No description available.

No description available.

Thesis equivalent (M.H.A.)--University of Michigan, 1970. / "HA 752-753."

Thesis equivalent (M.H.A.)--University of Michigan, 1970. / "HA 752-753."

No description available.

Phosphoinositide-3-kinase (PI3K)/Akt dependent signaling has been shown to improve outcome in sepsis/septic shock. There is also ample evidence that PI3K/Akt dependent signaling plays a crucial role in maintaining normal cardiac function. We hypothesized that PI3K/Akt signaling may ameliorate septic shock by attenuating sepsis-induced cardiac dysfunction. Cardiac function and survival were evaluated in transgenic mice with cardiac myocyte specific expression of constitutively active PI3K isoform, p110α (caPI3K Tg). caPI3K Tg and wild type (WT) mice were subjected to cecal ligation/puncture (CLP) induced sepsis. Wild type CLP mice showed dramatic cardiac dysfunction at 6 hrs. Septic cardiomyopathy was significantly attenuated in caPI3K CLP mice. The time to 100% mortality was 46 hrs in WT CLP mice. In contrast, 80% of the caPI3K mice survived at 46 hrs after CLP (p30 days (p

Background and Objectives: To date, no research has examined the prevalence and management of suspected fetal macrosomia in midwifery care, which may provide an alternative approach to cesarean section and induction with improvements in maternal and infant outcomes. The objectives of this study were to 1) determine the prevalence of fetal macrosomia and adverse outcomes that may result from a macrosomic birth in the MANAstats database; 2) identify the maternal characteristics which predict macrosomia; 3) determine the adverse maternal and infant outcome differences among macrosomic and normal weight infants in the MANAstats database. Methods: We analyzed 10,011 midwifery reported pregnancy and birth records from midwives across North America from January 2007- December 2009. After excluding for certain high-risk criteria, we compared the prevalence and adverse outcomes associated with macrosomic infants (4000-4499 grams, 4500-4999 grams, and >5000 grams) to non-macrosomic infants who weighed 3000-3000 grams. Results: The prevalence of macrosomia according to >4000 grams criteria was 24.7% and >4500 grams 5.53%. Maternal risk factors for macrosomia included: Caucasian race, married, maternal age between 15-34 years, and a gestational length greater than 40 weeks. The proportion of obstetric and infant complications showed a progressive and significant increase among the macrosomic birth weight categories with the highest risk at >5000 grams. The risk of shoulder dystocia (4000-4449-g infants: odds ratio, 4.08 [95% CI, 3.27-5.09]; 4500-4999-g infants: odds ratio, 8.31 [95% CI, 6.20-11.14]; and >5000-g infants: odds ratio, 29.92 [95% CI, 17.42-51.39]) and 5-minute Apgar scores 5000-g infants: odds ratio, 10.23 [95% CI, 2.32-45.13]) posed the highest risk in comparison to previous research on this topic. The prevalence of cesarean section among all groups was less than 9% and not found to be statistically significant by birthweight group. Conclusion: It is unclear if the risks shoulder dystocia and 5-minute Apgar scores < 3 outweigh the risks of prophylactic cesarean section on perceived macrosomic infants without jeopardizing maternal and infant health. Until further research regarding the risk versus benefit of alternatives to macrosomic vaginal birth, we recommend that strategies to prevent Grades II and III macrosomia need to be incorporated into the midwifery model of care. / Epidemiology

PCOS is one of the leading causes of infertility worldwide affecting 1 in 10 women of a reproductive age. One of the fundamental abnormalities in women with PCOS can be seen within hormonal irregularities, which may include hyperandrogenemia hyperinsulinemia and hyper secretion of luteinising hormone (LH); and it is hypothesised that a defect in steroid secreting ovarian theca cells is involved due to their contribution in non-PCOS hormonal synthesis. Hyperinsulinemia has been associated with hyper-androgenemia through in vitro studies of cultured PCOS theca, where it has been suggested that insulin increases progesterone and androstenedione secretion when compared to normal theca cells. Furthermore the augmented effects of LH and insulin have been seen to increase ovarian androgen synthesis in non-PCOS theca cultures whilst also increasing the expression of steroidogenic enzymes specific to the PI3-K pathway. Many theories exist toward the etiology of hyper androgenemia within PCOS. Very few approaches however, consider dysfunction in multiple tissue types that may contribute to hormonal imbalances. It is well established that an association between obesity and PCOS exists and it is often the first therapeutic target for re-establishing reproductive function in obese PCOS patients. Furthermore PCOS patients tend to show distinct gynoid body fat distribution, which is reported to aggravate PCOS symptoms. It was therefore valid to examine the involvement in adipocyte function and its contribution to androgen levels within peos. This is further supported through the link between metabolic disorders such as insulin resistance and hyperinsulinemia, and their associations to obesity. Our study employed isolated preadipocyte and thecal cultures with close regulation of the influential factors LH and insulin. In doing so, we analysed androgen synthesis through activation and expression of steroidogenic enzymes CYP17 within both normal and polycystic ovaries. This allowed us to examine whether protein/hormonal concentrations vary across non-PCOS and peos cultures. This also allowed us to examine the possibility of a novel pathway leading to localised adipocyte synthesis as well as pinpointing whether dysfunction existed within the insulin-signalling pathway of thecal androgen steroidogenesis. The work in this thesis shows that adipocytes derived from non-PCOS and PCOS women, maintained in vitro differ on the basis of their morphology, rates of differentiation and proliferation. Furthermore, they reacted differently under conditions designed to mimic PCOS in vitro (increased insulin and LH), with reduced non-PCOS proliferation, and increased non-PCOS androgen secretion on insulin treatment. We also found increased steroidogenic CYP 17 expression in PCOS cultures under insulin stimulation. However PCOS adipocytes androstenedione secretion remained unaffected by insulin stimulation and secreted constant levels of androstenedione similar to that seen by insulin stimulated non-PCOS adipocytes. Our examination of non-PCOS and PCOS primary thecal cultures showed CYP17 expression is increased in pcas theca under basal conditions and that increases in insulin and LH leads to increases in in vitro theca proliferation. These conditions were also seen to lead to significant increases in androstenedione secretion over non-PCOS thecal cultures, and the results suggest it to be acting through the PI3-K pathway. These results therefore point to a specific area of dysfunction that should be further targeted for examination. Furthermore, they suggest that an adipocyte dysfunction exists within PCOS patients that may significantly contribute to hyperandrogenemia through localized synthesis of androgens.

The purpose of this study was to ascertain the effects of music and relaxation techniques on pain and anxiety of gynecology patients undergoing colposcopy, punch biopsy, or cryosurgery. / Dependent variables measured for control and experimental subjects were pulse rate, respiratory rate, behavioral observations, and self reports of pain and anxiety during and twenty-four hours following the procedure. / Graphic analysis of the data revealed differences in scores between groups which were then statistically analyzed using a Mann-Whitney U test. / The results of the study showed a significantly higher respiratory rate (U = 1.5, n$\sb1$ = 3, n$\sb2$ = 5, $\alpha$ =.05) and behavioral observation score (U = 2.5, n$\sb1$ = 4, n$\sb2$ = 5, $\alpha$ =.05) for the control group during punch biopsy. Control subjects rated higher on pulse rate, respiratory rate, behavioral observations, and anxiety reports over all during the procedure, however these scores were not significantly higher than those of the experimental group. / Source: Masters Abstracts International, Volume: 29-04, page: 0655. / Adviser: Jayne M. Standley. / Thesis (M.M.)--The Florida State University, 1991.

The purpose of this project was to highlight an intervention to increase breastfeeding initiation and exclusive breastfeeding during the birth hospitalization in a coastal mid-Atlantic inner city hospital. Although researchers and national standards promote early initiation and exclusive breastfeeding, there continues to be a significant number of women who do not breastfeed and/or supplement with formula. The advantages of breastfeeding for mother and infant are substantial and include protecting babies from allergens to reducing maternal breast and ovarian cancer. Breastfeeding rates of initiation and exclusivity at the project hospital were below benchmarks set by international, national, and state agencies. The project intervention utilized bedside RNs who were educated and trained by the Perinatal Unit Clinical Nurse Specialist and the unit lactation counselors on bedside lactation support. The educational intervention capitalized on Dennis's theory of breast-feeding self-efficacy, which emphasizes maternal confidence in breastfeeding success. A convenience sample of breastfeeding rates of initiation and exclusivity from one month's delivered mothers pre-intervention (n = 203) compared to one month's breastfeeding rates of delivered mothers post-intervention (n = 220) was derived from electronic medical record nursing documentation and formed the data points for analysis. Outcome measures demonstrated an institutional increase in rates of breastfeeding initiation and in breastfeeding exclusivity. Chi-square analysis of both outcomes was not statistically significant; however progression towards the benchmarks was made, demonstrating clinical significance. Future social change from the project's success will be evident in reduction of sequelae from the above named maternal and infant acute and chronic illnesses.