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https://www.readbyqxmd.com/read/28445798/episiotomy-what-angle-do-you-cut-to-the-midline
#1
Kenneth Ma, Louise Byrd
OBJECTIVE: Although episiotomies are the commonest obstetric procedure performed the technique of performing one varies amongst obstetricians and midwives. The angle of episiotomy to the midline in particular has been shown to influence the risk of developing obstetric anal sphincter injuries (OASIS). In order to identify the differences in technique and to identify targets for training we undertook a practice survey of episiotomies to analyse the differences in technique between grades of obstetricians and midwives...
April 11, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28438352/burns-to-the-genitalia-perineum-and-buttocks-increase-the-risk-of-death-among-u-s-service-members-sustaining-combat-related-burns-in-iraq-and-afghanistan
#2
Michael S Clemens, Judson C Janak, Julie A Rizzo, John C Graybill, Michelle F Buehner, Steven J Hudak, Charles K Thompson, Kevin K Chung
PURPOSE: Among service members injured in Iraq and Afghanistan, to determine the risk of mortality associated with combat-related burns to the genitalia, perineum, and buttocks. MATERIALS AND METHODS: The prospectively maintained burn registry from the United States Army Institute of Surgical Research was retrospectively reviewed to identify all service members with combat-related burns sustained in Iraq and Afghanistan from March 2003 to October 2013. The two primary risk factors of interest were (1) any burn to the genitals, perineum, and/or buttocks (PB) and (2) burns involving the entire perineal, genital, and buttock region (complete PB)...
April 21, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28436214/a-comparison-of-the-cost-of-primary-closure-or-rectus-abdominis-myocutaneous-flap-closure-of-the-perineum-after-abdominoperineal-excision
#3
John Woodfield, Michael Hulme-Moir, Jasen Ly
AIM: Perineal wound complications following abdominoperineal resection continue to be a major challenge.. The aim of this study was to compare the clinical outcomes and cost of primary closure (PC) and rectus abdominis myocutaneous flap reconstruction (RAM). METHOD: Retrospective case review of consecutive patients by one surgeon over 11 years. Patient demographics, risk factors, operative details and complications were identified. Inpatient and outpatient costs were calculated...
April 24, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28414983/a-randomised-controlled-trial-in-comparing-maternal-and-neonatal-outcomes-between-hands-and-knees-delivery-position-and-supine-position-in-china
#4
Hongyu Zhang, Shurong Huang, Xiaolan Guo, Ningning Zhao, Yujing Lu, Min Chen, Yingxia Li, Junqin Wu, Lihua Huang, Fenglan Ma, Yuhong Yang, Xiaoli Zhang, Xiaoyu Zhou, Renfei Guo, Wenzhi Cai
BACKGROUND: the supine position is the most frequently offered for birth delivery in China and many other countries, but the hands-and-knees position is now gaining prominence with doctors in China. This study aims to examine the differences in maternal and neonatal outcomes among low-risk women who gave birth either in the hands-and-knees position or the supine position. METHODS: a randomised controlled trial was conducted in 11 hospitals in China from May to December in 2012...
March 31, 2017: Midwifery
https://www.readbyqxmd.com/read/28412037/relationship-between-the-degree-of-perineal-trauma-at-vaginal-birth-and-change-in-haemoglobin-concentration
#5
Ana Rubio-Álvarez, Milagros Molina-Alarcón, Antonio Hernández-Martínez
BACKGROUND: Postpartum anaemia is a problem with high prevalence that significantly affects maternal recovery. Among the causal factors is perineal trauma. However, it is still not known what degree of perineal trauma produces a greater reduction of haemoglobin. AIM: To assess the relationship between the degree of perineal trauma and change in haemoglobin concentration at vaginal birth. METHODS: An observational, analytical retrospective cohort study was performed at the Mancha-Centro Hospital (Spain) during the period 2010-2014...
April 12, 2017: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/28409269/short-term-outcomes-of-laparoscopic-ventral-rectopexy-for-obstructed-defecation-in-patients-with-overt-pelvic-structural-abnormalities-a-chinese-pilot-study
#6
G Y Ye, Z Wang, K E Matzel, Z Cui
AIM: As laparoscopic ventral rectopexy (LVR) gained increasing popularity in the past decade, studies from non-western area remain rare. The aim of this pilot study is to evaluate the efficacy and safety of LVR for obstructed defecation (OD) in Chinese patients with overt pelvic structural abnormalities. METHODS: A series of 19 consecutive patients is presented undergoing LVR for OD. All patients showed various forms of pelvic structural abnormalities which were verified by dynamic defecography exam...
April 13, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28407270/comparison-of-diagnostic-accuracy-for-the-low-type-imperforate-anus-between-prone-cross-table-radiography-and-sonography
#7
Takahiro Hosokawa, Mayumi Hosokawa, Yutaka Tanami, Shinya Hattori, Yumiko Sato, Yujiro Tanaka, Hiroshi Kawashima, Eiji Oguma, Yoshitake Yamada
OBJECTIVES: To compare the diagnostic accuracy for the low-type imperforate anus between prone cross-table radiography and sonography. METHODS: We included 20 neonates with imperforate anus: 13 with a surgically proven low type and 7 with an intermediate or high type. The distance between the distal rectal pouch and the perineum (pouch-perineum distance) was measured by both sonography and prone cross-table radiography. A previously established pouch-perineum distance of 10 mm was used as the cutoff for diagnosis of a low-type imperforate anus...
April 13, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28391147/influence-of-a-pelvic-floor-training-programme-to-prevent-perineal-trauma-a-quasi-randomised-controlled-trial
#8
Fatima Leon-Larios, Isabel Corrales-Gutierrez, Rosa Casado-Mejía, Carmen Suarez-Serrano
BACKGROUND: perineal injury is common after birth and may be caused by tears or episiotomy or both. Perineal massage has been shown to prevent episiotomies in primiparous women. On the other hand, pelvic floor exercises might have an influence by shortening the first and second stages of labour in the primigravida. AIM: the aim of this study was to investigate the effects of a pelvic floor training following a birth programme on perineal trauma. DESIGN: a single-blind quasi-randomized controlled trial with two groups: standard care and intervention...
March 27, 2017: Midwifery
https://www.readbyqxmd.com/read/28387074/-female-genital-mutilations-the-condition-in-liege
#9
L Swenen, G Brichant, A Kaluanga, V Masson, M Nisolle
Due to current migration flows, the practising obstetrician is likely to encounter parturient women carriers of female genital mutilations (FGM). This article describes the obstetrical complications related to the latter. We compared a group of mutilated patients (n = 69) to a control group (n = 162) and studied the data concerning pregnancy, childbirth, newborn, postpartum and length of hospital stay. Among the mutilated patients, 44% were group B streptococcus carriers against 23 % in the control group (p inferior to 0...
January 2017: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28386033/comparative-antinociceptive-and-sedative-effects-of-epidural-romifidine-and-detomidine-in-buffalo-bubalus-bubalis
#10
M A Marzok, S A El-Khodery
In this study, comparative antinociceptive and sedative effects of epidural administration of romifidine and detomidine in buffalo were evaluated. Eighteen healthy adult buffalo, allocated randomly in three groups (two experimental and one control; n=6) received either 50 μg/kg of romifidine or detomidine diluted in sterile saline (0.9 per cent) to a final volume of 20 ml, or an equivalent volume of sterile saline epidurally. Antinociception, sedation and ataxia parameters were recorded immediately after drug administration...
April 6, 2017: Veterinary Record
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
#11
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/28381140/proximal-type-epithelioid-sarcoma
#12
David Alfonso Suárez-Zamora, Luis Eduardo Barrera-Herrera, Paula Andrea Rodríguez-Urrego, Mauricio Alfonso Palau-Lázaro
Epithelioid sarcoma is a rare malignant mesenchymal neoplasm (less than 1% of all sarcomas) with epithelioid morphology. Among the 2 subtypes, proximal represents only one-third of cases and commonly involves deep tissues of pelvic region, including the perineum, genital area, and groin, and occurs more frequently in older patients who present a more aggressive course. In the female genital tract, proximal-type epithelioid sarcoma (PES) mainly affects the vulva and is extremely uncommon in the uterus. To our knowledge, only a few cases of PES involving the cervix and uterine body have been previously reported in the literature...
February 1, 2017: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28374043/variation-in-staphylococcus-aureus-colonization-in-relation-to-disease-severity-in-adults-with-atopic-dermatitis-during-av-five-month-follow-up
#13
Mikael Alsterholm, Louise Strömbeck, Annika Ljung, Nahid Karami, Johan Widjestam, Martin Gillstedt, Christina Åhren, Jan Faergemann
The aim of this study was to monitor Staphylococcus aureus colonization and disease severity in adults with atopic dermatitis (AD) during 5 months. Twenty-one patients attended 3 visits each for severity SCORing of Atopic Dermatitis (SCORAD) assessment, quantitative cultures from the skin and conventional cultures from the anterior nares, tonsils and perineum. S. aureus isolates were typed for strain identity with pulsed-field gel electrophoresis (PFGE). Seventy-one percent of patients were colonized with S...
April 4, 2017: Acta Dermato-venereologica
https://www.readbyqxmd.com/read/28373917/leflunomide-in-the-treatment-of-a-pseudotumoral-genital-herpes-simplex-virus-infection-in-an-hiv-patient
#14
Marie R Roger, Gregory M Anstead
The patient is a 52-year-old African American man with a past medical history of HIV infection (on antiretroviral therapy, CD4 count 399 cells/µL, and undetectable HIV viral load) and recurrent genital herpes. While on valacyclovir, the patient presented with four tumorous lesions on the perineum and scrotum. A biopsy specimen stained positively with HSV-1 and HSV-2 immunostains and displayed a lymphoplasmacytic infiltrate. The patient received foscarnet and imiquimod for two weeks with minimal improvement...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28369942/sonographic-evaluation-of-the-fetal-spine-position-and-success-rate-of-manual-rotation-of-the-fetus-in-occiput-posterior-position-a-randomized-controlled-trial
#15
Bianca Masturzo, Antonio Farina, Lorenza Attamante, Annalisa Piazzese, Alessandro Rolfo, Pietro Gaglioti, Tullia Todros
BACKGROUND: To evaluate whether sonographic (US) diagnosis of the fetal spine position could increase the success rate of manual rotation of the fetal occiput (MRFO) in second-stage arrest in persistent occiput posterior position (OPP). METHODS: In this randomized controlled parallel single-center trial, 58 nulliparous in second-stage arrest of labor with fetus in cephalic presentation and OPP diagnosed by US were randomly assigned to group A where the fetal spine position was not known by the operator or to group B where the operator knew it...
April 3, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28352487/giant-perineal-solitary-fibrous-tumor-a-rare-case-report
#16
Petronio Augusto de Souza Melo, Ana Maria Yoshino Bonifaci, Fabio da Silva Crochik, Claudio Bovolenta Murta, Joaquim Francisco de Almeida Claro, Joao Padua Manzano
Background. Solitary fibrous tumor (SFT) is a fibroblastic mesenchymal tumor that was initially described from the pleura but currently arises at almost every anatomic site. It is usually benign, and surgical resection is curative. SFT involving the perineum is extremely rare. This is the third case report of a perineal SFT in the literature. Case Presentation. We reported an uncommon case of a 64-year-old man presenting with a huge perineal mass that started growing 3 years before his arrival in our service...
2017: Case Reports in Urology
https://www.readbyqxmd.com/read/28352032/aggressive-angiomyxoma-of-transplanted-kidney-mimicking-posttransplant-lymphoproliferative-disorder
#17
Ujjwal Gorsi, Priyanka Naranje, Manish Rathi, Ritambhara Nada, Niranjan Khandelwal
Angiomyxoma is a scarce neoplasm arising from the soft tissues of perineum and pelvis, more commonly seen in the females. For such a tumor to arise in a renal allograft is rare and has previously been reported only in few case. We report a case of aggressive angiomyxoma arising de novo in the renal allograft nine-year posttransplantation. We describe its imaging features on ultrasound and computed tomography which closely mimic the more usual tumor of the transplanted kidney, posttransplant lymphoproliferative disorder and suggest that angiomyxoma may be considered as a differential diagnosis in a case of soft tissue mass arising within the renal allograft...
March 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28338594/the-association-of-non-accidental-trauma-with-historical-factors-exam-findings-and-diagnostic-testing-during-the-initial-trauma-evaluation
#18
Mauricio A Escobar, Marc Auerbach, Katherine Flynn-O'Brien, Gunjan Tiyyagura, Matthew A Borgman, Susan J Duffy, Kelly Falcone, Rita Burke, John M Cox, Sabine Maguire
Early identification of non-accidental trauma (NAT) is a critical component of pediatric trauma care. Literature searches were conducted related to the association of NAT with seven key areas: history, exam findings (burns, oral trauma, bruising) and imaging (fractures, abdominal and brain injuries). When available, odds ratios (OR) with 95% confidence intervals (CI) for associations with NAT are presented. Systematic reviews have been published in six of the seven key areas and are described. The operational definition of NAT was widely variable across studies, prohibiting meta-analysis...
March 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28329588/ustekinumab-for-treatment-of-cutaneous-crohn-s-disease
#19
Rana Abdat, Alina Markova, Francis A Farraye, Michael K Lichtman
Cutaneous Crohn disease (CD) affecting the vulva, perineum, and perianal skin, is a rare entity, which may accompany or precede gastrointestinal CD. Vulvar involvement, if untreated, may ultimately require extensive surgery including vulvectomy to gain control of the disease. Both gastrointestinal and cutaneous CD respond to biologics, which block TNF. In addition, ustekinumab, which targets both IL-12 and IL-23 cytokines, is effective in patients with gastrointestinal CD who fail TNF blockade. However, it is unclear if ustekinumab is effective for cutaneous CD...
October 15, 2016: Dermatology Online Journal
https://www.readbyqxmd.com/read/28327433/sonographic-prediction-of-outcome-of-vacuum-deliveries-a%C3%A2-multicenter-prospective-cohort-study
#20
Birgitte H Kahrs, Sana Usman, Tullio Ghi, Aly Youssef, Erik A Torkildsen, Elsa Lindtjørn, Tilde B Østborg, Sigurlaug Benediktsdottir, Lis Brooks, Lotte Harmsen, Pål R Romundstad, Kjell Å Salvesen, Christoph C Lees, Torbjørn M Eggebø
BACKGROUND: Safe management of the second stage of labor is of great importance. Unnecessary interventions should be avoided and correct timing of interventions should be focused. Ultrasound assessment of fetal position and station has a potential to improve the precision in diagnosing and managing prolonged or arrested labors. The decision to perform vacuum delivery is traditionally based on subjective assessment by digital vaginal examination and clinical expertise and there is currently no method of objectively quantifying the likelihood of successful delivery...
March 19, 2017: American Journal of Obstetrics and Gynecology
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