Hysteroscopic management of retained products of conception: A single center observational study.

BACKGROUND: Retained products of conception (RPOC) are defined as the presence of tissue inside the uterine cavity after delivery or termination of a pregnancy. Operative hysteroscopy is associated with increased surgical success and decreased postoperative formation of intrauterine adhesions. The aim of this study is to report our experience in hysteroscopic management of RPOC. METHODS: A retrospective chart review identified patients who underwent hysteroscopic removal of retained products of conception at a single center (n=45). Basic demographic data, surgical findings and applied technique were reviewed. Chi Square and independent samples t-tests were performed when appropriate. A significance level of p<0.05 was accounted. RESULTS: Of all cases included, 64% were the result of a spontaneous or elective abortion and 47% were from patients who had failed previous treatment. Previous medical or surgical treatment was observed in 37.9% of patients labeled as type 0-1 versus 62.5% of type 2-3 (p=0.1138). The timing between the end of the preceding pregnancy and hysteroscopic removal was in average 2.62 months in type 0-1 compared to 1.7 months in type 2-3 (p=0.1068). All patients who were classified as type 2-3 required the use of monopolar energy during the surgery, compared to zero patients who were classified as type 0-1 (p < 0.0001). CONCLUSION: Operative hysteroscopy remains a safe and highly effective option for the management of RPOC and should be the preferred method compared to traditional dilatation and suction curettage.

Forensic psychiatric nursing: a description of the role of the psychiatric nurse in a high secure psychiatric facility in Ireland.

The Central Mental Hospital is one of the oldest high secure mental health services in Europe dating back to 1845 but has been one of the last to introduce (forensic) psychiatric nurses. This paper describes the role of psychiatric nurses working in this high secure psychiatric facility in Ireland. The United Kingdom Central Council competency framework was considered to be a prudent starting point for beginning to understand this role in an Irish context. The study received a response rate of 74% and found that the Irish Forensic Mental Health Nurse experiences many of the same challenges as their international colleagues. A high proportion of nursing practice is focused on assessment, communication and creating a therapeutic environment based very much in keeping with the mainstream role in mental health nursing. Skills in specialist assessments and addressing offending behaviour were considered important but deficient at that time. The importance of recovery and human rights were considered paramount but challenged by the need for risk management and security.

Highly stereoselective syntheses of five- and seven-membered ring heterocycles from ylides generated by catalytic reactions of styryldiazoacetates with aldehydes and imines.

[reaction--see text] Styryldiazoacetates are effective reactants for ylide formation that results in the formation of dihydropyrroles and dihydroazepines with high stereocontrol and in high yields.

Epoxides and aziridines from diazoacetates via ylide intermediates.

An effective methodology is reported for stereospecific epoxidation and aziridination via carbonyl ylide intermediates using rhodium(II) acetate catalyzed reactions of phenyl- and styryldiazoacetates with aldehydes, ketones, or imines.

Completion of the series of M2(hpp)4Cl2 compounds from W to Pt: the W, Os, and Pt compounds.

The series of M2(hpp)4Cl2 complexes (hpp is the anion of 1,3,4,6,7,8-hexahydro-2H-pyrimido[1,2-a]pyrimidine) from M = W to M = Pt has been completed by the preparation and characterization of those with M = W, Os, and Pt. W(hpp)4Cl2 (1) has a W-W distance of 2.250(2) A, is diamagnetic, and can be assigned a W-W triple bond based on a sigma 2 pi 4 electron configuration. Os2(hpp)4Cl2 (2) has an Os-Os distance of 2.379(2) A and displays a temperature-independent paramagnetism. It can be assigned a sigma 2 pi 4 delta 2 delta*2 configuration. Pt2(hpp)4Cl2 has a Pt-Pt distance of 2.440(1) A and is diamagnetic. A bond order of 1, based on a configuration in which only the sigma* orbital is empty, is consistent with these data.

Brevitaxin, a new diterpenolignan from the bark of Taxus brevifolia.

The first terpenolignan, brevitaxin [1], has been isolated from the bark of Taxus brevifolia. Identification was carried out using spectral methods, and the regiochemistry and cytotoxicity of 1 are discussed.

Microorganisms of the upper atmosphere. I. Instrumentation for isokinetic air sampling at altitude.

An aircraft-mounted air-sampling system for the collection of microorganisms from the upper air is described. The system is highly suitable for use in upper air sampling from an aircraft because (i) it is an isokinetic system, (ii) it is simple to operate, (iii) it employs a dry filter, (iv) the volume sampled can be easily determined, and (v) it operates efficiently at all altitudes and ambient temperatures.