Limiting the caesarean section rate in low risk pregnancies is key to lowering the trend of increased abdominal deliveries: an observational study

<p>Abstract</p> <p>Background</p> <p>As the rate of Caesarean sections (CS) continues to rise in Western countries, it is important to analyze the reasons for this trend and to unravel the underlying motives to perform CS. This research aims to assess the incidence and trend of CS in a population-based birth register in order to identify patient groups with an increasing risk for CS.</p> <p>Methods</p> <p>Data from the Flemish birth register 'Study Centre for Perinatal Epidemiology' (SPE) were used for this historic control comparison. Caesarean sections (CS) from the year 2000 (N = 10540) were compared with those from the year 2008 (N = 14016). By means of the Robson classification, births by Caesarean section were ordered in 10 groups according to mother - and delivery characteristics.</p> <p>Results</p> <p>Over a period of eight years, the CS rise is most prominent in women with previous sections and in nulliparous women with a term cephalic in spontaneous labor. The proportion of inductions of labor decreases in favor of elective CS, while the ongoing inductions of labor more often end in non-elective CS.</p> <p>Conclusions</p> <p>In order to turn back the current CS trend, we should focus on low-risk primiparae. Avoiding unnecessary abdominal deliveries in this group will also have a long-term effect, in that the number of repeat CS will be reduced in the future. For the purpose of self-evaluation, peer discussion on the necessity of CS, as well as accurate registration of the main indication for CS are recommended.</p

Kuhnian revolutions in neuroscience: the role of tool development.

The terms "paradigm" and "paradigm shift" originated in "The Structure of Scientific Revolutions" by Thomas Kuhn. A paradigm can be defined as the generally accepted concepts and practices of a field, and a paradigm shift its replacement in a scientific revolution. A paradigm shift results from a crisis caused by anomalies in a paradigm that reduce its usefulness to a field. Claims of paradigm shifts and revolutions are made frequently in the neurosciences. In this article I will consider neuroscience paradigms, and the claim that new tools and techniques rather than crises have driven paradigm shifts. I will argue that tool development has played a minor role in neuroscience revolutions.The work received no fundin

International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

A Disease Without History? Evidence for the Antiquity of Head and Neck Cancers

There has been a long-running debate in anthropological, archaeological, and medical literature regarding the prevalence of cancer in various ancient human populations. At one extreme, some scholars have claimed that past human societies had rates of cancer roughly equivalent to those seen among modern peoples; at the other extreme, some researchers have effectively claimed that cancer is a disease of modernity. The present study aims to shed further light on this topic, at least insofar as cancers of the head and neck are concerned. A review of ancient art, medical texts, and paleopathological reports revealed somewhat discordant accounts of the age, geographical distribution, and prevalence of head and neck cancers. While representations of these neoplastic conditions in art are relatively rare and patchy in geographic distribution, descriptions of suspect lesions in ancient medical texts are rather more widespread, if unevenly distributed geographically, and the paleopathological record was found to contain surprisingly abundant evidence for cancers of the head and neck, especially as compared to what are, in modern societies, more ubiquitous cancers of the breast, lung, or prostate. While establishing the absolute prevalence of any of these conditions in antiquity is impossible, the present work establishes that cancers of the head and neck have long been present, and perhaps even prevalent, in human societies