Preterm Labor free essay sample

Preterm labor is defined as the presence of uterine contractions of sufficient frequency and intensity to effect progressive effacement and dilation of the cervix prior to term gestation (between 20 and 37 wk). Preterm labor precedes almost half of preterm births and preterm birth occurs in approximately 12% of pregnancies and is the leading cause of neonatal mortality in the United States. [1, 2] In addition, preterm birth accounts for 70% of neonatal morbidity, mortality, and health care dollars spent on the neonate, largely due to the 2% of American women delivering very premature infants ( 32 wk).Successful reduction of perinatal morbidity and mortality associated with prematurity may require the implementation of effective risk identification and behavioral modification programs for the prevention of preterm labor; these in turn require both an improved understanding of the psychosocial risk factors, etiology, and mechanisms of preterm labor and programs for accurate identificat ion of pregnant women at risk for premature labor and delivery. We will write a custom essay sample on Preterm Labor or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page In fact, recent evidence suggests that early identification of at-risk gravidas with timely referral for subspecialized obstetrical care may help identify women at risk for preterm labor and delivery and decrease the extreme prematurity ( 32 wk) rate, thereby reducing the morbidity, mortality, and expense associated with prematurity. ANATOMY : The exact mechanism(s) of preterm labor is largely unknown but is believed to include decidual hemorrhage, (eg, abruption, mechanical factors such as uterine overdistension from multiple gestation or polyhydramnios), cervical incompetence (eg, trauma, cone biopsy), uterine distortion (eg, mullerian duct abnormalities, fibroid uterus), cervical inflammation (eg, resulting from bacterial vaginosis [BV], trichomonas), maternal inflammation/fever (eg, urinary tract infection), hormonal changes (eg, mediated by maternal or fetal stress), and uteroplacental insufficiency (eg, hypertension, insulin-dependent diabetes, drug abuse, smoking, alcohol consumption). Preterm labor may be difficult to diagnose and a potential exists for overtreatment of uterine irritability.Tocolytic agents, while generally safe in appropriate dosages with proper clinical monitoring, have potential morbidity and should only be used after consideration of the risks and benefits of such use. Neonatal morbid ity and mortality are greatly affected by gestational age, especially when the pregnancy is less than 28 weeks’ gestation. Tocolysis should be used with caution when the fetus is previable because the expected prolongation of the pregnancy is limited, and the neonate has a minimal chance of survival at less than 23 weeks. The likelihood of survival is further reduced in the presence of significant medical complications, such as intra-amniotic infection (IAI) at these ages.

James Buchanan Was the Only President Who Never Married

James Buchanan Was the Only President Who Never Married There has never been an openly gay president of the United States, but some historians have argued that James Buchanan, the only president who never shared the White House with a first lady,  may have had feelings for a member of the same sex. The nations 15th president is the nations only bachelor president. Buchanan had been engaged to a woman named Ann Coleman long before he became president, but Coleman died before the two could wed. It would not have been unusual, nor would it have proved Buchanan not to have been gay, if they had married; history is filled with homosexual men who married straight women. Longtime Companions While he remained unmarried his entire life, Buchanan had a very close relationship with William Rufus De Vane King, a diplomat who served as U.S. senator and the nations 13th vice president- coincidentally, the only vice president never to have married. Buchanan and King lived together for more than two decades. It was a relatively common practice in the 1800s. Historians note, however, that the couple’s contemporaries in Washington reportedly described King as effeminate, calling him Miss Nancy and Buchanans better half. They also cite letters written by Buchanan about the man he described as his soul mate. After King left the United States to become the minister to France, Buchanan wrote to a friend: I am now solitary and alone, having no companion in the house with me. I have gone a wooing to several gentlemen, but have not succeeded with any one of them. I feel that it is not good for man to be alone; and should not be astonished to find myself married to some old maid who can nurse me when I am sick, provide good dinners for me when I am well, and not expect from me any very ardent or romantic affection. King showed his own affection for Buchanan at his departure by writing to him: I am selfish enough to hope you will not be able to procure an associate who will cause you to feel no regret at our separation. A Historian Makes His Claim James Loewen, a prominent American sociologist and historian,  has been outspoken in his claims that  Buchanan was the first gay president, writing in a 2012 essay: There can be no doubt that James Buchanan was gay, before, during, and after his four years in the White House. Moreover, the nation knew it, too- he was not far into the closet. Today, I know no historian who has studied the matter and thinks Buchanan was heterosexual. Loewen has argued that Buchanans homosexuality is not often discussed in modern times because Americans do not want to believe that society was more tolerant of gay relationships in the 19th century than they are now. Another Bachelor Candidate The closest the nation has come to having a bachelor president since  Buchanan was when Republican U.S. Sen. Lindsey Graham of South Carolina sought the partys presidential nomination in 2016. When asked who would be his first lady, Graham  said the position would be rotating. He also joked that his sister could play the role, if necessary. While Grover Cleveland entered the White House a bachelor in 1885, the 49-year-old was married a year later to 21-year-old Frances Folsom. The One and Only? Although it has long been rumored  that  Richard Nixon had a homosexual affair with his close friend Bebe Rebozo, Buchanan is still the most likely candidate for first, and only, gay American president. Thanks to his vocal support of gay marriage, President Barack Obama  did earn the title briefly, albeit symbolically, in a May 2012 Newsweek  magazine article, written by Andrew Sullivan. Tina Brown, editor-in-chief for Newsweek at the time, explained the term and the cover  photo  of Obama with a rainbow halo superimposed over his head by telling news site Politico, If  President Clinton  was the ‘first black president’ then Obama earns every stripe in that ‘gaylo’ with last week’s gay marriage proclamation.† In his article, Sullivan himself pointed out that the claim was not meant to be taken literally (Obama is married, with two daughters). Its obviously a play on Clinton being the first black president. I am aware that James Buchanan (and maybe Abraham Lincoln) have been in the Oval Office before.   Lincoln has come under speculation as well as having had gay or bisexual affections, but he did marry and father four children. He also was known to have courted women before his marriage to Mary Todd Lincoln. Sources Byers, Dylan. â€Å"Tina Brown Explains Obama Gaylo.†Ã‚  POLITICO, 14 May 2012. Sullivan, Andrew. â€Å"Andrew Sullivan on Barack Obamas Gay Marriage Evolution.†Ã‚  Newsweek, 15 May 2012.

Early stroke Essay Example | Topics and Well Written Essays - 250 words

Early stroke - Essay Example The patient may experience stiffness or spasticity. This can lead to difficulty with motion, mobility and range of motion. These changes affect equilibrium, balance and lead to abnormal walking. Shoulder hand syndrome: 1st stage: begin with tenderness and swelling of the hand and pain lead to limited shoulder and wrist and finger ROM. 2nd stage: further loss of shoulder and hand ROM, severe edema and loss of skin elasticity. 3rd stage: demineralization of bone, severs soft tissue deformity and joint contracture People who suffer from aphasia may be unable to express a basic idea, such as hunger, or remember a single word, like the names of their children. They may not be able to read a newspaper, or even write their name. There are many other changes that result from stroke. On the other hand, are many factors can affect stroke recovery as type of stroke, as it seems that ischemic stroke provide much better able to recover more than the severe type as it destroy the brain cells and have many complications include increased pressure and spasm of blood vessels (Dorhout, 2007). Other factors include timing of rehabilitation as neural plasticity becomes more effective in 1st 6 months of the lesion, so when we start our rehabilitation early it will provide us with a good prognosis and vice versa (Sabine, 2002). The stroke should therefore be treated at an early stage so as to prevent severe conditions that might be fatal. Being one of the Killer diseases the world, precautionary measures should also be put in