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https://www.readbyqxmd.com/read/28209490/surgical-site-infection-in-gynecologic-surgery-pathophysiology-and-prevention
#1
REVIEW
Holly L Steiner, Eric A Strand
Surgical site infections (SSIs) represent a well-known cause of patient morbidity as well as added healthcare costs. In gynecologic surgery, particularly hysterectomy, SSIs are often the result of a number of risk factors that may or may not be modifiable. As both the Centers for Medicaid and Medicare Services and the Joint Commission on the Accreditation of Healthcare Organizations have identified SSIs as a patient safety priority, gynecologic surgeons continue to seek out the most effective interventions for SSI prevention...
February 13, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28192735/risk-factors-for-postoperative-urinary-tract-infection-following-midurethral-sling-procedures
#2
Melike Doganay, Sabri Cavkaytar, Mahmut Kuntay Kokanali, Irfan Ozer, Orhan Seyfi Aksakal, Salim Erkaya
OBJECTIVE: To identify the potential risk factors for urinary tract infections following midurethral sling procedures. STUDY DESIGN: 556 women who underwent midurethral sling procedure due to stress urinary incontinence over a four-year period were reviewed in this retrospective study. Of the study population, 280 women underwent TVT procedures and 276 women underwent TOT procedures. Patients were evaluated at 4-8 weeks postoperatively and were investigated for the occurrence of a urinary tract infection...
February 6, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28182855/consensus-bundle-on-prevention-of-surgical-site-infections-after-major-gynecologic-surgery
#3
Joseph E Pellegrini, Paloma Toledo, David E Soper, William C Bradford, Deborah A Cruz, Barbara S Levy, Lauren A Lemieux
Surgical site infections are the most common complication of surgery in the United states. Of surgeries in women of reproductive age, hysterectomy is one of the most frequently performed, second only to cesarean birth. Therefore, prevention of surgical site infections in women undergoing gynecologic surgery is an ideal topic for a patient safety bundle. The primary purpose of this safety bundle is to provide recommendations that can be implemented into any surgical environment in an effot to reduce the incidence of surgical site infection...
February 6, 2017: AANA Journal
https://www.readbyqxmd.com/read/28182668/cross-sectional-study-of-mode-of-delivery-and-maternal-and-perinatal-outcomes-in-mainland-china
#4
Lei Hou, Susan Hellerstein, Allison Vitonis, Liying Zou, Yan Ruan, Xin Wang, Weiyuan Zhang
BACKGROUND: Cesarean delivery (CD) rates have risen globally with nearly 50% of the non-indicated CDs worldwide in China and Brazil. In China's One Child Policy era (1979-2015) most deliveries were women having their only child. Family size is a major determinant of the safety of medically non-indicated CD or CD on maternal request. The goal of this study is to document CD rates, indications, and analyze the relative safety of non-indicated CD compared to SVD and intrapartum CD. METHODS: Univariate and multivariate logistic regression analyses of the association between mode of delivery and short-term maternal and perinatal outcomes were performed on a cross-section of all deliveries at 39 hospitals in 14 provinces of China in 2011, presented as adjusted odds ratio (aOR), 99% confidence intervals (CI)...
2017: PloS One
https://www.readbyqxmd.com/read/28174186/avoiding-misdiagnosis-cystic-calcified-brain-metastases-of-uterine-cervical-cancer-mimicking-neurocysticercosis
#5
Jacopo Fantini, Arianna Sartori, Paolo Manganotti
The radiological finding of multiple calcified brain lesions is atypical for brain metastases and in absence of a clear evidence of disseminated neoplastic disease the differential diagnosis may be difficult. Calcified brain metastases (CBM) are rarely encountered in clinical practice and they mostly arise from lung, breast and gastrointestinal primitive tumours. Only one case of uterine cervical carcinoma (UCC) with CBM has been reported so far. We describe the case of a 41-year-old Caucasian woman with a history of hysterectomy and bilateral salpingo-oophorectomy for UCC 3 years prior to observation and no evidence of neoplastic recurrence that developed cystic CBM...
February 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28169182/reproductive-disorders-of-marsupials
#6
REVIEW
Cathy A Johnson-Delaney, Angela M Lennox
Marsupial reproduction differs significantly in anatomy and physiology from that of placental mammals. The gastrointestinal and urogenital tracts empty into a cloaca. Reproductive parameters include gestation and pouch time, as the fetus develops outside of the uterus. Captive marsupials discussed include sugar gliders), short-tailed opossums, Virginia opossums, and Tammar and Bennett's wallabies. Common disease conditions include joey eviction, pouch infections, mastitis, metritis, prostatitis, penile necrosis, and neoplasia...
February 4, 2017: Veterinary Clinics of North America. Exotic Animal Practice
https://www.readbyqxmd.com/read/28110586/prediction-of-maternal-near-miss-in-placenta-previa-a-retrospective-analysis-from-a-tertiary-center-in-ankara-turkey
#7
Bora Coskun, Iltac Akkurt, Rıza Dur, Mehmet O Akkurt, Seval Y Ergani, Ozerk T Turan, Bugra Coskun
AIM: To determine risk factors for severe complications during and after cesarean delivery (CD) in placenta previa (PP). METHODS: We reviewed retrospectively collected data from women with PP who underwent CD during a 6-year study period. We identified the complicated group based on the modified World Health Organization near-miss criteria. Complicated and non-complicated groups were compared considering clinical, laboratory, and sonographic features. RESULTS: Thirty-seven of 256 cases classified as near miss consisting of 14 peripartum hysterectomies, 12 uterine balloon placements, 10 great artery ligations, and 4 B-lynch suture placement procedures without maternal mortality...
January 23, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28004013/aberrant-expression-of-interleukin-6-and-its-receptor-in-fallopian-tubes-bearing-an-ectopic-pregnancy-with-and-without-tubal-cytomegalovirus-infection
#8
Ahmed Mohamed Ashshi
Cytomegalovirus (CMV) has recently been suggested as a potential risk factor for the development of ectopic pregnancy (EP) following upper genital tract infection in women. However, little is known about its associated underlying pathogenic mechanisms. This was a prospective case-control study that measured the prevalence of CMV infection in Fallopian tubes (FT) bearing an EP and its effects on the tubal expression of interleukin (IL)-6 and its signaling molecules, which are known to play significant roles in the immune response against CMV infection as well as embryo implantation...
December 2016: Virusdisease
https://www.readbyqxmd.com/read/28002311/committee-opinion-no-685-care-for-transgender-adolescents
#9
(no author information available yet)
Gender nonconforming youth are an underserved population who obstetrician-gynecologists are seeing increasingly in their practices. Currently, there are large gaps in training, knowledge, and comfort with transgender patients among obstetrician-gynecologists. The purpose of this document is to review current recommendations that apply to an obstetrician-gynecologist. It is important for obstetrician-gynecologists to be aware of the social and mental health risks for the transgender population. Consensus guidelines support initiating medical therapy after an adolescent has an established diagnosis of transgender identity and has reached Tanner stage II development...
January 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28002306/committee-opinion-no-685-summary-care-for-transgender-adolescents
#10
(no author information available yet)
Gender nonconforming youth are an underserved population who obstetrician-gynecologists are seeing increasingly in their practices. Currently, there are large gaps in training, knowledge, and comfort with transgender patients among obstetrician-gynecologists. The purpose of this document is to review current recommendations that apply to an obstetrician-gynecologist. It is important for obstetrician-gynecologists to be aware of the social and mental health risks for the transgender population. Consensus guidelines support initiating medical therapy after an adolescent has an established diagnosis of transgender identity and has reached Tanner stage II development...
January 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27955845/consensus-bundle-on-prevention-of-surgical-site-infections-after-major-gynecologic-surgery
#11
Joseph E Pellegrini, Paloma Toledo, David E Soper, William C Bradford, Deborah A Cruz, Barbara S Levy, Lauren A Lemieux
Surgical site infections are the most common complications of surgery in the United States. Of surgeries in women of reproductive age, hysterectomy is one of the most frequently performed, second only to cesarean birth. Therefore, prevention of surgical site infections in women undergoing gynecologic surgery is an ideal topic for a patient safety bundle. The primary purpose of this safety bundle is to provide recommendations that can be implemented into any surgical environment in an effort to reduce the incidence of surgical site infection...
January 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/27938988/incidence-and-risk-factors-for-surgical-site-infection-post-hysterectomy-in-a-tertiary-care-center
#12
Aurora Pop-Vicas, Jackson S Musuuza, Michelle Schmitz, Ahmed Al-Niaimi, Nasia Safdar
BACKGROUND: Preoperative antibiotic prophylaxis and surgical technological advances have greatly reduced, but not totally eliminated surgical site infection (SSI) posthysterectomy. We aimed to identify risk factors for SSI posthysterectomy among women with a high prevalence of gynecologic malignancies, in a tertiary care setting where compliance with the Joint Commission's Surgical Care Improvement Project core measures is excellent. METHODS: The study was a matched case-control, 2 controls per case, matched on date of surgery...
December 9, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/27926638/determining-optimal-route-of-hysterectomy-for-benign-indications-clinical-decision-tree-algorithm
#13
Jennifer J Schmitt, Daniel A Carranza Leon, John A Occhino, Amy L Weaver, Sean C Dowdy, Jamie N Bakkum-Gamez, Kalyan S Pasupathy, John B Gebhart
OBJECTIVE: To evaluate practice change after initiation of a robotic surgery program using a clinical algorithm to determine the optimal surgical approach to benign hysterectomy. METHODS: A retrospective postrobot cohort of benign hysterectomies (2009-2013) was identified and the expected surgical route was determined from an algorithm using vaginal access and uterine size as decision tree branches. We excluded the laparoscopic hysterectomy route. A prerobot cohort (2004-2005) was used to evaluate a practice change after the addition of robotic technology (2007)...
January 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27926634/consensus-bundle-on-prevention-of-surgical-site-infections-after-major-gynecologic-surgery
#14
Joseph E Pellegrini, Paloma Toledo, David E Soper, William C Bradford, Deborah A Cruz, Barbara S Levy, Lauren A Lemieux
Surgical site infections are the most common complication of surgery in the United States. Of surgeries in women of reproductive age, hysterectomy is one of the most frequently performed, second only to cesarean birth. Therefore, prevention of surgical site infections in women undergoing gynecologic surgery is an ideal topic for a patient safety bundle. The primary purpose of this safety bundle is to provide recommendations that can be implemented into any surgical environment in an effort to reduce the incidence of surgical site infection...
January 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27923167/long-term-outcomes-for-different-vaginal-cuff-closure-techniques-in-robotic-assisted-laparoscopic-hysterectomy-a-randomized-controlled-trial
#15
Ziv Tsafrir, Matthew Palmer, Marisa Dahlman, A Karim Nawfal, Joelle Aoun, Andrew Taylor, Jay Fisher, Evan Theoharis, David Eisenstein
OBJECTIVE: This randomized controlled trial aimed to evaluate the outcomes of different vaginal cuff closure techniques in robotic-assisted total laparoscopic hysterectomy. STUDY DESIGN: Ninety women undergoing robotic-assisted total laparoscopic hysterectomy for benign disease were randomized to three vaginal cuff closure techniques: running 2.0 V-Lock™ (Arm 1), 0 Vicryl™ figure-of-eight (Arm 2), and running 0 Vicryl™ with Lapra-Ty(®) (Arm 3). Patients' records were reviewed for age, body mass index, smoking status and relevant co-morbidities...
November 16, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27918335/consensus-bundle-on-prevention-of-surgical-site-infections-after-major-gynecologic-surgery
#16
Joseph E Pellegrini, Paloma Toledo, David E Soper, William C Bradford, Deborah A Cruz, Barbara S Levy, Lauren A Lemieux
Surgical site infections are the most common complication of surgery in the United States. Of surgeries in women of reproductive age, hysterectomy is one of the most frequently performed, second only to cesarean birth. Therefore, prevention of surgical site infections in women undergoing gynecologic surgery is an ideal topic for a patient safety bundle. The primary purpose of this safety bundle is to provide recommendations that can be implemented into any surgical environment in an effort to reduce the incidence of surgical site infection...
January 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27895842/postoperative-outcome-of-caesarean-sections-and-other-major-emergency-obstetric-surgery-by-clinical-officers-and-medical-officers-in-malawi
#17
Garvey Chilopora, Caetano Pereira, Francis Kamwendo, Agnes Chimbiri, Eddie Malunga, Staffan Bergström
BACKGROUND: Clinical officers perform much of major emergency surgery in Malawi, in the absence of medical officers. The aim of this study was to validate the advantages and disadvantages of delegation of major obstetric surgery to non-doctors. METHODS: During a three month period, data from 2131 consecutive obstetric surgeries in 38 district hospitals in Malawi were collected prospectively. The interventions included caesarean sections alone and those that were combined with other interventions such as subtotal and total hysterectomy repair of uterine rupture and tubal ligation...
September 2016: Malawi Medical Journal: the Journal of Medical Association of Malawi
https://www.readbyqxmd.com/read/27856389/mini-laparoscopy-of-removal-partial-adnexae-at-the-time-of-hysterectomy
#18
António Gutierrez Setúbal, João Sequeira Alves, Olga Lavado, Joana Faria
STUDY OBJECTIVE: To describe our technique of mini laparoscopic adnexectomy or salpingectomy at the time of total laparoscopic hysterectomy DESIGN: Step-by-step video explanation of our technique SETTING: The advantages of laparoscopic surgery have been widely recognised in the past two decades: improved vision, exposure, reduction in operative trauma because of smaller incisions and more gentle tissue´s handling, that result in a faster postoperative recovery. The technology development has allowed the use of smaller caliber instruments while maintaining the high standard surgical performance...
November 14, 2016: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/27848904/-a-postpartum-woman-with-toxic-shock-syndrome-group-a-streptococcal-infection-a-much-feared-postpartum-complication
#19
K Abbink, J C Kortekaas, M P Buise, J Dokter, S M I Kuppens, T H M Hasaart
BACKGROUND: The development of toxic shock syndrome (TSS) after an invasive group A streptococcal (GAS) infection in the postpartum period is a much feared complication. The mortality rate of TSS with necrotizing fasciitis is 30 to 50%. CASE DESCRIPTION: We present the case of a woman with atypical pelvic pain which was the first symptom of toxic shock syndrome as a consequence of a GAS infection. Clinical deterioration necessitated a hysterectomy. Also a fasciotomy was performed as consequence of lower extremity compartment syndrome...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27836494/associations-between-vaginal-infections-and-potential-high-risk-and-high-risk-human-papillomavirus-genotypes-in-female-sex-workers-in-western-kenya
#20
Sonia Menon, Davy Vanden Broeck, Rodolfo Rossi, Emilomo Ogbe, Stacy Harmon, Hillary Mabeya
PURPOSE: Infection with and persistence of high-risk human papillomavirus (HR HPV) are the strongest risk factors for cervical cancer. Little is known about the prevalence and role of concurrent sexually transmitted infections (STIs) found in HPV-infected female sex workers (FSW) in Africa. This study purports to test our a priori hypotheses that STIs are associated with genotypes pertaining to the α-group species 9. The objectives were to determine the prevalence of bacterial vaginosis (BV), Trichomonas vaginalis, and Candida spp in FSW, the association between these STIs and the prevalence of any potential HR and HR HPV genotypes in FSWs...
December 2016: Clinical Therapeutics
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