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Gynecologic sepsis

Carolyn Weaver Swenson, Neil S Kamdar, Helen Levy, Darrell A Campbell, Daniel M Morgan
OBJECTIVES: The aim of this study was to investigate the relationship between primary insurance type and major complications after hysterectomy. METHODS: A retrospective analysis was performed on women with Medicaid, Medicare, and private insurance who underwent hysterectomy from January 1, 2012, to July 1, 2014, and were included in the Michigan Surgical Quality Collaborative. Major complications within 30 days of surgery included the following: deep/organ space surgical site infection, deep venous and pulmonary thromboembolism, myocardial infarction or stroke, pneumonia or sepsis, blood transfusion, readmission, and death...
September 26, 2016: Female Pelvic Medicine & Reconstructive Surgery
Haller J Smith, Daniel N Pasko, Christen L Walters Haygood, Jonathan D Boone, Lorie M Harper, J Michael Straughn
OBJECTIVE: In 2014, our hospital implemented an early warning score (EWS) to identify inpatients at risk for clinical deterioration. EWS≥8 is associated with ≥10% mortality in medical admissions. Since postoperative hemodynamic changes may alter EWS, we evaluated EWS in post-laparotomy patients. METHODS: Gynecologic oncology patients admitted for laparotomy from 9/1/2014 to 7/31/2015 were categorized by highest EWS during admission: <5, 5-7, and ≥8. The primary outcome was a composite including death, ICU transfer, rapid response team activation, pulmonary embolus, sepsis, and reoperation...
October 2016: Gynecologic Oncology
Sumer K Wallace, Melissa J Fazzari, Hui Chen, William A Cliby, Eva Chalas
OBJECTIVE: To compare complications and outcomes after hysterectomy for benign compared with malignant indications in the United States. METHODS: Women who underwent hysterectomy in the United States for either benign or malignant indications from January 2008 to December 2012 were retrospectively identified using the National Surgical Quality Improvement Program database. Patients were excluded if the procedure was not performed for primary gynecologic indications...
September 2016: Obstetrics and Gynecology
Idris Usman Takai, Abdulkadir Abubakar
BACKGROUND: Combined uterine and urinary bladder rupture following prolonged obstructed labor is indeed a momentous uro-obstetric emergency. The urinary bladder involvement is distinctly rare in the absence of factors that predispose the bladder to be adherent to the lower uterine segment and is quite unusual in a primigravida. OBJECTIVE: To report a rare case of uterine rupture involving urinary bladder secondary to a prolonged obstructed labor in a primigravida from a low resource setting...
2016: International Journal of Women's Health
Seyed Hassan Emami-Razavi, Atefeh Mohammadi, Abbas Alibakhshi, Mehdi Jalali, Mahsa Ghajarzadeh
Sepsis and septic shock are among mortality causes following major surgeries. The Charlson co-morbidity index consists of 19 weighted categories related to chronic health which measures the burden of co-morbidity. The goal of this study was to determine the incidence of postoperative sepsis in patients underwent gynecological and gastrointestinal cancer surgeries and predictive role of Charlson index for this situation. Two hundred and twenty-two patients who underwent gynecological and gastrointestinal cancer surgeries were evaluated...
May 2016: Acta Medica Iranica
Gerardo Rogelio Robaina Castellanos, Solangel de la Caridad Riesgo Rodríguez
INTRODUCTION: Neonatal sepsis has been associated with poor neurodevelopmental outcome in very low birth weight infants (VLBW infants). The impact of neonatal sepsis on neurodevelopment in very low birth weight infants discharged from Cuban neonatal intensive care units is unknown. OBJECTIVE: To determine the impact of neonatal sepsis as a risk factor of neurodevelopmental disorders in a Cuban very low birth weight infants’ population. METHODS: A cohort study was carried out that enrolled 89 infants with birth weight less than 1500 g who were admitted during the period 2006-2010 to the Teaching Provincial Gynecological and Obstetrical Hospital of Matanzas...
2016: Medwave
Mahmoud Hanafy Melis, Ahmed Mohammed Samy Elagwany
BACKGROUND/OBJECTIVE: Patients with advanced ovarian cancer should be treated by radical debulking surgery aiming at complete tumor resection. Unfortunately, approximately 70% of patients present with advanced disease, when optimal debulking cannot be obtained, and, therefore, these patients gain little benefit from surgery. Neoadjuvant chemotherapy (NAC) followed by interval debulking surgery has been proposed as a novel therapeutic approach in such cases. METHODS: A prospective randomized controlled study was conducted on 30 women selected from patients attending the gynecologic clinic of El-Shatby Maternity University Hospital, Alexandria, Egypt...
March 17, 2016: Hematology/oncology and Stem Cell Therapy
Gökhan Selçuk Ozbalci, Marlen Sulaimanov, Selçuk M Hazinedaroğlu, Attila Törüner
Postoperative adhesion formation is still an important cause of morbidity and mortality. Hydrophilic polyethylene glycol-based adhesion barrier (SprayGel™, Confluent Surgical, Inc., Waltham, MA) is reported to prevent adhesion formation after gynecologic surgery. This study aims to determine the effectiveness of SprayGel™ on adhesion formation after laparotomy in an experimental septic peritonitis model. Wistar albino male rats with weights of 250-350 g were used in this study. Forty rats were grouped into four groups: group I (control), laparotomy and sham operation; group II, laparotomy and cecal ligation puncture (CLP); group III (SprayGel™), laparotomy, sham operation, and SprayGel™; group IV (CLP + SprayGel™), laparotomy, CLP, and SprayGel™...
December 2015: Indian Journal of Surgery
Lisa M Landrum, William E Brady, Deborah K Armstrong, Kathleen N Moore, Paul A DiSilvestro, David M O'Malley, Meaghan E Tenney, Peter G Rose, Paula M Fracasso
OBJECTIVE: To determine the maximum tolerated dose (MTD) and dose-limiting toxicities (DLTs) of veliparib combined with PLD and carboplatin (CD) in patients with recurrent, platinum-sensitive epithelial ovarian cancer. To determine the tolerability at the MTD combined with bevacizumab. METHODS: Patients received PLD (30mg/m(2), IV) and carboplatin (AUC 5, IV) on day 1 with veliparib on days 1-7 (intermittent) or days 1-28 (continuous). Standard 3+3 design was used in the dose escalation phase with DLTs based on the first cycle...
February 2016: Gynecologic Oncology
Andreas du Bois, Gunnar Kristensen, Isabelle Ray-Coquard, Alexander Reuss, Sandro Pignata, Nicoletta Colombo, Ursula Denison, Ignace Vergote, Jose M Del Campo, Petronella Ottevanger, Martin Heubner, Thomas Minarik, Emmanuel Sevin, Nikolaus de Gregorio, Mariusz Bidziński, Jacobus Pfisterer, Susanne Malander, Felix Hilpert, Mansoor R Mirza, Giovanni Scambia, Werner Meier, Maria O Nicoletto, Line Bjørge, Alain Lortholary, Martin Oliver Sailer, Michael Merger, Philipp Harter
BACKGROUND: Angiogenesis is a target in the treatment of ovarian cancer. Nintedanib, an oral triple angiokinase inhibitor of VEGF receptor, platelet-derived growth factor receptor, and fibroblast growth factor receptor, has shown activity in phase 2 trials in this setting. We investigated the combination of nintedanib with standard carboplatin and paclitaxel chemotherapy in patients with newly diagnosed advanced ovarian cancer. METHODS: In this double-blind phase 3 trial, chemotherapy-naive patients (aged 18 years or older) with International Federation of Gynecology and Obstetrics (FIGO) IIB-IV ovarian cancer and upfront debulking surgery were stratified by postoperative resection status, FIGO stage, and planned carboplatin dose...
January 2016: Lancet Oncology
M Nikolaou, G Androutsopoulos, G Michail, V Papadopoulos, G Adonakis, G Decavalas
OBJECTIVES: The aim of the present study was to evaluate the eticacy of microwave endometrial ablation after endometrial curettage, in selected patients with heavy menstrual bleeding. MATERIAL AND METHODS: Thirty-two premenopausal women with heavy menstrual bleeding underwent microwave endometrial ablation at the Department of Obstetrics and Gynecology of the University of Patras Medical School. All patients did not respond to previous medical treatment, had completed their childbearing, and did not desire future fertility...
2015: Clinical and Experimental Obstetrics & Gynecology
Virginia Benito, Silvia Romeu, Miriam Esparza, Sonia Carballo, Octavio Arencibia, Norberto Medina, Amina Lubrano
OBJECTIVE: The aims of this study were to evaluate prospectively the safety and feasibility of laparoscopic lymphadenectomy in gynecologic oncology and to analyze risk factors associated with surgical adverse events. MATERIALS AND METHODS: This study included 444 consecutive laparoscopic lymphadenectomy procedures conducted in 358 consecutive gynecologic oncology patients, between 2007 and 2014. Surgical adverse events were classified into intraoperative, early postoperative (≤6 weeks after surgery), and late postoperative (>6 weeks after surgery)...
November 2015: International Journal of Gynecological Cancer
Man-Wa Lui, Vincent Y T Cheung, Ting Chung Pun
OBJECTIVE: To review the clinical profiles and management outcomes of patients with pyometra. STUDY DESIGN: A retrospective review of all women admitted with a confirmed diagnosis of pyometra over an 8-year period (January 2003 to December 2010). The medical records, including operation notes, histological and microbiological results, were reviewed. RESULTS: A total of 57 patients accounting for 76 admissions were identified. The mean patient age was 82...
July 2015: Journal of Reproductive Medicine
S Easmin, T A Chowdhury, M R Islam, A Beg, M K Jahan, T Latif, S Dhar, M N Alam, M Akhter
Obstetric outcome in early onset and late onset GDM was compared in a prospective study conducted at the Department of Obstetrics & Gynecology in BIRDEM, Dhaka, Bangladesh. A total 120 pregnant women were recruited purposively for the study in which 60 were early onset GDM and 60 were late onset GDM during study period of January 2008 to December 2009. Patients were followed up in different periods of gestation, during delivery and early postpartum period & findings were compared between two groups. BMI & family history of diabetes were significantly higher in early GDM group (p<0...
July 2015: Mymensingh Medical Journal: MMJ
Toby Richards, Khaled M Musallam, Joseph Nassif, Ghina Ghazeeri, Muhieddine Seoud, Kurinchi S Gurusamy, Faek R Jamali
OBJECTIVE: To evaluate the effect of preoperative anaemia and blood transfusion on 30-day postoperative morbidity and mortality in patients undergoing gynecological surgery. STUDY DESIGN: Data were analyzed from 12,836 women undergoing operation in the American College of Surgeons National Surgical Quality Improvement Program. Outcomes measured were; 30-day postoperative mortality, composite and specific morbidities (cardiac, respiratory, central nervous system, renal, wound, sepsis, venous thrombosis, or major bleeding)...
2015: PloS One
Deepti Sharma, M K Janu, Ramesh Gaikwad, M G Usha
Obstructive mullerian anomalies give rise to a spectrum of clinical presentations and are uncommon in routine gynecologic practice. The patient usually becomes symptomatic in early reproductive years. Recurrent pelvic pain, dysmenorrhea, enlarging abdominopelvic mass, and abnormal vaginal discharge are the common presenting symptoms. We describe a rare case of a mullerian anomaly getting diagnosed 13 years after attaining menarche during the evaluation of postabortal sepsis. Patient presented 2 weeks following evacuation carried out for missed abortion, with acute abdominal pain, fever and foul smelling discharge per vaginum...
July 2011: Journal of Gynecological Endoscopy and Surgery
Ignace Vergote, Philip Debruyne, Frédéric Kridelka, Patrick Berteloot, Frédéric Amant, Brigitte Honhon, Willem Lybaert, Karin Leunen, Kurt Geldhof, Didier Verhoeven, Frédéric Forget, Peter Vuylsteke, Lionel D'Hondt, Manon Huizing, Heidi Van den Bulck, Annouschka Laenen
OBJECTIVE: To investigate the addition of prophylactic G-CSF to each weekly paclitaxel/carboplatin course in patients with recurrent platinum-resistant ovarian (OC), or recurrent or advanced endometrial (EC) or cervical carcinoma (CC). METHODS: 108 patients were enrolled i.e. 36 in each cohort. Eighteen courses of paclitaxel (60 mg/m(2)) and carboplatin (AUC 2.7) were administered weekly. G-CSF (filgrastim) was given to all patients on day 5 (and if needed on day 6)...
August 2015: Gynecologic Oncology
T Widelock, R Elkattah, S Gibbs, Z Mashak, S Mohling, S DePasquale
Fusobacterium necrophorum is infrequently implicated as a pathogenic organism. When pathogenic, the typical clinical presentation is that of pharyngitis, cervical adenopathy, and unilateral thrombophlebitis of the internal jugular vein. Infections caused by Fusobacterium necrophorum within the fields of obstetrics and gynecology have been infrequently reported. We describe a 19-year-old woman who underwent a cesarean delivery complicated by sepsis and purulent uterine necrosis secondary to Fusobacterium necrophorum infection...
2015: Case Reports in Obstetrics and Gynecology
Jenny Löfgren, Daniel Kadobera, Birger C Forsberg, Jude Mulowooza, Andreas Wladis, Pär Nordin
BACKGROUND: The world's poorest 2 billion people, benefit from no more than about 3.5% of the world's operative procedures. The burden of surgical disease is greatest in Africa, where operations could save many lives. Previous facility-based studies have described operative procedure caseloads, but prospective studies investigating interventions, indications and perioperative mortality rates (POMR), are rare. METHODS: A prospective, questionnaire-based collection of data on all major and minor operative procedures was undertaken at 2 hospitals in rural Uganda covering 4 and 3 months in 2011, respectively...
July 2015: Surgery
Carmen De Luca, Natalina Buono, Vincenzo Santillo, Angelo Licameli, Gianluca Straface, Giovanni Scambia, Marco De Santis
INTRODUCTION: Streptococcus agalactiae (Group B streptococcus [GBS]) is the most common cause of sepsis and meningitis in infants <3 months of age. Intrapartum antibiotic prophylaxis (IAP) is effective in preventing the transmission of GBS to newborns. The Centers for Disease Control and Prevention (CDC) guidelines suggest vaginal and rectal cultures to assess GBS colonization between 35 and 37 weeks' gestation. METHODS: Between July and December 2013, we identified 535 women admitted to the Obstetric and Gynecology Unit of Cardarelli Hospital (Campobasso, Italy) for delivery...
March 2016: Journal of Maternal-fetal & Neonatal Medicine
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