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Gynecology Emergency

Qifang Long, Weipei Zhu, Jundong Zhou, Jinchang Wu, Weixian Lu, Cui Zheng, Dongmei Zhou, Ling Yu, Ru Yang
Ovarian cancer is one of the most lethal malignant gynecologic tumors with a high relapse rate worldwide. Cancer stem cells (CSC) have been identified in ovarian cancer and other malignant tumors as a small population of cells that are capable of self-renew and multi-differentiation. CD133 positive (CD133(+)) ovarian cancer stem cells have been reported to be more tumorigenic and more resistant to chemotherapeutic treatment. Thus, CD133 has emerged as one of the most promising therapeutic markers for ovarian cancer treatment...
October 18, 2016: Oncology Research
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...
2016: Global Health Action
Haiyan Zhu, Xuejie Zhu, Lihong Zheng, Xiaoli Hu, LuZhe Sun, Xueqiong Zhu
Ovarian cancer is the major cause of death in women with gynecologic malignancies. There is emerging evidence that Androgen/androgen receptor (AR) signaling plays a critical role in the etiology and progression of this disease. Androgen receptor is frequently expressed in various subtypes of ovarian cancers and androgen/AR signaling has been shown to promote proliferation, migration, and invasion of ovarian cancer cells. Furthermore, shorter AR CAG repeats length and increased AR activity are associated with increased ovarian cancer risk and may be a useful prognosticator under certain circumstances...
October 11, 2016: Oncotarget
Georgios C Pratilas, Panagiotis Chatzis, Nikolaos Panteleris, Kimon Chatzistamatiou, Leonidas Zeipiridis, Konstantinos Dinas
A woman presented at the gynecological emergency clinic with severe lower abdominal pain. Even though she reported normal menses and had no risk factors for ectopic pregnancy, pregnancy test was positive and vaginal sonogram indicated heterotopic pregnancy at 12 weeks of gestation, with rupture of the ectopic pregnancy. Laboratory results indicated significant blood loss, and emergency laparotomy with salpingo-ophorectomy was performed. The intrauterine pregnancy continued uneventfully. Interestingly, the previous month the patient had also undergone investigation for vague abdominal pain and anemia...
October 8, 2016: Journal of Obstetrics and Gynaecology Research
Fang Ren, Jacson Shen, Huirong Shi, Francis J Hornicek, Quancheng Kan, Zhenfeng Duan
Ovarian cancer remains the leading cause of gynecological cancer-related mortality despite the advances in surgical techniques and chemotherapy drugs over the past three decades. Multidrug resistance (MDR) to chemotherapy is the major cause of treatment failure. Previous research has focused mainly on strategies to reverse MDR by targeting the MDR1 gene encoded P-glycoprotein (Pgp) with small molecular compound inhibitors. However, prior Pgp inhibitors have shown very limited clinical success because these agents have relatively low potency and high toxicity...
October 4, 2016: Biochimica et Biophysica Acta
Siavash Behbahani, Sameer Mittal, Michael N Patlas, Mariam Moshiri, Christine O Menias, Douglas S Katz
The purpose of this article is to familiarize radiologists and clinicians with a subset of common and uncommon incidental findings on abdominal and pelvic computed tomography examinations, including hepatic, splenic, renal, adrenal, pancreatic, aortic/iliac arterial, gynecological, and a few other miscellaneous findings, with an emphasis on "incidentalomas" discovered in the emergency setting. In addition, we will review the complex problem of diagnosing such entities, and provide current management recommendations...
September 30, 2016: Abdominal Radiology
P Yan, F Y Li, Y Yang, Y N Wang, A M Huang, H Yao
Objective: To investigate the prevalence of work-related musculoskeletal disorders (WMSDs) in nurses in Xinjiang, China, to analyze the influencing factors for the development of WMSDs, and to provide a reference for the prevention and treatment of WMSDs in nurses. Methods: Stratified cluster sampling was used to randomly select 8 422 nurses in 8 tertiary hospitals and 4 secondary hospitals in Xinjiang from January to October, 2015. A questionnaire survey was performed to investigate the prevalence of WMSDs in nurses from departments of internal medicine, surgery, gynecology, pediatrics, emergency, and intensive care and operating rooms and analyze related influencing factors...
August 20, 2016: Chinese Journal of Industrial Hygiene and Occupational Diseases
Johnathan Michael Sheele, Rachel Bernstein, Francis L Counselman
A negative urine pregnancy test in the emergency department traditionally excludes the diagnosis of pregnancy. We report a rare case of ruptured ectopic pregnancy in a patient with a negative urine pregnancy test but with a serum beta-human chorionic gonadotropin (β-hCG) of 10 mIU/mL. The patient developed hemoperitoneum and required laparoscopy by Obstetrics and Gynecology (OB/Gyn). This case highlights the fallibility of the urine pregnancy test in diagnosing early pregnancy.
2016: Case Reports in Emergency Medicine
N Gabunia, Iv Rodionov, T Chigogidze
Congenital renal malformations are the most common congenital malformations in humans, the most common being horseshoe kidney with joined lower poles present in up to 0.25% of general population. To the contrary renal fusions with ectopia are amongst the rare malformations affecting 1 in 2000 examined cadavers. Males are affected slightly more often then females (3:2), left to right crosses being more frequent. The value of early diagnosis of asymptomatic renal malformation is uncertain, except when other abnormalities might point to them and they can affect the clinical management strategy (severe ear deformity with facial malformation, gynecological abnormalities)...
July 2016: Georgian Medical News
Manisha Vernekar, Roy Rajib
INTRODUCTION: Uterine rupture is a catastrophic obstetrical emergency associated with a significant feto-maternal morbidity and mortality. Many risk factors for uterine rupture, as well as a wide range of clinical presentations, have been identified. OBJECTIVES: To analyze the frequency, predisposing factors, and maternal and fetal outcomes of uterine rupture. METHODS: A retrospective analysis of cases of unscarred uterine rupture was conducted at the Department of Obstetrics and Gynecology, RIMS, Imphal from June 1, 2010 to June 30, 2012...
October 2016: Journal of Obstetrics and Gynaecology of India
James Spain, Matthew Rheinboldt
Representing an ascending, sexually spread pyogenic infection of the female genital tract, pelvic inflammatory disease (PID) is a commonly encountered cause for emergency visits and hospitalizations among young and adult female patients. Though gynecologic evaluation and sonography constitute the mainstay of diagnosis, multidetector CT imaging of the abdomen and pelvis is not uncommonly performed, often as the initial imaging modality, due to the frequently vague and indeterminate clinical presentation. As such, knowledge and attenuation to the often subtle early imaging features of PID afford the radiologist a critical chance to direct and expedite appropriate pathways of patient care, minimizing the risk for secondary complications, including infertility, ectopic pregnancy, and enteric adhesions...
September 19, 2016: Emergency Radiology
Sumitra G Bakshi, Amol Mapari, T S Shylasree
BACKGROUND: Opioid-sparing pain management is important for Enhanced Recovery After Surgery. Rectus sheath (RS) blocks are emerging as a promising modality for pain relief following midline laparotomy; however, there are limited prospective clinical trials testing their efficacy. The purpose of this randomized-controlled trial is to assess the morphine-sparing effect of local anesthetic (LA) boluses through RS catheters following elective gynecological oncology surgery. METHOD: After patients' informed consent, bilateral RS catheters were placed intraoperatively in 74 females (American Society of Anesthesiologists physical status I-II) undergoing elective midline laparotomy under general anesthesia...
September 14, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
D Leguay
This article attempts to identify and put into perspective the different approaches that could globally prevent the suffering induced by schizophrenia, from the detection of early psychosis to the impact on individual and family functioning and emotional health. Schizophrenia causes, at the community level, a number of difficult consequences and associated costs, which likely could be reduced if specific strategies, already known and documented internationally, were applied. Two areas not explored in this article: the role of medication and the issue of suicide prevention...
September 9, 2016: L'Encéphale
Paolo Mannella, Giulia Palla, Armando Cuttano, Antonio Boldrini, Tommaso Simoncini
OBJECTIVE: To determine the effect of a simulation training program for residents in obstetrics and gynecology in terms of technical and nontechnical skills for the management of shoulder dystocia. METHODS: A prospective study was performed at a center in Italy in April-May 2015. Thirty-two obstetrics and gynecology residents were divided into two groups. Residents in the control group were immediately exposed to an emergency shoulder dystocia scenario, whereas those in the simulation group completed a 2-hour training session with the simulator before being exposed to the scenario...
August 27, 2016: International Journal of Gynaecology and Obstetrics
Amita Maheshwari, Neha Kumar, Umesh Mahantshetty
Gynecological cancers are among the most common cancers in women and hence an important public health issue. Due to the lack of cancer awareness, variable pathology, and dearth of proper screening facilities in developing countries such as India, most women report at advanced stages, adversely affecting the prognosis and clinical outcomes. Ovarian cancer has emerged as one of the most common malignancies affecting women in India and has shown an increase in the incidence rates over the years. Although cervical cancer is on a declining trend, it remains the second most common cancer in women after breast cancer...
July 2016: South Asian Journal of Cancer
Maria Rosana Ponisio, Kathryn J Fowler, Farrokh Dehdashti
This article summarizes recent advances in PET/MR imaging in gynecologic cancers and the emerging clinical value of PET/MR imaging in the management of the 3 most common gynecologic malignancies: cervical, endometrial, and ovarian cancers. PET/MR imaging offers superior soft tissue contrast, improved assessment of primary tumor involvement because of high-resolution multiplanar reformats, and functional MR techniques such as diffusion-weighted MR imaging and dynamic contrast-enhanced MR imaging. This article discusses the challenges, future directions, and technical advances of PET/MR imaging, and the emerging new multimodality, multiparametric imaging techniques for integrating morphologic, functional, and molecular imaging data...
October 2016: PET Clinics
Cristina M Beltran-Aroca, Eloy Girela-Lopez, Eliseo Collazo-Chao, Manuel Montero-Pérez-Barquero, Maria C Muñoz-Villanueva
BACKGROUND: Respect for confidentiality is important to safeguard the well-being of patients and ensure the confidence of society in the doctor-patient relationship. The aim of our study is to examine real situations in which there has been a breach of confidentiality, by means of direct observation in clinical practice. METHODS: By means of direct observation, our study examines real situations in which there has been a breach of confidentiality in a tertiary hospital...
2016: BMC Medical Ethics
Catalina Varas, Marion Ravit, Camille Mimoun, Pierre Panel, Cyrille Huchon, Arnaud Fauconnier
OBJECTIVES: Potentially life-threatening gynecological emergencies (G-PLEs) are acute pelvic conditions that may spontaneously evolve into a life-threatening situation, or those for which there is a risk of sequelae or death in the absence of prompt diagnosis and treatment. The objective of this study was to identify the best combination of non-invasive diagnostic tools to ensure an accurate diagnosis and timely response when faced with G-PLEs for patients arriving with acute pelvic pain at the Gynecological Emergency Department (ED)...
2016: PloS One
Carolina de Mendonça Coutinho E Silva, Octavio Muniz da Costa Vargens
OBJECTIVES: to describe the feelings and perceptions resulting from gynecologic surgery by women and analyze how they experience the changes caused by the surgery. METHOD: a qualitative, descriptive and exploratory study, which had Symbolic Interactionism and Grounded Theory as its theoretical framework. Participants of the study: 13 women submitted to surgery: Total Abdominal Hysterectomy, Total Abdominal Hysterectomy with bilateral Adnexectomy, Wertheim-Meigs surgery, Oophorectomy, Salpingectomy, Mastectomy, Quadrantectomy and Tracheloplasty...
2016: Revista Latino-americana de Enfermagem
Jason L Sanders, Ali S Raja, Kohei Hasegawa, Jane Bittner, Janice A Espinola, Brianna Olamiju, Ashley F Sullivan, Carlos A Camargo
STUDY OBJECTIVE: Emergency department (ED) consultation is a common practice. There are few data on consultant availability or changes in availability over time, which may hinder resource planning and allocation. We conduct serial surveys of Massachusetts EDs to investigate these trends. METHODS: We surveyed ED directors in Massachusetts in 2006 (n=61 EDs), 2009 (n=63), and 2015 (n=63) about ED characteristics in the previous year, including specialty-specific consultant availability in person (yes/no) and continuous consultant availability (yes/no)...
October 2016: Annals of Emergency Medicine
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