Zobrazení zdroje stránky Haymartensen7660

To describe the prevalence of negative childbirth experiences and to identify potential predictors, including demographic, prenatal, obstetric, and psychological factors, of these experiences among French women.<br /><br /> Descriptive, correlational, cross-sectional study.<br /><br /> A maternity ward in a hospital located near Paris, France.<br /><br /> A total of 256 women between the ages of 18 and 46 years were recruited while hospitalized in the maternity ward 1 to 6days after childbirth.<br /><br /> Participants completed a personal information form and five self-report scales the Dyadic Adjustment Scale, the General Self-Efficacy Scale, the State-Trait Anxiety Inventory, the Relationship Scales Questionnaire, and the Questionnaire Assessing the Childbirth Experience. We performed linear regression analyses and used scores on the Questionnaire Assessing the Childbirth Experience as the dependent variable. We considered prenatal, psychological, and obstetric factors as independent variables and adjusted results for covariates.<br /><br /> The prevaleo support women with risk factors. In the early postpartum period, health care professionals should focus on subjective variables of childbirth because they strongly predict the overall childbirth experience for women.<br /><br />Given that some prenatal factors influence women's perceptions of their birth experiences, preventive measures can be implemented by health professionals to support women with risk factors. In the early postpartum period, health care professionals should focus on subjective variables of childbirth because they strongly predict the overall childbirth experience for women.<br /><br /> To increase nurse self-efficacy and the use of continuous labor support and to reduce the rate of primary cesareans among nulliparous women with low-risk pregnancies by implementing the Promoting Comfort in Labor safety bundle.<br /><br /> A quality improvement project with a pre-post practice implementation design. This practice change was part of the Reducing Primary Cesarean Learning Collaborative from the American College of Nurse-Midwives.<br /><br /> A Level II regional hospital in Virginia with more than 2,600 births annually. Births are attended by certified nurse-midwives and physicians.<br /><br /> Nursing staff on the labor and delivery unit in March 2016 (n= 27), September 2017 (n= 20), and June 2019 (n= 24).<br /><br /> We updated policies, educated nurses, procured labor support equipment, and modified documentation of care. We measured nurse confidence and skill in labor support techniques with the Self-Efficacy Labor Support Scale over 4 years. We tracked how many women were provided continuous labor support and the primary cesarean birth rate among women who were nulliparous and low risk.<br /><br /> Nurses' mean self-efficacy scores increased from 76.67 in 2016 to 86.96 in 2019 (p&lt; .001). The proportion of women who were provided continuous labor support increased from a baseline of 4.38%(47/1,074) in January 2015 through March 2016 to 18.06%(82/454) in July through December 2019 (p&lt; .001). The primary cesarean birth rate for nulliparous women with low-risk pregnancies remained stable, at approximately 18%from 2015 to2019.<br /><br /> Implementation of the Comfort in Labor Safety Bundle improved nurse self-efficacy in labor support techniques and increased the frequency of continuous labor support.<br /><br />Implementation of the Comfort in Labor Safety Bundle improved nurse self-efficacy in labor support techniques and increased the frequency of continuous labor support.Intrinsic coronary anomalies in tetralogy of Fallot are rare manifestations that are difficult to diagnose, especially when accompanied with ventricular dysfunction in the postoperative period. We present a case of severe left ventricular dysfunction after repair of tetralogy of Fallot. Coronary angiography revealed intrinsic left main coronary stenosis. Therefore, we emergently performed patch augmentation of the left main coronary artery concomitantly with residual ventricular septal defect closure. While evaluating patients with tetralogy of Fallot, especially in the presence of ventricular dysfunction, intrinsic coronary anomalies should be kept in mind. Coronary angiography is effective in diagnosing coronary anomalies.We report a case of a left atrial appendage aneurysm (LAAA) in a 16-year-old boy presenting with supraventricular tachycardia (SVT). The aneurysm was detected incidentally on a routine echocardiogram performed prior to electrophysiology (EP) study for evaluation and management of the SVT. The aneurysm was successfully resected under cardiopulmonary bypass (CPB) via video-assisted thoracoscopic surgery (VATS). VATS is a useful approach for LAAA in the pediatric population.Traumatic pulmonary artery and intercostal artery pseudoaneurysms are rare pathologies that can occur after a penetrating injury. Most times, there is only one pseudoaneurysm that needs addressed. Options for management include simple observation, endovascular intervention with coiling, embolization, and stenting, and surgical intervention ranging from ligation to pneumonectomy. We present the case of a 20-year-old male who developed multiple pulmonary artery pseudoaneurysms and an intercostal artery pseudoaneurysm after sustaining a single gunshot wound to the chest. After multiple episodes of bleeding from several pseudoaneurysms, the patient ultimately required a pneumonectomy.AngioVac system (AngioDynamics, Latham, NY) has already been described for treatment of thrombotic formations concerning the venous district and the tricuspid valve. We describe an innovative application of the Angio-Vac system to treat the inferior vena cava thrombosis associated with renal cell carcinoma. In a high-surgical risk patient, we utilized a micro-invasive and a modified veno-arterial AngioVac circuit to remove the atrial thrombus, ensure a temporary circulatory support during abdominal surgery, and prevent pulmonary embolism.A 78-year-old patient who underwent an aortic valve replacement, presented 6 months later with clinical picture suspicious for prosthetic valve endocarditis. Echocardiography did not show any features suggestive of endocarditis but a18F-FDG PET/CT scan showed an area of hyper-uptake around the ascending aorta. It was realized that sheet of Surgicel® hemostat was placed over the aortotomy suture line at the time of surgery. Another follow-up PET/CT scan performed 22 months later showed that the hyper-uptake focus remained persistent. False-positive hyper-uptake on 18F-FDG PET/CT scan due to local hemostatics should be taken in consideration when interpreting the findings of this technique.<br /><br /> Frozen section is a standard of care procedure during thoracic surgery when an immediate diagnosis is needed. An alternative procedure is intraoperative cytology. Video-assisted thoracic surgery is currently widely used for thoracic surgical procedures. The aim of this study was to assess intraoperative cytology together with frozen section for accuracy, turnaround time, and total response time during video-assisted thoracic surgery.<br /><br /> Patients having video-assisted thoracic surgery between August 2018 and February 2019 at our institution were included. A cytopathologist and a surgical pathologist independently performed intraoperative cytology and frozen sections, respectively. [https://www.selleckchem.com/products/apo866-fk866.html Daporinad] Final histologic diagnosis was the gold standard. Intraoperative cytology, frozen section turnaround and total response times were analyzed.<br /><br /> Fifty-two specimens from twenty-seven patients were included. The intraoperative cytology correlated with final histology in 98% of cases. Frozen section correlated with final histology in 100% of cases. The intraoperative cytology turnaround and total response times were equal with a mean of 4.35 minutes (range 2-15). The mean frozen section turnaround and response times were 26.2 (range 9-61) and 36.7 minutes (range 16-90), respectively. A statistically significant difference between intraoperative cytology and frozen section turnaround time and total response times (p&lt; 0.001) was found.<br /><br /> This study highlights that intraoperative cytology could be as accurate and considerably faster (p&lt; 0.001) than frozen section during video-assisted thoracic surgery. Total response time could potentially be used as a quality metric for video-assisted thoracic surgery.<br /><br />This study highlights that intraoperative cytology could be as accurate and considerably faster (p less then 0.001) than frozen section during video-assisted thoracic surgery. Total response time could potentially be used as a quality metric for video-assisted thoracic surgery.<br /><br /> The thoracic lymphadenectomy during an esophagectomy for esophageal cancer includes resection of the thoracic duct (TD) compartment containing the thoracic duct lymph nodes (TDLN). However, the role of TD compartment resection is still a topic of debate since metastatic TDLNs have only been demonstrated in squamous cell carcinomas in Eastern esophageal cancer patients. Therefore, the aim of this study was to assess the presence and metastatic involvement of TDLNs in a Western population, in which adenocarcinoma is the predominant type of esophageal cancer.<br /><br /> From July 2017 to May 2020 all consecutive patients undergoing an open or robot-assisted transthoracic esophagectomy with concurrent lymphadenectomy and resection of the TD compartment in the University Medical Center Utrecht, The Netherlands and the Città della Salute e della Scienza University Hospital in Turin, Italy were included. The TD compartment was resected en bloc and was separated in the operation room by the operating surgeon after which it was macro- and microscopically assessed for (metastatic) TDLNs by the pathologist.<br /><br /> A total of 117 patients with an adenocarcinoma (73%) or squamous cell carcinoma (27%) of the esophagus were included. In 61 (52%) patients TDLNs were found, containing metastasis in 9 (15%) patients. No major complications related to TD compartment resection were observed.<br /><br /> This is the first study to demonstrate the presence of metastatic TDLNs in adenocarcinomas of the esophagus. This result provides a valid argument to routinely extend the thoracic lymphadenectomy with resection of the TD compartment during an esophagectomy for esophageal cancer.<br /><br />This is the first study to demonstrate the presence of metastatic TDLNs in adenocarcinomas of the esophagus. This result provides a valid argument to routinely extend the thoracic lymphadenectomy with resection of the TD compartment during an esophagectomy for esophageal cancer.Apert syndrome is a form of acrocephalosyndactyly involving craniosynostosis, syndactyly, and less commonly tracheal cartilaginous sleeve (TCS), a potential cause of tracheal stenosis. Slide tracheoplasty is performed in children with tracheal stenosis. No reports exist for its application in stenosis related to TCS. We present a case in which slide tracheoplasty was utilized for expansion of long segment tracheal stenosis due to TCS in a newborn with Apert syndrome. Using this technique, a safe and durable airway was achieved without tracheostomy.Bronchial arteriovenous malformations (AVMs) are usually asymptomatic findings noted on imaging but may present with massive hemoptysis following endobronchial rupture. Initial treatment usually involves transcatheter embolization with surgery reserved for refractory cases. Here, we present a patient with large-volume hemoptysis following bronchial AVM rupture. Attempted endovascular management was unsuccessful due to unfavorable anatomy and hemodynamic instability, necessitating emergent use of extracorporeal membrane oxygenation (ECMO) followed by right bilobectomy.