Objectives: In an established cohort of HER Salt Lake Contraceptive Initiative participants with a prior intrauterine device (IUD) placement, we sought to (1) define the proportion of participants who reported a negative Patient Acceptable Symptom State (PASS) response, (2) explore factors associated with an unacceptable PASS response, and (3) identify pain management preferences for IUD placement.
Study Design: A retrospective survey was sent to 1440 HER Salt Lake IUD users. A PASS question queried IUD placement pain experience acceptability. We explored associations between an unacceptable PASS response and sociodemographic, reproductive and other individual characteristics using t-tests, chi-square tests, and multivariable logistic regression.
Results: Of those surveyed, 620 responded (43%), and 41.6% reported an unacceptable PASS response. Those with an unacceptable PASS response reported a significantly higher experienced pain level (79.2 mm vs 51.8 mm; p < 0.01) than those with an acceptable response, were more likely to have an anxiety diagnosis (47.7% vs 37.1%; p < 0.01), and have a trauma history (33.7% vs 25.1%; p = 0.02). Most patients were not offered pain control options, but 29.4% used ibuprofen and 25.3% had a support person. Regardless of PASS response, if offered, 59.0% desired numbing medication, 56.8% ibuprofen, 51% heating pad, 33.2% support person, and 31.8% anti-anxiety medication, among others. In our multivariable logistic regression model, higher pain was associated with unacceptable PASS response (OR 1.07, 95% CI 1.05-1.08; p < 0.01).
Conclusions: The common finding of unacceptable pain experiences with IUD placement may cause negative perceptions of an otherwise desirable method. Incorporation of the PASS response into IUD pain management studies could expand our pain experience understanding.
Implications: IUD placement resulted in unacceptable pain experiences for 41.6% of respondents. Screening for anxiety and trauma history could identify at-risk patients to individualize pain management strategies. Incorporation of the PASS into future IUD pain management studies could result in a more comprehensive, patient-centered measure of patient experiences.
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http://dx.doi.org/10.1016/j.contraception.2024.110385 | DOI Listing |
Radiography (Lond)
January 2025
Discipline of Medical Imaging Science, University of Sydney, Camperdown, NSW, Australia. Electronic address:
Introduction: Radiography and medical students (RMS), upon graduation, require capabilities to provide life-saving care through identification and communication of urgent findings on radiological imaging. This preliminary study investigated RMS' ability to identify and categorise urgent findings on CT examinations. It also explored their experiences of image interpretation education.
View Article and Find Full Text PDFPlast Reconstr Surg Glob Open
January 2025
Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, OH.
Background: The first class of integrated plastic surgery residency applicants with pass/fail (P/F) step 1 assessments occurred during the 2023-2024 Match cycle. This study analyzes the results of a 2024 postmatch survey to program directors (PDs) regarding the impact of the conversion to P/F step 1 scoring and compares the results to the 2019 survey that attempted to predict how this conversion would influence decision-making when it was initially announced.
Methods: A 26-item survey evaluating PDs' perspectives on applicant characteristics and the application process following P/F step 1 scoring was distributed March 2024.
J Viral Hepat
February 2025
Clinica Universidad de Navarra, Pamplona, Spain.
Direct-acting antiviral (DAA) therapy is associated with a significant reduction in hepatocellular carcinoma (HCC) incidence among patients with cirrhosis, but data are conflicting about the risk of recurrence following DAA therapy. DAA-PASS was a prospective, pragmatic, observational study designed to estimate the risk of HCC recurrence associated with DAA therapy exposure during routine clinical care. Eligible patients were DAA treatment naive with Barcelona Clinic Liver Cancer (BCLC) stage A.
View Article and Find Full Text PDFF1000Res
January 2025
Department of Nephrology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India.
Background: We evaluated if the course of recovery from sepsis-induced acute kidney injury (AKI) can be predicted using variables collected at admission.
Methods: A total of 63 patients admitted for sepsis-induced AKI in our Mangalore ICU were evaluated and baseline demographic and clinical/laboratory parameters, including serum creatinine (SCr), base excess (BE), Plethysmographic Variability Index (PVI), Caval Index, R wave variability index (RVI), mean arterial pressure (MAP) and renal resistivity index (RI) using renal doppler and need for inotropes were assessed on admission. Patients were managed as per standard protocol.
Tuneable, variable, optical attenuation through an optical circulator with a broad, linear attenuation range of Δ ∼ (30-40) dB is demonstrated using non-reciprocal Faraday rotation in a double-pass configuration with a combination of permanent magnets and an electromagnet. A fiber-coupled magneto-optical variable optical attenuator (MVOA) operates over the near IR with an attenuation tuning range of Δ > 30 dB, a resolution of Δ ∼ 0.02 dB, a response time of < 2 ms, and a temperature dependence over = 25-70°C of Δ / Δ = -8 × 10 dB/°C.
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