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Operative delivery

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https://www.readbyqxmd.com/read/29156020/doubly-committed-ventricular-septal-defect-closure-using-eccentric-occluder-via-ultraminimal-incision
#1
Jin Yu, Lianglong Ma, Jingjing Ye, Zewei Zhang, Jianhua Li, Jiangen Yu, Guoping Jiang
OBJECTIVES: This study aimed to investigate the safety, feasibility and availability of doubly committed ventricular septal defect (DCVSD) closure via an ultraminimal intercostal incision under the guidance of transoesophageal echocardiography in children. METHODS: From August 2014 to August 2016, 35 children with DCVSDs (≤5 mm in diameter) were enrolled in this study. A left parasternal ultraminimal intercostal incision (≤1 cm) and a pericardium hanging technique were employed without sternal incision...
October 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29155194/a-case-of-prenatally-diagnosed-wilms-tumor-managed-with-laparoscopic-nephrectomy
#2
Amir Toussi, Candace F Granberg, Patricio C Gargollo
We present a case of prenatally diagnosed Wilms' tumor, subsequent operative approach and management. The patient was referred to our institution with an abnormal prenatal renal ultrasound. CT scan after delivery showed a multifocal enhancing left renal mass. She underwent an uncomplicated left laparoscopic radical nephrectomy and retroperitoneal lymph node sampling using a novel hidden incision endoscopic surgery (HIdES) technique. Final pathology revealed favorable histology Stage II Wilms' Tumor. She received adjuvant chemotherapy with Vincristine and Dactinomycin based on the EE4A regimen...
November 16, 2017: Urology
https://www.readbyqxmd.com/read/29152588/the-delivery-science-rapid-analysis-program-a-research-and-operational-partnership-at-kaiser-permanente-northern-california
#3
Julie A Schmittdiel, Rick Dlott, Joseph D Young, Michael B Rothmann, Wendy Dyer, Alyce S Adams
Introduction: Health care researchers and delivery system leaders share a common mission to improve health care quality and outcomes. However, differing timelines, incentives, and priorities are often a barrier to research and operational partnerships. In addition, few funding mechanisms exist to generate and solicit analytic questions that are of interest to both research and to operations within health care settings, and provide rapid results that can be used to improve practice and outcomes...
October 2017: Learn Health Syst
https://www.readbyqxmd.com/read/29152442/combination-intensity-modulated-proton-therapy-and-passive-scatter-boost-for-rapidly-progressing-nasal-cavity-squamous-cell-carcinoma
#4
Sweet Ping Ng, Ethan B Ludmir, Manuel A Oyervides, Richard Y Wu, Steve Frank, G Brandon Gunn
Cancers of the nasal cavity and septum are associated with poor prognosis and are usually treated with surgery followed by post-operative radiotherapy with or without concurrent chemotherapy. Definitive radiotherapy is used in cases where the tumor is unresectable, patient is unfit for surgery, and/or the patient declines surgical intervention. Here, we present a case of a patient, who for non-medical reasons, opted to have non-surgical management of his rapidly progressing nasal cavity tumor. He was successfully treated with concurrent chemoradiotherapy utilizing a combination of intensity modulated proton therapy (IMPT) with passive scatter boost to reduce dose to the adjacent critical neural structures...
September 14, 2017: Curēus
https://www.readbyqxmd.com/read/29151298/impact-of-body-mass-index-waist-circumference-and-pfannenstiel-sitetissue-thickness-and-elastosonography-on-operative-parameters
#5
Serap Gültekin, İsmail Burak Gültekin, Zehra Yılmaz, Bilal İçer, Afra Alkan, Tuncay Küçüközkan
Background/aim: This study aimed to evaluate the impact of body fat distribution measured by body mass index (BMI), waist circumference (WC) and Pfannenstiel incision site tissue thickness, and elastosonography on bleeding and operation time during cesarean delivery.Materials and methods: A prospective study was made of 52 healthy, term pregnant women with prior cesarean deliveries. The impact of BMI, WC, incision site thickness, and elastosonography on preoperative and postoperative differences in hemoglobin (Hb) and hematocrit (Htc) levels and operation times was evaluated...
November 13, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29149877/key-bottlenecks-to-the-provision-of-safe-obstetric-anaesthesia-in-low-income-countries-a-cross-sectional-survey-of-64-hospitals-in-uganda
#6
Isabella Epiu, Agnes Wabule, Andrew Kambugu, Harriet Mayanja-Kizza, Jossy Verel Bahe Tindimwebwa, Gerald Dubowitz
BACKGROUND: Despite recent advances in surgery and anaesthesia which significantly improve safety, many health facilities in low-and middle-income countries (LMICs) remain chronically under-resourced with inability to cope effectively with serious obstetric complications (Knight et al., PLoS One 8:e63846, 2013). As a result many of these countries still have unacceptably high maternal and neonatal mortality rates. Recent data at the national referral hospitals in East Africa reported that none of the national referral hospitals met the World Federation of Societies of Anesthesiologists (WFSA) international standards required to provide safe obstetric anaesthesia (Epiu I: Challenges of Anesthesia in Low-and Middle-Income Countries...
November 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29149500/ep-radiofrequency-generators-significant-offsets-between-selected-and-delivered-power
#7
Felix Bourier, Bernhard Schwarz, Amir Brkic, Lara Wolf, Verena Semmler, Marc Kottmaier, Elena Risse, Marta Telishevska, Stephanie Brooks, Sarah Lengauer, Marielouise Kornmayer, Katharina Koch-Büttner, Florian Berger, Gabriele Hessling, Isabel Deisenhofer, Tilko Reents
INTRODUCTION: For radiofrequency ablation, the EP Shuttle®, Ampere®, and SmartAblate® generator models are most frequently used in clinical practice. The aim of this study was to assess the correlation between selected and delivered RF power for different generators. METHODS AND RESULTS: In an experimental setup, ablation catheters were connected to the EP Shuttle®, Ampere®, and SmartAblate® generators. The power delivered by the generators was measured using a current converter and an oscilloscope...
November 17, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29148248/recurrent-coarctation-of-aorta-after-norwood-operation-in-single-ventricle-patients-the-case-of-the-missing-ideal-stent
#8
EDITORIAL
Dhaval R Parekh, Zvonimir Krajcer
Recurrent coarctation postoperative Norwood is poorly tolerated in single ventricle patients. Although transcatheter balloon angioplasty is considered first line, it often leads to inadequate or non-durable relief of obstruction. Transcatheter stent implantation provides excellent relief of obstruction but necessitates staged redilation to account for somatic growth in children. Stent technology, delivery systems, and procedural techniques will need to evolve to obviate reported adverse events mainly due to patient size...
November 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29148172/quality-of-handwritten-surgical-operative-notes-from-surgical-trainees-a-noteworthy-issue
#9
Tatenda C Nzenza, Todd Manning, Simeon Ngweso, Marlon Perera, Shomik Sengupta, Damien Bolton, Nathan Lawrentschuk
BACKGROUND: Surgical operation notes are crucial for medical record keeping and information flow in continued patient care. In addition to inherent medical implications, the quality of operative notes also has important economic and medico-legal ramifications. Further, well-documented records can also be useful for audit purposes and propagation of research, facilitating the improvement of delivery of care to patients. We aimed to assess the quality of surgical operation notes written by junior doctors and trainees against a set standard, to ascertain whether these standards were met...
November 17, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29148033/4218t-c-polymorphism-associations-with-post-cesarean-patient-controlled-epidural-fentanyl-consumption-and-pain-perception
#10
W Xie, W Zhuang, L Chen, W Xie, C Jiang, N Liu
BACKGROUND: The utilization of intrathecal opioids is an efficacious component of post-cesarean section pain management. Given that growing evidence indicates that calcitonin gene-related peptide (CGRP) plays a key role in the development of peripheral sensitization and is associated with enhanced pain, we hypothesized that CGRP 4218T/C polymorphism is associated with the variability in fentanyl consumption for post-cesarean analgesia. METHODS: We recruited 548 patients who presented for elective cesarean delivery, and used polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method to analyze CGRP 4218T/C polymorphism...
November 17, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29147871/an-optimized-and-feasible-preparation-technique-for-the-industrial-production-of-hydrogel-patches
#11
Wei-Ze Li, Wen-Xia Han, Xu-Liang Hao, Ning Zhao, Xi-Feng Zhai, Li-Bin Yang, Shu-Miao He, Yu-Chuan Cheng, Han Zhang, Li-Na Fu, Yan Zhang, Ze Liang
For hydrogel patches, the laboratory tests could not fully reveal the existing problems of full scale of industrial production, and there are few studies about the preparation technique for the industrial manufacturing process of hydrogel patches. So, the purpose of this work was to elucidate the effects of mainly technological operation and its parameters on the performance of hydrogel patches at the industrial-scale production. The results revealed the following: (1) the aqueous phase was obtained by polyvinylpyrrolidone (PVP) along with tartaric acid dissolved in purified water, then feeding this into a vacuum mixer as a whole in one batch, thus extended the crosslinking reaction time of hydrogel paste (matrix) and allowed the operation of coating/cutting-off to be carried out easily, and there was no permeation of backing layer; (2) the gel strength of the hydrogel patches increased with the increase of working temperature, however, once the temperature exceeded 35 ± 2 °C, the hydrogel paste would lose water severely and the resultant physical crosslinking structure which has lower gel/cohesive strength would easily bring gelatinization/residues during application; (3) the relative humidity (RH) of the standing-workshop was dynamically controlled (namely at 35 ± 2 °C, keeping the RH at 55 ± 5% for 4 days, then 65 ± 5% for 2 days), which would make patches with satisfactory characteristics such as better flexibility, higher adhesive force, smooth flat matrix surface, and without gelatinization/residues and warped edge during the using process; (4) the aging of the packaged hydrogel patches was very sensitive to storage temperature, higher temperature, higher gel strength and lower adhesiveness...
November 16, 2017: AAPS PharmSciTech
https://www.readbyqxmd.com/read/29147499/nano-microvehicles-for-efficient-delivery-and-bio-sensing-at-the-cellular-level
#12
S Campuzano, B Esteban-Fernández de Ávila, P Yáñez-Sedeño, J M Pingarrón, J Wang
A perspective review of recent strategies involving the use of nano/microvehicles to address the key challenges associated with delivery and (bio)sensing at the cellular level is presented. The main types and characteristics of the different nano/microvehicles used for these cellular applications are discussed, including fabrication pathways, propulsion (catalytic, magnetic, acoustic or biological) and navigation strategies, and relevant parameters affecting their propulsion performance and sensing and delivery capabilities...
October 1, 2017: Chemical Science
https://www.readbyqxmd.com/read/29144160/high-flow-nasal-cannula-oxygen-in-adults-an-evidence-based-assessment
#13
Matthew G Drake
High flow nasal cannula oxygenation has distinct advantages over other oxygen devices due to its unique effects on respiratory physiology. In particular, adjustable oxygen delivery and flow-dependent carbon dioxide clearance from the upper airway reduce work of breathing and can better match inspiratory demand during respiratory distress. Historically, few studies had evaluated whether the physiologic effects of these devices translated into clinical benefit. However, recent publications have begun to address this knowledge gap...
November 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29141473/development-of-a-nomogram-for-prediction-of-successful-membrane-sweeping
#14
Rani Haj Yahya, Yossef Ezra, Vincenzo Berghella, Shmuel Herzberg, Myriam Safrai, Adi Reuveni Salzman, Weissam Abu Ahmad, Doron Kabiri
OBJECTIVE: To evaluate the association of obstetric, maternal, and fetal variables with successful membrane sweeping and to develop a calculator that can predict spontaneous delivery within 24 hours of membrane sweeping. METHODS: This secondary analysis of the STRIP-G Study included all singleton term parturients who underwent membrane sweeping in a tertiary center in October 2011 - July 2013. Primary end point was a 24-hour time interval from sweeping to delivery...
November 15, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29137550/reengineering-electronic-fetal-monitoring-interpretation-using-the-fetal-reserve-index-to-anticipate-the-need-for-emergent-operative-delivery
#15
Robert D Eden, Mark I Evans, Shara M Evans, Barry S Schifrin
OBJECTIVE: The near-ubiquitous use of electronic fetal monitoring has failed to lower the rates of both cerebral palsy and emergency operative deliveries (EODs). Its performance metrics have low sensitivity, specificity, and predictive values for both. There are many EODs, but the vast majority have normal outcomes. The EODs, however, cause serious disruption in the delivery suite routine with increased complications, anxiety, and concern for all. METHODS: We developed the fetal reserve index (FRI) as multicomponent algorithm including 4 FHR components (analyzed individually), uterine activity, and maternal, obstetrical, and fetal risk factors to assess risk of cerebral palsy and EOD...
January 1, 2017: Reproductive Sciences
https://www.readbyqxmd.com/read/29137030/emergency-obstetric-hysterectomy-for-life-threatening-postpartum-hemorrhage-a-12-year-review
#16
Yulong Zhang, Jianying Yan, Qing Han, Tingting Yang, Lihong Cai, Yuelin Fu, Xiaolu Cai, Meimei Guo
The aim of the study was to review the operative experiences of emergency hysterectomy for life-threatening postpartum hemorrhage (PPH) performed over a 12-year period at Fujian Provincial Maternity and Children's Hospital; to examine the incidence and risk factors for emergency obstetric hysterectomy; and to evaluate the curative effectiveness and safety of subtotal hysterectomy for life-threatening PPH.The records of all cases of emergency obstetric hysterectomy performed at Fujian Maternity and Children Health Hospital between January 2004 and June 2016 were analyzed...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29136026/operative-technique-at-caesarean-delivery-and-risk-of-complete-uterine-rupture-in-a-subsequent-trial-of-labour-at-term-a-registry-case-control-study
#17
Dorthe L A Thisted, Laust H Mortensen, Lone Hvidman, Lone Krebs
OBJECTIVE: To estimate the relation of single-layer closure at previous caesarean delivery, and other pre-labour and intra-partum risk factors for complete uterine rupture in trial of vaginal birth after a caesarean (TOLAC) at term. STUDY DESIGN: Population-based case-control study. We identified all women (n = 39 742) recorded in the Danish Medical Birth Registry (DMBR) during a 12-year period (1997-2008) with a singleton pregnancy at term and TOLAC. Among these, all women with a complete uterine rupture were identified (cases)...
2017: PloS One
https://www.readbyqxmd.com/read/29133392/closed-loop-control-of-targeted-ultrasound-drug-delivery-across-the-blood-brain-tumor-barriers-in-a-rat-glioma-model
#18
Tao Sun, Yongzhi Zhang, Chanikarn Power, Phillip M Alexander, Jonathan T Sutton, Muna Aryal, Natalia Vykhodtseva, Eric L Miller, Nathan J McDannold
Cavitation-facilitated microbubble-mediated focused ultrasound therapy is a promising method of drug delivery across the blood-brain barrier (BBB) for treating many neurological disorders. Unlike ultrasound thermal therapies, during which magnetic resonance thermometry can serve as a reliable treatment control modality, real-time control of modulated BBB disruption with undetectable vascular damage remains a challenge. Here a closed-loop cavitation controlling paradigm that sustains stable cavitation while suppressing inertial cavitation behavior was designed and validated using a dual-transducer system operating at the clinically relevant ultrasound frequency of 274...
November 13, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/29131860/does-proximity-of-women-to-facilities-with-better-choice-of-contraceptives-affect-their-contraceptive-utilization-in-rural-ethiopia
#19
Solomon Shiferaw, Mark Spigt, Assefa Seme, Ayanaw Amogne, Stein Skrøvseth, Selamawit Desta, Scott Radloff, Amy Tsui, Dinant GeertJan
BACKGROUND: There is limited evidence of the linkage between contraceptive use, the range of methods available and level of contraceptive stocks at health facilities and distance to facility in developing countries. The present analysis aims at examining the influence of contraceptive method availability and distance to the nearby facilities on modern contraceptive utilization among married women in rural areas in Ethiopia using geo-referenced data. METHODS: We used data from the first round of surveys of the Performance Monitoring & Accountability 2020 project in Ethiopia (PMA2020/Ethiopia-2014)...
2017: PloS One
https://www.readbyqxmd.com/read/29130772/assessment-of-left-ventricular-function-using-the-myocardial-performance-index-in-term-fetuses-that-develop-intrapartum-compromise
#20
Amal A Alsolai, Larissa N Bligh, Ristan M Greer, Alexander Gooi, Sailesh Kumar
OBJECTIVE: To investigate the relationship between the prelabour left ventricular myocardial Performance Index (LVMPI) and intrapartum fetal compromise (IFC) in low risk term pregnancies. METHODS: A blinded, prospective observational cohort study at the Mater Mother's Hospital, Brisbane, Australia. A cohort of 284 women with uncomplicated singleton pregnancies underwent fortnightly ultrasound from 36 weeks until delivery. The LVMPI was assessed by conventional Doppler ultrasound and correlated with intrapartum outcomes...
November 12, 2017: Journal of Maternal-fetal & Neonatal Medicine
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