LIVIVO - Search results -

Search results

Result 1 - 10 of total 48

Search options

Article: The Quality and Utility of Referral Letters for Gender-Affirming Surgery.

Mehra, Geetika / Boskey, Elizabeth R / Ganor, Oren

Transgender health

2022 Volume 7, Issue 6, Page(s) 497–504

Abstract: Purpose: The World Professional Association for Transgender Health (WPATH) recommends referral by a mental health professional for gender-affirming chest and genital surgeries. However, several transgender health guidelines propose an informed consent ... ...

Abstract	Purpose: The World Professional Association for Transgender Health (WPATH) recommends referral by a mental health professional for gender-affirming chest and genital surgeries. However, several transgender health guidelines propose an informed consent model of care to respect patient autonomy. This research aimed to understand, characterize, and asses the quality of information gathered through referral letters for patients consulting for gender-affirming surgeries. Methods: A retrospective review of electronic medical records (EMRs), including referral letters from behavioral health (BH) and primary care providers (PCPs), was conducted for patients seeking chest or genital surgery by a single surgeon between 2017 and 2019. Data were abstracted manually and included medical and gender history and documentation of WPATH-recommended surgical criteria. Results: A total of 233 patient records, including 171 PCP letters and 231 BH letters, were reviewed. With respect to documentation of surgical criteria, 92% of BH letters documented a diagnosis of gender dysphoria, 63% ability to provide informed consent, and 51% management of BH comorbidities. More than half of individuals with chronic physical health conditions did not have those conditions documented in their referral letters. Similarly, BH letters often failed to document BH diagnoses endorsed by patients. For example, while 80% of patients endorsed a diagnosis of anxiety, more than half did not have it documented in their letters. Overall, greater than half of diagnoses across BH conditions were only documented as present in the EMR. Conclusion: Referral letters only variably documented WPATH-recommended surgical criteria and did not reliably document physical and mental health comorbidities. Our research suggests that multidisciplinary pre-surgical assessment may be more useful than referral letters in some settings.
Language	English
Publishing date	2022-11-29
Publishing country	United States
Document type	Journal Article
ISSN	2688-4887
ISSN	2688-4887
DOI	10.1089/trgh.2021.0057
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

Inter-library loan at ZB MED

Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

Article: Feasibility of an External Erectile Prosthesis for Transgender Men Who have Undergone Phalloplasty.

Boskey, Elizabeth R / Jolly, Divya / Mehra, Geetika / Ganor, Oren

Sexual medicine

2022 Volume 10, Issue 5, Page(s) 100560

Abstract: ... comfortably. Boskey ER, Jolly D, Mehra G, et al. Feasibility of an External Erectile Prosthesis ...

Abstract	Introduction: Transgender men interested in achieving penetration after phalloplasty are currently limited to internal devices and makeshift supports. More options are needed to support sexual penetration after phalloplasty. Aim: This study was designed to assess the feasibility of an external erectile prosthesis (the Elator) for transgender men who have undergone phalloplasty and wish to use their neophallus for sexual penetration, assess how the device affected the sexual experiences of men and their partners, and identify any side effects and concerns. Methods: Transgender men and their partners were provided with an erectile device to use for one month. They were surveyed at 4 time points: enrollment, measurement, receipt, and after using the device, using a combination of pre-existing and device-specific measures. Main outcome measure: The primary outcome was whether men found it feasible to use an external penile prosthesis for sexual penetration after phalloplasty - defined as interest in, and willingness to, use the device more than once over the study period; intention to continue using the device on the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS); and no decrease in relationship satisfaction on the Gay and Lesbian Relationship Satisfaction Scale (GLRSS). The secondary outcome was an increase in sexual or relationship satisfaction with use of the device, defined as a statistically significant increase on either the Quality of Sexual Experience Scale (QSE) or the GLRSS. Results: Fifteen couples enrolled in the pilot study. Of the 10 who completed the study, only 3 found device use feasible and endorsed strongly positive experiences, while the remaining 7 found it unusable. There were no changes in QSE or GLRSS scores. Most device issues were related to proper fit. Conclusion: There is a great deal of interest in non-surgical options for achieving penetration after phalloplasty. The tested external erectile device can work well, but its utility is limited to individuals with very specific post-phalloplasty anatomy. Most individuals and couples found the device unsuitable for the neophallus and/or that it could not be used comfortably. Boskey ER, Jolly D, Mehra G, et al. Feasibility of an External Erectile Prosthesis for Transgender Men Who have Undergone Phalloplasty. Sex Med 2022;10:100560.
Language	English
Publishing date	2022-08-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	2734882-9
ISSN	2050-1161
ISSN	2050-1161
DOI	10.1016/j.esxm.2022.100560
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article ; Online: Concerns About Internal Erectile Prostheses Among Transgender Men Who Have Undergone Phalloplasty.

Boskey, Elizabeth R / Mehra, Geetika / Jolly, Divya / Ganor, Oren

The journal of sexual medicine

2022 Volume 19, Issue 6, Page(s) 1055–1059

Abstract: ... in alternatives to current devices. Boskey ER, Mehra G, Jolly D, et al. Concerns About Internal Erectile ...

Abstract	Background: Transgender men who undergo gender-affirming phalloplasty have limited options for attaining sufficient rigidity for sexual penetration. Aim: The goal of this study was to understand interest in and concerns about internal erectile prostheses among transgender men who had undergone phalloplasty. Methods: As part of a pilot study of an external erectile device, transgender men (n = 15) were surveyed about their interest in, and concerns about, getting an internal prosthesis. Descriptive analyses were performed for structured questions and content analysis was used to analyze open responses. Outcomes: Measured outcomes included closed- and open-ended questions assessing patient attitudes about internal erectile prostheses. Results: Before starting the study, approximately half the men stated they were interested in getting an internal device, 20% said they weren't, and 33% said they didn't know. More than half of this postphalloplasty population stated they were somewhat or very concerned about the need for additional surgery (73%), side effects (pain, damage to the phallus; 100%), and the risk of device failure (100%). An additional 47% stated they were somewhat or very concerned about cost and 33% stated they were somewhat or very concerned about finding a surgeon. Clinical implications: There is a need to develop appropriate alternatives to current internal prostheses for penetrative function after phalloplasty. Strengths & limitations: Generalizability of results is limited by the fact that data are from men who had enrolled in a pilot study to test an external erectile prosthesis, and as such were explicitly interested in exploring nonsurgical alternatives to attain an erection. The combination of quantitative and qualitative data demonstrates that transgender men's concerns about internal prostheses are grounded in the current evidence. Conclusion: Transgender men who have undergone phalloplasty have substantial concerns about the risks of getting an internal prosthesis and there is significant interest in alternatives to current devices. Boskey ER, Mehra G, Jolly D, et al. Concerns About Internal Erectile Prostheses Among Transgender Men Who Have Undergone Phalloplasty. J Sex Med 2022;19:1055-1059.
MeSH term(s)	Humans ; Male ; Pilot Projects ; Prostheses and Implants ; Sex Reassignment Surgery/adverse effects ; Sex Reassignment Surgery/methods ; Transgender Persons ; Transsexualism/surgery
Language	English
Publishing date	2022-04-08
Publishing country	Netherlands
Document type	Case Reports ; Research Support, Non-U.S. Gov't
ZDB-ID	2251959-2
ISSN	1743-6109 ; 1743-6095
ISSN (online)	1743-6109
ISSN	1743-6095
DOI	10.1016/j.jsxm.2022.03.604
Database	MEDical Literature Analysis and Retrieval System OnLINE

In stock of ZB MED Cologne/Königswinter

Zs.A 6417: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
Zs.MO 505: Show issues

Order via subito

Details ▾
- See ZB MED holdings
- Order with fees

Article: Closed-Incision Negative Pressure Wound management Following Midline Laparotomy in Gynecological Oncology Operations: A Feasibility Pilot Study.

Yin, Lucia / Lau, Katherine / Mehra, Gautam / Sayasneh, Ahmad

Cureus

2021 Volume 13, Issue 11, Page(s) e19871

Abstract: Introduction Surgical site infections (SSIs) are a cause of considerable morbidity and mortality in healthcare. Increasingly, closed-incision negative pressure wound therapy (ciNPWT) is being studied as a potential method of reducing incidence of SSI ... ...

Abstract	Introduction Surgical site infections (SSIs) are a cause of considerable morbidity and mortality in healthcare. Increasingly, closed-incision negative pressure wound therapy (ciNPWT) is being studied as a potential method of reducing incidence of SSI with conflicting results in the literature. Few studies however have looked at its use in the field of gynecological oncology. Objectives We aimed to compare the incidence of SSI when using ciNPWT dressings versus conventional dressings in gynecological oncology patients undergoing midline laparotomies. Methods This was a pilot study involving 14 patients receiving the ciNPWT dressing and 26 control patients. All patients were followed up for a period of 30 days. We used the American College of Surgeons (ACS) risk calculator to estimate each patient's risk of SSI in order to risk stratify the groups. Results The incidence of wound infection was 21% (3/14) in the ciNPWT group and 23% (6/26) in the control group (p=0.886). The ciNPWT group was found to be at significantly higher risk for SSI as calculated by the ACS tool (8.8% ciNPWT, 6% control, p=0.004). After stratifying for this difference in risk, still no significant difference in incidence of SSI was found between the two groups (27% (3/11) ciNPWT, 29% (2/7) control p=0.929). Conclusion The incidence of SSI does not appear to decrease by the prophylactic use of the closed-incision negative pressure wound dressing.
Language	English
Publishing date	2021-11-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.19871
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article ; Online: A rare case of refractory disseminated leiomyomatosisperitonealis complicated by cauda equina compression.

Quaranta, M / Mehra, G / Nath, R / Culora, G / Sayasneh, A

European journal of obstetrics, gynecology, and reproductive biology

2018 Volume 229, Page(s) 205–207

MeSH term(s)	Cauda Equina Syndrome/etiology ; Female ; Humans ; Leiomyomatosis/complications ; Middle Aged ; Peritoneal Diseases/complications
Language	English
Publishing date	2018-08-28
Publishing country	Ireland
Document type	Case Reports ; Letter
ZDB-ID	190605-7
ISSN	1872-7654 ; 0301-2115 ; 0028-2243
ISSN (online)	1872-7654
ISSN	0301-2115 ; 0028-2243
DOI	10.1016/j.ejogrb.2018.08.580
Database	MEDical Literature Analysis and Retrieval System OnLINE

In stock of ZB MED Cologne/Königswinter

Zs.A 837: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
Jg. 1995 - 2021: Lesesall (1.OG)
ab Jg. 2022: Lesesaal (EG)

Order via subito

Details ▾
- See ZB MED holdings
- Order with fees

Article: Gynae-Oncology Surgeons' Preparedness to Undertake Colorectal Procedures during Cytoreductive Surgery for Ovarian Cancer: A Cross Sectional Survey.

Huddart, Daniel / Rajkumar, Savithri / Kolomainen, Desiree / Mehra, Gautam / Nath, Rahul / Sayasneh, Ahmad

Journal of clinical medicine

2022 Volume 11, Issue 21

Abstract: Cytoreductive surgery for advanced ovarian cancer commonly involves bowel resection. Although UK gynaecological oncologists are trained in bowel surgery, the degree to which they perform bowel surgery independently varies nationally. A recent joint ... ...

Abstract	Cytoreductive surgery for advanced ovarian cancer commonly involves bowel resection. Although UK gynaecological oncologists are trained in bowel surgery, the degree to which they perform bowel surgery independently varies nationally. A recent joint policy statement from the British Gynaecological Cancer Society (BGCS) emphasises the need for formalised colorectal support. An anonymous, online survey was emailed to BGCS members to assess the status of multidisciplinary working between UK gynaecological oncology and colorectal/general surgical teams. A total of 46 members responded (8.2% response rate). There was a large variety in the involvement of colorectal/general surgical teams in preoperative planning. A total of 13% of respondents had no formalised agreement for intraoperative support, 72.1% of respondents independently performed rectal peritoneal stripping and 60.5% independently performed small bowel resection. This was reduced to 27.9% for right hemicolectomy with primary anastomosis and 16.3% for left hemicolectomy with primary anastomosis. Respondents often involved colorectal support for post-operative complications. The majority of UK gynaecological oncologists involve colorectal/general surgical teams in bowel procedures, more commonly for large bowel procedures compared to small bowel and for left colon compared to right colon procedures. A total of 16.3% of respondents independently performed all surveyed bowel procedures. Future research should examine training and experience within these groups to address this disparity.
Language	English
Publishing date	2022-10-22
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm11216233
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article ; Online: Assessing Fertility Intentions in Patients Presenting for Gender-Affirming Surgery.

Mehra, Geetika / Boskey, Elizabeth R / Peters, Carson J / Njubigbo, Chinelo / Charlton, Brittany M / Ganor, Oren

LGBT health

2022 Volume 9, Issue 5, Page(s) 325–332

Abstract: Purpose: ...

Abstract	Purpose:
MeSH term(s)	Child ; Fertility Preservation ; Hormones ; Humans ; Infant, Newborn ; Intention ; Male ; Retrospective Studies ; Sex Reassignment Surgery ; Transgender Persons
Chemical Substances	Hormones
Language	English
Publishing date	2022-06-24
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2727303-9
ISSN	2325-8306 ; 2325-8292
ISSN (online)	2325-8306
ISSN	2325-8292
DOI	10.1089/lgbt.2021.0148
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article: Spontaneous Heterotopic Pregnancy Associated with Massive Intraperitoneal Haemorrhage and a Normal Heart Rate, Illustrating the Concept of Relative Bradycardia.

Gallaher, Charles / Tahmasebi, Farshad / Sayasneh, Ahmad / Mehra, Gautam

Case reports in obstetrics and gynecology

2019 Volume 2019, Page(s) 2893149

Abstract: A 28-year-old, 9 and a half weeks pregnant (spontaneous conception) multigravida presented with abdominal pain and vaginal bleeding. On examination, her abdomen was diffusely tender, particularly in the right iliac fossa, though guarding was absent. ... ...

Abstract	A 28-year-old, 9 and a half weeks pregnant (spontaneous conception) multigravida presented with abdominal pain and vaginal bleeding. On examination, her abdomen was diffusely tender, particularly in the right iliac fossa, though guarding was absent. Transabdominal and transvaginal ultrasonography demonstrated a viable intrauterine pregnancy and large-volume intraperitoneal haemoperitoneum; the right ovary could not be identified. The patient became hypotensive with decreased responsiveness, yet her heart rate remained normal. She proceeded to surgery where a ruptured right tubal ectopic pregnancy was identified and right salpingectomy was performed. Estimated blood loss was 3900ml. Postoperative recovery was uneventful. Ultrasound 3 days after surgery demonstrated a viable intrauterine pregnancy of gestational age 9 weeks + 1 day. The patient remains well. Her anomaly scan at 20 weeks and 6 days showed normal growth, amniotic fluid, and Dopplers with no obvious structural defects. She is currently 27 weeks pregnant and will be rescanned at 36 weeks.
Language	English
Publishing date	2019-03-18
Publishing country	United States
Document type	Case Reports
ZDB-ID	2627654-9
ISSN	2090-6692 ; 2090-6684
ISSN (online)	2090-6692
ISSN	2090-6684
DOI	10.1155/2019/2893149
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article: Surgery of Benign Ovarian Masses by a Gynecological Cancer Surgeon: A Cohort Study in a Tertiary Cancer Centre.

Quaranta, Michela / Nath, Rahul / Mehra, Gautam / Diab, Yasser / Sayasneh, Ahmad

Cureus

2020 Volume 12, Issue 7, Page(s) e9201

Abstract: Objectives This study aimed to evaluate diagnostic performance in characterising ovarian masses by our gynaecological oncology multidisciplinary team meeting (MDM). Surgical outcome and overall impact on patients and healthcare service were also assessed. ...

Abstract	Objectives This study aimed to evaluate diagnostic performance in characterising ovarian masses by our gynaecological oncology multidisciplinary team meeting (MDM). Surgical outcome and overall impact on patients and healthcare service were also assessed. Methods This was a prospective cohort study of all women with adnexal masses presenting to the gynaecological oncology MDM at a central London tertiary cancer centre between February 2017 and February 2018. The multidisciplinary team (MDT) outcome, imaging details, subjective opinion, tumour markers, surgical details, and final histological diagnosis were collected. Diagnostic performance was also determined. Results There were 200 eligible patients in the study period. MDM imaging review demonstrated a sensitivity of 98.4% (95% CI: 94.3% to 99.8%) and a specificity of 52% (95% CI: 40.2% to 63.7%). Thirty-five cases were false positive, either presumed invasive cancers (51%) or borderline tumours (49%). The most common histological types were serous (37%) and mucinous (31%) cystadenomas. A retrospective application of the International Ovarian Tumor Analysis (IOTA) Assessment of Different NEoplasias in the adneXa (ADNEX) model suggests a potential reduction in false-positive rates (17%). Among the false-positive cases, there was no postoperative (90 days) mortality and postoperative morbidity was 14% with only grade 2 (CD2) complications according to Clavien and Dindo's CD classification. Conclusion An MDT has high sensitivity but low specificity when characterising ovarian masses referred with possible ovarian cancer to the tertiary centre. False-positive values in ovarian cancers are an important indicator of over-treatment. More research is required to assess other methods, such as the IOTA ADNEX model, to reduce the false-positive value.
Keywords	covid19
Language	English
Publishing date	2020-07-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.9201
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article: Use of the Subfascial Plane for Gender-affirming Breast Augmentation: A Case Series.

Mehra, Geetika / Kaufman-Goldberg, Tal / Meshulam-Derazon, Sagit / Boskey, Elizabeth R / Ganor, Oren

Plastic and reconstructive surgery. Global open

2021 Volume 9, Issue 1, Page(s) e3362

Abstract: Transgender women seeking gender-affirming breast augmentation often present with differences in preoperative chest measurements and contours in comparison with cisgender women. These include a more robust pectoralis muscle and limited glandular tissue, ... ...

Abstract	Transgender women seeking gender-affirming breast augmentation often present with differences in preoperative chest measurements and contours in comparison with cisgender women. These include a more robust pectoralis muscle and limited glandular tissue, raising important considerations in determining the optimal anatomical plane for implantation. Abundant literature has described advantages and drawbacks of the available planes for breast augmentation in cisgender women. Certain drawbacks may be more pronounced for transgender women, given their distinct anatomy. The subfascial plane offers lower complication rates than the subglandular plane when using smooth implants, and avoids implant animation and displacement associated with the subpectoral plane. To our knowledge, existing studies have not yet addressed this discussion in the transfeminine population. The goal of this article is to highlight potential benefits of the subfascial plane for gender-affirming breast augmentation, utilizing a case series of 3 transfeminine patients, and to review the literature on surgical techniques and outcomes in this population. Methods: A retrospective chart review of patients presenting to a single surgeon for gender-affirming breast augmentation in 2019 was performed. A narrative literature review on surgical techniques and outcomes for gender-affirming breast augmentation was conducted. Results: Three cases of gender-affirming breast augmentation using subfascial implant placement are described. From the literature search, 12 articles inclusive of 802 transfeminine patients were identified. Conclusions: The subfascial plane represents an option for implant placement in gender-affirming breast augmentation that merits further investigation. There is a need for more research comparing surgical techniques and outcomes in the transfeminine population.
Language	English
Publishing date	2021-01-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2851682-5
ISSN	2169-7574 ; 2169-7574
ISSN (online)	2169-7574
ISSN	2169-7574
DOI	10.1097/GOX.0000000000003362
Database	MEDical Literature Analysis and Retrieval System OnLINE

In stock of ZB MED Cologne/Königswinter

Zs.A 7091: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
ab Jg. 2022: Lesesaal (EG)

Order via subito

Details ▾
- See ZB MED holdings
- Order with fees

To top

More links

Kategorien

Order via subito

Inter-library loan at ZB MED

More links

Kategorien

Order via subito

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

More links

Kategorien

Order via subito

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

More links

Kategorien

Order via subito

More links

Kategorien

Order via subito

More links

Kategorien

Order via subito

More links

Kategorien

Order via subito

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito