This article summarizes findings from the literature on the emotional and birth outcomes of women with low income receiving different types of prenatal care. This literature review included studies published between 2015 and 2020. The results indicated that women with low income have challenging experiences in traditional models of prenatal care. Evidence of improved birth outcomes with nontraditional prenatal care is mixed, but qualitative findings indicate that it is associated with better emotional outcomes for women with low income when compared to traditional prenatal care. Future research should investigate ways to improve the negative interpersonal and structural dimensions that can characterize prenatal care for women with low income.

The Ozaki procedure is an innovative surgical technique aiming at the reconstruction of the aortic valve with autologous pericardium to overcome the limitations of commercially available prostheses.

We retrospectively analysed 71 patients who underwent Ozaki operation at our centre between October 2014 and February 2020.

No in-hospital death occurred. Freedom from major adverse valve-related events (MAVRE) was 97%. The aortic gradients and transvalvular velocity are significantly lower at the 3-months echocardiographic control than at the pre-discharged echocardiography (10.93 ± 5.38, p= 0,0003 vs 16.24 ± 7.67 p= 0,0004 respectively). The median follow-up period was 20.7 months (range 2 to 47 months). Four patients showed mild/moderate aortic insufficiency (5.6%) and none showed severe aortic valve insufficiency. No patients underwent reoperation.

Mid-term outcome follow-up of Ozaki procedure showed optimal results in term of mortality, transaortic valve gradients, freedom from MAVRE and recurrence of aortic valve insufficiency.

Mid-term outcome follow-up of Ozaki procedure showed optimal results in term of mortality, transaortic valve gradients, freedom from MAVRE and recurrence of aortic valve insufficiency.

Leprosy is an infectious disease caused by Mycobacterium leprae. This study aimed to understand the distribution and impact of Hansen’s disease in different regions of Brazil and the outcome of cases in recent years.

An ecological study was conducted throughout the Brazilian territory for 11 years (2008-2018). The mortality rates, new cases of the disease, and proportion of physical disability and cure were assessed. Data were obtained using DATASUS. GraphPad Excel and “Prisma” programs were used for tabulation and data processing. To present an accurate perspective from all regions, the data were normalized according to the population.

Overall, the results demonstrated a significant reduction in the number of leprosy cases in Brazil over the last decade (p<0.05). North and Midwest regions showed higher mortality rates standardized by age (p<0.05). The largest number of cases were found in Tocantins and Mato Grosso, inner states of Brazil (p<0.05). The cure rates in the Southeast and South regions were negatively correlated with the mortality rate in these regions (p<0.05).

Actions to control the spread and unfavorable outcomes of leprosy have been effective in the last decade in most Brazilian states. On the other hand, the states of Tocantins and Mato Grosso, in the North and Midwest regions of Brazil, need to intensify the fight against the disease. Notwithstanding, measures against leprosy should continue and be intensified in regions with greater aggravations, aiming at an effective homogeneous control of the disease.

Actions to control the spread and unfavorable outcomes of leprosy have been effective in the last decade in most Brazilian states. On the other hand, the states of Tocantins and Mato Grosso, in the North and Midwest regions of Brazil, need to intensify the fight against the disease. Notwithstanding, measures against leprosy should continue and be intensified in regions with greater aggravations, aiming at an effective homogeneous control of the disease.Supplemental screening with MRI or ultrasound increases cancer detection rate (CDR) in women with standard screening mammography. Whether it also reduces interval cancer rate (ICR) is unclear. This study reviewed the evidence evaluating the effect of supplemental imaging on ICR in women undergoing screening mammography. This systematic review included studies that reported both CDR and ICR in women undergoing screening mammography alone compared to those undergoing screening mammography with supplemental imaging. Five studies (3 randomized trials) were eligible. These reported on 142,153 women undergoing mammography screening alone or mammography with supplemental imaging (3 ultrasound and 2 MRI studies). Two studies included a general screening population and 3 included special populations (young, high genetic risk and/or dense breasts). The incremental CDR for supplemental MRI was 14.2 to 16.5/1000 screens and for ultrasound was 0 to 4.4/1000 screens. Effect on ICR was variable but evidence of a reduced ICR was more consistent for studies using supplemental MRI (ICR 0.3 to 0.8 per 1000 screens) than those using ultrasound (ICR 0.49 to 1.9 per 1000 screens). The higher CDR and lower ICR with supplemental screening were associated with higher recall and biopsy rates particularly with supplemental MRI (9.5%-15.9%, up to 69/1000 screens). Cancers detected with supplemental imaging modalities were generally smaller and earlier stage. Mammography with supplemental MRI or ultrasound increases detection of cancers (versus mammography only) in some sub-groups but also increases recall and biopsy rates and may have a relatively modest effect in reducing ICR.

Sleep may be especially important for maintaining health and well-being in daily life amid the stress of the coronavirus disease 2019 (COVID-19) pandemic. This preregistered study examined the associations of sleep quality, duration, and efficiency with next-day physical symptoms, affect, and stressors during the COVID-19 pandemic in North America, in addition to evaluating individual differences in COVID-19 threat as a moderator.

From mid-March to early August 2020, 1025 adults from Canada and the United States aged 18-91 reported COVID-19 threat at baseline and subsequently completed twice-daily diaries for one week about their sleep, negative affect, stressors, and physical symptoms.

Within-persons, nights with better-than-usual sleep quality predicted lower next-day negative affect, physical symptoms, and stressor occurrence. Better-than-usual sleep efficiency and longer-than-usual sleep duration also predicted lower next-day physical symptoms. COVID-19 threat ratings moderated several of these assoated among people with higher COVID-19 threat. These findings highlight the role of heightened stress contexts when considering the benefits of sleep on daily health and well-being.

K-wire removal is a common procedure in the paediatric outpatient clinic that is a source of pain and anxiety. This study examined the current parental experience of k wire removal.

Twenty-six parents of children having k-wires removed in a paediatric outpatient clinic were asked to complete an electronic survey immediately post procedure. Questions explored prior knowledge, sedation and analgesia for the procedure. Data analysis used descriptive statistics.

Verbal information from the ward prior to the procedure was the greatest information source for parents 22/26(85%). Thirty-eight % (10/26) of parents had expected sedation but only 6/10(23%) reported receiving sedation information. Only 7/26(27%) of parents reported their child receiving analgesia from themselves or medical staff pre-procedure.

Parents recommended the need for more procedural information beforehand, especially regarding pain and sedation. Parents were unaware of the option of sedation and wanted analgesia before the procedure.

Parents recommended the need for more procedural information beforehand, especially regarding pain and sedation. Parents were unaware of the option of sedation and wanted analgesia before the procedure.This study aimed to clarify the characteristics of patients with lung cancer undergoing treatment until the onset of tuberculosis. Between 2005 and 2019, patients who were admitted to Tokyo National Hospital due to tuberculosis during lung cancer treatment were examined retrospectively. There were 42 patients, and detailed medical information was obtained in 39 patients. The median age of the 39 patients were 75 years (range 47-92 years), of which 33 were males and 36 were Japanese Baby Boomers or older. Regarding risk factors for developing tuberculosis, smoking was noted in 34 cases, oral corticosteroid use in 13, and previous tuberculosis in six. Thirty-seven patients had one risk factor and 19 had two or more risk factors, but diagnosis of latent tuberculosis infection (LTBI) was obtained in only one patients, and none had received LTBI treatment. The first-line treatment for lung cancer was resection in 13 cases, chemoradiotherapy in 6, chemotherapy in 10, radiation therapy in 3, laser therapy in 1, and best supportive care (BSC) alone in 6. Sodiumoxamate At tuberculosis onset, BSC accounted for 17 cases, but other situations were considerably existed such as anticancer medication (12 cases), and observation after lung cancer treatment (10 cases). Tuberculosis occurred in various situations in elderly patients with lung cancer. It is critical to actively evaluate the risk of tuberculosis and consider LTBI screening and treatment.The optimal timing of antibiotic administration relative to liver abscess aspiration is debatable. This retrospective cohort study investigated whether the timing affects the abscess culture positivity rate and clinical outcomes. Twenty-nine patients with 30 percutaneously drained liver abscess cases were analyzed. Antibiotics were administered before aspiration (pre-aspiration antibiotics) in 22 cases and following aspiration (post-aspiration antibiotics) in 8 cases (i.e., 1 patient underwent aspiration twice, both before and following antibiotics). Both groups demonstrated similar patient characteristics, short time to aspiration, and high antibiotic appropriateness. Most patients were immunocompetent and non-septic. Pre-aspiration antibiotics did not reduce the culture yield (95% with pre-aspiration antibiotics vs. 100% with post-aspiration antibiotics; p = 1). Post-aspiration antibiotics were not associated with higher mortality, longer length of hospitalization, or an increased rate of clinical deterioration following aspiration. With appropriate antibiotic and aspiration, antibiotics timing can be either before or after aspiration without compromising the culture positivity rate and clinical outcomes.Pulmonary oxalosis can be fatal, and Aspergillus tubingensis is commonly resistant to azoles in Japan. We report a case of bronchopulmonary oxalosis caused by A. tubingensis in a non-neutropenic patient who was successfully treated with voriconazole monotherapy. The susceptibility of the isolates to voriconazole and the effective elimination of contagious necrotic tissue by expectoration seemed to be two major factors contributing to the patient’s survival. According to the literature review, pulmonary oxalosis is associated with a high mortality rate over a short term. An exploration of detailed information about the genomic characteristics and drug susceptibility of Aspergillus isolates is important for the development of treatment strategies for this life-threatening disease.