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Use and risks of surgical mesh for pelvic organ prolapse surgery in women in New York state: population based cohort study

Objective To assess the use of mesh in pelvic organ prolapse surgery, and compare short term outcomes between procedures using and not using mesh.  
feeds.bmj.com
about 5 years ago
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Philippine teenager flies to Sudan to undergo life-saving heart surgery

Hospital in Khartoum that has become a world leader in complex heart operations agreed to perform critical procedure for free  
theguardian.com
about 5 years ago
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Boring Question | Do patients with liver disease need FFP before procedures? - CanadiEM

Dr. Garfinkle answers the complicated Boring question: Do patients with liver disease need FFP before procedures?  
boringem.org
about 5 years ago
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GastriSail Lights Up Stomach from Within for Accurate Sleeve Gastrectomy Procedures |

Medtronic just released in the U.S. the GastriSail gastric positioning system for sleeve gastrectomy procedures. The device was designed to speed up sleeve  
medgadget.com
about 5 years ago
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Digital Blocks of the finger: Is one injection better than two?

This post was written by Meredith Posner Shuch, a senior resident at Cincinnati Children’s Hospital Medical Center as a component of the Emergency Department Procedure Elective.  
pemcincinnati.com
about 5 years ago
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Patient controlled opioid analgesia versus non-patient controlled opioid analgesia for controlling postoperative pain | Cochrane

Patients may control pain after surgery by self administration of analgesics (pain killers) using devices designed for this purpose (patient controlled analgesia or PCA). PCA involves self administration (by pushing a button) of small doses of opioids (such as morphine) intravenously by means of a programmable pump. Previous studies have shown that often patients prefer PCA to traditional methods of pain management, such as a nurse administering an analgesic upon a patient's request. This review demonstrated moderate to low quality evidence that PCA provided slightly better pain control and increased patient satisfaction when compared with non-patient controlled methods. Patients tended to use slightly higher doses of medication with PCA and suffered a higher occurrence of itching, but otherwise side effects were similar between groups.  
cochrane.org
about 5 years ago
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Intrapartum care for healthy women and babies | 1-Recommendations | Guidance and guidelines | NICE

The following guidance is based on the best available evidence. The full guideline gives details of the methods and the evidence used to develop the guidance.  
nice.org.uk
about 5 years ago
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Intrapartum care for healthy women and babies | 1-Recommendations | Guidance and guidelines | NICE

The following guidance is based on the best available evidence. The full guideline gives details of the methods and the evidence used to develop the guidance.  
nice.org.uk
about 5 years ago
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83

Anaesthesia UK : Analgesia for labour

 There are many different techniques, both regional and non-regional, to provide labour analgesia.  Non-regional techniques are the most frequently employed methods for labour analgesia.  Meperidine (pethidine) is the most frequently used opioid for labour analgesia. Its limited efficacy and side-effects are well documented.  Inhalation of nitrous oxide relieves labour pain to a significant degree and is especially beneficial in hospitals where other analgesic options are not available.  Epidural analgesia, when compared with other methods, provides superior analgesia for labour.  There is no association between epidural analgesia and an increased risk of Caesarean delivery or post-partum backache. There is an association with prolongation of labour and increased operative vaginal delivery.  
anaesthesiauk.com
about 5 years ago
Www.bmj
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Dilatation and curettage procedure raises risk of premature birth in subsequent pregnancies, study finds

Use of dilatation and curettage in cases of miscarriage or for termination increases the risk of preterm birth and very preterm birth (under 32 weeks) in a subsequent pregnancy, a large analysis has found. The study’s lead author has called for a more “restrained use” of the procedure in favour of medical interventions.  
feeds.bmj.com
about 5 years ago
Www.bmj
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Dilatation and curettage procedure raises risk of premature birth in subsequent pregnancies, study finds

Use of dilatation and curettage in cases of miscarriage or for termination increases the risk of preterm birth and very preterm birth (under 32 weeks) in a subsequent pregnancy, a large analysis has found. The study’s lead author has called for a more “restrained use” of the procedure in favour of medical interventions.  
feeds.bmj.com
about 5 years ago
Www.bmj
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Mesh use in surgery for pelvic organ prolapse

By age 80 years, one in eight women will undergo surgery for pelvic organ prolapse (POP), a condition where the pelvic organs descend into or through the vaginal canal.1 In the United States, about 80% of procedures are performed transvaginally.2 3 4 Building on the experience of general surgeons and the treatment of abdominal hernias, pelvic surgeons began using synthetic mesh to augment prolapse repairs to reduce prolapse recurrence seen frequently after native tissue (non-mesh) repairs. However, use of synthetic mesh also results in increased adverse events, in some cases with serious consequences.2 5 As a result, the use of mesh for transvaginal POP surgery has been the source of much scrutiny, including two public health notifications from the US Food and Drug Administration (FDA), a change in the US regulatory process for mesh devices, and substantial litigation.2 6  
feeds.bmj.com
about 5 years ago
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The Crashing Patient with Cardiac Tamponade: ED Management - emdocs

An update on the deadly condition of cardiac tamponade, with pearls in management and the necessary procedures to save a patient's life.  
emdocs.net
about 5 years ago
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Transcutaneous Electrical Nerve Stimulation (TENS) to treat acute pain in adults | Cochrane

Acute pain is pain of recent onset and limited duration. Acute pain is associated with surgery, physical trauma (e.g. broken bones, burns and cuts) and medical procedures (e.g. venepuncture and sigmoidoscopy). Transcutaneous Electrical Nerve Stimulation (TENS) is a treatment to relieve pain by administering mild electrical currents to the body using electrode pads attached to the surface of the skin.  
cochrane.org
about 5 years ago
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Methods for assessing pre-induction cervical ripening, the ability of the cervix to open in response to spontaneous uterine contractions | Cochrane

In this review, researchers from The Cochrane Collaboration examined a comparison between the Bishop score and any other method for checking pre-induction cervical ripening in women admitted for induction of labour. The Bishop score is the traditional method of determining the readiness of the cervix to open (dilate) before labour induction. It also assesses the position, softening and shortening of the cervix, and the location of the presenting part of the baby. After searching for relevant trials up to 31 March 2015, we included two randomised controlled trials that recruited 234 pregnant women.  
cochrane.org
about 5 years ago
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A Manual of Laboratory and Diagnostic Tests

Now in its Eighth Edition, this leading comprehensive manual helps nurses deliver safe, effective, and informed care for patients undergoing diagnostic tests and procedures. The book covers a broad range of laboratory and diagnostic tests and studies that are delivered to varied patient populations in varied settings. Tests are grouped according to specimen and function/test type (e.g. blood, urine, stool, cerebrospinal fluid, etc.). Each test is described in detail, with step-by-step guidance on correct procedure, tips for accurate interpretation, and instructions for patient preparation and aftercare. Clinical Alerts highlight critical safety information.  
books.google.co.uk
about 5 years ago
28977
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PMC3279149

Materials and methods. 5711 patient’s records of the year 2008 and 6188 patient’s records of the year 2009 of Obstetric/Gynecologic hospital ‘Queen Geraldina’ have been consulted. The age of women that we studied in 2008 was between 23-35 and in 2009 was be-tween 25-34 years old. We have made a careful diagnose of inducted hypertension of pregnancy and preeclampsia.  
ncbi.nlm.nih.gov
about 5 years ago
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Critical Care

Endotracheal intubation in the ICU is a high-risk procedure, resulting in significant morbidity and mortality. Up to 40% of cases are associated with marked hypoxemia or hypotension. The ICU patient is physiologically very different from the usual patient who undergoes intubation in the operating room, and different intubation techniques should be considered. The common operating room practice of sedation and neuromuscular blockade to facilitate intubation may carry significant risk in the ICU patient with a marked oxygenation abnormality, particularly when performed by the non-expert. Preoxygenation is largely ineffective in these patients and oxygen desaturation occurs rapidly on induction of anesthesia, limiting the time available to secure the airway. The ICU environment is less favorable for complex airway management than the operating room, given the frequent lack of availability of additional equipment or additional expert staff. ICU intubations are frequently carried out by trainees, with a lesser degree of airway experience. Even in the presence of a non-concerning airway assessment, these patients are optimally managed as a difficult airway, utilizing an awake approach. Endotracheal intubation may be achieved by awake direct laryngoscopy in the sick ICU patient whose level of consciousness may be reduced by sepsis, hypercapnia or hypoxemia. As the patient’s spontaneous respiratory efforts are not depressed by the administration of drugs, additional time is available to obtain equipment and expertise in the event of failure to secure the airway. ICU intubation complications should be tracked as part of the ICU quality improvement process.  
ccforum.com
about 5 years ago
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Needle size for vaccination procedures in children and adolescents | Cochrane

Vaccines contain antigens that make our immune system produce antibodies that can protect against disease. Antigens are modified or partial forms of the virus, bacteria, or the toxin that cause the disease that the vaccine protects against. Because the antigen is altered from its original form it cannot cause disease, but it can produce an immune response.  
cochrane.org
about 5 years ago
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Family Medicine Obstetrics

Whether you offer comprehensive pregnancy care in your primary care facility, or provide prenatal and postpartum care, this book delivers the guidance you need to optimize health for both mothers and their babies. It covers all aspects of birth care, from preconception counseling and prenatal care, through labor and delivery (both low-risk and complicated), to postpartum care and the first month of life. The completely revised third edition includes the most up-to- date, evidence-based standards of care. It offers information that is patient centered, prevention oriented, educational, and sensitive to the care of the whole woman and her family.Features a reader-friendly outline/narrative format for ease of use in daily clinical practice. Describes how to care for patients with a wide range of medical conditions during pregnancy as well as pregnancy-related conditions. Takes a whole-family approach to maternity care, with discussions of maternal and paternal adjustment, marital adjustment, sibling adjustment, single-parent families, and return-to-work issues. Provides patient and family education materials on a full range of topics, from nutrition in pregnancy to breastfeeding.Features a section on alternative medicine in maternity care. Provides detailed instruction for a wide array of procedures, including cesarean delivery, perineal repair of simple and complex lacerations, circumcision, assisted deliveries, and amnioinfusion.A continued strong emphasis on evidence-based medicine includes an ongoing summary of Level A recommendations throughout the text.A new chapter summarizes practical applications of how to incorporate continuous quality improvement and enhanced medical safety into the maternity care setting.A new section details which immunizations can be used safely during pregnancy.A section on "Centering Pregnancy" discusses this new model of care and how it incorporates longitudinal group.  
books.google.co.uk
about 5 years ago