"I don't have a telephone to the fetus": Clinicians' conceptions of fetal patienthood in maternal-fetal surgery counseling.

Rationale: Maternal fetal surgery (MFS) has developed rapidly since the 1960s and centers for fetal diagnosis and therapy (CFDT) have proliferated. As a result, CFDT clinicians have intervened with fetuses through pregnant bodies for decades, yet the patienthood status of the fetus and its implications for the pregnant person's autonomy have been relatively unexamined.

Objective: Our overall research aims were threefold: (1) to explore how clinicians train for and provide counseling for MFS; (2) to examine how clinicians assess fetal patienthood and its implications; and (3) to understand clinicians' professed needs and their recommendations for education and training for the provision of MFS counseling.

Utility of Flexion and Extension MRI for Evaluating Isolated Cervical Spinal Cord Lesions: A Case Series.

The diagnosis of isolated spinal cord lesions is often challenging in clinical practice, and it is not uncommon for the etiology of such isolated lesions to remain unclear despite extensive workup and investigations. Magnetic resonance imaging (MRI) is extensively utilized for assessing spinal cord disease, despite certain radiological patterns suggesting certain pathologies, diagnostic uncertainty remains. Development of adjunct tests and techniques, radiographic or otherwise, is needed.

Pulsed Field or Conventional Thermal Ablation for Paroxysmal Atrial Fibrillation.

Background: Catheter-based pulmonary vein isolation is an effective treatment for paroxysmal atrial fibrillation. Pulsed field ablation, which delivers microsecond high-voltage electrical fields, may limit damage to tissues outside the myocardium. The efficacy and safety of pulsed field ablation as compared with conventional thermal ablation are not known.

Ethical Considerations in Total Joint Arthroplasty.

Hip and knee arthroplasty surgeries have excellent outcomes and notably improve quality of life. However, ethical issues permeate the practice of adult reconstruction, and as economics and technology evolve, these issues have become increasingly important. This article will review the currently published literature on ethical issues including industry influences, implants and instrumentations, surgical innovation, new technology adoptions, and healthcare policy-relevant issues, including patient cost sharing and bundled care programs.

"We All Want to Be Able to Tell You Something Hopeful": Clinicians' Experiences Providing Maternal-Fetal Surgery Counseling.

Introduction: Prenatal counseling about maternal-fetal surgery can be traumatic and confusing for pregnant people. It can also be technically and emotionally complex for clinicians. As maternal-fetal surgery rapidly advances and becomes more common, more evidence is needed to inform counseling practices.

Professional virtue of civility and the responsibilities of medical educators and academic leaders.

Incivility among physicians, between physicians and learners, and between physicians and nurses or other healthcare professionals has become commonplace. If allowed to continue unchecked by academic leaders and medical educators, incivility can cause personal psychological injury and seriously damage organisational culture. As such, incivility is a potent threat to professionalism.

Prevention of risks of overweight and obesity in pregnant women.

Overweight and obesity in pregnancy and prepregnancy are perinatal risks. Studies showed prevention of these risks with counseling about the risks and treatment strategies like lifestyle interventions as exercise on a daily basis, nutritional health and diet.

The use of antenatal corticosteroids for fetal maturation: clinical practice guideline by the WAPM-World Association of Perinatal Medicine and the PMF-Perinatal Medicine foundation.

This practice guideline follows the mission of the World Association of Perinatal Medicine in collaboration with the Perinatal Medicine Foundation, bringing together groups and individuals throughout the world, with the goal of improving the use of antenatal corticosteroids (ACS) for fetal maturation. In fact, this document provides further guidance for healthcare practitioners on the appropriate use of ACS with the aim to increase the timely administration and avoid unnecessary or excessive use. Therefore, it is not intended to establish a legal standard of care.

Professionally Responsible Counseling About Fetal Analysis.

Fetal analysis uses noninvasive and invasive methods to obtain images and tissues for interpretation that supports risk assessment and/or diagnosis of the fetus's condition. This article provides ethically justified, clinically applicable guidance for supporting the pregnant patient's decision making about fetal analysis. Topics include ethical reasoning using key ethical concepts, confidentiality, clarity about the pregnant woman as ultimate decision maker, offering fetal analysis, counseling about results, counseling about accepted maternal-fetal intervention, and counseling about innovation and research on maternal-fetal intervention.

Induced abortion and COVID-19 as contributing factors to declining fertility in Sardinia.

Objectives: Decreasing fertility implies considerable public health, societal, political, and international consequences. Induced abortion (IA) and the recent COVID-19 pandemic can be contributing factors to it but these have not been adequately studied so far. The purpose of this paper is to explore the relation of IA incidence and the COVID-19 pandemic to declining rates of delivery, as per our Sardinian experience.

Professionally responsible management of the ethical and social challenges of antenatal screening and diagnosis of β-thalassemia in a high-risk population.

Thalassemias are among the most frequent genetic disorders worldwide. They are an important social and economic strain in high-risk populations. The benefit of β-thalassemia screening programs is growing evident but the capacity to diagnose fetal β-thalassemia exceeds the treatment possibilities and even when treatment before birth becomes feasible, difficult decisions about the relative risks will remain.

Triaging Interventional Pain Procedures During COVID-19 or Related Elective Surgery Restrictions: Evidence-Informed Guidance from the American Society of Interventional Pain Physicians (ASIPP).

Background: The COVID-19 pandemic has worsened the pain and suffering of chronic pain patients due to stoppage of "elective" interventional pain management and office visits across the United States. The reopening of America and restarting of interventional techniques and elective surgical procedures has started. Unfortunately, with resurgence in some states, restrictions are once again being imposed.

Deep Learning AI Applications in the Imaging of Glioma.

This manuscript will review emerging applications of artificial intelligence, specifically deep learning, and its application to glioblastoma multiforme (GBM), the most common primary malignant brain tumor. Current deep learning approaches, commonly convolutional neural networks (CNNs), that take input data from MR images to grade gliomas (high grade from low grade) and predict overall survival will be shown. There will be more in-depth review of recent articles that have applied different CNNs to predict the genetics of glioma on pre-operative MR images, specifically 1p19q codeletion, MGMT promoter, and IDH mutations, which are important criteria for the diagnosis, treatment management, and prognostication of patients with GBM.

Loteprednol etabonate (submicron) ophthalmic gel 0.38% dosed three times daily following cataract surgery: integrated analysis of two Phase III clinical studies.

Purpose: To evaluate the efficacy and safety of a submicron formulation of loteprednol etabonate (LE) gel 0.38% instilled three times daily (TID) compared with vehicle for the treatment of inflammation and pain following cataract surgery with intraocular lens implantation, integrated across two multicenter, double-masked, randomized, parallel-group, Phase III studies.

Patients And Methods: Subjects ≥18 years of age with anterior chamber (AC) cells ≥grade 2 (6-15 cells) on day 1 after cataract surgery were randomized to receive 1 drop of LE gel 0.

Female Genital and Vaginal Plastic Surgery: An Overview.

Learning Objectives: After studying this article and viewing the video, the participant should be able to: 1. Accurately describe the relevant aesthetic anatomy and terminology for common female genital plastic surgery procedures. 2.

Current Concepts in Osteoarthritis of the Ankle: Review.

Ankle osteoarthritis constitutes a large burden to society and is a leading cause of chronic disability in the United States. Most commonly, it is post-traumatic, occurs in younger individuals, and is associated with obesity. This entity presents similarly to osteoarthritis of the other joints, with the typical nonspecific symptoms of stiffness, swelling, and pain.

Anaphylactoid hypersensitivity reaction from intra-arterial cetuximab: Clinical considerations and management.

Intra-arterial infusion of drugs shows promising results in terms of safety and efficacy. Intra-arterial cetuximab, a monoclonal antibody treatment, is currently being tested for its use in head and neck cancers. We present the case of a 45-year-old Asian male who developed an anaphylactoid hypersensitivity reaction, manifesting itself in the form of bronchospasm, tachycardia, and hypotension, during intra-arterial infusion of cetuximab.

Menopause-Related Cognitive Impairment.

Background: Identifying the cognitive changes associated with the menopausal transition prevents misattribution of symptoms to more ominous causes such as neurodegenerative disease.

Case: Two women with cognitive loss and objective evidence of menopause-related cognitive impairment are presented, misattributed to Alzheimer disease in one case and frontotemporal dementia in the other. Neurocognitive testing, neuroimaging, and laboratory findings are reviewed.

Submicron loteprednol etabonate ophthalmic gel 0.38% for the treatment of inflammation and pain after cataract surgery.

Purpose: To assess the safety and efficacy of a 0.38% submicron formulation of loteprednol etabonate (LE) gel for the treatment of postoperative inflammation and pain after cataract surgery.

Setting: Forty-five United States ophthalmology practices.

Reversal of Growth of Utilization of Interventional Techniques in Managing Chronic Pain in Medicare Population Post Affordable Care Act.

Background: Over the past 2 decades, the increase in the utilization of interventional techniques has been a cause for concern. Despite multiple regulations to reduce utilization of interventional techniques, growth patterns continued through 2009. A declining trend was observed in a previous evaluation; however, a comparative analysis of utilization patterns of interventional techniques has not been performed showing utilization before and after the enactment of the Affordable Care Act (ACA).

Trends in Cerebral Revascularization in the Era of Pipeline and Carotid Occlusion Surgery Study.

Background: In the past, microsurgical bypass was the best option for revascularization of cerebrovascular lesions that required flow replacement or flow augmentation. Over the last 2 decades with advancements in the field of neuroendovascular surgery, especially with the revolution of flow diverting stents as well as the results of the Carotid Occlusion Surgery Study, indications for microvascular bypass have significantly decreased. The purpose of this study was to evaluate trends in cerebral revascularization over the past 8 years.