Postpartum hemorrhage assessment and targeted treatment.

Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide, and mitigating it is a global health priority. In this review, we discuss the measurement, assessment, and treatment of PPH. We review different methods of quantifying blood loss, including gravimetry, calibrated drapes and canisters, and colorimetric techniques.

Evaluating tranexamic acid for the prevention and treatment of obstetric hemorrhage.

Purpose Of Review: Tranexamic acid (TXA) has emerged as a promising pharmacological adjunct to treat and prevent postpartum hemorrhage (PPH). We provide an overview of TXA, including its pharmacology, key findings of randomized trials and observational studies, and critical patient safety information.

Recent Findings: Pharmacokinetic data indicate that TXA infusions result in peak plasma concentration within 3 min (range: 1-6.

Phase II study of bemnifosbuvir in high-risk participants in a hospital setting with moderate COVID-19.

Background: Bemnifosbuvir, a novel, oral, nonmutagenic, nonteratogenic nucleotide analogue inhibits SARS-CoV-2 replication .

Materials & Methods: Adults in hospital settings with moderate COVID-19 were randomized 1:1 bemnifosbuvir/placebo. Study amended to two parts after interim analysis; part B enrollment limited owing to evolving standard of care.

A randomized controlled trial of spinal morphine with an enhanced recovery pathway and its effect on duration of analgesia after cesarean delivery.

Background: Intrathecal morphine is frequently administered after cesarean delivery to provide pain relief lasting up to 24 h. An enhanced recovery after cesarean pathways reduces the amount of postoperative opioids needed. The ideal dose of intrathecal morphine when combined with a pathway has not been determined.

Sexual Satisfaction After Gender Affirmation Surgery in Transgender Individuals.

Gender affirmation surgery (GAS) is a collection of surgical procedures that involve the reconstruction of patients' genitalia with the aim of achieving the physical appearance and functional abilities of the gender they desire. They are classified into male-to-female (MtF) and female-to-male (FtM). This study is aimed at assessing sexual satisfaction after MtF GAS.

Correction: Sexual Satisfaction After Gender Affirmation Surgery in Transgender Individuals.

[This corrects the article DOI: 10.7759/cureus.27365.

Comparison of Opioid-Based Patient-Controlled Analgesia with Physician-Directed Analgesia in Acute Pancreatitis: A Retrospective Cohort Study.

Background: Patient-controlled analgesia (PCA) is commonly used for acute postoperative pain management. Clinicians may also use PCA in the management of acute pancreatitis (AP); however, there is limited data on its impact on patient outcomes. We aimed to characterize a cohort of patients receiving PCA therapy for pain management in AP compared to those patients receiving standard physician-directed delivery of analgesia.

Estimating Obstetric Anaesthesia Workload: Number of Deliveries Compared to Time-Based Workload.

Background: Number of deliveries is utilised to estimate obstetric anaesthesiologist workload; however, this may not reflect true workload. The goal of this analysis was to assess if including type of procedure, time required and length of each shift would better predict clinical workloads.

Methods: We queried the electronic medical records at a high volume, academic centre for 12 consecutive months of maternal deliveries.

Transnasal Humidified Rapid-Insufflation Ventilatory Exchange for Elective Laryngeal Surgery During Pregnancy: A Case Report.

Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) maintains oxygenation and blunts the partial pressure of carbon dioxide (PaCO2) rise in nonpregnant subjects during apnea. Physiologic changes of pregnancy may attenuate the utility of THRIVE. We present a nulliparous patient at 31 weeks' gestation undergoing tracheal dilation requiring general anesthesia without intubation utilizing THRIVE.

Preoperative Fasting Times for Patients Undergoing Caesarean Delivery: Before and After a Patient Educational Initiative.

Objective: Prolonged preoperative fasting may lead to dehydration, hypoglycaemia, ketoacidosis and delayed recovery. We hypothesised that a patient educational initiative would decrease our preoperative fasting periods for elective caesarean delivery.

Methods: This was an observational quality improvement impact study.

Society for Obstetric Anesthesia and Perinatology Consensus Statement: Monitoring Recommendations for Prevention and Detection of Respiratory Depression Associated With Administration of Neuraxial Morphine for Cesarean Delivery Analgesia.

The majority of women undergoing cesarean delivery in the United States receive neuraxial morphine, the most effective form of postoperative analgesia for this surgery. Current American Society of Anesthesiologists (ASA) and American Society of Regional Anesthesia and Pain Medicine (ASRA) recommend respiratory monitoring standards following neuraxial morphine administration in the general surgical population that may be too frequent and intensive when applied to the healthy obstetric population receiving a single dose of neuraxial morphine at the time of surgery. There is limited evidence to support or guide the optimal modality, frequency, and duration of respiratory monitoring in the postoperative cesarean delivery patient receiving a single dose of neuraxial morphine.

Impact of patient choice for different postcesarean delivery analgesic protocols on opioid consumption: a randomized prospective clinical trial.

Background: Choice of postcesarean delivery analgesic protocol may improve pain experience and reduce analgesic requirements.

Methods: Cesarean delivery patients were randomly assigned either to choose their postcesarean delivery analgesia protocol or to have no choice and receive routine care. Choices were low (50 μg intrathecal morphine), medium (identical to routine care: 150 μg intrathecal morphine), or high (300 μg intrathecal morphine with 600 mg oral gabapentin).

Use of Intravenous Acetaminophen in Postoperative Pain Management After Partial and Full Bony Impacted Third Molar Extractions: A Randomized Double-Blind Controlled Trial.

Purpose: Currently, there is a concern at the national level of the overuse of both prescription and nonprescription opioid use. The purpose of this study was to identify whether the use of the intravenous (IV) formulation of acetaminophen (Ofirmev; Mallinckrodt Pharmaceuticals, Staines-upon-Thames, United Kingdom) is an effective tool in the reduction of postoperative pain, with a secondary goal of reduction of postoperative narcotic use.

Materials And Methods: A total of 72 patients with previously diagnosed either partial bony or complete bony impacted third molars were selected with care to avoid long-acting local anesthetics or dissociative anesthetic agents.

Hemodynamic effects of once-daily tadalafil in men with signs and symptoms of benign prostatic hyperplasia on concomitant α1-adrenergic antagonist therapy: results of a multicenter randomized, double-blind, placebo-controlled trial.

Objective: To investigate the safety of daily coadministration of α-blockers with tadalafil 5 mg in men with lower urinary tract symptoms secondary to benign prostatic hyperplasia. The standard-of-care medical therapy for moderate to severe symptoms of benign prostatic hyperplasia is α(1)-adrenergic antagonist (α-blocker) therapy.

Methods: Men aged ≥ 45 years receiving stable α-blocker therapy were evaluated for eligibility before a 2-week single-blind, placebo lead-in period.

The effectiveness of alcohol policies in 4-year public universities.

The objective of this study was to evaluate the type of alcohol policy in place in 4-year public universities against the odds of heavy drinking. Data was collected during the months of April-June 2010 using the Core Alcohol and Drug Survey. The participants included a random sample of undergraduate students from 4 public universities in the Midwest.

The impact of robotics on treatment of localized prostate cancer and resident education in Rochester, New York.

Background And Purpose: Robot-assisted radical prostatectomy (RARP) has been performed in Rochester, NY, since 2003. Currently, 10 area urologists perform RARP, and robotic training has become an important component of the residency. We present data describing the timeline for adoption, both in clinical practice and in the residency program.

Basal cell carcinoma-associated paratumoral follicular and epidermal hyperplasia.

Reactive epithelial hyperplasia is a well-known phenomenon which occurs adjacent to certain neoplasms such as cutaneous fibrous histiocytoma, granular cell tumor, Spitz nevus, and melanoma. We report 46 cases of paratumoral follicular and epidermal hyperplasia associated with basal cell carcinoma (BCC). This reactive process associated with BCC has certain characteristic features.