Preconception Counseling and Care.

Primary care for women and other patients with similar reproductive potential can include a discussion about pregnancy and, depending on the patient's intent, contraceptive care or preconception care. Folic acid supplementation of at least 400 mcg per day is recommended to reduce the risk of neural tube defects, because many pregnancies are unplanned. Having a body mass index of 18.5 to 24.9 kg per m2 before pregnancy also reduces complications. Patients with a history of bariatric surgery should delay pregnancy for at least 12 months post-procedure and ensure that their nutritional status is adequate before conception. It is essential to review the patient's medications and chronic medical conditions to avoid teratogens and optimize treatment before conception to reduce maternal and fetal morbidity and mortality. Having a prepregnancy A1C level of less than 6.5% is strongly recommended for patients with diabetes mellitus to minimize congenital anomalies and complications. Vaccinations should be updated to prevent adverse outcomes related to infections. Infectious disease screenings should be updated before conception to allow for treatment, prophylaxis, or timing of pregnancy to avoid complications. Screening and counseling should be provided for substance use and potential environmental exposures to identify and mitigate detrimental exposures before pregnancy.

Ulcerative Colitis: Rapid Evidence Review.

Ulcerative colitis is a relapsing and remitting inflammatory bowel disease of the large intestine. Risk factors include recent Salmonella or Campylobacter infection and a family history of ulcerative colitis. Diagnosis is suspected based on symptoms of urgency, tenesmus, and hematochezia and is confirmed with endoscopic findings of continuous inflammation from the rectum to more proximal colon, depending on the extent of disease. Fecal calprotectin may be used to assess disease activity and relapse. Medications available to treat the inflammation include 5-aminosalicylic acid, corticosteroids, tumor necrosis factor-alpha antibodies, anti-integrin antibodies, anti-interleukin-12 and -23 antibodies, and Janus kinase inhibitors. Choice of medication and method of delivery depend on the location and severity of mucosal inflammation. Other treatments such as fecal microbiota transplantation are considered experimental, and complementary therapies such as probiotics and curcumin have mixed data. Surgical treatment may be needed for fulminant or refractory disease. Increased risk of colorectal cancer and use of immunosuppressive therapies affect the preventive care needs for these patients.

Nucleic acid separations using superficially porous silica particles.

Ion pair reverse-phase liquid chromatography has been widely employed for nucleic acid separations. A wide range of alternative stationary phases have been utilised in conjunction with ion pair reverse-phase chromatography, including totally porous particles, non-porous particles, macroporous particles and monolithic stationary phases. In this study we have utilised superficially porous silica particles in conjunction with ion pair reverse-phase liquid chromatography for the analysis of nucleic acids. We have investigated a range of different pore-sizes and phases for the analysis of a diverse range of nucleic acids including oligonucleotides, oligoribonucleotides, phosphorothioate oligonucleotides and high molecular weight dsDNA and RNA. The pore size of the superficially porous silica particles was shown to significantly affect the resolution of the nucleic acids. Optimum separations of small oligonucleotides such as those generated in RNase mapping experiments were obtained with 80Å pore sizes and can readily be interfaced with mass spectrometry analysis. Improved resolution of larger oligonucleotides (>19mers) was observed with pore sizes of 150Å. The optimum resolution for larger dsDNA/RNA molecules was achieved using superficially porous silica particles with pore sizes of 400Å. Furthermore, we have utilised 150Å pore size solid-core particles to separate typical impurities of a fully phosphorothioated oligonucleotide, which are often generated in the synthesis of this important class of therapeutic oligonucleotide.