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There is a lack of knowledge on the intersection between prematurity, small for gestational age, and hypertensive disorders of pregnancy (HDP). Therefore, the aim of this systematic review was to examine the outcomes of preterm infants who were small for gestational age born to women with HDP. Searches were conducted with no date restriction through the final search date of May 13, 2020, in the following databases: PubMed, Web of Science Core Collection, Cumulative Index of Nursing and Allied Health Literature Plus with Full Text (EBSCOhost), and Embase (Elsevier). A total of 6 studies were eligible for this review. The adjusted odds of mortality and necrotizing enterocolitis were significantly lower in the pregnancy-induced hypertension (PIH)/HDP group than in the non-PIH/HDP group. There was no significant difference in the odds of respiratory distress syndrome, bronchopulmonary dysplasia, and intraventricular hemorrhage between PIH/HDP and non-PIH/HDP groups. There was no significant difference between PIH/HDP and non-PIH/HDP groups in cystic periventricular leukomalacia, retinopathy of prematurity, late-onset sepsis, patent ductus arteriosus, length of hospital stays, duration of supplemental oxygen use, duration of mechanical ventilation, and continuous airway pressure. The studies included in this systematic review demonstrated that PIH/HDP is associated with lower infant mortality and necrotizing enterocolitis.

The aim of the study was to determine prevalence and characterize sucrase-isomaltase (SI) gene variants of congenital sucrase-isomaltase deficiency in non-Hispanic white pediatric and young adult patients with functional gastrointestinal disorders (FGIDs), and abnormal sucrase activity on histologically normal duodenal biopsy. Clinical symptoms and disaccharidase activities data were collected for an abnormal (low) sucrase (=25.8 U, n?=?125) activity group, and 2 normal sucrase activity groups with moderate (=25.8–=55 U, n?=?250) and high (>55 U, n?=?250) sucrase activities. SIgene variants were detected by next-generation sequencing of DNA from formalin-fixed paraffin-embedded tissues of these patients. FGIDs symptoms based on Rome IV criteria and subsequent clinical management of abnormal sucrase activity cases with pathogenic SIgene variants were analyzed. Thirteen SIgene variants were found to be significantly higher in abnormal sucrase cases with FGIDs symptoms (36/125, 29%; 71% did not have a pathogenic variant) compared to moderate normal (16/250, 6.4%, P?

The Childhood Health and Asthma Management Program (CHAMP) is a behavioral family lifestyle intervention for youth with overweight or obesity (OV/OB) and asthma. This pilot, randomized controlled trial examined the feasibility, acceptability, and preliminary efficacy of CHAMP. A sample of 24 children (Mage= 8.67) with asthma and a BMI at the 85th percentile or higher and their caregivers participated in the trial. Families were recruited from local pediatrician offices and pediatric pulmonary and allergy clinics and randomized to CHAMP or a health education attention control condition. Children’s height, weight, lung function, asthma control, and asthma-related quality of life (QOL) were collected at baseline, postintervention, and 6-months posttreatment. Analysis of covariance and standardized mean differences were used to assess changes in outcome variables among participants attending >50% of sessions (n= 12). Families participating in CHAMP reported high satisfaction; however, there were a number of barriers to recruitment and regular session attendance. There were no statistically significant between-group differences at postintervention or long-term follow-up. From baseline to postintervention, there were small to large effect sizes favoring CHAMP for BMI zscores, asthma control, and measures of lung function. There were small to medium effect sizes favoring CHAMP at long-term follow-up for BMI zscores, asthma control, and asthma-related QOL. CHAMP had adequate acceptability in this trial. We did not find significant results favoring CHAMP compared with the control group, however, lessons learned provide important directions for modifications in anticipation of a larger trial.Implications for Impact Statement Children with overweight or obesity (OV/OB) and asthma are at higher risk for experiencing negative health outcomes than their nonobese peers. We developed the Childhood Health and Asthma Management Program (CHAMP), a 16-week family-based intervention for school-aged youth with overweight or obesity and asthma. Families reported high satisfaction with CHAMP and some modestly positive outcomes were found with regard to weight change and asthma outcomes; however, families reported several barriers to intervention attendance, suggesting the need for more feasible interventions to improve outcomes within this population.

Background/aimsThe objective of this study is to evaluate the accuracy and speed of trainees and experienced glaucoma specialists using the MatchedFlicker software against the manual examination of stereoscopic disc photographs for detecting glaucomatous optic disc change.MethodsThree experienced glaucoma specialists, two resident ophthalmologists and one glaucoma fellow from multiple institutions independently evaluated the same 140 image pairs from 100 glaucomatous/ocular hypertensive eyes using a handheld stereo viewer and the MatchedFlicker programme. Fifty had progression to glaucoma as determined by the Ocular Hypertension Treatment Study (OHTS) Optic Disc Reading Group and endpoint committee, and 50 more were negative controls for progression with photos taken a few minutes apart. Twenty photo pairs from each of the two groups were duplicated for reviewer variability analysis. The initial viewing method was randomised and then alternated for each group of 70 image pairs. Reviewer accuracy and evaluation time for each method were measured.ResultsEvaluators averaged 8.6 s faster per image pair (26%) with the MatchedFlicker programme than with the stereo viewer (p=0.0007). Evaluators correctly identified more image pairs when using the MatchedFlicker software over the stereo viewer (p=0.0003). There was no significant difference between the expert and trainee group in speed or overall accuracy for either method. Experts were significantly more consistent than trainees with the duplicate image pairs (p=0.029). Trainees appeared more reluctant to designate eyes as showing glaucoma progression than experts.ConclusionsBoth expert glaucoma specialists and ophthalmologists in various stages of training had greater accuracy and speed with the MatchedFlicker programme than with a handheld stereoscopic viewer.

Background: Physician care influences patient satisfaction. Inherent physician attributes may also affect scores.Objective: To determine the relationship between physician characteristics and patient satisfaction regarding physician care and communication.Method: Observational retrospective study. We examined patient satisfaction surveys from inpatient adults across 9 questions (HCAHPS: Courtesy, Listen, and Explain; Press Ganey: Time, Concern, Informed, Friendliness, Skill, Rating) in relation to physician gender, age, ethnicity, race, and specialty.Results: We analyzed 51 896 surveys on 914 physicians. In univariate analysis, males were rated significantly more often in the highest category (top box) compared to females on Informed and Skill, and whites were rated in the top box more often than nonwhites on all questions. In multivariate analysis, there were no significant associations between ratings and physician gender, ethnicity, and race. On all questions, the odds of being rated in the top box were highest for obstetricians, second highest for surgeons, and lowest for medicine providers. On the question of Skill, the odds of being rated in the top box were higher with increasing age.Conclusion: Patient satisfaction regarding physicians is associated with physician specialty and age.

Objectives:Nitric oxide (NO) is a reactive gas generated by inflammatory cells and mucosal epithelial cells of the nose and paranasal sinuses and is an important mediator in nonspecific host defense against infectious agents. However, NO also mediates physiologic events such as vasodilation, mucus hypersecretion, and mucosal disruption that are associated with inflammatory conditions, and it is a regulator of ciliary beat frequency. In the present study, we hypothesized that lifestyle exposure to tobacco smoke, whether through active smoking or by inadvertent exposure to secondhand tobacco smoke, would result in higher detectable levels of nasal NO (nNO) than are found in well-documented nonsmokers.Methods:Nasal NO measurements were obtained concomitant with assays of urine cotinine from well-documented nonsmokers, active smokers, and individuals exposed by lifestyle to secondhand smoke. These parameters were statistically analyzed to determine whether increasing levels of tobacco smoke exposure yield higher concentrations of nNO.Results:Our results and subsequent statistical analyses imply that active smokers who exhibit high urine cotinine levels exhibit significant increases in nNO levels in comparison to both nonsmokers and nonsmokers exposed to secondhand smoke.Conclusions:There is an increased level of nNO associated with tobacco smoke exposure that may contribute to the inflammatory processes characteristic of disease pathogenesis in smokers.