Contraception
Elaine Cooper, John Guillebaud, Morgan Williams in Sexuality and Disability, 2017
An advantage for people with disabilities, either physical or learning, in using the combined oral contraceptive Pill is the control it allows over menstrual flow. Periods can be a particular problem for anyone unable to deal with the practicalities of menstrual hygiene. Sitting on soggy sanitary towels is very uncomfortable and some young women with learning disabilities are frightened by the bleeding that occurs. Bleeding usually signifies something bad, for example, injury. Distress can be caused when, after struggling to gain bladder control, this blood flow is uncontrollable. Using the combined oral contraceptive Pill allows the possibility of small planned periods (‘being caught on the hop’ is difficult for people with a learning disability), or having fewer periods (e.g. by tricycling or continuous Pill-taking). If breakthrough bleeding occurs this can be managed by having a withdrawal bleed for the usual length of time and then restarting the Pill.
Applied Surgical Anatomy
Tjun Tang, Elizabeth O'Riordan, Stewart Walsh in Cracking the Intercollegiate General Surgery FRCS Viva, 2020
What is the source of bleeding?GDA pseudoaneurysm is a common source of bleeding following pancreatic resections.This usually presents with warning or herald signs of haemorrhagic drain output and then overtly presents with significant bleed, which leads to haemodynamic instability.CT angiogram is the investigation of choice with embolisation as the therapeutic option in patients with a blush.Intra-operatively, a surgeon could take some precautions to avoid GDA pseudoaneurysm: Leave behind a longer stumpCover the stump with tissue, e.g., falciform ligament; omentumCover the stump with topical haemostatic productsMark the stump with metal clips to facilitate detection by imagingPlace drain in the proximity of pancreatic anastomosis
Vaginal Approach to Fixation of Vaginal Apex
Linda Cardozo, Staskin David in Textbook of Female Urology and Urogynecology - Two-Volume Set, 2017
HemorrhAge: This is the most commonly reported complicAtion with An AverAge blood loss rAnging from 75 to 839 mL [94]; sze And KArrAm reviewed 1229 cAses of sAcrospinous ligAment suspension And found thAt only 27 (2%) cAses required trAnsfusion [89]. bArksdAle et Al. dissected 10 femAle cAdAveric pelvises And concluded thAt the inferior gluteAl Artery is the vessel most likely to be injured. This is becAuse of its perpendiculAr course relAtive to the sAcrospinous ligAment, ApproximAtely midwAy between the ischiAl spine And the sAcrum, lying in A position immediAtely posterior to the most common locAtion of suture plAcement. Injury of the pudendAl vessels is uncommon becAuse the pudendAl neurovAsculAr bundle wAs found to be relAtively protected by the ischiAl spine And would respond to ligAtion of the internAl iliAc Artery. MAssive intrAoperAtive bleeding should be deAlt with by pAcking And vAsculAr clips or pAcking And ArteriAl embolizAtion [105]. other cAuses of bleeding Are injury to
Therapeutic advances in wound healing
Published in Journal of Dermatological Treatment, 2022
André Oliveira, Sandra Simões, Andreia Ascenso, Catarina Pinto Reis
Although NPWT has been demonstrated to be effective in the treatment of numerous wounds as previously mentioned, there are some potential complications associated with its use. Therefore, clinicians should be aware of strategies to prevent them. There are three major complications, which can potentially be life-threatening, such as bleeding, infection, and retention of the foam dressing (147,149). The primary cause of bleeding is the mechanical damage of the underlying tissues and can be aggravated by infection, necrotic tissue or coagulopathy (149). Thereupon, it is not recommended NPWT’s foam dressing to be in direct contact with exposed blood vessels, organ, nerves, or anastomotic sites since the risk of fistulae formation in the presence of exposed organ or hemorrhage with exposed blood vessels is increased (147). Regarding the infections, the relation between infection and application of NPWT is not clearly defined although some authors have described chronic wound sepsis caused by retention of the foam dressing (150). Infections should be treated before NPWT application (147). Finally, retention of the foam in the wound may cause infection or bleeding since the dressing materials used with NPWT do not dissolve, and therefore, provoke an inflammatory reaction slowing the wound healing process down. Other complications include pain associated with dressing changes and patient’s allergy to the adhesive dressing or the foam material (in these cases, NPWT is not recommended) (147).
Comparing about three types of endoscopic therapy methods for upper gastrointestinal submucosal tumors originating from the muscularis propria layer
Published in Scandinavian Journal of Gastroenterology, 2019
Hui Xiu, Cheng-Ye Zhao, Fu-Guo Liu, Xue-Guo Sun, Hui Sun, Xi-Shuang Liu
Intraprocedural bleeding is another major complication during ER. Usually, intraprocedural bleeding is caused by the injury of vessels. Minor bleeding can be controlled by hemostatic forceps and (or) the electrocoagulation. In our study, only 1 patient in ESE group suffered from intraprocedural hemorrhage and successful hemostasis with hemoclips. However, the postoperative complication rates were relatively high (28.9% in ESE, 42.6% in EFTR and 62.8% in STER), but there were no severe complications and no treatment-related deaths. In detail, slight pain, moderate fever or nausea accounted for the most part, which were cured by medical drug treatment in a day or two. Air leakage symptoms happened in 13 patients in STEP group, the gas was resolved spontaneously and 3 required drainage. Although the air leakage complications are common adverse events after STER, most of them were minor and do not require therapeutic intervention [14,17]. With the increase of the experience and the use of CO2, air leakage complication rate has reduced [22].
Prevention of recurrent thromboembolism in myeloproliferative neoplasms: review of literature and focus on direct oral anticoagulants
Published in Postgraduate Medicine, 2021
Joan How, Charlotte Story, Jean Marie Connors
Independent of the use of aspirin, MPN patients also have increased bleeding risk, with bleeding complications reported in 6% of MPN patients in one meta-analysis[25]. Bleeding complications are usually not major, with the majority of events consisting of mucosal, cutaneous, or gastrointestinal bleeding. However, in patients with Budd-Chiari syndrome, clinically significant bleeding is an important consideration given the development of varices from portal hypertension. Bleeding risk factors are not as well described compared to thrombotic risk factors, and have included thrombocytosis and leukocytosis across studies [36,63]. Driver mutation allele status has not been definitively shown to predict bleeding[64]. The mechanism of bleeding in MPNs is multifactorial, and likely related to qualitative defects in hematopoietic cells. Extreme thrombocytosis results in paradoxical bleeding rather than thrombosis, which in some cases may be due to an acquired von Willebrand syndrome, in which large von Willebrand multimers are sheared by increased platelet numbers[65]. However, the development of acquired von Willebrand corresponds poorly to any specific platelet threshold[66].
Related Knowledge Centers
- Mouth
- Circulatory System
- Blood
- Blood Vessel
- Urethra
- Vagina
- Internal Bleeding
- Nose
- Ear
- Anus