Search

Aim: To evaluate the effect of intrauterine growth restriction (IUGR) on the success rate of labor induction of preterm pregnancies complicated by hypertensive disorders. Methods: A retrospective cohort study conducted using data from the Centers for Disease Control and Prevention's Linked Birth‐Infant Death File in the United States from 2009 to 2013. Our cohort included live normal singleton cephalic pregnancies complicated by hypertensive disorders that underwent induction of labor and delivered between 24 and 35.6 weeks' gestation. Study subjects were categorized by the presence or absence of IUGR. Multivariate logistic regression was used to estimate the adjusted effect of IUGR on risk of caesarean deliveries. Results: Of 41 640 births meeting study criteria, 39 890 had no IUGR and 1750 had IUGR infants. The overall caesarean delivery rate was 22.2%, with caesarean delivery risk being higher among pregnancies complicated by IUGR versus those not complicated by IUGR (33.2% vs 21.7%, respectively) (odds ratio 2.00, 95% confidence interval 1.78–2.25). The effect of IUGR on risk of caesarean sections was most pronounced for gestational ages between 28 and 36 weeks. The effect of IUGR was highest among obese women, with the risk of caesarean in IUGR vs non‐IUGR pregnancies being 62.8% vs 41.4%, respectively (odds ratio 2.53, 95% confidence interval 1.98–3.24). Conclusion: Induction of labor of preterm pregnancy complicated by hypertensive disorders should be considered a reasonable option for delivery; however, in the context of IUGR, women should be informed of the considerable higher risk of caesarean delivery. [ABSTRACT FROM AUTHOR]

Objective: To examine the association between walnut consumption and measures of cognitive function in the US population. Design: Nationally representative cross sectional study using 24 hour dietary recalls of intakes to assess walnut and other nut consumption as compared to the group reporting no nut consumption. Setting: 1988-1994 and 1999-2002 rounds of the National Health and Nutrition Examination Survey (NHANES). Population: Representative weighted sample of US adults 20 to 90 years of age. Main Outcome Measure: The Neurobehavioral Evaluation System 2 (NES2), consisting of simple reaction time (SRTT), symbol digit substitution (SDST), the single digit learning (SDLT), Story Recall (SRT) and digit-symbol substitution (DSST) tests. Results: Adults 20-59 years old reporting walnut consumption of an average of 10.3 g/d required 16.4ms less time to respond on the SRTT, P=0.03, and 0.39s less for the SDST, P=0.01. SDLT scores were also significantly lower by 2.38s (P=0.05). Similar results were obtained when tertiles of walnut consumption were examined in trend analyses. Significantly better outcomes were noted in all cognitive test scores among those with higher walnut consumption (P < 0.01). Among adults 60 years and older, walnut consumers averaged 13.1 g/d, scored 7.1 percentile points higher, P=0.03 on the SRT and 7.3 percentile points higher on the DSST, P=0.05. Here also trend analyses indicate significant improvements in all cognitive test scores (P < 0.01) except for SRTT (P = 0.06) in the fully adjusted models. Conclusion: These significant, positive associations between walnut consumption and cognitive functions among all adults, regardless of age, gender or ethnicity suggest that daily walnut intake may be a simple beneficial dietary behavior. [ABSTRACT FROM AUTHOR]

The risk of developing tuberculosis (TB) may be related to nutritional status. To determine the impact of nutritional status on TB incidence, the authors analyzed data from the First National Health and Nutrition Examination Survey (NHANES I) Epidemiologic Follow-up Study (NHEFS). NHANES I collected information on a probability sample of the US population in 1971–1975. Adults were followed up in 1982–1992. Incident TB cases were ascertained through interviews, medical records, and death certificates. TB incidences were compared across different levels of nutritional status after controlling for potential confounding using proportional hazards regression appropriate to the complex sample design. TB incidence among adults with normal body mass index was 24.7 per 100,000 person-years (95% confidence interval (CI): 13.0, 36.3). In contrast, among persons who were underweight, overweight, and obese, estimated TB incidence rates were 260.2 (95% CI: 98.6, 421.8), 8.9 (95% CI: 2.2, 15.6), and 5.1 (95% CI: 0.0, 10.5) per 100,000 person-years, respectively. Adjusted hazard ratios were 12.43 (95% CI: 5.75, 26.95), 0.28 (95% CI: 0.13, 0.63), and 0.20 (95% CI: 0.07, 0.62), respectively, after controlling for demographic, socioeconomic, and medical characteristics. A low serum albumin level also increased the risk of TB, but low vitamin A, thiamine, riboflavin, and iron status did not. A population's nutritional profile is an important determinant of its TB incidence. [ABSTRACT FROM PUBLISHER]