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1.
J Ovarian Res ; 14(1): 35, 2021 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-33602258

RESUMO

China and the rest of the world are experiencing an outbreak of the 2019 novel coronavirus disease (COVID-19). Patients with cancer are more susceptible to viral infection and are more likely to develop severe complications, as compared to healthy individuals. The growing spread of COVID-19 presents challenges for the clinical care of patients with gynecological malignancies. Ovarian debulking surgery combined with the frequent need for chemotherapy is most likely why ovarian cancer was rated as the gynecologic cancer most affected by COVID-19. Therefore, ovarian cancer presents a particular challenging task. Concerning the ovarian cancer studies with confirmed COVID-19 reported from large-scale general hospitals in Wuhan, we hold that the treatment plan was adjusted appropriately and an individualized remedy was implemented. The recommendations discussed here were developed mainly based on the experience from Wuhan. We advise that the management strategy for ovarian cancer patients should be adjusted in the light of the local epidemic situation and formulated according to the pathological type, tumor stage and the current treatment phase. Online medical service is an effective and convenient communication platform during the pandemic.


Assuntos
/prevenção & controle , Neoplasias Ovarianas/terapia , /isolamento & purificação , /epidemiologia , China/epidemiologia , Feminino , Ginecologia/métodos , Hospitais Gerais , Humanos , Oncologia/métodos , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/epidemiologia , Pandemias , /fisiologia
2.
Aust N Z J Obstet Gynaecol ; 61(1): 9-10, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33523473
3.
Medicine (Baltimore) ; 100(1): e24268, 2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33429837

RESUMO

ABSTRACT: Query of Prescription Drug Monitoring Programs (PDMPs) is recommended before prescribing opioids by the US Centers for Disease Control and Prevention, to inform clinical practice and aid diversion prevention. Many states mandate prescriber PDMP use; however, little is known about PDMP perception of utility and use among Obstetricians-Gynecologists (OB/GYN), who are the primary provider for most women during pregnancy.This study examined OB/GYN perceptions and utilization of their state PDMP.Survey items were developed by expert consensus. A voluntary anonymous survey was emailed to a random sample of 5000 OB/GYNs (adjusted participants n = 1470, minus unread/refusals). Responses were stratified by state policy environment, where response frequency distributions were compared for OB/GYNs practicing in states with mandatory vs voluntary PDMP query.Adjusted response rate was 27% (n = 397). Most OB/GYNs (78%) were registered with their PDMP. The majority agreed that "…mandating physician use of the PDMP was a good idea" (51.4% mandatory state vs 58.3% voluntary state). Respondents in mandatory states reported that the primary purpose of the PDMP was "to allow the physician to verify medications that the patient is being prescribed" less frequently than those in voluntary states (38.3% vs 52.8%). Several report speaking with patients about controlled substance prescriptions after viewing PDMP reports (27.8% in mandatory vs 26.3% in voluntary states). In qualitative responses, reported frustration with PDMPs was evident.OB/GYNs are diverse in their perceptions regarding the utility and purpose of PDMPs. Tailored education is needed regarding clinical utility of PDMPs for OB/GYN practice.


Assuntos
Atitude do Pessoal de Saúde , Ginecologia , Obstetrícia , Padrões de Prática Médica/estatística & dados numéricos , Programas de Monitoramento de Prescrição de Medicamentos , Estudos Transversais , Feminino , Humanos , Masculino , Inquéritos e Questionários , Estados Unidos
4.
Rev Med Suisse ; 17(720-1): 38-41, 2021 Jan 13.
Artigo em Francês | MEDLINE | ID: mdl-33443829

RESUMO

In Switzerland, tobacco smoking is a major public health problem, especially among pregnant women. Health problems encountered by pregnant women and their fetuses require specific care to assist smoking cessation. A specific consultation to support smoking cessation during pregnancy was created in May 2019 at the maternity ward of the University Hospitals of Geneva, with the support of the Fondation Privée des Hôpitaux Universitaires de Genève and Carrefour addictionS/CIPRET-Genève. The creation of a network of health professionnals trained in smoking cessation is an important step to support women during their cessation process.


Assuntos
Ginecologia/métodos , Obstetrícia/métodos , Assistência Perinatal/métodos , Complicações na Gravidez/prevenção & controle , Gestantes , Abandono do Hábito de Fumar/métodos , Prevenção do Hábito de Fumar/métodos , Feminino , Humanos , Gravidez , Suíça
5.
6.
Am J Obstet Gynecol ; 224(1): B2-B14, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33386103

RESUMO

Placenta accreta spectrum includes the full range of abnormal placental attachment to the uterus or other structures, encompassing placenta accreta, placenta increta, placenta percreta, morbidly adherent placenta, and invasive placentation. The incidence of placenta accreta spectrum has increased in recent years, largely driven by increasing rates of cesarean delivery. Prenatal detection of placenta accreta spectrum is primarily made by ultrasound and is important to reduce maternal morbidity associated with the condition. Despite a large body of research on various placenta accreta spectrum ultrasound markers and their screening performance, inconsistencies in the literature persist. In response to the need for standardizing the definitions of placenta accreta spectrum markers and the approach to the ultrasound examination, the Society for Maternal-Fetal Medicine convened a task force with representatives from the American Institute of Ultrasound in Medicine, the American College of Obstetricians and Gynecologists, the American College of Radiology, the International Society of Ultrasound in Obstetrics and Gynecology, the Society for Radiologists in Ultrasound, the American Registry for Diagnostic Medical Sonography, and the Gottesfeld-Hohler Memorial Ultrasound Foundation. The goals of the task force were to assess placenta accreta spectrum sonographic markers on the basis of available data and expert consensus, provide a standardized approach to the prenatal ultrasound evaluation of the uterus and placenta in pregnancies at risk of placenta accreta spectrum, and identify research gaps in the field. This manuscript provides information on the Placenta Accreta Spectrum Task Force process and findings.


Assuntos
Placenta Acreta/diagnóstico por imagem , Ultrassonografia Pré-Natal/métodos , Ultrassonografia Pré-Natal/normas , Cesárea/efeitos adversos , Cicatriz/diagnóstico por imagem , Feminino , Idade Gestacional , Ginecologia , Humanos , Obstetrícia , Placenta/diagnóstico por imagem , Placenta Acreta/epidemiologia , Gravidez , Sensibilidade e Especificidade , Sociedades Médicas , Estados Unidos , Útero/diagnóstico por imagem
10.
Brazilian Journal of Development ; 7(1): 1276-1291, 2021. tab, graf
Artigo em Português | LILACS, MOSAICO - Saúde integrativa | ID: biblio-1147500

RESUMO

O alho é um alimento utilizado em diversas culturas na forma de alimentação e apresenta várias propriedades que atuam no sistema imunológico, principalmente conhecido por ter efeito antibiótico e antifúngico. O artigo tem o propósito de expansão dos conhecimentos acerca da eficácia do alho na ginecologia natural objetivando-o como alternativa a um modelo médico tradicional. O estudo trata-se de uma revisão integrativa da literatura com seis etapas para a obtenção da síntese final, foram encontrados treze artigos relacionados ao tema que trouxeram resultados favoráveis acerca do uso do alho e sua utilização como terapia complementar.


Assuntos
Humanos , Feminino , Alho , Ginecologia , Medicina Tradicional , Antibacterianos , Antifúngicos
11.
Maturitas ; 143: 89-95, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33308642

RESUMO

OBJECTIVE: The objective of this study was to present an updated picture of the knowledge and attitudes of Italian gynecologists with regard to the genitourinary syndrome of menopause (GSM). STUDY DESIGN: An anonymous survey was sent via electronic mail to 3892 gynecologists. The survey consisted of 32 multiple-choice questions divided into four different areas: 1. general demographics of the respondents; 2. knowledge of GSM; 3. most frequently prescribed therapies; and 4. perception of patient compliance and satisfaction with current therapeutic options. MAIN OUTCOME MEASURES: Knowledge of vulvo-vaginal atrophy (VVA) and attitudes of the gynecologists to its management. RESULTS: Three hundred and seventy-four out of 3892 invited Italian gynecologists replied to the survey (response rate 9.7 %). Most (84 %) had a good knowledge of GSM and 74 % reported that they investigated it during clinic visits, but most of them underestimated its prevalence. The most frequently prescribed treatment was topical hormonal therapy (60 %), followed by vaginal moisturizers and lubricants (16 %), ospemifene (12 %) and systemic hormone therapy (12 %). According to the clinical experience of respondents, the most effective therapy is local hormonal therapy (36 %), followed by ospemifene (30 %). According to respondents, less than 50 % of patients continue therapy after 12 months, due to the discomfort in vaginal application, the cost of oral therapies and the fear of possible side-effects. CONCLUSIONS: With the limitation of the low response rate, this study suggests that although Italian gynecologists who answered the survey had some knowledge of GSM, they underestimated its prevalence, did not know its most bothersome symptoms and had inadequate knowledge of the efficacy of treatments, patient compliance and satisfaction.


Assuntos
Competência Clínica , Doenças Urogenitais Femininas , Ginecologia , Menopausa , Médicos , Atrofia , Atitude do Pessoal de Saúde , Feminino , Humanos , Itália , Masculino , Inquéritos e Questionários , Síndrome , Vagina/patologia , Vulva/patologia
12.
Gynecol Oncol ; 160(3): 649-654, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33358197

RESUMO

BACKGROUND: Surgery is the cornerstone of gynecological cancer management, but inpatient treatment may expose both patients and healthcare staff to COVID-19 infections. Plans to mitigate the impact of the COVID-19 pandemic have been implemented widely, but few studies have evaluated the effectiveness of these plans in maintaining safe surgical care delivery. AIM: To evaluate the effects of mitigating plans implemented on the delivery of gynecological cancer surgery during the COVID-19 pandemic. METHODS: A comparative cohort study of patients treated in a high-volume tertiary gyneoncological centre in the United Kingdom. Prospectively-recorded consecutive operations performed and early peri-operative outcomes during the same calendar periods (January-August) in 2019 and 2020 were compared. RESULTS: In total, 585 operations were performed (296 in 2019; 289 in 2020). There was no significant difference in patient demographics. Types of surgery performed were different (p = 0.034), with fewer cytoreductive surgeries for ovarian cancer and laparoscopic procedures (p = 0.002) in 2020. There was no difference in intra-operative complication rates, critical care admission rates or length of stay. One patient had confirmed COVID-19 infection (0.4%). The 30-day post-operative complication rates were significantly higher in 2020 than in 2019 (58 [20.1%] versus 32 [10.8%]; p = 0.002) for both minor and major complications. This increase, primarily from March 2020 onwards, coincided with the first peak of the COVID-19 pandemic in the UK. CONCLUSIONS: Maintaining surgical throughput with meticulous and timely planning is feasible during the COVID-19 pandemic but this was associated with an increase in post-operative complications due to a multitude of reasons.


Assuntos
/prevenção & controle , Assistência à Saúde/organização & administração , Neoplasias dos Genitais Femininos/cirurgia , Procedimentos Cirúrgicos em Ginecologia/estatística & dados numéricos , Ginecologia/organização & administração , Oncologia Cirúrgica/organização & administração , Idoso , Estudos de Coortes , Procedimentos Cirúrgicos de Citorredução/estatística & dados numéricos , Assistência à Saúde/métodos , Feminino , Ginecologia/métodos , Pessoal de Saúde , Humanos , Controle de Infecções/métodos , Unidades de Terapia Intensiva/estatística & dados numéricos , Complicações Intraoperatórias/epidemiologia , Laparoscopia/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Programas de Rastreamento , Pessoa de Meia-Idade , Serviço Hospitalar de Oncologia , Equipamento de Proteção Individual , Complicações Pós-Operatórias/epidemiologia , Quarentena , Medicina Estatal , Oncologia Cirúrgica/métodos , Centros de Atenção Terciária , Reino Unido
18.
Medicine (Baltimore) ; 99(43): e22562, 2020 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-33120744

RESUMO

Simulation and Objective Structured Clinical Examination assessment of learners can teach clinical skills proficiency in a safe environment without risk to patients. Interprofessional simulation-based education (IPSE) contributes to a transformation in students' understanding of teamwork and professional roles. Long term outcomes for stimulation and IPSE sessions, are less well studied. We hypothesized that a progressive interprofessional education simulation program incorporating both faculty and interprofessional student collaboration would improve medical students' knowledge retention, comfort with procedural skills, positive teamwork and respectful interaction between students.An Obstetrics and Gynecology IPSE for medical and nursing students (NS) was developed in collaboration between a school of medicine and a school of nursing from 2014 to 2017. By 2017, content includedFrom 2014 to 2016, medical students completed attitude, knowledge, and perception surveys both pre and immediately post simulation, at 4 months, and 8 months. In 2017; all students completed self-assessments and received faculty-assessments.The program trained 443 medical and 136 NS. Medical students' knowledge, comfort, and interest increased significantly post simulation. Outcome scores decreased but were still significantly improved at 4 months but nearly dissipated by 8 months. There were no significant differences between medical and NS self-assessment or faculty-assessment scores regarding IUD insertion, cervical examination, or contraception quiz scores. Medical students' birth simulation self-assessment versus faculty-assessment scores were 8.6 vs 8.9, P < .001.Simulation improved students' short-term medical knowledge, comfort, and perception with some long-term persistence at 4-8 months. Medical and NS learned obstetrics and gynecology skills in a collaborative environment and in role-specific situations. Medical students had the opportunity to learn from NS. Positive teamwork and respectful interaction occurred between the students.


Assuntos
Ginecologia/educação , Obstetrícia/educação , Treinamento por Simulação , Estudantes de Medicina , Estudantes de Enfermagem , Atitude do Pessoal de Saúde , Competência Clínica , Estudos de Coortes , Comportamento Cooperativo , Currículo , Educação de Graduação em Medicina , Educação em Enfermagem , Humanos , Relações Interprofissionais
19.
J Gynecol Oncol ; 31(6): e92, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33078597

RESUMO

OBJECTIVE: Coronavirus disease 2019 (COVID-19) has caused rapid and drastic changes in cancer management. The Italian Society of Gynecology and Obstetrics (SIGO), and the Multicenter Italian Trials in Ovarian cancer and gynecologic malignancies (MITO) promoted a national survey aiming to evaluate the impact of COVID-19 on clinical activity of gynecologist oncologists and to assess the implementation of containment measures against COVID-19 diffusion. METHODS: The survey consisted of a self-administered, anonymous, online questionnaire. The survey was sent via email to all the members of the SIGO, and MITO groups on April 7, 2020, and was closed on April 20, 2020. RESULTS: Overall, 604 participants completed the questionnaire with a response-rate of 70%. The results of this survey suggest that gynecologic oncology units had set a proactive approach to COVID-19 outbreak. Triage methods were adopted in order to minimize in-hospital diffusion of COVID-19. Only 38% of gynecologic surgeons were concerned about COVID-19 outbreak. Although 73% of the participants stated that COVID-19 has not significantly modified their everyday practice, 21% declared a decrease of the use of laparoscopy in favor of open surgery (19%). However, less than 50% of surgeons adopted specific protection against COVID-19. Additionally, responders suggested to delay cancer treatment (10%-15%), and to perform less radical surgical procedures (20%-25%) during COVID-19 pandemic. CONCLUSIONS: National guidelines should be implemented to further promote the safety of patients and health care providers. International cooperation is of paramount importance, as heavily affected nations can serve as an example to find out ways to safely preserve clinical activity during the COVID-19 outbreak.


Assuntos
Infecções por Coronavirus/prevenção & controle , Ginecologia/métodos , Controle de Infecções/métodos , Oncologia/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Betacoronavirus , Infecções por Coronavirus/transmissão , Feminino , Neoplasias dos Genitais Femininos/terapia , Procedimentos Cirúrgicos em Ginecologia/estatística & dados numéricos , Humanos , Cooperação Internacional , Itália , Pneumonia Viral/transmissão , Sociedades Médicas , Inquéritos e Questionários , Triagem/métodos , Triagem/estatística & dados numéricos
20.
Obstet Gynecol ; 136(5): 987-994, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33030868

RESUMO

OBJECTIVE: To assess whether a pediatric and adolescent gynecology electronic learning (eLearning) module improves knowledge and clinical performance among obstetrics and gynecology residents. METHODS: We conducted a multi-institutional, single-blinded, randomized controlled trial across four university programs; three had pediatric and adolescent gynecology rotations, and two had pediatric and adolescent gynecology fellowship-trained faculty. Applying permutated block randomization, residents were randomized to no intervention or completion of a validated eLearning module on prepubertal bleeding. All residents subsequently completed a pediatric and adolescent gynecology-related knowledge assessment that queried understanding of prepubertal bleeding and an objective structured clinical examination that assessed history collection, performance of a prepubertal genital examination, vaginal culture, and vaginoscopy for a pediatric patient. Objective structured clinical examinations were videotaped and reviewed by two faculty, blinded to randomization group; interrater reliability score was 97%. We calculated descriptive frequencies and compared randomization groups using χ analyses and Fisher exact tests for categorical variables, and median tests for continuous variables; a value of P<.05 was considered significant. RESULTS: From July 2018 to June 2019, we invited 115 residents to participate; 97 (83%) completed both objective structured clinical examination and follow-up knowledge assessments. Most were female (91%) and the majority reported limited pediatric and adolescent gynecology didactic or clinical experience, with 36% reporting prior didactics on prepubertal vaginal bleeding and 33% reporting prior exposure to the prepubertal genital examination. Forty-five participants (46%) were randomized to the module and groups were similar across training levels. Residents assigned to the module scored significantly higher on the knowledge assessment (4/5 vs 2/5, P<.001) and objective structured clinical examination (13/16 vs 7/16, P<.001) and were more likely to avoid a speculum in the examination of a pediatric patient (95.6% vs 57.7%, P<.001). CONCLUSION: Our pediatric and adolescent gynecology eLearning module resulted in improved short-term resident knowledge and simulated clinical skills among obstetrics and gynecology residents. Applying this learning technique in other programs may help address deficiencies in pediatric and adolescent gynecology education and training.


Assuntos
Competência Clínica/estatística & dados numéricos , Ginecologia/educação , Internato e Residência/estatística & dados numéricos , Pediatria/educação , Treinamento por Simulação/métodos , Adolescente , Adulto , Criança , Currículo , Avaliação Educacional , Bolsas de Estudo/métodos , Bolsas de Estudo/estatística & dados numéricos , Feminino , Ginecologia/métodos , Humanos , Internato e Residência/métodos , Pediatria/métodos , Reprodutibilidade dos Testes , Método Simples-Cego
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