Another look at religious objections to obstetric anaesthesia

Starting with the earliest biographies of James Young Simpson, the topic of religious opposition to obstetric anaesthesia in 1847 was gradually embellished in historical articles. Objective data are lacking and it has been suggested that this is a myth of recent medical history. A search for more information led to a contemporaneous case-book of the maternity hospital in Edinburgh, which was examined. The provision of anaesthesia in the 11 months before publication of Simpson’s pamphlet Answer to the Religious Objections was compared with that in the 11 months after. This revealed a marked increase (P<0.01) in the provision of anaesthesia for childbirth after the publication of Simpson’s pamphlet in December 1847. This analysis supports the existence of opposition to obstetric anaesthesia and the success of Simpson’s pamphlet in overcoming it, but the introduction of chloroform about six weeks earlier, may also have contributed.     

综合护理对妇产科患者术后疼痛的效果观察

目的探讨综合护理对妇产科患者术后疼痛的改善效果。方法选取我院从2013年1月~2014年1月所收治的260例妇产科患者作为临床研究对象,将所有患者随机分为护理组和对照组两组,对照组患者采用常规护理措施,护理组患者采用综合护理措施。评价两组患者的术后疼痛情况,以评价护理效果。结果护理组患者0级率为36.2%,对照组为15.4%;护理组患者3级率为1.5%,对照组为18.5%。两组比较,差异有统计学意义(P0.05)。结论综合护理干预能对妇产科手术患者的术后疼痛有较好的缓解,促进患者的快速康复。     

A Novel Approach to Detecting Postpartum Hemorrhage Using Contrast-Enhanced Ultrasound

The aim of this study was to estimate the efficacy of contrast-enhanced ultrasound (CEUS) in detecting postpartum hemorrhage (PPH) after cesarean section. This is the first study of CEUS in obstetric hemorrhage. A total of 37 patients, operated at Nagoya University Hospital, underwent CEUS. We evaluated the findings of CEUS, which were qualitatively defined as positive when pooling or leakage of contrast agent was observed in the uterine cavity, by measuring the amount of bleeding during the first 4 h after cesarean section. The time–intensity curve patterns of leaked contrast agents were also analyzed for quantitative prediction of the amount of blood loss. Significant differences between the excessive hemorrhage (N = 7) and non-excessive hemorrhage groups (N = 30) were noted in the occurrence of positive CEUS (p = 0.011). Additionally, mean postpartum blood loss markedly increased in patients with a positive CEUS (p = 0.002). From a quantitative perspective, the time until leakage of contrast agents was detected correlated with the amount of bleeding, but the other characteristics of the time–intensity curve pattern did not provide valuable information. In conclusion, CEUS, which enables bedside assessment and rapid diagnosis, is a promising strategy for the detection of PPH.     

Paclitaxel-related dermatological problems: Not only alopecia occurs

ObjectiveDermatological problems after chemotherapy are often neglected with gynecological oncologists. Since paclitaxel is one of most popular agents for gynecology organ-related cancers, dermatologic change after paclitaxel treatment is seldom reported before.Case reportTwo patients with gynecological organ malignancy who underwent the postoperative dose-dense weekly schedule of paclitaxel 80 mg/m² plus carboplatin (area of curve 5) every three weeks had repeat dermatological problems (skull, facial and upper trunk areas) during the treatment. They included dermatitis, eczema, and folliculitis. Topical use of anti-fungal cream and oral anti-histamine agents stopped the disease progression and all had completed their chemotherapy without interruption.ConclusionClinicians should be aware of paclitaxel-induced skin toxicities, especially on the skull, face and upper trunk areas to minimize the occurrence of severe morbidity and to provide the better quality of life when cure is our primary priority in the management of gynecological organs-related malignancies.