Journal articles on the topic 'Childbirth Alternative treatment Victoria'
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1
Irwin, R., A. Surapaneni, D. Smith, J. Schmidt, H. Rigby, and S. R. Smith. "Verification of an alternative sludge treatment process for pathogen reduction at two wastewater treatment plants in Victoria, Australia." Journal of Water and Health 15, no. 4 (May 26, 2017): 626–37. http://dx.doi.org/10.2166/wh.2017.316.
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At South East Water wastewater treatment plants (WwTPs) in Victoria, Australia, biosolids are stockpiled for three years in compliance with the State guidelines to achieve the highest pathogen reduction grade (T1), suitable for unrestricted use in agriculture and landscaping. However, extended stockpiling is costly, may increase odour nuisance and greenhouse gas emissions, and reduces the fertiliser value of the biosolids. A verification programme of sampling and analysis for enteric pathogens was conducted at two WwTPs where sludge is treated by aerobic and anaerobic digestion, air drying (in drying pans or solar drying sheds) and stockpiling, to enumerate and, if present, monitor the decay of a range of enteric pathogens and parasites. The sludge treatment processes at both WwTPs achieved T1 grade biosolids with respect to prescribed pathogenic bacterial numbers (<1 Salmonella spp. 50 g−1 dry solids (DS) and <100 Escherichia coli g−1 DS) and >3 log10 enteric virus reduction after a storage period of one year. No Ascaris eggs were detected in the influent to the WwTPs, confirming previous studies that the presence of helminth infections in Victoria is extremely low and that Ascaris is not applicable as a control criterion for the microbiological quality of biosolids in the region.
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Andreeva, Margarita V., Elena P. Shevtsova, and Anastasia V. Neklyudova. "POSSIBILITIES OF PHYSIOTHERAPY IN PREVENTION OF INFECTIOUS COMPLICATIONS AFTER CESARIAN SECTION OPERATION." Journal of Volgograd State Medical University 19, no. 1 (March 31, 2022): 179–83. http://dx.doi.org/10.19163/1994-9480-2022-19-1-179-183.
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. Infectious complications after cesarean section are still the focus of attention in obstetric practice. This is due to the fact that endometritis and wound infection after abdominal delivery develop 6–10 times more often than after natural childbirth [1, 2]. At the same time, traditional methods of treatment and prevention of postoperative infectious complications do not give a positive effect, which necessitates the use of alternative options.
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Zeng, Chunyan, Feng Yang, Chunhua Wu, Junlin Zhu, Xiaoming Guan, and Juan Liu. "Uterine Prolapse in Pregnancy: Two Cases Report and Literature Review." Case Reports in Obstetrics and Gynecology 2018 (October 22, 2018): 1–5. http://dx.doi.org/10.1155/2018/1805153.
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Uterine prolapse complicating pregnancy is rare. Two cases are presented here: one patient had uterine prolapse at both her second and third pregnancy, and the other developed only once prolapse during pregnancy. This report will analyze etiology, clinical characteristics, complication, and treatment of uterine prolapse in pregnancy. Routine gynecologic examination should be carried out during pregnancy. If uterine prolapse occurred, conservative treatment could be used to prolong the gestational period as far as possible. Vaginal delivery is possible, but caesarean section seems a better alternative when prolapsed uterus cannot resolve during childbirth.
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Feng, Jiaxing, Jing Wang, Yuehui Zhang, Yizhuo Zhang, Liyan Jia, Dongqi Zhang, Jiao Zhang, Yanhua Han, and Shoujuan Luo. "The Efficacy of Complementary and Alternative Medicine in the Treatment of Female Infertility." Evidence-Based Complementary and Alternative Medicine 2021 (April 23, 2021): 1–21. http://dx.doi.org/10.1155/2021/6634309.
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Female infertility is a state of fertility disorder caused by multiple reasons. The incidence of infertility for females has significantly increased due to various factors such as social pressure, late marriage, and late childbirth, and its harm includes heavy economic burden, psychological shadow, and even marriage failure. Conventional solutions, such as hormone therapy, in vitro fertilization (IVF), and embryo transfer, have the limitations of unsatisfied obstetric outcomes and serious adverse events. Currently, complementary and alternative medicine (CAM), as a new treatment for infertility, is gradually challenging the dominant position of traditional therapies in the treatment of infertility. CAM claims that it can adjust and harmonize the state of the female body from a holistic approach to achieve a better therapeutic effect and has been increasingly used by infertile women. Meanwhile, some controversial issues also appeared; that is, some randomized controlled trials (RCTs) confirmed that CAM had no obvious effect on infertility, and the mechanism of its effect could not reach a consensus. To clarify CAM effectiveness, safety, and mechanism, this paper systematically reviewed the literature about its treatment of female infertility collected from PubMed and CNKI databases and mainly introduced acupuncture, moxibustion, and oral Chinese herbal medicine. In addition, we also briefly summarized psychological intervention, biosimilar electrical stimulation, homeopathy, hyperbaric oxygen therapy, etc.
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Junengsih, Junengsih, Ani Kusumastuti, and Juli Oktalia. "THE EFFECT OF COUNSELING USING LABOR PREPARATION MODULE ON INCREASING KNOWLEDGE AND ATTITUDE OF PREGNANT MOTHERS." SEAJOM: The Southeast Asia Journal of Midwifery 8, no. 1 (July 30, 2022): 24–32. http://dx.doi.org/10.36749/seajom.v8i1.146.
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Background: The birth of a baby is the most impressive, enjoyable, and even life-changing life experience for a woman. Every woman wants every birth plan according to her hopes and desires. Birth planning is a simple, clear statement of a woman's preferences for childbirth. The current weakness is that providers often plan births according to their wishes. But less in support as desired by every mother. One alternative in preparing for childbirth is to provide counseling through the provision of modules. The delivery preparation module contains information about a fun delivery guide, it is hoped that every mother can develop a coveted birth plan
The purpose of the study was to determine the effect of counseling using the delivery preparation module on the knowledge and attitudes of pregnant women in the third trimester of childbirth.
Methods: Quantitative research, quasi-experimental type with pre-test-post-test control group design. The subjects of this study were 3rd trimester pregnant women. Sampling was done by randomized assignment method, the treatment group was in the Pasar Rebo Health Center area and the control group was at the Ciracas District Health Center. Data were analyzed using Wilcoxon test, independent t test and Mann Whitney test.
Results: there was a significant difference in the mean score of knowledge (p= 0.0001) and attitude (p= 0.0001) of third trimester pregnant women in post-test-pre-test measurements between the treatment group and the control group. There is a higher difference in scores for the knowledge and attitudes of third trimester mothers who are given intensive counseling using the delivery preparation module in readiness for childbirth
Conclusion: the knowledge and attitudes scores of mothers who were given intensive counseling using the delivery preparation module were significantly higher than those who were not given intensive counseling.
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Brici, Paolo, Giovanna Franconi, Cristina Scatassa, Elisabetta Fabbri, and Paolo Assirelli. "Turning Foetal Breech Presentation at 32-35 Weeks of Gestational Age by Acupuncture and Moxibustion." Evidence-Based Complementary and Alternative Medicine 2019 (June 9, 2019): 1–5. http://dx.doi.org/10.1155/2019/8950924.
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Introduction. Foetal breech presentation is an obstetric problem that often leads to caesarean section. Stimulation of the acupoint BL67 by moxibustion may correct breech presentation. Methods. We observed 93 pregnant women in the 32nd-35th week of gestation with normal pregnancy and ultrasound diagnosis of breech presentation. The patients received stimulation of acupoint BL67 by self-administered moxibustion once a day for two weeks and if foetuses still were in breech presentation, moxibustion, and needle in the points BL65 and SI1, lasting 30 minutes, for three days in one week. The main outcome was vaginal birth with vertex presentation at delivery; the secondary outcome was compliance in the self-administration of the moxibustion treatment. Results. We observed cephalic version and natural childbirth in 62.4% of all treated women. The treatment was accepted by 98.9% women (93/94), and compliance was 91.4% (85/93) for self-administered moxibustion and 37.5% (12/32) for moxibustion and needle treatment. Conclusions. On the basis of our results, self-administered home treatment moxibustion followed by moxibustion and needle stimulations may be an effective and low-cost treatment for inducing cephalic version.
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Admasari, Yuli, Bedjo Santoso, Titi Suherni, Imam Djamaluddin Mashoedi, and Mardiyono Mardiyono. "BREAST MILK AS AN ALTERNATIVE FOR POSTPARTUM PERINEAL CARE." Belitung Nursing Journal 3, no. 3 (June 7, 2017): 238–45. http://dx.doi.org/10.33546/bnj.101.
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Background: Perineal laceration during childbirth is very common among mothers; however some of them may suffer from its complication if not treated properly.Objective: To prove the effectiveness of breast milk as an alternative topical ingredient in the treatment of perineal wound in postpartum mothers.Methods: This was a quasi-experimental study with non-equivalent control group posttest only design. There were 30 respondents selected in this study, with 15 assigned in the intervention and control group. Accidental sampling was used to select the samples with the criteria that the respondents had perineal laceration in level 1 and 2. Data were analzed using Mann Whitney test.Results: Effective wound healing process can be seen in the intervention group from 80% of poor category in 6-10 hours (1st period) of postpartum became 86.7% of good category in 7 days of postpartum (4th period). Different from the control group that showed the slow progress of wound healing, which was 86.7% of poor category in the 1st period to only 33.3% of good category in the 4th period. Mann Whitney test showed that there was a significant mean difference of the perineal wound healing process between the intervention group (11.23) and the control group (19.77) with p-value 0.002 (<0.05).Conclusion: Breast milk was more effective than povidone iodine in the treatment of perineal wound. It is suggested for health workers, especially midwife to apply this intervention to accelerate the healing of perineal wound in midwifery care.
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Eastwood, Kathryn, Dhanya Nambiar, Rosamond Dwyer, Judy A. Lowthian, Peter Cameron, and Karen Smith. "Ambulance dispatch of older patients following primary and secondary telephone triage in metropolitan Melbourne, Australia: a retrospective cohort study." BMJ Open 10, no. 11 (November 2020): e042351. http://dx.doi.org/10.1136/bmjopen-2020-042351.
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BackgroundMost calls to ambulance result in emergency ambulance dispatch (direct dispatch) following primary telephone triage. Ambulance Victoria uses clinician-led secondary telephone triage for patients identified as low-acuity during primary triage to refer them to alternative care pathways; however, some are returned for ambulance dispatch (secondary dispatch). Older adult patients are frequent users of ambulance services; however, little is known about the appropriateness of subsequent secondary dispatches.ObjectivesTo examine the appropriateness of secondary dispatch through a comparison of the characteristics and ambulance outcomes of older patients dispatched an emergency ambulance via direct or secondary dispatch.DesignA retrospective cohort study of ambulance patient data between September 2009 and June 2012 was conducted.SettingThe secondary telephone triage service operated in metropolitan Melbourne, Victoria, Australia during the study period.ParticipantsThere were 90 086 patients included aged 65 years and over who had an emergency ambulance dispatch via direct or secondary dispatch with one of the five most common secondary dispatch paramedic diagnoses.Main outcome measuresDescriptive analyses compared characteristics, treatment and transportation rates between direct and secondary dispatch patients.ResultsThe dispatch groups were similar in demographics, vital signs and hospital transportation rates. However, secondary dispatch patients were half as likely to be treated by paramedics (OR 0.51; CI 0.48 to 0.55; p<0.001). Increasing age was associated with decreasing treatment (p<0.005) and increasing transportation rates (p<0.005).ConclusionSecondary triage could identify patients who would ultimately be transported to an emergency department. However, the lower paramedic treatment rates suggest many secondary dispatch patients may have been suitable for referral to alternative low-acuity transport or referral options.
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Sudakov, Dmitriy S., Igor P. Nikolayenkov, Yulia R. Dymarskaya, and Diana V. Bubnova. "High-intensity focused ultrasound: opportunities and prospects in the treatment of uterine fibroid and deep infiltrative endometriosis." Journal of obstetrics and women's diseases 70, no. 2 (June 17, 2021): 129–38. http://dx.doi.org/10.17816/jowd52982.
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This literature review is devoted to the use of focused ultrasound in gynecological practice as an alternative to the traditional surgical treatment of uterine fibroids and deep infiltrating endometriosis. According to available data, the effectiveness of the treatment of uterine fibroids with focused ultrasound varies widely, ranging from 16.4% to 93.0%. Due to the lack of prospective studies, it is not possible to draw reliable conclusions about the effect of ablation of uterine fibroid with focused ultrasound on fertility. However, unplanned pregnancies after such treatment occurred up to 19.5%, and in 66.3% of cases, pregnancies ended with the childbirth. Research results demonstrate that in 87% of cases, treatment of retrocervical infiltrative endometriosis using focused ultrasound is feasible. Further data accumulation is required to determine the range of patients with uterine fibroids and deep infiltrating endometriosis, to whom the treating technique could be most effective and safe.
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Noviani, Ni Wayan, Ni Luh Putu Citrawati, and Putu Savitri Astikasari. "PENGARUH AROMATERAPI LAVENDER TERHADAP KECEMASAN IBU BERSALIN PADA PANDEMI COVID-19 DI PUSKESMAS I DENPASAR TIMUR." JOMIS (Journal of Midwifery Science) 6, no. 1 (January 25, 2022): 65–74. http://dx.doi.org/10.36341/jomis.v6i1.2142.
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Non-natural disasters caused by the Covid 19 virus that is currently engulfing Indonesia is currently one of the factors that can cause anxiety in mothers who will face childbirth. Anxiety in childbirth is a common condition for pregnant women. Mothers who experience anxiety in the labor process can cause pathological conditions. An alternative treatment to reduce anxiety in maternity mothers is to use aromatherapy. The results of this study aim to find out the effect of lavender aromatherapy on the anxiety of maternity mothers in the covid-19 pandemic. This type of research is a quasi experiment with one group pretest-posttes without control. The population in this study was all mothers who were pregnant in the working area of Puskesmaa I Denpasar Timur with a sample of 20 maternity mothers who fit the criteria of inclusion and taken purposive sampling. The data collection tool used is a DASS questionnaire. The results of this study using a paired t-test showed that there was a meaningful difference between the level of anxiety before being given aromatherapy and after being given aromatherapy judging from the p-value of < 0.05.
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Karo Karo, Hilda Yani, Noor Pramono, Sri Wahyuni, Imam Djamaluddin Mashoedi, and Leny Latifah. "LAVENDER (LAVANDULA ANGUSTIFOLIA) AROMATHERAPY AS AN ALTERNATIVE TREATMENT IN REDUCING PAIN IN PRIMIPAROUS MOTHERS IN THE ACTIVE FIRST STAGE OF LABOR." Belitung Nursing Journal 3, no. 4 (August 31, 2017): 420–25. http://dx.doi.org/10.33546/bnj.159.
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Background: Labor and childbirth is an extremely painful process. Aromatherapy is considered as one of the nonpharmacological methods to reduce labor pain.Objective: To determine the effect of Lavender (Lavandula Angustifolia) aromatherapy on the level of pain in primipara in the first stage of labor.Methods: A quasy-experimental research with pretest and posttest design with control group conducted between October until November 2016. Forthy respondents selected using consecutive sampling, which 20 assigned in each group. a Numerical Rating Scale (NRS) pain scale was used. Paired and independent t-test were used for data analyses.Results: The results showed that the p-value of labor pain after intervention was 0.000 (<0.05), which indicated that there was statistically mean difference of labor pain between intervention (6.10) and control group (4.05) in primipara in the first active stage of labor.Conclusion: The women in the lavender aromatherapy group reported lower intensity of labor pain. The intervention study could be practiced in the community health centers for pregnant women in order for them to apply this healing method.
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Philip Bill Okaka, Olan’g Alfred, Florence Ondieki - Mwaura, and Maurice Sakwa. "Effect of Community Health Support Systems and Technology Obsolescence on Utilization of mHealth Information by Teenagers Living with HIV/AIDS in Island Communities of Lake Victoria, Kenya." International Journal of World Policy and Development Studies, no. 73 (July 11, 2021): 45–56. http://dx.doi.org/10.32861/ijwpds.73.45.56.
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The emergence of mHealth as an alternative access point for care and treatment is lauded by development agencies as ingenious innovation for bridging health care access for teenagers living with HIV/AIDS among detached communities like the islands of Lake Victoria. It is also presumed that mHealth transcends beyond teenagers’ concerns with location and unfriendly hours of operation of health facilities. mHealth is alleged to increase privacy and confidentiality, reduce the cost of service delivery, and loops over retrogressive cultural beliefs and attitudes exhibited by health care providers and caregivers, consequently increasing access to health information, care, and treatment. Specifically, the study sought to determine the technology obsolescence and explore community-based health support systems that facilitate suitable utilization of mHealth by teenagers living with HIV from the island communities of Lake Victoria and its effect on treatment access. To support this study, two philosophies: The theory of Reasoned Action and the Technology Adoption Lifecycle Model were applied. Anchored on cross-sectional study design, stratified sampling identified the psychosocial support groups of teenagers living with HIV. The probit model was applied to the study. With a study population of approximately 409 in Ringiti, Remba, Rusinga, Mfangano, and Mageta Islands, questionnaires were administered to 173 sampled teenagers living with HIV as a unit of analysis, and a control group made up of 30 percent of the sample ascertained effect of mHealth on treatment access. Five focus group discussions and key informant interviews of 10 and 3 were held on each Island. Multiple linear regression analysis was used to estimate the effect of the independent variables on the dependent variable. Further, the results showed that technology obsolescence and community-based health support systems had a significant effect on access to treatment by teenagers living with HIV/AIDS in the Island communities of Lake Victoria. Consequently, this study provides organizations promoting access to access to treatment by teenagers living with HIV/AIDS through mHealth. The study recommended that government and organizations involved in HIV/AIDS related activities should adopt a culture of enhancing mHealth by focusing on technology obsolescence and community-based health support systems. This could go a long way in ensuring there is improved access to treatment by teenagers living with HIV/AIDS in Island communities of Lake Victoria.
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Li, Jung-Miao, Cheng-Li Lin, Ke-Ru Liao, and Chung-Chih Liao. "Use of Traditional Chinese Medicine for Patients Diagnosed with Postpartum Depression: A Nationwide Population-Based Study." Evidence-Based Complementary and Alternative Medicine 2020 (July 20, 2020): 1–8. http://dx.doi.org/10.1155/2020/7060934.
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Postpartum depression (PPD) is one of most common postnatal complications, affecting approximately 10%–15% of women after childbirth annually. Traditional Chinese medicine (TCM) has been gaining popularity as the choice of treatment for PPD in Taiwan. Hence, our aim was to analyze the utilization of TCM among PPD patients in Taiwan. A cross-sectional study was conducted using a random sample of one million beneficiaries selected from the Taiwanese National Health Insurance Research Database. We identified patients with PPD who had received either TCM treatment or non-TCM treatment from the database during 2000–2012. Multivariate logistic regression analysis was used to identify the factors associated with the use of TCM. A total of 653 patients with PPD were enrolled. The majority of patients with PPD were 26–30 years old, lived in a highly urbanized area of Taipei, had a monthly income <20,000 NT$, and were private enterprise employees. Around 52.7% of PPD patients had the motivation to seek TCM services. Younger women, who resided in central and southern Taiwan and who had used TCM one year before PPD diagnosis, were more likely to use TCM services. PPD patients who underwent TCM treatment had a lower overall medical expenditure than non-TCM users. Most TCM users chose simple Chinese herbal medicine. The coexisting factors that made PPD patients to seek TCM services were respiratory or oral infections. We demonstrated the characteristics of those that seek TCM for PPD, which may provide useful insights to health care providers towards resource allocation.
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Gilbert, Julia, and Jane Boag. "‘To die, to sleep’ – assisted dying legislation in Victoria: A case study." Nursing Ethics 26, no. 7-8 (November 19, 2018): 1976–82. http://dx.doi.org/10.1177/0969733018806339.
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Background: Assisted dying remains an emotive topic globally with a number of countries initiating legislation to allow individuals access to assisted dying measures. Victoria will become the first Australian state in over 13 years to pass Assisted Dying Legislation, set to come into effect in 2019. Objectives: This article sought to evaluate the impact of Victorian Assisted Dying Legislation via narrative view and case study presentation. Research design: Narrative review and case study. Participants and research context: case study. Ethical considerations: This legislation will provide eligible Victorian residents with the option to request access to assisted dying measures as a viable alternative to a potentially painful, protracted death. Findings: This legislation, while conservative and inclusive of many safeguards at present, will form the basis for further discussion and debate on assisted dying across Australia in time to come. Discussion: The passing of this legislation by the Victorian parliament was prolonged, emotive and divided not only the parliament but Australian society. Conclusion: Many advocates for this legislation proclaimed it was well overdue and will finally meet the needs of contemporary society. Protagonists claim that medical treatment should not provide a means of ending life, despite palliative care reportedly often failing to relieve the pain and suffering of individuals living with a terminal illness.
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Fitriahadi, Enny, and Yekti Satriyandari. "PEMUTUSAN RANTAI PENULARAN CORONAVIRUS DISEASE (COVID-19) MELALUI PEMANFAATAN TANAMAN OBAT KELUARGA (TOGA) PADA IBU HAMIL, NIFAS, MENYUSUI DAN LANSIA." Jurnal Abdi Masyarakat Kita 1, no. 2 (July 29, 2021): 131–41. http://dx.doi.org/10.33759/asta.v1i2.152.
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The pandemic period requires people to always be vigilant and adhere to health protocols. The period in which a woman from pregnancy, childbirth, postpartum, breastfeeding to the elderly is a continuous process. In the process, they experience various discomforts such as fatigue, vaginal discharge, cravings, frequent urination, emesis gravidarum, dizziness, aches and many other complaints. Early detection of complications of pregnancy, childbirth, postpartum, breastfeeding and the elderly can be assessed through integrated service standards that are usually carried out at posyandu and health centers. During the current pandemic, people are still afraid to go to the nearest health facility for examination and treatment. For this reason, it is health workers who provide solutions or alternative health service activities through cadres or community leaders. The next problem is the increasing number of Covid-19 cases in Sleman Regency which will have an impact on women's health, which is still quite worrying and the lack of knowledge of mothers regarding the prevention of COVID-19 in the family and surrounding areas. The service team from Aisyiyah University Yogyakarta helped PRA Aisyiyah Nogotirto and the community together to break the chain of transmission of COVID-19 through the consumption of rhizomes. Based on the results of the pre and post tests regarding knowledge of covid-19 prevention in the family and community, PRA Nogotirto mothers understand and are able to implement healthy living and always maintain health protocols in the family and community environment.
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Gray, S., and N. Booker. "Wastewater services for small communities." Water Science and Technology 47, no. 7-8 (April 1, 2003): 65–71. http://dx.doi.org/10.2166/wst.2003.0672.
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Connection to centralised regional sewage systems has been too expensive for small-dispersed communities, and these townships have traditionally been serviced by on-site septic tank systems. The conventional on-site system in Australia has consisted of an anaerobic holding tank followed by adsorption trenches. This technique relies heavily on the uptake of nutrients by plants for effective removal of nitrogen and phosphorus from the effluent, and is very seasonal in its efficiency. Hence, as these small communities have grown in size, the environmental effects of the septic tank discharges have become a problem. In locations throughout Australia, such as rural Victoria and along the Hawkesbury-Nepean River, septic tanks are being replaced with the transport of sewage to regional treatment plants. For some isolated communities, this can mean spending $20,000-$40,000/household, as opposed to more common connection prices of $7,000/household. This paper explores some alternative options that might be suitable for these small communities, and attempts to identify solutions that provide acceptable environmental outcomes at lower cost. The types of alternative systems that are assessed in the paper include local treatment systems, separate blackwater and greywater collection and treatment systems both with and without non-potable water recycling, a small township scale treatment plant compared to either existing septic tank systems or pumping to a remote regional treatment facility.The work demonstrated the benefits of a scenario analysis approach for the assessment of a range of alternative systems. It demonstrated that some of the alternatives systems can achieve better than 90% reductions in the discharge of nutrients to the environment at significantly lower cost than removing the wastewater to a remote regional treatment plant. These concepts allow wastewater to be retained within a community allowing for local reuse of treated effluent.
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Miranda-Garcia, Maite, Cristina Domingo Gómez, Cristina Molinet-Coll, Betina Nishishinya, Ikram Allaoui, M. Dolores Gómez Roig, and Josefina Goberna-Tricas. "Effectiveness and Safety of Acupuncture and Moxibustion in Pregnant Women with Noncephalic Presentation: An Overview of Systematic Reviews." Evidence-Based Complementary and Alternative Medicine 2019 (December 3, 2019): 1–8. http://dx.doi.org/10.1155/2019/7036914.
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Background. Breech presentation at the time of delivery is 3.8–4%. Fetuses that maintain a noncephalic presentation beyond 32 weeks will have a lower probability of spontaneous version before labor. Given the increasing interest in exploring the use of complementary medicine during pregnancy and childbirth, the moxibustion technique, a type of traditional Chinese medicine, could be another option to try turning a breech baby into a cephalic presentation. Objectives. To review the evidence from systematic reviews (SR) on the efficacy and safety of acupuncture and moxibustion in pregnant women with noncephalic presentation. Main Results. Our SR synthesizes the results from five clinical trials on pregnant women with a singleton noncephalic presentation. There is evidence that moxibustion reduces the number of noncephalic presentations at the time of birth compared with no treatment. The adverse effects that acupuncture and moxibustion can cause seem to be irrelevant. Most SRs agree that there are no adverse effects directly related to acupuncture and moxibustion. Conclusions. Even though the results obtained are positive and the five reviews conclude that moxibustion reduces the number of noncephalic presentations at birth (alone or combined with postural techniques or acupuncture), there is considerable heterogeneity between them. Better methodologically designed studies are required in the future to reaffirm this conclusion.
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ROCHA, VINÍCIUS MAGNO DA, JOÃO ANTONIO MATHEUS GUIMARÃES, ANTÔNIO PAULO DE OLIVAES FILHO, FELIPE MOURA CARRASCO, ANTÔNIO EULALIO PEDROSA ARAUJO JUNIOR, DIEGO PINHEIRO AGUIAR, and ANDRÉ LUIZ LOYELO BARCELLOS. "SACRAL FRACTURE TREATMENT WITH A VARIATION OF THE LUMBOPELVIC FIXATION TECHNIQUE." Coluna/Columna 17, no. 1 (March 2018): 69–73. http://dx.doi.org/10.1590/s1808-185120181701174141.
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ABSTRACT Spinopelvic instability is an uncommon injury that is caused by high-energy traumas. Surgical treatment is used, in the majority of cases, to restore stability and enable early mobilization. Various stabilization techniques have been used in the treatment of spinopelvic instability, and lumbopelvic fixation (LPF) is currently the technique of choice due to its biomechanical superiority. One of its limitations is the fact that the technique does not directly address the lower sacral segment, permitting a residual kyphotic deformity. This deformity has been attributed to unsatisfactory outcomes, including late development of pelvic floor muscle defects and complications during childbirth. We report a case of a patient with spinopelvic instability due to sacral fracture, which was treated using a variation of the LPF technique, in which rods and screws originally developed for cervicothoracic fixation were adapted to correct sacral deformity in the sagittal plane. The upper sacral segment was reduced indirectly using hip extension and femoral traction manoeuvres, associated with distraction manoeuvres via rods. Bone reduction forceps were used to reduce the kyphotic deviation in the lower sacral fragment, enabling its fixation to the lumbopelvic rod and screws system. There were no complications of infection, suture dehiscence, or breakage of the implants, and at the end of the first year of follow-up, the sacral kyphosis was normal and radiographic consolidation was confirmed. Our technique provides a viable and promising alternative to traditional LPF, making it especially useful in fractures with accentuated deviations of the lower sacral fragment. Level of Evidence: 4.Type of study: Case series
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Li, Yongle, Zijie Chen, Ning Yu, Keyu Yao, Yiwen Che, Yupeng Xi, and Shuangqing Zhai. "Chinese Herbal Medicine for Postpartum Depression: A Systematic Review of Randomized Controlled Trials." Evidence-Based Complementary and Alternative Medicine 2016 (2016): 1–20. http://dx.doi.org/10.1155/2016/5284234.
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Background. Postpartum depression (PPD) does great harm to women following childbirth. The aim of this study was to conduct a systematic review of the literature to assess the efficacy and safety of CHM for the treatment of PPD.Methods. Published or ongoing registered trials were searched for from the inception of the various databases to December 31, 2015. Data extraction and methodology assessment were conducted independently by two researchers. RevMan 5.3 software was used to analyze the data.Results. Forty-seven registered clinical trials (RCTs) were identified and reviewed. The results showed CHM alone or in combination with routine treatments could reduce HAMD score, EPDS score, incidence of adverse events, TESS, and SERS. CHM combined with routine treatment was more effective in increasing serum estradiol levels and reducing progesterone levels than routine treatment alone. Meanwhile, pooled data revealed that MRLQS combined with routine treatments or MRLQS plus MSHS combined with routine treatments were more effective than other therapeutic methods in TCM. MRLQS plus MSHS alone was found to be an effective alternative when compared to routine treatments.Conclusions. This review suggested that CHM was safe and effective in the treatment of PPD. However, this could not be proven conclusively. To ensure evidence-based clinical practice, more rigorously designed trials are warranted.
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Feeley, Claire, Gill Thomson, and Soo Downe. "Understanding how midwives employed by the National Health Service facilitate women’s alternative birthing choices: Findings from a feminist pragmatist study." PLOS ONE 15, no. 11 (November 20, 2020): e0242508. http://dx.doi.org/10.1371/journal.pone.0242508.
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UK legislation and government policy favour women’s rights to bodily autonomy and active involvement in childbirth decision-making including the right to decline recommendations of care/treatment. However, evidence suggests that both women and maternity professionals can face challenges enacting decisions outside of sociocultural norms. This study explored how NHS midwives facilitated women’s alternative physiological birthing choices–defined in this study as ‘birth choices that go outside of local/national maternity guidelines or when women decline recommended treatment of care, in the pursuit of a physiological birth’. The study was underpinned by a feminist pragmatist theoretical framework and narrative methodology was used to collect professional stories of practice via self-written narratives and interviews. Through purposive and snowball sampling, a diverse sample in terms of age, years of experience, workplace settings and model of care they operated within, 45 NHS midwives from across the UK were recruited. Data were analysed using narrative thematic that generated four themes that described midwives’ processes of facilitating women’s alternative physiological births: 1. Relationship building, 2. Processes of support and facilitation, 3. Behind the scenes, 4. Birth facilitation. Collectively, the midwives were involved in a wide range of alternative birth choices across all birth settings. Fundamental to their practice was the development of mutually trusting relationships with the women which were strongly asserted a key component of safe care. The participants highlighted a wide range of personal and advanced clinical skills which was framed within an inherent desire to meet the women’s needs. Capturing what has been successfully achieved within institutionalised settings, specifically how, maternity providers may benefit from the findings of this study.
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Kovala-Demertzi, D., T. Varadinova, P. Genova, P. Souza, and M. A. Demertzis. "Platinum(II) and Palladium(II) Complexes of Pyridine-2-Carbaldehyde Thiosemicarbazone as Alternative Antiherpes Simplex Virus Agents." Bioinorganic Chemistry and Applications 2007 (2007): 1–6. http://dx.doi.org/10.1155/2007/56165.
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The cytotoxicity and the antivirus activity of Pd(II) and Pt(II) complexes with pyridine-2-carbaldehyde thiosemicarbazone (HFoTsc) against HSV replication were evaluated on four HSV strains—twowtstrains Victoria (HSV-1) and BJA (HSV-2) and twoACVRmutants with differenttkgene mutations R-100 (TKA, HSV-1) and PU (TKN, HSV-2). The experiments were performed on continuous MDBK cells and four HSV 1 and HSV 2 strains were used, two sensitive to acyclovir and two resistant mutants. The five complexes of HFoTsc, [Pt(FoTsc)Cl], [Pt(FoTsc)(H2FoTsc)]Cl2, [Pt(FoTsc)2], [Pd(FoTsc)(H2FoTsc)]Cl2, and [Pd(FoTsc)2], were found to be effective inhibitors of HSV replication. The most promising, active, and selective anti-HSV agent was found to be complex [Pt(FoTsc)(H2FoTsc)]Cl2. This complex could be useful in the treatment of HSV infections, since it is resistant to ACV mutants. PCR study of immediate early 300 bp ReIV Us1 region reveals that the complex [Pt(FoTsc)(H2FoTsc)]Cl2specifically suppressedwtHSV-1 genome 2 hours after the infection, not inducing apoptosis/necrosis on the 8 hours after virus infection. The target was found to be most probably the viral, instead of the host cell DNA.
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Tsmur, O., O. Levchuk, K. Liashyna, and N. Boyko. "Results of using the domestic synbiotic Bifiten for treatment of bacterial vaginosis of pregnant women." HEALTH OF WOMAN, no. 6(112) (July 29, 2016): 66–72. http://dx.doi.org/10.15574/hw.2016.112.66.
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The article shows the research results of vaginal microbiome correction of pregnant women with bacterial vaginosis before and after oral using of synbiotic Bifiten. This biopreparation differs from others recommended for vaginal microbiome correction by its combined anti-inflammatory and specific pro- and antimicrobial activity. The aim of research is to define the clinical efficacy of oral administration of the non-medicinal biological (synbiotic) preparation Bifiten to pregnant women with bacterial vaginosis. Materials and Methods. Clinical and statistical analysis of pregnant women's individual cards, childbirth stories had been held. Vaginal microbiome had been studied by using classic microbiological methods and qRT-PCR. Immune parameters of vagina secrets had been detected by immunosorbent assay (ELISA). Results. A positive dynamics of subjective and objective state of pregnant women had been observed. It was shown that following to the oral administration of Bifiten mucous membranes of vagina were settled by both commensal and transit microbiota, which in turn leads to reduction the perinatal complications for the mother and newborn. The effectiveness of the application of Bifiten against agents of gardnerellez and candidiasis is clinically proved. Conclusion. Feasibility of using synbiotic Bifiten to treat pregnant women with bacterial vaginosis had been clinically proved. Good tolerability, complementarity or alternative taking with antibiotic therapy, no side effects, convenient form of release make reasonable to recommend it for the gynecology for the effective treatment of pregnant women with bacterial vaginosis. Key words: bacterial vaginoses, vagina microbiome, synbiotic, aerobic and anaerobic pathogens, commensals, cytokines.
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Schmid, Florian A., J. Koudy Williams, Thomas M. Kessler, Arnulf Stenzl, Wilhelm K. Aicher, Karl-Erik Andersson, and Daniel Eberli. "Treatment of Stress Urinary Incontinence with Muscle Stem Cells and Stem Cell Components: Chances, Challenges and Future Prospects." International Journal of Molecular Sciences 22, no. 8 (April 12, 2021): 3981. http://dx.doi.org/10.3390/ijms22083981.
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Urinary incontinence (UI) is a major problem in health care and more than 400 million people worldwide suffer from involuntary loss of urine. With an increase in the aging population, UI is likely to become even more prominent over the next decades and the economic burden is substantial. Among the different subtypes of UI, stress urinary incontinence (SUI) is the most prevalent and focus of this review. The main underlying causes for SUI are pregnancy and childbirth, accidents with direct trauma to the pelvis or medical treatments that affect the pelvic floor, such as surgery or irradiation. Conservative approaches for the treatment of SUI are pelvic physiotherapy, behavioral and lifestyle changes, and the use of pessaries. Current surgical treatment options include slings, colposuspensions, bulking agents and artificial urinary sphincters. These treatments have limitations with effectiveness and bear the risk of long-term side effects. Furthermore, surgical options do not treat the underlying pathophysiological causes of SUI. Thus, there is an urgent need for alternative treatments, which are effective, minimally invasive and have only a limited risk for adverse effects. Regenerative medicine is an emerging field, focusing on the repair, replacement or regeneration of human tissues and organs using precursor cells and their components. This article critically reviews recent advances in the therapeutic strategies for the management of SUI and outlines future possibilities and challenges.
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Toussaint, Nigel D., Lawrence P. McMahon, Gregory Dowling, Stephen G. Holt, Gillian Smith, Maria Safe, Richard Knight, et al. "Introduction of Renal Key Performance Indicators Associated with Increased Uptake of Peritoneal Dialysis in a Publicly Funded Health Service." Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis 37, no. 2 (March 2017): 198–204. http://dx.doi.org/10.3747/pdi.2016.00149.
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BackgroundIncreased demand for treatment of end-stage kidney disease has largely been accommodated by a costly increase in satellite hemodialysis (SHD) in most jurisdictions. In the Australian State of Victoria, a marked regional variation in the uptake of home-based dialysis suggests that use of home therapies could be increased as an alternative to SHD. An earlier strategy based solely on increased remuneration had failed to increase uptake of home therapies. Therefore, the public dialysis funder adopted the incidence and prevalence of home-based dialysis therapies as a key performance indicator (KPI) for its health services to encourage greater uptake of home therapies.MethodsA KPI data collection and bench-marking program was established in 2012 by the Victorian Department of Health and Human Services, with data provided monthly by all renal units in Victoria using a purpose-designed website portal. A KPI Working Group was responsible for analyzing data each quarter and ensuring indicators remained accurate and relevant and each KPI had clear definitions and targets. We present a prospective, observational study of all dialysis patients in Victoria over a 4-year period following the introduction of the renal KPI program, with descriptive analyses to evaluate the proportion of patients using home therapies as well as home dialysis modality survival.ResultsFollowing the introduction of the KPI program, the net growth of dialysis patient numbers in Victoria remained stable over 4 years, at 75 – 80 per year (approximately 4%). However, unlike the previous decade, about 40% of this growth was through an increase in home dialysis, which was almost exclusively peritoneal dialysis (PD). The increase was identified particularly in the young (20 – 49) and the elderly (> 80). Disappointingly, however, 67% of these incident patients ceased PD within 2 years of commencement, 46% of whom transferred to SHD.ConclusionsIntroduction of a KPI program was associated with an increased uptake of PD but not home HD. This change in clinical practice restricted growth of SHD and reduced pressure on satellite services. The effect was offset by a modest PD technique survival. Many patients in whom PD was unsuccessful were subsequently transferred to SHD rather than home HD.
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Anuhgera, Diah Evawanna, Nikmah Jalilah Ritonga, Riris Sitorus, and Juni Mariati Simarmata. "PENERAPAN BIRTH BALL DENGAN TEKNIK PELVIC ROCKING TERHADAP LAMA PERSALINAN PADA KALA I FASE AKTIF." JURNAL KEPERAWATAN DAN FISIOTERAPI (JKF) 4, no. 1 (October 31, 2021): 70–76. http://dx.doi.org/10.35451/jkf.v4i1.837.
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A comfortable childbirth is the dream of mothers. Faster delivery progress can lead to quality midwifery care. Birth ball is a tool that can be used by mothers to position the pelvis properly, especially applied the pelvic rocking technique. This review study aimed to evaluate the evidence regarding the effect of using birth ball with pelvic rocking in duration of labor in kala I active phase. This study followed a quasi experimental research design with posttest control group design.The sample consisted of 12 treatment people dan 12 controls with the purposive sampling.Partograph was measured duration of labor in kala I active phase. The difference in duration of labor for the treatment and control group were tested with Mann Whitney. There was a difference in the effect of using a birth ball with pelvic rocking technique in length of labor in kala I active phase in the treatment and control groups with p-value 0.001. The use of birth ball with pelvic rocking technique is evidence to speed the duration of labor in kala I active phase. Birth ball with pelvic rocking are recommended to be use an alternative to speed the duration of labor in kala I active phase in midwifery services
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Yang, Chunguang, Yutao Wang, Jiayang He, Wen Yan, Haiming Jiang, Qiaolian Chen, Li Li, and Zifeng Yang. "Lianhua-Qingwen Displays Antiviral and Anti-Inflammatory Activity and Synergistic Effects with Oseltamivir against Influenza B Virus Infection in the Mouse Model." Evidence-Based Complementary and Alternative Medicine 2020 (June 5, 2020): 1–12. http://dx.doi.org/10.1155/2020/3196375.
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Influenza B virus (IBV) is one of the main pathogens of the annual influenza epidemic, and the disease burden is significant, especially among children and young teenagers. In this study, the antiviral and anti-inflammatory effects of a traditional Chinese medicine prescription, the Lianhua-Qingwen capsule, were evaluated. Our results showed that Lianhua-Qingwen capsule can inhibit both Victoria and Yamagata lineages, and the 50% inhibitive concentrations ranged from 0.228 ± 0.150 to 0.754 ± 0.161 mg/mL. The time course results demonstrated that IBV yields were reduced with treatment at 0–4 h after infection, and the mechanistic research verified that Lianhua-Qingwen capsule has hemagglutination inhibition activity against B/Guangzhou/0215/2012 but not A/California/04/2009. In addition to antiviral activity, Lianhua-Qingwen capsule can also inhibit excessive expression of RANTES, IL-6, IL-8, IP-10, TNF-α, MCP-1, MIP-1β, and IFN-λ at the mRNA level and prevent a severe inflammatory response. The in vivo results confirmed that orally administered Lianhua-Qingwen capsule (100–400 mg/kg/day) does not reduce IBV-induced lung viral load and mortality in mice. However, the pathological change in lungs was alleviated, and there were fewer inflammatory cells in the lungs of Lianhua-Qingwen capsule treated mice than those in controls. Further research confirmed that the combination treatment of 200 mg/kg/day of Lianhua-Qingwen capsule with 2 mg/kg/day of oseltamivir significantly reduced IBV infection over the individual administration of either alone in vivo. Our findings prove that Lianhua-Qingwen capsule could be used as an assistant medicine to enhance the effect of oseltamivir against influenza B virus infection.
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Tumwine, Christopher, Peter Aggleton, and Stephen Bell. "Interface between biomedical and traditional systems of treatment and care among HIV positive fisher folk in two fishing communities on Lake Victoria, Uganda." African Health Sciences 21, no. 3 (September 27, 2021): 1040–47. http://dx.doi.org/10.4314/ahs.v21i3.11.
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Background: Fisherfolk have been identified as a key population in the HIV response in Uganda due to high HIV preva- lence and low engagement in HIV services. While studies have examined lifestyles and risk, much remains to be understood about help and health seeking experiences, including the combined use of biomedical and traditional health care.
Objective: To examine the use of biomedical and traditional health care in two fishing communities around Lake Victoria in Uganda.
Methods: Exploratory, in-depth qualitative study involving semi-structured interviews with 42 HIV positive fisherfolk.
Results: Prior to HIV diagnosis, participants who described becoming ill sought different forms of help including biomedical treatment prescribed by health workers or self-prescribed; biomedical and herbal medicines together; herbal medicines only; or no form of treatment. Following HIV diagnosis, the majority of participants used ART exclusively, while a smaller number used both ART and traditional care strategies, or reported times when they used alternative therapies instead of ART. Prior to HIV diagnosis, fisherfolk’s health care seeking practices inhibited engagement with HIV testing and access to biomedical HIV treatment and care. After HIV diagnosis, most resorted only to using ART.
Conclusion: Study findings provide insight into how fisherfolk’s use of biomedical and traditional care prior to diagnosis influences subsequent engagement with HIV treatment. Efforts are needed to reach fisherfolk through everyday health seeking networks to ensure HIV is diagnosed and treated as early as possible.
Keywords: HIV care; fisherfolk; HIV; Uganda; traditional healers; anti-retroviral therapy.
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Strand, Roland T., Florinda da Silva, and Staffan Bergström. "Use of Cholera Beds in the Delivery Room: A Simple and Appropriate Method for Direct Measurement of Postpartum Bleeding." Tropical Doctor 33, no. 4 (October 2003): 215–16. http://dx.doi.org/10.1177/004947550303300408.
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Abundant obstetric bleeding is a predominant cause of maternal death, with the immediate postpartum period being the most critical time. Visual estimation of postpartum haemorrhage (PPH) often leads to severe underestimation and delay in treatment. Various methods have been developed in order to measure blood loss accurately, but none has proved appropriate in poor settings. The aim of this study was to present a method which is appropriate for measuring postpartum blood loss in a setting with limited resources. Parturient women ( n=814) with active management of third stage of labour in Luanda, Angola were studied. Vaginal bleeding immediately after birth and during the first 2 hours postpartum was collected using a combination of a plastic sheet and a bucket below a cholera bed, in which the women rested during postpartum observation. Monitoring postpartum blood loss in the same way as cholera patients are monitored for loss of stool fluid was found to be a useful and practical way of measuring haemorrhage of parturient women after childbirth. The method described here is simple and appropriate, which makes it a good alternative to more costly methods in detecting and quantifying PPH.
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Zakaria, Alif Aiman, Mohd Hezmee Mohd Noor, Hafandi Ahmad, Hasliza Abu Hassim, Mazlina Mazlan, and Mohd Qayyum Ab Latip. "A Review on Therapeutic Effects of Labisia pumila on Female Reproductive Diseases." BioMed Research International 2021 (September 15, 2021): 1–9. http://dx.doi.org/10.1155/2021/9928199.
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The Labisia pumila (LP) is a traditional plant that is locally known as Kacip Fatimah, Selusuh Fatimah, or Pokok Ringgang by the Malaysian indigenous people. It is believed to facilitate their childbirth, treating their postchild birth and menstrual irregularities. The water extract of LP has shown to contain bioactive compounds such as flavonoids, ascorbic acid, β-carotene, anthocyanin, and phenolic acid, which contribute extensive antioxidant, anti-inflammatory, antimicrobial, and antifungal. The LP ethanolic extract exhibits significant estrogenic effects on human endomentrial adenocarcinoma cell in estrogen-free basal medium and promoting an increase in secretion of alkaline phosphate. Water based has been used for many generations, and studies had reported that it could displace in binding the antibodies and increase the estradiol production making it similar to esterone and estradiol hormone. LP extract poses a potential and beneficial aspect in medical and cosmeceutical applications. This is mainly due to its phytoestrogen properties of the LP. However, there is a specific functionality in the application of LP extract, due to specific functional group in phytoconstituent of LP. Apart from that, the extraction solvent is important in preparing the LP extract as it poses some significant and mild side effects towards consuming the LP extracts. The current situation of women reproductive disease such as postmenopausal syndrome and polycystic ovary syndrome is increasing. Thus, it is important to find ways in alternative treatment for women reproductive disease that is less costly and low side effects. In conclusion, these studies proven that LP has the potential to be an alternative way in treating female reproductive related diseases such as in postmenopausal and polysystic ovarian syndrome women.
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Pawsey, Nicholas, Jayanath Ananda, and Zahirul Hoque. "Rationality, accounting and benchmarking water businesses." International Journal of Public Sector Management 31, no. 3 (April 9, 2018): 290–315. http://dx.doi.org/10.1108/ijpsm-04-2017-0124.
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Purpose The purpose of this paper is to explore the sensitivity of economic efficiency rankings of water businesses to the choice of alternative physical and accounting capital input measures. Design/methodology/approach Data envelopment analysis (DEA) was used to compute efficiency rankings for government-owned water businesses from the state of Victoria, Australia, over the period 2005/2006 through 2012/2013. Differences between DEA models when capital inputs were measured using either: statutory accounting values (historic cost and fair value), physical measures, or regulatory accounting values, were scrutinised. Findings Depending on the choice of capital input, significant variation in efficiency scores and the ranking of the top (worst) performing firms was observed. Research limitations/implications Future research may explore the generalisability of findings to a wider sample of water utilities globally. Future work can also consider the most reliable treatment of capital inputs in efficiency analysis. Practical implications Regulators should be cautious when using economic efficiency data in benchmarking exercises. A consistent approach to account for the capital stock is needed in the determination of price caps and designing incentives for poor performers. Originality/value DEA has been widely used to explore the role of ownership structure, firm size and regulation on water utility efficiency. This is the first study of its kind to explore the sensitivity of DEA to alternative physical and accounting capital input measures. This research also improves the conventional performance measurement in water utilities by using a bootstrap procedure to address the deterministic nature of the DEA approach.
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Nor Aini, Yuni, Hadi Hadi, Sri Rahayu, Noor Pramono, and Donny Kristanto Mulyantoro. "EFFECT OF COMBINATION OF OXYTOCIN MASSAGE AND HYPNOBREASTFEEDING ON UTERINE INVOLUTION AND PROLACTIN LEVELS IN POSTPARTUM MOTHERS." Belitung Nursing Journal 3, no. 3 (June 7, 2017): 213–20. http://dx.doi.org/10.33546/bnj.102.
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Background: The absence of contractions after childbirth can lead to a slow-running uterine involution process. Thus, the effort to maintain and accelerate the process is needed. Oxytocin massage and hypnobreastfeeding are considered as an alternative treatment, but the effect of the combination of the two treatments have not yet been examined.Objective: To examine the effect of combination of oxytocin massage and hypnobreastfeeding on uterine involution and prolactin levels in post partum.Methods: A Quasy experimental study with pretest posttest control group design. a total of 40 respondents were recruited using simple random sampling, with 20 respondents assigned in the treatment and control group. Metline and ELISA methods were used to measure uterine involution prolactin levels. Paired t-test and independent t-test were used to analyze the data.Results: There was a significant decrease of uterine involution in the experiment group and control group after intervention with p-value 0.000 (<0.05), and it can be seen that the uterine involution in the experiment group (6.05) was faster than uterin involution in the control group (7.00). Findings also showed that the prolactin level in the experiment group (273.53) was higher than the prolactin level in the control group (209.37).Conclusion: There was statistically significant effect of the combination of oxytocin massage and hypnobreastfeeding on the uterine involution and prolactin level in postpartum mothers in the General Hospital of Semarang. It is expected that the combination of oxytocin massage and hypnobreastfeeding can be used as consideration and references in providing postpartum midwifery care.
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Jalindar, Miss Chole Laxmi. "Prapration of Tablet from Pencil Cactus for Treatment of Piles by Direct Compression method." International Journal for Research in Applied Science and Engineering Technology 9, no. 12 (December 31, 2021): 1666–70. http://dx.doi.org/10.22214/ijraset.2021.39597.
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Abstract: The intention of current review is to make available upto-date information on morphology, ecological biodiversity, medicinal uses, phytochemistry and pharmacological activities on different parts of Euphorbia tirucalli (E. tirucalli). This plant has a number of medicinal uses. Latex of E. tirucalli is vesicant and rubefacient which is used for rheumatism, warts, cough, asthma, ear-ache, tooth-ache and neuralgia. It acts as a purgative in small doses while in big doses it is bitter irritant and emetic. Milky juice is alexiteric, carminative and purgative. It is useful in whooping cough is used in treatment of piles. gonorrhea, asthma, leprosy, dropsy, dyspepsia, enlargement of spleen, colic, jaundice and stone in bladder. The fresh milky juice is good alternative in syphilis and a good application in neuralgia. A decoction of branches is used in gastralgia and colic. Bark is used in treatment of fractures. Poultices prepared from the stem are useful to repair the broken bones. Boiled root liquid acts as an emetic in cases of snake-bite and for infertility in women. The wood is used for rafters, toys and veneering purposes. It is also useful against leprosy and foot paralysis subsequent to childbirth. E. tirucalli is reported to have euphol, β-sitosterol, euphorbol hexacosonate, cycloeuphordenol, cyclotirucanenol, tirucalicine, tri-methyl ellagic acid, gallic acids, terpenic alcohol. genotoxic/mutagenic, hepatoprotective, insect repellants, immunomodulatory, larvicidal, molluscicidal/ovicidal/piscicidal, myelopoiesis, proteolytic/chitinolytics pharmacological activities. There is a need to isolate dynamic constituents, their biological trial, molecular mechanisms, experimental protection and legalization of therapeutic uses of E. tirucalli. The collected information will be helpful to locate up study protocol for expansion in curative and treat a variety used in treatment of piles., isoeuphorol, taraxasterol, tirucallol, euphorone, euphorcinol, euphorbins, 12-deoxy4βhydroxyphorbol-13-phenyl acetate-20-acetate, 12, 20- dideoxyphorbol-13-isobutyrate, glut-5-en-3-β-ol, 3,3′- diO-methylellagic acid, euphorbin-A (polyphenol), tirucallin-A (7) (tannin), tirucallin-B (11), euphorbin-F (14) (dimers), cycloartenol, 24- methylenecycloartenol, ingenol triacetate, 12-deoxy-4β-hydroxyphorbol- 13- phenyl acetate-20-acetate, taraxerone, euphorginol, taraxerol, campesterol, stigmasterol, palmitic acid, linoleic acid, β-amyrin, etc. Active phytoconstituents. E. tirucalli have possessed activity in humanly mphocytes, analgesic, anthelmintics, antiarthritic, antibacterial/antifungal/antimicrobial Antihemerrhoids. Keywords: Euphorbia tirucalli Morphology Ecological biodiversity Medicinal uses Phytochemistry Anticance antihemerrhoids
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Lewis, Claire D., Leah C. Marett, Bill Malcolm, S. Richard O. Williams, Tori C. Milner, Peter J. Moate, and Christie K. M. Ho. "Economic Threshold Analysis of Supplementing Dairy Cow Diets with Betaine and Fat during a Heat Challenge: A Pre- and Post-Experimental Comparison." Animals 12, no. 1 (December 31, 2021): 92. http://dx.doi.org/10.3390/ani12010092.
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Ex ante economic analysis can be used to establish the production threshold for a proposed experimental diet to be as profitable as the control treatment. This study reports (1) a pre-experimental economic analysis to estimate the milk production thresholds for an experiment where dietary supplements were fed to dairy cows experiencing a heat challenge, and (2) comparison of these thresholds to the milk production results of the subsequent animal experiment. The pre-experimental thresholds equated to a 1% increase in milk production for the betaine supplement, 9% increase for the fat supplement, and 11% increase for fat and betaine in combination, to achieve the same contribution to farm profit as the control diet. For the post-experimental comparison, previously modelled climate predictions were used to extrapolate the milk production results from the animal experiment over the annual hot-weather period for the dairying region in northern Victoria, Australia. Supplementing diets with fat or betaine had the potential to produce enough extra milk to exceed the production thresholds, making either supplement a profitable alternative to feeding the control diet during the hot-weather period. Feeding fat and betaine in combination failed to result in the extra milk required to justify the additional cost when compared to the control diet.
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Ginting, Keleng Ate, Raini Panjaitan, and Andreais Boffil Cholilullah. "PROMOSI KESEHATAN DENGAN PEMBERIAN JUS BAYAM MERAH (AMARANTHUS GANGETICUS) DALAM MENCEGAH ANEMIA PADA IBU HAMIL." JURNAL PENGMAS KESTRA (JPK) 1, no. 1 (June 30, 2021): 41–44. http://dx.doi.org/10.35451/jpk.v1i1.710.
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During pregnancy anemia often occurs, anemia is a term that is often used for a decrease in hemoglobin (Hb) levels. Anemia during pregnancy can increase the risk of death during childbirth, give birth to babies with low birth weight, miscarriage and increase the risk of premature birth. Health promotion activities through the provision of red spinach juice can be used as an alternative in socializing the prevention and treatment of anemia in pregnant women. The purpose of implementing community service is to maintain the health quality of pregnant women so that they are not at risk of anemia during pregnancy through health promotion and providing simple treatment through the provision of red spinach juice.
This community service was carried out for two days at the Salma clinic, Perbaungan District. On the first day of the activity, starting from registration, checking hemoglobin levels before giving red spinach juice, delivering material, demonstration of making red spinach juice and giving red spinach juice. On the second day of implementation, checking hemoglobin levels to see changes in hemoglobin levels after giving spinach juice. red. The results of the examination of hemoglobin levels showed that the mean hemoglobin level before administration of red spinach juice to pregnant women was 10.30 and after administration of 10.89 with a median value before administration of 10.15 and after administration of 10.75, SD value before administration of 0. ,6 and the SD value after administration was 0.5 with a minimum hemoglobin level before administration of 10 and after administration of 10, the maximum hemoglobin level before administration was 12 and after administration was 13.
Keywords: Health Promotion; Red Spinach; Hemoglobin Level; Anemia
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Coursol, Christian J., and Sabrina E. Sanzari. "Impact of Stress Ulcer Prophylaxis Algorithm Study." Annals of Pharmacotherapy 39, no. 5 (May 2005): 810–16. http://dx.doi.org/10.1345/aph.1d129.
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BACKGROUND: In the intensive care unit at Royal Victoria Hospital, we noted that drugs prescribed for stress ulcer prophylaxis were not always indicated or optimal. Accordingly, we implemented an algorithm for stress ulcer prophylaxis to guide the medical team in their decisions. The agents selected for the algorithm were intravenous famotidine and omeprazole suspension or tablets, depending on the available administration route. OBJECTIVE: To evaluate the impact of a treatment algorithm on the appropriateness of prescriptions for stress ulcer prophylaxis. METHODS: A quasi-experimental—type evaluative study was conducted based on a pre-/post-intervention design without a concurrent control group. A total of 555 complete admissions met the selection criteria; 303 patients formed the pre-intervention group, and 252 made up the post-intervention group (exposed to the treatment algorithm). RESULTS: After implementation of the algorithm, the proportion of inappropriate prophylaxis was decreased (95.7% vs 88.2%; p = 0.033). The number of days of inappropriate prophylaxis was also reduced significantly (p = 0.013), as was the cost per patient (p = 0.003) for all admissions. However, no difference was observed when the subgroup of patients who received prophylaxis alone was studied (p = 0.098 and p = 0.918). The presence of bleeding was similar in both groups. CONCLUSIONS: Introduction by pharmacists of a treatment algorithm for stress ulcer prophylaxis in intensive care units allows a reduction of inappropriate prescriptions and thus a reduction in the cost of drugs. The use of omeprazole suspension seems to be an alternative to intravenous histamine2-inhibitors; however, a large-scale study is necessary to confirm the efficacy and safety of proton-pump inhibitors administered by an enteral tube.
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Yastrebova, E. B., A. V. Samarina, E. K. Fertyh, and L. V. Gutova. "PEDIATRIC PROBLEMS OF HIV INFECTION AND SOLUTIONS IN SAINT PETERSBURG." HIV Infection and Immunosuppressive Disorders 11, no. 1 (April 7, 2019): 31–37. http://dx.doi.org/10.22328/2077-9828-2019-11-1-31-37.
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Survey objective: analysis of transmission routes of HIV infection, its course and treatment in children with the aim of determining the common problems and solutions. Materials and methods. Observation of 388 HIV-infected children at the age from month to 17 years was held for the purpose of analysis of common problems on the basis of Motherhood and Childhood Department of State Budgetary Healthcare Institution «St. Petersburg Center on Prevention and Control of AIDS and Infectious Diseases». Statistical processing of data was carried out using Statistica for Windows software (v. 8.0). Survey results. It was found that 363 of children were infected with HIV during perinatal period (93,6%), 23% (5,9%) were infected during childbirth and 2 children — through injected drugs (0,5%). Of the 16 children with perinatally acquired AIDS diagnosed in 2017, breastfeeding was reported in 6 (37,5%) cases that evaluates HIV-screening of sexual partners of pregnant women. 378 (97,4%) of children take ART when clinically, immunologically and virologically indicate. Of this number, first line ART regimen is used in 130 children (34,4%). 199 (80,2%) switched to second-line ART regimen due to adverse effects, 49 (19,8%) after virological failure. Prevailing adverse effects such as dyslipidemia (40,8%), polyneuropathy (22,6%) and anemia (12,6%) were a reason for switching to alternative regimen with combined medications. Presently, it is a great problem that parents or foster parents of a child — HIV-dissidents refuse of children care and treatment that led to lethal outcome in 18 cases. In light of this, pediatricians of Centers on Prevention and Control of AIDS have to protect children’s rights for health by making request and applications to the guardianship authorities, courts, prosecutors, law enforcement agencies. 57 appeals to these authorities have been made in total.
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Widiastuti, Ni Made Rai, and Ni Nyoman Ayuk Widiani. "Improved breastfeeding with back massage among postnatal mothers." International Journal of Research in Medical Sciences 8, no. 2 (January 27, 2020): 580. http://dx.doi.org/10.18203/2320-6012.ijrms20200239.
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Background: The achieving target of exclusive breast milk in Indonesia has not been achieved. The unsuccessful approval of exclusive breastfeeding is partly due to the mother's reasons for the inadequacy of milk production. Physiologically, oxytocin and prolactin are responsible for the smooth production of breast milk. The release of the hormone oxytocin in addition to being transferred by stimulation to the nipple through the baby's mouth or through spinal massage. Application of back massage techniques or oxytocin massage to provide stimulation that is expected to increase patient comfort, prevent oxytocin release, and increasing milk production.Methods: This research is a quasi-experimental design with a time series design and a control time series design. The sample this study were 15 postpartum mothers treated group and 15 postpartum mothers in the control group. Data was collected by the method of intervention and direct observation on the frequency of urinating infants. Data analysis using repeated ANOVA test.Results: Based on the results of research on the frequency of urinating in the control group had an average of 5.6 and a treatment group of 6.9. This is reinforced by the value of p=0.0001 (p<0.005) which means that there is an effect of giving back massage to increase milk production in postpartum mothers.Conclusion: This study suggests that giving back massage techniques to postpartum mothers as an alternative to increase milk production in postpartum mothers and included as one of the basic care for postpartum mothers since the first day after childbirth.
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Gurdán, Zsuzsanna, József Szalma, and Pálma Benedek. "Az achondroplasia a fogszabályozás szemszögéből." Orvosi Hetilap 162, no. 17 (April 25, 2021): 683–88. http://dx.doi.org/10.1556/650.2021.32074.
Full textAbstract:
Összefoglaló. Az achondroplasia kialakulásáért az FGFR3-gén mutációja tehető felelőssé, mely a porc növekedési lemezében található chondrocyták érésében okoz zavart. Az esetbemutatásban szereplő lánygyermeknél a születést követő első hónapban a klinikai, laboratóriumi és röntgenvizsgálatok alapján achondroplasia igazolódott. A klinikai tünetek közé tartoznak a rövid végtagok – különösen a proximalis szegmensben –, a macrocephalia, a hypotonia és a horkolás. Szembetűnő a középarc hypoplasiája. A középfül diszfunkciója tovább súlyosbítja a kórképet, sok esetben megfigyelhető a hallás nagyfokú csökkenése, illetve kezelés hiányában akár a hallás elvesztése. A közlemény részletesen bemutatja az obstruktív alvási apnoe szindróma diagnózisrendszerét és kezelési alternatíváit, hangsúlyozva az orthodontiai szempontokat. A fül-orr-gégészeti és a fogszabályozó terápiának köszönhetően, a diagnózistól számított harmadik évre, az alvási apnoe szindróma megszüntetésével a folyamatos pozitív nyomású lélegeztetést el lehetett hagyni. A horkolás és az alvási apnoe szindróma kezelése napjainkban egyre nagyobb hangsúlyt kap, melynek komplex kezelésében a fogszabályozás is jelentős lehet. A harmonikus együttműködés és teamkezelés betegünknél jelentős életminőség-javulást eredményezett. Orv Hetil. 2021; 162(17): 683–688. Summary. Development of achondroplasia is due to the mutation of FGFR3 gene, which disrupts the maturation of chondrocytes found in the growth plate. The diagnosis of the girl in the present case study was established based on clinical symptoms, laboratory tests and X-ray imaging in the first month following childbirth. Clinical symptoms include shorter limbs especially in the proximal segments, macrocephaly, hypotonia and snoring. Hypoplasia of the midface is apparent. Dysfunction of the middle ear further worsens the condition, in many cases severe hearing loss and, without treatment, even deafness can be observed. The publication describes the diagnostic criteria and therapeutic options of obstructive sleep apnea syndrome in detail, with an emphasis on the orthodontic aspects. A comprehensive combined three-year oto-laryngological and orthodontic treatment finally succeeded in controlling the sleep apnea syndrome and it was possible to discontinue the continuous positive airway pressure therapy by the end of the orthodontic therapy. Nowadays, even more alternative therapeutic approaches are available to treat snoring and sleep apnea syndromes, in which the role of orthodontics must not be neglected. Harmonic collaboration and team work treatment resulted in a significant improvement in the quality of life of our patient. Orv Hetil. 2021; 162(17): 683–688.
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Moate, P. J., D. E. Dalley, K. Martin, and C. Grainger. "Milk production responses to turnips fed to dairy cows in mid lactation." Australian Journal of Experimental Agriculture 38, no. 2 (1998): 117. http://dx.doi.org/10.1071/ea97101.
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Summary. Recently, many dairy farmers in Victoria have grown turnips as a summer fodder crop for lactating dairy cows. This paper reports on a 1 month experiment in which cows were individually fed indoors, and milk yield responses to feeding combinations of turnips and barley were measured. Forty cows in mid lactation were evenly allocated to 5 treatment groups. The control group were offered a basal diet of pasture hay and pasture silage which is similar to that available on many Victorian dairy farms during summer. Cows in the other 4 groups were offered the basal diet and various combinations of turnips and/or barley. Marginal milk responses from barley, turnips and a 50 : 50 mixture of turnips and barley were 0.62, 0.49 and 0.59 L/kg dry matter of supplement eaten. Milk composition of all groups was similar. Despite diets differing greatly in the proportions and physical form of dietary constituents, the mean milk production of each group was accurately predicted by their mean dry matter intake. Measurement of plasma minerals (calcium, magnesium, sodium, potassium and phosphorus) and rumen fluid pH showed that dietary treatments caused some significant (P<0.05) differences but all values were within the normal range. In this experiment, the milk production responses from barley, turnips and combinations of barley and turnips were similar. Since the cost of turnips is generally about half that of barley, it is concluded that turnips are an economic alternative to barley as a feed supplement for summer milk production.
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Coulson, Graeme, Christopher D. Nave, Geoff Shaw, and Marilyn B. Renfree. "Long-term efficacy of levonorgestrel implants for fertility control of eastern grey kangaroos (Macropus giganteus)." Wildlife Research 35, no. 6 (2008): 520. http://dx.doi.org/10.1071/wr07133.
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Overabundant populations of kangaroos pose substantial management problems in small parks on the fringe of urban areas in Australia. Translocation is impractical and culling is often not publicly acceptable, but fertility control offers an acceptable alternative. One potential contraceptive is levonorgestrel, which provides effective long-term contraception in women, and prevents births in some marsupials for up to five years. We evaluated the long-term efficacy of levonorgestrel in free-ranging eastern grey kangaroos (M. giganteus) at two sites in Victoria, Australia. We trapped 25 adult females at one site (Portland Aluminium), treating 18 with two subcutaneous 70-mg levonorgestrel implants and seven with control (inert) implants. We darted 25 adult females at the other site (Woodlands Historic Park), treating all with two 70-mg levonorgestrel implants. We monitored the reproductive status of the kangaroos, as indicated by the obvious presence of a pouch young, in spring each year for up to seven years. In the first three years at Portland, 81–86% of levonorgestrel-treated females were infertile, compared with 12–29% in the control group, but the effectiveness of fertility control declined over time. At this site, the proportions of treated females breeding in the fourth, fifth, sixth and seventh years of the trial were 36%, 50%, 67% and 100% respectively. Fecundity at Woodlands was similar. Although this protocol achieved fertility control for several years, it was likely that more than one treatment or a higher dose rate would be required for effective fertility control in this long-lived species.
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Vardanyan, Vardan G., Alexandr I. Alekhin, Natalya A. Mezhlumova, Galina Yu Pevgova, and Anton A. Alekhin. "New aspects in the surgical correction of pelvic organ prolapse." RUDN Journal of Medicine 26, no. 4 (December 23, 2022): 373–81. http://dx.doi.org/10.22363/2313-0245-2022-26-4-373-381.
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Relevance . The relevance of the problem of pelvic prolapse is due to the prevalence of the disease, the tendency to rejuvenation and progression. This, according to the survey, affects the quality of life of women, leads to disruption of sexual functioning, and reduces the ability to work. The methods of surgical treatment that exist in the arsenal of modern operative gynecology can contribute to the development of cicatricial adhesions, infectious complications and recurrence of prolapse, which creates the need for repeated interventions. The development and introduction into practice of new methods of treatment is a natural necessity. The most effective technique for the surgical treatment of genital prolapse is laparoscopic sacrocolpopexy using titanium silk implants. Materials and Methods. A prospective cohort study of 30 patients aged 37 to 74 years with clinical manifestations of grade II-IV prolapse, statistical data analysis and analysis of the results of a survey of patients in the postoperative period in dynamics over 3-6-12 months from 2019 to 2021 was carried out. The study used a three-stage method of surgical assistance (patent dated September 15, 2020 No. 2020130382/14 (054923) in the volume - laparoscopic promontofixation, MacCoul sacro-uterine ligament plasty, colporrhaphy, colpoperineorrhaphy, levatoroplasty. Results and Discussion. It has been established that pregnancy and childbirth are among the main factors provoking the development of pelvic floor muscle failure. The duration of postoperative follow-up in our study was 3-14 months. No complications were diagnosed during this period. In 12 patients (40.0 %) during the first month there were periodic pulling pains in the lower abdomen and perineum, in 2 (6.6 %) - urinary incontinence. Titanium silk has a lower affinity for surrounding tissues compared to polypropylene scaffold systems, which makes it possible to consider it as an alternative material to synthetic analogues and reduce the risk of mesh-associated complications. The resistance of the titanium endoprosthesis to antiseptics and microbial agents predisposes to its long-term use and the absence of the need for replacement. Conclusion. The data obtained make it possible to judge the high efficiency of the developed technique for the surgical treatment of pelvic prolapse of pelvic floor defects in patients with rectocele and cystocele, minimizing the recurrence of the disease and the risk of developing mesh-associated complications, which allows choosing a personalized management strategy for this cohort of patients.
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Collins, Anna, Sue-Anne McLachlan, and Jennifer Philip. "Initial perceptions of palliative care: An exploratory qualitative study of patients with advanced cancer and their family caregivers." Palliative Medicine 31, no. 9 (April 3, 2017): 825–32. http://dx.doi.org/10.1177/0269216317696420.
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Background: Despite evidence for early integration of palliative care for people with advanced cancer and their families, patterns of late engagement continue. Prior research has focused on health professionals’ attitudes to palliative care with few studies exploring the views of patients and their carers. Aim: To explore initial perceptions of palliative care when this is first raised with patients with advanced cancer and their families in Australian settings. Design: Cross-sectional, prospective, exploratory qualitative design, involving narrative-style interviews and underpinned by an interpretative phenomenological framework. Setting/participants: Purposively sampled, English-speaking, adult patients with advanced cancer ( n = 30) and their nominated family caregivers ( n = 25) recruited from cancer services at a tertiary metropolitan hospital in Melbourne, Victoria, Australia. Results: Three major themes evolved which represent the common initial perceptions of palliative care held by patients with advanced cancer and their carers when this concept is first raised: (1) diminished care, (2) diminished possibility and (3) diminished choice. Palliative care was negatively associated with a system of diminished care which is seen as a ‘lesser’ treatment alternative, diminished possibilities for hope and achievement of ambitions previously centred upon cure and diminished choices for the circumstances of one’s care given all other options have expired. Conclusion: While there is an increasing move towards early integration of palliative care, this study suggests that patient and caregiver understandings have not equally progressed. A targeted public health campaign is warranted to disentangle understandings of palliative care as the ‘institutional death’ and to reframe community rhetoric surrounding palliative care from that of disempowered dying to messages of choice, accomplishment and possibility.
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Chong, Krystle Y., Yee K. Mak, Beverley Vollenhoven, and Ben W. Mol. "An Audit of Management of Ectopic Pregnancy in a Major Tertiary Healthcare Service." Fertility & Reproduction 03, no. 01 (March 2021): 14–18. http://dx.doi.org/10.1142/s266131822150002x.
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Background: Ectopic pregnancy remains the most common cause of early pregnancy mortality, with management options differing according to clinical presentation and investigations. This audit aims to investigate the indications for medical and surgical management of ectopic pregnancy at a tertiary hospital network, in order to assess variances in practice and adherence to local hospital protocols. Methods: A retrospective audit of the management of women with a diagnosis of ectopic pregnancy was performed over 12 months from July 2018 to June 2019, at three hospitals in the largest healthcare network in Victoria, Australia. Information collected included patient demographics, risk factors for ectopic pregnancy, pathology and radiology results, documented indication for surgery, and any complications of treatment. A subgroup analysis of data was done to investigate changes and deficiency in management of ectopic pregnancy compared to local hospital protocol. Results: Over a 12-month period, 138 women were diagnosed with an ectopic pregnancy, of which 99 (72%) received surgical management and 39 (28%) received medical management. Four women within the medical group were excluded from analysis, one due to loss of follow-up and three patients who were diagnosed with nontubal ectopic pregnancies. About 94% (33/35) of women who received methotrexate were within hospital guidelines for medical management and 91% (32/35) were successfully managed without surgery. All women who received surgical management underwent a salpingectomy and 97% (96/99) had clear indications documented for surgery within local protocol. Conclusion: Overall, the majority of women with ectopic pregnancy were treated according to local guidelines. Expectant management and the option of salpingostomy as a surgical alternative could be considered in the local guidelines. The dissemination of this clinical audit data is aimed at continuing clinical governance and improvements in outcomes.
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Moate, P. J., C. Grainger, D. E. Dalley, K. Martin, J. R. Roche, and M. Hannah. "Turnips and protein supplements for lactating dairy cows." Australian Journal of Experimental Agriculture 39, no. 4 (1999): 389. http://dx.doi.org/10.1071/ea98176.
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Many farmers in southern Victoria grow fodder turnips as a summer feed for lactating dairy cows. This paper reports on 2 experiments that measured the milk yields and liveweight changes of cows offered a basal forage diet and combinations of turnips, barley and protein supplements (cottonseed meal or lupins). A stall feeding experiment was conducted over 26 days with 40 Friesian cows in mid lactation offered 1 of 5 dietary treatments. All cows were offered 10 kg DM/day of a basal diet comprising pasture, pasture hay and pasture silage which is similar to that available on many southern Victorian dairy farms during summer. Cows in a control group did not receive additional feed supplements. Cows in the other 4 groups were offered a supplement of 5 kg DM/cow.day of either turnips, barley or a mixture containing 3 kg DM/cow.day of turnips and 2.0 kg DM/cow.day of either crushed lupins or cottonseed meal. The marginal milk responses from barley, turnips, turnips + lupins and turnips + cottonseed meal were 0.80, 0.92, 1.15 and 1.00 L/kg DM of supplement eaten. There were no significant differences (P>0.05) in the liveweight changes of the supplemented groups. Samples of the feeds used in this experiment were placed in nylon bags and incubated in the rumen of non-lactating dairy cows. The ‘Ørskov’ protein degradation parameters for these feeds are compared with the published values for a range of Australian feeds. The rate and extent of degradation of protein from the turnip leaves, turnip bulbs and crushed barley were all similar. A grazing experiment was conducted over 65 days with 56 Friesian cows in mid lactation, offered 1 of 4 dietary treatments. All groups were allowed to graze pasture (5 kg DM/cow.day), were offered 3 kg DM/cow.day of pasture silage and were fed different combinations of barley, cottonseed meal and lupins. In addition, 3 of the groups separately strip-grazed turnips (about 5 kg DM/cow.day). The group fed a supplement of 8.0 kg/cow.day of barley yielded similar quantities (18.3 L/cow.day) of milk and milk constituents as another group fed 4.0 kg DM/cow.day of barley and 4.5 kg DM/cow.day of turnips. Furthermore, when either 1.5 kg DM of cottonseed meal or 2.0 kg of lupins were fed in place of barley, milk yield increased by 1.4 L/cow.day. Dietary treatment had no significant (P>0.05) effects on liveweight changes. From this grazing experiment it is concluded that turnips can be used as a cheaper alternative to barley in order to maintain high levels of milk production in summer–autumn. We estimate that if the above quantities of protein supplement were fed with turnips, at 1997–98 prices, lupins would increase profits by 12 cents/cow.day, but there would be no financial benefit from the cottonseed meal. The findings from both experiments show that supplements of rumen-degradable protein (lupins) can produce an economic milk response when fed to cows on typical summer diets (pasture/silage/barley and turnips) in southern Victoria.
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Dobbie, Meredith Frances. "Typing Colonial Perceptions of Carrum Carrum Swamp: The Expected and the Surprising." Land 11, no. 2 (February 18, 2022): 311. http://dx.doi.org/10.3390/land11020311.
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Carrum Carrum Swamp was a vast wetland to the south-east of Melbourne, Victoria, Australia, at the time that it was first sighted by white colonists in 1803. By 1878, the colonists had commenced converting the swamp to dry land for agricultural and horticultural pursuits, and 100 years later it was predominantly residential land. Shifting values in the 1970s led to environmental concerns about water quality in local creeks and Port Phillip Bay and subsequent residential development on the former swamp included the construction of stormwater treatment wetlands. Perceptions of wetlands are now diverse, including positive perceptions that support their presence in urban settings. In contrast, traditionally, wetlands have been perceived negatively, as waste lands, leading to their drainage. Nevertheless, alternative, perhaps positive, perceptions could have existed, only to be overwhelmed by the negative perceptions driving drainage. Understanding the full range of past perceptions is important to ensure that the historical record is correct and to provide historical context to contemporary perceptions of wetlands. It will better equip natural resource managers and designers and managers of constructed wetlands in urban locations to ensure that wetlands are healthy, functioning and appreciated by their local and wider communities. Thus, the perceptions of Carrum Carrum Swamp by colonists from 1803 to 1878 were examined through qualitative content analysis of historical documents, and a typology was developed. Seven different perceptions were identified: scientific, premodern, exploitative, romantic, aesthetic, medico-mythic and ecological. Most could be traced to the colonists’ predominantly British heritage, but one perception arose in the colony in response to the specific environmental conditions that the colonists encountered. This ecological perception valued wetlands as places of predictable water supply in a land of unpredictable rainfall. It recognised wetlands as part of a broader hydrological system, with influences on the local climate. Its proponents promoted the need for a different approach to the management of wetlands than in Britain and Europe. Nevertheless, a dominant exploitative perception prevailed, leading to the drainage of Carrum Carrum Swamp. The typology developed in this study will be useful for exploring perceptions of other wetlands, both colonial and contemporary.
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Rawstorn, Jonathan Charles, Kylie Ball, Brian Oldenburg, Clara K. Chow, Sarah A. McNaughton, Karen Elaine Lamb, Lan Gao, et al. "Smartphone Cardiac Rehabilitation, Assisted Self-Management Versus Usual Care: Protocol for a Multicenter Randomized Controlled Trial to Compare Effects and Costs Among People With Coronary Heart Disease." JMIR Research Protocols 9, no. 1 (January 27, 2020): e15022. http://dx.doi.org/10.2196/15022.
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Background Alternative evidence-based cardiac rehabilitation (CR) delivery models that overcome significant barriers to access and delivery are needed to address persistent low utilization. Models utilizing contemporary digital technologies could significantly improve reach and fidelity as complementary alternatives to traditional center-based programs. Objective The aim of this study is to compare the effects and costs of the innovative Smartphone Cardiac Rehabilitation, Assisted self-Management (SCRAM) intervention with usual care CR. Methods In this investigator-, assessor-, and statistician-blinded parallel 2-arm randomized controlled trial, 220 adults (18+ years) with coronary heart disease are being recruited from 3 hospitals in metropolitan and regional Victoria, Australia. Participants are randomized (1:1) to receive advice to engage with usual care CR or the SCRAM intervention. SCRAM is a 24-week dual-phase intervention that includes 12 weeks of real-time remote exercise supervision and coaching from exercise physiologists, which is followed by 12 weeks of data-driven nonreal-time remote coaching via telephone. Both intervention phases include evidence- and theory-based multifactorial behavior change support delivered via smartphone push notifications. Outcomes assessed at baseline, 12 weeks, and 24 weeks include maximal aerobic exercise capacity (primary outcome at 24 weeks), modifiable cardiovascular risk factors, exercise adherence, secondary prevention self-management behaviors, health-related quality of life, and adverse events. Economic and process evaluations will determine cost-effectiveness and participant perceptions of the treatment arms, respectively. Results The trial was funded in November 2017 and received ethical approval in June 2018. Recruitment began in November 2018. As of September 2019, 54 participants have been randomized into the trial. Conclusions The innovative multiphase SCRAM intervention delivers real-time remote exercise supervision and evidence-based self-management behavioral support to participants, regardless of their geographic proximity to traditional center-based CR facilities. Our trial will provide unique and valuable information about effects of SCRAM on outcomes associated with cardiac and all-cause mortality, as well as acceptability and cost-effectiveness. These findings will be important to inform health care providers about the potential for innovative program delivery models, such as SCRAM, to be implemented at scale, as a complement to existing CR programs. The inclusion of a cohort comprising metropolitan-, regional-, and rural-dwelling participants will help to understand the role of this delivery model across health care contexts with diverse needs. Trial Registration Australian New Zealand Clinical Trials Registry (ACTRN): 12618001458224; anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374508. International Registered Report Identifier (IRRID) DERR1-10.2196/15022
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Mariani, Andrea. "Rola społeczna aptek jezuickich w dawnej Rzeczypospolitej." Wiek Oświecenia, no. 37 (November 9, 2021): 42–83. http://dx.doi.org/10.31338/0137-6942.wo.37.2.
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The article presents the social role of Jesuit pharmacies in the Polish-Lithuanian Commonwealth based on the sources of religious provenance and inventories of Jesuit colleges drawn up as a result of the dissolution of the Society of Jesus in 1773. In the first part, the author analyzes the ecclesiastical and secular legislation and its impact on the activities of Jesuit pharmacies. Canon law did not forbid clergymen to deal with medicine, but only limited the possibility of obtaining academic education in this field and conducting surgical procedures. By adopting these rules, Jesuit legislation placed the main emphasis on superiors’ control over the finances of pharmacies and limited the sale of drugs to protect the order from being accused of unfair competition by the townspeople. In the context of state pharmaceutical law, the privilege of June 30, 1662, which allowed for the liberation of journeymen by Jesuit pharmacists, was of great importance. In this way, a path of professional education in the field of pharmacy under the management of the Society, an alternative to the guild system, was created. The second part of the article discusses the social factors that favoured the establishment of monastic pharmacies. Particularly noteworthy is the uneven distribution of Jesuit pharmacies in the former Polish-Lithuanian Commonwealth. While in Royal Prussia the Jesuits did not run pharmacies to avoid conflicts with the Protestant bourgeoisie, in the eastern borderlands of the Polish-Lithuanian state, Jesuit pharmacies were often the only institutions of this type. The third part of the work presents the financial situation of Jesuit pharmacies. They had significant income, but also required considerable investments related to the purchase of raw materials and equipment in the Baltic ports. The fourth part of the article concerns the social scope of the activity of Jesuit pharmacists, who not only provided medicines to the poor, but also treated nobles, magnates and high church dignitaries. Not being obliged by guild regulations, apart from preparing medicines, they also diagnosed them, performed minor surgical procedures and assisted women during childbirth. The last part of the article discusses drugs and raw materials in terms of their availability to the broadly understood clientele. The offer of Jesuit pharmacies included both cheap products derived from the local flora, intended for the treatment of the poor, and expensive raw materials from abroad. Moreover, among the medical matter there were preparations for women and infants, as well as for people suffering from syphilis. In the end, the author emphasizes the centrality of pharmacies in the Jesuit pastoral strategy. Thanks to their high level, pharmacies not only corresponded to the ideal of mercy, but also contributed to gaining the favour and trust of representatives of social elites. In this context, the dissolution of the Society is an important turning point not only in cultural and religious life, but also in the history of medicine and pharmacy in the former Polish-Lithuanian Commonwealth.
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Garcia-Delgado, Regina, Donal P. McLornan, László Rejtő, Eric Jourdan, Haifa Kathrin Al-Ali, Andrzej Pluta, Marek Hus, et al. "An Open-Label, Phase 2 Study of KRT-232, a First-in-Class, Oral Small Molecule Inhibitor of MDM2, for the Treatment of Patients with Myelofibrosis (MF) Who Have Previously Received Treatment with a JAK Inhibitor." Blood 134, Supplement_1 (November 13, 2019): 2945. http://dx.doi.org/10.1182/blood-2019-123836.
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Background: Myelofibrosis (MF) is a myeloproliferative neoplasm (MPN) characterized by progressive bone marrow fibrosis, ineffective erythropoiesis, dysplastic megakaryocyte hyperplasia, and extramedullary hematopoiesis. MF includes primary MF (PMF), post-polycythemia vera MF (post-PV-MF), and post-essential thrombocythemia MF (post-ET-MF). Clinical presentation is heterogeneous, marked by splenomegaly, progressive anemia, and constitutional symptoms. The median survival in patients with high-risk disease is approximately 2 years. Hematopoietic Stem Cell Transplant (HSCT) is a potentially curative therapy, however due to considerable morbidity and mortality rates, HSCT is not appropriate for most patients, including elderly patients with intermediate-II and high-risk disease. The Janus kinase (JAK) inhibitor ruxolitinib is approved in the US and EU for the treatment of patients with intermediate or high-risk MF, including PMF, post-PV-MF, and post-ET-MF. In clinical studies, treatment with ruxolitinib has been shown to reduce spleen volume by International Working Group (IWG) criteria in approximately 28% to 42% of patients and improve constitutional symptoms of MF in approximately 46% of patients (Verstovsek, J Hematol Oncol. 2017). Ruxolitinib provides symptomatic improvement, however, does not target the malignant clone or appreciably reduce the degree of fibrosis; some patients experience disease progression and leukemic transformation while on therapy (Versotvsek, NEJM. 2010; Harrison, NEJM. 2012; Kremyanskaya, Br J Hem. 2014). Moreover, ruxolitinib is associated with AEs including anemia and thrombocytopenia, which can lead to discontinuation. Approximately 50% of patients treated with ruxolitinib discontinued treatment within 3 years and 73% at 5 years (Verstovsek, Haematologica. 2015; Verstovsek, J Hematol Oncol. 2017; Cervantes, Blood. 2013; Harrison, Leukemia. 2016). Median overall survival in patients who discontinue ruxolitinib is 14-16 months, highlighting the need for novel therapies targeting alternative pathways in the setting of failure or intolerance of JAK inhibitor therapy (Newberry, Blood. 2017). The tumor suppressor protein p53 is the master regulator of cell-cycle arrest and apoptosis in response to cellular stress or DNA damage. Murine double minute 2 (MDM2) is a key regulator of p53, inhibiting its activity via ubiquitination, nuclear export, and direct inhibition of transcriptional activity. Increased MDM2 protein expression has been observed in MF CD34+ cells, suggesting that MF might be sensitive to MDM2 inhibition (Lu M, Blood. 2017). KRT-232 is a potent and selective, oral, small molecule drug that targets MDM2 and prevents MDM2-mediated p53 inhibition, allowing p53 to mediate tumor cell-cycle arrest and apoptosis. In MF, TP53 is observed to be wild-type in 96% of MF patients, suggesting MDM2 inhibition could be a successful therapeutic strategy in this disease (Raza, Am J Hematol. 2012). KRT-232 has been investigated as monotherapy and in combination with trametinib or dabrafenib in phase I studies of AML and melanoma; the most common treatment-related adverse events (TRAEs) observed were nausea, diarrhea, vomiting, decreased appetite, anemia, leukopenia, thrombocytopenia, and fatigue. The majority of TRAEs were grade 1 or 2. Methods: KRT-232 is being evaluated in an open-label phase 2 study in patients with MF who relapsed on or are refractory to JAK inhibitors (Figure). Up to 247 patients ≥ 18 years of age, with ECOG performance status ≤ 2, with high-, intermediate-2, or intermediate-1 risk disease by Dynamic International Prognostic System (DIPSS), and failure of prior treatment with JAK inhibitors will be enrolled. The study will be conducted in 2 parts. Part A will identify the recommended dose and schedule by testing varying doses and schedules across 7 treatment cohorts. Part B will evaluate safety and efficacy using the recommended dose and schedule from Part A. The primary endpoint of the study is to determine spleen response at week 24; secondary endpoints include improvement in MPN-SAF Total Symptom Score (weeks 24 and 48), red blood cell (RBC) transfusion independence, and rates of complete remission and partial remission (IWG-ERT and ELN) at week 24. This trial is enrolling at multiple sites in the United States and Europe (NCT03662126, EudraCT: 2018-001671-21). Disclosures Garcia-Delgado: Hospital Virgen De La Victoria Malaga: Employment; Novartis: Consultancy, Speakers Bureau; Celgene: Speakers Bureau. McLornan:Jazz Pharmaceuticals: Honoraria, Speakers Bureau; Novartis: Honoraria. Jourdan:Novartis: Honoraria; Astellas: Membership on an entity's Board of Directors or advisory committees; Celgene: Membership on an entity's Board of Directors or advisory committees. Al-Ali:Celgene: Research Funding; Novartis: Consultancy, Honoraria, Research Funding; CTI: Honoraria. Pluta:Freelight Poland: Honoraria; Sandoz: Honoraria; Servier: Honoraria; Jansen-Cilag: Honoraria; Novartis: Honoraria; Takeda: Honoraria; Roche: Honoraria; Specialistic Hospital in Brzozow,Dept of Haematooncology Ks.Bielawskiego 18 36-200 Brzozow, Poland: Employment; Teva: Honoraria; Roche Poland: Membership on an entity's Board of Directors or advisory committees; Jansen Cilag Poland: Membership on an entity's Board of Directors or advisory committees. Ewing:Novartis: Honoraria, Other: Meeting attendance sponsorship ; Bristol Myers-Squibb: Other: Meeting attendance sponsorship . Khan:Amgen: Consultancy; Celgene: Consultancy; Incyte: Honoraria; Pfizer: Consultancy; Takeda: Research Funding. Jost:Novartis: Research Funding; Celgene: Other: Travel Support; Pfizer: Consultancy, Speakers Bureau; Novartis: Consultancy, Speakers Bureau; Abbvie: Consultancy, Patents & Royalties: Royalty payments for the drug compound ABT-199, Research Funding; Bohringer: Consultancy, Research Funding; BMS: Consultancy, Speakers Bureau. Rothbaum:Kartos Therapeutics: Employment, Patents & Royalties: Pending; Quogue Bioventures LLC: Equity Ownership, Membership on an entity's Board of Directors or advisory committees. McGreivy:Kartos Therapeutics: Employment, Equity Ownership, Membership on an entity's Board of Directors or advisory committees. Verstovsek:Incyte: Research Funding; Roche: Research Funding; NS Pharma: Research Funding; Celgene: Consultancy, Research Funding; Gilead: Research Funding; Promedior: Research Funding; CTI BioPharma Corp: Research Funding; Genetech: Research Funding; Blueprint Medicines Corp: Research Funding; Novartis: Consultancy, Research Funding; Sierra Oncology: Research Funding; Pharma Essentia: Research Funding; Astrazeneca: Research Funding; Ital Pharma: Research Funding; Protaganist Therapeutics: Research Funding; Constellation: Consultancy; Pragmatist: Consultancy. OffLabel Disclosure: Yes, KRT-232 is an investigational small molecule MDM2 inhibitor. This trial-in-progress abstract describes a registered clinical trial that will evaluate the safety and efficacy of KRT-232 for patients with myelofibrosis.
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Franco Gomez, K. N., C. Plasencia, M. Novella-Navarro, D. Benavent, P. Bogas, R. Nieto, I. Monjo, et al. "AB0646 IS IT FEASIBLE TO ACHIEVE RECOMMENDED THERAPEUTICAL TARGET IN PATIENTS WITH AXIAL SPONDYLARTHRITIS IN CLINICAL PRACTICE? DATA FROM THE SpA-Paz COHORT." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 1617.1–1618. http://dx.doi.org/10.1136/annrheumdis-2020-eular.4617.
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Background:Current ASAS/EULAR recommendations for the management of patients with axial spondylarthritis (axSpA) establish that the therapeutic goal to achieve in clinical practice is remission, defined as the absence of both clinical and laboratory disease activity evaluated by BASDAI&CRP or preferably ASDAS and if this is not possible, low disease activity may be an alternative. Recently, ASDAS nomenclature has been modified, calling now low disease activity to what was previously called moderate activity. To this day we do not know if this target is feasible in clinical practice.Objectives:To analyze the frequency of patients with axSpA achieving maintained remission (R) or low disease activity (LDA) after receiving biological therapy. Secondary objectives included: i) to assess if the activity index used influences the frequency of maintained R/LDA, ii) analyze the prognostic factors for achieving maintained R/LDA.Methods:An observational, longitudinal study of a prospective cohort (SpA-Paz) including all patients with axSpA who initiated their first biological treatment between the years 2003-2017. Demographic, clinical and analytical data were collected at the beginning of treatment and clinical disease activity measured by BASDAI&CRP and ASDAS every 6 months for 2 years. Maintained R was defined as (BASDAI<2 & normal CRP and/or ASDAS <1.3) and maintained LDA (BASDAI <4 & normal CRP and/or ASDAS <2.1) on at least 3 consecutive visits. Statistical analysis: i) measures of central tendency and dispersion for quantitative variables and frequencies for qualitative variables; ii) univariate and multivariate analysis of binomial logistic regression model and calculation of OR and 95% CI.Results:Out of 186 patients with axSpA who started treatment during the study period, 63% were men with a mean age of 54 ± 14.1 years. 75.3% of the patients had radiographic axSpA and 74.7% were HLA-B27 positive. Other baseline characteristics (not shown due to space restrictions). Overall, 80% of the patients achieved ASDAS R/LDA (R36%/LDA44%) in at least one of the visits after 2 years of follow-up, but only 40% (R27%/LDA13%) fulfilled the maintained ASDAS R/LDA state. On the other hand, 73% of patients were classified as BASDAI&CRP R/LDA (R31%/LDA42%) in at least one of the visits, but only 31% (R21%/LDA10%) obtained the maintained BASDAI&CRP R/LDA state. In the multivariate analysis, we observed an independent statistically significant association with male sex (OR=3.19; 95% CI=1.46-6.99), younger age at the beginning of the biological treatment (OR=0.97; 95% CI=0.95-0.99) and the use of methotrexate (OR=3.07; 95% CI=1.39-6.78) in patients who achieved maintained BASDAI&CRP R/LDA and with male sex (OR=4.01; 95% CI=1.83-8.77), younger age at the beginning of the biological therapy (OR=0.96; 95% CI=0.94-0.99) and HLA B27 presence (OR=4.30; 95% CI=1.68-11.01) in patients who achieved maintained ASDAS R/LDA.Conclusion:Although the majority of patients with axSpA who initiate biological therapy achieve the recommended therapeutic goal in the first two years of treatment, the percentage of patients who manage to maintain the R/LDA status is limited. In our study, maintained R was more frequent than maintained LDA, being somewhat higher when measured by ASDAS. This fact may suggest that patients who achieve maintained R have a greater inhibition of their inflammatory activity and, therefore, it remains in time. Male sex and younger age at the beginning of the biological therapy were the main baseline predictors for achieving maintained R/LDA.Graphics:Disclosure of Interests:Karen Nathalie Franco Gomez: None declared, Chamaida Plasencia: None declared, Marta Novella-Navarro: None declared, Diego Benavent: None declared, Patricia Bogas: None declared, Romina Nieto: None declared, Irene Monjo: None declared, Laura Nuño: None declared, Alejandro Villalva: None declared, Diana Peiteado Grant/research support from: AbbVie, Lilly, MSD, and Roche, Speakers bureau: AbbVie, Roche, and MSD, Alejandro Balsa Grant/research support from: BMS, Roche, Consultant of: AbbVie, Gilead, Lilly, Pfizer, UCB, Sanofi, Sandoz, Speakers bureau: AbbVie, Lilly, Sanofi, Novartis, Pfizer, UCB, Roche, Nordic, Sandoz, Victoria Navarro-Compán Consultant of: Abbvie, Lilly, Novartis, Pfizer, UCB, Speakers bureau: AbbVie, MSD, Lilly, Novartis, Pfizer, UCB
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Espinosa-Bravo, Martin, Victoria Reyes Lopez, Clara Morales Comas, Joaquín Rivero Déniz, Javier de La Torre Fernández de Vega, Irene Vives Roselló, Christian Sisó Raber, et al. "Abstract PD7-09: Safety of conservative surgery with accelerated partial breast re-irradiation for isolated ipsilateral breast cancer recurrence regardless of immunohistochemical subtype. A multicentric prospective study." Cancer Research 82, no. 4_Supplement (February 15, 2022): PD7–09—PD7–09. http://dx.doi.org/10.1158/1538-7445.sabcs21-pd7-09.
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Abstract Background. The standard of care for patients (pts) with an ipsilateral breast tumour recurrence (IBTR) after breast conserving therapy (BCT) is a salvage mastectomy. However there is no solid data providing a clear advantage of radical surgery for IBTR in terms of the outcome for patients with isolated local recurrence after BCT. Nevertheless, there is a growing interest in the feasibility of repeating BCT for these patients (pts). We analyzed the oncological outcomes of repeated breast-conserving therapy (rBCT) related to the immunohistochemical subtype. Materials and methods. Between 2014 and 2020, 35 pts were selected for a 2nd BCT, a new lumpectomy with accelerated partial breast re-irradiation (APBrI), and prospectively followed in three university hospitals in Barcelona. Inclusion criteria were pts older than 50y with a late (> 48m from primary treatment) isolated IBTR less than 2cm, without having primary major radiotherapy toxicity. Oncological outcomes were analyzed. Results. At IBTR, median age was 65y and median time to ITBR was 154m. Patients characteristics are shown in table 1. Tumor’s recurrence was DCIS in 5 pts (14.3%) and invasive carcinoma in 30 pts (85.7%), where Luminal A in 10 pts (33.3%), Luminal B-HER2 negative in 12 pts (40%), Luminal B-HER2 positive in 2 (6.7%), non-Luminal HER2 positive in 3 (10%) and triple negative in 3 (10%). With a median follow-up of 37 months, there were 4 relapses (11.4%), one was a 2nd IBTR (2.85%) after in-situ IBTR, and 3 were metastatic recurrences (8.6%), two after invasive and one after in-situ IBTR. Both metastatic progressions after invasive IBTR, were hormone receptor positive and HER2 negative (Luminal B). There were 2 deaths not related with breast cancer. The 2nd IBTR rate was 2.85%. Five-year regional-free survival, metastasis-free survival, and overall survival was 82.4% (95% IC 52.6 - 94.4 %), %, 84.6% (95% IC 51 - 96 %) and 93.3% (95% IC 61.2 - 99%), respectively. Conclusion. Conservative treatment with breast conserving surgery and APBrI for isolated IBTR after BCT seems like a feasible technique as an alternative to mastectomy in selected patients. Second local recurrences and overall survival are similar to the rates described for salvage mastectomy for isolated ipsilateral breast tumour recurrence. In this cohort of patients, the immunohistochemical subtype tumors with poor prognosis (HER2 positive and triple negative) did not show increase in the local recurrence rate. Table 1.Patients Characteristicsn%Histology TypeIDC2777.1ILC0DCIS514.3Others38.6Differentiation gradeWell differentiated1028.6Moderately differentiated1851.4Poorly differentiated720Estrogen-receptor statusPositive2880Negative720Progesteron-receptor statusPositive1645.7Negative1748.6Unknown25.7HER2 statusOver-expressed617.1Non-over-expressed2674.3Unknown38.6Ki67< 20 %1748.6> 20 %1337.2Unknown514.3IHC subtypeLuminal A1033.3Luminal B1240Luminal B-HER2 positive26.7Non-luminal HER2 positive310Triple negative310IBTR locatedSame quadrant1748.6Different quadrant1645.7Unknwon25.7APBrI3D-CRT927.3IORT26.1IMRT2266.7 Citation Format: Martin Espinosa-Bravo, Victoria Reyes Lopez, Clara Morales Comas, Joaquín Rivero Déniz, Javier de La Torre Fernández de Vega, Irene Vives Roselló, Christian Sisó Raber, Manuel Altabas Gonzalez, Alexandra Giraldo Marin, Inma Alonso, Nuria Argudo, Pau Nicolau, Manel Algara, Xavier Sanz, Xavier Caparrós, Gabriela Oses, Jordi Saez, María Vernet-Tomas, Meritxell Mollà. Safety of conservative surgery with accelerated partial breast re-irradiation for isolated ipsilateral breast cancer recurrence regardless of immunohistochemical subtype. A multicentric prospective study [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr PD7-09.