Obstetrics and gynecology
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Obstetrics and gynecology · Jul 2019
EditorialGenetically Modified Babies and a First Application of Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR-Cas9).
The world's first babies with CRISPR-Cas9 (Clustered Regularly Interspaced Short Palindromic Repeats)-edited genes were born on November 25, 2018. Dr. ⋯ Dr. He's objectives and an assessment of how well they were achieved are discussed in the context of existing research in this area.
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Obstetrics and gynecology · Sep 2018
Editorial ReviewRole of Preexposure Prophylaxis in the Reproductive Health of Women at Risk for Human Immunodeficiency Virus Infection.
Women in the United States and especially women of color continue to acquire human immunodeficiency virus (HIV) infection. During reproductive health visits, health care providers are ideally positioned to assess HIV risk and offer HIV prevention strategies, including preexposure prophylaxis (also known as "PrEP"), a once-daily fixed-dose combination of emtricitabine with tenofovir disoproxil fumarate approved by the U. S. ⋯ Family planning, pregnancy, and postpartum visits provide an opportunity to ask sensitive questions about sexual and reproductive health and to help women navigate preference-sensitive decisions, including an individualized plan for HIV prevention. Exposure to a fixed-dose combination of emtricitabine with tenofovir disoproxil fumarate during pregnancy and breastfeeding appears to be safe with respect to maternal and infant outcomes. This article reviews the critical issues, challenges, and opportunities when implementing preexposure prophylaxis for women at risk for HIV who are seeking family planning services or pregnancy or postpartum care.
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Obstetrics and gynecology · Apr 2018
EditorialGottesfeld-Hohler Memorial Foundation Zika Virus Think Tank Summary.
At a think tank bringing together experts on fetal neuroimaging, obstetric infectious diseases, and public health, we discussed trends in all of these areas for Zika virus. There is a wide variety of imaging findings in affected fetuses, influenced by timing of infection and probably host factors. The resources for diagnosis and interventions also vary by location with the hardest hit areas often having the fewest resources. We identified potential areas for both research and clinical collaboration as the Zika virus epidemic continues to evolve.
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Obstetrics and gynecology · Apr 2018
EditorialA Unique Institutional Response to the Zika Virus Epidemic.
In 2015, Zika virus rapidly emerged as a concern for obstetric patients and health care providers as the disease spread geographically and it was discovered that Zika virus infection had the potential to cause devastating birth defects. Essentially overnight, obstetric care providers were faced with an influx of rapidly evolving information and an increased workload. New systems, workflows, and personnel were needed to effectively address the new patient care needs fueled by the burgeoning Zika virus epidemic. ⋯ The position has enabled a Zika virus response that has been tightly coordinated, consistent, and thorough without overburdening health care providers. The Zika Response Nurse Coordinator Role serves as a template for how institutions can model coordinated Zika virus care and prepare for future threats that will necessitate a focused and rapid response. Timely institutional financial support is critical for an appropriate response to emerging diseases for not only Zika virus but future epidemics as well.
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In a possible first, the heritable transmission of a fatal mitochondrial DNA disease (Leigh syndrome) may have been prevented by replacing the mutation-bearing mitochondria of oocytes with donated mutation-free counterparts. The procedure, carried out by a U. S.-led team, took place in Mexico in circumvention of a statutory U. ⋯ This development calls into question the regulatory utility of a national moratorium in a globalized world wherein cross-border care is increasingly prevalent. This development also calls to account the moral defensibility of a moratorium that acquiesces in the birth of gravely ill children whose afflictions could have been prevented. In this Current Commentary, we outline a potential path forward by analyzing the dual imprint of the moratorium, examining its legislative shortcomings, exploring its motivational roots, considering its national effect, and proposing its unlinking from the related yet distinct ban on editing the genome of the human embryo.