ABSTRACT
Managing respiratory status of patients with COVID-19 is a high resource, high risk healthcare challenge. Interventions that decrease need for invasive respiratory support and utilization of bedside staff would benefit patients and healthcare personnel alike. Proning has been established as optimal positioning that may reduce the need for escalation of respiratory support. We propose a new application of a wearable device to decrease supine positioning and ameliorate these risks.
Subject(s)
COVID-19/physiopathology , COVID-19/therapy , Lung/physiopathology , Models, Biological , Prone Position/physiology , SARS-CoV-2 , Wearable Electronic Devices , Accelerometry/instrumentation , COVID-19/complications , Computer Systems , Humans , Patient Positioning/instrumentation , Patient Positioning/methods , Remote Sensing Technology/instrumentation , Remote Sensing Technology/methods , Respiratory Distress Syndrome/etiology , Respiratory Distress Syndrome/physiopathology , Respiratory Distress Syndrome/therapyABSTRACT
Diabetes is a common metabolic complication of pregnancy and affected women fall into two subgroups: women with pre-existing diabetes and those with gestational diabetes mellitus (GDM). When pregnancy is affected by diabetes, both mother and infant are at increased risk for multiple adverse outcomes. A multidisciplinary approach to care before, during, and after pregnancy is effective in reducing these risks. The PubMed database was searched for English language studies and guidelines relating to diabetes in pregnancy. The following search terms were used alone and in combination: diabetes, pregnancy, gestational diabetes, GDM, prepregnancy, and preconception. A date restriction was not applied. Results were reviewed by the authors and selected for inclusion based on relevance to the topic. Additional articles were identified by manually searching reference lists of included articles. Using data from this search we herein summarize the evidence relating to pathophysiology and management of diabetes in pregnancy. We discuss areas of controversy including the method and timing of diagnosis of GDM, and choice of pharmacologic agents to treat hyperglycemia during pregnancy. Therefore, this review is intended to serve as a practical guide for clinicians who are caring for women with diabetes and their infants.
Subject(s)
Diabetes Mellitus , Diabetes, Gestational , Pregnancy Complications , Prenatal Exposure Delayed Effects , Diabetes Mellitus/physiopathology , Diabetes Mellitus/therapy , Diabetes, Gestational/physiopathology , Diabetes, Gestational/therapy , Female , Humans , Infant , Patient Care Management , Pregnancy , Pregnancy Complications/physiopathology , Pregnancy Complications/therapy , Prenatal Exposure Delayed Effects/etiology , Prenatal Exposure Delayed Effects/therapyABSTRACT
Overweight and obesity in pregnancy confer a wide range of risks on mother, fetus, and offspring throughout their lives. In addition to compounding many common pregnancy complications, including both iatrogenic preterm delivery and cesarean delivery, obesity is associated with multiple fetal anomalies, metabolic sequelae including diabetes and obesity, allergy and asthma, attention-deficit disorder, and likely many other challenges for the offspring. As targeted interventions are being developed, encouraging solid nutrition and exercise in women of childbearing age may stave off risks and mitigate obesity in the next generation.
Subject(s)
Behavioral Symptoms , Congenital Abnormalities , Metabolic Diseases , Neurodevelopmental Disorders , Obesity, Maternal , Overweight , Pediatric Obesity , Prenatal Exposure Delayed Effects , Stillbirth , Adult , Behavioral Symptoms/etiology , Child , Congenital Abnormalities/etiology , Female , Humans , Metabolic Diseases/etiology , Neurodevelopmental Disorders/etiology , Obesity, Maternal/complications , Overweight/complications , Pediatric Obesity/etiology , Pregnancy , Prenatal Exposure Delayed Effects/etiologyABSTRACT
Resident well-being is a significant issue affecting our future physicians' abilities to fulfill their potential in training and practice. In the 2017 Council on Resident Education in Obstetrics and Gynecology National Wellness Survey, residents identified many challenges to wellness and had the opportunity to provide free-text responses about these issues. Secondary analysis of these responses revealed clusters of symptoms associated with mood disorders, including high rates of reported anxiety and depression symptoms, and even suicidality. The prevalence of these self-reported symptoms underscores the importance of targeting wellness programming efforts, improving health care work environments, advancing access to care, and destigmatizing mental health concerns for our learners.
