The neurotoxicity of intrathecal lidocaine is enhanced in postpartum compared to virgin rats

During the perinatal period, the pharmacokinetics and pharmacodynamics of drugs may be altered. Data about the neurotoxicity of intrathecal local anesthetics in the peripartum period are lacking. So we hypothesized that the neurotoxicity of intrathecal lidocaine during perinatal period may be changed. Therefore, we designed the present study to determine whether the neurotoxicity of intrathecal lidocaine in postpartum rats would be different from that in nonpregnant, virgin rats. Postpartum and nonpregnant rats randomly received an intrathecal infusion of lidocaine 50 mg/mL in saline, lidocaine 20 mg/mL in saline, or saline for 1 h at a rate of 1 μL/min. Four days after drug infusion, the rats were assessed for persistent impairment of sensory and motor function (MF) using the tail‐flick (TF) test, paw pressure test, and MF score. Spinal cords and nerve roots were obtained for light and electron microscopic examinations, and the injury scores were compared between groups. The TF latencies and the mean nerve injury scores of the postpartum group were significantly higher than those of nonpregnant group. Lidocaine induced a dose‐dependent impairment in TF latencies and nerve injury scores. There was no significant interaction between postpartum and the drug. Our results suggest that the neurotoxicity of intrathecal lidocaine is enhanced in rats during the early postpartum period compared with nonpregnant, virgin rats.     

Sonographic diagnosis of postpartum pseudoaneurysms of the uterine artery: A report of 2 cases

Two cases of post‐partum uterine artery pseudoaneurysm are described, 1 after normal vaginal delivery and the other after Caesarean section. Both cases were complicated by heavy bleeding and treated with catheter embolization. A turbulent arterial‐type velocity waveform with high peak velocity and forward end‐diastolic flow was registered in the feeding vessel. The peak blood flow velocity was high in both cases. The resistance index in the uterine artery was lower in the affected side of the uterus. Three‐dimensional angiosonography was used to calculate the volume of the lesion, demonstrate its shape, and identify the feeding vessel. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2010     

产后抑郁相关危险因素多元回归分析

[目的]探讨影响产后抑郁发生的危险因素,为干预产后抑郁提供理论依据。[方法]采用围产期孕妇一般情况调查表、爱丁堡产后抑郁量表(EPDS)、生活事件量表(LES)、A型行为问卷(TABQ)、艾森克个性问卷(EPQ)、社会支持评定量表(SSRS)、症状自评量表(SCL-90)、特质焦虑量表(T-AI)、状态焦虑量表(S-AI)对129名围产期孕妇进行跟踪调查,直至分娩,并进行统计学分析。[结果]产后抑郁组受教育年限低于正常组;EPQ神经质原始分、SSRS客观支持分、怀有戒心或敌意特征、产妇年龄是影响产后抑郁发生的危险因素。高神经质组产前Sc l-90抑郁分、焦虑分、强迫分、躯体化等分值及负性生活事件分值均高于低神经质组,社会支持总分及利用度均低于低神经质组。[结论]神经质、低客观支持、怀有戒心或敌意及产妇年龄是产后抑郁发生的危险因素。     

盐酸氟西汀治疗非典型性牙痛临床疗效评价

目的评价盐酸氟西汀治疗非典型性牙痛(AO)的疗效。方法对48例AO患者给予盐酸氟西汀治疗4周。治疗前和治疗后用抑郁自评量表(SDS)和疼痛视觉模拟评分(VAS)评价其临床治疗效果。结果治疗前AO伴有抑郁症状者有72.9%(35/48),VAS评分为7.3±1.8,治疗后两者分别下降为25.0%(P<0.05)和2.0±1.7(P<0.01)。结论盐酸氟西汀对非典型性牙痛患者精神状态和局部疼痛有明显改善作用。     

Iatrogenic secondary post‐partum haemorrhage: Apropos of two uncommon cases

In this article we would like to highlight uterine pseudoaneurysm as a cause of secondary post‐partum haemorrhage following Caesarean section. We would like to stress Doppler ultrasound scan as the initial screening modality for this condition. We also describe angioembolization as the prudent treatment option for this condition rather than resorting to surgery.     

Marital disharmony four and a half years post partum. Effects on parent-child relationships and child development

This longitudinal study of primiparous women concerns factors related to the quality of the marital relationship 4 1/2 years after the birth of the first child. Information was independently collected from the women, their husbands and children. A poor relationship to the partner and impaired mental health in the women post partum were associated with marital disharmony at follow-up. In disharmonious marriages more often than in others parents were estimated to have a rejecting attitude towards their child and the child to have a rejecting attitude towards its parents. Further, in these marriages poor parental relationships of boys were more common than those of girls and socially immature boys as compared to socially immature girls overrepresented.     

IUD appendicitis

A case of uterine perforation by an IUD with acute and chronic irritation of the appendix is presented. The patient, a 30-year old gravida 4, para 4, was admitted to the hospital with severe abdominal pain, fever, and diarrhea. A Lippes loop IUD had been inserted 3 years previously. The device could not be visualized at laparoscopy. At laparotomy the IUD was palpable within a large inflammatory mass in the right lower abdomen . Dissection of the adhesions revealed the IUD twisted around the appendix, and appendectomy was performed. This is the 1st reported case of a perforated, nonmedicated IUD causing appendicitis. The 2 cases of IUD appendicitis previously described in the literature involved Copper-7 devices, which have been shown to cause considerable tissue response when placed in the peritoneal cavity. Abdominal signs and symptoms associated with a missing IUD string should alert physicians to the possibility of IUD appendicitis.     

急性胰腺炎中全身炎症反应综合征与抗炎症反应综合征

急性胰腺炎是一种常见的急重症,被公认为是炎症紊乱的过程.早期暴发性的促炎细胞因子释放引起全身炎症反应综合征,导致多器官功能障碍综合征引起死亡.后期由于大量的抗炎细胞因子,引发抗炎症反映综合征,机体免疫功能受到抑制,诱发感染,进而形成毒血症.因此,重新建立SIRS/CARS的平衡对急性胰腺炎患者发病过程及转归有着重要的临床意义.本文就急性胰腺炎引起的SIRS、CARS有关参与冈子及机制做一综述.     

分娩相关因素与产后盆底肌肉强度关系分析

目的探讨分娩相关因素与产后盆底肌肉强度的关系。方法通过问卷调查形式对1024例初产妇的盆底肌收缩力状态进行评估。结果剖宫产对耻骨尾骨肌（PC肌）强度影响要小于顺产;分娩时间越短,会阴侧切伤口长度越小,对PC肌强度影响影响越小。结论产后盆底肌肉强度与生理和心理因素有关,产妇应该加强盆底肌肉训练,并积极接受心理治疗。