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Direct-access online care model may effectively manage chronic atopic dermatitis

...online group and in-person group was comparable at 27.4 and 28, respectively. Using IGA scores, the direct-access online group showed 38.4% (95% CI, 27.7% to 49.3%) of patients achieved near-clearance of their disease as compared to 43.65% (95% CI, 32.6%-54.6%) in the in-person group. The POEM metric demonstrated that the direct-access online group’s scores improved by month 12 from a mean baseline of 13.04 to 7.94 (within group difference of -5....

Cervical length may predict preterm delivery

...k. Prematurity is a major cause of neonatal morbidity and mortality and early identification of potentially premature infants can help ensure that parents receive adequate anticipatory guidance and that the infants receive appropriate health care. Current methods available to providers to predict risk of impending delivery include digital examination (which may demonstrate cervical dilation), fetal fibronectin (which may indicate preterm rupture o...

Prophylactic tranexamic acid prevents significant blood loss after cesarean delivery

...avoid significant postpartum hemorrhage. Tranexamic acid is an antifibrinolytic drug that can help prevent significant blood loss in other elective surgeries and may be applicable to cesarean delivery procedures. As such, this study examined the effect of prophylactic tranexamic acid treatment in women undergoing cesarean delivery. The study determined the patients receiving tranexamic acid experienced a lower incidence of significant postpartum...

Artificial pancreas lowers the risk of overnight hypoglycemia in children

...hildren with type 1 diabetes. 2. There was significantly less variation in overnight glycemic levels using the artificial pancreas. This multi-national crossover study measured the efficacy of an artificial pancreas compared to a sensor-augmented insulin pump in children with type 1 diabetes at a camp. The authors of the study found that artificial pancreas use was associated with a lower risk of hypoglycemia. Some strengths of the study are its s...
Classics Series, Landmark Trials in Medicine

Progesterone injections reduce recurrent preterm birth [Classics Series]

...to the relatively high infant mortality rate in the United States. Currently, preterm delivery complicates 11.2% of U.S. pregnancies. History of prior spontaneous preterm birth is the strongest predictor of preterm birth such that women with this history experience a 2.5 fold increased risk for recurrent preterm birth. Despite much study, the mechanisms contributing to the impairment of normal cervical physiology in pregnancy remain poorly charac...
Classics Series, Landmark Trials in Medicine

Risks associated with a Trial of Labor after Cesarean Delivery (TOLAC) [Classics Series]

...have been more likely to present with a favorable cervix and thus more likely to achieve vaginal delivery. This may bias results toward the null. Lack of information on use of specific prostaglandin agents disallowed assessment of which were associated with uterine rupture. Additionally, the study was not powered to detect differences in maternal mortality. Click to read study in The New England Journal of Medicine Background reading: U.S. Dept of...

#VisualAbstract: A Randomized Trial of Prenatal n−3 Fatty Acid Supplementation and Preterm Delivery

...ar to control. Evidence Rating Level: 1 (Excellent) Study Rundown: Preterm delivery, delivery before 37 weeks of gestation, is associated with increased childhood morbidity and mortality. N-3 long-chain polyunsaturated fatty acids are known to play a role in modulating proinflammatory prostaglandins such as PGE2 and PGF2a that are associated with cervical ripening and uterine contractility. In this multicenter, double-blind randomized control tria...

2 Minute Medicine Rewind September 2, 2019

...both mother and infant. In addition to maternal and fetal assessment, timely delivery after 37 weeks’ gestation is recommended to minimize maternal and perinatal morbidity. In women with late preterm preeclampsia, between 34 and 37 weeks’ gestation, however, there is a lack of consensus surrounding the optimal time for delivery, with some centers opting for expectant management until 37 weeks’ gestation, or earlier delivery if indicated in the se...

Childbearing decreased after C-sections

...men experiencing pregnancy and childbirth complications during their first delivery were less likely to have a subsequent live birth. Evidence Rating Level: 2 (Good) Study Rundown: This study used delivery data from over 50,000 primiparous women to determine whether Cesarean delivery, a common procedure in the U.S., is associated with decreased subsequent childbearing. Existing literature has produced mixed results. The present work uses a large s...

Spontaneous early term delivery associated with subsequent preterm birth

...In women who experienced spontaneous onset of labor, those who spontaneously delivered early term (37-39wga) pregnancies were more likely to experience subsequent sPTB (OR 3.0, CI 1.44-6.16, p=0.003), while those who delivered spontaneously after 38.9wga were no less likely (p=0.8). By Denise Pong, MPH and Leah Hawkins, MD, MPH More from this author: Donor oocyte IVF making strides, Shortage of evidence assessing teratogenic drugs, HPV infection...

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