This document discusses pelvic floor dysfunction and pelvic organ prolapse. It begins by describing normal pelvic anatomy including ligaments, tendons, fascia and muscles that provide support. Three levels of vaginal support are identified. Pelvic organ prolapse is then defined as the protrusion of pelvic organs into or outside the vaginal canal. Etiology and risk factors for pelvic organ prolapse are outlined. Assessment, symptoms, and conservative and surgical management options are reviewed for anterior, posterior, and apical prolapse. Surgical procedures including anterior and posterior colporrhaphy, paravaginal repair, and abdominal, laparoscopic and vaginal vault suspension techniques are described.
This document discusses different methods for performing a cesarean section and simultaneous repair of a small umbilical hernia. It describes three methods: 1) using separate incisions for the c-section and hernia repair, 2) using a single midline incision, or 3) using a Pfannenstiel incision for the c-section and performing a transabdominal hernia repair. For small hernias less than 5cm, the preferred repair is tension-free using an intraperitoneal mesh patch. Larger hernias may require closure of the defect with sutures or reinforcement with a mesh.
Guide hygiène et sécurité - télécharger : http://goo.gl/NoFrdWHani sami joga
Un Guide pratique pour l'hygiène et la sécurité des chantiers - OFPPT Maroc - pour télécharger ce fichier allez à cette page : télécharger : http://goo.gl/NoFrdW
STABILITÉ DE L'EXPANSION PALATINE ASSISTÉE CHIRURGICALEMENT COMPARÉE À UNE OS...Dr Sylvain Chamberland
Thèse de maîtrise
Résumé:
Ce projet visait à comparer deux traitements chirurgicaux d’expansion palatine pour la correction des déficits transverses des maxillaires. Dans une étude prospective, les données de 22 sujets ayant terminé leur traitement orthodontique et ayant eu une expansion palatine assistée chirurgicalement (EPRAC) sont comparées à un groupe contrôle historique traité avec une ostéotomie Le Fort 1. L’expansion et la récidive dentaire et squelettique obtenue avec l’EPRAC ainsi que la récidive ont été mesurées sur des modèles d’étude et des radiographies céphalométriques postéro-antérieures standardisées à cinq moments durant le traitement.
Dans le groupe EPRAC, l'expansion dentaire moyenne est 7,48 ± 1,39 mm. La récidive est 2,22 ± 1,69 mm (30 %). À la fin de la distraction osseuse, 3,49 ± 1,37 mm d’expansion squelettique ont été obtenus. Lors d’une EPRAC, il faut anticiper la perte du tiers de l’expansion dentaire alors que l’expansion squelettique est stable. La récidive postchirurgicale de l’EPRAC semble similaire aux changements de l’arcade dentaire après une expansion à l’aide d’une ostéotomie maxillaire segmentée (3,06 ± 1,31 mm).
Abstract
The aim of this study was to compare two surgical treatment of maxillary expansion for the correction of a transverse deficiency. In a prospective study, data from 22 enrolled patients who completed their orthodontic treatment and received a surgically assisted rapid palatal expansion (SARPE) were collected and compared to an historical control group treated with a segmented Le Fort 1. The amount of dental and skeletal expansion with SARPE and its stability was assessed, using standardized P-A cephalograms and dental casts taken at five observation points in treatment.
With SARPE, the mean maximum dental expansion was 7,48 ± 1,39 mm and the mean relapse was 2,22 ± 1,69 mm (30%). At the maximum, 3,49 ± 1,37 mm skeletal expansion was obtained. Clinicians should anticipate loss of about one-third of the transverse dental expansion obtained with SARPE although the skeletal expansion is quite stable. The amount of post-surgical relapse with SARPE appears quite similar to the changes in dental arch dimensions after segmental maxillary osteotomy for expansion (3,06 ± 1,31 mm).
Since the advent of laparoscopic surgery in the 1980s, laparoscopic surgery has been popularized by surgeons throughout the world. However, routine laparoscopic surgery has been slow to catch the pregnant patient.
Antiphospholipid antibody syndrome is a condition characterized by the presence of antibodies that cause an increased risk of blood clots, pregnancy complications such as miscarriage, and preeclampsia. These antibodies interfere with prostacyclin and thromboxane, leading to vasoconstriction and thrombosis. Diagnosis requires at least one clinical criteria of vascular events, pregnancy morbidity, or autoimmune disease plus a positive test for antiphospholipid antibodies. Management involves pre-conception counseling, low-dose aspirin, anticoagulation with heparin, prevention and monitoring of complications during pregnancy, and postpartum care including continued anticoagulation.
This document provides information on breech presentation and delivery. It defines breech presentation as when the fetus is in longitudinal lie and its buttocks enter the pelvis first. It discusses the types of breech presentations including frank, complete, and incomplete breech. It describes the mechanisms, risks, and methods of both vaginal and cesarean breech deliveries. Key points include that vaginal breech delivery can be attempted for selected cases using techniques like partial or total breech extraction, but cesarean section is recommended when there are risk factors like a large fetus or unfavorable pelvis. Both maternal and neonatal risks are outlined.
This document discusses pelvic floor dysfunction and pelvic organ prolapse. It begins by describing normal pelvic anatomy including ligaments, tendons, fascia and muscles that provide support. Three levels of vaginal support are identified. Pelvic organ prolapse is then defined as the protrusion of pelvic organs into or outside the vaginal canal. Etiology and risk factors for pelvic organ prolapse are outlined. Assessment, symptoms, and conservative and surgical management options are reviewed for anterior, posterior, and apical prolapse. Surgical procedures including anterior and posterior colporrhaphy, paravaginal repair, and abdominal, laparoscopic and vaginal vault suspension techniques are described.
This document discusses different methods for performing a cesarean section and simultaneous repair of a small umbilical hernia. It describes three methods: 1) using separate incisions for the c-section and hernia repair, 2) using a single midline incision, or 3) using a Pfannenstiel incision for the c-section and performing a transabdominal hernia repair. For small hernias less than 5cm, the preferred repair is tension-free using an intraperitoneal mesh patch. Larger hernias may require closure of the defect with sutures or reinforcement with a mesh.
Guide hygiène et sécurité - télécharger : http://goo.gl/NoFrdWHani sami joga
Un Guide pratique pour l'hygiène et la sécurité des chantiers - OFPPT Maroc - pour télécharger ce fichier allez à cette page : télécharger : http://goo.gl/NoFrdW
STABILITÉ DE L'EXPANSION PALATINE ASSISTÉE CHIRURGICALEMENT COMPARÉE À UNE OS...Dr Sylvain Chamberland
Thèse de maîtrise
Résumé:
Ce projet visait à comparer deux traitements chirurgicaux d’expansion palatine pour la correction des déficits transverses des maxillaires. Dans une étude prospective, les données de 22 sujets ayant terminé leur traitement orthodontique et ayant eu une expansion palatine assistée chirurgicalement (EPRAC) sont comparées à un groupe contrôle historique traité avec une ostéotomie Le Fort 1. L’expansion et la récidive dentaire et squelettique obtenue avec l’EPRAC ainsi que la récidive ont été mesurées sur des modèles d’étude et des radiographies céphalométriques postéro-antérieures standardisées à cinq moments durant le traitement.
Dans le groupe EPRAC, l'expansion dentaire moyenne est 7,48 ± 1,39 mm. La récidive est 2,22 ± 1,69 mm (30 %). À la fin de la distraction osseuse, 3,49 ± 1,37 mm d’expansion squelettique ont été obtenus. Lors d’une EPRAC, il faut anticiper la perte du tiers de l’expansion dentaire alors que l’expansion squelettique est stable. La récidive postchirurgicale de l’EPRAC semble similaire aux changements de l’arcade dentaire après une expansion à l’aide d’une ostéotomie maxillaire segmentée (3,06 ± 1,31 mm).
Abstract
The aim of this study was to compare two surgical treatment of maxillary expansion for the correction of a transverse deficiency. In a prospective study, data from 22 enrolled patients who completed their orthodontic treatment and received a surgically assisted rapid palatal expansion (SARPE) were collected and compared to an historical control group treated with a segmented Le Fort 1. The amount of dental and skeletal expansion with SARPE and its stability was assessed, using standardized P-A cephalograms and dental casts taken at five observation points in treatment.
With SARPE, the mean maximum dental expansion was 7,48 ± 1,39 mm and the mean relapse was 2,22 ± 1,69 mm (30%). At the maximum, 3,49 ± 1,37 mm skeletal expansion was obtained. Clinicians should anticipate loss of about one-third of the transverse dental expansion obtained with SARPE although the skeletal expansion is quite stable. The amount of post-surgical relapse with SARPE appears quite similar to the changes in dental arch dimensions after segmental maxillary osteotomy for expansion (3,06 ± 1,31 mm).
Since the advent of laparoscopic surgery in the 1980s, laparoscopic surgery has been popularized by surgeons throughout the world. However, routine laparoscopic surgery has been slow to catch the pregnant patient.
Antiphospholipid antibody syndrome is a condition characterized by the presence of antibodies that cause an increased risk of blood clots, pregnancy complications such as miscarriage, and preeclampsia. These antibodies interfere with prostacyclin and thromboxane, leading to vasoconstriction and thrombosis. Diagnosis requires at least one clinical criteria of vascular events, pregnancy morbidity, or autoimmune disease plus a positive test for antiphospholipid antibodies. Management involves pre-conception counseling, low-dose aspirin, anticoagulation with heparin, prevention and monitoring of complications during pregnancy, and postpartum care including continued anticoagulation.
This document provides information on breech presentation and delivery. It defines breech presentation as when the fetus is in longitudinal lie and its buttocks enter the pelvis first. It discusses the types of breech presentations including frank, complete, and incomplete breech. It describes the mechanisms, risks, and methods of both vaginal and cesarean breech deliveries. Key points include that vaginal breech delivery can be attempted for selected cases using techniques like partial or total breech extraction, but cesarean section is recommended when there are risk factors like a large fetus or unfavorable pelvis. Both maternal and neonatal risks are outlined.
Pelvic organ prolapse is a common condition that can diminish quality of life. Signs include descent of the anterior vaginal wall, posterior vaginal wall, uterus, vaginal apex or perineum. Symptoms include vaginal bulging, pelvic pressure and splinting. Risk factors include vaginal childbirth. Treatment options include expectant management, pessaries, pelvic floor exercises, and surgery. Surgical options range from obliterative procedures that close the vagina to reconstructive procedures like sacrocolpopexy that repair prolapse.
This document discusses decreased fetal movements (DFM) and provides guidance on evaluating and managing cases of reported DFM. Key points include:
- DFM can be an early sign of fetal compromise and is associated with 16.4% of stillbirths.
- There is no agreed upon definition of reduced fetal movements. Guidelines recommend focusing on qualitative maternal perception.
- Evaluation of DFM includes history, exam, NST, ultrasound to check growth, amniotic fluid and anatomy, and may include BPP, Doppler, biophysical profile if indicated.
- For persistent unexplained DFM, monitoring with NST and ultrasound twice weekly is suggested under 37 weeks, induction after 37 weeks if cervix is
PELVIC ORGAN PROLAPSE, uterine prolapse , cystocele, rectocele, urethrocele, supports of uterus, sling surgeries, pessaries, grades of prolapse, uterine preserving surgery for pop, pelvic floor repair, vaginal hysterectomy, ward mayos surgery, pop q grading, grading of prolapse, laproscopic surgeries for prolapse, peregee, apogee , mesh repair, tot, tvt, colpo suspension, colpoclysis, SUI management, epidemiology of prolapse, decubitus ulcer, best ppt for pelvic organ prolapse, better understanding of pelvic organ prolapse and pelvic floor. dr . m. gokul reshmi, dr. gokulreshmi m
EXPERT LOGISTIQUE, rigoureux, à l'écoute et pragmatique, je recherche de nouveaux challenges. Régulièrement confronté aux aléas du métier, je suis capable de répondre aux imprévus en parfaite autonomie, sécurité, de relever les défis et atteindre les objectifs confiés par un dialogue de qualité avec mes collaborateurs.
This presentation describes epidemiology, risk factors, pathology, clinical examination, staging and management of cervical carcinoma. SCREENING is not included
Obstructed labour occurs when progress of labour stops due to mechanical factors despite adequate uterine contractions. It is a leading cause of maternal and fetal morbidity and mortality worldwide. Risk factors include cephalopelvic disproportion, malnutrition, osteomalacia, teenage pregnancy and macrosomia. Prolonged obstructed labour can result in uterine rupture, obstetric fistula, maternal death and stillbirth. Treatment involves relieving obstruction through caesarean section if fetus is alive or craniotomy/caesarean if not. Prevention strategies include good antenatal care, early referral and use of a partograph during labour.
Maintenance des bâtiments : comment travailler en hauteur en toute sécurité ?CCI du Luxembourg belge
C’est à cette question que le CPT-Lux et la Chambre de commerce ont voulu répondre lors d’une journée d’information organisée avec le soutien du CNAC le 22 septembre 2016.
Christian LAMBINET, Inspecteur au Contrôle du Bien-Etre au Travail (SPF Emploi) a tout d’abord retracé les contours réglementaires de la question.
Henri MEYS, Vice-Président de BIB.co, a apporté le point de vue des coordinateurs sécurité.
Enfin, Michel DENONCIN, conseiller en prévention et responsable projets chez Jindal Films, a expliqué comment l’entreprise procède lorsqu’elle doit faire des travaux de maintenance en hauteur et faire appel à des sous-traitants en toute sécurité.
Pour plus d’infos : am.barbette@ccilb.be
Utilisation des feuilles de manioc (Manihot esculenta Crantz) comme source al...Université de Dschang
A l'issue des échanges avec le jury ce 01er juillet 2016, Mme. Mweugang Nguopo Nathalie a été faite Dr./Ph.D en Biotechnologies et Productions Animales avec la mention très honorable à l'unanimité des membres du jury.
The document discusses breech presentation and its management. It defines breech as the fetal buttocks and feet presenting first in labor. The main types of breech presentation are discussed as well as risk factors. Diagnosis involves physical examination, vaginal examination and ultrasound. Management includes attempting external cephalic version to turn the baby, and planning the mode of delivery which is usually c-section for full term breech babies. Complications of breech presentation and factors influencing choice of vaginal versus c-section delivery are also outlined.
Pelvic organ prolapse is a common condition that can diminish quality of life. Signs include descent of the anterior vaginal wall, posterior vaginal wall, uterus, vaginal apex or perineum. Symptoms include vaginal bulging, pelvic pressure and splinting. Risk factors include vaginal childbirth. Treatment options include expectant management, pessaries, pelvic floor exercises, and surgery. Surgical options range from obliterative procedures that close the vagina to reconstructive procedures like sacrocolpopexy that repair prolapse.
This document discusses decreased fetal movements (DFM) and provides guidance on evaluating and managing cases of reported DFM. Key points include:
- DFM can be an early sign of fetal compromise and is associated with 16.4% of stillbirths.
- There is no agreed upon definition of reduced fetal movements. Guidelines recommend focusing on qualitative maternal perception.
- Evaluation of DFM includes history, exam, NST, ultrasound to check growth, amniotic fluid and anatomy, and may include BPP, Doppler, biophysical profile if indicated.
- For persistent unexplained DFM, monitoring with NST and ultrasound twice weekly is suggested under 37 weeks, induction after 37 weeks if cervix is
PELVIC ORGAN PROLAPSE, uterine prolapse , cystocele, rectocele, urethrocele, supports of uterus, sling surgeries, pessaries, grades of prolapse, uterine preserving surgery for pop, pelvic floor repair, vaginal hysterectomy, ward mayos surgery, pop q grading, grading of prolapse, laproscopic surgeries for prolapse, peregee, apogee , mesh repair, tot, tvt, colpo suspension, colpoclysis, SUI management, epidemiology of prolapse, decubitus ulcer, best ppt for pelvic organ prolapse, better understanding of pelvic organ prolapse and pelvic floor. dr . m. gokul reshmi, dr. gokulreshmi m
EXPERT LOGISTIQUE, rigoureux, à l'écoute et pragmatique, je recherche de nouveaux challenges. Régulièrement confronté aux aléas du métier, je suis capable de répondre aux imprévus en parfaite autonomie, sécurité, de relever les défis et atteindre les objectifs confiés par un dialogue de qualité avec mes collaborateurs.
This presentation describes epidemiology, risk factors, pathology, clinical examination, staging and management of cervical carcinoma. SCREENING is not included
Obstructed labour occurs when progress of labour stops due to mechanical factors despite adequate uterine contractions. It is a leading cause of maternal and fetal morbidity and mortality worldwide. Risk factors include cephalopelvic disproportion, malnutrition, osteomalacia, teenage pregnancy and macrosomia. Prolonged obstructed labour can result in uterine rupture, obstetric fistula, maternal death and stillbirth. Treatment involves relieving obstruction through caesarean section if fetus is alive or craniotomy/caesarean if not. Prevention strategies include good antenatal care, early referral and use of a partograph during labour.
Maintenance des bâtiments : comment travailler en hauteur en toute sécurité ?CCI du Luxembourg belge
C’est à cette question que le CPT-Lux et la Chambre de commerce ont voulu répondre lors d’une journée d’information organisée avec le soutien du CNAC le 22 septembre 2016.
Christian LAMBINET, Inspecteur au Contrôle du Bien-Etre au Travail (SPF Emploi) a tout d’abord retracé les contours réglementaires de la question.
Henri MEYS, Vice-Président de BIB.co, a apporté le point de vue des coordinateurs sécurité.
Enfin, Michel DENONCIN, conseiller en prévention et responsable projets chez Jindal Films, a expliqué comment l’entreprise procède lorsqu’elle doit faire des travaux de maintenance en hauteur et faire appel à des sous-traitants en toute sécurité.
Pour plus d’infos : am.barbette@ccilb.be
Utilisation des feuilles de manioc (Manihot esculenta Crantz) comme source al...Université de Dschang
A l'issue des échanges avec le jury ce 01er juillet 2016, Mme. Mweugang Nguopo Nathalie a été faite Dr./Ph.D en Biotechnologies et Productions Animales avec la mention très honorable à l'unanimité des membres du jury.
The document discusses breech presentation and its management. It defines breech as the fetal buttocks and feet presenting first in labor. The main types of breech presentation are discussed as well as risk factors. Diagnosis involves physical examination, vaginal examination and ultrasound. Management includes attempting external cephalic version to turn the baby, and planning the mode of delivery which is usually c-section for full term breech babies. Complications of breech presentation and factors influencing choice of vaginal versus c-section delivery are also outlined.
The document discusses classifications and management of gestational disorders including vomiting of pregnancy, preeclampsia, edema, and eclampsia. It classifies vomiting based on severity from mild to severe hyperemesis gravidarum. Preeclampsia is classified based on symptoms and can range from mild to severe. Edema is classified based on the extent of edema from the feet to generalized anasarca. Eclampsia is a severe condition involving seizures that requires immediate delivery and intensive medical care in a specialized unit. Management involves hospitalization, monitoring, supportive care, and often early delivery to treat the condition and protect the health of the mother and fetus.
Gestosis is a multiorgan systemic complication of pregnancy characterized by various symptoms. It is caused by imbalances in prostaglandins that impact vascular resistance and platelet activation. Risk factors include age over 40, primigravida under 17 or over 30, family history, chronic conditions like hypertension and diabetes, and multiple gestation. Preeclampsia is defined as new hypertension and proteinuria developing after 20 weeks of pregnancy. Eclampsia involves preeclampsia with seizures. HELLP syndrome is a variant associated with hemolysis, elevated liver enzymes and low platelets, more common in multiparous women over 25. Early identification and treatment of pregestosis, a preclinical form, can help prevent severe
Лекція "Діагностика і лікування захворювань органів дихання"
Автор: Олександр Бунчук
Турклуб КПІ Глобус (http://www.tkg.org.ua)
Джерело: http://www.tkg.org.ua/node/24222
Acute abdominal pain in children is one of the more frequent reasons for emergency room visits and pediatric surgical consultations. Acute appendicitis was responsible for nearly 90,000 pediatric emergency department visits during 2013 in the United States [1]. Both medical and surgical diagnoses present with acute abdominal pain and the incidence of these varies with age and gender.