Intussusception in pregnancy after gastric bypass: a case report

Laparoscopic Roux-en-Y gastric bypass (RYGB) remains the gold standard procedure in obesity surgery and is mostly performed in young women of reproductive age. Since the worldwide prevalence of obesity is increasing and fertility improves after surgery, more complications in the pregnant population will emerge. The differential diagnosis of acute abdominal pain in patients with a history of gastric bypass is rather broad and includes mainly anastomotic ulcers, leaks, and small bowel obstructions. Early diagnosis and treatment of these complications is of utmost importance and should be performed on a multidisciplinary basis. Whether surgery should be performed by laparoscopy or laparotomy remains subject of discussion. We report a case of a 29-year-old pregnant woman at 33 + 5 weeks gestational age, presenting with an intussusception after RYGB. A successful surgical reduction was performed by laparotomy.

Influence of the radiographer on the pain felt during mammography

Mammography is the only useful examination in screening for breast cancer. Mortality from breast cancer can be reduced if women go regularly for a screening mammography. Moreover, it is still the key examination in diagnosis of breast diseases and in the follow-up of patients treated for breast cancer. Pain with mammography can deter women from going for regular screening or follow-up; therefore, it is important to reduce pain experience or discomfort from mammography. In this study we evaluate the impact of the "radiographer" on the pain risk during mammography by analysing questionnaires filled in by women and radiographers. Study results reveal that the opinion of the radiographer, the information and communication during the examination and the number of years of experience are important factors in pain and discomfort experience. The attitude of the radiographer plays an important role in the pain experience.

The limits to patient compliance with directly observed therapy for tuberculosis: a socio-medical study in Pakistan

Complying with the prescriptions of the directly observed therapy (DOT), one of the components of the Global Tuberculosis Programme of the WHO, is problematic for many patients. The factors leading to patient (non-) compliance with DOT are placed in a structural equation model. The study is based on a survey carried out in one general hospital in the Punjab province of Pakistan, amongst all sputum positive pulmonary TB patients (n = 621) who arrived at the TB unit from September 1997 to October 1998. The tested sequence of manifest variables and latent constructs shows that the social stratification perspective has to be extended by the stigmatization perspective. The advantages of universally applying DOT will increase even further when the latter perspective is involved in the analysis of non-compliance. There is a real danger that the patients reached by selective DOT will be stigmatized even more.

Risk factors of pain in mammographic screening

Mammography is an important tool in the secondary prevention of breast cancer. However, earlier research has pointed out that an unpleasant experience during a previous mammography can deter women from returning for mammography screening. It is known that mammography can be a painful examination for some women. The research presented in this article focuses on the experience of pain during and after mammography (247 patients). Firstly, the study sets out to determine the extent to which women actually experience pain as a result of mammographic examination. Secondly, it focuses on identifying the factors that determine the risk of a painful experience during the screening procedure. A pain model was developed that takes into account a broad range of potential pain factors, including other than woman-related factors and factors associated with the actual examination. Special attention was paid to the examination context, the mammographic procedure and the screening staff. The research results show that the majority of women experience pain during mammography. With a logistic regression a number of women-related factors, staff-related and procedural factors were found significant in assessing the pain risk during mammography.