Reports of Two Broken Nexplanon(R) Rods

This report describes 2 cases of Nexplanon® rod breakage in an 18-year-old female and a 25-year-old female. The literature regarding damaged progestin implants is reviewed. These reports often involve an alteration in menstrual bleeding pattern and patients frequently request removal of bent or broken implants. The overall incidence of rod breakage and impact of damaged implants on contraceptive efficacy is not clear. Evidence based guidelines to inform management of suspected damage to contraceptive implants would be helpful. In the meantime, a shared decision-making process offering removal and replacement of damaged implants would seem reasonable.
Source: Journal of the American Board of Family Medicine - Category: Primary Care Authors: Tags: Brief Reports Source Type: research

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ConclusionsThe degree of aspirin effect immediately prior to cardiac surgery was weakly associated with the risks of postoperative bleeding and allogeneic blood product transfusion, suggesting that measuring aspirin-induced antiplatelet effect prior to cardiac surgery may be useful as an adjunct in optimizing patient blood management for patients who are at high-risk of bleeding and requiring allogeneic blood transfusion.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Abstract BACKGROUND: This large cohort study aimed to investigate the effect of acquired thrombocytopenia on the prognosis of patients with stable coronary artery disease undergoing percutaneous coronary intervention (PCI). MATERIALS AND METHODS: Patients with stable coronary artery disease undergoing elective PCI were prospectively enrolled during 2013. All patients were followed for a median of 30 months (the 25th and 75th percentiles for follow-up time were 27 and 32 months). After excluding patients with baseline thrombocytopenia (
Source: The American Journal of the Medical Sciences - Category: General Medicine Authors: Tags: Am J Med Sci Source Type: research
DR JOHN SANTANIELLO (Oak Lawn, IL): The CRASH II and MATTERs trials established that tranexamic acid (TXA) benefits patients with hemorrhage in a select cohort, namely, those with fibrinolysis ≥3% on a rapid thrombelastography (TEG). Tranexamic acid did reduce mortality in CRASH II, but it was unclear whether it was due to prevention of clot lysis and improved coagulation with decreased bleeding, because there was no statistical difference in RBC transfusion in those groups. Because TXA inhibits plasmin, it has been speculated that improved survival may be caused by an attenuated inflammatory response by inhibiting its ...
Source: Journal of the American College of Surgeons - Category: Surgery Tags: Western surgical association article Source Type: research
AbstractIntroductionStop the Bleed (STB) program was launched by the White House, for the use of bleeding control techniques at the scene of traumatic injury. The purpose of this study was to conduct an STB course in private security and law enforcement personnel.MethodsPre- and post-questionnaire using the Likert scale was shared with participants on their knowledge and comfort level with the use of tourniquets. Participants were also observed while placing tourniquets and the time for placement recorded. The didactic portion and practical session of the STB was then taught and participants were again observed placing tou...
Source: European Journal of Trauma and Emergency Surgery - Category: Emergency Medicine Source Type: research
Conclusions: In conclusion, appropriately targeted IC in the management of children with GI symptoms is a safe, fast, and useful investigation. TI intubation rates of 100% are achievable and desirable and can be conducted quickly. Poor bowel preparation impacts negatively on this and IC duration may be faster in younger children. High diagnostic yields have been recorded in patients with a clinical suspicion of IBD. Diagnostic yield in isolated recurrent abdominal pain is low. Training to excellence in pediatric IC should be a persistent goal.
Source: Journal of Pediatric Gastroenterology and Nutrition - Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research
ConclusionThough personalized treatment can be formalized to some extent, it is expected that medical treatment skills and management by tacit knowledge are affected in individualized treatment based on standardized treatment. Medical institutions and medical staff are the main body sharing and deploying measures to disseminate and utilize medical devices, cooperating with them can be an effective management of standardized and individualized treatment.
Source: Personalized Medicine Universe - Category: Drugs & Pharmacology Source Type: research
Authors: Chatterjee S, Dubey S, Lahiri D, Ray BK Abstract Recent trial data have expanded the horizons of newer indications of non vitamin K oral anticoagulants (NOAC). Most recently they are being evaluated for use in embolic stroke of undetermined source (ESUS). ESUS are particularly known for their recurrences. So, identifying the causes and treating those etiological factors are the keys to secondary prevention of ESUS. Although traditional experts still opine for the use of antiplatelets for secondary prevention of ESUS as for other causes of embolic stroke, there are still room for improvement in delivery of ...
Source: Minerva Cardioangiologica - Category: Cardiology Tags: Minerva Cardioangiol Source Type: research
ConclusionIn our experience, robot-assisted enucleation of liver hemangiomas offers low morbidity, fast recovery, excellent cosmetic results, and it could become a therapeutic option when the location of the hemangioma allows this approach.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
This study was conducted to investigate the short-term effects of a self-ligating appliance for orthodontic treatment of severe adult periodontitis. Thirty patients diagnosed as severe periodontitis were recruited at Nanjing Stomatological Hospital, P. R.China, between January 2012 and January 2016. General clinical and demographic data were collected from the patients, all of whom were treated with a self-ligating appliance. Probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP) and plaque index (PI) were measured before appliance placement, and at 1 and 3 months after appliance placement, ...
Source: Journal of oral science - Category: Dentistry Tags: J Oral Sci Source Type: research
This study reports a cohort of 16 patients with APS, who underwent oral surgery between 2010 and 2017 at the Nagasaki University Hospital. Because oral antithrombotic therapy was continued in the perioperative period, all wounds were strictly closed by suturing to prevent postoperative bleeding. Perioperative laboratory dates and medications were assessed. All patients achieved local postoperative hemostasis and did not exhibit systemic complications. Moreover, there were no postoperative systemic and/or local infections. Oral surgeons should suture oral wounds and ensure local hemostasis to prevent postoperative bleeding....
Source: Journal of oral science - Category: Dentistry Tags: J Oral Sci Source Type: research
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