Purpose This study investigates the feasibility and potential utility of head-mounted displays for real-time wireless vital sign monitoring during surgical procedures. Methods In this randomized controlled pilot study, surgery residents (n = 14) performed simulated bedside procedures with traditional vital sign monitors and were randomized to addition of vital sign streaming to Google Glass. Time to recognition of preprogrammed vital sign deterioration and frequency of traditional monitor use was recorded. User feedback was collected by electronic survey. Results The experimental group spent 90% less time looking away from the procedural field to view traditional monitors during bronchoscopy (P = .003), and recognized critical desaturation 8.8 seconds earlier; the experimental group spent 71% (P = .01) less time looking away from the procedural field during thoracostomy, and recognized hypotension 10.5 seconds earlier. Trends toward earlier recognition of deterioration did not reach statistical significance. The majority of participants agreed that Google Glass increases situational awareness (64%), is helpful in monitoring vitals (86%), is easy to use (93%), and has potential to improve patient safety (85%). Conclusion In this early feasibility study, use of streaming to Google Glass significantly decreased time looking away from procedural fields and resulted in a nonsignificant trend toward earlier recognition of vital sign deterioration. Vital sign streaming with Google Glass or similar platforms is feasible and may enhance procedural situational awareness.
Objective
To examine the relationship between maternal serum Bisphenol-A (BPA) concentration at the time of the missed period and miscarriage risk.
Design
Retrospective cohort of prospectively collected serum samples.
Setting
Academic fertility center.
Patients
Women presenting for early pregnancy monitoring with singleton pregnancies.
Intervention
Stored serum samples from 4-5 weeks gestation were analyzed for conjugated serum BPA concentrations.
Main Outcomes
Live birth, miscarriage, and chromosome content of miscarriage.
Results
Of the 115 included subjects, there were 47 live births and 68 clinical miscarriages (46 aneuploid and 22 euploid). Median conjugated BPA concentrations were higher in women with miscarriages than those with live births (0.101 vs 0.075 ng/ml). Women with the highest quartile of conjugated BPA had an increased relative risk of miscarriage (1.83, 95% CI 1.14-2.96) compared to women in the lowest quartile. We found a similar increase risk for both euploid and aneuploid miscarriages.
Conclusions
Maternal conjugated BPA was associated with higher risk of aneuploid and euploid miscarriage in this cohort. The impact of reducing individual exposures on future pregnancy outcomes deserves further study.
Objectives-To explore the prevalence of Orofacial Pain (OFP) among patients with Vulvar Vestibulitis Syndrome (VVS) and to examine the relationship between signs and symptoms of OFP and clinical characteristics of women with VVS; we specifically sought to investigate differences in psychological characteristics and self-reported severity of painful intercourse.Methods-In this cross-sectional exploratory study, 137 women with VVS completed questionnaires that assessed self-reported levels of pain, anxiety, somatization, and presence of signs and symptoms suggestive of clinical and sub-clinical OFP. Demographic data were gathered from medical records.
Results-OrofacialPain was found to be a highly prevalent (78%) condition among women with VVS. Compared to women with no OFP symptoms (n=30), those with symptoms (n=64) had higher levels of anxiety (45.0 vs. 37.8, Bonferroni adjusted p=0.017), somatization (125.2 vs. 96.0, Bonferroni adjusted p<0.001), and psychological distress (62.8 vs. 56.0, Bonferroni adjusted p=0.002). While we observed a similar trend among women with sub-clinical OFP (n=43), this trend only reached statistical significance with respect to somatization. Differences were not detected for demographics, duration of pain, and severity of pain during intercourse across the three groups.Discussion-Orofacial Pain is a common condition among women with VVS. Because severity and duration of painful intercourse did not differ by OFP classification but psychological characteristics did, we must begin to question a uni-dimensional focus on vestibular mucosa as a reason for pain and persistent distress.
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