Search

Background: Adherence to the Ten Steps of the Baby-Friendly Hospital Initiative has been shown to have a protective role for the initiation and maintenance of breastfeeding., Research Aims: (1) To determine the breastfeeding rate during the first 6 months of life in children of mothers diagnosed with COVID-19 infection at the time of birth; and (2) to assess the possible influence of being born in a center with Baby-Friendly Hospital Initiative accreditation., Methods: This was a two-group comparative longitudinal observational study of infants born to mothers with COVID-19 at the time of birth, between March 13-May 31, 2020 (the first wave of the pandemic) in Spain. Fourteen Spanish hospitals participated, five (35.7%) were Baby-Friendly Hospital Initiative accredited. Type of feeding was assessed prospectively at discharge, 1, 3, and 6 months of age. A total of 248 newborns were included in the study., Results: A total of 117 (47.3%) newborns were born in Baby-Friendly Hospital Initiative (BFHI) accredited centers. These centers applied skin-to-skin contact with greater probability ( OR = 1.9; 95% CI [1.18, 3.29]) and separated the newborns from their mothers less frequently ( OR = 0.46; 95% CI [0.26, 0.81]) than non-accredited centers. No differences were observed in relation to the presence of a companion at the time of birth. At discharge, 49.1% ( n = 57) of newborns born in BFHI-accredited centers received exclusive breastfeeding versus 35.3% ( n = 46) in non-accredited centers ( p = .03). No differences were observed in breastfeeding rates throughout follow-up., Conclusions: The exclusive breastfeeding rate at discharge in children of mothers with COVID-19 infection at birth was higher in Baby-Friendly Hospital Initiative accredited centers, which most frequently applied skin-to-skin contact at birth as well as rooming-in.

In current practice, inferior vena cava (IVC) filters are commonly used in the prevention of pulmonary embolism. Despite their widespread use, periprocedural as well as late complications do occur. Filter penetration of the IVC wall into surrounding structures, including bowel, is a known although rare complication. This complication may manifest with abdominal pain, gastrointestinal bleeding, duodenocaval fistula, or small bowel obstruction. The authors present a case of abdominal pain from duodenal penetration by a Greenfield IVC filter 13 years after insertion. A detailed operative description and pertinent review of the literature is provided.

Randomized clinical trials have documented clinical equipoise when comparing endovascular abdominal aortic aneurysm repair (EVAR) with open aneurysm repair (OAR). Studies using large administrative databases in the United States have documented a trend whereby the majority of patients undergoing elective abdominal aortic aneurysm (AAA) repair in the United States are being repaired using endovascular techniques. However, few specific guidelines, outside of anatomic criteria for EVAR, exist to aid the physician in determining which approach is best for the individual patient. Variables to be considered in order to determine which approach is best for the patient who requires an AAA repair include age and comorbidities, arterial anatomy, and provider characteristics.