Wound infection in gynecologic surgery.

OBJECTIVE: We sought to determine the wound infection rate among patients undergoing elective gynecologic surgery at a single tertiary care center and to determine the predictive value of various factors that contribute to infection. We further investigated the adequacy of hospital records in documenting infection rates as well as the timing of presentation of wound infections. METHODS: The records of 115 patients undergoing elective gynecologic surgery at our institution were reviewed. Patients were further subdivided based on route of surgery. We analyzed the importance of antibiotic prophylaxis, route of surgery, smoking, diabetes, and body mass index (BMI). RESULTS: The overall wound infection rate was 12.17% with no significant difference in the subgroups by route of surgery. Overall, antibiotic prophylaxis significantly decreased infection rates (P = 0.0118), but the route of surgery, BMI, smoking, and diabetes were not significant predictors of infection. Only one case of infection was detected during the initial hospital stay (6.1%). Fifty percent of the patients with infection required readmission, and of these 35.7% required an additional surgical procedure. The average length of hospital stay was 2.4 days longer in patients with infection. CONCLUSIONS: Antibiotic prophylaxis has a role in the management of patients undergoing abdominal gynecologic surgery. In today's environment of cost containment, an increased hospital stay and the added likelihood of additional surgical intervention associated with wound infection are important targets for prevention. Most patients with wound infection were diagnosed after discharge from the hospital. In our population, among whom transportation problems and remote residence are prevalent, strategies for infection surveillance should be integral to discharge planning

HRV in active-duty special forces and public order military personnel

Heart rate variability (HRV) is a simple, non-invasive, real-time analyzable, and highly reproducible measurement that captures incidences for assessing a person’s health and physical condition. Public security jobs are characterized by major exposure to risk factors known to influence the cardiovascular response to stimuli, e.g., night shifts, highly physically demanding activity, and acute stress activity. This study aimed to evaluate the HRV parameters in a population of 112 male personnel of the special forces and public order of the Carabinieri, aged 25-59, when engaged in several duty tasks, such as paratroopers, night shift police station officers, night shift patrol, dynamic precision shooting evaluative team, dynamic precision shooting non-evaluative team, and office clerks (used as control group). During the specific task of each participant, the HRV parameters were collected with wearable devices and processed. The HRV parameters in the time and frequency domains collected were average heart rate, standard deviation of all normal RR intervals, root mean square of successive differences in adjacent normal-to-normal (NN) intervals, very-low-frequency power, low-frequency power, high-frequency power, stress index, parasympathetic nervous system activity index, and sympathetic nervous system activity index. Parametric tests for independent series to compare the HRV parameters by subgroups within the study subjects were used. A multivariate linear regression analysis was conducted to evaluate the association between the HRV parameters and some personal and organizational factors. The comparison between different subgroups showed that activities with a high demand for concentration and precision, as is the case with paratroopers and dynamic precision shooters, differ significantly from activities that can be defined as routine, such as office work. Other activities, such as patrolling or remote management from operations centers, although including critical elements, did not deviate significantly from the control group. The study of HRV parameters is therefore a useful tool for occupational physicians, both for addressing work suitability assessments and for better targeting health promotion campaigns, to be considered as being aimed at monitoring the subject’s physiological parameters, and not at the diagnosis of any pathological condition, which should always be carried out by the medical specialist

Visual influences on perception of speech and nonspeech vocal-tract events

We report four experiments designed to determine whether visual information affects judgments of acoustically-specified nonspeech events as well as speech events (the "McGurk effect"). Previous findings have shown only weak McGurk effects for nonspeech stimuli, whereas strong effects are found for consonants. We used click sounds that serve as consonants in some African languages, but that are perceived as nonspeech by American English listeners. We found a significant McGurk effect for clicks presented in isolation that was much smaller than that found for stop-consonant-vowel syllables. In subsequent experiments, we found strong McGurk effects, comparable to those found for English syllables, for click-vowel syllables, and weak effects, comparable to those found for isolated clicks, for excised release bursts of stop consonants presented in isolation. We interpret these findings as evidence that the potential contributions of speech-specific processes on the McGurk effect are limited, and discuss the results in relation to current explanations for the McGurk effect

Metabolites from the aerial parts of the Sicilian population of Artemisia alba Turra

Phytochemical investigation of the CH2Cl2 extract of the aerial parts of Artemisia alba Turra afforded one new irregular sesquiterpenoid, artemiric acid, and five known metabolites: hydroxydavanone, the coumarins isofraxidin and scopoletin, (6S*,7S*,10R*)-6,10-dimethyl-7,10-epoxyocta-11-enoic acid and artalbic acid. From the MeOH extract three flavonoids were identified: chrysoeriol, quercetin and isorhamnetin. The possible biogenetic pathways of artemiric and artalbic acids are discussed

Obstetric hemorrhage survey: Attitudes and practices of maternal-fetal medicine fellows.

OBJECTIVE: To evaluate experiences related to obstetric hemorrhage and suspected abnormal placentation among first year maternal-fetal medicine fellows. STUDY DESIGN: A cross-sectional anonymous survey was administered at the Society for Maternal-Fetal Medicine fellow retreat in March 2013. Fellows were asked about management strategies that reflected both their individual and institutional practices. RESULTS: There was a 56% response rate (55/98). In cases of postpartum hemorrhage due to uterine atony, there was variable use of the uterine tamponade device. The median incremental time for balloon deflation was every 5 hours (IQR = 2-12). Compared to the east coast, fellows from the west coast performed more hysterectomies (mean±SD; 2.9±2.4 vs. 1.2±1.2, p = 0.004). During a peripartum hysterectomy, 29% of fellows used a handheld cautery device such as Ligasure® or Gyrus®. Fifty-six percent responded that their institution never recommend planned delayed hysterectomies for abnormal placental implantation. CONCLUSION: There is wide variation in practice among first year maternal-fetal medicine fellows in management of peripartum hysterectomy and postpartum hemorrhage

Laser-induced rotation and cooling of a trapped microgyroscope in vacuum

This work was supported by the UK Engineering and Physical Sciences Research Council (EPSRC grant numbers: EP/J01771X/1 and EP/G061688/1)Quantum state preparation of mesoscopic objects is a powerful playground for the elucidation of many physical principles. The field of cavity optomechanics aims to create these states through laser cooling and by minimizing state decoherence. Here we demonstrate simultaneous optical trapping and rotation of a birefringent microparticle in vacuum using a circularly polarized trapping laser beam—a microgyroscope. We show stable rotation rates up to 5 MHz. Coupling between the rotational and translational degrees of freedom of the trapped microgyroscope leads to the observation of positional stabilization in effect cooling the particle to 40 K. We attribute this cooling to the interaction between the gyroscopic directional stabilization and the optical trapping field.Publisher PDFPeer reviewe