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Postpartum Office Visit

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1281. A Fifty-two-week Study to Evaluate the Safety of Saredutant in Adult and Elderly Patients With Depression

or disease Intervention/treatment Phase Depressive Disorder Drug: Saredutant succinate (SR48968C) Phase 3 Detailed Description: The study is a multicenter, US, open-label study consisting of two segments (A and B). Segment A is a minimum 1-week (maximum 4-week) screening period and Segment B is a 52-week, open-label period. All treated patients must complete a post-study telephone visit and a post-study office visit 3 days and 1 week, respectively, after intake of the last dose of study medication. Study (...) Rating Scale (HAM-D). Exclusion Criteria: Patients whose current depressive episode is diagnosed with psychotic features, catatonic features, seasonal pattern or post-partum onset. The duration of the current depressive episode is greater than 2 years. Patients who are currently suicidal or have a history of a suicide attempt within 3 years prior to entry. Patients whose current depressive episode is secondary to a general medical disorder. Patients with a history or presence of bipolar disorders

2005 Clinical Trials

1282. An Eight-Week Study to Evaluate the Efficacy and Safety of Saredutant in Patients With Depression

for enrollment into Segment C, a 44-week, double blind extension. All randomized patients must complete a post-study visit 1 week after intake of the last dose of study medication. Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 465 participants Allocation: Randomized Intervention Model: Parallel Assignment Masking: Double (Participant, Investigator) Primary Purpose: Treatment Official Title: An Eight-Week, Multicenter, Double-Blind (...) and Statistical Manual of Mental Disorders, 4th edition, Text Revision criteria and confirmed by the semi-structured Mini International Neuropsychiatric Interview (MINI), recurrent episode for at least one month prior to the entry. 8.Minimum total score of 22 on the Montgomery-Asberg Depression Rating Scale (MADRS). Exclusion Criteria: 1.Patients whose current depressive episode is diagnosed with psychotic features, catatonic features, seasonal pattern or post-partum onset. 2.The duration of the current

2005 Clinical Trials

1283. An Eight-week Study to Evaluate the Efficacy and Safety of Saredutant in Patients With Depression

for enrollment into Segment C, a 44-week, double blind extension. All randomized patients must complete a post-study telephone visit and a post-study office visit 3 days and 1 week, respectively, after intake of the last dose of study medication. Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 452 participants Allocation: Randomized Intervention Model: Parallel Assignment Masking: Double (Participant, Investigator) Primary Purpose (...) , seasonal pattern or post-partum onset. 2.The duration of the current depressive episode is greater than 2 years. 3.Patients who are currently suicidal or have a history of a suicide attempt within 3 years prior to entry. 4.Patients whose current depressive episode is secondary to a general medical disorder. 5.Patients with a history or presence of bipolar disorders or psychotic disorders according to the D and L criteria of the MINI. 6.Patients with alcohol dependence or abuse or substance dependence

2005 Clinical Trials

1284. An Eight-week Study to Evaluate the Efficacy and Safety of Saredutant in Patients With Depression

B may be eligible for enrollment into Segment C, a 44-week, double blind extension. All randomized patients must complete a post-study telephone visit and a post-study office visit 3 days and 1 week, respectively, after intake of the last dose of study medication. Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 460 participants Allocation: Randomized Intervention Model: Parallel Assignment Masking: Double (Participant (...) features, catatonic features, seasonal pattern or post-partum onset. 2.The duration of the current depressive episode is greater than 2 years. 3.Patients who are currently suicidal or have a history of a suicide attempt within 3 years prior to entry. 4.Patients whose current depressive episode is secondary to a general medical disorder. 5.Patients with a history or presence of bipolar disorders or psychotic disorders according to the D and L criteria of the MINI. 6.Patients with alcohol dependence

2005 Clinical Trials

1285. Impact of Maternal Vitamin A or Beta-Carotene Supplementation on Maternal and Infant Mortality in Bangladesh

status, including apparent birth defects that are later physician-confirmed. An additional home health assessment occurs at 6 months post partum, and vital status is recorded for mother and infant at one year postpartum. A ~3% subsample of enrolled pregnant women participate in a substudy involving enhanced clinical, anthropometric, biochemical, body compositional, morbidity and interview-based assessment protocols in the 1st, 2nd and 3rd trimesters, and at 3 months post-partum. Reported maternal (...) , Pregnancy-related Mortality [ Time Frame: Deaths during pregnancy through 12 weeks postpartum ] Mortality evaluated on intent-to-treat basis Secondary Outcome Measures : All-cause 3-month Infant Mortality [ Time Frame: Deaths through the 1st 12 weeks of life ] Maternal Morbidity, Including Obstetric Complications [ Time Frame: through the 1st 24 weeks following termination of pregnancy ] Gestational Age at Birth [ Time Frame: within 24 weeks after birth ] Fetal Growth and Postnatal Infant Growth Through

2005 Clinical Trials

1286. Community Based Interventions to Reduce Neonatal Mortality in Bangladesh

Based Interventions to Reduce Neonatal Mortality in Bangladesh The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT00198705 Recruitment Status : Completed First Posted : September 20, 2005 Last Update Posted : September 16, 2014 Sponsor: Johns Hopkins Bloomberg School of Public Health Collaborators (...) the Children/USA, Bangladesh Field Office (SC/BFO), d) Shimantik, a Bangladeshi NGO, e) BRAC/Bangladesh, f) Dhaka Shishu Hospital and g) the Institute of Child and Mother Health (ICMH). The project is funded through four mechanisms: 1) USAID Global funding to cover expenses of JHSPH to design and to provide technical assistance in the implementation and evaluation of the various components of the project, 2) SNL/SC funding to JHSPH to sub-contract the Bangladeshi institutions listed above to support

2005 Clinical Trials

1287. Effect of massaging babies on mothers: pilot study on the changes in mood states and salivary cortisol level. (Abstract)

Effect of massaging babies on mothers: pilot study on the changes in mood states and salivary cortisol level. The purpose of this pilot study was to evaluate the effects of baby massage for 3 months after delivery on mothers' mood status and salivary cortisol level. Study participants were a convenient sample of mothers who delivered their babies at a hospital in Japan, and were recruited at the time of the routine 5-6 weeks postnatal visit to the pediatric office. Thirty-nine mothers were

2006 Complementary Therapies in Clinical Practice Controlled trial quality: uncertain

1288. Maternal depressive symptoms and children's receipt of health care in the first 3 years of life. Full Text available with Trip Pro

Maternal depressive symptoms and children's receipt of health care in the first 3 years of life. Maternal depression is widely recognized to negatively influence mother-child interactions and children's behavior and development, but little is known about its relation to children's receipt of health care.To determine if maternal depressive symptoms reported at 2 to 4 and 30 to 33 months postpartum are associated with children's receipt of acute and preventive health care services in the first 30 (...) months.Cohort study of data collected prospectively as part of the National Evaluation of Healthy Steps for Young Children (HS). Data sources included medical records abstracted for the first 32 months, enrollment questionnaires, and parent interviews when children were 2 to 4 and 30 to 33 months old. Acute care use included hospitalizations and emergency department visits. Preventive care included well-child visits and vaccinations. Maternal depressive symptoms were assessed by using the Center

2005 Pediatrics

1289. Rett Syndrome

dystrophy. . . A variety of (usually rare) neurodegenerative conditions that may affect children in their second decade. Diagnostic Criteria for Rett Syndrome In spite of molecular genetics, Rett syndrome remains a clinical diagnosis. The diagnostic criteria were updated in 2010 [ ] . The diagnosis of Rett syndrome should be considered when there has been a postnatal deceleration of head growth. Typical or classic Rett syndrome For this, the following are required: A period of regression followed (...) of acquired spoken language. Gait abnormalities: impaired (dyspraxic), or absence of, ability. Stereotypic hand movements such as hand-wringing/squeezing, clapping/tapping, mouthing and washing/rubbing automatisms. Exclusion criteria for typical Rett syndrome Brain injury secondary to trauma (perinatally or postnatally), neurometabolic disease, or severe. Infection that causes neurological problems. Grossly abnormal psychomotor development in first six months of life. Supportive criteria for atypical Rett

2008 Mentor

1290. Retained Placenta

with active management or 60 minutes if allowed to deliver the placenta physiologically with maternal effort. [ ] Retained placenta is important as it is one of the causes of , which is the third leading cause of maternal mortality in the UK. [ ] Retained placenta increases the risks of a postpartum haemorrhage by five-fold (3.36-7.87; 99% confidence interval (CI)). [ ] Aetiology There are three main types of retained placenta following vaginal delivery, which can all be treated by manual removal (...) of the placenta: [ ] Placenta adherens, when the myometrium fails to contract behind the placenta. Trapped placenta, when a detached placenta is trapped behind a closed cervix. Partial accreta, when there is a small area of adherent placenta preventing detachment. Rarely there is an which leads it to penetrate the myometrium to a varying degree preventing manual removal without risking significant postpartum haemorrhage. Epidemiology The incidence and importance of retained placenta vary greatly around

2008 Mentor

1291. Retinopathy of Prematurity (Retrolental Fibroplasia)

of weeks of age since conception. [ ] The timing of screening and therefore the window of opportunity for treatment depends on this rather than the baby's post-birth age, especially in the more preterm infants. Current guidelines are: Screen all infants born at <32 weeks of gestational age or weighing <1501 g. Babies born before 27 weeks are screened at 30-31 weeks of PMA. Babies born between 27-32 weeks OR weighing <1501 g are screened at 28-35 days of postnatal age. Screening is weekly or fortnightly (...) agree to our and . Subscribe Thanks for your feedback. if you would like to report a specific issue with this page, please visit our . Thank you, we just sent a survey email to confirm your preferences. Further reading and references ; Retinopathy of prematurity and the peripheral retina. J Pediatr. 2008 Nov153(5):591-2. ; Incidence of retinopathy of prematurity in Lothian, Scotland, from 1990 to 2004. Arch Dis Child Fetal Neonatal Ed. 2008 Nov93(6):F422-6. Epub 2008 May 7. ; Retinopathy

2008 Mentor

1292. Resuscitation in Hypovolaemic Shock

of haemorrhage [ ] . It involves introducing a balloon via the femoral artery into the aorta, which is then inflated and in effect cuts off blood supply above the haemorrhaging point. It has been used in various settings, including postpartum haemorrhage, trauma, upper gastrointestinal bleeding and ruptured aortic aneurysm. It is only a temporary measure until more definitive treatment to halt the haemorrhage can take place. The evidence base is currently limited [ , ] . Complications Blood is directed away (...) slight dehydration has a marked adverse effect on fitness. Did you find this information useful? Thanks for your feedback! Why not subscribe to the newsletter? Email address * We'd love to send you our articles and latest news by email, giving you the best opportunity to stay up to date with expert written health and lifestyle content. By clicking 'Subscribe' you agree to our and . Subscribe Thanks for your feedback. if you would like to report a specific issue with this page, please visit our

2008 Mentor

1293. Renal Disease in Pregnancy

generally take up to three months postpartum to subside. Renal function in pregnancy Values considered normal when not pregnant may reflect decreased renal function in pregnancy. Creatinine above 75 μmol/L and urea above 4.5 mmol/L are indications for further investigation. [ ] The use of (eGFR) is not recommended in pregnancy. [ ] Glycosuria is common and does not usually indicate diabetes or impaired glucose tolerance. Urinary protein excretion increases during pregnancy, but never to more than 300 mg (...) and UTIs in pregnancy should be treated with antibiotics. Antibiotic prophylaxis should be given to women with recurrent bacteriuria or UTIs and kidney disease. [ ] 20% of women having pyelonephritis in pregnancy have underlying renal tract abnormalities and an intravenous urogram (IVU) or ultrasound at 12 weeks postpartum should be considered. Pregnancy in patients with pre-existing renal disease Women with renal disease who are considering pregnancy should be offered pre-pregnancy assessment

2008 Mentor

1294. Pyometra

for postpartum haemorrhage to avoid hysterectomy - eg, the B-Lynch suture. Congenital cervical anomalies. [ ] Forgotten intrauterine device. Genital tuberculosis. Radiotherapy. Following egg retrieval in IVF. [ ] Epidemiology Pyometra is a rare disorder in humans, with a reported incidence of 0.01-0.5% of gynaecological patients. [ ] However, it is more common in elderly, postmenopausal women, usually with concurrent medical conditions. [ ] Pyometra is very rare in children but may occur. [ ] Presentation (...) Pyometra may exist without symptoms and is found as an incidental finding on imaging or post-mortem. Symptoms and signs may include: Blood-stained purulent vaginal discharge. Symmetrical uterine enlargement. Lower abdominal pain. Pyrexia (rare). Extremely rarely, a pyometra spontaneously perforates and the woman will present with an acute abdomen. [ ] Features on examination may be indistinguishable from other causes of peritonitis, with rigidity, tenderness rebound and guarding. [ ] Differential

2008 Mentor

1295. Pulmonary Hypoplasia

feedback. if you would like to report a specific issue with this page, please visit our . Thank you, we just sent a survey email to confirm your preferences. Further reading and references ; Unilateral pulmonary agenesis: a report of four cases, two diagnosed antenatally and literature review. Pediatr Pulmonol. 2014 Mar49(3):E96-102. doi: 10.1002/ppul.22920. Epub 2013 Oct 31. ; Online Mendelian Inheritance in Man (OMIM) ; Prenatal diagnosis of isolated right pulmonary agenesis using sonography alone (...) : case study and systematic literature review. J Ultrasound Med. 2012 Dec31(12):2017-23. ; Lung growth: implications for the newborn infant. Arch Dis Child Fetal Neonatal Ed. 2000 Jan ; Scimitar syndrome. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2006 ; Congenital lung abnormalities: embryologic features, prenatal diagnosis, and postnatal radiologic-pathologic correlation. Radiographics. 2010 Oct30(6):1721-38. doi: 10.1148/rg.306105508. ; Prenatal prediction of pulmonary hypoplasia

2008 Mentor

1296. Puerperal Pyrexia

. Nipple trauma and cellulitis. Usually caused by Staphylococcus spp. Postoperative infection following caesarean section : is the most important risk factor for puerperal pyrexia; there is a significantly increased risk of postpartum sepsis, wound problems, urinary tract infections and fever following LSCS. In the UK there is an 8% risk of infection following LSCS - appropriate antibiotic prophylaxis (not co-amoxiclav) before skin incision should be offered routinely. [ ] Prophylaxis reduces (...) , such as viral infection or chest infection. Glandular fever is probably a common cause of fever in the postpartum period. [ ] Presentation The symptoms with which the mother presents may well provide some idea of the source of the infection or there may be many symptoms referring to more than one system, which will require a systematic method of determining the problem. History A full history should be taken, to include a full history of the delivery - establish: When the membranes ruptured. The length

2008 Mentor

1297. Pulmonary Embolism

septum through a patent foramen ovale [ ] . Pregnancy [ ] PE is the leading cause of pregnancy-related maternal death in developed countries. The risk of PE is higher in the postpartum period, particularly after a caesarean section. Pregnancy does not alter the clinical features of PE but, as pregnant women often complain of breathlessness, this symptom should be interpreted with caution. See the separate article. Complications and prognosis If left untreated, the prognosis for PE is poor. Even when (...) from acute PE. Prevention See the separate article. Did you find this information useful? Thanks for your feedback! Why not subscribe to the newsletter? Email address * We'd love to send you our articles and latest news by email, giving you the best opportunity to stay up to date with expert written health and lifestyle content. By clicking 'Subscribe' you agree to our and . Subscribe Thanks for your feedback. if you would like to report a specific issue with this page, please visit our . Thank you

2008 Mentor

1298. Puerperal Mastitis Full Text available with Trip Pro

. You may find the article more useful, or one of our other . In this article In This Article Puerperal Mastitis In this article Mastitis means inflammation of the breast, and may be non-infectious or infectious in origin. In lactating women, it is essentially caused by an accumulation of milk. Epidemiology Between 10% and 33% of breast-feeding women develop lactation mastitis. [ , ] The incidence is highest in the first few weeks postpartum, decreasing gradually after that. [ ] However, cases may (...) to sleep through the whole night for example). Rapid weaning. Painful breasts. Preferred breast, leading to milk accumulation in the other. Pressure on the breast - due to tight clothing, seat belt, sleeping in the prone position. Nipple fissures, cracks and sores. Trauma to breasts. Blocked milk ducts. Presentation [ , ] Mastitis is diagnosed based on clinical symptoms and signs indicating inflammation - breast pain along with systemic features. Symptoms This normally presents ≥1 week postpartum

2008 Mentor

1299. Protein C Deficiency

and whether they still apply. Take into account the number of VTE events. Patients with ≥2 spontaneous VTEs normally require long-term anticoagulant prophylaxis. NB : long-term anticoagulation is required for patients with protein C deficiency who are homozygotes and compound heterozygotes for this condition. These patients would normally be identified and treated already, because of NPF or a childhood VTE. Pregnancy and postnatal period: [ ] Pregnancy and the puerperium are risk factors for VTE (...) compression stockings throughout the pregnancy. Seek haematology advice; however, in general: Women with previous VTE and thrombophilia should be offered thromboprophylaxis with low molecular weight heparin antenatally and for at least six weeks postpartum. Women with thrombophilia and no previous VTE should be stratified according to the level of risk associated with their thrombophilia. Consider using thromboprophylaxis antenatally and postpartum. Complications Possible complications include

2008 Mentor

1300. Small for Gestational Age (SGA) Babies

. By clicking 'Subscribe' you agree to our and . Subscribe Thanks for your feedback. if you would like to report a specific issue with this page, please visit our . Thank you, we just sent a survey email to confirm your preferences. Further reading and references ; MBRRACE-UK, Dec 2015 ; Royal College of Obstetricians and Gynaecologists Green-top guideline (Mar 2013) ; Intrauterine Growth Restriction: Antenatal and Postnatal Aspects. Clin Med Insights Pediatr. 2016 Jul 1410:67-83. doi: 10.4137/CMPed.S40070 (...) infection. The terms IUGR and SGA are often used synonymously. However, there is a difference in meaning [ ] : The SGA definition is based on the cross-sectional evaluation (either prenatal or postnatal) and this term has been used for those neonates whose birth weight is less than the 10th percentile for that particular gestational age or two standard deviations below the population norms on the growth charts. The definition considers only the birth weight without any consideration of the in-utero

2008 Mentor

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