READ Codes of Conditions Affecting Venous Thromboembolism
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Low-Lying Placenta
LOW- LYING PLACENTA LOW-LYING PLACENTA WHAT IS PLACENTA PRAEVIA? The placenta develops along with the baby in the uterus (womb) during pregnancy. It connects the baby with the mother’s blood system and provides the baby with its source of oxygen and nourishment. The placenta is delivered after the baby and is also called the afterbirth. In some women the placenta attaches low in the uterus and may be near, or cover a part, or lie over the cervix (entrance to the womb). If it is shown in early ultrasound scans, it is called a low-lying placenta. In most cases, the placenta moves upwards as the uterus enlarges. For some women the placenta continues to lie in the lower part of the uterus in the last months of pregnancy. This condition is known as placenta praevia. If the placenta covers the cervix, this is known as major placenta praevia. Normal Placenta Placenta Praevia Major Placenta Praevia WHAT ARE THE RISKS TO MY BABY AND ME? When the placenta is in the lower part of the womb, there is a risk that you may bleed in the second half of pregnancy. Bleeding from placenta praevia can be heavy, and so put the life of the mother and baby at risk. However, deaths from placenta praevia are rare. You are more likely to need a caesarean section because the placenta is in the way of your baby being born. HOW IS PLACENTA PRAEVIA DIAGNOSED? A low-lying placenta may be suspected during the routine 20-week ultrasound scan. Most women who have a low-lying placenta at the routine 20-week scan will not go on to have a low-lying placenta later in the pregnancy – only 1 in 10 go on to have a placenta praevia. -
Human Anatomy As Related to Tumor Formation Book Four
SEER Program Self Instructional Manual for Cancer Registrars Human Anatomy as Related to Tumor Formation Book Four Second Edition U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service National Institutesof Health SEER PROGRAM SELF-INSTRUCTIONAL MANUAL FOR CANCER REGISTRARS Book 4 - Human Anatomy as Related to Tumor Formation Second Edition Prepared by: SEER Program Cancer Statistics Branch National Cancer Institute Editor in Chief: Evelyn M. Shambaugh, M.A., CTR Cancer Statistics Branch National Cancer Institute Assisted by Self-Instructional Manual Committee: Dr. Robert F. Ryan, Emeritus Professor of Surgery Tulane University School of Medicine New Orleans, Louisiana Mildred A. Weiss Los Angeles, California Mary A. Kruse Bethesda, Maryland Jean Cicero, ART, CTR Health Data Systems Professional Services Riverdale, Maryland Pat Kenny Medical Illustrator for Division of Research Services National Institutes of Health CONTENTS BOOK 4: HUMAN ANATOMY AS RELATED TO TUMOR FORMATION Page Section A--Objectives and Content of Book 4 ............................... 1 Section B--Terms Used to Indicate Body Location and Position .................. 5 Section C--The Integumentary System ..................................... 19 Section D--The Lymphatic System ....................................... 51 Section E--The Cardiovascular System ..................................... 97 Section F--The Respiratory System ....................................... 129 Section G--The Digestive System ......................................... 163 Section -
Guidance for the Format and Content of the Protocol of Non-Interventional
PASS information Title Metformin use in renal impairment Protocol version identifier Version 2 Date of last version of 30 October 2013 protocol EU PAS register number Study not registered Active substance A10BA02 metformin Medicinal product Metformin Product reference N/A Procedure number N/A Marketing authorisation 1A Farma, Actavis, Aurobindo, Biochemie, Bluefish, holder(s) Hexal, Mylan, Orifarm, Pfizer, Sandoz, Stada, Teva Joint PASS No Research question and To assess the use and safety of metformin in patients objectives with and without renal insufficiency in current clinical practice in at least two EU Member States. Country(-ies) of study Denmark, United Kingdom Author Christian Fynbo Christiansen, MD, PhD Page 1/214 Marketing authorisation holder(s) Marketing authorisation N/A holder(s) MAH contact person N/A Page 2/214 1. Table of Contents PASS information .......................................................................................................... 1 Marketing authorisation holder(s) .................................................................................... 2 1. Table of Contents ...................................................................................................... 3 2. List of abbreviations ................................................................................................... 4 3. Responsible parties .................................................................................................... 5 4. Abstract .................................................................................................................. -
Technical Guidelines for Head and Neck Cancer IMRT on Behalf of the Italian Association of Radiation Oncology
Merlotti et al. Radiation Oncology (2014) 9:264 DOI 10.1186/s13014-014-0264-9 REVIEW Open Access Technical guidelines for head and neck cancer IMRT on behalf of the Italian association of radiation oncology - head and neck working group Anna Merlotti1†, Daniela Alterio2†, Riccardo Vigna-Taglianti3†, Alessandro Muraglia4†, Luciana Lastrucci5†, Roberto Manzo6†, Giuseppina Gambaro7†, Orietta Caspiani8†, Francesco Miccichè9†, Francesco Deodato10†, Stefano Pergolizzi11†, Pierfrancesco Franco12†, Renzo Corvò13†, Elvio G Russi3*† and Giuseppe Sanguineti14† Abstract Performing intensity-modulated radiotherapy (IMRT) on head and neck cancer patients (HNCPs) requires robust training and experience. Thus, in 2011, the Head and Neck Cancer Working Group (HNCWG) of the Italian Association of Radiation Oncology (AIRO) organized a study group with the aim to run a literature review to outline clinical practice recommendations, to suggest technical solutions and to advise target volumes and doses selection for head and neck cancer IMRT. The main purpose was therefore to standardize the technical approach of radiation oncologists in this context. The following paper describes the results of this working group. Volumes, techniques/strategies and dosage were summarized for each head-and-neck site and subsite according to international guidelines or after reaching a consensus in case of weak literature evidence. Introduction Material and methods Performing intensity-modulated radiotherapy (IMRT) The first participants (AM, DA, AM, LL, RM, GG, OC, in head and neck cancer patients (HNCPs) requires FM, FD and RC) were chosen on a voluntary basis training [1] and experience. For example, in the 02–02 among the HNCWG members. The group was coordi- Trans Tasman Radiation Oncology Group (TROG) nated by an expert head and neck radiation oncologist trial, comparing cisplatin (P) and radiotherapy (RT) (RC). -
Efficacy of Genetic Testing in Cases of Ambiguous Genitalia
EFFICACY OF GENETIC TESTING IN CASES OF AMBIGUOUS GENITALIA DETECTED ON PRENATAL! ULTRASOUND ! ! ! by! EVELYN ROSE! CRAWFORD ! ! Submitted in partial fulfillment of !the requirements for the degree of Master of! Science ! ! ! Thesis Advisor: Larisa! Baumanis, MS ! ! Genetic Counseling! Department !of Genetics CASE WESTERN RESERVE! UNIVERSITY ! ! ! ! ! ! ! August, 2014 ! ! CASE WESTERN RESERVE! UNIVERSITY SCHOOL OF GRADUATE! STUDIES We hereby approve! the thesis of: Evelyn Rose! Crawford candidate for the degree of !Master of Science degree.* ! ! Larisa Baumanis, MS (Committee Chair) ! Anne Matthews, RN, PhD ! Noam Lazebnik, MD ! Aditi Parikh, MD ! Sara Debanne, PhD ! ! ! ! Date of Defense June 20, 2014 ! ! ! ! ! *We also certify that written approval has been obtained for any proprietary material contained therein !2 ! ! ! TABLE OF CONTENTS List of Tables 4 List of Figures 5 Acknowledgements 6 Abstract 7 Introduction 8 Purpose of Study & Specific Aims 10 Background 11 Detection of Ambiguous Genitalia on Prenatal Ultrasound 11 Current use of Genetic testing in determining a specific diagnosis 13 The Importance of Prenatal Diagnosis in Cases of Ambiguous Genitalia 18 Significance for genetic counselors 19 Conclusions 20 Methodology 22 Systematic Review of the Literature 22 Chart Review 27 Algorithm & Analysis 29 Results 31 Analysis 52 Discussion 55 Appendix I: First Review Matrix Organization and summary of literature review articles 62 Appendix II: Second Review Matrix Organization and summary of case studies from the literature review 78 Appendix III: Third Review Matrix Organization and summary of chart review cases 94 References 102 !3 LIST OF TABLES ! !Table 1: Keyword Combinations for Literature Search 22 !Table 2: Example First Review Matrix 25 !Table 3: Example Second Review Matrix 25 !Table 4: Protocol Key 26 !Table 5: Example Third Review Matrix 29 Table 6: Imaging characteristics to differentiate cloacal exstrophy, bladder !exstrophy and cloacal malformation (Calvo-Garcia et al. -
ANATOMIC and PATHOLOGIC ASSESSMENT of FELINE LYMPH NODES USING COMPUTED TOMOGRAPHY and ULTRASONOGRAPHY Mauricio Tobón Restrepo
ADVERTIMENT. Lʼaccés als continguts dʼaquesta tesi queda condicionat a lʼacceptació de les condicions dʼús establertes per la següent llicència Creative Commons: http://cat.creativecommons.org/?page_id=184 ADVERTENCIA. El acceso a los contenidos de esta tesis queda condicionado a la aceptación de las condiciones de uso establecidas por la siguiente licencia Creative Commons: http://es.creativecommons.org/blog/licencias/ WARNING. The access to the contents of this doctoral thesis it is limited to the acceptance of the use conditions set by the following Creative Commons license: https://creativecommons.org/licenses/?lang=en Doctorand: Mauricio Tobón Restrepo Directores: Yvonne Espada Gerlach & Rosa Novellas Torroja Tesi Doctoral Barcelona, 29 de juliol de 2016 This thesis has received financial support from the Colombian government through the “Francisco José de Caldas” scholarship program of COLCIENCIAS and from the Corporación Universitaria Lasallista. DEDICATED TO A los que son la razón y la misión de esta tesis… LOS GATOS. A mis padres y hermanos. A Ismael. Vor mijn poffertje. ACKNOWLEDGMENTS Tal vez es la parte que se pensaría más fácil de escribir, pero sin duda se juntan muchos sentimientos al momento de mirar atrás y ver todo lo que has aprendido y todas las personas que han estado a tu lado dándote una palabra de aliento… y es ahí cuando se asoma la lágrima… Sin duda alguna, comienzo agradeciendo a los propietarios de todos los gatos incluidos en este estudio, sin ellos esto no habría sido posible. A continuación agradezco a mis directoras de tesis, la Dra. Rosa Novellas y la Dra. Yvonne Espada. Muchas gracias por creer en mí, por apoyarme y por tenerme tanta paciencia. -
M. H. RATZLAFF: the Superficial Lymphatic System of the Cat 151
M. H. RATZLAFF: The Superficial Lymphatic System of the Cat 151 Summary Four examples of severe chylous lymph effusions into serous cavities are reported. In each case there was an associated lymphocytopenia. This resembled and confirmed the findings noted in experimental lymph drainage from cannulated thoracic ducts in which the subject invariably devdops lymphocytopenia as the lymph is permitted to drain. Each of these patients had com munications between the lymph structures and the serous cavities. In two instances actual leakage of the lymphography contrrult material was demonstrated. The performance of repeated thoracenteses and paracenteses in the presenc~ of communications between the lymph structures and serous cavities added to the effect of converting the. situation to one similar to thoracic duct drainage .The progressive immaturity of the lymphocytes which was noted in two patients lead to the problem of differentiating them from malignant cells. The explanation lay in the known progressive immaturity of lymphocytes which appear when lymph drainage persists. Thankful acknowledgement is made for permission to study patients from the services of Drs. H. J. Carroll, ]. Croco, and H. Sporn. The graphs were prepared in the Department of Medical Illustration and Photography, Dowristate Medical Center, Mr. Saturnino Viloapaz, illustrator. References I Beebe, D. S., C. A. Hubay, L. Persky: Thoracic duct 4 Iverson, ]. G.: Phytohemagglutinin rcspon•e of re urctcral shunt: A method for dccrcasingi circulating circulating and nonrecirculating rat lymphocytes. Exp. lymphocytes. Surg. Forum 18 (1967), 541-543 Cell Res. 56 (1969), 219-223 2 Gesner, B. M., J. L. Gowans: The output of lympho 5 Tilney, N. -
Collaborative Stage Manual Part II
SEER Program Coding and Staging Manual 2004, Revision 1 Collaborative Staging Codes Nasal Cavity C30.0 C30.0 Nasal cavity (excludes nose, NOS C76.0) Note: Laterality must be coded for this site, except subsites Nasal cartilage and Nasal septum, for which laterality is coded 0. CS Tumor Size CS Site-Specific Factor 1 - Size of The following tables are available CS Extension Lymph Nodes at the collaborative staging CS TS/Ext-Eval CS Site-Specific Factor 2 - website: CS Lymph Nodes Extracapsular Extension, Lymph Nodes Histology Exclusion Table CS Reg Nodes Eval for Head and Neck AJCC Stage Reg LN Pos CS Site-Specific Factor 3 - Levels I- Lymph Nodes Size Table Reg LN Exam III, Lymph Nodes for Head and Neck CS Mets at DX CS Site-Specific Factor 4 - Levels IV- CS Mets Eval V and Retropharyngeal Lymph Nodes for Head and Neck CS Site-Specific Factor 5 - Levels VI- VII and Facial Lymph Nodes for Head and Neck CS Site-Specific Factor 6 - Parapharyngeal, Parotid, Preauricular, and Sub-Occipital Lymph Nodes, Lymph Nodes for Head and Neck Nasal Cavity CS Tumor Size SEE STANDARD TABLE Nasal Cavity CS Extension Code Description TNM SS77 SS2000 00 In situ; non-invasive Tis IS IS 10 Invasive tumor confined to site of origin T1 L L Meatus (superior, middle, inferior) Nasal chonchae (superior, middle, inferior) Septum Tympanic membrane 30 Localized, NOS T1 L L 40 Extending to adjacent connective tissue within the nasoethomoidal T2 RE RE complex Nasolacrimal duct 60 Adjacent organs/structures including: T3 RE RE Bone of skull Choana Frontal sinus Hard palate -
Antepartum Haemorrhage
OBSTETRICS AND GYNAECOLOGY CLINICAL PRACTICE GUIDELINE Antepartum haemorrhage Scope (Staff): WNHS Obstetrics and Gynaecology Directorate staff Scope (Area): Obstetrics and Gynaecology Directorate clinical areas at KEMH, OPH and home visiting (e.g. Community Midwifery Program) This document should be read in conjunction with this Disclaimer Contents Initial management: MFAU APH QRG ................................................. 2 Subsequent management of APH: QRG ............................................. 5 Management of an APH ........................................................................ 7 Key points ............................................................................................................... 7 Background information .......................................................................................... 7 Causes of APH ....................................................................................................... 7 Defining the severity of an APH .............................................................................. 8 Initial assessment ................................................................................................... 8 Emergency management ........................................................................................ 9 Maternal well-being ................................................................................................. 9 History taking ....................................................................................................... -
Mid-Trimester Preterm Premature Rupture of Membranes (PPROM): Etiology, Diagnosis, Classification, International Recommendations of Treatment Options and Outcome
J. Perinat. Med. 2018; 46(5): 465–488 Review article Open Access Michael Tchirikov*, Natalia Schlabritz-Loutsevitch, James Maher, Jörg Buchmann, Yuri Naberezhnev, Andreas S. Winarno and Gregor Seliger Mid-trimester preterm premature rupture of membranes (PPROM): etiology, diagnosis, classification, international recommendations of treatment options and outcome DOI 10.1515/jpm-2017-0027 neonates delivered without antecedent PPROM. The “high Received January 23, 2017. Accepted May 19, 2017. Previously pub- PPROM” syndrome is defined as a defect of the chorio- lished online July 15, 2017. amniotic membranes, which is not located over the inter- nal cervical os. It may be associated with either a normal Abstract: Mid-trimester preterm premature rupture of mem- or reduced amount of amniotic fluid. It may explain why branes (PPROM), defined as rupture of fetal membranes sensitive biochemical tests such as the Amniosure (PAMG-1) prior to 28 weeks of gestation, complicates approximately or IGFBP-1/alpha fetoprotein test can have a positive result 0.4%–0.7% of all pregnancies. This condition is associ- without other signs of overt ROM such as fluid leakage with ated with a very high neonatal mortality rate as well as an Valsalva. The membrane defect following fetoscopy also increased risk of long- and short-term severe neonatal mor- fulfils the criteria for “high PPROM” syndrome. In some bidity. The causes of the mid-trimester PPROM are multi- cases, the rupture of only one membrane – either the cho- factorial. Altered membrane morphology including marked rionic or amniotic membrane, resulting in “pre-PPROM” swelling and disruption of the collagen network which is could precede “classic PPROM” or “high PPROM”. -
Tests Spring 2012
Tests spring 2013 Test 1 Oral cavity 1. Vestibulum oris does not communicate with proper oral cavity through: :r1 oral part of pharynx :r2 tremata :r3 space behind last molar :r4 space when tooth is missing :r5 communicates through all mentioned ways -- 2. Into vestibule of oral cavity opens out: :r1 caruncula sublingualis :r2 papilla parotidea :r3 ductus nasolacrimalis :r4 plica sublingualis :r5 none of mentioned answers is correct -- 3. The underlay of lips is: :r1 m. labialis :r2 m. orbicularis oculi :r3 m. orbicularis oris :r4 m. buccalis :r5 none of mentioned answers is correct -- 4. The upper lip is partially connected with alveolar process using: :r1 lig. labii superioris :r2 m. platysma :r3 frenulum labii superioris :r4 plica labii superioris :r5 none of mentioned answers is correct -- 5. Cheek is not made up of: :r1 skin :r2 adipose body :r3 muscular layer :r4 adventitia :r5 none of mentioned answers is correct -- 6. Parotid duct passes through: :r1 m. masseter :r2 m. buccinator :r3 m. orbicularis oris :r4 m. pterygoideus lateralis :r5 none of mentioned answers is correct -- 7. The underlay of hard palate is not: :r1 praemaxilla :r2 vomer :r3 processus palatinus maxillae :r4 lamina horizontalis ossis palatini :r5 all mentioned bones form the underlay of hard palate -- 8. Which statement describing mucosa of hard palate is not correct: :r1 it contains big amount of submucosal connective tissue :r2 it is covered by columnar epithelium :r3 firmly grows together with periosteum :r4 it is almost not movable against the bottom :r5 it contains glandulae palatinae -- 9. Mark the true statement describing the palate: :r1 there is papilla incisiva positioned there :r2 mucosa contains glandulae palatinae :r3 there are plicae palatinae transversae positioned there :r4 the basis of soft palate is made by fibrous aponeurosis palatina :r5 all mentioned statements are correct -- 10. -
First Do No Harm
Çalik et al. BMC Pregnancy and Childbirth (2018) 18:415 https://doi.org/10.1186/s12884-018-2054-0 RESEARCHARTICLE Open Access First do no harm - interventions during labor and maternal satisfaction: a descriptive cross-sectional study Kıymet Yeşilçiçek Çalik1*, Özlem Karabulutlu2 and Canan Yavuz3 Abstract Background: Interventions can be lifesaving when properly implemented but can also put the lives of both mother and child at risk by disrupting normal physiological childbirth when used indiscriminately without indications. Therefore, this study was performed to investigate the effect of frequent interventions during labor on maternal satisfaction and to provide evidence-based recommendations for labor management decisions. Methods: The study was performed in descriptive design in a state hospital in Kars, Turkey with 351 pregnant women who were recruited from the delivery ward. The data were collected using three questionnaires: a survey form containing sociodemographic and obstetric characteristics, the Scale for Measuring Maternal Satisfaction in Vaginal Birth, and an intervention observation form. Results: The average satisfaction scores of the mothers giving birth in our study were found to be low, at 139.59 ± 29.02 (≥150.5 = high satisfaction level, < 150.5 = low satisfaction level). The percentages of the interventions that were carried out were as follows: 80.6%, enema; 22.2%, perineal shaving; 70.7%, induction; 95.4%, continuous EFM; 92.3%, listening to fetal heart sounds; 72.9%, vaginal examination (two-hourly); 31.9%, amniotomy; 31.3%, medication for pain control; 74.9%, intravenous fluids; 80.3%, restricting food/liquid intake; 54.7%, palpation of contractions on the fundus; 35.0%, restriction of movement; 99.1%, vaginal irrigation with chlorhexidine; 85.5%, using a “hands on” method; 68.9%, episiotomy; 74.6%, closed glottis pushing; 43.3%, fundal pressure; 55.3%, delayed umbilical cord clamping; 86.0%, delayed skin-to-skin contact; 60.1%, controlled cord traction; 68.9%, postpartum hemorrhage control; and 27.6%, uterine massage.