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Gynaecological Surgery

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https://www.readbyqxmd.com/read/29771998/risk-factors-for-inappropriate-blood-requisition-among-hospitals-in-tanzania
#1
Wilhellmuss I Mauka, Tara B Mtuy, Michael J Mahande, Sia E Msuya, Innocent B Mboya, Abdul Juma, Rune N Philemon
BACKGROUND: Blood is a critical aspect of treatment in life saving situations, increasing demand. Blood requisition practices greatly effect sufficient supply in blood banks. This study aimed to determine the risk factors for inappropriate blood requisition in Tanzania. METHODS: This was a cross sectional study using secondary data of 14,460 patients' blood requests from 42 transfusion hospitals. Primary data were obtained by using cluster-sampling design. Data were analysed using a two-level mixed-effects Poisson regression to determine fixed-effects of individual-level factors and hospital level factors associated with inappropriate blood requests...
2018: PloS One
https://www.readbyqxmd.com/read/29763509/surgical-approach-to-hysterectomy-and-barriers-to-using-minimally-invasive-methods
#2
Monika Janda, Nigel R Armfield, Gayle Kerr, Suzanne Kurz, Graeme Jackson, Jason Currie, Katie Page, Edward Weaver, Anusch Yazdani, Andreas Obermair
Minimally invasive approaches to hysterectomy have been shown to be safe, effective and have recovery advantages over open hysterectomy, yet in Australia 36% of hysterectomies are still conducted by open surgery. In 2006, a survey of Australian gynaecological specialists found the main impediment to increasing laparoscopic hysterectomy to be a lack of surgical skills training opportunities. We resurveyed specialists to explore contemporary factors influencing surgeons' approaches to hysterectomy; 258 (estimated ~19%) provided analysable responses...
May 15, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29754478/methicillin-resistant-staphylococcus-aureus-contamination-of-phlebotomy-tourniquets-and-faucets
#3
T Abeywickrama, K Amarasinghe, S Wijerathne, C Dharmaratne, D Fernando, B C Senaratna, H A K M Gunasekera
Introduction: Methicillin resistant Staphylococcus aureus (MRSA) is transmitted through direct contact or fomites. The most important means of nosocomial spread is by hospital personnel. However, fomites are being increasingly recognized as sources of nosocomial infection. Objectives: Our aim was to describe the MRSA contamination rate of phlebotomy tourniquets and faucets in a tertiary care hospital and to compare the contamination of plastic tourniquets with that of fabric tourniquets...
March 31, 2018: Ceylon Medical Journal
https://www.readbyqxmd.com/read/29744050/iatrogenic-nerve-lesion-following-laparoscopic-surgery-a-case-report
#4
Michele Vecchio, Andrea Santamato, Fortunato Geneovese, Giulia Malaguarnera, Vito Emanuele Catania, Saverio Latteri
Background: Peripheral neuropathy after surgical treatment is an under recognized potential untoward event. Pelvic surgery may be associated with nerve lesions by essentially three main mechanisms: transection, entrapment and pressure-stretching; the latter is the modality most frequently linked to patient's positioning on the operating room table. Presentation of the case: A 25 years old woman, after undergoing a laparoscopic gynaecologic procedure lasted >3 hours, on postoperative day one presented with numbness over her lateral right leg and dorsum of the foot, right foot drop and gait instability due to compression-stretching of the right superficial peroneal nerve...
April 2018: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/29739387/variability-and-dimensionality-of-students-and-supervisors-mini-cex-scores-in-undergraduate-medical-clerkships-a-multilevel-factor-analysis
#5
Christoph Berendonk, Anja Rogausch, Armin Gemperli, Wolfgang Himmel
BACKGROUND: The mini clinical evaluation exercise (mini-CEX)-a tool used to assess student-patient encounters-is increasingly being applied as a learning device to foster clinical competencies. Although the importance of eliciting self-assessment for learning is widely acknowledged, little is known about the validity of self-assessed mini-CEX scores. The aims of this study were (1) to explore the variability of medical students' self-assessed mini-CEX scores, and to compare them with the scores obtained from their clinical supervisors, and (2) to ascertain whether learners' self-assessed mini-CEX scores represent a global dimension of clinical competence or discrete clinical skills...
May 8, 2018: BMC Medical Education
https://www.readbyqxmd.com/read/29735328/gynaecologic-cancer-surgery-and-preservation-of-fertility
#6
E Bentivegna, A Maulard, G Miailhe, S Gouy, P Morice
For gynecological cancers, even at an early stage, the standard treatment is "radical excision" involving hysterectomy (radical or not) with bilateral salpingo-oophorectomy. But for young patients with early stage disease, many recent studies have focused on preservation of subsequent fertility by keeping at least one ovary and the uterus. The main objective of this fertility-sparing surgery is to preserve fertility, if this can be accomplished without increasing the oncological risks. Whether the initial site of the cancer is the cervix, uterine fundus or ovary, the oncologic validation of fertility-sparing treatment requires several evaluation criteria: a rigorous clinical, radiological and surgical staging to verify that the pathology is truly at an early initial stage; expert pathologic interpretation of biopsy specimens to validate the histological criteria of "good prognosis"; provision of complete and understandable patient education verifying the true objectives for this fertility-sparing treatment (whose intent is to retain a potential for subsequent fertility without guaranteeing it) and provision of an explanation of the oncological constraints and implications of fertility-sparing surgery in the event of a possible pregnancy...
May 4, 2018: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29710531/the-role-of-bevacizumab-on-tumour-angiogenesis-and-in-the-management-of-gynaecological-cancers-a-review
#7
REVIEW
Dinesh Kumar Chellappan, Kun Hooi Leng, Lee Jia Jia, Nur Amirah Binti Abdul Aziz, Wong Chun Hoong, Yap Cheng Qian, Fam Yi Ling, Gwee Sing Wei, Tiong Ying, Jestin Chellian, Gaurav Gupta, Kamal Dua
OBJECTIVE: The study aims to analyze the effectiveness of bevacizumab in addressing the complications associated with gynecological cancers and evaluates effective treatments for various gynecological cancers. METHODS: The study follows a systematic review approach that has been implemented to analyze the qualitative published data from previous studies. Studies related with the trials of angiogenesis and bevacizumab were selected in the review. RESULTS: In general, the management of gynecological cancers include chemotherapy, surgery and radiation therapy...
April 4, 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/29705676/a-case-of-retroperitoneal-desmoid-type-fibromatosis-that-involved-the-unilateral-ureter-after-gynaecologic-surgery
#8
Hitomi Ono, Kensuke Hori, Lena Tashima, Tomohiko Tsuruta, Shin-Ichi Nakatsuka, Kimihiko Ito
INTRODUCTION: Desmoid-type fibromatosis represents a rare, benign, soft tissue tumour that is locally invasive with high recurrence potential. PRESENTATION OF CASE: We encountered a case of retroperitoneal desmoid-type fibromatosis in a 45-year-old woman who presented with chief complaints of stomach ache and vomiting. She underwent total abdominal hysterectomy and left salpingo-oophorectomy due to uterine myoma and a paroophoritic cyst at 42 years of age. Abdominal computed tomography showed a 5-cm left retroperitoneal tumour and severe hydronephrosis of the left kidney...
March 29, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29696109/comparison-between-effects-of-acupuncture-and-metoclopramide-on-postoperative-nausea-and-vomiting-after-gynaecological-laparoscopy-a-randomized-controlled-trial
#9
Masoumeh Albooghobeish, Ahmadreza Mohtadi, Vahid Saidkhani, Habib Fallah, Kaveh Behaein, Sholeh Nesionpour, Roshan Nikbakht
Background: Gynaecological laparoscopy one ofthe most common operations thatis accompanied by postoperative nausea and vomiting (PONV). A non-pharmacological method of preventing PONV is acupuncture therapy. Objectives: This study is conducted to compare the effects of acupuncture and metoclopramide on post-operative nausea and vomiting (PONV) after gynaecological laparoscopy. Methods: In this double-blind, randomized, clinical trial study,122female, ASA I, aged 19 - 46, who had been referred to the Imam Khomini Hospital (Ahvaz, Iran) and were candidates for gynaecological laparoscopy were enrolled...
October 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29690917/health-consequences-for-mother-and-baby-of-substantial-pre-conception-weight-loss-in-obese-women-study-protocol-for-a-randomized-controlled-trial
#10
Sarah Price, Alison Nankervis, Michael Permezel, Luke Prendergast, Priya Sumithran, Joseph Proietto
BACKGROUND: Current guidelines for the management of obesity in women planning pregnancy suggest lifestyle modification before conception. However, there is little evidence that lifestyle modification alters pregnancy outcomes. Bariatric surgery results in significant weight loss. This appears to reduce the risk of adverse pregnancy outcomes for the mother but may increase the risk of adverse outcomes for the infant. In order to reduce the risks of obesity-related adverse pregnancy outcomes for both mother and offspring, alternative approaches to the management of obesity in women planning pregnancy are needed...
April 24, 2018: Trials
https://www.readbyqxmd.com/read/29681508/diagnosis-of-ovarian-torsion-is-it-time-to-forget-about-doppler
#11
Gilat L Grunau, Alison Harris, Jean Buckley, Nicole J Todd
OBJECTIVE: Accuracy of ultrasound in diagnosis of ovarian torsion remains controversial, with some studies reporting correct diagnosis in only 23% to 66% of cases. Normal Doppler flow does not necessarily exclude an ovarian torsion; in fact, it may lead to missing the diagnosis and has been show to delay management. The objective of our study was to assess sensitivity and specificity of ultrasound diagnosis of ovarian torsion and to analyze the factors contributing to correct and incorrect diagnosis...
April 19, 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29670294/the-surgical-intelligent-knife-distinguishes-normal-borderline-and-malignant-gynaecological-tissues-using-rapid-evaporative-ionisation-mass-spectrometry-reims
#12
David L Phelps, Júlia Balog, Louise F Gildea, Zsolt Bodai, Adele Savage, Mona A El-Bahrawy, Abigail Vm Speller, Francesca Rosini, Hiromi Kudo, James S McKenzie, Robert Brown, Zoltán Takáts, Sadaf Ghaem-Maghami
BACKGROUND: Survival from ovarian cancer (OC) is improved with surgery, but surgery can be complex and tumour identification, especially for borderline ovarian tumours (BOT), is challenging. The Rapid Evaporative Ionisation Mass Spectrometric (REIMS) technique reports tissue histology in real-time by analysing aerosolised tissue during electrosurgical dissection. METHODS: Aerosol produced during diathermy of tissues was sampled with the REIMS interface. Histological diagnosis and mass spectra featuring complex lipid species populated a reference database on which principal component, linear discriminant and leave-one-patient-out cross-validation analyses were performed...
April 19, 2018: British Journal of Cancer
https://www.readbyqxmd.com/read/29660578/implementing-the-risk-of-endometrial-malignancy-algorithm-rem-adding-obesity-as-a-predictive-factor-results-of-rem-b-in-a-single-center-survey
#13
Francesco Plotti, Stella Capriglione, Giuseppe Scaletta, Daniela Luvero, Salvatore Lopez, Francesca Fiori Nastro, Corrado Terranova, Carlo De Cicco Nardone, Roberto Montera, Roberto Angioli
OBJECTIVE: In 2013, our group assessed a risk stratification tool of endometrial cancer (EC), called REM (Risk of Endometrial Malignancy). A well known risk factor for EC is body mass index (BMI). In fact, (BMI > 30 and <35 kg/m2) and severe obesity (BMI > 35 kg/m2) were associated with a 2.6-fold and a 4.7-fold increase in EC risk, respectively. Therefore, in the present study we aim to improve the performance of REM, including BMI and developing a new scoring system, called REM-B (Risk of Endometrial Malignancy score associated to BMI), to classify patients into high risk or low risk groups for EC...
April 7, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29648645/does-human-endometrial-lgr5-gene-expression-suggest-the-existence-of-another-hormonally-regulated-epithelial-stem-cell-niche
#14
N Tempest, A M Baker, N A Wright, D K Hapangama
STUDY QUESTION: Is human endometrial leucine-rich repeat-containing G-protein-coupled receptor 5 (LGR5) gene expression limited to the postulated epithelial stem cell niche, stratum basalis glands, and is it hormonally regulated? SUMMARY ANSWER: LGR5 expressing cells are not limited to the postulated stem cell niche but LGR5 expression is hormonally regulated. WHAT IS KNOWN ALREADY: The human endometrium is a highly regenerative tissue; however, endometrial epithelial stem cell markers are yet to be confirmed...
April 10, 2018: Human Reproduction
https://www.readbyqxmd.com/read/29643163/effect-of-intratracheal-dexmedetomidine-administration-on-recovery-from-general-anaesthesia-after-gynaecological-laparoscopic-surgery-a-randomised-double-blinded-study
#15
Fei Wang, Haoxiang Zhong, Xiaoyan Xie, Weiping Sha, Caili Li, Zhenping Li, Zhuomei Huang, Chaojin Chen
OBJECTIVES: To examine the efficacy of intratracheal dexmedetomidine (Dex) injection for the prevention of the laryngeal response on emergence from general anaesthesia following gynaecological laparoscopic surgery. DESIGN: Prospective, randomised, double-blinded, controlled trial. SETTING: A general hospital, Guangdong Province, China. PARTICIPANTS: All patients who underwent elective laparoscopic gynaecological surgery, aged 18-60 years old, 40-80 kg in weight, American Society of Anesthesiologists class I-II were eligible...
April 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29626708/ureteral-injuries-during-different-types-of-hysterecomy-a-7-year-series-at-a-single-university-center
#16
Matija Barbic, Kalina Telenta, Marco Noventa, Mija Blaganje
OBJECTIVES: Accidental ureteral injury with gynaecologic surgery, especially hysterectomy, represents a high risk of patient morbidity. The incidence may vary from centre to centre. As the introduction of new minimally invasive surgical techniques and instruments may have affected the incidence of ureteral injury, we de novo analysed the incidence data for the last seven years. STUDY DESIGN: Incidence of ureteral injury was analysed stratifying the data according to the type of hysterectomy (n = 3071)...
March 23, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29626286/multidetector-ct-of-expected-findings-and-complications-after-hysterectomy
#17
REVIEW
Massimo Tonolini
Indicated to manage a variety of disorders affecting the female genital tract, hysterectomy represents the second most common gynaecological operation after caesarean section. Performed via an open, laparoscopic or vaginal approach, hysterectomy is associated with non-negligible morbidity and occasional mortality. Iatrogenic complications represent a growing concern for gynaecologists and may result in prolonged hospitalisation, need for interventional procedures or repeated surgery, renal impairment and malpractice claims...
April 6, 2018: Insights Into Imaging
https://www.readbyqxmd.com/read/29623148/diclofenac-potassium-in-acute-postoperative-pain-and-dysmenorrhoea-results-from-comprehensive-clinical-trial-reports
#18
REVIEW
R Andrew Moore, Sheena Derry
We compared the efficacy of diclofenac potassium in unpublished clinical study reports (CSRs) and published reports to examine publication bias, industry bias, and comprehensiveness. Novartis provided CSRs of randomised double-blind trials of diclofenac potassium involving postoperative patients following third molar extraction (3 trials, n =519), gynaecological surgery (3 trials, n =679), and dysmenorrhoea (2 trials, n =711) conducted in 1988-1990. Searches identified published reports of 6 trials. Information from 599/1909 patients was not published; trials with 846/1909 patients were published in a defunct journal...
2018: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/29621923/laparoscopic-hysterectomy-for-endometrial-cancer-impact-of-age-on-clinical-outcomes
#19
W W Ee, V Nellore, W McMullen, K Ragupathy
INTRODUCTION: Improvement in preoperative care for the ageing population has resulted in an increasing number of elderly patients to be considered for surgery. With an increased incidence of endometrial cancer, it is inevitable that a significant number of elderly patients are referred for surgery, despite the concerns over co-morbid conditions and diminished cardiopulmonary reserves. AIM: To evaluate the clinical outcomes of laparoscopic hysterectomy for elderly women operated on for endometrial cancer with comparison to younger patients...
April 6, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29604548/non-ablative-er-yag-laser-therapy-effect-on-stress-urinary-incontinence-related-to-quality-of-life-and-sexual-function-a-randomized-controlled-trial
#20
Mija Blaganje, Darija Šćepanović, Lidija Žgur, Ivan Verdenik, Franja Pajk, Adolf Lukanović
OBJECTIVE: Stress urinary incontinence (SUI) is a common complaint in women after childbirth. It affects their quality of life and sexual satisfaction and is one of the major reasons for gynaecological surgery. There is a need for effective non-invasive treatment alternatives. The aim of this study was to evaluate the efficacy and safety of non-ablative Er:YAG laser therapy in the treatment of SUI and improvement of sexual gratification in parous women. STUDY DESIGN: 114 premenopausal parous women with SUI were randomized in two groups of 57 women; a laser intervention group and sham group...
May 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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