausea, vomiting, and diarrhea. However, due to its broad and nonspecific presenting symptoms, the diagnosis of Rapunzel syndrome warrants consideration once other common etiologies have been excluded. Surgical intervention is often required to remove the abdominal mass. This unusual syndrome is often associated with psychiatric disorders, affecting young women most commonly. In this report, we will discuss a unique case of Rapunzel syndrome in a one-month postpartum woman. PMID:24171124

  16. Sorption of 2,4,6-trichlorophenol in model humic acid-clay systems.

    PubMed

    Wang, Xiao-ping; Shan, Xiao-quan; Luo, Lei; Zhang, Shu-Zhen; Wen, Bei

    2005-05-01

    Humic acids and clays are important soil components that influence the sorption and desorption of organic contaminants; however, it is unclear how humic acids influence the sorption of organic contaminants onto clays and their subsequent desorption. Sorption and desorption of 2,4,6-trichlorophenol (2,4,6-TCP) by and from humic acid-modified K(+)- and Ca(2+)-montmorillonite and -illite were compared with unmodified clays using batch equilibration methods. Commercial humic acid and the humic acid extracted from forest soil were employed in this experiment. The adsorbed amount of 2,4,6-TCP by commercial humic acid was almost twice as large as that adsorbed by the extracted soil humic acid. More 2,4,6-TCP was sorbed onto K(+)- and Ca(2+)-illite than onto K(+)- and Ca(2+)-montmorillonite. K(+) clays were more effective in adsorbing 2,4,6-TCP than Ca(2+) clays. Sorption of 2,4,6-TCP on humic acid-modified Ca(2+)- and K(+)-montmorillonite and -illite increased as compared with unmodified clays. The sorption nonlinearity of 2,4,6-TCP on humic acid-modified Ca(2+)- and K(+)-illite increased remarkably as compared with the unmodified clays. The sorption nonlinearity of 2,4,6-TCP on humic acid-modified Ca(2+)- and K(+)-montmorillonite increased slightly in contrast to unmodified montmorillonites. By comparing sorption and desorption results, we observed hysteresis for all sorbents including humic acids, clays, and humic acid-modified clays. Sorption nonlinearity and hysteresis were dependent on the structure of humic acids. Higher aromaticity of humic acids resulted in greater sorption nonlinearity and desorption hysteresis. In addition, sorption capacity (K(f)') was positively correlated with the humic acid content of the sorbents. These results show that modification of humic acids on clays can not only increase the adsorption ability of clays but also affect the sorption nonlinearity of 2,4,6-TCP, and the desorption hysteresis was probably due to the structural

  17. Antimony(III) complexes with 2-amino-4,6-dimethoxypyrimidines: Synthesis, characterization and biological evaluation.

    PubMed

    Tunç, Turgay; Karacan, Mehmet Sayım; Ertabaklar, Hatice; Sarı, Musa; Karacan, Nurcan; Büyükgüngör, Orhan

    2015-12-01

    Novel pyrimidine compound bearing disulfide bridge, 5,5'-disulfanediylbis(2-amino-4,6-dimetoxypyrimidine) (3) was synthesized by reduction of 2-amino-4,6-dimethoxy-5-thiocyanatopyrimidine for the first time, and its structure was confirmed by X-ray crystallographic analysis. Novel binuclear antimony(III) compound of (3), {Sb[5,5'-disulfanediylbis(2-amino-4,6-dimetoxypyrimidine)]Cl3}2 (4) and mononuclear antimony(III) compounds, SbL2Cl3, [L: 2-amino-5-thiol-4,6-dimethoxy pyrimidine (2) and 2-amino-5-(1H-tetrazol-5-ylthio)-4,6-dimethoxypyrimidine (6)] were synthesized and characterized with the help of elemental analysis, molecular conductivity, FT-IR, (1)H-NMR and LC-MS techniques. The geometrical structures optimized by a DFT/B3LYP/LANL2DZ method of the compounds, indicated that monomeric compounds have square pyramidal shape. Both antileishmanial activity against Leishmania tropica promastigote and glutathione reductase inhibitory activity were determined in vitro. The results showed that (3) has the best biological activity. PMID:26427018

  18. Antimony(III) complexes with 2-amino-4,6-dimethoxypyrimidines: Synthesis, characterization and biological evaluation.

    PubMed

    Tunç, Turgay; Karacan, Mehmet Sayım; Ertabaklar, Hatice; Sarı, Musa; Karacan, Nurcan; Büyükgüngör, Orhan

    2015-12-01

    Novel pyrimidine compound bearing disulfide bridge, 5,5'-disulfanediylbis(2-amino-4,6-dimetoxypyrimidine) (3) was synthesized by reduction of 2-amino-4,6-dimethoxy-5-thiocyanatopyrimidine for the first time, and its structure was confirmed by X-ray crystallographic analysis. Novel binuclear antimony(III) compound of (3), {Sb[5,5'-disulfanediylbis(2-amino-4,6-dimetoxypyrimidine)]Cl3}2 (4) and mononuclear antimony(III) compounds, SbL2Cl3, [L: 2-amino-5-thiol-4,6-dimethoxy pyrimidine (2) and 2-amino-5-(1H-tetrazol-5-ylthio)-4,6-dimethoxypyrimidine (6)] were synthesized and characterized with the help of elemental analysis, molecular conductivity, FT-IR, (1)H-NMR and LC-MS techniques. The geometrical structures optimized by a DFT/B3LYP/LANL2DZ method of the compounds, indicated that monomeric compounds have square pyramidal shape. Both antileishmanial activity against Leishmania tropica promastigote and glutathione reductase inhibitory activity were determined in vitro. The results showed that (3) has the best biological activity.

  19. Selective impact of CDK4/6 suppression on patient-derived models of pancreatic cancer

    PubMed Central

    Witkiewicz, Agnieszka K.; Borja, Nicholas A.; Franco, Jorge; Brody, Jonathan R.; Yeo, Charles J.; Mansour, John; Choti, Michael A.; McCue, Peter; Knudsen, Erik S.

    2015-01-01

    Pancreatic ductal adenocarcinoma (PDA) harbors an exceedingly poor prognosis, and is generally considered a therapy-recalcitrant disease due to poor response to conventional chemotherapy coupled with non-actionable genetic drivers (e.g. KRAS mutations). However, PDA frequently loses p16ink4a, thereby leading to deregulation of CDK4/6. Surprisingly, in established cell models and xenografts, CDK4/6 inhibition has a modest effect on proliferation and resistance develops rapidly. To determine if such weak response was an intrinsic feature of PDA, we developed primary tumor explants that maintain the tumor environment and recapitulate feuture of primary PDA. The CDK4/6 inhibitor PD-0332991 was highly efficient at suppressing proliferation in 14 of the 15 explants. In the single resistant explant, we identified the rare loss of the RB tumor suppressor as the basis for resistance. Patient-derived xenografts (PDXs) were developed in parallel, and unlike the xenografts emerging from established cell lines, the PDXs maintained the histoarchitecture of the primary tumor. These PDXs were highly sensitive to CDK4/6 inhibition, yielding a complete suppression of PDA proliferation. Together, these data indicate that primary PDA is sensitive to CDK4/6 inhibition, that specific biomarkers can delineate intrinsic resistance, and that established cell line models may not represent an adequate means for evaluating therapeutic sensitivities. PMID:26158861

  20. Selective impact of CDK4/6 suppression on patient-derived models of pancreatic cancer.

    PubMed

    Witkiewicz, Agnieszka K; Borja, Nicholas A; Franco, Jorge; Brody, Jonathan R; Yeo, Charles J; Mansour, John; Choti, Michael A; McCue, Peter; Knudsen, Erik S

    2015-06-30

    Pancreatic ductal adenocarcinoma (PDA) harbors an exceedingly poor prognosis, and is generally considered a therapy-recalcitrant disease due to poor response to conventional chemotherapy coupled with non-actionable genetic drivers (e.g. KRAS mutations). However, PDA frequently loses p16ink4a, thereby leading to deregulation of CDK4/6. Surprisingly, in established cell models and xenografts, CDK4/6 inhibition has a modest effect on proliferation and resistance develops rapidly. To determine if such weak response was an intrinsic feature of PDA, we developed primary tumor explants that maintain the tumor environment and recapitulate feuture of primary PDA. The CDK4/6 inhibitor PD-0332991 was highly efficient at suppressing proliferation in 14 of the 15 explants. In the single resistant explant, we identified the rare loss of the RB tumor suppressor as the basis for resistance. Patient-derived xenografts (PDXs) were developed in parallel, and unlike the xenografts emerging from established cell lines, the PDXs maintained the histoarchitecture of the primary tumor. These PDXs were highly sensitive to CDK4/6 inhibition, yielding a complete suppression of PDA proliferation. Together, these data indicate that primary PDA is sensitive to CDK4/6 inhibition, that specific biomarkers can delineate intrinsic resistance, and that established cell line models may not represent an adequate means for evaluating therapeutic sensitivities.

  1. Preparation of deuterium-labeled biotransformation products of 2,4,6-trinitrotoluene.

    PubMed

    Junk, Thomas; Carr, Jason A

    2013-06-15

    Methods for the preparation of deuterium-labeled analogs to six prominent biotransformation products of the explosive 2,4,6-trinitrotoluene were developed. These are useful as reference standards for stable isotope dilution techniques and for solid state (2)H NMR spectroscopic studies. Although syntheses for most of the target compounds in protiated form had been reported in the past, most of those were found to be poorly suited for the preparation of the deuterated materials. Selective reduction of [(2)H5]trinitrotoluene furnished [(2)H5]-4,6-dinitro-2-hydroxylaminotoluene, [(2)H5]-2,6-dinitro-4-hydroxylaminotoluene, [(2)H5]-2-amino-4,6-dinitrotoluene, and [(2)H5]-4-amino-2,6-dinitrotoluene. The syntheses of [(2)H10]-2,2'-azo-4,4',6,6'-tetranitrotoluene and [(2)H10]-4,4'-azo-2,2',6,6'-tetranitrotoluene were accomplished by selective oxidation of [(2)H5]-2-amino-4,6-dinitrotoluene and [(2)H5]-4-amino-2,6-dinitrotoluene, respectively.

  2. Innovative psycho-educational program to prevent common postpartum mental disorders in primiparous women: a before and after controlled study

    PubMed Central

    2010-01-01

    Background Universal interventions to prevent postnatal mental disorders in women have had limited success, perhaps because they were insufficiently theorised, not gender-informed and overlooked relevant risk factors. This study aimed to determine whether an innovative brief psycho-educational program for mothers, fathers and first newborns, which addressed salient learning needs about infant behaviour management and adjustment tasks in the intimate partner relationship, prevented postpartum mental health problems in primiparous women. Methods A before and after controlled study was conducted in primary care in seven local government areas in Victoria, Australia. English-speaking couples with one-week old infants were invited consecutively to participate by the maternal and child health nurse at the universal first home visit. Two groups were recruited and followed sequentially: both completed telephone interviews at four weeks and six months postpartum and received standard health care. Intervention group participants were also invited to attend a half-day program with up to five couples and one month old infants, facilitated by trained, supervised nurses. The main outcome was any Composite International Diagnostic Interview (CIDI) diagnosis of Depression or Anxiety or Adjustment Disorder with Depressed Mood, Anxiety, or Mixed Anxiety and Depressed Mood in the first six months postpartum. Factors associated with the outcome were established by logistic regression controlling for potential confounders and analysis was by intention to treat. Results In total 399/646 (62%) women were recruited; 210 received only standard care and 189 were also offered the intervention; 364 (91%) were retained at follow up six months postpartum. In women without a psychiatric history (232/364; 64%), 36/125 (29%) were diagnosed with Depression or Anxiety or Adjustment Disorder with Depressed Mood, Anxiety, or Mixed Anxiety and Depressed Mood in the control group, compared with 16

  3. Impact of forced separation policy on incarcerated postpartum mothers.

    PubMed

    Chambers, Angelina N

    2009-08-01

    The number of incarcerated women in the United States is steadily increasing with 9% giving birth while serving time. Mothers and babies are routinely separated immediately and during most of the postpartum period. This qualitative study examines the impact of this policy by exploring the nature and meaning of the mother-infant bonding experience when the mothers know separation is coming. Twelve incarcerated postpartum mothers were interviewed during the early postpartum period about their antepartum and postpartum relationships with their babies. Qualitative data analysis produced four relational themes: (a) "a love connection," (b) "everything was great until I birthed," (c) "feeling empty and missing a part of me," and (d) "I don't try to think too far in advance." Results of this qualitative study provide information to professionals exploring gender-sensitive prison policies for the growing female population.

  4. Postpartum Transitions in Adolescent Mothers' Romantic and Maternal Relationships.

    ERIC Educational Resources Information Center

    Gee, Christina B.; Rhodes, Jean E.

    1999-01-01

    Interviewed adolescent mothers at prepartum or early postpartum and 1 year later regarding maternal and romantic relationships, depression, and negative life events. Responses indicated that over time male partner support became more important than maternal support. (LBT)

  5. Vicarious nucleophilic substitution to prepare 1,3-diamino-2,4,6-trinitrobenzene or 1,3,5-triamino-2,4,6-trinitrobenzene

    DOEpatents

    Mitchell, Alexander R.; Pagoria, Philip F.; Schmidt, Robert D.

    1996-01-01

    The present invention relates to a process to produce 1,3-diamino-2,4,6-trinitrobenzene (DATB) or 1,3,5-triamino-2,4,6,-trinitrobenzene (TATB) by: (a) reacting at ambient pressure and a temperature of between about 0.degree. and 50.degree. C. for between about 0.1 and 24 hr, a trinitroaromatic compound of structure V: ##STR1## wherein X, Y, and Z are each independently selected from --H, or --NH.sub.2, with the proviso that at least 1 or 2 of X, Y, and Z are hydrogen, with an amount effective to produce DATB or TATB of 1,1,1-trialkylhydrazinium halide wherein alkyl is selected from methyl, ethyl, propyl or butyl and halide is selected from chloride, bromide or iodide. in the presence of a strong base selected from sodium butoxide, potassium butoxide, potassium propoxide, sodium propoxide, sodium ethoxide, potassium ethoxide, sodium methoxide, potassium methoxide, and combinations thereof; in a solvent selected from the group consisting of methanol, ethanol, propanol, butanol, dimethylsulphoxide, N-methylpyrrolidone, hexamethylphosphoramide, dimethylformide, dimethylacetamide and mixtures thereof, provided that when alcohols are present primarily DATB and picramide is formed; and (b) isolating the DATB or TATB produced. DATB and TATB are useful specialty explosives. TATB is also used for the preparation of benzenehexamine, a starting material for the synthesis of novel materials (optical imaging devices, liquid crystals, ferromagnetic compounds).

  6. Vicarious nucleophilic substitution to prepare 1,3-diamino-2,4,6-trinitrobenzene or 1,3,5-triamino-2,4,6-trinitrobenzene

    DOEpatents

    Mitchell, A.R.; Pagoria, P.F.; Schmidt, R.D.

    1996-10-29

    The present invention relates to a process to produce 1,3-diamino-2,4,6-trinitrobenzene (DATB) or 1,3,5-triamino-2,4,6,trinitrobenzene (TATB) by: (a) reacting at ambient pressure and a temperature of between about 0 and 50 C for between about 0.1 and 24 hr, a trinitroaromatic compound of the structure shown within where X, Y, and Z are each independently selected from --H, or --NH{sub 2}, with the proviso that at least 1 or 2 of X, Y, and Z are hydrogen, with an amount effective to produce DATB or TATB, or 1,1,1-trialkylhydrazinium halide wherein alkyl is selected from methyl, ethyl, propyl or butyl and halide is selected from chloride, bromide or iodide, in the presence of a strong base selected from sodium butoxide, potassium butoxide, potassium propoxide, sodium propoxide, sodium ethoxide, potassium ethoxide, sodium methoxide, potassium methoxide, and combinations thereof; in a solvent selected from the group consisting of methanol, ethanol, propanol, butanol, dimethylsulfoxide, N-methylpyrrolidone, hexamethylphosphoramide, dimethylformide, dimethylacetamide and mixtures thereof, provided that when alcohols are present primarily DATB and picramide is formed; and (b) isolating the DATB or TATB produced. DATB and TATB are useful specialty explosives. TATB is also used for the preparation of benzenehexamine, a starting material for the synthesis of novel materials (optical imaging devices, liquid crystals, ferromagnetic compounds).

  7. Design and calibration of pulsed vapor generators for 2,4,6-trinitrotoluene, cyclo-1,3,5-trimethylene-2,4,6-trinitramine, and pentaerythritol tetranitrate

    SciTech Connect

    Davies, J.P.; Blackwood, L.G.; Davis, S.G.; Goodrich, L.D.; Larson, R.A. )

    1993-11-01

    Computer-controlled pulsed explosive vapor generators for 2,4,6-trinitrotoluene (TNT), cyclo-1,3,5-trimethylene-2,4,6-trinitramine (RDX), and pentaerythritol (PETN) were built and calibrated to support an independent validation and verification facility for explosive detection systems for the Federal Aviation Administration at the Idaho National Engineering Laboratory. The explosive vapor generators will be used as quantitative vapor standards to establish the lower limits of detection of explosive detection systems. The generators were constructed using pure explosive suspended on quartz beads which were then loaded into a stainless steel tube. The tube was coiled and placed into a temperature-controlled chamber. A carrier gas (ultrapure air) was passed through the coil to carry the explosive molecules. The generators are capable of delivering a pulse of varying explosive mass through the control of coil temperature, airflow rate, and pulse width. Preliminary calibrations have been completed in the picogram to nanogram range using an ion mobility spectrometer as the calibrating instrument. 8 refs., 5 figs., 6 tabs.

  8. MotorWeek

    ScienceCinema

    None

    2016-07-12

    In 2008, PBS's MotorWeek, television's original automotive magazine, visited Argonne's Transportation Technology R&D Center "to learn what it really takes to make clean power sources a viable reality."

  9. MotorWeek

    SciTech Connect

    2009-01-01

    In 2008, PBS's MotorWeek, television's original automotive magazine, visited Argonne's Transportation Technology R&D Center "to learn what it really takes to make clean power sources a viable reality."

  10. Therapeutic Targeting of the Cyclin D3:CDK4/6 Complex in T Cell Leukemia

    PubMed Central

    Sawai, Catherine; Freund, Jacquelyn; Oh, Philmo; Ndiaye-Lobry, Delphine; Bretz, Jamieson C.; Strikoudis, Alexandros; Genesca, Lali; Trimarchi, Thomas; Kelliher, Michelle A.; Clark, Marcus; Soulier, Jean; Chen-Kiang, Selina; Aifantis, Iannis

    2012-01-01

    SUMMARY D-type cyclins form complexes with cyclin dependent kinases (CDK4/6), and promote cell cycle progression. Although cyclin D functions appear largely tissue specific, we demonstrate that cyclin D3 has unique functions in lymphocyte development and cannot be replaced by cyclin D2, which is also expressed during blood differentiation. We show that only combined deletion of p27Kip1 and Rb is sufficient to rescue the development of Ccnd3−/− thymocytes. Furthermore, we show that a small molecule targeting the kinase function of cyclin D3:CDK4/6 inhibits both cell cycle entry in human T cell acute lymphoblastic leukemia (T-ALL) and disease progression in animal models of T-ALL. These studies identify unique functions for cyclin D3:CDK4/6 complexes and suggest potential therapeutic protocols for this devastating blood tumor. PMID:23079656

  11. Inositol 1,3,4,6-tetrakisphosphate mobilizes calcium in Xenopus oocytes with high potency.

    PubMed Central

    Ivorra, I; Gigg, R; Irvine, R F; Parker, I

    1991-01-01

    Injection of Ins(1,3,4,6)P4 into Xenopus oocytes evoked Ca2(+)-dependent membrane currents with a potency 5-10 times less than Ins(1,4,5)P3, whereas Ins(1,3,4)P3 and Ins(1,3,4,5,6)P5 were almost ineffective. Responses to Ins(1,3,4,6)P4 arose through liberation of intracellular Ca2+ and through entry of extracellular Ca2+. These results, together with the observation that Ins(1,3,4,6)P4 facilitated responses to Ins(1,4,5)P3, suggests that both of these compounds may act on the same intracellular receptors. PMID:1991032

  12. Short communication: Changes in the composition of yak colostrum during the first week of lactation.

    PubMed

    Mi, J D; Zhou, J W; Ding, L M; Wang, L; Long, R J

    2016-01-01

    Although the great interest has been paid to colostrum utilization for calves, no systematic studies evaluating the compositional changes of yak colostrum during the first week after parturition have been reported. The aim of this study was to elucidate such postpartum nutritional changes. Colostrum samples from 12 multiparous (2-7 lactations) yaks, grazed on alpine pasture, were collected at exactly 1, 24, 48, 72, 96, 120, 144, and 168 h postpartum. Gross composition (fat, total solids, protein, and ash) were measured, as well as fat and water-soluble vitamins, fatty acid and mineral composition, and IgG. The colostrum, collected 1h postpartum, had the highest concentrations of crude protein, total solids, ash, vitamin A and E, β-carotene, and most minerals (Na, Mg, Zn, Cu, and Fe). These components decreased rapidly within 24h. Similarly, at 24h postpartum, IgG content decreased to 7.5% of the value (87.78 mg/mL) at 1h postpartum. In contrast, the concentration of vitamin C increased from 1 to 24h and then decreased consistently thereafter to the lowest value at 168 h. Phosphorus and Ca contents showed an increasing trend from 24 to 168 h after calving. Lactose content increased from 2.88% at 1h to 4.96% at 48 h postpartum and was steady to 168 h. Total n-3 fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, and n-3-to-n-6 fatty acid ratio were proportionally similar as a percentage of total fatty acid methyl esters during the first 168 h of milk production. However, the proportion of total n-6 fatty acid content to total fatty acid methyl esters decreased from 3.07% at 1h to 2.60% at 24h. In summary, experimental results indicate colostrum should be provided to yak calves as soon as possible after birth to provide nutrients and enhance passive immunity. PMID:26547651

  13. Postpartum Depression and Social Support in China: A Cultural Perspective.

    PubMed

    Tang, Lu; Zhu, Ruijuan; Zhang, Xueying

    2016-09-01

    This study explored how Chinese culture affects the relationship between social support and postpartum depression. In-depth interviews with 38 mothers in mainland China showed that discrepancies between expected and perceived available social support and conflicts among social support providers are two major contributors to the stress associated with postpartum depression. These dynamics are deeply rooted in the context of Chinese culture with its distinctive gender roles and family dynamics. These cultural norms further prevent women from seeking social support. PMID:27491938

  14. Dispelling myths to support breastfeeding in women with postpartum depression.

    PubMed

    Olson, Tonia; Bowen, Angela

    2014-01-01

    Increasing attention is being paid to the possible connection between infant feeding practices and postpartum depression. Nurses caring for women and their families in the postpartum period might wonder how to best support the breastfeeding relationship if a woman has a history of depression. Using evidence from the scientific literature, this article dispels some myths regarding breastfeeding and depression, and provides suggested dialogue nurses can use when counseling women about depression and breastfeeding. PMID:25145719

  15. Transformation of 2,4,6-trinitrotoluene under controlled eH/pH conditions. Final report

    SciTech Connect

    Price, C.B.; Brannon, J.M.; Hayes, C.A.

    1995-09-01

    The presence of 2,4,6-trinitrotoluene (TNT) in soil and groundwater can present serious environmental problems. The processes that control the mobility and transformation of TNT in these environments are not well understood. The objective of this study was to determine the effects of redox potential (Eh) and pH on the transformation of TNT. Soil components responsible for the transformation of TNT were also investigated. Laboratory investigations included testing at four different redox potentials and four pH levels. A 10:1 (water: soil) suspension spiked with 100 micro g of TNT/g, dry weight soil was used. The aqueous phase was sampled over a 2-week period for TNT and its transformation products. Soils were analyzed at completion of the 2-week incubation period. Results showed that redox potential and pH of the soil suspensions had a marked effect on TNT stability and transformation. The TNT was not stable under any Eh/pH conditions. TNT was least stable at any pH under highly reduced conditions. Results indicated that TNT persisted only under moderately reducing conditions and at lower pH levels.

  16. 2,3,4,6-Tetrachlorophenyl esters as antiseptics for fibrous materials

    SciTech Connect

    Stepanenko, N.I.; Ryakhovskaya, A.I.; Romanenko, O.A.; Garifullina, K.R.

    1983-09-10

    Wastes containing tri- and tetrachlorobenzenes are obtained during production of di- and trichlorobenzenes. One way of utilizing these wastes is conversion into di- and trichlorophenols by saponification. Chlorination of a mixture of di- and trichlorophenols converts it into 2,3,4,6-tetrachlorophenol with high yields (95-96 wt. %). The uses of tetrachlorophenol are limited by its strong specific odor and volatility. The possibility of obtaining esters of 2,3,4,6-tetrachlorophenol and saturated aliphatic C/sub 2/-C/sub 12/ monocarboxylic acids, which have good antiseptic properties in relation to fibrous materials are described.

  17. Isolation, characterization, and systematic significance of 2-pyrone-4,6-dicarboxylic acid in Rosaceae.

    PubMed

    Wilkes, S; Glasl, H

    2001-10-01

    2-Pyrone-4,6-dicarboxylic acid was isolated from Potentilla anserina. Until now this substance was only found in bacteria and not in higher plants. By sterile cultivation it was verified that this compound is genuine also in plants. In addition the systematic relevance of 2-pyrone-4,6-dicarboxylic acid within the Rosaceae was tested. The compound seems to be a chemotaxonomic marker for the Rosoideae sensu stricto proposed by Morgan et al. (Morgan, D.R., Soltis, D.E., Robertson, K.R., 1994. Systematic and evolutionary implications of rbcL sequence variation in Rosaceae. American Journal of Botany 81, 890-903).

  18. Toxicological characterization of 2,4,6-trinitrotoluene, its transformation products, and two nitramine explosives.

    PubMed

    Neuwoehner, Judith; Schofer, Andrea; Erlenkaemper, Bibiane; Steinbach, Klaus; Hund-Rinke, T Kerstin; Eisentraeger, Adolf

    2007-06-01

    The soil and groundwater of former ordnance plants and their dumping sites have often been highly contaminated with the explosive 2,4,6-trinitrotoluene (2,4,6-TNT) leading to a potential hazard for humans and the environment. Further hazards can arise from metabolites of transformation, by-products of the manufacturing process, or incomplete combustion. This work examines the toxicity of polar nitro compounds relative to their parent compound 2,4,6-TNT using four different ecotoxicological bioassays (algae growth inhibition test, daphnids immobilization test, luminescence inhibition test, and cell growth inhibition test), three genotoxicological assays (umu test, NM2009 test, and SOS Chromotest), and the Ames fluctuation test for detection of mutagenicity. For this study, substances typical for certain steps of degradation/transformation of 2,4,6-TNT were chosen for investigation. This work determines that the parent compounds 2,4,6-TNT and 1,3,5-trinitrobenzene are the most toxic substances followed by 3,5-dinitrophenol, 3,5-dinitroaniline and 4-amino-2-nitrotoluene. Less toxic are the direct degradation products of 2,4,6-TNT like 2,4-dinitrotoluene, 2,6-dinitrotoluene, 2-amino-4,6-dinitrotoluene, and 4-amino-2,6-dinitrotoluene. A weak toxic potential was observed for 2,4,6-trinitrobenzoic acid, 2,4-diamino-6-nitrotoluene, 2,4-dinitrotoluene-5-sulfonic acid, and 2,6-diamino-4-nitrotoluene. Octahydro-l,3,5,7-tetranitro-l,3,5,7-tetrazocine and hexahydro-1,3,5-trinitro-l,3,5-triazine show no hint of acute toxicity. Based on the results of this study, we recommend expanding future monitoring programs of not only the parent substances but also potential metabolites based on conditions at the contaminated sites and to use bioassays as tools for estimating the toxicological potential directly by testing environmental samples. Site-specific protocols should be developed. If hazardous substances are found in relevant concentrations, action should be taken to prevent

  19. Monoclinic structure of hydroxylpyromorphite Pb10(PO4)6(OH)2 - hydroxylmimetite Pb10(AsO4)6(OH)2 solid solution series

    NASA Astrophysics Data System (ADS)

    Giera, Alicja; Manecki, Maciej; Borkiewicz, Olaf; Zelek, Sylwia; Rakovan, John; Bajda, Tomasz; Marchlewski, Tomasz

    2016-04-01

    Seven samples of hydroxyl analogues of pyromorphite-mimetite solid solutions series were synthesized from aqueous solutions at 80° C in a computer-controlled chemistate: 200 mL aqueous solutions of 0.05M Pb(NO3)2 and 0.03M KH2AsO4 and/or KH2PO4 were dosed with a 0.25 mL/min rate to a glass beaker, which initially contained 100 mL of distilled water. Constant pH of 8 was maintained using 2M KOH. The syntheses yielded homogeneous fine-grained white precipitates composition of which was close to theoretical Pb10[(PO4)6-x(AsO4)x](OH)2, where x = 0, 1, 2, 3, 4, 5, 6. High-resolution powder X-ray diffraction data were obtained in transmission geometry at the beamline 11-BM at the Advanced Photon Source (Argonne National Laboratory in Illinois, USA). The structure Rietveld refinements based on starting parameters of either hexagonal hydroxylpyromorphite or monoclinic mimetite-M were performed using GSAS+EXPGUI software. Apatite usually crystallizes in the hexagonal crystal system with the space group P63/m. For the first time, however, the lowering of the hexagonal to monoclinic crystal symmetry was observed in the hydroxyl variety of pyromorphite-mimetite solid solution series. This is indicated by better fitting of the modeled monoclinic structure to the experimental data. The same is not the case for analogous calcium hydroxylapatite series Ca5(PO4)3OH - Ca5(AsO4)3OH (Lee et al. 2009). Systematical linear increase of unit cell parameters is observed with As substitution from a=9.88, b=19.75, and c=7.43 for Pb10(PO4)6(OH)2 to a=10.23, b=20.32, and c=7.51 for Pb10(AsO4)6(OH)2. A strong pseudohexagonal character (γ ≈ 120° and b ≈ 2a) of the analyzed monoclinic phases was established. This work is partially funded by AGH research grant no 11.11.140.319 and partially by Polish NCN grant No 2011/01/M/ST10/06999. Lee Y.J., Stephens P.W., Tang Y., Li W., Philips B.L., Parise J.B., Reeder R.J., 2009. Arsenate substitution in hydroxylapatite: Structural characterization

  20. Monoclinic structure of hydroxylpyromorphite Pb10(PO4)6(OH)2 - hydroxylmimetite Pb10(AsO4)6(OH)2 solid solution series

    NASA Astrophysics Data System (ADS)

    Giera, Alicja; Manecki, Maciej; Borkiewicz, Olaf; Zelek, Sylwia; Rakovan, John; Bajda, Tomasz; Marchlewski, Tomasz

    2016-04-01

    Seven samples of hydroxyl analogues of pyromorphite-mimetite solid solutions series were synthesized from aqueous solutions at 80° C in a computer-controlled chemistate: 200 mL aqueous solutions of 0.05M Pb(NO3)2 and 0.03M KH2AsO4 and/or KH2PO4 were dosed with a 0.25 mL/min rate to a glass beaker, which initially contained 100 mL of distilled water. Constant pH of 8 was maintained using 2M KOH. The syntheses yielded homogeneous fine-grained white precipitates composition of which was close to theoretical Pb10[(PO4)6‑x(AsO4)x](OH)2, where x = 0, 1, 2, 3, 4, 5, 6. High-resolution powder X-ray diffraction data were obtained in transmission geometry at the beamline 11-BM at the Advanced Photon Source (Argonne National Laboratory in Illinois, USA). The structure Rietveld refinements based on starting parameters of either hexagonal hydroxylpyromorphite or monoclinic mimetite-M were performed using GSAS+EXPGUI software. Apatite usually crystallizes in the hexagonal crystal system with the space group P63/m. For the first time, however, the lowering of the hexagonal to monoclinic crystal symmetry was observed in the hydroxyl variety of pyromorphite-mimetite solid solution series. This is indicated by better fitting of the modeled monoclinic structure to the experimental data. The same is not the case for analogous calcium hydroxylapatite series Ca5(PO4)3OH - Ca5(AsO4)3OH (Lee et al. 2009). Systematical linear increase of unit cell parameters is observed with As substitution from a=9.88, b=19.75, and c=7.43 for Pb10(PO4)6(OH)2 to a=10.23, b=20.32, and c=7.51 for Pb10(AsO4)6(OH)2. A strong pseudohexagonal character (γ ≈ 120° and b ≈ 2a) of the analyzed monoclinic phases was established. This work is partially funded by AGH research grant no 11.11.140.319 and partially by Polish NCN grant No 2011/01/M/ST10/06999. Lee Y.J., Stephens P.W., Tang Y., Li W., Philips B.L., Parise J.B., Reeder R.J., 2009. Arsenate substitution in hydroxylapatite: Structural characterization

  1. Effects of feeding wheat straw or orchardgrass at ad libitum or restricted intake during the dry period on postpartum performance and lipid metabolism.

    PubMed

    Litherland, N B; Weich, W D; Hansen, W P; Linn, J G

    2012-12-01

    The objectives of this study were to investigate the effects of forage source [wheat straw (WS) or orchardgrass hay (OG)] and total amount of diet dry matter fed [ad libitum or restricted to 70% of predicted dry matter intake (DMI)] prepartum on postpartum performance. The study design was a 2×2 factorial design with 10 cows per treatment. Treatments were WS total mixed ration (TMR) ad libitum, OG TMR ad libitum, WS TMR restricted, and OG TMR restricted. The WS TMR (dry matter basis) contained 30% WS, 20.7% corn silage, 10.0% alfalfa hay, 18.2% ground corn, 16.8% soybean meal, and 4.3% molasses mineral mix (14.7% CP, 1.5 Mcal/kg of net energy for lactation, 37.0% neutral detergent fiber). The OG TMR contained 30% OG, 46.2% corn silage, 10.0% alfalfa hay, 9.5% soybean meal, and 4.3% molasses (14.2% CP, 1.5 Mcal/kg of net energy for lactation, 41.0% neutral detergent fiber). Cows received 1 lactation diet after calving (17.7% CP, 1.6 Mcal/kg of net energy for lactation, 27.3% neutral detergent fiber). Total diet DMI prepartum was higher for ad libitum than for restricted as designed, but forage source had no effect on DMI. Total tract apparent digestibilities of DM and NDF were greater for OG than for WS. Postpartum DMI expressed as a percentage of body weight for the first week of lactation was higher for ad libitum than for restricted diets. Postpartum DMI during the first 30 d of lactation was higher for OG than for WS, but no effect was observed for the amount fed prepartum. Milk yield during the first week of lactation was higher for OG than for WS; however, during the first 30 d, 3.5% fat-corrected milk yield and yield of milk fat were highest for OG TMR restricted and WS TMR ad libitum. Prepartum treatments had a limited effect on pre- and postpartum lipid metabolism; however, cows fed WS TMR ad libitum had the highest postpartum β-hydroxybutyrate. Eating behavior was observed by 10-min video scans of 24-h video surveillance for 5d pre- and postpartum

  2. A structure-activity study on the sucrose taste antagonist methyl 4,6-dichloro-4,6-dideoxy-alpha-D-galactopyranoside.

    PubMed

    Vlahopoulos, V; Jakinovich, W

    1986-09-01

    In order to assess the effect of the antagonist methyl 4,6-dichloro-4,6-dideoxy-alpha-D-galactopyranoside (MAD-diCl-Gal) upon the gerbil's chorda tympani sucrose taste response, we tested several concentrations of this compound, as well as single concentrations of closely related derivatives, and found that MAD-diCl-Gal was the most potent inhibitor tested. It appears that the inhibition mechanism is very specific. For example, we have found that 2 chlorine atoms at the C-4 and C-6 positions on the glucopyranoside ring are required for inhibition. In addition, with regard to the orientation of the chlorine atoms, the galacto derivative seems to be more potent than the gluco derivative. We have also found that the methyl glycoside is more potent than the free sugar. With regard to the orientation of the methyl group, MAD-diCl-Gal is more potent than its beta-anomer. (Because of this discovery of the methyl group enhancement and orientation effect, we shall discontinue using the acronym diCl-Gal and replace it with the more specific MAD-diCl-Gal.) Of particular significance is the fact that there appears to be a structure-activity relationship between the most active stimulants and inhibitors in that the requirement for an axial orientation at C-1 and the enhancement by the methyl group at that position are the same in both cases. These results suggest that both the stimulator and the antagonist are acting at the same receptor site.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3746425

  3. Biotransformation of 2,4,6,8,10,12-hexanitro-2,4,6,8,10,12-hexaazaisowurtzitane (CL-20) by denitrifying Pseudomonas sp. strain FA1.

    PubMed

    Bhushan, Bharat; Paquet, Louise; Spain, Jim C; Hawari, Jalal

    2003-09-01

    The microbial and enzymatic degradation of a new energetic compound, 2,4,6,8,10,12-hexanitro-2,4,6,8,10,12-hexaazaisowurtzitane (CL-20), is not well understood. Fundamental knowledge about the mechanism of microbial degradation of CL-20 is essential to allow the prediction of its fate in the environment. In the present study, a CL-20-degrading denitrifying strain capable of utilizing CL-20 as the sole nitrogen source, Pseudomonas sp. strain FA1, was isolated from a garden soil. Studies with intact cells showed that aerobic conditions were required for bacterial growth and that anaerobic conditions enhanced CL-20 biotransformation. An enzyme(s) involved in the initial biotransformation of CL-20 was shown to be membrane associated and NADH dependent, and its expression was up-regulated about 2.2-fold in CL-20-induced cells. The rates of CL-20 biotransformation by the resting cells and the membrane-enzyme preparation were 3.2 +/- 0.1 nmol h(-1) mg of cell biomass(-1) and 11.5 +/- 0.4 nmol h(-1) mg of protein(-1), respectively, under anaerobic conditions. In the membrane-enzyme-catalyzed reactions, 2.3 nitrite ions (NO(2)(-)), 1.5 molecules of nitrous oxide (N(2)O), and 1.7 molecules of formic acid (HCOOH) were produced per reacted CL-20 molecule. The membrane-enzyme preparation reduced nitrite to nitrous oxide under anaerobic conditions. A comparative study of native enzymes, deflavoenzymes, and a reconstituted enzyme(s) and their subsequent inhibition by diphenyliodonium revealed that biotransformation of CL-20 is catalyzed by a membrane-associated flavoenzyme. The latter catalyzed an oxygen-sensitive one-electron transfer reaction that caused initial N denitration of CL-20. PMID:12957905

  4. Biotransformation of 2,4,6,8,10,12-Hexanitro-2,4,6,8,10,12-Hexaazaisowurtzitane (CL-20) by Denitrifying Pseudomonas sp. Strain FA1

    PubMed Central

    Bhushan, Bharat; Paquet, Louise; Spain, Jim C.; Hawari, Jalal

    2003-01-01

    The microbial and enzymatic degradation of a new energetic compound, 2,4,6,8,10,12-hexanitro-2,4,6,8,10,12-hexaazaisowurtzitane (CL-20), is not well understood. Fundamental knowledge about the mechanism of microbial degradation of CL-20 is essential to allow the prediction of its fate in the environment. In the present study, a CL-20-degrading denitrifying strain capable of utilizing CL-20 as the sole nitrogen source, Pseudomonas sp. strain FA1, was isolated from a garden soil. Studies with intact cells showed that aerobic conditions were required for bacterial growth and that anaerobic conditions enhanced CL-20 biotransformation. An enzyme(s) involved in the initial biotransformation of CL-20 was shown to be membrane associated and NADH dependent, and its expression was up-regulated about 2.2-fold in CL-20-induced cells. The rates of CL-20 biotransformation by the resting cells and the membrane-enzyme preparation were 3.2 ± 0.1 nmol h−1 mg of cell biomass−1 and 11.5 ± 0.4 nmol h−1 mg of protein−1, respectively, under anaerobic conditions. In the membrane-enzyme-catalyzed reactions, 2.3 nitrite ions (NO2−), 1.5 molecules of nitrous oxide (N2O), and 1.7 molecules of formic acid (HCOOH) were produced per reacted CL-20 molecule. The membrane-enzyme preparation reduced nitrite to nitrous oxide under anaerobic conditions. A comparative study of native enzymes, deflavoenzymes, and a reconstituted enzyme(s) and their subsequent inhibition by diphenyliodonium revealed that biotransformation of CL-20 is catalyzed by a membrane-associated flavoenzyme. The latter catalyzed an oxygen-sensitive one-electron transfer reaction that caused initial N denitration of CL-20. PMID:12957905

  5. Planet Patrol. An Environmental Unit on Solid Waste Solutions for Grades 4-6.

    ERIC Educational Resources Information Center

    Procter and Gamble Educational Services, Cincinnati, OH.

    This classroom unit was developed for use in grades 4-6 to help teach the concept of solid waste management. The teacher's guide provides an overview of the issue of solid waste disposal, a description of government, industry, and consumer roles in resolving the solid waste issue, and four lessons involving sanitary landfills, the reduction of…

  6. PCE/K-10 Activities for Career Education, Grades 4-6.

    ERIC Educational Resources Information Center

    Portland Public Schools, OR. Area II Office.

    The Portland (Oregon) Public School Project Career Education (PCE) Activities for grades 4-6 is based on the city's overall Area 2 program goals for career education which proposed that children completing school should have sufficient knowledge and competencies to enter into a field of employment or an advanced training program in that field.…

  7. BIOTRANSFORMATION OF 2,4,6-TRINITROTOLUENE (TNT) BY A PLANT-ASSOCIATED FUNGUS FUSARIUM OXYSPORUM

    EPA Science Inventory

    The capability of a plant-associated fungus, Fusarium oxyvorum, to transform TNT in liquid cultures was investigated. TNT was transformed into 2-amino-4, 6-dinitrotoluene (2-A-DNT), 4-amino-2, 6-dinitrotoluene (4-A- DNT), and 2, 4-diamino-6-nitrotoluene (2, 4-DAT) via 2- and 4-hy...

  8. Federal Aviation Administration Aviation Education Teacher's Guide, [Grades] 4-6.

    ERIC Educational Resources Information Center

    Federal Aviation Administration (DOT), Washington, DC.

    This guide is one in a series of four resource guides specifically designed for those interested in aviation education. Activities and lessons that can be used in a variety of content areas and grade levels are featured. Grades 4-6 are the focus of this guide, which is organized under the broad topics of properties of air, lighter than air flight,…

  9. A Curriculum in Written Composition, 4-6: A Guide for Teaching.

    ERIC Educational Resources Information Center

    Georgia Univ., Athens. English Curriculum Study Center.

    This guide for teaching composition in grades 4-6 (1) objectives for a curriculum in written composition, (2) sequence charts which relate subject content for each grade to basic understandings about composition, (3) illustrative learning experiences, and (4) units for teaching specific skills. The units for each grade are "Structuring a…

  10. Isopropyl 2,3,4,6-tetra-O-acetyl-β-d-glucopyran­oside

    PubMed Central

    Mönch, Bettina; Emmerling, Franziska; Kraus, Werner; Becker, Roland; Nehls, Irene

    2013-01-01

    The title compound, C17H26O10, was formed by a Koenigs–Knorr reaction of 2,3,4,6-tetra-O-acetyl-α-d-glucopyranosyl bromide and propan-2-ol. The central ring adopts a chair conformation. The crystal does not contain any significant inter­molecular inter­actions. PMID:23424447

  11. Teaching Writing in Grades 4-6 in Urban Schools in the Greater China Region

    ERIC Educational Resources Information Center

    Hsiang, Tien Ping; Graham, Steve

    2016-01-01

    A random sample of 1102 grade 4-6 Chinese language arts teachers in Beijing, Macao, and Taipei City were surveyed about their instructional writing practices. Seventy-eight percent (n = 857) of the teachers completed the survey. Teachers were generally positive about the usefulness of their college teacher preparation program. They slightly agreed…

  12. The Synthesis of 4,6,8-Trimethylazulene: An Organic Laboratory Experiment.

    ERIC Educational Resources Information Center

    Garst, Michael E.; And Others

    1983-01-01

    A two-stage synthesis of 4,6,8-trimethylazulene was developed for use in the undergraduate experiment, highlighting concepts not usually covered in the laboratory. The experiment requires purification procedures of chromatography and of sublimation and illustrates concepts of aromaticity, molecular orbital theory, and carbodium ion reactivity. (JN)

  13. 26 CFR 1.401(a)(4)-6 - Contributory defined benefit plans.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    .... § 1.401(a)(4)-6 Contributory defined benefit plans. (a) Introduction. This section provides rules... of § 1.401(a)(4)-1(b)(2). Paragraph (b) of this section provides rules for determining the amount of.... Paragraph (c) of this section provides the exclusive rules for determining whether a contributory DB...

  14. The Greatest Educational Change America Has Ever Seen, 2002: Lesson Plans for Grades 4-6.

    ERIC Educational Resources Information Center

    United States Mint (Dept. of Treasury), Washington, DC.

    This teacher's guide on the 50 state quarters emitted by the United States Mint includes 6 "teacher-friendly" lesson plans that fit easily into the curriculum for grades 4-6; reproducible student worksheets that coincide with each lesson; "fun" state facts and information on the new quarter designs; and USA map template with state outlines. These…

  15. The Greatest Educational Change America Has Ever Seen. [Teaching Guide]. Grades 4-6.

    ERIC Educational Resources Information Center

    United States Mint (Dept. of Treasury), Washington, DC.

    This teaching guide for grades 4-6 focuses on the 1999-2000 United States Mint 50 State Quarters Program, which includes new quarter designs for the following states: Delaware, Pennsylvania, New Jersey, Georgia, Connecticut, Massachusetts, Maryland, South Carolina, New Hampshire, and Virginia. The guide includes six lesson plans that fit easily…

  16. The Greatest Educational Change America Has Ever Seen, 2001: Lesson Plans for Grades 4-6.

    ERIC Educational Resources Information Center

    United States Mint (Dept. of Treasury), Washington, DC.

    This teacher's guide on the 50 state quarters produced by the United States Mint includes six lesson plans that fit easily into the social studies curriculum for grades 4-6. The lesson plans include reproducible student work pages that coincide with each lesson; state facts and information about the 2001 state quarter designs (New York, North…

  17. The Navajo Way of Life: A Resource Unit with Activities for Grades 4-6.

    ERIC Educational Resources Information Center

    Cordova, Dahlia

    A resource unit on the Navajo way of life, for grades 4-6, contains sections on Navajo history, art, and crafts, homes, music, poetry and games; Navajo and Pueblo cookery (including recipes); traditional Navajo dress, ceremony and legends; and successful Navajos, past and present. Sections include text, vocabulary words, drawings, maps, and…

  18. 43 CFR 2650.4-6 - National wildlife refuge system lands.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false National wildlife refuge system lands... SELECTIONS Alaska Native Selections: Generally § 2650.4-6 National wildlife refuge system lands. (a) Every conveyance which includes lands within the national wildlife refuge system shall, as to such lands,...

  19. 43 CFR 2650.4-6 - National wildlife refuge system lands.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false National wildlife refuge system lands... SELECTIONS Alaska Native Selections: Generally § 2650.4-6 National wildlife refuge system lands. (a) Every conveyance which includes lands within the national wildlife refuge system shall, as to such lands,...

  20. 43 CFR 2650.4-6 - National wildlife refuge system lands.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false National wildlife refuge system lands... SELECTIONS Alaska Native Selections: Generally § 2650.4-6 National wildlife refuge system lands. (a) Every conveyance which includes lands within the national wildlife refuge system shall, as to such lands,...

  1. 43 CFR 2650.4-6 - National wildlife refuge system lands.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false National wildlife refuge system lands... SELECTIONS Alaska Native Selections: Generally § 2650.4-6 National wildlife refuge system lands. (a) Every conveyance which includes lands within the national wildlife refuge system shall, as to such lands,...

  2. Explorations in Backyard Biology: Drawing on Nature in the Classroom, Grades 4-6.

    ERIC Educational Resources Information Center

    Raham, R. Gary

    This book is designed to guide students grades 4-6 in exploring new worlds of adventure in the life sciences. Students read short features on creatures as near as their own backyards, are invited to expand their interest with classroom and field activities, and are shown how to use drawing and writing skills to record their experiences in a…

  3. Kids, Crops, & Critters in the Classroom: An Agricultural Literacy Resource Guide for Grades 4-6.

    ERIC Educational Resources Information Center

    Illinois Farm Bureau, Bloomington.

    This resource guide provides teachers of grades 4-6 with ideas and materials to integrate agricultural concepts into classroom activities. The guide is organized into six categories: math, science, language arts, social studies, fine arts, and health/nutrition/safety. Each category contains 10 lessons organized in the following topic order:…

  4. Absorption, balance and metabolism of /sup 14/C-2, 4, 6-trichlorophenol in hydroponic tomato plants

    SciTech Connect

    Fragiadakis, A.; Sotiriou, N.; Korte, F.

    1981-12-01

    Most of the 2, 4, 6-TCP applied in the nutrient solution of the hydroculture test was volatilised; a proportion was absorbed by the developed plant roots and to a small extent isomerised. Significant portions of the non-extractable tomato plant residues were found in the isolated lignin and cellulose fractions.

  5. Teaching New Literacies in Grades 4-6: Resources for 21st-Century Classrooms

    ERIC Educational Resources Information Center

    Moss, Barbara, Ed.; Lapp, Diane, Ed.

    2009-01-01

    Upper-elementary students encounter a sometimes dizzying array of traditional and nontraditional texts both in and outside of the classroom. This practical handbook helps teachers in grades 4-6 harness the instructional potential of fiction, poetry, and plays; informational texts; graphic novels; digital storytelling; Web-based and multimodal…

  6. Living in Water. An Aquatic Science Curriculum for Grades 4-6. Second Edition.

    ERIC Educational Resources Information Center

    National Aquarium in Baltimore, MD. Dept. of Education.

    This document is a scientific study of water, aquatic environments and the plants and animals that live in water. It was written for grades 4-6 but many activities may also be of interest for use with older students. This curriculum covers both marine and freshwater habitats. Each of five sections addresses a question about water which is then…

  7. SAGE ANALYSIS OF TRANSCRIPTOME RESPONSES IN ARABIDOPSIS ROOTS EXPOSED TO 2,4,6-TRINITROTOLUENE

    EPA Science Inventory

    Serial Analysis of Gene Expression (SAGE) was used to profile transcript levels in Arabidopsis thaliana roots and assess their responses to 2,4,6-trinitrotoluene (TNT) exposure. SAGE libraries representing control and TNT-exposed seedling root transcripts were constructed, and ea...

  8. TOXICITY OF TETRYL (N-METHYL-N,2,4,6-TETRANITROANILINE) IN F344 RATS

    EPA Science Inventory

    The toxicity of tetryl (N-methyl-N,2,4,6-tetranitroaniline) in male and female F344 rats was evaluated after adminstration in the diet for 14 or 90 days. The 14-day study diet concentrations used were 0, 500, 1250, 2000, 2500, and 5000 ppm; the 90-day study diet concentrations we...

  9. Preparation of 1,3,5-triamo-2,4,6-trinitrobenzene of submicron particle size

    DOEpatents

    Rigdon, Lester P.; Moody, Gordon L.; McGuire, Raymond R.

    2001-05-01

    A method is disclosed for the preparation of very small particle size, relatively pure 1,3,5-triamino-2,4,6-trinitrobenzene (TATB). Particles of TATB prepared according to the disclosed method are of submicron size and have a surface area in the range from about 3.8 to 27 square meters per gram.

  10. Preparation of 1,3,5-triamino-2,4,6-trinitrobenzene of submicron particle size

    DOEpatents

    Rigdon, Lester P.; Moody, Gordon L.; McGuire, Raymond R.

    2001-01-01

    A method is disclosed for the preparation of very small particle size, relatively pure 1,3,5-triamino-2,4,6-trinitrobenzene (TATB). Particles of TATB prepared according to the disclosed method are of submicron size and have a surface area in the range from about 3.8 to 27 square meters per gram.

  11. Conserve & Renew. An Energy Education Activity Package for Grades 4-6.

    ERIC Educational Resources Information Center

    Tourtillot, Leeann

    This teaching guide contains a collection of energy education activities written and organized so that they might be used either as a unit on energy, or as individual activities to complement existing curricula in grades 4-6. The focus in on conservation and renewables. Most of 23 activities are designed as cooperative learning experiences and are…

  12. The Uncomplicated Elementary Career Education System for the "Real" Classroom. Career Capers for 4-6.

    ERIC Educational Resources Information Center

    Illinois State Office of Education, Springfield. Div. of Adult Vocational and Technical Education.

    Prepared by classroom teachers for the infusion of career education into existing curriculum, this notebook of student and teacher activities is designed for use with the monthly Factivities for grades 4-6 (CE 023 596). Each activity corresponds to one of the nine monthly topics: "me, myself, and I"; exploring the telephone book; transportation;…

  13. SOIL REDUCES 2,4,6-TRINITROTOLUENE BIOAVAILABILITY AND GENOTOXICITY IN VIVO

    EPA Science Inventory

    Soil Reduces 2,4,6- Trinitrotoluene Bioavailability and Genotoxicity In Vivo

    As chemicals age in soil, irreversible binding of chemical contaminants to organic components in the soil may occur, impacting the amount of chemical that is biologically available upon exp...

  14. Microbial transformation of 2,4,6-trinitrotoluene in aerobic soil columns

    SciTech Connect

    Bruns-Nagel, D.; Breitung, J.; Loew, E. von

    1996-07-01

    The explosive 2,4,6-trinitrotoluene (TNT) is a common contaminant of soil and groundwater at former muntion plants and their dumping sites. TNT is toxic to numerous organisms. This paper reports on an efficient aerobic circulating percolation reactor system for the microbial detoxification of TNT-contaminated soil. 36 refs., 4 figs., 1 tab.

  15. 42 CFR 4.6 - Reference, bibliographic, reproduction, and consultation services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Reference, bibliographic, reproduction, and... SERVICES GENERAL PROVISIONS NATIONAL LIBRARY OF MEDICINE § 4.6 Reference, bibliographic, reproduction, and... request, reference, bibliographic, reproduction, and consultation services. Priority will be given...

  16. 42 CFR 4.6 - Reference, bibliographic, reproduction, and consultation services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Reference, bibliographic, reproduction, and... SERVICES GENERAL PROVISIONS NATIONAL LIBRARY OF MEDICINE § 4.6 Reference, bibliographic, reproduction, and... request, reference, bibliographic, reproduction, and consultation services. Priority will be given...

  17. 42 CFR 4.6 - Reference, bibliographic, reproduction, and consultation services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Reference, bibliographic, reproduction, and... SERVICES GENERAL PROVISIONS NATIONAL LIBRARY OF MEDICINE § 4.6 Reference, bibliographic, reproduction, and... request, reference, bibliographic, reproduction, and consultation services. Priority will be given...

  18. 42 CFR 4.6 - Reference, bibliographic, reproduction, and consultation services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Reference, bibliographic, reproduction, and... SERVICES GENERAL PROVISIONS NATIONAL LIBRARY OF MEDICINE § 4.6 Reference, bibliographic, reproduction, and... request, reference, bibliographic, reproduction, and consultation services. Priority will be given...

  19. 42 CFR 4.6 - Reference, bibliographic, reproduction, and consultation services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Reference, bibliographic, reproduction, and... SERVICES GENERAL PROVISIONS NATIONAL LIBRARY OF MEDICINE § 4.6 Reference, bibliographic, reproduction, and... request, reference, bibliographic, reproduction, and consultation services. Priority will be given...

  20. Texas School Survey of Substance Use among Students: Grades 4-6, 1998.

    ERIC Educational Resources Information Center

    Wallisch, Lynn S.; Liu, Liang Y.

    This booklet reports on the results of the 1998 Texas School Survey of Substance Use among Students: Grades 4-6. The statewide school survey monitors trends in substance use among public school students, identifies emerging problem areas, and serves as a basis of comparison for local school surveys which are conducted annually by various school…

  1. Relationship between fatigue and sleepiness with general health of mothers in the postpartum period

    PubMed Central

    Khayamim, Nafiseh; Bahadoran, Parvin; Mehrabi, Tayebeh

    2016-01-01

    Background: Fatigue and changes in sleep patterns are one of the impressive features in the first year after birth, which have negative effects on work, family life, and social relationships. Therefore, the objective of this research was to investigate the relationship between fatigue and Stanford sleepiness with the general health of mothers in the postpartum period. Materials and Methods: The current research is a descriptive correlational study which was performed on 190 mothers between 2 and 24 postpartum weeks, referring to the health centers of Isfahan in 2014. All mothers meeting the inclusion criteria were selected through cluster purposive sampling. Data were collected by use of four questionnaires including profile and fertility, fatigue, Stanford sleepiness, and general health. Data were analyzed by statistical tests at a significance level of ≤0.05. Results: The results showed that 5.3%, 59.5%, and 35.3% of subjects had mild, moderate, and severe fatigue, respectively. In addition, 26.3% of women showed a public health disorder, and according to Stanford sleepiness, 20.5% of subjects had sleepiness. The statistical results indicated that there were significant relationships between fatigue (P ≤ 0.001, r = 0.52) and Stanford sleepiness (P = 0.04, r = 0.14), and mothers’ general health. Conclusions: According to prevalence of fatigue and sleepiness in the postpartum period and its relationship with maternal health, application of sleep health education and appropriate counseling during pregnancy and after delivery is recommended to prevent mothers’ mental complications in order to achieve a safe pregnancy. PMID:27563322

  2. Impact of a health promotion intervention on maternal depressive symptoms at 15 months postpartum.

    PubMed

    Surkan, Pamela J; Gottlieb, Barbara R; McCormick, Marie C; Hunt, Anne; Peterson, Karen E

    2012-01-01

    Given that diet, physical activity, and social support are associated with depression, we examined whether a health promotion intervention designed to modify these factors in low-income, postpartum women would reduce depressive symptoms. This study used a randomized, controlled design to examine the effect of the Just for You (JFY) Program, an educational intervention promoting healthy lifestyles through home visits by nutrition paraprofessionals and motivational telephone counseling, on postpartum depressive symptoms. A total of 679 women income-eligible for the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) were recruited at 6-20 weeks post delivery and randomized to Usual WIC Care or JFY. Using an intention-to-treat analysis, the authors modeled depressive symptoms on the Center for Epidemiologic Studies Depression Scale (CES-D) among 403 women (59%) completing follow-up at a mean of 15 months infant age, adjusting for baseline CES-D, age, household income and randomization strata (body mass index (BMI), race/region). As a secondary analysis, the authors evaluated potential mediators related to social support and self-efficacy to change one or more health behaviors targeted by the intervention. Women randomized to JFY reported 2.5 units lower CES-D score (P = 0.046) compared with those receiving Usual WIC Care alone. This relationship was attenuated by change in self-efficacy (β = -2.3; P = 0.065), suggesting this construct may partially have mediated the effect of JFY on maternal depressive symptoms. A health promotion intervention delivered through home visits and telephone calls can reduce depressive symptoms at 15 months postpartum among low-income, ethnically diverse women. PMID:21153759

  3. Does Impulsiveness Moderate Response to Financial Incentives for Smoking Cessation Among Pregnant and Newly Postpartum Women?

    PubMed Central

    Lopez, Alexa A.; Skelly, Joan M.; White, Thomas J.; Higgins, Stephen T.

    2015-01-01

    We examined whether impulsiveness moderates response to financial incentives for cessation among pregnant smokers. All participants were randomized to either a condition wherein financial incentives were delivered contingent on smoking abstinence or to a control condition wherein incentives were delivered independent of smoking status. The study was conducted in two steps: First, we examined associations between baseline impulsiveness scores and abstinence at late pregnancy and 24-weeks postpartum as part of a planned prospective study of this topic using data from a recently completed, randomized controlled clinical trial (N = 118). Next, to increase statistical power, we conducted a second analysis collapsing results across that recent trial and two prior trials involving the same contingent incentive and control conditions (N = 236). Impulsivity was assessed using a delay discounting (DD) of hypothetical monetary rewards task in all three trials and Barratt Impulsiveness Scale (BIS) in the most recent trial. Neither DD nor BIS predicted antepartum or postpartum smoking status in the single or combined trials. Receiving abstinence-contingent incentives, lower baseline smoking rate (cigs/day), and a history of quit attempts pre-pregnancy predicted greater odds of antepartum abstinence across the single and combined trials. No variable predicted postpartum abstinence across the single and combined trials, although a history of antepartum quit attempts and receiving abstinence-contingent incentives predicted in the single and combined trials, respectively. Overall, this study provides no evidence that impulsiveness as assessed by DD or BIS moderates response to this treatment approach while underscoring a substantial association of smoking rate and prior quit attempts with abstinence across the contingent incentives and control treatment conditions. PMID:25730417

  4. Who should be screened for postpartum anemia? An evaluation of current recommendations.

    PubMed

    Bodnar, Lisa M; Siega-Riz, Anna Maria; Miller, William C; Cogswell, Mary E; McDonald, Thad

    2002-11-15

    The authors evaluated the utility of selective screening criteria for postpartum anemia developed by the Centers for Disease Control and Prevention (CDC) versus criteria developed among low-income women using prevalence-based screening principles. Pregnant women in Raleigh, North Carolina, were followed up to the postpartum visit in 1997-1999 (n = 345). Prevalence of postpartum anemia was 19.1%. Independent risk markers, arrived at through multivariate logistic regression, were multiparity (odds ratio (OR) = 1.5, 95% confidence interval (CI): 0.8, 2.9), obesity (OR = 3.0, 95% CI: 1.6, 5.5), anemia at 24-29 weeks' gestation (OR = 2.3, 95% CI: 1.2, 4.4), anemia before delivery (OR = 3.4, 95% CI: 1.8, 6.7), and not exclusively breastfeeding (OR = 2.8, 95% CI: 1.0, 7.7). Risk scores were calculated by counting risk markers present. Likelihood ratios were determined for all possible risk scores of our algorithm and CDC's algorithm. Anemia screening decisions differed depending on clinic anemia prevalence. For example, if low test thresholds are assumed, when clinic prevalence is 10%, women with risk scores >3 on the authors' algorithm and >0 on CDC's algorithm should be screened. The authors' algorithm, in combination with prevalence information, can save clinics more money than CDC's current algorithm because a broader range of likelihood ratios was obtained, indicating a better ability to distinguish high- from low-risk women. However, if resources are available, universal screening should be considered in high-prevalence settings. PMID:12419762

  5. Randomized Trial of Psychological Interventions to Preventing Postpartum Depression among Iranian First-time Mothers

    PubMed Central

    Fathi-Ashtiani, Ali; Ahmadi, Ahmad; Ghobari-Bonab, Bagher; Azizi, Mohammed Parsa; Saheb-Alzamani, Sayeh Moosavi

    2015-01-01

    Background: The current study was conducted to examine the effect of cognitive behavior therapy on the reduction postpartum mood disorder and increasing the self-esteem of at-risk Iranian mothers. Methods: In this quasi-experimental study, 135 at-risk mothers were selected from the population by means of cluster sampling and randomly assigned into one of two groups: Intervention (n = 64), or control (n = 71). The control group received usual medical care, and the intervention group received an eight sessions’ cognitive behavior program during pregnancy. Assessments were administered at two time points (pretest at the beginning of the third trimester and posttest at 2 weeks postpartum). Beck anxiety, beck depression, Edinburgh postpartum depression, (PPD) Coopersmith self-esteem, and religious attitude questionnaire were used to collect data. Results: The mean age of participants was 25.8 ± 3.7 years. One-third of them had either bachelor or higher degrees in education (33%). About two-third of participants were unemployment with similar distribution in both the groups (intervention = 80%, control = 83%). The majority (70%) of the participants had cesarean section deliveries. There were no statistically significant differences respects to sociodemographic characteristics between the control and intervention groups (P > 0.05). The multivariate analysis of covariance results showed that the average scores of PPD were reduced significantly in the intervention group (P < 0.001). Also while the mean score of anxiety in the intervention group decreased from 23.31 (standard error [SE] =12.11) to 16.64 (SE = 8.33) and self-esteem increased from 29.09 (SE = 3.51) to 31.81 (SE = 2.76), no change was statistically significant in comparison to the control group. Conclusions: According to the findings of the present study, cognitive behavior intervention is effective in reducing PPD in at-risk mothers. PMID:26682030

  6. Levels of innate immune factors in preterm and term mothers' breast milk during the 1st month postpartum.

    PubMed

    Trend, Stephanie; Strunk, Tobias; Lloyd, Megan L; Kok, Chooi Heen; Metcalfe, Jessica; Geddes, Donna T; Lai, Ching Tat; Richmond, Peter; Doherty, Dorota A; Simmer, Karen; Currie, Andrew

    2016-04-14

    There is a paucity of data on the effect of preterm birth on the immunological composition of breast milk throughout the different stages of lactation. We aimed to characterise the effects of preterm birth on the levels of immune factors in milk during the 1st month postpartum, to determine whether preterm milk is deficient in antimicrobial factors. Colostrum (days 2-5 postpartum), transitional milk (days 8-12) and mature milk (days 26-30) were collected from mothers of extremely preterm (<28 weeks of gestation, n 15), very preterm (28-<32 weeks of gestation, n 15), moderately preterm (32-<37 weeks of gestation, n 15) and term infants (37-41 weeks of gestation, n 15). Total protein, lactoferrin, secretory IgA, soluble CD14 receptor (sCD14), transforming growth factor-β2 (TGF-β2), α defensin 5 (HD5), β defensins 1 (HBD1) and 2, IL-6, IL-10, IL-13, interferon-γ, TNF-α and lysozyme (LZ) were quantified in milk. We examined the effects of lactation stage, gestational age, volume of milk expressed, mode of delivery, parity and maternal infection on milk immune factor concentrations using repeated-measures regression analysis. The concentrations of all factors except LZ and HD5 decreased over the 1st month postpartum. Extremely preterm mothers had significantly higher concentrations of HBD1 and TGF-β2 in colostrum than term mothers did. After controlling for other variables in regression analyses, preterm birth was associated with higher concentrations of HBD1, LZ and sCD14 in milk samples. In conclusion, preterm breast milk contains significantly higher concentrations of some immune proteins than term breast milk.

  7. Body temperature in early postpartum dairy cows.

    PubMed

    Burfeind, O; Suthar, V S; Voigtsberger, R; Bonk, S; Heuwieser, W

    2014-07-01

    A strategy widely adopted in the modern dairy industry is the introduction of postpartum health monitoring programs by trained farm personnel. Within these fresh cow protocols, various parameters (e.g., rectal temperature, attitude, milk production, uterine discharge, ketones) are evaluated during the first 5 to 14 days in milk (DIMs) to diagnose relevant diseases. It is well documented that 14% to 66% of healthy cows exhibit at least one temperature of 39.5 °C or greater within the first 10 DIM. Although widely adopted, data on diagnostic performance of body temperature (BT) measurement to diagnose infectious diseases (e.g., metritis, mastitis) are lacking. Therefore, the objective of this study was to identify possible factors associated with BT in postpartum dairy cows. A study was conducted on a commercial dairy farm including 251 cows. In a total of 217 cows, a vaginal temperature logger was inserted from DIM 2 to 10, whereas 34 cows did not receive a temperature logger as control. Temperature loggers measured vaginal temperature every 10 minutes. Rectal temperature was measured twice daily in all cows. On DIM 2, 5, and 10, cows underwent a clinical examination. Body temperature was influenced by various parameters. Primiparous cows had 0.2 °C higher BT than multiparous cows. Multiparous cows that calved during June and July had higher BT than those that calved in May. In primiparous cows, this effect was only evident from DIM 7 to 10. Furthermore, abnormal calving conditions (i.e., assisted calving, dead calf, retained placenta, twins) affected BT in cows. This effect was more pronounced in multiparous cows. Abnormal vaginal discharge did increase BT in primiparous and multiparous cows. Primiparous cows suffering from hyperketonemia (beta-hydroxybutyrat ≥ 1.4 mmol/L) had higher BT than those not affected. In multiparous cows, there was no association between hyperketonemia and BT. The results of this study clearly demonstrate that BT is influenced

  8. Selective CDK4/6 inhibition with tumor responses by PD0332991 in patients with mantle cell lymphoma.

    PubMed

    Leonard, John P; LaCasce, Ann S; Smith, Mitchell R; Noy, Ariela; Chirieac, Lucian R; Rodig, Scott J; Yu, Jian Q; Vallabhajosula, Shankar; Schoder, Heiko; English, Patricia; Neuberg, Donna S; Martin, Peter; Millenson, Michael M; Ely, Scott A; Courtney, Rachel; Shaik, Naveed; Wilner, Keith D; Randolph, Sophia; Van den Abbeele, Annick D; Chen-Kiang, Selina Y; Yap, Jeffrey T; Shapiro, Geoffrey I

    2012-05-17

    Mantle cell lymphoma (MCL) carries an unfavorable prognosis and requires new treatment strategies. The associated t(11:14) translocation results in enhanced cyclin D1 expression and cyclin D1-dependent kinase activity to promote cell-cycle progression. A pharmacodynamic study of the selective CDK4/6 inhibitor PD0332991 was conducted in 17 patients with relapsed disease, using 2-deoxy-2-[(18)F]fluoro-D-glucose (FDG) and 3-deoxy-3[(18)F]fluorothymidine (FLT) positron emission tomography (PET) to study tumor metabolism and proliferation, respectively, in concert with pre- and on-treatment lymph node biopsies to assess retinoblastoma protein (Rb) phosphorylation and markers of proliferation and apoptosis. Substantial reductions in the summed FLT-PET maximal standard uptake value (SUV(max)), as well as in Rb phosphorylation and Ki-67 expression, occurred after 3 weeks in most patients, with significant correlations among these end points. Five patients achieved progression-free survival time of > 1 year (range, 14.9-30.1+ months), with 1 complete and 2 partial responses (18% objective response rate; 90% confidence interval, 5%-40%). These patients demonstrated > 70%, > 90%, and ≥ 87.5% reductions in summed FLT SUV(max) and expression of phospho-Rb and Ki67, respectively, parameters necessary but not sufficient for long-term disease control. The results of the present study confirm CDK4/6 inhibition by PD0332991 at a well-tolerated dose and schedule and suggest clinical benefit in a subset of MCL patients. This study is registered at www.clinicaltrials.gov under identifier NCT00420056.

  9. Prediction of incidence and bio-psycho-socio-cultural risk factors of post-partum depression immediately after birth in an Iranian population

    PubMed Central

    Abdollahi, Fatemeh; Zarghami, Mehran; Sazlina, Shariff-Ghazali; Zain, Azhar Md; Mohammad, Asghari Jafarabadi

    2016-01-01

    Introduction Post-partum depression (PPD) is the most prevalent mental problem associated with childbirth. The purpose of the present study was to determine the incidence of early PPD and possible relevant risk factors among women attending primary health centers in Mazandaran province, Iran for the first time. Material and methods A longitudinal cohort study was conducted among 2279 eligible women during weeks 32–42 of pregnancy to determine bio-psycho-socio-cultural risk factors of depression at 2 weeks post-partum using the Iranian version of the Edinburgh Postnatal Depression Scale (EPDS). Univariate and hierarchical multiple logistic regression models were used for data analysis. Results Among 1,739 mothers whose EPDS scores were ≤ 12 during weeks 32–42 of gestation and at the follow-up study, the cumulative incidence rate of depression was 6.9% (120/1,739) at 2 weeks post-partum. In the multivariate model the factor that predicted depression symptomatology at 2 weeks post-partum was having psychiatric distress in pregnancy based on the General Health Questionnaire (GHQ) (OR = 1.06, (95% CI: 1.04–1.09), p = 0.001). The risk of PPD also lower in those with sufficient parenting skills (OR = 0.78 (95% CI: 0.69–0.88), p = 0.001), increased marital satisfaction (OR = 0.94 (95% CI: 0.9–0.99), p = 0.03), increased frequency of practicing rituals (OR = 0.94 (95% CI: 0.89–0.99), p = 0.004) and in those whose husbands had better education (OR = 0.03 (95% CI: 0.88–0.99), p = 0.04). Conclusions The findings indicated that a combination of demographic, sociological, psychological and cultural risk factors can make mothers vulnerable to PPD. PMID:27695496

  10. Acceptability and feasibility of a mobile phone-based case management intervention to retain mothers and infants from an Option B+ program in postpartum HIV care

    PubMed Central

    SCHWARTZ, Sheree R; CLOUSE, Kate; YENDE, Nompumelelo; VAN RIE, Annelies; BASSETT, Jean; RATSHEFOLA, Mamothe; PETTIFOR, Audrey

    2016-01-01

    Objective To assess the acceptability and feasibility of a cell-phone based case manager intervention targeting HIV-infected pregnant women on highly-active antiretroviral therapy (HAART). Methods Pregnant women ≥36 weeks gestation attending antenatal care and receiving HAART through the Option B+ program at a primary care clinic in South Africa were enrolled into a prospective pilot intervention to receive text messages and telephone calls from a case manager through six weeks postpartum. Acceptability and feasibility of the intervention were assessed along with infant HIV testing rates and 10-week and 12-month postpartum maternal retention in care. Retention outcomes were compared to women of similar eligibility receiving care prior to the intervention. Results Fifty women were enrolled into the pilot from May-July 2013. Most (70%) were HAART-naive at time of conception and started HAART during antenatal care. During the intervention, the case manager sent 482 text messages and completed 202 telephone calls, for a median of 10 text messages and 4 calls/woman. Ninety-six percent completed the postpartum interview and 47/48 (98%) endorsed the utility of the intervention. Engagement in 10-week postpartum maternal HIV care was >90% in the pre-intervention (n=50) and intervention (n=50) periods; by 12-months retention fell to 72% and was the same across periods. More infants received HIV-testing by 10-weeks in the intervention period as compared to pre-intervention (90.0% vs. 63.3%, p<0.01). Conclusions Maternal support through a cell-phone based case manager approach was highly acceptable among South African HIV infected women on HAART and feasible, warranting further assessment of effectiveness. PMID:25656728

  11. Prediction of incidence and bio-psycho-socio-cultural risk factors of post-partum depression immediately after birth in an Iranian population

    PubMed Central

    Abdollahi, Fatemeh; Zarghami, Mehran; Sazlina, Shariff-Ghazali; Zain, Azhar Md; Mohammad, Asghari Jafarabadi

    2016-01-01

    Introduction Post-partum depression (PPD) is the most prevalent mental problem associated with childbirth. The purpose of the present study was to determine the incidence of early PPD and possible relevant risk factors among women attending primary health centers in Mazandaran province, Iran for the first time. Material and methods A longitudinal cohort study was conducted among 2279 eligible women during weeks 32–42 of pregnancy to determine bio-psycho-socio-cultural risk factors of depression at 2 weeks post-partum using the Iranian version of the Edinburgh Postnatal Depression Scale (EPDS). Univariate and hierarchical multiple logistic regression models were used for data analysis. Results Among 1,739 mothers whose EPDS scores were ≤ 12 during weeks 32–42 of gestation and at the follow-up study, the cumulative incidence rate of depression was 6.9% (120/1,739) at 2 weeks post-partum. In the multivariate model the factor that predicted depression symptomatology at 2 weeks post-partum was having psychiatric distress in pregnancy based on the General Health Questionnaire (GHQ) (OR = 1.06, (95% CI: 1.04–1.09), p = 0.001). The risk of PPD also lower in those with sufficient parenting skills (OR = 0.78 (95% CI: 0.69–0.88), p = 0.001), increased marital satisfaction (OR = 0.94 (95% CI: 0.9–0.99), p = 0.03), increased frequency of practicing rituals (OR = 0.94 (95% CI: 0.89–0.99), p = 0.004) and in those whose husbands had better education (OR = 0.03 (95% CI: 0.88–0.99), p = 0.04). Conclusions The findings indicated that a combination of demographic, sociological, psychological and cultural risk factors can make mothers vulnerable to PPD.

  12. L-Arginine supplementation 0.5% of diet during the last 90 days of gestation and 14 days postpartum reduced uterine fluid accumulation in the broodmare.

    PubMed

    Mesa, A M; Warren, L K; Sheehan, J M; Kelley, D E; Mortensen, C J

    2015-08-01

    L-Arginine is an essential amino acid in many species that has been shown to influence reproduction. However, in horses a dose of 1% L-arginine of total dietary intake impaired absorption of other amino acids, whereas a dose of 0.5% did not. The objectives of this experiment were to evaluate postpartum parameters on mares supplemented with 0.5% L-arginine through the last 90d of gestation and 14d postpartum. Sixteen light-horse mares were randomly divided in two groups: 8 mares supplemented with 0.5% L-arginine and 8 mares fed an isonitrogenous equivalent. Gestation length, days to uterine clearance and days to first ovulation were compared. Uterine body depth, diameter of uterine horns, and length of largest pocket of uterine fluid were recorded daily via transrectal ultrasound. Measurements of foal weight, height, and cannon bone circumference were recorded for 9 weeks. Arginine treatment had no effect on gestation length (P=0.58). Supplemented mares cleared fluid quicker postpartum (6.8±0.53d; P=0.026) compared to control (9.0±0.38d). Mares supplemented with L-arginine had smaller diameter of fluid present in the postpartum uterus (P≤0.05). Days to first postpartum ovulation were not affected by treatment nor any influence on uterine involution. Finally, treatment had no effect on any foal's measured parameters. L-Arginine supplementation fed at 0.5% of daily intake during the last 90d of gestation and early postpartum in mares decreased uterine fluid accumulation, yet did not appear to have any effect on any other parameters measured.

  13. Weight-related self-efficacy in relation to maternal body weight from early pregnancy to 2 years post-partum.

    PubMed

    Lipsky, Leah M; Strawderman, Myla S; Olson, Christine M

    2016-07-01

    Excessive gestational weight gain may lead to long-term increases in maternal body weight and associated health risks. The purpose of this study was to examine the relationship between maternal body weight and weight-related self-efficacy from early pregnancy to 2 years post-partum. Women with live, singleton term infants from a population-based cohort study were included (n = 595). Healthy eating self-efficacy and weight control self-efficacy were assessed prenatally and at 1 year and 2 years post-partum. Body weight was measured at early pregnancy, before delivery, and 6 weeks, 1 year and 2 years post-partum. Behavioural (smoking, breastfeeding) and sociodemographic (age, education, marital status, income) covariates were assessed by medical record review and baseline questionnaires. Multi-level linear regression models were used to examine the longitudinal associations of self-efficacy measures with body weight. Approximately half of the sample (57%) returned to early pregnancy weight at some point by 2 years post-partum, and 9% became overweight or obese at 2 years post-partum. Body weight over time was inversely related to healthy eating (β = -0.57, P = 0.02) and weight control (β = -0.99, P < 0.001) self-efficacy in the model controlling for both self-efficacy measures as well as time and behavioural and sociodemographic covariates. Weight-related self-efficacy may be an important target for interventions to reduce excessive gestational weight gain and post-partum weight gain.

  14. Phun Week: Understanding Physiology

    ERIC Educational Resources Information Center

    Limson, Mel; Matyas, Marsha Lakes

    2009-01-01

    Topics such as sports, exercise, health, and nutrition can make the science of physiology relevant and engaging for students. In addition, many lessons on these topics, such as those on the cardiovascular, respiratory, and digestive systems, align with national and state life science education standards. Physiology Understanding Week (PhUn…

  15. A Week of Observations

    ERIC Educational Resources Information Center

    Colasacco, Jenne

    2011-01-01

    Even the most effective teachers have room to grow, but it's not always easy for principals to give adequate guidance through short observations. High school principal Jenne Colasacco decided to bring more depth to her observations by observing each of her teachers during one class for an entire week. The new observation structure, which included…

  16. Swahili 12 Weeks Course.

    ERIC Educational Resources Information Center

    Defense Language Inst., Washington, DC.

    This 12-weeks course in basic Swahili comprises 55 lesson units in five volumes. The general course format consists of (1) perception drills for comprehension, oral production, and association using "situational picture" illustrations; (2) dialogs in English and Swahili, with cartoon guides; (3) sequenced pattern and recombination drills, and (4)…

  17. World breastfeeding week.

    PubMed

    Coleridge, Hannah-Lee

    2003-08-01

    'Breastfeeding in a globalised world for peace and justice' is the theme of this year's World Breastfeeding Week, which is to be held at the beginning of August. This article explores the aims of the campaign, the obstacles and benefits of globalisation and the activities that are being held around the world.

  18. Nutrition and the psychoneuroimmunology of postpartum depression.

    PubMed

    Ellsworth-Bowers, E R; Corwin, E J

    2012-06-01

    Postpartum depression (PPD) is a relatively common and often severe mood disorder that develops in women after childbirth. The aetiology of PPD is unclear, although there is emerging evidence to suggest a psychoneuroimmune connection. Additionally, deficiencies in n-3 PUFA, B vitamins, vitamin D and trace minerals have been implicated. This paper reviews evidence for a link between micronutrient status and PPD, analysing the potential contribution of each micronutrient to psychoneuroimmunological mechanisms of PPD. Articles related to PPD and women's levels of n-3 PUFA, B vitamins, vitamin D and the trace minerals Zn and Se were reviewed. Findings suggest that while n-3 PUFA levels have been shown to vary inversely with PPD and link with psychoneuroimmunology, there is mixed evidence regarding the ability of n-3 PUFA to prevent or treat PPD. B vitamin status is not clearly linked to PPD, even though it seems to vary inversely with depression in non-perinatal populations and may have an impact on immunity. Vitamin D and the trace minerals Zn and Se are linked to PPD and psychoneuroimmunology by intriguing, but small, studies. Overall, evidence suggests that certain micronutrient deficiencies contribute to the development of PPD, possibly through psychoneuroimmunological mechanisms. Developing a better understanding of these mechanisms is important for guiding future research, clinical practice and health education regarding PPD.

  19. Pharmacotherapy of postpartum depression: an update

    PubMed Central

    Kim, Deborah R; Epperson, C Neill; Weiss, Amy R; Wisner, Katherine L

    2014-01-01

    Introduction Postpartum depression (PPD) is a common and serious illness that affects up to 14% of women in the first month after childbirth. We present an update on the pharmacologic treatment of PPD, although there continues to be a lack of large, randomized controlled trials (RCTs). Areas covered A review of the literature on the use of antidepressants, hormonal supplements and omega-3 fatty acids for the prevention and the treatment of PPD published since the original review in 2009 and the authors’ opinion on the current status of the pharmacological treatment of PPD are covered. An electronic search was performed by using PubMed, Medline and PsychINFO. Inclusion criteria were: i) empirical articles in peer-reviewed English-language journals; ii) well-validated measures of depression; and iii) a uniform scoring system for depression among the sample. Expert opinion Since the last Expert Opinion review, four antidepressant treatment studies and one prevention study of PPD have been published. Six RCTs evaluating the use of omega-3 fatty acids (four for prevention and two for treatment) have been published. There continues to be lack of data regarding the pharmacotherapy of PPD. However, serotonin reuptake inhibitors should be considered first-line for women with PPD after it has been determined that the proper diagnosis is not bipolar disorder. It is important to individualize treatment for women with PPD and consider the risks and benefits of treatment while breastfeeding. PMID:24773410

  20. Postpartum depression: psychoneuroimmunological underpinnings and treatment

    PubMed Central

    Anderson, George; Maes, Michael

    2013-01-01

    Postpartum depression (PPD) is common, occurring in 10%–15% of women. Due to concerns about teratogenicity of medications in the suckling infant, the treatment of PPD has often been restricted to psychotherapy. We review here the biological underpinnings to PPD, suggesting a powerful role for the tryptophan catabolites, indoleamine 2,3-dixoygenase, serotonin, and autoimmunity in mediating the consequences of immuno-inflammation and oxidative and nitrosative stress. It is suggested that the increased inflammatory potential, the decreases in endogenous anti-inflammatory compounds together with decreased omega-3 poly-unsaturated fatty acids, in the postnatal period cause an inflammatory environment. The latter may result in the utilization of peripheral inflammatory products, especially kynurenine, in driving the central processes producing postnatal depression. The pharmacological treatment of PPD is placed in this context, and recommendations for more refined and safer treatments are made, including the better utilization of the antidepressant, and the anti-inflammatory and antioxidant effects of melatonin. PMID:23459664

  1. Nutrition and the psychoneuroimmunology of postpartum depression

    PubMed Central

    Ellsworth-Bowers, E. R.; Corwin, E. J.

    2013-01-01

    Postpartum depression (PPD) is a relatively common and often severe mood disorder that develops in women after childbirth. The aetiology of PPD is unclear, although there is emerging evidence to suggest a psychoneuroimmune connection. Additionally, deficiencies in n-3 PUFA, B vitamins, vitamin D and trace minerals have been implicated. This paper reviews evidence for a link between micronutrient status and PPD, analysing the potential contribution of each micronutrient to psychoneuroimmunological mechanisms of PPD. Articles related to PPD and women’s levels of n-3 PUFA, B vitamins, vitamin D and the trace minerals Zn and Se were reviewed. Findings suggest that while n-3 PUFA levels have been shown to vary inversely with PPD and link with psychoneuroimmunology, there is mixed evidence regarding the ability of n-3 PUFA to prevent or treat PPD. B vitamin status is not clearly linked to PPD, even though it seems to vary inversely with depression in non-perinatal populations and may have an impact on immunity. Vitamin D and the trace minerals Zn and Se are linked to PPD and psychoneuroimmunology by intriguing, but small, studies. Overall, evidence suggests that certain micronutrient deficiencies contribute to the development of PPD, possibly through psychoneuroimmunological mechanisms. Developing a better understanding of these mechanisms is important for guiding future research, clinical practice and health education regarding PPD. PMID:22853878

  2. Postpartum depression and culture: Pesado Corazon.

    PubMed

    Callister, Lynn Clark; Beckstrand, Renea L; Corbett, Cheryl

    2010-01-01

    The purpose of this article is to describe what the literature has shown about postpartum depression (PPD) in culturally diverse women. The majority of qualitative studies done with women identified as having PPD have been conducted with Western women, with the second largest group focusing on Chinese women. This article reviews the qualitative studies in the literature and discusses how the management of PPD in technocentric and ethnokinship cultures differs. Social support has been shown to be significantly related to fewer symptoms of PPD, and culturally prescribed practices may or may not be cultural mediators in decreasing the incidence of PPD. Nurses should be sensitive to the varied ways in which culturally diverse women perceive, explain, and report symptoms of PPD. Exemplary interventions for culturally diverse women suffering from PPD are examined in this article as well, although it is clear that additional research is needed to develop models for culturally competent interventions for PPD in culturally diverse women and to document the outcomes of such interventions.

  3. A case of taeniasis diagnosed postpartum.

    PubMed

    Noss, Matthew R; Gilmore, Katherine; Wittich, Arthur C

    2013-04-01

    A case of postpartum taeniasis will be discussed along with the pathophysiology, proper treatment, potential risks, and prevention of taeniasis infections to the pregnant mother, her infant, and her family members. Taenia spp. infections are relatively rare in developed societies. Increasing immigration to developed countries and an expanding role of medical aid in developing countries will lead to an increase in the number of taeniasis cases seen by medical providers. Taenia solium and T. saginata are the most common species and can be differentiated by proglottids (a segment of a tapeworm containing both male and female reproductive organs) or scolex (the head of a tapeworm which attaches to the intestine of the definitive host). Both carry different risks when considering autoinfection and transmission. Cystercercosis caused by T. solium is a risk for neonates and is cause for immediate treatment of the mother. A 23-year-old new mother, originally from Ethiopia, passed T. strobili shortly after giving birth. Her pregnancy was complicated by limited prenatal care. She did not experience any symptoms related to tapeworm infection. The patient received treatment with praziquantel. With a possible future increase in the number of cases seen by health care providers, understanding the risks of Taenia sp. infection is important as proper treatment and education are needed to halt the life cycle of the tapeworm before more serious infection ensues. PMID:23707843

  4. 17 CFR 4.6 - Exclusion for certain otherwise regulated persons from the definition of the term “commodity...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... otherwise regulated persons from the definition of the term âcommodity trading advisor.â 4.6 Section 4.6 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION COMMODITY POOL OPERATORS AND COMMODITY TRADING ADVISORS General Provisions, Definitions and Exemptions § 4.6 Exclusion for...

  5. Effect of alfaprostol, lasalocid, and once-daily suckling on postpartum interval in Brahman and Brahman crossbred cattle.

    PubMed

    Del Vecchio, R P; Randel, R D; Neuendorff, D A; Peterson, L A

    1988-10-01

    Brahman cows (n = 49) and primiparous heifers (n = 11), Brahman x Hereford primiparous F1 heifers (n = 86) and Simmental x Brahman primiparous F1 heifers (n = 13) were randomly allotted by breed, age and date of calving to one of eight treatment groups: 1) control; 2) once-daily suckling; 3) lasalocid (200 mg/hd/d); 4) alfaprostol (5 mg intermuscular injections on Days 21 and 32 post partum); 5) lasalocid + once-daily suckling; 6) alfaprostol + once daily suckling; 7) alfaprostol + lasalocid; 8) alfaprostol + lasalocid + once daily suckling. All animals received 2.3 kg/hd/d of a concentrate (6 corn : 1 cottonseed meal) and lasalocid was mixed and fed in the concentrate. Body weights and condition scores were taken on Day 1 post partum and every 28 d thereafter. All animals were maintained with sterile marker bulls with Brahman and Simmental x Brahman cattle artificially inseminated at first estrus. Blood samples were collected at weekly intervals starting on Day 21 post partum until estrus and at nine to twelve days post estrus when the ovaries were palpated for corpora lutea. After the first postpartum estrus with a corpora lutea, cows were placed with fertile bulls. Mean serum progesterone concentrations were below 0.5 ng/ml prior to treatment. Calf weight gains to 90 d were not affected by age (P > 0.10) but were lower in the once-daily suckling group (P < 0.05). Treatment did not affect cow weight or condition score (P > 0.10). Cows had a shorter postpartum interval (P < 0.0001) than heifers. Once-daily suckling shortened postpartum interval (P < 0.0001) and positively influenced the cumulative frequency of return to estrus by 40 d post partum (P < 0.02). Alfaprostol did not affect postpartum interval (P > 0.10) but did increase the cumulative frequency of return to estrus by 90 d post partum (P < 0.03). Lasalocid did not affect postpartum interval or cumulative frequency of return to estrus (P > 0.10). Both once-daily suckling and alfaprostol were effective in

  6. Effect of alfaprostol, lasalocid, and once-daily suckling on postpartum interval in Brahman and Brahman crossbred cattle.

    PubMed

    Del Vecchio, R P; Randel, R D; Neuendorff, D A; Peterson, L A

    1988-10-01

    Brahman cows (n = 49) and primiparous heifers (n = 11), Brahman x Hereford primiparous F1 heifers (n = 86) and Simmental x Brahman primiparous F1 heifers (n = 13) were randomly allotted by breed, age and date of calving to one of eight treatment groups: 1) control; 2) once-daily suckling; 3) lasalocid (200 mg/hd/d); 4) alfaprostol (5 mg intermuscular injections on Days 21 and 32 post partum); 5) lasalocid + once-daily suckling; 6) alfaprostol + once daily suckling; 7) alfaprostol + lasalocid; 8) alfaprostol + lasalocid + once daily suckling. All animals received 2.3 kg/hd/d of a concentrate (6 corn : 1 cottonseed meal) and lasalocid was mixed and fed in the concentrate. Body weights and condition scores were taken on Day 1 post partum and every 28 d thereafter. All animals were maintained with sterile marker bulls with Brahman and Simmental x Brahman cattle artificially inseminated at first estrus. Blood samples were collected at weekly intervals starting on Day 21 post partum until estrus and at nine to twelve days post estrus when the ovaries were palpated for corpora lutea. After the first postpartum estrus with a corpora lutea, cows were placed with fertile bulls. Mean serum progesterone concentrations were below 0.5 ng/ml prior to treatment. Calf weight gains to 90 d were not affected by age (P > 0.10) but were lower in the once-daily suckling group (P < 0.05). Treatment did not affect cow weight or condition score (P > 0.10). Cows had a shorter postpartum interval (P < 0.0001) than heifers. Once-daily suckling shortened postpartum interval (P < 0.0001) and positively influenced the cumulative frequency of return to estrus by 40 d post partum (P < 0.02). Alfaprostol did not affect postpartum interval (P > 0.10) but did increase the cumulative frequency of return to estrus by 90 d post partum (P < 0.03). Lasalocid did not affect postpartum interval or cumulative frequency of return to estrus (P > 0.10). Both once-daily suckling and alfaprostol were effective in

  7. School outcomes for minority-group adolescent mothers at 28 to 36 months postpartum: a longitudinal follow-up.

    PubMed

    Leadbeater, B J

    1996-01-01

    This study examines the educational status of 120 adolescent postpartum women in the US during 1987-88. Mothers were 14-19 years old at delivery. 53.1% were African American and 42.5% were Puerto Rican. All but 2 deliveries were first births. 71.7% lived with their own mothers. 64.6% came from families on welfare. The average number of years of completed schooling was 9.5. At 28-36 months postpartum the average age was 19.7 years, 52.4% lived with their mothers, 52.4% lived off their mother's public assistance, and 17.9% supported themselves. 7.9% were married. Interviews were conducted at 3-4 weeks, 6 months, 12 months, and 28-36 months postpartum. 94% had completed interviews by 12 months, and 71% had completed interviews by 28-36 months. 33% of mothers had attended school or graduated through the pregnancy and the last follow-up period. 19% who were not in school at the first birth returned or graduated by 28-36 months postpartum. 12% dropped out before the pregnancy and never returned; 36% dropped out during the pregnancy and never returned. Greater risk of delayed grade placement by 28-36 months was significantly associated with age at delivery and reports of stressful life events 1 year postpartum. Mothers who were more grade-delayed reported more depressive symptoms, more repeat pregnancies, and lower work plans. At 1 year postpartum, school returners reported significantly fewer stresses and more child care support than dropouts. 41% of the mothers had a new mate. 25.7% reported a close relationship with the baby's father. About 80% reported problems with the fathers such as drugs, promiscuity, jail, death, machismo, or physical abuse. Only 39% of attenders had a repeat pregnancy compared to 68% of returners, 93% of dropouts during pregnancy, and 70% of dropouts before pregnancy. Only half of the mothers were likely to pursue educational and occupational goals. PMID:12321351

  8. Does impulsiveness moderate response to financial incentives for smoking cessation among pregnant and newly postpartum women?

    PubMed

    Lopez, Alexa A; Skelly, Joan M; White, Thomas J; Higgins, Stephen T

    2015-04-01

    We examined whether impulsiveness moderates response to financial incentives for cessation among pregnant smokers. Participants were randomized to receive financial incentives delivered contingent on smoking abstinence or to a control condition wherein incentives were delivered independent of smoking status. The study was conducted in two steps: First, we examined associations between baseline impulsiveness and abstinence at late pregnancy and 24-weeks-postpartum as part of a planned prospective study of this topic using data from a recently completed, randomized controlled clinical trial (N = 118). Next, to increase statistical power, we conducted a second analysis collapsing results across that recent trial and two prior trials involving the same study conditions (N = 236). Impulsivity was assessed using a delay discounting (DD) of hypothetical monetary rewards task in all three trials and Barratt Impulsiveness Scale (BIS) in the most recent trial. Neither DD nor BIS predicted smoking status in the single or combined trials. Receiving abstinence-contingent incentives, lower baseline smoking rate, and a history of quit attempts prepregnancy predicted greater odds of antepartum abstinence across the single and combined trials. No variable predicted postpartum abstinence across the single and combined trials, although a history of antepartum quit attempts and receiving abstinence-contingent incentives predicted in the single and combined trials, respectively. Overall, this study provides no evidence that impulsiveness as assessed by DD or BIS moderates response to this treatment approach while underscoring a substantial association of smoking rate and prior quit attempts with abstinence across the contingent incentives and control treatment conditions.

  9. Does impulsiveness moderate response to financial incentives for smoking cessation among pregnant and newly postpartum women?

    PubMed

    Lopez, Alexa A; Skelly, Joan M; White, Thomas J; Higgins, Stephen T

    2015-04-01

    We examined whether impulsiveness moderates response to financial incentives for cessation among pregnant smokers. Participants were randomized to receive financial incentives delivered contingent on smoking abstinence or to a control condition wherein incentives were delivered independent of smoking status. The study was conducted in two steps: First, we examined associations between baseline impulsiveness and abstinence at late pregnancy and 24-weeks-postpartum as part of a planned prospective study of this topic using data from a recently completed, randomized controlled clinical trial (N = 118). Next, to increase statistical power, we conducted a second analysis collapsing results across that recent trial and two prior trials involving the same study conditions (N = 236). Impulsivity was assessed using a delay discounting (DD) of hypothetical monetary rewards task in all three trials and Barratt Impulsiveness Scale (BIS) in the most recent trial. Neither DD nor BIS predicted smoking status in the single or combined trials. Receiving abstinence-contingent incentives, lower baseline smoking rate, and a history of quit attempts prepregnancy predicted greater odds of antepartum abstinence across the single and combined trials. No variable predicted postpartum abstinence across the single and combined trials, although a history of antepartum quit attempts and receiving abstinence-contingent incentives predicted in the single and combined trials, respectively. Overall, this study provides no evidence that impulsiveness as assessed by DD or BIS moderates response to this treatment approach while underscoring a substantial association of smoking rate and prior quit attempts with abstinence across the contingent incentives and control treatment conditions. PMID:25730417

  10. Low maternal serum vitamin D during pregnancy and the risk for postpartum depression symptoms.

    PubMed

    Robinson, Monique; Whitehouse, Andrew J O; Newnham, John P; Gorman, Shelley; Jacoby, Peter; Holt, Barbara J; Serralha, Michael; Tearne, Jessica E; Holt, Pat G; Hart, Prue H; Kusel, Merci M H

    2014-06-01

    Pregnancy is a time of vulnerability for vitamin D insufficiency, and there is an emerging literature associating low levels of 25(OH)-vitamin D with depressive symptoms. However, the link between 25(OH)-vitamin D status in pregnancy and altered risk of postnatal depressive symptoms has not been examined. We hypothesise that low levels of 25(OH)-vitamin D in maternal serum during pregnancy will be associated with a higher incidence of postpartum depressive symptoms. We prospectively collected sera at 18 weeks gestation from 796 pregnant women in Perth (1989-1992) who were enrolled in the Western Australian Pregnancy Cohort (Raine) Study and measured levels of 25(OH)-vitamin D. Women reported postnatal depressive symptoms at 3 days post-delivery. Women in the lowest quartile for 25(OH)-vitamin D status were more likely to report a higher level of postnatal depression symptoms than women who were in the highest quartile for vitamin D, even after accounting for a range of confounding variables including season of birth, body mass index and sociodemographic factors. Low vitamin D during pregnancy is a risk factor for the development of postpartum depression symptoms.

  11. Management of colorectal neoplasia during pregnancy and in the postpartum period

    PubMed Central

    Aytac, Erman; Ozuner, Gokhan; Isik, Ozgen; Gorgun, Emre; Stocchi, Luca

    2016-01-01

    AIM: To report our experience on management of colorectal neoplasia during pregnancy and in the postpartum period. METHODS: Patients who were diagnosed with colorectal cancer during pregnancy or in the postpartum period (< 6 mo), between 8/1997 and 4/2013, in our department were reviewed. Patient characteristics, operations, fetal health and follow-up during pregnancy, type of delivery and oncologic outcomes were analyzed. RESULTS: Eight patients met our study criteria. Median age at the time of diagnosis of colorectal cancer was 31 years. Median follow-up after surgery was 36 mo. Median duration of symptoms before diagnosis was 16 wk. Three patients were diagnosed with colorectal cancer during pregnancy and underwent surgery prior to delivery. None of the patients received adjuvant treatment during pregnancy. Five patients were diagnosed with colorectal cancer within a median of 2.1 mo after delivery and underwent surgery. No adverse neonatal outcomes were noted. All deliveries were at term (2 cesarean sections) except for one preterm delivery following low anterior resection on the 34th week of pregnancy. CONCLUSION: There has been a significant delay in the diagnosis of colorectal cancer which is probably due to overlap of symptoms and signs between these tumors and a normal pregnancy. Surgery for colorectal cancer during pregnancy can be performed safely without compromising maternal and fetal outcomes. PMID:27559434

  12. New evidence on breastfeeding and postpartum depression: the importance of understanding women's intentions.

    PubMed

    Borra, Cristina; Iacovou, Maria; Sevilla, Almudena

    2015-04-01

    This study aimed to identify the causal effect of breastfeeding on postpartum depression (PPD), using data on mothers from a British survey, the Avon Longitudinal Study of Parents and Children. Multivariate linear and logistic regressions were performed to investigate the effects of breastfeeding on mothers' mental health measured at 8 weeks, 8, 21 and 32 months postpartum. The estimated effect of breastfeeding on PPD differed according to whether women had planned to breastfeed their babies, and by whether they had shown signs of depression during pregnancy. For mothers who were not depressed during pregnancy, the lowest risk of PPD was found among women who had planned to breastfeed, and who had actually breastfed their babies, while the highest risk was found among women who had planned to breastfeed and had not gone on to breastfeed. We conclude that the effect of breastfeeding on maternal depression is extremely heterogeneous, being mediated both by breastfeeding intentions during pregnancy and by mothers' mental health during pregnancy. Our results underline the importance of providing expert breastfeeding support to women who want to breastfeed; but also, of providing compassionate support for women who had intended to breastfeed, but who find themselves unable to.

  13. New evidence on breastfeeding and postpartum depression: the importance of understanding women's intentions.

    PubMed

    Borra, Cristina; Iacovou, Maria; Sevilla, Almudena

    2015-04-01

    This study aimed to identify the causal effect of breastfeeding on postpartum depression (PPD), using data on mothers from a British survey, the Avon Longitudinal Study of Parents and Children. Multivariate linear and logistic regressions were performed to investigate the effects of breastfeeding on mothers' mental health measured at 8 weeks, 8, 21 and 32 months postpartum. The estimated effect of breastfeeding on PPD differed according to whether women had planned to breastfeed their babies, and by whether they had shown signs of depression during pregnancy. For mothers who were not depressed during pregnancy, the lowest risk of PPD was found among women who had planned to breastfeed, and who had actually breastfed their babies, while the highest risk was found among women who had planned to breastfeed and had not gone on to breastfeed. We conclude that the effect of breastfeeding on maternal depression is extremely heterogeneous, being mediated both by breastfeeding intentions during pregnancy and by mothers' mental health during pregnancy. Our results underline the importance of providing expert breastfeeding support to women who want to breastfeed; but also, of providing compassionate support for women who had intended to breastfeed, but who find themselves unable to. PMID:25138629

  14. Investigating analgesic and psychological factors associated with risk of postpartum depression development: a case–control study

    PubMed Central

    Suhitharan, Thangavelautham; Pham, Thi Phuong Tu; Chen, Helen; Assam, Pryseley Nkouibert; Sultana, Rehena; Han, Nian-Lin Reena; Tan, Ene-Choo; Sng, Ban Leong

    2016-01-01

    Aim The aim of this study was to investigate the role of peripartum analgesic and psychological factors that may be related to postpartum depression (PPD). Methods This case–control study was conducted in pregnant females who delivered at KK Women’s and Children’s Hospital from November 2010 to October 2013 and had postpartum psychological assessment. Demographic, medical, and postpartum psychological status assessments, intrapartum data including method of induction of labor, mode of labor analgesia, duration of first and second stages of labor, mode of delivery, and pain intensity on hospital admission and after delivery were collected. PPD was assessed using the Edinburgh Postnatal Depression Scale and clinical assessment by the psychiatrist. Results There were 62 cases of PPD and 417 controls after childbirth within 4–8 weeks. The odds of PPD was significantly lower (33 of 329 [10.0%]) in females who received epidural analgesia for labor compared with those who chose nonepidural analgesia (29 of 150 [19.3%]) ([odds ratio] 0.47 (0.27–0.8), P=0.0078). The multivariate analysis showed that absence of labor epidural analgesia, increasing age, family history of depression, history of depression, and previous history of PPD were independent risk factors for development of PPD. Conclusion The absence of labor epidural analgesia remained as an independent risk factor for development of PPD when adjusted for psychiatric predictors of PPD such as history of depression or PPD and family history of depression. PMID:27354803

  15. Chemical studies of L chondrites. V: compositional patterns for 49 trace elements in 14 L4-6 and 7 LL4-6 falls

    NASA Astrophysics Data System (ADS)

    Friedrich, Jon M.; Wang, Ming-Sheng; Lipschutz, Michael E.

    2003-07-01

    To study compositional trends associated with open-system thermal metamorphism and shock-induced collisional breakup of L4-6 chondrite parent(s), we used inductively coupled plasma mass spectrometry and radiochemical neutron activation analysis to determine 49 trace elements in 62 falls. Trends for the 49 elements, especially of the 14 rare earth elements in 5 members of a putative L/LL group (Bjurböle, Cynthiana, Holbrook, Knyahinya, Sultanpur) and 9 additional L chondrites (Aïr, Aumieres, Bachmut, Forksville, Kandahar, Kiel, Milean, Narellan, Santa Isabel) differed markedly from those in the remaining normal 46 samples. Here, we report the data for the 14 L and putative L/LL chondrites and 7 LL (Appley Bridge, Athens, Bandong, Ensisheim, Mangwendi, Olivenza, Soko-Banja), analyzed to test the affinity of the putative L/LL suite to well-characterized LL chondrites. Compositional trends of the 14 atypical L chondrites (including Aïr's unique and possibly contaminated signature) and Mangwendi, an LL6 chondrite, indicate that each is compositionally unrepresentative of well-sampled, whole-rock chondrites. Indeed, half of the unrepresentative chondrites were ≤ 2-g samples. Compositionally, members of the putative L/LL chondrites demonstrate no affinities to normal LL chondrite falls. To establish compositional trends accompanying open-system, thermal episodes involving the L chondrite parent(s), we should ignore data for the 14 unrepresentative L chondrites reported here.

  16. 2,4,6-Triarylphosphinines versus 2,4,6-triarylpyridines: an investigation of the differences in reactivity between structurally related aromatic phosphorus and nitrogen heterocycles.

    PubMed

    Weemers, Jarno J M; Wiecko, Jelena; Pidko, Evgeny A; Weber, Manuela; Lutz, Martin; Müller, Christian

    2013-10-18

    The novel atropisomeric pyridine derivative rac-10 has been synthesized and structurally characterized. In contrast to its phosphorus analogue 3, axially chiral 10 has a considerably lower rotational barrier as estimated by DFT calculations. However, the presence of the two enantiomers could be confirmed by means of chiral analytical HPLC analysis and by protonation experiments with a chiral acid. Compound rac-10 could be further dehydrogenated by treatment with DDQ to the benzo(h)quinoline derivative rac-12. This conversion failed for the phosphorus analogue rac-3. Interestingly, although 2,4,6-triarylphosphinines undergo facile CH activation with [Cp*IrCl2 ]2 in the presence of NaOAc, this reaction does not proceed with the corresponding pyridine derivatives. On the other hand, the latter ones can be selectively ortho-metalated with Pd(OAc)2 , leading to acetate-bridged dimeric species, which could be unambiguously confirmed by means of X-ray crystal structure analysis. The treatment of phosphinines with Pd(OAc)2 led instead to the formation of the unusual cofacial oxidative coupling products 16 and 17, which consist of a phosphorus-containing cage structure. PMID:24123238

  17. Decreased transpiration in poplar trees exposed to 2,4,6-trinitrotoluene

    SciTech Connect

    Thompson, P.L.; Ramer, L.A.; Guffey, A.P.; Schnoor, J.L.

    1998-01-01

    The improper handling of the toxic compound 2,4,6-trinitrotoluene (TNT) has led to the contamination of soil and groundwater, and the uptake of TNT by a variety of plants has been established. This article discusses the effects of various concentrations of the explosive 2,4,6-trinitrotoluene (TNT) on the transpiration of hybrid poplar trees growing in hydroponic media. Transpiration was measured daily by gravimetric means. The rapid removal of TNT from hydroponic solutions was a result of plant uptake and required a daily dosage of TNT to ensure a relatively constant exposure over time. Transpiration decreased with increasing TNT concentrations {ge}5 mg/L. Decreases in transpiration were accompanied by leaf chlorosis and abscission. A comparison between a laboratory study and a pilot-scale experiment showed good scale-up potential.

  18. Hydrolytic release of bound residues from composted soil contaminated with 2,4,6-trinitrotoluene

    SciTech Connect

    Thorne, P.G.; Leggett, D.C.

    1997-06-01

    The US Army is obligated to restore land previously contaminated with the explosive 2,4,6-trinitrotoluene (TNT). One remediation method that is being tried is composting. In this method, the soil to be treated is mixed with a readily decomposable source of organic carbon, which is usually a mixture of readily available organic material. Samples of composted soil were extracted with solvent, then hydrolyzed with acid or base. The concentrations of extractable, unbound 2,4,6-trinitrotoluene and its mono- and diamino metabolites fell rapidly after the first days of composting. Hydrolysis of the extracted residues released significant quantities of intact metabolites. The objectives of this work were to differentiate between bound and unbound explosives and their transformation products in composted soil, to investigate the time course of metabolite evolution and binding, and to evaluate various hydrolysis methods.

  19. Multiple Roles of Cyclin-Dependent Kinase 4/6 Inhibitors in Cancer Therapy

    PubMed Central

    Roberts, Patrick J.; Bisi, John E.; Strum, Jay C.; Combest, Austin J.; Darr, David B.; Usary, Jerry E.; Zamboni, William C.; Wong, Kwok-Kin; Perou, Charles M.

    2012-01-01

    Background Cyclin-dependent kinases (CDKs) regulate cell proliferation and coordinate the cell cycle checkpoint response to DNA damage. Although inhibitors with varying selectivity to specific CDK family members have been developed, selective CDK4/6 inhibitors have emerged as the most attractive antineoplastic agents because of the importance of CDK4/6 activity in regulating cell proliferation and the toxic effects associated with inhibition of other CDKs (eg, CDK1 and CDK2). Methods FVB/N wild-type mice (n = 13) were used to evaluate carboplatin-induced myelosuppression in bone marrow by complete blood cell counts after treatment with the CDK4/6 inhibitor PD0332991. Genetically engineered murine models of retinoblastoma (Rb)-competent (MMTV-c-neu) and Rb-incompetent (C3-TAg) breast cancer (n = 16 MMTV-c-neu mice in the carboplatin plus vehicle control group, n = 17 MMTV-c-neu mice in the carboplatin plus PD0332991 group, n = 17 C3-TAg mice in the carboplatin plus vehicle control group, and n = 14 C3-TAg mice in the carboplatin plus PD0332991 group) were used to investigate the antitumor activity of PD0332991 alone or in combination with chemotherapy. All statistical tests were two-sided. Results Coadministration of PD0332991 with carboplatin compared with carboplatin alone in FVB/N wild-type mice increased hematocrit (51.2% vs 33.5%, difference = 17.7%, 95% confidence interval [CI] = −26.7% to −8.6%, P < .001), platelet counts (1321 vs 758.5 thousand cells per μL, difference = 562.5 thousand cells per μL, 95% CI = −902.8 to −222.6, P = .002), myeloid cells (granulocytes and monocytes; 3.1 vs 1.6 thousand cells per μL, difference = 1.5 thousand cells per μL, 95% CI = −2.23 to −0.67, P < .001), and lymphocytes (7.9 vs 5.4 thousand cells per μL, difference = 2.5 thousand cells per μL, 95% CI = −4.75 to −0.18, P = .02). Daily administration of PD0332991 exhibited antitumor activity in MMTV-c-neu mice as a single agent. However, the combination of

  20. Committee Opinion No. 670 Summary: Immediate Postpartum Long-Acting Reversible Contraception.

    PubMed

    2016-08-01

    Immediate postpartum long-acting reversible contraception (LARC) has the potential to reduce unintended and short-interval pregnancy. Women should be counseled about all forms of postpartum contraception in a context that allows informed decision making. Immediate postpartum LARC should be offered as an effective option for postpartum contraception; there are few contraindications to postpartum intrauterine devices and implants. Obstetrician-gynecologists and other obstetric care providers should discuss LARC during the antepartum period and counsel all pregnant women about options for immediate postpartum initiation. Education and institutional protocols are needed to raise clinician awareness and to improve access to immediate postpartum LARC insertion. Obstetrician-gynecologists and other obstetric care providers should incorporate immediate postpartum LARC into their practices, counsel women appropriately about advantages and risks, and advocate for institutional and payment policy changes to support provision. PMID:27454730

  1. Committee Opinion No. 670: Immediate Postpartum Long-Acting Reversible Contraception.

    PubMed

    2016-08-01

    Immediate postpartum long-acting reversible contraception (LARC) has the potential to reduce unintended and short-interval pregnancy. Women should be counseled about all forms of postpartum contraception in a context that allows informed decision making. Immediate postpartum LARC should be offered as an effective option for postpartum contraception; there are few contraindications to postpartum intrauterine devices and implants. Obstetrician-gynecologists and other obstetric care providers should discuss LARC during the antepartum period and counsel all pregnant women about options for immediate postpartum initiation. Education and institutional protocols are needed to raise clinician awareness and to improve access to immediate postpartum LARC insertion. Obstetrician-gynecologists and other obstetric care providers should incorporate immediate postpartum LARC into their practices, counsel women appropriately about advantages and risks, and advocate for institutional and payment policy changes to support provision. PMID:27454734

  2. Food Insecurity During Pregnancy Leads to Stress, Disordered Eating, and Greater Postpartum Weight Among Overweight Women

    EPA Science Inventory

    This study examines food insecurity during and after pregnancy and how that affects postpartum weight retention. The results show that food insecurity was associated with higher levels of stress, eating behaviors, dietary fat intake, and higher postpartum weight status.

  3. Modeling postpartum depression in rats: theoretic and methodological issues

    PubMed Central

    Ming, LI; Shinn-Yi, CHOU

    2016-01-01

    The postpartum period is when a host of changes occur at molecular, cellular, physiological and behavioral levels to prepare female humans for the challenge of maternity. Alteration or prevention of these normal adaptions is thought to contribute to disruptions of emotion regulation, motivation and cognitive abilities that underlie postpartum mental disorders, such as postpartum depression. Despite the high incidence of this disorder, and the detrimental consequences for both mother and child, its etiology and related neurobiological mechanisms remain poorly understood, partially due to the lack of appropriate animal models. In recent decades, there have been a number of attempts to model postpartum depression disorder in rats. In the present review, we first describe clinical symptoms of postpartum depression and discuss known risk factors, including both genetic and environmental factors. Thereafter, we discuss various rat models that have been developed to capture various aspects of this disorder and knowledge gained from such attempts. In doing so, we focus on the theories behind each attempt and the methods used to achieve their goals. Finally, we point out several understudied areas in this field and make suggestions for future directions. PMID:27469254

  4. Modeling postpartum depression in rats: theoretic and methodological issues.

    PubMed

    Li, Ming; Chou, Shinn-Yi

    2016-07-18

    The postpartum period is when a host of changes occur at molecular, cellular, physiological and behavioral levels to prepare female humans for the challenge of maternity. Alteration or prevention of these normal adaptions is thought to contribute to disruptions of emotion regulation, motivation and cognitive abilities that underlie postpartum mental disorders, such as postpartum depression. Despite the high incidence of this disorder, and the detrimental consequences for both mother and child, its etiology and related neurobiological mechanisms remain poorly understood, partially due to the lack of appropriate animal models. In recent decades, there have been a number of attempts to model postpartum depression disorder in rats. In the present review, we first describe clinical symptoms of postpartum depression and discuss known risk factors, including both genetic and environmental factors. Thereafter, we discuss various rat models that have been developed to capture various aspects of this disorder and knowledge gained from such attempts. In doing so, we focus on the theories behind each attempt and the methods used to achieve their goals. Finally, we point out several understudied areas in this field and make suggestions for future directions. PMID:27469254

  5. 2-Anilino-4,6-dimethyl­pyrimidinium chloro­acetate

    PubMed Central

    Li, Jia-Cheng; Qiu, Xue-Qing; Feng, Yu-Hong; Lin, Qiang

    2008-01-01

    In the crystal structure of the title compound, C12H14N3 +·C2H2ClO2 −, the chloro­acetate anion is linked to the N-(4,6-dimethyl­pyrimidin-2-yl)aniline cation by N—H⋯O hydrogen bonding. Within the cation, the pyrimidine ring is twisted with respect to the phenyl ring by a dihedral angle of 7.59 (4)°. PMID:21200879

  6. Reflectance spectra of mafic silicates and phyllosilicates from .6 to 4.6 microns

    NASA Technical Reports Server (NTRS)

    Roush, Ted L.; Singer, Robert B.; Mccord, Thomas B.

    1987-01-01

    The results of spectral measurements for mafic silicates are given. The study provided valuable spectral reflectance information about mafic silicates and phyllosilicates in the 2.5 to 4.6 micron wavelength region. It was shown that the reflectance of these materials is strongly affected by the presence of H2O and OH. Therefore, the identification of these absorbing species is greatly enhanced.

  7. Spot test for 1,3,5-triamino-2,4,6-trinitrobenzene, TATB

    DOEpatents

    Harris, Betty W.

    1986-01-01

    A simple, sensitive and specific spot test for 1,3,5-triamino-2,4,6-trinitrobenzene, TATB, is described. Upon the application of the composition of matter of the present invention to samples containing in excess of 0.1 mg of this explosive, a bright orange color results. Interfering species such as TNT and Tetryl can be removed by first treating the sample with a solvent which does not dissolve much of the TATB, but readily dissolves these explosives.

  8. Spot test for 1,3,5-triamino-2,4,6-trinitrobenzene, TATB

    DOEpatents

    Harris, B.W.

    1984-11-29

    A simple, sensitive and specific spot test for 1,3,5-triamino-2,4,6-trinitrobenzene, TATB, is described. Upon the application of the composition of matter of the subject invention to samples containing in excess of 0.1 mg of this explosive, a bright orange color results. Interfering species such as TNT and Tetryl can be removed by first treating the sample with a solvent which does not dissolve the TATB, but readily dissolves these interfering explosives.

  9. Thermal decomposition of 2,4,6-trinitrotoluene in melt and solutions

    SciTech Connect

    Dubikhin, V.V.; Matveev, V.G.; Nazin, G.M.

    1995-08-01

    Thermal decomposition of 2,4,6-trinitrotoluene in the temperature range from 200 to 340{degrees}C in melt and in solutions was studied. The main features of the process (high initial rates, activation energies lower than those in the gaseous phase, a higher acceleration at the catalytic stage, and the effect of nonpolar solvents on initial rates) are explained in terms of a kinetic scheme corresponding to a degenerate branched chain reaction.

  10. Phase I study of palbociclib, a cyclin-dependent kinase 4/6 inhibitor, in Japanese patients.

    PubMed

    Tamura, Kenji; Mukai, Hirofumi; Naito, Yoichi; Yonemori, Kan; Kodaira, Makoto; Tanabe, Yuko; Yamamoto, Noboru; Osera, Shozo; Sasaki, Masaoki; Mori, Yuko; Hashigaki, Satoshi; Nagasawa, Takashi; Umeyama, Yoshiko; Yoshino, Takayuki

    2016-06-01

    This phase I study in Japanese patients evaluated the safety, pharmacokinetics, and preliminary efficacy of palbociclib, a highly selective and reversible oral cyclin-dependent kinase 4/6 inhibitor, as monotherapy for solid tumors (part 1) and combined with letrozole as first-line treatment of postmenopausal patients with estrogen receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer (part 2). Part 1 evaluated palbociclib 100 and 125 mg once daily (3 weeks on/1 week off; n = 6 each group) to determine the maximum tolerated dose. Part 2 evaluated palbociclib maximum tolerated dose (125 mg) plus letrozole 2.5 mg (n = 6). The most common treatment-related adverse event was neutropenia (all grades/grade 3/4): 100 mg, 83%/67%; 125 mg, 67%/33%; and palbociclib plus letrozole, 100%/83%. Heavier pretreatment with chemotherapy may have resulted in higher neutropenia rates observed with the 100-mg dose. Palbociclib exposure was higher with 125 vs 100 mg (mean area under the plasma concentration-time curve over dosing interval [τ]: 1322 vs 547.5 ng·h/mL [single dose], 2838 vs 1276 ng·h/mL [multiple dose]; mean maximum plasma concentration: 104.1 vs 41.4 ng/mL [single dose], 185.5 vs 77.4 ng/mL [multiple dose]). Half-life was 23-26 h. No drug-drug interactions between palbociclib and letrozole occurred. Four patients had stable disease (≥24 weeks in one patient with rectal cancer [100 mg] and one with esophageal cancer [125 mg]) in part 1; two patients had partial response and two had stable disease (both ≥24 weeks) in part 2. Palbociclib at the 125-mg dose (schedule 3/1) was tolerated and is the recommended dose for monotherapy and letrozole combination therapy in Japanese patients. The trials are registered with www.ClinicalTrials.gov: A5481010 and NCT01684215.

  11. New double molybdate Na9Fe(MoO4)6: Synthesis, structure, properties

    NASA Astrophysics Data System (ADS)

    Savina, Aleksandra A.; Solodovnikov, Sergey F.; Basovich, Olga M.; Solodovnikova, Zoya A.; Belov, Dmitry A.; Pokholok, Konstantin V.; Gudkova, Irina A.; Stefanovich, Sergey Yu.; Lazoryak, Bogdan I.; Khaikina, Elena G.

    2013-09-01

    A new double molybdate Na9Fe(MoO4)6 was synthesized using solid state reactions and studied with X-ray powder diffraction, second harmonic generation (SHG) technique, differential scanning calorimetry, X-ray fluorescence analysis, Mössbauer and dielectric impedance spectroscopy. Single crystals of Na9Fe(MoO4)6 were obtained and its structure was solved (the space group R3¯, a=14.8264(2), c=19.2402(3) Å, V=3662.79(9) Å3, Z=6, R=0.0132). The structure is related to that of sodium ion conductor II-Na3Fe2(AsO4)3. The basic structure units are polyhedral clusters composed of central FeО6 octahedron sharing edges with three Na(1)О6 octahedra. The clusters share common vertices with bridging МоО4 tetrahedra to form an open 3D framework where the cavities are occupied by Na(2) and Na(3) atoms. The compound melts incongruently at 904.7±0.2 K. Arrhenius type temperature dependence of electric conductivity σ has been registered in solid state (σ=6.8×10-2 S сm-1 at 800 K), thus allowing considering Na9Fe(MoO4)6 as a new sodium ion conductor.

  12. Pharmacologic inhibition of cdk4/6 arrests the growth of glioblastoma multiforme intracranial xenografts

    PubMed Central

    Michaud, Karine; Solomon, David A.; Oermann, Eric; Kim, Jung-Sik; Zhong, Wei-Zhu; Prados, Michael D.; Ozawa, Tomoko; James, C. David; Waldman, Todd

    2010-01-01

    Activation of cyclin-dependent kinases 4 and 6 (cdk4/6) occurs in the majority of glioblastoma multiforme (GBM) tumors, and represents a promising molecular target for the development of small molecule inhibitors. In the current study we investigated the molecular determinants and in vivo response of diverse GBM cell lines and xenografts to PD-0332991, a cdk4/6 specific inhibitor. In vitro testing of PD-0332991 against a panel of GBM cell lines revealed a potent G1 cell cycle arrest and induction of senescence in each of 16 Rb-proficient cell lines regardless of other genetic lesions, whereas each of 5 cell lines with homozygous inactivation of Rb were completely resistant to treatment. shRNA depletion of Rb expression conferred resistance of GBM cells to PD-0332991, further demonstrating a requirement of Rb for sensitivity to cdk4/6 inhibition. PD-0332991 was found to efficiently cross the blood-brain barrier and proved highly effective in suppressing the growth of intracranial GBM xenograft tumors, including those that had recurred after initial therapy with temozolomide. Remarkably, no mice receiving PD-0332991 had significant disease progression or died while on therapy. Additionally, the combination of PD-0332991 and radiation therapy resulted in significantly increased survival benefit compared with either therapy alone. In total, our results support clinical trial evaluation of PD-0332991 against newly-diagnosed as well as recurrent GBM, and indicate that Rb status is the primary determinant of potential benefit from this therapy. PMID:20354191

  13. CDK4/6 Inhibitor PD0332991 in Glioblastoma Treatment: Does It Have a Future?

    PubMed Central

    Schröder, Lisette B. W.; McDonald, Kerrie L.

    2015-01-01

    Glioblastoma is aggressive, highly infiltrating, and the most frequent malignant form of brain cancer. With a median survival time of only 14.6 months, when treated with the standard of care, it is essential to find new therapeutic options. A specific CDK4/6 inhibitor, PD0332991, obtained accelerated approval from the Food and Drug Administration for the treatment of patients with advanced estrogen receptor-positive and HER2-negative breast cancer. Common alterations in the cyclin D1-cyclin-dependent kinase 4/6-retinoblastoma 1 pathway in glioblastoma make PD0332991 also an interesting drug for the treatment of glioblastoma. Promising results in in vitro studies, where patient derived glioblastoma cell lines showed sensitivity to PD0332991, gave motive to start in vivo studies. Outcomes of these studies have been contrasting in terms of PD0332991 efficacy within the brain: more research is necessary to conclude whether CDK4/6 inhibitor can be beneficial in the treatment of glioblastoma. PMID:26649278

  14. Isolation of a recombinant desulfurizing 4,6-diproply dibenzothiophene in n-tetradecane.

    PubMed

    Noda, Ken-Ichi; Watanabe, Kimiko; Maruhashi, Kenji

    2003-01-01

    Rhodococcus erythropolis strain KA2-5-1 is unable to desulfurize 4,6-dipropyl dibenzothiophene (DBT) in the oil phase. The dsz desulfurization gene cluster from R. erythropolis strain KA2-5-1 was transferred into 22 rhodococcal and mycobacterial strains using a transposon-transposase complex. The recombinant strain MR65, from Mycobacterium sp. NCIMB10403, was able to grow on a minimal medium supplemented with 1.0 mM 4,6-dipropyl DBT in n-tetradecane (50%, v v ) as the sole sulfur source. Resting cells of recombinant strain MR65 could desulfurize 68 mg l- of sulfur in light gas oil (LGO) containing 126 mg sulfur l-. Strain MR65 had about 1.5-times the LGO desulfurization activity of R. erythropolis strain KA2-5-1. The application of a recombinant, which is able to utilize 4,6-dipropyl DBT in the oil phase, was effective in enhancing LGO biodesulfurization.

  15. Potential of activated carbon to decrease 2,4,6-trinitrotoluene toxicity and accelerate soil decontamination.

    PubMed

    Vasilyeva, G K; Kreslavski, V D; Oh, B T; Shea, P J

    2001-05-01

    Activated carbon can be used to decrease 2,4,6-trinitrotoluene (TNT) toxicity and promote bioremediation of highly contaminated soil. Adding activated carbon at 0.25, 0.75, and 1.0% (w/w) to Sharpsburg soil contaminated with 500, 1,000, and 2,000 mg TNT/kg decreased concentrations of TNT and its transformation products in soil solution to 5 mg/L or less, resulting in low toxicity to corn plants (Zea mays L.) and soil microorganisms. As much as 50% of the added TNT was rapidly bound to the soil-activated carbon matrix. Simultaneous accumulation of 2,4,6-trinitrobenzaldehyde (TNBAld) indicated that the activated carbon promoted oxidation of TNT. Some of the TNBAld was further oxidized to 1,3,5-trinitrobenzene, followed by reduction to 3,5-dinitroaniline. Reversibly bound TNT was gradually transformed to 2-amino-4,6-dinitrotoluene and 4-amino-2,6-dinitrotoluene, and both were bound to the soil-activated carbon matrix. The transformation and binding of TNT to soil were further promoted by incorporating shredded corn plants after growing for 52 d in the activated carbon-amended soil. After 120 d, these amendments reduced extractable TNT and transformation products by 91% in soil containing 2,000 mg TNT/kg, compared to 55% in unamended soil. These results demonstrate the potential use of activated carbon in combination with plants to promote in situ bioremediation of soils highly contaminated with explosives.

  16. p18 inhibits reprogramming through inactivation of Cdk4/6

    PubMed Central

    Zhu, Shaohua; Cao, Jiani; Sun, Hongyan; Liu, Kun; Li, Yaqiong; Zhao, Tongbiao

    2016-01-01

    Pluripotent stem cells (PSCs), including embryonic and induced pluripotent stem cells (iPSCs), show atypical cell cycle regulation characterized by a high proliferation rate and a shorter G1 phase compared with somatic cells. The mechanisms by which somatic cells remodel their cell cycle to achieve the high proliferation rate of PSCs during reprogramming are unclear. Here we identify that the Ink4 protein p18, which is expressed at high levels in somatic cells but at low levels in PSCs, is a roadblock to successful reprogramming. Mild inhibition of p18 expression enhances reprogramming efficiency, while ectopic expression of p18 completely blocks reprogramming. Mechanistic studies show that expression of wild-type p18, but not a p18D68N mutant which cannot inhibit Cdk4/6, down-regulates expression of Cdk4/6 target genes involved in DNA synthesis (TK, TS, DHFR, PCNA) and cell cycle regulation (CDK1 and CCNA2) and thus inhibits reprogramming. These results indicate that p18 blocks reprogramming by targeting Cdk4/6-mediated cell cycle regulation. Taken together, our results define a novel pathway that inhibits somatic cell reprogramming, and provide a new target to enhance reprogramming efficiency. PMID:27484146

  17. Associations of trimester-specific gestational weight gain with maternal adiposity and systolic blood pressure at 3 and 7 years postpartum

    PubMed Central

    Walter, Jessica R.; Perng, Wei; Kleinman, Ken P.; Rifas-Shiman, Ms. Sheryl L.; Rich-Edwards, Janet W.; Oken, Emily

    2014-01-01

    OBJECTIVE Our objective was to examine the associations of total and trimester-specific gestational weight gain (GWG) rate with postpartum maternal weight and cardiometabolic risk. We hypothesized the first trimester GWG would be most strongly associated with long-term maternal health. METHODS We studied 801 women enrolled during the 1st trimester of pregnancy in the Boston-area Project Viva cohort 1999–2002. At 3 years postpartum we measured maternal weight, waist circumference, and systolic blood pressure (SBP) and collected fasting blood from a subset. At 7 years postpartum we again measured weight and waist circumference. We used multivariable linear regression to evaluate relations of total and trimester-specific GWG rate with weight change (vs. self-reported pre-pregnancy weight) and waist circumference at each timepoint, stratified by pre-pregnancy weight, as well as associations with SBP and insulin resistance at 3 years. RESULTS Median age at enrollment was 34.0 years (range: 16.4–44.9); 65% were white. Mean (SD) total GWG rate was 0.38 (0.14) kg/week. Women gained weight faster during the second (0.47 [0.19] kg/week) and third trimesters (0.44 [0.22] kg/week) than the first (0.22 [0.22] kg/week). Total and first trimester GWG rate were most strongly associated with postpartum weight change. Among normal weight women, each 1 SD increase in total and first trimester GWG rate corresponded with 0.85 (95% CI: 0.07, 1.63) kg and 2.08 (1.32, 2.84) kg greater weight change at 3 and 7 years postpartum respectively, but there was not strong evidence of association for either second (−0.30 kg; 95% CI: −1.08, 0.48) or third trimester (−0.26 kg; 95% CI: −1.08, 0.55) GWG. First trimester GWG rate also related to 3-year postpartum weight change in overweight (2.28 kg; 95% CI: 0.95, 3.61) and obese (2.47 kg; 95% CI: 0.98, 3.97) women. Greater total and first trimester GWG rate were associated with larger waist circumference and higher SBP but not insulin

  18. Hypertensive crisis during pregnancy and postpartum period.

    PubMed

    Too, Gloria T; Hill, James B

    2013-08-01

    Hypertension affects 10% of pregnancies, many with underlying chronic hypertension, and approximately 1-2% will undergo a hypertensive crisis at some point during their lives. Hypertensive crisis includes hypertensive urgency and emergency; the American College of Obstetricians and Gynecologists describes a hypertensive emergency in pregnancy as persistent (lasting 15 min or more), acute-onset, severe hypertension, defined as systolic BP greater than 160 mmHg or diastolic BP >110 mmHg in the setting of pre-eclampsia or eclampsia. Pregnancy may be complicated by hypertensive crisis, with lower blood pressure threshold for end-organ damage than non-pregnant patients. Maternal assessment should include a thorough history. Fetal assessment should include heart rate tracing, ultrasound for growth and amniotic assessment, and Doppler evaluation if growth restriction is suspected. Initial management of hypertensive emergency (systolic BP >160 mmHg or diastolic BP >110 mmHg in the setting of pre-eclampsia or eclampsia) generally includes the rapid reduction of blood pressure through the use of intravenous antihypertensive medications, with goal systolic blood pressure between 140 mmHg and 150 mmHg and diastolic pressure between 90 mmHg and 100 mmHg. First-line intravenous drugs include labetalol and hydralazine, but other agents may be used, including esmolol, nicardipine, nifedipine, and, as a last resort, sodium nitroprusside. Among patients with hypertensive urgency, slower blood pressure reduction can be provided with oral agents. The objective of this article is to review the current understanding, diagnosis, and management of hypertensive crisis during pregnancy and the postpartum period.

  19. Postpartum hemorrhage in resource-poor settings.

    PubMed

    Geller, S E; Adams, M G; Kelly, P J; Kodkany, B S; Derman, R J

    2006-03-01

    Despite the strong interest of international health agencies, worldwide maternal mortality has not declined substantially over the past 10 years. Postpartum hemorrhage (PPH) is the most common cause of maternal death across the world, responsible for more than 25% of deaths annually. Although effective tools for prevention and treatment of PPH are available, most are not feasible or practical for use in the developing world where many births still occur at home with untrained birth attendants. Application of many available clinical solutions in rural areas would necessitate substantial changes in government infrastructure and in local culture and customs surrounding pregnancy and childbirth. Before treatment can be administered, prompt and accurate diagnosis must be made, which requires training and appropriate blood measurement tools. After diagnosis, appropriate interventions that can be applied in remote settings are needed. Many uterotonics known to be effective in reducing PPH in tertiary care settings may not be useful in community settings because they require refrigeration and/or skilled administration. Moreover, rapid transfer to a higher level of care must be available, a challenge in many settings because of distance and lack of transportation. In light of these barriers, low-technological replacements for treatments commonly applied in the developed-world must be utilized. Community education, improvements to emergency care systems, training for birth attendants, misoprostol, and Uniject have shown promise as potential solutions. In the short term, it is expedient to capitalize on practical opportunities that utilize the existing strengths and resources in each community or region in order to implement appropriate solutions to save the lives of women during childbirth.

  20. Postpartum hemorrhage in resource-poor settings.

    PubMed

    Geller, S E; Adams, M G; Kelly, P J; Kodkany, B S; Derman, R J

    2006-03-01

    Despite the strong interest of international health agencies, worldwide maternal mortality has not declined substantially over the past 10 years. Postpartum hemorrhage (PPH) is the most common cause of maternal death across the world, responsible for more than 25% of deaths annually. Although effective tools for prevention and treatment of PPH are available, most are not feasible or practical for use in the developing world where many births still occur at home with untrained birth attendants. Application of many available clinical solutions in rural areas would necessitate substantial changes in government infrastructure and in local culture and customs surrounding pregnancy and childbirth. Before treatment can be administered, prompt and accurate diagnosis must be made, which requires training and appropriate blood measurement tools. After diagnosis, appropriate interventions that can be applied in remote settings are needed. Many uterotonics known to be effective in reducing PPH in tertiary care settings may not be useful in community settings because they require refrigeration and/or skilled administration. Moreover, rapid transfer to a higher level of care must be available, a challenge in many settings because of distance and lack of transportation. In light of these barriers, low-technological replacements for treatments commonly applied in the developed-world must be utilized. Community education, improvements to emergency care systems, training for birth attendants, misoprostol, and Uniject have shown promise as potential solutions. In the short term, it is expedient to capitalize on practical opportunities that utilize the existing strengths and resources in each community or region in order to implement appropriate solutions to save the lives of women during childbirth. PMID:16427056

  1. Postpartum haemorrhage: a cause of maternal morbidity.

    PubMed

    Shirazee, Hasibul Hasan; Saha, Sudip Kr; Das, Indrani; Mondal, Tanmoy; Samanta, Sandip; Sarkar, Moloy

    2010-10-01

    To identify and analyse the risk factors associated with postpartum haemorrhage (PPH) and assess their impact on the maternal morbidity, a prospective observational study was carried out over a period of one year in a tertiary level referral institute in Kolkata, West Bengal, India. All the cases of PPH were identified and studied. Data analyses were done using Chi-square test. Out of 210 cases of maternal morbidity, 79 (37.6%) were found to have PPH as the causative factor. Uterine atonicity was found to be the main cause leading to 45 cases (56.9%) of PPH. With respect to the mode of delivery severe PPH was found in 34.3% of vaginally and 60% of operatively delivered patients which had statistical significance. More number of severe PPH cases, 17/31 (54.8%), had delivered outside the medical college. Here comes the role of 24-hour quality emergency obstetric care (EMOC), active management of 3rd stage of labour and early referral to the higher centre. The case fatality rate of PPH during the study period was 7.5%. This finding is quite close to the observation made in a North Indian tertiary hospital based study. In order to reduce maternal morbidity and thereby indirectly maternal mortality and to improve the overall maternal health, prevention and control of PPH can play a significant role. An integrated approach at all levels of healthcare delivery system, active management of labour and efficient emergency obstetric care will help in controlling the PPH. PMID:21510550

  2. Postpartum safety: a patient-centered approach to fall prevention.

    PubMed

    Lockwood, Suzy; Anderson, Kandace

    2013-01-01

    Falls in the perinatal setting have received minimal attention and have not been well documented. Women are at risk for falling following vaginal or cesarean birth, especially during initial attempts at ambulation. Recently, a women's hospital that averages over 500 births per month recorded a postpartum fall rate that exceeded the national mean for adult surgical patient falls. A fall prevention team (FPT) of five nurses was formed with a goal to decrease the incidence of postpartum patient falls to zero within the following 7 months. A patient-centered fall prevention strategy was developed. The results of this project have laid the foundation for additional research of a program that will consider not only prevention of falls in a healthy population but also the development of a risk assessment tool specific to women in the immediate postpartum period.

  3. Postpartum smoking abstinence and smoke-free environments.

    PubMed

    Ashford, Kristin; Hahn, Ellen; Hall, Lynne; Peden, Ann R; Rayens, Mary Kay

    2011-01-01

    The purpose of this exploratory study was to describe factors that contribute to successful postpartum smoking abstinence among women who quit smoking during pregnancy. Research questions addressed the primary motivators and lifestyle characteristics of women who do not return to postpartum smoking. Participants were recruited from a feasibility study (N = 16) based on their ability to remain smoke free for at least 6 months following delivery. Individual interviews were analyzed using content analysis strategies. Women's narratives described the process of postpartum smoking abstinence. Four themes emerged: (a) child's health as the primary motivator, (b) demanding a smoke-free home or environment, (c) smoking perception changes from one of primarily comfort to one of disgust, and (d) viewing abstinence as a lifelong change. Clinical implications include educating families about the effects of smoke-free environments on the health of their children while redirecting smoking habits with healthy behaviors.

  4. Stability of immobilized 2,4,6-trinitrotoluene metabolites in soil under long-term leaching conditions.

    PubMed

    Achtnich, C; Lenke, H

    2001-02-01

    2,4,6-Trinitrotoluene (TNT)-contaminated soil was remediated by an anaerobic/aerobic slurry process. Prior to treatment, the soil was spiked with [14C]-TNT. Leaching experiments were carried out with the decontaminated soil to determine the degree of binding of the radiolabel under a variety of conditions. To simulate natural degradation processes of soil organic matter, each of three columns was subjected to a different treatment known to enhance biological transformation over a 92-week period. Only minor amounts of radioactivity (1.0% of the bound radioactivity) were released from treated soil incubated in the presence of the lignin-degrading fungus Phanerochaete chrysosporium. Simulation of seasonal variation in temperature, including freezing of the soil, did not cause a significant release of radioactivity (1.4%). Growth and flowering of the bush bean Phaseolus vulgaris only released 0.8% of the bound radioactivity to the eluate; however, during the decomposition phase, an additional 7.7% of the bound radioactivity was released. We propose that this radioactivity was bound to soluble humic material that was mobilized due to a pH shift during the decomposition of the plant organic matter. This is supported by the observation that neither free TNT nor its metabolites were present in the eluate. During the different incubation experiments, 3.9 to 8.5% of the bound radioactivity was found as 14CO2. The results indicate a slow turnover of even strongly bound immobilized metabolites of TNT.

  5. Effects and bioavailability of 2,4,6-trinitrotoluene in spiked and field-contaminated soils to indigenous microorganisms

    SciTech Connect

    Gong, P.; Siciliano, S.D.; Greer, C.W.; Paquet, L.; Hawari, J.; Sunahara, G.I.

    1999-12-01

    The response of potential nitrification activity (PNA), nitrogen-fixation activity (NFA), and dehydrogenase activity (DHA) in soil to 2,4,6-trinitrotoluene (TNT) was assessed. Two garden soils of contrasting texture were spiked with TNT. Soil microbial activities and TNT residues were analyzed 1 week later. The estimated IC50 ranged from 39 to 533 mg/kg of the acetonitrile-extractable (AE) TNT, depending on indicators and soils. The lowest LOEC (lowest-observed-effect concentration) was 1 mg AE TNT/kg. Field soil was collected from three known contaminated sites in an abandoned TNT manufacturing facility. Microbial toxicity significantly correlated to TNT levels in these soils. The LOEC and NOEC (no-observed-effect concentration) values were site and indicator specific, with the lowest LOEC being 1 mg AE TNT/kg and the lowest NOEC being 0.4 mg AE TNT/kg. The IC50 of the pooled field samples was 51 mg AE TNT/kg for PNA or 157 mg AE TNT/kg for DHA. These results indicate that microbial responses were consistent and comparable between the laboratory and the field and that TNT could significantly inhibit soil microbial activities at very low levels. Both AE TNT and deionized water-extractable (DW) TNT concentrations correlated well with microbial toxicity, but AE TNT provided a better evaluation of TNT bioavailability than did DW TNT.

  6. Postpartum depression: Etiology, treatment and consequences for maternal care.

    PubMed

    Brummelte, Susanne; Galea, Liisa A M

    2016-01-01

    This article is part of a Special Issue "Parental Care". Pregnancy and postpartum are associated with dramatic alterations in steroid and peptide hormones which alter the mothers' hypothalamic pituitary adrenal (HPA) and hypothalamic pituitary gonadal (HPG) axes. Dysregulations in these endocrine axes are related to mood disorders and as such it should not come as a major surprise that pregnancy and the postpartum period can have profound effects on maternal mood. Indeed, pregnancy and postpartum are associated with an increased risk for developing depressive symptoms in women. Postpartum depression affects approximately 10-15% of women and impairs mother-infant interactions that in turn are important for child development. Maternal attachment, sensitivity and parenting style are essential for a healthy maturation of an infant's social, cognitive and behavioral skills and depressed mothers often display less attachment, sensitivity and more harsh or disrupted parenting behaviors, which may contribute to reports of adverse child outcomes in children of depressed mothers. Here we review, in honor of the "father of motherhood", Jay Rosenblatt, the literature on postnatal depression in the mother and its effect on mother-infant interactions. We will cover clinical and pre-clinical findings highlighting putative neurobiological mechanisms underlying postpartum depression and how they relate to maternal behaviors and infant outcome. We also review animal models that investigate the neurobiology of maternal mood and disrupted maternal care. In particular, we discuss the implications of endogenous and exogenous manipulations of glucocorticoids on maternal care and mood. Lastly we discuss interventions during gestation and postpartum that may improve maternal symptoms and behavior and thus may alter developmental outcome of the offspring.

  7. Efficacy of rectal misoprostol for prevention of postpartum hemorrhage.

    PubMed

    Mirteimouri, Masoumeh; Tara, Fatemeh; Teimouri, Batool; Sakhavar, Nahid; Vaezi, Afsaneh

    2013-01-01

    Postpartum hemorrhage is an important cause of maternal morbidity and mortality after delivery. Active management of postpartum hemorrhage by an uterotonic drug decreases the rate of postpartum hemorrhage. The aim of this study is to evaluate the efficacy of rectal misoprostol for prevention of postpartum hemorrhage. This double blind randomized clinical trial was performed on full term pregnant women candidate for vaginal delivery, referred to Zahedan Imam Ali Hospital during 2008-2009. They were randomly divided into two groups of rectal misoprostol and oxytocin. The women in misoprostol group received 400 μg rectal misoprostol after delivery and the women in oxytocin group received 3 IU oxytocin in 1 L ringer serum, intravenously. Rate of bleeding, need to any surgery interventions, rate of transfusion and changes in hemoglobin and hematocrite were compared between two groups. A total of 400 patients (200 cases in misoprostol group and 200 in oxytocin group) entered to the study. Rate of bleeding > 500 cc was significantly higher in oxytocin group than misoprostol group (33% vs. 19%) (p = 0.005). Also, need to excessive oxytocin for management of postpartum hemorrhage was significantly lower in misoprostol group than oxytocin group (18% vs. 30%) (p = 0.003). Decrease in hematocrite was significantly more observed in oxytocin group than misoprostol group (mean decrease of hematocrite was 1.3 ± 1.6 in misoprostol group and 1.6 ± 2.2 in oxytocin group). Two groups were similar in terms of side-effects. Rectal misoprostol as an uterotonic drug can decrease postpartum hemorrhage and also can prevent from decrease of hemoglobin as compared to oxytocin. PMID:24250623

  8. [Infanticide as a consequence of postpartum bonding disorder].

    PubMed

    Hornstein, C; Trautmann-Villalba, P

    2007-05-01

    Parental killing of their own children in the 1st year constitutes a rare phenomenon. Studies on infanticide show that mothers who kill their children are frequently psychiatrically disturbed. Depression is the most common postpartum disorder and may represent a vital danger for both mother and child. The association between depression and infanticide can usually be explained by maternal psychopathologic symptoms. The importance of a mother's bonding to her infant has not often been examined in respect to infanticide. The present case report underlines the importance of postpartum bonding disorder and its relation to a higher risk of infanticide.

  9. Postpartum ovarian vein thrombosis after cesarean delivery: a case report

    PubMed Central

    Royo, Pedro; Alonso-Burgos, Alberto; García-Manero, Manuel; Lecumberri, Ramón; Alcázar, Juan Luis

    2008-01-01

    Introduction Postpartum ovarian vein thrombosis is an uncommon complication; incidence varies between 0.002% and 0.05%. It most often occurs during the 2–15 days following delivery. Case presentation A 22-year-old pregnant woman at term presented to hospital with uterine contractions, abdominal pain, nausea and vomiting. After delivery an ovarian vein thrombosis was diagnosed. Conclusion Low-molecular weight heparin with broad-spectrum antibiotics are the accepted therapy in non-complicated cases of postpartum ovarian vein thrombosis. PMID:18400095

  10. a week in space

    NASA Astrophysics Data System (ADS)

    collette, christian

    2016-04-01

    COLLETTE Christian Institut Saint Laurent Liège Belgium. I am a science teacher at a technical high school. Generally, my students don't come from a privileged social background and are not particularly motivated for studies. For 10 years, I organize, for one of my sections, a spatial (and special) school year that ends in a spatial week. Throughout this year, with the help of my colleagues, I will introduce into all themes a lot of concepts relating to space. French, history, geography, English, mathematics, technical courses, sciences, and even gymnastics will be training actors in space culture. In spring, I will accompany my class in the Euro Space Center (Redu- Belgium) where we will live one week 24 hours on "like astronauts" One third of the time is dedicated to astronaut training (moonwalk, remote manipulator system, mission simulation, weightless wall, building rockets, satellites, etc.), One third to more intellectual activities on space (lectures, research, discovery of the outside run) the last one third of time in outside visits (museums, site of ESA-Redu) or in movies about space (October sky, Apollo 13, etc.) During this year, the profits, so educational as human, are considerable!

  11. CDK4/6 inhibition induces epithelial cell cycle arrest and ameliorates acute kidney injury

    PubMed Central

    DiRocco, Derek P.; Bisi, John; Roberts, Patrick; Strum, Jay; Wong, Kwok-Kin; Sharpless, Norman

    2013-01-01

    Acute kidney injury (AKI) is common and urgently requires new preventative therapies. Expression of a cyclin-dependent kinase (CDK) inhibitor transgene protects against AKI, suggesting that manipulating the tubular epithelial cell cycle may be a viable therapeutic strategy. Broad spectrum small molecule CDK inhibitors are protective in some kidney injury models, but these have toxicities and epithelial proliferation is eventually required for renal repair. Here, we tested a well-tolerated, novel and specific small molecule inhibitor of CDK4 and CDK6, PD 0332991, to investigate the effects of transient cell cycle inhibition on epithelial survival in vitro and kidney injury in vivo. We report that CDK4/6 inhibition induced G0/G1 cycle arrest in cultured human renal proximal tubule cells (hRPTC) at baseline and after injury. Induction of transient G0/G1 cycle arrest through CDK4/6 inhibition protected hRPTC from DNA damage and caspase 3/7 activation following exposure to the nephrotoxins cisplatin, etoposide, and antimycin A. In vivo, mice treated with PD 0332991 before ischemia-reperfusion injury (IRI) exhibited dramatically reduced epithelial progression through S phase 24 h after IRI. Despite reduced epithelial proliferation, PD 0332991 ameliorated kidney injury as reflected by improved serum creatinine and blood urea nitrogen levels 24 h after injury. Inflammatory markers and macrophage infiltration were significantly decreased in injured kidneys 3 days following IRI. These results indicate that induction of proximal tubule cell cycle arrest with specific CDK4/6 inhibitors, or “pharmacological quiescence,” represents a novel strategy to prevent AKI. PMID:24338822

  12. Biotransformation of 2,4,6-trinitrotoluene in Anabaena sp. cultures

    SciTech Connect

    Pavlostathis, S.G.; Jackson, G.H.

    1999-03-01

    The transformation of 2,4,6-trinitrotoluene (TNT) was investigated in cultures of the cyanobacterium Anabaena sp. by conducting a series of batch assays. 2,4,6-Trinitrotoluene was added to Anabaena sp. cultures in single and consecutive additions, at various initial concentrations, to determine its transformation kinetics, to identify products formed, to evaluate potential toxicity, and to determine the effect of light deprivation on the TNT transformation process. 2,4,6-Trinitrotoluene disappearance occurred only in the presence of Anabaena sp. cultures maintained under a normal 16-h photoperiod. Toxicity leading to culture chlorosis and death was observed in batch systems with an initial TNT concentration greater than 10 mg/L. A low rate and extent of TNT disappearance was observed in light-deprived cultures, which were inhibited even at low TNT concentrations. At pH values between 7.5 and 8.5, azoxy-tetranitrotoluene isomers were detected in both the culture medium and solvent extracts of biomass and accounted for only 20 and 4.4% of the initially added TNT moles, respectively. At a culture pH range between 5.6 and 5.9, achieved by aeration with a 5% CO{sub 2}/air mixture, hydroxylaminodinitrotoluene equimolar to the TNT addition was produced and then depleted from the culture medium with prolonged incubation. Although TNT reduction in Anabaena sp. cultures occurred, yielding low levels of azoxy-tetranitrotoluene isomers or hydroxylaminodinitrotoluene, uptake and other transformation reactions of TNT and/or its transformation products by Anabaena sp. may have taken place. Based on a less than 15% observed increase of biomass concentration over the relatively short incubation periods and by considering the mean biomass concentration constant, the TNT disappearance rate followed pseudo-first-order kinetics. The biomass carbon-normalized TNT disappearance rates in Anabaena sp. cultures were about three orders of magnitude higher than previously reported TNT

  13. Reduction of the explosive 2,4,6-trinitrotoluene by enzymes from aquatic sediments

    SciTech Connect

    Beelen, P. van; Burris, D.R.

    1995-12-01

    Enzymes were extracted from aquatic sediments. Some of these enzymes reduced 2,4,6-trinitrotoluene (TNT) with nicotinamide adenosine dinucleotide phosphate (NADPH) as an electron donor under aerobic conditions. The origin of these enzymes was not clear as the enzymes were extracted from a sediment containing plant roots and microorganisms. Aquatic plants were determined to e a source of TNT-reducing enzymes. Chemical reduction was not a rate-limiting process in the assays as the enzymatic activity was inhibited by heating or the addition of proteases. Enzymatic activity in the extracts was further characterized. Partial purifications of enzymes from the sediment extracts shows that several proteins capable of reducing NT with NADPH were present. The enzymes did not require flavins and preferred NADPH over NADH as the electron donor. The pH optimum for the stability of the enzymes was near neutral, and the temperature optimum was in the 37 to 45 C range. Addition of dithiothreitol improved the stability of the enzymes. The enzymes reduced 2,4,6-trinitrotoluene to 2-amino-4,6-dinitrotoluene, 4-amino-2,6-dinitrotoluene, 2,4-diamino-6-nitrotoluene, and 2,6-diamino-4-nitrotoluene under aerobic conditions with NADPH. When used as a starting substrate, the aminodinitrotoluenes were not reduced by the enzymes. It might be possible that the hydroxylaminodinitrotoluenes are reduced to di[hydroxylamine]nitrotoluenes prior to the formation of the diaminonitrotoluenes. Sediments from 11 surface water bodies were examined for the presence of TNT-reducing enzymes, and 10 were found to have activity. These enzymes appear to be ubiquitous and are present in both freshwater and saltwater sediments. Reduction of TNT by sediment enzymes can be a significant environmental fate process for TNT in aquatic systems.

  14. CDK4/6 inhibition induces epithelial cell cycle arrest and ameliorates acute kidney injury.

    PubMed

    DiRocco, Derek P; Bisi, John; Roberts, Patrick; Strum, Jay; Wong, Kwok-Kin; Sharpless, Norman; Humphreys, Benjamin D

    2014-02-15

    Acute kidney injury (AKI) is common and urgently requires new preventative therapies. Expression of a cyclin-dependent kinase (CDK) inhibitor transgene protects against AKI, suggesting that manipulating the tubular epithelial cell cycle may be a viable therapeutic strategy. Broad spectrum small molecule CDK inhibitors are protective in some kidney injury models, but these have toxicities and epithelial proliferation is eventually required for renal repair. Here, we tested a well-tolerated, novel and specific small molecule inhibitor of CDK4 and CDK6, PD 0332991, to investigate the effects of transient cell cycle inhibition on epithelial survival in vitro and kidney injury in vivo. We report that CDK4/6 inhibition induced G0/G1 cycle arrest in cultured human renal proximal tubule cells (hRPTC) at baseline and after injury. Induction of transient G0/G1 cycle arrest through CDK4/6 inhibition protected hRPTC from DNA damage and caspase 3/7 activation following exposure to the nephrotoxins cisplatin, etoposide, and antimycin A. In vivo, mice treated with PD 0332991 before ischemia-reperfusion injury (IRI) exhibited dramatically reduced epithelial progression through S phase 24 h after IRI. Despite reduced epithelial proliferation, PD 0332991 ameliorated kidney injury as reflected by improved serum creatinine and blood urea nitrogen levels 24 h after injury. Inflammatory markers and macrophage infiltration were significantly decreased in injured kidneys 3 days following IRI. These results indicate that induction of proximal tubule cell cycle arrest with specific CDK4/6 inhibitors, or "pharmacological quiescence," represents a novel strategy to prevent AKI.

  15. Management of intractable postpartum haemorrhage in a tertiary center: A 5-year experience

    PubMed Central

    Cengiz, Hüseyin; Yaşar, Levent; Ekin, Murat; Kaya, Cihan; Karakaş, Sema

    2012-01-01

    Background: The purpose of this study is to describe treatment alternatives to prevent postpartum hysterectomy after failure of conventional therapies. Prevention of hysterectomy was the main outcome studied. Materials and Methods: This is a retrospective study of 19 patients diagnosed to have intractable postpartum hemorrhage and not managed with medical treatment who were subsequently treated with operative interventions in our unit between January 2004 and January 2009. The cases were identified by review of medical records. Results: In the period under review, a total of 17,341 deliveries were conducted, out of which 19 women were managed for intractable PPH. The incidence of severe PPH unresponsive to standard medical treatment was 0.1%. The mean maternal age was 33.5±3.4 years (range 27–39 years). The mean gestational age was 38.3±1.3 weeks (range 37–41 weeks). Organ preserving surgery methods were utilized in all the patients with a success rate 78.9%. The mean duration of surgery was 95 minutes (range 50–130 minutes) and the mean hospital stay was for 5 days. The mean transfused blood volume was 2.4 units as packed red cells. Among these 19 cases, 4 cases were resorted to hysterectomy. Conclusions: In the presence of uncontrolled hemorrhage, this simple procedure should be tried before other complex treatment alternatives are undertaken. Our case series suggests that the combination of uterine artery ligation with B-Lynch sutures might be the best surgical approach because it preserves future fertility better than other methods and avoids high operative risks and morbidity. PMID:23271852

  16. Microbial Transformation of 2,4,6-Trinitrotoluene in Aerobic Soil Columns

    PubMed Central

    Bruns-Nagel, D.; Breitung, J.; von Low, E.; Steinbach, K.; Gorontzy, T.; Kahl, M.; Blotevogel, K.; Gemsa, D.

    1996-01-01

    2,4,6-Trinitrotoluene (TNT)-contaminated soil material of a former TNT production plant was percolated aerobically in soil columns. Nineteen days of percolation with a potassium phosphate buffer supplemented with glucose or glucose plus ammonium sulfate caused an over 90% decline in the amount of extractable nitroaromatics in soils containing 70 to 2,100 mg of TNT per kg (dry weight). In the percolation solution, a complete elimination of TNT was achieved. Mutagenicity and soil toxicity were significantly reduced by the percolation process. 4-N-Acetylamino-2-amino-6-nitrotoluene was generated in soil and percolation fluid as a labile TNT metabolite. PMID:16535369

  17. UV photolysis for enhanced phenol biodegradation in the presence of 2,4,6-trichlorophenol (TCP).

    PubMed

    Song, Jiaxiu; Wang, Wenbing; Li, Rongjie; Zhu, Jun; Zhang, Yongming; Liu, Rui; Rittmann, Bruce E

    2016-02-01

    A bacterial strain isolated from activated sludge and identified as Bacillus amyloliquefaciens could biodegrade phenol, but 2,4,6-trichlorophenol (TCP) inhibited phenol biodegradation and biomass growth. UV photolysis converted TCP into dichlorocatechol, monochlorophenol, and dichlorophenol, and this relieved inhibition by TCP. Phenol-removal and biomass-growth rates were significantly accelerated after UV photolysis: the monod maximum specific growth rate (μ(max)) increased by 9% after TCP photolysis, and the half-maximum-rate concentration (K(S)) decreased by 36%. Thus, the major benefit of UV photolysis in this case was to transform TCP into a set of much-less-inhibitory products.

  18. Chemical stability of molten 2,4,6-trinitrotoluene at high pressure

    NASA Astrophysics Data System (ADS)

    Dattelbaum, Dana M.; Chellappa, Raja S.; Bowden, Patrick R.; Coe, Joshua D.; Margevicius, Madeline A.

    2014-01-01

    2,4,6-trinitrotoluene (TNT) is a molecular explosive that exhibits chemical stability in the molten phase at ambient pressure. A combination of visual, spectroscopic, and structural (x-ray diffraction) methods coupled to high pressure, resistively heated diamond anvil cells was used to determine the melt and decomposition boundaries to >15 GPa. The chemical stability of molten TNT was found to be limited, existing in a small domain of pressure-temperature conditions below 2 GPa. Decomposition dominates the phase diagram at high temperatures beyond 6 GPa. From the calculated bulk temperature rise, we conclude that it is unlikely that TNT melts on its principal Hugoniot.

  19. Comparison of water quality criteria and health advisories for 2,4,6-trinitrotoluene

    SciTech Connect

    Ross, R.H.; Hartley, W.R. )

    1990-04-01

    The U.S. Environmental Protection Agency (USEPA) has recently recommended health advisories (HAs) for 2,4,6-trinitrotoluene (TNT). The purpose of this brief article is to present these values so that the reader can compare them with the water quality criteria that have been proposed in another article. In that article, a water quality criterion of 140 micrograms/liter for TNT in drinking water was proposed, and in the present article the methodology by which USEPA calculated a lifetime HA of 2 micrograms/liter is presented. The reasons why the water quality criterion and the HA differ are discussed.

  20. Factors affecting 2,4,6-trinitrotoluene degradation in contaminated soil

    SciTech Connect

    Bradley, P.M.; Chapelle, F.H.

    1995-12-31

    Recent microcosm studies at an inactive ordnance works at Weldon Spring, Missouri indicated that the indigenous microorganisms are capable of complete transformation oaf 2,4,6-trinitrotoluene (TNT) within approximately 22 days. However, the continuing presence of TNT at the Weldon Spring site suggests that some combination of environmental factors is inhibiting microbial degradation at the site. This paper briefly summarizes the results of investigations of the effects of carbon substrate availability, soil moisture content, TNT concentration, and oxygen condition on TNT degradation by the microorganisms indigenous to Weldon Spring.

  1. Crystal structure of 2,4,6-triisopropyl-2',5'-dimethoxybiphenyl

    NASA Astrophysics Data System (ADS)

    Sharma, N.; Prashanth, T.; Lakshmi Ranganatha, V.; Ara Khanum, S.; Kant, R.; Gupta, V. K.

    2015-12-01

    The title compound, 2,4,6-triisopropyl-2',5'-dimethoxybiphenyl was synthesized from 1-choloro-2.5-dimethoxy benzene, 1,3,5-triisopropylbenzene boronic acid and potassium phosphate in the presence of lead acetate as a catalyst and toluene as a solvent. Its crystal structure is determined by X-ray structure analysis. The crystals are the orthorhombic, a = 12.3281(4), b = 17.4235(5), c = 19.6550(6) Å, Z = 8, sp. gr. Pbca. R = 0.0603 for 2494 observed reflections.

  2. Toxicity and mutagenicity of 2,4,-6-trinitrotoluene and its microbial metabolites.

    PubMed Central

    Won, W D; DiSalvo, L H; Ng, J

    1976-01-01

    TNT (2,4,6-trinitrotoluene) of explosive grade is highly toxic to marine forms that included fresh water unicellular green algae (Selenastrum capricornutum), tidepool copepods (Tigriopus californicus), and oyster larvae (Crassostrea gigas), and mutagenic to Salmonella typhimurium. On the basis of mutagenic assays carried out with a set of histidine-requiring strains of the bacterium, TNT was detected as a frameshift mutagen that significantly accelerates the reversion rate of a frameshift tester, TA-98. In contrast, the major microbial metabolites of TNT appeared to be nontoxic and nonmutagenic. Images PMID:773306

  3. The use of amino compounds for binding 2,4,6-trinitrotoluene in water.

    PubMed

    Fant, F; De Sloovere, A; Matthijsen, K; Marlé, C; el Fantroussi, S; Verstraete, W

    2001-01-01

    Sites polluted with 2,4,6-trinitrotoluene (TNT) constitute a worldwide problem. In this work, chemical reactions for binding TNT to amino-compounds are proposed as an initial step for developing new remediation techniques to clean-up groundwater and soils contaminated with TNT. Indeed, addition of aniline and an amino acid-like cysteine caused a decrease in free TNT of 86% and 68-100%, respectively. Using 13C-NMR spectroscopy, it was shown that TNT chemically forms a Meisenheimer complex with cysteine and aniline in 1/1 (by vol.) H2O/d6-acetone.

  4. The Use of Parenteral Iron Therapy for the Treatment of Postpartum Anemia.

    PubMed

    Nash, Christopher M; Allen, Victoria M

    2015-05-01

    Rates of postpartum hemorrhage have been increasing in Canada over the last 10 years, with postpartum iron deficiency anemia as the most common consequence. Postpartum anemia is treated with oral iron supplementation and/or blood transfusion. Recent studies have evaluated the use of parenteral iron as a better tolerated treatment modality. Compared with oral iron supplements, parenteral iron is associated with a more rapid rise in serum ferritin and hemoglobin and improved maternal fatigue scores in the postpartum period. It may also decrease rates of blood transfusion. Parenteral iron may be considered in select clinical situations for the treatment of postpartum anemia.

  5. 2,4,6,8-Tetrachlorodibenzothiophene in the Newark Bay Estuary: the likely source and reaction pathways.

    PubMed

    Parette, Robert; Pearson, Wendy N

    2014-09-01

    Historic industrial activity along the Newark Bay Estuary has resulted in pollution from a number of contaminants; one of which is 2,4,6,8-tetrachlorodibenzothiophene (2,4,6,8-TCDT), a unique chemical contaminant whose origins have not been adequately explained. This research demonstrates that the probable source of 2,4,6,8-TCDT was the chlorination of phenol produced via the sulfonation method. Thiophenol, the major impurity in this type of phenol, was likely converted to 2,4,6,8-TCDT through one or more pathways during the production of 2,4-dichlorophenol, 2,4-dichlorophenoxyacetic acid (2,4-D), or 2,4,6-trichlorophenol. From a mass balance standpoint, production of these chemicals at an industrial plant along the Passaic River could account for the 2,4,6,8-TCDT in the Newark Bay Estuary. PMID:24997913

  6. Visual detection of 2,4,6-trinitrotolune by molecularly imprinted colloidal array photonic crystal.

    PubMed

    Lu, Wei; Asher, Sanford A; Meng, Zihui; Yan, Zequn; Xue, Min; Qiu, Lili; Yi, Da

    2016-10-01

    We developed a photonic crystal (PhC) sensor for the quantification of 2,4,6-trinitrotoluene (TNT) in solution. Monodisperse (210nm in diameter) molecularly imprinted colloidal particles (MICs) for TNT were prepared by the emulsion polymerization of methyl methacrylate and acrylamide in the presence of TNT as a template. The MICs were then self-assembled into close-packed opal PhC films. The adsorption capacity of the MICs for TNT was 64mg TNT/g. The diffraction from the PhC depended on the TNT concentration in a methanol/water (3/2, v/v) potassium dihydrogen phosphate buffer solution (pH=7.0, 30mM). The limit of detection (LOD) of the sensor was 1.03μg. The color of the molecularly imprinted colloidal array (MICA) changed from green to red with an 84nm diffraction red shift when the TNT concentration increased to 20mM. The sensor response time was 3min. The PhC sensor was selective for TNT compared to similar compounds such as 2,4,6-trinitrophenol, 2,4-dinitrotoluene, 2,6-dinitrotoluene, 2-nitromesitylene, 4-nitrotoluene, 2-nitrotoluene, 1,3-dinitrobenzene, methylbenzene, 4-nitrophenol, 2-nitroaniline, 3-aminophenol and 3-nitroaniline. The sensor showed high stability with little response change after three years storage. This sensor technology might be useful for the visual determination of TNT. PMID:27214001

  7. Dosimetric shield evaluation with tungsten sheet in 4, 6, and 9MeV electron beams.

    PubMed

    Fujimoto, Takahiro; Monzen, Hajime; Nakata, Manabu; Okada, Takashi; Yano, Shinsuke; Takakura, Toru; Kuwahara, Junichi; Sasaki, Makoto; Higashimura, Kyoji; Hiraoka, Masahiro

    2014-11-01

    In electron radiotherapy, shielding material is required to attenuate beam and scatter. A newly introduced shielding material, tungsten functional paper (TFP), has been anticipated to become a very useful device that is lead-free, light, flexible, and easily processed, containing very fine tungsten powder at as much as 80% by weight. The purpose of this study was to investigate the dosimetric changes due to TFP shielding for electron beams. TFP (thickness 0-15mm) was placed on water or a water-equivalent phantom. Percentage depth ionization and transmission were measured for 4, 6, and 9MeV electron beams. Off-center ratio was also measured using film dosimetry at depth of dose maximum under similar conditions. Then, beam profiles and transmission with two shielding materials, TFP and lead, were evaluated. Reductions of 95% by using TFP at 0.5cm depth occurred at 4, 9, and 15mm with 4, 6, and 9MeV electron beams, respectively. It is found that the dose tend to increase at the field edge shaped with TFP, which might be influenced by the thickness. TFP has several unique features and is very promising as a useful tool for radiation protection for electron beams, among others.

  8. Concentrations of organochlorine pesticides and 2,4,6-trichloroanisole in cork bark.

    PubMed

    Olivella, M Àngels; Caixach, Josep; Planas, Carles; Oliveras, Anna; Jové, Patrícia

    2012-02-01

    Organochlorine pesticides are persistent lipophilic organic pollutants and tend to accumulate in growing plants. During growth, cork is in contact with the open air for long periods (9-12 years). Owing to the previous widespread use of organochlorine pesticides and their high persistence in the environment, there is a risk that residues of such pesticides may be present in cork. In this study, the concentrations of 14 organochlorine pesticides-all of which are indicators of environmental pollution-were analyzed in cork bark samples from three regions in Spain and one in Portugal. In addition, the concentrations of 2,4,6-trichlorophenol (TCP) and 2,4,6-trichloroanisole (TCA) were also analyzed. Our results show only very low concentrations of lindane, γ-HCH (<2.6 ng g(-1)) and its byproducts α-HCH (<3.5 ng g(-1)) and β-HCH (<0.6 ng g(-1)). Among the DDT and its metabolites, only two were found: p,p'-DDT was found in a cork sample from Extremadura (0.1 ng g(-1)) and p,p'-DDE was present at a maximum concentration of 2.9 ng g(-1) in a cork sample from Castile-La Mancha. However, all concentrations were well below the legal limit established by Regulation (EC) No. 396/2005 (10 ng g(-1) in foodstuffs). We can conclude, therefore, that the cork samples we studied complied with food safety standards.

  9. Growth and characterization of a new nonlinear optical organic crystal: 2,4,6-Trimethylacetanilide

    NASA Astrophysics Data System (ADS)

    Upadhyaya, V.; Prabhu, Sharada G.

    2015-09-01

    A new nonlinear optical organic material, 2,4,6-trimethylacetanilide (246TMAA), also known as N-[2,4,6- trimethylphenyl]acetamide, has been synthesized and grown as a single crystal by the slow evaporation technique by organic solvents. The grown crystals have been characterized by morphology study. The crystals are prismatic. Surface examination shows granular dendritic pattern in optical micrograph. The Scanning Electron Micrograph shows the layered growth of the crystal. The Differential Scanning Calorimeter plot shows no phase change until melting point (219°C). The density of the crystals is 1.1g/cc and the crystals are soft. The crystals are transparent in the visible region and in the ultra-violet region till 280 nm. 246TMAA crystallizes with 2 molecules in a monoclinic unit cell in the noncentrosymmetric point group m, space group Pn. Refractive indices of this optically biaxial crystal along the three crystallophysical axes have been measured at 633 nm. The optical second harmonic generation efficiency of the crystal at 1064 nm is about half that of the urea crystal, measured by powder method using Nd:YAG laser. The results show that the 246TMAA crystal can efficiently be used for up-conversion of infrared radiation into visible green light. The powder X-ray diffraction spectrum of the crystal has been obtained.

  10. Soil sorption and plant uptake of 2,4,6-trinitrotoluene

    SciTech Connect

    Pennington, J.C.

    1988-01-01

    Potential environmental hazards are posed by the presence of 2,4,6-trinitrotoluene (TNT) contamination in soils of US Army Ammunition Plants (AAPs). Adsorption and desorption studies were conducted on soil samples collected from 13 AAPs. TNT adsorption correlated most highly with cation exchange capacity, extractable iron, clay content, and percent organic carbon. Sequential desorption indicated that almost all of the adsorbed TNT was desorbed after three sequential desorption cycles. Plant uptake of TNT and two of its principal degradation products, 4-amino-2,6-dinitrotoluene (4ADNT) and 2-amino-4,6-dinitrotoluene (2ADNT), was also investigated. Results indicated that little TNT and 4ADNT, and no 2ADNT was absorbed by leafy portions of the test plant, yellow nutsedge (Cyperus esculentus). Plant uptake was greatest from 4ADNT-treated silts, an indication that 4ADNT is more readily mobilized into the plant than TNT or 2ANDT. Greater plant uptake from silt than from clay indicated that bioavailability is reduced in the clay. The reduction in bioavailability may be due to an increase in soil sorption of TNT and its degradation products over time.

  11. Oxidative degradation of 2,4,6-trinitrotoluene by ozone in an electrohydraulic discharge reactor

    SciTech Connect

    Lang, P.S.; Ching, W.K.; Willberg, D.M.; Hoffmann, M.R.

    1998-10-15

    The electrohydraulic discharge process in the presence of ozone has been used to investigate the rapid degradation and mineralization of aqueous 2,4,6-trinitrotoluene (TNT) solutions that were directly exposed to high-energy electrical discharges between two submerged electrodes. The 165 {micro}M solutions of TNT were completely mineralized over the course of 300 electrical discharges of 7 kJ each. The kinetics of TNT degradation were investigated as a function of the aqueous-phase ozone concentration, pH, discharge energy, and electrode gas length. The rate of TNT degradation increases with an increase in aqueous-phase ozone concentration of up to 150 {micro}M, an increase in pH from 3.0 to 7.9, an increase in discharge energy from 5.5 to 9 kJ, and a decrease in the electrode gap length from 10 to 6 mm. The rapid rates of mineralization are attributed to the action of UV light in the reactor chamber on O{sub 3} to produce a high flux of hydroxyl radicals per discharge. The primary reaction intermediates were 2,4,6-trinitrobenzaldehyde and trinitrobenzene.

  12. 2,4,6-Trinitrotoluene reduction by carbon monoxide dehydrogenase from Clostridium thermoaceticum

    SciTech Connect

    Huang, S.; Lindahl, P.A.; Wang, C.; Bennett, G.N.; Rudolph, F.B.; Hughes, J.B.

    2000-03-01

    Purified CO dehydrogenase (CODH) from Clostridium thermoaceticum catalyzed the transformation of 2,4,6-trinitrotoluene (TNT). The intermediates and reduced products of TNT transformation were separated and appear to be identical to the compounds formed by C. acetobutylicum, namely, 2-hydroxylamino-4,6-dinitrotoluene (2 HA46DNT), 4-hydroxylamino-2,6-dinitrotoluene (4HA26DNT), 2,4-dihydroxylamino-6-nitrotoluene (24DHANT), and the Bamberger rearrangement product of 2,4-dihydroxylamino-6-nitrotoluene. In the presence of saturating CO, CODH catalyzed the conversion of TNT to two monohydroxylamino derivatives (2HA46DNT and 4HA26DNT), with 4HA26DNT as the dominant isomer. These derivatives were then converted to 24DHANT, which slowly converted to the Bamberger rearrangement product. Apparent K{sub m} and k{sub cat} values of TNT reduction were 165 {+-} 43 {micro}M for TNT and 400 {+-} 94 s{sup {minus}1}, respectively. Cyanide, an inhibitor for the CO/CO{sub 2} oxidation/reduction activity of CODH, inhibited the TNT degradation activity of CODH.

  13. Phytodetoxification of the environmental pollutant and explosive 2,4,6-trinitrotoluene.

    PubMed

    Rylott, Elizabeth L; Gunning, Vanda; Tzafestas, Kyriakos; Sparrow, Helen; Johnston, Emily J; Brentnall, Andrew S; Potts, Jennifer R; Bruce, Neil C

    2015-01-01

    Our recent study highlights the role of 2 glutathione transferases (GSTs) in the detoxification of the environmental pollutant, 2,4,6-trinitrotoluene (TNT) in Arabidopsis thaliana. TNT is toxic and highly resistant to biodegradation in the environment, raising both health and environmental concerns. Two GSTs, GST-U24 and GST-U25, are upregulated in response to TNT treatment, and expressed predominantly in the root tissues; the site of TNT location following uptake. Plants overexpressing GST-U24 and GST-U25 exhibited significantly enhanced ability to withstand and detoxify TNT, and remove TNT from contaminated soil. Analysis of the catalytic activities of these 2 enzymes revealed that they form 3 TNT-glutathionyl products. Of particular interest is 2-glutathionyl-4,6-dinitrotoluene as this represents a potentially favorable step toward subsequent degradation and mineralization of TNT. We demonstrate how GSTs fit into what is already known about pathways for TNT detoxification, and discuss the short and longer-term fate of TNT conjugates in planta.

  14. Determination of hemoglobin adducts in workers exposed to 2,4, 6-trinitrotoluene.

    PubMed

    Sabbioni, G; Wei, J; Liu, Y Y

    1996-07-12

    2,4,6-Trinitrotoluene (TNT) is an important occupational and environmental pollutant. TNT can be taken up through the skin and by inhalation. It is therefore essential to have fast and reliable methods to monitor human exposure. In rat experiments, it has been shown that TNT binds covalently to blood proteins and to tissue proteins. Hemoglobin (Hb) adducts of TNT are markers for the internal dose and possibly for the toxic effects of TNT, e.g. cataracts. In the present paper we introduce a new efficient method to quantify Hb adducts of TNT. Precipitated Hb was hydrolyzed with base in the presence of the surrogate internal standard 3,5-dinitroaniline (35DNA). The released 2-amino-4,6-dinitrotoluene (2ADNT) and 4-amino-2,6-dinitrotoluene (4ADNT) were quantified against 35DNA by gas chromatography-mass spectrometry with negative-ion chemical ionization. Hb of 50 workers and controls from a Chinese munition factory were investigated. The Hb adduct levels ranged from 3.7 to 522 ng for 4ADNT and from 0 to 14.7 ng for 2ADNT per gram of Hb. However, in control samples from Germany no Hb adducts of 4ADNT or 2ADNT could be found.

  15. Dosimetric shield evaluation with tungsten sheet in 4, 6, and 9MeV electron beams.

    PubMed

    Fujimoto, Takahiro; Monzen, Hajime; Nakata, Manabu; Okada, Takashi; Yano, Shinsuke; Takakura, Toru; Kuwahara, Junichi; Sasaki, Makoto; Higashimura, Kyoji; Hiraoka, Masahiro

    2014-11-01

    In electron radiotherapy, shielding material is required to attenuate beam and scatter. A newly introduced shielding material, tungsten functional paper (TFP), has been anticipated to become a very useful device that is lead-free, light, flexible, and easily processed, containing very fine tungsten powder at as much as 80% by weight. The purpose of this study was to investigate the dosimetric changes due to TFP shielding for electron beams. TFP (thickness 0-15mm) was placed on water or a water-equivalent phantom. Percentage depth ionization and transmission were measured for 4, 6, and 9MeV electron beams. Off-center ratio was also measured using film dosimetry at depth of dose maximum under similar conditions. Then, beam profiles and transmission with two shielding materials, TFP and lead, were evaluated. Reductions of 95% by using TFP at 0.5cm depth occurred at 4, 9, and 15mm with 4, 6, and 9MeV electron beams, respectively. It is found that the dose tend to increase at the field edge shaped with TFP, which might be influenced by the thickness. TFP has several unique features and is very promising as a useful tool for radiation protection for electron beams, among others. PMID:24953537

  16. CDK4/6 inhibitor suppresses gastric cancer with CDKN2A mutation

    PubMed Central

    Huang, Shiliang; Ye, Hua; Guo, Wenying; Dong, Xianwen; Wu, Nali; Zhang, Xie; Huang, Zhigang

    2015-01-01

    Aim: Gastric cancer is a major health problem and current treatment lacks lasting effect. Targeted therapy for gastric cancer with specific genetic background is in urgent need. Methods: We have studied The Cancer Genomic Atlas (TCGA) and The Genomics of Drug Sensitivity in Cancer (GDSC) databases to reveal genes with high frequency of mutation and possible sensitive compound against such gene mutation. In vitro studies were conducted to validate the in silico findings. Results: CDKN2A is frequently mutated in gastric cancer, revealed in TCGA database. CDK4/6 inhibitor PD-0332991 was sensitive in cancer cells with CDKN2A mutation, revealed in GDSC database. In vitro studies showed that PD-0332991 could selectively inhibit proliferation of gastric cancer cell with CDKN2A mutation. PD-0332991 could also inhibit cell invasion, migration, and colony formation of gastric cancer cell with CDKN2A mutation. PD-0332991 induced cell cycle arrest but not apoptosis. PD-0332991 inhibited xenograft gastric cancer mouse model. Conclusion: Gastric cancer with CDKN2A mutation is sensitive to CDK4/6 inhibitor. PD-0332991 is a potential therapeutic agent for gastric cancer. PMID:26380006

  17. Synthesis and crystal structure of Na4Ni7(AsO4)6

    PubMed Central

    David, Rénald

    2016-01-01

    The title compound, tetra­sodium hepta­nickel hexa­arsenate, was obtained by ceramic synthesis and crystallizes in the monoclinic space group C2/m. The asymmetric unit contains seven Ni atoms of which two have site symmetry 2/m and three site symmetry 2, four As atoms of which two have site symmetry m and two site symmetry 2, three Na atoms of which two have site symmetry 2, and fifteen O atoms of which four have site symmetry m. The structure of Na4Ni7(AsO4)6 is made of layers of Ni octa­hedra and As tetra­hedra assembled in sheets parallel to the bc plane. These layers are inter­connected by corner-sharing between NiO6 octa­hedra and AsO4 tetra­hedra. This linkage creates tunnels running along the c axis in which the Na atoms are located. This arrangement is similar to the one observed in Na4Ni7(PO4)6, but the layers of the two compounds are slightly different because of the disorder of one of the Ni sites in the structure of the title compound. PMID:27308006

  18. Spectral properties of new N, N'-bis-alkyl-1,4,6,8-naphthalenediimide complexes

    NASA Astrophysics Data System (ADS)

    Refat, M. S.; Grabchev, I.; Chovelon, J.-M.; Ivanova, G.

    2006-05-01

    The photophysical properties of two N, N'-bis-alkyl-1,4,6,8-naphthalenediimide (DCN1 and DCN2) have been studied in chloroform and N, N-dimethylformamide solvents. The ability of DCN2 in N, N-dimethylformamide to detect metal cations have been monitored by the fluorescence emission spectroscopy. It has been shown that the fluorescent intensity is very sensitive to the concentration of Fe 3+ cations. The reaction of iodine with N, N'-bis-alkyl-1,4,6,8-naphthalenediimide in chloroform solution have been investigated by spectrophotometric method. The results indicate the formation of two CT-complexes [(DCN1)I] +·I 3- and [(DCN2)I] +·I 3- at donor:acceptor molar ratio of 1:2. The [(DCN1)I] +·I 3- shows the characteristic absorptions of I 3- ion at 290 and 360 nm while the charge-transfer transition of [(DCN2)I] +·I 3- occurs at 310 nm. Three characteristic bands at the far infrared region in each iodine complex are observed around 135, 105 and 85 cm -1 due to νas (I-I), νs (I-I) and δ (I 3-), respectively with C2v symmetry. The values of the complex formation constant, K, and the absorptivity, ɛ have been calculated.

  19. Emission switching of 4,6-diphenylpyrimidones: solvent and solid state effects.

    PubMed

    Adjaye-Mensah, Edward; Gonzalez, Walter G; Bussé, David R; Captain, Burjor; Miksovska, Jaroslava; Wilson, James N

    2012-08-30

    The photophysics of 1-ethyl-4,6-bis(4-methoxyphenyl)-2(1H)-pyrimidone (1) and 1-ethyl-4,6-bis(4-(dimethylamino)phenyl)-2(1H)-pyrimidone (2) were investigated to determine the mechanisms of emission switching in response to protonation. UV-vis and steady state emission spectroscopy of the protonated and unprotonated forms across a range of solvents reveal the polarity dependence of the vertical excitation energies. Emission lifetimes and quantum yields show the solvent dependency of the excited states. Emission enhancements were observed in polyethylene glycol solutions and in the solid state (both thin film and single crystal), demonstrating the role of intramolecular rotation in thermal relaxation of the excited states. TD-DFT calculations provide insights into the excited state geometries and the role of intramolecular charge transfer. The collected data show that emission of diphenylpyrimidones can be modulated by four factors, including the identity of the electron-donating auxochrome, protonation state, solvent polarity, and viscosity. PMID:22856457

  20. Influences of metabolic traits on subclinical endometritis at different intervals postpartum in high milking cows.

    PubMed

    Senosy, W S; Izaike, Y; Osawa, T

    2012-08-01

    Seventy pluriparous high-yielding cows were used to investigate the impact of metabolic traits and body condition score (BCS) during early lactation on subclinical endometritis diagnosed at weeks 5, 6 and 7 postpartum (pp). Blood samples were collected from animals with no peripartum problems from the second (W2) to seventh (W7) weeks pp to estimate some blood metabolites including non-esterified fatty acids (NEFA), β-hydroxybutyric acid (BHBA), blood glucose, total cholesterol (T-chol) and blood urea nitrogen (BUN). Reproductive tract examination was carried out at weeks 5, 6 and 7 pp by endometrial cytology (percentage of polymorphonuclear cells; PMN%). Based on PMN%, animals having <5% were defined as subclinical endometritis group (ENDM group) while animals unaffected by endometritis were defined as no subclinical endometritis group (NOENDM group). Animals with endometritis during week 5 were identified as ENDM5, during week 6 identified as ENDM6 and during week 7 identified as ENDM7 or animals with no endometritis during weeks 5 (NOENDM5), 6 (NOENDM6) and 7 (NOENDM7) pp. Animals diagnosed at week 5; BUN and BCS were lower p < 0.05 in ENDM 5 than NOENDM5 group at W2, W4, W6 and W7. Cows diagnosed at week 6; T-chol was significantly higher (p = 0.05) in ENDM6 group (279.2 ± 12.5 mg/dl) than NOENDM6 group (246 ± 9.5 mg/dl) at W7. Moreover, blood glucose was significantly low (p < 0.05) in ENDM6 group when compared to NOENDM group at W4 pp (49.2 ± 1.8 vs 53.8 ± 1.3 mg/dl). BCS was significantly lower (p < 0.001) in animals suffered from endometritis during week 7 when compared to NOENDM7 cows at W3, W4, W5, W6 and W7. In conclusion, lower blood glucose, BUN and BCS could be a risk factor for cytologically diagnosed endometritis at weeks 5, 6 and 7 pp.

  1. Preparation of 1,3,5-triamino-2,4,6-trinitrobenzene from 3,5-dichloroanisole

    SciTech Connect

    Ott, Donald G.; Benziger, Theodore M.

    1991-01-01

    Preparation of 1,3,5-triamino-2,4,6-trinitrobenzene (TATB) from 3,5-dichloroanisole. Nitration of 3,5-dichloroanisole under relatively mild conditions gave 3,5-dichloro-2,4,6-trinitroanisole in high yield and purity. Ammonolysis of this latter compound gave the desired TATB. Another route to TATB was through the treatment of the 3,5-dichloro-2,4,6-trinitroanisole with thionyl chloride and dimethylformamide to yield 1,3,5-trichloro-2,4,6-trinitrobenzene. Ammonolysis of this product produced TATB.

  2. Preparation of 1,3,5-triamino-2,4,6-trinitrobenzene from 3,5-dichloranisole

    SciTech Connect

    Oh, D.G.; Benziger, T.M.

    1990-08-28

    This patent describes the preparation of 1,3,5-triamino-2,4,6- trinitrobenzene (TATB) from 2,5-dichloroanisole. Nitration of 3,5- dichloroanisole under relatively mild conditions gave 3,5-dichloro-2,4,6- trinitroanisole in high yield and purity. Ammonolysis of this latter compound gave the desired TATB. Another route to TATB was through the treatment of the 3,5-dichloro-2,4,6-trinitroanisole with thionyl chloride and dimethylformamide to yield 1,3,5-trichloro-2,4,6- trinitrobenzene. Ammonolysis of this product produced TATB.

  3. Preparation of 1,3,5-triamino-2,4,6-trinitrobenzene from 3,5-dichloroanisole

    SciTech Connect

    Ott, D.G.; Benziger, T.M.

    1991-03-05

    Preparation of 1,3,5-triamino-2,4,6-trinitrobenzene (TATB) from 3,5-dichloroanisole is described. Nitration of 3,5-dichloroanisole under relatively mild conditions gave 3,5-dichloro-2,4,6-trinitroanisole in high yield and purity. Ammonolysis of this latter compound gave the desired TATB. Another route to TATB was through the treatment of the 3,5-dichloro-2,4,6-trinitroanisole with thionyl chloride and dimethylformamide to yield 1,3,5-trichloro-2,4,6-trinitrobenzene. Ammonolysis of this product produced TATB. 8 figures.

  4. Preparation of 1,3,5-triamino-2,4,6-trinitrobenzene from 3,5-dichloranisole

    SciTech Connect

    Ott, Donald G.; Benziger, Theodore M.

    1990-01-01

    Preparation of 1,3,5-triamino-2,4,6-trinitrobenzene (TATB) from 3,5-dichloroanisole. Nitration of 3,5-dichloroanisole under relatively mild conditions gave 3,5-dichloro-2,4,6-trinitroanisole in high yield and purity. Ammonolysis of this latter compound gave the desired TATB. Another route to TATB was through the treatment of the 3,5-dichloro-2,4,6-trinitroanisole with thionyl chloride and dimethylformamide to yield 1,3,5-trichloro-2,4,6-trinitrobenzene. Ammonolysis of this product produced TATB.

  5. Acyclic Nucleoside Bisphosphonates: Synthesis and Properties of Chiral 2-Amino-4,6-bis[(phosphonomethoxy)alkoxy]pyrimidines

    PubMed Central

    Doláková, Petra; Dračínský, Martin; Masojídková, Milena; Šolínová, Veronika; Kašička, Václav; Holý, Antonín

    2009-01-01

    2-Amino-4,6-bis[(phosphonomethoxy)alkoxy]pyrimidines bearing two equal or different achiral or chiral phosphonoalkoxy chains have been prepared either by aromatic nucleophilic substitution of 2-amino-4,6-dichloropyrimidine or by alkylation of 4,6-dihydroxy-2-(methylsulfanyl)pyrimidine with appropriate phosphonate–bearing building block. Alkylation of 4,6-dihydroxy-2-(methylsulfanyl)pyrimidine proved to be the method of choice for efficient preparation of variety of bisphosphonates. The enantiomerical purity of selected compounds was determined by capillary electrophoresis. Antiviral activity of bisphosphonates is discussed. PMID:18992968

  6. Preventing excessive weight gain during pregnancy and promoting postpartum weight loss: A pilot lifestyle intervention for overweight and obese African American women

    PubMed Central

    Liu, Jihong; Wilcox, Sara; Whitaker, Kara; Blake, Christine; Addy, Cheryl

    2014-01-01

    Objectives To test the feasibility and acceptability of a theory-based lifestyle intervention designed to prevent excessive weight gain during pregnancy and promote weight loss in the early postpartum period in overweight and obese African American women. Methods Sixteen pregnant women (≤18 weeks gestation) were recruited from prenatal clinics in Columbia, South Carolina in 2011 and assigned to a lifestyle intervention program. The intervention, guided by formative research, consisted of an individual counseling session followed by 8 group sessions alternated with telephone counseling contacts that continued through 36 weeks of gestation. At 6–8 weeks postpartum, participants received a home visit and up to three counseling calls through week 12. Medical charts were reviewed for 38 contemporary controls who met the same inclusion criteria and attended the same prenatal clinics. Results Compared to controls, study participants gained less total weight, had a smaller weekly rate of weight gain across the 2nd and 3rd trimesters (0.89 vs. 0.96 lbs), and were less likely to exceed weight gain recommendations (56.3 vs. 65.8%). At 12 weeks postpartum, study participants retained 2.6 lbs from their prepregnancy weight, half of study participants were at their prepregnancy weight or lower, and only 35% retained ≥5 lbs. The intervention also demonstrated success in promoting physical activity and reducing caloric intake, and was well-received by participants. Conclusions The initial results were promising. The lessons learned can help inform future studies. The efficacy of our intervention will be tested in a large randomized controlled trial. PMID:25051907

  7. Relationship between body condition score at calving and reproductive performance in young postpartum cows grazing native range.

    PubMed

    Mulliniks, J T; Cox, S H; Kemp, M E; Endecott, R L; Waterman, R C; Vanleeuwen, D M; Petersen, M K

    2012-08-01

    Body condition score is used as a management tool to predict competency of reproduction in beef cows. Therefore, a retrospective study was performed to evaluate association of BCS at calving with subsequent pregnancy rate, days to first postpartum ovulation, nutrient status (assessed by blood metabolites), and calf BW change in 2- and 3-yr-old cows (n = 351) managed and selected to fit their environment of grazing native range over 6 yr at the Corona Range and Livestock Research Center, Corona, NM. Cows were managed similarly before calving, without manipulation of management, to achieve predetermined BCS at parturition. Palpable BCS (scale of 1 to 9) were determined by 2 experienced technicians before calving. Cows were classified to 1 of 3 BCS groups prior calving: BCS 4 (mean BCS = 4.3 ± 0.02), 5 (mean BCS = 5.0 ± 0.03), or 6 (mean BCS = 5.8 ± 0.06). Cows were weighed weekly after calving and serum was collected once weekly (1 yr) or twice weekly (5 yr) for progesterone analysis to estimate first postpartum ovulation beginning 35 d postpartum. Year effects also were evaluated, with years identified as either above or below average precipitation. Days to first postpartum ovulation did not differ among calving BCS groups (P = 0.93). Pregnancy rates were not influenced by calving BCS (P = 0.83; 92%, 91%, 90% for BCS 4, 5, and 6, respectively). Days to BW nadir was not influenced by BCS at calving (P = 0.95). Cow BW was different at all measuring points (P < 0.01) with BCS 6 cows having the heaviest BW and cows with BCS 4 the lightest. Cows with calving BCS 4 and 5 lost more (P = 0.06) BW from the initiation of the study to the end of breeding than cows with BCS 6. However, cow BW change at all other measurement periods was not different (P ≥ 0.49) among calving BCS groups. Serum glucose and NEFA concentrations were not influenced by calving BCS (P ≥ 0.51). Calf BW at birth (P = 0.60), branding (55-d BW; P = 0.76), and weaning (205-d BW; P = 0.60) were not

  8. Impact of inherited bleeding disorders on pregnancy and postpartum hemorrhage.

    PubMed

    Shahbazi, Shirin; Moghaddam-Banaem, Lida; Ekhtesari, Fatemeh; Ala, Fereydoun A

    2012-10-01

    Inherited bleeding disorders are caused by various genetic defects in the proteins involved in haemostasis. Female patients or carriers are faced with the risk of haemorrhage throughout life. During pregnancy and postpartum, this complication affects the health of either the mother or the baby, or both. This retrospective cohort study was designed to assess the occurrence of obstetric bleeding in the three trimesters of pregnancy, along with primary and secondary postpartum haemorrhage among 100 women with inherited bleeding disorders. A questionnaire was designed in order to collect historical data. The patients were evaluated in three groups: haemophilia carriers, von Willebrand disease (VWD) and rare bleeding disorders. In comparison with normal women, significantly severe bleeding was observed among patients in all of the five stages. VWD patients showed a higher frequency of bleeding in first trimester but the rate of miscarriage was lower. Haemophilia carriers were threatened with bleeding complications during the prenatal period, but they also had the highest frequency of postpartum haemorrhage. Based on our results, vaginal bleeding is a serious threat in all three patient groups, especially during the first trimester of pregnancy and in the postpartum period.

  9. Does spontaneous genital tract trauma impact postpartum sexual function?

    PubMed Central

    Rogers, Rebecca G.; Borders, Noelle; Leeman, Lawrence M.; Albers, Leah L.

    2009-01-01

    Changes in sexual function are common in postpartum women. In this comparative, descriptive study, a prospective cohort of midwifery patients consented to documentation of genital trauma at birth and assessment of sexual function three months postpartum. The impact of spontaneous genital trauma on postpartum sexual function was the focus of the study. Trauma was categorized into minor trauma (no trauma or 1st degree perineal or other trauma that was not sutured) or major trauma (2nd, 3rd, or 4th degree lacerations or any trauma that required suturing). Women who underwent episiotomy or operative delivery were excluded. Fifty eight percent (326/565) of enrolled women gave sexual function data; of those, 276 (85%) reported sexual activity since delivery. Seventy percent (193) of women sustained minor trauma and 30% (83) sustained major trauma. Sexually active women completed the Intimate Relationship Scale (IRS), a 12 item questionnaire validated as a measure of postpartum sexual function. Both trauma groups were equally likely to be sexually active. Total IRS scores did not differ between trauma groups nor did complaints of dyspareunia. However, for two items, significant differences were demonstrated: women with major trauma reported less desire to be held, touched, and stroked by their partner than women with minor trauma, and women who required perineal suturing reported lower IRS scores than women who did not require suturing. PMID:19249654

  10. Postpartum depression, suicidality, and mother-infant interactions.

    PubMed

    Paris, Ruth; Bolton, Rendelle E; Weinberg, M Katherine

    2009-10-01

    To date, few studies have examined suicidality in women with postpartum depression. Reports of suicidal ideation in postpartum women have varied (Lindahl et al. Arch Womens Ment Health 8:77-87, 2005), and no known studies have examined the relationship between suicidality and mother-infant interactions. This study utilizes baseline data from a multi-method evaluation of a home-based psychotherapy for women with postpartum depression and their infants to examine the phenomenon of suicidality and its relationship to maternal mood, perceptions, and mother-infant interactions. Overall, women in this clinical sample (n = 32) had wide ranging levels of suicidal thinking. When divided into low and high groups, the mothers with high suicidality experienced greater mood disturbances, cognitive distortions, and severity of postpartum symptomotology. They also had lower maternal self-esteem, more negative perceptions of the mother-infant relationship, and greater parenting stress. During observer-rated mother-infant interactions, women with high suicidality were less sensitive and responsive to their infants' cues, and their infants demonstrated less positive affect and involvement with their mothers. Implications for clinical practice and future research directions are discussed.

  11. Promoting Postpartum Exercise: An Opportune Time for Change.

    ERIC Educational Resources Information Center

    Ringdahl, Erika N.

    2002-01-01

    During the postpartum period clinicians can promote the importance of physical fitness, help patients incorporate exercise into lifestyle changes, and encourage them to overcome barriers to exercise. New responsibilities, physical changes, and time constraints may make exercise seem impossible. By emphasizing weight control, stress reduction, and…

  12. Knowledge of blood loss at delivery among postpartum patients

    PubMed Central

    Miller, Claire M.; Ramachandran, Bharathi; Hegde, Priya; Akbar, Kulsum; Goodnough, Lawrence Tim; Butwick, Alexander J.

    2016-01-01

    Background Postpartum hemorrhage (PPH) is a leading cause of obstetric morbidity. There is limited understanding of patients’ knowledge about blood loss at delivery, PPH, and PPH-related morbidities, including transfusion and anemia. Methods We surveyed 100 healthy postpartum patients who underwent vaginal or cesarean delivery about blood loss, and whether they received information about transfusion and peripartum hemoglobin (Hb) testing. Responses were compared between women undergoing vaginal delivery vs. cesarean delivery; P < 0.05 considered as statistically significant. Results In our cohort, 49 women underwent vaginal delivery and 51 women underwent cesarean delivery. Only 29 (29%) of women provided blood loss estimates for their delivery. Women who underwent cesarean delivery were more likely to receive clear information about transfusion therapy than those undergoing vaginal delivery (43.1% vs. 20.4% respectively; P = 0.04). Women who underwent vaginal delivery were more likely to receive results of postpartum Hb tests compared to those undergoing cesarean delivery (49% vs. 29.4%; P = 0.02). Conclusion Our findings suggest that women are poorly informed about the magnitude of blood loss at delivery. Hematologic information given to patients varies according to mode of delivery. Further research is needed to better understand the clinical implications of patients’ knowledge gaps about PPH, transfusion and postpartum anemia.

  13. Trajectories of Postpartum Maternal Depressive Symptoms and Children's Social Skills

    ERIC Educational Resources Information Center

    Wu, Yelena P.; Selig, James P.; Roberts, Michael C.; Steele, Ric G.

    2011-01-01

    The vast majority of new mothers experience at least some depressive symptoms. Postpartum maternal depressive symptoms can greatly influence children's outcomes (e.g., emotional, cognitive, language, and social development). However, there have been relatively few longitudinal studies of how maternal depressive symptoms may influence children's…

  14. Knowledge of blood loss at delivery among postpartum patients

    PubMed Central

    Miller, Claire M.; Ramachandran, Bharathi; Hegde, Priya; Akbar, Kulsum; Goodnough, Lawrence Tim; Butwick, Alexander J.

    2016-01-01

    Background Postpartum hemorrhage (PPH) is a leading cause of obstetric morbidity. There is limited understanding of patients’ knowledge about blood loss at delivery, PPH, and PPH-related morbidities, including transfusion and anemia. Methods We surveyed 100 healthy postpartum patients who underwent vaginal or cesarean delivery about blood loss, and whether they received information about transfusion and peripartum hemoglobin (Hb) testing. Responses were compared between women undergoing vaginal delivery vs. cesarean delivery; P < 0.05 considered as statistically significant. Results In our cohort, 49 women underwent vaginal delivery and 51 women underwent cesarean delivery. Only 29 (29%) of women provided blood loss estimates for their delivery. Women who underwent cesarean delivery were more likely to receive clear information about transfusion therapy than those undergoing vaginal delivery (43.1% vs. 20.4% respectively; P = 0.04). Women who underwent vaginal delivery were more likely to receive results of postpartum Hb tests compared to those undergoing cesarean delivery (49% vs. 29.4%; P = 0.02). Conclusion Our findings suggest that women are poorly informed about the magnitude of blood loss at delivery. Hematologic information given to patients varies according to mode of delivery. Further research is needed to better understand the clinical implications of patients’ knowledge gaps about PPH, transfusion and postpartum anemia. PMID:27635332

  15. The Structure of Women's Mood in the Early Postpartum

    ERIC Educational Resources Information Center

    Buttner, Melissa M.; O'Hara, Michael W.; Watson, David

    2012-01-01

    The "postpartum blues" is a mild, predictable mood disturbance occurring within the first several days following childbirth. Previous analyses of the "blues" symptom structure yielded inconclusive findings, making reliable assessment a significant methodological limitation. The current study aimed to explicate the symptom structure of women's mood…

  16. Postpartum Early and Extended Contact: Quality, Quantity or Both?

    ERIC Educational Resources Information Center

    Hopkins, John B.; Vietze, Peter M.

    This study examined the effects of early vs. extended mother-infant contact on infant, maternal and interactional outcomes in the lying-in period for 104 lower class mother-infant dyads. The early contact treatment consisted of placing the mother and neonate together for 10 to 45 minutes within the first 3 postpartum hours. The extended contact…

  17. A Family Approach to Treatment of Postpartum Depression

    ERIC Educational Resources Information Center

    McKay, Judith; Shaver-Hast, Laura; Sharnoff, Wendy; Warren, Mary Ellen; Wright, Harry

    2009-01-01

    Postpartum depression (PPD) has an impact on the entire family. The authors describe a model of intervention that emphasizes the family system and includes mothers, fathers, and children in the treatment of PPD. The intervention is provided by a multidisciplinary team consisting of a psychiatrist, social worker, child psychologist, and therapists.…

  18. Relaxation Training and Expectation in the Treatment of Postpartum Distress.

    ERIC Educational Resources Information Center

    Halonen, Jane S.; Passman, Richard H.

    1985-01-01

    Examined the effectiveness of relaxation training in reducing postpartum distress for 48 first-time mothers-to-be via a treatment-component strategy. Compared with nonrelaxation conditions, relaxation treatments reduced reported postpartal distress. Expectations about treatment effectiveness were not significant factors in treatment outcome.…

  19. Postpartum ovarian activity in South Asian zebu cattle.

    PubMed

    Brar, P S; Nanda, A S

    2008-07-01

    Timely onset of postpartum ovarian activity is vital for optimal reproductive performance of dairy cows. Much depends upon genetic constitution of an animal although several factors interplay to govern the onset of postpartum ovarian activity. South Asian zebu cattle have much longer service period when compared with other exotic or crossbred cattle reared in the same Asian environment, which suggests differences in their genetic makeup. However, the cows with same genetic configuration expressed better reproductive potential when reared under different environment, such as in Brazil and Mexico, which suggests the role of extrinsic factors such as management, nutrition, environment and disease conditions. Better management of animals (provision of proper shade, water and housing, efficient oestrous detection and timely insemination), good quality nutrition supplemented with appropriate minerals and vitamins, prevention of diseases (vaccination, deworming, suitable therapeutic interventions) and application of biotechnology have helped in improving postpartum ovarian activity and, therefore, reproductive performance of zebu cattle in Asia. No comprehensive study appears to have been carried out on the various aspects of reproduction in zebu cattle reared under South Asian socio-agro-climatic conditions. This paper is a modest effort to collect what ever information available and to critically review the postpartum ovarian activity in zebu cattle with special reference to the effect of the various managemental practices and pharmacological interventions. PMID:18638125

  20. Predicting Change in Postpartum Depression: An Individual Growth Curve Approach.

    ERIC Educational Resources Information Center

    Buchanan, Trey

    Recently, methodologists interested in examining problems associated with measuring change have suggested that developmental researchers should focus upon assessing change at both intra-individual and inter-individual levels. This study used an application of individual growth curve analysis to the problem of maternal postpartum depression.…