American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · May 2004
Randomized Controlled Trial Comparative Study Clinical TrialEffect of topical bupivacaine on postoperative pain after laparoscopic tubal sterilization with Filshie clips.
The purpose of this study was to evaluate postoperative pain after the administration of topical bupivacaine during laparoscopic sterilization with Filshie clips. ⋯ Topical bupivacaine that is applied to the fallopian tubes at the time of laparoscopic tubal sterilization with the Filshie clip decreases immediate postoperative pain.
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Am. J. Obstet. Gynecol. · May 2004
ReviewNeglected ethical dimensions of the professional liability crisis.
In response to the professional liability crisis, self-interest can become dominant and displace fiduciary professionalism from its central place in the moral lives of physicians and physician leaders. We provide preventive ethics tools to address this neglected ethical dimension of the professional liability crisis. We develop these tools on the basis of the concept of the physician as fiduciary of the patient, which was introduced in the English-language literature of medical ethics by Dr John Gregory (1714-1773). ⋯ Acceptable and unacceptable responses to the professional liability crisis are identified with the use of these 4 virtues. These virtues should be supported by an organizational culture of fiduciary professionalism. An organizational culture that is shaped by these 4 professional virtues should be used by physicians and physician leaders to create ethical best-practice models.
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Am. J. Obstet. Gynecol. · May 2004
A hospital-sponsored quality improvement study of pain management after cesarean delivery.
We undertook this study to systematically assess prevailing pain management regimes used at our hospital in women after cesarean delivery. ⋯ Pain relief was superior with the morphine regimens used and was positively associated with breastfeeding and infant rooming-in.
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Am. J. Obstet. Gynecol. · May 2004
Comparative StudyEmergency peripartum hysterectomy: a comparison of cesarean and postpartum hysterectomy.
The purpose of this study was to evaluate the incidence, risk factors, indications, outcomes, and complications of emergency hysterectomy performed after cesarean deliveries (cesarean hysterectomy) and vaginal deliveries (postpartum hysterectomy). ⋯ Uterine atony is the leading indication for emergency hysterectomy performed following cesarean and vaginal deliveries.
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Am. J. Obstet. Gynecol. · May 2004
Resident physician attire: does it make a difference to our patients?
This study was performed to examine the preferences of patients regarding physician attire, and if their perception of physician competence was influenced by the physicians' clothing style. ⋯ Resident physician attire makes a difference to patients. Our patients prefer the white coat with surgical scrubs. Casual clothing is less well liked by our patients.