Second-Degree Burn Sustained After Vaginal Steaming.

BACKGROUND: Vaginal steaming has gained increased popularity as a method to achieve empowerment by providing vaginal tightening and to "freshen" the vagina. CASE: A 62-year-old woman sustained second-degree burns following vaginal steaming in an attempt to reduce vaginal prolapse. CONCLUSION: Clinicians need to be aware of alternative treatments available to women so that counselling may mitigate any potential harm.

A postpartum haemorrhage package with condom uterine balloon tamponade: a prospective multi-centre case series in Kenya, Sierra Leone, Senegal, and Nepal.

OBJECTIVE: To evaluate the effectiveness and safety of an ultra-low-cost uterine balloon tamponade package (ESM-UBT™) for facility-based management of uncontrolled postpartum haemorrhage (PPH) in Kenya, Sierra Leone, Senegal, and Nepal. DESIGN: Prospective multi-centre case series. SETTING: Facilities in resource-scarce areas of Kenya, Sierra Leone, Nepal, and Senegal. POPULATION: Women with uncontrolled postpartum haemorrhage in 307 facilities across the four countries. METHODS: A standardised ESM-UBT package was implemented in 307 facilities over 29 months (1 September 2012 to 1 February 2015). Data were collected via a multi-pronged approach including data card completion, chart reviews, and provider interviews. Beginning in August 2014, women who had previously undergone UBT placement were sought and queried regarding potential complications associated with UBT use. MAIN OUTCOME MEASURES: All-cause survival, survival from PPH, and post-UBT use complications (surgery, hospitalisation, antibiotics for pelvic infection) associated with UBT use. RESULTS: 201 UBTs were placed for uncontrolled vaginal haemorrhage refractory to all other interventions. In all, 38% (71/188) of women were either unconscious or confused at the time of UBT insertion. All-cause survival was 95% (190/201). However, 98% (160/163) of women survived uncontrolled PPH if delivery occurred at an ESM-UBT online facility. One (1/151) potential UBT-associated complication (postpartum endometritis) was identified and two improvised UBTs were placed in women with a ruptured uterus. CONCLUSIONS: These pilot data suggest that the ESM-UBT package is a clinically promising and safe method to arrest uncontrolled postpartum haemorrhage and save women's lives. The UBT was successfully placed by all levels of facility-based providers. Future studies are needed to further evaluate the effectiveness of ESM-UBT in low-resource settings. TWEETABLE ABSTRACT: Evidence for ESM-UBT as a clinically promising and safe method to arrest uncontrolled PPH and save women's lives.

Evaluación de un preparado de Coriolus versicolor en pacientes con lesiones cervicales por papilomavirus / A ssessment of Coriolus versicolor in patients with cer vix lesions caused by human papillo- mavirus

Coriolus versicolor es un hongo con actividad inmunomoduladora inespecífica que puede ser útil como coadyuvante en el tratamiento de patologías oncológicas. Se realizó un estudio con el objetivo de evaluar la eficacia del tratamiento con un preparado a base de talo joven de C. versicolor en lesiones de cuello de úter o por papilomavirus humano (HPV). Las pacientes fueron divididas en dos grupos: en el primero se incluyeron 39 mujer es con lesiones escamosas in traepiteliales de bajo grado (LSIL) y se evaluó la negativización de anticuerpos HPV y la normalización citológica de las lesiones. En el segundo grupo, en el que participaron 35 pacientes con lesiones de alto grado (HSIL) sometidas a conización con asa diatérmica, se estudió la inversión del estado HPV positivo (HPV+) a negativo (HPV–) y el número de reincidencias tras 1 año, quedando pendiente la evaluación a los 2 años. A partir de los resultados obtenidos se puede concluir la eficacia de Coriolus versicolor como coadyuvante en el tratamiento de pacientes con lesiones escamosas de cuello de úter o por HPV (AU)

Coriolus versicolor is a mushroom with unspecific immunomodulating activity , which can be useful as an aid in the treatment of oncology pathologies. The aim of the present study was to assess the efficacy of Coriolus versicolor in the treatment of cervix lesions caused by human papillomavirus (HPV). The patients were distributed in two groups. The first one involved 39 patiens with low squamous intraepithelial lesions (LSIL), was evaluated for the negativation of HPV antibodies and the normalisation of the cytology of the lesions. In the second group, involving 35 patients with high squamous intraepithelial lesions (HSIL) subjected to conisation with a diathermic loop, the inversion of HPV state from positive (HPV+) to negative (HPV–) and the number of relapses were studied during one year, and will also be followed during a second year. From the results, it can be concluded that Coriolus versicolor is effective as an aid for the treatment of patients with cervical squamous intraepithelial lesions caused by HPV (AU)

Intraoperative and postoperative lower genital tract changes after global endometrial ablation using the Hydro ThermAblator device.

OBJECTIVE: To identify any heat transfer areas in the lower genital tract during a Hydro ThermAblator (HTA) (BEI Medical Systems) procedure and to characterize the changes in the cervix that occur in the immediate weeks after an HTA treatment. DESIGN: A prospective cohort study (Canadian Task Force classification II-3). SETTING: A university hospital in the United Kingdom. PATIENT(S): Twenty-five patients with menorrhagia. INTERVENTION(S): All patients underwent global endometrial ablation using the HTA device. Infrared thermal camera imaging of the lower genital tract was performed per-operatively, and colposcopic examinations of the cervix were performed at 2 and 4 weeks after the operation. MAIN OUTCOME MEASURE(S): The surface temperature rise of the cervix and vagina during a procedure. RESULT(S): Thermal temperature measurements of the lower genital tract in five patients and colposcopic examination at 2 and 4 weeks after the procedure. The maximum temperatures recorded during a procedure were those of the cervix, reaching 36.5 degrees C. Colposcopic images at 2 weeks showed that 15% of patients had a whitish discoloration of the cervix. At 4 weeks, the appearance of the cervix was normal. CONCLUSION(S): This study shows that during an HTA treatment cycle using a bivalve speculum to visualize the cervix, no area of the lower genital tract reaches a temperature at which thermal damage may occur. A whitish change in the cervix at 2 weeks is normal, and the lower genital tract should appear normal 4 weeks after the procedure.

[Immediate complications of surgical abortion]. / Complications immédiates de l'IVG chirurgicale.

While medical abortion is now available in non hospital facilities, abortions by vacuum aspiration remain illegal in non hospital settings. It is therefore important to assess through the literature the real risks associated with this method. All the most recent and large-scale studies showed that legal abortion by vacuum aspiration is an extremely safe procedure. It is less risky than other medical or surgical procedures performed outside the hospital. According to the studies, the death rate varies from 0 to 0.7 per 100,000 abortions, and is smaller when the procedure is done under local anesthesia than general anesthesia. The overall early complication rate (hemorrhage, uterine perforation, cervical injury) is between 0.01 and 1.16%. Complications are not more frequent than with medical abortions. In view of these low complication rates, surgical abortion by vacuum aspiration could be performed outside the hospital setting in France, as it is the case in many other countries.

Ensaio clínico com fitostimoline óvulos no pós-cautério / Clinical trial with tablets of cauterization fitostimoline after uterine cervial

Os autores avaliaram a açäo do fitostimoline óvulos no proceso de reepitelizaçäo do colo uterino após diatermocoagulaçäo. O ensaio foi do tipo duplo-cego randomizado, com grupo controle utilizando placebo. Foram avaliadas 50 pacientes, portadoras de lesöes benignas do colo uterino e submetidas a diatermocoagulaçäo, que foram subdivididas por randomizaçäo em 2 grupos (Grupos I e II). As pacientes do Grupo I receberam, por via tópica vaginal, tratamento com óvulos de fitostimoline. As pacientes do Grupo II receberam placebo na forma de óvulos exatamente iguais àqueles contendo droga ativa. A avaliaçäo do efeito dos óvulos, com droga ativa ou placebo, no processo de reepitelizaçäo do colo uterino, foi baseada nos resultados dos exames ginecológico/colposcópico realizados no 14§ dia e 28§ dia após o início do tratamento local com os óvulos. No primeiro controle, enquanto 20 casos (76,92%) do Grupo I (droga ativa) apresentavam epitelizaçäo satisfatória, apenas sete casos (29,17%) do Grupo II estavam neste estágio do processo de reepitelizaçäo. No 2§ controle, enquanto 21 casos (80,77%) do Grupo I se encontravam já com a epitelizaçäo completa, apenas oito casos (33,33%) do Grupo II mostravam a mesma situaçäo. Os autores concluem pela significante utilidade do fitostimoline óvulos como coadjuvante no tratamento das lesöes benignas do colo uterino, bem como, pela sua excelente tolerabilidade

Local versus general anesthesia: which is safer for performing suction curettage abortions?

The relative safety of suction curettage abortions performed with either local or general anesthesia has not been clearly established. To compare the safety of these two anesthetic techniques, we studied 36,430 women who received local anesthetics and 17,725 who received general anesthetics for this operation in the United States from 1971 through 1975. The aggregated major complication rates for the two groups were similar, but there were significant differences between local and general anesthesia for specific complications and treatments. Local anesthesia was associated with higher rates of febrile and convulsive morbidity; however, general anesthesia was associated with higher rates of hemorrhage, cervical injury, and uterine perforation. Both anesthetic techniques appear to be safe, with similar degrees of overall safety, although each is associated with a different spectrum of complications.