Download or read book Adverse pregnancy outcomes in systemic lupus erythematosus written by Muna Saleh and published by Linköping University Electronic Press. This book was released on 2024-10-09 with total page 122 pages. Available in PDF, EPUB and Kindle. Book excerpt: Abstract: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease of unknown etiology, characterized by a wide range of manifestations that can vary from mild to severe or even life-threatening multiple organ system involvement. SLE predominantly affects women and has a peak incidence during women’s reproductive age. Given the complexity of SLE, managing pregnancy in these women is particularly challenging, as the disease itself can impact pregnancy outcomes, and conversely, pregnancy can exacerbate SLE symptoms. This thesis aims to explore pregnancy complications among women with SLE and to assess the feasibility of utilizing specific biomarkers for evaluating the risk of adverse outcomes in SLE pregnancies, as well as their potential to predict these outcomes. Paper I: A descriptive study on adverse pregnancy outcomes (APOs) in a Swedish population was conducted, involving 28 women diagnosed with SLE and 59 pregnancies monitored from 2002 to 2018 at Skåne University Hospital. The study aimed to determine the prevalence of each APO and to assess demographic, clinical, and laboratory risk factors. Most pregnancies experienced at least one APO, although only a small number were categorized as severe. It was shown that a history of lupus nephritis was the clinical feature most strongly associated with APOs. Moreover, the co-occurrence of SLE and antiphospholipid syndrome was linked to an increased risk of miscarriage, and the presence of one or more antiphospholipid antibodies was correlated with APOs overall. In papers II and III, the aim was to investigate, in 100 healthy women with 100 normal pregnancies selected from the pregnancy register and biobank at Linköping University (GRABB), if pregnancy influences the normal reference values of biomarkers such as complement proteins and pentraxins, to establish a reference interval that is more appropriate for the pregnancy period. Paper II: This study investigated the complement system, which is a vital component of the humoral innate immune system that exhibits increased activity during pregnancy. This function is necessary for maintaining the host's defense and ensuring fetal survival. However, excessive or unbalanced activation of the complement system in the placenta has been linked to various APOs. The study found that maternal plasma C1q and the C3d/C3 ratio had their highest mean values during the first trimester, while C3, C4, and C3d levels increased until delivery. However, the reference limits for complement analyses used for the general population were generally suitable for most of the samples in the study. This suggests that while there were some deviations from the norm in complement levels in certain pregnant women, the standard reference values still adequately captured the overall trends in complement activity during pregnancy in this population. Paper III: This study investigated the same population as in paper II and focused on two types of pentraxins: the liver-produced short pentraxin C-reactive protein (CRP), which is commonly used in clinical practice, and the leukocyte-produced long pentraxin 3 (PTX3), which is structurally and functionally related to CRP. Both pentraxins were previously described as biomarkers related to various APOs. The study found that both CRP and PTX3 levels were significantly elevated in the third trimester compared to the other trimesters. This suggests that during pregnancy, particularly in the later stages, reference values for these biomarkers may need to be adjusted to account for these physiological changes, highlighting the importance of considering pregnancy-specific reference values for these markers. Paper IV: Plasma levels of CRP, PTX3, C3, and C4 were assessed during 123 pregnancies in 102 patients with SLE and 170 pregnancies in women from the general population concerning the risk of APOs. All the patients and controls were recruited from three Swedish cohorts: the Lund cohort, referenced in Paper I; the GRABB cohort, which is mentioned in Papers II and III; and the SLE-Placenta cohort (SLE-PLAC) which is a multicenter Swedish cohort. Only PTX3 showed higher levels in the first and third trimesters of SLE pregnancies with APOs. Even after including control pregnancies with APOs, PTX3 levels remained significantly higher in complicated pregnancies, suggesting that PTX3 could serve as a potential biomarker for identifying at-risk complicated pregnancies. Conclusion: The incidence of APOs in pregnancies affected by SLE is significantly higher than in the general population, highlighting the urgent need for risk stratification and increased attention to specific clinical and serological risk factors in these cases. It is essential to note that reference intervals for some biomarkers may require adjustment during the pregnancy period to ensure accurate interpretation. While our findings need to be confirmed, the pentraxins especially PTX3 could be used for the risk stratification of pregnant women with SLE.

Download or read book Consults in Obstetric Anesthesiology written by Suzanne K. W. Mankowitz and published by Springer. This book was released on 2018-11-15 with total page 628 pages. Available in PDF, EPUB and Kindle. Book excerpt: This text addresses the need for a book specifically aimed at obstetric anesthesia and covers topics such as pulmonary, cardiac renal, hepatic, hematologic, neurologic, endocrine and other diseases. The real anesthetic challenge arises when patients present to Labor and Delivery with unusual or complicated medical problems and, in recent years, a few of the larger institutions have developed an Obstetric Anesthesiology Consultation Service to prepare for the management of these patients. While most pregnant women who present to Labor and Delivery require anesthetic intervention, they typically meet the anesthesiologist for the first time in labor. Since the majority of laboring women are healthy without significant comorbidities, this does not present much of a challenge to the anesthesiologist and the anesthetic management tends to be straight-forward with favorable outcomes. However, using this new model, the anesthesiologist has the opportunity to discuss the various treatment modalities and potentially suggest diagnostic testing to be performed prior to delivery, similar to the pre-operative testing that is done in other surgical environments.

Download or read book Adverse Reproductive Outcomes in Families of Atomic Veterans written by Institute of Medicine and published by National Academies Press. This book was released on 1995-07-17 with total page 107 pages. Available in PDF, EPUB and Kindle. Book excerpt: Over the past several decades, public concern over exposure to ionizing radiation has increased. This concern has manifested itself in different ways depending on the perception of risk to different individuals and different groups and the circumstances of their exposure. One such group are those U.S. servicemen (the "Atomic Veterans" who participated in the atmospheric testing of nuclear weapons at the Nevada Test Site or in the Pacific Proving Grounds, who served with occupation forces in or near Hiroshima and Nagasaki, or who were prisoners of war in or near those cities at the time of, or shortly after, the atomic bombings. This book addresses the feasibility of conducting an epidemiologic study to determine if there is an increased risk of adverse reproductive outcomes in the spouses, children, and grandchildren of the Atomic Veterans.

Download or read book Outcome Measures and Metrics in Systemic Lupus Erythematosus written by Zahi Touma and published by Springer Nature. This book was released on 2021-07-22 with total page 418 pages. Available in PDF, EPUB and Kindle. Book excerpt: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease that manifests with a myriad of clinical and laboratory features. The assessment of SLE is comprehensive and includes different core set domains; disease activity, damage, health-related quality of life, adverse events and economic impact. This comprehensive book is focused on the instruments and outcome measures utilized in the assessment of SLE. It targets different audiences including physicians, scientists/researchers and different health professionals interested in learning about the art of measurement in SLE. The book highlights the importance of measurement in the assessment of SLE in a clinical settings, research and clinical trials. Each of the chapters provide a systematic approach to the instruments utilized in the assessment of a specific construct in SLE (e.g., disease activity, fatigue, etc.) and incorporate a comprehensive coverage of disease specific and disease generic measures. It also discusses different patient-reported outcomes that are crucial to reflect patient perceptions of their health condition and cover constructs such as fatigue, pain, anxiety and depression, cognition, frailty, and many others.

Download or read book Contraception and Pregnancy in Patients with Rheumatic Disease written by Lisa R. Sammaritano and published by Springer. This book was released on 2014-06-16 with total page 315 pages. Available in PDF, EPUB and Kindle. Book excerpt: Rheumatic (or systemic autoimmune) diseases disproportionately affect young women: the female-to-male ratio for patients with systemic lupus erythematosus during the reproductive years is approximately 9:1. In the mid- to late-twentieth century, women with rheumatic disease diagnoses were often advised to avoid pregnancy due to fear of disease exacerbation and adverse outcome. In more recent years, many women with rheumatic disease have deferred childbearing until a later age due to active disease or unsafe therapies. However, with advances in rheumatology therapies, obstetric monitoring, and reproductive medicine technologies, increasing numbers of women with rheumatic diseases are pursuing pregnancy. As a result, obstetricians and rheumatologists need to be aware of the current state of knowledge and the recommendations for management of pregnancy in these patients. Contraception and Pregnancy in Patients with Rheumatic Disease explains the basics of contraception, fertility treatment, and pregnancy in rheumatic disease patients and serves as a guide and reference tool for both rheumatologists and OB/GYNs. Most general rheumatologists and OB/GYNs have limited experience in caring for rheumatic disease patients during pregnancy, and many do not have ready access to expert colleagues in this area. This book summarizes the current state of knowledge and presents a general approach for assessment of the rheumatic disease patient considering pregnancy, hormonal contraception or infertility treatment.

Download or read book Skills in Rheumatology written by Hani Almoallim and published by Springer Nature. This book was released on 2021-01-05 with total page 562 pages. Available in PDF, EPUB and Kindle. Book excerpt: This Open Access book presents practical approaches to managing patients affected by various rheumatological diseases, allowing readers to gain a better understanding of the various clinical expressions and problems experienced by these patients. Discussing rheumatology from an organ systems perspective, it highlights the importance ofdetailed musculoskeletal examinations when treating patients affected by rheumatological diseases. The book first explores the latest diagnostic approaches and offers key tips for accurate musculoskeletal examinations before addressing the various treatment modalities, with a particular focus on the most common joints involved in rheumatoid arthritis: the wrists and the metacarpophalangeal joints (2nd and 3rd). Featuring easy-to-understand flow diagrams and explaining the common medical problems associated with rheumatic disease, such as shortness of breath and anemia, it is not only a valuable resource to rheumatologists, but will also appeal to medical students, junior residents, and primary healthcare physicians.

Download or read book Handbook of Obstetric Medicine written by Catherine Nelson-Piercy and published by CRC Press. This book was released on 2010-09-10 with total page 332 pages. Available in PDF, EPUB and Kindle. Book excerpt: The management of the pregnant woman with a medical problem presents the clinician with particular problems. An understanding of how a medical disease affects pregnancy and how any pre-existing medical condition is affected by pregnancy is required. In addition the clinician must take into account the second patient - the fetus - and be aware of ho

Download or read book Heart Disease in Pregnancy written by Celia Oakley and published by John Wiley & Sons. This book was released on 2008-04-15 with total page 368 pages. Available in PDF, EPUB and Kindle. Book excerpt: The new edition of this practical guide draws on the clinical skills of a wide range of international experts to help you recognize and manage heart disease in pregnancy. Designed for on-the-spot use, this convenient and concise text helps you identify a cardiac problem, understand its pathophysiology, and respond appropriately. Under the careful editorial direction of Drs. Oakley and Warnes, the Second Edition introduces new contributors from North America and Europe as well as new chapters on: pulmonary hypertension rheumatic heart disease artificial heart valves Marfan syndrome auto-immune diseases hypertrophic cardiomyopathy rhythm disorders hypertension cardiac intervention The entire book is scrupulously updated to reflect the most current standards of care. The contributors – all recognized leaders in their respective fields – outline the pathway to diagnosis and appropriate management by a multi-disciplinary team. Although heart disease is the leading medical cause of maternal death, clinical trials in this population are few and the evidence base is small. The expert recommendations in Heart Disease in Pregnancy, Second Edition, are a welcome source of information for cardiologists, obstetricians, general practitioners, and all members of the patient care team.

Download or read book Clinical Rheumatology written by Rohini Handa and published by Springer Nature. This book was released on 2021-02-10 with total page 259 pages. Available in PDF, EPUB and Kindle. Book excerpt: Clinical Rheumatology is a book written by a clinician for clinicians. It covers all the essential clinical aspects of Rheumatology in an engaging, clear, and concise manner, thereby fulfilling an unmet need. The focus of this book is to cover clinically pertinent and practically relevant issues while pruning unnecessary detail. Patient photographs, tables, and boxes enhance readability. The bedside clinical and investigative approach is discussed in a lucid fashion illustrated by clinical photographs, flowcharts, and algorithms. The evidence-based treatment is spelt out in an easy to comprehend fashion. Key messages have been listed at the beginning of each chapter. The book is intended for undergraduate and postgraduate medical students, residents, fellows, and clinicians who want to gain practical knowledge and clinical insight into rheumatic diseases. The book is likely to appeal to internists, rheumatologists, physiatrists, physiotherapists, occupational therapists, as well as orthopaedic surgeons. They will find their day to day questions answered in a knowledge format that can be applied straight away. Senior clinicians will find it a ready reckoner and a handy manual to refresh and update their knowledge. Basic scientists will find it useful to gain clinical insight into the rheumatic diseases they research without being intimidated by the size of the text. Teachers will find it full of helpful teaching messages. Clinical Rheumatology is a must-have book for all those who deal with rheumatic musculoskeletal diseases.

Download or read book Aortopathy written by Koichiro Niwa and published by Springer. This book was released on 2017-02-09 with total page 327 pages. Available in PDF, EPUB and Kindle. Book excerpt: This is the first textbook to focus on Aortopathy, a new clinical concept for a form of vasculopathy. The first section of the book starts from discussing general concept and history of Aortopathy, and then deals with its pathophysiology, manifestation, intrinsic factor, clinical implication, management and prevention. The second part closely looks at various disorders of the Aortopathy such as bicuspid aortic valve and coarctation of aorta. The book editors have published a lot of works on the topic and have been collecting relating data in the field of congenital heart disease for the past 20 years, thus present the book with confidence. The topic - an association of aortic pathophysiological abnormality, aortic dilation and aorto-left ventricular interaction - is getting more and more attention among cardiovascular physicians. This is the first book to refer for cardiologists, pediatric cardiologists, surgeons, ACHD specialists, etc. to acquire thorough knowledge on Aortopathy.

Download or read book Preterm Birth written by Institute of Medicine and published by National Academies Press. This book was released on 2007-05-23 with total page 791 pages. Available in PDF, EPUB and Kindle. Book excerpt: The increasing prevalence of preterm birth in the United States is a complex public health problem that requires multifaceted solutions. Preterm birth is a cluster of problems with a set of overlapping factors of influence. Its causes may include individual-level behavioral and psychosocial factors, sociodemographic and neighborhood characteristics, environmental exposure, medical conditions, infertility treatments, and biological factors. Many of these factors co-occur, particularly in those who are socioeconomically disadvantaged or who are members of racial and ethnic minority groups. While advances in perinatal and neonatal care have improved survival for preterm infants, those infants who do survive have a greater risk than infants born at term for developmental disabilities, health problems, and poor growth. The birth of a preterm infant can also bring considerable emotional and economic costs to families and have implications for public-sector services, such as health insurance, educational, and other social support systems. Preterm Birth assesses the problem with respect to both its causes and outcomes. This book addresses the need for research involving clinical, basic, behavioral, and social science disciplines. By defining and addressing the health and economic consequences of premature birth, this book will be of particular interest to health care professionals, public health officials, policy makers, professional associations and clinical, basic, behavioral, and social science researchers.

Download or read book Chesley s Hypertensive Disorders in Pregnancy written by Robert N. Taylor and published by Elsevier. This book was released on 2014-08-28 with total page 500 pages. Available in PDF, EPUB and Kindle. Book excerpt: Chesley's Hypertensive Disorders in Pregnancy continues its tradition as one of the beacons to guide the field of preeclampsia research, recognized for its uniqueness and utility. Hypertensive disorders remain one the major causes of maternal and fetal morbidity and death. It is also a leading cause of preterm birth now known to be a risk factor in remote cardiovascular disease. Despite this the hypertensive disorders remain marginally studied and management is often controversial. The fourth edition of Chesley's Hypertensive Disorders in Pregnancy focuses on prediction, prevention, and management for clinicians, and is an essential reference text for clinical and basic investigators alike. Differing from other texts devoted to preeclampsia, it covers the whole gamut of high blood pressure, and not just preeclampsia. - Features new chapters focusing on recent discoveries in areas such as fetal programming, genomics/proteomics, and angiogenesis - Includes extensive updates to chapters on epidemiology, etiological considerations, pathophysiology, prediction, prevention, and management - Discusses the emerging roles of metabolic syndrome and obesity and the increasing incidence of preeclampsia - Each section overseen by one of the editors; each chapter co-authored by one of the editors, ensuring coherence throughout book

Download or read book Maternal Hemodynamics written by Christoph Lees and published by Cambridge University Press. This book was released on 2018-05-03 with total page 281 pages. Available in PDF, EPUB and Kindle. Book excerpt: Discover new concepts in cardiovascular and hemodynamic functionality in feto-maternal medicine, from leading experts in the field.

Download or read book Doing Meta Analysis with R written by Mathias Harrer and published by CRC Press. This book was released on 2021-09-15 with total page 500 pages. Available in PDF, EPUB and Kindle. Book excerpt: Doing Meta-Analysis with R: A Hands-On Guide serves as an accessible introduction on how meta-analyses can be conducted in R. Essential steps for meta-analysis are covered, including calculation and pooling of outcome measures, forest plots, heterogeneity diagnostics, subgroup analyses, meta-regression, methods to control for publication bias, risk of bias assessments and plotting tools. Advanced but highly relevant topics such as network meta-analysis, multi-three-level meta-analyses, Bayesian meta-analysis approaches and SEM meta-analysis are also covered. A companion R package, dmetar, is introduced at the beginning of the guide. It contains data sets and several helper functions for the meta and metafor package used in the guide. The programming and statistical background covered in the book are kept at a non-expert level, making the book widely accessible. Features • Contains two introductory chapters on how to set up an R environment and do basic imports/manipulations of meta-analysis data, including exercises • Describes statistical concepts clearly and concisely before applying them in R • Includes step-by-step guidance through the coding required to perform meta-analyses, and a companion R package for the book

Download or read book Fetal Medicine written by Bidyut Kumar and published by Cambridge University Press. This book was released on 2016-04-07 with total page 383 pages. Available in PDF, EPUB and Kindle. Book excerpt: Based on the RCOG Training Module in Fetal Medicine, this book provides a knowledge base for practitioners in obstetrics and maternal-fetal medicine.

Download or read book Maternal Critical Care written by Marc van de Velde and published by Cambridge University Press. This book was released on 2013-07-04 with total page 503 pages. Available in PDF, EPUB and Kindle. Book excerpt: Addresses the challenges of managing critically ill obstetric patients, with chapters authored by intensivists/anesthesiologists and obstetricians/maternal-fetal medicine specialists.

Download or read book Pregnancy Thrombophilia written by Petar Ivanov and published by BoD – Books on Demand. This book was released on 2013-09-19 with total page 169 pages. Available in PDF, EPUB and Kindle. Book excerpt: Learn the recent statements concerning the impact and management of mother-fetal thrombophilia, the achievement necessary for gestation complication prevention and realizing a successful pregnancy valuation. Pregnancy Thrombophilia - The Unsuspected Risk encompasses complete many-sides aspects of thrombophilic conditions during pregnancy, including clinical and basic knowledge approach faced to: 1) Obstetricians, IVF involving gynecologists, Internists, and General practitioners, especially skilled in high risk pregnancy assessment will receive up to date evidence for mother thrombophilia testing indications, an incoming pharmacogenetic approach of individualized antithrombotic therapy and thrombotic tendency management in assisted reproductive technics; 2) Physicians, in particular geneticists, biologists and all researchers, who combine the science of the laboratory with teaching practice, will have essential benefits from the chapters of physiology, pathological and molecular basis of maternal/fetus thrombophilia; 3) The mother-health incorporated immunologists will find a new therapeutic approach beyond anticoagulant treatment in pregnancy with autoimmune conditions. Pregnancy Thrombophilia - The Unsuspected Risk gives you a chance to a rapid review of the recent stands, concerning maternal thrombotic state and authoritative and easy to read summary answers in your daily pregnancy follow up practice.