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Pre conceptional counseling

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https://www.readbyqxmd.com/read/28521194/preconception-care-for-women-with-type-2-diabetes-mellitus-a-mixed-methods-study-of-provider-knowledge-and-practice
#1
J Klein, J A Boyle, R Kirkham, C Connors, C Whitbread, J Oats, F Barzi, D McIntyre, I Lee, M Luey, J Shaw, A D H Brown, L J Maple-Brown
AIMS: Preconception care may decrease adverse pregnancy outcomes associated with pre-existing diabetes mellitus. Aboriginal Australians are at high risk of type 2 diabetes mellitus (T2DM), with earlier onset. We explored practitioner views on preconception care delivery for women with T2DM in the Northern Territory, where 31% of births are to Aboriginal women. METHODS: Mixed-methods study including cross-sectional survey of 156 health practitioners and 11 semi-structured interviews...
May 5, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28420934/preconception-management-of-thyroid-disorders
#2
Bharti Kalra, Yashdeep Gupta, Sanjay Kalra
Thyroid function is closely interlinked with pregnancy. Maternal and foetal outcomes can be improved if optimal thyroid function is achieved, and maintained prior to conception. This needs a systematic approach which includes rational screening, appropriate management, and pragmatic counseling. This review describes pre-conception management of thyroid disorders, and completes an earlier article on preconception management of other endocrine diseases.
April 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28418987/the-roles-of-behavioral-and-social-science-research-in-the-fight-against-hiv-aids-a-functional-framework
#3
Paul Gaist, Michael J Stirratt
Landmark advances have been made in HIV/AIDS prevention and treatment. These include proof-of-concept and public health implementation of pre-exposure prophylaxis (PrEP) and "treatment as prevention" (TasP) to reduce HIV transmission as well as definitive evidence of the clinical gain from early antiretroviral treatment (ART) initiation. Significant progress has been made in understanding and addressing the social contexts and behavioral factors that impact HIV prevention, care, and treatment interventions...
April 7, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28361508/delivering-safer-conception-services-to-hiv-serodiscordant-couples-in-kenya-perspectives-from-healthcare-providers-and-hiv-serodiscordant-couples
#4
Kenneth Ngure, Grace Kimemia, Kristin Dew, Njambi Njuguna, Nelly Mugo, Connie Celum, Jared M Baeten, Renee Heffron
INTRODUCTION: For HIV serodiscordant couples in resource-limited settings, pregnancy is common despite the risk of sexual and/or perinatal HIV transmission. Some safer conception strategies to reduce HIV transmission during pregnancy attempts are available but often not used for reasons including knowledge, accessibility, preference and others. We sought to understand Kenyan health providers' and HIV serodiscordant couples' perspectives and experiences with safer conception. METHODS: Between August 2015 and March 2016, we conducted key informant interviews (KIIs) with health providers from public and private HIV care and fertility clinics and in-depth interviews (IDIs) and focus group discussions (FGDs) with HIV serodiscordant couples participating in an open-label study of integrated pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART) for HIV prevention (the Partners Demonstration Project)...
March 8, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28361507/client-uptake-of-safer-conception-strategies-implementation-outcomes-from-the-sakh-umndeni-safer-conception-clinic-in-south-africa
#5
Sheree R Schwartz, Jean Bassett, Charles B Holmes, Nompumelelo Yende, Rebecca Phofa, Ian Sanne, Annelies Van Rie
INTRODUCTION: Implementation of safer conception services for HIV-affected couples within primary healthcare clinics in resource-limited settings remains limited. We review service utilization and safer conception strategy uptake during the first three years of Sakh'umndeni, which is a safer conception clinic in South Africa. METHODS: Sakh'umndeni is located at Witkoppen Health and Welfare Centre, a high-volume primary healthcare clinic in northern Johannesburg...
March 8, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28361503/offering-pre-exposure-prophylaxis-for-hiv-prevention-to-pregnant-and-postpartum-women-a-clinical-approach
#6
REVIEW
Dominika L Seidman, Shannon Weber, Deborah Cohan
INTRODUCTION: HIV prevention during pregnancy and lactation is critical for both maternal and child health. Pregnancy provides a critical opportunity for clinicians to elicit women's vulnerabilities to HIV and offer HIV testing, treatment and referral and/or comprehensive HIV prevention options for the current pregnancy, the postpartum period and safer conception options for future pregnancies. In this commentary, we review the safety of oral pre-exposure prophylaxis with tenofovir/emtricitabine in pregnant and lactating women and suggest opportunities to identify pregnant and postpartum women at substantial risk of HIV...
March 8, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28314442/-adult-congenital-heart-disease-medical-and-psychosocial-issues
#7
Magalie Ladouceur, Florence Pontnau, Laurence Iserin
The population of adults with congenital heart disease (ACHD) is continuously increasing with now a higher prevalence than that of the pediatric population. This concerns above all complex congenital heart diseases. Heart failure is the primary cause of death followed by arrhythmia, which is very common in ACHD. A specialized follow-up by dedicated centers is significantly associated with an improvement of survival of ACHD patients compared to non-expert follow-up. Extracardiac disorders (liver, kidney, respiratory) are frequent and require an accurate and specific management...
March 14, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28294527/peripartum-type-b-aortic-dissection-in-patients-with-marfan-syndrome-who-underwent-aortic-root-replacement-a-case-series-study
#8
S Sayama, N Takeda, T Iriyama, R Inuzuka, S Maemura, D Fujita, H Yamauchi, K Nawata, M Bougaki, H Hyodo, R Shitara, T Nakayama, A Komatsu, T Nagamatsu, Y Osuga, T Fujii
OBJECTIVE: To investigate pregnancy outcomes, especially the risk of pregnancy-related aortic dissection (AD), in patients with Marfan syndrome (MFS) after prophylactic aortic root replacement (ARR). DESIGN: Retrospective case series study. SETTING: Tertiary perinatal care centre at a university hospital. POPULATION: Pregnant women fulfilling the revised Ghent nosology (2010) criteria for MFS who were managed at our institute...
March 11, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28277140/interactive-case-based-learning-improves-resident-knowledge-and-confidence-in-reproductive-endocrinology-and-infertility
#9
Kara N Goldman, Ashley W Tiegs, Kristen Uquillas, Margaret Nachtigall, M Elizabeth Fino, Abigail F Winkel, Veronica Lerner
Resident physicians' scores on the REI section of the CREOG exam are traditionally low, and nearly 40% of house staff nation-wide perceive their REI knowledge to be poor. We aimed to assess whether an interactive case-based group-learning curriculum would narrow the REI knowledge gap by improving understanding and retention of core REI concepts under the time constraints affecting residents. A three-hour case-based workshop was developed to address four primary CREOG objectives. A multiple-choice test was administered immediately before and after the intervention and 7 weeks post-workshop, to evaluate both knowledge and confidence...
February 21, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/28259605/hands-on-physics-education-of-residents-in-diagnostic-radiology
#10
Jie Zhang, Peter A Hardy, David J DiSantis, M Elizabeth Oates
RATIONALE AND OBJECTIVES: The American Board of Radiology Core Examination integrates assessment of physics knowledge into its overall testing of clinical radiology, with an emphasis on understanding image quality and artifacts, radiation dose, and patient safety for each modality or subspecialty organ system. Accordingly, achieving a holistic approach to physics education of radiology residents is a huge challenge. The traditional teaching of radiological physics-simply through didactic lectures-was not designed for such a holistic approach...
March 1, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28190955/multi-level-correlates-of-safer-conception-methods-awareness-and-attitudes-among-ugandan-hiv-clients-with-fertility-intentions
#11
Glenn J Wagner, Mahlet A Woldetsadik, Jolly Beyeza-Kashesya, Kathy Goggin, Deborah Mindry, Sarah Finocchario-Kessler, Sarah Khanakwa, Rhoda K Wanyenze
Many people living with HIV desire childbearing, but low cost safer conception methods (SCM) such as timed unprotected intercourse (TUI) and manual self-insemination (MSI) are rarely used. We examined awareness and attitudes towards SCM, and the correlates of these constructs among 400 HIV clients with fertility intentions in Uganda. Measures included awareness, self-efficacy, and motivation regarding SCM, as well as demographics, health management, partner and provider characteristics. Just over half knew that MSI (53%) and TUI (51%) reduced transmission risk during conception, and 15% knew of sperm washing and pre-exposure prophylaxis...
March 2016: African Journal of Reproductive Health
https://www.readbyqxmd.com/read/28186620/an-update-on-the-diagnosis-surgical-management-and-fertility-outcomes-for-women-with-endometrioma
#12
REVIEW
Ryan Cranney, George Condous, Shannon Reid
Endometriosis is estimated to affect up to 50% of infertile women, and severity of endometriosis stage appears to correlate with reduced fertility. Ovarian endometriomas are found in up to 44% of women with endometriosis, and are significantly associated with the presence of pelvic deep infiltrating endometriosis, ovarian adhesions, and pouch of Douglas obliteration. Through the use of MEDLINE and PubMed databases, we conducted a literature review of all available research related to the diagnosis, surgical management and fertility outcomes for women with endometrioma...
February 10, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28155023/comparison-of-self-reported-and-measured-pre-pregnancy-weight-implications-for-gestational-weight-gain-counseling
#13
Annika L Bannon, Molly E Waring, Katherine Leung, Jessica V Masiero, Julie M Stone, Elizabeth C Scannell, Tiffany A Moore Simas
Objectives To examine clinical and demographic characteristics associated with availability of self-reported and measured pre-pregnancy weight, differences in these parameters, and characteristics associated with self-report accuracy. Methods Retrospective cohort of 7483 women who delivered at a large academic medical center between 2011 and 2014. Measured pre-pregnancy weights recorded within a year of conception and self-reported pre-pregnancy weights reported anytime during pregnancy were abstracted from electronic medical records...
February 2, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28137281/risk-estimates-of-recurrent-congenital-anomalies-in-the-uk-a-population-based-register-study
#14
Svetlana V Glinianaia, Peter W G Tennant, Judith Rankin
BACKGROUND: Recurrence risks for familial congenital anomalies in successive pregnancies are known, but this information for major structural anomalies is lacking. We estimated the absolute and relative risks of recurrent congenital anomaly in the second pregnancy for women with a history of a congenital anomaly in the first pregnancy, for all major anomaly groups and subtypes. METHODS: Population-based register data on 18,605 singleton pregnancies affected by major congenital anomaly occurring in 872,493 singleton stillbirths, live births and terminations of pregnancy for fetal anomaly were obtained from the Northern Congenital Abnormality Survey, North of England, UK, for 1985-2010...
January 31, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28120818/pregnancy-and-menopause-in-patients-with-systemic-lupus-erythematosus-and-or-antiphospholipid-syndrome-practical-guide-from-eular
#15
Roberta Vagelli, Chiara Tani, Marta Mosca
Over the last few decades, in reproductive medicine have allowed an improvement in the management and outcome of pregnancy in connective tissue diseases (CTD), such as Systemic progress Lupus Erythematosus and Antiphospholipid Syndrome; however, pregnancy and other related issues represent a crucial moment for patients and their family and some unmet needs are still present. In routine clinical practise, health professionals involved in the care of SLE and/or APS patients need to consider many aspects of the reproductive life of patients, involving not only pregnancy and family planning but also fertility, contraception, cancer surveillance and menopause...
January 25, 2017: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/28063572/suppl%C3%A3-mentation-pr%C3%A3-conceptionnelle-en-acide-folique-multivitamines-pour-la-pr%C3%A3-vention-primaire-et-secondaire-des-anomalies-du-tube-neural-et-d-autres-anomalies-cong%C3%A3-nitales-sensibles-%C3%A3-l-acide-folique
#16
R Douglas Wilson
OBJECTIF: Offrir des renseignements à jour sur l'utilisation pré et postconceptionnelle d'acide folique par voie orale, avec ou sans supplément de multivitamines / micronutriments, aux fins de la prévention des anomalies du tube neural et d'autres anomalies congénitales. Ces renseignements aideront les médecins, les sages-femmes, les infirmières et les autres professionnels de la santé à contribuer aux efforts de sensibilisation des femmes quant à l'utilisation et aux posologies adéquates de la supplémentation en acide folique / multivitamines, avant et pendant la grossesse...
December 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27930607/counseling-framework-for-hiv-serodiscordant-couples-on-the-integrated-use-of-antiretroviral-therapy-and-pre-exposure-prophylaxis-for-hiv-prevention
#17
Jennifer F Morton, Connie Celum, John Njoroge, Agnes Nakyanzi, Imeldah Wakhungu, Edna Tindimwebwa, Snaidah Ongachi, Eric Sedah, Emmanuel Okwero, Kenneth Ngure, Josephine Odoyo, Nulu Bulya, Jessica E Haberer, Jared M Baeten, Renee Heffron
BACKGROUND: For HIV-serodiscordant couples, integrated delivery of antiretroviral therapy (ART) for HIV-positive partners and time-limited pre-exposure prophylaxis (PrEP) for negative partners virtually eliminates HIV transmission. Standardized messaging, sensitive to the barriers and motivators to HIV treatment and prevention, is needed for widespread scale-up of this approach. METHODS: Within the Partners Demonstration Project, a prospective interventional project among 1013 serodiscordant couples in Kenya and Uganda, we offered ART to eligible HIV-positive partners and PrEP to HIV-negative partners before ART initiation and through the HIV-positive partner's first 6 months of ART use...
January 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/27923009/counseling-framework-for-hiv-serodiscordant-couples-on-the-integrated-use-of-antiretroviral-therapy-and-pre-exposure-prophylaxis-for-hiv-prevention
#18
Jennifer F Morton, Connie Celum, John Njoroge, Agnes Nakyanzi, Imeldah Wakhungu, Edna Tindimwebwa, Snaidah Ongachi, Eric Sedah, Emmanuel Okwero, Kenneth Ngure, Josephine Odoyo, Nulu Bulya, Jessica E Haberer, Jared M Baeten, Renee Heffron
BACKGROUND: For HIV-serodiscordant couples, integrated delivery of antiretroviral therapy (ART) for HIV-positive partners and time-limited pre-exposure prophylaxis (PrEP) for negative partners virtually eliminates HIV transmission. Standardized messaging, sensitive to the barriers and motivators to HIV treatment and prevention, is needed for widespread scale-up of this approach. METHODS: Within the Partners Demonstration Project, a prospective interventional project among 1013 serodiscordant couples in Kenya and Uganda, we offered ART to eligible HIV-positive partners and PrEP to HIV-negative partners before ART initiation and through the HIV-positive partner's first 6 months of ART use...
January 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/27917035/polyglandular-autoimmune-syndrome-in-pregnancy-case-report
#19
Basilio Pecorino, Maria Cristina Teodoro, Paolo Scollo
Type III Polyglandular Autoimmune Syndrome is a multiple endocrine disorders disease determined by autoimmunity; it can be diagnosed if a patient is affected by Type 1 Diabetes Mellitus and another autoimmune disease, except Addison Disease, for example Autoimmune Hashimoto Thyroiditis or Celiac Disease. R.D., 34-year-old woman (gravida 2 para 1), was referred to the High Risk Pregnancy Outpatient Clinic at Cannizzaro Hospital in Catania at 8 weeks' gestation. She was affected from type III Polyglandular Autoimmune Disease (Type 1 Diabetes Mellitus, Autoimmune Hashimoto Thyroiditis and Celiac Disease)...
September 2016: Italian Journal of Gynaecology & Obstetrics: Official Publication of the Societa Italiana di Ginecologia e Ostetricia (SIGO)
https://www.readbyqxmd.com/read/27869889/-anmco-sicp-sigo-consensus-document-pregnancy-and-congenital-heart-disease
#20
Innocenzo Bianca, Giovanna Geraci, Michele Massimo Gulizia, Gabriele Egidy-Assenza, Chiara Barone, Marcello Campisi, Annalisa Alaimo, Rachele Adorisio, Francesca Comoglio, Silvia Favilli, Gabriella Agnoletti, Maria Gabriella Carmina, Massimo Chessa, Berardo Sarubbi, Maurizio Mongiovì, Maria Giovanna Russo, Sebastiano Bianca, Giuseppe Canzone, Marco Bonvicini, Elsa Viora, Marco Poli
The success of cardiac surgery over the past 50 years has increased numbers and median age of survivors with congenital heart disease (CHD). Adults now represent two-thirds of patients with CHD; in the United States alone the number is estimated to exceed 1 million.In this population many affected women reach reproductive age and wish to have children. While in many CHD patients pregnancy can be accomplished successfully, some special situations with complex anatomy, iatrogenic or residual pathology are associated with an increased risk of severe maternal and fetal complications...
September 2016: Giornale Italiano di Cardiologia
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