De-freezing frozen patient management.

Objective: To compare the effectiveness of two methods in encouraging the consideration of a leap from one patient management routine to another: (i) real-time review of the facts by an external medical team (ii) implementation of the 're-thinking-protocol' ('de-Freezing') by both treating and external medical teams.

Design: Students accompanied doctors, nurses and patients as non-interrupting observers. When an obvious gap between the expected and actual findings occurred, it was discussed four times: by two teams (treating team, external medical team) in two discussion modes (real-time review, de-Freezing-questionnaire).

Time to follow guidelines, protocols, and structured procedures in medical care and time to leap out.

Present medical practice encourages management according to written guidelines, protocols, and structured procedures (GPPs). Daily medical practice includes instances in which "leaping" from one patient management routine to another is a must. We define "frozen patient management", when patient management leaping was required but was not performed.

Development of a novel method of female sterilization: II. Retention of tubal screws in patients undergoing simultaneous laparoscopic sterilization.

Background And Objectives: This study was a long-term follow-up of patients in whom hysteroscopic tubal screws had been applied at the time of laparoscopic sterilization.

Methods: Tubal screw application was performed before laparoscopic Filshie clip application. Follow-up ultrasonography was arranged 3, 6, and 9 months postoperatively to confirm retention.