低频电刺激联合盆底康复训练治疗对女性压力性尿失禁患者盆腔功能及性生活质量的影响

目的探讨低频电刺激联合盆底康复训练治疗对女性压力性尿失禁(stress urinary incontience,SUI)患者盆腔功能及性生活质量的影响。方法将2016年4月至2018年1月湖北省恩施市中心医院诊治的149例女性SUI患者为研究对象。按照就诊顺序将其分为联合组(75例,给予低频电刺激+盆底康复训练)和对照组(74例,给予盆底康复训练),治疗8周后,比较两组患者治疗前后盆底肌力、肌电位、A3反射、盆腔功能、尿失禁性生活质量问卷(PISQ)评分等变化。结果治疗后,两组患者盆底Ⅰ类纤维和Ⅱ类纤维肌力、SUI等级评分均有显著改善(均P0.05),肌电位、PISQ各维度评分及总分均有显著提高(均P0.05),A3反射异常、1h尿垫试验漏尿量及子宫脱垂、阴道前壁膨出、阴道后壁膨出发生率均有显著降低(均P0.05),联合组患者盆底肌力、肌电位、A3反射、1h尿垫试验漏尿量、盆腔功能和PISQ评分改善幅度均大于对照组患者(均P0.05)。结论低频电刺激联合盆底康复训练可以有效改善女性SUI患者尿失禁症状和盆腔功能,促进盆底肌力恢复,提高性生活质量。     

生物反馈治疗对压力性尿失禁患者盆底肌力及尿动力学的影响研究

目的:研究及观察生物反馈治疗对压力性尿失禁患者盆底肌力及尿动力学的影响程度。方法:选取2011年4月至2014年4月于本院进行治疗的60例压力性尿失禁患者为研究对象,将其随机分为对照组(常规盆底肌肉锻炼组)30例和观察组(生物反馈治疗组)30例,然后将两组患者的治疗前及治疗后4周及8周的排尿相关指标、盆底肌力、尿垫试验和ICS尿失禁生活质量调查表、尿动力学指标进行分别检测及比较。结果:观察组治疗后4周及8周的排尿相关指标、盆底肌力及尿动力学指标均显著好于对照组,P均0.05,均有显著性差异。结论:生物反馈治疗对压力性尿失禁患者盆底肌力及尿动力学的影响较大,更有助于患者疾病状态的有效改善。     

骶四针疗法配合盆底肌锻炼对产后压力性尿失禁患者盆底功能及性生活质量的影响

目的探讨骶四针疗法配合盆底肌锻炼对产后压力性尿失禁患者盆底功能及性生活质量的影响。方法选取2017年5月至2020年5月新疆医科大学第一附属医院收治的98例产后压力性尿失禁患者作为研究对象。采用随机数字表法分为研究组和对照组,各49例。两组均接受常规护理,对照组在常规护理的基础上给予盆底肌锻炼,研究组在对照组的基础上给予骶四针疗法,比较两组的临床疗效?1 h漏尿量?盆底肌力恢复情况及性生活情况。结果治疗后,研究组总有效率为91.84%,明显高于对照组的69.39%,差异具有统计学意义(P<0.05);与治疗前比较,治疗后两组1 h漏尿量减少,且研究组1 h漏尿量少于对照组,差异具有统计学意义(P<0.05);治疗后,两组盆底肌力分级均升高,且研究组盆底肌力分级高于对照组,差异具有统计学意义(P<0.05);治疗后,研究组性生活质量高水平比率为38.78%,高于对照组的20.41%,差异具有统计学意义(P<0.05)。结论骶四针疗法配合盆底肌锻炼用于产后压力性尿失禁患者,能改善患者的漏尿情况,提高其盆底肌力及性生活质量,临床疗效较好。     

不同分娩方式对产妇产后性功能的影响

目的:分析和探讨将不同分娩方式应用于产妇对其产后性功能的影响。方法:选择2015年3月~2017年3月在大冶市人民医院分娩的84例产妇作为临床研究病例,根据分娩方式不同将其分成两组。对照组42例,给予阴道分娩进行生产;观察组42例,采用剖宫产方式生产。比较两组产妇产后盆底肌力评分、性生活恢复时间和性功能评分。结果:产后3个月观察两组情况,观察组产妇性生活恢复率69.05%、盆底肌力评分(4.13±0.96)分、性欲(5.33±0.92)分、性高潮(10.98±1.31)分、性唤起(10.86±1.23)分、阴道润滑情况(15.98±1.56)分、性交疼(6.82±1.45)分、性满意度(8.25±1.32)分,对照组产妇性生活恢复率(42.86%)、盆底肌力评分(3.29±0.34)分、性欲(3.56±0.04)分、性高潮(7.76±1.32)分、性唤起(6.63±1.24)分、阴道润滑情况(12.66±1.43)分、性交疼(3.28±1.29)分、性满意度(5.76±1.97)分。观察组产妇各项评分均明显优于对照组,其差异均具有统计学意义(均P<0.05)。两组产妇产后6个月性生活恢复率、盆底肌力评分和性生活各项指标评分比较,其差异均无统计学意义(均P>0.05)。结论:产后初期阴道分娩方式对女性的性功能影响高于剖宫产方式,但随着时间推移,两种分娩方式对产妇性功能影响均恢复正常且差异无统计学意义(P>0.05)。     

PHENIX USB4神经肌肉刺激治疗仪与补中益气丸治疗中老年女性压力性尿失禁的临床对比研究

目的比较PHENIX USB4神经肌肉刺激治疗仪与补中益气丸治疗中老年女性压力性尿失禁(SUI)的临床效果。方法选取2018年11月至2020年6月安徽医科大学附属安庆第一人民医院诊治的120例中老年女性SUI患者作为研究对象,按照随机数字表法分为观察组(n=60)与对照组(n=60)。对照组采用补中益气丸治疗,观察组采用PHENIX USB4神经肌肉刺激治疗仪治疗,比较两组治疗后的临床效果,以及治疗前后盆底肌力、1h尿垫试验(1HPTV)指标及尿失禁生活质量量表(I-QOL)评分。结果治疗后,观察组总有效率(93.33%)高于对照组(80.00%)(P0.05);治疗后,两组盆底肌力水平、I-QOL评分均高于治疗前,且观察组高于对照组(P0.05);两组1HPTV水平均低于治疗前,且观察组低于对照组(P0.05)。结论 PHENIX USB4神经肌肉刺激治疗仪治疗中老年女性SUI患者,其疗效优于补中益气丸,有利于改善患者盆底肌功能,提高生活质量,且安全性高。     

产后盆底肌训练法对二胎产后压力性尿失禁产妇盆底功能康复及性生活质量的影响

目的探讨产后盆底肌训练法对二胎产后压力性尿失禁(SUI)产妇盆底功能康复及性生活质量的影响。方法选取2018年1月至2019年4月保定市第二医院收治的88例二胎产后SUI产妇作为研究对象。采用随机数字表法分为观察组(n=44)和对照组(n=44)。对照组采用生物电刺激疗法进行治疗,观察组在对照组基础上给予Kegel运动和Bobath球训练。比较两组干预前后盆底肌力、尿失禁、盆腔器官脱垂情况,以及干预后性生活质量改善情况。结果两组干预后盆底肌力、尿失禁、盆腔器官脱垂情况均得到显著改善(P<0.05),观察组干预后盆底肌力良好率(93.18%)高于对照组(77.27%),尿失禁发生率(4.55%)低于对照组(22.73%),盆腔器官脱垂率(2.27%)低于对照组(15.91%),差异具有统计学意义(P<0.05);观察组干预后性欲、性唤起、性高潮、阴道润滑度及性满意度评分均高于对照组,性交疼痛评分低于对照组,差异具有统计学意义(P<0.05)。结论盆底肌训练法可提高二胎产后SUI产妇盆底肌收缩能力,改善盆腔器官脱垂症状,降低尿失禁发生率,提高产后性生活质量,临床康复训练效果显著。     

盆底肌肉功能锻炼对中青年女性糖尿病卵巢切除术后性功能的影响

目的:探讨盆底肌肉功能锻炼对中青年女性糖尿病卵巢切除术后性功能的影响。方法:选择2013年1月至2015年3月本院收治的糖尿病且实施双侧卵巢切除术中青年性生活活跃患者80例,按照随机数字法分两组,各40例,观察组实施本研究盆底功能锻炼方法,对照组未针对盆底肌肉功能进行特殊干预,比较术后3d和术后3个月两组盆底肌电压、盆底肌力变化情况、术后3个月两组FSFI评分情况及两组存在性功能相关障碍情况。结果:术后3d两组盆底肌电压、盆底肌力差异无统计学意义(P>0.05),术后3个月两组盆底肌电压高于术后3d(P<0.05),盆底肌肌力高于术后3d(P<0.05);且术后3个月观察组盆底肌电压高于对照组(P<0.05),盆底肌肌力高于对照组(P<0.05)。术后3个月观察组FSFI评分中性欲、性唤起、性高潮及性心理的评分均显著高于对照组(P<0.05)。术后3个月观察组发生阴道干涩、性交痛、性欲低下及性高潮缺失的比例显著低于对照组(P<0.05)。结论:有效的盆底肌肉功能锻炼能显著改善中青年女性糖尿病患者实施卵巢切除术后盆底肌肉功能,提高患者性功能,改善患者生活质量。     

阴道哑铃结合盆底康复治疗仪对产后女性盆底肌功能的改善效果及对患者性功能的影响

目的 探究阴道哑铃结合盆底康复治疗仪改善产后女性盆底肌功能的效果及对性功能的影响。方法 选取2019年5月至2022年6月山西省晋城市第二人民医院收治的141例产妇作为研究对象。根据治疗方法的不同分为联合治疗组(n=76)和哑铃训练组(n=65)。两组均接受产后阴道哑铃训练,联合治疗组在此基础上使用盆底康复治疗仪给予生物反馈电刺激治疗。比较两组治疗前后性功能障碍治疗临床有效率、阴道收缩力(阴道动态压力、阴道收缩持续时间及阴道收缩肌电值)、女性性功能指数、盆底功能[盆底肌力、盆底功能影响问卷简表(PFIQ-7)、盆腔器官脱垂-尿失禁性功能问卷(PISQ-12)]。结果 治疗后,联合治疗组治疗总有效率高于哑铃训练组(P<0.05);治疗后,联合治疗组阴道动态压力、阴道收缩持续时间、阴道收缩肌电值均高于哑铃训练组(P<0.05);治疗后,联合治疗组女性性功能指数各项指标均高于哑铃训练组(P<0.05);治疗后,联合治疗组盆底肌力及PISQ-12评分高于哑铃训练组,PFIQ-7评分低于哑铃训练组(P<0.05)。结论 阴道哑铃结合盆底康复治疗仪能够有效增强产后女性阴道收...     

二至丸联合生物反馈电刺激治疗产后女性性功能障碍的临床研究

目的:观察分析二至丸联合生物反馈电刺激治疗产后女性性功能障碍的的临床疗效。方法:选取2013年2月至2016年2月于我院就诊的产后女性性功能障碍患者72例,采用数字随机法,均分为观察组(n=36)与对照组(n=36),观察组患者给予二至丸联合生物反馈电刺激治疗,对照组患者仅给予生物反馈电刺激治疗,对比两组患者的治疗效果。结果:观察组患者的治疗总有效率显著高于对照组(P0.05);治疗前,两组患者的盆底肌力、阴道动态压力对比差异无统计学意义(P0.05);治疗后,两组患者的盆底肌力、阴道动态压力均显著增加(P0.05),且观察组患者的盆底肌力、阴道动态压力显著优于对照组(P0.05);治疗前,两组患者的性功能对比差异无统计学意义(P0.05);治疗后,两组患者的性功能均显著升高(P0.05),且观察组患者的性功能显著高于对照组(P0.05)。结论:产后女性性功能障碍患者采用二至丸联合生物反馈电刺激治疗,能够有效改善患者的盆地肌肌力及性功能能力,治疗效果良好,具有临床推广使用价值。     

慢性盆腔炎对女性性功能的影响分析

目的:探讨慢性盆腔炎对女性性功能的影响分析,并提出相应的干预措施。方法:选取慢性盆腔炎女性117例及同期健康体检女性110例分别作为观察组和对照组,且使其在年龄、伴侣年龄、性生活年限、妊娠次数以及分娩次数均有可比性。采用《国际女性性功能评估量表》对两组女性性功能状况进行评价,统计两组女性性高潮频率。结果:观察组女性性欲、性唤起、性生活频率、性生活接受度、性高潮、性关系满意度、性行为症状出现7项评分中得分分别为(3.31±0.34)分、(3.17±0.25)分、(2.41±0.16)分、(3.62±0.35)分、(2.33±0.17)分、(3.36±0.28)分和(2.28±0.16)分,对照组女性分别为(6.62±0.21)分、(6.35±0.22)分、(4.96±0.35)分、(7.11±0.53)分、(5.22±0.31)分、(7.32±0.36)分和(4.41±0.38)分,观察组女性明显低于对照组;观察组女性没有性高潮、性高潮频率≤1次/周、1次/周分别有80例(68.38%)、27例(23.08%)和10例(8.55%),对照组女性分别为11例(10.00%)、29例(26.36%)和70例(63.64%),观察组女性性高潮频率明显低于对照组。上述比较两组差异有统计学意义(P0.05)。性功能障碍患者年龄≥35岁、有分娩史者分别占73.68%和80.26%,无性功能障碍者分别占24.39%和46.34%,两组比较差异有统计学意义(P0.05)。结论:慢性盆腔炎会对女性患者的性功能产生不良影响,应积极治疗慢性盆腔炎,改善患者性功能状况,对于年龄较大以及有分娩史,容易发生性功能障碍的患者还应给予适当的心理辅导。     

New fillers for the new man

ABSTRACT:  Two new collagen-based lidocaine-containing dermal fillers, ArteSense™/ArteFill™ (Artes Medical, San Diego, CA) and Evolence® (Colbar LifeScience Ltd., Herzliya, Israel), have proved to be of particular interest to men, many of whom seek a long-lasting or permanent correction. ArteFill™ has been available in the United States since 2006, and it is expected that Evolence® will reach the American market in 2008. The properties of the two products will be described, and experience based on the administration of many hundreds of syringes of both products by a Canadian dermatologist will be detailed here, with tips and precautions to optimize patient outcomes.     

Outcomes and adverse effects of ablative vs nonablative lasers for skin resurfacing: A systematic review of 1093 patients

It is generally believed that ablative laser therapies result in prolonged healing and greater adverse events when compared with nonablative lasers for skin resurfacing. To evaluate the efficacy of ablative laser use for skin resurfacing and adverse events as a consequence of treatment in comparison to other modalities, a PRISMA‐compliant systematic review (Systematic Review Registration Number: 204016) of twelve electronic databases was conducted for the terms “ablative laser” and “skin resurfacing” from March 2002 until July 2020. Studies included meta‐analyses, randomized control trials, cohort studies, and case reports to facilitate evaluation of the data. All articles were evaluated for bias. The search strategy produced 34 studies. Of 1093 patients included in the studies of interest, adverse events were reported in a total of 106 patients (9.7%). Higher rates of adverse events were described in nonablative therapies (12.2% ± 2.19%, 31 events) when compared with ablative therapy (8.28% ± 2.46%, 81 events). 147 patients (13.4%) reported no side effects, 68 (6.22%) reported expected, transient self‐resolving events, and five (0.046%) presented with hypertrophic scarring. Excluding transient events, ablative lasers had fewer complications overall when compared with nonablative lasers (2.56% ± 2.19% vs 7.48% ± 3.29%). This systematic review suggests ablative laser use for skin resurfacing is a safe and effective modality to treat a range of pathologies from photodamage and acne scars to hidradenitis suppurativa and posttraumatic scarring from basal cell carcinoma excision. Further studies are needed, but these results suggest that ablative lasers are a superior, safe, and effective modality to treat damaged skin.     

Genetic alterations in RAS‐regulated pathway in acral lentiginous melanoma

Studies integrating clinicopathological and genetic features have revealed distinct patterns of genomic aberrations in Melanoma. Distributions of BRAF or NRAS mutations and gains of several oncogenes differ among melanoma subgroups, while 9p21 deletions are found in all melanoma subtypes. In the study, status of genes involved in cell cycle progression and apoptosis was evaluated in a panel of 17 frozen primary acral melanomas. NRAS mutations were found in 17% of the tumors. In contrast, BRAF mutations were not found. Gains of AURKA gene (20q13.3) were detected in 37.5% of samples, gains of CCND1 gene (11q13) or TERT gene (5p15.33) in 31.2% and gains of NRAS gene (1p13.2) in 25%. Alterations in 9p21 were identified in 69% of tumors. Gains of 11q13 and 20q13 were mutually exclusive, and 1p13.2 gain was associated with 5p15.33. Our findings showed that alterations in RAS‐related pathways are present in 87.5% of acral lentiginous melanomas.     

Self‐resolving superficial primary cutaneous mucormycosis in a 7‐week‐old infant

A 7‐week‐old girl, born at 30 weeks' gestational age, presented to clinic for evaluation of a crop of vesicular lesions that were noted after removal of a bandage that had been in place for 4 days. A punch biopsy of the lesion revealed fungal elements that were later identified as Rhizopus spp. The lesion began to self‐resolve, and no further treatment was needed, with full resolution of the lesion by 1 month after presentation. Clinicians should be aware of the variable presentations of mucormycosis and consider fungal infection in the differential diagnosis when evaluating vulnerable patients with skin eruptions.     

Multiple New-Onset Subcutaneous Nodules of the Upper Extremity Digits: Giant Cell Tumor of Tendon Sheath and Lipoma

A black woman with the concurrent onset of two subcutaneous nodules located on the digits of her upper extremities is described. Initially, a single systemic disorder was considered; yet, the lesions differed in morphology and consistency. Microscopic examination of the nodules showed a giant cell tumor of tendon sheath and a lipoma. Although Occam's “razor” suggests that multiple lesions in the same person are more likely to represent variable manifestations of a single disorder than several different diseases in that individual, the simultaneously appearing lesions in this patient represented two different conditions.     

Medición del impacto psicológico en pacientes con psoriasis en tratamiento sistémico

Background and objectives

The negative impact of psoriasis on patient quality of life can be as important as the physical consequences of the disease. We could assume that clearance of the disease would also lead to an improvement in its psychosocial impact. The present study assesses the psychological state of patients with psoriasis receiving systemic treatment in a psoriasis unit, especially those with mild or no disease involvement.

Descripción de los ingresos dermatológicos en España (2005-2010). Datos de base poblacional del conjunto mínimo básico de datos

Little is known about the availability and use of dermatological hospitalization, or its temporal trends and the percentage of potentially dermatological diseases treated by non-dermatology departments.