scholarly journals Non-obstetric surgery during pregnancy – an eleven-year retrospective analysis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
J. Vujic ◽  
K. Marsoner ◽  
A. H. Lipp-Pump ◽  
P. Klaritsch ◽  
H. J. Mischinger ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Medical Records ◽  
Preterm Labor ◽  
Postoperative Intensive Care ◽  
Elective Setting ◽  
General Surgeons ◽  
Adnexal Pathology ◽  
Skin To Skin ◽  
Obstetric Surgery ◽  
Perinatal Database

Abstract Background Diagnosis and management of non-obstetric abdominal pathologies during pregnancy are clinically challenging for both obstetricians and general surgeons. Our aim was to evaluate the outcome of pregnant patients who had undergone non-obstetric abdominal surgery. Methods We retrospectively reviewed 76 pregnant patients who had required surgery for non-obstetric abdominal pathologies during pregnancy at our department from January 2005 to December 2015. Data were collected retrospectively from medical records as well as from our institutional perinatal database. We evaluated data for clinical presentation, perioperative management, preterm labor, and maternal and fetal outcomes. Results The patients’ mean age was 29 (interquartile range IQR 25–33) years. Indications for surgery were acute appendicitis in 63%, adnexal pathology in 11%, cholecystolithiasis in 5% and other indications in 21%; surgery was performed in an elective setting in 18% and in an emergent/urgent setting in 82%. In five cases, complications, three of them oncological, called for further surgery. Ninety-seven percent of operations were conducted under general anesthesia. Median skin-to-skin time was 50 (37–80) minutes, median in-hospital stay was 4 (3.5–6) days, and 5 % required postoperative intensive care. Preterm labor occurred in 15%, miscarriage in 7% (none of them directly related to abdominal surgery). Conclusion Abdominal surgery for non-obstetric pathology during pregnancy can be performed safely, if mandatory, without increases in maternal and fetal pathology, miscarriage, and preterm birth rates.

scholarly journals Epidemiological characteristics of neonatal admissions in a public maternity / Características epidemiológicas das internações neonatais em uma maternidade pública / Características epidemiológicas de admisión neonatal en una maternidad..

2018 ◽  
Vol 6 (4) ◽  
pp. 28
Author(s):  
Danubia Jacomo Da Silva Cardoso ◽  
Beatriz Schumacher
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Medical Records ◽  
Preterm Labor ◽  
Neonatal Intensive Care ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Maternal Complications ◽  
Epidemiological Characteristics

Descriptive retrospective Research with quantitative approach. Aims: Meet the epidemiological characteristics of hospitalization in Neonatal intensive care unit, relating them to the possible maternal factors, in a public maternity in southern Brazil. Performed with newborns that they put in the NICU, forwarded with the clinical summary to the Municipal program precious baby. The data were collected, with the following variables: maternal age, type of birth, number of pre-natal consultations, complications in pregnancy, and number of days of hospitalization in neonatal intensive care unit, in the period from January to December 2013. Were analyzed medical records 72, prematurity was the most prevalent with 61% of the babies, and their consequences such as the use of mechanical ventilation and apneas 55.5% were repeated and 52.7% respectively. Among the most frequent maternal complications was observed the Preterm Labor (31.3%) and premature rupture of membranes (23.8%). Thus the identification of the factors that lead to preterm labor and premature rupture of membranes, could meet the maternal background and consequently reduce the prematurity and low birth weight.

Laparoscopic placement of distal ventriculoperitoneal shunt catheters

2008 ◽  
Vol 2 (4) ◽  
pp. 282-285 ◽  
Author(s):  
Michael H. Handler ◽  
Brian Callahan
Keyword(s):  
Medical Records ◽  
Foreign Bodies ◽  
Senior Author ◽  
General Surgeon ◽  
Ventriculoperitoneal Shunts ◽  
First Choice ◽  
Early Failures ◽  
Abdominal Operations ◽  
General Surgeons ◽  
Choice Approach

Object Ventriculoperitoneal shunts (VPSs) are commonly placed into the peritoneal cavity via a small laparotomy or blindly by using a split trocar. Larger patients require larger incisions, and placement is made more difficult by previous abdominal operations and obesity. For general surgeons, laparoscopy has become the first-choice approach for abdominal procedures, using 1 or several very small incisions. The authors discuss their pediatric series of patients in whom laparoscopy was used to place distal shunt catheters. Methods The authors reviewed the medical records accrued over a 9-year period, noting VPS operations performed using laparoscopy. Complications, morbidity, and alterations of planned management were noted. Results One hundred thirty-seven VPS operations in 126 patients were identified, 92 performed by the senior author (M.H.H.) alone and 45 conducted with the assistance of a general surgeon. A second port was placed for lysis of adhesions or retrieval of old catheters in 7 cases. There were no immediate complications. The infection rate was 6.6%, comparable with the institutional norm (6.3%) over an 8-year period. There were 3 early failures due to abdominal malabsorption without infection. Five catheters later broke at the level where they were introduced into the abdomen due to shearing by the abdominal trocar. Conclusions Laparoscopic placement of distal VPS catheters is relatively safe and allows insertion via inconspicuous incisions. It can allow for inspection or lysis of adhesions and removal of foreign bodies, help determine if and where the abdomen can absorb shunt fluid, and make VPS surgery in the obese patient easier.

scholarly journals Boas Práticas na atenção obstétrica e sua interface com a humanização da assistência [Good Partices in obstetric care and its interface with humanization of assistance] [Buenas Prácticas en la atención obstétrica y su interrelación com la huamanización de la asistencia]

2017 ◽  
Vol 25 ◽  
pp. e26442
Author(s):  
Larisse Ferreira Benevides de Andrade ◽  
Quessia Paz Rodrigues ◽  
Rita de Cássia Velozo da Silva
Keyword(s):  
Medical Records ◽  
Public Hospital ◽  
Secondary Data ◽  
Obstetric Care ◽  
High School Education ◽  
Good Practices ◽  
Skin Contact ◽  
Las Mujeres ◽  
Skin To Skin ◽  
Buenas Prácticas

Objetivo: analisar as boas práticas adotadas na atenção à mulher e ao recém-nascido, em uma maternidade pública baiana, apoiada pela Rede Cegonha. Método: estudo descritivo com abordagem quantitativa, do tipo retrospectivo, a partir de dados secundários. A pesquisa documental foi realizada em prontuários de 337 mulheres, em setembro de 2015. O projeto obteve a aprovação do Comitê de Ética em Pesquisa da organização hospitalar, com o parecer consubstanciado nº 1.185.928/2015. Resultados: as mulheres do estudo predominaram entre 20 a 35 anos, a maioria negra e parda, com ensino médio e primípara. Identificou-se o uso das seguintes boas práticas: presença de acompanhante (79,2%), métodos não farmacológicos para o alívio da dor (23,1%), contato pele a pele imediato (51,6%) e amamentação na sala de parto (38%). A maioria dos partos (95,3%) foi assistida por médicos. Conclusão: dentre as boas práticas analisadas, apenas a presença de acompanhante e o contato pele e pele ocorreu com a maioria das mulheres. As demais apresentaram baixa adesão. É preciso empenho da organização e da equipe para que as boas práticas sejam efetivamente adotadas.ABSTRACTObjective: to analyze good practices adopted in caring for the woman and the newborn in a public hospital from Bahia supported by Brazilian Rede Cegonha. Method: it is a descriptive and retrospective study with a quantitative approach, based on secondary data. The documental research used the medical records of 337 women, on September 2015. The study was approved by the Research Ethics Committee of the hospital (registered as number 1185928 / 2015). Results: the predominant women in the study were 20 to 35 years old, afrodecendents, with high school education and in the first parturition. It was identified the use of the following good practices: the presence of companion (79,2%), non-pharmacological methods of pain relief (23,1%), immediate skin-to-skin contact (51,6%) and breastfeeding in the delivery room (38%). Most of parturition (95,3%) were assisted by doctors. Conclusion: among the good practices analyzed, only the presence of companion and skin to skin contact occurred with the majority of women. The others had low adherence. It is necessary the commitment from the organization and the team in order to make good practices effectively adopted.RESUMENObjetivo: analizar las buenas prácticas adoptadas en el cuidado de la mujer y el recién nacido en un hospital público de Bahía apoyado por la Rede Cegonha. Método: es un estudio descriptivo y retrospectivo con enfoque cuantitativo, basado en datos secundarios. La investigación documental utilizó los registros médicos de 337 mujeres, en septiembre de 2015. El estudio fue aprobado por el Comité de Ética en Investigación del hospital (registrado como número 1185928/2015). Resultados: las mujeres predominantes en el estudio fueron de 20 a 35 años, afrodescendientes, con educación secundaria y en el primer parto. Se identificó el uso de las siguientes buenas prácticas: presencia de acompañante (79,2%), métodos no farmacológicos de alivio del dolor (23,1%), contacto inmediato piel a piel (51,6%) y lactancia materna en la sala de partos (38%). La mayoría de los partos (95,3%) fueron atendidos por médicos. Conclusión: entre las buenas prácticas analizadas, solo la presencia del compañero y el contacto piel con piel ocurrió con la mayoría de las mujeres. Los otros tenían poca adherencia. Es necesario el compromiso de la organización y el equipo para hacer que las buenas prácticas se adopten efectivamente. DOI: http://dx.doi.org/10.12957/reuerj.2017.26442

877 Validation of Small Bowel Obstruction and Abdominal Surgery Diagnostic Codes in an Electronic Medical Records Database

2015 ◽  
Vol 148 (4) ◽  
pp. S-1125
Author(s):  
Frank I. Scott ◽  
Ronac Mamtani ◽  
David S. Goldberg ◽  
Najjia N. Mahmoud ◽  
James Lewis
Keyword(s):  
Small Bowel ◽  
Abdominal Surgery ◽  
Small Bowel Obstruction ◽  
Electronic Medical Records ◽  
Bowel Obstruction ◽  
Medical Records ◽  
Diagnostic Codes

scholarly journals Cardiac Repair in Patients with Trisomy 18: Total or Palliative?

2021 ◽  
Vol 31 (2) ◽  
Author(s):  
Ji Hee Kwak ◽  
Jinyoung Song ◽  
I-Seok Kang ◽  
June Huh ◽  
Ji-Hyuk Yang ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Medical Records ◽  
Operative Mortality ◽  
Palliative Surgery ◽  
Cardiac Repair ◽  
Trisomy 18 ◽  
One Stage ◽  
Operative Outcomes ◽  
Postoperative Intensive Care ◽  
Postoperative Intensive Care Unit

Background: There are reports about cardiac surgery in patients with trisomy 18. However, total cardiac repair with bypass is limited in those patients. Objectives: We aimed to evaluate palliative cardiac surgery and compare it to total cardiac repair in patients with trisomy 18. Methods: Retrospectively, 11 patients’ medical records were reviewed. The patients were grouped as palliative surgery (3 patients), total repair followed by palliative surgery (6 patients), and one-stage total repair (2 patients). A total of 17 cardiac surgeries in all patients consisted of nine palliative surgeries and eight total cardiac repairs with bypass. The cumulative survival and post-operative outcomes including complications were investigated. Results: Eleven patients underwent 17 cardiac surgeries in total. Four patients survived, with a median age of 827.5 days. The survivors consisted of two after one-stage total repair and two after total repair followed by palliative surgery. No survivors were found after only palliative surgery. When post-operative outcomes after palliative surgery in nine patients were compared to those after total cardiac repair in eight patients, there were no differences in operative mortality, postoperative intensive care unit stay, and hospital stay. No differences in post-operative complications were found. Conclusions: For post-operative outcomes and survival, palliative surgery in patients with trisomy 18 was not different from total cardiac repair with bypass but involved a difficult postoperative course including various complications similar to those after total repair with bypass.

scholarly journals HUBUNGAN JENIS PERSALINAN DENGAN KEJADIAN SEPSIS NEONATORUM DI RSUP PROF. DR. R. D. KANDOU MANADO

e-CliniC ◽  
2014 ◽  
Vol 2 (1) ◽  
Author(s):  
Maria Y. Lihawa
Keyword(s):  
Neonatal Sepsis ◽  
Medical Records ◽  
Preterm Labor ◽  
Sampling Method ◽  
Perinatal Asphyxia ◽  
Invasive Procedure ◽  
Neonatal Infection ◽  
Developed Countries ◽  
Chi Square ◽  
Key Word

Abstract: Neonatal sepsis is a bacterial infection that occurs in neonates which happens during the first months of life. WHO estimated that sepsis neonatorum cause 1 billion death every year, which accounts for 10% of all death below age 5. In developing countries, death because of sepsis is about 34 per 1000 birth and for developed countries it is only 5 per 1000 birth. There are some factors triggering neonatal sepsis that come from the mother, these factors include: preterm labor and birth, premature rupture membrane more than 18-24 hours, chorioamnionitis, usage of device during labor, maternal fever (>38oC), maternal UTI, and mother’s nutrition. There are also factors that come from the baby itself, include: perinatal asphyxia, low birth weight, preterm birth, invasive procedure, and congenital abnormality. The aim of this study is to find out the correlation between types of delivery and the incident of neonatal sepsis. This study was conducted in RSUP Prof. DR. R.D. Kandou Manado from August 2012 – August 2013. This is a retrospective analytic study, using total sampling method. Data were obtained from the medical records. Analysis using chi square shows a significant correlation between types of delivery and incident of neonatal sepsis (P = 0.001). Key word: sepsis neonatal, neonatal infection, risk factor of sepsis.    Abstrak: Sepsis neonatorum adalah infeksi bakteri pada neonatus yang terjadi selama bulan pertama kehidupan. WHO memperkirakan 1 juta kematian per tahun (10% dari jumlah kematian berusia dibawah lima tahun) karena sepsis neonatal. Di negara berkembang, kematian neonatus dari seluruh penyebab sepsis kira-kira 34/1000 kelahiran dan di negara maju, hanya sekitar 5/1000 kelahiran.Ada beberapa faktor pencetus sepsis neonatorum yaitu faktor dari ibu (persalinan dan kelahiran kurang bulan, ketuban pecah lebih dari 18-24 jam, korioamnionitis, persalinan dengan tindakan, demam pada ibu (>38,4oC), ISK pada ibu, dan gizi ibu).Dan faktor dari bayi (asfiksia perinatal, berat lahir rendah, bayi kurang bulan, prosedur invasif dan kelainan bawaan).Tujuan penelitian ini untuk mengetahui hubungan jenis persalinan dengan kejadian sepsis neonatorum.Penelitian ini dilakukan di RSUP Prof. Dr. R. D. Kandou Manado periode Agustus 2012- Agustus 2013. Penelitian ini bersifat analitik retrospektif yang diambil dalam bentuk data rekam medik dengan pengambilan sampel menggunakan teknik total sampling.Data yang dikumpulkan diolah dengan menggunakan uji Chi-square. Dari hasil analisa data didapatkan nilai P = 0,001 (P<0,05). Nilai ini menunjukkan bahwa terdapat hubungan yang signifikan antara jenis persalinan dengan kejadian sepsis neonatorum. Kata kunci: sepsis neonatorum, infeksi neonatus, faktor risiko sepsis.

scholarly journals SKIN-TO-SKIN CONTACT FOLLOWED BY BREASTFEEDING IN THE FIRST HOUR OF LIFE: ASSOCIATED FACTORS AND INFLUENCES ON EXCLUSIVE BREASTFEEDING

2019 ◽  
Vol 28 ◽  
Author(s):  
Márcia Carneiro Saco ◽  
Kelly Pereira Coca ◽  
Karla Oliveira Marcacine ◽  
Érika de Sá Vieira Abuchaim ◽  
Ana Cristina Freitas de Vilhena Abrão
Keyword(s):  
Risk Factors ◽  
Protective Factors ◽  
Exclusive Breastfeeding ◽  
Medical Records ◽  
Maternal Age ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Skin Contact ◽  
Final Sample ◽  
Skin To Skin

ABSTRACT Objective: to verify the factors associated with the practice of skin-to-skin contact with breastfeeding in the first hour of life and its influence on exclusive breastfeeding in the first month. Method: a retrospective cross-sectional study with medical records from a breastfeeding outpatient clinic in São Paulo, Brazil. The sample included all the medical records of the mother-baby dyad who had been consulted by nurses between 2004 and 2010. Data were collected from the medical records between 2014 and 2015. Results: 1,030 medical records were identified, 71 were excluded and the final sample was 959. The prevalence of skin-to-skin contact with breastfeeding in the first hour was 37.2%. The Apgar score between 8 and 10 in the first minute of life and the higher birth weight of the newborn were protective factors of contact with early breastfeeding; lower maternal age and cesarean delivery and forceps were risk factors for this practice. Exclusive breastfeeding was statistically higher in the group of newborns who had contact with breastfeeding in the first hour; however, there was no association with duration of exclusive breastfeeding. Conclusion: good birth conditions were protective factors for breastfeeding followed by skin-to-skin contact in the first hour, while younger maternal age and surgical deliveries proved to be risk factors. Exclusive breastfeeding in the baby´s first month of life was not associated with skin-to-skin contact followed by breastfeeding in the first hour of life.

Impairment Tutorial: Spinal Cord Stimulation and Intraspinal Opioids:Impairment Rating Issues

2000 ◽  
Vol 5 (5) ◽  
pp. 4-5
Author(s):  
James B. Talmage ◽  
Leon H. Ensalada
Keyword(s):  
Medical Records ◽  
Evaluation Process ◽  
Current Approach ◽  
Satisfaction Survey ◽  
Start Time ◽  
Medical Evaluation ◽  
Independent Medical Evaluation ◽  
Other Information ◽  
Physician Reviews ◽  
Written Informed Consent

Abstract Evaluators must understand the complex overall process that makes up an independent medical evaluation (IME), whether the purpose of the evaluation is to assess impairment or other care issues. Part 1 of this article provides an overview of the process, and Part 2 [in this issue] reviews the pre-evaluation process in detail. The IME process comprises three phases: pre-evaluation, evaluation, and postevaluation. Pre-evaluation begins when a client requests an IME and provides the physician with medical records and other information. The following steps occur at the time of an evaluation: 1) patient is greeted; arrival time is noted; 2) identity of the examinee is verified; 3) the evaluation process is explained and written informed consent is obtained; 4) questions or inventories are completed; 5) physician reviews radiographs or diagnostic studies; 6) physician records start time and interviews examinee; 7) physician may dictate the history in the presence of the examinee; 8) physician examines examinee with staff member in attendance, documenting negative, physical, and nonphysiologic findings; 9) physician concludes evaluation, records end time, and provides a satisfaction survey to examinee; 10) examinee returns satisfaction survey before departure. Postevaluation work includes preparing the IME report, which is best done immediately after the evaluation. To perfect the IME process, examiners can assess their current approach to IMEs, identify strengths and weaknesses, and consider what can be done to improve efficiency and quality.

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