Obstetric Management of Patients with Spinal Cord Injuries: ACOG Committee Opinion Summary, Number 808.
Obstetric Management of Patients with Spinal Cord Injuries: ACOG Committee Opinion Summary, Number 808. Obstet Gynecol. 2020 May;135(5):1247-1249 Authors: Abstract Approximately 17,730 new spinal cord injuries (SCIs) occur per year in the United States. Effective rehabilitation and modern reproductive technology may increase the number of these patients considering pregnancy. Obstetrician-gynecologists and other obstetric care professionals who care for such patients should be familiar with problems related to SCIs that may occur throughout pregnancy and during the postpartum period. Autonomic dysreflexia (sometimes called autonomic hyperreflexia) is the most serious medical complication that occurs in women with SCIs and is found in 85% of patients with lesions at or above T6 level. It is important to avoid stimuli that can lead to autonomic dysreflexia, such as distension or manipulation of the vagina, bladder, urethra, or bowel. Women with SCIs may give birth vaginally. Although pain perception is impaired in women with SCIs at or above T10, neuraxial anesthesia is the treatment of choice to reduce the risk of autonomic dysreflexia because it blocks neurologic stimuli arising from the pelvic organs. Adequate anesthesia, spinal or epidural if possible, is needed for cesarean births in all patients with SCIs. In addition to routine postpartum care, obstetrician-gynecologists and other obstetric care professionals should ensure that perineal and cesarea...
Publication date: Available online 10 July 2020Source: Revista Clínica Española (English Edition)Author(s): J.J. Hijona Elósegui, A.L. Carballo García, A.C. Fernández Risquez, M. Bermúdez Quintana, J.F. Expósito Montes
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Publication date: Available online 10 July 2020Source: International Journal of Surgery Case ReportsAuthor(s): Philippe Hantson, Catherine Hubert, Audrey Dieu, Diego Castanares-Zapatero, Julie Lelotte, Pierre-François Laterre
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CONCLUSIONS: HFNO provides a hands-free induction of general anaesthesia and yields adequate preoxygenation and peroxygenation, with a significant improvement in the quality of care. PMID: 32643359 [PubMed - as supplied by publisher]
CONCLUSIONS: Interfascial dexmedetomidine adjuvant to QLB provided better postoperative analgesia in terms of less morphine consumption, better pain scores and longer time to first analgesic request when compared with the IV dexmedetomidine. PMID: 32643358 [PubMed - as supplied by publisher]
CONCLUSIONS: VIS was feasible in clinical routine. Compared to the other evaluated blocks, the VIS for the infragluteal access to the sciatic nerve was rated worst. VIS is found to be worse in obese patients. Further research is needed to evaluate VIS and its suitability for specific questions as for instance anesthetists' learning curves, comparison of different patient populations, ultrasound devices or different nerve blocks. PMID: 32643357 [PubMed - as supplied by publisher]
You’ve probably seen plenty of examples of values that you don’t respect or admire in the world lately. What about the values you do admire though? Do you praise and encourage them when you see them? Here are some values I admire that I like to praise and encourage when I see them in others. Growth I admire people who embrace growth. I’m impressed by those who keep turning towards opportunities to make positive changes. I especially respect people who do this when dealing with challenging circumstances by staying focused on what they want. People with fixed mindsets are so dreadfully dull. I pref...
Publication date: Available online 5 July 2020Source: Asian Nursing ResearchAuthor(s): Jianfei Xie, Min Liu, Zhuqing Zhong, Qiuxiang Zhang, Jianda Zhou, Lu Wang, Keke Ma, Siqing Ding, Andy S.K. Cheng, Xiaohong Zhang, Qian Sun
CONCLUSION: Our observational study suggests that intake of lorazepam impedes the response to rTMS. The impact of lorazepam and other BZD on rTMS should receive more attention and be further investigated in prospective, hypothesis-based treatment studies to determine causal relationships between medication treatments and outcome. This could lead to specific recommendations for pharmacological treatment for depressed patients undergoing rTMS. PMID: 32648109 [PubMed - as supplied by publisher]