Summary
Background
Maternal anti‐viral treatment prevents mother‐to‐infant transmission of hepatitis B virus (HBV), but the role of neonatal viremia on subsequent HBV infection is not clear.
Aims
To ...investigate the effect of maternal anti‐viral treatment on neonatal serum HBV DNA and hepatitis B surface antigen (HBsAg) in infants born to highly viremic mothers and the roles of neonatal markers in predicting chronic HBV infection in children.
Methods
Serum HBV DNA and HBsAg were tested in children. Of the 201 pregnant mothers, 110 received tenofovir during the third trimester. Chronic infection in children was defined by HBsAg seropositivity at 6 or 12 months lasting more than 6 months.
Results
The maternal HBV viral loads from baseline to delivery were 8.25 ± 0.48 to 4.29 ± 0.98 log10 IU/mL; and 8.29 ± 0.49 to 8.12 ± 0.68 log10 IU/mL in the tenofovir and control group respectively. Of the 208 children, those in the tenofovir group had a lower rate of neonatal HBV DNA seropositivity at birth (5.22% vs 30.11%, P < 0.0001) and HBsAg seropositivity at 6 months (1.74% vs 11.83%, P = 0.003) and 12 months (1.74% vs 10.75%, P = 0.007). In a first multivariate analysis, maternal HBV DNA level at delivery (odds ratio = 1.70, P = 0.0172) and neonatal HBsAg positivity (odds ratio = 19.37, P < 0.0001) were significantly associated with children's chronic HBV infection. In a second model, neonatal HBV DNA positivity was a strong independent influence variable (odds ratio = 61.89, P = 0.0002).
Conclusions
Maternal tenofovir therapy decreased maternal viral load and neonatal viremia. Positive neonatal HBV DNA was highly correlated with chronic HBV infection in children. Clinical Trial Identifier: NCT01312012.
Breastfeeding during the first week postpartum is recognised as essential, affecting the mother's mental health. The human milk from early breastfeeding also protects against infections via the ...secretory IgA antibodies and plays an important role in the newborn's development. At a Baby-Friendly Hospital, early breastfeeding was promoted to increase the benefits for the newborn, but few focussed on the mother's health. The association between breastfeeding and postpartum depression (PPD) has not been fully addressed. This study aimed to investigate the relationship between breastfeeding and postpartum depression (PPD) and it included 333 Taiwanese pregnant women. Women who had a higher score of Edinburgh Postnatal Depression Scale (EPDS) were significant older (age ≥ 35, p < .037), had a caesarean section delivery (p < .001), and a higher score of Brief Symptom Rating Scale-5 (p < .001). Higher scores on EPDS were significantly associated with lower rates of breastfeeding, which reflected cessation of breastfeeding as an important risk factor for PPD (Odds ratio: 2.159, CI: 1.220-3.821, p = .008). Other risk factors included caesarean section delivery (Odds ratio: 2.814, CI: 1.617-4.899, p < .001) and age ≥35 years (Odds ratio: 1.821, CI: 1.057-3.137, p = .031).
IMPACT STATEMENT
What is already known on this subject: Breastfeeding during the first week postpartum is recognised as essential, affecting the mother's mental health. The human milk from early breastfeeding also protects against infections via the secretory IgA antibodies and plays an important role in the newborn's development. The detail association between breastfeeding and postpartum depression has not yet been fully addressed.
What the results of this study add: Higher scores on EPDS were significantly associated with lower rates of breastfeeding, which reflected cessation of breastfeeding as an important risk factor for PPD (Odds ratio: 2.159, CI: 1.220-3.821, p = .008). Other risk factors included caesarean section delivery (Odds ratio: 2.814, CI: 1.617-4.899, p < .001) and age ≥35 years (Odds ratio: 1.821, CI: 1.057-3.137, p = .031).
What the implications are of these findings for clinical practice and/or further research? The early breastfeeding was significantly associated with postpartum depression. Other risk factors included caesarean section delivery and age ≥35 years.
Objective: The pandemic Coronavirus Disease 2019 (COVID-19) is a global public health crisis. Many maternity units worldwide are currently establishing the management protocols for these patients. ...Case report: We report the first critically ill pregnant woman with COVID-19-induced respiratory failure undergoing emergent caesarean delivery at 32 weeks of gestation, in the setting of a positive pressure operating room (OR) with negative pressure anteroom in Taiwan. Conclusion: Multidisciplinary planning and collaboration are necessary to achieve satisfactory clinical outcomes in pregnancies with critical COVID-19 pneumonia. The combinations of comprehensive evaluation, timely treatment as well as establishment of rigorous protocol and safe environment for the emergent delivery are important.
Phellinus linteus, a species of mushroom, has been shown to contribute to health benefits, such as anti-inflammatory activity and immunomodulatory efficacy. The aim of this study was to analyze the ...most effective constituents of P. linteus fermented broths, polysaccharides, and to evaluate their immunoregulatory effects on T cells. Four fermented broths (PL1–4) and the dialyzate medium (MD) were prepared from P. linteus mycelia, and the polysaccharide contents of each were analyzed. The P. linteus samples were tested for biological activity in the regulation of T cell activation. In T cells, the production of mitogen-induced interleukin (IL)-2 and cell cycle progression were dose-responsively inhibited by PL3 and MD, primarily through cell-cycle arrest in S phase. PL3 broth, which contained large quantities of polysaccharides, significantly decreased the ratio of interferon-gamma (IFN-γ) to interleukin 4 (IL-4) in T cells. Thus, P. linteus fermented broths produced additive effects on the regulation of the Th1/Th2 balance and show promise for the development of immunomodulatory therapeutics.
Limb ischemia–reperfusion (I/R) causes remote organ injury (e.g., liver injury). Oxidation and inflammation are crucial mechanisms. We investigated the effects of cepharanthine, a potent ...antioxidative and anti-inflammatory drug, on alleviating liver injury induced by limb I/R.
Twenty-four adult male Sprague-Dawley rats were randomized to receive sham operation (Sham), Sham plus cepharanthine, I/R, or I/R plus cepharanthine and designated as the Sham, Sham+Cep, I/R, or I/R+Cep group, respectively (n = 6 in each group). I/R was induced by applying rubber band tourniquets high around each hind limb for 3 hours followed by reperfusion for 24 hours.
The plasma levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) of the Sham and Sham+Cep groups were low, and the levels of AST and ALT of the I/R group were significantly higher than those of the Sham group (both p<0.001). By contrast, the AST and ALT of the I/R+Cep group were significantly lower than those of the I/R group (both p<0.001). The hepatic levels of nitric oxide (NO), malondialdehyde (MDA), macrophage inflammatory protein 2 (MIP-2), interleukin-6 (IL-6), and cyclooxygenase-2 (COX-2)/prostaglandin E2 (PGE2) of the Sham and Sham+Cep groups were also low. As expected, the NO, MDA, MIP-2, IL-6, and COX-2/PGE2 of the I/R group were significantly higher than those of the Sham group (all p<0.001). By contrast, the NO, MDA, MIP-2, IL-6, and COX-2/PGE2 of the I/R+Cep group were significantly lower than those of the I/R group (all p<0.05).
Cepharanthine alleviates liver injury in a rodent model of limb I/R. The mechanisms may involve reducing oxidation and inflammation.
Large parasagittal meningioma in a pregnant woman Chen, Kuo-Hu; Chang, Yin-Kuang; Hsu, Hsien-Ta ...
Formosan journal of surgery : the official publication of the Surgical Association ... et al.,
December 2015, 2015-12-00, Letnik:
48, Številka:
6
Journal Article
Recenzirano
Odprti dostop
Large parasagittal meningioma is rare in pregnant women. In this paper, we report the successful treatment of a pregnant woman with a large parasagittal meningioma. A 35-year-old woman in her 37th ...week of pregnancy presented with acute consciousness disturbances after experiencing headache and nausea for 2 weeks. We performed a successful cesarean delivery under general anesthesia, and immediately after the delivery, brain computed tomography was performed. The scan revealed a large tumor (8.3 × 6.8 × 7.1 cm3) in the left frontal region, thickening of the adjacent skull base, and perifocal edema. Twenty-four hours after the delivery, the patient underwent imaging studies, namely, magnetic resonance imaging and angiography. The parasagittal meningioma was removed through craniotomy, and the surgical outcome was highly satisfactory. Although meningioma is benign, the tumor mass can expand rapidly during pregnancy. In our patient, an early cesarean section was first performed for a successful delivery, and imaging studies and transarterial embolization of the tumor blood supply were performed prior to the second operation for craniotomy and total tumor excision. A multidisciplinary team was critical for successfully treating this patient.
The efficacy and safety of maternal tenofovir disoproxil fumarate (TDF) in reducing mother‐to‐infant hepatitis B virus (HBV) transmissions is not clearly understood. We conducted a prospective, ...multicenter trial and enrolled 118 hepatitis B surface antigen (HBsAg)– and hepatitis B e antigen–positive pregnant women with HBV DNA ≥7.5 log10 IU/mL. The mothers received no medication (control group, n = 56, HBV DNA 8.22 ± 0.39 log10 IU/mL) or TDF 300 mg daily (TDF group, n = 62, HBV DNA 8.18 ± 0.47 log10 IU/mL) from 30‐32 weeks of gestation until 1 month postpartum. Primary outcome was infant HBsAg at 6 months old. At delivery, the TDF group had lower maternal HBV DNA levels (4.29 ± 0.93 versus 8.10 ± 0.56 log10 IU/mL, P < 0.0001). Of the 121/123 newborns, the TDF group had lower rates of HBV DNA positivity at birth (6.15% versus 31.48%, P = 0.0003) and HBsAg positivity at 6 months old (1.54% versus 10.71%, P = 0.0481). Multivariate analysis revealed that the TDF group had lower risk (odds ratio = 0.10, P = 0.0434) and amniocentesis was associated with higher risk (odds ratio 6.82, P = 0.0220) of infant HBsAg positivity. The TDF group had less incidence of maternal alanine aminotransferase (ALT) levels above two times the upper limit of normal for ≥3 months (3.23% versus 14.29%, P = 0.0455), a lesser extent of postpartum elevations of ALT (P = 0.007), and a lower rate of ALT over five times the upper limit of normal (1.64% versus 14.29%, P = 0.0135) at 2 months postpartum. Maternal creatinine and creatinine kinase levels, rates of congenital anomaly, premature birth, and growth parameters in infants were comparable in both groups. At 12 months, one TDF‐group child newly developed HBsAg positivity, presumably due to postnatal infection and inefficient humoral responses to vaccines. Conclusions: Treatment with TDF for highly viremic mothers decreased infant HBV DNA at birth and infant HBsAg positivity at 6 months and ameliorated maternal ALT elevations. (Hepatology 2015;62:375–386
碩士
國立臺灣大學
臨床醫學研究所
99
Introduction :
In recent years, with the rapid development of genetic diagnostic technologies, more and more diseases have been linked to genetic mutation. Because isolation of ...high quality DNA from dried blood spots on traditional filter paper blotters for subsequent DNA analysis is not easy, Taiwan''s current newborn screening is still limited to congenital metabolic and endocrine diseases. Newborn genetic screening is still not available now. So, how to create a newborn genetic screening technology, has become an important issue without delay.
Congenital central hypoventilation syndrome (CCHS) is a rare neurological disorder characterized by abnormal autonomic central nervous system control of breathing during sleep. In the past, CCHS was diagnosed on the basis of clinical criteria proposed by the American Thoracic Society in 1999. CCHS is characteristically diagnosed in the newborn period almost without family history. Some cases of sudden infant death may be related to this disease.T
Organisms are always confronted with multiple stressors simultaneously. Combinations of stressors, rather than single stressor, may be more appropriate in evaluating the stress they experience.
is ...one of predatory mite species that are commercialized for controlling spider mites. However, their biological control efficiency was often reduced because of high temperature and desiccation in summer. To understand how to improve the tolerance of
to combined heat and desiccation stress, we pre-exposed the adult female of
to high temperature, desiccation and high temperature × desiccation stress for acclimation. After proper recovery time, mites were subjected to high temperature × desiccation stress again to detect the acclimation effects. The results are as follows: (1) No decrease in mortality rate were observed under high temperature × desiccation stress after heat acclimation. Instead, it increased significantly with acclimation temperature and time. (2) Dehydration acclimation both at 25 °C and high temperatures reduced mortality rate under high temperature × desiccation stress. Mortality rate was only significantly correlated with the amount of water loss, but not with temperature or water loss rate in acclimation, suggesting the increased tolerance is related to dehydration stress rather than heat stress. Among all acclimations, chronic dehydration at 25 °C, 50% relative humidity were the most effective treatment. This study indicated dehydration acclimation is effective to enhance tolerance of
to combined heat and desiccation stress, which can improve the efficiency of biological control under multiple stressors.
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