This review provides the largest aggregate of cases in which recombinant factor VIIa has been used to control obstetrical bleeding. A review of these cases suggests that this agent may be a useful and safe adjunctive therapy in the management of postpartum hemorrhage.
The proportional income tax is popular in countries of Central and East Europe and 14 CEE countries adopted it with different tax rates from 1994 till 2008 year. But four of them have replaced it with the progressive tax yet. The main criticisms towards the proportional income tax is that it leads to an increase of the inequality after taxation. The article aims to evaluate the impact of the proportional income tax without non-taxable minimum on inequality in Bulgaria, measured by the Gini index. The relationship between the Gini index and the growth rates of GDP per capita, the gross average income and net average income was studied. The methods of Ordinary Least Square (OLS) and correlation were applied to determine the impact of proportional income tax on income inequality in Bulgaria. The research covers the period from 2008 till 2019. National statistical institute of Bulgaria data (12 observations) has been used. The empirical results confirm positive relationship between Gini index and the growth rates of GDP per capita, the gross average income and net average income in system of proportional income tax. Inequality in Bulgaria had increased by 22% after introducing the proportional income tax in 2008, the highest incomes have increased by 113% and the lowest only by 85%. The results of the study show that the increase of the gross average income and net average income leads to increase of the inequality measured with Gini index. Therefore, after taxation of incomes with proportional income tax the inequality does not decrease, but continues to increase. It may be inferred that the proportional taxation increase inequality in Bulgaria.
Pneumonia reportedly increases the risk of maternal and fetal illness and death, and in the United States is a significant cause of nonobstetrical maternal death. Maternal mortality has fallen dramatically since the advent of antibiotics. This prospective study enrolled 28 women who developed pneumonia while pregnant, and presented with signs and symptoms thereof, as well as an acute pulmonary infiltrate, to one of six hospitals in Edmonton, Alberta during a 2-year period in 2001-2003. The incidence was 1.1 per 1000 deliveries. A comparison group included 333 nonpregnant women 20 to 40 years of age who had pneumonia (incidence, 1.3 per 1000).The commonest symptoms of pneumonia in pregnant women were cough, fever, and shortness of breath. None of those affected had received influenza vaccine. Cough, fever, and sputum production dominated in nonpregnant women. Co-morbid conditions were conspicuously absent in the pregnant women. In contrast, the nonpregnant group included women with chronic obstructive lung disease, diabetes, heart disease, liver disease, cancer, and HIV infection. The gestational age when pneumonia developed averaged 29 weeks; more than half the patients were in the third trimester. In no pregnant woman was multilobar involvement observed, but four pregnant women had pleural effusion. Levels of hemoglobin, hematocrit, and albumin all were lower in pregnant women. All of the pregnant women had relatively low scores for severity of illness using the PORT (Pneumonia Patient Outcome Research Team) system. More than 95% of the comparison group also had low-risk PORT scores.Apart from an abortion at 10 weeks' gestation there were no fetal deaths. Live-born infants had a mean birth weight of 3320 gm and a mean 1-minute Apgar score of 8.6. None of the newborn infants had evident anomalies. The only woman who died was not pregnant. The 28 pregnant women received many different antibiotics, most commonly cefuroxime, azithromycin, and erythromycin. Pregnant women were twice as likely to be admitted to hospital than nonpregnant women in the same age group, but they had a shorter length of stay.These findings suggest that pregnant women tolerate pneumonia well and are unlikely to develop pulmonary or immunological complications. Pregnancy itself does not increase the risk of pneumonia. Neither the clinical findings nor the outcomes differ from those in nonpregnant women with pneumonia. EDITORIAL COMMENT(The abstracted study of Shariatzadeh is an important contribution to the literature. The data in it were collected prospectively and are populationrepresentative. The diagnosis of pneumonia was standard and straightforward, requiring both clinical symptoms and signs such as fever, cough, sputum production, shortness of breath, pleuritic chest pain, crackles, or evidence of consolidation by examination, and a confirmatory chest x-ray.This study suggests that pregnant women are no more vulnerable to pneumonia than nonpregnant women. The incidence of community acquired pneumonia among pregnant women was 1.1 per 10...
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