Articles: surgery.
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While receiving estrogen therapy, three women with classic type I von Willebrand's disease showed significantly less bleeding and improved hemostasis. One took estrogens to prevent menopausal symptoms, and two used oral contraceptives. ⋯ Furthermore, two other women with type I von Willebrand's disease also exhibited improved hemostasis while taking oral contraceptives. These experiences suggest a short course of estrogen therapy may effectively prepare some women with von Willebrand's disease for elective surgery.
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A new technique is presented that combines the use of two juxtaposed Y-V plasties which, when advanced, create a W-shaped sutured wound used to correct bridle-burn scar deformities. Since a considerable amount of the scar can be removed and there are two Y-V advancements, the cosmetic results are better than those obtained with traditional or modified Z-plasty when contracted scars are wide, severe, and unsuitable for Y-V advancement.
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Comparative Study
Dilatation and evacuation procedures and second-trimester abortions. The role of physician skill and hospital setting.
Some clinicians have hesitated to perform dilatation and evacuation (D & E) procedures at 13 weeks' gestation or later because D & Es are more difficult to perform safely than suction-curettage procedures. Moreover, many clinicians still believe all second-trimester abortion procedures should be performed in a hospital. ⋯ In addition, D & E had lower rates for most other specific complications. We conclude that D & E, while requiring more operator skill than earlier suction-curettage procedures, can be learned by gynecologists familiar with suction-curettage, can be performed more safely than the alternative instillation procedures, and can be safely practiced in selected ambulatory settings.