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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
Funded by The Federal Ministry for Economic Affairs and Energy; Grant: 01MD19013D, Smart-MD Project, Digital Technologies
Dr. Lamaze was influenced by childbirth practices in the Soviet Union, which involved breathing and relaxation techniques under the supervision of a ""monitrice"", or midwife. The Lamaze method gained popularity in the United States after Marjorie Karmel wrote about her experiences in her 1959 book "Thank You, Dr. Lamaze", and with the formation of the American Society for Psycho prophylaxis in Obstetrics (ASPO Lamaze). Currently Lamaze International, founded by Karmel and Elisabeth Bing, is the premier childbirth education certifying organization in the world.
Modern Lamaze childbirth classes teach expectant mothers many ways to work with the labor process to reduce the pain associated with childbirth and promote normal (physiological) birth including the first moments after birth. Techniques include allowing labour to begin on its own, movement and positions, massage, aromatherapy, hot and cold packs, breathing techniques, the use of a "birth ball" (yoga or exercise ball), spontaneous pushing, upright positions for labour and birth, breastfeeding techniques, and keeping mother and baby together after childbirth. Each class has a specific curriculum that includes learning about common medical interventions and pain relief such as an epidural in an evidence based, non-biased manner.
The Lamaze technique, also known as the psychoprophylactic method or simply Lamaze, started as a prepared childbirth technique popularized in the 1950s by French obstetrician Dr. Fernand Lamaze based on his observations in the Soviet Union as an alternative to the use of medical intervention during childbirth. Today, Lamaze has become a popular way to get information about pregnancy, birth, and parenting through Lamaze International.
The stated goal of Lamaze is to increase a mother's confidence in her ability to give birth; classes help pregnant women understand how to cope with pain in ways that both facilitate labor and promote comfort, including relaxation techniques, movement and massage.
Although the definition is imprecise, it occurs in approximately 0.3-1% of vaginal births.
The incidence of anesthesia awareness is higher and has more serious sequelae when muscle relaxants or neuromuscular-blocking drugs are used. This is because without relaxant the patient will move and the anesthesiologist will deepen the anesthesia.
One study has indicated this phenomenon occurs in about 1 or 2 per 1000 patients or 0.13%. There is conflicting data however as another study suggested it is a rare phenomenon, with an incidence of 0.0068% after review of their data from a patient population of 211,842 patients.
Post operative interview by an anesthetist is common practice to elucidate if awareness occurred in the case. If awareness is reported a case review is immediately performed to identify machine, medication, or operator error.
Very rare causes of awareness include drug tolerance, or a tolerance induced by the interaction of other drugs. Some patients may be more resistant to the effects of anesthetics than others; factors such as younger age, obesity, tobacco smoking, or long-term use of certain drugs (alcohol, opiates, or amphetamines) may increase the anesthetic dose needed to produce unconsciousness but this is often used as an excuse for poor technique. There may be genetic variations that cause differences in how quickly patients clear anesthetics, and there may be differences in how the sexes react to anesthetics as well. In addition, anesthetic requirement is increased in persons with naturally red hair. Marked anxiety prior to the surgery can increase the amount of anesthesia required to prevent recall.
About 16% of deliveries where shoulder dystocia occurs will have conventional risk factors.
There are well-recognized risk factors, such as diabetes, fetal macrosomia, and maternal obesity, but it is often difficult to predict, despite recognised risk factors. Despite appropriate obstetric management, fetal injury (such as brachial plexus injury) or even fetal death can be a complication of this obstetric emergency.
Risk factors:
- Age >35
- Short in stature
- Small or abnormal pelvis
- More than 42 weeks gestation
- Estimated fetal weight > 4500g
- Maternal diabetes (2-4 fold increase in risk)
Factors which increase the risk/are warning signs:
- the need for oxytocics
- a prolonged first or second stage of labour
- turtle sign
- head bobbing in the second stage
- failure to restitute
- No shoulder rotation or descent
- Instrumental delivery
Recurrence rates are relatively high (if you had shoulder dystocia in a previous delivery the risk is now 10% higher than in the general population).
The reported incidence of constriction ring syndrome varies from 1/1200 and 1/15000 live births. The prevalence is equally in male and female.
Fetomaternal factors like prematurity, maternal illnes, low birth weight and maternal drug exposure are predisposing factors for the constriction ring syndrome.
No positive relationship between CRS and genetic inheritance has been reported.
Audioanalgesia (also known as audio-analgesia) is the relief of pain using white noise or music without using pharmacological agents while doing painful medical procedures such as dental treatments. It was first introduced by Gardner and Licklider in 1959.
There are many studies of this technique in dental, obstetric, and palliative care contexts. The most recent review reports mixed results for effectiveness. This questionable pain management strategy might prove useful in distraction and sensory confusion, but only when combined with actual pain relief medications. There is no research to suggest these dubious results will ever be effective other than as a means of self-distraction. This measure is similar to breathing exercises during cramps before administration of epidurals.
It has also been suggested that music may stimulate the production of endorphins and catecholamines.
Via a photo shown on a Facebook page, the mother of a child previously diagnosed with this condition recognised the symptoms and reported them to the family involved, resulting in an immediate diagnosis that medical professionals had overlooked in all earlier consultations.
Anesthesia dolorosa or anaesthesia dolorosa or deafferentation pain is pain felt in an area (usually of the face) which is completely numb to touch. The pain is described as constant, burning, aching or severe. It can be a side effect of surgery involving any part of the trigeminal system, and occurs after 1–4% of peripheral surgery for trigeminal neuralgia. No effective medical therapy has yet been found. Several surgical techniques have been tried, with modest or mixed results. The value of surgical interventions is difficult to assess because published studies involve small numbers of mixed patient types and little long term follow-up.
- Gasserian ganglion stimulation is stimulation of the gasserian ganglion with electric pulses from a small generator implanted beneath the skin. There are mixed reports, including some reports of marked, some of moderate and some of no improvement. Further studies of more patients with longer follow-up are required to determine the efficacy of this treatment.
- Deep brain stimulation was found in one review to produce good results in forty-five percent of 106 cases. Though relief may not be permanent, several years of relief may be achieved with this technique.
- Mesencephalotomy is the damaging of the junction of the trigeminal tract and the periaqueductal gray in the brain, and has produced pain relief in a group of patients with cancer pain; but when applied to six anesthesia dolorosa patients, no pain relief was achieved, and the unpleasant sensation was in fact increased.
- Dorsal root entry zone lesioning, damaging the point where sensory nerve fibers meet spinal cord fibers, produced favorable results in some patients and poor results in others, with incidence of ataxia at 40%. Patient numbers were small, follow-up was short and existing evidence does not indicate long term efficacy.
- One surgeon treated thirty-five patients using trigeminal nucleotomy, damaging the nucleus caudalis, and reported 66% "abolition of allodynia and a marked reduction in or (less frequently) complete abolition of deep background pain."
Several risk factors of CMC OA of the thumb are known. Each of these risk factors does not cause CMC OA by itself, but acts as a predisposing factor influencing the process of OA in some way. Risk factors include: female gender, suffering from obesity, repetitive heavy manual labor, familial predisposition and hormonal changes, such as menopause.
The highest rate of neurological problems of single suture synostosis are seen in patients with trigonocephaly. Surgery is performed generally before the age of one because of claims of better intellectual outcome. Seemingly surgery does not influence the high incidence of neurodevelopment problems in patients with metopic synostosis. Neurological disorders such as ADHD, ASD, ODD and CD are seen in patients with trigonocephaly. These disorders are usually also associated with decreased IQ. The presence of ADHD, ASD and ODD is higher in cases with an IQ below 85. This is not the case with CD which showed an insignificant increase at an IQ below 85.
The causes of premature ejaculation are unclear. Many theories have been suggested, including that PE was the result of masturbating quickly during adolescence to avoid being caught, of performance anxiety, of an unresolved Oedipal conflict, of passive-aggressiveness, and having too little sex; but there is little evidence to support any of these theories.
Several physiological mechanisms have been hypothesized to contribute to causing premature ejaculation including serotonin receptors, a genetic predisposition, elevated penile sensitivity, and nerve conduction atypicalities.
The nucleus paragigantocellularis of the brain has been identified as having involvement in ejaculatory control. Scientists have long suspected a genetic link to certain forms of premature ejaculation. In one study, 91 percent of men who have had premature ejaculation for their entire lives also had a first-relative with lifelong premature ejaculation. Other researchers have noted that men who have premature ejaculation have a faster neurological response in the pelvic muscles.
PE may be caused by prostatitis or as a drug side effect.
CMC OA is the most common form of OA affecting the hand. Dahaghin et al. showed that about 15% of women and 7% of men between 50 and 60 years of age suffer from CMC OA of the thumb. However, in about 65% of people older than 55 years, radiologic evidence of OA was present without any symptoms. Armstrong et al. reported a prevalence of 33% in postmenopausal women, of which one third was symptomatic, compared to 11% in men older than 55 years. This shows CMC OA of the thumb is significantly more prevalent in women, especially in postmenopausal women, compared to men.
Surgical correction is recommended when a constriction ring results in a limb contour deformity, with or without lymphedema.
Premature ejaculation (PE) occurs when a man experiences orgasm and expels semen soon after sexual activity and with minimal penile stimulation. It has also been called "early ejaculation," "rapid ejaculation," "rapid climax," "premature climax," and (historically) "ejaculatio praecox." There is no uniform cut-off defining "premature", but a consensus of experts at the International Society for Sexual Medicine endorsed a definition including "ejaculation which always or nearly always occurs prior to or within about one minute". The International Classification of Diseases (ICD-10) applies a cut-off of 15 seconds from the beginning of sexual intercourse. Hong argued that rapid ejaculation is an evolutionary adaptation.
Although men with premature ejaculation describe feeling that they have less control over ejaculating, it is not clear if that is true, and many or most average men also report that they wish they could last longer. Men's typical ejaculatory latency is approximately 4–8 minutes. The opposite condition is delayed ejaculation.
Men with PE often report emotional and relationship distress, and some avoid pursuing sexual relationships because of PE-related embarrassment. Compared with men, women consider PE less of a problem, but several studies show that the condition also causes female partners distress.
As unequal leg length may contribute to a tilted pelvis, this may contribute to lower back pain.
A hypothesis is that the lower back pain caused by a tilted pelvis, easily may be mistaken for menstrual pain, as women with lower back pain experience increased pain during their periods.
Pectus excavatum occurs in an estimated 1 in 150 to 1 in 1000 births, with male predominance (male-to-female ratio of 3:1). In 35% to 45% of cases family members are affected.
Researchers are unsure of the cause of pectus excavatum but assume that there is a genetic component for at least some of the cases as 37% of individuals have an affected first degree family member. As of 2012, a number of genetic markers for pectus excavatum have also been discovered.
Pectus excavatum is a relatively common symptom of Noonan syndrome, Marfan syndrome and Loeys-Dietz syndrome and sometimes is found in other connective tissue disorders such as Ehlers–Danlos Syndrome. Many children with spinal muscular atrophy develop pectus excavatum due to their diaphragmatic breathing. Pectus excavatum also occurs in about 1% of persons diagnosed with celiac disease for unknown reasons.
The prevalence of uterine malformation is estimated to be 6.7% in the general population, slightly higher (7.3%) in the infertility population, and significantly higher in a population of women with a history of recurrent miscarriages (16%).
After an anterior shoulder dislocation, the risk of a future dislocation is about 20%. This risk is greater in males than females.
Twin anemia-polycythemia sequence, abbreviated as TAPS, is a form of chronic inter-twin transfusion.
The observation has been made many times that globozoospermia arises in siblings which points towards an underlying genetic cause. Recent progress has been made into determining what genes could be implicated in this pathology, with the previously mentioned genes being found to play a role. There are more genes which have been shown to be mutated in globozoospermia in mice, but these are yet to be connected to the human disease process. Examples of these include Gopc, Hrb and Csnka2. There are thousands of genes which guide the process of spermatogenesis, and knowing how they’re involved in globozoospermia is an important current area of research.
The incidence of ovarian remnant syndrome is difficult to determine. The available data are limited to case reports or to retrospective case series. The best available data are from a study describing the frequency and outcome of laparoscopy in women with chronic pelvic pain and/or a pelvic mass who were found to have ovarian remnants. In 119 women who underwent hysterectomy and oophorectomy by laparoscopy, ovarian remnants were known in 5 and were found during surgery in 21 patients (18%).[2] However, this was a small study and the participants were only symptomatic women. Therefore, it is not known whether the data can be extrapolated to include all women who have undergone oophorectomy.
The most common causes of nipple inversion include:
- Born with condition
- Trauma which can be caused by conditions such as fat necrosis, scars or it may be a result of surgery
- Breast sagging, drooping or ptosis
- Breast cancer
- breast carcinoma
- Paget's disease
- Inflammatory Breast Cancer (IBC)
- Breast infections or inflammations
- mammary duct ectasia
- breast abscess
- mastitis
- Genetic variant of nipple shape such as
- Weaver syndrome
- congenital disorder of glycosylation type 1A & 1 L
- Kennerknecht-Sorgo-Oberhoffer syndrome
- Gynecomastia
- Holoprosencephaly, recurrent infections and monocytosis
- Tuberculosis
Around 10–20% of all women are born with this condition. Most common nipple variations that women are born with are caused by short ducts or a wide areola muscle sphincter.
Inverted nipples can also occur after sudden and major weight loss.
Tendonitis is a very common, but misleading term. By definition, the suffix "-itis" means "inflammation of". Inflammation is the body's local response to tissue damage which involves red blood cells, white blood cells, blood proteins with dilation of blood vessels around the site of injury. Tendons are relatively avascular.
Corticosteroids are drugs that reduce inflammation. Corticosteroids can be useful to relieve chronic tendinopathy pain, improve function, and reduce swelling in the short term. However, there is a greater risk of long-term recurrence. They are typically injected along with a small amount of a numbing drug called lidocaine. Research shows that tendons are weaker following corticosteroid injections. Tendinitis is still a very common diagnosis, though research increasingly documents that what is thought to be tendinitis is usually tendinosis.