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Boucoiran I, Kaida A, Blakeley C, Skerritt L, Khan S, Bakombo MD, Greene S, Kennedy VL, Brophy J, Balleny R, Gormley R, Loutfy M, de Pokomandy A. Practices, support and stigma related to infant feeding and postpartum engagement in care among women living with HIV in Canada. AIDS Care 2023; 35:1971-1981. [PMID: 36919583 DOI: 10.1080/09540121.2023.2186341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 01/12/2023] [Indexed: 03/16/2023]
Abstract
Background: Breastfeeding is not recommended for women living with HIV (WLWH) in Canada. We described the prevalence of breastfeeding and explored experiences of care, support, and stigma related to infant feeding. Setting: Quebec, Ontario, and British Columbia (Canada). Methods: Data were obtained from the HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS) surveys, conducted between 2013 and 2018. Results: Breastfeeding was reported by 73.5% of the 786 women who delivered before HIV diagnosis and 7.3% of the 289 women who delivered after HIV diagnosis. Among them, earlier year of delivery, delivery outside of Canada, and African, Caribbean, Black ethnicity were independently associated with increased odds of breastfeeding. Among WLWH who had a live birth during the last year, 77% (40/52) felt that they had received support regarding infant feeding practices, and 77% (23/30) were concerned that not breastfeeding could lead to them being identified as WLWH. Among 71 women within one year postpartum at any one of the study waves, 89% reported having an undetectable viral load. Conclusion: Breastfeeding experiences were common among WLWH, most often prior to HIV diagnosis. Fear of unintentional HIV status disclosure when not breastfeeding and challenges to maintain an undetectable HIV viral load are important issues to address during postpartum care.
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Affiliation(s)
- Isabelle Boucoiran
- Women and Children's Infectious Diseases Center, Centre Hospitalier Universitaire Sainte-Justine, Montréal
- Department of Obstetrics and Gynecology and School of public Health, Université de Montréal, Montreal
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Burnaby
| | - Camille Blakeley
- Women and Children's Infectious Diseases Center, Centre Hospitalier Universitaire Sainte-Justine, Montréal
| | | | - Sarah Khan
- Dept of Pediatrics, McMaster University, Hamilton
| | | | - Saara Greene
- School of Social Work, McMaster University, Hamilton
| | - V Logan Kennedy
- Women's College Research Institute, Women's College Hospital, Toronto, Canada
| | - Jason Brophy
- Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada
| | - Rosa Balleny
- Faculty of Health Sciences, Simon Fraser University, Burnaby
| | - Rebecca Gormley
- Faculty of Health Sciences, Simon Fraser University, Burnaby
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver
| | - Mona Loutfy
- Women's College Research Institute, Women's College Hospital, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto
| | - Alexandra de Pokomandy
- Department of Family Medicine, McGill University, Montreal
- Research Institute of McGill University Health Centre, Montreal, Canada
- Chronic Viral Illness Service, McGill University Health Centre, Montreal
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2
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Pagano-Therrien J, Griswold MK, Amoah RK. "Go With the Flow": A Qualitative Description of Infant Feeding Experiences Among Women With HIV in the United States. J Assoc Nurses AIDS Care 2023; 34:376-388. [PMID: 37199426 DOI: 10.1097/jnc.0000000000000411] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
ABSTRACT Breastfeeding affords numerous health benefits to mothers and children, but for women with HIV in the United States, avoidance of breastfeeding is recommended. Evidence from low-income countries demonstrates low risk of HIV transmission during breastfeeding with antiretroviral therapy, and the World Health Organization recommends exclusive breastfeeding and shared decision making about infant feeding options in low-income and middle-income countries. In the United States, gaps in knowledge exist surrounding the experiences, beliefs, and feelings of women with HIV surrounding infant feeding decisions. Undergirded by a framework of person-centered care, this study describes the experiences, beliefs, and feelings of women with HIV in the United States surrounding recommendations for breastfeeding avoidance. Although no participants reported consideration of breastfeeding, multiple gaps were identified with implications for the clinical care and counseling of the mother-infant dyad.
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Affiliation(s)
- Jesica Pagano-Therrien
- Jesica Pagano-Therrien, PhD, RN, CPNP-PC is an Associate Professor, Tan Chingfen Graduate School of Nursing, UMass Chan Medical School, Worcester, Massachusetts, USA. Michele K. Griswold, PhD, MPH, RN, IBCLC is an Assistant Professor, Department of Public Health, College of Health and Human Services, Southern Connecticut State University, New Haven, Connecticut, USA. Rita Amoah, PhD, RN, is an Assistant Professor, Tan Chingfen Graduate School of Nursing, UMass Chan Medical School, Worcester, Massachusetts, USA
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3
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Khan S, Tsang KK, Brophy J, Kakkar F, Kennedy VL, Boucoiran I, Yudin MH, Money D, Read S, Bitnun A. Canadian Paediatric and Perinatal HIV/AIDS Research Group consensus recommendations for infant feeding in the HIV context. JOURNAL OF THE ASSOCIATION OF MEDICAL MICROBIOLOGY AND INFECTIOUS DISEASE CANADA 2023; 8:7-17. [PMID: 37008587 PMCID: PMC10052908 DOI: 10.3138/jammi-2022-11-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Background: Providing comprehensive infant feeding guidance to families affected by HIV is complex and requires a multidisciplinary approach. While exclusive formula feeding remains the preferred recommendation for infants born to women living with HIV (WLWH) in high-income countries, a more nuanced approach that may include the option of breastfeeding under certain circumstances is emerging in many resource-rich countries. Methods: The Canadian Paediatric & Perinatal HIV/AIDS Research Group (CPARG) hosted a Canadian Institute of Health Research-funded meeting in 2016 to develop consensus among multidisciplinary providers around counselling and recommendations for infant feeding. After presentations by adult and pediatric health care providers, basic scientists, and community-based researchers, a subgroup drafted summary evidence-informed recommendations. Along with revisions among CPARG members, a community review was performed by a convenience sample of WLWH who had given birth in the past 5 years from Ontario and Quebec. A legal review was also conducted to ensure understanding of the criminalization potential and concern of HIV transmission and exposure. Results: The Canadian consensus guidelines continue to support formula feeding as the preferred method of infant feeding as it eliminates any residual risk of postnatal vertical transmission. Formula should be made available for all infants born to mothers living with HIV for their first year of life. A comprehensive approach to counselling WLWH is outlined to assist providers to effectively counsel on current evidence to ensure WLWH are fully informed in their decision making. For women meeting criteria to and elect to breastfeed, frequent maternal virologic monitoring, and follow-up is required of both mother and infant. Antiretroviral prophylaxis and monitoring are recommended for breastfed infants. The community review highlighted the importance of other supports and counselling needed for implementing effective formula feeding, aside from access to formula. The legal review provided clarifying language around child protection services involvement and the need to provide referral to legal resources or information upon request. Surveillance systems to monitor for cases of breastmilk transmission should be in place to improve gaps in care and develop further knowledge in this area. Conclusion: The Canadian infant feeding consensus guideline is designed to inform and enable better care for WLWH and their babies. Ongoing evaluation of these guidelines as new evidence emerges will be important.
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Affiliation(s)
- Sarah Khan
- McMaster Children’s Hospital, Division of Infectious Diseases, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Kara K. Tsang
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jason Brophy
- Children’s Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada
| | - Fatima Kakkar
- Mother and Child Infection Center, Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, Quebec, Canada; Department of Pediatrics, University of Montreal, Montreal, Quebec, Canada
| | - V Logan Kennedy
- Women’s College Research Institute, Women’s College Hospital and Maple Leaf Medical Clinic, Toronto, Ontario, Canada
| | - Isabelle Boucoiran
- Mother and Child Infection Center, Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, Quebec, Canada; Departments of Obstetrics and Gynecology and Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Mark H. Yudin
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, and Associate Professor, Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada
| | - Deborah Money
- Department of Obstetrics and Gynecology, an associate member in the Department of Medicine and the School of Population and Public Health, Faculty of Medicine, an Associate Member of the Department of Microbiology & Immunology, Faculty of Science, at the University of British Columbia, Vancouver, British Columbia, Canada
| | - Stanley Read
- Department of Pediatrics and Pathobiology, University of Toronto, Toronto, Canada
| | - Ari Bitnun
- The Hospital for Sick Children, and Professor, Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
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4
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Naz F, Malik A, Riaz M, Mahmood Q, Mehmood MH, Rasool G, Mahmood Z, Abbas M. Bromocriptine Therapy: Review of mechanism of action, safety and tolerability. Clin Exp Pharmacol Physiol 2022; 49:903-922. [DOI: 10.1111/1440-1681.13678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 05/24/2022] [Accepted: 05/25/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Faiza Naz
- Punjab University College of Pharmacy University of the Punjab Lahore Pakistan
| | - Abdul Malik
- College of Pharmacy University of Sargodha Sargodha Pakistan
| | - Muhammad Riaz
- Department of Allied Health Sciences University of Sargodha Sargodha Pakistan
| | - Qaisar Mahmood
- College of Pharmacy University of Sargodha Sargodha Pakistan
| | - Malik Hassan Mehmood
- Department of Pharmacology, Faculty of Pharmaceutical Sciences Government College University Faisalabad Pakistan
| | - Ghulam Rasool
- Department of Allied Health Sciences University of Sargodha Sargodha Pakistan
| | - Zahed Mahmood
- Department of Biochemistry Government College University Faisalabad Pakistan
| | - Mazhar Abbas
- Department of Biochemistry College of Veterinary and Animal Sciences, University of Veterinary and Animal Sciences (Jhang Campus) Lahore Pakistan
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5
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Chen Y, Du F, Tang L, Xu J, Zhao Y, Wu X, Li M, Shen J, Wen Q, Cho CH, Xiao Z. Carboranes as unique pharmacophores in antitumor medicinal chemistry. Mol Ther Oncolytics 2022; 24:400-416. [PMID: 35141397 PMCID: PMC8807988 DOI: 10.1016/j.omto.2022.01.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Carborane is a carbon-boron molecular cluster that can be viewed as a 3D analog of benzene. It features special physical and chemical properties, and thus has the potential to serve as a new type of pharmacophore for drug design and discovery. Based on the relative positions of two cage carbons, icosahedral closo-carboranes can be classified into three isomers, ortho-carborane (o-carborane, 1,2-C2B10H12), meta-carborane (m-carborane, 1,7-C2B10H12), and para-carborane (p-carborane, 1,12-C2B10H12), and all of them can be deboronated to generate their nido- forms. Cage compound carborane and its derivatives have been demonstrated as useful chemical entities in antitumor medicinal chemistry. The applications of carboranes and their derivatives in the field of antitumor research mainly include boron neutron capture therapy (BNCT), as BNCT/photodynamic therapy dual sensitizers, and as anticancer ligands. This review summarizes the research progress on carboranes achieved up to October 2021, with particular emphasis on signaling transduction pathways, chemical structures, and mechanistic considerations of using carboranes.
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Affiliation(s)
- Yu Chen
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
| | - Fukuan Du
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
| | - Liyao Tang
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
| | - Jinrun Xu
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
| | - Yueshui Zhao
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
| | - Xu Wu
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
| | - Mingxing Li
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
| | - Jing Shen
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
| | - Qinglian Wen
- Department of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
- Luzhou Key Laboratory of Cell Therapy & Cell Drugs, Southwest Medical University, Luzhou 646000, China
| | - Chi Hin Cho
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
- Luzhou Key Laboratory of Cell Therapy & Cell Drugs, Southwest Medical University, Luzhou 646000, China
- Faculty of Medicine, School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Zhangang Xiao
- Department of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
- Luzhou Key Laboratory of Cell Therapy & Cell Drugs, Southwest Medical University, Luzhou 646000, China
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6
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Zhou G, Han J, Zhao W, Xu X. A comparative study of bilateral and unilateral early sucking within 2 hours of delivery on lactation. Am J Transl Res 2021; 13:9715-9721. [PMID: 34540100 PMCID: PMC8430129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 04/30/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE This study explored and analyzed the effects of bilateral and unilateral early sucking within 2 h after delivery on lactation. METHODS From August 2019 to August 2020, 392 primiparas with full-term, singleton, natural delivery, and normal breast conditions were submitted to the Obstetrics Department of our hospital and were enrolled as the research subjects. The subjects were randomly divided into an experimental group and a control group, with 196 in each group. Both groups implemented early sucking with the assistance of a midwife within 2 h after delivery. The experimental group conducted bilateral breast sucking and the control group received unilateral sucking. The onset time of colostrum, the lactation volume, and the prolactin levels at 6 h, 24 h, 48 h, and 72 h after delivery, including neonatal urination and incidence of complications were compared between the two groups. RESULTS The onset time of colostrum in the experimental group was much earlier than that in the control group with a statistically significant difference (P<0.05). The postpartum filling time of the experimental group was shorter than that of the control group, with a statistically significant difference (P<0.05). There was a statistically insignificant difference in the distribution of lactation yield between the two groups at 6 h of postpartum (P>0.05). The lactation yield distribution in the experimental group at 24 h, 48 h, and 72 h was critically superior to that in control group, with statistically significant difference (P<0.05). The degree of prolactin in the experimental group was higher than that in the control group (P<0.05). There was no significant difference in urination frequency and the incidence of complications between the two groups of neonates at 24 h, 48 h, and 72 h (P>0.05). CONCLUSION The effect of bilateral early lactation within 2 h after delivery is superior to that of unilateral early lactation, which is worthy of clinical application.
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Affiliation(s)
- Guoxia Zhou
- Department of Obstetrics and Gynecology, Jiaozhou Central Hospital of QingdaoShandong 266300, China
| | - Jun Han
- Department of Obstetrics and Gynecology, Qingdao Eighth People’s HospitalQingdao 266100, Shandong, China
| | - Wenling Zhao
- Department of Obstetrics and Gynecology, Jiaolai Town Central Health Center of Jiaozhou CityJiaozhou 266300, Shandong, China
| | - Xiaoqin Xu
- Department of Radiology, Taizhou Municipal HospitalTaizhou 318000, Zhejiang, China
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Coban A, Bayraktar S, Yıldız N, Tunçel D, Gökçay G, Ince Z. A Case Study of Early Postpartum Excessive Breast Engorgement: Is it Related to Feedback Inhibition of Lactation? J Hum Lact 2021; 37:414-418. [PMID: 33030995 DOI: 10.1177/0890334420962073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION There is limited information about problems of feedback inhibition of lactation which should be considered as a rare cause of breast engorgement. We report the management of excessive breast engorgement in a mother with a presumptive diagnosis of a defect in the feedback inhibition of lactation. MAIN ISSUE The participant, who had been discharged on postpartum Day 2 while breastfeeding her infant, was readmitted to the hospital the next day with engorgement of the breasts and cessation of milk flow. Pumping and application of cold dressings alone did not work effectively. The severity of the symptoms decreased only after the addition of an anti-inflammatory drug and a prolactin inhibitor. MANAGEMENT The participant received breastfeeding counseling, family-centered care, and support for pumping equipment. An anti-inflammatory drug was started and a low dose prolactin inhibitor was given. The difficulty was the management of extensive and painful breast engorgement and the re-establishment of milk flow. At postpartum Day 14, the participant and her infant were discharged with effective breastfeeding status. CONCLUSIONS The recognition of a problem in the feedback inhibition of lactation as a cause of breast engorgement is important because it may be unresponsive to classical treatment methods resulting in cessation of milk flow. With the cautious use of low-dose cabergoline, in addition to other treatment strategies, milk flow can be reduced in a controlled manner while ensuring the continuity of milk production. An early diagnosis, interdisciplinary approach, and a close follow-up of the mother-infant pair are essential for preserving lactation.
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Affiliation(s)
- Asuman Coban
- 37516 Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Istanbul, Turkey.,37516 Istanbul University, Institute of Child Health, Department of Social Pediatrics, Istanbul, Turkey
| | - Sema Bayraktar
- 221265 Bezmialem Vakıf University, Faculty of Health Sciences, Nursing, Istanbul, Turkey
| | - Nevin Yıldız
- 37516 Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Istanbul, Turkey
| | - Duygu Tunçel
- 37516 Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Istanbul, Turkey
| | - Gülbin Gökçay
- 37516 Istanbul University, Institute of Child Health, Department of Social Pediatrics, Istanbul, Turkey
| | - Zeynep Ince
- 37516 Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Istanbul, Turkey.,37516 Istanbul University, Institute of Child Health, Department of Social Pediatrics, Istanbul, Turkey
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Boucoiran I, Roy M, Poliquin V, Elwood C, Sheehan NL, Thibaudeau R, Ferreira E, Autmizguine J, Kakkar F, Boucher M, Money D, Tulloch K. Evaluation of cabergoline for lactation inhibition in women living with HIV. Int J STD AIDS 2021; 32:654-661. [PMID: 33612017 DOI: 10.1177/0956462420984694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We wished to evaluate the efficacy, safety, and acceptability of cabergoline for lactation inhibition in women who live with HIV. In this multicenter prospective observational study, cabergoline was offered as a single oral dose of 1 mg within the first 48 h postpartum. Women were recruited if they delivered a live infant after 35 weeks of gestational age. Participants filled out a questionnaire regarding symptoms of lactation and cabergoline adverse effects on day 2 and day 14 postpartum. On day 14, they also completed a questionnaire about their satisfaction with cabergoline treatment. Prolactin serum level was measured on both visits. Among 68 participants, all but one received cabergoline. The overall effectiveness defined by partial or complete success at day 14 was 98.3% (confidence intervals: 89.5-99.9). At day 14, 67.4% of women who received cabergoline had prolactin serum levels <25 mcg/L (threshold necessary for galactopoiesis). Mild nonspecific adverse effects were experienced by 24 (29.9%) women on day 2 and 24 (41.4%) on day 14, and lasted 48 h or less. Overall, 96% of women were satisfied with cabergoline's ability to prevent postpartum lactation symptoms. In conclusion, cabergoline is an effective, well-accepted, and well-tolerated medication for lactation inhibition in WLWH.
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Affiliation(s)
- Isabelle Boucoiran
- Department of Obstetrics and Gynecology, Division of Maternofetal Medicine, 5622Université de Montréal, Montreal, Canada.,Department of Social and Preventive Medicine, 5622École de Santé Publique de Université de Montréal, Montreal, QC, Canada.,Women and Children's Infectious Diseases Center, CHU Sainte-Justine Research Center, Montreal, Canada
| | - Melissa Roy
- Department of Obstetrics and Gynecology, Division of Maternofetal Medicine, 5622Université de Montréal, Montreal, Canada
| | - Vanessa Poliquin
- Department of Obstetrics and Gynecology, 8664University of Manitoba, Winnipeg, Canada
| | - Chelsea Elwood
- Department of Obstetrics and Gynecology, 12358University of British Columbia, Vancouver, Canada.,Women's Health Research Institute, Vancouver, Canada
| | - Nancy L Sheehan
- Québec Antiretroviral Therapeutic Drug Monitoring Program, 54473McGill University Health Centre, Montréal, Canada.,Department of Pharmacology and Physiology, 5622Université de Montréal, Montréal, Canada
| | - Rosie Thibaudeau
- Department of Obstetrics and Gynecology, Division of Maternofetal Medicine, 5622Université de Montréal, Montreal, Canada
| | - Ema Ferreira
- Department of Pharmacology and Physiology, 5622Université de Montréal, Montréal, Canada.,Department of Pharmacy, CHU Sainte-Justine, Montreal, Canada
| | - Julie Autmizguine
- Women and Children's Infectious Diseases Center, CHU Sainte-Justine Research Center, Montreal, Canada.,Department of Pharmacology and Physiology, 5622Université de Montréal, Montréal, Canada.,Department of Pediatrics, Division of Infectious Diseases, CHU Sainte-Justine, 5622Université de Montréal, Montreal, Canada
| | - Fatima Kakkar
- Women and Children's Infectious Diseases Center, CHU Sainte-Justine Research Center, Montreal, Canada.,Department of Pediatrics, Division of Infectious Diseases, CHU Sainte-Justine, 5622Université de Montréal, Montreal, Canada
| | - Marc Boucher
- Department of Obstetrics and Gynecology, Division of Maternofetal Medicine, 5622Université de Montréal, Montreal, Canada.,Women and Children's Infectious Diseases Center, CHU Sainte-Justine Research Center, Montreal, Canada
| | - Deborah Money
- Department of Obstetrics and Gynecology, 12358University of British Columbia, Vancouver, Canada.,Women's Health Research Institute, Vancouver, Canada
| | - Karen Tulloch
- Department of Pharmacy, BC Women's Hospital and Health Centre, Vancouver, Canada
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9
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Harris K, Yudin MH. HIV
Infection in Pregnant Women: A 2020 Update. Prenat Diagn 2020; 40:1715-1721. [DOI: 10.1002/pd.5769] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 05/12/2020] [Accepted: 06/14/2020] [Indexed: 11/09/2022]
Affiliation(s)
- Kristin Harris
- Department of Obstetrics and Gynaecology University of Toronto Toronto Ontario Canada
| | - Mark H. Yudin
- Department of Obstetrics and Gynaecology St. Michael's Hospital, University of Toronto Toronto Ontario Canada
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Somasundaram NP, Ranathunga I, Ratnasamy V, Wijewickrama PSA, Dissanayake HA, Yogendranathan N, Gamage KKK, de Silva NL, Sumanatilleke M, Katulanda P, Grossman AB. The Impact of SARS-Cov-2 Virus Infection on the Endocrine System. J Endocr Soc 2020; 4:bvaa082. [PMID: 32728654 PMCID: PMC7337839 DOI: 10.1210/jendso/bvaa082] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 06/17/2020] [Indexed: 02/06/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus has spread across the globe rapidly causing an unprecedented pandemic. Because of the novelty of the disease, the possible impact on the endocrine system is not clear. To compile a mini-review describing possible endocrine consequences of SARS-CoV-2 infection, we performed a literature survey using the key words Covid-19, Coronavirus, SARS CoV-1, SARS Cov-2, Endocrine, and related terms in medical databases including PubMed, Google Scholar, and MedARXiv from the year 2000. Additional references were identified through manual screening of bibliographies and via citations in the selected articles. The literature review is current until April 28, 2020. In light of the literature, we discuss SARS-CoV-2 and explore the endocrine consequences based on the experience with structurally-similar SARS-CoV-1. Studies from the SARS -CoV-1 epidemic have reported variable changes in the endocrine organs. SARS-CoV-2 attaches to the ACE2 system in the pancreas causing perturbation of insulin production resulting in hyperglycemic emergencies. In patients with preexisting endocrine disorders who develop COVID-19, several factors warrant management decisions. Hydrocortisone dose adjustments are required in patients with adrenal insufficiency. Identification and management of critical illness-related corticosteroid insufficiency is crucial. Patients with Cushing syndrome may have poorer outcomes because of the associated immunodeficiency and coagulopathy. Vitamin D deficiency appears to be associated with increased susceptibility or severity to SARS-CoV-2 infection, and replacement may improve outcomes. Robust strategies required for the optimal management of endocrinopathies in COVID-19 are discussed extensively in this mini-review.
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Affiliation(s)
| | - Ishara Ranathunga
- Diabetes and Endocrine Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka
| | - Vithiya Ratnasamy
- University Medical Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka
| | | | | | | | | | - Nipun Lakshitha de Silva
- Diabetes and Endocrine Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka.,Department of Clinical Sciences, Faculty of Medicine, General Sir John Kotelawala Defence University, Sri Lanka, Rathmalana, Sri Lanka
| | | | - Prasad Katulanda
- University Medical Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka.,Diabetes Research Unit, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Sri Lanka, Colombo, Sri Lanka
| | - Ashley Barry Grossman
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, University of Oxford, London, UK.,Centre for Endocrinology, Barts and the London School of Medicine, Queen Mary University of London, Oxford, UK
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