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Freiman A, Rekab A, Bergner AL, Pereira EM, Lin Y, Ahimaz P. Exploring the evolving roles of clinical geneticists and genetic counselors in the era of genomic medicine. Am J Med Genet A 2024; 194:e63502. [PMID: 38102777 DOI: 10.1002/ajmg.a.63502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 11/28/2023] [Accepted: 11/30/2023] [Indexed: 12/17/2023]
Abstract
The increased utilization of clinical genomic sequencing in the past decade has ushered in the era of genomic medicine, requiring genetics providers to acquire new skills and adapt their practices. The change in workplace responsibilities of clinical/medical geneticists (CMGs) and genetic counselors (GCs) in North America, due to the evolution of genetic testing, has not been studied. We surveyed CMGs (n = 80) and GCs (n = 127) with experience in general/pediatric genetics to describe their current practice of clinical tasks and the change in regularity of performing these tasks over the past 5-10 years. Currently, complementarity of responsibilities between CMGs and GCs clearly exists but providers who have been in the field for longer have noted role changes. Trends indicate that fewer experienced CMGs perform physical exams and select genetic tests than before and fewer experienced GCs complete requisitions and write result letters. The frequency of CMGs and GCs who investigate genetic test results, however, has increased. This study provides insight into the changing landscape of clinical genetics practice. Our findings suggest that the roles and responsibilities of CMGs and GCs have shifted in the past decade.
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Affiliation(s)
- Andrew Freiman
- Genetic Counseling Graduate Program, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
- Rare Disease Institute, Children's National Hospital, Washington, DC, USA
| | - Aisha Rekab
- Genetic Counseling Graduate Program, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
- Department of Pediatrics, Division of Clinical Genetics, Columbia University, New York, New York, USA
| | - Amanda L Bergner
- Genetic Counseling Graduate Program, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
- Department of Genetics and Development, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Elaine M Pereira
- Department of Pediatrics, Division of Clinical Genetics, Columbia University, Vagelos College of Physicians and Surgeons and New York Presbyterian, New York, New York, USA
| | - Yuhuan Lin
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Priyanka Ahimaz
- Genetic Counseling Graduate Program, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
- Department of Pediatrics, Division of Clinical Genetics, Columbia University, New York, New York, USA
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Zhu Y, Xu L, Beejadhursing R, Chen S. External fetus in fetu presenting in the second trimester: A case report and literature review. Clin Case Rep 2023; 11:e8057. [PMID: 38028032 PMCID: PMC10675099 DOI: 10.1002/ccr3.8057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/28/2023] [Accepted: 10/03/2023] [Indexed: 12/01/2023] Open
Abstract
Fetus in fetu (FIF) is a rare congenital anomaly that originates from various sites of the host twin's body. The clinical manifestations of FIF are diverse and the location and size of FIF indicate the degree of threat, which may directly affect the prognosis. A 33-year-old woman presented at the hospital with an abdominal mass in her fetus. Prenatal ultrasound observed that mass included soft tissue, bone-like structures, and fluid. Immature cartilage, nerve tissue, muscle tissue, and glands in the parasitic fetus without signs of neoplastic lesions were reported by histological examination. CNV (copy number variation) and WES (whole exome sequencing) did not detect any abnormal mutations. FIF can continue to grow with gestational age or host infant growth. So complete resection is essential for improving the outcome of the host twin. It is also important that long-term follow-up is recommended to monitor any residual or recurrent cysts or malignancies.
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Affiliation(s)
- Ying Zhu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Le Xu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Rajluxmee Beejadhursing
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Suhua Chen
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
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Bian W, Yuan J, Yao Y. Hemorrhage and necrosis of the liver caused by hepatic arteriovenous malformations in a fetus: A case report. Medicine (Baltimore) 2023; 102:e33380. [PMID: 36961151 PMCID: PMC10036009 DOI: 10.1097/md.0000000000033380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 03/08/2023] [Indexed: 03/25/2023] Open
Abstract
RATIONALE Hepatic arteriovenous malformations (HAVMs) are a rare disorder reported in association with hereditary hemorrhagic telangiectasia (HHT), known as Rendu-Osler-Weber syndrome. HAVMs are usually detected in adulthood. PATIENT CONCERNS A 29-year-old pregnant woman underwent a routine prenatal examination at 37 weeks of pregnancy. DIAGNOSIS AND INTERVENTIONS There were fetal liver anomalies detected by prenatal ultrasonography and were managed. Furthermore, a hepatic mass was detected and was subsequently analyzed by fetal magnetic resonance imaging. There were no typical imaging findings in this case which was once misdiagnosed as a hepatoblastoma. OUTCOMES Considering the massive hepatic lesion, labor induction was performed on a pregnant woman to avoid adverse maternal and fetal outcomes. Histopathological examination confirmed the diagnosis of HAVMs. Lesions detected by imaging were determined to be hemorrhagic and necrotic. LESSONS Prenatal hepatic hemorrhage and necrosis due to an arteriovenous malformation are rare. The authors describe their observations and results.
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Affiliation(s)
- Wei Bian
- Department of Radiology, Jiaxing Maternity and Child Health Care Hospital, Jiaxing, China
| | - Jun Yuan
- Department of Pathology, Jiaxing Maternity and Child Health Care Hospital, Jiaxing, China
| | - Yuan Yao
- Department of Radiology, Jiaxing Maternity and Child Health Care Hospital, Jiaxing, China
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