Harefuah
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Recent research has put the spotlight on two different aspects of pregnancy after bariatric surgery: safety of the mother and fetus, and the procedure's effectiveness in preventing the complications surrounding reproduction and pregnancy often seen in the obese woman. ⋯ Pregnancy after bariatric surgery appears to be safe, and in general perinatal outcome is better when compared to pregnancies of obese women. Providers should be familiar with potential complications related to postoperative pregnancies and be prepared to provide appropriate interventions such as nutritional supplementation and band adjustment when necessary.
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Comparative Study
[Atosiban treatment for preterm labor--financial considerations and savings by implementing clinical guidelines].
Preterm delivery is a significant cause of neonatal morbidity and mortality. Pregnant women, with symptoms and signs consistent with preterm labor, can be treated with various tocolytic drugs. Atosiban is one of many drugs indicated to arrest imminent preterm labor. Various studies show that the efficacy of atosiban is similar to other tocolytic drugs. The main advantage of atosiban is a relativeLy low incidence of adverse maternal reactions. Its considerable shortcoming is the financial cost, compared to other available drugs. ⋯ Implementing and enforcing a simple protocol of supervision on the use of atosiban enables a considerable reduction of financial costs related to atosiban, without hampering medical care.
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Anticoagulant therapy is based on two veteran drugs, which have been in use for over 60 years: heparin and warfarin. Due to the limitations of these agents, new parenteral anticoagulants have been introduced, mainly the low molecular weight heparins, fondaparinux and direct thrombin inhibitors. The need to develop new drugs has led to major efforts by the pharmaceutical industry and many promising anticoagulant oral agents are being tested. ⋯ Two oral agents, dabigatran and rivaroxaban, have recently been approved in Europe. Dabigatran inhibits thrombin, while rivaroxaban is factor X inhibitor. Other drugs include apixaban, idraparinux and are in Phase III studies.
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Autologous platelet-rich plasma (PRP) is a relatively new biotechnology backed by over two decades of research in diverse areas. With its growing use for the treatment of musculoskeletal injuries, Orthopaedic Sports Medicine may be the discipline in which translational use of PRP has progressed most rapidly. PRP therapy involves the injection of a small volume of plasma or the application of PRP gel foam directly to the site of injury. ⋯ Clinical interventions in sports and musculoskeletal medicine aim to achieve predictable, rapid tissue repair and enhance wound heating and to restore the high mechanical performance and functional levels of non-injured tissue in the shortest possible time. PRP may be a remarkable step forward in this quest. This review will evaluate the evolution and most recent contributions of PRP treatment.
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Data on the determinants of breastfeeding in the Israeli Arab population are scarce. ⋯ The rate of exclusive breastfeeding is low and early breastfeeding weaning is common in Arab infants. The predictors of early and prolonged breastfeeding are in part behavioral and modifiable. Breastfeeding practices among IsraeLi Arab infants can be improved by adequate health education. Such interventions should also be oriented to Arab fathers.