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Academic literature on the topic 'Fetal death Risk factors'

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Published: 10 December 2022
Last updated: 29 January 2023

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Journal articles on the topic "Fetal death Risk factors"

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Aquino, Márcia Maria Auxiliadora de, José Guilherme Cecatti, and Coríntio Mariani Neto. "Risk factors associated to fetal death." Sao Paulo Medical Journal 116, no. 6 (November 1998): 1852–57. http://dx.doi.org/10.1590/s1516-31801998000600005.

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OBJECTIVE: The purpose of this study was to investigate risk factors associated to fetal death in a Brazilian population. DESIGN: A case control study. SETTING: The Hospital Maternidade Leonor Mendes de Barros in São Paulo. PARTICIPANTS:122 pregnant women with diagnosis of fetal death and gestation age of 20 or more weeks and 244 controls of pregnant women who delivered liveborns. VARIABLES STUDIED: The fetal death (dependent variable), independent variable (the social demographic factors, clinical and obstetrical history, prenatal care indicators and pathological conditions). RESULTS: The risk factors associated to fetal death were abruptio placentae, syphilis, few prenatal care visits, one or more previous stillbirths, hospitalization during pregnancy, diabetes, age above or equal to 25 years, hypertension during pregnancy, anemia and age below 20 years. CONCLUSIONS: Results of the current study might be useful to orientate a primary prevention health program, specially those concerning antenatal care.
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Sheiner, E., M. Hallak, T. Oron, T. Silberstein, I. Shoham-Vardi, M. Katz, and M. Mazor. "Antepartum fetal death: obstetrical risk factors." International Journal of Gynecology & Obstetrics 70 (2000): C93. http://dx.doi.org/10.1016/s0020-7292(00)80630-x.

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Thakur, Achala, Pritha Basnet, Rubina Rai, and Ajay Agrawal. "Risk Factors Related to Intrauterine Fetal Death." Journal of Nepal Health Research Council 17, no. 01 (April 28, 2019): 46–50. http://dx.doi.org/10.33314/jnhrc.v17i01.1534.

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Background: Intrauterine fetal death is a traumatic event. Stillbirth rate is an important indicator to assess the quality of antenatal care. The objective of the study was to identify the risk factors related to intrauterine fetal death in patients admitted with intrauterine fetal death.Methods: It was a descriptive study conducted in the department of Obstetrics and Gynaecology at B. P. Koirala Institute of Health Sciences from January to December 2014. Patients admitted with singleton pregnancy with intrauterine fetal death after 28 weeks gestation were included. Results: There were 11,006 obstetric admissions. Of them, 152 women had intrauterine fetal death. There were 128(84.2%) women between 20-35 years of age. Out of 152, 81(53.3%) women were preterm and 39(2.1%) women were postterm. Primigravida were 77(50.7%) followed by 35(23%) of second gravida. Hypertension was the commonest identified risk factor in 30(26.78%) women. Out of 152 women, 49(32.2%) had not received formal education. Ten (6.6%) women had a past history of fetal death. Four (2.6%) women had medical disorder before pregnancy. One hundred and twenty five (82.2%) women had vaginal delivery, 21(13.8%) had caesarean section and 6(3.9%) had laparotomy for rupture uterus. The commonest indication for caesarean section was placenta previa for 7(33.33%) women. Four (2.6%) women had diabetes. Ninety five (62.5%) were male and 57(37.5%) were female babies. Five (3.3%) babies had malformations. Conclusions: Hypertension in pregnancy was found to be the most common identified risk factor for intrauterine fetal death. Keywords: Fetal death; pregnancy; risk factors.
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Válková, Andrea, and Petr Hubka. "Covid-19 as a possible risk factor of intrauterine fetal death." Česká gynekologie 86, no. 6 (December 21, 2021): 410–13. http://dx.doi.org/10.48095/cccg2021410.

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Objective: To summarize information about possible effects of covid-19 on intrauterine fetal death and present three cases of intrauterine fetal death in women with recent covid-19 infection. Methods: Review of available information about pregnancy with covid-19 and comparison with own observation of cases during spring 2021. Conclusion: Covid-19 influences risk of intrauterine fetal death, preeclampsia/eclampsia or HELLP syndrome. Coagulation changes and drop of platelets is considered as one of the causes of intrauterine fetaldeath due to fetal vascular malperfusion. Key words: covid-19 – intrauterine fetal death – obstetrics
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Zhang, Jun, and Wen-wei Cai. "Risk factors associated with antepartum fetal death." Early Human Development 28, no. 3 (March 1992): 193–200. http://dx.doi.org/10.1016/0378-3782(92)90166-e.

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Zhang, J., and W. W. Cai. "Risk factors associated with antepartum fetal death." International Journal of Gynecology & Obstetrics 39, no. 4 (December 1992): 367. http://dx.doi.org/10.1016/0020-7292(92)90308-6.

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Ohana, Oded, Gershon Holcberg, Ruslan Sergienko, and Eyal Sheiner. "Risk factors for intrauterine fetal death (1988–2009)." Journal of Maternal-Fetal & Neonatal Medicine 24, no. 9 (February 11, 2011): 1079–83. http://dx.doi.org/10.3109/14767058.2010.545918.

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Almeida, Marcia Furquim de, Gizelton Pereira Alencar, Hillegonda Maria Dutilh Novaes, Ivan França Jr, Arnaldo Augusto Franco de Siqueira, Oona M. R. Campbell, Daniela Schoeps, and Laura Cunha Rodrigues. "Risk-factors for antepartum fetal deaths in the city of São Paulo, Brazil." Revista de Saúde Pública 41, no. 1 (February 2007): 35–43. http://dx.doi.org/10.1590/s0034-89102007000100006.

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OBJECTIVE: To assess risk factors for antepartum fetal deaths. METHODS: A population-based case-control study was carried out in the city of São Paulo from August 2000 to January 2001. Subjects were selected from a birth cohort from a linked birth and death certificate database. Cases were 164 antepartum fetal deaths and controls were drawn from a random sample of 313 births surviving at least 28 days. Information was collected from birth and death certificates, hospital records and home interviews. A hierarchical conceptual framework guided the logistic regression analysis. RESULTS: Statistically significant factors associated with antepartum fetal death were: mother without or recent marital union; mother's education under four years; mothers with previous low birth weight infant; mothers with hypertension, diabetes, bleeding during pregnancy; no or inadequate prenatal care; congenital malformation and intrauterine growth restriction. The highest population attributable fractions were for inadequacy of prenatal care (40%), hypertension (27%), intrauterine growth restriction (30%) and absence of a long-standing union (26%). CONCLUSIONS: Proximal biological risk factors are most important in antepartum fetal deaths. However, distal factors - mother's low education and marital status - are also significant. Improving access to and quality of prenatal care could have a large impact on fetal mortality.
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Theodorou, Dimitrios A., George C. Velmahos, Irene Souter, Linda S. Chan, Pantelis Vassiliu, Raymond Tatevossian, James A. Murray, and Demetrios Demetriades. "Fetal Death after Trauma in Pregnancy." American Surgeon 66, no. 9 (September 2000): 809–12. http://dx.doi.org/10.1177/000313480006600901.

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Trauma in pregnancy places the mother and fetus at risk. The objective of this study is to identify risk factors independently associated with acute termination of pregnancy and/or fetal mortality after trauma. The medical and trauma registry records of 80 injured pregnant patients were reviewed. Data were collected and then analyzed by univariate and multivariate analysis. Three patients died (3.7%), 23 had the pregnancy acutely terminated (30%), and 14 suffered fetal death (17.5%). The only independent risk factors for fetal mortality were an Injury Severity Score (ISS) ≥9 and a nonviable pregnancy (<23 weeks). The combination of both risk factors increased the likelihood of fetal mortality by fivefold over that of patients without either risk factor. Maternal hemodynamic parameters did not predict fetal loss. Two patients lost their fetuses despite insignificant trauma (ISS = 1) and normal hemodynamic parameters, whereas eight delivered normal babies despite major trauma (ISS ≥ 16). Hemodynamic stability on admission does not predict fetal mortality. Although the presence of moderate to severe injuries (ISS ≥ 9) increases the likelihood of fetal mortality, this complication may occur even with insignificant trauma. Close maternal and fetal monitoring is justified, regardless of maternal hemodynamic presentation or severity of injury.
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Ohana, Oded, Gershon Holcberg, Ruslan Sergienko, and Eyal Sheiner. "702: Risk factors for intrauterine fetal death (1988-2009)." American Journal of Obstetrics and Gynecology 204, no. 1 (January 2011): S278. http://dx.doi.org/10.1016/j.ajog.2010.10.724.

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Dissertations / Theses on the topic "Fetal death Risk factors"

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Bell, Ruth. "Trends in late fetal death 1982-2000 : the influence of changing risk factors." Thesis, University of Newcastle upon Tyne, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.424086.

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Myers, Patricia D. "The Association of Maternal Pregnancy Complications and Sudden Infant Death Syndrome." [Tampa, Fla.] : University of South Florida, 2003. http://purl.fcla.edu/fcla/etd/SFE0000068.

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Maia, Carolina Bastos. "Predição do resultado perinatal em gestações trigemelares." Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/5/5139/tde-26082014-114541/.

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O presente estudo tem como objetivo descrever a mortalidade perinatal em gestações trigemelares, e analisar os fatores preditores dos seguintes desfechos: número de crianças vivas no momento da alta hospitalar, nenhuma criança viva no momento da alta hospitalar (desfavorável) e pelo menos uma criança viva no momento da alta hospitalar (favorável). Realizado de forma retrospectiva, envolveu pacientes com gestações trigemelares que apresentavam três fetos vivos na primeira ultrassonografia realizada após 11 semanas, no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), no período de 1998 a 2012. Foram incluídas 67 pacientes das quais 77,6% referiam concepção espontânea. Quanto à corionicidade, 49,2% eram tricoriônicas e 50,8% eram não tricoriônicas; 16,4% apresentavam antecedente clínico prévio à gestação e 49,2% eram nulíparas. Em relação às intercorrências, a incidência de complicações obstétricas e/ou clínicas na gestação foi de 52,2%, e de intercorrências fetais, 25,2%, dentre as quais: 13,4% mal formações, 7,5% sindrome da transfusão feto fetal (STFF), 5,9% óbito fetal (OF), 4,5% insuficiência placentária, 4,4% fetos unidos, 1,5% feto acárdico. A idade gestacional média do parto foi de 31,9 ± 3,1 semanas, dos quais 83,5% foram cesáreas. O peso médio dos recém-nascidos vivos de 1.683 ± 508 g. Em relação à discordância de peso ao nascer: 57% apresentaram até 20%, 23,2% entre 20 e 30% e 19,6% acima de 30%. A taxa de óbitos fetais foi de 31,7%o nascimentos (IC95%: 11,7 - 67,8) e a mortalidade perinatal 249%o nascimentos (IC95%: 189 - 317). O tempo médio de internação dos recém-nascidos, que foram de alta vivos, foi de 29,3 ± 24,7 dias. A predição dos desfechos foi investigada por meio de regressão logística \"stepwise\", e incluiu as seguintes variáveis: idade materna, paridade (nulípara ou um ou mais partos anteriores), antecedente clínico, idade gestacional do primeiro ultrassonografia no HCFMUSP, corionicidade (gestações tricoriônicas e gestações não tricoriônicas), presença de complicação obstétrica ou clínica durante a gestação, intercorrência fetal e idade gestacional do parto. O nível de significância estatística utilizado foi de 0,005. Foram fatores significativos para predição do número de crianças vivas no momento da alta hospitalar: presença de intercorrência fetal (OR 0,1, IC95%: 0,03 - 0,36; p < 0,001) e idade gestacional do parto (OR 1,55, IC95%: 1,31-1,85; p < 0,001). Para a predição dos desfechos favoráveis e desfavoráveis a idade gestacional do parto apresentou significância estatística (OR 1,84, IC95%: 1.26 - 2.7; p=0,002 e OR 0.54, IC 95%: 0.37-0.79; p=0.002, respectivamente)
The present study, involving triplet pregnancies, describes perinatal mortality and investigates predictors of the following outcomes: number of children alive, no child alive (unfavorable outcome) and at least one child alive (favorable outcome) at hospital discharge. It is a retrospective study involving triplet pregnancies with live fetuses at the first ultrasound scan, performed after 11 weeks of gestation, at the Department of Obstetrics and Gynecology, São Paulo University Medical School Hospital, between 1998 and 2012. Final sample included 67 women, 77.6% reported spontaneous conception. Regarding the chorionicity, 49.2% were trichorionic; 16.4% had a medical complication prior to pregnancy, and 49.2% were nulliparous. The incidence of obstetric and/or clinical complications during pregnancy was 52.2%, and fetal complications occurred in 25.2%, (13.4% of major fetal abnormalities, 7.5% twin-to-twin transfusion syndrome, 5.9% stillbirth, 4.5% placental insufficiency, 4.4% conjoined twins and 1.5% acardic twin). The average gestational age at delivery was 31.9 ± 3.1 weeks, and 83.5% were cesarean. The average birthweight was 1683 ± 508 g and birth weight discordance up to 20% occurred in 57% of the cases; 23,2% had 20 to 30% discordance and 19.6%, was greater than 30%. The rate of stillbirth was 31.7%o births (95%CI: 11.7 - 67.8) and the perinatal mortality was 249%o births (95%CI: 189 - 317). The average hospital stay was 29.3 ± 24.7 days amongst children that were discharged alive. Stepwise logistic regression analysis was used to investigate prediction according to: maternal age, parity (nuliparous/multiparous), prior clinical history, gestational age at the first ultrasound scan at HCFMUSP, pregnancy chorionicity (trichorionic/non trichorionic), occurrence of clinical and/or obstetric complications during pregnancy, occurrence of fetal complications and gestational age at delivery. Significance level was set at 0.05. The number of children alive at hospital discharge was correlated with the occurrence of fetal complications (OR 0,1, 95%IC: 0,03 - 0,36; p < 0,001) and gestational age at delivery (OR 1,55, IC95%: 1,31-1,85; p < 0,001). Whereas favorable and unfavorable outcome were associated with gestational age at delivery (OR 1.84, 95%CI: 1.26 - 2.7-; p=0,002 and OR 0.54, 95%CI: 0.37-0.79; p=0.002, respectively)
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Ødegård, Rønnaug A. "Preeclampsia - maternal risk factors and fetal growth." Doctoral thesis, Norwegian University of Science and Technology, Department of Cancer Research and Molecular Medicine, 2002. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-484.

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Preeclampsia is a complex and variable maternal disturbance that ranges from a dramatic onset at early gestation to slowly developing symptoms towards term. Hypertension and renal involvement with proteinuria are cardinal signs, which are often accompanied by fluid retention, blood-clotting dysfunction, and reduced organ perfusion. HELLP (haemolysis, elevated liver enzymes, and low platelet count) syndrome is regarded as a variant of preeclampsia, and the fulminante disease, eclampsia, includes convulsions. Preeclampsia is the main cause of maternal and fetal morbidity and mortality in western countries (1, 2), and in Nordic countries, 17 percent of maternal deaths have been ascribed to preeclampsia (2). Antenatal care in Norway includes on average 12 doctor/midwife consultations per pregnancy (3), and since blood pressure monitoring and urinary testing are main aims of the consultations, preeclampsia is a pregnancy complication that also generates substantial societal costs.


Paper II, III, IV and V reproduced with permission of Elsevier, sciencedirect.com
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Smoleniec, John Stefan. "Preterm fetal behavioural states and the risk of sudden infant death syndrome." Thesis, University of Bristol, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.324366.

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Moore, Vivienne M. "Fetal growth and cardiovascular risk factors in an Australian cohort /." Title page, contents and abstract only, 1997. http://web4.library.adelaide.edu.au/theses/09PH/09phm824.pdf.

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Stephansson, Olof. "Epidemiological studies of stillbirth and early neonatal death /." Stockholm, 2002. http://diss.kib.ki.se/2002/91-7349-143-8.

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Blair, Peter Sinclair Paul. "Assessing the changing risk factors associated with Sudden Infant Death Syndrome." Thesis, University of Bristol, 1998. http://hdl.handle.net/1983/275cdd77-5f8e-487d-8e8d-3aa62eea16e8.

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Radford-Paz, Elisa. "Risk and protective factors for criminality among adults with FASD." Thesis, Laurentian University of Sudbury, 2013. https://zone.biblio.laurentian.ca/dspace/handle/10219/2128.

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This research explored the risk and protective factors associated with criminality among adults with Fetal Alcohol Spectrum Disorder (FASD). While previous research has focused on identifying the factors that contribute to legal issues, there is a paucity of research on the protective factors that may lead to more positive outcomes for adults with FASD. The first paper examined the methodological issues encountered while conducting a mixed methods study on the experience of offenders and non-offenders with FASD. Difficulties with participant recruitment, the sample size, the terminology employed, and the appropriateness of psychometric measures were significant challenges that emerged during the research project. The second paper was a qualitative study that investigated the experience of adults with prenatal alcohol exposure and their families to determine the risk and protective factors for criminality. Families reported that neurobehavioural impairments such as difficulty with self-regulation and social skills deficits, combined with environmental demands that exceeded the capabilities of the individual with FASD, were important contributors to criminality. However, structure and supervision, education and employment, social and financial support, and positive peer influence were found to mitigate the risk of criminal behavior among adults with FASD. The findings from this thesis highlight the importance of including families in the research process as well as the need to have more family-centered services.
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Peterson, Caroline. "Psycho-Socio-Cultural Risk Factors for Breech Presentation." Scholar Commons, 2008. https://scholarcommons.usf.edu/etd/451.

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The Breech Baby Study is a mixed methods study which combines qualitative and quantitative inquiry. This study explores psycho-social-cultural risk factors for breech presentation from an evolutionary perspective. The quantitative component of the study uses Florida birth certificate and Medicaid data sets from 1992-2003 to evaluate the influence of ethnicity and socio-economic status on breech presentation. Ethnicity and socio-economic status account for less than two percent of the variance of risk factors for breech presentation. The qualitative study includes 114 mothers of breech and cephalic presentation babies who completed the State Trait Personality Inventory and a socio-demographic survey. Of these, 52 mothers of cephalic presentation babies and 23 mothers of breech presentation also participated in an in-depth interview about formative life experiences and peri-conception through delivery. The primary data analysis found mothers of breech presentation babies exhibit psycho-social-cultural characteristics unlike those found in mothers of cephalic presentation babies. These characteristics include being idealistic, analytical, polished, overextended, and fearful. Mothers of cephalic presentation babies were better equipped to adapt to unexpected situations and to be pragmatic in the face of unresolvable circumstances. Mothers of breech presentation babies were further separated into two categories. One category is achievement focused woman while the other is non-present focused woman. While both sets of breech presentation mothers were idealistic, the achievement focused mothers were more likely to be analytical, polished, and overextended. In contrast, the non-present focused mothers had a history of abuse and were more likely to have an unresolved pregnancy outcome or to be fearful. Breech presentation is interpreted by attachment theory, evolutionary ecological reproductive theory, and developmental plasticity theory as a fetal strategy to adapt to the intra-uterine relationship environment and an attempt to predict the extra-uterine relationship environment.
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Books on the topic "Fetal death Risk factors"

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Surles, Kathryn. Infant death: Sociodemographic and medical risk factor analyses for North Carolina. Raleigh, N.C: State Center for Health and Environmental Statistics, 1994.

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Surles, Kathryn. Infant death: Sociodemographic and medical risk factor analyses for North Carolina. Raleigh, N.C: State Center for Health and Environmental Statistics, 1994.

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Cieślik, Krystyna. Matczyne czynniki ryzyka a prawidłowość rozwoju człowieka w okresie prenatalnym. Poznán: Akademia Wychowania Fizycznego im. E. Piaseckiego w Poznaniu, 1999.

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Medical and life-style risk factors affecting fetal mortality, 1989-90. Hyattsville, Md: U.S. Dept. of Health and Human Services, Public Health Service, Centers for Disease Control, National Center for Health Statistics, 1996.

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Barnett, Elizabeth. Maternal obesity and excess risk of perinatal mortality: Evidence from a large biracial population. Raleigh, N.C: Dept. of Environment, Health, and Natural Resources, State Center for Health and Environmental Statistics, 1994.

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Barnett, Elizabeth. Maternal obesity and excess risk of perinatal mortality: Evidence from a large biracial population. Raleigh, N.C: Dept. of Environment, Health, and Natural Resources, State Center for Health and Environmental Statistics, 1994.

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Hopkins, Richard S. Perinatal periods of risk: An assessment approach to understanding fetal and infant deaths in Florida, 1995-1998. [Tallahassee, Fla.]: The Bureau, 2001.

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Sudden death in epilepsy: Forensic and clinical issues. Boca Raton: CRC Press, 2011.

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E, Hrudey S., ed. Risk of death in Canada: What we know and how we know it. Edmonton: University of Alberta Press, 1997.

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National Center for Health Statistics (U.S.), ed. Maternal weight gain and the outcome of pregnancy, United States, 1980: An analysis of maternal weight gain during pregnancy by demographic characteristics of mothers and its association with birth weight and the risk of fetal death. Hyattsville, Md: U.S. Dept. of Health and Human Services, Public Health Service, National Center for Health Statistics, 1986.

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Book chapters on the topic "Fetal death Risk factors"

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Silver, Robert M. "Protocol 37: Fetal Death and Stillbirth." In Protocols for High-Risk Pregnancies, 306–14. Chichester, UK: John Wiley & Sons, Ltd, 2015. http://dx.doi.org/10.1002/9781119001256.ch37.

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Silver, Robert M. "Missed Abortion and Antepartum Fetal Death." In Protocols for High-Risk Pregnancies, 391–98. Oxford, UK: Wiley-Blackwell, 2010. http://dx.doi.org/10.1002/9781444323870.ch48.

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Bowling, Ann. "Risk Factors Associated with Mortality among the Elderly Bereaved." In A Safer Death, 69–73. Boston, MA: Springer US, 1988. http://dx.doi.org/10.1007/978-1-4615-8359-2_11.

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Navarro-Lopez, Francisco. "Risk factors of sudden cardiac death after acute myocardial infarction." In Sudden Cardiac Death, 223–37. Dordrecht: Springer Netherlands, 1991. http://dx.doi.org/10.1007/978-94-009-0573-3_20.

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Entringer, Sonja, Karin de Punder, Glenn Verner, and Pathik D. Wadhwa. "Fetal Programming of Telomere Biology: Role of Maternal Nutrition, Obstetric Risk Factors, and Suboptimal Birth Outcomes." In Diet, Nutrition, and Fetal Programming, 569–93. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-60289-9_41.

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Brenner, Sue Anne, and Eric K. Noji. "Risk factors for death or injury in tornadoes: An epidemiologic approach." In Geophysical Monograph Series, 543–44. Washington, D. C.: American Geophysical Union, 1993. http://dx.doi.org/10.1029/gm079p0543.

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Green, Darren, Diana Y. Y. Chiu, and Philip A. Kalra. "Sudden Cardiac Death in CKD and ESKD: Risk Factors, Mechanisms, and Therapeutic Strategies." In Cardio-Nephrology, 21–33. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-56042-7_3.

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Hu, Xiao, John H. Zhang, and Xinyue Qin. "Risk Factors of Early Death in Patients with Hypertensive Intracerebral Hemorrhage During Hospitalization." In Intracerebral Hemorrhage Research, 387–91. Vienna: Springer Vienna, 2011. http://dx.doi.org/10.1007/978-3-7091-0693-8_66.

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Jenkins, C. D. "The Epidemiology of Sudden Cardiac Death: Incidence, Clinical Features, Biomedical and Psychosocial Risk Factors." In Developments in Cardiovascular Medicine, 17–43. Boston, MA: Springer US, 1985. http://dx.doi.org/10.1007/978-1-4613-2587-1_2.

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Villagrana-Bañuelos, Karen E., Laura A. Zanella-Calzada, Irma E. Gonzalez-Curiel, Jorge I. Galván-Tejada, and Carlos E. Galván-Tejada. "Fatty Chain Acids Risk Factors in Sudden Infant Death Syndrome: A Genetic Algorithm Approach." In Advances in Soft Computing, 235–45. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-60884-2_18.

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Conference papers on the topic "Fetal death Risk factors"

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Chen, Ping-Hsin, and Bernadette Hohl. "Exploring risk factors for firearm death." In NAPCRG 49th Annual Meeting — Abstracts of Completed Research 2021. American Academy of Family Physicians, 2022. http://dx.doi.org/10.1370/afm.20.s1.2939.

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Lee, Sung Hee, and Eun Young Lee. "Factors Influencing Maternal-Fetal attachment in High-Risk Pregnancy." In Healthcare and Nursing 2015. Science & Engineering Research Support soCiety, 2015. http://dx.doi.org/10.14257/astl.2015.104.09.

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Turcanu, Tamara. "P306 Risk factors- marker to infants with maternal- fetal herpes infection." In 8th Europaediatrics Congress jointly held with, The 13th National Congress of Romanian Pediatrics Society, 7–10 June 2017, Palace of Parliament, Romania, Paediatrics building bridges across Europe. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2017. http://dx.doi.org/10.1136/archdischild-2017-313273.394.

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Sedain, Bhagabati, and Yogendra Bahadur Gurung. "378 Road traffic death, injuries and its risk factors in Nepal." In 14th World Conference on Injury Prevention and Safety Promotion (Safety 2022) abstracts. BMJ Publishing Group Ltd, 2022. http://dx.doi.org/10.1136/injuryprev-2022-safety2022.167.

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Karseladze, Rusudan, Maka Chigladze, and Liana Lorjoliani. "P311 Risk factors of retardation the fetal development and their predictorative significance." In Faculty of Paediatrics of the Royal College of Physicians of Ireland, 9th Europaediatrics Congress, 13–15 June, Dublin, Ireland 2019. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2019. http://dx.doi.org/10.1136/archdischild-2019-epa.660.

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Hines, S. E., K. Ringen, K. Cranford, P. Quinn, and J. Dement. "Risk Factors for Lung Cancer Death Among Former Department of Energy Construction Workers." In American Thoracic Society 2020 International Conference, May 15-20, 2020 - Philadelphia, PA. American Thoracic Society, 2020. http://dx.doi.org/10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a5967.

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Noda, Julio R., Lidia M. López, Verónica De los Santos, Juan Agapito, and Roberto A. Accinelli. "Risk Factors For Default, Failure, And Death Among Patients In Supervised Tuberculosis Treatment." In American Thoracic Society 2010 International Conference, May 14-19, 2010 • New Orleans. American Thoracic Society, 2010. http://dx.doi.org/10.1164/ajrccm-conference.2010.181.1_meetingabstracts.a5379.

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Mosgaard, B., A. Meaidi, C. Hogdall, and M. Noer. "P143 Risk factors for early death among ovarian cancer patients – a nationwide cohort study." In ESGO Annual Meeting Abstracts. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/ijgc-2019-esgo.205.

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Kahr, M., F. Winder, L. Vonzun, M. Meuli, U. Moehrlen, L. Mazzone, F. Krähenmann, M. Hüsler, R. Zimmermann, and N. Ochsenbein-Kölble. "Risk factors for preterm birth following open fetal myelomeningocele repair – results from a prospective cohort." In 62. Kongress der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe – DGGG'18. Georg Thieme Verlag KG, 2018. http://dx.doi.org/10.1055/s-0038-1671180.

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TAVARES, Lívia Hygino, and Bruno MOURA. "DIABETES IN PREGNANCY AND FETAL CARDIAC RISK: LITERATURE REVIEW." In SOUTHERN BRAZILIAN JOURNAL OF CHEMISTRY 2021 INTERNATIONAL VIRTUAL CONFERENCE. DR. D. SCIENTIFIC CONSULTING, 2022. http://dx.doi.org/10.48141/sbjchem.21scon.45_abstract_tavares.pdf.

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Gestational diabetes mellitus (MGD) is associated with poor cardiac malformation in the fetus. It is related to changes in the clinical course of the disease and pre-gestational periods. The prevalence and incidence of MGD have been increasing worldwide. Early screening, diagnosis, and lifestyle change, such as physical exercise and healthy eating, provide better outcomes for children's health. This study aims to analyze the data concerning gestational diabetes and fetal malformations and to group the various protocols for diagnosis, highlighting the risk factors associated with MGD and their prevention. A systematic review of the literature was conducted with the PubMed, Scielo, Medline databases with English, Portuguese, and Spanish articles. The studies gathered clinical trials, randomized clinical trials, and original articles. In 12 articles analyzed maternal alterations, while 11 articles analyzed fetal alterations, and 9 articles analyzed how to diagnose cardiac changes in the fetus. The patient with MGD should be inserted in multidisciplinary activities seeking the change of lifestyle, physical exercises, and food reeducation, intending to give the fetus the appropriate nutrients and optimize the drug treatment; cardiac malformations are among the most severe and recurrent complications. However, they can be avoided with the control of pre-gestational diabetes (stricter follow-up from the moment the patient feels the desire to become pregnant) and the diagnosis and treatment of early gestational diabetes, as strict control of maternal blood glucose during pregnancy reduces morbidities and mortality. The study showed that hyperglycemic status during pregnancy is related to increased mortality and morbidity, even if it is asymptomatic. Therefore, it is necessary to guide the diabetic woman to plan her pregnancy in a euglycemic period because only this control can guarantee health to the fetus. The diagnosis of pregnant women with gestational diabetes needs to be early to optimize treatment.
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Reports on the topic "Fetal death Risk factors"

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Zhu, Qiaochu, Jin Zhou, Hai Huang, Jie Han, Biwei Cao, Dandan Xu, Yan Zhao, and Gang Chen. Risk factors associated with amyotrophic lateral sclerosis: a protocol for systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, September 2022. http://dx.doi.org/10.37766/inplasy2022.9.0118.

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Review question / Objective: To identify and list the risk factors associated with the onset and progression of ALS. Condition being studied: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder affecting the upper and lower motor neurons in the spinal bulb, cerebral cortex, and spinal cord. The clinical processing symptoms accompany muscle atrophy, fasciculation, and fatigue of limbs, which can lead to general paralysis and death from respiratory failure within 3-5 years after the onset of this disease. Though the pathogenesis of ALS is still unclear, exploring the associations between risk factors and ALS can provide reliable evidence to find the pathogenesis in the future. This meta-analysis aims to synthesize all related risk factors on ALS, comprehensively understand this disease, and provide clues to mechanism research and clinicians.
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Mateș, Letiția, Marius Emil Rusu, Ionel Fizeșan, Daniela-Saveta Popa, and Daniel Leucuța. Walnut intake interventions targeting biomarkers of metabolic syndrome and inflammation in middle-aged and older adults: a systematic review and meta-analysis of randomized controlled trials research protocol. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, June 2022. http://dx.doi.org/10.37766/inplasy2022.6.0058.

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Review question / Objective: The aim of this study was to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) in order to properly examine the evidence on the effects of walnut consumption on chosen indicators of inflammation and metabolic syndrome in mature adults. Condition being studied: Metabolic syndrome (MetS), chronic, low-grade inflammation, and oxidative stress are all important risk factors for morbidity and death, with a higher frequency in the elderly population. Information sources: We conducted a comprehensive search in five databases: Pubmed, EMBASE, Scopus, Cochrane, ClinicalTrials, from inception.
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Travis, Amanda, Margaret Harvey, and Michelle Rickard. Adverse Childhood Experiences and Urinary Incontinence in Elementary School Aged Children. University of Tennessee Health Science Center, October 2021. http://dx.doi.org/10.21007/con.dnp.2021.0012.

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Purpose/Background: Adverse Childhood Experiences (ACEs) have an impact on health throughout the lifespan (Filletti et al., 1999; Hughes et al., 2017). These experiences range from physical and mental abuse, substance abuse in the home, parental separation or loss, financial instability, acute illness or injury, witnessing violence in the home or community, and incarceration of family members (Hughes et al., 2017). Understanding and screening for ACEs in children with urinary incontinence can help practitioners identify psychological stress as a potentially modifiable risk factor. Methods: A 5-month chart review was performed identifying English speaking patients ages 6-11 years presenting to the outpatient urology office for an initial visit with a primary diagnosis of urinary incontinence. Charts were reviewed for documentation of individual or family risk factors for ACEs exposure, community risk factors for ACEs exposures, and records where no related documentation was included. Results: For the thirty-nine patients identified, no community risk factors were noted in the charts. Seventy-nine percent of patients had one or more individual or family risk factors documented. Implications for Nursing Practice This chart review indicates that a significant percentage of pediatric, school-aged patients presenting with urinary incontinence have exposure to ACEs. A formal assessment for ACEs at the time of initial presentation would be helpful to identify those at highest risk. References: Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the adverse childhood experiences (ACE) study. Am J Prev Med. 1998;14:245–258 Hughes, K., Bellis, M.A., Hardcastle, K.A., Sethi, D., Butchart, D., Mikton, C., Jones, L., Dunne, M.P. (2017) The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. Lancet Public Health, 2(8): e356–e366. Published online 2017 Jul 31.doi: 10.1016/S2468-2667(17)30118-4 Lai, H., Gardner, V., Vetter, J., & Andriole, G. L. (2015). Correlation between psychological stress levels and the severity of overactive bladder symptoms. BMC urology, 15, 14. doi:10.1186/s12894-015-0009-6
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Cao, Xianling, Xuanyou Zhou, Naixin Xu, Songchang Chang, and Chenming Xu. Association of IL-4 and IL-10 Polymorphisms with Preterm Birth Susceptibility: A Systematic Review and Meta-Analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, April 2022. http://dx.doi.org/10.37766/inplasy2022.4.0044.

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Review question / Objective: The aim of our systematic review and meta-analysis was to summarize the effects of IL-4 and IL-10 gene polymorphism and clarify their possible association with PTB. Condition being studied: World Health Organization (WHO) defines preterm birth (PTB) as babies born alive before 37 weeks of pregnancy are completed. The new estimates show that the prevalence of PTB during 2014 ranged from 8.7% to13.4% of all live births, about 15 million preterm babies born each year. Besides, PTB is the leading cause of death worldwide for children below 5 years of age. Babies born preterm are at an increased risk of short-term and long-term complications attributed to immaturity of multiple organ systems, such as cerebral palsy, intellectual disabilities, vision and hearing impairments, and impaired cognitive development. PTB has become a worldwide public health problem, but its etiology remains unclear. Accumulating evidence shows that PTB is a syndrome that can be attributed to a variety of pathological processes(5). Inflammatory diseases and genetic background are known risk factors for PTB, many studies had shown that genetic variations in proinflammatory cytokines such as tumor necrosis factor-α (TNF-α) and interleukin-1 α (IL-1 α) are associated with increased risk of PTB, but the relationship between genetic polymorphism in anti-inflammatory cytokines and risk of PTB remains controversial.
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Jauny, Ray, and John Parsons. Delirium Assessment and Management: A qualitative study on aged-care nurses’ experiences. Unitec ePress, November 2017. http://dx.doi.org/10.34074/ocds.72017.

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Aged residential care (ARC) residents with morbid health conditions frequently experience delirium. This condition is associated with diminished quality of life, preventable morbidity and untimely death. It is challenging and costly to manage delirium because of the complex interplay of physical and psychiatric symptoms associated with this condition in both primary and secondary services. With awareness of risk factors and knowledge about delirium, ARC nurses can play a vital role in early identification, assessment and treatment, but most importantly in preventing delirium in aged-care residents as well as improving health outcomes. Focus groups were carried out with ARC nurses to ascertain their opinions on how they assess and manage delirium in ARC facilities in South Auckland, New Zealand. Findings identified that there were strengths and weaknesses, as well as gaps in assessment and management of delirium. Nurses would benefit from delirium education, appropriate tools and adequate resources to help them manage delirium. Issues with diagnosing delirium, anxiety about challenging behaviours, family dynamics, lack of training and absence of IV treatment were noticeable features in this study.
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Stall, Nathan M., Kevin A. Brown, Antonina Maltsev, Aaron Jones, Andrew P. Costa, Vanessa Allen, Adalsteinn D. Brown, et al. COVID-19 and Ontario’s Long-Term Care Homes. Ontario COVID-19 Science Advisory Table, January 2021. http://dx.doi.org/10.47326/ocsat.2021.02.07.1.0.

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Key Message Ontario long-term care (LTC) home residents have experienced disproportionately high morbidity and mortality, both from COVID-19 and from the conditions associated with the COVID-19 pandemic. There are several measures that could be effective in preventing COVID-19 outbreaks, hospitalizations, and deaths in Ontario’s LTC homes, if implemented. First, temporary staffing could be minimized by improving staff working conditions. Second, homes could be further decrowded by a continued disallowance of three- and four-resident rooms and additional temporary housing for the most crowded homes. Third, the risk of SARS-CoV-2 infection in staff could be minimized by approaches that reduce the risk of transmission in communities with a high burden of COVID-19. Summary Background The Province of Ontario has 626 licensed LTC homes and 77,257 long-stay beds; 58% of homes are privately owned, 24% are non-profit/charitable, 16% are municipal. LTC homes were strongly affected during Ontario’s first and second waves of the COVID-19 pandemic. Questions What do we know about the first and second waves of COVID-19 in Ontario LTC homes? Which risk factors are associated with COVID-19 outbreaks in Ontario LTC homes and the extent and death rates associated with outbreaks? What has been the impact of the COVID-19 pandemic on the general health and wellbeing of LTC residents? How has the existing Ontario evidence on COVID-19 in LTC settings been used to support public health interventions and policy changes in these settings? What are the further measures that could be effective in preventing COVID-19 outbreaks, hospitalizations, and deaths in Ontario’s LTC homes? Findings As of January 14, 2021, a total of 3,211 Ontario LTC home residents have died of COVID-19, totaling 60.7% of all 5,289 COVID-19 deaths in Ontario to date. There have now been more cumulative LTC home outbreaks during the second wave as compared with the first wave. The infection and death rates among LTC residents have been lower during the second wave, as compared with the first wave, and a greater number of LTC outbreaks have involved only staff infections. The growth rate of SARS-CoV-2 infections among LTC residents was slower during the first two months of the second wave in September and October 2020, as compared with the first wave. However, the growth rate after the two-month mark is comparatively faster during the second wave. The majority of second wave infections and deaths in LTC homes have occurred between December 1, 2020, and January 14, 2021 (most recent date of data extraction prior to publication). This highlights the recent intensification of the COVID-19 pandemic in LTC homes that has mirrored the recent increase in community transmission of SARS-CoV-2 across Ontario. Evidence from Ontario demonstrates that the risk factors for SARS-CoV-2 outbreaks and subsequent deaths in LTC are distinct from the risk factors for outbreaks and deaths in the community (Figure 1). The most important risk factors for whether a LTC home will experience an outbreak is the daily incidence of SARS-CoV-2 infections in the communities surrounding the home and the occurrence of staff infections. The most important risk factors for the magnitude of an outbreak and the number of resulting resident deaths are older design, chain ownership, and crowding. Figure 1. Anatomy of Outbreaks and Spread of COVID-19 in LTC Homes and Among Residents Figure from Peter Hamilton, personal communication. Many Ontario LTC home residents have experienced severe and potentially irreversible physical, cognitive, psychological, and functional declines as a result of precautionary public health interventions imposed on homes, such as limiting access to general visitors and essential caregivers, resident absences, and group activities. There has also been an increase in the prescribing of psychoactive drugs to Ontario LTC residents. The accumulating evidence on COVID-19 in Ontario’s LTC homes has been leveraged in several ways to support public health interventions and policy during the pandemic. Ontario evidence showed that SARS-CoV-2 infections among LTC staff was associated with subsequent COVID-19 deaths among LTC residents, which motivated a public order to restrict LTC staff from working in more than one LTC home in the first wave. Emerging Ontario evidence on risk factors for LTC home outbreaks and deaths has been incorporated into provincial pandemic surveillance tools. Public health directives now attempt to limit crowding in LTC homes by restricting occupancy to two residents per room. The LTC visitor policy was also revised to designate a maximum of two essential caregivers who can visit residents without time limits, including when a home is experiencing an outbreak. Several further measures could be effective in preventing COVID-19 outbreaks, hospitalizations, and deaths in Ontario’s LTC homes. First, temporary staffing could be minimized by improving staff working conditions. Second, the risk of SARS-CoV-2 infection in staff could be minimized by measures that reduce the risk of transmission in communities with a high burden of COVID-19. Third, LTC homes could be further decrowded by a continued disallowance of three- and four-resident rooms and additional temporary housing for the most crowded homes. Other important issues include improved prevention and detection of SARS-CoV-2 infection in LTC staff, enhanced infection prevention and control (IPAC) capacity within the LTC homes, a more balanced and nuanced approach to public health measures and IPAC strategies in LTC homes, strategies to promote vaccine acceptance amongst residents and staff, and further improving data collection on LTC homes, residents, staff, visitors and essential caregivers for the duration of the COVID-19 pandemic. Interpretation Comparisons of the first and second waves of the COVID-19 pandemic in the LTC setting reveal improvement in some but not all epidemiological indicators. Despite this, the second wave is now intensifying within LTC homes and without action we will likely experience a substantial additional loss of life before the widespread administration and time-dependent maximal effectiveness of COVID-19 vaccines. The predictors of outbreaks, the spread of infection, and deaths in Ontario’s LTC homes are well documented and have remained unchanged between the first and the second wave. Some of the evidence on COVID-19 in Ontario’s LTC homes has been effectively leveraged to support public health interventions and policies. Several further measures, if implemented, have the potential to prevent additional LTC home COVID-19 outbreaks and deaths.
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Rankin, Nicole, Deborah McGregor, Candice Donnelly, Bethany Van Dort, Richard De Abreu Lourenco, Anne Cust, and Emily Stone. Lung cancer screening using low-dose computed tomography for high risk populations: Investigating effectiveness and screening program implementation considerations: An Evidence Check rapid review brokered by the Sax Institute (www.saxinstitute.org.au) for the Cancer Institute NSW. The Sax Institute, October 2019. http://dx.doi.org/10.57022/clzt5093.

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Background Lung cancer is the number one cause of cancer death worldwide.(1) It is the fifth most commonly diagnosed cancer in Australia (12,741 cases diagnosed in 2018) and the leading cause of cancer death.(2) The number of years of potential life lost to lung cancer in Australia is estimated to be 58,450, similar to that of colorectal and breast cancer combined.(3) While tobacco control strategies are most effective for disease prevention in the general population, early detection via low dose computed tomography (LDCT) screening in high-risk populations is a viable option for detecting asymptomatic disease in current (13%) and former (24%) Australian smokers.(4) The purpose of this Evidence Check review is to identify and analyse existing and emerging evidence for LDCT lung cancer screening in high-risk individuals to guide future program and policy planning. Evidence Check questions This review aimed to address the following questions: 1. What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? 2. What is the evidence of potential harms from lung cancer screening for higher-risk individuals? 3. What are the main components of recent major lung cancer screening programs or trials? 4. What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Summary of methods The authors searched the peer-reviewed literature across three databases (MEDLINE, PsycINFO and Embase) for existing systematic reviews and original studies published between 1 January 2009 and 8 August 2019. Fifteen systematic reviews (of which 8 were contemporary) and 64 original publications met the inclusion criteria set across the four questions. Key findings Question 1: What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? There is sufficient evidence from systematic reviews and meta-analyses of combined (pooled) data from screening trials (of high-risk individuals) to indicate that LDCT examination is clinically effective in reducing lung cancer mortality. In 2011, the landmark National Lung Cancer Screening Trial (NLST, a large-scale randomised controlled trial [RCT] conducted in the US) reported a 20% (95% CI 6.8% – 26.7%; P=0.004) relative reduction in mortality among long-term heavy smokers over three rounds of annual screening. High-risk eligibility criteria was defined as people aged 55–74 years with a smoking history of ≥30 pack-years (years in which a smoker has consumed 20-plus cigarettes each day) and, for former smokers, ≥30 pack-years and have quit within the past 15 years.(5) All-cause mortality was reduced by 6.7% (95% CI, 1.2% – 13.6%; P=0.02). Initial data from the second landmark RCT, the NEderlands-Leuvens Longkanker Screenings ONderzoek (known as the NELSON trial), have found an even greater reduction of 26% (95% CI, 9% – 41%) in lung cancer mortality, with full trial results yet to be published.(6, 7) Pooled analyses, including several smaller-scale European LDCT screening trials insufficiently powered in their own right, collectively demonstrate a statistically significant reduction in lung cancer mortality (RR 0.82, 95% CI 0.73–0.91).(8) Despite the reduction in all-cause mortality found in the NLST, pooled analyses of seven trials found no statistically significant difference in all-cause mortality (RR 0.95, 95% CI 0.90–1.00).(8) However, cancer-specific mortality is currently the most relevant outcome in cancer screening trials. These seven trials demonstrated a significantly greater proportion of early stage cancers in LDCT groups compared with controls (RR 2.08, 95% CI 1.43–3.03). Thus, when considering results across mortality outcomes and early stage cancers diagnosed, LDCT screening is considered to be clinically effective. Question 2: What is the evidence of potential harms from lung cancer screening for higher-risk individuals? The harms of LDCT lung cancer screening include false positive tests and the consequences of unnecessary invasive follow-up procedures for conditions that are eventually diagnosed as benign. While LDCT screening leads to an increased frequency of invasive procedures, it does not result in greater mortality soon after an invasive procedure (in trial settings when compared with the control arm).(8) Overdiagnosis, exposure to radiation, psychological distress and an impact on quality of life are other known harms. Systematic review evidence indicates the benefits of LDCT screening are likely to outweigh the harms. The potential harms are likely to be reduced as refinements are made to LDCT screening protocols through: i) the application of risk predication models (e.g. the PLCOm2012), which enable a more accurate selection of the high-risk population through the use of specific criteria (beyond age and smoking history); ii) the use of nodule management algorithms (e.g. Lung-RADS, PanCan), which assist in the diagnostic evaluation of screen-detected nodules and cancers (e.g. more precise volumetric assessment of nodules); and, iii) more judicious selection of patients for invasive procedures. Recent evidence suggests a positive LDCT result may transiently increase psychological distress but does not have long-term adverse effects on psychological distress or health-related quality of life (HRQoL). With regards to smoking cessation, there is no evidence to suggest screening participation invokes a false sense of assurance in smokers, nor a reduction in motivation to quit. The NELSON and Danish trials found no difference in smoking cessation rates between LDCT screening and control groups. Higher net cessation rates, compared with general population, suggest those who participate in screening trials may already be motivated to quit. Question 3: What are the main components of recent major lung cancer screening programs or trials? There are no systematic reviews that capture the main components of recent major lung cancer screening trials and programs. We extracted evidence from original studies and clinical guidance documents and organised this into key groups to form a concise set of components for potential implementation of a national lung cancer screening program in Australia: 1. Identifying the high-risk population: recruitment, eligibility, selection and referral 2. Educating the public, people at high risk and healthcare providers; this includes creating awareness of lung cancer, the benefits and harms of LDCT screening, and shared decision-making 3. Components necessary for health services to deliver a screening program: a. Planning phase: e.g. human resources to coordinate the program, electronic data systems that integrate medical records information and link to an established national registry b. Implementation phase: e.g. human and technological resources required to conduct LDCT examinations, interpretation of reports and communication of results to participants c. Monitoring and evaluation phase: e.g. monitoring outcomes across patients, radiological reporting, compliance with established standards and a quality assurance program 4. Data reporting and research, e.g. audit and feedback to multidisciplinary teams, reporting outcomes to enhance international research into LDCT screening 5. Incorporation of smoking cessation interventions, e.g. specific programs designed for LDCT screening or referral to existing community or hospital-based services that deliver cessation interventions. Most original studies are single-institution evaluations that contain descriptive data about the processes required to establish and implement a high-risk population-based screening program. Across all studies there is a consistent message as to the challenges and complexities of establishing LDCT screening programs to attract people at high risk who will receive the greatest benefits from participation. With regards to smoking cessation, evidence from one systematic review indicates the optimal strategy for incorporating smoking cessation interventions into a LDCT screening program is unclear. There is widespread agreement that LDCT screening attendance presents a ‘teachable moment’ for cessation advice, especially among those people who receive a positive scan result. Smoking cessation is an area of significant research investment; for instance, eight US-based clinical trials are now underway that aim to address how best to design and deliver cessation programs within large-scale LDCT screening programs.(9) Question 4: What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Assessing the value or cost-effectiveness of LDCT screening involves a complex interplay of factors including data on effectiveness and costs, and institutional context. A key input is data about the effectiveness of potential and current screening programs with respect to case detection, and the likely outcomes of treating those cases sooner (in the presence of LDCT screening) as opposed to later (in the absence of LDCT screening). Evidence about the cost-effectiveness of LDCT screening programs has been summarised in two systematic reviews. We identified a further 13 studies—five modelling studies, one discrete choice experiment and seven articles—that used a variety of methods to assess cost-effectiveness. Three modelling studies indicated LDCT screening was cost-effective in the settings of the US and Europe. Two studies—one from Australia and one from New Zealand—reported LDCT screening would not be cost-effective using NLST-like protocols. We anticipate that, following the full publication of the NELSON trial, cost-effectiveness studies will likely be updated with new data that reduce uncertainty about factors that influence modelling outcomes, including the findings of indeterminate nodules. Gaps in the evidence There is a large and accessible body of evidence as to the effectiveness (Q1) and harms (Q2) of LDCT screening for lung cancer. Nevertheless, there are significant gaps in the evidence about the program components that are required to implement an effective LDCT screening program (Q3). Questions about LDCT screening acceptability and feasibility were not explicitly included in the scope. However, as the evidence is based primarily on US programs and UK pilot studies, the relevance to the local setting requires careful consideration. The Queensland Lung Cancer Screening Study provides feasibility data about clinical aspects of LDCT screening but little about program design. The International Lung Screening Trial is still in the recruitment phase and findings are not yet available for inclusion in this Evidence Check. The Australian Population Based Screening Framework was developed to “inform decision-makers on the key issues to be considered when assessing potential screening programs in Australia”.(10) As the Framework is specific to population-based, rather than high-risk, screening programs, there is a lack of clarity about transferability of criteria. However, the Framework criteria do stipulate that a screening program must be acceptable to “important subgroups such as target participants who are from culturally and linguistically diverse backgrounds, Aboriginal and Torres Strait Islander people, people from disadvantaged groups and people with a disability”.(10) An extensive search of the literature highlighted that there is very little information about the acceptability of LDCT screening to these population groups in Australia. Yet they are part of the high-risk population.(10) There are also considerable gaps in the evidence about the cost-effectiveness of LDCT screening in different settings, including Australia. The evidence base in this area is rapidly evolving and is likely to include new data from the NELSON trial and incorporate data about the costs of targeted- and immuno-therapies as these treatments become more widely available in Australia.
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Gindi, Renee. Health, United States, 2019. Centers for Disease Control and Prevention (U.S.), 2021. http://dx.doi.org/10.15620/cdc:100685.

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Health, United States, 2019 is the 43rd report on the health status of the nation and is submitted by the Secretary of the Department of Health and Human Services to the President and the Congress of the United States in compliance with Section 308 of the Public Health Service Act. This report was compiled by the National Center for Health Statistics (NCHS) of the Centers for Disease Control and Prevention (CDC). The Health, United States series presents an annual overview of national trends in key health indicators. The 2019 report presents trends and current information on selected measures of morbidity, mortality, health care utilization and access, health risk factors, prevention, health insurance, and personal health care expenditures in a 20-figure chartbook. The Health, United States, 2019 Chartbook is supplemented by several other products including Trend Tables, an At-a-Glance table, and Appendixes available for download on the Health, United States website at: https://www.cdc.gov/nchs/hus/ index.htm. The Health, United States, 2019 Chartbook contains 20 figures and 20 tables on health and health care in the United States. Examining trends in health informs the development, implementation, and evaluation of health policies and programs. The first section (Figures 1–13) focuses on health status and determinants: life expectancy, infant mortality, selected causes of death, overdose deaths, suicide, maternal mortality, teen births, preterm births, use of tobacco products, asthma, hypertension, heart disease and cancer, and functional limitations. The second section (Figures 14–15) presents trends in health care utilization: use of mammography and colorectal tests and unmet medical needs. The third section (Figures 16–17) focuses on health care resources: availability of physicians and dentists. The fourth section (Figures 18–20) describes trends in personal health care expenditures, health insurance coverage, and supplemental insurance coverage among Medicare beneficiaries. The Highlights section summarizes major findings from the Chartbook. Suggested citation: National Center for Health Statistics. Health, United States, 2019. Hyattsville, MD. 2021.
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Newman-Toker, David E., Susan M. Peterson, Shervin Badihian, Ahmed Hassoon, Najlla Nassery, Donna Parizadeh, Lisa M. Wilson, et al. Diagnostic Errors in the Emergency Department: A Systematic Review. Agency for Healthcare Research and Quality (AHRQ), December 2022. http://dx.doi.org/10.23970/ahrqepccer258.

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Objectives. Diagnostic errors are a known patient safety concern across all clinical settings, including the emergency department (ED). We conducted a systematic review to determine the most frequent diseases and clinical presentations associated with diagnostic errors (and resulting harms) in the ED, measure error and harm frequency, as well as assess causal factors. Methods. We searched PubMed®, Cumulative Index to Nursing and Allied Health Literature (CINAHL®), and Embase® from January 2000 through September 2021. We included research studies and targeted grey literature reporting diagnostic errors or misdiagnosis-related harms in EDs in the United States or other developed countries with ED care deemed comparable by a technical expert panel. We applied standard definitions for diagnostic errors, misdiagnosis-related harms (adverse events), and serious harms (permanent disability or death). Preventability was determined by original study authors or differences in harms across groups. Two reviewers independently screened search results for eligibility; serially extracted data regarding common diseases, error/harm rates, and causes/risk factors; and independently assessed risk of bias of included studies. We synthesized results for each question and extrapolated U.S. estimates. We present 95 percent confidence intervals (CIs) or plausible range (PR) bounds, as appropriate. Results. We identified 19,127 citations and included 279 studies. The top 15 clinical conditions associated with serious misdiagnosis-related harms (accounting for 68% [95% CI 66 to 71] of serious harms) were (1) stroke, (2) myocardial infarction, (3) aortic aneurysm and dissection, (4) spinal cord compression and injury, (5) venous thromboembolism, (6/7 – tie) meningitis and encephalitis, (6/7 – tie) sepsis, (8) lung cancer, (9) traumatic brain injury and traumatic intracranial hemorrhage, (10) arterial thromboembolism, (11) spinal and intracranial abscess, (12) cardiac arrhythmia, (13) pneumonia, (14) gastrointestinal perforation and rupture, and (15) intestinal obstruction. Average disease-specific error rates ranged from 1.5 percent (myocardial infarction) to 56 percent (spinal abscess), with additional variation by clinical presentation (e.g., missed stroke average 17%, but 4% for weakness and 40% for dizziness/vertigo). There was also wide, superimposed variation by hospital (e.g., missed myocardial infarction 0% to 29% across hospitals within a single study). An estimated 5.7 percent (95% CI 4.4 to 7.1) of all ED visits had at least one diagnostic error. Estimated preventable adverse event rates were as follows: any harm severity (2.0%, 95% CI 1.0 to 3.6), any serious harms (0.3%, PR 0.1 to 0.7), and deaths (0.2%, PR 0.1 to 0.4). While most disease-specific error rates derived from mainly U.S.-based studies, overall error and harm rates were derived from three prospective studies conducted outside the United States (in Canada, Spain, and Switzerland, with combined n=1,758). If overall rates are generalizable to all U.S. ED visits (130 million, 95% CI 116 to 144), this would translate to 7.4 million (PR 5.1 to 10.2) ED diagnostic errors annually; 2.6 million (PR 1.1 to 5.2) diagnostic adverse events with preventable harms; and 371,000 (PR 142,000 to 909,000) serious misdiagnosis-related harms, including more than 100,000 permanent, high-severity disabilities and 250,000 deaths. Although errors were often multifactorial, 89 percent (95% CI 88 to 90) of diagnostic error malpractice claims involved failures of clinical decision-making or judgment, regardless of the underlying disease present. Key process failures were errors in diagnostic assessment, test ordering, and test interpretation. Most often these were attributed to inadequate knowledge, skills, or reasoning, particularly in “atypical” or otherwise subtle case presentations. Limitations included use of malpractice claims and incident reports for distribution of diseases leading to serious harms, reliance on a small number of non-U.S. studies for overall (disease-agnostic) diagnostic error and harm rates, and methodologic variability across studies in measuring disease-specific rates, determining preventability, and assessing causal factors. Conclusions. Although estimated ED error rates are low (and comparable to those found in other clinical settings), the number of patients potentially impacted is large. Not all diagnostic errors or harms are preventable, but wide variability in diagnostic error rates across diseases, symptoms, and hospitals suggests improvement is possible. With 130 million U.S. ED visits, estimated rates for diagnostic error (5.7%), misdiagnosis-related harms (2.0%), and serious misdiagnosis-related harms (0.3%) could translate to more than 7 million errors, 2.5 million harms, and 350,000 patients suffering potentially preventable permanent disability or death. Over two-thirds of serious harms are attributable to just 15 diseases and linked to cognitive errors, particularly in cases with “atypical” manifestations. Scalable solutions to enhance bedside diagnostic processes are needed, and these should target the most commonly misdiagnosed clinical presentations of key diseases causing serious harms. New studies should confirm overall rates are representative of current U.S.-based ED practice and focus on identified evidence gaps (errors among common diseases with lower-severity harms, pediatric ED errors and harms, dynamic systems factors such as overcrowding, and false positives). Policy changes to consider based on this review include: (1) standardizing measurement and research results reporting to maximize comparability of measures of diagnostic error and misdiagnosis-related harms; (2) creating a National Diagnostic Performance Dashboard to track performance; and (3) using multiple policy levers (e.g., research funding, public accountability, payment reforms) to facilitate the rapid development and deployment of solutions to address this critically important patient safety concern.
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10

Chejanovsky, Nor, Diana Cox-Foster, Victoria Soroker, and Ron Ophir. Honeybee modulation of infection with the Israeli acute paralysis virus, in asymptomatic, acutely infected and CCD colonies. United States Department of Agriculture, December 2013. http://dx.doi.org/10.32747/2013.7594392.bard.

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Abstract:
Honey bee (Apis mellifera) colony losses pose a severe risk to the food chain. The IAPV (Israeli acute paralysis virus) was correlated with CCD, a particular case of colony collapse. Honey bees severely infected with IAPV show shivering wings that progress to paralysis and subsequent death. Bee viruses, including IAPV, are widely present in honey bee colonies but often there are no pathological symptoms. Infestation of the beehive with Varroa mites or exposure to stress factors leads to significant increase in viral titers and fatal infections. We hypothesized that the honey bee is regulating/controlling IAPV and viral infections in asymptomatic infections and this control is broken through "stress" leading to acute infections and/or CCD. Our aims were: 1. To discover genetic changes in IAPV that may affect tissue tropism in the host, and/or virus infectivity and pathogenicity. 2. To elucidate mechanisms used by the host to regulate/ manage the IAPV-infection in vivo and in vitro. To achieve the above objectives we first studied stress-induced virus activation. Our data indicated that some pesticides, including myclobutanil, chlorothalonil and fluvalinate, result in amplified viral titers when bees are exposed at sub lethal levels by a single feeding. Analysis of the level of immune-related bee genes indicated that CCD-colonies exhibit altered and weaker immune responses than healthy colonies. Given the important role of viral RNA interference (RNAi) in combating viral infections we investigated if CCD-colonies were able to elicit this particular antiviral response. Deep-sequencing analysis of samples from CCD-colonies from US and Israel revealed high frequency of small interfering RNAs (siRNA) perfectly matching IAPV, Kashmir bee virus and Deformed wing virus genomes. Israeli colonies showed high titers of IAPV and a conserved RNAi pattern of targeting the viral genome .Our findings were further supported by analysis of samples from colonies experimentally infected with IAPV. Following for the first time the dynamics of IAPV infection in a group of CCD colonies that we rescued from collapse, we found that IAPV conserves its potential to act as one lethal, infectious factor and that its continuous replication in CCD colonies deeply affects their health and survival. Ours is the first report on the dominant role of IAPV in CCD-colonies outside from the US under natural conditions. We concluded that CCD-colonies do exhibit a regular siRNA response that is specific against predominant viruses associated with colony losses and other immune pathways may account for their weak immune response towards virus infection. Our findings: 1. Reveal that preventive measures should be taken by the beekeepers to avoid insecticide-based stress induction of viral infections as well as to manage CCD colonies as a source of highly infectious viruses such as IAPV. 2. Contribute to identify honey bee mechanisms involved in managing viral infections.
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