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1.
Obstet Gynecol ; 139(4): 699, 2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-35594132
2.
Obstet Gynecol ; 139(4): 698-717, 2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-35594133

RESUMO

PURPOSE: To provide updated evidence-based recommendations for the treatment of postmenopausal osteoporosis. TARGET POPULATION: Postmenopausal patients with primary osteoporosis. METHODS: This guideline was developed using an a priori protocol in conjunction with a writing team consisting of two specialists in obstetrics and gynecology appointed by the ACOG Committee on Clinical Practice Guidelines-Gynecology and one external subject matter expert. ACOG medical librarians completed a comprehensive literature search for primary literature within Cochrane Library, Cochrane Collaboration Registry of Controlled Trials, EMBASE, PubMed, and MEDLINE. Studies that moved forward to the full-text screening stage were assessed by two authors from the writing team based on standardized inclusion and exclusion criteria. Included studies underwent quality assessment, and a modified GRADE (Grading of Recommendations Assessment, Development, and Evaluation) evidence-to-decision framework was applied to interpret and translate the evidence into recommendation statements. RECOMMENDATIONS: This Clinical Practice Guideline includes updated recommendations on who should receive osteoporosis pharmacotherapy, the benefits and risks of available pharmacotherapy options, treatment monitoring and follow-up, and the role of calcium and vitamin D in the management of postmenopausal osteoporosis. Recommendations are classified by strength and evidence quality. Ungraded Good Practice Points are included to provide guidance when a formal recommendation could not be made because of inadequate or nonexistent evidence.


Assuntos
Ginecologia , Obstetrícia , Osteoporose Pós-Menopausa , Osteoporose , Cálcio na Dieta , Feminino , Humanos , Osteoporose Pós-Menopausa/diagnóstico , Osteoporose Pós-Menopausa/terapia , Gravidez
5.
Female Pelvic Med Reconstr Surg ; 28(5): 336-340, 2022 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-35420558

RESUMO

IMPORTANCE: The COVID-19 pandemic has caused a noticeable disruption in national medical and surgical care, including medical training. OBJECTIVES: We designed a survey to examine the educational effect of the pandemic on female pelvic medicine and reconstructive surgery (FPMRS) training and secondarily to identify areas for innovation and opportunity in FPMRS fellowship training. STUDY DESIGN: We used an online survey, approved by the American Urogynecologic Society Scientific Committee and distributed it to FPMRS fellows with responses obtained and stored in REDCap. Demographic data, educational and surgical experiences, the implications of the changes, and data regarding working from home were collected. RESULTS: The survey was completed by 88 fellows, with 92% of respondents being obstetrics and gynecology- based. All 10 geographic regions had at least one response. Six regions had a 50% or greater redeployment rate. Only 16% of respondents were not redeployed or on-call to be redeployed. Eighty-five percent of the ob/gyn fellow redeployments were within their home department. There was no relationship between training region and redeployment. Only 31.7% of the respondents continued to perform any FPMRS surgery. Approximately 35% of the fellows desired the opportunity for surgical simulation training because surgical cases were reduced.No relationship was seen between either redeployment status and needs (P = 0.087-0.893) or difficulties (P = 0.092-0.864) nor training location and needs (P = 0.376-0.935) or difficulties (P = 0.110-0.921). CONCLUSIONS: There was a high rate of redeployment among fellows; however, this was not associated with their reported needs and difficulties. The FPMRS-related surgical experience was affected during this time, and the fellows desired increased surgical simulation training.


Assuntos
COVID-19 , Ginecologia , Procedimentos Cirúrgicos Reconstrutivos , COVID-19/epidemiologia , Bolsas de Estudo , Feminino , Ginecologia/educação , Humanos , Pandemias , Gravidez , Procedimentos Cirúrgicos Reconstrutivos/educação , Inquéritos e Questionários , Estados Unidos
6.
Arch Iran Med ; 25(2): 112-117, 2022 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-35429948

RESUMO

BACKGROUND: There is limited evidence on the epidemiology and time trend analysis of incidence rates of gynecological cancer in Asia as a whole. We conducted this study to demonstrate breast and gynecological cancers incidence and trends in selected Asian populations. METHODS: We conducted this ecological study using cancer and population data from cancer incidence in five continents (CI5). We extracted the data of breast, uterine, cervix and ovary cancers in selected Asian populations from 1998 to 2012 from CI5plus. We used Joinpoint regression model (version 4.8.0.1) to evaluate the annual percentage change (APC), which characterizes trends in cancer rates over time, and the average annual percent changes (AAPCs), which describes the average APCs over a period of multiple years. Results were considered statistically significant at P < 0.05. RESULTS: Between breast and gynecological cancers, breast cancer has the highest incidence rates among women in Asia. The time trend of the incidence rates showed a constant growth in breast, ovary and corpus uteri cancers. This rising trend was obviously sharper for uterine cancer (AAPC 95% CI = 3.4 [3.0, 3.7]) followed by breast [AAPC 95% CI = 2.1 (2.0, 2.2)] and ovarian cancers (AAPC 95% CI = 0.5 [-0.4, 1.3]). The age-adjusted incidence rate (ASR) of cervical cancer displayed a declining trend from 1998 to 2012 (AAPC 95% CI = -1.4 [-2.4, -0.5]). CONCLUSION: Incidence rates of breast and gynecological cancers have a rising trend in Asian countries. However, breast and gynecological cancers have different patterns of time trend.


Assuntos
Neoplasias da Mama , Ginecologia , Neoplasias Ovarianas , Neoplasias Uterinas , Ásia/epidemiologia , Neoplasias da Mama/epidemiologia , Feminino , Humanos , Incidência , Masculino , Neoplasias Ovarianas/epidemiologia , Neoplasias Uterinas/epidemiologia
8.
Med Educ Online ; 27(1): 2068993, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35473575

RESUMO

BACKGROUND: In response to COVID-19, the AAMC recommended that hospitals conduct interviews in a virtual setting. OBJECTIVE: To evaluate whether fellowship video conference interviews (VCIs) are an acceptable alternative to in-person interviews from both the applicant and program perspectives. METHODS: Applicants and faculty from a single academic institution with five OBGYN subspecialty fellowship programs were invited to complete surveys regarding their experience using VCIs during the 2020 interview season. Survey responses used a 5-point Likert scale (strongly disagree to strongly agree). Comparative analyses between faculty and applicants responses to survey questions were performed with two-tailed Student's t-tests. RESULTS: 45 faculty members and 131 applicants received the survey. Response rate for faculty members and applicants was 95.6% (n = 43) and 46.6% (n = 61), respectively. Faculty and applicants agreed that the VCIs allowed them to accurately represent themselves (83.7% vs. 88.6%, p = 0.48). Most applicants (62.3%, n = 38) reported a fundamental understanding of the fellowship's culture. The majority of applicants (77.1%, n = 47) and faculty (72.1%, n = 31) agreed that they were able to develop connections during the virtual interview (p = 0.77). Faculty and applicants stated that VCIs assisted them in determining whether the candidate or program, respectively, was a good fit (83.7% vs. 67.2%, p = 0.98). CONCLUSIONS: The VCI fellowship recruitment process allowed OBGYN fellowship applicants and programs to accurately represent themselves compared to in-person interviews. Most applicants and faculty were able to develop relationships over the virtual platform. Although not explicitly assessed, it is possible that the virtual interviews can achieve a suitable match between applicant and program across all OBGYN subspecialty fellowships. The VCI process may be a long-term resolution to minimize both the financial burden and time commitment presented by traditional in-person interviews. Follow-up studies should assess the performance of the virtually selected fellows compared to those selected in previous years using traditional in-person interviews.


Assuntos
COVID-19 , Ginecologia , Obstetrícia , Docentes , Bolsas de Estudo , Humanos
9.
Sante Publique ; Vol. 33(5): 629-634, 2022 Mar 11.
Artigo em Francês | MEDLINE | ID: mdl-35485119

RESUMO

The concept of “gynecological and obstetric violence”, which emerged in the early 2000s in Latin America in activist and scientific circles, has been debated since the 2010s in French and European feminist and political circles. We show here how this concept is defined, what realities and practices it covers and by whom and in what context it is used in the public space in France and internationally, and in academic research. This concept allows for a new approach to medical care in gynecology and obstetrics that takes into account the experiences, both objective and subjective, of women and medical practices that are now technical, sometimes impersonal and disrespectful. Although there is a growing body of work in the social sciences that uses this conceptual approach, it focuses more on childbirth and less on strictly gynecological medical care.


Assuntos
Ginecologia , Parto Obstétrico , Feminino , Humanos , Parto , Gravidez , Saúde Pública , Violência
10.
J Grad Med Educ ; 14(2): 229-232, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35463159

RESUMO

Background: Pudendal nerve block is an important alternative to neuraxial anesthesia, yet studies demonstrate that 3% to 50% of pudendal nerve blocks are ineffective. Lack of clinician training is the most common cause, and there are no simulation models currently described. Objective: To develop and test a novel, low-cost, low-fidelity simulation model for training residents in the placement of a pudendal nerve block. Methods: A pudendal nerve block model was developed using commonly found supplies, with a cost of $20.57. First-year to fourth-year obstetrics and gynecology (OB/GYN) and family medicine (FM) residents were invited to 1 of 4 pudendal nerve block 1-hour simulation sessions from December 2019 to March 2021 during their required teaching sessions. Expert faculty led a discussion of pudendal nerve blocks, then participants practiced with the described model. A survey about the model was created by the authors and administrated prior to and immediately after the session. Pre- and post-surveys were analyzed by Wilcoxon signed rank tests, and Bonferroni correction was performed. Results: Thirty-four out of a total of 36 eligible residents participated (94%). Residents showed improvement in knowledge (median pre-simulation score 43.99 compared with 70.06 post-simulation, P<.00625) and self-assessed confidence (median pre-simulation score 1.7 compared with 3.2 post-simulation, P<.00625) of a pudendal block placement after simulation training. Conclusions: This new, low-cost, reusable, low-fidelity simulation model for pudendal nerve block placement improved knowledge and confidence in OB/GYN and FM residents after 1 hour of simulation training.


Assuntos
Ginecologia , Internato e Residência , Obstetrícia , Nervo Pudendo , Treinamento por Simulação , Feminino , Ginecologia/educação , Humanos , Obstetrícia/educação , Gravidez
12.
Medicina (Kaunas) ; 58(4)2022 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-35454390

RESUMO

Background and Objectives: Since the Food and Drug Administration's (FDA) approval in 2005, the application of robotic surgery (RS) in gynecology has been adopted all over the world. This study aimed to provide an update on RS in benign gynecological pathology by reporting the scientific recommendations and high-value scientific literature available to date. Materials and Methods: A systematic review of the literature was performed. Prospective randomized clinical trials (RCT) and large retrospective trials were included in the present review. Results: Twenty-two studies were considered eligible for the review: eight studies regarding robotic myomectomy, five studies on robotic hysterectomy, five studies about RS in endometriosis treatment, and four studies on robotic pelvic organ prolapse (POP) treatment. Overall, 12 RCT and 10 retrospective studies were included in the analysis. In total 269,728 patients were enrolled, 1721 in the myomectomy group, 265,100 in the hysterectomy group, 1527 in the endometriosis surgical treatment group, and 1380 patients received treatment for POP. Conclusions: Currently, a minimally invasive approach is suggested in benign gynecological pathologies. According to the available evidence, RS has comparable clinical outcomes compared to laparoscopy (LPS). RS allowed a growing number of patients to gain access to MIS and benefit from a minimally invasive treatment, due to a flattened learning curve and enhanced dexterity and visualization.


Assuntos
Endometriose , Ginecologia , Laparoscopia , Procedimentos Cirúrgicos Robóticos , Endometriose/cirurgia , Feminino , Procedimentos Cirúrgicos em Ginecologia , Humanos , Histerectomia , Estados Unidos
13.
J Obstet Gynaecol Can ; 44(4): 343-345, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35400515
15.
J Med Life ; 15(2): 168-173, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35419109

RESUMO

Avicenna used his medical knowledge and experience of scientists from different nations to create a new style in medicine. For this reason, his textbook, Canon of Medicine, has been considered a medical reference in all universities worldwide for centuries. In this article, some valuable and interesting diagnostic and therapeutic clinical experiences mentioned in the Canon of Medicine are described in five sections. This research was conducted to review Avicenna's specific clinical observations and interventions in PubMed, Google Scholar, and Scopus databases using the keywords "Avicenna" and "Canon of Medicine". In this article, we presented several examples of diagnostic and therapeutic clinical experiences mentioned in the Canon of Medicine in 5 areas, including semiology, therapeutic strategy, urology, neurology, obstetrics, and gynecology. Canon of Medicine, as a complete medical series containing the medical experiences from different nations and Iranian medical scientists, has influenced the world's medical knowledge for several centuries. Some of Avicenna's clinical and experimental views can be useful from both a historical point of view and new research.


Assuntos
Ginecologia , Medicina Arábica , Médicos , Humanos , Irã (Geográfico) , Medicina Arábica/história
16.
Clin Obstet Gynecol ; 65(2): 223-224, 2022 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-35394963
17.
Clin Obstet Gynecol ; 65(2): 290-301, 2022 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-35467576

RESUMO

Within the evolving field of obstetrics and gynecology, providers should possess the ability to effectively and critically evaluate medical literature in order to best adapt and incorporate evidence-based practice. For both clinicians and researchers alike, we provide a systematic approach for reviewing a journal article published in the medical literature. We summarize the various types of study designs, with dedicated attention to observational and experimental studies, and examine sources of bias inherent to these study designs. Finally, we review important considerations when interpreting the validity and significance of the results and conclusions of a research study.


Assuntos
Ginecologia , Obstetrícia , Viés , Feminino , Humanos , Gravidez , Projetos de Pesquisa
18.
Harefuah ; 161(4): 251-254, 2022 Apr.
Artigo em Hebraico | MEDLINE | ID: mdl-35466611

RESUMO

INTRODUCTION: The goal of the study is to analyze the gynecological system in Maccabi HMO in the aspect of risk management and to define points for improving patient safety and minimalization of the risk of lawsuits. Maccabi's risk management system aims to improve the safety of treatment, which is based on independent gynecologists in private clinics (662 doctors), 20 women's health centers and 4 emergency centers in gynecology which provide solutions to urgent cases beyond working hours in community medicine. The service provides an answer to about 870,000 women with about 940,000 annual visits. Characteristics of events in gynecology at Maccabi: events related to pregnancy - 41%, to gynecologist 40%, laboratory 11% and doctor-patient interaction: 8% Event distribution by claim or claim potential: pregnancy 70%, gynecology 30%; in cases of pregnancy - 60% of claims are related to malformations. In the field of obstetrics: in 74% of cases there was a risk factor that could be detected during pregnancy. In pregnancy-related claims reveal that in most cases there are missing or structural defects or a genetic defect that was not diagnosed; in most cases of not finding a structural defect (64%) there was a maternal factor or other suspicious factor during pregnancy follow-up, that would contribute to an early diagnosis. In most cases of non-detection of a genetic defect (92%), some suspicious factor (maternal, familial or findings during pregnancy) could have been defined, which might have contributed to the diagnosis. In gynecological events occurring: about 17% were connected to PAP smears and 13% to intrauterine devices. There is a need for an organizational culture that will encourage reporting: direct reporting to the risk management department, reporting to field risk management referrals and reporting by entities not directly involved.


Assuntos
Ginecologia , Obstetrícia , Médicos , Feminino , Humanos , Masculino , Gravidez , Gestão de Riscos , Esfregaço Vaginal
19.
Aust N Z J Obstet Gynaecol ; 62(2): 336-338, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35396853

RESUMO

'Tomorrow belongs to those who can hear it coming' David Bowie. Language is a living entity that moves and changes. Use of gender-neutral language in medical literature is increasingly common. It is time for obstetricians and gynaecologists in Australia and New Zealand to interrogate their own bias and desire to maintain the status quo, and to consider reasons for change.


Assuntos
Ginecologia , Obstetrícia , Médicos , Austrália , Humanos , Nova Zelândia
20.
Contrast Media Mol Imaging ; 2022: 6027965, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35386725

RESUMO

In order to evaluate the application of EEG intelligent detection in gynecological anesthesia depth, the application of ANGEL-6000 EEG depth monitor in laparoscopic gynecological anesthesia was proposed. This method was applied to 60 patients who underwent elective laparoscopic gynecological surgery in our hospital from February to August 2016. Inclusion criteria were ASA i ∼ ii; the average age was (37.8 ± 6.6) years from 20 to 50 years old; the average body weight was (51.53 ± 3.87) kg; conscious and no communication barriers; and patients without instrument ventilation. The patients were divided into observation group and control group according to the random number table method, with 30 patients in each group. The two groups were anesthetized with the same anesthetic drugs, and their consciousness index was monitored. IoC values were recorded before induction of anesthesia (T0), 5 min after intubation (T1), 5 min after operation (T2), intraoperative exploration (T3), at the end of operation (T4), 1 min before extubation (T5), and 5 min after extubation (T6). The dosage of anesthetic drugs, operation time, extubation time, and operation time of the two groups were statistically analyzed. Compared with the operation time of patients in the two groups, the extubation time, awake time, and time out of the operating room of patients in the control group were longer than the observation group. The IoC values of patients in the control group at T0 and T6 time points were lower than those in the observation group at each time point from T1 to T5. Comparison of perioperative dose of remifentanil and atracurium between the two groups was performed. The control group used more propofol dose in perioperative period. The application of neuroelectric signal in laparoscopic gynecological surgery to detect changes in perioperative IoC value can well reflect the level of consciousness of patients and reflect the effect of perioperative stimulation at different time points on the EEG of patients in real time.


Assuntos
Anestesia Obstétrica , Ginecologia , Obstetrícia , Propofol , Adulto , Humanos , Pessoa de Meia-Idade , Remifentanil , Adulto Jovem
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