Prenatal Genetic Screening and Diagnostic Testing: Assessing Patients' Knowledge, Clinical Experiences, and Utilized Resources in Comparison to Provider's Perceptions.

 This survey study aimed to assess patient knowledge, clinical resources, and utilized resources about genetic screening and diagnostic testing.  A one-time anonymous paper survey was distributed to 500 patients at a major urban obstetrics and gynecology department, and an online survey was sent to 229 providers. Descriptive statistics and chi-squared analyses were performed.

Differentially Regulated miRNAs and Their Related Molecular Pathways in Lichen Sclerosus.

Lichen sclerosus (LS) is a chronic inflammatory skin disorder with unknown pathogenesis. The aberrant expression of microRNAs (miRNAs) is considered to exert a crucial role in LS. We used the next-generation sequencing technology (RNASeq) for miRNA profiling and Ingenuity Pathway Analysis (IPA) for molecular network analysis.

Outcomes of women age 40 or more undergoing repeat cesarean or trial of labor after cesarean.

Aim: Despite the increasing trend in delayed childbirth and the known associated complications in advancing maternal age, limited information exists regarding outcomes in very advanced maternal age by delivery type. This study aims to evaluate maternal and neonatal outcomes in women age 40 or more undergoing cesarean delivery or trial of labor after cesarean delivery.

Materials And Methods: We performed a secondary analysis of the Cesarean Section Registry Maternal-Fetal Medicine Units (MFMU) Network data, which was a prospective study of women undergoing repeat cesarean delivery or trial of labor after cesarean delivery from 1 January 1999 to 31 December 2002.

Dynamically decreased miR-671-5p expression is associated with oncogenic transformation and radiochemoresistance in breast cancer.

Background: Understanding the molecular alterations associated with breast cancer (BC) progression may lead to more effective strategies for both prevention and management. The current model of BC progression suggests a linear, multistep process from normal epithelial to atypical ductal hyperplasia (ADH), to ductal carcinoma in situ (DCIS), and then invasive ductal carcinoma (IDC). Up to 20% ADH and 40% DCIS lesions progress to invasive BC if left untreated.

Lichen Sclerosus: An autoimmunopathogenic and genomic enigma with emerging genetic and immune targets.

Lichen sclerosus (LS) is an inflammatory dermatosis with a predilection for anogenital skin. Developing lesions lead to vulvar pain and sexual dysfunction, with a significant loss of structural anatomical architecture, sclerosis, and increased risk of malignancy. Onset may occur at any age in both sexes, but typically affects more females than males, presenting in a bimodal fashion among pre-pubertal children and middle-aged adults.

Perinatal outcomes of women undergoing cesarean delivery after prior myomectomy.

The American College of Obstetricians and Gynecologists recommends that women who have had a prior myomectomy that entered the endometrial cavity undergo cesarean delivery in order to avoid the possible complication of uterine rupture. Women with prior myomectomies may also have intraabdominal adhesions, complicating future surgery and if myomas remain after myomectomy, they may have more bleeding complications during their subsequent pregnancies. The purpose of this study was to evaluate maternal and neonatal outcomes after prior myomectomy in women undergoing planned cesarean delivery.

Teaching obstetric ultrasound at Mulago Hospital - Kampala, Uganda.

Background: Mulago Hospital is a high volume referral hospital under the Makerere University School of Medicine and Health Sciences. Basic obstetric ultrasound is a useful skill that can aid patient care.

Objectives: The purpose of the study was to assess the effectiveness of an intervention implemented to teach basic ultrasound skills to medical students and house officers at Mulago Hosptial, Kampala, Uganda.

Evolution of Knowledge, Awareness, and Practices regarding Zika Virus from 2016 to 2017.

Objective: Our team created a knowledge, attitudes, and practice (KAP) survey in order to assess changes over time in healthcare provider and community member awareness of Zika virus symptoms, transmission, treatment, and current and future concerns.

Study Design: The cross-sectional survey was issued at an academic medical center in Washington, DC, and via an online link to healthcare providers and community members between June and August 2016. Survey distribution was then repeated the following year, from March to April 2017.

Provider and Patient Knowledge and Views of Office Practices on Weight Gain and Exercise during Pregnancy.

Objective: This study sought to assess provider and patient knowledge and beliefs on gestational weight gain (GWG) and exercise during pregnancy, outline current clinical practices and the perceived value of educational tools.

Study Design: Providers and patients at the George Washington Medical Faculty Associates Obstetricians and Gynecologists clinic were recruited for a voluntary survey. Descriptive statistics of responses were compared and chi-square analysis tested for significant associations.

Adult Respiratory Distress Disorder Due to Legionnaires Disease in Pregnancy: A Case Report.

Background: Pneumonia caused by the atypical pathogen Legionella pneumophila during pregnancy is a rare occurrence that carries substantial maternal and fetal risk.

Case: A 36-year-old woman, G3P2002, presented at 33(2/7) weeks' gestation with 6 days of worsening cough, fever, and shortness of breath. She was admitted to the intensive care unit and suffered acute respiratory failure requiring mechanical ventilation.

Improving nurse practitioners' competence with genetics: Effectiveness of an online course.

Purpose: The purpose of this study was to assess the effectiveness of an online genetics course for improving nurse practitioners' knowledge, competence, and comfort with genetic principles and their application to clinical practice.

Data Sources: A genetics knowledge test and survey were administered to 232 nurse practitioner students, between 2011 and 2013, before and after completing a 15-week online genetics course taught by a multidisciplinary team of instructors at a private east coast U.S.

Racial disparities in maternal hemoglobin concentrations and pregnancy outcomes.

Objective: To examine the association of maternal hemoglobin (Hb) concentrations with preterm and low birth weight (LBW) deliveries in African Americans compared to Caucasians.

Methods: We conducted a retrospective analysis of perinatal data on 17,338 African-American and Caucasian pregnant women who delivered at the George Washington University Hospital (GWUH) between January 1990 and December 2003. We used univariate and logistic regression analyses to examine for associations.

In utero copper treatment for Menkes disease associated with a severe ATP7A mutation.

Menkes disease is a lethal X-linked recessive neurodegenerative disorder of copper transport caused by mutations in ATP7A, which encodes a copper-transporting ATPase. Early postnatal treatment with copper injections often improves clinical outcomes in affected infants. While Menkes disease newborns appear normal neurologically, analyses of fetal tissues including placenta indicate abnormal copper distribution and suggest a prenatal onset of the metal transport defect.

Assessment of genetics knowledge and skills in medical students: insight for a clinical neurogenetics curriculum.

The pace of discovery in biochemistry and genetics and its effect on clinical medicine places new curricular challenges in medical school education. We sought to evaluate students' understanding of neurogenetics and its clinical applications to design a pilot curriculum into the clinical neurology clerkship. We utilized a needs assessment and a written examination to evaluate the genetics knowledge of 81 third- and fourth-year medical students.

Maternal asthma, race and low birth weight deliveries.

Background: Asthma during pregnancy may compromise the well-being of the fetus and potentially impact an infant's birth weight via different mechanisms.

Aims: 1) To assess the influence of asthma during pregnancy on the incidence of LBW outcomes in white non-Hispanic (WNH) and black non-Hispanic (BNH) women. 2) To identify other risk factors that affect low birth weight (LBW) (birth weight<2500g) outcomes among asthmatic women.

Development of a culturally specific assessment tool for pelvic organ prolapse in a Mayan population.

Introduction: Pelvic organ prolapse is a common condition that can significantly affect a woman's life, including her sexual, urinary, and social functioning. In Guatemala, anecdotal evidence suggests that the daily activities of Mayan women contribute to and worsen the degree of pelvic organ prolapse. The objective of this research was to develop a culturally specific assessment tool to better evaluate how pelvic organ prolapse affects the daily activities of Mayan women in rural Guatemala.

Maternal healthcare needs assessment survey at Rabia Balkhi Hospital in Kabul, Afghanistan.

Objective: Since the Department of Health and Human Services chose Rabia Balkhi Hospital (RBH) in Kabul, Afghanistan, as a site for intervention in 2002, the status of women's health there has been of interest. This study created a tool to assess accessibility and quality of care of women admitted from May to July, 2005.

Methods: A 39-item questionnaire was created in English and translated into Dari.

Improving teaching skills in obstetrics and gynecology residents: evaluation of a residents-as-teachers program.

Objective: The purpose of this study was to determine if a residents-as-teachers program improves residents' teaching skills.

Study Design: Twenty-four residents (13 intervention, 11 controls) participated in a controlled trial of a residents-as-teachers program. The intervention group attended a 10.

Arrhythmogenic right ventricular dysplasia in pregnancy: a case report.

Background: Arrhythmogenic right ventricular dysplasia (ARVD) is characterized by progressive fibrous or fibrofatty tissue replacement of the right ventricular myocardium. Interspersed adipocytes and fibrous tissue may provide foci for arrhythmias. The clinical spectrum of ARVD may include asymptomatic premature ventricular complexes to ventricular tachycardia and sudden death.

Pregnancy in a woman with a continent appendicovesicostomy: a case report.

Background: Few cases of pregnancy following the Mitrofanoff procedure (continent appendicovesicostomy) have been reported, but in those cases there was an increased rate of cesarean delivery with no long-term consequences to renal function or to the urinary diversion.

Case: A 15-year-old primagravida with a prior nephrectomy for a dysplastic kidney and prior continent appendicovesicostomy for urinary retention due to spina bifida occulta and neurogenic bladder had a pregnancy complicated by preterm premature rupture of membranes, preterm labor, breech presentation and cesarean delivery with the assistance of a urologist. The patient had a minimal decline in renal function, and she and the infant did well.

Rapid growth of a fetal sacrococcygeal teratoma in an HIV-infected woman: a case report.

Background: Sacrococcygeal teratoma, the most common congenital neoplasm of the newborn, associated with fetal hydrops and high morbidity and mortality related to the secondary effects of the tumor mass, is of unknown etiology. Prompt diagnosis and early treatment have proven to be effective.

Case: A 24-year-old woman, gravida 3, para 2, at 385/7 weeks' gestation, with a pregnancy complicated by HIV diagnosed during pregnancy, seizure disorder and tobacco use, presented with premature rupture of membranes.

Faculty members' perceptions of medical genetics and its integration into nurse practitioner curricula.

This study assessed faculty members' perceived knowledge of medical genetics concepts and conditions, the importance of integrating this content into NP curricula and how this was being done. During a national NP conference, 40 NP faculty voluntarily completed surveys. Participants' perceived knowledge of genetics varied; 35% noted low or very low knowledge, and only 5% reported high or very high knowledge.

Use of a doula for labor coaching in a patient with indolent systemic mastocytosis in pregnancy.

Background: Few cases of pregnancy in women with systemic mastocytosis have been reported. The effects of this disease on pregnancy have not been well documented, nor have the benefits of doula services for labor been reported for mastocytosis.

Case: A 35-year-old woman with indolent systemic mastocytosis sought preconception counseling regarding the effects of her disease on pregnancy and the effects of drugs and anesthesia on her disease.