Public Health

Clinical effectiveness and safety of time-lapse imaging systems for embryo incubation and selection in in-vitro fertilisation treatment (TILT) is a multicentre, three-parallel-group, double-blind, randomised controlled trial published in the Lancet. It found that in women undergoing IVF or ICSI treatment, the use of time-lapse imaging systems for embryo culture and selection does not increase the odds of live birth compared with standard care without time-lapse imaging. This finding triggered post-publication peer review by those interested in TILT to which the trialists responded robustly. This vlog presents the entire story of the TILT trial from its very beginning to post publication.

Maternal Perinatal Suicide: Suicide is one of the leading causes of death worldwide. It is considered a priority problem in global public health by the World Health Organisation (WHO). In the United States, maternal mortality increased by 26.6% between 2000 and 2014, with suicide being the leading cause of this increase. In various European countries, suicide is one of the leading causes of maternal mortality. Suicidal ideation is also associated with various effects on the mother and newborn, such as low birth weight, congenital anomalies, prematurity, and even a negative impact that can affect the mother-child bond or later child development. In women with suicidal ideation, the risk of perinatal loss increases sixfold. These mothers also suffer serious and lasting health consequences. Domestic violence is a risk factor, and skin-to-skin contact is protective.

There is unequal shared decision-making in cancer care. This vlog is delivered by Professor Khalid Khan at the University of Granada and Dr Marta Maes-Carballo, General Surgeon, Digestive System Consultant, Breast Cancer and Aesthetic Surgery at Hospital Público de Verín, Ourense, Spain. Patient's gender, a characteristic protected by law, often goes unprotected in healthcare oncology practice where recommendations for shared decision-making are made infrequently for women compared to men!! Prostate cancer guidelines frequently recommend shared decision-making, but endometrial cancer guidelines do not.

This vlog is delivered by by Professor Khalid Khan and Dr Carmen Amezcua, of the University of Granada, Spain.

The vlog delves into a crucial topic: Should overweight mothers eat for two during pregnancy or focus on managing their weight? #obseityinpregnancy #maternaldiet #mediterraneandiet #gestationaldiabetesprevention #gestationalweightgain

Este vlog explica la importancia de seguridad de madres durante cesarea. Anestesia es un parte fundamental de cesarea. La mortalidad materna puede estar relacionada con anestesia en un porcentaje de madres. El porcentaje es alto en paises sin desarrollo. Hay necesidad para mejorar los recursos humanos para el acto anestesiologico.

A form of abuse, known as obstetric violence, is a harsh reality faced by mothers during childbirth daily. Risk factors for experiencing abuse from obstetricians, midwives, and birth attendants include factors like age, education levels, and previous abortion history. The significant power held by healthcare providers over mothers during childbirth, coupled with professional ignorance, often manifests as obstetric violence. The repercussions of this violence are severe and can lead to issues such as depression, breastfeeding challenges, PTSD, and reduced postpartum and childcare consultations.

Summary Appetite may go up but "eating for two" to gain weight in pregnancy is not really healthy for otherwise healthy women. When you are overweight, it is best to cut weght down in time before embarking on pregnancy. During this period taking folate supplements can help. However, as many conceptions are unplanned the burden of diet and weight mangement will fall on the shoulders of most mothers after the event. Being overweight before pregnancy increases the risk of various complications during pregnancy and gaining too much weight during pregnancy on top can increase risks to both the mother and the baby further. For overweight mothers it is best to seek professional help during antenatal care for nurtitional, exercise and weight managemnet advice. Appetite in pregnancy It is correct that your appetite will go up, but for healthy mothers "eating for two" is not necessary. Weight gain, if excessive, is not good. It can be associated with conditions such as diabet...

Summary Miscarriage, trivialised by many as the spontaneous loss of a pregnancy that occurs before the fetus can survive outside the uterus, is not a minor issue. Technically, the limit of viability is set at the 24th week of gestation, but this is subject to change in line with developments in neonatal care. Miscarriages have been described as early (under 12 weeks of gestation) or late (13-24 weeks of gestation). Recurrent miscarriage is defined as the occurrence of 3 or more consecutive miscarriages in some texts and as 2 or more miscarriages, consecutive or not, in others. Regardless, it affects 1% of women of reproductive age. Verification of diagnosis, using ultrasound, may be tricky at times and it is better to take the approach of being 'safe than sorry'. Miscarriage vs  Abortion Aroound a quarter of women who miss a period and have a positive pregnancy test end up with a pregnancy loss. Perhpas more pregnancies are lost as in the absence of testing it is not possible t...

Summary In polycystic ovary syndrome or PCOS, the name associated with the presence of multiple small cysts in the ovary, is related to anovulation, infertility and features due to higher than usual levels of male hormones. Alternative names used for this condition also include polycystic ovaries, polycystic ovary disease, Stein-Leventhal syndrome and polyfollicular ovarian disease.  The signs and symptoms of PCOS manifest early after the first menstrual period during puberty.  Excess androgen. Elevated levels of the male hormone can cause physical signs, such as excess facial and body hair (hirsutism), and sometimes severe acne and male pattern baldness.  Unfortunately, frequently due to medical incompetence, the diagnosis is delayed till later life, compromising women's life quality.  Polycystic ovary syndrome Polycystic ovary syndrome (PCOS) is a disease in which women has high levels of androgens (male) hormones. Many problems can occur as a result of this increa...

Summary Epilepsy, a chronic condition with a continuous predisposition to experiencing epileptic seizures, has consequences for the sufferer. These include a negative impact on the neurobiological, cognitive, psychological and social function of the affected individuals and their families. Pregnancy affects epilepsy control and predisposes the offspring to a range of risks.  Epilepsy One per cent of the world population suffers from Epilepsy, a chronic condition with a continuous predisposition to experiencing epileptic seizures. It has consequences serious for the sufferer. There are over 50 million people affected, with a higher incidence in developing countries. Women and their pregnancies are particularly at risk.  Epilepsy can cause disability through memory alteration and language, mental retardation, defects in reasoning, attention and concentration deficit, motor and learning difficulties, drowsiness and behaviour problems. These disorders influence the quality of life...

Summary A dietary pattern rich in health-promoting foods, including plant-based foods - fresh fruits and vegetables, whole grains, soya, nuts - with low levels of animal proteins and sugars, need to remain our priority. The most common causes of mortality like diabetes, obesity and cardiovascular problems respond to these simple nutritional interventions. New evidence shows that the Mediterranean diet during pregnancy has benefits both in maternal weight gain and prevention of gestational diabetes. These advantages can also help reduce the overall risk of complications for the offspring at the beginning of life. Effects of the Mediterranean diet during pregnancy will likely produce lifelong health benefits both for both mother and baby.  Nutrition in pregnancy Mediterranean diet is the Cultural Heritage of Humanity according to Unesco. It has been purported to be the best option whenever we seek to eat well. This is part of the  reason why I moved to Granada , Spain. As...

Summary It is important to make a profound change in the way we think about chronic pelvic pain. The notion that endometriosis is the sole cause of chronic pelvic pain is wrong; it delays correct diagnosis and leads to unrealistic expectations about treatment success. It is an outdated view perpetuated by many gynaecologists who are selective in their focus. Negative laparoscopy with persistent symptoms deserves as much, if not more attention and care. The key to managing a complex disease like chronic pelvic pain is to see it as a condition that cannot be cured but can be managed successfully. This idea is like the successful treatment of diabetes and hypertension, other chronic conditions which can be controlled. From the outset, a multimodal and a multidisciplinary approach is required. Chronic pelvic pain Lets first define what we are talking about. Chronic pelvic pain is non-cyclic or cyclical pain lasting more than 3 months located in the anatomical area of the pelvis, the anter...