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https://www.readbyqxmd.com/read/28212182/what-s-new-in-obstetric-anesthesia-the-2016-gerard-w-ostheimer-lecture
#1
Philip E Hess
This special article presents potentially important trends and issues affecting the field of obstetric anesthesia drawn from publications in 2015. Both maternal mortality and morbidity in the United States have increased in recent years because, in part, of the changing demographics of the childbearing population. Pregnant women are older and have more pre-existing conditions and complex medical histories. Cardiovascular and noncardiovascular medical diseases now account for half of maternal deaths in the United States...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28211264/genetics-diagnosis-and-clinical-features-of-congenital-hypodysfibrinogenaemia-a-systematic-literature-review-and-report-of-a-novel-mutation
#2
A Casini, T Brungs, C Lavenu-Bombled, R Vilar, M Neerman-Arbez, P de Moerloose
BACKGROUND: Hypodysfibrinogenaemia is a rare disease characterised by decreased levels of a dysfunctional fibrinogen. It shares features with both hypo- and dysfibrinogenaemia, although with specific molecular patterns and clinical phenotypes. OBJECTIVES: To better define the genetics, the diagnosis and the clinical features of hypodysfibrinogenaemia. PATIENTS/METHODS: A systematic literature search led to 167 records. After removal of duplicates, abstract screening and full-text reviewing, 56 molecular and/or clinical studies were analysed, including a novel FGB missense mutation in a woman with a mild bleeding phenotype...
February 16, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28209132/urinary-tract-infection-among-fistula-patients-admitted-at-hamlin-fistula-hospital-addis-ababa-ethiopia
#3
Matifan Dereje, Yimtubezinesh Woldeamanuel, Daneil Asrat, Fekade Ayenachew
BACKGROUND: Urinary Tract Infection (UTI) causes a serious health problem and affects millions of people worldwide. Patients with obstetric fistula usually suffer from incontinence of urine and stool, which can predispose them to frequent infections of the urinary tract. Therefore the aim of this study was to determine the etiologic agents, drug resistance pattern of the isolates and associated risk factor for urinary tract infection among fistula patients in Addis Ababa fistula hospital, Ethiopia...
February 16, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28208940/neurological-disorders-complicating-pregnancy-focus-on-obstetric-outcome
#4
Sandya Renukesh, Lavanya Rai
INTRODUCTION: Neurological disorders in pregnancy can be pregnancy related or can be caused by exacerbation of a pre-existing neurological condition or sometimes may even be detected for the first time during pregnancy in which it might be an incidental finding. The diagnosis and management of the neurological disorders in pregnancy is always a challenging task due to varied symptomatology and risks to the fetus. The evaluation and management should be performed in a stepwise fashion and requires multidisciplinary approach...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28203253/the-use-of-laparoscopy-simulation-to-explore-gender-differences-in-resident-surgical-confidence
#5
Rebecca L Flyckt, Eliza E White, Linnea R Goodman, Catherine Mohr, Sanjeev Dutta, Kristine M Zanotti
Background. The objective of this study was to determine whether female surgical residents underestimate their surgical abilities relative to males on a standardized test of laparoscopic skill. Methods. Twenty-six male and female general surgery residents and 25 female obstetrics and gynecology residents at two academic centers were asked to predict their score prior to undergoing the Fundamentals of Laparoscopic Surgery standardized skills exam. Actual and predicted score as well as delta values (predicted score minus actual score) were compared between residents...
2017: Obstetrics and Gynecology International
https://www.readbyqxmd.com/read/28197879/impact-of-xpert-mrsa-sa-blood-culture-pcr-assay-on-management-of-positive-blood-cultures-in-obstetric-patients-a-retrospective-audit
#6
A Page, S O'Rourke, M Brennan, L Clooney, D Le Blanc, J Griffin, M Eogan, R J Drew
BACKGROUND: The Xpert MRSA/SA blood culture assay (Cepheid, USA) is a rapid PCR test which can be used for positive blood cultures where Gram-positive cocci in clusters are seen. It can detect Staphylococcus aureus and also the mecA gene, which encodes for β-lactam resistance. The assay was introduced into the Rotunda Hospital for positive blood cultures to allow earlier detection of MRSA and methicillin susceptible S. aureus. AIM: To assess the impact of the Xpert MRSA/SA blood culture assay on the management of obstetric patients with a positive blood culture where Gram-positive cocci in clusters were seen...
February 14, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28194206/evaluating-performance-of-the-operational-managers-of-obstetrics-and-gynecology-service-providing-wards
#7
Zahra Parvaresh, Ashraf Kazemi, Soheila Ehsanpour, Haniye Sadat Sajadi
BACKGROUND: The goal of hospitals, as the most important health care providing centers, is to improve the health level of the society. Achieving this goal is directly related with performance of the managers. This study was conducted to evaluate the performance of operational managers of obstetrics and gynecology service providing wards from the point of view of the staff at educational hospitals of Isfahan University of Medical Sciences in 2015. MATERIALS AND METHODS: In this descriptive study, target population comprised all supervisors and the staff working at obstetrics and gynecology and maternity wards...
November 2016: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/28193482/cultural-competence-of-obstetric-and-neonatal-nurses
#8
Ella T Heitzler
OBJECTIVES: To measure the cultural competence level of obstetric and neonatal nurses, explore relationships between cultural competence and selected sociodemographic variables, and identify factors related to cultural competence. DESIGN: Descriptive correlational study. SETTING: Online survey. PARTICIPANTS: A convenience sample of 132 obstetric and neonatal registered nurses practicing in the United States. METHODS: Nurse participants completed the Cultural Competence Assessment (CCA) instrument, which included Cultural Awareness and Sensitivity (CAS) and Cultural Competence Behaviors (CCB) subscales, and a sociodemographic questionnaire...
February 9, 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/28193186/afghan-migrants-face-more-suboptimal-care-than-natives-a-maternal-near-miss-audit-study-at-university-hospitals-in-tehran-iran
#9
Soheila Mohammadi, Soraya Saleh Gargari, Masoumeh Fallahian, Carina Källestål, Shirin Ziaei, Birgitta Essén
BACKGROUND: Women from low-income settings have higher risk of maternal near miss (MNM) and suboptimal care than natives in high-income countries. Iran is the second largest host country for Afghan refugees in the world. Our aim was to investigate whether care quality for MNM differed between Iranians and Afghans and identify potential preventable attributes of MNM. METHODS: An MNM audit study was conducted from 2012 to 2014 at three university hospitals in Tehran...
February 13, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28188768/frequency-of-toxocara-spp-antibodies-in-umbilical-cords-of-newborns-attended-atthe-university-hospital-in-southern-brazil-and-factors-associated-with-infection
#10
Paula Costa Santos, Paula Lima Telmo, Lis Maurente Lehmann, Carolina Lorenzi, Carolina Hirsch, Gabriela Torres Mattos, Gabriel Baracy Klafke, Maria Elisabeth Aires Berne, Carla Vitola Gonçalves, Carlos James Scaini
Toxocariasis is a neglected and geographically widespread parasitic disease. The detection of specific antibodies associated with this disease is required to confirm its clinical diagnosis and to aid in prevention. Although helminth infection during pregnancy can promote foetal immune responses with long-term effects, specific information regarding the risk of Toxocara spp. infection to the human foetus during pregnancy is lacking.Therefore,the present study aimed to investigate the frequency of antibodies against Toxocara spp...
February 7, 2017: Acta Tropica
https://www.readbyqxmd.com/read/28187100/prognostic-significance-of-the-standardized-uptake-value-of-pretherapeutic-18f-labeled-2-fluoro-2-deoxyglucose-positron-emission-tomography-computed-tomography-in-patients-with-locally-advanced-cervical-cancer
#11
Ajit Gubbi, Shimoni Kacheria, Sarfraz Ahmad, Nicole M Stavitzski, James E Kendrick
OBJECTIVES: To determine the prognostic significance of the pretreatment and posttreatment maximum standardized uptake value (SUVmax) of F-labeled 2-fluoro-2-deoxyglucose positron emission tomography (PET)/computed tomography imaging in patients with stage IB2-IVA cervical cancer. METHODS: This was a retrospective review of cervical cancer patients with International Federation of Gynecology and Obstetrics stages IB2-IVA, from March 2008 to April 2014. All patients had pretreatment and posttreatment PET imaging and received primary whole pelvic radiation therapy with concurrent radiosensitizing chemotherapy, followed by intracavitary brachytherapy...
March 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28187097/agreement-between-preoperative-endometrial-sampling-and-surgical-specimen-findings-in-endometrial-carcinoma
#12
Tiago Selbach Garcia, Márcia Appel, Raquel Rivero, Lúcia Kliemann, Maria Celeste Osório Wender
OBJECTIVES: The aims of the study were to evaluate agreement between preoperative endometrial samples and surgical specimens in endometrial carcinoma and to correlate this agreement with sample and patient characteristics. METHODS: Patients who received primary surgical treatment for endometrial carcinoma at a tertiary care center and had undergone preoperative endometrial sampling were included. Medical records were reviewed to collect information from pathology reports and data on patient characteristics...
March 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28182605/assisted-reproductive-technology-surveillance-united-states-2014
#13
Saswati Sunderam, Dmitry M Kissin, Sara B Crawford, Suzanne G Folger, Denise J Jamieson, Lee Warner, Wanda D Barfield
PROBLEM/CONDITION: Since the first U.S. infant conceived with assisted reproductive technology (ART) was born in 1981, both the use of ART and the number of fertility clinics providing ART services have increased steadily in the United States. ART includes fertility treatments in which eggs or embryos are handled in the laboratory (i.e., in vitro fertilization [IVF] and related procedures). Women who undergo ART procedures are more likely than women who conceive naturally to deliver multiple-birth infants...
February 10, 2017: MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries
https://www.readbyqxmd.com/read/28179211/primary-thrombophilia-in-m%C3%A3-xico-xii-miscarriages-are-more-frequent-in-persons-with-the-sticky-platelet-syndrome-sps
#14
Guillermo J Ruiz-Delgado, Yahveth Cantero-Fortiz, Mariana A Mendez-Huerta, Mónica Leon-Gonzalez, Ana K Nuñez-Cortes, Andrés A Leon-Peña, Juan Carlos Olivares-Gazca, Guillermo J Ruiz-Argüelles
BACKGROUND: The sticky platelet syndrome (SPS) is an inherited condition which leads into arterial and venous thrombosis. There is scant information about the association between the SPS and obstetric complications. OBJECTIVE: To assess the relationship of the SPS and fetal loss in a single institution. MATERIALS AND METHODS: The obstetric history of all the consecutive female patients prospectively studied along a 324 month period, in a single institution with a history of thrombosis and a clinical marker of primary thrombophilia was reviewed...
February 9, 2017: Turkish Journal of Haematology: Official Journal of Turkish Society of Haematology
https://www.readbyqxmd.com/read/28178769/improving-post-caesarean-analgesia-where-to-next
#15
Alexander Butwick
The provision of effective pain relief to mothers after caesarean section (CS) is a priority for both obstetric and anaesthesia providers. To meet this goal, multimodal analgesic regimens have been endorsed to manage pain and reduce opioid requirements after CS. Post-CS, typical oral analgesic regimens may comprise paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), and an oral opioid. The inclusion of paracetamol and NSAIDs is important as each drug has an opioid sparing effect, thereby reducing the incidence of opioid related side-effects...
February 8, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28178062/strategies-for-successful-recruitment-of-pregnant-patients-into-clinical-trials
#16
Elizabeth F Sutton, Loren E Cain, Porsha M Vallo, Leanne M Redman
Clinical research in the pregnant population allows for delivery of quality, evidence-based care in obstetrics. However, in recent years, the field of obstetrics has faced severe challenges in the recruitment of the pregnant population into clinical trials, a struggle also shared by several other medical disciplines. We candidly describe our failure to recruit a healthy population of overweight and obese pregnant women in their first trimester. We were then able to glean unsuccessful and successful recruitment approaches and improve our recruitment effort by autopsy of failed strategies and with guidance from a survey disseminated to improve our understanding of community feelings about participating in research while pregnant...
February 6, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28178059/less-restrictive-food-intake-during-labor-in-low-risk-singleton-pregnancies-a-systematic-review-and-meta-analysis
#17
Andrea Ciardulli, Gabriele Saccone, Hannah Anastasio, Vincenzo Berghella
OBJECTIVE: To evaluate benefits and harms of food intake during labor. DATA SOURCES: Electronic databases such as MEDLINE and ClinicalTrials.gov were searched from their inception until October 2016. METHODS OF STUDY SELECTION: We included randomized trials comparing a policy of less-restrictive food intake with a policy of more restrictive food intake during labor. The primary outcome was the mean duration of labor. Meta-analysis was performed using the random-effects model of DerSimonian and Laird to produce summary treatment effects in terms of either a relative risk or a mean difference with 95% confidence interval (CI)...
February 6, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28176511/prevalence-of-illicit-drug-use-at-the-end-of-pregnancy-a-cross-sectional-study-at-the-time-of-birth
#18
Amadeu Roca Comas, Joan S Vila Domènech, Joana Massa Solé, Patricia Timoneda Paz, Mar Peñas Boira, Francisco J Herrero Espinet, Josep Sánchez Jiménez, Anna Ballester Martínez
BACKGROUND: Drug use during pregnancy is associated with adverse perinatal outcomes. This study was conducted to assess the prevalence of consumption of drugs of abuse in pregnant women at the end of gestation. METHODS: Cross-sectional study of all consecutive pregnant women in labor admitted to a regional hospital in Calella (Barcelona, Spain) in labor over one year period (2014- 2015). Women who gave written consent to take part in the study provided a urine sample on admission and completed a questionnaire with toxic habits-related questions...
February 7, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/28176193/obstetric-outcomes-of-recurrent-pregnancy-loss-patients-diagnosed-w%C3%A4-th-inherited-thrombophilia
#19
C Karadağ, T Yoldemir, S D Karadağ, C İnan, Z N Dolgun, L Aslanova
BACKGROUND: Recurrent pregnancy loss (RPL) is defined by two or more failed pregnancies. The relation between RPL and inherited thrombophilia requires anticoagulant therapy during pregnancy. However the obstetric outcomes have not been well defined in these RPL patients diagnosed with inherited thrombophilia, who have been given anticoagulant therapy. AIM: To investigate the obstetric outcomes in pregnant women with RPL who are given low molecular weight heparin (LMWH) and low-dose aspirin due to diagnosis of inherited thrombophilia...
February 7, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28170398/emergency-obstetric-care-in-a-rural-district-of-burundi-what-are-the-surgical-needs
#20
E De Plecker, R Zachariah, A M V Kumar, M Trelles, S Caluwaerts, W van den Boogaard, J Manirampa, K Tayler-Smith, M Manzi, K Nanan-N'zeth, B Duchenne, B Ndelema, W Etienne, P Alders, R Veerman, R Van den Bergh
OBJECTIVES: In a rural district hospital in Burundi offering Emergency Obstetric care-(EmOC), we assessed the a) characteristics of women at risk of, or with an obstetric complication and their types b) the number and type of obstetric surgical procedures and anaesthesia performed c) human resource cadres who performed surgery and anaesthesia and d) hospital exit outcomes. METHODS: A retrospective analysis of EmOC data (2011 and 2012). RESULTS: A total of 6084 women were referred for EmOC of whom 2534(42%) underwent a major surgical procedure while 1345(22%) required a minor procedure (36% women did not require any surgical procedure)...
2017: PloS One
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