Changes in Emergency Department Practices After Implementation of a Standardized Heavy Menstrual Bleeding Guideline.

Objective: The aim of the study is to assess the effect of an emergency department (ED) standardized clinical guideline for adolescent heavy menstrual bleeding on the rate of return ED visits and ED provider history-taking and management of this condition.

Methods: This was a retrospective cohort study. Patients less than 18 years old presenting to a single academic children's hospital ED between 2010 and 2020 with a chief complaint of heavy menstrual bleeding were included.

When and How to Utilize Pudendal Nerve Blocks for Treatment of Pudendal Neuralgia.

Chronic pelvic pain is a common cause of pain in reproductive age women with debilitating consequences for affected women's health and quality of life. Treatment providers must be well versed in all treatment options for these patients, understanding the overlap in the management and treatment of chronic pelvic pain caused by pudendal neuralgia, myofascial pelvic pain, and vulvodynia. Pudendal blocks are a simple and quick procedure that can be performed in the office and often helps improve all the above conditions when used along with other treatment options.

Postoperative Risks for Hispanic Patients Undergoing Hysterectomy for Benign Indications.

Background: Hispanic patients have previously been shown to have relatively lower odds of complication following hysterectomy compared with non-Hispanic white patients, but little is known about specific risks for this group. Our primary objective was to identify differences in proportions of specific complications experienced by Hispanic patients following hysterectomy for benign indications as compared with non-Hispanic white patients.

Design: Retrospective cohort study examining differences in complication rates following benign hysterectomy between Hispanic and non-Hispanic white patients in NSQIP-participating hospitals from 2012 to 2016.

Office Operative Hysteroscopy: An Update.

Hysteroscopy is considered the gold standard for the evaluation of intracavitary pathology in both premenopausal and postmenopausal patients associated with abnormal uterine bleeding, as well as for the evaluation of infertile patients with suspected cavity abnormalities. Office-based operative hysteroscopy allows patients to resume activities immediately and successfully integrates clinical practice into a "see and treat" modality, avoiding the added risks of anesthesia and the inconvenience of the operating room. For 2017, the Centers for Medicare and Medicaid Services has provided a substantial increase in reimbursement for a select number of office-based hysteroscopic procedures.

A comprehensive review of Asherman's syndrome: causes, symptoms and treatment options.

Purpose Of Review: Intrauterine adhesions, also known as Asherman's syndrome, can have an impact on both reproductive outcomes and gynaecologic symptoms. Understanding the cause of intrauterine adhesions and the common clinical presentation will increase awareness of the condition and guide the patient to appropriate therapy. Surgical management offers favourable fertility outcomes and is often successful in restoring menstruation.

SCN5A variant that blocks fibroblast growth factor homologous factor regulation causes human arrhythmia.

Nav channels are essential for metazoan membrane depolarization, and Nav channel dysfunction is directly linked with epilepsy, ataxia, pain, arrhythmia, myotonia, and irritable bowel syndrome. Human Nav channelopathies are primarily caused by variants that directly affect Nav channel permeability or gating. However, a new class of human Nav channelopathies has emerged based on channel variants that alter regulation by intracellular signaling or cytoskeletal proteins.

Cellular energy depletion resets whole-body energy by promoting coactivator-mediated dietary fuel absorption.

All organisms have devised strategies to counteract energy depletion and promote fitness for survival. We show here that cellular energy depletion puts into play a surprising strategy that leads to absorption of exogenous fuel for energy repletion. The energy-depletion-sensing kinase AMPK binds, phosphorylates, and activates the transcriptional coactivator SRC-2, which in a liver-specific manner promotes absorption of dietary fat from the gut.

Biventricular and novel pacing mechanisms in heart failure.

Biventricular pacing, often referred to as cardiac resynchronization therapy (CRT), improves subjective and objective measures and promotes reverse ventricular remodeling in patients with chronic New York Heart Association (NYHA) class III or IV heart failure despite optimal medical therapy, QRS duration of more than 130 ms, and left ventricular ejection fraction of less than 35%. However, there are many nonresponders and other patients who do not meet criteria for CRT, limiting the efficacy of therapy. Recent investigations (eg, the REVERSE trial) have shown that patients with minimal symptoms (NYHA class I-II) can benefit from the mechanical and functional effects of CRT, specifically reverse remodeling.