Peripartum issues in the inflammatory arthritis patient: A survey of the RAPPORT registry.

Childbearing women with rheumatoid (RA) and psoriatic arthritis (PsA) have significant peripartum issues. A retrospective anonymous RedCAP survey of peripartum period in females with RA/PsA in the RAPPORT registry was performed. Completed analyses included descriptive statistics, Chi-square and Fisher's exact test. 162 patients (133 RA/29 PsA) completed the survey (103 women having 234 pregnancies), 164 pregnancies occurring before and 70 pregnancies occurring after diagnosis. Pregnancy outcomes from 103 patients included: 96% live births, 1.9% stillbirths, 23% miscarriages, and 15% therapeutic abortions. A third of patients had fewer children than desired due to disease activity, medications and other reasons. For 63 pregnancies after diagnosis: (1) 49% of pregnancies received pre-conception counseling; (2) 65% described good disease control during pregnancy but 74% flared in the first 3 months postpartum; (3) 79% of pregnancies discontinued IA medications; (4) 35% of pregnancies occurred on biologic therapy at or prior to conception. Gestational age at time of delivery was 37-40 weeks in 58% (33/57) post-arthritis vs 66% (83/126) pre-arthritis pregnancies. No statistically significant differences occurred between pregnancies before or after RA/PsA diagnosis for: pregnancy planning, fertility treatment, pregnancy and labour/delivery complications, birth defect frequency or neonatal complications. Neonatal ICU admissions were significantly lower in pre- compared to post-arthritis pregnancies (3.2% vs 14.5%). No pregnancy complications were noted in 24/54 pregnancies on medications compared to 6/9 pregnancies not on medications. The impact of RA/PsA before, during and after pregnancy varied considerably in this cohort emphasizing the importance of informed-decision making at all stages.

Experimental Study of a TET System for Implantable Biomedical Devices.

Time-varying magnetic fields can be used to transfer power across the skin to drive implantable biomedical devices without the use of percutaneous wires. However, the main challenges of a transcutanoues energy transfer (TET) system are the temperature rise caused by power loss in the implanted circuitry and the changes in positioning between the external and internal coils due to fitting and changes in posture. This study presents a TET system with a closed-loop frequency-based power regulation method to deliver the right amount of power to the load under variable coil coupling conditions. After implanting a TET system into adult sheep, the temperature rise in the internal and external coils of a TET system was measured for power delivery in the range of 5 W to 15 W. The sheep was housed in a temperature controlled (16 plusmn1degC, humidity 50plusmn10%) room, in accordance with the standard protocols implemented at the University of Auckland for sheep studies. A power-loss analysis for the overall system was performed. The system was capable of regulating power for axially aligned separations of up to 16 mm. The maximum power efficiency of the overall system was 82.1% and a maximum temperature rise of 2.7degC was observed on the implanted secondary coil.