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https://www.readbyqxmd.com/read/29157866/vaginal-progesterone-for-preventing-preterm-birth-and-adverse-perinatal-outcomes-in-singleton-gestations-with-a-short-cervix-a-meta-analysis-of-individual-patient-data
#1
Roberto Romero, Agustin Conde-Agudelo, Eduardo Da Fonseca, John M O'Brien, Elcin Cetingoz, George W Creasy, Sonia S Hassan, Kypros H Nicolaides
BACKGROUND: The efficacy of vaginal progesterone for preventing preterm birth and adverse perinatal outcomes in singleton gestations with a short cervix has been questioned after publication of the OPPTIMUM study. OBJECTIVE: To determine whether vaginal progesterone prevents preterm birth and improves perinatal outcomes in asymptomatic women with a singleton gestation and a midtrimester sonographic short cervix. DATA SOURCES: MEDLINE, EMBASE, LILACS, and CINAHL (from their inception to September 2017), Cochrane databases, bibliographies, and conference proceedings...
November 16, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29055173/safety-and-efficacy-of-the-cervical-pessary-combined-with-vaginal-progesterone-for-the-prevention-of-spontaneous-preterm-birth
#2
Georgios Daskalakis, Dimitrios Zacharakis, Marianna Theodora, Panagiotis Antsaklis, Nikolaos Papantoniou, Dimitris Loutradis, Aris Antsaklis
INTRODUCTION: The aim of this study was to evaluate the safety and efficacy of the combined treatment of cervical pessary and endovaginal progesterone for the prevention of spontaneous preterm birth (SPB) in women with a short cervical length (CL) between 20 and 24 weeks of gestation. MATERIALS AND METHODS: This is a prospective study of women with a singleton pregnancy and a sonographically detected mid-trimester CL ≤25 mm. The primary outcome measure was spontaneous delivery before 34 weeks (238 days) of gestation...
October 21, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28870155/pessary-or-progesterone-to-prevent-preterm-delivery-in-women-with-short-cervical-length-the-quadruple-p-randomised-controlled-trial
#3
Maud D van Zijl, Bouchra Koullali, Christiana A Naaktgeboren, Ewoud Schuit, Dick J Bekedam, Etelka Moll, Martijn A Oudijk, Wilhelmina M van Baal, Marjon A de Boer, Henricus Visser, Joris van Drongelen, Flip W van de Made, Karlijn C Vollebregt, Moira A Muller, Mireille N Bekker, Jozien T J Brons, Marieke Sueters, Josje Langenveld, Maureen T Franssen, Nico W Schuitemaker, Erik van Beek, Hubertina C J Scheepers, Karin de Boer, Eveline M Tepe, Anjoke J M Huisjes, Angelo B Hooker, Evelyn C J Verheijen, Dimitri N Papatsonis, Ben Willem J Mol, Brenda M Kazemier, Eva Pajkrt
BACKGROUND: Preterm birth is in quantity and in severity the most important topic in obstetric care in the developed world. Progestogens and cervical pessaries have been studied as potential preventive treatments with conflicting results. So far, no study has compared both treatments. METHODS/DESIGN: The Quadruple P study aims to compare the efficacy of vaginal progesterone and cervical pessary in the prevention of adverse perinatal outcome associated with preterm birth in asymptomatic women with a short cervix, in singleton and multiple pregnancies separately...
September 4, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28776100/dalbavancin-for-outpatient-parenteral-antimicrobial-therapy-of-skin-and-soft-tissue-infections-in-a%C3%A2-returning-traveller-proposal-for-novel-treatment-indications
#4
Johannes Mischlinger, Heimo Lagler, Nicole Harrison, Michael Ramharter
Skin and soft tissue infections (SSTIs) are among the most common health problems in travellers returning from tropical and subtropical countries. Importantly, the prevalence of Staphylococcus aureus, the most common pathogen for purulent SSTIs, with specific drug resistance, such as methicillin resistant Staphylococcus aureus (MRSA) and those expressing virulence genes, such as Panton-Valentine-leukocidin is higher in tropical regions than in most high resource settings. This poses challenges for the empirical antimicrobial treatment of SSTIs in returning travellers...
September 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28769766/breakthrough-cancer-pain-is-associated-with-spinal-gap-junction-activation-via-regulation-of-connexin-43-in-a-mouse-model
#5
Xin Li, Siqing Jiang, Hui Yang, Qian Liao, Shousong Cao, Xuebin Yan, Dong Huang
Breakthrough cancer pain (BTcP) is a high-intensity, short-duration, unpredictable and uncontrollable pain. Recent studies have shown that activation of gap junction (GJ) in spinal cord plays an important role in the pathogenesis of BTcP. We examined the expressions of Glial fibrillary acidic protein (GFAP), connexin (Cx) 43 protein and phosphorylation of Cx43 (p-Cx43) in the spinal cord of mice. In addition, we investigated the effects of Gap26, a selective GJ blocker, on the expressions of GFAP, Cx43 and p-Cx43 in BTcP mice...
2017: Frontiers in Cellular Neuroscience
https://www.readbyqxmd.com/read/28758378/fear-of-cancer-recurrence-and-its-predictors-among-cervical-cancer-survivors
#6
Jitti Hanprasertpong, Alan Geater, Ingporn Jiamset, Laaong Padungkul, Phongchawee Hirunkajonpan, Nartya Songhong
OBJECTIVE: To identify the characteristics of fear of cancer recurrence (FCR) in cervical cancer survivors (CCSs) and investigate the relationship of FCR with demographic and medical characteristics, level of quality of life (QOL), and psychological distress. We also aimed to determine the predictors of FCR. METHODS: The short version of the Fear of Progression Questionnaire (FoP-Q-SF), the Hospital Anxiety and Depression Scale (HADS), and the Functional Assessment of Cancer Therapy-Cervical (FACT-Cx) questionnaire were administered to 699 CCSs who had complete treatment at Songklanagarind Hospital between 2006 and 2016...
November 2017: Journal of Gynecologic Oncology
https://www.readbyqxmd.com/read/28702405/the-impact-of-irradiation-dose-on-the-computed-tomography-radiographic-response-of-metastatic-nodes-and-clinical-outcomes-in-cervix-cancer-in-a-low-resource-setting
#7
Matthew Ryan McKeever, Lindsay Hwang, Jennifer Barclay, Yin Xi, April Bailey, Kevin Albuquerque
INTRODUCTION: The aim of this study is to investigate the relationship between the radiation dose to pelvic and para-aortic lymph nodes, nodal response, and clinical outcomes in a resource-poor setting based on computed tomography (CT) nodal size alone. MATERIALS AND METHODS: This retrospective study from 2009 to 2015 included 46 cervical cancer patients with 133 metastatic pelvic and para-aortic lymph nodes definitively treated with chemoradiation and brachytherapy in a public hospital with limited access to positron emission tomography (PET) scans...
April 2017: South Asian Journal of Cancer
https://www.readbyqxmd.com/read/28669650/next-generation-dna-sequencing-of-tissues-from-infected-diabetic-foot-ulcers
#8
M Malone, K Johani, S O Jensen, I B Gosbell, H G Dickson, H Hu, K Vickery
We used next generation DNA sequencing to profile the microbiome of infected Diabetic Foot Ulcers (DFUs). The microbiota was correlated to clinical parameters and treatment outcomes to determine if directed antimicrobial therapy based on conventional microbiological cultures are relevant based on genomic analysis. Patients≥18years presenting with a new Diabetic Foot Infection (DFI) who had not received topical or oral antimicrobials in the two weeks prior to presentation, were eligible for enrolment. Tissue punch biopsies were obtained from infected DFUs for analysis...
July 2017: EBioMedicine
https://www.readbyqxmd.com/read/28662632/timing-of-delivery-in-a-high-risk-obstetric-population-a-clinical-prediction-model
#9
Dane A De Silva, Sarka Lisonkova, Peter von Dadelszen, Anne R Synnes, Laura A Magee
BACKGROUND: The efficacy of antenatal corticosteroid treatment for women with threatened preterm birth depends on timely administration within 7 days before delivery. We modelled the probability of delivery within 7 days of admission to hospital among women presenting with threatened preterm birth, using routinely collected clinical characteristics. METHODS: Data from the Canadian Perinatal Network (CPN) were used, 2005-11, including women admitted to hospital with preterm labour, preterm pre-labour rupture of membranes, short cervix without contractions, or dilated cervix or prolapsed membranes without contractions at preterm gestation...
June 29, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28639717/a-prospective-study-on-transvaginal-ultrasound-of-cervical-length-cl-in-the-first-and-second-trimester-in-a-low-risk-population
#10
C B Wulff, L Rode, S Rosthøj, E Hoseth, O B Petersen, A Tabor
OBJECTIVES: To assess cervical length (CL) longitudinally in the first and second trimester and to determine the proportion of women with a short CL. Further, to assess if women with a short CL at 19-24 weeks could be identified at the combined first-trimester screening (cFTS) at 11-14 weeks in relation to a potential implementation of CL screening in the Danish population. METHODS: We recruited singleton pregnant women attending the combined first-trimester screening from 1 November 2013 to 1 December 2014 to a longitudinal prospective study at three University Hospitals in Denmark...
June 22, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28604577/pain-after-cochlear-implantation-an-unusual-complication
#11
Charlotte Celerier, Isabelle Rouillon, Marion Blanchard, Marine Parodi, Françoise Denoyelle, Natalie Loundon
OBJECTIVE: To analyze clinical signs and better define the underestimated long-term pain after implantation, to discuss etiological hypothesis, and to propose our department treatment algorithm and results. STUDY DESIGN AND SETTING: Retrospective review of children implanted with complaints of atypical pain in the area of device implantation, not in the immediate postoperative period, more than or equal to 4 on the Visual Analog Pain Scale (VAPS: 0-10) in the ENT pediatric department of Trousseau and Necker Enfants Malades Hospitals between 1998 and 2015...
August 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28586127/cervical-stitch-cerclage-for-preventing-preterm-birth-in-singleton-pregnancy
#12
REVIEW
Zarko Alfirevic, Tamara Stampalija, Nancy Medley
BACKGROUND: Cervical cerclage is a well-known surgical procedure carried out during pregnancy. It involves positioning of a suture (stitch) around the neck of the womb (cervix), aiming to give mechanical support to the cervix and thereby reduce risk of preterm birth. The effectiveness and safety of this procedure remains controversial. This is an update of a review last published in 2012. OBJECTIVES: To assess whether the use of cervical stitch in singleton pregnancy at high risk of pregnancy loss based on woman's history and/or ultrasound finding of 'short cervix' and/or physical exam improves subsequent obstetric care and fetal outcome...
June 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28546709/salvage-surgery-for-cervical-cancer-recurrences
#13
P Rema, Arun Peter Mathew, S Suchetha, Iqbal Ahmed
Cervical cancer usually presents in advanced stages and is treated with chemoradiation. About 15-20 % patients present with local recurrence after chemoradiation. Radical surgical resection is the only treatment modality offering long term survival benefit in recurrent cervical cancer. The most common surgical option for these patients is pelvic exenteration. Radical hysterectomy may be done for patients with a small centrally located recurrence in the cervix with no infiltration of adjacent structures. The aim of this study was to evaluate the morbidity and survival outcome following radical hysterectomy and pelvic exenteration for recurrent cancer cervix...
June 2017: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28545978/benralizumab-for-patients-with-mild-to-moderate-persistent-asthma-bise-a-randomised-double-blind-placebo-controlled-phase-3-trial
#14
Gary T Ferguson, J Mark FitzGerald, Eugene R Bleecker, Michel Laviolette, David Bernstein, Craig LaForce, Lyndon Mansfield, Peter Barker, Yanping Wu, Maria Jison, Mitchell Goldman
BACKGROUND: Benralizumab is a humanised, anti-interleukin 5 receptor α monoclonal antibody that directly and rapidly depletes eosinophils, reduces asthma exacerbations, and improves lung function for patients with severe eosinophilic asthma. The objective of this trial was to assess the safety and efficacy of benralizumab for patients with mild to moderate, persistent asthma. METHODS: In this randomised, double-blind, placebo-controlled, phase 3 trial, we recruited patients aged 18-75 years, weighing at least 40 kg, and with a postbronchodilator reversibility in forced expiratory volume in 1 s (FEV1) of at least 12% at screening, from 52 clinical research centres in six countries...
July 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28502186/effectiveness-of-dydrogesterone-17-oh-progesterone-and-micronized-progesterone-in-prevention-of-preterm-birth-in-women-with-a-short-cervix
#15
Olga Pustotina
OBJECTIVE: To compare the efficacy of dydrogesterone, 17-OH progesterone (17OHP) and oral or vaginal micronized progesterone with cerclage for the prevention of preterm birth in women with a short cervix. METHODS: The study included 95 women with singleton gestation and cervical length (CL) ≤ 25 mm. Among these, 35 women were asymptomatic at 15-24 weeks and 60 had symptoms of threatened late miscarriage (LM) or preterm delivery (PD) at 15-32 weeks. Patients were randomized to receive dydrogesterone, 17OHP or oral/vaginal micronized progesterone; after one week of therapy 15 women underwent cerclage...
May 29, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28254220/preliminary-preventive-protocol-from-first-trimester-of-pregnancy-to-reduce-preterm-birth-rate-for-dichorionic-diamniotic-twins
#16
Masako Matsui, Yuichiro Takahashi, Shigenori Iwagaki, Rika Chiaki, Kazuhiko Asai, Ichiro Kawabata
OBJECTIVE: The preterm birth rate of twins is reportedly higher than that of single pregnancies. We performed preliminary preventive interventions at our center focused on evaluating the risk of each case before 14 weeks of gestation to reduce the spontaneous preterm birth rate. MATERIALS AND METHODS: The participants included 184 dichorionic-diamniotic twins delivered at our center during the 8 years from 2006. We evaluated each patient regarding high-risk status (at least 1 additional factor as follows: threatened abortion, history of chorioamnionitis, cervicitis, and bacterial vaginosis), based on available evidence; patients deemed high risk gave their informed consent and underwent treatment for cervicitis and cerclage if indicated...
February 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28209998/cervical-pessary-for-prevention-of-preterm-birth-a-meta-analysis
#17
Xin-Hang Jin, Dan Li, Li-Li Huang
To investigate the efficacy of cervical pessary placement in preventing preterm birth and perinatal morbidity and mortality in asymptomatic women with a singleton pregnancy and a short cervix, we searched literature in relevant databases. The meta-analysis of the 3 included trials (1412 women) showed cervical pessary placement did not reduce the risk of spontaneous preterm birth <34 weeks in these women (risk ratio (RR), 0.71; 95% confidence interval (CI), 0.21-2.43, P = 0.59; I(2) = 90%). The sensitivity analyses by excluding one trial at one time showed the same results...
February 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28209456/the-role-of-stereotactic-ablative-body-radiotherapy-in-gynaecological-cancers-a-systematic-review
#18
REVIEW
L C Mendez, E Leung, P Cheung, L Barbera
AIMS: To summarise and evaluate the current literature in gynaecological tumours treated with stereotactic ablative body radiotherapy (SABR) through a systematic review using the Preferred Reported Items for Systematic Reviews and Meta-analysis (PRISMA) guideline. MATERIALS AND METHODS: A literature search through Medline, EMBASE and Cochrane databases resulted in 22 pertinent manuscripts. Selected studies evaluated the locoregional role of SABR in gynaecological tumours, regardless of SABR clinical indication...
June 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/28166925/-is-universal-screening-for-cervical-length-among-singleton-pregnancies-with-no-history-of-preterm-birth-justified
#19
REVIEW
P Rozenberg
The ultrasonographic measurement of cervical length with a cutoff of 15mm is currently the best method to identify a group of asymptomatic women in the general population at risk of spontaneous preterm birth, especially among asymptomatic patients with a singleton pregnancy with no history of preterm birth. Cerclage and 17 alpha-hydroxyprogesterone caproate (17OHP-C) are ineffective to reduce the risk of preterm birth among asymptomatic patients with a short cervix in midtrimester. However, vaginal progesterone (200-mg capsules of micronized progesterone or gel containing 90mg progesterone) has been demonstrated effective in 2 large randomized trials to reduce the risk of preterm birth and possibly the composite morbidity and perinatal mortality associated among asymptomatic women with a short cervix in the general population screened by ultrasound of the cervix in midtrimester...
December 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/28103952/the-interaction-between-vaginal-microbiota-cervical-length-and-vaginal-progesterone-treatment-for-preterm-birth-risk
#20
Lindsay M Kindinger, Phillip R Bennett, Yun S Lee, Julian R Marchesi, Ann Smith, Stefano Cacciatore, Elaine Holmes, Jeremy K Nicholson, T G Teoh, David A MacIntyre
BACKGROUND: Preterm birth is the primary cause of infant death worldwide. A short cervix in the second trimester of pregnancy is a risk factor for preterm birth. In specific patient cohorts, vaginal progesterone reduces this risk. Using 16S rRNA gene sequencing, we undertook a prospective study in women at risk of preterm birth (n = 161) to assess (1) the relationship between vaginal microbiota and cervical length in the second trimester and preterm birth risk and (2) the impact of vaginal progesterone on vaginal bacterial communities in women with a short cervix...
January 19, 2017: Microbiome
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