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Cord And Clamping

Cecily M Begley, Gillian Ml Gyte, Declan Devane, William McGuire, Andrew Weeks, Linda M Biesty
BACKGROUND: Active management of the third stage of labour involves giving a prophylactic uterotonic, early cord clamping and controlled cord traction to deliver the placenta. With expectant management, signs of placental separation are awaited and the placenta is delivered spontaneously. Active management was introduced to try to reduce haemorrhage, a major contributor to maternal mortality in low-income countries. This is an update of a review last published in 2015. OBJECTIVES: To compare the effects of active versus expectant management of the third stage of labour on severe primary postpartum haemorrhage (PPH) and other maternal and infant outcomes...
February 13, 2019: Cochrane Database of Systematic Reviews
Melina P da Silva, Davi José A Moraes, Leni G H Bonagamba, André de Souza Mecawi, Wamberto A Varanda, Benedito H Machado
KEY POINTS: Acute hypoxia induces active expiration in Rectus Abdominis (RA) muscles in conscious freely moving rats, but its overall contribution is smaller than internal oblique (IO) muscles. Tonically active and silent RA motoneurons were identified in in vitro preparations of rat spinal cords. Sustained hypoxia (SH) increased the synaptic strength and induced morphological changes in tonically active RA motoneurons. Expiratory RA motoneurons were recorded in the in situ preparation and SH enhanced the excitability as well as the synaptic transmission in those firing during the stage 2 expiration...
February 12, 2019: Journal of Physiology
Sabine Wipper, Tilo Kölbel, Harleen K Sandhu, Daniel Manzoni, Anna Duprée, Anthony L Estrera, Hazim Safi, Charles C Miller, Nikolaos Tsilimparis, E Sebastian Debus
OBJECTIVES: SPIDER-graft for thoracoabdominal aortic aneurysm repair avoiding thoracotomy and extracorporeal circulation was modified, enabling reimplantation of lumbar arteries to prevent spinal cord ischemia and compared with open aortic repair (control) in a pig model. METHODS: Graft implantation was performed in 7 pigs per group (75-85 kg). For SPIDER-graft (groups I and II), the infra-diaphragmatic aorta was exposed through retroperitoneal access. The right iliac branch was first temporarily anastomosed end-to-side to the distal aorta maintaining periprocedural retrograde visceral perfusion...
December 15, 2018: Journal of Thoracic and Cardiovascular Surgery
Siddarth Ramji, Ashish Jain
RMNCH+A is a platform for delivering adolescent, maternal, newborn and child health in an integrated manner using a life cycle approach. The new initiatives under this strategy that would impact newborn health include antenatal corticosteroids in preterm labor, delayed clamping of cord at birth, skin-to-skin contact at birth and Kangaroo mother care, Family participatory care, Lactation management centers and care beyond newborn survival under the Rashtriya Bal Swasthya Karyakram. Even though the coverage of many of the existing initiatives has been moderately high, there are concerns about the quality of delivery of these interventions and slow progress in the roll out of the newer interventions...
February 8, 2019: Indian Journal of Pediatrics
Mengye Zhu, Daying Zhang, Sicong Peng, Nana Liu, Jing Wu, Haixia Kuang, Tao Liu
Recent whole-cell patch-clamp studies from substantia gelatinosa (SG) neurons have provided a large body of information about the spinal mechanisms underlying sensory transmission, nociceptive regulation, and chronic pain or itch development. Implementations of electrophysiological recordings together with morphological studies based on the utility of acute spinal cord slices have further improved our understanding of neuronal properties and the composition of local circuitry in SG. Here, we present a detailed and practical guide for the preparation of spinal cord slices and show representative whole-cell recording and morphological results...
January 18, 2019: Journal of Visualized Experiments: JoVE
Balaji Govindaswami, Matthew Nudelman, Sudha Rani Narasimhan, Angela Huang, Sonya Misra, Gilbert Urquidez, Alganesh Kifle, Monica Stemmle, Cathy Angell, Rupalee Patel, Christina Anderson, Dongli Song, Glenn DeSandre, James Byrne, Priya Jegatheesan
Introduction: Avoiding intubation and promoting noninvasive modes of ventilator support including continuous positive airway pressure (CPAP) in preterm infants minimizes lung injury and optimizes neonatal outcomes. Discharge home on oxygen is an expensive morbidity in very preterm infants (VPI) with lung disease. In 2007 a standardized bundle was introduced for VPI admitted to the neonatal care unit (NICU) which included delayed cord clamping (DCC) at birth and noninvasive ventilation as first-line cardiorespiratory support in the delivery room (DR), followed by bubble CPAP upon NICU admission...
2019: BioMed Research International
Mattia Musto, Rossana Rauti, Artur Filipe Rodrigues, Elena Bonechi, Clara Ballerini, Kostas Kostarelos, Laura Ballerini
Graphene-based nanomaterials are increasingly engineered as components of biosensors, interfaces or drug delivery platforms in neuro-repair strategies. In these developments, the mostly used derivative of graphene is graphene oxide (GO). To tailor the safe development of GO nanosheets, we need to model in vitro tissue responses, and in particular the reactivity of microglia, a sub-population of neuroglia that acts as the first active immune response, when challenged by GO. Here, we investigated central nervous system (CNS) tissue reactivity upon long-term exposure to GO nanosheets in 3D culture models...
2019: Frontiers in Systems Neuroscience
J D Toledo, S Rodilla, A Pérez-Iranzo, A Delgado, Y Maazouzi, M Vento
OBJECTIVE: Intraventricular hemorrhage (IVH) is a common complication in extremely preterm infants. We aimed to demonstrate that umbilical cord milking (UCM) would reduce the incidence of IVH in this at risk population. STUDY DESIGN: We compared the incidence of IVH in a prospective cohort of consecutively born preterm infants <32 weeks' gestation receiving UCM (n = 33) with a historical cohort that underwent immediate cord clamping (ICC) (n = 36). RESULTS: No significant differences regarding perinatal characteristics were present between both groups except for chorioamnionitis and preterm rupture of membranes which were more frequent in the UCM group...
February 5, 2019: Journal of Perinatology: Official Journal of the California Perinatal Association
Jacques Berger, Nanna Roos, Valérie Greffeuille, Marjoleine Dijkhuizen, Frank Wieringa
Objective The SMILING (Sustainable Micronutrient Interventions to Control Deficiencies and Improve Nutritional Status and General Health in Asia) project aimed at creating awareness and improving policies around micronutrient deficiencies in five Southeast Asian countries (Vietnam, Laos, Thailand, Cambodia and Indonesia). Results The project showed large gaps in recent data on micronutrient status in most of the five countries. By updating existing, or creating national food composition tables, the SMILING project enabled analyses of food consumption in women of reproductive age and young children...
February 1, 2019: Maternal and Child Health Journal
Jiachen Tang, Rachel Fullarton, Sheri-Lee Samson, Yu Chen
BACKGROUND: Although delayed umbilical cord clamping has been shown to have significant benefits for both term and preterm infants, currently, data on its impact on blood gas analysis have been scant and conflicting. METHODS: In a retrospective review, we compared the demographic characteristics and blood gas parameters of 114 delayed cord clamping (DCC-births between 45 and 90 s in length; 109 being for 60 s) versus 407 early cord clamping births (ECC-immediately after delivery) collected over a 1-year period...
January 17, 2019: Archives of Gynecology and Obstetrics
Gaofeng Yu, Shangyi Jin, Jinghui Chen, Weifeng Yao, Xingrong Song
OBJECTIVE: Meperidine used to control shivering during perioperative period have associated side effects. This study compared the safety of selective α2-adrenoreceptor agonist dexmedetomidine and meperidine for anti-shivering in primiparas after caesarean delivery under combined spinal-epidural anesthesia. METHODS: 100 primiparas scheduled for caesarean delivery were randomly allocated to dexmedetomidine group (group D, n =50) and meperidine positive control group (group M, n =50)...
January 14, 2019: Bioscience Reports
Zhi-Yong Wang, Li-Hua Qin, Wei-Guang Zhang, Pei-Xun Zhang, Bao-Guo Jiang
Qian-Zheng-San, a traditional Chinese prescription consisting of Typhonii Rhizoma, Bombyx Batryticatus, Scorpio, has been found to play an active therapeutic role in central nervous system diseases. However, it is unclear whether Qian-Zheng-San has therapeutic value for peripheral nerve injury. Therefore, we used Sprague-Dawley rats to investigate this. A sciatic nerve crush injury model was induced by clamping the right sciatic nerve. Subsequently, rats in the treatment group were administered 2 mL Qian-Zheng-San (1...
April 2019: Neural Regeneration Research
Daisuke Uta, Tsuyoshi Hattori, Megumu Yoshimura
PURPOSE: Naftopidil ((±)-1-[4-(2-methoxyphenyl) piperazinyl]-3-(1-naphthyloxy) propan-2-ol) is prescribed in several Asian countries for lower urinary tract symptoms suggestive of benign prostatic hyperplasia. Previous animal experiments showed that intrathecal injection of naftopidil abolished rhythmic bladder contraction in vivo. Naftopidil facilitated spontaneous inhibitory postsynaptic currents in substantia gelatinosa (SG) neurons in spinal cord slices. These results suggest that naftopidil may suppress the micturition reflex at the spinal cord level...
December 2018: International Neurourology Journal
Soheila Nouraie, Sedigheh AMIRALIl Akbari, Roshanak Vameghi, Alireza Akbarzade Baghban
Objectives: Delayed umbilical cord clamping (DCC) increases blood transfer to newborns. Hence we investigated the effect of the timing of DCC on hemoglobin levels, neonatal outcomes and developmental status in infants at four months old. Materials & Methods: This clinical trial examined infants born to 400 pregnant women immediately upon birth and at the age of four months in Isfahan, central Iran in 2016. A table of random numbers was used to randomly allocate the newborns to intervention group with a 90-120-sec delay in umbilical cord clamping and the control group with a clamping delay of below 60 sec, and blood samples were taken from their umbilical cords...
2019: Iranian Journal of Child Neurology
Katharine Ker, Ian Roberts, Rizwana Chaudhri, Bukola Fawole, Danielle Beaumont, Eni Balogun, Danielle Prowse, Tracey Pepple, Kiran Javaid, Aasia Kayani, Sabaratnam Arulkumaran, Imelda Bates, Haleema Shakur-Still
BACKGROUND: Postpartum haemorrhage (PPH) is responsible for about 100,000 maternal deaths every year, most of which occur in low- and middle-income countries. Tranexamic acid (TXA) reduces bleeding by inhibiting the enzymatic breakdown of fibrin blood clots. TXA decreases blood loss in surgery and reduces death due to bleeding after trauma. When given within 3 h of birth, TXA reduces deaths due to bleeding in women with PPH. However, for many women, treatment of PPH is too late to prevent death...
December 29, 2018: Trials
Yasar Karatas, Mehmet Fatih Erdi, Bülent Kaya, Fatih Keskin, Gökhan Cüce, Ibrahim Kılınc, Mehmet Uyar, Emir Kaan Izci, Erdal Kalkan
STUDY DESIGN: Experimental rabbit spinal cord ischemia-reperfusion (I/R) inury model. OBJECTIVES: We aimed to evaluate neuroprotective effects of tocilizumab on spinal cord I/R inury. SETTING: Animal Research Laboratory, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey. METHODS: Twenty four adult New Zealand rabbits were randomly divided into three groups: Group 1, control group (n=8); Group 2, ischemia-reperfusion (I/R) group and group 3 (n=8), I/R injury+ tocilizumab (4 mg/kg,ip) treatment group...
December 26, 2018: World Neurosurgery
Stefano Ghirardello, Mariarosaria Di Tommaso, Stefano Fiocchi, Anna Locatelli, Barbara Perrone, Simone Pratesi, Paola Saracco
At delivery, if the cord is not clamped, blood continues to pass from the placenta to the newborn during the first minutes of life, allowing the transfer of 25-35 ml/kg of placental blood to the newborn, depending on gestational age, the timing of cord clamping, the position of the infant at birth, the onset of respiration, and administration of uterotonics to the mother. However, deriving benefits from delayed cord clamping (DCC) are not merely related to placental-to-fetal blood transfusion; establishing spontaneous ventilation before cutting the cord improves venous return to the right heart and pulmonary blood flow, protecting the newborn from the transient low cardiac output, and systemic arterial pressure fluctuations...
2018: Frontiers in Pediatrics
Simone Pratesi, Simona Montano, Stefano Ghirardello, Fabio Mosca, Luca Boni, Lorenzo Tofani, Carlo Dani
Background: Preterm newborns receiving briefly delayed cord clamping or cord milking at birth have better neonatal outcomes. However, the time frame in which both these procedures are performed (< 60 s of life) is too short to explore the possible beneficial effects on early infant postnatal adaptation and outcomes of a prolonged transfusion strategy associated with neonatal respiration. Methods and Design: We have designed a randomized, multicenter, controlled two-phase study: phase 1 to assess the feasibility of carrying out the protocol in a large randomized trial, and phase 2 to assess the efficacy of bedside assistance with intact placental circulation for 3 min in comparison to cord milking to improve outcome in the neonatal period; we present here the feasibility and safety phase of the study...
2018: Frontiers in Pediatrics
Elizabeth Sager, Joseph Hagan, Shweta Parmekar
No abstract text is available yet for this article.
December 11, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
M Mansour, J Degheili, I Khalifeh, H Tamim, R F Jaafar, Y El-Hout
BACKGROUND: Testicular torsion is a surgical emergency mainly affecting adolescent boys, with a relatively high rate of missed torsion and testicular loss secondary to delay in prompt diagnosis and surgical intervention. With ischemic reperfusion injury as its underlying culprit, testicular torsion may respond favorably to remote ischemic conditioning (RIC) where a non-privileged site (e.g. limb) is concurrently rendered ischemic to divert the cascade of reperfusion injury from the privileged organ (e...
September 24, 2018: Journal of Pediatric Urology
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