scholarly journals Midline and Mediolateral Episiotomy: Risk Assessment Based on Clinical Anatomy

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 221
Author(s):  
Danielle K. Garner ◽  
Akash B. Patel ◽  
Jun Hung ◽  
Monica Castro ◽  
Tamar G. Segev ◽  
...  
Keyword(s):  
Vaginal Delivery ◽  
Clinical Anatomy ◽  
Surgical Incision ◽  
Risk Of Injury ◽  
Vaginal Orifice ◽  
Short And Long Term ◽  
Potential Risks ◽  
Indirect Injury ◽  
Nerve Muscle

Episiotomy is the surgical incision of the vaginal orifice and perineum to ease the passage of an infant’s head while crowning during vaginal delivery. Although episiotomy remains one of the most frequently performed surgeries around the world, short- and long-term complications from the procedure are not uncommon. We performed midline and mediolateral episiotomies with the aim of correlating commonly diagnosed postepisiotomy complications with risk of injury to perineal neuromuscular and erectile structures. We performed 61 incisions on 47 female cadavers and dissected around the incision site. Dissections revealed that midline incisions did not bisect any major neuromuscular structures, although they did increase the risk of direct and indirect injury to the subcutaneous portion of the external anal sphincter. Mediolateral incisions posed greater risk of iatrogenic injury to ipsilateral nerve, muscle, erectile, and gland tissues. Clinician discretion is advised when weighing the potential risks to maternal perineal anatomy during vaginal delivery when episiotomy is indicated. If episiotomy is warranted, an understanding of perineal anatomy may benefit diagnosis of postsurgical complications.

scholarly journals A Comprehensive Review of Hypertension in Pregnancy

2012 ◽  
Vol 2012 ◽  
pp. 1-19 ◽  
Author(s):  
Reem Mustafa ◽  
Sana Ahmed ◽  
Anu Gupta ◽  
Rocco C. Venuto
Keyword(s):  
The United States ◽  
Diagnostic Tools ◽  
Hypertension In Pregnancy ◽  
Hypertensive Disorders ◽  
Drug Classes ◽  
Hypertensive Disorders In Pregnancy ◽  
Short And Long Term ◽  
Potential Risks ◽  
In Pregnancy

Hypertension is the most common medical disorder encountered during pregnancy. Hypertensive disorders are one of the major causes of pregnancy-related maternal deaths in the United States. We will present a comprehensive update of the literature pertinent to hypertension in pregnancy. The paper begins by defining and classifying hypertensive disorders in pregnancy. The normal vascular and renal physiological changes which occur during pregnancy are detailed. We will summarize the intriguing aspects of pathophysiology of preeclampsia, emphasizing on recent advances in this field. The existing diagnostic tools and the tests which have been proposed for screening preeclampsia are comprehensively described. We also highlight the short- and long-term implications of preeclampsia. Finally, we review the current management guidelines, goals of treatment and describe the potential risks and benefits associated with various antihypertensive drug classes. Preeclampsia still remains an enigma, and the present management focuses on monitoring and treatment of its manifestations. We are hopeful that this in depth critique will stimulate the blossoming research in the field and assist practitioners to identify women at risk and more effectively treat affected individuals.

Transmission of human cytomegalovirus via breastmilk and potential risks to very preterm infants

2015 ◽  
Vol 36 (4) ◽  
pp. 190
Author(s):  
Klaus Hamprecht ◽  
Rangmar Goelz
Keyword(s):  
Preterm Infants ◽  
Human Cytomegalovirus ◽  
Viral Infections ◽  
Short Term ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Short And Long Term ◽  
Potential Risks ◽  
Iq Scores

Breastfeeding has clear short-term benefits for the baby1. Additionally, based on a prospective long-term cohort study from Brazil, breastfeeding is associated with improved IQ scores and increased educational attainment 30 years later2. During lactation, mother-to-infant transmission of viral infections like HIV, hepatitis B (HBV), and human cytomegalovirus (HCMV), may occur. The article presented here will focus on the dynamics of HCMV shedding into breastmilk, describe the short- and long-term risks of HCMV infection of small preterm infants, and options for prevention.

scholarly journals Ruptured Sinus of Valsalva Aneurysm

KYAMC Journal ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 211-213
Author(s):  
Mohammad Arifur Rahman ◽  
Md Lutfar Rahman ◽  
Jayanta Kumar Saha ◽  
ASM Shariful Islam ◽  
Mezanur Rahman ◽  
...  
Keyword(s):  
Coronary Sinus ◽  
Sinus Of Valsalva ◽  
Sinus Of Valsalva Aneurysm ◽  
Aortic Media ◽  
Surgical Options ◽  
Grade Ii ◽  
Short And Long Term ◽  
Potential Risks ◽  
The Right

Sinus of Valsalva Aneurysms are extremely rare cardiac anomalies.The sinus of Valsalva aneurysm (SVA) is a small dilatation caused by a separation between the aortic media and annulus fibrosus. Its may be either acquired or congenital. The right coronary sinus is most frequently affected. The most common complication being rupture.We present the case of a 12-year old girl with ruptured non-coronary sinus of valsalva aneurysm associated with ventricular septal defect , mitral regurgitation grade II and severe pulmonary hypertension. Echocardiography is sufficient to diagnose SVA, its complications, repercussions, and surgical options. SVA, even if asymptomatic, has potential risks of expansion,rupture, cardiac failure, endocarditis, embolism and sudden death. This justifies surgical correction, with a low mortality rate in both the short- and long-term. KYAMC Journal Vol. 10, No.-4, January 2020, Page 211-213

Weight Implications on Pregnancy Outcomes

2016 ◽  
Vol 3 (1) ◽  
Author(s):  
Lindsay Elizabeth Carter
Keyword(s):  
Pregnancy Outcomes ◽  
Well Being ◽  
Healthcare Services ◽  
Diabetes Research ◽  
Increased Risk ◽  
Retrospective Cohort Studies ◽  
Short And Long Term ◽  
Potential Risks ◽  
The Life Course

The incidence of rising weight in reproducing women has potential for adverse maternal and fetal outcomes, both short and long term. The purpose of the project was to identify the extent of potential implications resulting from maintaining a body mass index larger than 25 throughout a pregnancy. Select authors have conducted quantitative, retrospective cohort studies by requesting participants to complete a questionnaire during pregnancy providing information on variables of social determinants of health with a control study of woman with a BMI under 25 and excluding mothers without a recorded BMI in antenatal records and mothers with pre-existing diabetes. Research resulted in overarching implications for both maternal and fetal well-being with added potential burden on the health care system. Neonate’s born under influence of a maternal BMI larger than 25 risk complications including preterm birth, congenital anomalies, fetal macrosomia, and death. Mothers are at increased risk for preeclampsia, gestational diabetes, postpartum hemorrhage, caesarian section and require more healthcare services. Continued longitudinal studies may provide greater insight into the life course trajectories of children born under such circumstances, and offer interventions appropriate to aid consequences of weight implications on pregnancy outcomes. Furthermore, additional studies on appropriate and safe interventions throughout the pregnancy may minimize potential risks on maternal and fetal well-being. This discussion is designed to explain the gravity of weight juxtaposed with pregnancy, and provide strategies aimed at optimizing health outcomes. 

scholarly journals Which Milk during the Second Year of Life: A Personalized Choice for a Healthy Future?

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3412
Author(s):  
Elvira Verduci ◽  
Elisabetta Di Profio ◽  
Antonio Corsello ◽  
Lorenzo Scatigno ◽  
Giulia Fiore ◽  
...  
Keyword(s):  
Protein Intake ◽  
Cow’S Milk ◽  
Cow's Milk ◽  
Second Year Of Life ◽  
Iron And Zinc ◽  
Short And Long Term ◽  
Potential Risks ◽  
Second Year ◽  
Nutrient Profiles

Nutrition in early life is a crucial element to provide all essential substrates for growth. Although this statement may appear obvious, several studies have shown how the intake of micro and macronutrients in toddlers differs a lot from the recommendations of scientific societies. Protein intake often exceeds the recommended amount, while the intake of iron and zinc is frequently insufficient, as well as Vitamin D. Nutritional errors in the first years of life can negatively impact the health of the child in the long term. To date, no clear evidence on which milk is suggested during the second year of life is yet to be established. In this study, we compare the nutrient profiles of cow’s milk and specific formulas as well as nutritional risks in toddlers linked to growth and childhood obesity development. The purpose of this review is to resume the latest clinical studies on toddlers fed with cow’s milk or young children formula (YCF), and the potential risks or benefits in the short and long term.

scholarly journals Resources and Risks: Perceptions on the Application of Sewage Sludge on Agricultural Land in Sweden, a Case Study

2021 ◽  
Vol 5 ◽  
Author(s):  
Nelson Ekane ◽  
Karina Barquet ◽  
Arno Rosemarin
Keyword(s):  
Sewage Sludge ◽  
Agricultural Sector ◽  
Agricultural Land ◽  
Political Factors ◽  
Short And Long Term ◽  
Potential Risks ◽  
The Subject ◽  
Agricultural Input

To spread or not to spread sewage sludge on agricultural land in Sweden remains the subject of a highly polarized debate among different stakeholders in the Swedish agricultural sector. This article presents insights on how stakeholders in Sweden see and explain the potentials and safety of spreading sewage sludge on agricultural land. This is done by drawing on risk perception literature and qualitative research methods. The findings reveal that fear of contamination and feeling of disgust are major deterrents of the use of sludge as an agricultural input. These are partly explained by unknowns and unfamiliarity about risks of unwanted substances in sludge. The study shows that while actors engaged in the practice amplify benefits of sludge as a resource and reiterate the need for emphasis on upstream measures including improved risk management systems, actors in charge of controlling toxins in society amplify actual and potential risks, highlight gaps in monitoring and minimizing risks, and would rather have a complete ban on the practice. This study highlights the complex combination of technical, environmental, socio-economic, psychological, and political factors influencing judgment and decision-making regarding sludge and its use as fertilizer in agriculture and concludes that the clash between facts and feelings which epitomizes the Swedish sludge debate may have implications for public trust and effective risk communication. As contribution to the Swedish sewage sludge debate, this study emphasizes that the benefits of sludge in agriculture is important but not enough to drive the practice to scale. It is even more important to improve understanding on the controllability and severity of risks in short and long-term.

scholarly journals Role of Revascularization in the Treatment of Claudication

1997 ◽  
Vol 2 (3) ◽  
pp. 252-256 ◽  
Author(s):  
Thomas A Whitehill
Keyword(s):  
Ankle Brachial Index ◽  
Vascular Reconstruction ◽  
Transluminal Angioplasty ◽  
Gainful Employment ◽  
Relative Indication ◽  
Surgical Bypass ◽  
Short And Long Term ◽  
Potential Risks ◽  
Long Term Prognosis

Intermittent claudication is a relative indication for vascular reconstruction. Conservative management with a combination of risk factor control, exercise training and medical therapy will relieve or at least improve claudication in some patients. If claudication precludes gainful employment or imposes an unacceptable alteration in lifestyle, surgical revascularization should be considered. Surgical bypass for claudication will produce optimal results in younger patients, in whom near-normalization of the ankle/brachial index can be anticipated. Proximal axial (in-line) reconstructions maintain their patencies longer than more distal, and often technically more challenging, bypasses. These tenets also apply well to percutaneous transluminal angioplasty. Both surgical and catheter-based interventions carry potential risks of short- and long-term morbidity, although overall morbidity associated with surgery for claudication is acceptably low. Interventions are justified only if they are safe, effective and durable, and if they are performed after the long-term prognosis for both life and limb is considered.

Short- and Long-Term Results of Total vs Subtotal Thyroid- ectomies in the Surgical Treatment of Graves' Disease

Swiss Surgery ◽  
2001 ◽  
Vol 7 (1) ◽  
pp. 20-24 ◽  
Author(s):  
Robert ◽  
Mariéthoz ◽  
Pache ◽  
Bertin ◽  
Caulfield ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Laryngeal Nerve ◽  
Long Term Results ◽  
Graves Disease ◽  
Laryngeal Nerve Palsy ◽  
Short And Long Term

Objective: Approximately one out of five patients with Graves' disease (GD) undergoes a thyroidectomy after a mean period of 18 months of medical treatment. This retrospective and non-randomized study from a teaching hospital compares short- and long-term results of total (TT) and subtotal thyroidectomies (ST) for this disease. Methods: From 1987 to 1997, 94 patients were operated for GD. Thirty-three patients underwent a TT (mostly since 1993) and 61 a ST (keeping 4 to 8 grams of thyroid tissue - mean 6 g). All patients had received propylthiouracil and/or neo-mercazole and were in a euthyroid state at the time of surgery; they also took potassium iodide (lugol) for ten days before surgery. Results: There were no deaths. Transient hypocalcemia (< 3 months) occurred in 32 patients (15 TT and 17 ST) and persistent hypocalcemia in 8 having had TT. Two patients developed transient recurrent laryngeal nerve palsy after ST (< 3 months). After a median follow-up period of seven years (1-15) with five patients lost to follow-up, 41 patients having had a ST are in a hypothyroid state (73%), thirteen are euthyroid (23%), and two suffered recurrent hyperthyroidism, requiring completion of thyroidectomy. All 33 patients having had TT - with follow-ups averaging two years (0.5-8) - are receiving thyroxin substitution. Conclusions: There were no instances of persistent recurrent laryngeal nerve palsy in either group, but persistent hypoparathyroidism occurred more frequently after TT. Long after ST, hypothyroidism developed in nearly three of four cases, whereas euthyroidy was maintained in only one-fourth; recurrent hyperthyroidy was rare.

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