Analysis of the Effects of Maternal Body Mass Index and Gestational Weight Gain on Maternal and Neonatal Outcomes in Twin Pregnancy

Objective:To investigate the effects of maternal body mass index(BMI)and gestational weight gain on maternal and neonatal outcomes in twin pregnancies.Methods:Five hundred cases of twin pregnancies were divided into a low body weight group(68 cases),a normal weight group(355 cases),an overweight group(65 cases),and an obesity group(12 cases)according to the World Health Organization(WHO)Body Mass Index(BMI)classification guidelines Results:Comparison of weight gain during different pregnancies revealed that pregnant women were mainly of low weight and average weight.The higher the BMI before pregnancy,the higher the incidence of excessive weight gain during pregnancy.The incidences of gestational diabetes mellitus(GDM)and premature rupture of membranes in women with low weight gain were significantly higher than those in women with average weight gain and high weight gain(P<0.05).The incidences of gestational hypertension,preeclampsia,and anemia in women with high weight gain were significantly higher than those in women with low weight gain and average weight gain(P<0.05).The incidence of neonatal birth weight,fetal distress,and macrosomia in the high weight gain group was significantly higher than those in the low weight gain and average weight gain groups(P<0.05).The birth weight of newborns in low-weight gain mothers was significantly lower than that of normal-weight gain mothers(P<0.05).Conclusion:Poor maternal and infant outcomes were common in women with insufficient or excessive weight gain during pregnancy.Therefore,for women with twin pregnancies,weight management is crucial to ensure maternal and infant health.

Intoxication Induced by Urea Containing Diets in Broiler Chickens: Effect on Weight Gain, Feed Conversion Ratio, Hematological and Biochemical Profiles

Urea as a source of cheap non-protein nitrogen is used to adulterate fish and meat meals which are basic components of broiler diets. The present study was carried out to elucidate the effects of urea on weight gain, and hematological and biochemical profiles. A total of 48 broiler chicks were randomly allotted into 4 groups, designated Groups 1, 2, 3 and 4 of 12 birds each. Birds in Groups 2, 3 and 4 were fed on diets containing urea at the levels of 1%, 2.5% and 4%, respectively. Birds in Group 1 served as control and were not exposed to urea. Experimentation period was for 3 weeks and experiment was terminated when birds were 42 days of age. Body weight of all intoxicated birds at the various intervals was significantly decreased in comparison with that of the untreated control. Compared with control, all intoxicated broilers manifested significant (P ≤ 0.05) decrease in all hematological parameters involving erythrocytic and total leucocytic counts, Hemoglobin (Hb) and Packed Cell Volume (PCV) on a dose- and time-pattern. In comparison with the control levels, biochemical profile of the intoxicated birds disclosed significant decrease in blood glucose level and significant increase in serum uric acid, urea, Alkaline Phosphatase (ALP) and Lactate Dehydrogenase (LDH) levels. Based upon the present data, it was concluded that the addition of urea to broiler diets bears serious sequences concerning the general health condition, performance, weight gain, and hematological and biochemical profiles.

Longitudinal changes in body weight of breastfeeding mothers in the first year after delivery and its relationship with human milk composition:a combined longitudinal and cross-sectional cohort study

Objective:Postpartum weight retention(PPWR)is a common problem among women after childbirth.The main objectives of this study are to understand the changes in body weight of breastfeeding mothers during long-term follow-up and preliminarily explore the relationship between maternal body weight and human milk composition,including macronutrients,leptin,and adiponectin.Methods:The study included a longitudinal cohort(122 mothers),and a cross-sectional cohort(37 mothers).The human milk,maternal weight,and dietary surveys were collected in the longitudinal cohort at different follow-up time points(1-14 days postpartum,2-4 months postpartum,5-7 months postpartum,and 12-17 months postpartum).The maternal body weight was analyzed using the responses in the survey questionnaires.A milk analyzer based on the mid-infrared spectroscopy(MIRS)was used to determine milk composition,and nutrition analysis software evaluated dietary intakes.In the cross-sectional cohort,participating mothers were asked to provide blood and human milk samples and pertinent information related to maternal body composition.Maternal body composition was measured by bioelectrical impedance analysis(BIA),while ELISA analyzed leptin and adiponectin in milk and serum.Results:At 5-7 months postpartum,the PPWR of breastfeeding mothers was(2.46±3.59)kg.At 12-17 months postpartum,the PPWR was(0.98±4.06)kg.PPWR was found to be negatively correlated with milk fat content within 14 days postpartum and positively correlated at 2-4 months postpartum.In addition,the maternal weight and body muscle mass were positively correlated with leptin and adiponectin in milk.Plasma leptin was positively correlated with the mother’s body weight,body mass index(BMI),FAT percentage,and body fat mass,while plasma adiponectin did not correlate with any parameter.The results also indicate that the PPWR did not correlate with leptin and adiponectin in plasma or milk.Conclusions:Breastfeeding mothers may retain considerable weight gain one year after delivery.Human milk composition may be related to changes in maternal body weight.Leptin and adiponectin in breast milk and leptin in plasma are associated with the maternal body composition.This study supports the notion that maternal nutritional status may affect offspring health through lactation,and future research should focus on exploring weight management of postpartum mothers.

Effects of Molasses-Urea Supplementation on Weight Gain,Ruminal Fermentation and Major Microbe Populations of Winter-Grazing Sheep in Inner Mongolia

The present experiment was conducted to determine the effects of Molasses-Urea Supplementation （MUS） on weight gain, ruminal fermentation and major microbial populations in sheep on a winter grazing regime in Inner Mongolia. Total 40 sheep, allowed free consumption of MUS after grazing, served as a treatment group, while 30 sheep, fed only by pasture grazing, served as a control group. Ruminal fermentation parameters, consisted of pH, Bacterial Crude Protein （BCP） and ammonia nitrogen （NH3-N） were measured. In addition, numbers of five symbiotic bacteria were investigated. The results showed as follows： the average daily weight gain, concentration of NH3-N and numbers of protozoa were significantly higher （p〈0.05） in the treatment group than those in the control group. Contrastingly, no significant difference was found in BCP concentration and pH between the two groups. At the end of the experiment, the populations of Selenomonas ruminantium, Anaerovibrio lipolytica, Fibrobacter succinogenes, Ruminococcus flaveciens and Ruminococcus albus in the treatment group were significantly higher than those of the control group （p〈0.05）. These results demonstrated that greater weight gain could be induced during winter in Inner Mongolia by improved nutritional status through promotion of microbial populations using urea and sugar.

Weight gain following breast cancer diagnosis: Implication and proposed mechanisms

Weight gain occurs in the majority of women following breast cancer treatment. An overview of studies describing weight gain amongst women treated with early to modern chemotherapy regimens is included. Populations at higher risk include women who are younger, closer to ideal body weight and who have been treated with chemotherapy. Weight gain ranges between 1 to 5 kg, and may be associated with change in body composition with gain in fat mass and loss in lean body mass. Women are unlikely to return to pre-diagnosis weight. Possible mechanisms including inactivity and metabolic changes are explored. Potential interventions are reviewed including exercise, dietary changes andpharmacologic agents. Although breast cancer prognosis does not appear to be significantly impacted, weight gain has negative consequences on quality of life and overall health. Future studies should explore change in body composition, metabolism and insulin resistance. Avoiding weight gain in breast cancer survivors following initial diagnosis and treatment should be encouraged.

B Vitamins Can Reduce Body Weight Gain by Increasing Metabolism-related Enzyme Activities in Rats Fed on a High-Fat Diet

B vitamins are enzyme cofactors that play an important role in energy metabolism.The aim of this study was to elucidate whether B vitamin administration can reduce body weight(BW)gain by improving energy metabolism-related enzyme activities in rats fed on a highfat diet.Fifty rats were randomly assigned to one of the following five groups:control group(C),including rats fed on standard rat chow;four treatment groups(H0,H1,H2,and H3),in which rats were fed on a high-fat diet.Rats in the H1 group were treated daily with 100 mg/kg BW thiamine(VB1),100 mg/kg BW riboflavin(VB2),and 250 mg/kg BW niacin(VPP);rats in the H2 group were treated daily with 100 mg/kg BW pyridoxine(VB6),100 mg/kg BW cobalamin(VB12),and 5 mg/kg BW folate(FA);and rats in the H3 group were treated daily with all of the B vitamins administered to the H1 and H2 groups.After 12 weeks,the BW gains from the initial value were 154.5±58.4 g and 159.1±53.0 g in the H1 and C groups,respectively,which were significantly less than the changes in the H0 group(285.2±14.8 g,P〈0.05).In the H0 group,the plasma total cholesterol(CHO)and triglyceride(TG)levels were 1.59±0.30 mmol/L and 1.55±0.40 mmol/L,respectively,which were significantly greater than those in the H1 group(1.19±0.18 mmol/L and 0.76±0.34 mmol/L,respectively,P〈0.05).The activities of transketolase(TK),glutathione reductase,and Na^+/K^+adenosine triphosphatase were significantly increased in the B vitamin-treated groups and were significantly greater than those in the H0 group(P〈0.05).Furthermore,the glucose-6-phosphate dehydrogenase,pyruvic acid kinase,and succinate dehydrogenase activities also were increased after treatment with B vitamins.Supplementation with B vitamins could effectively reduce BW gain and plasma levels of lipids by improving energy metabolism-related enzyme activities in rats,thus possibly providing potential benefits to humans.

Association between pre-pregnancy body mass index and gestational weight gain and the risk of preeclampsia:A systematic review and meta-analysis

Objective:To analyze the relationship between body mass index(BMI)before pregnancy and gestational weight gain throughout pregnancy with the incidence of preeclampsia.Methods:This was a systematic review-meta analysis of literature collected from three e-databases:Scopus,PubMed,and Science Direct.Quality assessment was measured with the Effective Public Health Practice Project methods.Meta-analysis was done by calculating the fixed and random-effects of odds ratio(OR)for each BMI category and gestational weight gain as compared with the incidence of preeclampsia.Results:Overweight was associated with a significantly increased risk of preeclampsia(OR=2.152,95%CI 1.363-3.400;P=0.001).Obesity was also associated with a noticeably increased risk of preeclampsia(OR=2.856,95%CI 1.755-4.649;P<0.001).Meanwhile,underweight was associated with a significantly reduced risk of preeclampsia(OR=0.639,95%CI 0.500-0.817;P<0.001)when compared with normal BMI.Pregnant women who gained weight below the standard throughout pregnancy was a protective factor from preeclampsia(OR=0.813,95%CI 0.610-1.083;P=0.157)whereas pregnant women who gained weight above the standard had almost doubled risk of preeclampsia(OR=1.850,95%CI 1.377-2.485;P<0.001).Conclusions:The result of this study affirms the role of overweight-obesity pre-pregnancy,and gestational weight gain above the standard during pregnancy as significant risk factors for developing preeclampsia.

The Potential of Duck Hepatitis Virus(DHV-1) Stimulating the Body Weight Gain and the Effects of Silymarin on It in Duckling

To evaluate the effects of duck hepatitis virus-1 （DHV-1） on the body weight gain in duck and the effects of silymarin on it in vivo, 100 10-d-old ducks, both male and female, were collected to be subjected to the test. The experiments were conducted in 8 groups： in group 1-3, the animals were inoculated with 1：105 diluted duck hepatitis virus （DHV-1） infected allantoic fluid and given 0, 30, and 50 mg kg^-1 BW d^-1 silymarin orally, respectively. In group 4-6, the animals were inoculated with 1：5 × 105 diluted DHV-1 infected allantoic fluid and given 0, 10, and 30 mg kg^-1 BW d^-1 silymarin orally, respectively. In group 7, the animals were given 10 mg kg^-1 BW d^-1 silymafin only. Group 8 was the control one treated by injecting sterillized saline into the leg muscles. All the silymarin was given from 0 to 4 d after inoculation of the virus. By the 5th d after inoculation, the vein blood was drawn from the dorsal foot vein and the plasma samples were collected and stored at -20℃. The body weight gain （BWG） was measured from 0 to 10 d after inoculation. The plasma IGF-I, T3, and T4 concentrations were measured by radioimmunoassay （RIA）. At the virus dose of 1：5 ×105 diluted virus infected allantoic fluid, the inoculation of the virus enhanced the BWG significantly compared with that of the control （P〈 0.01）, while 10-50 mg kg^-1 BW d^-1 silymarin could counteract the effects of the virus on the BWG dose-dependently. The plasma IGF-I levels showed no correlation with the BWG, but the T3 levels showed a same tropism with the body weight gain. The present results indicated that sublethal DHV-1 enhanced the body weight gain of ducklings significantly, and the silymarin could counteract this effect in vivo.

Associations of Gestational Diabetes Mellitus and Excessive Gestational Weight Gain with Offspring Obesity Risk

Objective Gestational diabetes mellitus(GDM)and gestational weight gain(GWG)are important risk factors that are known to affect offspring growth,but these outcomes are inconsistent and it remains unknown if both risk factors have a synergetic effect on early childhood growth.The present study aimed to conduct offspring body mass index-for-age Z-scores(BMIZ)trajectories and to evaluate the independent and interactive effect of the status of GDM and excessive GWG on the risks of overweight/obesity from birth to 24 months of age.Methods A total of 7949 mother-child pairs were enrolled in this study.The weight and length of children were measured at birth,6,12,and 24 months of age to calculate BMIZ.Results The status of GDM was positively associated with offspring BMIZ and risk of macrosomia at birth but was not associated with offspring BMIZ or the risks of overweight/obesity at 6,12,and 24 months of age.In contrast,excessive GWG was positively linked to offspring BMIZ,the stable high BMIZ trajectory pattern,and risks of overweight/obesity in the first 24 months of age.These two risk factors also had a significant synergistic effect on macrosomia at birth,but the interactive effect was only significant in boys during the follow-up years in the sex-stratified analyses.Conclusion The maternal GWG was a more pronounced predictor than GDM with relation to BMIZ and risk of overweight/obesity in early childhood.The interactive effect between these risk factors on offspring overweight/obesity may vary by sex.

Effects of Pleurotus eryngii Residue on Weight Gain of Chick and Duck

In the present study, Pleurotus eryngii residue was added into conventional feed of Chai chicks and meat-type ducks at different ratios to measure its effects on the production performance of chicks and ducks. The results revealed that the growth performance of chicks and ducks was the best when 20% Pleurotus eryngii residue was added into the feed. Under such condition, the daily weight gain of 8 - 11 and 12 - 15-week-old Chai chicks was increased by 6.8% and 13.5%, and that of 8 - 11 and 12 - 15-week-old ducks was increased by 11.5% and 19.3%, respectively.

Excessive Weight Gain during Pregnancy and Prognosis of Childbirth in Douala (Cameroun)

The objective was to describe the maternofetal outcome of childbirth in women with excessive weight gain during pregnancy. We conducted a cross-sectional analytical study over a period of 03 months in the Obstetrics Department of Laquintinie Hospital in Douala (HLD). Our study population consisted of any pregnant in labor or waiting for a caesarean section. We compared two groups of pregnant women with excessive weight gain during pregnancy (exposed) and those without excessive weight gain during pregnancy (unexposed). We recorded 240 pregnant women who gave birth at the HLD maternity, 59 of whom had excessive weight gain during pregnancy, which gave us a proportion of 24.6%. The only sociodemographic characteristic associated with excessive weight gain during pregnancy was the married marital status of the pregnant women (OR: 2.0 (1.1 - 3.8) P = 0.023). Pregnant women with maternal complications associated with excessive weight gain had an average elevated uterine height of 35.4 (P = 0.007). The increase in caesarean section rate (P = 0.094) and the onset of pregnancy-related hypertension (HTA) showed differences close to significance (P = 0.063). Mean birth weight was higher (P = 0.023) in pregnant women with excessive weight gain during pregnancy. Ultimately, excessive weight gain during pregnancy has deleterious effects on the course of pregnancy and childbirth. It promotes the onset of pregnancy HTA and macrosomia.

Artificial Sweeteners as a Cause of Obesity: Weight Gain Mechanisms and Current Evidence

The obesity epidemic gathers growing media attention recently, as overweight and obesity’s prevalence keeps rising. This comes along with an increase in the intake of artificial sweeteners in food products. A causal relationship between the consumption of sweeteners and obesity is so far not clear in the medical literature. This paper describes the development of artificial sweeteners in a historical context. It collects epidemiological and experimental evidence that possibly relates the use of artificial sweeteners with weight gain. Finally, these effects are explained based on the neuroscience of food reward, the possible effects of glucose on the metabolism and the association between sweeteners and gut microbiota.

Interdialytic Weight Gain in Hemodialysis Patients: Worse Hospital Admissions and Intradialytic Hypotension

Introduction: Interdialytic weight-gain (IDWG) has been linked to various complications in hemodialysis (HD) patients. Method: Prospective clinical-observational study to evaluate the effect of IDWG in HD patients on the rate of hospital admissions over a 12-month period, and the impact of high IDWG on the frequency of IDH. Results: Of the 240 patients, those who had IDWG ≥ 4%, 81% had at least one hospital admission due to volume-overload or the need for extra HD-session(s). On the other hand, only 19% of those having IDWG < 4% had been admitted or got extra HD sessions (p < 0.001). Of those who were admitted (over 12 months) due to volume overload;74.1% had IDWG ≥ 4%, while 25.9% had IDWG < 4% (p < 0.001). Regarding IDH, 87% of patients having IDWG ≥ 4% had at least one episode of IDH/week. On the other hand, only 22.5% of those with IDWG < 4% had one episode of IDH/week (p < 0.001). When analyzing those who had at least one IDH episode/week;72.9% of them had IDWG ≥ 4%, while only 27.1% had IDWG < 4% (p < 0.001). Conclusion: In HD patients, the frequency of hospital admission due to volume-overload and the need for extra HD-sessions is strongly related to the amount of IDWG (>4% in our patients), the same stands for the frequency of IDH. Thus, control of IDWG in HD patients is of great importance, keeping in mind the importance of the nutrition status of HD patients that may also impact IDWG.

Excessive 5-year weight gain predicts metabolic syndrome development in healthy middle-aged adults

AIM:To quantitatively examine the impacts of an easyto-measure parameter-weight gain-on metabolic syndrome development among middle-aged adults. METHODS:We conducted a five-year interval observational study.A total of 1384 middle-aged adults not meeting metabolic syndrome(MetS)criteria at the initial screening were included in our analysis.Baseline data such as MetS-components and lifestyle factors were collected in 2002.Body weight and MetS-components were measured in both 2002 and 2007.Participants were classified according to proximal quartiles of weight gain(WG)in percentages(%WG≤1%,1%< %WG≤5%,5%<%WG≤10%and%WG>10%, defined as:control,mild-WG,moderate-WG and severe-WG groups,respectively)at the end of the follow-up. Multivariate models were used to assess the association between MetS outcome and excessive WG in the total population,as well as in both genders. RESULTS:In total,175(12.6%)participants fulfilled MetS criteria within five years.In comparison to the control group,mild-WG adults had an insignificant risk for MetS development while adults having moderate-WG had a 3.0-fold increased risk for progression to MetS [95%confidence interval(CI),1.8-5.1],and this risk was increased 5.4-fold(95%CI,3.0-9.7)in subjects having severe-WG.For females having moderate-and severe-WG,the risk for developing MetS was 3.6(95% CI,1.03-12.4)and 5.5(95%CI,1.4-21.4),respectively. For males having moderate-and severe-WG,the odds ratio for MetS outcome was respectively 3.0(95%CI, 1.6-5.5)and 5.2(95%CI,2.6-10.2). CONCLUSION:For early-middle-aged healthy adults with a five-year weight gain over 5%,the severity of weight gain is related to the risk for developing metabolic syndrome.

Outcome of cesarean delivery in women with excessive weight gain during pregnancy

The objective of this study was to assess the effects of excessive weight gain during pregnancy on the outcome of cesarean delivery. It was a cohort study comparing the outcome of cesarean delivery between 56 pregnant women with excessive weight gain during pregnancy and 75 pregnant women with no excessive weight gain during pregnancy, consecutively recruited at the Yaoundé Gyneco-Obstetric and Pediatric Hospital, Cameroon. In women delivered by cesarean section, excessive weight gain during pregnancy was found to predispose to: time interval from parietal incision to fetal extraction of more than five minutes, duration of cesarean section more than 60 minutes, blood loss more than 1000 ml during surgery, post-operative maternal complications, especially sepsis, fetal weight >3.5 kg and macrosomia. A systematic screening of excessive weight gain should be offered to all pregnant women, so as to prevent the adverse effects of excessive gestational weight gain on cesarean outcome.

Experiences of Low Gestational Weight Gain: A Phenomenological Study with Pregnant Women

Low maternal, gestational weight gain is associated with preterm birth, intrauterine growth restriction, low birthweight, small-for-gestational-age infants, neural tube defects, infant death, failure to initiate breastfeeding, and childhood asthma. The advantage of qualitative research is it can provide valuable insights for health care professionals into the experience and perceptions of low gestational weight gain from the vantage point of women with first-hand lived experience. In this Heideggarian interpretive phenomenological study, the meaning and experiences of weight gain for pregnant women with low gestational weight gain were explored. Data were collected through interviews with 10 pregnant women from Atlantic Canada. Conroy’s pathway for interpretive phenomenology was utilized. A hermeneutical spiral of interpretation identified six patterns or major themes: confronting one’s mortality;defending oneself against a permanent metamorphosis into a stranger;playing with fire and brimstone;slipping under the radar;trying to find peace;and riding an emotional roller coaster. The findings point to a war that is being waged over pregnant bodies with respect to weight that leaves pregnant women fending for themselves, apparently with little help from their health care providers. Implications of the findings for health practice, education, and research are discussed.

Postnatal weight gain in very low birth weight infants in Beijing and the risk of retinopathy of prematurity

AIMTo analyze the low weight gain (WG) from birth to 4 and 6wk of life to predict the development of retinopathy of prematurity (ROP) among very low birth weight (VLBW) preterm babies.METHODSThree hundred and three newborns with VLBW were analyzed. Body weight measurements were recorded weekly. In all patients, the proportion of the WG was defined as the preterm weight measured at the 4th and 6th weeks of life minus the birth weight (BW) divided by the BW. Other risk factors for ROP were also analyzed.RESULTSMean gestational age and mean BW of the whole cohort were 29.56±1.44wk and 1270.58±176.18g respectively. WG proportion at 4wk postnatal age (18.89%±13.58%) were significantly lower in infants with ROP (P=0.003). WG proportion at 6wk was not different between ROP and no ROP group (42.48%±20.36% vs 46.43%±15.65% P=0.118). When all the other risk factors significant for ROP were included in the logistic regression poor WG did not arise as an independent risk factor. Area under the ROC curve was 0.591 (95%CI: 0.515-0.666; P=0.016). For ROP, the best discriminative cutoff of 18.06% of the proportional WG at the 4th week over the BW, sensitivity and specificity values were 67.3% and 50.0% respectively.CONCLUSIONLow WG proportion in the first 4wk of life is maybe an additional predictor of ROP in very low BW infants. Preterm babies with low BW and low WG proportion should be followed closely for ROP.

Effects of Dietary Carbohydrate Sources on Daily Weight Gain and Digestive Enzyme Activities of Juvenile Peanut Worm(Sipunculus nudus)

In the study,glucose,sucrose,dextrin,tapioca starch,potato starch,corn starch and gelatinized corn starch were selected to make the diets with same nitrogen and lipid,and Juvenile peanut worms( Sipunculus nudus) were fed with the diets came from different carbohydrate sources,effects of diets with different carbohydrate sources on daily weight gain and digestive enzyme activities of S. nudus were studied. Results showed that diets with different carbohydrate sources had significant influences on daily weight gain and digestive enzyme activities of S. nudus( P < 0. 05). Daily weight gain in gelatinized corn starch group was significantly higher than that in other groups( P < 0. 05); daily weight gain in glucose group was significantly lower than that in other groups( P < 0. 05); daily weight gain in the three ungelatinized starch groups was significantly higher than that in glucose,sucrose and dextrin groups( P < 0. 05). Analysis of digestive enzyme activities showed that dietary carbohydrate sources had significant influences on digestive enzyme activities of S. nudus( P < 0. 05). Protease activities and amylase activities of S. nudus in sucrose group were the highest,which were significantly higher than that in the other groups( P < 0. 05); lipase activities of S. nudus in glucose group were the lowest,which were significantly lower than that in other groups( P < 0. 05). In conclusion,growth-promoting effects of macromolecules carbohydrates( starch) were better than that of disaccharide( sucrose) and monosaccharide( glucose),which of gelatinized starch were better than that of ungelatinized starch.

Design and application of weight gain graphs based on Bandura’s self-efficacy theory for patients on maintenance haemodialysis

Purpose:To design interdialytic and daily weight gain graphs for patients on maintenance haemodialysis and to evaluate their effect on patient adherence to restricted fluid intake.Methods:Forty-five patients on maintenance haemodialysis were recruited from August to October 2012.The graphs were applied for 12 weeks based on Bandura’s self-efficacy theory.Adherence to restricted fluid intake,dialysis adequacy,and satisfaction were compared before and after the graphs were applied.Results:Adherence to restricted fluid intake increased from 53.3%to 91.1%;the mean rate of urea clearance(Kt/V)decreased from 1.197 to 1.311,and the qualified rate increased from 42.5%to 70%.The rate of adherence was 86.77%;acceptance and satisfaction rates were 100%.Conclusion:It is acceptable to apply the graphs clinically for subsequent effective improvement of adherence to restricted fluid intake,promoting dialysis adequacy,and increasing patient satisfaction.Therefore,clinical application of the graphs is worthwhile.

The Alexandria retinopathy of prematurity model(Alex-ROP): postnatal weight gain screening algorithm application in a developing country

AIM: To suggest a novel retinopathy of prematurity(ROP) screening model in developing countries incorporating postnatal weight gain ratios(PWGR) to traditional parameters to maintain sensitivity and improve specificity in detecting ROP. METHODS: Analysis of weekly PWGR of infants from one tertiary referral center during six months to determine the age at which the PWGR with the highest predictability for ROP development which was referred to as the postnatal net weight gain ratio(NWGR). NWGR was added to conventional criteria to describe a new model(The Alex-ROP model). RESULTS: Of 560 infants were included. NWGR 28 d after birth was the most predictive factor for the development of ROP. A new model Alex-ROP recommending screening infants with gestational age(GA) ≤33 wk or birth weight ≤1500 g and NWGR at 28 d after birth <0.3 was suggested. A second screening model referred to as High-grade AlexROP(Hg Alex-ROP) model to detect worse grade ROP(Both type 1 and type 2) recommending a cutoff point of NWGR <0.15 between birth and 28^(th) day. CONCLUSION: Both Alex-ROP and Hg Alex-ROP models are easy to apply to improve the specificity of ROP screening in developing countries while maintaining high sensitivity.