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https://www.readbyqxmd.com/read/28938298/safety-and-efficacy-of-epidural-analgesia
#1
Elke M E Bos, Markus W Hollmann, Philipp Lirk
PURPOSE OF REVIEW: Epidural analgesia remains a widely used analgesic technique. This article aims to assess the safety of epidural analgesia by balancing efficacy and complications, of epidural analgesia for acute, labor and chronic pain. RECENT FINDINGS: Main indications for epidural analgesia include major open abdominal surgery, thoracotomy and labor analgesia. Past and current literature show that epidural analgesia leads to statistically significant, but possibly clinically less meaningful, reductions in pain scores compared with intravenous analgesia...
September 21, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28937843/emergency-department-visits-for-postpartum-complications
#2
Erin Christine Brousseau, Valery Danilack, Fei Cai, Kristen A Matteson
INTRODUCTION: Most estimates of the prevalence and types of postpartum complications are based on hospital readmissions. However, using hospital readmissions (which occurs in only 1%-2% of postpartum women) is problematic as it fails to include women with postpartum complications assessed in the office or emergency department (ED). We utilized data from a cohort of women evaluated in an ED setting to better characterize complications experienced by women in the postpartum period. MATERIALS AND METHODS: We performed a retrospective analysis of all postpartum visits to the ED at a tertiary care women's hospital over 6 months...
September 22, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28937705/interventions-for-treating-genital-chlamydia-trachomatis-infection-in-pregnancy
#3
REVIEW
Catherine Cluver, Natalia Novikova, David Oa Eriksson, Kevin Bengtsson, Göran K Lingman
BACKGROUND: Genital Chlamydia trachomatis (C.trachomatis) infection may lead to pregnancy complications such as miscarriage, preterm labour, low birthweight, preterm rupture of membranes, increased perinatal mortality, postpartum endometritis, chlamydial conjunctivitis and C.trachomatis pneumonia.This review supersedes a previous review on this topic. OBJECTIVES: To establish the most efficacious and best-tolerated therapy for treatment of genital chlamydial infection in preventing maternal infection and adverse neonatal outcomes...
September 22, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28936881/quality-indicators-in-pediatric-colonoscopy-an-australian-tertiary-center-experience
#4
H K Singh, G D Withers, L C Ee
OBJECTIVES: Quality indicators for colonoscopy in adults are largely driven by colorectal cancer screening, and include cecal intubation rates, with rates of >90% recommended. In contrast, colorectal cancer is rare in childhood, with paucity of data on relevant quality indicators for pediatric colonoscopy. It is also unclear whether high rates of cecal intubation are achievable in small children. Our aim was to audit all colonoscopies performed in a tertiary pediatric center to examine clinical indications for procedure, completeness of examination with cecal and ileal intubation, significant findings, and complications...
September 22, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28936714/prevalence-of-abdominal-artery-calcification-in-dialysis-patients-with-end-stage-renal-disease-a-systematic-review-and-meta-analysis
#5
Zhihui Yao, Congxia Wang, Qiaona Zhang, Shan Ma, Baosong Gui, Chaoyang Duan
PURPOSE: To systematically determine the prevalence of abdominal artery calcification (AAC) in dialysis patients with end-stage renal disease (ESRD) and identify reasons for heterogeneity. METHODS: We searched PubMed, EMBASE, and Web of Science from database inception to March 2017. Cross-sectional or cohort (only used baseline data) studies reporting estimates of AAC prevalence in dialysis adult patients with ESRD were included. We performed a random-effects meta-analysis to generate pooled prevalence estimates...
September 21, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28935558/immediate-interruption-of-sedation-compared-with-usual-sedation-care-in-critically-ill-postoperative-patients-sos-ventilation-a-randomised-parallel-group-clinical-trial
#6
Gerald Chanques, Matthieu Conseil, Claire Roger, Jean-Michel Constantin, Albert Prades, Julie Carr, Laurent Muller, Boris Jung, Fouad Belafia, Moussa Cissé, Jean-Marc Delay, Audrey de Jong, Jean-Yves Lefrant, Emmanuel Futier, Grégoire Mercier, Nicolas Molinari, Samir Jaber
BACKGROUND: Avoidance of excessive sedation and subsequent prolonged mechanical ventilation in intensive care units (ICUs) is recommended, but no data are available for critically ill postoperative patients. We hypothesised that in such patients stopping sedation immediately after admission to the ICU could reduce unnecessary sedation and improve patient outcomes. METHODS: We did a randomised, parallel-group, clinical trial at three ICUs in France. Stratified randomisation with minimisation (1:1 via a restricted web platform) was used to assign eligible patients (aged ≥18 years, admitted to an ICU after abdominal surgery, and expected to require at least 12 h of mechanical ventilation because of a critical illness defined by a Sequential Organ Failure Assessment score >1 for any organ, but without severe acute respiratory distress syndrome or brain injury) to usual sedation care provided according to recommended practices (control group) or to immediate interruption of sedation (intervention group)...
September 18, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28935285/is-the-pelvic-examination-still-crucial-in-patients-presenting-to-the-emergency-department-with%C3%A2-vaginal-bleeding-or-abdominal-pain-when-an-intrauterine-pregnancy-is-identified-on-ultrasonography-a-randomized-controlled-trial
#7
Judith A Linden, Benjamin Grimmnitz, Laura Hagopian, Alan H Breaud, Breanne K Langlois, Kerrie P Nelson, Lauren L Hart, James Feldman, Jeremy Brown, Marc Reid, Elise Desormeau, Patricia Mitchell
STUDY OBJECTIVE: We determine whether omitting the pelvic examination in emergency department (ED) evaluation of vaginal bleeding or lower abdominal pain in ultrasonographically confirmed early intrauterine pregnancy is equivalent to performing the examination. METHODS: We conducted a prospective, open-label, randomized, equivalence trial in pregnant patients presenting to the ED from February 2011 to November 2015. Patients were randomized to no pelvic examination versus pelvic examination...
September 18, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28935227/physiotherapy-education-and-training-prior-to-upper-abdominal-surgery-is-memorable-and-has-high-treatment-fidelity-a-nested-mixed-methods-randomised-controlled-study
#8
Ianthe Boden, Doa El-Ansary, Nadia Zalucki, Iain K Robertson, Laura Browning, Elizabeth H Skinner, Linda Denehy
OBJECTIVES: To (1) assess memorability and treatment fidelity of pre-operative physiotherapy education prior to elective upper abdominal surgery and, (2) to explore patient opinions on pre-operative education. DESIGN: Mixed-methods analysis of a convenience sample within a larger parallel-group, double-blinded, randomised controlled trial with concealed allocation and intention-to-treat analysis. SETTING: Tertiary Australian hospital. PARTICIPANTS: Twenty-nine patients having upper abdominal surgery attending pre-admission clinic within six-weeks of surgery...
September 1, 2017: Physiotherapy
https://www.readbyqxmd.com/read/28935219/medical-abortion-can-be-provided-safely-and-effectively-by-pharmacy-workers-trained-within-a-harm-reduction-framework-nepal
#9
Anand Tamang, Mahesh Puri, Sazina Masud, Deepak Kumar Karki, Diksha Khadka, Minal Singh, Poonam Sharma, Subash Gajurel
OBJECTIVES: To examine the treatment efficacy, safety and satisfaction of women using medical abortion (MA) pills provided by pharmacists following an education intervention based on a harm reduction approach. STUDY DESIGN: This was an operations research study over a six-month period in 2015, using a non-inferiority design. We provided training to dispense MA pills, based on a harm reduction approach, to a group of pharmacy workers in Makwanpur district (GROUP 2)...
September 18, 2017: Contraception
https://www.readbyqxmd.com/read/28935064/no-231-guidelines-for-the-management-of-vasa-previa
#10
Robert Gagnon
OBJECTIVES: To describe the etiology of vasa previa and the risk factors and associated condition, to identify the various clinical presentations of vasa previa, to describe the ultrasound tools used in its diagnosis, and to describe the management of vasa previa. OUTCOMES: Reduction of perinatal mortality, short-term neonatal morbidity, long-term infant morbidity, and short-term and long-term maternal morbidity and mortality. EVIDENCE: Published literature on randomized trials, prospective cohort studies, and selected retrospective cohort studies was retrieved through searches of PubMed or Medline, CINAHL, and the Cochrane Library, using appropriate controlled vocabulary (e...
October 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28934198/-koko-et-les-lunettes-magiques-an-educational-entertainment-tool-to-prevent-parasitic-worms-and-diarrheal-diseases-in-c%C3%A3-te-d-ivoire
#11
Clémence Essé, Véronique A Koffi, Abel Kouamé, Kouassi Dongo, Richard B Yapi, Honorine M Moro, Christiane A Kouakou, Marta S Palmeirim, Bassirou Bonfoh, Eliézer K N'Goran, Jürg Utzinger, Giovanna Raso
BACKGROUND: Integrated control programs, emphasizing preventive chemotherapy along with health education, can reduce the incidence of soil-transmitted helminthiasis and schistosomiasis. The aim of this study was to develop an educational animated cartoon to improve school children's awareness regarding soil-transmitted helminthiasis, diarrheal diseases, and related hygiene practices in Côte d'Ivoire. The key messages included in the cartoon were identified through prior formative research to specifically address local knowledge gaps...
September 21, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28934085/laparoscopy-in-the-second-and-third-trimesters-of-pregnancy-for-abdominal-surgical-emergencies
#12
S Guterman, L Mandelbrot, H Keita, F Bretagnol, D Calabrese, S Msika
OBJECTIVE: To assess complications and outcomes of pregnancies following laparoscopic abdominal surgery during the second and third trimesters of pregnancy. MATERIAL AND METHODS: Retrospective single-center study of 23 cases of laparoscopic surgery in the second or third trimesters of pregnancy between January 2005 and May 2016. RESULTS: The laparoscopies were performed between 15 and 33 weeks of gestation, a mean of 23 weeks+2 days, with 6 cases in the 3rd trimester...
May 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/28932352/novel-technique-of-abdominal-wall-nerve-block-for-laparoscopic-colostomy-rectus-sheath-block-with-transperitoneal-approach
#13
Jun Nagata, Jun Watanabe, Yusuke Sawatsubashi, Masaki Akiyama, Koichi Arase, Noritaka Minagawa, Takayuki Torigoe, Kotaro Hamada, Yoshifumi Nakayama, Keiji Hirata
A 62-year-old man who had acute rectal obstruction due to a large rectal cancer is presented. He underwent emergency laparoscopic colostomy. We used the laparoscopic puncture needle to inject analgesia with the novel transperitoneal approach. In this procedure, both ultrasound and laparoscopic images assisted with the accurate injection of analgesic to the correct layer. The combination of laparoscopic visualization and ultrasound imaging ensured infiltration of analgesic into the correct layer without causing damage to the bowel...
August 27, 2017: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28932266/risk-factors-for-surgical-site-infections-in-obstetrics-a-retrospective-study-in-an-ethiopian-referral-hospital
#14
Teshager Mamo, Tilaye Workneh Abebe, Tesfaye Yitna Chichiabellu, Antehun Alemayehu Anjulo
BACKGROUND: Pregnant women are at risk of infection during labor and delivery. Infection in obstetrics accounts for the second most common cause of maternal mortality next to post partum hemorrhage. Knowing the prevalence and associated risk factors would help to undertake optimal precautions and standard surgical techniques to reduce surgical site infection which poses increased hospital cost and total hospital stay of the patients. METHOD: Facility based retrospective observational study design was carried out purposively to assess the prevalence of surgical site infections and associated risk factors among mothers who had delivery related surgery at obstetric ward of Assela teaching referral hospital from April, 23, 2015 to September 5, 2015...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28931203/scalpel-versus-electrosurgery-for-major-abdominal-incisions
#15
REVIEW
Kittipat Charoenkwan, Zipporah Iheozor-Ejiofor, Kittipan Rerkasem, Elizabeth Matovinovic
BACKGROUND: Scalpels or electrosurgery can be used to make abdominal incisions. The potential benefits of electrosurgery may include reduced blood loss, dry and rapid separation of tissue, and reduced risk of cutting injury to surgeons. Postsurgery risks possibly associated with electrosurgery may include poor wound healing and complications such as surgical site infection. OBJECTIVES: To assess the effects of electrosurgery compared with scalpel for major abdominal incisions...
June 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28930812/role-of-radiation-therapy-in-the-multidisciplinary-management-of-uterine-carcinosarcoma
#16
Jillian R Gunther, Eva N Christensen, Pamela K Allen, Lois M Ramondetta, Anuja Jhingran, Nicole D Fleming, Elizabeth D Euscher, Karen H Lu, Patricia J Eifel, Ann H Klopp
OBJECTIVES: This study aimed to evaluate the impact of radiation therapy on outcomes for patients with uterine carcinosarcoma (UC). METHODS/MATERIALS: We retrospectively reviewed the records of 155 women with stage I (98), II (11), or III (46) UC who underwent total abdominal hysterectomy/bilateral salpingo-oophorectomy at our institution between 1990 and 2011. Survival rates were assessed using the Kaplan-Meier method and log-rank test. Univariate and multivariate Cox regression analyses were performed...
September 19, 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28930036/role-for-laparoscopy-in-the-management-of-bile-duct-injuries
#17
Vaibhav Gupta, Shiva Jayaraman
Common bile duct (CBD) injury is the most serious complication of laparoscopic cholecystectomy. Recently, laparoscopic techniques have been used in the management of postoperative bile leak and CBD injury; this literature has not been reviewed. We reviewed the literature on CBD injury, the approach to its diagnosis and management, and reports of laparoscopic management techniques. We combined this review with our experience in laparoscopic methods to highlight diagnostic and therapeutic options. Laparoscopic techniques can be used to prevent, diagnose and treat CBD injuries...
September 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28929343/a-comparison-of-isomaltulose-versus-maltodextrin-ingestion-during-soccer-specific-exercise
#18
Emma J Stevenson, Anthony Watson, Stephan Theis, Anja Holz, Liam D Harper, Mark Russell
PURPOSE: The performance and physiological effects of isomaltulose and maltodextrin consumed intermittently during prolonged soccer-specific exercise were investigated. METHODS: University soccer players (n = 22) performed 120 min of intermittent exercise while consuming 8% carbohydrate-electrolyte drinks (equivalent to ~ 20 g h(-1)) containing maltodextrin (Glycaemic Index: 90-100), isomaltulose (Glycaemic Index: 32) or a carbohydrate-energy-free placebo in a manner replicating the practices of soccer players (i...
September 19, 2017: European Journal of Applied Physiology
https://www.readbyqxmd.com/read/28929125/the-association-of-inflammatory-markers-with-nonalcoholic-fatty-liver-disease-differs-by-human-immunodeficiency-virus-serostatus
#19
Jennifer C Price, Ruibin Wang, Eric C Seaberg, Matthew J Budoff, Lawrence A Kingsley, Frank J Palella, Mallory D Witt, Wendy S Post, Chloe L Thio
BACKGROUND: We aimed to determine the relationship of circulating adipokines and inflammatory biomarkers with fatty liver among men in the Multicenter AIDS Cohort Study. METHODS: Noncontrast computed tomography was used to assess fatty liver and measure abdominal visceral adipose tissue (VAT) area in 526 participants without history of cardiovascular disease, heavy alcohol use, or viral hepatitis infection. Multivariable logistic regression was used to assess associations of circulating biomarker levels with fatty liver...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28928658/anti-inflammatory-antinociceptive-and-antioxidant-activities-of-methanol-and-aqueous-extracts-of-anacyclus-pyrethrum-roots
#20
Houria Manouze, Otmane Bouchatta, A Chemseddoha Gadhi, Mohammed Bennis, Zahra Sokar, Saadia Ba-M'hamed
Anacyclus pyrethrum (L.) is a plant widely used in Moroccan traditional medicine to treat inflammatory and painful diseases. The objective of the present study was to evaluate the antinociceptive, anti-inflammatory and antioxidant activities of aqueous and methanol extracts of Anacyclus pyrethrum roots (AEAPR and MEAPR). The anti-inflammatory effect of AEAPR and MEAPR was determined in xylene-induced ear edema and Complete Freund's Adjuvant (CFA)-induced paw edema. The antinociceptive activity of AEAPR and MEAPR (125, 250, and 500 mg/kg) administered by gavage was examined in mice by using acetic acid-induced writhing, hot plate, and formalin tests, and the mechanical allodynia were assessed in CFA-induced paw edema...
2017: Frontiers in Pharmacology
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