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Preconception management

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https://www.readbyqxmd.com/read/28056690/2016-guidelines-of-the-american-thyroid-association-for-the-diagnosis-and-management-of-thyroid-disease-during-pregnancy-and-the-postpartum
#1
Erik K Alexander, Elizabeth N Pearce, Gregory A Brent, Rosalind S Brown, Herbert Chen, Chrysoula Dosiou, William Grobman, Peter Laurberg, John H Lazarus, Susan J Mandel, Robin Peeters, Scott Sullivan
BACKGROUND: Thyroid disease in pregnancy is a common clinical problem. Since the American Thyroid Association's (ATA's) guidelines for the management of these disorders were first published in 2011, significant clinical and scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, researchers, and health policy makers on published evidence relating to the diagnosis and management of thyroid disease in women during pregnancy, preconception and the postpartum period...
January 6, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28048902/we-g-brc-00-experiences-with-tg100-in-clinical-use
#2
Grace Gwe-Ya Kim
: Failure Mode and Effects Analysis (FMEA) originated as an industrial engineering technique used for risk management and safety improvement of complex processes. In the context of radiotherapy, the AAPM Task Group 100 advocates FMEA as the framework of choice for establishing clinical quality management protocols. However, there is concern that widespread adoption of FMEA in radiation oncology will be hampered by the perception that implementation of the tool will have a steep learning curve, be extremely time consuming and labor intensive, and require additional resources...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048251/we-g-brc-01-risk-assessment-for-radiosurgery
#3
G Kim
: Failure Mode and Effects Analysis (FMEA) originated as an industrial engineering technique used for risk management and safety improvement of complex processes. In the context of radiotherapy, the AAPM Task Group 100 advocates FMEA as the framework of choice for establishing clinical quality management protocols. However, there is concern that widespread adoption of FMEA in radiation oncology will be hampered by the perception that implementation of the tool will have a steep learning curve, be extremely time consuming and labor intensive, and require additional resources...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047604/we-g-brc-02-risk-assessment-for-hdr-brachytherapy
#4
J Mayadev
: Failure Mode and Effects Analysis (FMEA) originated as an industrial engineering technique used for risk management and safety improvement of complex processes. In the context of radiotherapy, the AAPM Task Group 100 advocates FMEA as the framework of choice for establishing clinical quality management protocols. However, there is concern that widespread adoption of FMEA in radiation oncology will be hampered by the perception that implementation of the tool will have a steep learning curve, be extremely time consuming and labor intensive, and require additional resources...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046955/we-g-brc-03-risk-assessment-for-physics-plan-review
#5
S Parker
: Failure Mode and Effects Analysis (FMEA) originated as an industrial engineering technique used for risk management and safety improvement of complex processes. In the context of radiotherapy, the AAPM Task Group 100 advocates FMEA as the framework of choice for establishing clinical quality management protocols. However, there is concern that widespread adoption of FMEA in radiation oncology will be hampered by the perception that implementation of the tool will have a steep learning curve, be extremely time consuming and labor intensive, and require additional resources...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/27990841/management-of-pregnancy-in-cardiomyopathies-and-heart-failure
#6
Enrica Golia, Rita Gravino, Alessandra Rea, Daniele Masarone, Marta Rubino, Annapaola Cirillo, Roberta Pacileo, Fiorella Fratta, Maria Giovanna Russo, Giuseppe Pacileo, Giuseppe Limongelli
Pregnancy exposes women with inherited cardiomyopathies to increased risk for arrhythmias and heart failure. In asymptomatic patients with inherited cardiomyopathies, pregnancy is generally well tolerated. Preconception evaluation, risk assessment and proper counseling by a team of experienced physicians are mandatory in managing women with inherited cardiomyopathies planning pregnancy. In this paper, we reviewed the clinical course, risk assessment and management during pregnancy of women with cardiomyopathies...
January 2017: Future Cardiology
https://www.readbyqxmd.com/read/27901552/diagnosis-and-management-of-hyperthyroidism-in-pregnancy-a-review
#7
Jennifer Renae King, Ruben Lachica, Richard H Lee, Martin Montoro, Jorge Mestman
Importance: Hyperthyroidism has important implications for pregnancy, affecting both mother and fetus. Appropriate maternal and fetal management iscritical to avoiding adverse pregnancy outcomes and requires a multidisciplinary approach. Objective: To describe maternal diagnosis and management of hyperthyroidism, across all stages of pregnancy. In addition, to review clinical signs of fetal thyroid dysfunction due to maternal Graves disease and discuss management considerations...
November 2016: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/27889099/eating-disorders-in-the-context-of-preconception-care-fertility-specialists-knowledge-attitudes-and-clinical-practices
#8
Iolanda S Rodino, Susan M Byrne, Katherine A Sanders
OBJECTIVE(S): To gauge fertility specialists' knowledge, clinical practices, and training needs in regard to eating disorders. DESIGN: Cross-sectional study. SETTINGS: Fertility clinics. PARTICIPANTS: Eighty Australian and New Zealand fertility specialists who were members of the Fertility Society of Australia. INTERVENTION(S): None. MAIN OUTCOME MEASURES(S): Responses to an anonymously completed online questionnaire...
November 23, 2016: Fertility and Sterility
https://www.readbyqxmd.com/read/27855048/-relationship-between-the-level-of-maternal-glycated-hemoglobin-and-fetal-hypertrophic-cardiomyopathy
#9
Karla Lucía Sánchez-Martínez, Luis Fernando Oseguera-Torres, Joel Ávalos-Nuño
BACKGROUND: Diabetes mellitus is a metabolic disorder commonly associated with pregnancy. It is shown that as the management of diabetes during pregnancy is optimized, decreases the frequency and severity of fetal and neonatal complications. The aim of this paper is to identify the relation between the level of maternal glycated hemoglobin and fetal hypertrophic cardiomyopathy. METHODS: An analitytic cross-sectional study was conducted. It included patients with single pregnancy of 28-37 weeks diagnosed with gestational or preconception diabetes mellitus...
2016: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/27830948/getting-help-quickly-older-people-and-community-worker-perspectives-of-contingency-planning-for-falls-management
#10
Kimberly Charlton, Carolyn M Murray, Saravana Kumar
PURPOSE: Older people living in the community need to plan for getting help quickly if they have a fall. In this paper planning for falls is referred to as contingency planning and is not a falls prevention strategy but rather a falls management strategy. This research explored the perspectives of older people and community workers (CWs) about contingency planning for a fall. METHOD: Using a qualitative descriptive approach, participants were recruited through a community agency that supports older people...
November 10, 2016: Disability and Rehabilitation
https://www.readbyqxmd.com/read/27830098/a-pregnancy-with-severe-hypertrophic-obstructive-cardiomyopathy-after-surgery-for-an-implantable-cardioverter-defibrillator-a-case-report-and-literature-review
#11
Takashi Mitsui, Hisashi Masuyama, Kentaro Ejiri, Kei Hayata, Hiroshi Ito, Yuji Hiramatsu
Hypertrophic obstructive cardiomyopathy (HOCM) is cardiac hypertrophy of ventricular myocardium with left ventricular outflow tract obstruction. We report a pregnancy with HOCM after defibrillator implantation surgery. The patient was a 33-year-old nulligravida and was categorized as New York Heart Association class II. Her brain natriuretic peptide (BNP) level was 724.6 pg/dL at preconception. She received careful pregnancy management. However, because frequent uterine contractions were observed at 25 weeks and 6 days of pregnancy, she was hospitalized, and magnesium sulfate was started as a tocolytic agent...
2016: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27812519/in-depth-medical-nutrition-therapy-for-a-woman-with-diabetes-from-pregnancy-to-delivery
#12
Miyoung Jang, Dal Lae Ju, MeeRa Kweon, Misun Park
Diabetes in pregnancy is associated with higher rates of miscarriage, pre-eclampsia, preterm labor, and fetal malformation. To prevent these obstetric and perinatal complications, women with diabetes have to control levels of blood sugar, both prior to and during pregnancy. Thus, individualized medical nutrition therapy for each stage of pregnancy is essential. We provided in-depth medical nutrition therapy to a 38-year-old pregnant woman with diabetes at all stages of pregnancy up to delivery. She underwent radiation therapy after surgery for breast cancer and was diagnosed with diabetes...
October 2016: Clinical Nutrition Research
https://www.readbyqxmd.com/read/27812077/preconception-management-of-endocrine-disorders
#13
Bharti Kalra, Yashdeep Gupta, Sanjay Kalra
Endocrine function is closely interlinked with pregnancy. Maternal and foetal outcomes can be improved if optimal endocrine 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 aspects of pre conception management related to various endocrine glands. Pre conception management of diabetes and thyroid will be covered in later articles.
November 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27809899/prenatal-sonographic-diagnosis-of-fetal-valproate-syndrome-a-case-report
#14
Norihiko Kikuchi, Satoshi Ohira, Ryoichi Asaka, Kyoko Tanaka, Akiko Takatsu, Tanri Shiozawa
BACKGROUND: Prenatal exposure of mother to valproate (VPA) causes teratogenic effects in the fetus, namely fetal valproate syndrome (FVS). We report a case of fetal valproate syndrome rarely diagnosed by prenatal sonographic examination. CASE PRESENTATION: Our patient was a female infant who was born to a 27-year-old nulliparous Japanese woman with epilepsy. The mother was diagnosed with infantile epilepsy at 1 year of age and had been using three antiepileptic drugs, including valproate, but preconceptional counseling was not performed...
November 3, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27787503/a-comprehensive-strategy-for-exome-based-preconception-carrier-screening
#15
Suzanne C E H Sallevelt, Bart de Koning, Radek Szklarczyk, Aimee D C Paulussen, Christine E M de Die-Smulders, Hubert J M Smeets
PURPOSE: Whole-exome sequencing (WES) provides the possibility of genome-wide preconception carrier screening (PCS). Here, we propose a filter strategy to rapidly identify the majority of relevant pathogenic mutations. METHODS: Our strategy was developed using WES data from eight consanguineous and five fictive nonconsanguineous couples and was subsequently applied to 20 other fictive nonconsanguineous couples. Presumably pathogenic variants based on frequency and database annotations or generic characteristics and mutation type were selected in genes shared by the couple and in the female's X-chromosome...
October 27, 2016: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/27785167/pharmacists-perceptions-of-advancing-public-health-priorities-through-medication-therapy-management
#16
Lucas M Casserlie, Natalie A Dipietro Mager
BACKGROUND: Public health priorities can be addressed by pharmacists through channels such as medication therapy management (MTM) to optimize patient and population outcomes. However, no studies have specifically assessed pharmacists' perceptions of addressing public health priorities through MTM. OBJECTIVE: The objective of this study was to assess pharmacists' opinions regarding the feasibility and appropriateness of addressing seven areas of public health priority through MTM services to impact public health in direct patient care settings...
July 2016: Pharmacy Practice
https://www.readbyqxmd.com/read/27757064/genomic-sequencing-in-clinical-practice-applications-challenges-and-opportunities
#17
Joel B Krier, Sarah S Kalia, Robert C Green
The development of massively parallel sequencing (or next-generation sequencing) has facilitated a rapid implementation of genomic sequencing in clinical medicine. Genomic sequencing (GS) is now an essential tool for evaluating rare disorders, identifying therapeutic targets in neoplasms, and screening for prenatal aneuploidy. Emerging applications, such as GS for preconception carrier screening and predisposition screening in healthy individuals, are being explored in research settings and utilized by members of the public eager to incorporate genomic information into their health management...
September 2016: Dialogues in Clinical Neuroscience
https://www.readbyqxmd.com/read/27751798/trends-and-racial-and-ethnic-disparities-in-the-prevalence-of-pregestational-type-1-and-type-2-diabetes-in-northern-california-1996-2014
#18
Tiffany Y Peng, Samantha F Ehrlich, Yvonne Crites, John L Kitzmiller, Michael W Kuzniewicz, Monique M Hedderson, Assiamira Ferrara
BACKGROUND: Despite concern for adverse perinatal outcomes in women with diabetes mellitus before pregnancy, recent data on the prevalence of pregestational type 1 and type 2 diabetes mellitus in the United States are lacking. OBJECTIVE: The purpose of this study was to estimate changes in the prevalence of overall pregestational diabetes mellitus (all types) and pregestational type 1 and type 2 diabetes mellitus and to estimate whether changes varied by race-ethnicity from 1996-2014...
October 15, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27743975/preconceptional-and-maternal-obesity-epidemiology-and-health-consequences
#19
REVIEW
Lucilla Poston, Rishi Caleyachetty, Sven Cnattingius, Camila Corvalán, Ricardo Uauy, Sharron Herring, Matthew W Gillman
Obesity in women of reproductive age is increasing in prevelance worldwide. Obesity reduces fertility and increases time taken to conceive, and obesity-related comorbidities (such as type 2 diabetes and chronic hypertension) heighten the risk of adverse outcomes for mother and child if the woman becomes pregnant. Pregnant women who are obese are more likely to have early pregnancy loss, and have increased risk of congenital fetal malformations, delivery of large for gestational age infants, shoulder dystocia, spontaneous and medically indicated premature birth, and stillbirth...
December 2016: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/27741549/management-of-hyperthyroidism-during-the-preconception-phase-pregnancy-and-the-postpartum-period
#20
Sudipa Sarkar, Lindsay A Bischoff
Hyperthyroidism can occur during pregnancy and the postpartum period, and the treatment of hyperthyroidism should be considered in the preconception phase. Pregnancy has multiple normal physiologic effects on thyroid hormone, which is a separate process distinct from syndromes such as transient hyperthyroidism of hyperemesis gravidarum. The rationale regarding antithyroid drug use during different stages of pregnancy is reviewed, including the literature regarding adverse neonatal outcomes such as aplasia cutis and methimazole embryopathy in the setting of first trimester maternal methimazole use...
November 2016: Seminars in Reproductive Medicine
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