Evaluation of Physician Knowledge of the Key Safety Information for Aflibercept in Canada: Evaluation of Risk-Minimization Measures.

Background: As part of the risk-management plan (RMP) for aflibercept, materials have been developed to educate physicians in Canada on the key safety information and safe use for aflibercept.

Objective: The objectives of this study were to assess whether physicians in Canada received and reviewed the aflibercept educational materials (i.e.

The effects of maternal supplementation of polyunsaturated Fatty acids on visual, neurobehavioural, and developmental outcomes of the child: a systematic review of the randomized trials.

Polyunsaturated fatty acid (PUFA) use in pregnancy has been promoted as beneficial for visual and neurobehavioural development in the fetus. However, no systematic review of the randomized trials has been conducted. The objective of this review was to evaluate potential advantages of this regiment by reviewing all randomized trials in pregnancy.

Safety of infliximab use during pregnancy.

Infliximab is a chimeric IgG1 monoclonal antibody to tumor necrosis factor alpha (TNF)-α used in the treatment of inflammatory bowel disease and rheumatoid arthritis. Infliximab does not actively cross the placenta during the first trimester, but undergoes efficient placental transfer during the late second and third trimesters and is detectable in the infant's serum for several months after birth. This raises concerns about immunological risks of infection and response to vaccines.

H1N1 influenza in pregnancy: risks, vaccines, and antivirals.

When pregnant women are infected by the H1N1 influenza A virus, the consequences are more serious than they are in other groups of patients. It is imperative to vaccinate pregnant women against this virus. Unvaccinated women who come in contact with the virus should receive prophylactic antiviral therapy.

Guidelines for maternal codeine use during breastfeeding.

Question: In light of the recent evidence of adverse events in infants whose mothers use codeine medication, we have been struggling with the issue of how to manage codeine analgesia in our postpartum patients. What are some guidelines for the safe use of codeine during breastfeeding?

Answer: Motherisk has summarized recent scientific evidence into suggested guidelines for the safe use of codeine during breastfeeding.

In utero exposure to therapeutic radiation for Hodgkin lymphoma.

Question: One of my patients was incidentally found to be pregnant after completion of radiotherapy for Hodgkin lymphoma. What are the possible effects that I should discuss with her before she makes a final decision regarding continuation of her pregnancy?

Answer: Radiotherapy might not be an absolute contraindication in pregnant women who are diagnosed with cancer located in areas remote from the pelvis. However, the fetal exposure should be carefully estimated, and the known dose-response information has to be discussed individually to allow informed decisions to be made.

Use of hypoglycemic drugs during lactation.

Question: My patient was taking glipizide (an oral sulfonylurea) for type 2 diabetes. Now she is pregnant and taking insulin instead. She is very anxious to return to her previous treatment immediately after delivery because of the pain and hurdles associated with the administration of insulin.

Does treatment with bisphosphonates endanger the human pregnancy?

Bisphosphonates are clinically used in the treatment of various bone diseases including corticosteroid-induced osteoporosis, hypercalcemia associated with malignancy, and osteogenesis imperfecta. They are therefore often used in women of childbearing age, but little is known about their possible effects on the human embryo and fetus. Animal studies have revealed unfavourable effects of bisphosphonate treatment on the fetus, mainly in the skeleton.

Medications for restless legs syndrome in pregnancy.

According to epidemiological data, pregnant women have a two or three times higher risk of experiencing restless legs syndrome (RLS) than the general population. Current evidence suggests that dopaminergic dysfunction, impaired iron homeostasis, and genetic predisposition may be involved in the pathophysiology of RLS. Four classes of medications have been used for patients with RLS, but pregnancy elicits a therapeutic concern.