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https://www.readbyqxmd.com/read/29777348/the-effect-of-labor-epidural-analgesia-on-maternal-fetal-outcomes-a-retrospective-cohort-study
#1
Qian Wang, Sheng-Xing Zheng, Yu-Fei Ni, Yuan-Yuan Lu, Bing Zhang, Qing-Quan Lian, Ming-Pin Hu
PURPOSE: To evaluate the impact of labor epidural analgesia on maternal-fetal safety outcomes in a signal Chinese academic medical center. METHODS: A single-intervention impact study was conducted at The Second Affiliated Hospital, Wenzhou Medical University. The study period was divided into three phases: (1) baseline phase: from January 1 and June 30, 2009 when no analgesic method was routinely employed during labor; (2) phase-in period: the epidural analgesia was implemented 8 a...
May 18, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29768662/immersion-in-water-during-labour-and-birth
#2
REVIEW
Elizabeth R Cluett, Ethel Burns, Anna Cuthbert
BACKGROUND: Water immersion during labour and birth is increasingly popular and is becoming widely accepted across many countries, and particularly in midwifery-led care settings. However, there are concerns around neonatal water inhalation, increased requirement for admission to neonatal intensive care unit (NICU), maternal and/or neonatal infection, and obstetric anal sphincter injuries (OASIS). This is an update of a review last published in 2011. OBJECTIVES: To assess the effects of water immersion during labour and/or birth (first, second and third stage of labour) on women and their infants...
May 16, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29757716/us-assessment-of-sports-related-hip-injuries
#3
Eugen Lungu, Johan Michaud, Nathalie J Bureau
Traumatic and overuse hip injuries occur frequently in amateur and professional athletes. After clinical assessment, imaging plays an important role in diagnosis and in defining care management of these injuries. Ultrasonography (US) is being increasingly used in assessment of hip injuries because of the wide availability of US machines, the lower cost, and the unique real-time imaging capability, which allows both static and dynamic evaluation as well as guidance of point-of-care interventions such as fluid aspiration and steroid injection...
May 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29757662/a-review-of-the-surgical-management-of-perineal-hernias-in-dogs
#4
Sukhjit Singh Gill, Robert D Barstad
Perineal hernia refers to the failure of the muscular pelvic diaphragm to support the rectal wall, resulting in herniation of pelvic and, occasionally, abdominal viscera into the subcutaneous perineal region. The proposed causes of pelvic diaphragm weakness include tenesmus associated with chronic prostatic disease or constipation, myopathy, rectal abnormalities, and gonadal hormonal imbalances. The most common presentation of perineal hernia in dogs is a unilateral or bilateral nonpainful swelling of the perineum...
May 14, 2018: Journal of the American Animal Hospital Association
https://www.readbyqxmd.com/read/29756068/patient-satisfaction-and-treatment-adherence-for-urban-adolescents-and-young-adults-with-pelvic-inflammatory-disease
#5
Jennifer Anders, Alexandra Hill, Shang-En Chung, Arlene Butz, Richard Rothman, Charlotte Gaydos, Jamie Perin, Maria Trent
Objectives: Urban adolescents with pelvic inflammatory disease (PID) often seek care in emergency departments (ED). This study examines the effect of the ED patient experience - wait time (WT) and length of stay (LOS) - on satisfaction and medication adherence among urban adolescents with PID. Methods: Adolescents with PID were enrolled in an urban teaching hospital ED. Chart data were matched with 2-week interview queries about satisfaction and medication adherence...
January 2018: Trauma and Emergency Care
https://www.readbyqxmd.com/read/29741208/induction-of-labour-for-improving-birth-outcomes-for-women-at-or-beyond-term
#6
REVIEW
Philippa Middleton, Emily Shepherd, Caroline A Crowther
BACKGROUND: Beyond term, the risks of stillbirth or neonatal death increase. It is unclear whether a policy of labour induction can reduce these risks. This Cochrane review is an update of a review that was originally published in 2006 and subsequently updated in 2012 OBJECTIVES: To assess the effects of a policy of labour induction at or beyond term compared with a policy of awaiting spontaneous labour or until an indication for birth induction of labour is identified) on pregnancy outcomes for infant and mother...
May 9, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29727829/maternal-and-perinatal-outcomes-by-planned-place-of-birth-among-women-with-low-risk-pregnancies-in-high-income-countries-a-systematic-review-and-meta-analysis
#7
REVIEW
Vanessa L Scarf, Chris Rossiter, Saraswathi Vedam, Hannah G Dahlen, David Ellwood, Della Forster, Maralyn J Foureur, Helen McLachlan, Jeremy Oats, David Sibbritt, Charlene Thornton, Caroline S E Homer
BACKGROUND: The comparative safety of different birth settings is widely debated. Comparing research across high-income countries is complex, given differences in maternity service provision, data discrepancies, and varying research techniques and quality. Studies of births planned at home or in birth centres have reported both better and poorer outcomes than planned hospital births. Previous systematic reviews have focused on outcomes from either birth centres or home births, with inconsistent attention to quality appraisal...
April 3, 2018: Midwifery
https://www.readbyqxmd.com/read/29682212/relationship-between-hospital-volume-and-short-term-outcomes-a-nationwide-population-based-study-including-75-280-rectal-cancer-surgical-procedures
#8
Salvatore Pucciarelli, Manuel Zorzi, Nicola Gennaro, Francesco Marchegiani, Andrea Barina, Massimo Rugge, Matteo Zuin, Alessandro Perin, Isacco Maretto, Francesca Bergamo, Caterina Boso, Emanuele Damiano Luca Urso, Patrick Frambach, Maria Chiara Corti
There is growing interest on the potential relationship between hospital volume (HV) and outcomes as it might justify the centralization of care for rectal cancer surgery. From the National Italian Hospital Discharge Dataset, data on 75,280 rectal cancer patients who underwent elective major surgery between 2002 and 2014 were retrieved and analyzed. HV was grouped into tertiles: low-volume performed 1-12, while high-volume hospitals performed 33+ procedures/year. The impact of HV on in-hospital mortality, abdominoperineal resection (APR), 30-day readmission, and length of stay (LOS) was assessed...
March 30, 2018: Oncotarget
https://www.readbyqxmd.com/read/29679245/a-systematic-review-of-minimally-invasive-surgery-for-retrorectal-tumors
#9
REVIEW
T G Mullaney, A L Lightner, M Johnston, S R Kelley, D W Larson, E J Dozois
Retrorectal tumors are rare tumors that require resection for symptoms, malignancy and potential malignant transformation. Traditional approaches have included laparotomy, perineal excision or a combination. Multiple minimally invasive techniques are available which have the potential to minimize morbidity and enhance recovery. We performed a systematic review of the literature to determine the feasibility and surgical outcomes of retrorectal tumors approached using minimally invasive surgical techniques. Publications in which adult patients (≥ 18 years) had a minimally invasive approach (laparoscopic or robotic) for resection of a primary retrorectal tumor were included...
April 20, 2018: Techniques in Coloproctology
https://www.readbyqxmd.com/read/29655872/-contribution-of-the-scrotal-flap-for-the-coverage-of-ischial-and-perineal-pressure-ulcers
#10
M Vantomme, R Viard, R Aimard, P-L Vincent, J-P Comparin, D Voulliaume
INTRODUCTION: The ischiatric pressure sore is a common pathology in rehabilitated spinal cord injured people, despite careful prevention. Medical treatment by discharge and directed healing is not always sufficient and surgery using local musculocutaneous flaps is often essential. Unfortunately, recidivism is frequent and the availability of local flaps is limited. The scrotal flap is an excellent complement to classic flaps, gluteal flaps or hamstrings. It can be used alone or in addition to another musculocutaneous flap, in first or second intention...
April 11, 2018: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/29607580/effectiveness-of-antenatal-perineal-massage-in-reducing-perineal-trauma-and-post-partum-morbidities-a-randomized-controlled-trial
#11
Emmanuel Onyebuchi Ugwu, Eric Sunday Iferikigwe, Samuel Nnamdi Obi, George Uchenna Eleje, Benjamin Chukwuma Ozumba
AIM: The study aimed to evaluate the effectiveness of antenatal perineal massage (APM) in reducing perineal trauma and post-partum morbidities. METHODS: A randomized controlled trial of 108 primigravidae at the University of Nigeria Teaching Hospital, Enugu, Nigeria, was conducted from January 2013 to May 2014. The intervention group received APM, while the control group did not receive APM. RESULTS: Women who received APM were significantly more likely to have an intact perineum after childbirth [27/53 (50...
April 2, 2018: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29605189/outbreak-of-invasive-group-a-streptococcus-investigations-using-agar-settle-plates-detects-perineal-shedding-from-a-healthcare-worker
#12
Nikunj Mahida, Katie Prescott, Carl Yates, Fay Spencer, Vivienne Weston, Tim Boswell
BACKGROUND: Outbreaks of group A streptococcus (GAS) infections can occur in healthcare settings. Transmission to patients is sometimes linked to colonised healthcare workers and/or a contaminated environment. AIM: This report describes the investigation and control of an outbreak of healthcare-associated GAS on an elderly care medical ward, over six months. METHODS: Four patients developed septicaemia due to GAS infection without a clinically obvious site of infection...
March 29, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29602552/screening-practices-and-associated-anomalies-in-infants-with-anorectal-malformations-results-from-the-midwest-pediatric-surgery-consortium
#13
Peter C Minneci, Rashmi S Kabre, Grace Z Mak, Devin R Halleran, Jennifer N Cooper, Amin Afrazi, Casey M Calkins, Cynthia D Downard, Peter Ehrlich, Jason Fraser, Samir K Gadepalli, Michael A Helmrath, Jonathan E Kohler, Rachel Landisch, Matthew P Landman, Constance Lee, Charles M Leys, Daniel L Lodwick, Rodrigo Mon, Beth McClure, Beth Rymeski, Jacqueline M Saito, Thomas T Sato, Shawn D St Peter, Richard Wood, Marc A Levitt, Katherine J Deans
BACKGROUND: This study evaluates screening practices and the incidence of associated anomalies in infants with anorectal malformations (ARM). METHODS: We performed a multi-institutional retrospective cohort study of children born between 2007 and 2011 who underwent surgery for ARM at 10 children's hospitals. ARM type was classified based on the location of the distal rectum, and all screening studies were reviewed. RESULTS: Among 506 patients, the most common ARM subtypes were perineal fistula (40...
March 7, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29581628/the-effect-of-interval-from-completion-of-short-course-radiotherapy-to-surgery-on-the-post-operative-morbidity-and-mortality-of-patients-with-rectal-cancer
#14
T D A Neely, C J Tan, S T Irwin
Aim: Surgery is the mainstay of treatment for invasive rectal cancer. Advances in surgical technique and radiotherapy over the past few decades have resulted in improved local control and survival.1 - 3 Some concern remains regarding the morbidity associated with performing surgery within a short window following radiotherapy. The current study assessed whether the interval between short-course radiotherapy and surgery influences all cause post-operative morbidity and mortality. Methods: All patients who had undergone short-course radiotherapy for rectal cancer within the Belfast Health and Social Care Trust from 2005 to 2014 held on a prospective database were included (n=102)...
September 2017: Ulster Medical Journal
https://www.readbyqxmd.com/read/29580304/impact-of-discontinuing-contact-precautions-for-methicillin-resistant-staphylococcus-aureus-and-vancomycin-resistant-enterococcus-an-interrupted-time-series-analysis
#15
Gonzalo Bearman, Salma Abbas, Nadia Masroor, Kakotan Sanogo, Ginger Vanhoozer, Kaila Cooper, Michelle Doll, Michael P Stevens, Michael B Edmond
OBJECTIVETo investigate the impact of discontinuing contact precautions among patients infected or colonized with methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE) on rates of healthcare-associated infection (HAI). DESIGN: Single-center, quasi-experimental study conducted between 2011 and 2016.METHODSWe employed an interrupted time series design to evaluate the impact of 7 horizontal infection prevention interventions across intensive care units (ICUs) and hospital wards at an 865-bed urban, academic medical center...
June 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29577777/factors-associated-with-spontaneous-perineal-lacerations-in-deliveries-without-episiotomy-in-a-university-maternity-hospital-in-the-city-of-recife-brazil-a-cohort-study
#16
Vanessa Maria Laranjeiras Lins, Fernanda Barros Lima Vasconcelos, Leila Katz, Isabela Coutinho, Melania Amorim
OBJECTIVES: To determine factors associated with spontaneous perineal laceration in low-risk pregnant women who delivered vaginally without episiotomy in a university maternity hospital in Recife, Pernambuco, Brazil. METHODS: A prospective cohort study was conducted with 222 low-risk, full-term pregnant women admitted in labor with a single fetus in cephalic presentation. Women with malformed fetuses were excluded from the study. The variables analyzed were: the frequency and severity of lacerations, the women's biological, sociodemographic, clinical and obstetrical characteristics, neonatal characteristics and data on their deliveries and procedures...
March 25, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29575180/sonographic-assessment-of-the-anal-sphincter-after-obstetric-anal-sphincter-injury-oasi-using-transperineal-ultrasound-tpus
#17
EDITORIAL
Vered H Eisenberg, Dan V Valsky, Simcha Yagel
Obstetric anal sphincter injury (OASI) is the most common cause of anal incontinence and ano-rectal symptoms in women1 . Reported rates of anal incontinence following primary repair of OASI range between 15-61%, with a mean of 39%2, 3 . Other possible complications of OASI include perineal pain, dyspareunia, and less commonly, abscess formation, wound breakdown, and rectovaginal fistulae. Symptom onset may occur immediately, several years postpartum, or only late in life when aging of tissues adds to the delivery insult...
March 24, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29559867/opiate-prescribing-practices-in-the-postpartum-unit
#18
Angela Nakahara, Nicole D Ulrich, Rajiv Gala
Background: Louisiana is significantly impacted by the opioid epidemic. In preparation for a quality improvement project aimed at decreasing postpartum narcotics prescriptions, we evaluated routine prescribing practices on a postpartum unit and the number of patient-initiated encounters for postpartum pain. Methods: We conducted a retrospective medical record review of all vaginal deliveries occurring at Ochsner Baptist Medical Center in New Orleans, LA in December 2016 and January 2017...
2018: Ochsner Journal
https://www.readbyqxmd.com/read/29533258/patients-at-high-risk-for-obstructive-sleep-apnea-are-at-increased-risk-for-atrial-fibrillation-after-cardiac-surgery-a-cohort-analysis
#19
Nika Karimi, Marta Kelava, Perin Kothari, Nicole M Zimmerman, A Marc Gillinov, Andra E Duncan
BACKGROUND: Patients with obstructive sleep apnea (OSA) experience intermittent hypoxia, hypercarbia, and sympathetic activation during sleep, which increases risk for paroxysmal atrial fibrillation and other cardiac arrhythmias. Whether patients with OSA experience increased episodes of atrial fibrillation after cardiac surgery is unclear. We examined whether patients at increased risk for OSA, assessed by the STOP-BANG (snoring, tired during the day, observed stop breathing during sleep, high blood pressure, body mass index more than 35 kg/m, age more than 50 years, neck circumference more than 40 cm, and male gender) questionnaire, had a higher incidence of new-onset postoperative atrial fibrillation after cardiac surgery...
March 12, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29530664/vulvar-field-resection-based-on-ontogenetic-cancer-field-theory-for-surgical-treatment-of-vulvar-carcinoma-a-single-centre-single-group-prospective-trial
#20
Michael Höckel, Sophia Trott, Nadja Dornhöfer, Lars-Christian Horn, Bettina Hentschel, Benjamin Wolf
BACKGROUND: The incidence of vulvar cancer is increasing, but surgical treatment-the current standard of care-often leads to unsatisfactory outcomes, especially in patients with node-positive disease. Preliminary results at our centre showed that locoregional spread of vulvar carcinoma occurs within tissue domains defined by stepwise embryonic and fetal development (ontogenetic cancer fields and associated lymph node regions). We propose that clinical translation of these insights into practice could improve outcomes of surgical treatment of vulvar cancer...
April 2018: Lancet Oncology
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