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"Cohen, Joel"
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Misgav‐Ladach or modified Misgav‐Ladach versus Pfannenstiel‐Kerr methods for cesarean deliveries: A systematic review and meta‐analysis
Background Caesarean sections (CSs) constitute a large proportion of fetal deliveries, yet no consensus exists on optimal surgical method. Objectives To investigate the safety and efficacy of the Pfannenstiel‐Kerr method (PKM) in comparison to Misgav‐Ladach method (MLM) and Modified Misgav‐Ladach method (MMLM) for CS. Search Strategy Cochrane, Embase, PubMed, CiNAHL, Scopus, and Web of Science were searched from database inception to March 2023. Selection Criteria Prospective studies comparing MLM with PKM or MMLM with PKM. Data Collection and Analysis Three authors independently conducted data extraction and assessed quality. Pooled means and proportions were analyzed using inverse variance and Mantel‐Haenszel methods. Main Results Twenty‐seven studies with 15 251 patients, met the selection criteria. Both MLM (mean difference [MD]: −12.09 min, 95% confidence interval [CI]: −14.40, −9.77, Tau2 = 16.79, I2 = 97%), (MD: −125.98 mL, 95% CI: −172.13, −79.83, Tau2 = 3458.59, I2 = 87%) and MMLM (MD: −11.38 min, 95% CI: −14.72, −8.04, Tau2 = 30.56, I2 = 100%), (MD: −62.61 mL, 95% CI: −103.13, −22.09, Tau2 = 1451.35, I2 = 92%) demonstrated shorter operative time and decreased blood loss, respectively, compared to PKM. Similarly, both MLM (MD: −1.70 min, 95% CI: −2.26, −1.14, Tau2 = 0.51, I2 = 97%), (MD: −0.77 d, 95% CI: −1.35, −0.19, Tau2 = 0.60, I2 = 98%) and MMLM (MD: −2.80 min, 95% CI: −3.89, −1.70, Tau2 = 1.74, I2 = 100%), (MD: −0.58 d, 95% CI: −1.00, −0.17, Tau2 = 0.29, I2 = 100%) demonstrated shorter fetal extraction time and length of hospital stay, respectively, compared to PKM. Conclusions MLM and MMLM should be considered safe and effective alternative approaches to CSs. Tweetable A meta‐analysis of 27 trials found that in comparison to the Pfannenstiel‐Kerr method, the Misgav‐Ladach and Modified Misgav‐Ladach methods should be considered safe and effective alternative approaches to cesarean section.
Journal Article
Grupo Cisneros, de Venezuela, le inyecta capital a Cuponidad
Las negociaciones se iniciaron en diciembre y significan una inyección de capital de 4 millones de dólares a la filial que abrió Cuponidad en noviembre pasado para conquistar el mercado venezolano, explicó Joel Cohen, Regional Manager de la empresa. Allí, el Grupo [El Grupo Cisneros] queda con una participación del 51 por ciento. En la actualidad, se esta negociado también las condiciones para que entre como socio a las operaciones en Colombia y Perú. En este último país, Cuponidad se instaló hace poco tras adquirir la operación que tenía en ese mercado Groupalia, otra firma del sector.
Trade Publication Article
A Serious Man and The Red Book
The film A Serious Man depicts the tribulations of a middle-age Jewish man living a \"collective\" life in 1967 Midwestern America during the countercultural revolution occurring at that time. The author uses examples from C. G. Jung's inner turmoil as depicted in The Red Book to amplify the inner-world workings of the film's main character, especially the interplay of the absurd and the profound. The author also illustrates the potential for the same interplay in the audience who watches the film. The protagonist takes hard won steps toward emotional growth as he increasingly faces the human condition.
Journal Article
Technical aspects of the cesarean section
The aim of this study was to evaluate every part of the surgical procedure during cesarean section (CS) to prevent complications and improve the clinical outcome. We researched on PubMed, Medline, and Cochrane. The evidence-based research suggests a transverse incision of the skin, blunt dissection of the subcutaneous tissue, omission of the bladder flap, blunt extension of the hysterotomy, prophylactic antibiotics, spontaneous placental removal, leaving the peritoneum open, and suture closure of the subcutaneous tissue when thickness is ≥2 cm. We hope that all evidence-based description will help to perform the CS safer, and for all surgical procedures not yet studied, further research is needed.
Journal Article
Comparison between the use of the Joel-Cohen incision and its modification during Stark's cesarean section
Objective. A comparative evaluation between the Joel-Cohen incision and its modification for the Stark's cesarean section (CS).
Materials and methods. In a retrospective study, 477 women who underwent a Stark's CS were evaluated: 204 with the Joel-Cohen incision (JC) and 273 with a modified Joel-Cohen incision (MJC). All patients were checked for the following parameters: febrile morbidity, the need for painkillers, duration of hospital stay, and ultrasound examination for blood collection (BC) on the third postoperative day. The collections, when diagnosed were divided into three groups: (1) in the abdominal wall, (2) in the pouch of Douglas, and (3) in the lower uterine segment (LUS). Those included in the study were low-risk primiparae at term, presenting for CS for breech presentation, macrosomia, and on demand, and who had combined spinal-epidural anesthesia. Statistical evaluation was performed using SAS V12 software.
Results. There were no statistical differences between the two groups with regard to febrile morbidity, duration of need for painkillers, and hospital stay. Statistically more blood collections were found in the MJC incision group (5.4% in the abdominal wall, 12.4% in the pouch of Douglas, and 11.7% in the LUS) than in the classical JC incision group (3.9% in the abdominal wall, 10.2% in the pouch of Douglas, and 8.8% in the LUS), however without any clinical significance.
Conclusions. The routine use of the classical JC incision during the Stark's CS seems to be more rational, and causes fewer blood collections.
Journal Article
Cesarean Delivery
By the mid‐20th century, cesarean delivery was firmly established in Western obstetric practice, primarily as a procedure to improve maternal outcomes in labor. With the evolution of neonatal medicine through the latter half of the century, cesarean delivery has been increasingly performed for fetal indications. The 15‐year interval from 1970 through 1985 saw an unparalleled increase in the cesarean delivery rate, both in the USA and elsewhere, with the rate in the USA temporarily peaking at 24.4% in 1987. The ensuing 15‐year interval saw a stabilization of this rate (down to 20.6% in 1996), in large part as a result of efforts to encourage vaginal birth following previous cesarean delivery. The first decade of the 21st century has again witnessed a progressive increase in the cesarean delivery rate, primarily as a result of evolving pressures against vaginal birth following previous cesarean delivery in community hospitals and an increasing frequency of vaginal birth following previous cesarean delivery for failure to make adequate progress in labor [5]. An additional factor, the performance of vaginal birth following previous cesarean delivery on demand, has become more widespread since its endorsement by the American College of Obstetricians and Gynecologists. The most recent US vaginal birth following previous cesarean delivery rate available at the time of this writing is 32%, a 53% increase from 1996.
Book Chapter
The Decision Making Process of Individual Credit Buying: an Analysis of the Effect for the Payment Conditions, Type of Product and Individual Differences
The present research carried out a study about decision making process that occurs in the context of the individual credit buying, from theories and studies of economic psychology and consumer behavior. The main objective was to verify the effect that the type of product and payment conditions have in the decision-making process of credit purchasing. During the research it was sought to recognize if changing the type of product (from hedonic to utility) and the payment conditions (with or without discount and interest rate) there would be a change in the propensity of credit purchasing. Therefore, it aimed to identify how rational and behavioral variables influenced the individual decision. Also it was intended to observe if people with the same characteristics maintain or not their payment decision in each scenario. Finally, it was asked which variables are used to better explain the credit purchase decision.
Conference Proceeding
