Optimization of therapy in menopause in specific patient groups

GYNECOLOGY ◽  
2021 ◽  
Vol 23 (5) ◽  
pp. 459-467

From September 29 to October 1, 2021, Moscow hosted the XXII Russian Scientific and Educational Forum "Mother and Child" the largest and most significant event for specialists in the field of obstetrics, gynecology and related fields of medicine. Within the framework of the congress, a round table meeting "Optimization of therapy in menopause in special groups of patients". We offer a review of speeches.

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Julia Becker ◽  
Gerald Huschak ◽  
Hannes-Caspar Petzold ◽  
Volker Thieme ◽  
Sebastian Stehr ◽  
...  

Abstract Background Operation room (OR) planning is a complex process, especially in large hospitals with high rates of unplanned emergency procedures. Postponing elective surgery in order to provide capacity for emergency operations is inevitable at times. Elderly patients, residents of nursing homes, women, patients with low socioeconomic status and ethnic minorities are at risk for undertreatment in other contexts, as suggested by reports in the medical literature. We hypothesized that specific patient groups could be at higher risk for having their elective surgery rescheduled for non-medical reasons. Methods In this single center, prospective observational trial, we analysed 2519 patients undergoing elective surgery from October 2018 to May 2019. A 14-item questionnaire was handed out to illicit patient details. Additional characteristics were collected using electronic patient records. Information on the timely performance of the scheduled surgery was obtained using the OR’s patient data management system. 6.45% of all planned procedures analysed were postponed. Association of specific variables with postponement rates were analysed using the Mann–Whitney U test and Fisher's exact test/χ2-test. Results Significantly higher rates of postponing elective surgery were found in elderly patients. No significant differences in postponing rates were found for the variables gender, nationality (Germany, EU, non-EU), native language, professional medical background and level of education. Significantly lower rescheduling rates were found in patients with ties to hospital staff and in patients with a private health insurer. Conclusions Elderly patients, retirees and nursing home residents seem to be at higher risk for having their elective surgery rescheduled. However, owing to the study design, causality could not be proven. Our findings raise concern about possible undertreatment of these patient groups and provide data on short-term postponement of elective surgery. Trial registration DRKS00015836. Retrospectively registered.


2021 ◽  
pp. 1-21
Author(s):  
Ranjana Jairam ◽  
Jamie Drossaerts ◽  
Tom Marcelissen ◽  
Gommert van Koeveringe ◽  
Desiree Vrijens ◽  
...  

<b><i>Introduction:</i></b> Sacral neuromodulation (SNM) is an effective treatment in patients with overactive bladder syndrome or nonobstructive urinary retention when conservative treatment fails. Several factors that could impact outcome with SNM have been studied. This systematic review investigated these predictive factors and their relevance for clinical practice. <b><i>Methods:</i></b> Systematic review according to the PRISMA guidelines was conducted. This review is registered in the PROSPERO register (CRD42015016256). <b><i>Results:</i></b> Seventy-eight studies (of which 11 abstracts) were included. Females, younger patients, and a tined lead procedure tend to be predictive in successful SNM outcome. Factors that did not influence SNM outcome were prior back surgery, surgery for stress urinary incontinence, affective symptoms, and duration of complaints. Reduced detrusor contractility is associated with a lower success rate. The level of evidence of most studies (graded according to the Centre for Evidence-Based Medicine) was 3b. <b><i>Conclusion:</i></b> Even though this systematic review investigated predictive factors (gender, age, type of procedure, type of lead, and detrusor contractility), no general consensus on predictive factors could be made. Most studies are small, retrospective, and involve a heterogeneous population. Therefore, prospective research in larger specific patient groups remains necessary to find predictors of SNM outcome.


Author(s):  
Yu. N. Stolyarov

The XI all-Russian scientific and practical conference of heads and specialists of information services on culture and art "Information context of culture: resources, technologies, service", organized by the Russian state library, the Russian state library of arts and the St. Petersburg state Institute of culture, was held in Moscow. It was attended by more than 90 representatives of the cultural authorities, Federal, Central regional and municipal libraries, universities and training centers for training, as well as other institutions of culture, science, education, media and bookselling 24 regions of theRussian Federation. Thanks to online broadcasts, the total audience of the event increased by almost 200 people. Heads and specialists of the national libraries ofArmenia,BelarusandKazakhstantook part in the event via video link. The program included 36 reports and presentations. They were presented at a special session "Year of theatre in the library", Round table" national library as a center of information on culture and art", section "Information potential of cultural organizations in the implementation of the state cultural policy". As a result of such events, the Russian state library publishes collections of materials. The last one was released in 2018.


2008 ◽  
Vol 59 (8) ◽  
pp. 1097-1104 ◽  
Author(s):  
Daniel H. Solomon ◽  
Robert J. Glynn ◽  
Kenneth J. Rothman ◽  
Sebastian Schneeweiss ◽  
Soko Setoguchi ◽  
...  

2020 ◽  
Vol 9 (5) ◽  
pp. 1439 ◽  
Author(s):  
Siddhant Thukral ◽  
Suresh Vedantham

Acute deep vein thrombosis (DVT) causes substantial short-term and long-term patient morbidity. Medical, lifestyle, and compressive therapies have been investigated for the prevention of pulmonary embolism (PE) and recurrence of venous thromboembolism (VTE). However, patient-centered outcomes such as resolution of presenting DVT symptoms and late occurrence of post-thrombotic syndrome (PTS) have not been prioritized to the same degree. Imaging-guided, catheter-based endovascular therapy has been used in selected patients to alleviate these sequelae, but important questions remain about their optimal use. In this article, we review the available evidence and summarize the rationale for use of catheter-based therapy in specific patient groups.


Author(s):  
Jeremy Prout ◽  
Tanya Jones ◽  
Daniel Martin

This chapter on transfer medicine includes transfer indications, decisions, general considerations and complications as well as legal aspects of patient transfer. Considerations for specific patient groups are described for neurosurgical, trauma, spinal injury, burns and obstetric patients. Complications and management are detailed in an ABCDE format. Transfer equipment including ventilators with modes of ventilation are also considered.


2007 ◽  
Vol 6 (2) ◽  
pp. 83-91 ◽  
Author(s):  
M. McJury ◽  
B. Foran ◽  
J. Conway ◽  
S. Dixon ◽  
K. Wilcock ◽  
...  

AbstractBackground and purpose: Currently, optimal use of virtual simulation for all treatment sites is not entirely clear. This study presents data to identify specific patient groups for whom conventional simulation may be completely eliminated and replaced by virtual simulation.Sampling and method: Two hundred and sixty patients were recruited from four treatment sites (head and neck, breast, pelvis, and thorax). Patients were randomly assigned to be treated using the usual treatment process involving conventional simulation, or a treatment process differing only in the replacement of conventional plan verification with virtual verification. Data were collected on set-up accuracy at verification, and the number of unsatisfactory verifications requiring a return to the conventional simulator. A micro-economic costing analysis was also undertaken, whereby data for each treatment process episode were also collected: number and grade of staff present, and the time for each treatment episode.Results: The study shows no statistically significant difference in the number of returns to the conventional simulator for each site and study arm. Image registration data show similar quality of verification for each study arm. The micro-costing data show no statistical difference between the virtual and conventional simulation processes.Conclusions: At our institution, virtual simulation including virtual verification for the sites investigated presents no disadvantage compared to conventional simulation.


2006 ◽  
Vol 135 (3) ◽  
pp. 417-426 ◽  
Author(s):  
L. J. BRANT ◽  
M. HURRELLE ◽  
M. A. BALOGUN ◽  
P. KLAPPER ◽  
F. AHMAD ◽  
...  

This paper describes sentinel laboratory surveillance of hepatitis C antibody testing in England. Demographic and test result data were supplemented by follow-up questionnaires sent to the requesting clinician. Between October 2002 and September 2003 almost 75000 anti-HCV tests were performed in eight sentinel centres. More males were tested than females and over half of those tested were aged 25–44 years. Overall 5·7% (3333/58144, range 2·8–7·7%) individuals tested positive. Follow-up questionnaire data showed that 82% (1043/1277) of the positives had injecting drug use reported as the main risk exposure. The majority of negative individuals were undergoing routine screening as recommended for specific patient groups. Most individuals were asymptomatic. Antibody prevalence was estimated to be 34% in current injecting drug users and 42% in former injectors. Comparing positives to routine national surveillance suggests that only 53% (1782/3333) of diagnosed cases were reported. Sentinel laboratory data can provide valuable supplementary data to national surveillance.


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