Last data update: Jun 03, 2024. (Total: 46935 publications since 2009)
Records 1-4 (of 4 Records) |
Query Trace: Miracle H [original query] |
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Notes from the field: Obstetric tetanus in an unvaccinated woman after a home birth delivery - Kentucky, 2016
Yaffee AQ , Day DL , Bastin G , Powell M , Melendez S , Allen N , Miracle J , Jones M , Brawley R . MMWR Morb Mortal Wkly Rep 2017 66 (11) 307-308 On July 11, 2016, state and local health departments in Kentucky were notified of a case of obstetric tetanus in an unvaccinated woman. Obstetric tetanus, which occurs during pregnancy or within 6 weeks of the end of pregnancy, follows contamination of wounds with Clostridium tetani spores during pregnancy, or the use of contaminated tools or practices during nonsterile deliveries or abortions. CDC did not identify any cases of obstetric tetanus in the United States during 1972–2008 (1,2). State and local health departments in Kentucky investigated this case to identify risk factors and provide recommendations. | The patient, a woman aged 30 years, is a member of an Amish community. In late June, she delivered a child at home, assisted by an unlicensed community childbirth assistant. She had never received a vaccination for tetanus. Delivery was complicated by breech presentation, but no birth trauma, unsterile conditions, or other complications were reported. Nine days postpartum, the patient experienced facial numbness and neck pain, which progressed over 24 hours to stiff neck and jaw and difficulty swallowing and breathing. She was admitted to the hospital where a clinical diagnosis of tetanus was made, and 6,000 international units of tetanus immunoglobulin were administered intramuscularly. Endotracheal intubation and mechanical ventilation were required. Her hospital course was complicated by seizures and a need for prolonged respiratory support. After approximately a month, the patient was stable and discharged home. |
Considerations for responsible antibiotic use in dentistry
Fluent MT , Jacobsen PL , Hicks LA . J Am Dent Assoc 2016 147 (8) 683-6 Alexander Fleming’s discovery of penicillin in 1928 is one of the greatest medical advancements in history.1 The introduction of antibiotics meant that infectious diseases that were once deadly could now be cured. Since 1928, countless lives have been saved, and antibiotics have been recognized as miracle drugs. However, as antibiotic use has become more prevalent, so have antibiotic-resistant bacteria and adverse events associated with their use.2,3 In his 1945 Nobel Lecture, Fleming warned of the danger of over-reliance on antibiotics and the threat of bacteria developing resistance.1 | | Misuse and overuse of antibiotics have contributed to selective pressure on bacteria to adapt to the antibiotics intended to kill them; antibiotic resistance is now one of our most serious global health threats.2 Every year in the United States, at least 2 million people become infected with antibiotic-resistant bacteria, and approximately 23,000 people die as a direct result of these infections.2 Concurrently, there has been a decrease in research and development of new antibiotics, which has compounded the antibiotic resistance crisis, making treatment of infections in some patients challenging.4–6 |
Monitoring health outcomes of assisted reproductive technology
Kissin DM , Jamieson DJ , Barfield WD . N Engl J Med 2014 371 (1) 91-3 During the past 35 years, assisted reproductive technology has been transformed from a miracle to a standard and common part of medical practice. Although this technology is believed to be safe and has resulted in more than 5 million infants born globally, rapid technological progress leading to treatment modifications makes it important to continually monitor the safety of assisted reproductive technology for the rapidly growing population of users of the technology and infants conceived with its use. | Although many countries have national registries to monitor the use and effectiveness of assisted reproductive technology, they are typically not designed to collect data beyond delivery. In the United States, the Centers for Disease Control and Prevention (CDC) maintains the National ART (Assisted Reproductive Technology) Surveillance System (NASS), which collects limited information about treatment outcome (live birth data are limited to plurality, infant sex, birth weight, and gestational age). Studying the long-term health outcomes of assisted reproductive technology is difficult owing to the relative infrequency of both the exposure to it and the outcomes of interest (e.g., birth defects, cancer, and developmental disorders) and to the sensitive nature of the fertility treatments. Our knowledge of the long-term effect of assisted reproductive technology on maternal and child health is thus quite limited.1 |
Prevalence and characteristics of women at risk for an alcohol-exposed pregnancy (AEP) in the United States: estimates from the national survey of family growth
Cannon MJ , Guo J , Denny CH , Green PP , Miracle H , Sniezek JE , Floyd RL . Matern Child Health J 2014 19 (4) 776-82 Non-pregnant women can avoid alcohol-exposed pregnancies (AEPs) by modifying drinking and/or contraceptive practices. The purpose of this study was to estimate the number and characteristics of women in the United States who are at risk of AEPs. We analyzed data from in-person interviews obtained from a national probability sample (i.e., the National Survey of Family Growth) of reproductive-aged women conducted from January 2002 to March 2003. To be at risk of AEP, a woman had to have met the following criteria in the last month: (1) was drinking; (2) had vaginal intercourse with a man; and (3) did not use contraception. During a 1-month period, nearly 2 million U.S. women were at risk of an AEP (95 % confidence interval 1,760,079-2,288,104), including more than 600,000 who were binge drinking. Thus, 3.4 %, or 1 in 30, of all non-pregnant women were at risk of an AEP. Most demographic and behavioral characteristics were not clearly associated with AEP risk. However, pregnancy intention was strongly associated with AEP risk (prevalence ratio = 12.0, P < 0.001) because women often continued to drink even after they stopped using contraception. Nearly 2 million U.S. women are at AEP risk and therefore at risk of having children born with fetal alcohol spectrum disorders. For pregnant women and women intending a pregnancy, there is an urgent need for wider implementation of prevention programs and policy approaches that can reduce the risk for this serious public health problem. |
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