Saint Francis University

About: Saint Francis University is a education organization based out in Loretto, Pennsylvania, United States. It is known for research contribution in the topics: Population & Osteoblast. The organization has 1694 authors who have published 2038 publications receiving 87149 citations.

Antenatal management and maternal/fetal outcomes associated with hyperglycaemia in pregnancy (HIP) in Uganda; a prospective cohort study.

Abstract: Hyperglycaemia in pregnancy (HIP) is associated with complications for both mother and baby. The prevalence of the condition is likely to increase across Africa as the continent undergoes a rapid demographic transition. However, little is known about the management and pregnancy outcomes associated with HIP in the region, particularly less severe forms of hyperglycaemia. It is therefore important to generate local data so that resources may be distributed effectively. The aim of this study was to describe the antenatal management and maternal/fetal outcomes associated with HIP in Ugandan women. A prospective cohort study of 2917 pregnant women in five major hospitals in urban/semi-urban central Uganda. Women were screened with oral glucose tolerance test (OGTT) at 24–28 weeks of gestation. Cases of gestational diabetes (GDM) and diabetes in pregnancy (DIP) were identified (WHO 2013 diagnostic criteria) and received standard care. Data was collected on maternal demographics, anthropometrics, antenatal management, umbilical cord c-peptide levels, and pregnancy outcomes. Two hundred and seventy-six women were diagnosed with HIP (237 classified as GDM and 39 DIP). Women had between one and four fasting capillary blood glucose checks during third trimester. All received lifestyle advice, one quarter (69/276) received metformin therapy, and one woman received insulin. HIP was associated with large birthweight (unadjusted relative risk 1.30, 95% CI 1.00–1.68), Caesarean delivery (RR 1.34, 95% CI 1.14–1.57) and neonatal hypoglycaemia (RR 4.37, 95% CI 1.36–14.1), but not perinatal mortality or preterm birth. Pregnancy outcomes were generally worse for women with DIP compared with GDM. HIP is associated with significant adverse pregnancy outcomes in this population, particularly overt diabetes in pregnancy. However pregnancy outcomes in women with milder forms of hyperglycaemia are similar to those with normoglycaemic pregnancies. Intervention strategies are required to improve current monitoring and management practice, and more research needed to understand if this is a cost-effective way of preventing poor perinatal outcomes.

Intravenous Warfarin and Heparin-Induced Thrombocytopenia Making the Diagnosis, Management, Modern Monitoring, and Multidisciplinary Care

Abstract: Objective: To describe the diagnosis, management, and monitoring of a patient with heparin-induced thrombocytopenia (HIT) with thrombosis and simultaneous bleeding risk treated with argatroban and transitioned to intravenous (IV) warfarin secondary to the inability to administer enteral medications. Case Summary: A 71-year-old man was admitted to the surgical intensive care unit (SICU) following aortic valve repair, coronary artery bypass, and ascending aortic aneurysm repair. On postoperative day 9, he was found to have a pulmonary embolism, and therapeutic heparin was started. The following day, his platelet count was found to have dropped precipitously. HIT was diagnosed, heparin was discontinued, and argatroban was initiated. On postoperative day 22, anticoagulation was discontinued because of massive gastrointestinal bleeding. On postoperative day 35, multiple venous thromboses were found, and argatroban was restarted. The patient developed a high-output enterocutaneous fistula, eliminating the optio...

Simultaneous primary lung sarcoma and carcinoma.

Abstract: Synchronous primary lung tumors are uncommon, and primary lung sarcomas are especially rare. We report an unusual case of a poorly differentiated carcinoma and a primary sarcoma of the lung. The surgical approach to patients with synchronous primary lung tumors should be aggressive. © 1992 Wiley-Liss, Inc.