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Hans Peter Dietz - One of the best experts on this subject based on the ideXlab platform.
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the effect of replacing vacuum with forceps in operative vaginal delivery an observational study
International Urogynecology Journal, 2020Co-Authors: Jessica Caudwell Hall, Clara Shek, Susanne Langer, Hans Peter DietzAbstract:An increase in vaginal delivery with forceps may increase rates of pelvic floor trauma. This study was designed to predict trauma rates resulting from policies preferencing forceps. This is an observational cohort study utilizing data from 660 primiparae enrolled in an RCT in two tertiary obstetric units in Sydney, Australia. Participants were assessed clinically and with 4D translabial ultrasound in the late third trimester and again at 3–6 months postpartum. Incidence of trauma associated with mode of delivery was adjusted to reflect change associated with a conversion of vacuum to forceps delivery. Primary outcome measures were third-/fourth-degree tear, levator avulsion (LA) and external anal sphincter (EAS) trauma diagnosed sonographically. Five hundred four women were seen at a mean of 5.1 (2.3–24.3) months postpartum. After exclusion of 21 because of missing data, 483 women were analysed: 112 (23%) had a CS, 268 (55%) a normal vaginal delivery (NVd), 69 (14%) a vacuum (Vd) and 34 (7%) a forceps (FD). One hundred fifty-two women had EAS trauma and/or LA; 17 sustained both. After Vd, 32/69 (46%) women suffered LA and/or EAS trauma; after FD, it was 33/34 (97%). Converting Vd to FD was estimated to result in an increase in trauma from 152/483 (31%) to 187/483 (39%). A formula can be generated based on local obstetric and ultrasound data to estimate trauma incidence. A change in obstetric practice resulting in the conversion of primary Vd to primary FD would be expected to substantially increase the likelihood of pelvic floor trauma.
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The effect of replacing vacuum with forceps in operative vaginal delivery: an observational study
International Urogynecology Journal, 2020Co-Authors: Jessica Caudwell Hall, Clara Shek, Susanne Langer, Hans Peter DietzAbstract:Introduction and hypothesis An increase in vaginal delivery with forceps may increase rates of pelvic floor trauma. This study was designed to predict trauma rates resulting from policies preferencing forceps. Methods This is an observational cohort study utilizing data from 660 primiparae enrolled in an RCT in two tertiary obstetric units in Sydney, Australia. Participants were assessed clinically and with 4D translabial ultrasound in the late third trimester and again at 3–6 months postpartum. Incidence of trauma associated with mode of delivery was adjusted to reflect change associated with a conversion of vacuum to forceps delivery. Primary outcome measures were third-/fourth-degree tear, levator avulsion (LA) and external anal sphincter (EAS) trauma diagnosed sonographically. Results Five hundred four women were seen at a mean of 5.1 (2.3–24.3) months postpartum. After exclusion of 21 because of missing data, 483 women were analysed: 112 (23%) had a CS, 268 (55%) a normal vaginal delivery (NVd), 69 (14%) a vacuum (Vd) and 34 (7%) a forceps (FD). One hundred fifty-two women had EAS trauma and/or LA; 17 sustained both. After Vd, 32/69 (46%) women suffered LA and/or EAS trauma; after FD, it was 33/34 (97%). Converting Vd to FD was estimated to result in an increase in trauma from 152/483 (31%) to 187/483 (39%). A formula can be generated based on local obstetric and ultrasound data to estimate trauma incidence. Conclusions A change in obstetric practice resulting in the conversion of primary Vd to primary FD would be expected to substantially increase the likelihood of pelvic floor trauma.
Murat Sinan Sarıcaoğlu - One of the best experts on this subject based on the ideXlab platform.
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examination of retinal vascular density changes via optical coherence tomography angiography in patients with glaucoma
International Ophthalmology, 2021Co-Authors: Berire şeyma Durmus Ece, Murat Sinan SarıcaoğluAbstract:PURPOSE The aim of this study was to investigate the changes in vessel density (Vd) in glaucoma patients and to investigate the relationship between Vd and structural parameters using optical coherence tomography angiography. METHODS Our study included 25 primary open-angle glaucoma (POAG) patients, 25 pseudoexfoliation glaucoma (PXG) patients and 25 healthy individuals. All patients underwent 6 × 6 mm retinal angiography (upper limit: internal limitan membrane [ILM], lower limit: 10 µm inferior to inner plexiform layer) and 4.5 × 4.5 mm disk angiography (upper limit: ILM, lower limit: posterior border of the retinal nerve fiber layer [RNFL]) via an optical coherence tomography (OCT) system (AngioVue, Optovue). Measures of vascular density were as follows: total area Vd (tVd), intrapapillary Vd (iVd), peripapillary Vd (pVd) and parafoveal Vd (pfVd). In addition to performing comparisons, the correlations between pVd, retinal nerve fiber layer (RNFL) thickness and optic nerve head measurement results were investigated. RESULTS A total of 75 individuals were included in our study. In the POAG and PXG groups, tVd and pVd values were significantly lower than the control group (median tVds were: 45.4, 45.9, 50.0, and median pVds were: 50.0, 50.3, 53.1, respectively) (confidence intervals were: - 9.8/- 1.1 for pVd and - 8.6/- 1.4 for tVd). Significantly lower pf-Vd values were detected in the PXG group compared to the control group (p < 0.05). There were strong positive correlations between RNFL thickness and pVd in in glaucoma groups (p < 0.001). There was no correlation between pVd and disk area, intraocular pressure and age in glaucoma patients. Patients using beta-blockers had significantly lower tVd and pVd values compared to those who did not (p < 0.05). CONCLUSION The low Vd values in glaucomatous eyes and the strong correlations between that values and RNFL thickness demonstrate a relationship between structural parameters and vascular parameters.
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Examination of retinal vascular density changes via optical coherence tomography angiography in patients with glaucoma
International Ophthalmology, 2020Co-Authors: Berire Şeyma Durmuş Ece, Murat Sinan SarıcaoğluAbstract:Purpose The aim of this study was to investigate the changes in vessel density (Vd) in glaucoma patients and to investigate the relationship between Vd and structural parameters using optical coherence tomography angiography. Methods Our study included 25 primary open-angle glaucoma (POAG) patients, 25 pseudoexfoliation glaucoma (PXG) patients and 25 healthy individuals. All patients underwent 6 × 6 mm retinal angiography (upper limit: internal limitan membrane [ILM], lower limit: 10 µm inferior to inner plexiform layer) and 4.5 × 4.5 mm disk angiography (upper limit: ILM, lower limit: posterior border of the retinal nerve fiber layer [RNFL]) via an optical coherence tomography (OCT) system (AngioVue, Optovue). Measures of vascular density were as follows: total area Vd (tVd), intrapapillary Vd (iVd), peripapillary Vd (pVd) and parafoveal Vd (pfVd). In addition to performing comparisons, the correlations between pVd, retinal nerve fiber layer (RNFL) thickness and optic nerve head measurement results were investigated. Results A total of 75 individuals were included in our study. In the POAG and PXG groups, tVd and pVd values were significantly lower than the control group (median tVds were: 45.4, 45.9, 50.0, and median pVds were: 50.0, 50.3, 53.1, respectively) (confidence intervals were: − 9.8/− 1.1 for pVd and − 8.6/− 1.4 for tVd). Significantly lower pf-Vd values were detected in the PXG group compared to the control group ( p
Clara Shek - One of the best experts on this subject based on the ideXlab platform.
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the effect of replacing vacuum with forceps in operative vaginal delivery an observational study
International Urogynecology Journal, 2020Co-Authors: Jessica Caudwell Hall, Clara Shek, Susanne Langer, Hans Peter DietzAbstract:An increase in vaginal delivery with forceps may increase rates of pelvic floor trauma. This study was designed to predict trauma rates resulting from policies preferencing forceps. This is an observational cohort study utilizing data from 660 primiparae enrolled in an RCT in two tertiary obstetric units in Sydney, Australia. Participants were assessed clinically and with 4D translabial ultrasound in the late third trimester and again at 3–6 months postpartum. Incidence of trauma associated with mode of delivery was adjusted to reflect change associated with a conversion of vacuum to forceps delivery. Primary outcome measures were third-/fourth-degree tear, levator avulsion (LA) and external anal sphincter (EAS) trauma diagnosed sonographically. Five hundred four women were seen at a mean of 5.1 (2.3–24.3) months postpartum. After exclusion of 21 because of missing data, 483 women were analysed: 112 (23%) had a CS, 268 (55%) a normal vaginal delivery (NVd), 69 (14%) a vacuum (Vd) and 34 (7%) a forceps (FD). One hundred fifty-two women had EAS trauma and/or LA; 17 sustained both. After Vd, 32/69 (46%) women suffered LA and/or EAS trauma; after FD, it was 33/34 (97%). Converting Vd to FD was estimated to result in an increase in trauma from 152/483 (31%) to 187/483 (39%). A formula can be generated based on local obstetric and ultrasound data to estimate trauma incidence. A change in obstetric practice resulting in the conversion of primary Vd to primary FD would be expected to substantially increase the likelihood of pelvic floor trauma.
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The effect of replacing vacuum with forceps in operative vaginal delivery: an observational study
International Urogynecology Journal, 2020Co-Authors: Jessica Caudwell Hall, Clara Shek, Susanne Langer, Hans Peter DietzAbstract:Introduction and hypothesis An increase in vaginal delivery with forceps may increase rates of pelvic floor trauma. This study was designed to predict trauma rates resulting from policies preferencing forceps. Methods This is an observational cohort study utilizing data from 660 primiparae enrolled in an RCT in two tertiary obstetric units in Sydney, Australia. Participants were assessed clinically and with 4D translabial ultrasound in the late third trimester and again at 3–6 months postpartum. Incidence of trauma associated with mode of delivery was adjusted to reflect change associated with a conversion of vacuum to forceps delivery. Primary outcome measures were third-/fourth-degree tear, levator avulsion (LA) and external anal sphincter (EAS) trauma diagnosed sonographically. Results Five hundred four women were seen at a mean of 5.1 (2.3–24.3) months postpartum. After exclusion of 21 because of missing data, 483 women were analysed: 112 (23%) had a CS, 268 (55%) a normal vaginal delivery (NVd), 69 (14%) a vacuum (Vd) and 34 (7%) a forceps (FD). One hundred fifty-two women had EAS trauma and/or LA; 17 sustained both. After Vd, 32/69 (46%) women suffered LA and/or EAS trauma; after FD, it was 33/34 (97%). Converting Vd to FD was estimated to result in an increase in trauma from 152/483 (31%) to 187/483 (39%). A formula can be generated based on local obstetric and ultrasound data to estimate trauma incidence. Conclusions A change in obstetric practice resulting in the conversion of primary Vd to primary FD would be expected to substantially increase the likelihood of pelvic floor trauma.
Xiao Rong - One of the best experts on this subject based on the ideXlab platform.
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Molecular Mechanisms of Vascular Dementia
Journal of Medical Molecular Biology, 2005Co-Authors: Zhao Jing, Xiao RongAbstract:Vascular dementia (Vd) is one of the most common causes of dementia, second only to Alzheimer's disease (AD). Cerebrovascular lesions, leukoaraiosis (LA) and AD-like tissue changes of brain shrinkage are the major etiological mechanisms. Moreover, the genetic factors play important roles in the development of Vd. So far, it has been found that the mutations or associated interactions of apo e, notch 3, Cystatin C gene, ASA-PD gene, ICAM-1 gene (K469E) and paraoxonase gene (pon 2) etc might be involved in the molecular mechanisms leading to Vd.
Susanne Langer - One of the best experts on this subject based on the ideXlab platform.
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the effect of replacing vacuum with forceps in operative vaginal delivery an observational study
International Urogynecology Journal, 2020Co-Authors: Jessica Caudwell Hall, Clara Shek, Susanne Langer, Hans Peter DietzAbstract:An increase in vaginal delivery with forceps may increase rates of pelvic floor trauma. This study was designed to predict trauma rates resulting from policies preferencing forceps. This is an observational cohort study utilizing data from 660 primiparae enrolled in an RCT in two tertiary obstetric units in Sydney, Australia. Participants were assessed clinically and with 4D translabial ultrasound in the late third trimester and again at 3–6 months postpartum. Incidence of trauma associated with mode of delivery was adjusted to reflect change associated with a conversion of vacuum to forceps delivery. Primary outcome measures were third-/fourth-degree tear, levator avulsion (LA) and external anal sphincter (EAS) trauma diagnosed sonographically. Five hundred four women were seen at a mean of 5.1 (2.3–24.3) months postpartum. After exclusion of 21 because of missing data, 483 women were analysed: 112 (23%) had a CS, 268 (55%) a normal vaginal delivery (NVd), 69 (14%) a vacuum (Vd) and 34 (7%) a forceps (FD). One hundred fifty-two women had EAS trauma and/or LA; 17 sustained both. After Vd, 32/69 (46%) women suffered LA and/or EAS trauma; after FD, it was 33/34 (97%). Converting Vd to FD was estimated to result in an increase in trauma from 152/483 (31%) to 187/483 (39%). A formula can be generated based on local obstetric and ultrasound data to estimate trauma incidence. A change in obstetric practice resulting in the conversion of primary Vd to primary FD would be expected to substantially increase the likelihood of pelvic floor trauma.
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The effect of replacing vacuum with forceps in operative vaginal delivery: an observational study
International Urogynecology Journal, 2020Co-Authors: Jessica Caudwell Hall, Clara Shek, Susanne Langer, Hans Peter DietzAbstract:Introduction and hypothesis An increase in vaginal delivery with forceps may increase rates of pelvic floor trauma. This study was designed to predict trauma rates resulting from policies preferencing forceps. Methods This is an observational cohort study utilizing data from 660 primiparae enrolled in an RCT in two tertiary obstetric units in Sydney, Australia. Participants were assessed clinically and with 4D translabial ultrasound in the late third trimester and again at 3–6 months postpartum. Incidence of trauma associated with mode of delivery was adjusted to reflect change associated with a conversion of vacuum to forceps delivery. Primary outcome measures were third-/fourth-degree tear, levator avulsion (LA) and external anal sphincter (EAS) trauma diagnosed sonographically. Results Five hundred four women were seen at a mean of 5.1 (2.3–24.3) months postpartum. After exclusion of 21 because of missing data, 483 women were analysed: 112 (23%) had a CS, 268 (55%) a normal vaginal delivery (NVd), 69 (14%) a vacuum (Vd) and 34 (7%) a forceps (FD). One hundred fifty-two women had EAS trauma and/or LA; 17 sustained both. After Vd, 32/69 (46%) women suffered LA and/or EAS trauma; after FD, it was 33/34 (97%). Converting Vd to FD was estimated to result in an increase in trauma from 152/483 (31%) to 187/483 (39%). A formula can be generated based on local obstetric and ultrasound data to estimate trauma incidence. Conclusions A change in obstetric practice resulting in the conversion of primary Vd to primary FD would be expected to substantially increase the likelihood of pelvic floor trauma.