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Pain management in labor

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https://www.readbyqxmd.com/read/28898687/outcomes-of-mifepristone-usage-for-cervical-ripening-and-induction-of-labour-in-full-term-pregnancy-randomized-controlled-trial
#1
Oleg R Baev, Valentina P Rumyantseva, Oleg V Tysyachnyu, Olga A Kozlova, Gennady T Sukhikh
OBJECTIVE: The most commonly used approved indications for mifepristone in obstetrics include: termination of early pregnancy, cervical dilatation prior to abortion, labour induction in case of fetal death in utero. Fewer studies have been conducted on the effect of mifepristone on cervical ripening and induction of labour in term pregnancy with a live fetus. The aim of our study was to evaluate efficacy and safety of mifepristone use for cervical ripening and induction of labour versus expectant management in full-term pregnancy...
September 1, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28843244/in-vitro-leukoagglutination-a-rare-hematological-cause-of-spurious-leukopenia
#2
Sadia Sultan, Syed Muhammad Irfan
Leukopenia secondary to leukocytic agglutination is caused by an ethylene diamine tetra acetic acid (EDTA) which may appear in both benign and malignant states. Ethylene diamine tetra acetic acid induced platelets clumping in peripheral blood has been well established, but invitro leukocytic aggregation is very rarest hematological finding. Pseudo-leukopenia resulting from leukoagglutinins has been reported in the cirrhotic state, infections, autoimmune disorders, uremia, in immunosuppressed state or in various malignancies...
June 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/28840194/rectus-muscle-reapproximation-at-cesarean-delivery-and-postoperative-pain-a-randomized-controlled-trial
#3
Deirdre J Lyell, Mariam Naqvi, Amy Wong, Renata Urban, Brendan Carvalho
Objective  Rectus muscle reapproximation at cesarean delivery (CD) is performed frequently by some obstetricians; however, the effect on postoperative pain is unclear. To this end, we investigated whether rectus muscle reapproximation increases postoperative pain. Materials and Methods  This is a prospective, double-blind, randomized controlled trial of women undergoing primary CD with singleton or twin pregnancy at >35 weeks' gestation. Women were randomized to rectus muscle reapproximation with three interrupted sutures or no reapproximation...
July 2017: Surg J (N Y)
https://www.readbyqxmd.com/read/28810113/an-unusual-presentation-of-an-unusual-disease-spontaneous-pneumomediastinum
#4
Kalyan Chakravarthy Potu, Maheedhar Gedela, Kashif Abbas Shaikh, Sujithasree Ketineni, Eric Larson
We report a case of spontaneous pneumomediastinum with unusual clinical presentation. The most common symptoms of spontaneous mediastinum are chest pain and shortness of breath. Our patient presented with neck swelling and change in voice, an unusual presentation for spontaneous pneumothorax. A 30-year-old previously healthy man presented with complaints of neck swelling and hoarseness of voice beginning after an intense coughing spell. He had no other complaints. He denied any trauma to the chest, nausea, vomiting, recent air travel, scuba diving or recreational drug use...
November 2016: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28767472/intrathecal-migration-of-an-epidural-catheter-while-using-a-programmed-intermittent-epidural-bolus-technique-for-labor-analgesia-maintenance-a-case-report
#5
Francesca Betti, Brendan Carvalho, Edward T Riley
We describe a case of intrathecal migration of a wire-reinforced epidural catheter in a parturient who received epidural labor analgesia. Epidural analgesia was initiated with a combined-spinal epidural technique and maintained by programmed intermittent epidural boluses. Epidural catheter aspiration after insertion was negative for cerebrospinal fluid. The patient's response to the first four doses of local anesthetic was consistent with epidural drug delivery. After the fifth dose, she developed a complete lower extremity motor block, hypotension, and high sensory blockade...
August 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28723767/return-of-the-cadaver-key-role-of-anatomic-dissection-for-plastic-surgery-resident-training
#6
Swenn Maxence Krähenbühl, Paul Čvančara, Thomas Stieglitz, Raphaël Bonvin, Murielle Michetti, Marjorie Flahaut, Sébastien Durand, Lina Deghayli, Lee Ann Applegate, Wassim Raffoul
Successful Plastic Surgery Residency training is subjected to evolving society pressure of lower hourly work weeks imposed by external committees, labor laws, and increased public awareness of patient care quality. Although innovative measures for simulation training of surgery are appearing, there is also the realization that basic anatomy training should be re-enforced and cadaver dissection is of utmost importance for surgical techniques.In the development of new technology for implantable neurostimulatory electrodes for the management of phantom limb pain in amputee patients, a design of a cadaveric model has been developed with detailed steps for innovative transfascicular insertion of electrodes...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28666671/arthroscopic-management-of-elbow-osteoarthritis
#7
REVIEW
Leo T Kroonen, Samantha L Piper, Andrew C Ghatan
The incidence of osteoarthritis in the general population is low, but it can be seen in manual laborers, throwing athletes, and people dependent on crutches and wheelchairs. Patients often complain of pain at the terminal extents of motion, and imaging shows osteophyte formation at the tips of the coronoid and olecranon processes as well as thickening of the bone between the coronoid and the olecranon fossae. Recent advances in arthroscopic instrumentation and techniques have led to a growing interest in the arthroscopic treatment of elbow osteoarthritis...
June 28, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28661774/the-impact-of-physical-disability-on-pregnancy-and-childbirth
#8
Linda Long-Bellil, Monika Mitra, Lisa I Iezzoni, Suzanne C Smeltzer, Lauren Smith
BACKGROUND: Women with physical disabilities increasingly aspire to become pregnant and bear children. Limited information about the potential interaction of their disabling conditions with pregnancy and childbirth exists to guide these women and their clinicians. MATERIALS AND METHODS: The interview guide was created with questions on topics such as pregnancy complications and secondary conditions, the impact of prior surgeries, experiences with pain relief during labor, and the impact on women's independence and participation in life activities...
August 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28620569/the-optimal-pain-management-approach-for-a-laboring-patient-a-review-of-current-literature
#9
REVIEW
Albert Kelly, Quang Tran
There is a general agreement that a patient in labor should be given the option to have an epidural block for pain management. Despite this consensus, there are differences in practice patterns as to when to initiate an epidural and how to minimize its impact on the duration and outcome of a patient's labor. A review of the literature suggests epidural analgesia does prolong stages one and two of labor, but not significantly. Cesarean delivery rates are not affected by the early initiation of epidural analgesia...
May 10, 2017: Curēus
https://www.readbyqxmd.com/read/28607658/exploring-perceptions-of-instructors-about-childbirth-preparation-training-courses-a-qualitative-study
#10
Marzieh Otogara, Akram Karimi-Shahanjarini, Seyed Mohammad Mehdi Hazavehei, Jalal Poorolajal, Nahid Radnia, Forouzan Akrami, Fahimeh Bagheri
BACKGROUND: Childbirth preparation training courses on maternal and neonatal health increase awareness, and capability of pregnant women in overcoming fear and anxiety and managing labor pains. OBJECTIVE: To identify the affecting factors and barriers of these courses from the perspective of their instructors. METHODS: This qualitative study of the content analysis type, has been conducted on 16 certified teachers of the training courses of the Hamadan city in 2015...
April 2017: Electronic Physician
https://www.readbyqxmd.com/read/28593072/recovery-and-return-to-work-after-a-pelvic-fracture
#11
Antonios N Papasotiriou, Nikolaos Prevezas, Konstantinos Krikonis, Evangelos C Alexopoulos
BACKGROUND: Pelvic ring fractures (PRFs) may influence the daily activities and quality of life of the injured. The aim of this retrospective study was to explore the functional outcomes and factors related to return to work (RTW) after PRF. METHODS: During the years 2003-2012, 282 injured individuals aged 20-55 years on the date of the accident, were hospitalized and treated for PRFs in a large tertiary hospital in Athens, Greece. One hundred and three patients were traced and contacted; 77 who were on paid employment prior to the accident gave their informed consent to participate in the survey, which was conducted in early 2015 through telephone interviews...
June 2017: Safety and Health At Work
https://www.readbyqxmd.com/read/28577712/management-and-surgical-options-for-articular-defects-in-the-shoulder
#12
REVIEW
Bryan M Saltzman, Timothy Leroux, Brian J Cole
Isolated, full-thickness chondral lesions of the glenohumeral joint are a significant pathology encountered by laborers, athletes, and the elderly. A thorough history should be obtained in any patient presenting to the office with shoulder pain and concern for the etiology being an articular cartilage defect. The first-line imaging should include plain radiographs of the glenohumeral joint; MRI and CT can be ordered as necessary to provide greater detail. Typically, the initial treatment of glenohumeral chondral disease is nonsurgical; however, many surgical treatment options have been refined to provide pain relief, create reparative tissue, or restore the articular surface...
July 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/28560223/epidemiological-and-economic-evaluation-of-alternative-on-farm-management-scenarios-for-ovine-footrot-in-switzerland
#13
Dana Zingg, Sandro Steinbach, Christian Kuhlgatz, Matthias Rediger, Gertraud Schüpbach-Regula, Matteo Aepli, Gry M Grøneng, Salome Dürr
Footrot is a multifactorial infectious disease mostly affecting sheep, caused by the bacteria Dichelobacter nodosus. It causes painful feet lesions resulting in animal welfare issues, weight loss, and reduced wool production, which leads to a considerable economic burden in animal production. In Switzerland, the disease is endemic and mandatory coordinated control programs exist only in some parts of the country. This study aimed to compare two nationwide control strategies and a no intervention scenario with the current situation, and to quantify their net economic effect...
2017: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/28556573/initiating-intrapartum-nitrous-oxide-in-an-academic-hospital-considerations-and-challenges
#14
Laura Migliaccio, Robyn Lawton, Lawrence Leeman, Amanda Holbrook
A 50%-50% mixture of nitrous oxide and oxygen has long been used for managing pain during labor in many countries, but only recently has this intrapartum analgesic technique become popular in the United States. Nitrous oxide is considered minimal sedation and a safe pain management alternative. Many facilities are now interested in providing laboring women this analgesic option. The process of establishing use of nitrous oxide in a large institution can be complicated and may seem daunting. This brief report describes the challenges that occurred during the process of initiating nitrous oxide for pain management during childbirth at an academic medical center and discusses various committee roles...
May 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28520654/systematic-review-of-hydrotherapy-research-does-a-warm-bath-in-labor-promote-normal-physiologic-childbirth
#15
Jenna Shaw-Battista
Health sciences research was systematically reviewed to assess randomized controlled trials of standard care versus immersion hydrotherapy in labor before conventional childbirth. Seven studies of 2615 women were included. Six trials examined hydrotherapy in midwifery care and found an effect of pain relief; of these, 2 examined analgesia and found reduced use among women who bathed in labor. One study each found that hydrotherapy reduced maternal anxiety and fetal malpresentation, increased maternal satisfaction with movement and privacy, and resulted in cervical dilation progress equivalent to standard labor augmentation practices...
May 17, 2017: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/28507834/clinical-and-radiological-improvement-following-ozone-disc-nucleolysis-a-case-report
#16
Sharad Ghatge, Pranav D Modi, Dhaval B Modi
The results of traditional open surgery for herniated intervertebral disc are often limited by complications and failed back surgery syndrome (FBSS). Over the past few decades, a considerable amount of research has been done in the field of minimally invasive procedures as a treatment option for herniated intervertebral disc disease. Ozone disc nucleolysis is one such procedure which has results equal to or better than traditional surgery with virtually no complications. A 27-year-old post-partum female presented to the clinic with acute onset of severe lower back pain radiating to the left lower limb for one month...
April 13, 2017: Curēus
https://www.readbyqxmd.com/read/28494909/remifentanil-as-an-alternative-to-epidural-analgesia-for-vaginal-delivery-a-meta-analysis-of-randomized-trials
#17
Myeongjong Lee, Fang Zhu, Jessica Moodie, Zhe Zhang, Davy Cheng, Janet Martin
OBJECTIVES: Although epidural analgesia is considered the gold standard for labor pain management, its use may be restricted in some conditions due to clinical contraindications or availability, and suitable alternatives may be required. The objective of this meta-analysis was to determine whether evidence from randomized trials suggests remifentanil PCA (R-PCA) results in significant differences in maternal satisfaction, analgesic efficacy, and safety compared with conventional epidural analgesia (EA)...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28448331/a-nurse-directed-model-for-nitrous-oxide-use-during-labor
#18
Toni Pinyan, Kelly Curlee, Mellanie Keever, Kathleen M Baldwin
BACKGROUND: Nitrous oxide has a long history of use and has been well documented in the literature as a safe, effective, and inexpensive option for pain management in labor in other countries, but it is underused in the United States. LOCAL PROBLEM: Pain relief options for laboring women in rural community hospitals with a small perinatal service are limited due to lack of availability of in-house anesthesia coverage. METHOD: This quality improvement project involved development and implementation of a nurse-driven, self-administered, demand-flow nitrous oxide program as an option for pain relief for laboring women in a rural community hospital...
May 2017: MCN. the American Journal of Maternal Child Nursing
https://www.readbyqxmd.com/read/28382061/effect-of-breathing-technique-of-blowing-on-the-extent-of-damage-to-the-perineum-at-the-moment-of-delivery-a-randomized-clinical-trial
#19
Zohre Ahmadi, Shahnaz Torkzahrani, Firouze Roosta, Nezhat Shakeri, Zohre Mhmoodi
INTRODUCTION: One of the important tasks in managing labor is the protection of perineum. An important variable affecting this outcome is maternal pushing during the second stage of labor. This study was done to investigate the effect of breathing technique on perineal damage extention in laboring Iranian women. MATERIALS AND METHODS: This randomized clinical trial was performed on 166 nulliparous pregnant women who had reached full-term pregnancy, had low risk pregnancy, and were candidates for vaginal delivery in two following groups: using breathing techniques (case group) and valsalva maneuver (control group)...
January 2017: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/28376565/implementation-of-a-hydrotherapy-protocol-to-improve-postpartum-pain-management
#20
Meghann Batten, Eleanor Stevenson, Deb Zimmermann, Christine Isaacs
INTRODUCTION: A growing number of women are seeking alternatives to traditional pharmacologic pain management during birth. While there has been an extensive array of nonpharmacologic options developed for labor, there are limited offerings in the postpartum period. The purpose of this quality improvement project was to implement a hydrotherapy protocol in the early postpartum period to improve pain management for women choosing a nonmedicated birth. PROCESS: The postpartum hydrotherapy protocol was initiated in a certified nurse-midwife (CNM) practice in an urban academic medical center...
March 2017: Journal of Midwifery & Women's Health
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