There are all kinds of problems associated with providing care based on risk rather than on individual women. Risk is a very personal concept and different women will consider different risks to be significant to them. Everything we do in life involves risk. All women can do is choose the option with the risks they are most willing to take. However, in order to make a decision women need adequate information about the risks involved in each option. Induction for prolonged pregnancy is not right or wrong if the choice is made by a woman who has an understanding of all the options and associated risks. It is my job to share information and support decisions — not to judge. The idea of a prolonged pregnancy assumes that all women naturally gestate their babies for the same length of time. The length of gestation may also be influenced by factors such as diet McAlpine et al. The initiation of labour is likely caused by the baby who secretes surfactant protein and platelet-activating factor into the amniotic fluid as their lungs mature Mendelson ; Science Daily.
The dating scene could be a confusing place in world where at least some social distancing seems likely for the foreseeable future. And while many people will have maintained or begun contact with romantic partners online during lockdown, video chats and text messages are clearly not a long-term substitute for intimate or even non-intimate physical contact. Parental investment theory, for example, predicts that in humans and other animals , it is the sex investing more heavily in their offspring who will be more choosy or selective in securing a mate.
Male reproduction requires relatively little investment over and above a few minutes of sexual contact, whereas female reproductive effort requires nine months or longer. To see how these sex differences were evident in online opposite-sex dating, we conducted a study in which participants viewed and responded to photographs of potential dates in a simulated online dating environment.
Obstet Gynecol. In , the overall incidence of postterm pregnancy in the United States was 5. The incidence of postterm pregnancies may vary by population, in part as a result of differences in regional management practices for pregnancies that go beyond the estimated date of delivery. Accurate determination of gestational age is essential to accurate diagnosis and appropriate management of late-term and postterm pregnancies. Antepartum fetal surveillance and induction of labor have been evaluated as strategies to decrease the risks of perinatal morbidity and mortality associated with late-term and postterm pregnancies.
The purpose of this document is to review the current understanding of late-term and post-term pregnancies and provide guidelines for management that have been validated by appropriately conducted outcome-based research when available. Additional guidelines on the basis of consensus and expert opinion also are presented. The risk of stillbirth increases beyond 41 weeks. Oligohydramnios is more common in postterm pregnancies and has been associated with cord compression, fetal heart rate abnormalities, meconium-stained amniotic fluid, and fetal acidosis.
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In our cohort of medically indicated IOL, a dating US before 20 weeks was not associated with a difference in neonatal respiratory morbidity.
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Massive Pecan Tree at IOL, Dating to 1860s, Destroyed by Isaias
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lens implants (IOLs). A device that resides in the middle of this processing continuum is the accommo- dating IOL, Crystalens being the first one to receive FDA.
A s intraocular lenses have become more technologically advanced, the issues surrounding patient selection, lens implantation and patient management have become more complex. Nevertheless, problems can still occur. Essentially, our patients are our customers, and good customer service underlies everything. Leaving clinical issues unresolved will lead to dissatisfaction. Here, surgeons offer insights regarding how to manage problems that may arise, along with a few pearls for preoperative patient management that can help to minimize these postoperative issues.
Refractive Surprises Although an imperfect lens power calculation is always a possibility when a postoperative refractive surprise occurs, such issues are becoming less common. Other issues such as corneal problems and toric lens rotation also need to be considered. Many of our older patients may not feel dry, per se, or they may not have the classic symptom of irritation. They may only have a fluctuating vision issue, if the disease is mild preoperatively.
But postoperatively, a subclinical or asymptomatic case of dry eye may become clinically symptomatic. The reasons are not completely straightforward, but use of medications relating to the cataract surgery is a common etiology. A refractive surprise can result from subtle corneal problems missed before the surgery—or that occurred after the surgery because of the use of postoperative drops.
Adding to the complexity of the problem, a refractive surprise can also be the result of other subtle corneal problems that were missed before the surgery—or that have occurred following surgery because of the postoperative drops.
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Several IOL makers are attempting to do exactly that, with incremental success. Premium intraocular lenses are no longer a novelty. And though they cannot mimic the precision of the human crystalline lens, these IOLs continue to evolve, as manufacturers enhance them to offer patients the potential of largely spectacle-free lives.
Henderson, MD. The companies have been responsive to early concerns and have made significant attempts at improving their products. As long as patients are given accurate information regarding the advantages and disadvantages of these lenses, most patients are thrilled with the postoperative results. Henderson is an assistant clinical professor of ophthalmology at Harvard University. Yet while most ophthalmologists acknowledge that the newer versions of these lenses are better, the industry has yet to reach the ultimate goal: a lens that delivers essentially perfect distance, medium and near vision.
The ReStor and Crystalens, in particular, have been modified in recent years to improve visual outcomes, said Dr. Specifically, the ReStor platform is now available with an aspheric lens as well as a decreased add power to extend the near focal point. The Crystalens has increased add power to improve near vision. The ReZoom lens is essentially unchanged, but following are some perspectives on current developments for the other three lenses.
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It also erased some history. Several trees on the Institute of Living (IOL) grounds, dating to the s, were destroyed — including a famed pecan tree. “The pecan.
Massive Pecan Tree a Tropical Storm Isaias made history when it barreled through the region Aug. It also erased some history. Several trees on the Institute of Living IOL grounds, dating to the s, were destroyed — including a famed pecan tree. Add to Chrome. Sign in. Home Local Classifieds. News Break App. News Break Massive Pecan Tree a CBS New York. Massapequa, NY 5h.
Thousands of trees appear half dead. Only half of the tree is shedding brown leaves, while the other half appears healthy. John Fee of Massapequa is
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dating IOL is inserted by piggybacking, the silicone poly- mers are injected between the 2 IOLs. The PCCC is created to help prevent PCO (Figure 4). Figure 1.