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61.
Severe adverse effects during the use of ovulation inhibitors occur mostly in women who have an elevated risk for the development of certain diseases owing to hereditary or acquired factors. By means of a careful personal or family history analysis as well as specific laboratory examinations, an existing predisposition may frequently be diagnosed and the individual risk associated with the use of oral contraceptive inhibitors may be estimated. The present contribution describes the potential effects of treatment with ovulation inhibitors on women with thrombophilia, cardiovascular disease, diabetes mellitus, dyslipidemia, overweight or underweight, tumors, psychiatric and neurological diseases and autoimmune disease. The hormonal methods and non-hormonal alternatives available for contraception are elucidated according to existing lesions and risk factors and the advantages and disadvantages are discussed. 相似文献
62.
Dr. R. Hinrichs L. Weber K. Scharffetter-Kochanek 《Der Hautarzt; Zeitschrift für Dermatologie, Venerologie, und verwandte Gebiete》2006,57(5):455-458
Ohne Zusammenfassung 相似文献
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Ashutosh Singh M.Ch. Vidyut Kumar Sinha M.Ch. Jayant Khandekar M.Ch. Nandkishor Agrawal M.Ch. Anil Patwardhan M.Ch. Dr. Jagdish Kharideparkar M.Ch. 《Indian Journal of Thoracic and Cardiovascular Surgery》2006,22(2):121-125
Objective The degree of Left Ventricular Mass Index (LVMI) regression following aortic valve replacement correlates with long-term survival.
This study aims to assess the extent of LVMI regression at 3 months following aortic valve replacement (AVR) with different
types and sizes of mechanical valves in rheumatic aortic valve disease.
Methods The LVMI regression was studied in 34 consecutive patients, undergoing elective AVR for rheumatic aortic stenosis and/or regurgitation.
They were grouped in A and B, matched in age, body surface area and pre-operative LVMI, receiving respectively a tilting disc
and a bileaflet mechanical valve. The LVMI was calculated by M-mode echocardiography using the Devereux' formula pre-operatively
and three months post-operatively. The trend of LVMI reduction was compared between the two groups and amongst the patients
with stenotic, regurgitant and mixed aortic valve, pathologies; and receiving different sizes of valves.
Results The mean preoperative LVMI was 199g±79.5 g/m2. At three months post aortic valve replacement, the mean LVMI was 130g±49.0 g/m2. There was a significant reduction of LVMI post-operatively (p=0.001) at three months follow-up. The extent of LVMI regression
following surgery amongst the groups A and B did not vary significantly (p=0.92). The extent of LVMI regression did not vary
significantly in patients with different aortic valve pathology nor with different sizes of the valves implanted.
Conclusions There is a significant early LVMI regression following aortic valve replacement in rheumatic aortic valve disease. The type
and the size of the mechanical prosthesis or the rheumatic pathology do not appear to influence this regression. 相似文献
66.
In obstetrics and gynaecology, as well as in many other fields of medicine, ultrasound has become an indispensable diagnostic tool. Ultrasound training, however, still lacks proper quality assessment and control. In fact, in prenatal diagnostics most fetal anomalies requiring diagnosis during pregnancy are extremely rare. Therefore, effective training opportunities are limited to the very few medical centres which treat many such cases. Ultrasound simulator-based training, as performed with the Sonofit Sonotrainer, has been demonstrated to partly overcome this dilemma. In this article, the authors summarize their experience in using and evaluating various teaching concepts after the implementation of the ultrasound simulator under different conditions. Furthermore, an overview of the advantages of the Sonotrainer-based ultrasound training and its acceptance among trainees is provided. The authors also focus on aspects of quality assessment in gynaecological and prenatal ultrasound. 相似文献
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Dr. Menon Raj Gopal M.Ch. AlDelamie Taha FRCS Valliathu John FRCS Zacharias Sunny FRCS Lawati Al Adil FRCS Venkatraman M.Ch. 《Indian Journal of Thoracic and Cardiovascular Surgery》2006,22(3):173-177
Background Despite improving surgical techniques, treatment of heart valve disease in children remains controversial. Somatic growth
and adequate anticoagulation are of concern when children undergo valve replacement. We conducted this study to evaluate the
performance of valves in this age group.
Methods 42 children under the age of 13 years who underwent valve replacement were included in this study. Totally, 50 valves were
implanted in 42 patients: 48 were mechanical prostheses, two were bioprosthetic both in pulmonary position. 37 (74%) valves
were implanted in mitral position, 10 (20%) in aortic position, 1 (2%) in tricuspid position and 2 (4%) in pulmonary position.
Preoperatively, 14 (33,3%) patients were in New York Heart Association (NYHA) class IV, while 27 (64.2%) were in NYHA class
III.
Results There were 2 (4.7%) hospital deaths and 2 (4.7%) late deaths while 2 (4.7%) patients were lost to follow up. The mean follow
up period was 9.4 yrs. 35 (83.3%) patients are in NYHA Class I and free of all medications except warfarin. 3 (7.1%) patients
have undergone 5 successful pregnancies. The median INR was 2.23. Major thrombo-embolic episode occurred in 1 (2.3%) patient.
Conclusions In view of the problems of sizing, anticoagulation and need for re-operation at an early age, there is a reluctance to replace
valves in children. This study shows that despite these problems, valve replacement can be undertaken safely and successfully
in children, when repair has failed or not technically feasible. 相似文献