Project description:One hundred and twenty-five million women in malaria-endemic areas become pregnant each year (see Dellicour et al. PLoS Med7: e1000221 [2010]) and require protection from infection to avoid disease and death for themselves and their offspring. Chloroquine prophylaxis was once a safe approach to prevention but has been abandoned because of drug-resistant parasites, and intermittent presumptive treatment with sulfadoxine-pyrimethamine, which is currently used to protect pregnant women throughout Africa, is rapidly losing its benefits for the same reason. No other drugs have yet been shown to be safe, tolerable, and effective as prevention for pregnant women, although monthly dihydroartemisinin-piperaquine has shown promise for reducing poor pregnancy outcomes. Insecticide-treated nets provide some benefits, such as reducing placental malaria and low birth weight. However, this leaves a heavy burden of maternal, fetal, and infant morbidity and mortality that could be avoided. Women naturally acquire resistance to Plasmodium falciparum over successive pregnancies as they acquire antibodies against parasitized red cells that bind chondroitin sulfate A in the placenta, suggesting that a vaccine is feasible. Pregnant women are an important reservoir of parasites in the community, and women of reproductive age must be included in any elimination effort, but several features of malaria during pregnancy will require special consideration during the implementation of elimination programs.

| S-EPMC5453384 | biostudies-literature

Infection control management strategy for operating room during COVID-19 pandemic.

Project description:Coronavirus disease 2019 (COVID-19) outbreaks have occurred in many countries around the world. The numbers of confirmed cases and deaths continue to increase. It is increasingly likely that COVID-19 patients will require emergency surgeries in the operating room (OR). As COVID-19 can easily be transmitted to healthcare workers and other patients during surgery, it is important to establish a set of infection prevent and control management strategy to prevent COVID-19 from spreading in the OR. Based on our experience in COVID-19 prevention and control in the OR, we introduce this COVID-19 prevention and control management strategy for preventing COVID-19 from spreading in the OR. This management strategy includes a number of COVID-19 prevention and control procedures including (I) conduct COVID-19 knowledge training at the early stage of outbreak, (II) formulate the surgery arrangement procedures and suspend the elective surgery if the patient confirmed to COVID-19, (III) divide an isolated OR area for COVID-19 surgery, (IV) preoperative preparation procedures, (V) procedures for wearing and removing personal protective equipment, (VI) anesthesia management, intraoperative management, (VII) post-operative disposable waste management and disinfection. This management strategy has worked very effectively since the outbreak of COVID-19 in Wuhan at the end of 2019. We have performed emergency surgeries on several COVID-19 confirmed patient and dozens of COVID-19 suspected patients under this COVID-19 prevention and control management strategy, and have achieved an excellent result of zero COVID-19 infection in the OR.

| S-EPMC9761131 | biostudies-literature

Aerosolisation during tracheal intubation and extubation in an operating theatre setting.

Project description:Aerosol-generating procedures such as tracheal intubation and extubation pose a potential risk to healthcare workers because of the possibility of airborne transmission of infection. Detailed characterisation of aerosol quantities, particle size and generating activities has been undertaken in a number of simulations but not in actual clinical practice. The aim of this study was to determine whether the processes of facemask ventilation, tracheal intubation and extubation generate aerosols in clinical practice, and to characterise any aerosols produced. In this observational study, patients scheduled to undergo elective endonasal pituitary surgery without symptoms of COVID-19 were recruited. Airway management including tracheal intubation and extubation was performed in a standard positive pressure operating room with aerosols detected using laser-based particle image velocimetry to detect larger particles, and spectrometry with continuous air sampling to detect smaller particles. A total of 482,960 data points were assessed for complete procedures in three patients. Facemask ventilation, tracheal tube insertion and cuff inflation generated small particles 30-300 times above background noise that remained suspended in airflows and spread from the patient's facial region throughout the confines of the operating theatre. Safe clinical practice of these procedures should reflect these particle profiles. This adds to data that inform decisions regarding the appropriate precautions to take in a real-world setting.

| S-EPMC7675280 | biostudies-literature

Project description:BackgroundThe COVID-19 pandemic poses a critical global public health crisis. Operating room (OR) best practice in this crisis is poorly defined. This systematic review was performed to identify contemporary evidence relating to OR practice in the context of COVID-19.MethodsMEDLINE was searched systematically using PubMed (search date 19 March 2020) for relevant studies in accordance with PRISMA guidelines. Documented practices and guidance were assessed to determine Oxford Centre for Evidence-Based Medicine (OCEBM) levels of evidence, and recommendations for practice within five domains were extracted: physical OR, personnel, patient, procedure, and other factors.ResultsThirty-five articles were identified, of which 11 met eligibility criteria. Nine articles constituted expert opinion and two were retrospective studies. All articles originated from the Far East (China, 9; Singapore, 2); eight of the articles concerned general surgery. Common themes were identified within each domain, but all recommendations were based on low levels of evidence (median OCEBM level 5 (range 4-5)). The highest number of overlapping recommendations related to physical OR (8 articles) and procedural factors (13). Although few recommendations related to personnel factors, consensus was high in this domain, with all studies mandating the use of personal protective equipment.ConclusionThere was little evidence to inform this systematic review, but there was consensus regarding many aspects of OR practice. Within the context of a rapidly evolving pandemic, timely amalgamation of global practice and experiences is needed to inform best practice.

| S-EPMC7272923 | biostudies-literature

Smoking cessation therapy during pregnancy.

Project description:Despite being highly motivated to quit, many of my patients struggle with smoking cessation during pregnancy. Can you comment on the current treatment options and discuss their safety and efficacy during pregnancy?Given the considerable and well-documented adverse effects of antenatal smoking on mother and fetus, pharmacotherapy for smoking cessation should be considered. Available medications include nicotine replacement therapy, sustained-release bupropion, and varenicline. Nicotine replacement therapy and bupropion do not appear to increase the risk of major malformations; however, there is currently limited evidence on the use of varenicline during pregnancy. Given that these agents are only marginally successful in smoking cessation, their use should always be accompanied by behavioural counseling and education to maximize quit rates.

| S-EPMC3352787 | biostudies-other

Biomechanics of gait during pregnancy.

Project description:INTRODUCTION: During pregnancy women experience several changes in the body's physiology, morphology, and hormonal system. These changes may affect the balance and body stability and can cause discomfort and pain. The adaptations of the musculoskeletal system due to morphological changes during pregnancy are not fully understood. Few studies clarify the biomechanical changes of gait that occur during pregnancy and in postpartum period. PURPOSES: The purpose of this review was to analyze the available evidence on the biomechanical adaptations of gait that occur throughout pregnancy and in postpartum period, specifically with regard to the temporal, spatial, kinematic, and kinetic parameters of gait. METHODS: Three databases were searched and 9 studies with a follow-up design were retrieved for analysis. RESULTS: Most studies performed temporal, spatial, and kinematic analysis. Only three studies performed kinetic analysis. CONCLUSION. The adaptation strategies to the anatomical and physiological changes throughout pregnancy are still unclear, particularly in a longitudinal perspective and regarding kinetic parameters.

| S-EPMC4283355 | biostudies-other

Mouse pancreatic islets during pregnancy

Project description:During pregnancy, pancreatic islets undergo structural and functional changes that lead to enhance insulin release in response to increased insulin demand, which is rapidly reversed at parturition. One of the most important changes is expansion of pancreatic Î²-cell mass mainly by increased proliferation of Î² cells. We used microarrays to detail the global programme of gene expression and identified distinct up- or down-regulated genes during pregnancy. Maternal islet were isolated from mice at dpc 0 and 12.5 dpc of pregnancy for RNA extraction and hybridization on Affymetrix microarrays. We sought to identify the responsible factors for the proliferation of islets during pregnancy.

2010-06-16 | E-GEOD-22125 | biostudies-arrayexpress

DNA methylation dynamics during pregnancy

Project description:DNA methylation dynamics during pregnancy

| PRJNA930683 | ENA