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Medscape
an hour ago
- Medscape
First-Trimester TMP-SMX Antibiotics and Birth Defects
Infants of mothers treated in the first trimester of pregnancy with trimethoprim/sulfamethoxazole (TMP-SMX) antibiotics for urinary tract infection (UTI) appeared to have a higher risk for any malformation, severe cardiac malformation, and cleft lip and palate than those exposed to beta-lactam antibiotics, a large cohort study of commercially insured pharmaceutical claims found. Recommended routine screening for asymptomatic bacteriuria at the initial prenatal visit often leads to antibiotics being given in the first trimester when the fetus is most susceptible to teratogenic medications and adverse effects from infections. The study, published in JAMA Network Open found no elevated malformation risk for nitrofurantoin, however, although current American College of Obstetricians and Gynecologists (ACOG) guidance recommends that it be avoided in the first trimester unless there is no other appropriate alternative. Anne M. Butler, PhD, MS By type of defect, TMP-SMX was associated with an increased risk for severe cardiac malformations (relative risk [RR], 2.09; 95% CI, 1.09-3.99), other cardiac malformations (RR,1.52; 95% CI, 1.02-2.25), and cleft lip and palate (RR, 3.23; 95% CI,1.44-7.22) compared with beta-lactam antibiotics, according to Anne M. Butler, PhD, MS, a pharmacoepidemiologist at Washington University in St. Louis, and colleagues. The findings emerged from an examination of 71,604 pregnancies in women aged 15-49 years with a median age of 30. Common in pregnancy, UTIs include asymptomatic bacteriuria and acute cystitis; both are associated with adverse perinatal outcomes, including preterm birth, low birth weight, pyelonephritis, and maternal sepsis. 'There is limited guidance on antibiotic selection for UTI treatment in the first trimester due to the potential risk of congenital malformations associated with some antibiotics commonly used to treat UTIs,' Butler told Medscape Medical News. 'But outside of the first trimester of pregnancy, nitrofurantoin and TMP-SMX are considered first-line agents for UTI treatment.' Median gestational age at exposure differed by antibiotic with TMP-SMX prescribed significantly earlier in pregnancy than others: TMP-SMX, 26 (13-59) days; nitrofurantoin, 62 (45-77) days; fluoroquinolones, 18 (9-27) days; and beta-lactams, 63 (48-77) days. Very little TMP-SMX use occurred at 10-13 weeks, when asymptomatic bacteriuria screening typically occurs. The authors conjectured that TMP-SMX-exposed individuals may have had more unrecognized or unplanned pregnancies than their beta-lactam-exposed counterparts. That could result in residual confounding because such pregnancies may be more exposed to teratogenic prescription medications, tobacco, alcohol, or illicit drugs. Malformation Risks Per 1000 infants, the absolute risk for any malformation was 19.8 (95% CI, 18.0-21.8) for beta-lactams; 21.2 (95% CI,19.9-22.7) for nitrofurantoin; 23.5 (95% CI, 18.8-28.9) for fluoroquinolones; and 26.9 (95% CI, 21.8-32.8) for TMP-SMX. After accounting for confounding, the relative risk for any congenital malformation was highest for TMP-SMX (RR, 1.35; 95% CI, 1.04-1.75). Risk was similar for nitrofurantoin (RR, 1.12; 95% CI, 1.00-1.26) and fluoroquinolones (RR, 1.18; 95% CI, 0.87-1.60) compared with beta-lactams. Nitrofurantoin and TMP-SMX are more effective for UTIs than beta-lactams. 'TMP-SMX resistance can be high in some geographical areas such that it shouldn't be used in the absence of culture results,' Butler said. She added that nitrofurantoin works well for lower UTIs such as acute cystitis and asymptomatic bacteriuria but is not recommended for suspected upper UTIs such as pyelonephritis. Butler said that their results support the current ACOG recommendation for caution in using TMP-SMX during the first trimester but do not support current recommendations to limit nitrofurantoin use. Rachel Newman, MD Commenting on the research but not involved in it, Rachel Newman, MD, an assistant professor and maternal-fetal medicine specialist at UTHealth Houston, called it a well-done study that removes the confounding of previous studies. It used an active comparator design and restricted the cohort to individuals treated for UTI rather than for any indication. 'It should be generalizable with the caveat that different practice communities have different degrees of resistance to individual antibiotics,' Newman said. However, the commercial database findings may not be applicable to government-insured and uninsured patients, she noted. Newman stressed that any antibiotic use in pregnancy should be a thoughtful weighing of risks and benefits, but abundant data have demonstrated the safety of all the antibiotics in this study for pregnant women. 'It is reassuring to me that we may be able to use more nitrofurantoin than we've been since there is less resistance to this than to beta-lactams,' she said, which provides another option making UTIs easier to treat before they progress to greater morbidity. 'But the study points out that antibiotics, though safe in general, should not be used lightly in pregnancy.'
Yahoo
an hour ago
- Yahoo
Quantum Breakthrough Could Make Your Devices 1,000 Times Faster
Your days of being frustrated by a sluggish smartphone or laptop could be coming to an end: scientists have discovered a new technique for controlling electronic states in quantum materials that could eventually make our gadgets up to 1,000 times faster. Quantum materials are those that display strange behaviors and properties governed by quantum mechanics. They provide a glimpse into a separate realm of physics, where the standard laws don't apply. Here, researchers from institutions across the US manipulated the temperature of a layered quantum material called 1T-TaS₂, enabling it to instantly shift between two opposite electronic phases: insulation and conduction. That ability to block or allow the flow of electricity is key to how transistors in computer chips work. Of course it's a long journey from a physics lab to consumer electronics, but the technology has the potential to transform the clock speeds of the processors in our gadgets – essentially, how quickly they run. Related: "Everyone who has ever used a computer encounters a point where they wish something would load faster," says physicist Gregory Fiete, from Northeastern University. "There's nothing faster than light, and we're using light to control material properties at essentially the fastest possible speed that's allowed by physics." Every electronic device requires both conductive and insulating materials, which then need to be linked together. If this technology can be developed, we'll have a smaller, faster, single material that can be controlled by light to switch between the two states. The researchers call their process "thermal quenching". The material 1T-TaS₂ has previously shown promise in switching between a conductor and an insulator, but the breakthrough here is doing so at more practical temperatures, rather than cryogenic ones, and for months at a time rather than seconds. Key to those improvements were the heating and cooling approach used by the researchers, and the timing of the temperature changes: fast enough to be effective, but not so fast that the necessary quantum states collapse. "One of the grand challenges is, how do you control material properties at will?" says Fiete. "What we're shooting for is the highest level of control over material properties. We want it to do something very fast, with a very certain outcome, because that's the sort of thing that can be then exploited in a device." Silicon semiconductor components have of course served us well for decades, but we're now approaching the physical limits of what these chips can offer. As such, manufacturers are looking for alternative options. While the techniques used with 1T-TaS₂ here are nowhere near ready to stuff inside our gadgets right now, they do open potential paths towards different types of components and different approaches to electronics that can provide serious performance jumps in the years to come. "We're at a point where in order to get amazing enhancements in information storage or the speed of operation, we need a new paradigm," says Fiete. "Quantum computing is one route for handling this, and another is to innovate in materials. That's what this work is really about." The research has been published in Nature Physics. New Viral Indie Rock Sensation Reveals They're 100% AI ChatGPT: 5 Surprising Truths About How AI Chatbots Actually Work You Can Now Rent a Flesh Computer Grown in a British Lab
Yahoo
an hour ago
- Yahoo
Why July 9 May Be the Shortest Day in Recorded History
Originally appeared on E! Online The summer months may bring longer daylight hours, but the days themselves are actually getting shorter. In fact, July 9 could end up being the shortest day ever recorded by the International Earth Rotation and Reference Systems Service (IERS), which tracks the length of each day down to the millisecond. It's expected to clock in at roughly 1.3 milliseconds shorter than the typical 86,400 seconds in a 24-hour span, according to the BBC. The phenomenon may even occur more than once, as July 22 and Aug. 5 are also predicted to be slightly shorter than normal. On these dates, the moon will be furthest from the equator, which experts have tied to the momentum of the Earth's rotation, per the outlet. Indeed, experts have observed a steady acceleration in the Earth's rotation since 2020. Currently, the shortest day ever was logged on July 5, 2024, which was 1.66 milliseconds shorter than usual, according to Time and Date. For some of the most out-of-this-world celebrity quotes, keep reading. More from E! Online Kanye "Ye" West's Wife Bianca Censori Looks So Different With Bold New Hairstyle Kate Middleton's Personal Assistant of 15 Years Exits Palace Camp Mystic Survivor, 13, Details "Hysterical" Scene During Texas Flood But the moon's placement alone doesn't account for the years-long trend of Earth's rotation speeding up. 'The cause of this acceleration is not explained,' Moscow State University researcher Leonid Zotov told Time and Date in an interview published June 16. 'Most scientists believe it is something inside the Earth. Ocean and atmospheric models don't explain this huge acceleration.' While most people are unlikely to notice the effects of the occurrences, the IERS has periodically added a leap second to the year—most recently in 2016—to ensure high-precision clocks are unaffected. But the recent string of condensed days could have a subtle effect in the future, resulting in a leap second being taken off the clock for the first time in 2029. Fortunately, though, Zotov predicted that the Earth's momentum would eventually subside. 'I think we have reached the minimum,' he said. 'Sooner or later, Earth will decelerate.' For some of the most out-of-this-world celebrity quotes, keep reading. Gayle KingKaty PerryWilliam ShatnerLance BassMichael StrahanKim KardashianElon MuskLeonardo DiCaprioJustin BieberTom HanksAshton KutcherPrince WilliamCameron DiazMichael FassbenderCharlize TheronParis Hilton For the latest breaking news updates, click here to download the E! News App
