This appears to be a CD case or insert for a children's CD titled "Kiki's World" published in 2010 by EN Recording Corporation, as it contains instructions to insert the CD and references the website and copyright information for the publisher.
Architecting R into Storm Application Development ProcessDataWorks Summit
This document discusses combining R and Storm to perform real-time analytics on streaming data. R is a programming language for advanced statistics while Storm is a framework for processing streaming data. The document proposes running R code inside Storm bolts to leverage R's statistical capabilities for online change point detection on streaming data. As a demonstration, it detects change points in Oakland A's game score differences during their 2002 20-game winning streak, but does not find any, as it is not using the optimal data. Integrating further with data modeling teams is suggested. Combining R and Storm provides benefits like independent development timelines while enabling real-time statistical analysis on data streams.
This appears to be a CD case or insert for a children's CD titled "Kiki's World" published in 2010 by EN Recording Corporation, as it contains instructions to insert the CD and references the website and copyright information for the publisher.
Architecting R into Storm Application Development ProcessDataWorks Summit
This document discusses combining R and Storm to perform real-time analytics on streaming data. R is a programming language for advanced statistics while Storm is a framework for processing streaming data. The document proposes running R code inside Storm bolts to leverage R's statistical capabilities for online change point detection on streaming data. As a demonstration, it detects change points in Oakland A's game score differences during their 2002 20-game winning streak, but does not find any, as it is not using the optimal data. Integrating further with data modeling teams is suggested. Combining R and Storm provides benefits like independent development timelines while enabling real-time statistical analysis on data streams.
펜벤다졸 구매대행 및 복용방법 상담
카톡 ID : fbdz
#펜벤다졸구매 #펜벤다졸직구 #펜벤다졸구입처
강아지 구충제 펜벤다졸, 회충약 파나쿠어정 효능 및 성분, 부작용 & CBD오일 효능과 복용방법
갑자기 며칠 동안 강아지구충제(회충약)인 펩탈(Febtal), 파나쿠어(Panacure), 옴니쿠어가 이슈로 떠오르고 있다.
2019년 10월 31일자 방영된 KBS2 TV프로그램 “제보자들”에 개그맨 겸 가수 김철민씨도 펜벤다졸을 복용하는 것이 방영되었다.
강아지 구충제로 암을 정복할 수 있다고 하는데, 과연 이 것이 사실일까?!
사실이라면 전세계의 암 환우, 가족들에게 이보다 더한 희소식은 없을 것이다.
Safety of Mebendazole Use During Lactationmothersafe
This case series study evaluated the safety of mebendazole use in 45 lactating women and their infants. Mebendazole was administered using single or repeated doses and was well tolerated by both the mothers and infants, with no adverse effects observed in infants. Mild GI irritability occurred in two treated mothers. This study provides the first evidence that mebendazole is safe for use in breastfeeding.
펜벤다졸 구매대행 및 복용방법 상담
카톡 ID : fbdz
#펜벤다졸구매 #펜벤다졸직구 #펜벤다졸구입처
강아지 구충제 펜벤다졸, 회충약 파나쿠어정 효능 및 성분, 부작용 & CBD오일 효능과 복용방법
갑자기 며칠 동안 강아지구충제(회충약)인 펩탈(Febtal), 파나쿠어(Panacure), 옴니쿠어가 이슈로 떠오르고 있다.
2019년 10월 31일자 방영된 KBS2 TV프로그램 “제보자들”에 개그맨 겸 가수 김철민씨도 펜벤다졸을 복용하는 것이 방영되었다.
강아지 구충제로 암을 정복할 수 있다고 하는데, 과연 이 것이 사실일까?!
사실이라면 전세계의 암 환우, 가족들에게 이보다 더한 희소식은 없을 것이다.
Safety of Mebendazole Use During Lactationmothersafe
This case series study evaluated the safety of mebendazole use in 45 lactating women and their infants. Mebendazole was administered using single or repeated doses and was well tolerated by both the mothers and infants, with no adverse effects observed in infants. Mild GI irritability occurred in two treated mothers. This study provides the first evidence that mebendazole is safe for use in breastfeeding.
This document summarizes a study that examined the relationship between the drug domperidone, which is commonly used off-label to stimulate lactation, and the risk of ventricular arrhythmia and mortality during the postpartum period. The study used a retrospective cohort of over 225,000 women in British Columbia between 2002-2011. It found a possible doubling of the risk of hospitalization for ventricular arrhythmia among those exposed to domperidone, though the results were not statistically significant. Larger studies are needed to confirm any association.
This document summarizes key findings from several studies on exposures during pregnancy and lactation. The studies found:
- Teratogen information services receive thousands of calls annually regarding exposures to medications, infections, herbs and other substances during pregnancy and breastfeeding. The majority of calls concern analgesics, cold medications, herbs and dietary supplements.
- Most calls are made by exposed individuals themselves, highlighting a need for more education during prenatal care about risks of nonprescription drugs and vaccines.
- While some drugs used to treat autoimmune diseases like methotrexate and leflunomide can cause harm if taken during early pregnancy, others like sulfasalazine, azathioprine and antimalarials are
(마더리스크라운드) Thyroid disease in pregnancy 임신 중 갑상선mothersafe
This study examined pregnancy outcomes for women exposed to antithyroid medications or levothyroxine for thyroid disorders. The study found that infants of mothers treated for hyperthyroidism with antithyroid medications were more likely to be born preterm or with low birth weight. However, treatment of hypothyroidism with levothyroxine did not negatively impact birth outcomes and showed no increased risk of infant mortality. Additionally, the study found no evidence that levothyroxine exposure increased the risk of major congenital anomalies.
Diclectin in NVP, 44th 유럽기형학회보고 / 한정열 교수mothersafe
This document summarizes a presentation on making a difference as concerned scientists in an environmentally contaminated world. It discusses how scientists have identified problems like chemical pollution and investigated effects on human health. It provides examples like Rachel Carson's Silent Spring which brought attention to pesticide impacts and led to regulations. Endocrine disrupting chemicals can alter fetal development with impacts like reduced intelligence only appearing later. The document then summarizes several talks on topics like the impacts of maternal health conditions like diabetes and epilepsy during pregnancy, using the human placenta to test chemical safety, prenatal metal exposure and DNA methylation in the placenta, free fetal hemoglobin as a potential cause and target for preeclampsia, and revising guidelines
Maternal smoking during pregnancy was associated with an increased risk of major malformations in newborns. A study of over 2000 pregnancies found the risk of major malformations was 3.3 times higher for babies exposed to maternal smoking compared to non-exposed babies. Paternal smoking was also high among the smoking mothers, occurring in over 60% of smoking mothers compared to 38% of non-smoking mothers. Exposure to alcohol and lower education levels were also associated with increased risk of maternal smoking during pregnancy.
This document summarizes guidelines and studies on screening and management of subclinical hypothyroidism during pregnancy. Key points include:
- Guidelines from thyroid societies recommend trimester-specific reference ranges for TSH and treatment of SCH with levothyroxine.
- Studies show mixed results on associations between SCH and adverse pregnancy/child outcomes, and limited benefits of levothyroxine treatment.
- Targeted high-risk screening misses a significant percentage of women with thyroid dysfunction compared to universal screening.
- While evidence is still limited, most experts recommend universal screening to detect and treat overt hypothyroidism given potential benefits.
This document provides information about external cephalic version (ECV):
1. ECV is a procedure performed near term to manually turn a breech baby into a head-down position. The success rate of ECV is reported between 35-86%.
2. ECV has been performed since ancient times but was improved in the 1970s by performing it under tocolysis after screening with ultrasound and fetal monitoring. Recent studies show ECV effectively reduces non-cephalic births and C-sections for malpresentation.
3. Guidelines from obstetric organizations recommend offering ECV to women with a breech fetus near term due to evidence it can reduce C-sections. Factors like adequate amni
1. Proper management of diabetes before and during pregnancy is important to reduce risks of complications. Tight glucose control through medical nutrition therapy, exercise, and insulin treatment can decrease risks of fetal anomalies and growth issues.
2. Gestational diabetes is diagnosed through an oral glucose tolerance test and treated with lifestyle changes and possibly insulin to control blood glucose. Women with a history of GDM require follow up after pregnancy to screen for diabetes.
3. Preconception counseling and care is crucial for women with pre-existing diabetes to optimize health before pregnancy in order to lower risks during pregnancy through strict glucose monitoring and management.
This document discusses alcohol intake during pregnancy and fetal alcohol spectrum disorders (FASD). It provides statistics on alcohol use during pregnancy from various studies. It notes that a safe level of alcohol during pregnancy has not been determined, as the effects of alcohol on the fetus are variable depending on factors like the mother's metabolism and drinking patterns. Low to moderate prenatal alcohol exposure has not shown effects in some studies, but other research has found children with FAS even with reported low alcohol intake. The document describes clinical features of FASD including facial abnormalities, growth issues, central nervous system anomalies, and functional impairments. It discusses diagnostic criteria from various organizations and guidelines for diagnosing FASD.
5. 아기의 의학적 문제:모유수유
• 신생아 관련 질환
: 저혈당증, 황달, 신생아 가사 및 저산소증, 미숙아
• 급성질환
: 호흡기 질환 및 중이염, 위장관 질환
• 만성질환
- 대사이상질환 : 갈락토오즈혈증, 페닐케톤뇨증
- 다운증후군, 선천성 심장질환, 구순열, 구개열
- 신경학적 이상이 있는 환아
• 입원한 환아 / 수술할 환아의 모유수유
6. 호흡기 질환과 중이염
• 감기
- 코막힘
- 모유수유 시에도 Upright position(with sling or carrier)
- Cool-mist vaporizer를 틀어놓는다
- 짧게, 자주 먹인다
• 중이염
- 빨 때 귀 내 압력이 증가하여 아프다
- 먹기를 거부하면 모유를 짜서 스푼이나 컵으로 먹인다
7. 신경학적 이상
: 근력 저하를 일으킬 수 있는 질환
• 신경계 또는 근육 이상
• 대사, 내분비, 혹은 영양 장애
• 결체조직 질환
• 염색체 이상(다운증후군)
• 주산기 저산소증, 근력 저하성 뇌성마비,
비특이적 정신박약 등
8. 신경학적 이상
• 모유수유가 중요한 이유
- 감염, 특히 호흡기계 감염을 낮춘다.
- 근 긴장 저하시 구강안면 근육의 발달을 돕는다.
- 심장 기형 동반된 경우 수유 중 스트레스를 줄여
산소포화도와 체온조절 용이
- 엄마와 아기 사이의 강한 유대감을 가능케 한다.
• 근긴장도가 저하 Dancer Hand position
• 수유 보충기사용
(힘이 약한 아기가 쉽게 지치지 않도록 도움이 된다.)
9. 수술을 앞둔 아기
• NPO 시간을 단축
- 분유는 6시간, 물은 2시간, 모유는 3시간
- 아기가 보채면 미리 젖을 짜서 버리고 빈젖을
물린다.
10. 바이러스 질환
Hepatitis A, B,C
Herpes virus
Herpes Zoster
Rubella
Chicken Pox
대부분의 경우 모유 수유 가능, 권장
모유 수유가 불가능한 경우
HIV-1, HIV-2, HTLV-I, HTLV-II
11. 수두 감염
• 엄마의 피부 병변에 직접 접촉하면 안 된다.
• 엄마와 아기는 딱지가 생기고 새로운 발진이 생기지
않을 때 까지 격리 (5일 내외)
• 직접 수유는 어려우나, 모유는 먹일 수 있다.
• 유방에 skin lesions이 없거나, 영아에게 VZIG을 준 후
모유수유 가능
12. 세균성 감염
• 엄마가 세균에 감염시
– 모유를 통해서 아기에게 감염이 되는 경우
거의 없다.
• 모유에서 균이 발견되는 경우
– 엄마의 혈액에 균이 있을 때
– 매우 심한 질병 상태
– Life Threatening Illness
13. 매독
• 병변이 breast, nipple, 아기가 접촉하는 부위
전염 가능
• 치료 후 24시간
– 피부를 통한 전염력 소실
– 24시간 동안 모유를 짜서 버린다.
– 모유수유 가능
– breast에 sore가 있는 경우 (X)
14. 간질
• 경련 – rarely problem for lactation
• 항경련제
: not contraindication , 반감기 고려
: phenobarbital(L3), primidone(L3), phenytoin(L2),
carbamazepine(L2), valproic acid(L2),
diazepam(L3), topiramate(L3), ethosuximide(L4)
아기가 잠자는 시간이 많으면 한번씩 bottle feeding
고려
• Dropping or Harming
– no more probable than bottle feeding.
15. 그외
• 흡연
• 예방접종
• 머리 염색, 파마
• 유방 확대 수술/유방 축소 수술
• 검사(X-선, 핵의학검사, 수면검사 등)
17. 수유부의 약물 관련 질문, 언제?
의사가 수유부에게 약물 때문에
모유수유를 중단하라고 할 때
18. Counseling 원칙
1. 아기는 몇개월이나 되었는지?
2. 아기의 몸무게?
3. 조산아 인지?
4. 아기의 건강 상태?
5. 사용되는 약?
19. Lactation risk category
L1: safest, large No. Control study
L2: safer, limited No. Control study
L3: moderately safer, Control study
non-threatening adverse effects
L4: possibly hazardous
L5 : contraindicated
Thomas W. Hale
26. Medicine Lactation Risk Consideration
Metronidazole L2 Case: diarrhea
Tobramycin L3
Cefa 3rd gen. 예, caftazidin L1
Epocelin Cephalosporine계 L1~L2
Mucolytic agent로 동물실험에서
Bisolvone Bromhexine no adverse outcome,
모유수유시 문제될 것 같지 않음
Gaster Famotidine L1
Trolac Ketorolac L2
Nalbuphine L2
fentanyl L2
lasix Furosemide L3
Classifications of Lactation risk by Thomas W. Hale L1 : Safest L2: Safer L3: Moderatly safe
** 아기의 성숙 정도는 중요합니다. 만약 미숙아인 경우는 일부 약물 Phenobarbital은 미숙아의 몸에 오래 남아
있으면서 문제를 일으킬 수 있습니다.
48. 연구 요약
수유부-영아 722쌍 중 :
병원 치료가 필요한 부작용은 나타나지 않음
수유부가 약 복용 시 모유수유 중단율 : 9.4%
수유부가 약 복용 시 수유중단 후 재수유율: 6.8%
수유부가 상담 후 약물 복용율 : 76.5%
수유부에서 일부 약물들은 모유량의 감소와 관련 있음
수유아에서의 부작용은 설사, 무른변, 졸리움
52. 상담사례
• 출생 시 3kg, 상담 시 5개월, 7.1kg의 건강한 아기 완모중인
산모
• 우울증으로 alprazolam 약물 상담 후 복용 시작
• 추적 결과 9개월, 8.7kg이었으며 4개월간
P.O medication 후 증상 호전으로 약물 중단 상태
• 약물 복용 기간 중 완모 하였으며 아기 호흡곤란, 기면, 수유거
부 등의 증상 없이 현재 모유수유 지속중임