Exceptionally Fast Ion Diffusion in Block Copolymer-Based Porous Carbon Fibers.

Confined ionic liquids in hydrophilic porous media have disrupted lattices and can be divided into two layers: An immobile ion layer adheres to the pore surfaces, and an inner layer exhibits faster mobility than the bulk. In this work, we report the first study of ionic liquids confined in block copolymer-based porous carbon fibers (PCFs) synthesized from polyacrylonitrile--polymethyl methacrylate (PAN--PMMA). The PCFs contain a network of unimodal mesopores of 13.

Effects of Periodic Intensive Insulin Therapy: An Updated Review.

Background: Traditional insulin treatment for diabetes mellitus with insulin administered subcutaneously yields nonpulsatile plasma insulin concentrations that represent a fraction of normal portal vein levels. Oral hypoglycemic medications result in the same lack of pulsatile insulin response to blood glucose levels. Intensive treatments of significant complications of diabetes are not recommended due to complicated multidrug regimens, significant weight gain, and the high risk of hypoglycemic complications.

Management of Nephrotic Syndrome in the Pregnant Patient.

Objective: To present a case series of pregnant women with nephrotic syndrome, describe maternal and fetal outcomes, and propose treatment strategies.

Study Design: A retrospective cohort case review of 11 pregnant women with nephrotic syndrome was performed over 2 years. Treatment regimens and trends were recorded.

Risks and Benefits of Magnesium Sulfate Tocolysis in Preterm Labor (PTL).

The U.S. Food and Drug Administration issued a drug safety communication on 05/30/2013 recommending "against prolonged use of magnesium sulfate to stop preterm labor (PTL) due to bone changes in exposed babies.

The evidence regarding maintenance tocolysis.

Preterm delivery is a public health issue of major proportion. More than 12% of deliveries in the United States that occur at less than 37 weeks gestation preterm labor (PTL) represents the largest single reason for preterm birth (PTB). Attempts to prevent PTB have been unsuccessful.

A critical appraisal of the potential harmful effects of terbutaline sulfate use in pregnancy.

Beta2-adrenergic agonist medications such as albuterol and terbutaline are often prescribed during pregnancy to treat conditions such as asthma, pulmonary disease, preterm labor, or acute non-reassuring fetal heart rate abnormalities during labor. Recently a review article questioned the safety of beta2-adrenergic agonist use in pregnancy, postulating a "biologically plausible" link between the use of these agents and autism spectrum disorder in offspring of mothers exposed to these drugs. While it is imperative to determine any harmful effects of any medication during pregnancy, it is important to weigh the risks and known benefits of treatment versus nontreatment of conditions such as preterm labor with medications such as terbutaline, given the known rates of morbidity and mortality associated with prematurity.

The medical and legal aspects of maternal mortality.

Sudden unexpected changes in the life of a family create many different emotions in various family members. The death of a young woman during or after her pregnancy is especially difficult because of the strain it places on family dynamics. One of the consequences is that there is, commonly, a newborn, and perhaps other children, without a mother and caregiver.

Umbilical artery aneurysm.

Background: Umbilical artery aneurysm is a rare condition associated with increased risk for aneuploidy and fetal demise.

Case: We report a case of umbilical artery aneurysm discovered at 27 weeks of gestation in one fetus of a dichorionic, diamniotic twin pregnancy. The patient was hospitalized to monitor for expansion of the aneurysm.

The reliability of patient-reported pregnancy outcome data.

Pregnancy and neonatal outcome information is frequently used in disease management to evaluate the cost-effectiveness of prenatal interventions and for other research and reporting activities. The purpose of this study was to determine if a telephone interview process is a reliable methodology for collecting pregnancy outcomes. High-risk patients from a large maternal-fetal medicine practice who received outpatient preterm labor management services from January 1996 to June 2001 were identified.

In defense of magnesium sulfate.

Magnesium sulfate has been used by obstetricians for more than 25 years to treat preterm labor. Magnesium sulfate is effective in delaying delivery for at least 48 hours in patients with preterm labor when used in higher dosages. There do not seem to be any harmful effects of the drug on the fetus, and indeed there is a neuroprotective effect in reducing the incidence of cerebral palsy in premature newborns weighing less than 1,500 g.

The impact of acute tocolysis on neonatal outcome in women hospitalized with preterm labor at 32 to 34 weeks' gestation.

We compared neonatal outcomes from singleton pregnancies in women hospitalized with preterm labor (PTL) at 32 0/7 to 34 6/7 weeks managed with and without acute tocolysis. Women enrolled for outpatient surveillance who were hospitalized and diagnosed with PTL between 32 0/7; to 34 6/7 weeks' gestation without conditions necessitating interventional delivery during hospitalization were identified ( N = 2921). Patients with contraindications to pregnancy prolongation were excluded ( N = 168).

Preterm labor in twins and high-order multiples.

Preterm labor (PTL) in a multiple gestation occurs frequently and is a common reason for preterm delivery (PTD). Management strategies for multiple gestations must be directed at early detection of PTL and effective strategies to delay or prevent PTD. Unlike singleton gestation where identification of patients at risk for PTL is often difficult, every multiple gestation is at risk for PTL, so all patients can be managed as being at risk.

High-order multiple gestations.

Infertility treatments have produced an increase in multiple gestations with twins accounting for 3.3% of births in the United States in 2002. Over that same time period, premature deliveries increased from 10.

Preterm labor in twins and high-order multiples.

Preterm labor (PTL) is common in multiple gestations. Management of patients includes attempts at prevention of PTL, acute tocolysis when PTL is diagnosed, and long-term maintenance tocolysis. Clinical therapeutics should be aggressively directed at minimizing the background uterine contractions to reduce the incidence of PTL and to provide a greater chance of suppressing PTL allowing delivery at the ideal gestational age.

A randomized multicenter study to determine the efficacy of activity restriction for preterm labor management in patients testing negative for fetal fibronectin.

Objective: To assess the impact of activity restriction (AR) on the incidence of preterm birth in women treated for preterm labor testing negative for fetal fibronectin (fFN).

Study Design: Women who were diagnosed with preterm labor and tocolyzed with magnesium sulfate were concurrently screened with fFN for the purpose of subsequent management. Included were consenting patients with negative fFN, gestational age 23 0/7-33 6/7 weeks, cervical dilation < or =3 cm, and minimal vaginal bleeding.

Management of wound complications from cesarean delivery.

Unlabelled: Multiple factors account for the increasing number of cesarean delivery wound complications in the United States; among them are an increase in cesarean delivery and an increase in the number of overweight and obese patients. This article reviews the pathophysiology of acute wound healing. Risk factors for cesarean delivery wound complications are identified and described.

Is peripartum hysterectomy more common in multiple gestations?

Objective: To compare the occurrence of peripartum hysterectomy between singleton and multiple gestations.

Methods: This was a historical cohort study comparing the occurrence of peripartum hysterectomy between singleton and multiple gestations at Banner Good Samaritan Regional Medical Center, Phoenix, Arizona, from January 1, 1996, to December 31, 2001.

Results: During the study years, 42,595 singleton, 1,131 twin, 164 triplet, 35 quadruplet, and 2 quintuplet deliveries occurred.

Management of high-order multiple gestation.

High-order multiple gestation presents unique challenges to the clinician to obtain the best possible outcome. An aggressive proactive approach works best compared with a wait-and-treat strategy when complications occur. Frequent ultrasound evaluations, fetal fibronectin testing, and contraction monitoring are important diagnostic tools.

The occurrence of adverse events in women receiving continuous subcutaneous terbutaline therapy.

Objective: The purpose of this study was to determine the frequency of serious adverse events in patients receiving continuous subcutaneous terbutaline after arrested preterm labor.

Study Design: Women with singleton, twin, and triplet pregnancies prescribed continuous subcutaneous terbutaline were studied. Electronic patient records were reviewed for patient tolerance of medication and serious adverse events.

Indicated and non-indicated preterm delivery in twin gestations: impact on neonatal outcome and cost.

Objective: To identify the etiology and impact of preterm delivery in twin gestations.

Study Design: Twin gestations delivered at 33.0 to 36.

Twins and triplets: the effect of plurality and growth on neonatal outcome compared with singleton infants.

Objective: Information on outcome by gestational age from large numbers of twins and triplets is limited and is important for counseling and decision-making in obstetric practice. We reviewed one of the largest available neonatal databases to describe mortality and morbidity rates and growth in newborn infants from multiple gestations and compared these data with data for singletons.

Study Design: Data from a large prospectively recorded neonatal database that incorporated neonatal records from January 1997 to July 2002 were reviewed.

Consequences of nonindicated preterm delivery in singleton gestations.

Objective: To determine the neonatal and economic consequences of nonindicated preterm delivery in singleton gestations.

Study Design: From a database of women with high-risk pregnancies enrolled for outpatient nursing services between October 1995 and February 2000, singleton gestations with induced labor or scheduled cesarean delivery and a gestational age at delivery of 34-36 weeks were identified. Excluded were women with preterm premature rupture of the membranes or medically indicated delivery.

Complications associated with peripherally inserted central catheter use during pregnancy.

Objective: The purpose of this study was to evaluate the complications of peripherally inserted central catheter use in an obstetrics population at a single institution over a 5-year period.

Study Design: We conducted a descriptive retrospective review of all obstetrics patients with peripherally inserted central catheter insertion during the antepartum period at Good Samaritan Regional Medical Center, from January 1, 1997, through September 30, 2001.

Results: During the 5 years of the study, complete data regarding the primary admission diagnoses for peripherally inserted central catheter placement and associated complications were available for 52 cases.