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Predicting preeclampsia for safer pregnancies

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Dr. Stella Daskalopoulou, scientist in the Cardiovascular Health Across the Lifespan Program of the RI-MUHC

RI-MUHC scientist Dr. Stella Daskalopoulou aims to reduce pregnancy complications by developing a reliable early screening tool

Preeclampsia is a serious pregnancy disorder affecting 2 to 10% of pregnancies worldwide, according to the World Health Organization. Women with preeclampsia have high blood pressure, and in serious cases, organ damage in the second half of pregnancy. If left untreated, this disease can put both mother and baby at risk of severe complications and even death.

Currently, there are no accurate screening tests to predict if a woman will develop preeclampsia until symptoms appear, which is often too late. A reliable early screening tool would ensure that at-risk women can access proper care early in pregnancy to keep themselves and their babies healthy. Unfortunately, no such tool exists at this time.

In a recent study, a team led by Dr. Stella Daskalopoulou, a scientist in the Cardiovascular Health Across the Lifespan Program of the RI-MUHC aimed to address the need for an early screening tool for preeclampsia.

“Effective prediction of preeclampsia would allow timely identification of pregnant women who would benefit most from preventive measures,” said Dr. Daskalopoulou. “It would ensure that limited health care resources are directed towards those women who are truly at high risk. This would in turn decrease the number of women who are wrongly considered “high-risk” and undergo excessive medical supervision during pregnancy.”

Her previous research has found that women destined to develop preeclampsia have greater arterial hardening throughout pregnancy, particularly in the second trimester, and midgestation sleep apnea is associated with increased arterial hardening and incraesed risk for preeclampsia. Because the hardening of the arteries can be performed safely and non-invasively, it may be a promising tool for early preeclampsia prediction.

The scientists used a measurement of arterial hardening called carotid femoral pulse wave velocity (cfPWV). The researchers found that cfPWV measurements functioned as a better predictor of preeclampsia in the first trimester than any of the other predictive tools currently used in clinical practice. Their results are the first evidence that measuring arterial hardening in the first trimester of pregnancy can help better predict preeclampsia.

Dr. Daskalopoulou is now leading a multinational prospective large study title study titled “Early Prediction of Preeclampsia Using arteriaL Stiffness in High-risk prEgnancies” (PULSE). The ongoing PULSE research study will measure the hardening of pregnant women’s arteries in the first trimester. It will compare the predictive performance of this measure to other known clinical risk factors for preeclampsia, as well as to alternative tools for detection of the disorder, like ultrasound and blood tests. The same assessments will also be performed in the second trimester to determine whether preeclampsia risk prediction can be improved.

“We anticipate that our work will help to identify preeclampsia much earlier than is currently possible, and thus contribute to the reduction of morbidity and mortality of pregnant women and babies around the world,” added Dr. Daskalopoulou.

Pulse is currently recruiting in 9 sites – 6 across Canada and 3 internationally. PULSE is fully funded by CIHR and Dr. Daskalopoulou’s top-ranked proposal received McGill University’s largest grant. Access more information about PULSE here.

The authors gratefully acknowledge funding by the Canadian Institutes of Health Research, Fonds de recherche du Québec – Santé, the Heart and Stroke Foundation, the Canadian Foundation of Woman’s Health, and the Academic Enrichment Fund from the Obstetrics Department at McGill University Health Centre.

_ Source: RI-MUHC

 

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.

The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.

Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.

“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”

The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.

A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.

Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.

“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.

Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.

The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.

“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.

This report by The Canadian Press was first published Sept. 11, 2024.

The Canadian Press. All rights reserved.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.

Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.

Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.

Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.

The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.

“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.

Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.

Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.

Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.

A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.

This report by The Canadian Press was first published Sept. 10, 2024.

The Canadian Press. All rights reserved.

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Bizarre Sunlight Loophole Melts Belly Fat Fast!

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