Adolescent endometriosis in china: a retrospective analysis of 63 cases

Study ObjectiveTo investigate the clinical presentations, diagnosis, treatment modalities and prognosis of endometriosis in adolescents in China.DesignRetrospective study.SettingData were collected from records of the Peking Union Medical College Hospital from 1992–2010.ParticipantsThis study consisted of 63 patients ≤20 years old with surgically diagnosed endometriosis. Their clinical presentations, auxiliary examinations, surgical outcomes, and post-operative medical treatments were analyzed. The follow-up information of 35 cases was collected.ResultsMean age at diagnosis was 18.41 ± 1.84 years with a much earlier disease onset in adolescents with genital tract malformations. Of the 35 patients with follow-up time that ranged from 12–98 months, nine in 15 patients who didn't proceed with medical treatment after operation had a recurence (9/15), seven in 15 patients who took oral contraceptive pills (OCP) or progestin only pills had reoccurrence recurred (7/15), and none of the five patients received gonadotropin-releasing hormone agonist (GnRHa) therapy recurred (0/5). In this study, multiple sites lesions was defined as more than one site being involved of the following four sites: the left ovary, the right ovary, the rectovaginal pouch and the uterosacral ligament. Among the 15 cases without postoperative medical therapy, all five cases with multiple sites lesions had recurrence (5/5), while only four of the other 10 cases had relapse (4/10). The difference was of statistical significance (Fisher exact test, P = 0.044).ConclusionMultiple sites lesions found in operation was a risk factor of recurrence. GnRHa was effective to prevent the recurrence.     

Sexual dysfunctions in urban china: a population-based national survey of men and women

IntroductionWhile sexual dysfunctions are closely related to overall well-being, epidemiological data based on population-based surveys remain scant.AimTo investigate the prevalence and correlates for sexual dysfunctions in urban China.MethodsOf the 4,157 urbanites sampled nationally, 3,159 participants completed the interview, giving a response rate of 76%. The focus was on 78% of these participants (2,478 adults aged 20–64) who were sexually active within a stable sexual relationship, typically with the spouse.Main Outcome MeasurePrevalence and correlates for sexual dysfunctions.ResultsFully 35% of women and 21% of men had at least one persistent sexual dysfunction. Prevalence by age was similar to the results from Western developed countries. With sharp differences for men and women, the correlates for distress in China were multiple, with aging and physical issues accounting for only a portion of the total set of mental health, stress, relationship, and values and knowledge issues related to reports of sexual dysfunctions.ConclusionsBoth the prevalence and correlates for sexual dysfunctions in urban China were similar to those in other societies. Mental distress, age, and poor communication (producing the report that “my partner does not understand my sexual needs”) were the correlates shared by both men and women. Other correlates were more distinct by gender. The multiplicity of correlates for men and women suggests a need for a holistic approach to sexual dysfunctions. Parish WL, Laumann EO, Pan S, and Hao Y. Sexual dysfunctions in urban China: A population-based national survey of men and women.     

Chances in current prenatal diagnosis

Authors present the actual trends in prenatal imaging diagnoses: screening obstetrical ultrasound (performed in every ultrasound lab), genetic (targeted) US + fetal echocardiography (performed in selected ultrasound lab), US 3D and 4D, panoramic studies, surgical US, fetal MR and social US study. Authors also present opinion about who, where and how should perform counseling after detection of fetal anomaly. Also current trends in obstetrical education are presented based on examples from West Europe and USA.     

Anticonvulsive therapy in eclampsia--its current status

Conflicting opinions on the adequate and appropriate anticonvulsive therapy for eclampsia stems from the fact that a lot of unclarity still exists as per the reasons for eclamptic seizures. The authors reviews current data from literature on the problem of anticonvulsive therapy for eclampsia and tries to clarify the uncertainties on the optimal approach for eclamptic seizures. Despite the fact that many neurologists in the U.S. as well as a great number of obstetricians in Europe are now sceptical about the anticonvulsive effect of magnesium sulphate and prefer other anticonvulsive agents, the parenteral application of magnesium is still the principal approach for eclampsia. There is a need however for a new strategy for prophylaxis and therapy of eclampsia. Which will lead to a significant reduction of the fatality rate in cases of grave preeclampsia-eclampsia.     

Asthma in pregnancy: current concepts

Asthma complicates pregnancy with the same frequency as cardiac disease (1%) does. Although the incidence of severe asthma during pregnancy is low, its effect on the mother and fetus can be disastrous. Recent advances have improved the management of this problem. Representative cases and a review of asthma treatment in pregnancy are presented.     

Animal-derived surfactants versus past and current synthetic surfactants: current status

In this review, the authors assess major outcomes resulting from head-to-head comparison trials of animal-derived surfactants with previous and newer synthetic surfactants and among them. They also pay special attention to issues of study design and quality of the trials reviewed. Animal-derived surfactants that contain surfactant proteins (Survanta, Infasurf, and Curosurf) perform clinically better than Exosurf, a synthetic surfactant containing only phospholipids, primarily in outcomes related to acute management of respiratory distress syndrome (RDS; faster weaning and pneumothorax) but not in overall mortality or incidence of bronchopulmonary dysplasia (BPD). Trials comparing various animal-derived surfactants that provide different amounts of surface protein B (SP-B) or phospholipids have shown minor differences in outcomes related to the management of RDS or none at all. The exception is the suggestion of better survival using a high initial dose of Curosurf when compared with Survanta. This observation is based on analysis of trials of relatively lesser quality that have included a smaller number of infants than other surfactant comparisons, however. Data from recent trials comparing a new-generation synthetic surfactant that contains a peptide mimicking the action of SP-B, Surfaxin, have shown that it performs better than Exosurf (faster weaning and less BPD) and at least as well as the animal-derived surfactants Survanta and Curosurf. The ideal surfactant comparison trial to demonstrate which surfactant is better has yet to be conducted. Future surfactant comparison trials should pay particular attention to study design, be appropriately sized, and include long-term follow-up.     

Umbilical cord prolapse in current obstetric practice

OBJECTIVE: To assess the incidence, risk factors and outcomes of umbilical cord prolapse in current obstetric practice. STUDY DESIGN: This study was a retrospective chart review at both a community hospital and a tertiary referral center. RESULTS: There were 52 cases of cord prolapse in our patient population, for an incidence of 3.0/1,000, similar to that in the literature. Of viable singleton pregnancies with frank prolapse, the rate was 1.6/1,000. In this series we found an approximately 40% higher rate of frank cord prolapse in induced patients at the community hospital than in the general population. Other than 2 fetal deaths related to extreme prematurity, all mothers and infants did well. CONCLUSION: The higher incidence of cord prolapse among women with induction of labor in this population merits further study. The lack of significant morbidity and mortality in the study suggests that modern obstetric practices may influenced the natural history of umbilical cord prolapse.     

The role of acupuncture in current perinatology

Acupuncture--the old Chinese method of treatment seems to establish its role in current medicine including perinatology. There are a lot of symptoms accompanying pregnancy that could be diminished by above method. The review summarizes results from current literature concerning indications, effectiveness and social acceptance of acupuncture in western countries obstetrics.     

Antenatal care; current practice in debate

Summary. The antenatal screening practice of 67 teaching hospitals in the European Community was assessed by use of a written questionnaire. There were minor differences in mean numbers of tests performed in different countries, but only limited agreement was found on the selection of tests that were performed. There was no unity of practice within the countries. No correlations were found between the number of screening tests performed and the size of the units, or the composition of the attending staff.