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Chapter 36 - Intestinal transplantation
- from Section 6 - Other abdominal organs
- Edited by Andrew A. Klein, Clive J. Lewis, Joren C. Madsen
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- Book:
- Organ Transplantation
- Published online:
- 07 September 2011
- Print publication:
- 11 August 2011, pp 303-312
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Summary
The most common causes of death after the first year following liver transplantation are recurrent and de novo malignancy, return of the original liver disease in the graft, sepsis, cardiovascular disease, and chronic rejection. Review frequency varies between centers and depends partly on patient morbidity. The aim of follow-up is to screen for graft dysfunction and the late complications of liver transplantation. Complications of immune suppression may be related to the original etiology or unrelated and similar to other organs. Azathioprine (AZA) or mycophenolate mofetil (MMF) are often used as long-term maintenance immunosuppression. Up to 45% of liver transplant recipients have metabolic syndrome that includes excessive weight gain, hypertension, diabetes, and hyperlipidemia. Biliary stricture and incisional hernia are the most common late surgical complications after liver transplantation. Psychosocial health should be considered as an important facet in the long-term management of liver transplant recipient.
Contributors
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- By Graeme J.M. Alexander, Heung Bae Kim, Michael Burch, Andrew J. Butler, Tanveer Butt, Roy Calne, Edward Cantu, Robert B. Colvin, Paul Corris, Charles Crawley, Hiroshi Date, Francis L. Delmonico, Bimalangshu R. Dey, Kate Drummond, John Dunning, John D. Firth, John Forsythe, Simon M. Gabe, Robert S. Gaston, William Gelson, Paul Gibbs, Alex Gimson, Leo C. Ginns, Samuel Goldfarb, Ryoichi Goto, Walter K. Graham, Simon J.F. Harper, Koji Hashimoto, David G. Healy, Hassan N. Ibrahim, David Ip, Fadi G. Issa, Neville V. Jamieson, David P. Jenkins, Dixon B. Kaufman, Kiran K. Khush, Heung Bae Kim, Andrew A. Klein, John Klinck, Camille Nelson Kotton, Vineeta Kumar, Yael B. Kushner, D. Frank. P. Larkin, Clive J. Lewis, Yvonne H. Luo, Richard S. Luskin, Ernest I. Mandel, James F. Markmann, Lorna Marson, Arthur J. Matas, Mandeep R. Mehra, Stephen J. Middleton, Giorgina Mieli-Vergani, Charles Miller, Sharon Mulroy, Faruk Özalp, Can Ozturk, Jayan Parameshwar, J.S. Parmar, Hari K. Parthasarathy, Nick Pritchard, Cristiano Quintini, Axel O. Rahmel, Chris J. Rudge, Stephan V.B. Schueler, Maria Siemionow, Jacob Simmonds, Peter Slinger, Thomas R. Spitzer, Stuart C. Sweet, Nina E. Tolkoff-Rubin, Steven S.L. Tsui, Khashayar Vakili, R.V. Venkateswaran, Hector Vilca-Melendez, Vladimir Vinarsky, Kathryn J. Wood, Heidi Yeh, David W. Zaas, Jonathan G. Zaroff
- Edited by Andrew A. Klein, Clive J. Lewis, Joren C. Madsen
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- Book:
- Organ Transplantation
- Published online:
- 07 September 2011
- Print publication:
- 11 August 2011, pp vii-x
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five - Children’s health
- Edited by Shirley Dex, Heather Joshi
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- Book:
- Children of the 21st Century
- Published by:
- Bristol University Press
- Published online:
- 22 January 2022
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- 12 October 2005, pp 133-158
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Summary
Children in the UK are growing up against a background of changing family size and structure as well as changing demographic, economic and societal circumstances, which together have important implications for their health (Peckham, 1998). It is important to understand how the changes in patterns of caring for children and family context influence health in early childhood and the adoption of child health promoting behaviours by parents and carers. In recent years, there has been increasing interest in the contribution of these changes to obesity, asthma and related allergic diseases, autoimmune conditions, and disorders of social communication and behaviour (Gent et al 1994; Bach, 2002; Lobstein et al, 2004). The factors underlying these trends remain poorly understood, although they are clearly of great public health and human importance. The importance of an interdisciplinary perspective combining social, environmental and biological approaches to elucidate their causes is increasingly recognised.
Plan of this chapter
In this chapter, after considering the data sources in more detail, we describe the health during infancy of the cohort children through investigating the baby's birthweight, its infant weight at 8-9 months, and the early nutrition and patterns of breastfeeding. A range of parental and community influences on the baby's health are then considered – namely, parental smoking and alcohol use, immunisation, health problems and other use of services. Finally, the chapter examines indicators of good health in infancy and concludes with the implications of the findings for child health policy.
Data sources
At the first contact with the families when the children were aged around 9 months, information was obtained by parental (usually maternal) report on a wide range of measures. This included those relevant to the prevention of illness and promotion of health in the child, such as breastfeeding, parental smoking and immunisation status, and to conditions and illnesses that have implications for growth and development. Also included were measures which provide a baseline for examining later patterns and trajectories which will change with increasing age – for example, birthweight and bodyweight.
Data were also enhanced with respect to child health information by verifying maternal reports at the time of interview from information recorded in the personal child health record (Walton et al, 2005) and, subsequently, by linkage to routine birth registration records and health service information either at the individual or health service level (Bartington et al, 2005; Tate et al, 2005).
four - Pregnancy and childbirth
- Edited by Shirley Dex, Heather Joshi
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- Book:
- Children of the 21st Century
- Published by:
- Bristol University Press
- Published online:
- 22 January 2022
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- 12 October 2005, pp 109-132
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The Millennium Cohort Study (MCS) collected information about pregnancy and delivery retrospectively at 9-10 months after the child's birth. For this and other reasons, midwives and other clinical staff were not involved in the data collection, unlike the 1946, 1958 and 1970 cohort studies which started as birth surveys. This limited the potential for collecting reliable detailed information about topics such as complications in pregnancy and at delivery. Clearly, pregnancy and childbirth have got safer over time. In the 1946 birth cohort, 4.0% of babies died in the first week after birth, 3.3% in the 1958 cohort and 2.4% in the 1970 cohort (Williams, 1997). On the other hand, the MCS covered some issues not included in the earlier, more clinically oriented birth cohort surveys.
Many but not all of the topics in this chapter are monitored through routine data systems in the four countries of the UK. Birth registration and NHS maternity statistics systems collect information about trends in demographic structure and patterns of care at delivery, although the ways in which they do so differ between countries. What these routine systems do not provide, however, is much information about the social factors which lie behind these changes in care and in the population giving birth. In addition, NHS maternity systems are largely based on information about hospital care. They do not contain information about encounters which usually take place in the community, notably women's first NHS consultations about maternity care and their use of other services such as antenatal classes. The NHS records also contain only limited information about births outside hospital. The aim of this chapter is both to analyse the data about pregnancy and mothers’ use of services in their social context, and to relate them to the trends documented elsewhere.
The national service framework for children, young people and maternity, published in 2004, has a social as well as a clinical agenda (DfES and DH, 2004): ‘Women have easy access to supportive, high quality maternity services, designed around their individual needs and those of their babies.’ ‘Standard 11, maternity’ emphasises choice for women in planning their own care and choosing the place to give birth. It also prioritises the needs of marginalised women, particularly those from disadvantaged groups. Fieldwork for the first sweep of the MCS took place before most of these policies were implemented.
Pregnancy Smoking and Childhood Conduct Problems: A Causal Association?
- Barbara Maughan, Colin Taylor,, Alan Taylor, Neville Butler, John Bynner
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- Journal:
- The Journal of Child Psychology and Psychiatry and Allied Disciplines / Volume 42 / Issue 8 / November 2001
- Published online by Cambridge University Press:
- 23 January 2002, pp. 1021-1028
- Print publication:
- November 2001
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Recent investigations have highlighted associations between maternal smoking in pregnancy and antisocial behaviour in offspring, and suggested the possibility of a causal effect. We used data from the 1970 British birth cohort study (BCS70) to examine these links in a large, population-based sample studied prospectively from birth to age 16. We found a strong dose-response relationship between the extent of pregnancy smoking and childhood-onset conduct problems, but no links with adolescent-onset antisocial behaviours. Effects on childhood-onset conduct problems were as marked for girls as for boys, and were robust to controls for a variety of social background factors and maternal characteristics. Controls for mothers' subsequent smoking history modified this picture, however, suggesting that the prime risks for early-onset conduct problems may be associated with persistent maternal smoking—or correlates of persistent smoking—rather than with pregnancy smoking per se.