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Successful Completion (successful + completion)
Selected AbstractsIntroduction of early medical abortion in New Zealand: An audit of the first 67 casesAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 4 2005Carol SHAND Abstract Background:, In New Zealand, mifepristone became available in 2001, but because of uncertainty about the law, the first 67 cases were carried out under a very strict protocol. Once the prostaglandin had been administered it was necessary that the woman remain in the unit until the products of conception (POC) had been passed and, if this had not occurred within 8 h, she underwent suction curettage. Aims:, To demonstrate that an early medical termination of pregnancy (EMTOP) service could be offered as a safe option for women, despite the constraints of the law. Methods:, An audit of patient notes was carried out on the first 67 patients undergoing an EMTOP at the Level J Unit (LJU), Wellington Hospital. Data collected included age, ethnicity, parity, previous abortions, gestational age, length of time between the administration of mifepristone and misoprostol, length of time after administration of misoprostol to the completion of abortion, whether a fetal sac was seen, analgesia required, extent of heavy bleeding and any adverse effects. Patient characteristics were compared with those of the 3052 women who underwent surgical termination during the same time period. Data were analysed using EpiInfo 2000 (Centers for Disease Control and Prevention, Atlanta, GA) and Chi square tests for significance. Results:, Successful completion of EMTOP occurred in 63 of 67 cases (94%). Only four cases (6%) required completion by suction curettage and this was performed for legal and financial reasons, rather than for medical reasons. Clinical events requiring management, mainly bleeding problems, occurred in 11 patients (16%). Conclusions:, EMTOP with mifepristone and misoprostol was successfully introduced and the experience provides useful data for others contemplating a similar service. [source] Trust-based robust scheduling and runtime adaptation of scientific workflowCONCURRENCY AND COMPUTATION: PRACTICE & EXPERIENCE, Issue 16 2009Mingzhong Wang Abstract Robustness and reliability with respect to the successful completion of a schedule are crucial requirements for scheduling in scientific workflow management systems because service providers are becoming autonomous. We introduce a model to incorporate trust, which indicates the probability that a service agent will comply with its commitments to improve the predictability and stability of the schedule. To deal with exceptions during the execution of a schedule, we adapt and evolve the schedule at runtime by interleaving the processes of evaluating, scheduling, executing and monitoring in the life cycle of the workflow management. Experiments show that schedules maximizing participants' trust are more likely to survive and succeed in open and dynamic environments. The results also prove that the proposed approach of workflow evaluation can find the most robust execution flow efficiently, thus avoiding the need of scheduling every possible execution path in the workflow definition. Copyright © 2009 John Wiley & Sons, Ltd. [source] Thyroid hormone responses to endurance exerciseEQUINE VETERINARY JOURNAL, Issue S36 2006E. A. GRAVES Summary Reasons for performing study: Limited information exists about changes in circulating thyroid hormone concentrations during prolonged endurance exercise in horses. Objective: To examine the effects of prolonged exercise on serum iodothyronine concentrations in horses performing endurance exercise of varying distances. Methods: Serum concentrations of iodothyronines were measured in horses before and after completion of 40, 56, 80 and 160 km endurance rides (Study 1); daily during a 5 day, 424 km endurance ride (Study 2); and before and for 72 h after completion of a treadmill exercise test simulating a 60 km endurance ride (Study 3). Results: In Study 1, 40 and 56 km of endurance exercise had little effect on serum iodothyronine concentrations with the exception of a 10% decrease (P<0.05) in free thyroxine (FT4) concentration after the 56 km ride. In contrast, total thyroxine (T4), total triiodothyronine (T3), FT4 and free triiodothyronine (FT3) concentrations all decreased (P<0.05) after successful completion of 80 and 160 km rides, with decreases ranging from 13,31% and 47,54% for distances of 80 and 160 km, respectively. Further, pre-ride T4 concentration was lower (P<0.05) and FT3 concentration was higher (P<0.05) in horses competing 160 km as compared to horses competing over shorter distances. In Study 2, serum concentrations of T4, T3 and reverse triiodothyronine (rT3) progressively decreased (P<0.05) over the course of the multi-day ride. In Study 3, the greatest decrease (P<0.05) in all iodothyronines was observed at 12 h of recovery, ranging from 25% for FT4 to 53% for FT3, but all thyroid hormone concentrations had returned to the pre-exercise values by 24 h of recovery. Conclusion: Endurance exercise results in transient decreases in serum iodothyronine concentrations. Potential relevance: These data are important to consider when thyroid gland function is assessed by measurement of serum iodothyronine concentrations in endurance horses. [source] Assessing competency in Dentoalveolar surgery: a 3-year study of cumulative experience in the undergraduate curriculumEUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 4 2007J. A. Durham Aim:, To assess and observe the development of competence in oral surgical skills during a 3-year undergraduate programme. Method:, Over a 3-year period 75 students were followed through from the beginning of their clinical course to their Bachelor of Dental Surgery graduation and their surgical experience monitored by the use of logbooks. Their development of competence was assessed objectively through structured assessments and subjectively by a single tutor responsible for each year. Assessments were made of their ability in exodontia, pre-surgical assessment and the surgical extraction of teeth/roots. Results:, Seventy-three students completed the course (97%). Successful completion rates for the objective testing were 100% for both exodontia and pre-surgical assessment. The surgical assessment, (surgical extraction of a tooth or root) had a successful completion rate of only 23% and the caseload for students was low with a mean of four teeth removed surgically upon graduation. Relationships were examined between total numbers of teeth extracted, total number of minor oral surgical procedures completed and the successful completion of the surgical competence assessment, but no significant relationships were found. Conclusions:, This study demonstrates that it is possible to achieve objectively measurable levels of competence in undergraduates undertaking oral surgery procedures. It is however, a labour and time intensive process and appropriate clinical and teaching resources are required. National co-operation towards agreed standardised competencies should be encouraged to allow data to be pooled and more powerful analyses to occur. [source] A review of current large-scale mouse knockout effortsGENESIS: THE JOURNAL OF GENETICS AND DEVELOPMENT, Issue 2 2010Chunmei Guan Abstract After the successful completion of the human genome project (HGP), biological research in the postgenome era urgently needs an efficient approach for functional analysis of genes. Utilization of knockout mouse models has been powerful for elucidating the function of genes as well as finding new therapeutic interventions for human diseases. Gene trapping and gene targeting are two independent techniques for making knockout mice from embryonic stem (ES) cells. Gene trapping is high-throughput, random, and sequence-tagged while gene targeting enables the knockout of specific genes. It has been about 20 years since the first gene targeting and gene trapping mice were generated. In recent years, new tools have emerged for both gene targeting and gene trapping, and organizations have been formed to knock out genes in the mouse genome using either of the two methods. The knockout mouse project (KOMP) and the international gene trap consortium (IGTC) were initiated to create convenient resources for scientific research worldwide and knock out all the mouse genes. Organizers of KOMP regard it as important as the HGP. Gene targeting methods have changed from conventional gene targeting to high-throughput conditional gene targeting. The combined advantages of trapping and targeting elements are improving the gene trapping spectrum and gene targeting efficiency. As a newly-developed insertional mutation system, transposons have some advantages over retrovirus in trapping genes. Emergence of the international knockout mouse consortium (IKMP) is the beginning of a global collaboration to systematically knock out all the genes in the mouse genome for functional genomic research. genesis 48:73,85, 2010. © 2010 Wiley-Liss, Inc. [source] Infancy is not a quiescent period of testicular developmentINTERNATIONAL JOURNAL OF ANDROLOGY, Issue 1 2001Héctor E. Chemes Postnatal evolution of the testis in most laboratory animals is characterized by the close continuity between neonatal activation and pubertal development. In higher primates, infancy, a long period of variable duration, separates birth from the beginning of puberty. This period has been classically considered as a quiescent phase of testicular development, but is actually characterized by intense, yet inapparent activity. Testicular volume increases vigorously shortly after birth and in early infancy due to the growth in length of seminiferous cords. This longitudinal growth results from active proliferation of infantile Sertoli cells which otherwise display a unique array of functional capabilities (oestrogen and anti-müllerian hormone secretion, increase of FSH receptors and maximal response to FSH). Leydig cells also show recrudescence after birth, possibly determined by an active gonadotrophic-testicular axis which results in increased testosterone secretion of uncertain functional role. This postnatal activation slowly subsides during late infancy when periodic phases of activation of the hypothalamo-pituitary-testicular axis are paralleled by incomplete spermatogenic spurts. The beginning of puberty is marked by the simultaneous reawakening of Leydig cell function and succeeding phases of germ cell differentiation/degeneration which ultimately lead to final spermatogenic maturation. The marked testicular growth in this stage is due to progressive increase at seminiferous tubule diameter. Sertoli cells, which have reached mitotic arrest, develop and differentiate, establishing the seminiferous tubule barrier, fluid secretion and lumen formation, and acquiring cyclic morphological and metabolic variations characteristic of the mature stage. All of these modifications indicate that, far from being quiescent, the testis in primates experiences numerous changes during infancy, and that the potential for pubertal development and normal adult fertility depends on the successful completion of these changes. [source] Involving consumers in peer-facilitated home-based food hygiene trainingINTERNATIONAL JOURNAL OF CONSUMER STUDIES, Issue 3 2003L. Stevenson A community-based food hygiene initiative was piloted in the Toxteth,Granby area of Liverpool between December 2001 and March 2002. The project aimed to increase awareness and behaviour, related to poor food purchase, storage and handling practices, by actively involving members of the local community in home-based peer-facilitated training. Facilitators (23) were actively recruited from within the Toxteth,Granby community, and undertook a 4-day induction and training programme, which included successful completion of the CIEH Basic Food Hygiene course. Facilitators subsequently recruited and visited nearly 1000 households (992) within the Toxteth,Granby electoral ward, undertook an observation sheet, a detailed questionnaire, and spent approximately 1 hour delivering food hygiene training. Facilitators returned to all households within an 8-week period, and completed further observation sheets and questionnaires, for use in a comparative analysis. Facilitators and householders received incentives for their involvement in the project. Analysis of the data collected showed that general awareness of a range of food hygiene issues was high (such as hand washing before handling food), and most participants (73.8%) were able to recognise the main symptoms of food borne disease. As a result of the home-based hygiene training there were significant changes in knowledge, attitudes, and food handling practices, including the use of refrigerators, purchase of chilled and frozen foods, washing or peeling of fruits and vegetables, and the cooking of meat-based products. The project demonstrates that it is possible for communities to improve their food hygiene awareness and food handling behaviours through home-based peer-facilitated training programmes, with minimal input from professionals. [source] The search for low energy conformational families of small peptides: Searching for active conformations of small peptides in the absence of a known receptor,INTERNATIONAL JOURNAL OF QUANTUM CHEMISTRY, Issue 15 2007Katrina W. Lexa Abstract Breast cancer is the most common cancer among women. Tamoxifen is the preferred drug for estrogen receptor-positive breast cancer treatment, yet many of these cancers are intrinsically resistant to tamoxifen or acquire resistance during treatment. Therefore, scientists are searching for breast cancer drugs that have different molecular targets. Previous work revealed that 8-mer and cyclic 9-mer peptides inhibit breast cancer in mouse and rat model systems, interacting with an unknown receptor, while peptides smaller than eight amino acids did not inhibit breast cancer. We have shown that the use of replica exchange molecular dynamics predicts structure and dynamics of active peptides, leading to the discovery of smaller peptides with full biological activity. These simulations identified smaller peptide analogs with a conserved turn, a ,-turn formed in the larger peptides. These analogs inhibit estrogen-dependent cell growth in a mouse uterine growth assay, a test showing reliable correlation with human breast cancer inhibition. We outline the computational methods that were tried and used with the experimental information that led to the successful completion of this research. © 2007 Wiley Periodicals, Inc. Int J Quantum Chem, 2007 [source] The Nurse Educator's clinical roleJOURNAL OF ADVANCED NURSING, Issue 1 2005Odette Griscti MHSc RN Aim., This paper reports a two-phase descriptive study exploring the clinical role of the nurse educator in Malta. Background., Previous studies indicate a number of similarities and differences in the clinical role of nurse educators by country of practice. These include importance assigned to the role, factors inhibiting/facilitating the role, means to eliminate barriers to the role, and perceptions of the ideal role. Design and methods., Data were collected using both quantitative and qualitative strategies. The quantitative phase involved asking all educators to fill in a time log of their academic and clinical activities for a 2-week period. In the qualitative phase, the first author interviewed five educators, five nurses and five students about their perceptions of factors which impact the nurse educator's clinical role, as well as what the ideal clinical role of the nurse educator should be. Findings., Maltese nurse educators allot minimal time to their clinical role. Main reasons cited included workload, perceived lack of control over the clinical area, and diminished clinical competence. Nurse educators who frequented the clinical settings (who were either university or joint university and health service employees) where the study took place perceived that employment inequities among the various categories of nurse educators played an important role in the amount of time dedicated by each group to their clinical roles, and the importance individuals in these groups assigned to that role. The majority of interviewees saw the current role of nurse educators in Malta as preparing students for successful completion of the didactic sections of their programme, rather than preparing them with all the knowledge and clinical skills necessary to be competent practitioners. Participants considered that, when in clinical areas, nurse educators did focus on their students, as they should. However, they also thought that they often did not take the opportunity to forge links with professional staff. Conclusion., The clinical role of the Maltese nurse educator needs to be more multifaceted in approach. [source] Mentoring Global Dual-Career Couples: A Social Learning PerspectiveJOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 1 2010Michael Harvey This paper explores the dimensions and means to implement a global dual-career expatriate couple mentoring program. The rationale is that learning from an experienced mentor mitigates the complexity of global assignments, leading to more successful completion of overseas assignments. We explored the impact of such mentoring programs on "nontraditional" global managers, along with their trailing spouses. Social learning theory was used as the foundation for the development of such a mentoring program. To add to the contextual understanding of global assignments imposed on global dual-career couples, we explored the effectiveness of mentoring by investigating temporal (before, during, after expatriation) and gender-related dimensions. Further, we analyzed the level of mentor involvement (personal, organizational, and professional) regarding psychosocial and career development. [source] Post-operative epidural analgesia: introducing evidence-based guidelines through an education and assessment processJOURNAL OF CLINICAL NURSING, Issue 2 2001DipDN, Janet Richardson BSc ,,The aim of this project was to re-introduce post-operative epidural analgesia on to two orthopaedic wards using an evidence-based practice approach. This was achieved through the provision of appropriate staff education and information, assessment of staff competence, and provision of relevant and appropriate staff support. ,,An education programme was developed which included study days, ward-based teaching and the assessment of competence. ,,The introduction of guidelines followed an audit cycle in order to measure the success of the education programme. ,,All nursing staff involved in the project were asked to complete a questionnaire which assessed their knowledge of caring for patients with postoperative epidural analgesia. This was completed before and following the education programme. ,,The outcome measures were: (i) successful completion of competence-based assessment; (ii) levels of knowledge as assessed by the knowledge questionnaire; and (iii) participant perceptions of the project. ,,The results of the questionnaire demonstrated significant improvements in knowledge following the education programme. Participants commented on the importance of the ward-based teaching. They also felt that pain was controlled more effectively using this method of analgesia. [source] Reasons for terminating psychotherapy: a general population studyJOURNAL OF CLINICAL PSYCHOLOGY, Issue 9 2010Robin Westmacott Abstract Clients' (N=693) reasons for ending psychotherapy and their associations with demographics, mental disorder caseness, and type of mental health care service provider were examined. The most frequently reported reason for termination was feeling better, however, a substantial minority of individuals reported terminating because of treatment dissatisfaction or wanting to solve problems independently. Lower income was associated with lower odds of termination because of feeling better and higher odds of termination because of a perception that therapy was not helping. Meeting criteria for an anxiety disorder, a mood disorder, or substance dependence decreased the odds of termination because of feeling better. These findings provide important information on the challenges to the successful completion of psychotherapy. © 2010 Wiley Periodicals, Inc. J Clin Psychol: 66:1,13, 2010. [source] Caring for people in the ,virtual ward': the practical ramifications for acute nursing workJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 4 2003M. DEACON, ba (hons) m.phil rmn srn enb(810) This paper discusses an aspect of data analysis arising from an ethnographic study of acute mental health nursing conducted in an inner city psychiatric unit. The data were collected in the form of field notes. These were made during and following episodes of participant observation on one acute ward and on a psychiatric intensive care unit over a period of 20 months. Acute wards have been subject to continuing criticism as both sites of care and treatment for mentally ill people and of nursing work. However, the practical operations of this social world remain largely unexamined. It is argued that without this understanding, mundane work methods will always be regarded as an impediment to work that is regarded as ,therapeutic' and therefore, of importance. The focus will be on phenomena named the ,virtual ward'. The research has demonstrated that the boundaries of nurses' responsibility reach far beyond the ward's spatial environment, both physically and communicatively. The complexity of the work that takes place within the virtual ward and the skills required for its successful completion are taken for granted, but are also a practical source of frustration. Anonymized examples from the practice site studied are used to illuminate the discussion. Working within the virtual ward is part of the messy reality of nurses' work. It is argued that understanding and respecting this reality is necessary if we are to be seriously and consistently ambitious about practice development. [source] The surprising benefits of a parallel universeMANAGERIAL AND DECISION ECONOMICS, Issue 2 2009Manfredi M.A. La Manna Suppose that the successful completion of a project requires performing n tasks, each of which has a probability of success p. The paper establishes under what conditions it may be profitable to engage in parallel multi-tasking, i.e. tackling each task by following two independent routes. It is found that for ,n>1 parallel multi-tasking is profitable for a wide range of parameters when costs are linear and is always profitable for convex costs. Copyright © 2008 John Wiley & Sons, Ltd. [source] Solving a sticky problem: new genetic approaches to host cell adhesion by the Lyme disease spirocheteMOLECULAR MICROBIOLOGY, Issue 5 2005Jenifer Coburn Summary The Lyme disease spirochetes, comprised of at least three closely related species, Borrelia burgdorferi, Borrelia garinii and Borrelia afzelii, are fascinating and enigmatic bacterial pathogens. They are maintained by tick-mediated transmission between mammalian hosts, usually small rodents. The ability of these bacteria, which have relatively small genomes, to survive and disseminate in both an immunocompetent mammal and in an arthropod vector suggests that they have evolved elegant and indispensable strategies for interacting with their hosts. Recognition of specific mammalian and tick tissues is likely to be essential for successful completion of the enzootic life cycle but, given the historical difficulties in genetic manipulation of these organisms, characterization of factors promoting cell adhesion has until recently largely been confined to either the manipulation of host cells or the analysis of potential bacterial ligands in the form of recombinant proteins. These studies have led to the identification of several mammalian receptors for Lyme disease spirochetes, including glycosaminoglycans, decorin, fibronectin and integrins, as well as a tick receptor for the bacterium, and also candidate cognate bacterial ligands. Recent advances in our ability to genetically manipulate Lyme disease spirochetes, particularly B. burgdorferi, are now providing us with firm evidence that these ligands indeed do promote bacterial adherence to host cells, and with new insights into the roles of these multifacted Borrelia,host cell interactions during mammalian and arthropod infection. [source] Dynamic policies for uncertain time-critical tasking problemsNAVAL RESEARCH LOGISTICS: AN INTERNATIONAL JOURNAL, Issue 2 2008Kevin D. Glazebrook Abstract A recent paper by Gaver et al. 6 argued the importance of studying service control problems in which the usual assumptions (i) that tasks will wait indefinitely for service and (ii) that successful service completions can be observed instantaneously are relaxed. Military and other applications were cited. They proposed a model in which arriving tasks are available for service for a period whose duration is unknown to the system's controller. The allocation of a large amount of processing to a task may make more likely its own successful completion but may also result in the loss of many unserved tasks from the system. Gaver et al. 6 called for the design of dynamic policies for the allocation of service which maximizes the rate of successful task completions achieved, or which come close to doing so. This is the theme of the paper. We utilize dynamic programming policy improvement approaches to design heuristic dynamic policies for service allocation which may be easily computed. In all cases studied, these policies achieve throughputs close to optimal. © 2008 Wiley Periodicals, Inc. Naval Research Logistics, 2008 [source] The Kalgoorlie Otitis Media Research Project: rationale, methods, population characteristics and ethical considerationsPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 1 2008Deborah Lehmann Summary Otitis media (OM) is one of the most common paediatric illnesses for which medical advice is sought in developed countries. Australian Aboriginal children suffer high rates of OM from early infancy. The resultant hearing loss can affect education and quality of life. As numerous factors contribute to the burden of OM, interventions aimed at reducing the impact of single risk factors are likely to fail. To identify key risk factors and understand how they interact in complex causal pathways, we followed 100 Aboriginal and 180 non-Aboriginal children from birth to age 2 years in a semi-arid zone of Western Australia. We collected demographic, obstetric, socio-economic and environmental data, breast milk once, and nasopharyngeal samples and saliva on seven occasions. Ear health was assessed by clinical examination, tympanometry, transient evoked otoacoustic emissions and audiometry. We considered the conduct of our study in relation to national ethical guidelines for research in Aboriginal and Torres Strait Islander health. After 1 year of community consultation, the study was endorsed by local committees and ethical approval granted. Fieldwork was tailored to minimise disruption to people's lives and we provided regular feedback to the community. We saw 81% of non-Aboriginal and 65% of Aboriginal children at age 12 months. OM was diagnosed on 55% and 26% of routine clinical examinations in Aboriginal and non-Aboriginal children respectively. Aboriginal mothers were younger and less educated, fewer were employed and they lived in more crowded conditions than non-Aboriginal mothers. Sixty-four per cent of Aboriginal and 40% of non-Aboriginal babies were exposed to environmental tobacco smoke. Early consultation, provision of a service while undertaking research, inclusion of Aboriginal people as active members of a research team and appropriate acknowledgement will assist in ensuring successful completion of the research. [source] Factors Associated with Failure to List HIV-Positive Kidney Transplant CandidatesAMERICAN JOURNAL OF TRANSPLANTATION, Issue 6 2009D. Sawinski With improved survival in the antiretroviral era, data from ongoing studies suggest that HIV patients can be safely transplanted. The disproportionate burden of HIV-related end-stage renal disease in minority populations may impose additional obstacles to successful completion of the transplant evaluation. We retrospectively reviewed 309 potentially eligible HIV patients evaluated for kidney transplant at our institution since 2000. Only 20% of HIV patients have been listed, compared to 73% of HIV-negative patients evaluated over the same period (p < 0.00001). Failure to provide documentation of CD4 and viral load (36% of candidates) was the most common reason for failure to progress beyond initial evaluation. Other factors independently associated with failure to complete the evaluation included CD4 < 200 at initial evaluation (OR 15.17; 95% CI 1.94,118.83), black race (OR 2.33; 95% CI 1.07,5.06), and history of drug use (OR 2.56; 95% CI 1.22,5.37). More efficient medical record sharing and an awareness of factors associated with failure to list HIV-positive transplant candidates may enable transplant centers to more effectively advocate for these patients. [source] A randomised controlled trial of two instruments for vacuum-assisted delivery (Vacca Re-Usable OmniCup and the Bird anterior and posterior cups) to compare failure rates, safety and use effectivenessAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 3 2010Glen D.L. MOLA Background:, Most previous trials of vacuum-assisted delivery have been in settings with high rates of instrumental vaginal delivery (8,12%) and high rates of failure to deliver with the intended instrument (20,30%). Over the past 20 years, vacuum-assisted delivery rates at the Port Moresby General Hospital have been 3,4% with failure rates of <3%. Objective:, The objective is to compare the failure rates of two vacuum extractor instruments, the Vacca Re-Usable Omnicup and the Bird Vacuum delivery system (anterior and posterior cups). Setting:, Port Moresby General national referral and teaching Hospital (PMGH), Papua New Guinea. Population:, Two hundred consecutive women requiring assisted delivery, June,December, 2007. Methods:, When a woman required an assisted delivery, she was randomised into either the Vacca Re-Usable Omnicup (Clinical Innovations Inc.) or Bird anterior or posterior metal cup (depending upon the position of the vertex). One hundred women were randomised to each vacuum device. Statistical analysis was on ,an intention-to-treat' basis. Main outcome measures:, The main outcome measure was the successful completion of the delivery with the allocated instrument. Secondary outcomes were maternal trauma (episiotomy and trauma to the maternal genital tract), significant scalp trauma (sub-galeal haemorrhage or serious abrasion) and fetal and neonatal outcomes (Apgar score less than seven at 5 minutes, days spent in the Special Care Nursery and neonatal death). Results:, Failure rates for both Omnicup (2/100) and Bird metal cups (6/100) were not statistically different (RR 1.05, 95% CI 0.99,1.12; P = 0.17). Rates of maternal trauma and fetal scalp trauma were similar in both groups. Conclusion:, Both the Vacca re-useable Omnicup and the Bird metal cups are very effective instruments to achieve successful assisted delivery and equally so. Failures and problems were associated with not applying the vacuum cup to the flexion point on the fetal scalp and the mechanical faults with vacuum equipment devices. [source] Laparoscopic ureterolysis with omental wrap for idiopathic retroperitoneal fibrosisBJU INTERNATIONAL, Issue 5 2010Robert J. Stein Study Type , Therapy (case series) Level of Evidence 4 OBJECTIVE To describe various approaches for ureterolysis with an omental wrap using minimally invasive techniques, as surgery for idiopathic retroperitoneal fibrosis includes tissue biopsy, ureterolysis, and intraperitonealization or omental wrap. PATIENTS AND METHODS Since 2006 we have performed ureterolysis in four patients diagnosed with retroperitoneal fibrosis in two institutions. The ureterolysis in two cases was bilateral, using a standard laparoscopic approach for one case and a hand-assisted technique for the other. Unilateral ureterolysis was completed using a standard laparoscopic approach in one case and was converted to a hand-assisted technique in the other due to difficulty with ureteric identification. An omental wrap was used after ureterolysis for all renal units. RESULTS A minimally invasive technique was used for all ureterolysis procedures and none required open conversion. There was fascial dehiscence after surgery at the hand-port site in one patient, and required re-operation for wound closure. The median (range) hospital stay for all patients was 2.5 (2,10) days and the median blood loss was 100 (50,550) mL. No patient required a blood transfusion. At a median 16.5 (12,32) months of follow-up, there was symptomatic and radiographic success in all patients. CONCLUSIONS Ureterolysis can be a challenging operation depending on the extent of the retroperitoneal mass. An understanding of various laparoscopic techniques can provide the flexibility for successful completion of nearly all of these procedures using a minimally invasive approach. [source] | ||||||||||||||||||||||