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https://www.readbyqxmd.com/read/29166183/the-development-of-an-interactive-health-education-model-based-on-the-djuwita-application-for-adolescent-girls
#1
Sri Djuwitaningsih, Setyowati
Alarming incidents of maternal deaths in Indonesia are due to three major causes: bleeding, sepsis, and hypertension, in addition to other non-obstetric causes and unsafe abortions. Adolescent girls contributed to maternal mortality based on early marriage, unwanted pregnancy, and childbirth. Prevention efforts have been taken through government programs and non-governmental organizations, but in practice those were considered ineffective. Thus, a preventative effort in the form of health education should be made, preferably embedded in a popular mobile application that most teenagers would be apt to use...
2017: Compr Child Adolesc Nurs
https://www.readbyqxmd.com/read/29161262/the-value-of-confirmatory-testing-in-early-infant-hiv-diagnosis-programmes-in-south-africa-a-cost-effectiveness-analysis
#2
Lorna Dunning, Jordan A Francke, Divya Mallampati, Rachel L MacLean, Martina Penazzato, Taige Hou, Landon Myer, Elaine J Abrams, Rochelle P Walensky, Valériane Leroy, Kenneth A Freedberg, Andrea Ciaranello
BACKGROUND: The specificity of nucleic acid amplification tests (NAATs) used for early infant diagnosis (EID) of HIV infection is <100%, leading some HIV-uninfected infants to be incorrectly identified as HIV-infected. The World Health Organization recommends that infants undergo a second NAAT to confirm any positive test result, but implementation is limited. Our objective was to determine the impact and cost-effectiveness of confirmatory HIV testing for EID programmes in South Africa...
November 2017: PLoS Medicine
https://www.readbyqxmd.com/read/29121458/placental-drug-transport-on-a-chip-a-microengineered-in-vitro-model-of-transporter-mediated-drug-efflux-in-the-human-placental-barrier
#3
Cassidy Blundell, Yoon-Suk Yi, Lin Ma, Emily R Tess, Megan J Farrell, Andrei Georgescu, Lauren M Aleksunes, Dongeun Huh
The current lack of knowledge about the effect of maternally administered drugs on the developing fetus is a major public health concern worldwide. The first critical step toward predicting the safety of medications in pregnancy is to screen drug compounds for their ability to cross the placenta. However, this type of preclinical study has been hampered by the limited capacity of existing in vitro and ex vivo models to mimic physiological drug transport across the maternal-fetal interface in the human placenta...
November 9, 2017: Advanced Healthcare Materials
https://www.readbyqxmd.com/read/29060149/estimates-of-peak-electric-fields-induced-by-transcranial-magnetic-stimulation-in-pregnant-women-as-patients-using-an-fem-full-body-model
#4
J Yanamadala, G M Noetscher, S N Makarov, A Pascual-Leone
Transcranial magnetic stimulation (TMS) for treatment of depression during pregnancy is an appealing alternative to fetus-threatening drugs. However, no studies to date have been performed that evaluate the safety of TMS for a pregnant mother patient and her fetus. A full-body FEM model of a pregnant woman with about 100 tissue parts has been developed specifically for the present study. This model allows accurate computations of induced electric field in every tissue given different locations of a shape-eight coil, a biphasic pulse, common TMS pulse durations, and using different values of the TMS intensity measured in SMT (Standard Motor Threshold) units...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29053768/investigating-the-impact-of-maternal-residential-mobility-on-identifying-critical-windows-of-susceptibility-to-ambient-air-pollution-during-pregnancy
#5
Joshua L Warren, Ji-Young Son, Gavin Pereira, Brian P Leaderer, Michelle L Bell
Identifying periods of increased vulnerability during pregnancy to air pollution with respect to the development of adverse birth outcomes can improve understanding of possible mechanisms of disease development and provide guidelines for protection of the child. Exposure to air pollution during pregnancy is typically based on the residence at delivery, potentially resulting in exposure misclassification and biasing the estimation of critical windows. In this work, we determine the impact of maternal residential mobility during pregnancy on defining weekly exposure to PM10 and the estimation of windows of susceptibility for term low birth weight utilizing birth cohort datasets from Connecticut (1988-2008) that include information on all residential addresses for each woman between conception and delivery...
October 19, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/29045283/timing-of-initiation-of-antiretroviral-therapy-and-risk-of-preterm-birth-in-studies-of-hiv-infected-pregnant-women-the-role-of-selection-bias
#6
Marie C D Stoner, Stephen R Cole, Joan Price, Jennifer Winston, Jeff S A Stringer
BACKGROUND: Women who initiate antiretroviral therapy (ART) during pregnancy are reported to have lower risk of preterm birth compared to those who enter pregnancy care already receiving ART. We hypothesize this association can be largely attributed to selection bias. METHODS: We simulated a cohort of 1000 preconceptional, HIV-infected women, where half were randomly allocated to receive immediate ART and half to delay ART until their presentation for pregnancy care...
October 16, 2017: Epidemiology
https://www.readbyqxmd.com/read/29029267/evaluation-of-universal-versus-genotype-guided-efavirenz-dose-reduction-in-pregnant-women-using-population-pharmacokinetic-modelling
#7
Adeniyi Olagunju, Alessandro Schipani, Oluseye Bolaji, Saye Khoo, Andrew Owen
Objectives: Lack of data on the pharmacokinetics of efavirenz in pregnant women at the 400 mg reduced dose currently prevents universal roll-out. Population pharmacokinetic modelling was used to explore pharmacokinetic endpoints at 200, 400 and 600 mg daily doses in pregnant women stratified by CYP2B6 metabolic status. Methods: The analysis was based on 252 plasma efavirenz concentrations from 77 pregnant women (77 sparse, 175 intensive) who received antiretroviral regimens containing 600 mg of efavirenz...
September 26, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28994813/a-primary-human-trophoblast-model-to-study-the-effect-of-inflammation-associated-with-maternal-obesity-on-regulation-of-autophagy-in-the-placenta
#8
Bailey Simon, Matthew Bucher, Alina Maloyan
Maternal obesity is associated with an increased risk of adverse perinatal outcomes that are likely mediated by compromised placental function that can be attributed to, in part, the dysregulation of autophagy. Aberrant changes in the expression of autophagy regulators in the placentas from obese pregnancies may be regulated by inflammatory processes associated with both obesity and pregnancy. Described here is a protocol for sampling of villous tissue and isolation of villous cytotrophoblasts from the term human placenta for primary cell culture...
September 27, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28994515/role-of-pelvic-ultrasound-simulation
#9
Sushila Arya, Zuber D Mulla, Sanja Kupesic Plavsic
BACKGROUND: Pelvic ultrasound is a critical diagnostic imaging tool in obstetrics and gynaecology. Training opportunities in transvaginal ultrasound have not kept pace with the demand among learners because of the increased complexity of modern ultrasound technology and duty-hour restrictions. Ultrasound simulation training has the potential to overcome this gap. Training opportunities in transvaginal ultrasound have not kept pace with the demand OBJECTIVE: Our study aimed to determine the usefulness, applicability and attitudes toward pelvic ultrasound simulation training among residents, sonographers and practising doctors...
October 10, 2017: Clinical Teacher
https://www.readbyqxmd.com/read/28985732/cost-effectiveness-of-malaria-preventive-treatment-for-hiv-infected-pregnant-women-in-sub-saharan-africa
#10
Sung Eun Choi, Margaret L Brandeau, Eran Bendavid
BACKGROUND: Malaria is a leading cause of morbidity and mortality among HIV-infected pregnant women in sub-Saharan Africa: at least 1 million pregnancies among HIV-infected women are complicated by co-infection with malaria annually, leading to increased risk of premature delivery, severe anaemia, delivery of low birth weight infants, and maternal death. Current guidelines recommend either daily cotrimoxazole (CTX) or intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) for HIV-infected pregnant women to prevent malaria and its complications...
October 6, 2017: Malaria Journal
https://www.readbyqxmd.com/read/28969502/a-hierarchical-modeling-approach-for-assessing-the-safety-of-exposure-to-complex-antiretroviral-drug-regimens-during-pregnancy
#11
Katharine Correia, Paige L Williams
Combination antiretroviral regimens have achieved tremendous success in reducing perinatal HIV transmission, and have become standard of care in pregnant women with HIV. However, the large variety of combination antiretroviral regimens utilized in practice raises the question of whether some of these highly potent drugs pose other risks to the pregnancy or infant. While HIV-infected pregnant women are almost always exposed to multiple antiretrovirals concurrently, standard safety screening strategies typically consider each individual antiretroviral separately, which fails to account for potential confounding due to simultaneous exposure to other antiretrovirals...
January 1, 2017: Statistical Methods in Medical Research
https://www.readbyqxmd.com/read/28962699/quantitative-prediction-of-fetal-plasma-concentration-of-fluvoxamine-during-dosage-tapering-to-the-mother
#12
Sayo Matsuoka, Satoko Hori, Hiroki Satoh, Takeshi Nagamatsu, Tomoyuki Fujii, Yasufumi Sawada
INTRODUCTION: Although selective serotonin reuptake inhibitors have been used during pregnancy for the treatment of depression and anxiety disorders, the fetal plasma concentration profiles of them remained unclear. Therefore, the aim of this study was to develop a pharmacokinetic model to estimate fetal plasma concentration profiles of fluvoxamine, and to clarify the differences with those of paroxetine. METHODS: Perfusion studies using human placentae obtained from full-term pregnant women were conducted to estimate transplacental pharmacokinetic parameters for fluvoxamine...
October 2017: Placenta
https://www.readbyqxmd.com/read/28959176/face-and-content-validity-of-the-virtual-reality-simulator-scantrainer%C3%A2
#13
Amal Alsalamah, Rudi Campo, Vasilios Tanos, Gregoris Grimbizis, Yves Van Belle, Kerenza Hood, Neil Pugh, Nazar Amso
BACKGROUND: Ultrasonography is a first-line imaging in the investigation of women's irregular bleeding and other gynaecological pathologies, e.g. ovarian cysts and early pregnancy problems. However, teaching ultrasound, especially transvaginal scanning, remains a challenge for health professionals. New technology such as simulation may potentially facilitate and expedite the process of learning ultrasound. Simulation may prove to be realistic, very close to real patient scanning experience for the sonographer and objectively able to assist the development of basic skills such as image manipulation, hand-eye coordination and examination technique...
2017: Gynecological Surgery
https://www.readbyqxmd.com/read/28954567/optimal-timing-of-delivery-for-women-with-breast-cancer-according-to-cancer-stage-and-hormone-status-a-decision-analytic-model
#14
Kelly Kuo, Aaron B Caughey
OBJECTIVE: To compare strategies for the timing of delivery in women with breast cancer and known cancer stage or hormone receptor subtype, and to determine the optimal gestational age for induction in regards to maternal-fetal outcomes. STUDY DESIGN: A decision-analytic model was designed comparing eight different strategies for scheduled delivery at 30, 31, 32, 33, 34, 35, 36, and 37 weeks gestation. Optimal breast cancer treatment was assumed to be delayed until after delivery...
September 27, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28943130/estimation-and-reduction-of-the-radiation-dose-to-the-fetus-from-external-beam-radiotherapy
#15
REVIEW
Michalis Mazonakis, John Damilakis
The appearance of a malignant disease during pregnancy is relatively rare. The use of external-beam radiation therapy is limited to non-pelvic tumors which are usually located above the diaphragm. However, supradiaphragmatic radiotherapy unavoidably exposes the fetus to secondary radiation due to head leakage, scatter from the machine and scatter produced inside the patient. This fetal exposure may be associated with an elevated risk for the development of deterministic harmful effects and/or carcinogenesis...
September 21, 2017: Physica Medica: PM
https://www.readbyqxmd.com/read/28942518/projecting-the-potential-impact-of-the-cap-score%C3%A2-on-clinical-pregnancy-live-births-and-medical-costs-in-couples-with-unexplained-infertility
#16
Joseph B Babigumira, Fady I Sharara, Louis P Garrison
PURPOSE: The Cap-Score™ was developed to assess the capacitation status of men, thereby enabling personalized management of unexplained infertility by choosing timed intrauterine insemination (IUI), versus immediate in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) in individuals with a low Cap-Score™. The objective of this study was to estimate the differences in outcomes and costs comparing the use of the Cap-Score™ with timed IUI (CS-TI) and the standard of care (SOC), which was assumed to be three IUI cycles followed by three IVF-ICSI cycles...
September 23, 2017: Journal of Assisted Reproduction and Genetics
https://www.readbyqxmd.com/read/28941740/fetal-radiation-dose-in-three-common-ct-examinations-during-pregnancy-monte-carlo-study
#17
A Kelaranta, T Mäkelä, T Kaasalainen, M Kortesniemi
PURPOSE: To determine fetal doses in different stages of pregnancy in three common computed tomography (CT) examinations: pulmonary CT angiography, abdomino-pelvic and trauma scan with Monte Carlo (MC) simulations. METHODS: An adult female anthropomorphic phantom was scanned with a 64-slice CT using pulmonary angiography, abdomino-pelvic and trauma CT scan protocols. Three different sized gelatin boluses placed on the phantom's abdomen simulated different stages of pregnancy...
September 20, 2017: Physica Medica: PM
https://www.readbyqxmd.com/read/28938125/selective-immuno-modulatory-effect-of-prolactin-upon-pro-inflammatory-response-in-human-fetal-membranes
#18
Pilar Flores-Espinosa, Eduardo Preciado-Martínez, Araceli Mejía-Salvador, Gabriela Sedano-González, Luisa Bermejo-Martínez, Adalberto Parra-Covarruvias, Guadalupe Estrada-Gutiérrez, Rodrigo Vega-Sánchez, Isabel Méndez, Braulio Quesada-Reyna, Andrea Olmos-Ortiz, Veronica Zaga-Clavellina
During pregnancy, prolactin (PRL) is a neuro-immuno-cytokine that contributes actively to the crosstalk between the immune and endocrine systems and, thus, to the creation of an immune-privileged milieu. This work aims to analyze the capacity of PRL to modulate the synthesis and secretion of pro-inflammatory markers associated with labor. Studies were conducted using human fetal membranes at term mounted in a model of two independent chambers. The choriodecidual region was stimulated with 500-ng/mL lipopolysaccharide (LPS), and the amnion and choriodecidual region were co-simulated with different concentrations of PRL that can arise during pregnancy: 250, 500, 1000, and 4000ng/mL...
September 2017: Journal of Reproductive Immunology
https://www.readbyqxmd.com/read/28931691/vertical-transmission-of-hepatitis-c-virus-variable-transmission-bottleneck-and-evidence-of-midgestation-in-utero-infection
#19
Sébastien Fauteux-Daniel, Ariane Larouche, Virginie Calderon, Jonathan Boulais, Chanel Béland, Doris G Ransy, Marc Boucher, Valérie Lamarre, Normand Lapointe, Isabelle Boucoiran, Armelle Le Campion, Hugo Soudeyns
Hepatitis C virus (HCV) can be transmitted from mother to child during pregnancy and childbirth. However, the timing and precise biological mechanisms that are involved in this process are incompletely understood, as are the determinants that influence transmission of particular HCV variants. Here we report results of a longitudinal assessment of HCV quasispecies diversity and composition in 5 cases of vertical HCV transmission, including 3 women coinfected with human immunodeficiency virus type 1 (HIV-1). The population structure of HCV variant spectra based on E2 envelope gene sequences (nucleotide positions 1491 to 1787), including hypervariable regions 1 and 2, was characterized using next-generation sequencing and median-joining network analysis...
December 1, 2017: Journal of Virology
https://www.readbyqxmd.com/read/28930821/sonographic-image-of-cervix-epithelioid-trophoblastic-tumor-coexisting-with-mucinous-adenocarcinoma-in-a-postmenopausal-woman-a-case-report
#20
Yi Zhu, Guo-Nan Zhang, Rui-Bo Zhang, Yu Shi, Deng-Feng Wang, Rong He
RATIONALE: Epithelioid trophoblastic tumor (ETT) is a distinctive but rare gestational trophoblastic neoplasia (GTN) composed of chorionic-type intermediate trophoblast cells. Approximately 50% ETT arose from the uterine cervix or lower uterine segment following a previous pregnancy with vaginal bleeding. With its unusual ability to simulate an invasive epithelioid neoplasm, ETT frequently poses a diagnostic challenge, especially involving the uterine cervix. PATIENT CONCERNS: We herein report the case of a 60-year-old female with persistent vaginal bleeding and middle-level elevation of serum human chorionic gonadotropin (hCG)...
September 2017: Medicine (Baltimore)
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