Rare white matter disorders share a breakdown in protein production - McGill University

Rates of hypertensive disorders of pregnancy are rising nationwide and are at crisis levels in some communities. In Cuyahoga County, where Cleveland Clinic’s Main Campus, Fairview and Hillcrest hospitals are located, the condition now affects as many as one in three patients, says obstetrician/gynecologist Monique Yoder Katsuki, MD, MPH. Follow-up with a primary care provider is essential for these patients, not just during the postpartum period but for the rest of their lives. Hypertensive disorders of pregnancy, including gestational hypertension and preeclampsia, are associated with an increased lifetime risk for cardiovascular disease. Patients may need routine health screenings at an earlier age and more frequently, as well as medication management that takes their future reproductive plans into account. “It’s really important to get a patient’s pregnancy-related history,” Dr. Katsuki says. “Did they have gestational diabetes? Were they on insulin? Did they have a hypertensive disorder of pregnancy? Did they have preeclampsia? Did they take blood pressure medication?

MainHypertensive disorders of pregnancy (HDPs), including gestational hypertension (GHTN), preeclampsia, chronic hypertension (CHTN) with superimposed preeclampsia (PEC) and eclampsia, affect 2–15% of pregnancies and represent the second leading cause of maternal mortality worldwide1. HDPs increase the risk of acute maternal complications such as renal dysfunction, pulmonary edema, stroke and death2 and contribute to adverse fetal outcomes, including small for gestational age, preterm delivery and stillbirth3. Long-term, they are associated with elevated maternal risk of hypertension, coronary artery disease, stroke and vascular dementia4,5,6 and elevated offspring risk of cardiovascular and neurodevelopmental disorders7. Despite their burden, HDPs are typically diagnosed after 20 weeks of gestation, when symptoms such as hypertension, proteinuria or organ dysfunction become clinically apparent. Severe features, including systolic blood pressure (BP) ≥ 160 mmHg or diastolic BP ≥ 110 mmHg, thrombocytopenia and visual symptoms, guide early delivery decisions because of high maternal–fetal risk8.

IntroductionHigher levels of physical activity (PA) and reduced sedentary time are independently associated with decreased mortality risk and improved cardiometabolic health outcomes among adults1, as well as other favorable health outcomes (e.g., mental health, physical function)2. Despite awareness of these benefits, insufficient PA and sedentary behavior remain highly prevalent in Western populations due to numerous biological, psychological, sociocultural, and environmental factors3. Individuals with certain chronic pain disorders face a paradox: they are at increased risk for sedentary behavior due to pain-related interference, even though significant gains in symptom relief and health benefits from increasing their PA for symptom management have been demonstrated4. One such population that merits particular attention comprises women with chronic pelvic pain disorders (CPPDs; e.g., endometriosis, adenomyosis, fibroids, etc.). With an estimated prevalence of one in seven persons, people living with CPPDs comprise a clinically significant yet understudied group, with many unmet patient needs due to the currently inadequate treatment options5,6.