Dysfunctional labor and hemoperitoneum secondary to an incidentally discovered dysgerminoma: a case report.

Background: Ovarian dysgerminoma, a subtype of malignant germ cell tumor (GCT), is a rare ovarian neoplasm that is infrequently found in the gravid patient. When dysgerminomas do occur in pregnancy, the rapidly growing tumors can have a heterogeneous presentation and lead to peripartum complications and morbidity. Due to the rarity of this condition, diagnostic and therapeutic strategies are not well described in the literature.

Hypothesis: A wearable device may help COVID-19 patients improve lung function.

Managing respiratory status of patients with COVID-19 is a high resource, high risk healthcare challenge. Interventions that decrease need for invasive respiratory support and utilization of bedside staff would benefit patients and healthcare personnel alike. Proning has been established as optimal positioning that may reduce the need for escalation of respiratory support.

A National Curriculum to Address Professional Fulfillment and Burnout in OB-GYN Residents.

Background: Physician well-being is a priority in graduate medical education as residents suffer high rates of burnout. With complex stressors affecting the clinical environment, conflicting evidence exists as to whether a formal curriculum improves resident well-being.

Objective: We assessed the feasibility and impact of a national pilot of a yearlong wellness curriculum for obstetrics and gynecology (OB-GYN) residents.

A Review of the Pathophysiology and Management of Diabetes in Pregnancy.

Diabetes is a common metabolic complication of pregnancy and affected women fall into two subgroups: women with pre-existing diabetes and those with gestational diabetes mellitus (GDM). When pregnancy is affected by diabetes, both mother and infant are at increased risk for multiple adverse outcomes. A multidisciplinary approach to care before, during, and after pregnancy is effective in reducing these risks.

Effects of Overweight and Obesity in Pregnancy on Health of the Offspring.

Overweight and obesity in pregnancy confer a wide range of risks on mother, fetus, and offspring throughout their lives. In addition to compounding many common pregnancy complications, including both iatrogenic preterm delivery and cesarean delivery, obesity is associated with multiple fetal anomalies, metabolic sequelae including diabetes and obesity, allergy and asthma, attention-deficit disorder, and likely many other challenges for the offspring. As targeted interventions are being developed, encouraging solid nutrition and exercise in women of childbearing age may stave off risks and mitigate obesity in the next generation.

New drug controls and reduced hospital presentations due to novel psychoactive substances in Edinburgh.

Aims: Recreational use of novel psychoactive substance (NPS) has become increasingly common. We aimed to assess the association of national legislation and local trading standards activity with hospital presentations.

Methods: We established observational cohorts of patients with recreational drug toxicity presenting to Edinburgh Royal Infirmary and dying with detectable recreational drugs in Edinburgh.

Effect of the UK's revised paracetamol poisoning management guidelines on admissions, adverse reactions and costs of treatment.

Aims: In September 2012 the UK's Commission on Human Medicines (CHM) recommended changes in the management of paracetamol poisoning: use of a single '100 mg l(-1) ' nomogram treatment line, ceasing risk assessment, treating all staggered/uncertain ingestions and increasing the duration of the initial acetylcysteine (NAC) infusion from 15 to 60 min. We evaluated the effect of this on presentation, admission, treatment, adverse reactions and costs of paracetamol poisoning.

Methods: Data were prospectively collected from adult patients presenting to three large UK hospitals from 3 September 2011 to 3 September 2013 (year before and after change).

Management of poisoning in adults.

Nurses play a key role in the care of patients presenting with poisoning. Assessment and management of such patients can be challenging, especially if they are intoxicated, have co-ingested other agents or their mental health is compromised. In addition, some nurses may be unfamiliar with current management guidelines.

Assessment and management of paracetamol poisoning in adults.

Paracetamol is a low cost, effective analgesic that is widely available in the UK. Paracetamol is the drug most commonly taken in overdose and can lead to acute liver failure, which can be fatal. This article focuses on the assessment and management of paracetamol poisoning in adults.

An integrated care pathway improves the management of paracetamol poisoning.

Background: Paracetamol poisoning remains a major cause of morbidity and mortality. Clinical care of paracetamol poisoning depends on a range of patient variables and typically involves both medical and nursing care. An integrated care pathway (ICP) is a multidisciplinary management plan that incorporates guidelines and best practice to enhance care and documentation for a specific patient group.

Third-trimester uterine rupture without previous cesarean: a case series and review of the literature.

We sought to describe a case series and literature review of uterine rupture in the absence of a previous cesarean delivery. In addition to four cases in our institution, a search of the literature from 1994 to 2008 identified cases of uterine rupture unrelated to a prior cesarean. Uterine rupture in the absence of a previous cesarean may be associated with remote unrecognized uterine perforation, myomectomy, thermal injury, and obstructed labor.

Lower incidence of anaphylactoid reactions to N-acetylcysteine in patients with high acetaminophen concentrations after overdose.

Background: Mechanisms responsible for anaphylactoid reactions to N-acetylcysteine (NAC) are poorly understood, and acetaminophen itself may play an important role. The present study examined the relationship between serum acetaminophen concentrations and risk of anaphylactoid reactions.

Methods: Prospective study of adverse reactions to NAC administered according to standardized clinical protocols in patients who present to hospital after acute acetaminophen overdose.