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Feasibility of establishing a Canadian Obstetric Survey System (CanOSS) for severe maternal morbidity: results of a nationwide survey.

OBJECTIVE: Obtaining data on events, processes, and circumstances leading to severe maternal morbidity (SMM) could enable targeted interventions to improve care. We aimed to assess the feasibility of gathering such data from across Canada through an Obstetric Survey System (CanOSS). STUDY DESIGN: A nationwide survey. METHODS: We administered the electronic survey in French or English to birthing unit leads across all Canadian provinces and territories using REDCap. We presented pooled participation rates (95 % confidence intervals [CI]) across birthing units from lowest, medium, and highest …

Expanding the Estimated Fetal Weight Definition of Growth Restriction by Adding Small Abdominal Circumference: Prediction of Neonatal Morbidity.

OBJECTIVE: The Society for Maternal-Fetal Medicine's (SMFM) diagnostic criteria for fetal growth restriction (FGR) recently added abdominal circumference (AC) <10th percentile to estimated fetal weight (EFW) <10th percentile; however, its prediction of neonatal morbidity is unknown. Our objective was to compare the two definitions for their prediction of composite neonatal morbidity. METHODS: Secondary analysis of the Fetal Growth Study-Singletons, 2009-2013. The last ultrasound (mean 36.9 ± 2.3 weeks) was included from non-anomalous fetuses. Composite neonatal morbidity was the primary outco…

The delivery modes and morbidity/mortality in very preterm infants with birth weight <1,500 g: a retrospective cohort study.

INTRODUCTION: Compare outcomes of very preterm infants (VPIs) with a birth weight<1,500 g based on delivery mode and propensity score matching (PSM). METHODS: This was a retrospective study (2016-2021) of 1,375 VPIs (692 vaginal and 683 cesarean deliveries). PSM created 390 matched pairs. Outcomes included respiratory and neurological morbidity and mortality. RESULTS: PSM revealed no significant difference between the two groups at baseline or after antenatal corticosteroids administration. The incidence rates of birth asphyxia, delivery room resuscitation, neonatal respiratory distress synd…

Identification of shared diagnostic biomarkers and potential co-morbidity mechanisms between primary Sjogren's syndrome and chronic kidney disease.

BACKGROUND: The mechanisms linking primary Sjogren's syndrome (pSS) to chronic kidney disease (CKD) are obscure. Our study sought to uncover … NCLUSION: This study uncovered crucial genes shared between pSS and CKD, shedding light on their co-morbidity mechanisms and possible diagnostic biomarkers. Key Points • This study unveils for the first time the immunological association between PSS and CKD. • NUDT1 and COMMD2 are identified as key molecules in the comorbidity mechanism of PSS and CKD. • A …

Permanent neurosensory disturbances in the Danish population after removal of a mandibular third molar: incidence, distribution, and morbidity.

OBJECTIVES: To assess the incidence, distribution and morbidity of neurosensory disturbances of the inferior alveolar nerve (IAN), lingual nerve (LN), and buccal nerve (BN) after removal of mandibular third molars in the Danish population. STUDY DESIGN: Based on data from 2016-2021 from the Danish Dental Compensation system, relevant information regarding the quantity and quality of neurosensory disturbances after removal of a mandibular third molar was extracted. The incidence of neurosensory disturbance for each nerve branch was calculated. RESULTS: 357 patients had a mandibular third mola…

Hospital Use, Morbidity, and Cancer Risk by Age Group in Neurofibromatosis Type 1: A Nationwide Retrospective Cohort Study.

Neurofibromatosis type 1 (NF1) affects multiple organs progressively, leading to a shortened life expectancy. This study aimed to identify the complications that are prominent in each age group by comparing 28,082 patients with NF1 and 84,246 matched controls. Benign and malignant neoplasms along with neurological complications were the primary contributors to hospital use across most age groups. Respiratory and circulatory disorders were a common cause of hospital use in children and older adults, respectively. Except for soft tissue and central nervous system-originated malignancies, which a

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… Vasculopathy is a well-known morbidity in patients with NF1 and a Swedish study revealed that hypertension was significantly related to higher mortality ( 6 , 26 ). … In general, the significant contribution of malignancies to morbidity and mortality in patients with NF1 is well established. …

High burden of hospital morbidity and mortality due to Chagas disease in Bahia state, Northeast Brazil, 2000-2022.

Chagas disease (CD) is a chronic condition associated with high morbidity and mortality in endemic regions of Brazil, particularly in the state of Bahia. The clinical-epidemiologic analysis of hospital admissions is strategic due to limited data on chronic CD infections and the general lack of access to diagnosis and treatment. This study examines sociodemographic and clinical-epidemiological patterns of hospital morbidity and mortality from CD and its temporal trends from 2000 to 2022 in Bahia, Northeast Brazil. A mixed ecological study was conducted using data from hospital and mortality inf…

Unmasking Wiskott-Aldrich Syndrome in Adulthood in a Case of Long-Standing Bleeding, Infections, and Steroid-Induced Morbidity.

Wiskott-Aldrich syndrome (WAS) is a rare X-linked primary immunodeficiency characterized by the classic triad of microthrombocytopenia, recurrent infections, and eczema, with most cases diagnosed during infancy or early childhood. Adult presentation is uncommon and often leads to diagnostic delay or misdiagnosis. We report the case of a 28-year-old male who presented with multiple episodes of bleeding, petechiae, recurrent skin and respiratory infections, and chronic eczematous lesions. Over several years, he underwent repeated hospitalizations and was treated for immune thrombocytopenia (ITP)

Molecular signatures of neuro-HIV and methamphetamine co-morbidity revealed by Raman spectroscopy in postmortem human brain tissue.

HIV infection and comorbid methamphetamine (METH) use contribute significantly to neurocognitive impairment, yet the molecular brain alterations remain poorly defined. We employed confocal Raman micro-spectroscopy on formalin-fixed, paraffin-embedded cortical sections from Control (HIV-METH-), HIV + METH-, and HIV + METH + individuals, analyzing spectra (950-1800 cm-1) via SVD and classification modeling. Key Raman bands were biochemically assigned and correlated with gene expression data from QPCR. Distinct spectral profiles emerged across cohorts. HIV + and HIV + METH + brains showed reduced

Morbidity, Mortality, and Epidemiological Features of Clinical Invasive Listeriosis Isolates from Sentinel Surveillance in Beijing, China, 2013-2022.

Listeriosis is a relatively rare but severe foodborne disease, which has significant public health concern of persons with underlying conditions and pregnant women. This study aimed to estimate the morbidity, mortality, and fatality rates of listeriosis over a 10-year period and clarify the epidemiological features of the pathogen in Beijing, China, based on voluntary reporting of sentinel surveillance. A total of 228 listeriosis cases were reported with annual morbidity rate of 1.054 per million inhabitants, including 113 maternal-neonatal cases with mean annual morbidity rate of 63.401 per m…

Coping style and psychopathological morbidity in patients with advanced melanoma: differences between cancer therapy, metastatic location and staging.

BACKGROUND: The incidence of melanoma has been steadily increasing in recent years and remains one of the most frequent cancers in adolescents and young adults. The literature shows how a high percentage of melanoma patients present with high anxiety and depression scores and a correlation between worsening quality of life and impaired body image has been shown. The present study aimed to investigate the relationship between cutaneous and visceral metastasis in a group of 73 patients with advanced melanoma in relation to body image, anxiety, depression, and coping style. METHODS: Hospital Anx

30-day Morbidity and Mortality after Cholecystectomy for Benign Gallbladder Disease (AMBROSE): A Prospective, International Collaborative Cohort Study.

OBJECTIVE: This study aimed to assess 30-day morbidity and mortality rates following cholecystectomy for benign gallbladder disease and identify the factors associated with complications. SUMMARY BACKGROUND DATA: Although cholecystectomy is common for benign gallbladder disease, there is a gap in the knowledge of the current practice and variations on a global level. METHODS: A prospective, international, observational collaborative cohort study of consecutive patients undergoing cholecystectomy for benign gallbladder disease from participating hospitals in 57 countries between January 1 and…

Open Revascularization for Acute Mesenteric Ischemia is Associated with Increased Morbidity and Mortality when Compared to Endovascular Intervention.

OBJECTIVES: Historically, open approaches have been considered the primary treatment for acute mesenteric ischemia (AMI) due to the potentia … esection and comorbidities, open revascularization for AMI is associated with higher peri-operative morbidity and mortality compared to endovascular intervention. Thus, the need for bowel resection should not preclude endovascular treatment for AMI.

Response to letter to editor, re-predictors of morbidity and in-hospital mortality following procedure-related cardiac tamponade.

We had included only the patients with cardiac tamponade, excluded those coded for pericardial effusion. The feasibility of comparison of the databases of two regions needs to be evaluated. There are some inherent limitations for the studies carried out from the National In-patient Samples (NIS) database.

Postpartum recovery after severe maternal morbidity in Kilifi, Kenya: a grounded theory of recovery trajectories beyond 42 days.

INTRODUCTION: The burden of severe maternal morbidity is highest in sub-Saharan Africa, and its relative contribution to maternal (ill) health may increase as maternal mortality continues to fall. Women's perspective of their long-term recovery following severe morbidity beyond the standard 42-day postpartum period remains largely unexplored. METHODS: This woman-centred, grounded theory study was nested within the Pregnancy Care Integrating Translational Science Everywhere (PRECISE) study in Kilifi, Kenya. Purposive and theoretical sampling was used to recruit 20 women who experienced either …

Impact on neonatal morbidity of moderate to severe early foetal growth restriction defined by doppler criteria: multicentre study.

INTRODUCTION: In recent years, there has been a change in the conceptualization of foetal growth restriction (FGR), which has gone from bein … l of 105 patients (50 cases, 55 controls) were included. We found a higher frequency of respiratory morbidity in the FGR group, with an increased need of surfactant (30% vs. 27.3%; OR, 5.3 [95% CI, 1.1-26.7]), an increased need for supplemental oxygen (66% vs. 49.1%; OR, 5.6 [95% CI, 1.5-20.5]), and a decreased survival without bronchopulmonary dysplasia (7 …

Maternal and perinatal infectious morbidity in term prelabor rupture of membrane according to two induction of labor protocols.

PURPOSE: The optimal labor-induction protocol in women with prelabor rupture of membranes (PROM) is unknown. Whether the management of women with a previous cesarean delivery (CD) with PROM is different remains controversial. We investigated maternal and perinatal outcomes according to two induction protocols of 24 h vs. 12 h. METHODS: In July 2021, our protocol of induction of labor in term-PROM was extended from 12 h to 24 h post-PROM. We compared obstetrical and neonatal outcomes before and after the change. A subgroup analysis of women with previous CD was performed. Results were compared

Surgical Morbidity following Planned Hysterectomy versus Conservative Management for Placenta Accreta Spectrum: A Systematic Review and Meta-analysis.

In recent years, the management of placenta accreta spectrum (PAS) has fallen into two categories: planned hysterectomy and conservative management to preserve fertility. However, optimal management remains unclear. Therefore, we conducted a systematic review and meta-analysis comparing the two to evaluate which approach was associated with lower surgical morbidity.MEDLINE, Scopus, Cochrane Library, and ClinicalTrials.gov were searched from inception to July 31, 2023, for trials comparing conservative management versus planned hysterectomy. We included all prospective or retrospective cohort s…

Utility of Risk Analysis Index for Assessing Morbidity in Patients Undergoing Posterior Spinal Fusion for Adult Spinal Deformity.

BACKGROUND: This study investigates the predictive values of the Risk Analysis Index (RAI), the modified 5-item Frailty Index (mFI-5), and advanced age for predicting 30-day extended length of stay (LOS), 30-day complications, and readmissions in patients undergoing posterior spinal fusion (PSF) for adult spinal deformity (ASD). METHODS: A retrospective cohort study was performed using the 2012-2021 American College of Surgeons National Surgical Quality Improvement Program database. Adults undergoing PSF for ASD were identified using Current Procedural Terminology and International Classifica

Higher Morbidity and Mortality in Females With Fournier Gangrene Compared With Males: Insights From National Inpatient Sample Data.

PURPOSE: We compare Fournier gangrene in female and male patients and identify mortality-associated characteristics in both. MATERIALS AND METHODS: We used National Inpatient Sample data (2016-2020) to identify Fournier gangrene cases and extracted demographic, comorbidity, and procedural variables. Multivariable regression models were used to identify mortality risk factors for both cohorts. RESULTS: We identified 2875 female (31%) and 6451 male patients (69%) with Fournier gangrene corresponding to an estimated 14,375 (95% CI, 13,784-14,966) and 32,255 (95% CI, 31,390-33,120) cases, respec…