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Gynaecological Surgery

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https://www.readbyqxmd.com/read/29139105/preoperative-medical-therapy-before-surgery-for-uterine-fibroids
#1
REVIEW
Anne Lethaby, Lucian Puscasiu, Beverley Vollenhoven
BACKGROUND: Uterine fibroids occur in up to 40% of women aged over 35 years. Some are asymptomatic, but up to 50% cause symptoms that warrant therapy. Symptoms include anaemia caused by heavy menstrual bleeding, pelvic pain, dysmenorrhoea, infertility and low quality of life. Surgery is the first choice of treatment. In recent years, medical therapies have been used before surgery to improve intraoperative and postoperative outcomes. However, such therapies tend to be expensive.Fibroid growth is stimulated by oestrogen...
November 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29132430/hospital-choice-in-germany-from-the-patient-s-perspective-a-cross-sectional-study
#2
Werner de Cruppé, Max Geraedts
BACKGROUND: In many countries health policy encourages patients to choose their hospital, preferably by considering information of performance reports. Previous studies on hospital choice mainly have focused on patients undergoing elective surgery. This study examined a representative sample of hospital inpatients across disciplines and treatment interventions in Germany. Its research questions were: How many patients decide where to go for hospital treatment? How much time do patients have before admission? Which sources of information do they use, and which criteria are relevant to their decision? METHODS: Cross-sectional observational study covering 1925 inpatients of 46 departments at 17 hospitals in 2012...
November 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29125183/ovarian-surgery-for-symptom-relief-in-women-with-polycystic-ovary-syndrome
#3
REVIEW
Sam Lepine, Junyoung Jo, Mostafa Metwally, Ying C Cheong
BACKGROUND: Polycystic ovary syndrome (PCOS) is a common endocrine condition, affecting approximately one in 10 women. PCOS is defined by two of three features: oligo- or anovulation, clinical or biochemical hyperandrogenism or both, or polycystic ovaries.Women with PCOS can have a wide range of health problems, including infrequent and irregular periods, unwanted hair growth and acne, and subnormal fertility. Long-term health concerns include an increased risk of heart disease, diabetes and the development of precancerous disease of the womb...
November 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29124344/three-dimensional-computed-tomography-angiography-reconstruction-of-the-origin-of-the-uterine-artery-and-its-clinical-significance
#4
Alexandra Arfi, Julia Arfi-Rouche, Vincent Barrau, Krystel Nyangoh Timoh, Cyril Touboul
PURPOSE: In women, the uterine artery is the main branch of the internal iliac artery, vascularizing most of the uterus. Knowledge of its origin and variations is essential during extensive gynaecological surgery and interventional radiological procedures. We aimed to investigate its origin and explore its anatomical variations by three-dimensional (3D) reconstructed computed tomography (CT) angiography. METHODS: This was a retrospective, monocentric observational study involving CT scans of the abdomen and lower limbs of women < 50 years old with 3D reconstructed CT images of the internal and external iliac arterial axes...
November 9, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/29123075/evaluation-of-the-awareness-of-attitude-to-and-knowledge-about-fertility-preservation-in-cancer-patients-among-clinical-practitioners-in-hong-kong
#5
J Pw Chung, T Th Lao, T C Li
INTRODUCTION: Individuals can be exposed to gonadotoxic agents in the course of treatment for cancers and other medical conditions. Fertility preservation refers to strategies that aim to preserve fertility by protecting it against the damage inflicted by gonadotoxic treatment. Many young patients are prescribed gonadotoxic treatment without prior counselling. This study aimed to study the awareness of, attitude to, and knowledge about fertility preservation among clinicians in Hong Kong...
November 10, 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/29111787/performance-status-prognostic-scoring-and-parenteral-nutrition-requirements-predict-survival-in-patients-with-advanced-cancer-receiving-home-parenteral-nutrition
#6
Niamh Keane, Konstantinos C Fragkos, Pinal S Patel, Friderike Bertsch, Shameer J Mehta, Simona Di Caro, Farooq Rahman
We describe a cohort of Home Parenteral Nutrition (HPN) patients with advanced cancer in order to identify factors affecting prognosis. Demographic, anthropometric, biochemical and medical factors, Karnofsky Performance Status (KPS), Glasgow Prognostic Score (GPS), and PN requirements were recorded. Univariate and multivariate analyses were performed including Kaplan-Meier curves, Cox Regression, and correlation analyses. In total, 107 HPN patients (68 women, 39 men, mean age 57 yr) with advanced cancer were identified...
November 7, 2017: Nutrition and Cancer
https://www.readbyqxmd.com/read/29100739/selected-highlights-in-clinical-anesthesia-research
#7
REVIEW
Mark C Kendall, Zachary M Robbins, Alexander Cohen, Mary Minn, Scott E Benzuly, Andrew S Triebwasser, Zachary L McCormick, Michelle Gorgone
STUDY OBJECTIVE: To review research highlights of manuscripts published in 2016 that pertain to all aspects of the clinical practice of anesthesiology. DESIGN: Narrative review. SETTING: N/A. MATERIALS: The major themes address broad categories of general anesthesia including airway management, abdominal surgery, and obstetrical and gynaecological anesthesia. In addition, recent advancements in specialties of anesthesiology including regional anesthesia are reviewed...
October 31, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29090018/incidence-root-cause-and-outcomes-of-unintentionally-retained-intraabdominal-surgical-sponges-a-retrospective-case-series-from-two-hospitals-in-togo
#8
Boyodi Tchangai, Mazamaesso Tchaou, Iroukora Kassegne, Kpatekana Simlawo
BACKGROUND: The term gossypiboma refers to a sponge that has been forgotten in the surgical field. It is the most common retained surgical item, and constitutes a continuing problem for surgical safety. We performed a hospital-based study to examine their incidence, root cause, and outcomes, as an effort toward improving prevention. METHODS: This retrospective study covered 10 years (2006-2015) and included surgically confirmed cases of abdominal gossypibomas occurring after 45,011 abdominal and gynaecological operations in 2 public hospitals in Lome (Togo)...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/29081997/implementation-of-effective-practices-in-health-facilities-a-systematic-review-of-cluster-randomised-trials
#9
Emma R Allanson, Özge Tunçalp, Joshua P Vogel, Dina N Khan, Olufemi T Oladapo, Qian Long, Ahmet Metin Gülmezoglu
BACKGROUND: The capacity for health systems to support the translation of research in to clinical practice may be limited. The cluster randomised controlled trial (cluster RCT) design is often employed in evaluating the effectiveness of implementation of evidence-based practices. We aimed to systematically review available evidence to identify and evaluate the components in the implementation process at the facility level using cluster RCT designs. METHODS: All cluster RCTs where the healthcare facility was the unit of randomisation, published or written from 1990 to 2014, were assessed...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29079464/retroperitoneal-lumboaortic-lymphadenectomy-using-vessel-sealing-device-in-10-steps
#10
Marie Schaub, Lise Lecointre, Emilie Faller, Thomas Boisramé, Arnaud Wattiez, Jean-Jacques Baldauf, Cherif Akladios
STUDY OBJECTIVE: Describe the surgical technique of laparoscopic retroperitoneal lumboaortic lymphadenectomy using vessel-sealing device in 10 steps DESIGN: Educative video (Canadian Task Force Classification III) SETTING: Tertiary referral center in Strasbourg, France. The local institutional review board approved the video. BACKGROUND: Lumboaortic lymphadenectomy is frequently performed in the surgical management of different gynaecologic pelvic malignancies: cervical endometrial and ovarian cancer...
October 24, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29071360/prospective-observational-study-of-the-impact-of-vaginal-surgery-pelvic-organ-prolapse-with-or-without-urinary-incontinence-on-female-sexual-function
#11
Veenu Tyagi, Mahesh Perera, Karen Guerrero, Suzanne Hagen, Stewart Pringle
INTRODUCTION AND HYPOTHESIS: There is a difference of opinion in the literature as to whether pelvic organ prolapse (POP) is a direct cause of female sexual dysfunction (FSD). Sexual function in women is negatively impacted by the presence of urinary symptoms. Thus, sexual dysfunction (SD) might be improved, unchanged, or worsened by pelvic floor surgery. METHODS: In this study, we observed SD and impact of surgical intervention on female sexual function (FSF) using a validated Prolapse/Urinary Incontinence Sexual Questionnaire Short Form (PISQ-12) in women undergoing surgery for POP with or without urinary incontinence...
October 25, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/29063881/antimicrobial-prescribing-patterns-of-surgical-speciality-in-a-tertiary-care-hospital-in-india-role-of-persuasive-intervention-for-changing-antibiotic-prescription-behaviour
#12
Chand Wattal, Shilpi Khanna, Neeraj Goel, Jaswinder Kaur Oberoi, B K Rao
BACKGROUND: Inappropriate use of antibiotics globally has been linked to increase in antibiotic resistance. OBJECTIVES: This interventional study assessed the impact of antibiotic prescription feedback and focus group discussions (FGD) on hospital-based prescribers before and after the FGD. STUDY DESIGN: The present study was performed at a tertiary care centre in New Delhi, wherein 45 units from surgical specialities were included for FGD...
July 2017: Indian Journal of Medical Microbiology
https://www.readbyqxmd.com/read/29061399/-lynch-syndrome-and-endometrial-cancer
#13
REVIEW
Anne-Sophie Bats, Léa Rossi, Marie-Aude Le Frere-Belda, Céline Narjoz, Caroline Cournou, Marie Gosset, Charlotte Ngo, Myriam Delomenie, Claude Nos, Hélène Blons, Pierre Laurent-Puig, Fabrice Lecuru
Lynch syndrome is a hereditary predisposition to many tumors, in the forefront of which endometrial cancer in women. It is related to the mutation of a mismatch repair gene, involved in DNA mismatch repair. This mutation leads to a loss of expression of the corresponding protein, and to genome instability in tumor cells. Cumulative risk at the age of 70 years is over 40 %. Endometrial cancers related to Lynch syndrome are most of the time sentinel (They reveal the predisposition in half of families.) and are characterized by young age at onset (before 60 years) and low body mass index compared with patients presenting sporadic tumors...
October 21, 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/29046901/chirurgia-e-management-delle-pazienti-anziane-affette-da-carcinoma-ovarico
#14
Paolo Scollo, Giuseppe Scibilia, Basilio Pecorino
The median life expectancy of population among industrialized countries has dramatically expanded in recent years. On the other hand, the risk of developing cancer increases with age.The treatment for gynaecological malignancies is well defined with respect to the surgery, radiation treatment and chemotherapy. However, elderly patients receives substandard treatment when compared to the younger people, generally due to the presence of associated medical conditions. The assessment of the co-morbidity is an important aspect of the surgical decision-making process...
2017: Argom Oncol Geriatr
https://www.readbyqxmd.com/read/29039136/cancer-risk-management-in-tasmanian-women-with-brca1-and-brca2-mutations
#15
Stephanie Kearton, Karen Wills, Michael Bunting, Penny Blomfield, Paul A James, Jo Burke
Women carrying germline mutations in BRCA1 or BRCA2 have significantly increased lifetime risks of breast and tubo-ovarian cancer. To manage the breast cancer risk women may elect to have breast screening by MRI/mammogram from age 30, to take risk-reducing medication, or to have a prophylactic bilateral mastectomy. To manage the tubo-ovarian cancer risk, the only effective strategy is to have a bilateral salpingo-oophorectomy, recommended by age 40 (BRCA1) or 'around' age 40 (BRCA2). Early studies suggested that uptake of these cancer risk-reducing strategies was low...
October 16, 2017: Familial Cancer
https://www.readbyqxmd.com/read/29032064/laparoscopic-and-robotic-assisted-hysterectomy-for-uterine-leiomyomas-a-comparison-of-complications-and-costs
#16
Tin Yan Tina Ngan, Andrew Zakhari, Nicholas Czuzoj-Shulman, Togas Tulandi, Haim Arie Abenhaim
OBJECTIVE: Robotic surgery is increasingly being used for treatment of malignant and benign gynaecologic diseases. The purpose of our study is to compare patient perioperative complications and costs of laparoscopic versus robotic-assisted hysterectomy for uterine leiomyomas. METHODS: A retrospective cohort study using the Nationwide Inpatient Sample database from the United States was conducted, comparing patients who underwent robotic-assisted hysterectomy and laparoscopic hysterectomy (total laparoscopic hysterectomy and laparoscopic-assisted vaginal hysterectomy) for uterine fibroids between 2008 and 2012...
October 11, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29031864/bloodstream-infections-following-different-types-of-surgery-in-a-finnish-tertiary-care-hospital-2009-2014
#17
Kirsi Skogberg, Keiju S K Kontula, Asko Järvinen, Outi Lyytikäinen
We evaluated the risk and outcome of bloodstream infections (BSIs) following surgery. BSIs were identified in Helsinki University Hospital during 2009-2014 as part of the national surveillance. Of 711 BSIs identified, 51% were secondary and 49% primary. The rate was highest after cardiovascular surgery (8.7/1000 procedures) and lowest after gynaecologic (1.0/1000). Surgical site infection was the most common source of secondary BSIs (34%) and 45% of primary BSIs were central line-associated. The 28-day case fatality ranged from 0% in gynaecology/obstetrics to 21% in cardiovascular surgery...
October 12, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29026387/the-effect-of-a-preanaesthesia-clinic-consultation-on-adult-patient-anxiety-at-a-tertiary-hospital-in-kenya-a-cohort-study
#18
Anthony Kamau, Vitalis Mung'ayi, Gerald Yonga
BACKGROUND: Preoperative anxiety is a common perioperative complication seen in approximately 11-80% of adults undergoing surgery. One of the goals of the preanaesthesia clinic is to allay anxiety. A preanaesthesia clinic evaluation has been shown to reduce anxiety however current studies on anxiety and the preanaesthesia clinic have not quantified this reduction. OBJECTIVE: To determine the reduction in anxiety in patients evaluated in the clinic versus those evaluated in the ward...
March 2017: African Health Sciences
https://www.readbyqxmd.com/read/29020786/-what-is-the-risk-of-pelvic-organ-prolapse-recurrence-after-vaginal-hysterectomy-with-colporrhaphy
#19
M Nováčková, Z Pastor, T Brtnický, R Chmel
OBJECTIVE: To determine the risk of prolapse recurrence in patients after vaginal hysterectomy with colporrhaphy. DESIGN: Retrospective clinical study. SETTING: Department of Obstetrics and Gynaecology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague. METHODS: The trial involved 220 women who underwent vaginal hysterectomy with anterior and posterior kolporrhaphy at our department for uterine prolapse at least grade 2...
2017: Ceská Gynekologie
https://www.readbyqxmd.com/read/29017913/the-use-of-natural-compounds-for-the-targeting-and-chemoprevention-of-ovarian-cancer
#20
Francesca Pistollato, Ruben Calderón Iglesias, Roberto Ruiz, Silvia Aparicio, Jorge Crespo, Luis Dzul Lopez, Francesca Giampieri, Maurizio Battino
Among gynaecological cancers, ovarian cancer represents the leading cause of death in women. Current treatment for ovarian cancer entails surgery followed by combined chemotherapy with platinum and taxane, which are associated, particularly cisplatin, with severe side effects. While this treatment approach appears to be initially effective in a high number of patients, nearly 70% of them suffer a relapse within a few months after initial treatment. Therefore, more effective and better-tolerated treatment options are clearly needed...
October 7, 2017: Cancer Letters
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