Efectos maternos y neonatales del parto en el agua. Una revisión sistemática

The objective of this literature review is to determine the maternal and neonatal effects of immersion in water during childbirth. A literature review was carried out in the PubMed, Medline, Scopus, and Cinahl databases. The search terms used were: “Water”, “Delivery”, “Obstetrics”, “Labour”, “Parturition”, and “water birth”. A total of 526 results published in the last 5 years were obtained, of which 13 articles were selected according to the inclusion and exclusion criteria. The studies aimed to evaluate maternal and / or neonatal outcomes after immersion in water during childbirth, although some of them only focus on one of these two aspects. In conclusion, immersion in water provides a reduction in pain and in the duration of labour at maternal level. At neonatal level, no adverse effects are found in newborns.     

腹部开放性损伤合并海水浸泡时血浆酶的变化

目的 观察腹部开放性损伤合并海水浸泡时，在不同的时间血浆酶的变化。方法 60只雄性Wistar鼠随机分为2组：对照组(n=30)及实验组(n=30)。对照组为单纯腹部开放伤，伤后直接观察。实验组(海水浸泡组)为单纯腹部开放伤后立即置人海水中，入水后30、60、120min时间段各取1O只鼠采血，检测血浆肌酸激酶(CK)、乳酸脱氢酶(LDH)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)的变化。结果 实验组血浆酶在短时间内就发生了剧烈的变化，其检测指标与对照组比相差非常显。结论 实验组与对照组比酶学变化有明显不同，经海水浸泡的时间愈长，上述变化愈严重，对机体的危害性愈大。     

浅述蒙医浸泡疗法之发展

浸泡疗法是蒙古族传统医学中的一类外治疗法，包括瑟必素疗法、矿泉疗法、药浴、喷酒法等。其历史悠久，在古代文献中（汉文或蒙古文）有所记载。它的起源与发展与蒙古高原游牧文化有着密切联系。     

Effective compliance of the circulation in the upright sitting posture

The effective compliance is defined as the relation of change in blood volume to change in central venous pressure. It was measured in 8 upright sitting male subjects and amounted to 3.3 ml/(mm Hg×kg BW). It is, therefore, by about 50% greater than the effective compliance in the supine subject which amounts to 2.3 ml/(mm Hg×kg BW). This difference is probably due to the posture dependent blood volume distribution in the low pressure system whose upper and lower sections have nonlinear pressure-volume characteristics. Immersion to the neck reduces the effective compliance to about half the control value (1.9 ml/(mm Hg×kg BW) which probably constitutes the effective compliance of the intrathoracic circulatory compartment.The results were partly presented at the Annual Meeting of the German Physiological Society [Pflügers Arch.355, R24 (1975)]     

The effect of graded immersion on heart volume,central venous pressure,pulmonary blood distribution,and heart rate in man

The present experiments have been conducted to study the immediate effects of graded immersion on the central circulation. When taking heart volume as an indicator, it was found that immersion to the diaphragm of a standing subject produces the same changes as assumption of the supine posture. Heart volume increases by approximately 130ml. When the water level is raised to the neck, an extra pressure corresponding to a water column extending from the diaphragm to the surface of the water of approximately 25 cm H₂O forces blood into the thorax. The heart becomes distended by an additional 120ml. Correspondingly the central venous pressure at the height of the right atrium increases from 2.5 to 12.8 mm Hg when the water level rises from the diaphragm to the neck. The greater filling of the pulmonary circulation is accompanied by a decrease in vital capacity and visualized by scintigrams. The preferential increase in blood volume of the apical regions is striking. When raising the water level from the symphysis to the xiphoid heart rate falls by about 15%.     

Time course of cardiac distension with rapid immersion in a thermo-neutral bath

13 subjects standing in a narrow upright tank were exposed to rapid water immersion up to the neck. The tank was filled from an elevated reservoir in less than 4 s. In 8 subjects heart size was measured by Roentgen-cinematography combined with video tape recording. Planimetry of the diastolic postero-anterior area of the heart showed an average increase in heart size of 30% within 6 s. In 5 subjects central venous pressure and the height of hydrostatic pressure in the tank were recorded. The two pressures rose and fell simultaneously without delay when the hydrostatic pressure exceeded the level of the diaphragm. Rapid immersion caused a fall in heart rate of approximately 20%. The findings speak in favor of the concept that the right heart does not constitute a resistance and that the pulmonary circulation and the systemic capacitance vessels form a functional unit.     

Effect of changing water depth on muscle activity and motion kinematics during sit-to-stand motion

BackgroundSit-to-stand (STS) movement is a fundamental activity in daily life. Studies have examined the effect of water depth during aquatic exercise; however, no investigation has examined the effect of water depth on STS movements.Research questionThis study examined whether changing water depth affected muscle activity and motion kinematics during the STS movement.MethodsEleven participants performed the STS movement on the ground (land) and at different water depths (1.0-m [deep] and 0.6-m [shallow]) at a self-determined pace. Lower extremity and trunk muscle activity, lower extremity joint angle, and trunk segment inclination angle were measured. Mean muscle activity during STS movement, initial and final postures, and range of motion of each angle was evaluated. Correlations of a normalised time-series pattern of electromyography and motion kinematics measures between land and shallow (land-shallow) and between land and deep (land-deep) were investigated.ResultsThe rectus femoris was more active in shallow than in deep water STS movement but less than that in land STS. Other muscles showed no significant differences between shallow and land STS movement. Correlation of the time series pattern in the tibialis anterior, rectus femoris, and erector spinae muscles was higher in the land-shallow than the land-deep STS. The trunk showed more forward inclination in the shallow STS than the land but less than the deep. Correlation of the time series pattern in the hip joint and trunk inclination angles was higher in the land-shallow STS than in the land-deep STS.SignificanceSTS exercise in the shallow water depth reduced muscle load for the knee extensor but not for other muscles. The muscle activity pattern showed a higher correlation between the land STS and shallow water than deep. Sitting posture becomes upright when the water depth decreases, but a similar motion pattern could be attained regardless of water depth.     

The effects of immersion and exercise on prolactin during pregnancy

Summary Prolactin is an important hormone during pregnancy, affecting mother, fetus, and amniotic fluid volume. Immersion is known to affect prolactin levels significantly. To determine the effect of immersion and exercise on the prolactin response during pregnancy, we examined serum prolactin levels at 15, 25, and 35 weeks' gestation and 10 weeks post partum. Twelve women completed 20 min land rest, 20 min immersion in 30° C water to the xiphoid, and 20 min exercise in the water at 60% Resting prolactin levels were 1.91±0.32, 4.55±0.5, and 5.85±0.27 nmol·l^–1 ±standard error of the mean at 15, 25, and 35 weeks' gestation, respectively. Postpartum lactating women had a resting mean prolactin level of 3.95±1.6 versus 0.22±0.4 nmol· l^–1 in non-lacting women. Prolactin levels declined significantly during immersion even after correction for dilution by plasma volume shifts. The immersion response was inversely related to the duration of pregnancy with 29%, 22%, and 12% drops during 15-, 25- and 35-week trials, respectively. Compared to rest, exercise prolactin levels remained depressed during the 15th and 25th week trials. We hypothesize that immersion in water caused prolactin levels to decline.     

海水浸泡踝膝关节开放损伤的治疗

目的：探讨海水浸泡踝、膝关节开放损伤的治疗。方法：自1986-02～2003-0l,海水浸泡踝、膝关节开放损伤共4l例47个关节,均于彻底清创后关节内骨折复位内固定、一期闭合创面、一期行局部皮瓣或肌皮瓣转移修复关节周围软组织明显缺损。结果：皮瓣或肌皮瓣全部存活。创部Ⅱ／甲愈合25个关节(占51．2％),Ⅱ／乙愈合18个关节(占38．3％),仅4个关节出现感染征象(占8．5％)。随访6个月～16年10个月,关节内骨折均愈合,踝、膝关节功能恢复满意,膝关节功能优6例,良4例,可l例;踝关节功能优14例,良8例,可l例,差l例。但是,伤后5～7年以上者匀出现不同程度的关节退变表现。结论：海水浸泡时间不超过2h、伤后时间在6～8h以内的踝、膝关节开放损伤,均可于彻底清创后一期处理关节内骨折和闭合创面,局部皮瓣或肌皮瓣转移修复软组织缺损是可行的。     

Flexural strength of fluorapatite-leucite and fluorapatite porcelains exposed to erosive agents in cyclic immersion

Objective

The aim of this study was to evaluate the flexural strength of two porcelain materials (IPS d.SIGN and IPS e.max Ceram) exposed to erosive agents

Material and Methods

One hundred and twenty bar-shaped specimens were made from each of fluorapatite-leucite porcelain (IPS d.SIGN) and fluorapatite porcelain (IPS e.max Ceram) and divided into 8 groups of 15 specimens each. Six groups were alternately immersed in the following storage agents for 30 min: deionized water (control), citrate buffer solution, pineapple juice, green mango juice, cola soft drink and 4% acetic acid. Then, they were immersed for 5 min in deionized water at 37°C. Seven cycles were completed, totalizing 245 min. A 7^th group was continuously immersed in 4% acetic acid at 80°C for 16 h. The final, 8^th, group was stored dry at 37°C for 245 min. Three-point bending tests were performed in a universal testing machine. The data were analyzed statistically by 2-way ANOVA, Tukey’s HSD test and t-test at significance level of 0.05.

Results

The flexural strengths of all groups of each porcelain after exposure to erosive agents in cyclic immersion did not differ significantly (p>0.05). For both types of porcelain, dry storage at 37°C yielded the highest flexural strength, though without significant difference from the other groups (p>0.05). The flexural strengths of all groups of fluorapatite porcelains were significantly higher (p<0.05) than those of the fluorapatite-leucite porcelains.

Conclusions

This study demonstrated that the erosive agents evaluated did not affect the flexural strength of the tested dental porcelains.