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Genetic and transcriptional profiling results converged to implicate multiple candidate genes, including two previously associated with metabolism and mood Trhr and Ucp2. Results also highlighted bHR/bLR functional differences in the hippocampus, including a network essential for neurodevelopmental programming, proliferation, and differentiation, centering on Bmp4 and Mki67. Finally, we observed differential expression related to microglial activation, which is important for synaptic pruning, including 2 genes within implicated chromosomal regions C1qa and Mfge8.

These candidate genes and functional pathways may direct bHR/bLR rats along divergent developmental trajectories and promote a widely different reactivity to the environment.

These candidate genes and functional pathways may direct bHR/bLR rats along divergent developmental trajectories and promote a widely different reactivity to the environment.The use of telehealth is gaining momentum in providing obstetric care. Telehealth through various platforms provides obstetricians and gynecologists and other providers of obstetric and postpartum care with the tools to better facilitate prenatal, intrapartum, and postpartum encounters. Telehealth helps facilitate consultation with specialists and subspecialists in maternal-fetal medicine in a team-based fashion to improve quality and safe obstetric practices in a fragmented obstetric care delivery system, especially in rural access communities. Telehealth can be beneficial especially in the postpartum period for breastfeeding and lactation assistance and for postpartum depression follow-up.Heart disease is the leading cause of mortality in adult women. Beyond the traditional risk factors of obesity, diabetes, and hypercholesterolemia, women with the pregnancy complications of preeclampsia, gestational diabetes, prematurity, and low birth weight for gestational age (fetal growth restriction) are at higher risk for later development of cardiovascular disease. Education of women and providers about the association of pregnancy complications and cardiovascular disease should begin in the postpartum period. Postpartum cardiovascular risk screening and lifestyle modifications should be considered standard of care and are essential to improving cardiac health as a preventive strategy.Pelvic floor disorders are common in the postpartum period. These disorders can significantly affect one’s quality of life during a period that is already filled with emotional and physiologic change. ML141 manufacturer focuses on the presentation, diagnosis, and treatment of the 3 major pelvic floor disorders in postpartum women, namely, urinary incontinence, fecal incontinence, and pelvic organ prolapse.Pregnancy and the postpartum period are ideal times for health care providers to identify and address the contraceptive needs and desires of patients. In addition to the opportunity to promote healthy pregnancy spacing, individuals can also be cared for at a time when it is convenient, they have access to health care, and they are motivated to prevent repeat pregnancy. Patient-centered care using a shared medical decision-making framework can not only promote positive patient-provider interactions but also increase positive outcomes. Comprehensive provision of information on all methods and identification of contraceptive preferences can help patients select the best option.Post-traumatic stress disorder (PTSD) accompanies miscarriage, intrauterine fetal demise, and preterm birth. #link# Levels of PTSD may be higher for women who experience acute, life-threatening events during labor and delivery. Severe maternal morbidities or near misses for maternal death disproportionately impact African American, Hispanic, American Indian, and women in rural communities. Expanding research demonstrates association between severe maternal morbidity or near-miss events and PTSD. Multiple preceding conditions and intrapartum and postpartum events place women at higher risk for PTSD. Postpartum evaluation provides an opportunity for PTSD screening. Untreated perinatal PTSD impacts long-term maternal and child health and contributes to health disparities.A systematic, effective stillbirth evaluation is important for identification of potential causes of fetal death. Knowledge of potential causes of fetal death facilitates emotional closure for patients and informs recurrence risk as well as future pregnancy management. The highest-yield components of a stillbirth evaluation for finding a cause of fetal death are fetal autopsy, placental pathology, and genetic testing. All patients should be offered these tests following a stillbirth. A clear plan for postpartum follow-up should be made with the patient in order to ensure ongoing support through the grief and recovery process.Cesarean delivery (CD) wound complications disrupt the time a mother spends with her newborn. Surgical site infections (SSI) may result in unplanned office visits, emergency room visits, and hospital readmissions. Despite increasing attention to preoperative preparation, the CD SSI rate remains high. Local practices must be evaluated, and new methods to reduce CD SSI must be used.Pregnant and postpartum women with opiate use disorder present a challenge in perinatal care. It is important for health care teams to provide sensitive and compassionate evidence-based care for these women, who often are stigmatized during the prenatal, delivery, and postpartum periods. Women with opiate use disorder are at risk for inadequate prenatal and postpartum care and for complications. Infants are at risk for neonatal abstinence syndrome and are expected to require neonatal intensive care. Pain management during labor and for cesarean delivery requires consultation and collaboration with providers who have expertise in management of addiction. Postpartum follow-up is essential.Perinatal care, including the management of mental health issues, often falls under the auspices of primary care providers. Postpartum depression (PPD) is a common problem that affects up to 15% of women. Most women at risk can be identified before delivery based on psychiatric history, symptoms during pregnancy, and recent psychosocial stressors. link2 Fortunately, there have been a variety of treatment studies using antidepressants, nonpharmacologic interactions, and most recently, allopregnanolone (Brexanolone) infusion that have shown benefits. The most commonly used screening scale, Edinburgh Postnatal Depression Scale, a 10-item self-rated scale, has been translated into a variety of languages.Rates of obesity continue to be a cause of morbidity and mortality, requiring intervention. Excessive gestational weight gain is related to postpartum weight retention and subsequent development of obesity, which translates into higher risk of adverse maternal and neonatal outcomes in future pregnancies and long-term excess cardiovascular disease and cancer for the mothers. Limiting gestational weight gain to within recommended limits prevents postpartum weight retention. This article provides an overview of methods and practices aimed at helping women achieve a healthy weight between pregnancies by improving gestational weight gain. These interventions include lifestyle behavioral changes, diet and exercise, and motivational interviewing.Gestational diabetes mellitus (GDM) is the most common obstetric metabolic disorder. Long-term health consequences, including type 2 diabetes, metabolic syndrome, and cardiovascular disease, are common with GDM. Postpartum glucose screening is recommended for women with a prior GDM pregnancy. link3 Rates of postpartum screening compliance remain low. Interventions ranging from appointment reminder systems to personalized chronic disease education are being used, emphasizing future chronic disease risk for patients with a history of GDM. With these practice changes, clinicians can more thoroughly engage in the early identification, intervention, and prevention of chronic disease for women with a history of GDM.The health benefits of breastfeeding are well documented, and more than 80% of US women initiate breastfeeding; however, mothers in the United States face substantial challenges in meeting their personal breastfeeding goals, with approximately 60% weaning earlier than they had intended. In addition, there are significant racial/ethnic inequities in infant-feeding behaviors, and these inequities are a major public health concern. Enabling women to meet their breastfeeding goals is a public health priority. Infant feeding should be addressed as a modifiable health behavior, rather than a lifestyle choice.

Spain has been one of the countries most affected by the COVID-19 pandemic.

To create a registry of patients with COVID-19 hospitalized in Spain, in order to improve our knowledge of the clinical, diagnostic, therapeutic, and prognostic aspects of this disease.

A multicentre retrospective cohort study, including consecutive patients hospitalized with confirmed COVID-19 throughout Spain. Epidemiological and clinical data, additional tests at admission and at seven days, treatments administered, and progress at 30 days of hospitalization were collected from electronic medical records.

Up to June 30th 2020, 15,111 patients from 150 hospitals were included. Their median age was 69.4 years (range 18-102 years) and 57.2% were male. Prevalences of hypertension, dyslipidemia, and diabetes mellitus were 50.9%, 39.7%, and 19.4%, respectively. The most frequent symptoms were fever (84.2%) and cough (73.5%). High values of ferritin (73.5%), lactate dehydrogenase (73.9%), and D-dimer (63.8%), as well as lymphopenia (52.8%), were frequent. The most used antiviral drugs were hydroxychloroquine (85.6%) and lopinavir/ritonavir (61.4%); 33.1% developed respiratory distress. Overall mortality rate was 21.0%, with a marked increase with age (50-59 years 4.7%, 60-69 years 10.5%, 70-79 years 26.9%, ≥80 years 46.0%).

The SEMI-COVID-19 Network provides data on the clinical characteristics of patients with COVID-19 hospitalized in Spain. Patients with COVID-19 hospitalized in Spain are mostly severe cases, as one in three patients developed respiratory distress and one in five patients died. These findings confirm a close relationship between advanced age and mortality.

The SEMI-COVID-19 Network provides data on the clinical characteristics of patients with COVID-19 hospitalized in Spain. Patients with COVID-19 hospitalized in Spain are mostly severe cases, as one in three patients developed respiratory distress and one in five patients died. These findings confirm a close relationship between advanced age and mortality.Left atrial (LA) structural and functional evaluation have recently emerged as powerful biomarkers for adverse events in a variety of cardiovascular conditions. Moreover, noninvasive evaluation of LA pressure has gained importance in the characterization of the hemodynamic profile of patients. This review describes the methodology, benefits and pitfalls of measuring LA size and function by echocardiography and provides a brief overview of the prognostic utility of newer echocardiographic metrics of LA geometry and function (i.e., three-dimensional volumes, longitudinal strain, and phasic function parameters).