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Gynecology Emergency

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https://www.readbyqxmd.com/read/28333243/polycystic-ovary-syndrome-is-associated-with-anogenital-distance-a-marker-of-prenatal-androgen-exposure
#1
Yingchen Wu, Guangzheng Zhong, Shengfu Chen, Chengyu Zheng, Dehua Liao, Meiqing Xie
STUDY QUESTION: Is the presence of polycystic ovary syndrome (PCOS) associated with anogenital distance (AGD), a biomarker for the prenatal hormonal environment? SUMMARY ANSWER: The presence of PCOS is associated with longer AGD. WHAT IS KNOWN ALREADY: Although the aetiology of PCOS is unclear, emerging data suggest that the natural history of PCOS may originate from intrauterine life. Prenatal exposure to androgen hormones is considered an important factor of PCOS...
March 1, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28290956/multidisciplinary-in-situ-simulation-based-training-as-a-postpartum-hemorrhage-quality-improvement-project
#2
Monica A Lutgendorf, Carmen Spalding, Elizabeth Drake, Dennis Spence, Jason O Heaton, Kristina V Morocco
BACKGROUND: Postpartum hemorrhage is a common obstetric emergency affecting 3 to 5% of deliveries, with significant maternal morbidity and mortality. Effective management of postpartum hemorrhage requires strong teamwork and collaboration. We completed a multidisciplinary in situ postpartum hemorrhage simulation training exercise with structured team debriefing to evaluate hospital protocols, team performance, operational readiness, and real-time identification of system improvements...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28286604/a-review-of-mtor-pathway-inhibitors-in-gynecologic-cancer
#3
REVIEW
Andréia Cristina de Melo, Eduardo Paulino, Álvaro Henrique Ingles Garces
The treatment of advanced gynecologic cancers remains palliative in most of cases. Although systemic treatment has entered into the era of targeted drugs the antitumor efficacies of current therapies are still limited. In this context there is a great need for more active treatment and rationally designed targeted therapies. The PI3K/AKT/mTOR is a signaling pathway in mammal cells that coordinates important cell activities. It has a critical function in the survival, growth, and proliferation of malignant cells and was object of important research in the last two decades...
2017: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/28282875/a-perspective-on-ovarian-cancer-biomarkers-past-present-and-yet-to-come
#4
Frederick R Ueland
The history of biomarkers and ultrasonography dates back over more than 50 years. The present status of biomarkers used in the context of ovarian cancer is addressed. Attention is given to new interpretations of the etiology of ovarian cancer. Cancer antigen 125 (CA125) and multivariate index assays (Ova1, Risk of Ovarian Malignancy Algorithm, Overa) are biomarker-driven considerations that are presented. Integration of biomarkers into ovarian cancer diagnostics and screening are presented in conjunction with ultrasound...
March 8, 2017: Diagnostics
https://www.readbyqxmd.com/read/28277591/the-role-of-fluorescent-angiography-in-anastomotic-leaks
#5
Sarath Sujatha-Bhaskar, Mehraneh D Jafari, Michael J Stamos
Anastomotic leaks following colorectal anastomosis has substantial implications including increased morbidity, longer hospitalization, and reduced overall survival. The etiology of leaks includes patient factors, technical factors, and anastomotic perfusion. An intact anastomotic blood supply is especially crucial in the physiology of anastomotic healing. To date, no established intraoperative methods have been developed that reliably and reproducibly identify and prevent leak occurrence. Recently, fluorescent angiography (FA) with indocyanine green (ICG) has emerged as an innovative modality for intraoperative perfusion assessment...
March 9, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28258747/psychotherapy-with-somatosensory-stimulation-for-endometriosis-associated-pain-the-role-of-the-anterior-hippocampus
#6
Florian Beissner, Christine Preibisch, Annemarie Schweizer-Arau, Roxana M Popovici, Karin Meissner
BACKGROUND: Endometriosis is a gynecological disorder affecting 6%-10% of all women in their reproductive age. There is an emerging view in the literature that psychological trauma plays a central role in the pathogenesis of pelvic pain, one of the core symptoms of endometriosis. Here we report central nervous system mechanisms of a novel combination of psychotherapy and somatosensory stimulation that has recently shown remarkable effects in reducing pain, anxiety, and depressive symptoms in these patients...
January 16, 2017: Biological Psychiatry
https://www.readbyqxmd.com/read/28257538/multidisciplinary-approach-to-complicated-pregnancy
#7
Josip Andelo Borovac, Josko Bozic, Tina Ticinovic Kurir, Nikola Zaja, Kresimir Kolic, Vedran Hrboka
A nulliparous pregnant woman in her mid-20s and in the 32nd week of gestation presented to the emergency department with severe headache and vomiting. She had an uneventful medical history; however, the physical examination upon hospital admission revealed a hypertensive emergency, papilledema, and 2+ dipstick proteinuria. Upon establishing the diagnosis of preeclampsia, aggressive therapy with corticosteroids, antihypertensive medication, and seizure prophylaxis was initiated. Hemodynamic stability was achieved within 24 hours and the patient remained in the observation unit located within the gynecology clinic...
March 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28231684/emergency-peripartum-hysterectomy-a-challenge-or-an-obstetrical-defeat
#8
Aneta Malinowska-Polubiec, Ewa Romejko-Wolniewicz, Julia Zareba-Szczudlik, Agnieszka Dobrowolska-Redo, Agnieszka Sotowska, Roman Smolarczyk, Jan Wilczynski, Krzysztof Czajkowski
OBJECTIVES: Peripartum hysterectomy remains an obstetric nightmare. Most obstetricians consider it a defeat. The aim of our study was to assess the prevalence, indications, procedures and complications of emergency peripartum hysterectomy (EPH) in the 2nd Department of Obstetrics & Gynecology, Medical University of Warsaw during a 7 year period (2007-2013). METHODS: A retrospective evaluation of 21,144 deliveries was performed. We analyzed all cases of EPH, including the maternal characteristics, obstetrical history, course of pregnancy and delivery, type of surgery and complications...
October 2016: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/28221179/natural-orifice-transluminal-endoscopic-surgery-notes-in-gynecology
#9
Karl Jallad, Mark D Walters
Natural Orifice Transluminal Endoscopic Surgery (NOTES) is an emerging field in minimally invasive surgery. NOTES can be performed via a variety of approaches, including through the stomach, esophagus, bladder, and rectum, but the majority of cases have been performed transvaginally. Potential advantages of natural orifice surgery in gynecology include the lack of abdominal incisions, less operative pain, shorter hospital stay, improved visibility, and the possibility to circumvent extensive lysis of adhesion to reach the pelvic cavity...
February 17, 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28218155/perceptions-of-nonsurgical-permanent-contraception-among-potential-users-providers-and-influencers-in-wardha-district-and-new-delhi-india-exploratory-research
#10
Jennifer C Aengst, Elizabeth K Harrington, Pramod Bahulekar, Poonam Shivkumar, Jeffrey T Jensen, B S Garg
BACKGROUND: New permanent contraceptive methods are in development, including nonsurgical permanent contraception (NSPC). OBJECTIVE: In the present study, perceptions of NSPC in India among married women, married men, mothers-in-law, providers, and health advocates in Eastern Maharashtra (Wardha district) and New Delhi were examined. METHODS: We conducted semi-structured interviews with 40 married women and 20 mothers-in-law; surveys with 150 married men; and focus group discussions with obstetrics/gynecology providers and advocates...
January 2017: Indian Journal of Public Health
https://www.readbyqxmd.com/read/28179200/laparoscopic-management-of-abdomininal-pregnancy
#11
Francesco Cosentino, Cristiano Rossitto, Luigi Carlo Turco, Salvatore Gueli Alletti, Carmine Vascone, Lavinia Di Meglio, Giovanni Scambia, Mario Malzoni
CASE REPORT OBJECTIVE: To show the surgical management in laparoscopy of a particular localization of an extra-uterine pregnancy misunderstood until 12 week of EG complicated by hemoperitoneum and abortion. BACKGROUND: The prevalence of ectopic pregnancy among women who go to an emergency department with first trimester bleeding, pain, or both ranges from 1 to 16 percent [1]. The most common localization of ectopic pregnancy are the Fallopian tubes while abdominal pregnancy represent at least 1 percent of extra-uterine pregnancies...
February 4, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28178918/global-health-training-among-u-s-residency-specialties-a-systematic-literature-review
#12
Duncan K Hau, Luke R Smart, Jennifer I DiPace, Robert N Peck
BACKGROUND: Interest in global health training during residency is increasing. Global health knowledge is also becoming essential for health-care delivery today. Many U.S. residency programs have been incorporating global health training opportunities for their residents. We performed a systematic literature review to evaluate global health training opportunities and challenges among U.S. residency specialties. METHODS: We searched PubMed from its earliest dates until October 2015...
2017: Medical Education Online
https://www.readbyqxmd.com/read/28168128/three-dimensional-printing-of-a-hemorrhagic-cervical-cancer-model-for-postgraduate-gynecological-training
#13
Michael Bartellas, Stephen Ryan, Gregory Doucet, Deanna Murphy, Jacqueline Turner
INTRODUCTION: A realistic hemorrhagic cervical cancer model was three-dimensionally (3D) printed and used in a postgraduate medical simulation training session. MATERIALS AND METHODS: Computer-assisted design (CAD) software was the platform of choice to create and refine the cervical model. Once the prototype was finalized, another software allowed for the addition of a neoplastic mass, which included openings for bleeding from the neoplasm and cervical os. 3D printing was done using two desktop printers and three different materials...
January 1, 2017: Curēus
https://www.readbyqxmd.com/read/28164685/declined-natural-killer-cells-emerging-in-women-with-unexplained-recurrent-spontaneous-abortion-and-further-reducing-after-medical-therapy
#14
Xianghua Lin, Dijin Lin, Jiao Liu, Yunwen Bao, Zhaofan Luo, Junyue Fang, Ying Wang, Mingpeng Zhao, Chaohui Duan
BACKGROUND: As focus grows on reproduction, the issue of Recurrent Spontaneous Abortion (RSA), especially for unexplained reasons (URSA), is grabbing more and more attention in gynecological immunology. We investigated the changes of peripheral lymphocyte subsets focusing on whether they had some relationship with development of URSA. METHODS: The percentage and absolute count of lymphocyte subsets (T cells, Th cells, Ts cells, B cells, NK cells) were simultaneously evaluated by flow cytometry in URSA patients (n = 48) and healthy controls (HC, n = 22)...
November 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28164320/perception-of-point-of-care-ultrasound-performed-by-emergency-medicine-physicians
#15
Whitney Hansen, Carl E Mitchell, Bikash Bhattarai, Napatkamon Ayutyanont, Jeffrey R Stowell
PURPOSE: Point-of-care ultrasound (POCUS) is integral to the practice of emergency medicine (EM). Furthermore, EM-performed POCUS (EM-POCUS) offers consultants the opportunity to avoid delays in care due to wait times for confirmatory imaging studies. This study is the first to describe the perception of POCUS to consulting services at a single institution where EM-POCUS is routinely performed. METHODS: This study was conducted as a survey distributed to residents from consultant specialties (internal medicine [IM], general surgery [GS], and obstetrics and gynecology [OB-GYN])...
February 6, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28156638/rolapitant-for-control-of-chemotherapy-induced-nausea-and-vomiting-cinv-in-patients-with-gynecologic-cancer
#16
Lee Steven Schwartzberg, Sujata Arora, Daniel Powers, Karin Jordan, Rudolph M Navari
223 Background: Rolapitant, a long-acting neurokinin-1 receptor antagonist, protected against CINV in patients receiving highly or moderately emetogenic chemotherapy (HEC or MEC). METHODS: In 3 double-blind phase 3 studies, patients were randomized to receive oral rolapitant 180 mg or placebo before administration of HEC or MEC. All patients received a 5-hydroxytryptamine type 3 receptor antagonist and dexamethasone. In a post hoc analysis of 3 pooled studies (2 HEC and 1 MEC), we assessed the efficacy and safety of rolapitant in patients with gynecologic (ovarian, uterine, or cervical) cancer...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152936/improving-transitions-of-care-through-implementation-of-a-standardized-handoff-at-a-comprehensive-cancer-center
#17
Mohamed Ait Aiss, Helene P Phu, Lakeisha R Day, Varkey Abraham, Karen Chen, Mejia Rodrigo, Shehla Razvi, Carmen E Gonzalez, Norman Brito-Dellan, Srinivas Banala, David Rubio, Nicole Vaughan-Adams, Debra S Ruiz, Tan Jens, Charles F Levenback, Michael M Frumovitz, Behrouz Zand, Carmelita P Escalante
242 Background: Communication failures cause two-thirds of sentinel events in hospitals. These adverse occurrences are often both fatal and preventable. Consequently, improving the quality of handoffs has been identified by multiple accreditation constituents as a top priority patient safety goal. This project was part of an institutional initiative to standardize handoffs among physicians, trainees, and midlevel providers. METHODS: Four subgroups were identified as pilot areas: Gynecologic Oncology (Gyn Onc) fellows to nocturnalists, Surgical Oncology fellows, Pediatric Oncology residents and fellows, and Emergency Center attending staff to inpatient hospitalists...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28146046/brazilian-specialists-perspectives-on-the-patient-referral-process
#18
Carmen Juliani, Maura MacPhee, Wilza Spiri
Since 1988, healthcare has been considered a citizen's right in Brazil. The Sistema Único de Saúde (SUS), has undergone development and expansion to ensure universal health coverage for the Brazilian public, the world's fifth largest population. The coordination of effective communications between primary care physicians, specialists and patients is a significant challenge, particularly the referral process. Our study objective was to understand the facilitators and barriers associated with referral process communications between primary care physicians and regional university hospital specialists in the State of Sao Paulo...
January 29, 2017: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/28144123/state-of-simulation-in-healthcare-education-an-initial-survey-in-beijing
#19
Zichen Zhao, Pengfei Niu, Xiang Ji, Robert M Sweet
BACKGROUND AND OBJECTIVES: In 2013, medical error was the third leading cause of death in the United States.(1) In China, as in the case with the United States, training and assessment are developing as a strategy to reduce the occurrence of such errors. The objective of this study was to assess the current state of the use of simulation-based training in Beijing and to explore the barriers to further development. METHODS: This study included hospitals in Beijing accredited by the Standardized Residency Training (SRT) program...
January 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28124015/effect-of-formative-evaluation-using-direct-observation-of-procedural-skills-in-assessment-of-postgraduate-students-of-obstetrics-and-gynecology-prospective-study
#20
Naina Kumar, Namit Kant Singh, Samar Rudra, Swanand Pathak
INTRODUCTION: Direct Observation of Procedural Skills (DOPS) is a way of evaluating procedural skills through observation in the workplace. The purpose of this study was to assess the role of DOPS in teaching and assessment of postgraduate students and to know the effect of repeated DOPS on improvement of the skills and confidence of the students. METHODS: In both phases, significant difference was observed between the two groups on first DOPS comparison (1st phase: p=0...
January 2017: Journal of Advances in Medical Education & Professionalism
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