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New York Times Series Examines Maternal Mortality In Tanzania
The New York Times on Sunday examined maternal mortality in Tanzania, in the opening of a three-part series on maternal mortality in Africa. According to the Tanzanian Ministry of Health, the country has a maternal death rate of 578 per 100,000 births, though the World Health Organization puts the count at 950 maternal deaths per 100,000 births. Roughly 13,000 Tanzanian women die of pregnancy- or childbirth-related causes annually, giving it "neither the best nor the worst record in Africa," the Times reports. Tanzania is one of the world"s poorest countries and faces shortages in several areas -- including health workers, drugs, equipment and infrastructure -- that contribute to maternal mortality.The Times profiled obstetrical care at a rural hospital in Berega, Tanzania, that typifies efforts to reduce maternal mortality in Africa. Facing a shortage of doctors and nurses, the hospital has been training "assistant medical officers" to perform caesarean sections and other procedures. Meanwhile, the government also is attempting to train more assistants and midwives, build more clinics and nursing schools, offer housing to attract health workers to rural areas and provide places for pregnant women to stay closer to hospitals.According to the Times, many women who die in childbirth are young and healthy, and most maternal deaths are preventable with basic obstetrical care. The five leading causes of maternal death are bleeding, infection, high blood pressure, prolonged labor and complications resulting from abortions, the Times reports. In discussing maternal mortality, experts often refer to what are known as "the three delays": a woman"s delay in going to the hospital, the time spent traveling there and the hospital"s delay in starting treatment upon the woman"s arrival. Although only around 15% of births have dangerous complications, the problems are almost impossible to predict, and seemingly normal labors can quickly progress into serious emergencies. Worldwide, more than 536,000 women die annually from pregnancy or childbirth, according to WHO (Grady, New York Times, 5/24).
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New Global Subsidy For Malaria Medicines Must Ensure Quality Of Care
A new subsidy designed to increase access to life-saving antiretrovirals
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New Center Of Excellence Targets Reducing Disparities In Cancer Care And Outcomes
The University of South Florida and Moffitt Cancer Center have been awarded a highly competitive, $6-million federal grant to create a National Center on Minority Health and Health Disparities (NCMHD) Center of Excellence. The five-year program grant from the NCMHD, National Institutes of Health, will focus on research, education and training, and community outreach activities to reduce cancer-related health disparities among minority and underserved communities in Florida.
Public Health

Temperature Rises After Skull Surgery For Pfeiffer Syndrome

In children with the rare disease Pfeiffer syndrome, craniofacial surgery to correct skull defects is followed by a distinct pattern of increases in body temperature, reports a study in the January Journal of Craniofacial Surgery. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals, and institutions in medicine, nursing, allied health, pharmacy and the pharmaceutical industry. Together with previous studies, the results suggest that the postoperative temperature spikes are normal after surgery to correct craniosynostosis even when the skull defect is the only abnormality, and not part of a larger syndrome like Pfeiffer syndrome. The study was performed by Dr. Ikkei Tamada and colleagues of the Australian Craniofacial Unit at Women"s and Children"s Hospital, Adelaide, Australia. "Bimodal" Pattern Is Normal after Craniosynostosis Surgery The researchers analyzed temperature changes after skull surgery in 21 infants and children with Pfeiffer syndrome: a rare genetic condition affecting about 1 in 100,000 people. Infants with Pfeiffer syndrome develop craniosynostosis, in which the joints (sutures) between the bones of the skull close prematurely, resulting in abnormal growth of the skull and brain. Craniofacial surgeons, in concert with other professionals, design effective treatments to correct the skull deformity, prevent complications, and promote good long-term functioning. Patients with Pfeiffer syndrome may have other abnormalities as well, such as hearing loss and defects of the fingers and toes. This is in contrast to the more common "nonsyndromic" forms of craniosynostosis, in which the skull defect is the only abnormality. In the children with Pfeiffer syndrome, temperature changes followed a "bimodal" pattern, with two spikes in body temperature occurring within the first 48 hours after surgery. The temperature spikes were higher and longer lasting in children with more complex procedures for example, those whose surgery took longer. The swings in body temperature were also more pronounced, and more complicated, in children whose surgery was complicated by leakage of cerebrospinal fluid (fluid that helps to cushion the brain and spinal cord). In contrast, the temperature spikes were less prolonged in infants less than six months old. In a previous study, Dr. Tamada and colleagues found an almost identical pattern of temperature spikes in children undergoing surgery for simple, nonsyndromic craniosynostosis. As in Pfeiffer syndrome patients, the temperature changes resolved by 48 hours after surgery, remaining normal thereafter. The causes of the temperature changes after surgery for skull defects aren"t clear. A similar bimodal pattern has been found in patients undergoing heart surgery, but not other types of procedures. Fever is one of the most important signs of complications after surgery, especially infection. However, the new results suggest that increases in body temperature after craniofacial surgery for craniosynostosis alone or as part of a syndrome like Pfeiffer syndrome are normal and apparently not related to infection. Surgeons and others caring for children with craniosynostosis should be aware of the normal bimodal pattern of temperature spikes in the first 48 hours after corrective skull surgery, according to the researchers. Other patterns, especially if more complex, should lead to further evaluation for infection or other complications. Lippincott Williams & Wilkins


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