MedicalResearch.com Interview with:
Lauren Corona BS
Wayne State University School of Medicine
Detroit, MI
Medical Research: What is the background for this study? What are the main findings?
Response: Hysterectomy is the most commonly performed major gynecologic surgery in the United States. This study sought to examine how often alternative treatment is considered prior to hysterectomy for benign indications and how often pathology in the surgical specimen supports the need for hysterectomy. We utilized data from the Michigan Surgical Quality Collaborative, a statewide hospital collaborative, and limited the analysis to patients having a hysterectomy for uterine fibroids, abnormal uterine bleeding, endometriosis, and/or pelvic pain. Alternative treatment to hysterectomy was not documented prior to surgery in 38% (i.e. no documentation that the patient declined, was unable to tolerate, or failed any alternative treatment). A progesterone intrauterine device (IUD) was the least utilized form of alternative treatment, documented in only 12% of patients. In addition, nearly 1 in 5 (18.3%) had pathology reported that did not support the need for hysterectomy—i.e. the uterus was described as normal or unremarkable or only had minor amounts of pathology. Women <40 years had the highest rate of unsupportive pathology at 38%.
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MedicalResearch.com Interview with:
Keith P. West, Jr., Dr.P.H., R.D.
Professor and Director
Program and Center in Human Nutrition
Department of International Health
Bloomberg School of Public Health
Johns Hopkins University Baltimore, Maryland 21205Medical Research: What is the background for this study? What are the main findings?
Dr. West: Deficiencies in vitamins and minerals (micronutrients) that must be provided by the diet, are a major public health concern in undernourished societies. In rural South Asia, where some 35 million babies are born each year, maternal micronutrient deficiencies are common and may increase risk of adverse pregnancy outcomes such as preterm birth, low birth weight or stillbirth and infant mortality. Further, a newborn of low birth weight faces higher risks of poor postnatal growth, infection and mortality. Where prenatal care exists, iron-folic acid supplements are often prescribed as standard care to prevent iron deficiency anemia. But it is likely that many micronutrient deficiencies emerge from an inadequate diet, raising the possibility that a supplement that provides each day a recommended dietary allowance of most essential vitamins and minerals could measurably improve the health of the mother, fetus and infant. Because prenatal multinutrient supplements are rarely taken in low income countries, it is important to assess their potential to improve health before recommending this practice. We did this be conducting a large prenatal supplementation trial in rural Bangladesh, randomizing 44,567 pregnant women in their 1st trimester to receive a supplement with 15 vitamins and minerals or only iron and folic acid, followed their pregnancies and survival of their 28,516 infants to 6 months of age.
Medical Research: What are the main findings?Dr. West: The multiple micronutrient supplement had the effect of extending the length of gestation compared to the iron-folic acid supplement, by about 2 days on average. This was enough to lower risk of preterm birth, below 37 weeks, by 15%. The extra time in the womb also allowed the fetus to grow a little larger, increasing birth weight (by 54 grams or about 2 ounces) as well as length and other measures of size, leading to a 12% reduction in low birth weight. In addition, there was an 11% reduction in risk of stillbirth. These are all indications of a healthier pregnancy. Although we observed a 14% lower mortality from all causes in girls, there was not a similar effect in boys, leading to no overall effect. We are continuing to investigate possible reasons for this difference.
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MedicalResearch.com Interview with:
Pedro Moro MD MPH
Immunization Safety Office, Division of Healthcare Quality Promotion
National Center for Emerging and Zoonotic Infectious Diseases
Centers for Disease Control and Prevention
Medical Research: What is the background for this study? What are the main findings?
Dr. Moro: Gardasil® is a human papillomavirus (HPV) vaccine recommended for all girls and boys at age 11 or 12, and teens and young adults who did not get the vaccine when they were younger. Because there is limited safety data available on use of the vaccine during pregnancy, it is not currently recommended for pregnant women. However, some pregnant women will inadvertently receive Gardasil® because they do not yet know that they are pregnant at the time of vaccination.
The study reviewed non-manufacturer reports to the Vaccine Adverse Event Reporting System (VAERS) about pregnant women who received Gardasil®. VAERS is a national vaccine safety surveillance program co-administered by the Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA). VAERS accepts reports of health problems that occur after any US-licensed vaccine (these are called adverse events). VAERS may also accept reports not describing any health problem but vaccination errors (for example, administration of a vaccine not recommended to a particular group of people like pregnant women). VAERS is an early-warning system and cannot generally assess if a vaccine caused an adverse event.
After reviewing all non-manufacturer reports of Gardasil vaccination during pregnancy, this study found no unexpected patterns of safety issues for pregnant woman who received Gardasil®, or for their babies. This finding is reassuring and reconfirms the safety of this vaccine for pregnant women, as was previously reported by the pregnancy registry maintained by Gardasil®’s manufacturer.
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MedicalResearch.com Interview with:
Cheryl K. Walker, MD
Associate Professor
Department of Obstetrics & Gynecology
Faculty, The MIND Institute
School of Medicine, University of California, Davis
Medical Research: What is the background for this study? What are the main findings?Dr. Walker: Autism spectrum disorder (ASD) is a neurobehavioral condition identified in 1 in 68 U.S. children and is part of a broader group of developmental disabilities that affects 1 in 6 children. Growing evidence suggests that Autism spectrum disorder and developmental delay originate during fetal life. Preeclampsia is a complicated and frequently dangerous pregnancy condition that appears to arise from a shallow placental connection and may increase the risk of abnormal neurodevelopment through several pathways.
Medical Research: What are the main findings?Dr. Walker: Children with Autism spectrum disorder were more than twice as likely to have been exposed to preeclampsia compared with children with typical development. Risk for ASD was increased further in children born to mothers with more severe presentations of preeclampsia. Mothers of children with developmental delay were more than 5 times more likely to have had severe forms preeclampsia – often with evidence of reduced placental function – compared with mothers of children with typical development.
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MedicalResearch.com Interview with:Stefan Johansson, MD PhD
consultant neonatologist
Stockholm, Sweden
Medical Research:What is the background for this study?Dr. Johansson: Maternal obesity (BMI ≥ 30) has previously been linked to increased infant mortality. However, research has not produced consistent results. For example, there are disagreements whether infants to overweight mothers (BMI 25-29) are at increased risk, and research on BMI-related specific causes of death is scarce.
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MedicalResearch.com Interview with:Karin B. Michels, ScD, PhD
Associate Professor of Obstetrics, Gynecology and Reproductive Biology
Harvard Medical School
Medical Research:What is the background for this study? What are the main findings?Dr. Michels: We were interested in studying the long-term effects of oral contraceptive use on mortality. Given the widespread use of oral contraceptives, this is an important question pertaining to millions of women worldwide. We explored this question in the large Nurses’ Health Study, a cohort of 121,700 women in the US, who have been followed for 38 years. We found that oral contraceptive use does not impact overall mortality. However, breast cancer mortality was slightly increased, especially with long-term use of oral contraceptives.
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MedicalResearch.com Interview with: Ian R. Macumber MD
Pediatric Nephrology, Seattle Children's Hospital
Seattle, Washington
Medical Research: What are the main findings of the study?Dr. Macumber: The main finding is that there is a strong association between maternal obesity and odds of congenital anomalies of the kidney and urinary tract (CAKUT) in offspring. This relationship remains strong when looking at offspring with renal malformation (excluding non-renal congenital anomalies of the kidney and urinary tract), or in offspring with isolated congenital anomalies of the kidney and urinary tract (no congenital anomalies elsewhere in the body). There is a dose-response relationship to this association, with the offspring of extremely obese mothers have even higher odds of having congenital anomalies of the kidney and urinary tract.
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MedicalResearch.com Interview with: Mostafa Borahay, MD, FACOG
Assistant Professor, Director of Simulation Education
Department of Obstetrics and Gynecology
University of Texas Medical BranchCo-director of Minimally Invasive Gynecologic Surgery University of Texas Medical Branch
Medical Research: What is the background for this study? What are the main findings?Dr. Borahay: Uterine fibroids are the most common type of tumor in the female reproductive system, accounting for half of the 600,000 hysterectomies done annually in the U.S. Their estimated annual cost is up to $34 billion in the U.S. alone. Despite this, the exact cause of these tumors is not well understood, as there are several genetic, familial and hormonal abnormalities linked with their development. Even more, we currently don’t have a satisfactory medical treatment for these tumors.
Our team investigated the impact of simvastatin on human uterine fibroid cell growth. Statins, such as simvastatin, are commonly prescribed to lower high cholesterol levels. Statins work by blocking an early step in cholesterol production. Beyond these well-known cholesterol-lowering abilities, statins also combat certain tumors. Statins have previously been shown to have anti-tumor effects on breast, ovarian, prostate, colon, leukemia and lung cancers. However, the effect of statins on uterine fibroids was unknown.
We found that simvastatin impedes the growth of uterine fibroid tumor cells. We also studied the way simvastatin works to suppress these tumors. Simvastatin was shown to inhibit ERK phosphorylation, which is a critical step in the molecular pathway that prompts the growth of new cells. In addition, simvastatin stops the progression of tumor cells that have already begun to grow and induces calcium-dependent cell death mechanisms in fibroid tumor cells. Therefore, we identified a novel pathway by which simvastatin induces the death of uterine fibroid tumor cells.
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MedicalResearch.com Interview with: Paula Braveman, MD, MPH
Director, Center on Social Disparities in Health
Professor, Family and Community Medicine
University of California San Francisco
San Francisco, CA 94118
Medical Research: What are the main findings of the study?Dr. Braveman: There were a couple of striking findings from this study of preterm birth (PTB) among non-Latino White and Black women born in the U.S..
First, we found that women who were poor or socioeconomically disadvantaged in other ways (who had not or whose parents had not graduated from high school or who lived in neighborhoods (census tracts) with highly concentrated (25% or more of residents) poverty) had similarly high preterm birth rates. In addition, we found that while preterm birth rates among White women consistently improved as their socioeconomic status (SES) improved, higher-SES Black women generally did no better –and sometimes did worse—than lower-SES Black women.
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MedicalResearch.com: Interview with: Dr. Cora Peterson PhD
Health Economist at Centers for Disease Control
Medical Research: What is the background for this study? What are the main findings?Dr. Peterson: Women with pregestational diabetes mellitus (PGDM) have increased risk for adverse birth outcomes. Preconception care for women with pregestational diabetes mellitus reduces the frequency of such outcomes, most likely by improving glycemic control before and during the critical first weeks of pregnancy.
Preconception care for women with pregestational diabetes mellitus includes the following activities:
medical or dietary blood sugar control, blood sugar monitoring, screening and treatment of complications due to diabetes,
counseling and education about the risks of diabetes in pregnancy, and
using effective birth control or contraceptives until appropriate levels of blood sugar are achieved.
In this study, CDC researchers estimated the number of preterm births, birth defects, and perinatal deaths (death between the time a baby is at least 20 weeks old in the mother’s womb to one week after the baby is born) that could be prevented and the money that could potentially be saved if preconception care was available to and used by all women with pregestational diabetes mellitus before pregnancy.
Researchers estimated about 2.2% of births (88,081 births each year) in the United States are to women with pregestational diabetes mellitus, including women who know they have diabetes before they become pregnant and those who are unaware they have diabetes. Preconception care before pregnancy among women with known pregestational diabetes mellitus could potentially generate benefits of up to $4.3 billion by preventing preterm births, birth defects, and perinatal deaths. Up to an additional $1.2 billion in benefits could be produced if women who do not know they have diabetes were diagnosed and received preconception care.
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MedicalResearch.com Interview with:Prof. Zvi Laron
Professor Emeritus of Pediatric Endocrinology
TAU's Sackler Faculty of Medicine,
Director of the Endocrinology and Diabetes Research Unit
Schneider Children's Medical Center of Israel
Head WHO Collaborating Center for the Study of Diabetes in Youth
Medical Research: What are the main findings of the study? What was most surprising about results?Prof. Laron: The main findings were the finding of specific antibodies to the pancreatic insulin secreting beta cells together with antibodies against rota-virus in both the mother at delivery and in the newborn's cord blood. We were not surprised, but pleased to find proof to our hypothesis that part, if not the majority of childhood onset Type 1 (autoimmune diabetes) starts "in utero".
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Medical Research Interview with:
Eva Morales, MD, PhD, MPH
Centre for Research in Environmental Epidemiology (CREAL)
Barcelona Biomedical Research Park
Barcelona, Spain
Medical Research: What are the main findings of the study?
Dr. Morales:We aimed to assess the consequences of exposure to outdoor air pollution during specific trimesters of pregnancy and postnatal lifetime periods on lung function in preschool children. We conducted a longitudinal study by using data from 620 mother-child pairs participating in the INfancia y Medio Ambiente (INMA) Project – a population-based cohort study set up in several geographic areas in Spain. We found that exposure to outdoor air pollution during the second trimester of pregnancy in particular raises the risk of harm to a child’s lung function at preschool age. (more…)
MedicalResearch.com Interview with:Jason D. Wright, M.D.
Sol Goldman Associate Professor of Obstetrics and Gynecology
Chief, Division of Gynecologic Oncology
Columbia University College of Physicians and Surgeons
New York, New York 10032
Medical Research: What are the main findings of the study?Dr. Wright: The use of robotic assisted ovarian surgery (oophorectomy and cystectomy) has increased rapidly and compared to laparoscopic alternatives, robotically assisted surgery is associated with a small increase in complication rates and substantially greater costs.
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MedicalResearch.com Interview with: Dr. Jeff Peipert MD, PhD
Institute for Public Health
Robert J. Terry Professor, Department of Obstetrics & Gynecology, School of Medicine
Washington University in St. Louis
Medical Research: What are the main findings of this study?Dr. Peipert: In the Contraceptive CHOICE Project, over 70% of teenage girls and women who were provided no-cost contraception and were educated about the effectiveness and benefits of long-acting reversible contraceptive (LARC) methods selected the intrauterine device (IUD) or contraceptive implant. This group of over 1400 young women aged 15-19 years had rates of pregnancy, birth, and abortion that were far below national rates for sexually experienced teens.
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MedicalResearch.com Interview with:Rebecca J. Schmidt, M.S., Ph.D.
Assistant Professor
Department of Public Health Sciences
The MIND Institute School of Medicine
University of California Davis
Davis, California 95616-8638
MedicalResearch: What are the main findings of the study?Dr. Schmidt: Women who had children with autism reported taking iron supplements during pregnancy and breastfeeding less often than women who children who were typically developing. Mothers of children with autism also had lower average iron intake.
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MedicalResearch.com Interview With: Ruth C. E. Hughes
Department of Obstetrics and Gynecology
University of Otago, Christchurch Women’s Hospital
Christchurch, New Zealand
Medical Research: What are the main findings of the study?Dr. Hughes: The increasing prevalence of undiagnosed type 2 diabetes in women of childbearing age was the main driver behind our study. In clinical practice, we were finding that women with probable undiagnosed diabetes (and pre-diabetes) had already started developing pregnancy complications at the time they were diagnosed with gestational diabetes diagnosis in the late second trimester. It seemed logical to try to identify them in early pregnancy, with the idea that they might benefit from earlier intervention. We thus explored the usefulness of first trimester HbA1c measurements to identify women with unrecognised pre-existing diabetes.
In our study, an HbA1c of 5.9% (41mmol/mol) was the optimal screening threshold for diabetes in early pregnancy. We found that a threshold of 6.5% (48mmol/mol), which is endorsed by the World Health Organization and American Diabetes Association for diagnosing diabetes in pregnancy, would miss almost 50% of women with probable pre-existing diabetes. Of great relevance, women with an early HbA1c of 5.9%-6.4% (41-46mmol/mol) had poorer pregnancy outcomes than those with an HbA1c <5.9% (<41mmol/mol), with a 2.5-3 fold higher relative risk of major congenital anomaly, preeclampsia, shoulder dystocia, and perinatal death. These women were also more likely to deliver before 37 weeks gestation.
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MedicalResearch.com Interview with: Audrey J. Gaskins, Sc.D.
Postdoctoral Research Fellow
Department of Nutrition
Harvard School of Public Health
Medical Research: What are the main findings of the study?Answers: In our large prospective cohort study, we found that higher adherence to several healthy dietary patterns (e.g. the Alternate Healthy Eating Index 2010, Alternate Mediterranean Diet, and Fertility Diet) prior to pregnancy was not associated with risk of pregnancy loss.
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MedicalResearch.com Interview with: Steven Ball
Telethon Kids Institute
University of Western Australia
West Perth, WA 6872, Australia
Medical Research: What are the main findings of the study?Answer:Our study suggests that the amount of time between pregnancies has less of an effect on birth outcomes than previously thought.
Relative to pregnancies that started 18-23 months after a previous birth, pregnancies that followed shorter spacing had very little increased risk of preterm birth, low birth weight or small-for-gestational-age. Longer pregnancy spacing showed increased risk of low birth weight and small-for-gestational-age, but not of preterm birth.
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MedicalResearch.com Interview with: Jason D. Wright, M.D.
Levine Family Assistant Professor of Women's Health
Florence Irving Assistant Professor of Obstetrics and Gynecology
Division of Gynecologic Oncology
Columbia University College of Physicians and Surgeons
161 Fort Washington Ave, New York, New York 10032
Medical Research: What are the main findings of the study?Dr. Wright:This study is one of the first large scale studies to examine the risk of cancer specifically in women who underwent hysterectomy with electric power morcellation. Among 32,000 women treated at over 500 hospitals across the US we noted cancer in 27 per 10,000 women.
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MedicalResearch.com Interview with:Dr. Dong-Xin Wang, MD, PhD
Department of Anesthesiology and Surgical Intensive Care
Peking University First Hospital
Beijing 100034, China
Medical Research: What are the main findings of the study?Answer: We found that use of epidural analgesia during labor is associated with decreased risk of postpartum depression.
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MedicalResearch.com Interview with:
Donna Parker, Sc.D., FAHA
Director of Community Health and Research
Center for Primary Care and Prevention
Memorial Hospital of RI
Pawtucket, RI 02860
MedicalResearch: What are the main findings of the study?Answer: The main findings of the study are that women with a history of one or more miscarriages or one or more stillbirths appear to be at increased risk of cardiovascular disease. We found that the multivariable adjusted odds ratio for coronary heart disease for one or more stillbirths was 1.27 (95 percent CI, 1.07-1.51) compared with no stillbirth; for women with a history of one miscarriage, the odds ratio was 1.19 (95 percent CI, 1.08-1.32); and for women with a history of two or more miscarriages, the odds ratio was 1.18 (95 percent CI, 1.04-1.34) compared with no miscarriage. However, we did not find a significant association of ischemic stroke and pregnancy loss. The association between pregnancy loss and CHD appeared to be independent of hypertension, body mass index, waist-to-hip ratio and white blood cell count.
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MedicalResearch.com Interview with: Jared Baeten, MD PhD
Professor, Departments of Global Health and Medicine
Adjunct Professor, Department of Epidemiology
University of Washington
Seattle, WA 98104
Medical Research: What are the main findings of the study?Dr. Baeten: Among heterosexual African couples in which the male was HIV positive and the female was not, receipt of antiretroviral pre-exposure preventive (PrEP) therapy did not result in significant differences in pregnancy incidence, birth outcomes, and infant growth compared to females who received placebo.
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MedicalResearch.com Interview with: David Olds, Ph.D.
Professor of Pediatrics and Director
Prevention Research Center for Family and Child Health
University of Colorado Department of Pediatrics
Aurora, Colorado 80045
Medical Research: What are the main findings of the study?Dr. Olds: We’ve conducted a randomized controlled trial of a program of nurse home visiting for low-income women with no previous live firths during pregnancy and the first two years of the child’s life, with randomization of participants beginning in 1990. In our most recent follow-up of mothers and children in Memphis, those who received nurse-visitation were less likely to have died over a 2-decade period following the child’s birth than those in the control group. Death among mothers and children in these age ranges in the US is rare and extraordinarily important for what it tells us about the health of the population studied in this trial.
For children, the reduction in death was present for preventable causes, that is, sudden infant death syndrome, injuries, and homicide. All of the child deaths for preventable causes were in the control group, for whom the rate was 1.6%. None of the nurse-visited children died of preventable causes.
The reductions in maternal mortality were found for two nurse-visited groups combined for this report: one received prenatal and newborn visitation and a second received visitation during pregnancy and through child age two. Overall, mothers assigned to the control group were nearly 3 times more likely to die than those assigned to the two nurse-visited conditions. The relative reduction in maternal mortality was particularly pronounced for deaths linked to maternal behaviors -- suicide, drug overdose, injuries, and homicide; for these external causes of death, 1.7% of the mothers in the control group had died, compared to 0.2% of those visited by nurses.
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MedicalResearch.com Interview with: Dr Anju Joham
PhD student, SPHPM
Endocrinologist, Monash Health
MedicalResearch: What is the background for your study?Dr. Joham: This research led by Professor Helena Teede and Dr Anju Joham, from the School of Public Health and Preventive Medicine at Monash University analysed a large-scale epidemiological study, called the Australian Longitudinal Study of Women’s Health (ALSWH).
Polycystic Ovary Syndrome (PCOS) is a condition affecting nearly 20% of Australian women. Women with PCOS may experience irregular menstrual cycles, reduced fertility, increased risk of diabetes, high cholesterol and psychological features such as depression and reduced quality of life.
MedicalResearch: What are the main findings of the study?Dr. Joham: Approximately 6000 women aged between 25-30 years were monitored for nine years, including nearly 500 women with diagnosed PCOS. Our research found that there is a clear link between PCOS and type 2 diabetes. The incidence and prevalence of type 2 diabetes was three to five times higher in women with PCOS. In analysing the key contributing factors to the increased diabetes risk, we found that having PCOS was in itself a key contributing factor.
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MedicalResearch.com Interview with:Dr. Ali Abbara
Imperial College London, United Kingdom
Dr. Abbara: What are the main findings of the study?
MedicalResearch: We found that a novel blood test for kisspeptin was able to identify asymptomatic pregnant women who were at increased risk of subsequent miscarriage. Blood kisspeptin performed better than the more commonly measured pregnancy hormone BHCG in identifying women at increased risk of miscarriage. (more…)
MedicalResearch.com Interview Invitation Dr. Krista Huybrechts MD PhD
Brigham & Women’s Hospital
Department of Medicine
Division of Pharmacoepidemiology & Pharmacoeconomics
Boston, MA 02120
MedicalResearch: What are the main findings of the study?Dr. Huybrechts: In this cohort study including 949,504 pregnant women enrolled in Medicaid, we examined whether the use of selective serotonin reuptake inhibitors (SSRIs) and other antidepressants during the first trimester of pregnancy is associated with increased risks for congenital cardiac defects. In order to control for potential confounding by depression and associated factors, we restricted the cohort to women with a depression diagnosis and used propensity score adjustment to control for depression severity and other potential confounders. We found no substantial increased risk of cardiac malformations attributable to SSRIs. Relative risks for any cardiac defect were 1.25 (95%CI, 1.13-1.38) unadjusted, 1.12 (1.00-1.26) depression-restricted, and 1.06 (0.93-1.22) depression-restricted and fully-adjusted. We found no significant associations between the use of paroxetine and right ventricular outflow tract obstruction (1.07, 0.59-1.93), or the use of sertraline and ventricular septal defects (1.04, 0.76-1.41); two potential associations that had been of particular concern based on previous research findings.
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MedicalResearch.com Interview with: Sergio R. Ojeda, D.V.M.
Division Head and Senior Scientist Division of Neuroscience
Division of Neuroscience, OR National Primate Research Center/Oregon Health and Science University,
Beaverton OR 97006
MedicalResearch: What are the main findings of the study?Dr. Ojeda:The study shows that a receptor for two growth factors (brain-derived neurotrophic factor [BDNF] and neurotrophin 4/5 [NT4/5]) that are known to be important for development of the nervous system is also essential for maintaining oocyte integrity and survival in the mammalian ovary. Intriguingly, the full-length form of this receptor (known as NTRK2-FL) is not expressed in oocytes until the time of the first ovulation. At this time, the pre-ovulatory gonadotropin discharge stimulates granulosa cells of ovarian follicles to produce not only more BDNF, but also more of a peptide known as kisspeptin, to induce the formation of NTRK2-FL in oocytes. To date, kisspeptin was known to be only critical for the hypothalamic control of reproduction. To induce NTRK2-FL, BDNF binds to truncated NTRK2 receptors (NTRK2-T1), which are abundant in oocytes throughout prepubertal development. Kisspeptin, on the other hand, does so by activating its receptor KISS1R, also expressed in oocytes. Once present after the first ovulation, NTRK2-FL is able to activate a survival pathway in oocytes following gonadotropin stimulation, presumably at every cycle. In the absence of NTRK2-FL, oocytes die, follicular structure disintegrates and a condition of premature ovarian failure ensues.
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MedicalResearch.com: Interview withRachel Thompson PhD
Postdoctoral Research Fellow
The Dartmouth Center for Health Care Delivery Science
Dartmouth College
MedicalResearch: What are the main findings of the study?Dr. Thompson: This study, which surveyed 417 women aged 15-45 years and 188 contraceptive care providers in 2013, found important differences in what matters most to these two groups when it comes to discussing and deciding on a contraceptive method. Women’s most important question when choosing a contraceptive was “Is it safe?” – this was in the top three questions for 42% of women but only 21% of providers. Alternatively, providers’ most important question was “How is it used?”. Information on side effects and how a method actually works to prevent pregnancy was also a higher priority for women than for providers.
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MedicalResearch.com Interview with:
Antonio E. Frias, MD
Associate Professor | Division of Maternal Fetal Medicine
Oregon Health & Science University
Director, Diabetes and Pregnancy Program
Assistant Scientist | Oregon National Primate Research Center
Portland, Oregon 97239
MedicalResearch: What are the main findings of the study?Dr. Frias: Resveratrol supplementation in pregnant nonhuman primates fed a Western-style diet improved maternal metabolism, restored placental blood flow, reduced placental inflammation and improved lipid deposition in the fetal liver. However, there was an unexpected disruption of fetal pancreatic development that is very concerning.
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MedicalResearch.com Interview with : Dr. Francesco Fiorentino
CEO and Lab Director
ROME - ITALY
MedicalResearch: What are the main findings of the study?Dr. Fiorentino: This study describes findings from first and second of a three-phase strategy to validate the use of next-generation sequencing (NGS) for comprehensive aneuploidy screening, as a preclinical step toward its routine use in the diagnosis of chromosomal aneuploidy on embryos. The first phase involved a large preclinical validation study on single cells, and demonstrated that the NGS-based 24-aneuploidy screening protocol was accurate and reliable. The results provided 100% consistency for aneuploid embryo call with array-CGH, the highly validated method of aneuploidy screening.
The second phase of the study, instead, focused on the clinical application of the NGS-based protocol for the detection of all chromosomes in embryos. A prospective trial involving analysis of human embryos at the blastocyst stage of development was designed for this purpose, in order to establish similar levels of chromosome-specific NGS copy number assignment concordance compared with 24sure array as those observed in the first phase of the study. Consistency of NGS-based aneuploidy detection was assessed matching the results obtained with array-CGH–based diagnoses,
Embryos obtained from 55 consecutive clinical PGS cycles, blindly assessed in parallel with both NGS and array-CGH techniques, displayed 100% concordance for aneuploid embryo call. Consistency obtained during this investigation was similar to those obtained in the first phase of the study that used NGS to examine single cell samples, demonstrating the reliability of the NGS-based method in detection of chromosome aneuploidy also in embryos at blastocyst stage derived from clinical preimplantation genetic screening (PGS) cycles. The clinical outcomes obtained in this study from preimplantation genetic screening cycles performed with the NGS approach were very encouraging, resulting in a clinical pregnancy rate per embryo transfer of 63.8% (mean age 38.5+2.1 years) and an ongoing implantation rate of 64.0%, values that are comparable with recent results from other comprehensive chromosome screening approaches.
In conclusion, the results achieved in this study demonstrate the reliability of the NGS-based protocol for detection of whole chromosome aneuploidies, mosaicism occurrences and segmental changes in embryos.
(more…)
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