Specialty Of Gynecology Research Articles

Aday Doktorların Mezuniyet Öncesi Dönemde Temel Hekimlik Uygulamalarındaki Yeterlik Düzeyi

Background: Competency is the knowledge, skills, ability, and behaviors or capacities that a person possesses to perform tasks correctly and skillfully. Competency is an important criterion for medical students. “Basic Medical Practices” (BMP) are among the core components of the National Core Education Program (NCEP). These domains have four levels of learning. This study aims to evaluate the competencies in “BMP” domains of final year medical students’ who could complete almost 9-month of education on site before the COVID-19 pandemic. Materials and Method: The final year medical students who completed 9 months of internship during the 2019-2020 academic year constitute the sample group at Akdeniz University Faculty of Medicine. The students were asked to self evaluate their competency levels of the BMP stated in NCEP-2020. Self-evaluated competency levels are compared based on receiving in-clinic versus online education. For the analysis of the study chi-squared test is used. Results: 262 students filled out the questionnaire. The difference between self-evaluated competency levels of specific practices pertaining to Forensic Medicine, Psychiatry, and Obstetrics and Gynecology specialties were found to be statistically significant between the students who completed the clerkships and those who did not (p<0,05). When the total of the skills in NCEP-2020 is reviewed, it is seen that there is a loss of being able to do after graduation about 25%. Conclusion: The study showed that some of the medical students were not sufficient for primary health care services according to the fundamental medical skills defined in the NCEP-2020. It is necessary to investigate which skills are inadequate and the reasons of the inadequacy. Although the students are feeling confident in many skills, it is noted that making adjustments in the education system, the core education program, and the healthcare system is necessary.

Women in academic surgery over the last four decades.

As the number of female medical students and surgical residents increases, the increasing number of female academic surgeons has been disproportionate. The purpose of this brief report is to evaluate the AAMC data from 1969 to 2018 to compare the level of female academic faculty representation for surgical specialties over the past four decades. The number of women as a percentage of the total surgeons per year were recorded for each year from 1969-2018, the most recent year available. Descriptive statistics were performed. Poisson regression examined the percentage of women in each field as the outcome of interest with the year and specialty (using general surgery as a reference) as two predictor variables. Data from the American Association of Medical Colleges (AAMC). All full-time academic faculty physicians in the specialties of obstetrics and gynecology (OB/GYN), general surgery, ophthalmology, otolaryngology (ENT), plastic surgery, plastic surgery, urology, neurosurgery, orthopaedic surgery and cardiothoracic surgery as per AAMC records. The percentage of women in surgery for all specialties evaluated increased from 1969 to 2018 (OR 1.04, p<0.001). Compared with general surgery, the rate of yearly percentage change increased more slowly in neurosurgery (OR 0.84; P = .004), orthopaedic surgery (OR 0.82; P = .002), urology (OR 0.59; P < .001), and cardiothoracic surgery (OR 0.38; P < .001). There was no significant difference in the rate of yearly percentage change for plastic surgery (OR 1.01; P = .840). The rate of yearly percentage change increased more rapidly in OB/GYN (OR 2.86; P < .001), ophthalmology (OR 1.79; P < .001) and ENT (OR 1.70; P < .001). Representation of women in academic surgery is increasing overall but is increasing more slowly in orthopaedic surgery, neurosurgery, cardiothoracic surgery and urology compared with that in general surgery. These data may be used to inform and further the discussion of how mentorship and sponsorship of female students and trainees interested in surgical careers may improve gender equity in the future.

EBCOG position statement – Simulation-based training for obstetrics and gynaecology during the COVID-19 pandemic

The specialty of Obstetrics and Gynaecology has been on the forefront of introducing simulation in post graduate education for the past two decades. Simulation training is known to enhance psychomotor skills and is considered an important step in the transition from classroom learning to clinical practice. Training on simulators allows trainees to acquire basic skills before getting involved in day to day care in real life situations. Clinical circumstances around the COVID 19 pandemic have highlighted the key importance of simulation training in delivering post graduate curriculum.

Clinical characteristics, management, maternal and neonatal outcome among seven severe and critically ill pregnant women with COVID-19 pneumonia

Pneumonia caused by the Novel coronavirus disease 2019 (COVID-19) is a highly infectious disease and the ongoing outbreak has been declared as a Pandemic by the World health organization. Pneumonia is a serious disease in pregnancy and requires prompt attention. Viral pneumonia has higher morbidity and mortality compared to bacterial pneumonia in pregnancy. All efforts are well exerted to understand the newly emerged disease features but still some areas are gray. The treatment is primarily supportive with antivirals, steroids, anticoagulation and antibiotics for secondary bacterial infection. Severe cases require intensive care monitoring with oxygen support, mechanical ventilation. Investigational therapies include convalescent plasma, cytokine release inhibitors and other immunomodulatory agents like interferons. The mortality appears driven by the presence of severe Adult Respiratory Syndrome (ARDS) and organs failure. COVID pandemic is a challenging and stressful socio-economic situation with widespread fear of infection, disease and death. In the specialty of obstetrics and gynecology, studies are being conducted to ascertain the manifestation of disease in pregnant women and the fetal outcome. The aim of our case series is to describe the demographics, clinical characteristics, laboratory and radiological findings, feto- maternal outcome of severe and critical COVID pneumonia in pregnant women in Latifa Hospital.

Comparison of Short-Duration and Chronic Premenarchal Vulvar Complaints.

To compare clinical characteristics, treatment histories, and microbiology of premenarchal girls who presented to a pediatric gynecology specialty clinic with short-duration and chronic vulvar symptoms. Retrospective cohort study. Pediatric and adolescent gynecology clinic at a tertiary care children's hospital. One hundred eighty-two premenarchal patients ages 2-14years who presented to a pediatric gynecology specialty clinic with vulvar complaints and who were evaluated with a yeast and/or bacterial culture. None. Chronic and short-duration vulvar symptoms, microbiology, and diagnosis. Patients with chronic symptoms were more likely to present with itching (59/102 (57.8%) vs 34/80 (42.5%); P=.04), redness or rash (53/102 (52.0%) vs 22/80 (27.5%); P=.0009), and discomfort (59/102 (57.8%) vs 30/80 (37.5%); P=.006), compared with patients with short-duration symptoms. Overall, 44.5% of patients had a history of antifungal treatment, with a greater proportion of patients with chronic symptoms having received antifungal treatment compared with those with short-duration symptoms (53/102 (52.0%) vs 28/80 (35.0%); P=.02). Despite a history of antifungal treatment in nearly half of the patients, Candida albicans was isolated in only 3/144 (2.1%) yeast cultures. Bacterial vulvar cultures were positive in 75/159 (47.2%), and there was no difference among the symptom duration groups (38/71 (53.5%) vs 37/88 (42.1%); P=.15). Vulvovaginitis is a common gynecological diagnosis among premenarchal girls with short-duration and chronic vulvar symptoms. Regardless of symptom duration, yeast cultures are rarely positive. Antifungal treatment should be avoided in toilet-trained prepubertal girls.

Design and Application of Intelligent Information System for Comprehensive Management of Obstetrics and Gynecology Health Care

With the cross-infiltration of information technology in the field of hospital management and the application of computer network technology, the digital construction of hospitals has been gradually promoted and applied, which laid the foundation for the development of hospital nursing management system. Obstetrics and Gynecology Nursing is a discipline with strong theoretical, practical and operational skills. At the same time, the specialty of obstetrics and gynecology, the privacy of the cause and the influence of traditional ideas make nursing staff in clinical nursing work. Was hindered. At this stage, the nursing management information system is a software system for processing nursing information established by using information science theory and computer technology method, and is an important part. It can improve the utilization of important resources and the quality and efficiency of nursing work. Based on this, this paper develops and applies the integrated management information system for obstetrics and gynecology health care, and under the guidance of modern software engineering methods, completes the analysis, design and implementation of the system. PowerBuilder is selected as the front-end development tool, and the network structure of the system C/S mode is realized by combining the Oracle database. As a self-developed system, it has great flexibility.

Ultrasound in Obstetrics and Gynecology

Advanced ultrasound offers an important diagnostic clinical tool for the specialty of Obstetrics (OB) and Gynecology (GYN). The advanced ultrasound technologies, such as power Doppler angiography, with its assessment of vascular flow, adds to the described clinical benefits. The imaging technology that this represents, offers diagnostic abilities for a variety of obstetric and gynecologic conditions.

Abstract C126: Challenges implementing anal cancer screening for women living with HIV: Clinical providers and staff perspectives

Abstract Purpose: The HIV Medicine Association recommends anal Pap tests for women living with HIV (WLWH) with a history of abnormal cervical Pap tests, ano-receptive intercourse, or genital warts. This study describes current anal cancer screening practices and provider- and staff-identified challenges conducting anal cancer screening for WLWH in an integrated safety-net healthcare institution and community healthcare organization serving underinsured patients in a metropolitan city in Texas. Findings inform our understanding of factors that need to be addressed prior to implementation of system-level anal cancer screening policies and protocols for WLWH, a population at increased risk for anal cancer due to persistent HPV infection. Methods: We purposefully sampled providers, clinical staff, and administrative staff to participate in in-person semi-structured interviews assessing participant experiences with anal cancer screening, documentation, and follow up, and attitudes toward future anal cancer screening among WLWH. Audio-recorded interviews and field notes were transcribed and thematically analyzed using an iterative deductive and inductive coding scheme. Results: We completed interviews with 25 individuals: providers (n=11: 7 safety-net, 4 community), clinical staff (n=10: 8 safety-net, 2 community), and administrative staff (n=4: safety-net). Current practices. No system-level policies or protocols for anal cancer screening existed within the safety-net institution or community organization for WLWH. Instead, HIV providers performed anal Pap tests ad hoc, most frequently as diagnostic evaluations based on visual inspections or patient-reported symptoms. To follow up on abnormal test results, providers referred patients to Proctology Clinic, where wait for an appointment was about one year. Challenges. Without anal cancer screening policies or protocols, clinical teams were unclear on whether the HIV team or gynecology specialty team should lead screening efforts. Electronic health records only recorded cervical Pap test results in the “Pap” field, leaving providers to record anal Pap results in a notes section. This limited the ability to produce systematic reports or track screening. Finally, providers and staff expressed reluctance to conduct systematic anal cancer screening until greater infrastructure existed to manage referrals for abnormal anal Pap test results. Conclusions: Anal cancer screening and follow-up for WLWH require organization and coordination between multiple care teams, and protocols should clarify clinical pathways and responsibilities as patients transition between HIV, gynecology, and proctology teams. Further, clinical information systems must be updated to facilitate teams’ communication and to support anal Pap test ordering and documentation. Finally, downstream infrastructure to support follow-up must accompany upstream implementation of an anal cancer screening policy. Citation Format: Serena A Rodriguez, Robin T Higashi, Andrea B Betts, Cynthia Ortiz, Jasmin A Tiro, Amneris Luque, Arti Barnes. Challenges implementing anal cancer screening for women living with HIV: Clinical providers and staff perspectives [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C126.

Rule extraction from scientific texts: Evaluation in the specialty of gynecology

Due to the considerable increase in freely available data (especially on the Web), extracting relevant information from textual content is a critical challenge. Most of the available data is embedded in unstructured texts and is not linked to formalized knowledge structures such as ontologies or rules. A potential solution to this problem is to acquire such knowledge through natural language processing (NLP) tools and text mining techniques. Prior work has focused on the automatic extraction of ontologies from texts, but the acquired knowledge is generally limited to simple hierarchies of terms. This paper presents a polyvalent framework for acquiring complex relationships from texts and coding these in the form of rules. Our approach begins with existing domain knowledge represented as an OWL ontology, and applies NLP tools and text matching techniques to deduce different atoms, such as classes, properties and literals, to capture deductive knowledge in the form of new rules. For the reason, to enrich the existing domain ontology by these rules, in order to obtain higher relational expressiveness, make reasoning and produce new facts. The approach was tested using medical reports, specifically, in the specialty of gynecology. It reports an F-measure of 95.83% on test our corpus.

Repeated bullying at the workplace in medical students and young doctors: the MESSIAEN national study.

Despite clues indicating high Bullying at the Work Place (BWP) rates in French hospitals, there has been no quantitative study so far. To determine the prevalence of repeated BWP in a national sample of French young physicians; its risk factors, and the mental health consequences of BWP. The study is a cross-sectional observational epidemiological national study addressed to young physicians. The online internet anonymous questionnaire was elaborated according to previous studies exploring BWP. In addition, we explored the quality of initial training. BWP was defined according to the French legal definition. Mental health was assessed by Hamilton Anxiety and Depression scale, psychotropic drug consumption and psychotherapy follow-up. A Structured Equation Modeling (SEM) was carried out to confirm our theoretical model. 2003 participants of the 37 French medical faculties were included. At least one history of BWP was identified in 41.7% of the participants. The SEM model showed good fit (RMSEA = 0.025, CFI = 0.93, TLI = 0.92, WRMR = 1.285). In the SEM model, BWP was associated with age and number of monthly night shifts and weekly worked hours. Obstetric gynecology, psychiatry, surgery, and medical specialties and low-quality initial training were associated with higher risk of BWP. BWP was associated with increased anxiety and depressive symptoms, daily antidepressant and anxiolytic consumption, and psychotherapy follow-up. Decreasing worked hours and night shifts and improving the quality of the initial training may help preventing BWP among medical students and young physicians. Obstetric gynecology, surgical and medical specialties, and psychiatry should be targeted with a focus on developing prevention programs.

Clinical outcomes and adherence to topical corticosteroid therapy in women with vulvar lichen sclerosus: A retrospective cohort study

Vulvarlichen sclerosus is a progressive dermatitis with significant itching, pain, and sexual dysfunction. To investigate topical steroid use and clinical improvement across multiple specialties. Retrospective cohort study at dermatology, gynecology, and vulvovaginal specialty clinics from 2012 to 2017. Descriptive statistics and panel logistic regression were performed. A total of 333 women attended 1525 visits (median 6/patient; range, 1-24 visits). Patients used steroids exactly as prescribed at 66% of visits, less than prescribed at 26%, and not at all at 8%. Versus no use, exact use improved symptoms (odds ratio [OR], 4.6; 95% confidence interval [CI], 2.2-9.6) and physical examination findings (OR, 6.9; 95% CI, 2.7-17.6) more than infrequent steroid use (symptoms: OR, 2.5; 95% CI, 1.2-5.4; physical examination findings: OR, 4.2; 95% CI, 1.6-11.0). Sexual activity status was noted in 93% of vulvovaginal, 29% of gynecology, and 0% of dermatology visits. At intake, 42% of women were sexually inactive because of pain; of these, 37% became sexually active after steroid treatment. Steroid adherence was not associated with change in sexual activity. Women with vulvar lichen sclerosus improve more when topical steroids are used exactly as prescribed, although some improvement occurs with imperfect use. Sexual activity documentation is inconsistent, limiting quality of life follow-up.

Career preferences among final year medical students and house officers: A multicentre survey in Southwest Nigeria

Objective: Career preferences of medical trainees have the potential to shape the future of the healthcareworkforce of any nation. This study aimed to determine the factors that influence career choices ofmedical students and house officers (interns) in two institutions located in Southwest Nigeria.Methods: A cross-sectional study was carried out amongst final year medical students and interns in twomedical universities and their corresponding teaching hospitals in Southwest Nigeria. A questionnairewas used to obtain socio-demographic data, career choices, reasons behind career choices and thepresence and influence of mentorship on career choices. Responses were analyzed using the StatisticalPackage for Social Sciences Version 21, and descriptive statistics generated.Results: Obstetrics &amp; Gynecology and Surgical specialties were the most preferred career choices by themedical students, while Surgical and Medical specialties were most preferred by the interns. Personalinterest and other personal reasons were the top motivating factors for the career choices amongst themedical students of both institutions, while personal interest and future job opportunities were the topreasons for the career choices amongst the interns of both institutions. Mentorship was lacking for most ofthe medical students and house officers, except in one of the teaching hospitals, where over half of theinterns had career mentors.Conclusion: Attention should be paid to the reasons behind career choices, in order to channel effortstowards making clinical specialties become attractive to young medical trainees, as the future of the healthworkforce in the nation depends on it.Keywords: Career Choices, Medical Students, House officers, Medical Education, Nigeria

Determinants of Infertility among Married Women Attending Dessie Referral Hospital and Dr. Misganaw Gynecology and Obstetrics Clinic, Dessie, Ethiopia.

Background Infertility is the inability to become pregnant after one year of sexual intercourse without the use of contraception. Epidemiological data suggest that 10 to 15% of couples around the world are suffering from infertility. The exact meaning of marriage is mainly fulfilled if the couple conceives and bears children. Failure of this often leads to unhappy married lives, divorces, and high levels of psychiatric morbidity. There is scarcity of data about determinants of infertility in Ethiopia. Therefore, the aim of this study is to identify the determinants of infertility among married women attending Dessie Referral Hospital and Dr. Misganaw gynecology and obstetrics specialty clinic, Dessie, Ethiopia, 2019. Methods An institution-based case-control study was conducted on 281 participants. The participants were selected by a systematic random sampling technique. Data were collected using a structured interviewer-administered questionnaire. Data were entered into EpiData version 3.1 and exported to SPSS version 23 for analyses. Variables with p < 0.25 in bivariable logistic regression were entered into multivariable logistic regression. Odds ratio with its 95% confidence interval was estimated to measure the direction and strength of the association. The level of statistical significance was set at p < 0.05. Results The determinants of women's infertility were age at the first pregnancy (AOR = 2.89; 95% CI: 1.105, 7.564), age at menarche (AOR = 3.2; 95% CI: 1.278, 7.975), menstruation flow in days (AOR = 4.17; 95% CI: 0.062, 0.929), multiple sexual partners (AOR = 5.33; 95% CI: 2.124, 13.397), and history of STI (AOR = 2.79; 95% CI: 1.088, 7.159). Conclusion Age at the first pregnancy, age at menarche, multiple sexual partners, number of days of menstruation flow, and history of STI were determinants of women's infertility. Infertility may bring about unhappy married lives, divorces, and high levels of psychiatric morbidity. Therefore, couples need to have heath education about risk factors for infertility.

Knowledge and Attitude Regarding Telemedicine Among Doctors in Karachi

BackgroundTelemedicine is an affordable use of information and communication technology (ICT) to enable long-distance patient care and health care services. While the developed world continues to take advantage of this technology, its concept remains new to Pakistan. This study aims to assess the knowledge and perceptions regarding telemedicine among health care professionals in Karachi, Pakistan.Methods This cross-sectional study was carried out among doctors employed in the public health sector in Karachi from June 2018 to August 2018. Data were collected using a self-designed well-structured questionnaire using a five-point Likert scale, built after an extensive literature review. Statistical analysis was carried out using SPSS version 22. Categorical data were reported as frequencies and percentages.ResultsA total of 224 doctors, working in the Department of Internal Medicine (27.6%), Pediatrics (9.8%), Cardiology (6.6%), Gynecology (5.35%), Neurology (5.8%), and other specialties (44.6%), participated in the study. A total of 80.7 % of the doctors were aware of the definition of telemedicine. A total of 28.1% of them believed telemedicine to be effective in providing faster medical care while 23.2% thought of it as a means of reducing the white coat syndrome. A total of 42.9% believed that telemedicine disrupts the doctor-patient relationship and causes a breach of patient privacy. A total of 34.8% of the doctors favored the idea of introducing national standards for practicing telemedicine while 33.5% of doctors also agreed that providing a legal explanation of telemedicine to patients was of paramount importance. Poverty and lack of education (90.6%) was thought to be the biggest barrier to the practice of telemedicine in the developing world.ConclusionsThe knowledge regarding telemedicine among doctors in Karachi was found to be average. However, the perceptions about and attitude towards the introduction and implementation of this new technology were welcomed by the majority of participants with an emphasis on increasing awareness. Conferences and workshops are needed to increase knowledge about telemedicine in Pakistan.

Saudi medical students' views on obstetrics and gynecology as a future career specialty.

Background:The specialty of obstetrics and gynecology is showing a widening gap between the vacant positions and the number of applicants as reported by the Saudi Commission for Health Specialties (SCFHS). This study was conducted to explore the medical students’ views on obstetrics and gynecology as a future career and identify factors influencing these views.Methods:An observational survey was conducted on 148 medical students in years 5 and 6 at Jazan University between June 2019 and July 2019. Participants completed a self-report online questionnaire covering their sociodemographic details, interest in obstetrics and gynecology, and views on the specialty.Results:Overall, obstetrics and gynecology was selected as the first specialty choice by 8.8% and second choice by 17.6%. Intention to take a career in obstetrics and gynecology was associated with female sex (P = 0.01). While over half of the participants emphasized the merits of obstetrics and gynecology as exciting, interesting, and challenging, over 40% viewed the specialty as stressful, over one-third described it as demanding, and over one-quarter appreciated its riskiness.Conclusion:This study showed that 8.8% of the respondents chose obstetrics and gynecology as their first career choice. Sex was the only factor influencing the views of medical students on the specialty, with more females favoring the specialty than males. To improve its appeal, students should be supplied with more information about the specialty and its training opportunities, as well as exposure to areas of special interest.

Relevance of Calcium and Vitamin D in Supporting Bone Health: An Expert Panel Recommendation in Indonesia

Osteoporosis is a bone health related condition that weakens the bones, making individuals fragile and prone to breaks. Nutrients such as calcium and vitamin D are essential for bone health. Calcium helps in building and maintaining bone mass while vitamin D aids in the absorption and utilization of calcium. According to WHO, 28.8% men and 32.3% women in Indonesia have osteoporosis, and this is inspite of the international recommendations for the daily intake of calcium and vitamin D intake. This could be attributed to low community awareness on how to prevent and care for osteoporosis. Several high-risk population groups have been identified such as those with osteopenia, undergoing rehabilitation and pregnancy/lactation periods. Therefore, in this review, an expert panel comprising of specialties of dietetics, rehabilitation medicine, orthopaedic, obstetrics & gynaecology, pharmacology, and geriatrics, convened to provide an evidence-based guidance on the prevention and care for osteoporosis. The recommendations are as follows: (i) It is important to know that calcium and vitamin D work synergistically to maintain bone health. (ii) The intake of calcium and vitamin D must start early. (iii) We should be aware that our diet and lifestyle today does not allow us to meet the recommended daily intake of calcium and vitamin D required for optimal bone health. (iv) Supplementation can compensate for the deficits in both calcium and vitamin D intake, thereby strengthening bone health. This study could guide the primary health care team, who plays a critical role in community care, to encourage early bone health awareness and care in Indonesia.

Caution is needed when assessing results of home birth–Authors’ reply

Meta-analyses are employed when clinical equipoise exists without definitive studies to provide certainty. Such analyses include all events from each study; data are treated as a whole data set. No disadvantage results from including small studies; indeed exclusion may bias outcomes. Where larger studies exist, the inclusion of smaller studies may not contribute significantly to point estimates, but are likely to decrease variance [1]. Only 17% of 3905 meta-analyses in Cochrane Reviews in the specialty of gynecology had at least two adequately powered studies [1].

2675 Ovarian Vein Thrombosis as Cause of Acute Pelvic Pain After Total Laparoscopic Hysterectomy

Study Objective Reported cases of ovarian vein thrombosis associated with laparoscopic hysterectomy for benign reasons are rare. The majority of cases described have been postpartum; other risk factors include malignancy, sepsis, and recent pelvic/abdominal surgery. We present a case of a 29 y/o G4P2 diagnosed with right ovarian vein thrombosis two weeks status post uncomplicated total laparoscopic hysterectomy (TLH), bilateral salpingectomy, and cystoscopy for chronic pelvic pain and abnormal uterine bleeding related to endometriosis. Design Case report/literature review. Setting Academic affiliated gynecology specialty clinic. Patients or Participants 29 y/o G4P2022 half pack per day smoker with chronic pelvic pain previously treated with levonorgestrel containing IUD, depo medroxyprogesterone, and continuous OCPs without symptom resolution. She previously underwent diagnostic laparoscopies with fulguration and excision of endometriosis, as well as a robotic assisted presacral neurectomy. She underwent an uncomplicated TLH/bilateral salpingectomy/cystoscopy. She presented two weeks post-op with severe right sided pelvic pain and fever. A right ovarian vein thrombosis was discovered on CT scan. Interventions Patient was admitted for antibiotics and therapeutic anticoagulation with enoxaparin, then discharged home at forty-eight hours. Two weeks later she was readmitted for continued vaginal bleeding. Anticoagulation was discontinued and patient was discharged home. Due to continued severe RLQ pain, interventional radiology was contacted for possible thrombectomy but were unable to do so. The patient then underwent a laparoscopic right oophorectomy and right ovarian vein thrombectomy seven weeks after her initial TLH. Measurements and Main Results Right ovarian vein thrombus visualized and dissected out on laparoscopy with resolution of acute localized pelvic pain. Conclusion While multiple etiologies for pelvic pain and fever after TLH exist, it is important not to overlook gonadal vein thrombosis. We recommend pre-/post-operative anticoagulation in patients with high thrombotic risk undergoing any major procedure. This case illustrates a rare diagnosis of ovarian vein thrombosis in a non-pregnant patient after minimally invasive surgery.

The image of the profession in the mass consciousness

The issues of nursing staff shortage and quality of their work are relevant for the health-care management today. In this regard, the established image of the profession is important, as it can lead to the unpopularity of nursing profession and affect the effectiveness of the treatment process through the self-perception of nurses. So studying the image of nursing in social media is of particular relevance today. The role of social media in dissemination of opinions is increasing every day. Unloading (31613 messages) from social media was made using keywords for 2017. А random subsample (403 messages) was formed from them, coded manually by coders (authors). According to analysis of the obtained data, nursing is perceived as a “female profession,” a nurse is a Caucasoid woman in a white uniform. She works at public hospitals, her work is discussed primarily in the context of the specialties of obstetrics, gynecology and pediatrics. Her status is rather low, nursing is not perceived as an intellectual and promising profession. Messages about nurses are mostly neutral, emotionally colored messages are devoted mainly to the personal qualities of nurses. Autoimage (self-perception) of nurses is poor. In conclusion, there is given a number of recommendations for improving the image of nurses. Implementation of organizational changes may contribute to enhancing the prestige of the profession: introducing special insignia for nurses, designating career prospects. It is also possible for these purposes to conduct an information policy aimed at demonstrating the attractive aspects of nursing and emphasizing the gender neutrality of the profession.

Caracterização das infecções de sítio cirúrgico em um hospital público de ensino na cidade de Cascavel, Paraná

Introduction: Surgical Site Infection (SSI) is one of the major Health Care-Related Infections (HAI) and a persistent problem in the hospital setting. Objective: To characterize SSI in a public teaching hospital located in the city of Cascavel-PR. Method: cross-sectional retrospective study of documentary source and quantitative approach. The SSIs notified from May 2017 to May 2018 were analyzed. The variables of interest were tabulated and submitted to descriptive statistical analysis. Results: there were 5,169 surgical procedures in the period, with 196 (100%) cases of SSI. Of these, there was a predominance in young adults aged between 21 and 40 years (39.3%). The specialty of Gynecology / Obstetrics (30.1%) and General Surgery (29.1%) presented the highest rates of SSI, most frequently in Potentially Contaminated surgeries (53.1%); with superficial incisional SSI (59.7%); and with clinical confirmation criteria (79.1%). Regarding the microorganisms isolated in the cultures, Pseudomonas aeruginosa (16.7%) and Enterococcus spp (16.7%) stood out. Conclusions: It is noted that there is a need to review SSI prevention measures, especially due to the proportion of clean surgeries that developed the adverse event. However, considering the values reported in the literature, the overall rate of SSI was discrete.