Mercy Hospital for Women

About: Mercy Hospital for Women is a healthcare organization based out in Melbourne, Victoria, Australia. It is known for research contribution in the topics: Pregnancy & Population. The organization has 682 authors who have published 1257 publications receiving 34582 citations.

Burch colposuspension for the treatment of coital urinary leakage secondary to genuine stress incontinence.

Abstract: The efficacy of Burch colposuspension in treating the symptom of coital urinary leakage in women with genuine stress incontinence has to date never been reported. Women who presented to our clinic with regular coital urinary leakage and urodynamically proven genuine stress incontinence between 1993 and 1997, and who proceeded to a Burch colposuspension procedure, were reviewed to determine the outcome of surgery. Fifty-five women were identified (mean age 46.1 years) with a mean follow-up interval after surgery of 18 months (range 3-42 months). All 55 women had symptoms of stress, urge and coital incontinence preoperatively. Following colposuspension, the subjective cure rates for stress and urge incontinence were 84% and 85%, respectively. Of 52 women that were sexually active after surgery, 81% described no further coital incontinence. The success or failure of surgery was not influenced by whether leakage occurred with penetration or orgasm preoperatively.

Critical haemoglobin thresholds in premature infants

Abstract: Blood transfusion is an integral part of neonatal intensive care. Unfortunately, transfusion practice is often based on expert opinion1 2 and anecdote rather than scientific evidence. Historically, blood transfusions have been used as therapy for apnoea and bradycardia, poor feeding, poor weight gain, and pallor. Although many studies have examined these outcomes,3 few are methodologically sound, many lack sufficient power, and most contribute little to the discussion. Theoretically, red blood cell transfusion is used to avoid the pathological state in which oxygen demand is greater than supply.4 5 As such, the principal outcome of any study of transfusion practice would need to incorporate measures of end organ hypoxia, specifically ischaemic brain injury, chronic lung disease, retinopathy of prematurity, and death. At the present time there are no methodologically sound prospective trials of transfusion practice that include long term neurodevelopmental outcome, the end result of brain hypoxia. This is in part because of the complexities of a randomised, non-blinded study but also because of the dynamic balance between systemic oxygen transport (SOT) and oxygen consumption (Vo 2) (see fig 1). In order to understand the concept of a critical haemoglobin threshold, if one exists, it is necessary to examine the balance between SOT and demand or VO2. Oxygen is used by the electron transport chain within the mitochondria for oxidative phosphorylation. Its supply depends on many factors, in particular the distance between the capillary and the cell, the diffusion characteristics, and the oxygen pressure gradient between the capillary and the cell.6 This pressure gradient depends on regional blood flow, oxygen transport, and the characteristics of the haemoglobin–oxygen dissociation curve (HODC).6 SOT is cardiac output multiplied by arterial oxygen content. The arterial oxygen content is determined by the haemoglobin concentration, oxygen carrying capacity, oxygen …

Cannabis: An ancient friend or foe? What works and doesn't work.

Abstract: Cannabis has been cultivated by mankind for a multitude of uses over a period of thousands of years. This review explores how our relationship with the cannabis plant has evolved over this period of time, including the use of cannabis for recreational purposes and for its medicinal properties. The endocannabinoid system plays a complex role in the development of the fetal, infant and adolescent brain. Use of exogenous cannabinoids has the potential to result in supra-physiological stimulation and impact on normal central nervous system development. Cannabis is the most frequently used recreational drug in western societies and its use is common amongst pregnant women. This review summaries much of the evidence about what is known of the long term effects of in utero cannabis exposure. Further, the potential impact of use of medicinal cannabis products during pregnancy is considered and the implications to health professionals caring for pregnant women and their babies are explored.