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Pediatrics, obstetrics

Faye M Evans, Juan C Duarte, Carolina Haylock Loor, Wayne Morriss
There is an urgent need to train more anesthesia providers in low- and middle-income countries (LMICs). There is also a need to provide more educational opportunities in subspecialty areas of anesthetic practice such as trauma management, pain management, obstetric anesthesia, and pediatric anesthesia. Together, these subspecialty areas make up a large proportion of the clinical workload in LMICs. In these countries, the quality of education may be variable, there may be few teachers, and opportunities for continued learning and mentorship are rare...
April 2018: Anesthesia and Analgesia
Wayne W Morriss, Miodrag S Milenovic, Faye M Evans
There are inadequate numbers of anesthesia providers in many parts of the world. Good quality educational programs are needed to increase provider numbers, train leaders and teachers, and increase knowledge and skills. In some countries, considerable external support may be required to develop self-sustaining programs. There are some key themes related to educational programs in low- and middle-income countries:(1) Programs must be appropriate for the local environment-there is no "one-size-fits-all" program...
April 2018: Anesthesia and Analgesia
P S Huguelet, G ChelvaKumar, L Conner, T Dumont, N Fleming, M Abraham, N W Karjane, J Sheeder, H J Talib, K Teelin, C Wheeler, P Kaul
BACKGROUND: Resident education in Pediatric and Adolescent Gynecology (PAG) is challenging. It encompasses patients from neonates to young adults with different disorders involving multiple subspecialties. Residents have inadequate exposure to PAG topics and report lack of knowledge in this area. OBJECTIVE: To determine if the North American Society for Pediatric and Adolescent Gynecology (NASPAG) Short Curriculum improves self-reported knowledge in PAG among Obstetrics and Gynecology (ObGyn), Family Medicine and Pediatric residents...
February 27, 2018: Journal of Pediatric and Adolescent Gynecology
Eduardo de Almeida Guimarães Nogueira, Vitor Martinez de Carvalho, Marcos Vinicius de Queiroz, Gleysson Rodrigues Rosa, Yara Dadalti Fragoso
Augusta Marie Déjerine-Klumpke (1859-1927) was a formidable neurologist, neuroanatomist and researcher in France. One of the first women to be accepted for medical internship, externship and research in Paris, Augusta made her name studying and teaching anatomy, histology and dissection, attending clinical activities in neurology, obstetrics, pediatrics and neurologic trauma, performing necropsies, and writing scientific papers and book chapters. Her main research in neurology awarded her an eponym for the avulsion of the lowest root of the brachial plexus (Klumpke's palsy)...
February 2018: Arquivos de Neuro-psiquiatria
Matthias David, Katrin Alexandra Scherer, Wolfgang Henrich, Jürgen Breckenkamp
Objectives: Does the incidence and/or indication(s) for emergency cesarean section differ if the pregnant woman has an immigrant background (IB)? Does a lack of language proficiency (communication problems) and a low acculturation level result in a longer decision-to-delivery interval (D-D interval)? Are neonates born to women with IB by emergency cesarean section in a poorer condition post delivery? Patient cohorts and method: Standardized interviews were carried out before or immediately after delivery in three Berlin obstetric hospitals...
February 2018: Geburtshilfe und Frauenheilkunde
Lars H Breimer, Torbjörn K Nilsson, Michael E Breimer
Declaration of conflicts of interest (COI, understood mainly as financial) in medical publications is long established. Most journals refer only to the guidelines of the International Committee of Medical Journal Editors (ICMJE) but not to those of the WAME (World Association of Medical Editors). We surveyed 17 journals and found only one (BJOG), which explicitly mentioned "religious interest" as an example of a possible COI and one other journal included "personal belief" (Journal of Obstetrics and Gynaecology of India) as a COI...
February 7, 2018: Indian Journal of Medical Ethics
Márton Doleschall, Dóra Török, Katalin Mészáros, Andrea Luczay, Zita Halász, Krisztina Németh, Nikolette Szücs, Róbert Kiss, Judit Tőke, János Sólyom, György Fekete, Attila Patócs, Péter Igaz, Miklós Tóth
Congenital adrenal hyperplasia is a group of genetic diseases due to the disablement of 7 genes; one of them is steroid 21-hydroxylase deficiency. The genes of congenital adrenal hyperplasia encode enzymes taking part in the steroidogenesis of adrenal gland. Steroid 21-hydroxylase deficiency is an autosomal recessive disorder caused by mutations of the steroid 21-hydroxylase gene. The mutations of steroid 21-hydroxylase gene cause 95% of the congenital adrenal hyperplasia cases. Although the non-classic steroid 21-hydroxylase deficiency with mild symptoms is seldom diagnosed, the classic steroid 21-hydroxylase deficiency may lead to life-threatening salt-wasting and adrenal crises due to the insufficient aldosterone and cortisol serum levels...
February 2018: Orvosi Hetilap
Amala James Alenchery, Joanne Thoppil, Carl Denis Britto, Jimena Villar de Onis, Lavina Fernandez, P N Suman Rao
BACKGROUND: Skin to skin contact (SSC) at birth is the standard of care for newborns without risk factors. However, implementation of SSC at birth has been far from optimal. A qualitative study was undertaken to determine the barriers, enablers and potential solutions to implementation of SSC at birth in healthy newborn infants in a level III neonatal-care facility in Bangalore, India. METHODS: Consultants and residents/postgraduates (PG) from the departments of Obstetrics (n = 19) and Pediatrics (n = 14) and nurses (n = 8) in the labor room (LR) participated in the study...
February 9, 2018: BMC Pediatrics
Isabel A Barata, Joriane M Stadnyck, Meredith Akerman, Kate OʼNeill, Jill Castaneda, Anupama Subramony, Paula Fessler, Charles Schleien, John DʼAngelo
STUDY OBJECTIVE: A gap analysis of emergency departments' (EDs') pediatric readiness across a health system was performed after the appointment of a service line health system pediatric emergency medicine (PEM) quality director. METHODS: A 55-question survey was completed by each eligible ED to generate a weighted pediatric readiness score (WPRS). The survey included questions regarding volume, ED configuration, presence of a pediatric emergency care coordinator (PECC), quality initiatives, policies and procedures, and equipment...
February 5, 2018: Pediatric Emergency Care
Lee A Learman
Depression in pregnancy and the postpartum period is common, burdensome, and underrecognized. Guidelines from multiple organizations support routine screening once during pregnancy and again in the postpartum period. A variety of validated patient questionnaires are effective screening tools for pregnant and postpartum women. Universal screening programs can successfully overcome patient, clinician, and system barriers and reduce the burden of disease. Novel approaches include postpartum screening in pediatric settings and the use of e-screening to optimize privacy and facilitate scoring and interpretation...
January 31, 2018: Clinical Obstetrics and Gynecology
Pratibha Issar, Sirasapalli Chinna, Sanjeev Kumar Issar
Objective: To study and compare cerebral parenchymal changes and sinuses involvement in CT with MRI and MRV in Cerebral Venous Thrombosis patients. Method: This study was carried out in the Department of Radiodiagnosis, JLN Hospital and Research Center, Bhilai, Chhattisgarh from October 2012 to Nov 2014 and includes fifty patients of all age groups presenting with clinical symptoms of CVT, admitted in Neurology, Neurosurgery, Medicine, Pediatric, obstetric and Gynecology wards...
November 2017: Journal of the Association of Physicians of India
C-O Bagayoko, M Niang, A Anne, D Traoré, H Sangho, A-K Traoré, A Geissbuhler
The PACT-Denbaya project (Program for community access to telemedicine for families) aimed to help improve the health of mothers and child in rural communities through the delegation of obstetric-gynecologic and pediatric tasks, supported by teleconsultations. This operational research took place in 6 community health centers in the Dioïla health district in Mali. Our method was based of the delegation of tasks, supported by teleconsultations. Experts in pediatrics and obstetrics/gynecology provided a week-long training program to general practitioners and midwives, in the management of the most common problems in the field and in the use of the "Bogou" teleconsultation and "Dudal" tele-education platforms to ensure exchanges and follow-up...
November 1, 2017: Médecine et Santé Tropicales
Paula M Frew, Laura A Randall, Fauzia Malik, Rupali Lamaye, Andrew Wilson, Sean T O'Leary, Daniel Salmon, Meghan Donnelly, Kevin Ault, Matthew Z Dudley, Vincent L Fenimore, Saad B Omer
Pregnancy is an ideal time to communicate with women about vaccines for themselves and their infants, yet maternal immunization rates remain suboptimal. This study aimed to identify clinic, provider, and staff-related attributes and facilitators to be utilized for a comprehensive vaccine intervention in ob-gyn clinical settings. We conducted in-depth interviews with 24 providers, both healthcare providers (e.g., physicians, nurse practitioners, midwives) and practice managers, from urban and suburban ob-gyn practices in Georgia and Colorado about their immunization attitudes, practices, and patient experiences...
January 9, 2018: Human Vaccines & Immunotherapeutics
Thomas Caskey
Precision medicine was conceptualized on the strength of genomic sequence analysis. High-throughput functional metrics have enhanced sequence interpretation and clinical precision. These technologies include metabolomics, magnetic resonance imaging, and I rhythm (cardiac monitoring), among others. These technologies are discussed and placed in clinical context for the medical specialties of internal medicine, pediatrics, obstetrics, and gynecology. Publications in these fields support the concept of a higher level of precision in identifying disease risk...
December 20, 2017: Annual Review of Medicine
Andreas Chiabi, Félicitée D Nguefack, Florine Njapndounke, Marie Kobela, Kelly Kenfack, Séraphin Nguefack, Evelyn Mah, Georges Nguefack-Tsague, Fru Angwafo
BACKGROUND: Vaccination is a major, but simple and cost effective public health intervention in the prevention of infectious diseases, especially in children. Nowadays, many children still miss scheduled vaccines in the Extended Program of Immunization (EPI) or are being vaccinated after the recommended ages.This study was aimed at assessing vaccination completeness and timeliness in children aged 0 to 11 months attending the vaccination clinic of the Yaounde Gynaeco-Obstetric and Pediatric Hospital...
December 19, 2017: BMC Pediatrics
Natasha K Sriraman
The numerous benefits for both mother and baby of breastfeeding are evidence-based and well-defined. Breastmilk is the physiologic norm for infant nutrition, offering multiple health benefits and protections for mothers and babies. Although major medical and health organizations, which represent the health of women and children, such as the American Academy of Pediatrics (AAP), American College of Obstetrics and Gynecology (ACOG), American Academy of Family Practice (AAFP), Centers for Disease Control (CDC), UNICEF, the World Health Organization (WHO) and the National Public Health Service (NPHS), all recommend exclusive breastfeeding, few women meet the recommended goals for duration and exclusivity, despite high initiation rates...
December 2017: Current Problems in Pediatric and Adolescent Health Care
Susan Humphrey-Murto, Mylène Côté, Debra Pugh, Timothy J Wood
Construct: The purpose of this study was to provide validity evidence for the mini-clinical evaluation exercise (mini-CEX) as an assessment tool for clinical skills in the workplace. BACKGROUND: Previous research has demonstrated validity evidence for the mini-CEX, but most studies were carried out in internal medicine or single disciplines, therefore limiting generalizability of the findings. If the mini-CEX is to be used in multidisciplinary contexts, then validity evidence should be gathered in similar settings...
December 14, 2017: Teaching and Learning in Medicine
Eric Y Chen, Andrew Marcantonio, Paul Tornetta
Importance: The United States is experiencing an opioid abuse epidemic. Opioid overprescription by physicians may contribute to this epidemic. Objectives: To determine if there was a correlation between a postoperative patient's 24-hour predischarge opioid use and the amount of opioids prescribed at hospital discharge and to determine the number of patients who used no opioids prior to discharge but were still prescribed opioids after hospital discharge. Design, Setting, and Participants: This cross-sectional study performed a retrospective record review of 18 343 postoperative patients at Boston Medical Center and Lahey Hospital and Medical Center-Burlington Campus who were discharged home after a postoperative inpatient admission of at least 24 hours...
December 13, 2017: JAMA Surgery
Sunil Garg, Rubeena Arora, Sunil Kumar, Gautam Bir Singh
Specialty choices among medical graduates have undergone changes over time. We aimed to analyze status of otorhinolaryngology as specialty of choice among female medical graduates and factors affecting it. A total of 123 female medical graduates were surveyed during their internship over a period of 1 year in a tertiary-care hospital. Each intern was assessed using a questionnaire at the end of otorhinolaryngology rotation. The survey included nine questions about future career choices with special focus on ENT as a choice for specialization...
December 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
Anahi Perlas, Cristian Arzola, Peter Van de Putte
This narrative review summarizes the current knowledge on point-of-care ultrasound (POCUS) of gastric contents in order to inform an assessment of aspiration risk and guide anesthetic management at the bedside. An I-AIM framework (Indication, Acquisition, Interpretation, and Medical decision-making) is used to summarize and organize the content areas. This narrative review spans the breadth of the literature on pediatric and adult subjects as well as on special patient populations such as obstetric and severely obese individuals...
April 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
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