The association between the introduction of quantitative assessment of postpartum blood loss and institutional changes in clinical practice: an observational study

2020 ◽  
Vol 42 ◽  
pp. 4-10 ◽  
Author(s):  
D. Katz ◽  
R. Wang ◽  
L. O'Neil ◽  
C. Gerber ◽  
A. Lankford ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Blood Loss ◽  
Observational Study ◽  
Quantitative Assessment ◽  
Institutional Changes ◽  
Postpartum Blood Loss

Oxytocin administration for induction and augmentation of labour in Polish maternity units– an observational study

2020 ◽  
Author(s):  
Barbara Baranowska ◽  
Anna Kajdy ◽  
Iwona Kiersnowska ◽  
Dorota Sys ◽  
Urszula Tataj-Puzyna ◽  
...  
Keyword(s):  
Blood Loss ◽  
Observational Study ◽  
Cumulative Dose ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Labour Induction ◽  
National Guidelines ◽  
Short Term ◽  
Apgar Scores ◽  
Postpartum Blood Loss

Abstract Background: There is not enough data regarding practices and protocols that healthcare personnel follow and the amount of oxytocin that women receive during labour. Empirical evidence indicates that compliance with the guidelines improves the quality of healthcare and reduces adverse effects. The study aimed to evaluate practices of oxytocin provision for labour induction and augmentation in Polish maternity units. Methods: The article presents a prospective observational study. Data collection took place in two selected maternity units between January 15 and July 31, 2019 (n=545). The analysis included the total amount and cumulative dose of oxytocin during labour. We analysed the relationship between the cumulative dose of oxytocin and short term perinatal outcomes (mode of delivery, use of epidural anaesthesia, Apgar scores, birth weight and postpartum blood loss). The study examines the compliance of oxytocin supply during labour with national guidelines in the following five criteria: medium, start dose, escalation rate, interval, the continuation of infusion after established labour. Results: The average total amount of oxytocin administrated to women before birth was 7.329µg following labour induction and 3.952µg following labour augmentation. The actual administration of oxytocin deviated both from the unit and national guidelines in 93.6% of all observed labours (mainly because of continuation of infusion after established labour). We found no statistically significant correlation between the cumulative dose of oxytocin administered and mode of delivery, immediate postpartum blood loss or Apgar scores. There was no observed effect of cumulative dose oxytocin on short-term perinatal outcomes. Hospitals with similar protocols did not differ significantly in terms of total oxytocin amount, rates of induction and augmentation - the only observed difference was the mode of delivery. Conclusions: There was no practical effect of cumulative dose oxytocin on short-term perinatal outcomes. In the study, we observed significant discrepancies between protocols and practice.

The impact of prepartum factor XIII activity on postpartum blood loss

2019 ◽  
Author(s):  
C Haslinger ◽  
W Korte ◽  
T Hothorn ◽  
R Brun ◽  
C Greenberg ◽  
...  
Keyword(s):  
Blood Loss ◽  
Factor Xiii ◽  
Postpartum Blood Loss ◽  
The Impact

scholarly journals Pharmacological and clinical evaluation of deferasirox formulations for treatment tailoring

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Andrea Piolatto ◽  
Paola Berchialla ◽  
Sarah Allegra ◽  
Silvia De Francia ◽  
Giovanni Battista Ferrero ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Renal Impairment ◽  
Observational Study ◽  
Iron Overload ◽  
Iron Loading ◽  
Comprehensive Comparison ◽  
Dispersible Tablets ◽  
One Year ◽  
Safety Features

AbstractDeferasirox (DFX) is the newest among three different chelators available to treat iron overload in iron-loading anaemias, firstly released as Dispersible Tablets (DT) and more recently replaced by Film-Coated Tablets (FCT). In this retrospective observational study, pharmacokinetics, pharmacodynamics, and safety features of DFX treatment were analyzed in 74 patients that took both formulations subsequently under clinical practice conditions. Bioavailability of DFX FCT compared to DT resulted higher than expected [Cmax: 99.5 (FCT) and 69.7 (DT) μMol/L; AUC: 1278 (FCT) and 846 (DT), P < 0.0001]. DFX FCT was also superior in scalability among doses. After one year of treatment for each formulation, no differences were observed between the treatments in the overall iron overload levels; however, DFX FCT but not DT showed a significant dose–response correlation [Spearman r (dose-serum ferritin variation): − 0.54, P < 0.0001]. Despite being administered at different dosages, the long-term safety profile was not different between formulations: a significant increase in renal impairment risk was observed for both treatments and it was reversible under strict monitoring (P < 0.002). Altogether, these data constitute a comprehensive comparison of DFX formulations in thalassaemia and other iron-loading anaemias, confirming the effectiveness and safety characteristics of DFX and its applicability for treatment tailoring.

scholarly journals Initial Experience of the Levodopa–Entacapone–Carbidopa Intestinal Gel in Clinical Practice

2021 ◽  
Vol 11 (4) ◽  
pp. 254
Author(s):  
Mezin Öthman ◽  
Erik Widman ◽  
Ingela Nygren ◽  
Dag Nyholm
Keyword(s):  
Cardiac Arrest ◽  
Clinical Practice ◽  
Observational Study ◽  
Prospective Studies ◽  
Infusion Rate ◽  
Treatment Duration ◽  
Initial Experience ◽  
Morning Dose ◽  
Efficacy And Safety ◽  
User Friendliness

Patients in fluctuating stages of Parkinson’s disease (PD) require device-aided treatments. Continuous infusion of levodopa–carbidopa intestinal gel (LCIG) is a well-proven option in clinical practice. We now report the first clinical experience of levodopa–entacapone–carbidopa intestinal gel (LECIG) therapy. An observational study of the first patients to start LECIG in our clinic was performed. Twenty-four patients (11 females, 13 males) were included. The median age was 71.5 years, and the median duration since PD diagnosis was 15.5 years. The median treatment duration was 305 days. Median doses were: 6.0 mL as morning dose, 2.5 mL/h as infusion rate, and 1.0 mL as extra dose. Half of the patients were switched directly from LCIG. These patients express improvements in the size and weight of the pump. Furthermore, most of them considered the new pump to be improved regarding user-friendliness. Six patients discontinued LECIG, three due to diarrhea, one due to hallucinations and two deceased (one cardiac arrest and one COVID-19). LECIG has shown to be possible to use in patients with PD, efficacy and safety as expected. Patients are generally happy with the size and usability of the pump, but some technical improvements of the software are warranted, as well as larger, prospective studies.

scholarly journals Physiological and pathological roles of the accommodation response in lower esophageal sphincter relaxation during wet swallows

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kazumasa Muta ◽  
Eikichi Ihara ◽  
Shohei Hamada ◽  
Hiroko Ikeda ◽  
Masafumi Wada ◽  
...  
Keyword(s):  
Clinical Practice ◽  
High Resolution ◽  
Observational Study ◽  
Lower Esophageal Sphincter ◽  
Relaxation Function ◽  
Esophagogastric Junction ◽  
Prospective Observational Study ◽  
Outflow Obstruction ◽  
High Resolution Manometry ◽  
Esophageal Sphincter

AbstractThe preparatory accommodation response of lower esophageal sphincter (LES) before swallowing is one of the mechanisms involved in LES relaxation during wet swallows, however, the physiological and/or pathological roles of LES accommodation remain to be determined in humans. To address this problem, we conducted a prospective observational study of 38 patients with normal high-resolution manometry (HRM) and 23 patients with idiopathic esophagogastric junction outflow obstruction (EGJOO) to assess dry and wet swallows. The LES accommodation measurement was proposed for practical use in evaluating the LES accommodation response. Although swallow-induced LES relaxation was observed in both dry and wet swallows, LES accommodation (6.4, 3.1–11.1 mmHg) was only observed in wet swallows. The extent of LES accommodation was impaired in idiopathic EGJOO (0.6, − 0.6–6 mmHg), and the LES accommodation measurement of patients with idiopathic EGJOO (36.8, 29.5–44.3 mmHg) was significantly higher in comparison to those with normal HRM (23.8, 18–28.6 mmHg). Successful LES relaxation in wet swallowing can be achieved by LES accommodation in combination with swallow-induced LES relaxation. Impaired LES accommodation is characteristic of idiopathic EGJOO. In addition to the IRP value, the LES accommodation measurement may be useful for evaluating the LES relaxation function in clinical practice.

scholarly journals A European Observational Study to Evaluate the Safety and the Effectiveness of Safinamide in Routine Clinical Practice: The SYNAPSES Trial

2021 ◽  
pp. 1-1
Author(s):  
Giovanni Abbruzzese ◽  
Jaime Kulisevsky ◽  
Bruno Bergmans ◽  
Juan C. Gomez-Esteban ◽  
Georg Kägi ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Observational Study ◽  
Routine Clinical Practice
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