Antepartum Perineal Massages is Effective to Prevent Intrapartum Perineal Rupture: Pijat Perineum Antepartum Efektif Mencegah Ruptur Perineum Intrapartum

Objective: To provide a summary of evidence about the benefi ts and effectiveness of perineal massage in preventing perineal rupture during labour.Methods: Evidence-based review of research articles with an evidence-based level 1a.Results: Intervention of perineal massage not only reduced the incidence of perineal rupture but also reduced the incidence of episiotomy requiring stitches, as well as reducing perineal pain after 3 months of postpartum.Conclusions: Perineal massage intervention is an intervention that is easy to do, effective, inexpensive, and has the potential to benefi t more than the potential harm in preventing perineal rupture.Keywords: intrapartum, perineal massage, perineal rupture.AbstrakTujuan: memberikan ringkasan bukti penelitian tentang manfaat dan efektifi tas dari pijat perineum dalam mencegah ruptur perineum selama persalinan.Metode: evidence-based review dengan level evidence based 1a.Hasil: Intervensi pijat perineum tidak hanya menurunkan insiden ruptur perineum tetapi juga menurunkan insiden episiotomi yang membutuhkanj jahitan, serta mengurangi nyeri perineum setelah 3 bulan postpartum.Kesimpulan: Intervensi pijat perineum merupakan intervensi yang mudah untuk dilakukan, efektif, murah, serta mempunyai potensi menguntungkan lebih banyak daripada potensi merugikan dalam mencegah ruptur perineum.Kata kunci: intrapartum, pijat perineum, ruptur perineum

Media Access Schemes for Indirect Diffused Free-Space Optical Networks

In this paper, we propose a set of three media access control (MAC) schemes for an indirect diffused light free-space optical communications (ID-FSOCs). ID-FSOC has been recently proposed to establish wireless high-speed (i.e., ≥1 Gbps) network access using FSO from stations that have no line-of-sight (LOS) with the access point. ID-FSOC employs a diffuse reflector (DR) to uniformly reflect diffused light from an incident laser to all directions, except towards the DR. To establish a link, ID-FSOC requires LOS between the transmitter and the DR and between DR and the receiver. In this way, ID-FSOC relaxes the location of stations as long as they keep LOS to the DR. We analyze the performance and scalability of proposed schemes. We also consider the impact of the zoom-in time of a receiver in our evaluations. Our results show that our proposed MAC schemes achieve high channel utilization and higher throughput than carrier-sense multiple access schemes

The Impact of Telemedicine in the Diagnosis of Erythema Migrans during the COVID Pandemic: A Comparison with In-Person Diagnosis in the Pre-COVID Era

Background: Erythema migrans (EM) is the hallmark manifestation of the Lyme borreliosis (LB), and therefore its presence and recognition are sufficient to make a diagnosis and to start proper antibiotic treatment to attempt to eradicate the infection. Methods: In this study we compared the clinical data of 439 patients who presented an EM either according to the diagnostic modality through physical assessment or through telemedicine. Conclusions: Our data clearly show that telemedicine for EM diagnosis is useful as it enables prompt administration of appropriate antibiotic therapy, which is critical to avoid complications, especially for neurologic and articular entities. Therefore, telemedicine is a tool that could be adopted for the diagnosis of Lyme disease both by specialized centers but also by general practitioners

Disseminated superficial porokeratosis and pyoderma gangrenosus

Disseminated Superficial Actinic Porokeratosis (DSAP) is usually triggered by sun exposure. In some cases sun exposure is not essential and this skin disease is related to immunosuppression. Many associated diseases are described in the literature. We report a clinical case of a patient affected by pyoderma gangrenosum, who developed DSAP

Improving the early diagnosis of early nodular melanoma: can we do better?

Introduction: Cutaneous melanoma is the sixth most common malignant cancer in the USA. Among different subtypes of melanoma, nodular melanoma (NM) accounts about 14% of all cases but is responsible for more than 40% of melanoma deaths. Early diagnosis is the best method to improve melanoma prognosis. Unfortunately, early diagnosis of NM is particularly challenging given that patients often lack identifiable risk factors such as many moles or freckles. Moreover, early NM may mimic a range of benign skin lesions that are not routinely excised or biopsied in every day practice. For this reason, specific clinical and skin imaging clues have been proposed to improve early detection of NM.Areas covered: The review discusses about the noninvasive tools to diagnose thin melanoma, particularly NM. Expert commentary: Currently, dermatologists present a wide opportunity of diagnostic tools. Current data suggest that the early diagnosis of NM is a major challenge as the majority of early NM are symmetric, roundish, and lack specific pattern. Another promising strategy is based on recent data suggesting that artificial intelligence based on deep convolutional neural networking is able to outperform average dermatologist. Further research is necessary to validate the performance of this method in the real world and in the clinical setting

Parry-Romberg syndrome: A case with a possible association with lyme disease

Parry-Romberg syndrome is an acquired slowly progressive disease characterized by an atrophy mostly involving half of the face. The pathogenesis of this disfiguring condition is still controversial. The relationship between Parry-Romberg syndrome and Lyme disease needs to be considered in depth. A 16-year-old woman from Albania presented with linear depressions of the right side of the face, clinically compatible with Parry-Romberg syndrome. She had a positive history of Lyme disease. Borrelia infection was confirmed by the positivity of PCR and the presence of IgM antibodies. The patient received intravenous penicillin and metronidazole for 14 days. After treatment and during a 2-year follow-up, the clinical disease progression was halted and the serological and microbiological tests for Borrelia burgdorferi sensu lato were negative. We cannot exclude a coincidence, however, of the bacteriological and serological evidence. Moreover, the interruption of the disease progression after the antibiotic therapy is difficult to ignore without claiming that this association is at least suggestive

Abdominopelvic post-irradiation morphea in a prostate cancer patient: the first case of an under recognized condition

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COVID-19 and psoriasis: Is it time to limit treatment with immunosuppressants? A call for action

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Dynamic Community Discovery Method Based on Phylogenetic Planted Partition in Temporal Networks

As most of the community discovery methods are researched by static thought, some community discovery algorithms cannot represent the whole dynamic network change process efficiently. This paper proposes a novel dynamic community discovery method (Phylogenetic Planted Partition Model, PPPM) for phylogenetic evolution. Firstly, the time dimension is introduced into the typical migration partition model, and all states are treated as variables, and the observation equation is constructed. Secondly, this paper takes the observation equation of the whole dynamic social network as the constraint between variables and the error function. Then, the quadratic form of the error function is minimized. Thirdly, the Levenberg–Marquardt (L–M) method is used to calculate the gradient of the error function, and the iteration is carried out. Finally, simulation experiments are carried out under the experimental environment of artificial networks and real net-works. The experimental results show that: compared with FaceNet, SBM + MLE, CLBM, and Pi-sCES, the proposed PPPM model improves accuracy by 5% and 3%, respectively. It is proven that the proposed PPPM method is robust, reasonable, and effective. This method can also be applied to the general social networking community discovery field