Personal narrative essay for college youtube

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artist essays Emil Orlik was born Prague on 21st July 1870 . At that time Prague was the capital of a province of the Austro-Hungarian Empire and narrative essay for college thus he was an Austrian citizen, not Czechoslovakian as is frequently stated. His family, being Jewish, lived near the Prague ghetto. His father was a master tailor as was his brother Hugo. There was a large German speaking community in Prague (called Bohemian Germans) including an military artistic circle which included friends of Orlik's such as Franz Kafka, Franz Werfel, Max Brod and Rainer Maria Rilke. Throughout his school years Orlik had been passionate about drawing and on Personal essay for college, leaving school in 1889 he was allowed by his father to go to Germany, hoping to be enrolled at the Academy of Fine Art there. Jawaharlal? He was not accepted however, so he enrolled at essay for college the private art school of Heinrich Knirr in Munich, where a fellow pupil was Paul Klee. Orlik's target remained the Munich Academy and he gained a place in 1891 under Professor von Lindenschmit who soon recognised his talents and allocated him a small studio. Orlik worked hard, copying old masters at the Munich Pinakothek, constantly improving his techniques. In 1893 he won the Order of writing jawaharlal silver medal for two of his pastel drawings which were shown at the academy's annual exhibition, with the honour of hanging near works by Adolph von Menzel, one of the most prominent artists in Germany. The Academy had a department led by Personal narrative essay youtube Professor Raab teaching copper engraving.

Orlik enrolled for modern writers these classes but was at loggerheads with the professor for branching away from the curriculum, experimenting with all aspects of essay for college youtube, etching and lithography. He was soon doing work beyond Raab's understanding. In 1893 Orlik impetuously left the academy as he felt constrained by conservative academic training. He wanted to start working in more modern styles and was drawn to the Munich Naturalistic movement and the circle around Wilhelm Leibl. After a year of military training he returned to Prague in 1894 and painted and made prints of his friends and Make an essay good surroundings there. In 1896 Orlik returned to Munich to essay for college youtube, work with his fellow pupil and Mandatory military service in jordan life-long friend Bernhard Pankok on their first essays in the making of Personal essay for college, colour woodcut prints. They had seen examples of Japanese woodcut prints and were fascinated by Mandatory military service in jordan them. He began contributing illustrations to the journal Jugend . By 1897 Orlik was such an for college accomplished print-maker that four of his small etchings were chosen for publication in the prestigious art magazine PAN. Also illustrated in PAN was a reproduction of his first poster 'Die Weber', designed for the play of the same name produced by write essay Gerhart Hauptmann. Essay Youtube? Hauptmann was so impressed by the poster that he invited Orlik to Berlin to visit his studio and this was the first stepping stone to Orlik's involvement in the theatre.

He went on to become a leading set and costume designer for many productions. Through his friend the military writer Maria Rainer Rilke came the opportunity to become a book illustrator. By the Personal essay for college youtube end of 1897 Max Lehrs, assistant director of the Kupferstichkabinett (Graphics Collection) in for me Dresden began to add prints by essay youtube Orlik to this important museum print collection. Lehrs can be considered to be the japanese 'discoverer' of Orlik and he bought may of Orlik's prints for Personal narrative essay youtube his own extensive collection. They were lifetime friends and Best japanese writers maintained a correspondence almost until the artist's death. Much of the details of Orlik's travels and day-to-day life is known from this correspondence, which has amazingly been preserved. A book titled Malergr?sse (Artists Greetings) was published by Prestel in Personal narrative for college youtube 1981 illustrating and transcribing the Best writers profusely illustrated letters and postcards. In 1898 Orlik made his first journey abroad, visiting England, Scotland, Belgium and essay youtube Holland as well as making the first of his many visits to Paris. There he came into an essay jawaharlal nehru contact with the woodcut artist Felix Vallotton and in London with William Nicholson who was making highly innovative woodcut posters and prints.

He recorded his travels in numerous etchings, lithographs and woodcuts. On returning to Prague he established himself in Personal for college an atelier in an old tower with fine views over the picturesque city. He retained this studio until 1904. Best Modern? But by 1899 he was living in Vienna and showed works in the third exhibition of the Vienna Secession, of which, as a member, he also contributed to essay, the group's publications on modern art trends, including 'Japonisme'. The Society was gaining in importance and visitors came from abroad, including K?the Kollwitz and Max Liebermann from Germany, and Auguste Renoir, Henri de Toulouse-Lautrec and Camille Pissarro from Paris. There was much interchanging of ideas and discussion of Japonisme which was having such an impact throughout Europe, particularly on Art Nouveau and Jugendstil artists, and the Nabis school in Paris.

At the same time artists in America were also coming under this influence (notably Mary Cassatt and Helen Hyde). In February 1900 Orlik had great success with his first one-man exhibition in Br?nn in Austria, showing works in Order of writing jawaharlal many media. It was at this time that Max Lehr introduced Orlik to youtube, Marie von Gomperz and her family. Her father, Max von Gomperz was a wealthy industrialist and patron of the arts. He bought from and commissioned many paintings and other works by Orlik. Marie Gomperz and Orlik developed a life-long friendship documented through their correspondence which continued until the modern japanese time of Orlik's death. The extensive Gomperz collection of his work was exhibited at the Jewish Museum in Vienna in 1997. Orlik's oeuvre reflects this patronage and friendship through many portraits of Personal essay for college, members of the family and of their country estate of Best japanese writers, Oslawan in Slovakia and its surroundings. Meanwhile, in March of 1900 Orlik undertook his first voyage to the Far East, the momentous 'Reise nach Japan'.

He wanted to learn at first hand and at its source how to master the techniques which were of such fascination to him. He absorbed much knowledge from the artists, woodblock-carvers and printers with whom he worked. He wrote many letters with descriptions of his travels in Japan to friends in Europe and Reiner Maria Rilke contributed an article to the magazine 'Ver Sacrum' relating the descriptions written to him by Orlik. He wrote to Max Lehr on 22nd February 1901 that he had spent a fortune on acquiring prints, netsuke and other Japanese artefacts. As soon as Orlik arrived home in November 1901 he had to prepare for narrative for college an important exhibition of his work to be held at the prestigious Cassirer Gallery in Berlin in How to write a scholarship December. During the following year Orlik had a series of one-man shows in many venues, including one at Personal narrative youtube the Rudolphinum in Prague at which the entire exhibition was bought by the Prague Kupferstichabinett.. At the XIIIth exhibition of the Vienna Secession he showed 16 works, all of Japanese subjects, alongside works by Max Klinger. His name now appeared in the index of the Berlin Secession, together with those of Klimmt, Monet and Camille Pissarro. Many articles appeared in various publications about his Japanese travels, the artefacts he brought back and his work.

He travelled again to England and Paris, where the work of an essay nehru, C?zanne made a great impression on him. Personal For College Youtube? At the Writing yourself begin end of 1904 Orlik was appointed head of the department for graphic art and book illustration at the Academy of the Museum of Applied Arts in Berlin, the teaching post he retained until his retirement in 1930. For College Youtube? Among his many pupils who gained fame in their own right was George Grosz who wrote admiringly of Write my essay for me application, Orlik's teaching in his autobiography. Orlik was now established in Berlin and began working on his costume and stage designs for the Deutsches Theater, led by Max Reinhardt. Many more articles about him and his work appeared in various publications, including one in 'The Studio' in London. At this time Orlik met and became friendly with the narrative youtube Berlin Secession group led by Max Liebermann, who had just returned from Paris and was to become the leading German Impressionist painter. Other important members of the group were Lovis Corinth, Erich B?ttner and Max Slevogt. The SPOG group was also founded (Slevogt, Pankok, Orlik and Grundberg. Grunberg was a dentist but also a fine amateur artist). Orlik had met the military service author Lafcadio Hearn in Japan.

Hearn had assumed Japanese citizenship under a Japanese name and Personal narrative youtube he lectured at a number of universities writing many books on the country and its culture which were widely read in England and America and look good greatly furthered knowledge in Europe of Japanese life, philosophy and art. Orlik both translated Hearn's books into German and essay for college illustrated them. Over the next few years Orlik was indefatigable in a scholarship begin holding exhibitions in many venues and in working in theatre design. In 1912 he made his next important journey abroad, visiting North Africa, Ceylon, China, Korea and Japan, returning via Siberia. In Egypt he executed an outstanding series of etchings later published in a portfolio Aus Aegypten . Returning to Germany he continued to play a leading role in Personal narrative youtube the Berlin Secession until 1913 when he and Liebermann both resigned. Book design became an important part of Orlik's oeuvre, as well as ex libris labels for literally hundreds of friends and book collectors. Book collectors of the time vied with each other in commissioning well known artists to designing their label, many having numerous designs. In all, Orlik designed 136 ex libris and although about write essay a dozen were made gratis for close friends, the work was lucrative. He was paid up to 500 marks each, a considerable sum in youtube pre-World War I days. Orlik was also called upon to design colour posters for exhibitions, theatre productions and Make an essay for me even commercial products.

He produced hundreds of posters most of which are today highly sought after and scarce. In December 1917 Orlik was appointed official artist to the Best-Litovsk Peace Conference at which Russia and Germany ended their conflict. He produced 72 portrait studies at the conference, including a number of Personal youtube, Leo Trotsky. Many of these he later published as lithographs in a portfolio. After the war he continued working at a frantic pace, exhibiting at many venues throughout Europe. He also became interested in photography, experimenting with the use of light. He was one of the pioneers in the use of Writing about yourself, photographs as studies for graphics and paintings, particularly for his portraits of leading celebrities.

He claimed that photography permitted him to obtain the essence of essay youtube, his endeavours towards the perfect portrait. His earliest essays in photography were made around 1917, but by the mid-twenties he produced brilliant photo portraits of Marlene Dietrich, Albert Einstein and many others. In December 1923 Orlik made his last voyage out of Europe. Write A Scholarship Essay? He received a commission to Personal narrative essay for college, paint the portrait of a sitter in Cincinnati. His passage and a two month's stay in the U S A were provided. While in America he had an exhibition in New York. The City fascinated him and How to write a scholarship he wrote to Personal youtube, Gerhart Hauptmann : After overcoming the first confusion it is a completely different world. The city is amazing. The dollar rules here!.

He said he found it easier to get used to China than to New York. After his return to Europe he continued to work intensely and his fame increased. He became one of the best known artists of the Writing a scholarship essay about begin day. He continued travelling in Europe - to Spain, Italy, England and France. Portrait commissions and graphic work kept him busy till the essay youtube time of his death from a heart attack in Berlin on 28th September 1932, nine days after his great friend Max Slevogt. His brother Hugo inherited his considerable estate, including many paintings, drawings and prints. During his many visits to Paris he had acquired a fine collection of works by his friend Henri Matisse and by many other prominent artists, including C?zanne. Hugo Orlik and his family perished during the war at the hands of the Nazis. The only survivor of the family was an aunt who, after the write essay on goals war, regained some of what was left of narrative for college youtube, Emil's effects. In 1963 the first post-war German exhibitions of Best japanese, Orlik's works were held in Berlin and Stuttgart and then in 1977 there was a major retrospective in Austria. Interest in his work was rekindled and his stature and importance once again recognised.

Many books about narrative essay for college Orlik and Mandatory military service in jordan his works have been published and once again he has taken his place in art history as an important painter and ground-breaking print-maker.

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ob rn resume Presentamos nuestra experiencia prospectiva de cerclaje cervical electivo (CCE) con técnica de McDonald, en pacientes con historia obstétrica sugerente de incompetencia cervical uterina (IC), y los resultados perinatales, en 4 años de estudio. PALABRAS CLAVE: Cerclaje cervical electivo, incompetencia cervical. We present a prospective experience in for college youtube elective cervical cerclage, with McDonald technique in my essay for me patients with obstetric history of essay youtube cervical incompetence, and an essay for me look good perinatals outcome in for college four years. KEY WORDS: Elective cervical cerclage, cervical incompetence. L a incompetencia cervical (IC), mencionada por Culpepper, Cole y Rowland en 1658, y descrita en el Lancet por Gream en 1865 toma su real dimensión cuando Palmer y Lacomme en el año 1948 recomiendan su tratamiento, y luego Lash y Lash proponen el término de IC para definir este problema en 1950 1 . Military. Shirodkar introduce el cerclaje cervical con cinta “en ceñidor” el año 1955, y por su parte en 1957 Ian McDonald presenta su experiencia con una técnica simple de punto no absorbible y señala que: “la historia obstétrica de la paciente constituye el factor más relevante para corroborar el diagnóstico” 2 . Personal Narrative Essay For College Youtube. En 1965 Benson y Durfee describen un procedimiento transabdominal eficaz de cerclaje cérvico ístmico en vez de CC transvaginal 3 , y luego de estudios alternativos Golfier y cols apuntan que la vía vaginal para el cerclaje cérvicoistmico en la zona más alta posible, tiene ventajas y es más simple y rápida que la vía transabdominal 4 . Look Good. En 1979 Sarti y cols apuntan a que el examen ultrasonográfico del segmento y cuello uterino y sus modificaciones patológicas durante la gestación, orienta a su tratamiento con el objeto de prevenir el aborto y el parto prematuro 5 . Se define IC o insuficiencia ístmica cervical, como la incapacidad del cuello uterino para conservar las características propias de rigidez necesarias para mantener un embarazo hasta el término, debido a anormalidades estructurales y/o funcionales. Narrative Essay Youtube. Esta patología tiene una incidencia entre 0,2 a 1% de todos los embarazos y clínicamente se manifiesta como abortos repetidos de segundo trimestre o como parto prematuro con dilatación cervical progresiva en ausencia de contracciones uterinas dolorosas. An Essay Look. Su incidencia se estima en 4,6 por 1000 nacidos vivos para la incompetencia cervical genuina, aunque se discute su importancia en la génesis del parto prematuro.

La mayoría de las veces la etiología es desconocida, sin embargo existe una asociación con legrados uterinos previos, conización cervical, partos operatorios vaginales, exposición in Personal essay for college youtube utero a Dietilbestrol y con anomalías Mullerianas 2,6 . For Me In 3. Clásicamente la incompetencia cervical ha sido tratada con la colocación de una sutura en el cuello uterino o cerclaje cervical (CC), por vía transvaginal, en forma programada o electiva entre las 12 y 14 semanas (CCE) o en el transcurso de la evolución de la dilatación cervical o de urgencia (CCU). Narrative For College. No obstante la utilización del CC transvaginal sigue siendo un tema polémico en la obstetricia actual, debido a que la evidencia científica no ha demostrado su real utilidad, salvo en pacientes con historia clásica de incompetencia cervical y un CCE entre las 12 y 14 semanas de gestación. Best Modern Japanese Writers. Sin embargo, la evidencia no es concluyente respecto a cuál es la mejor opción terapéutica para las pacientes sin historia característica, pero en riesgo de incompetencia cervical (acortamiento cervical ultrasonográfico o antecedente de parto prematuro). Narrative Essay For College. Los autores son enfáticos en manifestar que se requiere de estudios randomizados de buen diseño para resolver las interrogantes en cada grupo 7-15 . En el presente trabajo de investigación damos a conocer nuestra experiencia prospectiva en pacientes sometidas a CCE con técnica de McDonald en el Hospital Luis Tisné Brousse entre los años 2002 y 2005, con un protocolo simple para evaluar la efectividad y la seguridad del CCE o profiláctico (antes de que el cuello uterino se haya dilatado). Se analizaron los datos obtenidos de pacientes sometidas a CCE con técnica de McDonald, entre el 20 de agosto del 2002 y el 31 de Julio del 2006, que aceptaron un protocolo previo en el que se tuvo en cuenta su paridad y abortos, edad de gestación, ecografía transvaginal para medición de cuello uterino y presencia de funnel , cultivo vaginal y exámenes generales de acuerdo al control prenatal habitual de nuestro servicio.

Se sometió a CCE a aquella paciente que tenía antecedentes de abortos previos y parto prematuro, poniendo énfasis en la historia y de acuerdo a las recomendaciones de Ian McDonald7, con gestación preferentemente entre 12 a 17 semanas, con un consentimiento informado por su médico tratante. Consiste en colocar a la paciente en posición de litotomía dorsal, pudiéndose ocupar anestesia regional, general, así como también con infiltración paracervical o con bloqueo pudendo. Writing Essay Yourself. Desinfección quirúrgica perineal y vaginal, luego se toma el labio anterior y posterior del cuello con pinzas Pfoester, ubicando el nivel del receso de la vejiga con una tracción suave hacia atrás y adelante. Personal Essay. Luego a 5 mm del receso, se pasa un punto en forma de bolsa de tabaco (en jareta) o circular rodeando el cuello en 4 pasadas para ceñirlo. A Scholarship Essay. El material de sutura usado debe ser firme y no absorbible. Narrative For College. Cada punto debe pasarse profundo para incluir el estroma del cuello, pero sin ingresar en el canal endocervical, además el cerclaje debe insertarse lo más cerca de los ligamentos útero sacros posible, sin atravesar el fondo de saco posterior. Hours Application. El nudo se realiza en la parte anterior del cuello desplazado hacia derecha o izquierda evitando la uretra. En nuestra casuística el CCE fue realizado en pabellón con anestesia raquídea, con la técnica ya descrita, tomando ambos labios del cuello uterino con pinzas Pfoester y pasando cuatro puntos a las 10, 7, 5 y 2 horarias para el cirujano diestro (Figura 1), incluyendo el estroma del cuello, sin ingresar en el canal endocervical (Figura 2), el material de sutura fue Prolene® del Nº 1, con siete nudos dejándolos desplazados hacia el lado parauretral derecho, el cierre del OCI se comprobó con el dedo índice al anudar (Figura 3). Personal Youtube. En el intraoperatorio las pacientes recibieron una dosis profiláctica de cefazolina ev, según norma del servicio.

En el postoperatorio Progendo® 100 mg vo por dos veces al día por 1 semana hasta su control en el policlínico de alto riesgo obstétrico a los siete días. Se descartaron del estudio aquellas pacientes con gestación en las que el aborto o parto prematuro era inminente, con cuello ampliamente dilatado cuyas membranas eran protruyentes en bolsa de reloj de arena y signos de corioamnionitis. La Tabla 1, resume los datos y características obstétricas, la edad de gestación a la que se realizó el CCE, las complicaciones, el retiro del cerclaje y el resultado perinatal para cada una de las pacientes resueltas. Mandatory Military In Jordan. El promedio de edad fue de 27.9 años (17-38). Narrative. La edad de gestación promedio al colocar el CCE fue de 15.8 semanas (12-24). Essay Begin. De las 23 pacientes, 18 se resolvieron por parto vaginal o cesárea, con RN adecuados para la edad de gestación calculada y test de Apgar normal, uno de los RN presenta Síndrome de Down, 14 fueron de término con un peso promedio de 3.245.9 g (2.690-3.700g) y 4 partos de pre término con pesos de 1.355, 1.685, 1.840, y 2.690 g. Narrative Essay For College. En las 18 pacientes se retiró el CC entre las 28 y 38 semanas, haciendo notar que los que se retiraron precozmente fue por infección ovular a las 28 semanas, otras por trabajo de parto prematuro con modificaciones cervicales. A Scholarship Begin. Complicaciones sólo en 1 paciente con infección ovular a las 20 semanas y aborto. Narrative For College. En este trabajo se incluyen 4 pacientes cuyos embarazos aún no llegan a término, por lo tanto, sus resultados neonatales están pendientes. Look. En 9 pacientes se resolvió el parto por cesárea (47.3%), 1 con espátulas de Thierry, el resto se resolvió por parto vaginal eutócico; de las cesáreas destacamos una por infección ovular, otra por presentación podálica, y en el resto por causa obstétrica, dilatación estacionaria, monitorización electrónica alterada, o distocia de posición con dilatación incompleta y presencia de meconio y circulares del cordón pesquisada en su resolución. For College Youtube. En una de las pacientes se pesquisó Streptococcus agalactiae , que se trató en su trabajo de parto según normativa, con buen resultado peri natal.

No hubo mortalidad materna ni perinatal en este grupo de pacientes. Pese a que la IC se conoce desde 1658 2 , es una patología en la cual no existe unanimidad respecto de su definición, diagnóstico y tratamiento 7-15 . How To A Scholarship On Goals. Por décadas hemos utilizado el CCE, para prevenir la pérdida del embarazo en curso en aquellas pacientes con historia previa de abortos de segundo trimestre y partos prematuros, en quienes existió dilatación del cuello uterino no asociada a contracciones. Personal Narrative Essay For College Youtube. Mayor duda ha existido, sin embargo, en el grupo de pacientes cuya historia no es categórica. Writing A Scholarship Essay About Yourself Begin. En la actualidad no existen respuestas a la fisiopatología de este fenómeno que pueda bien explicar la IC, las publicaciones postulan una deficiencia de colágeno o elastina u otro de los componentes estructurales del cérvix, como la causa de esta patología, sumado a lo anterior debemos considerar el peso que ejerce el feto y anexos ovulares sobre un cuello uterino “debilitado” 16 . Hemos considerado relevante la opinión de Miranda y Carvajal 6 , quienes en un análisis crítico, han hecho un gran aporte a las interrogantes en el manejo de la incompetencia cervical y la realización de un cerclaje, por lo que gran parte de la discusión se basa en los datos aportados en su publicación. El aporte de la ultrasonografía transvaginal, sugiere que se trata de una patología multifactorial, ya que sólo se repite en 40% de los embarazos subsecuentes de pacientes con clara historia de IC 5 . Personal Narrative Essay For College. La idea es que no se trata de una condición todo o nada, si no de un fenómeno gradual, cuyo extremo patológico está representado por lo que conocemos como IC genuina 5 . How To On Goals. En el otro extremo, grados menores de IC pueden manifestarse como parto prematuro de segundo o tercer trimestre, que apoyan el rol de IC en el síndrome de parto prematuro 9-11 . La IC es una patología frecuente y grave, requiere de un diagnóstico preciso y tratamiento oportuno, pese a las dificultades mencionadas respecto a como interpretar esta condición patológica 11-13 . Actualmente los parámetros estudiados y que se enumeran en las publicaciones sobre el tema son 6 : es la dilatación del orificio cervical interno cuyo vértice se encuentra en el canal cervical. Essay For College Youtube. Las membranas ovulares suelen acompañar al funneling , la manifestación tardía de este evento ocurre cuando las membranas protruyen por el orificio cervical externo.

Diversos estudios han asignado valor pronóstico a este hallazgo ultrasonográfico, el que estaría presente en 14-25% de las pacientes con IC 5 . es la medición del canal cervical entre los orificios interno y externo, o entre la cuña del funnel y el orificio externo, es el parámetro ecográfico más estudiado y utilizado para evaluar riesgo de IC. Writing Essay Yourself Begin. La curva normal de distribución en la población general encuentra sus percentiles 10 y 90 entre los 25 mm y 45 mm respectivamente, entre las 24 y 28 semanas. Personal Narrative For College Youtube. Una medición cervical bajo el percentil 10 le otorga un riesgo relativo de parto prematuro de 4,5 veces respecto a la población general; con un valor predictivo positivo de 55% para parto prematuro antes de las 35 semanas 5, 6,18 . corresponde a la medición del la longitud cervical ejerciendo presión trasfúndica uterina, este examen permitiría seleccionar mejor a las pacientes que presentarán incompetencia cervical. Mandatory Service In Jordan. Un estudio sobre 10 pacientes con riesgo de incompetencia cervical, a las que se les midió por ultrasonografía la longitud cervical en el segundo trimestre de su embarazo y se sometieron a presión transfúndica durante el examen, en 9 hubo acortamiento cervical significativo (longitud menor a 10mm). Youtube. En el seguimiento posterior se demostró un acortamiento significativo de la longitud cervical en las pacientes que respondieron positivamente a la prueba de estrés 17 . Se estima, entonces, que la evaluación de estos parámetros ultrasonográficos permitirá adelantarse a los cambios clínicamente evidentes de un cuello uterino incompetente. Writing Yourself. Un estudio que involucró 96 pacientes con factores de riesgo para incompetencia cervical, evaluó mediante seguimiento ultrasonográfico la longitud cervical, y demostró que las pacientes con un canal menor de 25 mm medido entre las 14-20 semanas de edad gestacional tienen 70% de riesgo de parto prematuro (menor a 35 semanas), en tanto este porcentaje se reducía a 14% si la longitud cervical era mayor a 25 mm 18 . Personal. La ultrasonografía transvaginal en la medición de la longitud del cuello uterino juega un rol importante en el diagnóstico de la IC en el síndrome de parto prematuro, evidenciando que no corresponde a una variable del tipo todo o nada, si no más bien a una variable continua, que en grados menores de incompetencia puede llevar a abortos y parto prematuro de segundo o tercer trimestre 5 . Make Look Good. De esta forma se postula que mediante la vigilancia por ultrasonografía de la longitud cervical en pacientes con factores de riesgo para IC, es posible adelantarse a los cambios cervicales detectables mediante el tacto vaginal 17 . Para demostrar la efectividad y seguridad del CCE, se han realizado estudios principalmente de diseño observacional y retrospectivo cuyo resultado no es homogéneo. Personal Narrative Essay For College Youtube. Del mismo modo, los estudios de naturaleza prospectiva y randomizada, distan mucho del ideal.

Estos incluyen una variada gama de pacientes en riesgo de parto prematuro o de incompetencia cervical, casi todos sin cálculo del tamaño de la muestra, que incluyen un número de pacientes tal que impide una conclusión definitiva. La evidencia disponible sugiere que aquella paciente con historia clínica característica de IC como lo planteaba McDonald, se beneficiaría con CCE entre las 12-14 semanas 8 . Of Writing An Essay Nehru. La evidencia disponible, sin embargo, no permite concluir cuál es la mejor opción terapéutica para el manejo de las pacientes con IC, es decir pacientes con historia dudosa, o aquellas con antecedentes de partos prematuros, o aquellas en que se evidencia acortamiento cervical mediante el ultrasonido 9-11 . Personal Essay. Por lo anterior el manejo adecuado de la IC no se ha establecido con seguridad. How To On Goals. Se necesita diferenciar los grupos de pacientes con historia típica de IC, o con historia dudosa, y aquel que solo tiene factores de riesgo, incluyendo la detección ecográfica de acortamiento cervical. Essay Youtube. Estudios prospectivos, randomizados, con criterios de inclusión uniformes y adecuado tamaño de las muestras resolverá las preguntas para cada grupo en particular 6 . Con los resultados expuestos, recomendamos la realización y adiestramiento en la técnica de McDonald para CCE por su simplicidad, su bajo costo, y que hace énfasis en la historia obstétrica sugerente de IC de la paciente (abortos de segundo trimestre a repetición, sin dinámica uterina dolorosa), para su ejecución usar una sutura firme y no absorbible. 1. Order Of Writing Nehru. LASH AF, LASH SR.

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