Thesis (M.D.)--University of Pennsylvania, 1811. / Microform version available in the Readex Early American Imprints series.

Prostate cancer is the most common cancer in men. One type of treatment is internal radiation therapy, brachytherapy. This treatment requires the patient to lie completely motionless and in lithotomy position. The purpose of this study was to investigate the prevalence of pressure ulcers associated with brachytherapy in prostate cancer at the UniversityHospitalin Uppsala. Furthermore, the purpose was to identify the most common location of pressure ulcer and to examine whether there were any connection between risk factors and possible pressure ulcers. Thirty patients participated in the study. The data collection was carried out partly by the nurse anesthetist and partly by the nurse in the oncology ward in fall 2009 to spring 2010. The study showed that seven of thirty patients (23.3%) developed pressure ulcers after brachytherapy. All of these were stage 1 according to EPUAP's pressure ulcer scale. Only one of the patients (3.3%) had remaining pressure ulcer the day after treatment. The most common location were lower legs/calves (16.7%). No statistically significant relationship was found between risk factors and the development of pressure ulcers. The results of this study showed a relatively high incidence of pressure ulcers (23.3%). All of stage 1 and only one of the pressure ulcers were remaining the day after brachytherapy. This indicates a good pressure-relieving measures and equipment, and that the patients in this study have a relatively good general          condition.Keywords: brachytherapy, pressure ulcers, lithotomy position, risk factors / Prostatacancer är den vanligast förekommande cancersjukdomen hos män. En av behandlingsformerna är intern strålbehandling, brachyterapi. Denna behandling kräver att patienten ligger helt stilla och i gynekologiskt läge. Syftet med studien var att undersöka förekomsten av trycksår i samband med brachyterapi vid prostatacancer på Akademiska sjukhuset i Uppsala. Vidare var syftet med studien att kartlägga de vanligaste lokalisationerna samt att undersöka om de fanns några samband mellan riskfaktorer och eventuella trycksår. Trettio patienter deltog i studien. Datainsamlingen utfördes dels av anestesisjuksköterskan och dels av patientansvarig sjuksköterska på onkologavdelningen under hösten 2009 till våren 2010. Resultatet av studien visade att sju av trettio patienter (23,3 %) utvecklade trycksår efter behandlingen. Alla dessa var av grad 1 enligt EPUAP:s trycksårsskala. Endast en av patienterna (3,3 %) hade kvar trycksåret dagen efter behandlingen. Den vanligaste lokalisationen för trycksår var underben/vader (16,7 %). Inga statistiskt säkra samband kunde ses mellan riskfaktorerna och utvecklandet av trycksår. Studien visade en relativt hög frekvens av trycksår (23,3 %). Dock var samtliga av grad 1 och endast ett trycksår var kvarstående till dagen efter brachybehandlingen. Detta tyder på bra tryckavlastande åtgärder och utrustning samt att patienterna i den aktuella undersökningsgruppen har relativt gott allmäntillstånd.   Nyckelord: brachyterapi, trycksår, gynekologiskt läge, riskfaktorer

Traditionally, the lithotomy position is the most commonly used birthing position in western cultures. The purpose of this literature review was to examine the differences in maternal and neonatal outcomes when alternative labor positions are used. Implications for future use of alternative labor positions were explored. Peer reviewed, English-language research articles published from 2009 to 2015 were included for synthesis. Study results revealed that the lithotomy position is linked to multiple negative maternal outcomes. Birthing in a water pool or in a lateral position has been linked to more optimal maternal and neonatal outcomes compared to other positions. Health care providers, and nurses in particular, should be educated on the benefits and consequences of both the lithotomy position and alternative labor positions. Using this evidenced based research, health care professionals can educate women and families as they encounter the birthing process. Further research is needed to identify additional birthing outcomes of labor positions, specifically neonatal outcomes of the lithotomy position. In addition, research on innovative obstetric monitoring techniques will expand the opportunity to use alternative labor positions while protecting the mother and fetus.

Many babies are delivered by using the standard lithotomy birthing position. However, evidence shows several benefits to an upright birthing position. The purpose of this study is to discover birthing positions that lead to more positive outcomes in laboring women delivering in hospitals. This research was conducted by examining previous studies conducted on a similar topic. However, the studies found mainly focused on the benefits of squatting positions and the implementation of devices that helps achieve an upright position. All findings support an upright birthing position provides a more optimal position for birthing a child due to the force of a more natural pelvic expansion and gravity. One of the barriers of this area of study includes the lack of pregnant mothers willing to participate in a study skewing the reliability of many studies. In conclusion, the articles analyzed provide pertinent information that supports the intervention of nurses and midwives providing patient education to explore birthing options outside of standard practice that could lead to more positive outcomes.