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Gynecology Emergency

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https://www.readbyqxmd.com/read/28919404/emergency-in-the-clinic-a-simulation-curriculum-to-improve-outpatient-safety
#1
Eve Espey, Gillian Baty, John Rask, Michelle Chungtuyco, Brenda Pereda, Lawrence Leeman
BACKGROUND: Emergency response skills are essential when events such as seizure, anaphylaxis or hemorrhage occur in the outpatient setting. As services and procedures increasingly move outside the hospital, training to manage complications may improve outcomes. OBJECTIVE: The objective of this study was to evaluate a simulation-based curriculum in outpatient emergency management skills with the outcome measures of graded objective performance and learner self-efficacy...
September 14, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28899594/delayed-detection-of-spontaneous-bilateral-tubal-ectopic-pregnancies-after-methotrexate-treatment
#2
Nicole E Brown, Shereen A Singer, Joe Suyama
BACKGROUND: Bilateral tubal ectopic pregnancies are a rare subset of ectopic pregnancy that can pose a diagnostic dilemma for clinicians. There is no distinct clinical presentation for bilateral tubal ectopic pregnancies, although they are typically associated with assistive reproductive techniques. In addition, there is no single diagnostic feature to help clinicians delineate bilateral tubal ectopic pregnancies from other types of ectopic pregnancy prior to passing the discriminatory zone (such as heterotopic pregnancy or twin ectopic [two gestational sacs in one tube])...
September 9, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28884300/what-every-radiologist-should-know-about-adnexal-torsion
#3
Guillaume Ssi-Yan-Kai, Anne-Laure Rivain, Caroline Trichot, Marie-Chantal Morcelet, Sophie Prevot, Xavier Deffieux, Jocelyne De Laveaucoupet
Adnexal torsion is the fifth most common gynecologic surgical emergency, requiring clinician and radiologist awareness. It involves the rotation of the ovarian tissue on its vascular pedicle leading to stromal edema, hemorrhagic infarction, and necrosis of the adnexal structures with the subsequent sequelae. Expedient diagnosis poses a difficult challenge because the clinical presentation is variable and often misleading. Adnexal torsion can mimic malignancy as it can take a subacute, intermittent, or chronic course, and thereby can be complicated to diagnose...
September 7, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28879096/spontaneous-miscarriage-in-first-trimester-pregnancy-is-associated-with-altered-urinary-metabolite-profile
#4
Chee Wai Ku, Zhen Wei Tan, Mark Kit Lim, Zhi Yang Tam, Chih-Hsien Lin, Sean Pin Ng, John Carson Allen, Sze Min Lek, Thiam Chye Tan, Nguan Soon Tan
Threatened miscarriage is the most common gynecological emergency, occurring in about 20% of pregnant women. Approximately one in four of these patients go on to have spontaneous miscarriage and the etiology of miscarriage still remains elusive. In a bid to identify possible biomarkers and novel treatment targets, many studies have been undertaken to elucidate the pathways that lead to a miscarriage. Luteal phase deficiency has been shown to contribute to miscarriages, and the measurement of serum progesterone as a prognostic marker and the prescription of progesterone supplementation has been proposed as possible diagnostic and treatment methods...
December 2017: BBA Clinical
https://www.readbyqxmd.com/read/28874936/factors-influencing-participation-in-clinical-trials-emergency-medicine-vs-other-specialties
#5
Anita Kurt, Hope M Kincaid, Charity Curtis, Lauren Semler, Matthew Meyers, Melanie Johnson, Beth A Careyva, Brian Stello, Timothy J Friel, Mark C Knouse, John C Smulian, Jeanne L Jacoby
INTRODUCTION: This study investigated factors that influence emergency medicine (EM) patients' decisions to participate in clinical trials and whether the impact of these factors differs from those of other medical specialties. METHODS: A survey was distributed in EM, family medicine (FM), infectious disease (ID), and obstetrics/gynecology (OB/GYN) outpatient waiting areas. Eligibility criteria included those who were 18 years of age or older, active patients on the day of the survey, and able to complete the survey without assistance...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28840453/immunotherapy-in-gynecologic-cancers-are-we-there-yet
#6
REVIEW
Janelle B Pakish, Amir A Jazaeri
Immune-targeted therapies have demonstrated durable responses in many tumor types with limited treatment options and poor overall prognosis. This has led to enthusiasm for expanding such therapies to other tumor types including gynecologic malignancies. The use of immunotherapy in gynecologic malignancies is in the early stages and is an active area of ongoing clinical research. Both cancer vaccines and immune checkpoint inhibitor therapy continue to be extensively studied in gynecologic malignancies. Immune checkpoint inhibitors, in particular, hold promising potential in specific subsets of endometrial cancer that express microsatellite instability...
August 24, 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28811044/learning-how-to-teach-one-a-needs-assessment-of-the-state-of-faculty-development-within-the-consortium-of-the-american-college-of-surgeons-accredited-education-institutes
#7
John T Paige, Nehal N Khamis, Jeffrey B Cooper
BACKGROUND: Developing faculty competencies in curriculum development, teaching, and assessment using simulation is critical for the success of the Consortium of the American College of Surgeons Accredited Education Institutes program. The state of and needs for faculty development in the Accredited Education Institute community are unknown currently. The Faculty Development Committee of the Consortium of the Accredited Education Institutes conducted a survey of Accredited Education Institutes to ascertain what types of practices are used currently, with what frequency, and what needs are perceived for further programs and courses to guide the plan of action for the Faculty Development Committee...
August 12, 2017: Surgery
https://www.readbyqxmd.com/read/28799272/results-of-a-national-multicenter-audit-assessment-of-gynecologic-history-in-surgical-patients
#8
Michael S J Wilson, Matilda Powell-Bowns, Andrew G Robertson, Andreas Luhmann, Colin H Richards
OBJECTIVE: To determine the adequacy of assessing gynecologic history for females of reproductive age (FRA) admitted to a general surgery department. METHODS: The present prospective multicenter audit included FRA who were admitted for elective or emergency procedures to general surgery departments in Scotland between May 11 and May 25, 2015. Data were compared between patients who were admitted for elective and emergency treatment. RESULTS: There were 530 FRA included from 18 centers, including 169 (31...
August 11, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28796031/anti-yo-positive-and-late-onset-paraneoplastic-cerebellar-degeneration-associated-with-ovarian-carcinoma-a-case-report
#9
Dan Cui, Li Xu, Wen-Yi Li, Wei-Dong Qian
RATIONALE: Paraneoplastic cerebellar degeneration (PCD) is a rare nonmetastatic neurological complication often associated with ovarian, breast, and other gynecologic cancers. Anti-Yo is one of the antionconeural antibodies found in patients with PCD. It primarily emerges before a malignancy is detected. PATIENT CONCERNS: In this report, we describe an unusual case involving a patient who exhibited anti-Yo-positive PCD 1 year after being diagnosed with ovarian cancer...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28795915/where-teachers-are-few-documenting-available-faculty-in-five-tanzanian-medical-schools
#10
Charles A Mkony, Ephata E Kaaya, Alex J Goodell, Sarah B Macfarlane
Background Faced with one of the lowest physician-to-population ratios in the world, the Government of Tanzania is urging its medical schools to train more physicians. The annual number of medical students admitted across the country rose from 55 in the 1990s to 1,680 approved places for the 2015/16 academic year. These escalating numbers strain existing faculty. Objective To describe the availability of faculty in medical schools in Tanzania. Design We identified faculty lists published on the Internet by five Tanzanian medical schools for the 2011/12 academic year and analyzed the appointment status, rank, discipline, and qualifications of faculty members...
December 2016: Global Health Action
https://www.readbyqxmd.com/read/28760367/effects-of-metformin-on-endometrial-cancer-systematic-review-and-meta-analysis
#11
REVIEW
Cinthia G Meireles, Sidney A Pereira, Luciana P Valadares, Daniela F Rêgo, Luiz A Simeoni, Eliete N S Guerra, Adriana Lofrano-Porto
BACKGROUND: Endometrial cancer is one of the most common gynecological cancers, which is frequently preceded by atypical endometrial hyperplasia, a premalignant lesion. Metformin, an antidiabetic drug, has emerged as a new adjunctive strategy for different cancer types, including endometrial cancer. This systematic review and meta-analysis aimed to evaluate the effects of metformin in atypical endometrial hyperplasia and endometrial cancer patients. METHODS: The search was conducted on January 2017 and the articles were collected in Cochrane, LILACS, PubMed, Scopus and Web of Science...
July 28, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28759301/a-rare-case-struma-ovarii-in-a-14-year-old-girl
#12
Elif Iltar, Isin Ureyen, Tayfun Toptas, Melike Savas, Sema Çekiç, Aysel Uysal
Ovarian tumors presented with ovarian mass in childhood and adolescence, these are uncommon but an important part of gynecological cases. Struma ovarii is one of the rare cystic benign ovarian tumors that is observed predominantly in women who are between the ages of 40 and 60 years old. It is extremely rare in adolescents. Herein, we present a 14-year-old adolescent girl with struma ovarii who presented to the emergency room with abdominal pain.
July 31, 2017: Journal of Adolescent and Young Adult Oncology
https://www.readbyqxmd.com/read/28758042/small-bowel-obstruction-caused-by-internal-hernia-through-a-peritoneal-defect-of-the-pouch-of-douglas-report-of-a-case-and-review-of-the-literature
#13
Pyong Wha Choi
Herniation of small bowel through the peritoneal defect of the Pouch of Douglas is extremely rare type of internal hernia, and this type of internal hernia has been described as an entity of perineal hernia. Here, we describe a case of a 26-year-old female without history of abdominal surgery presenting with incarcerated small bowel hernia through a peritoneal defect of the Pouch of Douglas. She visited an emergency department presenting with abdominal pain and distension. Without improvement symptom by conservative management, an operation was performed...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28756902/bevacizumab-for-advanced-cervical-cancer-final-overall-survival-and-adverse-event-analysis-of-a-randomised-controlled-open-label-phase-3-trial-gynecologic-oncology-group-240
#14
Krishnansu S Tewari, Michael W Sill, Richard T Penson, Helen Huang, Lois M Ramondetta, Lisa M Landrum, Ana Oaknin, Thomas J Reid, Mario M Leitao, Helen E Michael, Philip J DiSaia, Larry J Copeland, William T Creasman, Frederick B Stehman, Mark F Brady, Robert A Burger, J Tate Thigpen, Michael J Birrer, Steven E Waggoner, David H Moore, Katherine Y Look, Wui-Jin Koh, Bradley J Monk
BACKGROUND: On Aug 14, 2014, the US Food and Drug Administration approved the antiangiogenesis drug bevacizumab for women with advanced cervical cancer on the basis of improved overall survival (OS) after the second interim analysis (in 2012) of 271 deaths in the Gynecologic Oncology Group (GOG) 240 trial. In this study, we report the prespecified final analysis of the primary objectives, OS and adverse events. METHODS: In this randomised, controlled, open-label, phase 3 trial, we recruited patients with metastatic, persistent, or recurrent cervical carcinoma from 81 centres in the USA, Canada, and Spain...
July 27, 2017: Lancet
https://www.readbyqxmd.com/read/28753380/ct-and-mr-imaging-of-gynecologic-emergencies
#15
Yuko Iraha, Masahiro Okada, Rin Iraha, Kimei Azama, Tsuneo Yamashiro, Maho Tsubakimoto, Yoichi Aoki, Sadayuki Murayama
Gynecologic emergencies include various diseases that result from adnexal and uterine disorders. Adnexal disorders may be classified into the following three categories: (a) disorders that cause hemorrhage (hemorrhagic ovarian cysts and ectopic pregnancies); (b) disorders related to adnexal tumors (adnexal torsion and rupture of ovarian tumors); and (c) disorders related to pelvic inflammatory disease, such as tubo-ovarian abscesses. Unusual adnexal torsion, such as massive ovarian edema, isolated fallopian tube torsion, and paraovarian cyst torsion, has also been described...
September 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28698009/a-randomised-open-label-phase-2-study-of-the-ido1-inhibitor-epacadostat-incb024360-versus-tamoxifen-as-therapy-for-biochemically-recurrent-ca-125-relapse-only-epithelial-ovarian-cancer-primary-peritoneal-carcinoma-or-fallopian-tube-cancer
#16
RANDOMIZED CONTROLLED TRIAL
Rebecca Kristeleit, Irina Davidenko, Vadim Shirinkin, Fatima El-Khouly, Igor Bondarenko, Michael J Goodheart, Vera Gorbunova, Carol A Penning, Jack G Shi, Xiangdong Liu, Robert C Newton, Yufan Zhao, Janet Maleski, Lance Leopold, Russell J Schilder
OBJECTIVE: Indoleamine 2,3-dioxygenase-1 (IDO1) is a key regulator of immune tolerance in ovarian cancer. This study investigated efficacy and safety of the IDO1 enzyme inhibitor epacadostat versus tamoxifen in patients with biochemical-only recurrence (CA-125 elevation) following complete remission after first-line chemotherapy for advanced epithelial ovarian, primary peritoneal, or fallopian tube cancer. METHODS: In this open-label, phase 2 study (NCT01685255), patients were randomised 1:1 to epacadostat 600mg or tamoxifen 20mg twice daily for successive 28-day cycles and stratified by time since completion of first-line chemotherapy to first CA-125 elevation (3 to <12 or ≥12months)...
September 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28688814/proceedings-beyond-ultrasound-first-forum-on-improving-the-quality-of-ultrasound-imaging-in-obstetrics-and-gynecology
#17
Beryl R Benacerraf, Katherine K Minton, Carol B Benson, Bryann S Bromley, Brian D Coley, Peter M Doubilet, Wesley Lee, Samuel H Maslak, John S Pellerito, James J Perez, Eric Savitsky, Norman A Scarborough, Joseph Wax, Alfred Z Abuhamad
The Beyond Ultrasound First Forum was conceived to increase awareness that the quality of obstetric and gynecologic ultrasound can be improved, and is inconsistent throughout the country, likely due to multiple factors, including the lack of a standardized curriculum and competency assessment in ultrasound teaching. The forum brought together representatives from many professional associations; the imaging community including radiology, obstetrics and gynecology, and emergency medicine among others; in addition to government agencies, insurers, industry, and others with common interest in obstetric and gynecologic ultrasound...
July 6, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28668157/mr-imaging-of-pelvic-emergencies-in-women
#18
REVIEW
Ursula S Knoepp, Michael B Mazza, Suzanne T Chong, Ashish P Wasnik
MR imaging is a useful adjunct imaging modality for evaluating women presenting with acute lower abdominal/pelvic pain who have negative or inconclusive sonographic findings. In pregnant women, although obstetric complications are of prime concern, gastrointestinal pathologies also warrant careful attention, and MR imaging is often useful in refining the diagnosis. In nonpregnant women, gynecologic pathologies and gastrointestinal pathologies are of major concern, and may necessitate evaluation with MR imaging...
August 2017: Magnetic Resonance Imaging Clinics of North America
https://www.readbyqxmd.com/read/28657992/ready-or-not-obstetrics-and-gynecology-resident-preparedness-for-female-pelvic-medicine-and-reconstructive-surgery-training
#19
Tanaka J Dune, Robert H Blackwell, Arianna Griffin, Susanne Taege, Juliana Sung, Elizabeth R Mueller, Linda Brubaker
OBJECTIVE: The aim of this study was to assess the perception of female pelvic medicine and reconstructive surgery (FPMRS) program directors (PDs) and obstetrics and gynecology (OG) FMPRS fellows regarding the adequacy of OG residency as preparation for FPMRS fellowship. METHODS: Electronic invitations to complete a modified version of a validated survey were extended to FPMRS PDs and their second- and third-year OG FPMRS fellows who had just completed their first or second year of FPMRS fellowship, respectively...
June 27, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28654894/therapeutic-utility-of-natural-estrogen-receptor-beta-agonists-on-ovarian-cancer
#20
Jinyou Liu, Suryavathi Viswanadhapalli, Lauren Garcia, Mei Zhou, Binoj C Nair, Edward Kost, Rajeshwar Rao Tekmal, Rong Li, Manjeet K Rao, Tyler Curiel, Ratna K Vadlamudi, Gangadhara R Sareddy
Ovarian cancer is the deadliest of all gynecologic cancers. Despite success with initial chemotherapy, the majority of patients relapse with an incurable disease. Development of chemotherapy resistance is a major factor for poor long-term survival in ovarian cancer. The biological effects of estrogens are mediated by estrogen receptor alpha (ERα) and estrogen receptor beta (ERβ). Emerging evidence suggests that ovarian cancer cells express ERβ that functions as a tumor suppressor; however, the clinical utility of ERβ agonists in ovarian cancer remains elusive...
July 25, 2017: Oncotarget
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