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Massive Hemorrhage and Transfusion Protocols in Trauma and Nontrauma Patients
Massive hemorrhage with hemodynamic instability or shock may arise from multiple causes and is a medical emergency requiring intensive care. Hemorrhagic shock typically develops with the loss of 30-40% of blood volume. Thankfully, its incidence is likely low. Treatment is focused on resuscitative efforts to restore blood volume and stop bleeding. Time is required to locate and secure the sources of blood loss. It is in this setting that resuscitation to maintain oxygen concentration, cardiac output, and circulating blood volume is necessary for survival. Massive transfusion protocols have been developed to provide rapid access to and administration of blood products in these situations.
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Expedited Partner Therapy: We Can Do More
This article reviews the current status of expedited partner therapy (EPT), which involves treating the heterosexual partners of patients diagnosed with chlamydia or gonorrhea by providing the medication or a prescription for the patient to give to the partner without a healthcare provider first examining the partner.
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Nocturia: Does Salt Intake Play a Role?
Researchers suggest that excessive salt intake can contribute to urinary frequency and nocturia.
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Premature Rupture of Membranes Revisited
An individual participant data meta-analysis from Australia suggests that expectant management of patients with premature rupture of membranes between 34 and 36 weeks, compared with immediate intervention, results in comparable levels of composite neonatal adverse outcomes but in mixed maternal adverse outcomes that balance out in the final analysis.
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Childhood Obesity: A Risk Factor for Infertility?
Results from a 25-year prospective study demonstrate a moderate association between childhood obesity before age 12 years and female infertility in adulthood.
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Why Are Cesarean Delivery Rates Higher With IVF Pregnancies?
SYNOPSIS: The major factors leading to increased odds of cesarean delivery in all infertile women, but particularly in those who conceive following in vitro fertilization, are advanced maternal age and previous uterine surgery.
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‘Dry Run’ for Radiology Improves Patient Safety
Radiology can be a complex process using the latest technology, and the results can drive the course of a patient’s care. Getting it right the first time is not always easy.
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Alarm Fatigue Still Serious, Solutions Slow to Come
Alarm fatigue still is a serious threat to patient safety, and years of effort have yielded minimal improvement, experts say.
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Ethics Involvement Needed With Complex Discharges
Ethicists are seeing increasing numbers of consults involving concerns with discharge planning.
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Study: Little Difference in Outcomes Between ACO and Non-ACO Patients
Accountable care organizations were established to reduce costs and improve quality of care, but do they achieve those goals?