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Guideline in gynecology

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
I P M Jordans, R de Leeuw, S I Stegwee, N N Amso, P N Barri-Soldevila, T van den Bosch, T Bourne, H A M Brolmann, O Donnez, M Dueholm, W J K Hehenkamp, N Jastrow, D Jurkovic, R Mashiach, O Naji, I Streuli, D Timmerman, L F Vd Voet, J A F Huirne
OBJECTIVES: To generate a uniform, internationally recognized guideline for detailed uterine niche evaluation by ultrasonography in non-pregnant women using a modified Delphi method amongst international experts. METHODS: Fifteen international gynecological experts were recruited by their membership of the European niche taskforce group. All experts were physicians with extensive experience in niche evaluation in clinical practice and/or authors of niche studies...
March 14, 2018: Ultrasound in Obstetrics & Gynecology
M Y Tan, D Wright, A Syngelaki, R Akolekar, S Cicero, D Janga, M Singh, E Greco, A Wright, K Maclagan, L C Poon, K H Nicolaides
OBJECTIVE: To test the hypothesis that the performance of first-trimester screening for pre-eclampsia (PE) by a method that uses Bayes' theorem to combine maternal factors with biomarkers is superior to that defined by current National Institute for Health and Care Excellence (NICE) guidelines. METHODS: This was a prospective multicenter study (screening program for pre-eclampsia (SPREE)) in seven National Health Service maternity hospitals in England, of women recruited between April and December 2016...
March 14, 2018: Ultrasound in Obstetrics & Gynecology
M Ballester, H Roman
Deep endometriosis with colorectal involvement is considered one of the most severe forms of the disease due to its impact on patients' quality of life and fertility but also by the difficulties encountered by the clinicians when proposing a therapeutic strategy. Although the literature is very rich, evidence based medicine remains poor explaining the great heterogeneity concerning the management of such patients. Surgery therefore remains a therapeutic option. It improves the intensity of gynecological, digestive and general symptoms and the quality of life...
March 10, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Lisa D DiMartino, Sarah A Birken, Laura C Hanson, Justin G Trogdon, Alecia S Clary, Morris Weinberger, Katherine Reeder-Hayes, Bryan J Weiner
BACKGROUND: The implementation science literature has contributed important insights regarding the influence of formal policies and practices on health care innovation implementation, whereas informal implementation policies and practices have garnered little attention. The broader literature suggests that informal implementation policies and practices could also influence innovation use. PURPOSE: We used the Organizational Theory of Innovation Implementation to further understand the role of formal and informal implementation policies and practices as determinants of implementation effectiveness...
March 12, 2018: Health Care Management Review
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
A Tardieu, F Sire, T Gauthier
OBJECTIVE: To provide clinical practice guidelines from the French college of obstetrics and gynecology (CNGOF) with the Haute Autorité de santé (HAS), based on the best evidence available, concerning the diagnosis accuracy of endoscopy (laparoscopy, hysteroscopy, fertiloscopy, cystoscopy, colonoscopy) in case of endometriosis. MATERIAL AND METHODS: English and French review of literature about the diagnosis accuracy of endoscopy in case of endometriosis. RESULTS AND CONCLUSION: Laparoscopy is useful in case of suspected endometriosis in patients with symptoms or infertility when appropriate preoperative assessment is negative (grade C)...
March 9, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
C Huchon, G Aubry, S Ploteau, A Fauconnier
In case of consultation for chronic pelvic pain or suspicion of endometriosis, it is recommended to evaluate the pain (intensity, resonance) and to search out the evocative and localizing symptoms of endometriosis (Grade B). The main symptoms suggestive of endometriosis are: severe dysmenorrhea (NP2), deep dyspareunia (NP2), painful defecation during menstruation (NP2), urinary tract symptoms during menstruation (NP2) and infertility (NP2). In patients with chronic pelvic pain, it is recommended to search deep infiltrating endometriosis in patients with painful defecation during menstruation or severe deep dyspareunia (Grade B)...
March 9, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Solina Tith, Garinder Bining, Laurent Bollag
Background : Opioid use during pregnancy is a growing concern in the United States. Buprenorphine has been recommended by "The American College of Obstetrics and Gynecology" as an alternative to methadone to decrease risks associated with the use of illicit opioids during pregnancy. The partial μ-opioid agonists' unique pharmacology, including its long half time and high affinity to the μ-opioid receptor, complicates patient management in a highly kinetic, and often urgent field like obstetric anesthesia...
2018: F1000Research
Kathleen R Cho, Kumarasen Cooper, Sabrina Croce, Bojana Djordevic, Simon Herrington, Brooke Howitt, Pei Hui, Philip Ip, Martin Koebel, Sigurd Lax, Bradley J Quade, Patricia Shaw, August Vidal, Anna Yemelyanova, Blaise Clarke, Lora Hedrick Ellenson, Teri A Longacre, Ie-Ming Shih, W Glenn McCluggage, Anais Malpica, Esther Oliva, Vinita Parkash, Xavier Matias-Guiu
The aim of this article is to propose guidelines and recommendations in problematic areas in pathologic reporting of endometrial carcinoma (EC) regarding special techniques and ancillary studies. An organizing committee designed a comprehensive survey with different questions related to pathologic features, diagnosis, and prognosis of EC that was sent to all members of the International Society of Gynecological Pathologists. The special techniques/ancillary studies group received 4 different questions to be addressed...
March 8, 2018: International Journal of Gynecological Pathology
Roberta Rossini, Giuseppe Tarantini, Giuseppe Musumeci, Giulia Masiero, Emanuele Barbato, Paolo Calabrò, Davide Capodanno, Sergio Leonardi, Maddalena Lettino, Ugo Limbruno, Alberto Menozzi, U O Alfredo Marchese, Francesco Saia, Marco Valgimigli, Walter Ageno, Anna Falanga, Antonio Corcione, Alessandro Locatelli, Marco Montorsi, Diego Piazza, Andrea Stella, Antonio Bozzani, Alessandro Parolari, Roberto Carone, Dominick J Angiolillo
Perioperative management of antithrombotic therapy in patients treated with coronary stents undergoing surgery remains poorly defined. Importantly, surgery represents a common reason for premature treatment discontinuation, which is associated with an increased risk in mortality and major adverse cardiac events. However, maintaining antithrombotic therapy to minimize the incidence of perioperative ischemic complications may increase the risk of bleeding complications. Although guidelines provide some recommendations with respect to the perioperative management of antithrombotic therapy, these have been largely developed according to the thrombotic risk of the patient and a definition of the hemorrhagic risk specific to each surgical procedure, key to defining the trade-off between ischemia and bleeding, is not provided...
March 12, 2018: JACC. Cardiovascular Interventions
Valerio Celentano, Neil Smart, John McGrath, Ronan A Cahill, Antonino Spinelli, Andreas Obermair, Hirotoshi Hasegawa, Pawanindra Lal, Alex M Almoudaris, Charlotte R Hitchins, Gianluca Pellino, Matthew G Browning, Takashi Ishida, Federico Luvisetto, Pinar Cingiloglu, Katherine Gash, Rhiannon Harries, Deena Harji, Francesca Di Candido, Elisa Cassinotti, Frank D McDermott, James E A Berry, Nick J Battersby, Esther Platt, Nicholas J Campain, Barrie D Keeler, Luigi Boni, Sharmila Gupta, John P Griffith, Austin G Acheson, Tom D Cecil, Mark G Coleman
OBJECTIVE: Consensus statement by an international multispecialty trainers and trainees expert committee on guidelines for reporting of educational videos in laparoscopic surgery. SUMMARY OF BACKGROUND DATA: Instructive laparoscopy videos with appropriate exposition could be ideal for initial training in laparoscopic surgery, but there are no guidelines for video annotation or procedural educational and safety evaluation. METHODS: Delphi questionnaire of 45 statements prepared by a steering group and voted on over 2 rounds by committee members using an electronic survey tool...
March 5, 2018: Annals of Surgery
Serena Wong, Elena Ratner, Natalia Buza
AIMS: Prophylactic total hysterectomy (TH) and bilateral salpingo-oophorectomy (BSO) have become routine procedures in women at genetic risk for gynecologic malignancies. Intraoperative pathology diagnosis of an occult malignancy provides the opportunity for immediate surgical staging and helps avoiding a second surgery. However, no standard guidelines exist for optimal intraoperative evaluation (IOE) of these specimens. We performed a retrospective analysis of prophylactic TH and BSO cases to assess the presence of gross findings, frozen and permanent section sampling practices, frozen section diagnoses and diagnostic discrepancies...
February 26, 2018: Histopathology
Courtney A Woodfield
Pelvic ultrasound examination is the primary imaging modality for evaluating a wide range of female pelvic symptomatology, and is often the first imaging test to detect a gynecologic malignancy. Ultrasound imaging is particularly useful for evaluating the thickness and appearance of the endometrium in patients with abnormal bleeding, and in detecting and characterizing ovarian lesions. This article reviews the ultrasound appearance of gynecologic neoplasms grouped by anatomic site of origin, the ultrasound appearance of select benign pelvic pathology not to be misinterpreted as malignancy, as well as available ultrasound imaging-based guidelines for managing potential gynecologic neoplasms...
April 2018: PET Clinics
Rachel C Nicholson, Jeremy Twigg, Alison Roberts, Georgios Angelopoulos, Derek Cruickshank
OBJECTIVE: Women with International Federation of Gynecology and Obstetrics stage 1A1 cervical carcinoma were evaluated to determine whether repeat excision for large loop excision transformation zone margins positive with cervical intraepithelial neoplasia (CIN) had been undertaken according to the National Health Service Cervical Screening Programme guidelines and if deviations from guidelines adversely affected patient outcome. MATERIALS AND METHODS: We retrospectively studied patients with 1A1 cervical carcinoma treated in our service between May 2010 and July 2015 to determine whether NHSCSP guidelines (May 2010) were followed...
February 23, 2018: Journal of Lower Genital Tract Disease
B Ludes, A Geraut, M Väli, D Cusack, D Ferrara, E Keller, P Mangin, D N Vieira
Sexual assault is a complex situation with medical, psychological, and legal aspects. Forensic experts play a major role in terms of forensic and gynecological medical examination and evidence collection in order to maintain the chain of custody. Victims should be examined by a specially trained medico-legal examiner in order to avoid multiple examinations in the surroundings that do not meet minimum health standards. The evolution and treatment of sexual assault victims are time-intensive and should optimally be provided by a team that includes a forensic medical doctor...
February 21, 2018: International Journal of Legal Medicine
Z Mike Chirenje, Nicholas Dhibi, H Hunter Handsfield, Elizabeth Gonese, Beth Tippett Barr, Lovemore Gwanzura, Ahmed S Latif, Dumisili Venessa Maseko, Ranmini S Kularatne, Mufuta Tshimanga, Peter H Kilmarx, Anna Machiha, Owen Mugurungi, Cornelis A Rietmeijer
INTRODUCTION: Symptomatic vaginal discharge is a common gynecological condition managed syndromically in most developing countries. In Zimbabwe, women presenting with symptomatic vaginal discharge are treated with empirical regimens that commonly cover both sexually transmitted infections (STI) and reproductive tract infections, typically including a combination of an intramuscular injection of kanamycin, and oral doxycycline and metronidazole regimens. This study was conducted to determine the current etiology of symptomatic vaginal discharge and assess adequacy of current syndromic management guidelines...
November 29, 2017: Sexually Transmitted Diseases
Krzysztof Nowosielski, Konrad S Jankowski, Robert Kowalczyk, Jacek Kurpisz, Małgorzata Normantowicz-Zakrzewska, Aleksandra Krasowska
INTRODUCTION: The sexual self-schema is a part of a broader concept of the self that is believed to be crucial for intrapersonal and interpersonal sexual relationships. AIM: To develop and perform psychometric validation of the Polish version of the Sexual Self-Schema Scale for Women (SSSS-W-PL). METHODS: 561 women 18 to 55 years old were included in the final analysis. Linguistic validation was performed in 4 steps in line with the MAPI Institute guidelines...
February 17, 2018: Sexual Medicine
Elie Hobeika, Ihab M Usta, Rami Helou, Salma Jabak, Faysal El Kak, Anwar H Nassar
We designed our study to evaluate the knowledge and immunization practices among Lebanese obstetricians and gynecologists (OBGYN) for women of different age groups. Anonymous questionnaires were used to assess the knowledge and immunization practices among OBGYN. The survey was conducted at the annual meeting of the Lebanese Society of Obstetrics and Gynecology on November 13-15, 2014. Data collected included demographics, type of practice, academic background and familiarity with vaccine guidelines. Descriptive statistical methods were used to evaluate the responses...
February 20, 2018: Human Vaccines & Immunotherapeutics
Locke Uppendahl, Caitlin Chiles, Stephanie Shields, Fanglong Dong, Elizabeth Kraft, Jennifer Duong, James Delmore
BACKGROUND: The purpose of this study was to establish compliance with guidelines published by the American College of Obstetricians and Gynecologists (ACOG) regarding prophylactic antibiotic use in gynecologic surgery at our institution, and define areas of improvement to promote antibiotic stewardship. PATIENTS AND METHODS: This was a retrospective cohort study at a single, large tertiary care and teaching hospital in Kansas. Patients who underwent inpatient or outpatient gynecologic surgery during 2013 were included...
February 16, 2018: Surgical Infections
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