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Pelvic Relaxation

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161. Gynaecological Cancers: a Handbook for Aboriginal and Torres Strait Islander Health Workers and Health Practitioners

Complementary therapies are treatments or therapies that can be used alongside conventional treatments to improve quality of life and overall wellbeing. Examples include relaxation therapy and meditation. Aboriginal and T orres Strait Islander women may wish to use bush medicine alongside conventional treatments. Some complementary therapies and bush medicine can reduce the effectiveness of conventional treatments provided by the doctors. That is why it is important that the doctors are aware of any bush (...) in the cervix • Stage II: cancer has spread to the vagina or other tissue next to the cervix • Stage III: cancer has spread to tissue on the side of the pelvis (pelvic sidewall) • Stage IV: cancer has spread to the bladder or rectum, or beyond the pelvis to the lung, liver or bones. i31 CERVICAL CANCER Treatments for cervical cancer The aims of treatment for cervical cancer are to: • remove the cancer • destroy the cancer cells and slow growth of the cancer and/or • manage the symptoms of cervical cancer

2018 Cancer Australia

163. WHO recommendations: intrapartum care for a positive childbirth experience

preferences. Recommended Opioid analgesia for pain relief 20. Parenteral opioids, such as fentanyl, diamorphine and pethidine, are recommended options for healthy pregnant women requesting pain relief during labour, depending on a woman’s preferences. Recommended Relaxation techniques for pain management 21. Relaxation techniques, including progressive muscle relaxation, breathing, music, mindfulness and other techniques, are recommended for healthy pregnant women requesting pain relief during labour

2018 World Health Organisation Guidelines

164. Erectile Dysfunction

should be counseled regarding post-operative expectations. (Clinical Principle) 20. Penile prosthetic surgery should not be performed in the presence of systemic, cutaneous, or urinary tract infection. (Clinical Principle) 21. For young men with ED and focal pelvic/penile arterial occlusion and without documented generalized vascular disease or veno-occlusive dysfunction, penile arterial reconstruction may be considered. (Conditional Recommendation; Evidence Level: Grade C) 22. For men with ED (...) benefit most patients (see Guideline Statement 6) and should be strongly considered when unresolved issues appear to be affecting the sexual relationship. 54-56 In situations in which sudden or severe ED is likely to develop (e.g., men considering definitive therapy for pelvic cancers) or in cases with complex psychosocial issues (e.g., history of sexual trauma, long-term/lifelong sexual dysfunction), early inclusion of psychosexual expertise on the treatment team is critical to development

2018 American Urological Association

165. The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm

mortality 33 Perioperative morbidity 33 Endoleak 34 Access site complications 34 Acute limb thrombosis 34 Postimplantation syndrome 34 Ischemic colitis 34 Role of elective EVAR in the high-risk and unfit patient 34 OSR 35 Indications 35 Surgical approach 35 Aortic clamping 35 Graft type and configuration 36 Maintenance of pelvic circulation 37 Management of associated intra-abdominal vascular disease 37 Management of associated intra-abdominal nonvascular disease 38 Perioperative outcomes of open AAA

2018 Society for Vascular Surgery

166. WHO recommendations: non-clinical interventions to reduce unnecessary caesarean sections

, Intervention, Comparator, Outcome PFMT Pelvic Floor Muscle T raining RCT Randomized Controlled T rial RD Risk Difference RR Risk Ratio TWG T echnical Working Group UNFPA United Nations Population Fund UNICEF United Nations Children’s Fund USAID United States Agency for International Development VBAC Vaginal Birth After Caesarean WHO World Health Organization8 WHO recommendations non-clinical interventions to reduce unnecessary caesarean sections Executive summary Introduction Caesarean section (...) relaxation training programme (content includes group discussion of anxiety and stress-related issues in pregnancy and purpose of applied relaxation, deep breathing techniques, among other relaxation techniques). ? ? Psychosocial couple-based prevention programme (content includes emotional self-management, conflict management, problem solving, communication and mutual support strategies that foster positive joint parenting of an infant). “Couple” in this recommendation includes couples, people

2018 World Health Organisation Guidelines

167. Spine Surgery

Surgery 6 Definitions Conservative management should include a combination of strategies to reduce inflammation, alleviate pain, and improve function, including but not limited to the following: ? Prescription strength anti-inflammatory medications and analgesics ? Adjunctive medications such as nerve membrane stabilizers or muscle relaxants ? Physician-supervised therapeutic exercise program or physical therapy ? Manual therapy or spinal manipulation ? Alternative therapies such as acupuncture (...) segments (List separately in addition to code for primary procedure) 22846 Anterior instrumentation; 4 to 7 vertebral segments (List separately in addition to code for primary procedure) 22847 Anterior instrumentation; 8 or more vertebral segments (List separately in addition to code for primary procedure) 22848 Pelvic fixation (attachment of caudal end of instrumentation to pelvic bony structures) other than sacrum (List separately in addition to code for primary procedure) 22849 Reinsertion of spinal

2018 AIM Specialty Health

168. Erectile Dysfunction

, or urinary tract infec- tion. (Clinical Principle) 21. For young men with ED and focal pelvic/penile arterial occlusion and without documented generalized vascular disease or veno-occlusive dysfunction, penile arterial reconstruction may be considered. (Conditional Recom- mendation; Evidence Level: Grade C) 22. For men with ED, penile venous surgery is not recommended. (Moderate Recommendation; Evidence Level: Grade C) 23. For men with ED, low-intensity extracorporeal shock wave therapy (ESWT) should (...) /sexuality expert into the treatment plan. Involvement of a mental health expert with knowledge and experience to address issues of sexuality with men and their partners can benefit most patients (see Guideline Statement 6) and should be strongly considered when unresolved issues appear to be affecting the sexual relationship. 54-56 In situations in which sudden or severe ED is likely to develop (e.g., men considering definitive therapy for pelvic cancers) or in cases with complex psychosocial issues

2018 American Urological Association

169. A letter to my younger self

to see a trauma patient with a reasonable mechanism – but because he is stable and pain-free, you’ll decide not to do the pelvic XRay. That’s a mistake. You’re going to miss his unstable pelvic fracture. Thankfully one of your colleagues will find it and the patient ends up being ok. But, know that this will eat at you for weeks. You’ll talk to friends and colleagues who will make you feel better, but honestly – nothing makes a mistake easy to swallow. You just have to learn from it, it’ll make you (...) and reputations tarnished by poor interactions with allied health professionals. When someone is being rude to a nurse, stand up for them. It isn’t until you’re more senior that you have the confidence to this, and you’ll regret not doing it in some situations, but remember that your allied health colleagues are advocating for patients, and don’t deserve any abuse, from anyone, ever. Take vacations Real ones. Where you completely step away from working / studying, and relax. You’ll come to realize when you’ve

2018 CandiEM

170. FDG-PET/CT(A) Imaging in Large Vessel Vasculitis and Polymyalgia Rheumatica: Joint Procedural Recommendation of the EANM, SNMMI, PET Interest Group, and endorsed by ASNC

be avoided within 24 hours 7 before FDG administration. At the moment and after administration of FDG, patients should relax in an adequately temperature-controlled room (20-22°C (68-71.6 °F)) to minimize physiologic uptake in muscles and brown fat [29]. In some cases, FDG uptake in brown fat can be reduced by beta-blocking drugs, e.g. oral administration 20 mg propranolol one hour before FDG injection [30]. Prior to positioning on the table, patients are asked to void urine. Patients with fever (...) being positive for active LVV (evidence level II, grade B). • Typical FDG joint uptake patterns including scapular and pelvic girdles, interspinous regions of the cervical and lumbar vertebrae or the knees should be 12 Diagnostic accuracy of FDG-PET/CT(A) for LVV and PMR The diagnostic performance of FDG-PET for the detection of LVV is overall good; individual studies are summarized in Table 4, and meta-analyses are summarized in Table 5. A recent meta-analysis of eight studies including 170 LVV

2018 Society of Nuclear Medicine and Molecular Imaging

171. Consensus Statement of Definitions for Anorectal Physiology and Rectal Cancer

. For that to happen, the termi- nology used must be precise and uniform. With medical information increasingly shared, a consensus about the terminology is desirable. The purpose of this document is to define standardized terminology for use in academic presentations and publications pertaining to defecatory pelvic floor disorders. METHODOLOGY The ASCRS, the Colorectal Surgical Society of Australia, and the Association of Coloproctology of Great Brit- ain and Ireland have previously published definitions (...) of anorectal physiology terms after consulting with se- lected experts within each represented society. 1 This re- vision of the above-mentioned definitions was created at the initiative of the ASCRS Pelvic Floor Disorders Committee and the Clinical Practice Guidelines Com- mittee. The Pelvic Floor Disorders Committee is com- posed of members who are chosen because they have demonstrated expertise in the care and treatment of pel- vic floor conditions. This committee was created to lead international

2018 American Society of Colon and Rectal Surgeons

172. Perineal care

Guideline: Perineal care Refer to online version, destroy printed copies after use Page 5 of 39 Abbreviations AOR Adjusted odds ratio APM Antenatal perineal massage CT Computed tomography CI Confidence intervals CS Caesarean section EAS External anal sphincter FGM Female genital mutilation GP General Practitioner HHS Hospital and Health Service IAP Intra-abdominal pressure IAS Internal anal sphincter IPM Intrapartum perineal massage IV Intravenous NSAID Non-steroidal anti-inflammatory drugs PFMT Pelvic (...) floor muscle training OASIS Obstetric anal sphincter injury or injuries OR Odds ratio OT Operating theatre PR Per rectum RCT Randomised controlled trial RR Relative risk USS Ultrasound scan Definition of terms Accoucheur Clinician directly assisting with birth of baby. Anal manometry A test which measures the pressures of the anal sphincter muscles. Crowning When the widest part of the fetal head (biparietal diameter) has passed through the pelvic outlet. Deinfibulation A surgical procedure to cut

2018 Queensland Health

173. Early Pregnancy Loss

to prevent early pregnancy loss. Therapies that have historically been recommended, such as pelvic rest, vitamins, uterine relaxants, and administration ofb-hCG,havenotbeen proved to prevent early pregnancy loss (60–62). Like- wise, bed rest should not be recommended for the prevention of early pregnancy loss (63). A 2008 Co- chrane review found no effect of prophylactic proges- terone administration (oral, intramuscular, or vaginal) in the prevention of early pregnancy loss (64). For threatened early (...) in the vacuum aspiration group (23, 42). How- ever, rates of hemorrhage-related hospitalization with or without transfusion are similar between treatment approaches (0.5–1%) (23, 43). Pelvic infection also can occur after any type of early pregnancy loss treat- ment. One systematic review concluded that although infection rates appeared lower among those undergo- ing expectant management than among those undergo- ing surgical evacuation (RR, 0.29; 95% CI, 0.09– 0.97), the overall rates of infection were low

2018 American College of Obstetricians and Gynecologists

174. Adult Urodynamics

and Reporting Patient Education Adult Urodynamics: AUA/SUFU Guideline (2012) Published 2012 This guideline developed by AUA in collaboration with the Society for Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction is intended to review the literature regarding the use of urodynamic testing in common lower urinary tract symptoms (LUTS) conditions. It presents the principles of application and technique to guide the clinician in the role of urodynamics in complex LUTS disorders. [pdf] [pdf (...) with reduction of the prolapse in women with high grade pelvic organ prolapse (POP) but without the symptom of SUI. Multi-channel urodynamics with prolapse reduction may be used to assess for occult stress incontinence and detrusor dysfunction in these women with associated LUTS. ( Option ; Evidence Strength : Grade C) Overactive Bladder (OAB), Urgency Urinary Incontinence (UUI), Mixed Incontinence 6. Clinicians may perform multi-channel filling cystometry when it is important to determine if altered

2018 American Urological Association

175. CRACKCast E180 – Labor & Delivery

don’t have the luxury of whisking off the patient to the OR Let’s kick it back to our obs/gyne block and think through the causative factors; or the three P’s The passage – narrow pelvic architecture The passenger – big head, or malpresentation The power problem – uterus isn’t pushing like it should Tired mom Mother is sedated too much Chorioamnionitis Electrolyte abnormality (Ks, Cas, Mg, Phos, Na) Usually the cause is multifactorial! 6) Describe the steps in a “normal” delivery (in the ER) Let’s (...) . At this point, reduce the infusion rate to 1 to 2 mL/min. 7) List 8 factors linked to pre-term labor. Describe the management of premature labor in the ED. List 3 tocolytics. Preterm labor is defined as uterine contractions with cervical changes before 37 weeks of gestation. Early maternal signs and symptoms include an increase or change in vaginal discharge, pain resulting from uterine contractions (sometimes perceived as back pain), pelvic pressure, vaginal bleeding, and fluid leak. Box 181.2 – Factors

2018 CandiEM

176. Utian Translational Science Symposium report: New Ttherapies for Leiomyomas: When Surgery May Not Be the Best Option

symptoms may produce pelvic pressure; uri- nary frequency, urgency, and incontinence; abdominal distension; constipation; back pain; or dyspareunia. 4 Repro- ductivedysfunction,althoughusuallyadiagnosisofexclusion from other factors, may include difficulty conceiving and recurrentpregnancyloss.Pregnanciesmaybecomplicatedby abnormalplacentation,small-for-gestational-ageinfants,pre- mature delivery, malpresentation, increases in caesarean delivery rates, or postpartum haemorrhage. 4,5 Risks for uterine (...) because of necrosis or torsion of a pedunculated leio- myoma, deep vein thrombosis because of physical obstruc- tion, or even polycythemia because of erythropoietin produced by the leiomyoma. 11 A mass may be observed or palpatedinthelowerabdomen,andirregularuterineenlarge- ment may be found during pelvic examination. A pelvic ultrasound will confirm the diagnosis. Magnetic resonance imaging(MRI)or3-Dultrasoundcanbeusedforpreoperative mappingandmayberequiredtodifferentiateanovarianfrom a uterine mass

2018 The North American Menopause Society

178. Urological Trauma

., et al. Diagnosis and management of ureteric injury: an evidence-based analysis. BJU Int, 2004. 94: 277. 121. Chou, M.T., et al. Prophylactic ureteral catheterization in gynecologic surgery: a 12-year randomized trial in a community hospital. Int Urogynecol J Pelvic Floor Dysfunct, 2009. 20: 689. 122. Delacroix, S.E., Jr., et al. Urinary tract injures: recognition and management. Clin Colon Rectal Surg, 2010. 23: 104. 123. Visco, A.G., et al. Cost-effectiveness of universal cystoscopy to identify (...) Kidney Autotransplantation: A Minimally Invasive Way to Salvage Kidneys. Eur Urol Focus, 2018. 4: 198. 152. Zhao, L.C., et al. Robotic Ureteral Reconstruction Using Buccal Mucosa Grafts: A Multi-institutional Experience. Eur Urol, 2017. 153. Pereira, B.M., et al. Bladder injuries after external trauma: 20 years experience report in a population-based cross-sectional view. World J Urol, 2013. 31: 913. 154. Figler, B.D., et al. Multi-disciplinary update on pelvic fracture associated bladder

2018 European Association of Urology

179. Neuro-urology

with urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct, 2008. 19: 955. 61. Henze, T. Managing specific symptoms in people with multiple sclerosis. Int MS J, 2005. 12: 60. 62. Liu, C.W., et al. The relationship between bladder management and health-related quality of life in patients with spinal cord injury in the UK. Spinal Cord, 2010. 48: 319. 63. Khalaf, K.M., et al. The impact of lower urinary tract symptoms on health-related quality of life among patients with multiple sclerosis. Neurourol (...) viewpoint. J Pediatr Urol, 2017. 97. Yang, C.C., et al. Bladder management in women with neurologic disabilities. Phys Med Rehabil Clin N Am, 2001. 12: 91. 98. Podnar, S., et al. Protocol for clinical neurophysiologic examination of the pelvic floor. Neurourol Urodyn, 2001. 20: 669. 99. Harrison, S., et al. Urinary incontinence in neurological disease: assessment and management. NICE Clinical Guideline 2012. [CG148]. 100. Liu, N., et al. Autonomic dysreflexia severity during urodynamics and cystoscopy

2018 European Association of Urology

180. Male Sexual Dysfunction

. Erectile dysfunction in the cardiovascular patient. Eur Heart J, 2013. 34: 2034. 50. Seftel, A.D., et al. Coexisting lower urinary tract symptoms and erectile dysfunction: a systematic review of epidemiological data. Int J Clin Pract, 2013. 67: 32. 51. Rosen, R., et al. Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the aging male (MSAM-7). Eur Urol, 2003. 44: 637. 52. Zhang, Y., et al. Erectile Dysfunction in Chronic Prostatitis/Chronic Pelvic Pain Syndrome (...) 2 and 4 years after radical prostatectomy. J Urol, 2009. 181: 731. 79. Incrocci, L., et al. Pelvic radiotherapy and sexual function in men and women. J Sex Med, 2013. 10 Suppl 1: 53. 80. Morgia, G., et al. Association between long-term erectile dysfunction and biochemical recurrence after permanent seed I(125) implant brachytherapy for prostate cancer. A longitudinal study of a single-institution. Aging Male, 2016. 19: 15. 81. Stember, D.S., et al. The concept of erectile function preservation

2018 European Association of Urology

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