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Gynecology Emergency

Michael A Mazzeffi, John M See, Brittney Williams, Justin Richards, Darin Zimmerman, Samuel Galvagno, Magali Fontaine, Kenichi Tanaka
BACKGROUND: Red blood cell (RBC) transfusion can be life-saving; however, the risks of RBC transfusion have been increasingly recognized, and current guidelines recommend restrictive transfusion in most patients. We hypothesized that RBC transfusions are decreasing in surgical patients. STUDY DESIGN AND METHODS: A retrospective review of the National Surgical Quality Improvement Program database was performed from 2011 to 2015. Index cases in five surgical specialties were studied: neurosurgery, thoracic surgery, gynecologic surgery, orthopedic surgery, and vascular surgery...
March 14, 2018: Transfusion
Dilek Uysal, Hakan Cokmez, Cetin Aydin, Tolga Ciftpinar
Postpartum haemorrhage is the most important cause of maternal morbidity and mortality, especially when all conservative measures, including syntometrine oxytocin and Bakri balloons have failed to accomplish haemostasis and expeditious surgical procedures, such as uterine artery ligation and emergency peripartum hysterectomy (EPH) are required. This retrospective study analysed 31 cases of EPH performed between January 2007 and January 2016 in the Department of Gynecology and Obstetrics of Izmir Ataturk Teaching and Research Hospital...
March 2018: JPMA. the Journal of the Pakistan Medical Association
Rosalyn E Maben-Feaster, R Brent Stansfield, AnneMarie Opipari, Maya M Hammoud
BACKGROUND: One-third of Americans use social media websites as a source of health care information. Twitter, a microblogging site that allows users to place 280-character posts-or tweets-on the Web, is emerging as an important social media platform for health care. However, most guidelines on medical professionalism on social media are based on expert opinion. OBJECTIVE: This study sought to examine if provider Twitter profiles with educational tweets were viewed as more professional than profiles with personal tweets or a mixture of the two, and to determine the impact of provider gender on perceptions of professionalism in an academic obstetrics and gynecology clinic...
March 12, 2018: Journal of Medical Internet Research
Luisa Bonilla, Amit Oza, Stephanie Lheureux
Epithelial Ovarian Cancer (EOC) is the most lethal gynecological malignancy. EOC outcomes remain unsatisfactory despite aggressive surgical approach, disease chemo-sensitivity and recent introduction of agents targeting angiogenesis and tumour genome instability. Advances in EOC research have allowed for a tailored treatment approach and accelerated development of novel treatments strategies from bench to bed side, anticipated to improve patient outcomes. Areas covered: Comprehensive review of growth factor receptor antagonists for EOC treatment currently in different stages of development was performed...
March 2018: Expert Opinion on Emerging Drugs
Jessica Janine Liu, John Justin Matelski, Chaim M Bell
BACKGROUND: Physician ratings websites have emerged as a novel forum for consumers to comment on their health care experiences. Little is known about such ratings in Canada. OBJECTIVE: We investigated the scope and trends for specialty, geographic region, and time for online physician ratings in Canada using a national data source from the country's leading physician-rating website. METHODS: This observational retrospective study used online ratings data from Canadian physicians (January 2005-September 2013; N=640,603)...
March 7, 2018: Journal of Medical Internet Research
N C Schmidt, V Fargnoli, M Epiney, O Irion
BACKGROUND: Migrant mothers in developed countries often experience more complicated pregnancy outcomes and less fewer women access preventive gynecology services. To enlighten health care providers to potential barriers, the objective of this paper is to explore barriers to reproductive health services in Geneva described by migrant women from a qualitative perspective. METHODS: In this qualitative study, thirteen focus groups (FG) involving 78 women aged 18 to 66 years were conducted in seven languages...
March 6, 2018: Reproductive Health
Ashraf Talaat Youssef
INTRODUCTION: Many uncommon obstetric and gynecologic problems associated with pregnancy and the early postpartum period can lead to severe abdominal pain and be life-threatening. The patient will be in urgent need of a quick and accurate decision. The means of management will depend on the ability to differentiate between these problems to achieve an optimal diagnosis. MATERIALS AND METHODS: 30 pregnant females attended a private obstetric ultrasound clinic with clinical picture of acute abdomen with pregnancy...
March 3, 2018: Journal of Ultrasound
Jason D Wright, Laura J Havrilesky, David E Cohn, Yongmei Huang, Jill Rathbun, Laurel W Rice, Carol L Brown, Ronald D Alvarez, Emily M Ko
OBJECTIVE: To design an endometrial cancer (EC) alternative payment (ECAP) model focused on surgical management of EC, as well as identify drivers of cost in order to develop opportunities for cost-savings while maintaining quality of care. METHODS: National practice patterns and reimbursements were compared between private payers (MarketScan data, years 2009-13) and public payers (Medicare, year 2014) of EC patients who underwent hysterectomy. An episode of care for EC included the hysterectomy, stratified by surgical approach (laparotomy versus robotic versus laparoscopy), and in- and outpatient reimbursements from 30days preoperatively to 60days postoperatively...
February 26, 2018: Gynecologic Oncology
Giulio Sozzi, Stefano Uccella, Roberto Berretta, Marco Petrillo, Francesco Fanfani, Giorgia Monterossi, Viola Ghizzoni, Tiziana Frusca, Fabio Ghezzi, Vito Chiantera, Giovanni Scambia
OBJECTIVE: The identification of patients with endometrial cancer (EC) at higher risk for relapse is critical to individualize and better tailor postoperative treatment. No evidence is available regarding the possible association between tumor size (TS) and the risk of local recurrence. The purpose of this study was to analyze the correlation between TS and risk/type of recurrence in EC patients, stratified according to the new European Society of Medical Oncology-European Society of Gynecological Oncology-European Society for Radiotherapy and Oncology classification...
February 28, 2018: International Journal of Gynecological Cancer
Ahmed Abu-Zaid, Mohannad Alsabban, Mohammed Abuzaid, Osama Alomar, Ismail A Al-Badawi, Hany Salem
INTRODUCTION: Inherited ABO blood groups have been shown to play possible contributions in the pathogenesis of various gynecologic and non-gynecologic carcinomas. With regard to gynecologic carcinomas, there is a confined number of studies that explored the relationship between ABO blood group and endometrial carcinoma (EC) in the PubMed-indexed literature. To the best of our knowledge, no such study has ever been conducted in Saudi Arabia. OBJECTIVES: Our study has two objectives: (I) to determine the prevalence of ABO blood groups among Saudi patients with EC, and (II) to explore the relationship between ABO blood group and several clinico-pathological prognostic parameters (namely: menopausal status [age], body mass index [BMI], tumor grade, FIGO [Fédération Internationale de Gynécologie et d'Obstétrique] stage and recurrence) in Saudi patients with EC...
December 18, 2017: Curēus
Lei Wang, Xing Cheng Wang, Xinyu Li, Yan Gu, Jun Zhou, Shuwan Jiang, Jiajia Liu, Chong Wu, Zhiyan Ding, Yafeng Wan, Chenghai Wang
In recent decades, emerging evidence demonstrates that ultraconserved elements (UCEs) encoding noncoding RNAs serve as regulators of gene expression. Until now, the role of uc.189 in human cancers remains undefined and the clinical significance of uc.189 in gynecological cancers remains unknown. This study was to identify the prognostic value of uc.189 expression in gynecological cancers. Tissue microarrays were constructed with 243 samples including 116 cervical squamous cell carcinomas (CSCCs), 98 endometrial adenocarcinomas (EACs), 29 ovarian cystoadenocarcinomas(OCAs), and corresponding normal tissues...
January 26, 2018: Oncotarget
Gigin Lin, Chyong-Huey Lai, Tzu-Chen Yen
Molecular imaging (mainly PET and MR imaging) has played important roles in gynecologic oncology. Emerging MR-based technologies, including DWI, CEST, DCE-MR imaging, MRS, and DNP, as well as FDG-PET and many novel PET radiotracers, will continuously improve practices. In combination with radiomics analysis, a new era of decision making in personalized medicine and precisely guided radiation treatment planning or real-time surgical interventions is being entered into, which will directly impact on patient survival...
April 2018: PET Clinics
Maria Cristina Marzola, Sotirios Chondrogiannis, Domenico Rubello
Ovarian cancer is one of the most common gynecologic cancers and one of the leading causes of cancer death in women. It is often asymptomatic in early stages, and thus most patients are diagnosed when it is of advanced stage. For these reasons, the role of biomarkers and tomographic imaging is crucial. Fludeoxyglucose F 18 PET/CT is a useful imaging modality in different clinical settings of the disease, overcoming some limits of conventional imaging and influencing prognosis and therapeutic approaches. PET/MR imaging is an emerging modality, and its potential role remains to be explored...
April 2018: PET Clinics
Brian R Wood, Vanessa M McMahan, Kelly Naismith, Jonathan B Stockton, Lori A Delaney, Joanne D Stekler
BACKGROUND: We aimed to assess HIV pre-exposure prophylaxis (PrEP) awareness and prescribing practices among Washington State medical providers from diverse professional disciplines and practice types. METHODS: In May 2016, we administered an anonymous online survey to licensed medical practitioners who provide primary, longitudinal, walk-in, emergency, obstetric, gynecologic, sexually transmitted infection (STI), or family planning care. RESULTS: Of 735 eligible providers, 64...
January 4, 2018: Sexually Transmitted Diseases
Casey M Hay, Joseph L Kelley, Robert P Edwards, Kathleen M Pombier, John T Comerci
Super-utilizers account for many emergency department visits (EDV) and hospitalizations. Among Medicare/Medicaid patients, 5% to 10% account for >50% of spending. Little is known about super-utilization in gynecologic oncology. Charts of 64 gynecologic oncology patients with ≥3 EDV and/or admissions over 12 months were reviewed retrospectively. Cancer type distribution was 47% ovarian, 23% cervical, 23% endometrial, and 6% vulvar. Treatment at index visit was 61% chemotherapy, 16% no treatment, 8% recent surgery, and 6% radiation...
February 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
William Shyy, Roneesha S Knight, Nathan A Teismann
BACKGROUND: Abdominal pain is one of the most common chief complaints of patients presenting to emergency departments, and emergency physicians (EPs) often evaluate patients with right lower quadrant abdominal pain. Ovarian torsion is a rare cause of abdominal pain, but early diagnosis is essential for salvage of the affected ovary. The diagnostic study of choice for ovarian torsion is a pelvic ultrasound with color Doppler, but it is important for EPs and radiologists to be aware of findings of ovarian torsion that might appear on computed tomography (CT)...
February 17, 2018: Journal of Emergency Medicine
Mimang Tembe, Sushma Dhakal, Ashis Shrestha, Josh Mugele, Darlene R House
OBJECTIVE: Natural disasters have a significant impact on the health sector. On April 25, 2015, Nepal was struck by a 7.8 magnitude earthquake. The aim of the study was to compare patient volumes and clinical conditions presenting to the emergency department pre- and post-earthquake. METHODS: A retrospective study was done at Patan Hospital Emergency Department in Kathmandu, Nepal. Volume, demographics, and patient diagnoses were collected for 4 months post-disaster and compared with cases seen the same months the year before the disaster to control for seasonal variations...
February 20, 2018: Disaster Medicine and Public Health Preparedness
Paulina Cybulska, Jocelyn M Stewart, Azin Sayad, Carl Virtanen, Patricia A Shaw, Blaise Clarke, Natalie Stickle, Marcus Q Bernardini, Benjamin G Neel
High-grade serous ovarian cancer (HGSC) is the leading cause of morbidity and mortality from gynecologic malignancy. Overall survival remains low, due to the nearly ubiquitous emergence of platinum-resistance and the paucity of effective next-line treatments. Current cell culture-based models show limited similarity to HGSC and are therefore unreliable predictive models for pre-clinical evaluation of investigational drugs. This deficiency could help explain the low overall rate of successful drug development and the decades of largely unchanged approaches to HGSC treatment...
February 16, 2018: American Journal of Pathology
Ahmed M Soliman, Eric Surrey, Machaon Bonafede, James K Nelson, Jane Castelli-Haley
INTRODUCTION: The prevalence of endometriosis and the need for treatment in the USA has led to the need to explore the contemporary cost burden associated with the disease. This retrospective cohort study compared direct and indirect healthcare costs in patients with endometriosis to a control group without endometriosis. METHODS: Women aged 18-49 years with endometriosis (date of initial diagnosis = index date) were identified in the Truven Health MarketScan® Commercial database between 2010 and 2014 and female control patients without endometriosis were matched by age and index year...
February 15, 2018: Advances in Therapy
Enrica Martinelli, Andrea Fattorossi, Alessandra Battaglia, Marco Petrillo, Giuseppina Raspaglio, Gian Franco Zannoni, Mara Fanelli, Daniela Gallo, Giovanni Scambia
Class III β-tubulin (TUBB3) overexpression in ovarian cancer (OC) associates with poor prognosis. We investigated whether TUBB3 overexpression elicited anti-TUBB3 antibody production in OC patients and whether these antibodies may have diagnostic and prognostic impact. The presence of serum anti-TUBB3 antibodies was investigated in 49 untreated OC patients and 44 healthy individuals by an in-house developed ELISA that used recombinant TUBB3 as the antigen. Receiver operating characteristic (ROC) curves were generated to assess the diagnostic accuracy of the assay...
February 12, 2018: Translational Oncology
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