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At least 523 records · Page 29Linked to original sources
PubMed1981

Evaluation of contemporary female sterilization methods.

Different methods of sterilization were evaluated. Laparoscopic techniques were the most satisfactory because they had lower pelvic and incision infection rates and shorter hospitalization and convalescent times than laparotomy lower pelvic infection rates than culdoscopy and culpotomy. Via laparoscopy, sterilization by coagulation and cutting, spring-loaded clips and bands was an effective, safe method. Mechanical problems with the applicator and optics and decreased visibility resulted in more technical failures and difficulties and more misapplication with the clip applicator. Although the total complication rates were similar with all methods, bleeding from the tubes and wound and pelvic infections were more frequent with silastic-band technique. Long-term complications, such as dysmenorrhea and menometrorrhagia and especially those resulting in hysterectomy after laparoscopy, are infrequent. Pregnancy rates are low after laparoscopic sterilization with coagulation and silastic bands as compared to the clip. Rates of complications with sterilization combined with abortion or delivery are only slightly higher than after abortion without sterilization and much less than the combined complications that would be anticipated from abortion and interval sterilization. To make colpotomy, culdoscopy and minilaparotomy easier and potentially safer, mechanical techniques using the spring-loaded clip and silastic band are being evaluated. Simplified techniques that can be administered via the cervix, such as Quinacrine, may be practical in the future.

Abortion, Induced↗
PubMed1977

Trauma centers: a pragmatic approach to need, cost, and staffing patterns.

Based on the recommendations of the Health Services Administration and the Committee on Trauma of the American College of Surgeons, optimal staffing patterns for a trauma center are unrealistic in cost and personnel needs for all but a few large, urban teaching hospitals. As an alternative, the staffing pattern for a trauma program for a nonuniversity community hospital consists of one general surgeon, an anesthesiologist and one emergency physician. In addition, surgical subspecialists in thoracic surgery, urology, obstetrics and gynecology, ophthalmology, otolaryngology and plastic surgery would be on call within 30 minutes. A paid, part-time program director and paid coordinator of nursing and allied health personnel would be on staff. Need for trauma centers versus trauma programs can be assessed by using 5% of the number of motor vehicle accidents in an area to forecast the number of traumatic injuries. This is done in California as an example.

Accidents, Traffic↗
PubMed1999

[Clinical evaluation of biapenem in various infectious diseases].

The clinical usefulness of injectable biapenem (BIPM) was examined for various infectious diseases in the fields of internal medicine, urology, surgery, orthopedics, obstetrics and gynecology, otorhinolaryngology, ophthalmology, dermatology, oral surgery, and plastic surgery. BIPM was administered by intravenous drip infusion at a dose of 150, 300, or 600 mg twice a day. The concentrations in various body fluid and tissues were also examined. 1. In the total enrollment of 256 cases, the numbers subjected to the analyses for clinical efficacy, bacteriological efficacy, side effects and abnormal laboratory findings were 214, 170, 252 and 251 cases, respectively. 2. The clinical efficacy rate was 85.5% (183/214 cases) as a whole, being 2/2 for sepsis, 6/8 for cellulitis and lymphangitis, 76.2% (16/21) for traumatic, operative wound and burn infections, 4/6 for osteomyelitis and arthritis, 92.9% (13/14) for peritonsillar abscess and peritonsillitis, 83.3% (15/18) for chronic lower respiratory tract infection, 7/7 for pneumonia, 83.3% (30/36) for complicated urinary tract infection, 100% (14/14) for cholecystitis and cholangitis, 88.2% (15/17) for peritonitis, 86.5% (32/37) for internal genital infection, 8/9 for pelvic peritonitis, 2/4 for corneal ulcer, orbital infection and panophthalmitis, 1/2 for otitis media, 4/4 for sinustitis, 93.3% (14/15) for osteitis of jaw and cellulitis of mouth floor. The efficacy rate in the poor responders to the pretreatment by other antibiotics was 86.4% (70/81). 3. 300 strains of causative organisms were isolated from 170 cases which contained polymicrobial infections. The elimination rate of causative organisms was 85.3% (256/300 strains), in terms of bacteriological efficacy. 4. Side effects were noted in 11 of 252 cases (4.4%) with 11 events. The signs and symptoms were the skin symptoms (5 cases), gastro-intestinal symptoms (3 cases), interstitial pneumonia (2 cases), and feeling bad (1 case), all of which disappeared during treatment or after the discontinuation of treatment. The abnormal laboratory findings were observed in 31 of 251 cases (12.4%) with 50 events, and major ones were an increase in eosinophils, and elevations of AST, ALT, gamma-GTP and Al-p. 5. The concentrations of BIPM in body fluid and tissues were determined in 46 cases (212 samples) most of which were administered 300 mg of BIPM by intravenous drip infusion for 60 minutes. The concentrations in the sputum within 6 hours after administration were 0.1-2.5 micrograms/g. The maximum concentrations in body fluid and tissues were 0.2-1.8 micrograms/g or ml in the bile, middle ear mucosa, tonsillar tissue, aqueous humor and bone tissues and were 2.0-5.7 micrograms/g or ml in the gallbladder, maxillary sinus mucous membrane, ethmoidal sinus mucous membrane, oral tissues, skin, woman genitals, synovia, joint tissue, and the eschar. The concentrations in the uterine arterial plasma and retroperitoneal fluid were almost similar to those in the cubitl vein plasma. From the above-mentioned results of clinical efficacy, bacteriological efficacy, and safety, injectable BIPM was confirmed to be useful in the treatment of moderate, severe and/or refractory infections in various fields.

Adult↗
PubMed2003

Management of obstetrical brachial plexus palsy evaluation, prognosis, and primary surgical treatment.

Primary surgery for obstetrical brachial plexus lesions is a young field of surgical expertise that offers the possibility of improved functional ability in carefully selected patients who would otherwise be faced with lifelong impairment and secondary skeletal deformities. One major challenge in this area of peripheral nerve surgery is the selection of patients most likely to derive benefit from surgical intervention. The key to the development of selection criteria and to the resolution of other considerations (such as the determination of root avulsion) is consistency, accuracy, and careful reporting of natural history and outcome data. In particular, we strongly feel that a statistically sound technique of assessment must be consistently applied from the time of presentation through long-term follow-up. Advancement to date has resulted from the application of evidence-based recommendations from large, well-designed, meticulous studies. As the field of obstetrical brachial plexopathy management continues to evolve, we can expect that questions will continue to be answered using such scientific methodology.

Brachial Plexus↗
PubMed1980

Sterilization by cesarean hysterectomy.

A study of 112 cesarean hysterectomies is presented. They were performed in a 220-bed community hospital by six obstetricians in private practice. Eighty-nine cases were planned during the prenatal course of uncomplicated pregnancies. Twenty-three were unplanned and were performed because of severe medical, surgical, or obstetric problems. Postoperative performance and rate of complications were more favorable in the planned group. True indications for cesarean hysterectomy are discussed. In selected cases, sterilization by cesarean hysterectopmy may be the procedure of choice at the time of repeat cesarean section.

Cesarean Section↗
PubMed2005

Musculoskeletal complaints among a group of Turkish nurses.

The aim of the present study was to describe the prevalence and distribution of symptoms of musculoskeletal complaints among Turkish nurses who are practicing general nursing. The study population consisted of 120 nursing staff from four large general hospitals in Erzurum, Turkey. In every hospital six departments (surgery, medical, obstetric and gynecology, psychiatry, pediatric, and neurology) were selected. A Nordic standardized questionnaire described by Kuorinka et al. (1987) about complaints of the musculoskeletal system and a self-administered questionnaire involved information on the respondent's job and employment history, individual characteristics, physical and psychosocial risk factors at work, and general health status, were used by the researchers. Test data were analyzed for the difference between two population proportion and percentage. In the total population, 90% of all nurses reported at least one musculoskeletal complaint, 60% reported at least two, and 36% reported spells of three complaints in the past 6 months. Low back complaints were the most prevalent of musculoskeletal complaints, reported by 69% of the nurses. Neck complaints were less prevalent than shoulder (46% and 54%, respectively). Nurses with back complaint more often reported neck (28%) and shoulder (34%) complaints. Chronic low back, neck, and shoulder complaints were experienced by 41%, 25%, and 33% nurses, respectively. On the other hand, chronic complaints showed a correlation with working departments. The nurses working in surgery and obstetric and gynecology departments have more chronic complaints than the nurses working in other department (p<.05). The article's findings do not differ from those of other countries. Despite its limitations, this study points to the importance of perceived worked-related physical demands in relation to reported neck, shoulder, and back musculoskeletal complaints in Turkish nurses. But, further inquiries are needed to identify other physical exposures that may be related to musculoskeletal complaints.

Adolescent↗
PubMed1992

Obstetric performance following conservative surgery for pelvic relaxation.

Over a period of three years (January 1987 to December 1990), 78 cases of conservative surgery for pelvic relaxation, either at our hospital or in some other hospitals, were studied. All of these patients were admitted in active labor or as cases of abortions. The complex nature of the problem of pelvic relaxation or genital prolapse is evident from the fact that we have encountered as many as six conservative operations in our series. The reproductive performance of a patient along with the time taken for the conception to occur after the surgery are emphasized in our study.

Adult↗
PubMed1989

Ectopic tubal pregnancy in Zimbabwe.

A study of 441 ectopic tubal pregnancies treated at Harare Central Hospital between 1981-84 was carried out. During that time, there were 162,964 deliveries in the unit. The incidence of tubal pregnancy in this study was only 0.27%. Patients ranged in age from 13-46 years with the majority (67%) between ages 20-29. 88% of the patients were parous, the mean parity being 2.6 96% of the patients complained of abdominal pain, 78% of amenorrhea, and 64% of abnormal uterine bleeding. Abdominal tenderness (96%) and cervical excitation (91%) were the most significant signs. Paracentesis was positive in 78% of the cases. It was a little value in the diagnosis of chronic or unruptured tubal pregnancy. There was 1 maternal death.

Africa↗
PubMed1988

Judgment, 11 October 1988.

The Supreme Court of France reversed a lower court ruling dismissing the suit of a woman who sought damages resulting from an unauthorized tubal ligation. The ligation had been performed without her consent following a Cesarean Section. The physician contended that, if he had sought her consent prior to the operation, it would have been unreasonable for her to refuse given the risk of a ruptured uterus if she became pregnant again. The Court held that a physician may not operate on a patient without that patient's free and informed consent except in cases of evident necessity or immediate danger. It concluded that neither of these existed here.

Cesarean Section↗
PubMed1988

Re Baby R, 5 August 1988.

The petitioner sought cancellation of an order confirming the apprehension of her newborn child and ordering permanent guardianship over it. The child had been apprehended under authorization of the Superintendent of Family and Child Services while still unborn when the mother refused to undergo a Cesarean section in order to give birth. The Supreme Court of British Columbia granted the petition, ruling that an unborn child is not a child within the meaning of the Family and Child Service Act and, thus, can not be apprehended as a child apparently in need of protection under the Act. It noted, however, that the Superintendent was free to reapprehend the child if there was sufficient evidence to warrant doing so.

Americas↗