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Clinical Trials That Have Changed Clinical Practice and Care of Pregnant People With HIV. 改变艾滋病病毒感染者孕妇的临床实践和护理的临床试验。
IF 1.5 4区 医学
Clinical obstetrics and gynecology Pub Date : 2024-06-01 Epub Date: 2024-03-07 DOI: 10.1097/GRF.0000000000000860
Stephanie A Fisher, Nigel Madden, Mariana Espinal, Patricia M Garcia, Jennifer K Jao, Lynn M Yee
{"title":"Clinical Trials That Have Changed Clinical Practice and Care of Pregnant People With HIV.","authors":"Stephanie A Fisher, Nigel Madden, Mariana Espinal, Patricia M Garcia, Jennifer K Jao, Lynn M Yee","doi":"10.1097/GRF.0000000000000860","DOIUrl":"10.1097/GRF.0000000000000860","url":null,"abstract":"<p><p>Over the last 4 decades, significant advances in the care of HIV during pregnancy have successfully reduced, and nearly eliminated, the risk of perinatal HIV transmission. The baseline risk of transmission without intervention (25% to 30%) is now <1% to 2% in the United States with contemporary antepartum, intrapartum, and postnatal interventions. In this review, we discuss 3 landmark clinical trials that substantially altered obstetric practice for pregnant individuals with HIV and contributed to this extraordinary achievement: 1) the Pediatric AIDS Clinical Trials Group 076 Trial determined that antepartum and intrapartum administration of antiretroviral drug zidovudine to the pregnant individual, and postnatally to the newborn, could reduce the risk of perinatal transmission by approximately two-thirds; 2) the European Mode of Delivery Collaboration Trial demonstrated performance of a prelabor cesarean birth before rupture of membranes among pregnant people with viremia reduced the risk of perinatal transmission compared with vaginal birth; and 3) the International Maternal Pediatric Adolescent AIDS Clinical Trials Network 2010 Trial identified that dolutegravir-containing, compared with efavirenz-containing, antiretroviral regimens during pregnancy achieved a significantly higher rate of viral suppression at delivery with shorter time to viral suppression, with fewer adverse pregnancy outcomes. Collectively, these trials not only advanced obstetric practice but also advanced scientific understanding of the timing, mechanisms, and determinants of perinatal HIV transmission. For each trial, we will describe key aspects of the study protocol and outcomes, insights gleaned about the dynamics of perinatal transmission, how each study changed clinical practice, and relevant updates to current practice since the trial's publication.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140048957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Antenatal Late Preterm Steroids: The Evolution of the ALPS Trial. 产前晚期早产类固醇：ALPS 试验的演变。
IF 1.5 4区 医学
Clinical obstetrics and gynecology Pub Date : 2024-06-01 Epub Date: 2024-04-29 DOI: 10.1097/GRF.0000000000000865
Cynthia Gyamfi-Bannerman
{"title":"Antenatal Late Preterm Steroids: The Evolution of the ALPS Trial.","authors":"Cynthia Gyamfi-Bannerman","doi":"10.1097/GRF.0000000000000865","DOIUrl":"https://doi.org/10.1097/GRF.0000000000000865","url":null,"abstract":"<p><p>The Antenatal Late Preterm Steroids (ALPS) trial was designed to address respiratory morbidity common in infants born late preterm. The study was published in April, 2016 and, shortly thereafter, changed clinical practice in obstetrics in the United States. The following chapter describes the ALPS trial study design in detail, including the background leading to the trial, the study outcomes, and the initial findings of the long-term follow-up study. The ALPS story would not be complete without Elizabeth Thom, PhD, who died before her time. Her brilliance largely contributed to the design of the ALPS trial.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11068095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Teeter-Totter or Tapestry: A Life in Academic Medicine. 跷跷板还是挂毯：学术医学生涯。
IF 1.5 4区 医学
Clinical obstetrics and gynecology Pub Date : 2024-06-01 Epub Date: 2024-01-15 DOI: 10.1097/GRF.0000000000000852
Kirtly Parker Jones
{"title":"Teeter-Totter or Tapestry: A Life in Academic Medicine.","authors":"Kirtly Parker Jones","doi":"10.1097/GRF.0000000000000852","DOIUrl":"10.1097/GRF.0000000000000852","url":null,"abstract":"<p><p>Constructing a career in academic medicine involves more than a focus on work-life balance. That image of a teeter-totter suggests that life is what happens when you are not working. The nature of the scope of interests (clinical, research, teaching) and values (service, leadership, curiosity, transparency, and honesty) creates a larger framework through which home life and work life become one interwoven tapestry. The author reflects on these perspectives as she looks back on a career in academic medicine.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139485271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Improving the Lives of Women With Ovarian Cancer. 改善卵巢癌妇女的生活。
IF 1.5 4区 医学
Clinical obstetrics and gynecology Pub Date : 2024-06-01 Epub Date: 2024-01-15 DOI: 10.1097/GRF.0000000000000851
Beth Y Karlan
{"title":"Improving the Lives of Women With Ovarian Cancer.","authors":"Beth Y Karlan","doi":"10.1097/GRF.0000000000000851","DOIUrl":"10.1097/GRF.0000000000000851","url":null,"abstract":"<p><p>Being a gynecologic oncologist is a privilege. Women with cancer address their challenges with grit and resilience. Their most basic questions motivated my career-long search for scientific answers hidden in genetics, novel therapeutics, and cancer prevention. But medicine is a team sport. Working alongside gifted colleagues and mentoring trainees to assume starring roles on the team has sustained and enriched my career. Advocating for patients and the specialty of gynecologic oncology provided another means to advance research and cancer awareness to improve patient outcomes. The author believe the most exciting times are yet to come.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11047303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139478282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Road Well Traveled: Making Choices, Ensuring Progress While Heeding the "Clarion Call". 康庄大道：在响应 "号角 "的同时做出选择、确保进步。
IF 1.5 4区 医学
Clinical obstetrics and gynecology Pub Date : 2024-06-01 Epub Date: 2024-01-22 DOI: 10.1097/GRF.0000000000000853
E Albert Reece
{"title":"The Road Well Traveled: Making Choices, Ensuring Progress While Heeding the \"Clarion Call\".","authors":"E Albert Reece","doi":"10.1097/GRF.0000000000000853","DOIUrl":"10.1097/GRF.0000000000000853","url":null,"abstract":"<p><p>The career path of everyone is quite unique based on the goals and the choices we make, and success can take time to unfold. My career choices have been greatly influenced by remarkable mentors and opportunities. Reciprocally I have had the pleasure, as a faculty member, department chair, and medical school dean to mentor promising young physicians and scientists to launch successful careers. We need to continue to attract physicians and scientists to academic medicine to ensure that our field continues to innovate and improve the lives of our patients. To influence positive change, we must stay relentlessly focused and have faith that success will come.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139511874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
When Change Chooses You: My Journey With Paralysis. 当改变选择你：我的瘫痪之旅
IF 1.5 4区 医学
Clinical obstetrics and gynecology Pub Date : 2024-06-01 Epub Date: 2024-02-12 DOI: 10.1097/GRF.0000000000000855
Dale B Hull
{"title":"When Change Chooses You: My Journey With Paralysis.","authors":"Dale B Hull","doi":"10.1097/GRF.0000000000000855","DOIUrl":"10.1097/GRF.0000000000000855","url":null,"abstract":"<p><p>Life sometimes provides unannounced challenges that threaten the structure of our existence. This personal account of an ob-gyn's encounter with paralysis will illustrate the impact of one such experience.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139721902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Career Reflections: The Winding Path From County Mayo, Ireland to New York City. 职业反思：从爱尔兰梅奥郡到纽约市的曲折之路。
IF 1.5 4区 医学
Clinical obstetrics and gynecology Pub Date : 2024-06-01 Epub Date: 2024-03-18 DOI: 10.1097/GRF.0000000000000862
Mary D'Alton
{"title":"Career Reflections: The Winding Path From County Mayo, Ireland to New York City.","authors":"Mary D'Alton","doi":"10.1097/GRF.0000000000000862","DOIUrl":"10.1097/GRF.0000000000000862","url":null,"abstract":"<p><p>Dr. Mary D'Alton's career journey intertwines her upbringing in County Mayo, Ireland, with impactful contributions to Obstetrics and Gynecology in New York City. From childhood lessons in community care to transformative experiences in Canada and prestigious mentorships, her leadership at Columbia University and NewYork-Presbyterian has fostered innovative initiatives addressing maternal health. Philanthropy plays a pivotal role in realizing her vision, including mental health integration within women's health care. International reach, exemplified by a successful fellowship program with Ireland, underscores her commitment to collaboration Dr. D'Alton's reflections illuminate the transformative power of teamwork, mentorship, and innovation in advancing women's health worldwide.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140142925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Into the Unknown: Navigating a Path as an Early-stage Physician-scientist in Obstetrics and Gynecology. 进入未知领域：作为妇产科早期医生科学家的导航之路。
IF 1.5 4区 医学
Clinical obstetrics and gynecology Pub Date : 2024-06-01 Epub Date: 2023-12-28 DOI: 10.1097/GRF.0000000000000850
Sarah A Wernimont
{"title":"Into the Unknown: Navigating a Path as an Early-stage Physician-scientist in Obstetrics and Gynecology.","authors":"Sarah A Wernimont","doi":"10.1097/GRF.0000000000000850","DOIUrl":"10.1097/GRF.0000000000000850","url":null,"abstract":"<p><p>This piece is a reflection of one early-stage physician-scientist's professional journey. It highlights a few challenges of navigating this path while calling for continued investment and support for physician-scientists to enhance maternal and child lifelong health.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139048356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The ARRIVE Trial. 到达审判。
IF 1.5 4区 医学
Clinical obstetrics and gynecology Pub Date : 2024-06-01 Epub Date: 2023-11-28 DOI: 10.1097/GRF.0000000000000844
William A Grobman
{"title":"The ARRIVE Trial.","authors":"William A Grobman","doi":"10.1097/GRF.0000000000000844","DOIUrl":"10.1097/GRF.0000000000000844","url":null,"abstract":"<p><p>Timing of delivery such that maternal and perinatal outcomes are optimized is among the most important and commonplace decisions in obstetric care. Given the importance of this determination, it is somewhat surprising that there has been, until relatively recently, little in the way of high-quality evidence to guide obstetric clinicians in this decision. This chapter describes the evolution of studies examining the effects of labor induction and the importance of the ARRIVE trial in that context.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138458324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Foreword: Clinical Trials That Have Changed Obstetric Practice. 前言
IF 1.4 4区 医学
Clinical obstetrics and gynecology Pub Date : 2024-06-01 Epub Date: 2024-03-15 DOI: 10.1097/GRF.0000000000000863
William A Grobman
{"title":"Foreword: Clinical Trials That Have Changed Obstetric Practice.","authors":"William A Grobman","doi":"10.1097/GRF.0000000000000863","DOIUrl":"10.1097/GRF.0000000000000863","url":null,"abstract":"","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140130934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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