•Resilience and relationships were negatively related to depressive symptoms.•Resilience partially mediated link between relationships and depressive symptoms.•Relationships partially mediated the ...association between sex and resilience.
The aim of this study was to explore the associations among interpersonal relationships, resilience and depressive symptoms, and to examine if resilience is a mediator between interpersonal relationships and depressive symptoms in senior high school students.
Of 463 randomly selected participants from among 3,900 high school students, 450 (97.19%) consented to and completed a structured 4-part questionnaire consisting of demographic items, Inventory of Adolescent Resilience, Taiwan Relationship Inventory for Children and Adolescents, and Center for Epidemiologic Studies Depression Scale for Children. The associations between interpersonal relations and resilience and their associations with depressive symptoms were analyzed using MPlus 8.0 software for structural equation modeling.
Results from structural equation modeling indicate that resilience and interpersonal relationships were negatively associated with students’ depressive symptoms, and resilience partially mediated the associations between interpersonal relationships and depressive symptoms after controlling for demographics.
Findings support that resilience and better interpersonal relationships are protective factors against depressive symptoms in adolescents. The positive association between the two protectors implies that interpersonal relationships might increase resilience and then alleviate depression amongst adolescents.
Abstract Objective The estimated incidence of rudimentary horn pregnancy is one in 76,000. It is a life-threatening entity with a 50% risk of uterine rupture. With advances in prenatal ultrasound in ...recent decades, there may be an opportunity to detect rudimentary horn pregnancy earlier, resulting in a lower incidence of maternal morbidity and mortality. Management is typically resection of the rudimentary horn and the ipsilateral fallopian tube by either laparotomy or laparoscopy. Case Report Here, we present the case of a 22-year-old woman with a suspected ectopic pregnancy of 12 weeks' gestation. Ultrasound and magnetic resonance imaging were performed as preoperative evaluations. A definitive diagnosis was made during laparotomy, and resection of the rudimentary horn pregnancy was performed. Conclusion Diagnosis and management of rudimentary horn pregnancy remain a challenge. We should be alert to prenatal ultrasound with the intention of making an earlier diagnosis, thereby resulting in decreased maternal morbidity and mortality.
Trisomy 18 is one of the major numerical chromosomal disorders. The incidence of trisomy 18 is approximately one in 6000 live births. Dandy-Walker malformation (DWM) is the most common congenital ...malformation of the cerebellum, with an incidence of about one in 5000 live births. The incidence of trisomy 18 associated with DWM is rare and long-term survival rate is very low.
A case involving a 39-year-old pregnant female with a case of trisomy 18 associated with DWM.
The incidence of trisomy 18 associated with DWM is rare, and our report presents an unusual case that supplements our knowledge of this condition. We report a case involving a 39-year-old pregnant female with a case of trisomy 18 associated with Dandy-Walker malformation (DWM). Fetal ultrasonography showed hypoplasia of the cerebellar vermis and dilatation of the fourth ventricle and was characterized by an enlarged posterior fossa. Fetal magnetic resonance imaging showed inferior vermian hypoplasia and a large posterior fossa cyst communicating with the fourth ventricle causing high insertion of the torcular herophili, which was compatible with DWM. Furthermore, the karyotyping report revealed trisomy 18. The incidence of trisomy 18 associated with DWM is rare, and our report presents an unusual case that supplements our knowledge of this condition.
Abstract Objective To present the correlation between severe pre-eclampsia and peripartum cardiomyopathy in pregnancy. Case report A 41-year-old parturient, gravida 3, para 1, at 34 4/7 weeks' ...gestation, was diagnosed with severe pre-eclampsia. At the time of admission, a plain chest film disclosed bilateral pleural effusions. An emergent cesarean section was planned because of decreased fetal movement, heavy daily protein loss, and bilateral pleural effusions. During the cesarean section, she developed shock with acute respiratory failure. She underwent advanced cardiac life support and intubation with mechanical ventilator support. Peripartum cardiomyopathy was subsequently diagnosed by echocardiography. Conclusion The presented case demonstrates that routine echocardiography is highly recommended for suspected peripartum cardiomyopathy in gravidas with severe pre-eclampsia and symptoms or signs of heart failure.
Abstract Objective To present a rare case of life-threatening postpartum hemorrhage due to uterine atony complicated by acute myocardial infarction and ischemic hepatitis. Case Report A 37-year-old ...parturient, gravida 1 para 0, presented with symptoms and signs of shock due to postpartum hemorrhage after delivery. Ischemic hepatitis, pulmonary edema, and adult respiratory distress syndrome developed the following morning. On the 7th postpartum day, she developed chest pain and was subsequently diagnosed with acute inferior myocardial infarction based on serial changes on the electrocardiogram (ECG) and myocardial enzymes. The clinical condition improved after a series of resuscitative efforts and percutaneous transluminal coronary angioplasty. Conclusion The presented case demonstrated that when hypovolemic shock develops with complications of pulmonary edema or ischemic hepatitis, the possibility of cardiovascular disease should be immediately investigated and preventive measures initiated.
Abstract Objective Neutropenia developed after continuous intravenous infusion of ritodrine hydrochloride (Yutopar) for preterm uterine contractions in a twin pregnancy. We successfully returned the ...low neutrophil count to the normal range after discontinuation of infusion of ritodrine and treatment with granulocyte colony stimulating factor (G-CSF). Case Report A 34-year-old woman with twin pregnancy was treated with ritodrine for preterm uterine contractions at 27 weeks and 6 days gestation. Neutropenia developed after continuous intravenous infusion of ritodrine for about 4 weeks. We ceased the ritodrine infusion immediately and treated the neutropenia with G-CSF. A cesarean delivery was performed the day after cessation of the ritodrine infusion because of uncontrolled preterm labor. There were no adverse side effects or infectious complications in the mother or the newborns. The maternal neutrophil count recovered to the normal range 4 days after administration of G-CSF. Conclusion Based on prior case reports and the clinical presentation of our case, G-CSF may be a useful treatment for pregnant women with ritodrine-induced neutropenia. However, more clinical studies are required to confirm the safety and efficacy of this treatment.
Abdominal ectopic pregnancy is rare among all ectopic pregnancies and only few cases were treated with laparoscopic surgery. The most challenging management is adequate hemostasis after the removal ...of gestational material. We present a case of abdominal ectopic pregnancy with massive hemoperitoneum who was treated with laparoscopy and manual hemostasis during the surgery. After the removal of gestational material, persistent bleeding from the rough surface of rectal serosa was observed. Thermal coagulation was dilemmatic due to proximity to the rectum. Then, we used manual compression with one index finger in the rectum combined with gauze compression by laparoscopic instrument. The hemostasis was achieved successfully.
Hemophagocytic lymphohistiocytosis (HLH) is a rare life-threatening disease characterized by a severe hyperinflammation caused by uncontrolled proliferation of activated lymphocytes and macrophages. ...Herein, we report a 58-year-old male who had Chlamydia pneumoniae-related pneumonia, followed by aggressive HLH. An abnormal cytogenetic profile was also detected. To our knowledge, this is the first report of an adult patient with C. pneumonia-associated HLH.
Background We compared our clinical experience with currently available reference oxygen saturation level (SpO2 ) values from the American Academy of Pediatrics/American Heart Association (AAP/AHA) ...neonatal resuscitation program guidelines. Methods We enrolled 145 healthy full-term neonates; infants showing respiratory distress and those with serious congenital anomalies were excluded. SpO2 values at every 1 minute until 10 minutes after birth were measured and recorded. Infants were classified into the cesarean section (CS) and normal spontaneous delivery (NSD) groups for evaluating differences. The 10th percentiles of SpO2 at each minute were used as the lower limits of normal oxygen saturation, and these were compared with the lowest target values recommended in the AAP/AHA guidelines. Results Overall, 130 vigorous full-term neonates (median gestational age: 38 5/7 weeks; body weight at birth: 2405–3960 g) were analyzed. The median SpO2 were 67% and 89% at the 1st and 4th minute, respectively. On average, SpO2 values reached >90% at the 5th minute. No statistical differences were noted in the SpO2 values between the CS and NSD groups after 5 minutes; however, a trend of higher SpO2 was observed in the NSD group. We noted a gradually increasing trend for SpO2 values over time, similar to that noted in the AAP/AHA guidelines. However, SpO2 values at the 10th percentiles of each minute within the first 5 minutes in our study were equal to or significantly lower than those in the AAP/AHA guidelines; moreover, at the 10th minute, SpO2 values at the 10th percentiles were significantly higher than those in the guidelines. Conclusion The delivery modes did not affect the SpO2 values of full-term healthy neonates. Discrepancies in SpO2 changes in full-term neonates not requiring resuscitation between this study and the AAP/AHA guidelines were significant. SpO2 ranges for each time point within the first 10 minutes after birth should therefore be reevaluated locally.
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.
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