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Article ; Online: Thyroid Nodules and Thyroid Cancer in Pregnancy.

Sullivan, Scott A

2019 Volume 62, Issue 2, Page(s) 365–372

Abstract: Thyroid nodules and thyroid cancer discovered during pregnancy can result in significant anxiety for patients may present a challenge for providers. The prevalence of thyroid nodules is reported to vary between 3% and 21%. The estimated overall ... ...

Abstract	Thyroid nodules and thyroid cancer discovered during pregnancy can result in significant anxiety for patients may present a challenge for providers. The prevalence of thyroid nodules is reported to vary between 3% and 21%. The estimated overall prevalence of thyroid cancer during pregnancy is 14.4 per 100,000 births. Imaging and possible tissue diagnosis should be considered for palpable thyroid nodules. Benign or stable nodules can usually be observed through pregnancy. Suspicious masses may require surgical treatment, best handled through multidisciplinary care. Clinicians should be aware of the care and management recommendations during the antepartum and postpartum periods.
MeSH term(s)	Biopsy, Fine-Needle ; Female ; Humans ; Pregnancy ; Pregnancy Complications, Neoplastic/diagnosis ; Pregnancy Complications, Neoplastic/therapy ; Protein Kinase Inhibitors/therapeutic use ; Thyroid Gland/diagnostic imaging ; Thyroid Gland/pathology ; Thyroid Neoplasms/diagnosis ; Thyroid Neoplasms/therapy ; Thyroid Nodule/diagnosis ; Thyroid Nodule/therapy ; Thyroidectomy ; Time-to-Treatment
Chemical Substances	Protein Kinase Inhibitors
Language	English
Publishing date	2019-03-26
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	391207-3
ISSN	1532-5520 ; 0009-9201
ISSN (online)	1532-5520
ISSN	0009-9201
DOI	10.1097/GRF.0000000000000431
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Article ; Online: Hypothyroidism in Pregnancy.

Sullivan, Scott A

Clinical obstetrics and gynecology

2019 Volume 62, Issue 2, Page(s) 308–319

Abstract: Hypothyroidism in pregnancy is defined as the presence of an elevated thyroid stimulating hormone during gestation, affecting 2% to 3% of the population. Overt hypothyroidism is diagnosed by a decreased FT4, while patients with a normal FT4 are ... ...

Abstract	Hypothyroidism in pregnancy is defined as the presence of an elevated thyroid stimulating hormone during gestation, affecting 2% to 3% of the population. Overt hypothyroidism is diagnosed by a decreased FT4, while patients with a normal FT4 are considered to have subclinical disease. Poorly controlled disease is associated with both pregnancy complications and developmental delays in the offspring. Treatment consists of replacement with levothyroxine and regular monitoring. Most pregnant women will require an increase in their dosing from 25% to 30%. While treatment for SCH remains controversial, current recommendations do not support universal screening of low-risk women during pregnancy.
MeSH term(s)	Abortion, Spontaneous ; Antibodies/blood ; Clinical Trials as Topic ; Female ; Fetal Development ; Humans ; Hypothyroidism/complications ; Hypothyroidism/drug therapy ; Iodide Peroxidase/immunology ; Pregnancy ; Pregnancy Complications/drug therapy ; Premature Birth ; Thyroxine/therapeutic use
Chemical Substances	Antibodies ; Iodide Peroxidase (EC 1.11.1.8) ; Thyroxine (Q51BO43MG4)
Language	English
Publishing date	2019-04-13
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	391207-3
ISSN	1532-5520 ; 0009-9201
ISSN (online)	1532-5520
ISSN	0009-9201
DOI	10.1097/GRF.0000000000000432
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Article ; Online: Parathyroid Diseases.

Sullivan, Scott A

Clinical obstetrics and gynecology

2019 Volume 62, Issue 2, Page(s) 347–358

Abstract: Although uncommon in pregnancy, parathyroid dysfunction may produce significant perinatal and maternal morbidity and mortality. The prevalence of hyperparathyroidism is 0.5%. The most common cause of primary hyperparathyroidism in pregnancy is a single ... ...

Abstract	Although uncommon in pregnancy, parathyroid dysfunction may produce significant perinatal and maternal morbidity and mortality. The prevalence of hyperparathyroidism is 0.5%. The most common cause of primary hyperparathyroidism in pregnancy is a single parathyroid adenoma, which is present in nearly 80% of cases. Surgery is the only definitive treatment for primary hyperparathyroidism, with a cure rate that is excellent. The most common etiology of hypoparathyroidism is damage to the parathyroid glands after surgery, with an incidence of 0.2%. Treatment of hypoparathyroidism is usually a high-calcium diet with vitamin D supplementation. Vitamin D deficiency is common, associated with perinatal morbidity and easily corrected.
MeSH term(s)	Calcitriol/administration & dosage ; Calcium, Dietary/administration & dosage ; Female ; Humans ; Hyperparathyroidism/diagnosis ; Hyperparathyroidism/therapy ; Hypocalcemia/etiology ; Hypoparathyroidism/diagnosis ; Hypoparathyroidism/therapy ; Infant, Newborn ; Infant, Newborn, Diseases/etiology ; Pregnancy ; Pregnancy Complications/diagnosis ; Pregnancy Complications/etiology ; Pregnancy Complications/therapy ; Vitamin D/administration & dosage ; Vitamin D Deficiency/complications ; Vitamin D Deficiency/drug therapy ; Vitamin D Deficiency/etiology ; Vitamins/administration & dosage
Chemical Substances	Calcium, Dietary ; Vitamins ; Vitamin D (1406-16-2) ; Calcitriol (FXC9231JVH)
Language	English
Publishing date	2019-03-28
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	391207-3
ISSN	1532-5520 ; 0009-9201
ISSN (online)	1532-5520
ISSN	0009-9201
DOI	10.1097/GRF.0000000000000447
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Article ; Online: Foreword: Thyroid Dysfunction in Pregnancy.

Sullivan, Scott A

Clinical obstetrics and gynecology

2019 Volume 62, Issue 2, Page(s) 300–301

MeSH term(s)	Female ; Humans ; Patient Care Team ; Pregnancy ; Pregnancy Complications/diagnosis ; Thyroid Diseases/diagnosis ; Thyroid Function Tests
Language	English
Publishing date	2019-03-19
Publishing country	United States
Document type	Introductory Journal Article
ZDB-ID	391207-3
ISSN	1532-5520 ; 0009-9201
ISSN (online)	1532-5520
ISSN	0009-9201
DOI	10.1097/GRF.0000000000000440
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Article: Update on sex specific risk factors in cardiovascular disease.

Nguyen, Andrew H / Hurwitz, Madelyn / Sullivan, Scott A / Saad, Antonio / Kennedy, Jamie L W / Sharma, Garima

Frontiers in cardiovascular medicine

2024 Volume 11, Page(s) 1352675

Abstract: Cardiovascular disease (CVD) is the leading cause of death worldwide and accounts for roughly 1 in 5 deaths in the United States. Women in particular face significant disparities in their cardiovascular care when compared to men, both in the diagnosis ... ...

Abstract	Cardiovascular disease (CVD) is the leading cause of death worldwide and accounts for roughly 1 in 5 deaths in the United States. Women in particular face significant disparities in their cardiovascular care when compared to men, both in the diagnosis and treatment of CVD. Sex differences exist in the prevalence and effect of cardiovascular risk factors. For example, women with history of traditional cardiovascular risk factors including hypertension, tobacco use, and diabetes carry a higher risk of major cardiovascular events and mortality when compared to men. These discrepancies in terms of the relative risk of CVD when traditional risk factors are present appear to explain some, but not all, of the observed differences among men and women. Sex-specific cardiovascular disease research-from identification, risk stratification, and treatment-has received increasing recognition in recent years, highlighting the current underestimated association between CVD and a woman's obstetric and reproductive history. In this comprehensive review, sex-specific risk factors unique to women including adverse pregnancy outcomes (APO), such as hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus, preterm delivery, and newborn size for gestational age, as well as premature menarche, menopause and vasomotor symptoms, polycystic ovarian syndrome (PCOS), and infertility will be discussed in full detail and their association with CVD risk. Additional entities including spontaneous coronary artery dissection (SCAD), coronary microvascular disease (CMD), systemic autoimmune disorders, and mental and behavioral health will also be discussed in terms of their prevalence among women and their association with CVD. In this comprehensive review, we will also provide clinicians with a guide to address current knowledge gaps including implementation of a sex-specific patient questionnaire to allow for appropriate risk assessment, stratification, and prevention of CVD in women.
Language	English
Publishing date	2024-02-06
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2781496-8
ISSN	2297-055X
ISSN	2297-055X
DOI	10.3389/fcvm.2024.1352675
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Article: Novel Telehealth Adaptations for Evidence-Based Outpatient Suicide Treatment: Feasibility and Effectiveness of the Crisis Care Program.

O'Neill, J Conor / O'Callaghan, Erin T / Sullivan, Scott / Winsberg, Mirène

Healthcare (Basel, Switzerland)

2023 Volume 11, Issue 24

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2023-12-13
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2721009-1
ISSN	2227-9032
ISSN	2227-9032
DOI	10.3390/healthcare11243158
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Article ; Online: Cannabidiol and hemp oils: Potential applications in oral and maxillofacial surgery.

Sullivan, Scott R / Hammad, Yousef / Neal, Timothy W / Schlieve, Thomas

Journal of the American Dental Association (1939)

2022 Volume 153, Issue 12, Page(s) 1111–1113

MeSH term(s)	Humans ; Cannabidiol/therapeutic use ; Cannabis ; Plant Oils ; Surgery, Oral
Chemical Substances	Cannabidiol (19GBJ60SN5) ; hempseed oil (69VJ1LPN1S) ; Plant Oils
Language	English
Publishing date	2022-09-26
Publishing country	England
Document type	Editorial
ZDB-ID	220622-5
ISSN	1943-4723 ; 0002-8177 ; 1048-6364
ISSN (online)	1943-4723
ISSN	0002-8177 ; 1048-6364
DOI	10.1016/j.adaj.2022.08.009
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Article ; Online: Ischemic heart disease in pregnancy: a practical approach to management.

Nguyen, Andrew H / Murrin, Ellen / Moyo, Axucillia / Sharma, Garima / Sullivan, Scott A / Maxwell, George L / Kennedy, Jamie L W / Saad, Antonio F

American journal of obstetrics & gynecology MFM

2024 Volume 6, Issue 3, Page(s) 101295

Abstract: Ischemic heart disease is a crucial issue during pregnancy. The term is composed of both preexisting conditions and acute coronary syndrome in pregnancy, including pregnancy-associated myocardial infarction, which can have a significant effect on ... ...

Abstract	Ischemic heart disease is a crucial issue during pregnancy. The term is composed of both preexisting conditions and acute coronary syndrome in pregnancy, including pregnancy-associated myocardial infarction, which can have a significant effect on maternal and fetal outcomes. This review provides a complete guide to managing ischemic heart disease in pregnant women, emphasizing the importance of multidisciplinary care and individualized treatment strategies. Cardiovascular disease, particularly ischemic heart disease, is now the leading cause of maternal mortality worldwide. Pregnancy introduces unique physiological changes that increase the risk of acute myocardial infarction, with pregnancy-associated myocardial infarction cases often associated with factors, such as advanced maternal age, chronic hypertension, and preexisting cardiovascular conditions. This review distinguishes between preexisting ischemic heart disease and pregnancy-associated myocardial infarction. It will emphasize the various etiologies of pregnancy-associated myocardial infarction, including coronary atherosclerosis and plaque rupture presenting as ST-elevation myocardial infarction, non-ST-elevation myocardial infarction, and other nonatherosclerotic causes, including spontaneous coronary artery dissection, vasospasm, and embolism. Our study discusses the practical management of ischemic heart disease in pregnancy, with a focus on preconception counseling, risk assessment, and tailored antenatal planning for women with preexisting ischemic heart disease. Moreover, this document focuses on the challenges of diagnosing cardiovascular disease, especially when presented with nonclassical risk factors and presentation. It provides insight into the appropriate diagnostic testing methods, such as electrocardiogram, cardiac biomarkers, and echocardiography. In addition, the review covers various treatment strategies, from medical management to more invasive procedures, including coronary angiography, percutaneous coronary intervention, and coronary artery bypass graft. Special attention is given to medication safety during pregnancy, including anticoagulation, beta-blockers, and antiplatelet agents. The complexities of delivery planning in women with ischemic heart disease are discussed, advocating for a multidisciplinary team-based approach and careful consideration of the timing and mode of delivery. Furthermore, the roles of breastfeeding and postpartum care are explored, emphasizing the long-term benefits and the suitability of various medications during lactation. Lastly, this review provides crucial insights into the management of ischemic heart disease in pregnancy, stressing the need for heightened awareness, prompt diagnosis, and tailored management to optimize maternal and fetal health outcomes.
MeSH term(s)	Female ; Humans ; Pregnancy ; Myocardial Ischemia/diagnosis ; Myocardial Ischemia/epidemiology ; Myocardial Ischemia/etiology ; Myocardial Infarction/diagnosis ; Myocardial Infarction/therapy ; Risk Factors ; Vascular Diseases ; Risk Assessment
Language	English
Publishing date	2024-01-25
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2589-9333
ISSN (online)	2589-9333
DOI	10.1016/j.ajogmf.2024.101295
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Article ; Online: Feasibility and acceptability of a novel telepsychiatry-delivered precision prescribing intervention for anxiety and depression.

O'Callaghan, Erin / Sullivan, Scott / Gupta, Carina / Belanger, Heather G / Winsberg, Mirène

BMC psychiatry

2022 Volume 22, Issue 1, Page(s) 483

Abstract: Background: Major Depressive Disorder and Generalized Anxiety Disorder are pervasive and debilitating conditions, though treatment is often inaccessible and based on trial-and-error prescribing methods. The present observational study seeks to describe ... ...

Abstract	Background: Major Depressive Disorder and Generalized Anxiety Disorder are pervasive and debilitating conditions, though treatment is often inaccessible and based on trial-and-error prescribing methods. The present observational study seeks to describe the use of a proprietary precision prescribing algorithm piloted during routine clinical practice as part of Brightside's telepsychiatry services. The primary aim is to determine the feasibility and acceptability of implementing this intervention. Secondary aims include exploring remission and symptom improvement rates. Methods: Participants were adult patients enrolled in Brightside who completed at least 12 weeks of treatment for depression and/or anxiety and received a prescription for at least one psychiatric medication. A prescription recommendation was made by Brightside's algorithm at treatment onset and was utilized for clinical decision support. Participants received baseline screening surveys of the PHQ-9 and GAD-7, and at weeks 2,4,6,8,10 and 12. Intent-to-treat (ITT) sensitivity analyses were conducted. Feasibility of the implementation was measured by the platform's ability to enroll and engage participants in timely psychiatric care, as well as offer high touch-point treatment options. Acceptability was measured by patient responses to a 5-star satisfaction rating. Results: Brightside accessed and treated 6248 patients from October 2018 to April 2021, treating a majority of patients within 4-days of enrollment. The average plan cost was $115/month. 89% of participants utilized Brightside's core medication plan at a cost of $95/month. 13.4% of patients in the study rated Brightside's services as highly satisfactory, averaging a 4.6-star rating. Furthermore, 90% of 6248 patients experienced a MCID in PHQ-9 or GAD-7 score. Remission rates were 75% (final PHQ-9 or GAD-7 score < 10) for the study sample and 59% for the ITT sample. 69.3% of Brightside patients were treated with the medication initially prescribed at intake. Conclusions: Results suggest that the present intervention may be feasible and acceptable within the assessed population. Exploratory analyses suggest that Brightside's course of treatment, guided by precision recommendations, improved patients' symptoms of anxiety and depression.
MeSH term(s)	Adult ; Anxiety/therapy ; Anxiety Disorders/drug therapy ; Depression/therapy ; Depressive Disorder, Major/diagnosis ; Depressive Disorder, Major/drug therapy ; Feasibility Studies ; Humans ; Psychiatry ; Telemedicine/methods
Language	English
Publishing date	2022-07-19
Publishing country	England
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2050438-X
ISSN	1471-244X ; 1471-244X
ISSN (online)	1471-244X
ISSN	1471-244X
DOI	10.1186/s12888-022-04113-9
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Article ; Online: Sex-specific and sex-independent steroid-related biomarkers in early second trimester maternal serum associated with autism.

Bilder, Deborah A / Worsham, Whitney / Sullivan, Scott / Esplin, M Sean / Burghardt, Paul / Fraser, Alison / Bakian, Amanda V

Molecular autism

2023 Volume 14, Issue 1, Page(s) 30

Abstract: Background: Prenatal exposure to maternal metabolic conditions associated with inflammation and steroid dysregulation has previously been linked to increased autism risk. Steroid-related maternal serum biomarkers have also provided insight into the in ... ...

Abstract	Background: Prenatal exposure to maternal metabolic conditions associated with inflammation and steroid dysregulation has previously been linked to increased autism risk. Steroid-related maternal serum biomarkers have also provided insight into the in utero steroid environment for offspring who develop autism. Objective: This study examines the link between autism among offspring and early second trimester maternal steroid-related serum biomarkers from pregnancies enriched for prenatal metabolic syndrome (PNMS) exposure. Study design: Early second trimester maternal steroid-related serum biomarkers (i.e., estradiol, free testosterone, total testosterone, and sex hormone binding globulin) were compared between pregnancies corresponding to offspring with (N = 68) and without (N = 68) autism. Multiple logistic regression analyses were stratified by sex and gestational duration. One-way ANCOVA with post hoc tests was performed for groups defined by autism status and PNMS exposure. Results: Increased estradiol was significantly associated with autism only in males (AOR = 1.13 per 100 pg/ml, 95% CI 1.01-1.27, p = 0.036) and only term pregnancies (AOR = 1.17 per 100 pg/ml, 95% CI 1.04-1.32, p = 0.010). Autism status was significantly associated with decreased sex hormone binding globulin (AOR = 0.65 per 50 nmol/L, 95% CI 0.55-0.78, p < 0.001) overall and when stratified by sex and term pregnancy status. The inverse association between sex hormone binding globulin and autism was independent of PNMS exposure. Limitations: The relative racial and ethnic homogeneity of Utah's population limits the generalizability of study results. Although significant differences by autism status were identified in concentrations of sex hormone binding globulin overall and of estradiol in participant subgroups, differences by PNMS exposure failed to reach statistical significance, which may reflect insufficient statistical power. Conclusion: Both elevated maternal serum estradiol in males only and low maternal serum sex hormone binding globulin in both sexes are associated with increased autism risk. Further investigation is merited to identify how steroid, metabolic, and inflammatory processes can interact to influence neurodevelopment in early second trimester.
MeSH term(s)	Male ; Female ; Pregnancy ; Humans ; Pregnancy Trimester, Second ; Sex Hormone-Binding Globulin/analysis ; Sex Hormone-Binding Globulin/metabolism ; Autistic Disorder ; Estradiol ; Testosterone ; Biomarkers
Chemical Substances	Sex Hormone-Binding Globulin ; Estradiol (4TI98Z838E) ; Testosterone (3XMK78S47O) ; Biomarkers
Language	English
Publishing date	2023-08-12
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2540930-X
ISSN	2040-2392 ; 2040-2392
ISSN (online)	2040-2392
ISSN	2040-2392
DOI	10.1186/s13229-023-00562-5
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