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Hegars Sign

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1. Hegar's Sign

Hegar's Sign Hegars Sign Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Hegar's Sign Hegar's Sign Aka: Hegar's Sign From Related (...) Chapters II. Indication Diagnosis of early pregnancy III. Physiology Occurs during first trimester of pregnancy Softening of at junction with (isthmus) IV. Signs Softened lower uterine segment on bimanual exam may seem to separate from fundus Contrast with firmness of uterine fundus Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Hegars Sign." Click on the image (or right click) to open the source website in a new browser window

2018 FP Notebook

2. Hegar's Sign

Hegar's Sign Hegars Sign Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Hegar's Sign Hegar's Sign Aka: Hegar's Sign From Related (...) Chapters II. Indication Diagnosis of early pregnancy III. Physiology Occurs during first trimester of pregnancy Softening of at junction with (isthmus) IV. Signs Softened lower uterine segment on bimanual exam may seem to separate from fundus Contrast with firmness of uterine fundus Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Hegars Sign." Click on the image (or right click) to open the source website in a new browser window

2015 FP Notebook

4. Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutritio

manifestations as a consequence of GER is not always clear. As this may lead to both over- and under- diagnoses and –treatment, the working group considered it impor- tant to provide an overview of common symptoms and signs to identify GERD. Clarifying ‘red flags’ (alarm features) red flags should warrant further investigation by health-care professionals to rule out complications of GERD and to uncover underlying dis- orders presenting with signs or symptoms of GER, particularly regurgitation (...) and/or vomiting (Algorithms 1 (infants) and 2 (chil- dren), Tables 1–3). For this purpose, the working group critically reviewed evi- dence from existing guidelines, systematic reviews and consensus documents to establish a comprehensive list of symptoms and signs indicative of GERD (Question 2, Table 1) (1,3,20,21). Additionally, the working group highlighted a number of clinical manifestations and features, including gastrointestinal and systemic manifestations, which they considered to be recognized

2018 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition

5. Canadian Diabetes Association 2013 clinical practice guidelines for the prevention and management of diabetes in Canada : Hypoglycemia

at that time of the day to prevent repeated hypoglycemia. If a meal is >1 hour away, a snack (including 15 g carbohydrate and a protein source) should be consumed. It is important to avoid overtreatment of hypoglycemia, since this can result in rebound hyperglycemia and weight gain. Key Messages for People with Diabetes Know the signs and symptoms of a low blood glucose level. Some of the more common symptoms of low blood glucose are trembling, sweating, anxiety, confusion, difficulty concentrating (...) is close to, or lower than, the threshold for the neuroglycopenic symptoms, such that the first sign of hypoglycemia is confusion or loss of consciousness. Severe hypoglycemia is often the primary barrier to achieving glycemic targets in people with type 1 diabetes and occurs frequently during sleep or in the presence of hypoglycemia unawareness . The sympathoadrenal response to hypoglycemia is reduced during sleep, and following exercise or alcohol consumption . Asymptomatic nocturnal hypoglycemia

2013 CPG Infobase

6. Surgical Management of Double/Triple Mandibular Fractures Involving the Condylar Segment: Our Perspective (PubMed)

approaches for different cases such as a periangular with a vestibular, a preauricular and a retromandibular with a vestibular were used according to the type of fractures. The accessibility to one difficult case with a medially displaced condyle was facilitated by using Hegar's uterine dilators. In all cases, good anatomical reduction was achieved with stable occlusion and without any signs of facial nerve impairment. The 'Condyle first' approach in the surgical management of double/triple mandibular

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2018 Journal of International Society of Preventive & Community Dentistry

7. A Trial for Peroperative Procedure and Postoperative Pain After Rectal Misoprostol or Rectal Hyoscine Administration

: December 2, 2017 Last Update Posted : December 27, 2018 Sponsor: Bezmialem Vakif University Information provided by (Responsible Party): Bezmialem Vakif University Study Details Study Description Go to Brief Summary: Dilatation of the cervix is necessary before operative hysteroscopic procedures. This dilatation with Hegar dilators has certain difficulties and is associated with pain. Cervical priming with various substances soften the cervix, ease the entry for the operation and decrease complications (...) [ Time Frame: During the surgery ] Initial cervical dilatation will be evaluated using the Hegar dilatator number Eligibility Criteria Go to Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Layout table

2017 Clinical Trials

8. CPG for Diabetes Mellitus Type 1

: Grafo, SA Graph, SA Cervantes etorb., 51 - 48970 Basauri (Bizkaia) NIPO: 725-12-022-9 (Ministry of Economy and Competitiveness) NIPO: 680-12-018-5 (Ministry of Health, Social Services and Equality) Legal Deposit: VI 130-201 It has been 5 years since the publication of this Clinical Practice Guideline and it is subject to updating. This CPG has been funded by the agreement signed by the Instituto de Salud Carlos III, an autonomous body of the Ministry of Science and Innovation, and the Agency (...) in the monitoring and control consultations, and how often? It has been 5 years since the publication of this Clinical Practice Guideline and it is subject to updating. CLINICAL PRACTICE GUIDELINE FOR DIABETES MELLITUS TYPE 1 21 Levels of evidence and grades of recommendations Levels of evidence and grades of recommendation SIGN 1:2 Levels of evidence 1++ High-quality meta-analyses, systematic reviews of clinical trials or high-quality clinical trials with very low risk of bias. 1+ Well-conducted meta-analyses

2012 GuiaSalud

9. Gastro-oesophageal reflux in children - what's the worry?

be a presenting symptom of food allergy requiring more intensive therapy than simple acid suppression. Regular review by the general practitioner to ascertain warning signs will ensure that other serious illnesses are not overlooked and that appropriate investigation and specialist referral are made. Case study James, aged 3 months, was brought to his general practitioner due to concerns about recurrent vomiting after feeds, which were nonbilious with no suggestion of haematemesis. James was born at term via (...) to receive appropriate education and understanding of the potential complications of surgery is required before a decision can be undertaken. Key points Gastro-oesophageal reflux is commonly seen in infants and usually only requires reassurance, education and support for parents. A thorough history and physical examination are required to exclude other causes of chronic/persistent vomiting in a child. Assessment should also include further investigation if there are warning signs of serious illness

2012 Clinical Practice Guidelines Portal

10. How effective is domperidone at reducing symptoms of gastro-oesophageal reflux in infants?

Response 93% Of domperidone group had ‘good’ or ‘excellent’ response versus 33% of controls (p Small cohort. Median age 4 years in treatment group and 6 years in control. Hegar et al, 2009 20 infants (aged 2–9 months) with symptoms and signs of GOR not controlled with optimisation of feeding regimen. Treated with domperidone (0.8 mg/kg/day) or cisapride (0.8 mg.kg/day) for 4 weeks. Symptom diary and pH monitoring Pilot prospective randomised study (without blinding), no placebo control group Efficacy (...) thriving. He has previously been investigated for his vomiting and you conclude that he has gastr­oeosphageal reflux without complications (GOR). In the first instance, positioning and thickened, small frequent feeds would be advised. The latter suggestion is not without difficulty for mothers exclusively breast feeding. As the mother is describing vomiting at least six times per day, but no signs suggestive of pain at present, could a pro-kinetic alone such as domperidone improve these symptoms

2012 BestBETS

11. Misoprostol Versus Effox as Cervical Ripening Agent Prior Surgical Evacuation

). For all participants, the route of administration was the intravaginal route (tablets were places high up in the posterior fornix of the vagina. Only patients were blinded to the nature of the tablets. 4 hrs later, the patient was admitted to the operating room for surgical evacuation with the following technique: under general anesthesia & after assessment of cervical consistency (soft or firm) & dilatation (tested by the number of the largest Hegar's dilator passed without resistance), ultrasound (...) -guided suction evacuation was done followed by fine curettage using the appropriate size curette. All participants were monitored for any changes in vital signs (every hour), occurrence of headache & severe abdominal cramps since the onset of drug administration till 6 hours postoperative. 1ry outcomes included cervical consistency & dilatation immediately before the procedure. 2ry outcomes included total duration of the operation and the occurrence of drug-related side effects namely high

2016 Clinical Trials

12. Effectiveness and Safety Evaluation of Aqueduct 100-device

technique uses expansible dry solid material, such as laminaria (seaweed) is inserted into the cervix in its dried stiff form. In the cervix it comes into contact with body fluids that cause the laminaria to swell and enlarge the cervical cavity. The second more widespread procedure, involves the use of series of solid, rod like instruments of graduated diameter used in serial fashion by the physician (Hegar dilators). The physician first inserts a rod like dilator and replaces it with the dilator (...) of next higher diameter. This procedure continues until adequate dilatation occurs. The Problem is that each of the above-mentioned methods has its shortcomings: the use of the laminaria method (rarely done) requires preliminary patient visit, for insertion of the laminaria rod and is extremely slow and typically involves often as much as 10-12 hours for a significant amount of dilatation to occur. The use of rod-like instruments (Hegar) requires general or regional anesthesia, when local anesthetics

2016 Clinical Trials

13. Effectiveness and Safety Evaluation of Aqueduct -100 Device

into contact with body fluids that cause the laminaria to swell and enlarge the cervical cavity. The second more widespread procedure, involves the use of series of solid, rod like instruments of graduated diameter used in serial fashion by the physician (Hegar dilators). The physician first inserts a rod like dilator and replaces it with the dilator of next higher diameter. This procedure continues until adequate dilatation occurs. The Problem is that each of the above-mentioned methods has its (...) shortcomings: the use of the laminaria method (rarely done) requires preliminary patient visit, for insertion of the laminaria rod and is extremely slow and typically involves often as much as 10-12 hours for a significant amount of dilatation to occur. The use of rod-like instruments (Hegar) requires general or regional anesthesia, when local anesthetics are used, the patient nevertheless frequently experiences a great amount of discomfort from the procedure. The mechanical dilatation of the cervix

2016 Clinical Trials

14. Management of diabetes

? Recommended best practice based on the clinical experience of the guideline development group NHS Quality Improvement Scotland (NHS QIS) is committed to equality and diversity and assesses all its publications for likely impact on the six equality groups defined by age, disability, gender, race, religion/belief and sexual orientation. SIGN guidelines are produced using a standard methodology that has been equality impact assessed to ensure that these equality aims are addressed in every guideline (...) . This methodology is set out in the current version of SIGN 50, our guideline manual, which can be found at www.sign.ac.uk/sign-50.html. The EQIA assessment of the manual can be seen at www.sign.ac.uk/assets/ sign50eqia.pdf. The full report in paper form and/or alternative format is available on request from the NHS QIS Equality and Diversity Officer. Every care is taken to ensure that this publication is correct in every detail at the time of publication. However, in the event of errors or omissions

2010 SIGN

15. Comparison of TOT 8/4 Versus TOT 6/3

. Wolfram Jäger, Klinikum der Universität Köln Study Details Study Description Go to Brief Summary: Transobturator tapes (TOT) are placed according to the surgical technique described by Delorme et al. in patients with a previous cervico-sacropexy (CESA) or vagino-sacropexy (VASA). Before final Fixation of the tapes and suturing the vaginal skin a Hegar dilator sound with either 8 mm or 6 mm diameter is placed in the urethra and a second Hegar dilator sound with either 4 mm or 3 mm diameter is placed (...) between the tape and the urethra. After suturing the vaginal skin the Hegar sounds are removed. Condition or disease Intervention/treatment Phase Urinary Incontinence Device: TOT 8/4 Device: TOT 6/3 Not Applicable Detailed Description: Retrospective studies demonstrated that the distance between urethra and suburethral sling can vary considerably between 1 mm and 10 mm. In order to standardize the placement of the suburethral sling we choose two different distances between urethra and sling

2015 Clinical Trials

16. Pregnancy Diagnosis (Treatment)

presents with amenorrhea, nausea, vomiting, generalized malaise, and breast tenderness. Upon physical examination, one may find an enlarged uterus after bimanual examination, breast changes, and softening and enlargement of the cervix (Hegar sign; observed at approximately 6 wk). The Chadwick sign is a bluish discoloration of the cervix from venous congestion and can be observed by 8-10 weeks. A gravid uterus may be palpable low in the abdomen if the pregnancy has progressed far enough, usually by 12 (...) weeks. Currently, through the use of chemical assays and ultrasonography, physicians are capable of making the diagnosis of pregnancy before many of the physical signs and symptoms are evident. [ ] Previous Next: Laboratory Evaluation Several hormones can be measured and monitored to aid in the diagnosis of pregnancy. The most commonly used assays are for the beta subunit of hCG. Other hormones that have been used include progesterone and early pregnancy factor. The cytotrophoblast

2014 eMedicine.com

17. Surgical Management of Abortion (Treatment)

mcg can be helpful in cervical preparation. Cases that might find cervical preparation helpful include uterine abnormalities and history of caesarian delivery. Prior to insertion, the cervix is prepared with Betadine, but the sterile or "no-touch" technique should be used throughout the procedure. Laminaria insertion requires a single-toothed tenaculum to stabilize the cervix. A paracervical block with lidocaine can provide comfort. The cervix may require dilation with Pratt, Hegar or Denniston (...) their abortion performed under "vocal sedation" (ie, talking the patient through the procedure) and local sedation. Most patients do not require intravenous access for medication. If heavy sedation is selected, then intravenous fluids with lactated Ringer solution or half isotonic sodium chloride solution is suitable, at rates appropriate for the patient's age and weight. If a patient receives intraoperative sedation, appropriate monitoring includes vital sign assessment, assessment of the patient's degree

2014 eMedicine.com

18. Preterm Labor (Treatment)

to pass a No. 8 Hegar dilator into the nonpregnant cervix; easy passage may be a sign of cervical incompetence. During pregnancy, whenever the suspicion of incompetent cervix exists, one should consider performing baseline transvaginal ultrasonography to assess cervical length, especially at 13-17 weeks’ gestation; abnormal findings include a length less than 2.5 cm, funneling greater than 5 mm, or dynamic changes. A cerclage may be indicated after 2 or more midtrimester losses consistent (...) months, but a clear association between these organisms and preterm delivery has not been established. BV is a vaginal syndrome associated with an alteration of the normal vaginal flora rather than an infection specific to any one organism and a lack of vaginal inflammation is evident when compared with vaginitis. The diagnosis of BV should be suspected with a positive Gram stain result or the presence of 3 of 4 traditional diagnostic signs (homogenous gray-white discharge, >20% clue cells on saline

2014 eMedicine.com

19. Penile Prosthesis Implantation (Treatment)

. This exposes the corporal spongy tissue. Exposure of the corpus cavernosum followed by placement of stay sutures in the walls of the corpus followed by corporotomy in anticipation of placing an intracavernosal rod. (Photograph courtesy of Chirpraya B. Dhabuwala, MD). A blunt Hegar dilator is used to dilate the spongy tissue of the corpus cavernosa from 8-14 mm proximally and 8-11 mm distally as depicted in the image below. A Dilamezinsert (DMI) instrument is used to measure the corporal length so (...) a prosthetic device of the proper length can be chosen. Meanwhile, throughout the operation, antibiotic solution is misted over the surgical sites and over the instruments at regular intervals and when each anatomical compartment is opened. Proximal dilation of the corpus with Hegar dilator. (Photograph courtesy of Chirpraya B. Dhabuwala, MD) The appropriate 3-piece prosthesis is selected, the package is opened, and the contents are sprayed copiously with antibiotic solution. The cylinder and pump

2014 eMedicine.com

20. Threatened Abortion (Treatment)

mcg can be helpful in cervical preparation. Cases that might find cervical preparation helpful include uterine abnormalities and history of caesarian delivery. Prior to insertion, the cervix is prepared with Betadine, but the sterile or "no-touch" technique should be used throughout the procedure. Laminaria insertion requires a single-toothed tenaculum to stabilize the cervix. A paracervical block with lidocaine can provide comfort. The cervix may require dilation with Pratt, Hegar or Denniston (...) their abortion performed under "vocal sedation" (ie, talking the patient through the procedure) and local sedation. Most patients do not require intravenous access for medication. If heavy sedation is selected, then intravenous fluids with lactated Ringer solution or half isotonic sodium chloride solution is suitable, at rates appropriate for the patient's age and weight. If a patient receives intraoperative sedation, appropriate monitoring includes vital sign assessment, assessment of the patient's degree

2014 eMedicine.com

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