The document summarizes the 25th International Conference of Organization of Teratology Information Specialists that was held in Baltimore in 2012. It discusses presentations on topics such as patient perception of teratogenic risks, how economic challenges are affecting teratology information services, epidemiological research on various exposures, and counseling approaches. The document also describes a visit by the director of the Korean Motherisk Program to learn about the program in Toronto to help shape the vision and future of the Korean Motherisk Program.
Isotretinoin is a novel treatment for severe, recalcitrant nodular acne sold under the brand names Accutane®, Amnesteem®, Claravis®, and Sotret®. It is the most widely used teratogenic drug in the United States. From a population based perspective, women and men use the drug in near equal proportions but the risks are exponentially greater for women of childbearing years. Serious developmental abnormalities have displayed a high tendency to occur in clusters in fetuses exposed to isotretinoin. This review of medical literature focuses on the public health implications of isotretinoin use and develops a case for continued risk management. Reduction of fetal isotretinoin exposure is contingent upon effective programming and continued adherence to strict standards.
The presentation will discuss; Increasing trend for fertility at midlife; Reasons; Problems; Advantages; Challenges; Chances of success naturally or with IUI or with IVF, role of PGT A; Delphi consensus Posieden criteria; Newer techniques with ovarian rejuvenation and CRISPR and ASRM recommendations and conclusions. We are seeing celebrities with millions of followers having babies at an older age. Aishwarya rai at 37 Rani mukherjee 37 Neha Dhupia 38 Kareen Kapoor 36 Farah Khan triplets at 40 yrs of age. An excellent publication from 2013 titled: Age shock: mis perceptions of the impact of age on fertility before and after IVF in women who conceived after age 40 K. Mac Dougall, Hum Reprod. 2013 Feb has put forth reasons for a mistaken belief in robust fertility
Isotretinoin is a novel treatment for severe, recalcitrant nodular acne sold under the brand names Accutane®, Amnesteem®, Claravis®, and Sotret®. It is the most widely used teratogenic drug in the United States. From a population based perspective, women and men use the drug in near equal proportions but the risks are exponentially greater for women of childbearing years. Serious developmental abnormalities have displayed a high tendency to occur in clusters in fetuses exposed to isotretinoin. This review of medical literature focuses on the public health implications of isotretinoin use and develops a case for continued risk management. Reduction of fetal isotretinoin exposure is contingent upon effective programming and continued adherence to strict standards.
The presentation will discuss; Increasing trend for fertility at midlife; Reasons; Problems; Advantages; Challenges; Chances of success naturally or with IUI or with IVF, role of PGT A; Delphi consensus Posieden criteria; Newer techniques with ovarian rejuvenation and CRISPR and ASRM recommendations and conclusions. We are seeing celebrities with millions of followers having babies at an older age. Aishwarya rai at 37 Rani mukherjee 37 Neha Dhupia 38 Kareen Kapoor 36 Farah Khan triplets at 40 yrs of age. An excellent publication from 2013 titled: Age shock: mis perceptions of the impact of age on fertility before and after IVF in women who conceived after age 40 K. Mac Dougall, Hum Reprod. 2013 Feb has put forth reasons for a mistaken belief in robust fertility
Newborn survival and perinatal health in resource-constrained settings in Asia and the Pacific: Applying Global Evidence to Priorities Beyond 2015
12 April 2013
Birth Defects: Care, preventing and counsellingPiLNAfrica
Birth Defects was written for healthcare workers who look after individuals with birth defects, their families, and women who are at increased risk of giving birth to an infant with a birth defect. This book is being used in the Genetics Education Programme which trains healthcare workers in genetic counselling in South Africa. It covers: modes of inheritance, medical genetic counselling, birth defects due to chromosomal abnormalities, single gene defects, teratogens, multifactorial inheritance
Update (2021) Oral Contraceptive Pill : Dr. Jyoti Agarwal Dr Sharda Jain Lifecare Centre
Update (2021) Oral Contraceptive Pill : Dr Sharda Jain
7 Billion 2011 & increasing a rate of 150 million per year
INDIA
Today – 1.3 billion 2050 – 1.628 expected
This Journal Club presentation provides a summary and discussion of the following free access article published in UOG:
Perinatal outcome in women treated with progesterone for the prevention of preterm birth: a meta-analysis
A. Sotiriadis, S. Papatheodrou, G. Makrydimas
Volume 40, Issue 3, Date: September 2012, pages 257-266
It can be accessed here:
http://onlinelibrary.wiley.com/doi/10.1002/uog.11178/abstract
Everyone agrees that all children react differently to shots, and some kids will have bad reactions. There cannot be compulsory vaccination in absence of controlled clinical trials of the childhood vaccine schedule.
Maternal sepsis is a severe bacterial infection, usually of the uterus (womb), which can occur in pregnant women or more commonly, in the days following childbirth. Infection that occurs just after childbirth is also known as puerperal sepsis
Newborn survival and perinatal health in resource-constrained settings in Asia and the Pacific: Applying Global Evidence to Priorities Beyond 2015
12 April 2013
Birth Defects: Care, preventing and counsellingPiLNAfrica
Birth Defects was written for healthcare workers who look after individuals with birth defects, their families, and women who are at increased risk of giving birth to an infant with a birth defect. This book is being used in the Genetics Education Programme which trains healthcare workers in genetic counselling in South Africa. It covers: modes of inheritance, medical genetic counselling, birth defects due to chromosomal abnormalities, single gene defects, teratogens, multifactorial inheritance
Update (2021) Oral Contraceptive Pill : Dr. Jyoti Agarwal Dr Sharda Jain Lifecare Centre
Update (2021) Oral Contraceptive Pill : Dr Sharda Jain
7 Billion 2011 & increasing a rate of 150 million per year
INDIA
Today – 1.3 billion 2050 – 1.628 expected
This Journal Club presentation provides a summary and discussion of the following free access article published in UOG:
Perinatal outcome in women treated with progesterone for the prevention of preterm birth: a meta-analysis
A. Sotiriadis, S. Papatheodrou, G. Makrydimas
Volume 40, Issue 3, Date: September 2012, pages 257-266
It can be accessed here:
http://onlinelibrary.wiley.com/doi/10.1002/uog.11178/abstract
Everyone agrees that all children react differently to shots, and some kids will have bad reactions. There cannot be compulsory vaccination in absence of controlled clinical trials of the childhood vaccine schedule.
Maternal sepsis is a severe bacterial infection, usually of the uterus (womb), which can occur in pregnant women or more commonly, in the days following childbirth. Infection that occurs just after childbirth is also known as puerperal sepsis
Professor Soo Downe presenting at the Doctoral Midwifery Research Society Alcohol & Medication in Pregnancy Conferene about 'Which horse for which courses? The EBM Problem in studies of pharmacological substances in maternity care'.
TOPIC: “Chemical Exposures & Life-Long Reproductive Health Impacts”
We will review what we understand about reproductive biology and environmental contamination exposure. We’ll discuss the role of environmental chemicals in breast development and puberty, increased susceptibility to breast cancer and exposures during early life development of both male and female offspring and life-long impacts from chemical exposure. We’ll also discuss some of the potential health implications of energy development based on what we currently understand about exposures during early reproductive and developmental biology.
SPEAKER BIO: Suzanne Fenton, Ph.D., is Group Leader, NIH, Reproductive Endocrinology Group, Mammary Gland Development/Lactation Biology and a reproductive endocrinologist working at the National Toxicology Program Laboratory with the Division of the National Toxicology Program at National Institute of Environmental Health Sciences.
American Journal of Multidisciplinary Research and Development is indexed, refereed and peer-reviewed journal, which is designed to publish research articles.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
4. Patient’s Perception of Teratogenic
risks- Effects on Compliance
By G.Koren
Dental x-ray
VAS
EDPS > 13 : high risk of Termination of pregnancy
Depression: 3-5% of pregnancy, suicide think : 32%
6. TIS adapting to New Economic Realities and
How it will Affect Research
by Dee Quinn
History of TIS :
1979 : 1st TIS at UCSD
1985 : 1st meeting in Philadelphia
1990 : Formation of OTIS in Salt Lake City
1999 : Incorporation of OTIS in Montreal
2003 : Start of OTIS national Program
2011 : OTIS & ENTIS Collaboration
Economic evaluation & study : asthma, autoimmune ds
Low dose MTX study
1992 : 38 in USA & Canada / 2000 - 2012 : 10 closed
Source funding?
7. An Epidemiological Enterprise : From Fluoride to Folate
by JD Ericson of CDC
Vietnam war veterans: herbicides(Agent orange) & Spina bifida
( 1996 law )
Interview : multivitamin use – lower risk
Periconception multivitamine study : S. bifida, VSD, ASD, CL+CL
8. An Epidemiological Enterprise : From Fluoride to Folate
Intervention Study in China :
USFDA : require fortification of folic acid
(25 states National birth defect prevention networks)
Increased colorectal cancer : decrease by adjusting age
Cognitive issues
Methylation & epigenetics
9.
10. The All or None Phenomenon :
How should we counsel ?
By Dr. Brent
Mouse vs Human
Preimplantation period (수정 후 2주 이내)
Usually not susceptible period to teratogen
Some highly susceptible period to teratogen
Surviving embryo : similar outcome
11. 예외:
Long half life
Teratogenic infectious agent
Maternal effect(large exposure)
Epigenetic effect
Mutagenic effect
Mouse data 이용 상담 : no thanks by Brent.
12. By JM Friedman
6days : implantation begin
Very little data
Chronic exposure
Few accumulative exposure situation
Czeizel : Hofpp study
24-42days of LMP :
Exposure vs Non-exposure
Live birth 92% -
BW 3,222 3,268
Anomaly 3.3% -
14. Zygotic induced anomaly
hydrops 22%
Bent limbs 24%
Abdominal wall defect 17%
---- multifactorial birth defects
strikingly absence of other common anormaly ( NTD, CHD…)
hydrops may be pathogenic , but mechanism is unknown
Post-zygotic period :
zygote와 다름 , Death more common
Answer by JD Friedman: We don’t know
Counseling : never say : “All or none”
But, risk is very low
15. Strategies of Reducing the impact of Known teratogen
The potential benefit of a Multi-micronutrient Supplementation in
Pregnant women who consume Alcohol by Christina D. Chambers
: Choline (precursor molecule for the neurotransmitter acetylcholine)
Alcohol : CNS의 acetylcholine inhibitor
RCT : Alcoholic pregnant women 300(control)/150(choline)
f/u : 6mo, 12mo
FASD : decreased in choline group
Next step “ 5세 (preschool neurobehavioral test)
16. Thyroid Hormone to Reduce Impact of Gestational Alcohol use in the rat
by EE Redei
가설 : Thyroid function abnormal--- like FASD
Maternal T4 administration – FASD 경감
Dio3 gene : epigenetic effect
Antiepileptic drugs : Cellular, Physiological, and behavioral evidence of
developmental Neurotoxicity by KN Gale
Phenobarbital, phenytoin, lamotrigine --- neurobehavioral abnormal
- brain growth에 영향(neuronal cell death induction) , But FA 완화
Future direction : “Antidote”
Epilepsy + AED + Antidote : reduce of risk of Adverse pregnancy outcome
=== AED use 증가( more compliance)
17. Thomas Sheperd Lecture
“ The future of Research : The View of NICHD “
by AE Guttmacher (NICHD director)
NICHD : 50 yrs celebration ( 1962 : President Kennedy sign)
The mission :
every person is born healthy
women suffer no harmful effects from reproductive processes
all children have the chance to achieve their full potential for
healthy and productive lives, free from disease or disability,
health, productivity, independence, and well-being of all people
through optimal rehabilitation
18. NICHD study :
Reproduction
Developmental biology
Pregnancy : biomarker
Early origin of health and disease, growth, development
: association is not equal to mechanism
placenta , multigenerational effect
Conduct of science
trans -disciplinary science
omics( genome, epigenome)
training
19. OTIS 25th Anniversary Session
By G. Koren : OTIS early challenges & future opportunities
Abuse of drugs and alcohol
Folic acid
Occupational exposure
Infection
Pharmacogenomics
methyl mercury
Drugs & breastfeeding
Biomarker : hair/meconium
By Tina : OTIS & NOFAS: partners in preventing birth defect
By M Kisor : Parents & OTIS – One mother’s experience with OTIS
By L Morrison : Birth defects prevention, risk reduction, and Awareness Act
By G. Koren : A model of industry-Academia collaboration for drugs in
pregnancy
20. Pregnancy registry workshop
What should pregnancy registries use for a comparison group(s)?
Pregnancy registries and REMS: opportunities for collaboration risk
(Risk Evaluation and Mitigation Strategy : to enhance labeling)
Conducting Global pregnancy registries- Challenges and opportunities
How can pregnancy registries Work with/Complement other sources of
Clinical and observational information? How does a registry fit in an
overall plan to obtain information?
Interpreting Data from pregnancy registries: Who, When, How?
21. Pregnancy registry
Advantage :
Aim of pregnancy registry : major birth defect, Birth defect trend
Used to generate hypothesis
Limitations :
Exposure의 classification - lack
Outcome(birth defect , developmental disability)의
universal determination - lack
Representation : voluntary
Loss to f/u : limit interpretation
22. Congenital malformation studies in Chernobyl Impacted
Regions of Ukraine: Lessons learned
by W. Werterlecki
Thyroid cancer
NTD increase
Birth weight decrease
23. 2012 Teratogen Update : ART
by JL Simpson (March of Dimes)
IVF alone (<1993) vs ICSI (>1993 대략 50%)
IVF alone : 1979-1993 : 2.9%
ICSI : De novo chromosomal abnormality - 1.66% ( 0.45% in general)
Hypospadias : RR 3.0( 1.09-6.50)
Beckwith-Wiedemann syndrome (BWS) :
epigenetic perturbation( MTHFR, IGF2)
Reasons : Underlying reasons for ART
old age
genetic disorder
balanced translocation
Limitation : no true comparison group
25. Motherisk Calls for 2011
Lines : Motherisk general help line : 31,201 calls
Alcohol and substance abuse line : 1,317 calls
NVP help line : 2,035 calls
82% : women & their partners , 18% : health care provider
34,553 calls : 63% regarding pregnancy , 37% regarding breastfeeding
Motherisk general help line : mc question : psychotropics(19-25%)
417 : clinical fellow on call
149 : in clinic ( 45% psychotropic)
26. A review of calls to MotherSafe regarding exposures
during lactation: 2000-2010 by Kennedy D.(Ausralia)
79% call : consumers
but, midwives & early childhood nurses
Consumer call : increase
Repeat caller : 35% in 2000 and 55% in 2010
Commonest concern exposure : antihistamines, cold, flu preparations
and antibiotics
Before contacting (79%) : 38% family doctor, 35% internet,
9% medical specialist, 9% pharmacist
F/U of breastfeeding practice ( 100 women) : positive with no women
stopping breastfeeding in order to take medication
27. - Abstracts -
E-teratogens: a case-report and a glance at the availability of
Isotretinoin on the Web : “buy isotretinoin” on Google
Safety of levetriacetam in pregnancy : 2.2%(20/897)
Are change in Steroid hormones associated with smoke exposure
responsible for pregnancy outcome? SA in cortisol high/ estrogen&
progesterone level lower, but not related cigarette smoke
Unplanned pregnancies and contraceptive utilization among women
calling the California TIS regarding exposure to category D or X
medication : 99% no contraceptive methods
Pregnancy outcome and factors associated with voluntary termination of
pregnancy in Korean women inadvertently exposed to Isotretinoin
: 25% ToP, by 1st contact physician Adj OR : 2.06
Pregnancy outcome after Licorice exposure in pregnancy : Stillbirth 2.3% vs 0.3%
28. Free Thyroid Hormone levels, Second-Hand Smoke, and pregnancy
outcome: SA 48 vs successful pregnancy outcome
Cotinine levels : no difference
FT4 : slightly higher/ FT3 : lower
---- may contribute to adverse pregnancy outcome including SA
Is lithium only a cardiovascular teratogen? A prospective comparative
multicenter observational study : in 219 lithium exposure vs 812 control
major anomaly : 8.6% in 1st exposure (2.6%)
CV anomaly : 3.9%(0.6%)
non-CV anomaly : 6.6%(2.0%)
Preterm delivery : 15.2%(6.2%)