Fetal macrosomia; risk factors and validity of its diagnostic tools

The problem of adequate diagnostic tools use for suicide risk assessment т medical research and practice is of extreme importance because of the high incidence of suicide in the population of psychotic patients and the high vulnerability of the latter to the known risk factors. The article provides ап overview of the existing psychometric instruments (scales) used to assess the risk of suicide in psychiatry as well as in general medicine.

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Current diagnostic tools and management modalities of Nocardia keratitis

Journal of Ophthalmic Inflammation and Infection ◽

10.1186/s12348-020-00228-w ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Mohammad Soleimani ◽

Ahmad Masoumi ◽

Sadegh Khodavaisy ◽

Mostafa Heidari ◽

Ali A. Haydar ◽

...

Keyword(s):

Risk Factors ◽

Trauma Surgery ◽

Clinical Manifestations ◽

Topical Steroid ◽

Nocardia Asteroides ◽

Diagnostic Tools ◽

Contact Lens Wear ◽

Drug Of Choice ◽

Good Visual Acuity ◽

Lens Wear

AbstractNocardia species are an uncommon but important cause of keratitis. The purpose of this review is to discus previous published papers relation to the epidemiology, etiology, diagnosis and management of Nocardia keratitis. Nocardia asteroides is the most frequently reported from Nocardia keratitis. Pain, photophobia, blepharospasm and lid swelling are mainly clinical manifestations. Usual risk factors for Nocardia keratitis are trauma, surgery, corticosteroids, and contact lens wear. Several antibiotics were used for treatment of Nocardia infection but according to studies, topical amikacin is the drug of choice for Nocardia keratitis. Topical steroid should not prescribe in these patients. In conclusion, although Nocardia keratitis is rare, early diagnosis and treatment are essential to prevent any scar formation and preserve a good visual acuity.

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Fetal macrosomia: obstetrical, psychological and social aspects

HEALTH OF WOMAN ◽

10.15574/hw.2020.153.36 ◽

2018 ◽

pp. 36-39

Author(s):

S.I. Zhuk ◽

◽

O.D. Shchurevska ◽

Keyword(s):

Risk Factors ◽

Weight Gain ◽

Gestational Diabetes ◽

Psychosocial Stress ◽

Fetal Macrosomia ◽

Medical Problems ◽

Medical Risk ◽

Pregnancy And Childbirth ◽

Medical Risk Factors ◽

Forced Migrants

One of the main markers of socially unfavorable pregnancy is anthropometric indicators of newborns. They reflect not only the narrow medical problems of complicated gestation but also social problems in general, the quality and access to the medical care. The objective: to determine the risk factors for fetal macrosomia in pregnancy with high levels of psychosocial stress. Materials and methods. The course of pregnancy and childbirth, demographic and medical risk factors for a fetal macrosomia were analyzed in 140 pregnant women with different levels of psychosocial stress. They were divided into 2 groups: 1 group (main) – 56 women-forced migrants from Luhansk and Donetsk regions, 2 group – 84 women with low and moderate level stress according to the questionnaires and psychological tests (L. Reeder, Spielberg–Khanin scale). Results. Gestational diabetes was the main reason for the birth of heavy children in both groups. Women–forced migrants had late manifestation of impaired tolerance to carbohydrates and a higher frequency of pathological weight gain. Male neonates are at risk for macrosomia. Childbirth in women with macrosomia is accompanied by a high frequency of complications and abnormal births. Conclusions. The frequency of births of macrosomic children in women - forced migrants is higher than in women at low risk of psychosocial stress. Risk factors in this group of pregnants include: the level of stress and behavioral responses to stress, impaired carbohydrate tolerance due to gestational diabetes, abnormal weight gain due to malnutrition and male sex of the fetus. Keywords: macrosomia, pregnancy, childbirth, women–forced migrants psychosocial stress, gestational diabetes, weight gain.

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A clinical study of trends of ectopic pregnancy and its management in a tertiary care hospital

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20195330 ◽

2019 ◽

Vol 8 (12) ◽

pp. 4834

Author(s):

Chandana M. Puttaraju ◽

Nagothi Nagendra Prasad ◽

M. P. A. Sailakshmi

Keyword(s):

Risk Factors ◽

Ectopic Pregnancy ◽

Sex Education ◽

Descriptive Analysis ◽

Tertiary Care ◽

Diagnostic Tools ◽

Care Hospital ◽

Care Teaching ◽

Β Hcg ◽

Ectopic Pregnancies

Background: Ectopic gestation is a gynaecological emergency which culminates in pregnancy loss and causes significant maternal morbidity, mortality besides jeopardizing future conception. The study discusses the incidence, risk factors, symptomatology and management of ectopic pregnancy in a tertiary care teaching hospital.Methods: This was a prospective study of 45 cases of ectopic pregnancies at a tertiary care teaching hospital from January 2012 to December 2013. Information was collected in a structured proforma, tabulated and descriptive analysis was carried out.Results: The incidence of ectopic pregnancy was 1.17%. Majority of the patients (80%) belonged to 20-30 yrs age group. Second gravidas predominated (42.2%). Fallopian tube was the most common site (95.5%). Rudimentary horn ectopic accounted for 4.65%. Previous abdominopelvic surgery (31.1%), IUCD usage (22.2%), PID (20%), abortions (20%), tubectomy (15.5%) were the principal risk factors. 42% of the patients had no risk factor. The triad of amenorrhea, bleeding per vaginum and abdominal pain was seen in 51.1% of cases. Ultrasound, UPT, β-hCG estimation were the diagnostic tools. Ruptured ectopic pregnancy accounted for 64.4%. Nearly 95.5% of patients underwent surgery; salpingectomy (76%). Methotrexate was successful in 4.44%. There was no maternal mortality.Conclusions: Mostly diagnosis, prompt surgical or medical management is cornerstone of treatment. Primary prevention such as improved access to family planning services, sex education, treatment of STI, PID, surgical asepsis and haemostasis, implementing legislation for dispensing MTP drugs ameliorate risk factors and hence reduce ectopic pregnancy.

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Advances In Glaucoma Management: Risk Factors, Diagnostic Tools, Therapies and the Role of Prostaglandin Analogs

Survey of Ophthalmology ◽

10.1016/j.survophthal.2008.08.013 ◽

2008 ◽

Vol 53 (6) ◽

pp. S1-S2 ◽

Cited By ~ 2

Author(s):

Carl Camras ◽

Carol Toris

Keyword(s):

Risk Factors ◽

Diagnostic Tools

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Risk factors, diagnosis and non-surgical treatment for meniscal tears: evidence and recommendations: a statement paper commissioned by the Danish Society of Sports Physical Therapy (DSSF)

British Journal of Sports Medicine ◽

10.1136/bjsports-2017-098429 ◽

2018 ◽

Vol 52 (9) ◽

pp. 557-565 ◽

Cited By ~ 10

Author(s):

Jonas Bloch Thorlund ◽

Carsten Bogh Juhl ◽

Lina Holm Ingelsrud ◽

Søren Thorgaard Skou

Keyword(s):

Risk Factors ◽

Diagnostic Tests ◽

Young Patients ◽

Evaluation Framework ◽

Diagnostic Tools ◽

Meniscal Tears ◽

Predictive Values ◽

And Function ◽

Surgical Treatments ◽

Quality Evidence

This statement aimed at summarising and appraising the available evidence for risk factors, diagnostic tools and non-surgical treatments for patients with meniscal tears. We systematically searched electronic databases using a pragmatic search strategy approach. Included studies were synthesised quantitatively or qualitatively, as appropriate. Strength of evidence was determined according to the Grading of Recommendations Assessment Development and Evaluation framework. Low-quality evidence suggested that overweight (degenerative tears, k=3), male sex (k=4), contact and pivoting sports (k=2), and frequent occupational kneeling/squatting (k=3) were risk factors for meniscal tears. There was low to moderate quality evidence for low to high positive and negative predictive values, depending on the underlying prevalence of meniscal tears for four common diagnostic tests (k=15, n=2474). Seven trials investigated exercise versus surgery (k=2) or the effect of surgery in addition to exercise (k=5) for degenerative meniscal tears. There was moderate level of evidence for exercise improving self-reported pain (Effect Size (ES)−0.51, 95% CI −1.16 to 0.13) and function (ES −0.06, 95% CI −0.23 to 0.11) to the same extent as surgery, and improving muscle strength to a greater extent than surgery (ES −0.45, 95% CI −0.62 to −0.29). High-quality evidence showed no clinically relevant effect of surgery in addition to exercise on pain (ES 0.18, 95% 0.05 to 0.32) and function (ES, 0.13 95% CI −0.03 to 0.28) for patients with degenerative meniscal tears. No randomised trials comparing non-surgical treatments with surgery in patients younger than 40 years of age or patients with traumatic meniscal tears were identified. Diagnosis of meniscal tears is challenging as all clinical diagnostic tests have high risk of misclassification. Exercise therapy should be recommended as the treatment of choice for middle-aged and older patients with degenerative meniscal lesions. Evidence on the best treatment for young patients and patients with traumatic meniscal tears is lacking.

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Leaving a foreign object in the body of a patient during abdominal surgery: still a current problem

Polish Journal of Surgery ◽

10.5604/01.3001.0013.2024 ◽

2019 ◽

Vol 91 (3) ◽

pp. 1-5

Author(s):

Marcin Szymocha ◽

Marta Pacan ◽

Mateusz Anufrowicz ◽

Tomasz Jurek ◽

Marta Rorat

Keyword(s):

Risk Factors ◽

Adverse Events ◽

Abdominal Cavity ◽

Epidemiological Data ◽

Significant Loss ◽

The Body ◽

Diagnostic Tools ◽

Foreign Object ◽

Scientific Publications ◽

Legal Security

Introduction: Leaving a foreign object (retained the surgical item, or RSI) during surgery involving the abdominal cavity and pelvis minor is a relatively frequent, underestimated phenomenon which is dangerous to the health of the patient and the legal security of medical personnel. These adverse events are easy to avoid through the use of appropriate means of prevention. The aim of the present paper is the collection of epidemiological data and determination of risk factors, symptomatology, health effects, and prevention methods associated with RSIs. Material and methods: Analysis of global scientific publications in the databases PubMed, ClinicalKey, Google Scholar, ScienceDirect, and Scopus related to the subject of RSIs. Results: The frequency of RSI incidents ranges from 1 to 10 in 10,000 intra-abdominal surgeries, which results in at least one case in an average multispeciality hospital on a yearly basis. The items most frequently left behind include soft foreign objects, such as swabs and bandages (90%). Risk factors include emergency surgical procedures, high patient BMI, significant loss of blood during surgery, and neglect in counting material and surgical tools. The postoperative course, although in many cases asymptomatic, may be complicated by inflammation, bleeding, or perforation, leading to the necessity of a second operation and, in 2 to 4% of cases, even ending in death. Imaging tests are effective diagnostic tools. Effective methods of preventing RSIs are based on checklists and systems for counting and monitoring the location of material and tools. Conclusions: The globally occurring problem of RSIs requires the education of operating block personnel regarding risk factors and the identification and elimination of adverse events of this type. Diagnostics based on imaging should take into account non-specific complaints resulting from a possible oligosymptomatic course. An RSI should not be regarded as a medical error. Changes in the perception of the phenomenon are aimed at minimizing the legal liability of staff in the event of leaving a foreign object in the patient’s body.

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