Harefuah
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Elective cesarean section on maternal request is a debatable issue with regard to all of its aspects. Current literature discusses topics such as its prevalence, risks and benefits in comparison with vaginal delivery, as well as ethical, judicial and economical questions regarding its execution. ⋯ There are no clear research findings which indicate that overall, elective cesarean section on maternal request is better, or alternatively, more perilous, in comparison with vaginal delivery, from both maternal and fetal or neonatal aspects. Due to its prevalence, there is a need for the obstetric establishment in Israel to make a formal statement regarding its attitude towards this issue.
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Bronchial thermoplasty was approved for treating severe refractory asthma that is not well controlled by high-dose inhaled corticosteroids and long-acting bronchodilator therapy. This article reviews its indications, its safety profile, evidence of short-term and long-term efficacy, and clinical protocols.
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Cesarean section on maternal request is defined as a primary prelabor cesarean delivery on maternal request with no maternal or fetal indications. There are many controversies surrounding this issue encompassing medical, legal and ethical aspects. ⋯ However, in cases in which cesarean delivery on maternal request is planned it should not be performed before the gestational age of 39 weeks due to higher respiratory morbidity and other complications reported to be associated with late prematurity. In addition, cesarean delivery on maternal request should not be recommended for women desiring several children since the risk for placenta accreta and hysterectomy increase with each cesarean section.
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We report our initial experience combining cytoreductive surgery (CRS) plus intraperitoneal chemotherapy with hyperthermia (HIPEC) in a selected group of patients presenting with disseminated peritoneal carcinomatosis (PC) of colorectaL or appendiceaL origin at a single tertiary referral institution. ⋯ The selective use of cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy for patients with peritoneal carcinomatosis from colorectal or appendiceal origin is safe with acceptable morbidity and low mortality.