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Mode of delivery and pelvic floor muscle strength and sexual function after childbirth. 总被引:3,自引:0,他引:3
Y B Baytur A Deveci Y Uyar H T Ozcakir S Kizilkaya H Caglar 《International journal of gynaecology and obstetrics》2005,88(3):276-280
OBJECTIVE: To investigate the respective roles of the mode of delivery and strength of pelvic floor muscles in the sexual function of women. METHOD: Thirty-two women who were delivered vaginally and 21 women who underwent cesarean delivery at the Celal Bayar University School of Medicine Obstetrics Department were enrolled in the study, and 15 nulliparas were recruited as controls. Sexual function was assessed in all women by a validated questionnaire (the Female Sexual Function Index). Desire, arousal, lubrication, orgasm, satisfaction, and pain were measured separately, and pelvic floor muscle strength was assessed by a perineometer. Sexual function was compared among the 3 groups. The correlation between pelvic floor muscle strength and sexual function was also investigated. RESULTS: Pelvic floor muscle strength was significantly lower in the group vaginally delivered compared with the group delivered by cesarean section and the nulliparous group (P<0.05). There was no difference between the groups regarding sexual function (P>0.05), and there was also no correlation between sexual function and pelvic muscle strength. CONCLUSION: Pelvic floor muscle strength and mode of delivery did not affect sexual function in our study participants. The muscular component of female sexual function should be further investigated. 相似文献
74.
设计开发了一个医疗器材智能管理系统,改善了医疗器材采购与管理流程,降低了库存量。此系统具有智能、稳定、易用的特点,克服了现有的一些医院M IS的通病。本系统的开发实施,为日益复杂的医院医疗器材的采购与管理事务提供了一个有效的解决方案。 相似文献
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The selective serotonin reuptake inhibitors (SSRIs) have emerged as a major therapeutic advance in psychiatry. They have emphasized the pathophysiological role of serotonin (5-HT) in affective disorders. Indeed, SSRIs were developed for inhibition of the neuronal uptake for serotonin (5-HT), a property shared with the TCAs (tricyclic anti-depressants), but without affecting the other various central neuroreceptors (ie, histamine, acetylcholine and adrenergic receptors) that are responsible for many of the safety and tolerability problems with TCAs. In this way, fluoxetine and other SSRIs represent a major advance over tricyclics, because of their lower toxicity. While the position of fluoxetine relative to other selective serotoninergic antidepressants requires further investigation, fluoxetine has a more favorable tolerability profile for a similar efficacy in comparison to tricyclic antidepressants. The pharmacokinetic and pharmacodynamic properties of fluoxetine are well described. After oral administration, fluoxetine is almost completely absorbed. Due to hepatic first-pass metabolism, the oral bioavailability is < 90%. Fluoxetine has a half-life of 2-7 days, whereas the half-life of norfluoxetine ranges between 4 and 15 days. This long half-life of fluoxetine may be advantageous when the patient omits a dose since drug concentrations decrease slightly. On the other hand, in the case of fluoxetine non-response, long washout periods are necessary before switching the patient to a TCA or a MAO inhibitor to avoid drug interactions or the development of a 5-HT syndrome. As a class, SSRIs are considerably more selective in comparison to TCAs in terms of their central nervous system mechanisms, but differ in other clinically relevant aspects. This action affects several specific 5-HT receptors, which, in turn, effects a multitude of neural systems and signalization pathways. However, despite the facilitating serotoninergic neurotransmission, the direct mechanism by which a SSRI exerts its anti-depressant activity remains uncertain. The therapeutic response in major depression for SSRIs (ie 15-20 days) maybe due to a progressive desensitization of somatodendritic 5-HT autoreceptors in the midbrain raphe nucleus. On the other hand, it has also been postulated that 5-HT is a modulator of several neurophysiological pathways, including dopamine, noradrenaline, but also neurotrophic factors, intra-cytoplasmic phosphorylations and nuclear genes expression. Therapeutic activity of SSRIs may finally results in a complex modulation and homeostasis between monoaminergic neurotransmisson and neuronal plasticity. In term of health-care, the introduction of fluoxetine and other SSRIs in the 1980s has radically changed the treatment of depressive disorder worldwide and they have emerged as the first line of treatment for depressive disorders. The efficacy of fluoxetine is now well established in the treatment of major depressive disorder. Indeed, this efficacy has been assessed in numerous clinical controlled trials involving patients with major depressive disorders. Meta-analysis were carried out and confirmed that fluoxetine was as effective as the tricyclic antidepressants, and appeared more effective than placebo in improving the symptoms of depression. However, there is no scientific evidence to suggest that any one SSRI is more effective than another, but not all patients respond to the same agent. Looking to the future, we need further comparative studies of the SSRIs with the next generation of antidepressants such as 5-HT noradrenaline reuptake inhibitors (SNRIs, Venlafaxine). Actually, it is interesting to note that, whereas the emphasis with the SSRIs has been on their selectivity, recent developments have tended to move towards less selective agents, and now to other neurobiological pathways (ie neurotrophic factors). Finally, fluoxetine, in common with other SSRIs, remains today a first-line treatment option for major depressive disorder. 相似文献
77.
王广顺 《中国烧伤创疡杂志》2003,15(1):75-80
目的:为了适应教育服务与复合型人才培养要求,探讨原位再生医学教育人才培养策略。方法:试从原位再生医学教育面临的问题、再生医学教育背景、教育模式、培养目标和再生医学精神方面论述原位再生医学教育人才培养模式思考。通过科学和艺术双重特点教育手段.再生医学基础理论突出实用性;再生医学专业理论突出针对性、再生医学人文知识突出应用性、淡化烧伤外科意识和学科意识。通过教学培育再生医学精神,如平等的多元化意识,理性的批判态度、自由的个性特征和非功利的超现实追求。使之成为毕生昂然进取、发奋建树、渴望勤勉之后的荣誉和荣誉之后淡泊的超越前人的一代“再生医学人”.通过教学培育人文精神.如“经验、体察、认知为特征的利学主体精种.以仁爱、克己、敬业为特征的伦理主体精神,以激情、想象、形象为特征的审美主体精神。将烧伤新例分析救治过程引入课堂,构建学习再生医学知识、培养能力、提高素质融为一体的课程体系.以再生医学技术应用能力和基本知识为主线的理论教学体系和实践教学体系,即课堂教学-临床见习教学-实习教学一体的培养模式。结果:经过十余年的艰苦探索和实践.再生医学教育的教学成果不仅使我们拥有了3届专业思想稳定,深受用人单位欢迎的毕业生,更重要是锻炼了以烧伤科为基础的一支具有一定专业知识和教学能力的教师队伍。结论:构建我国原位再生医学教育人才培养模式,对于培养质量高的、具有创新和竞争力的高级原位再生医学专门人才有着重要意义。 相似文献
78.
Purpose. We conducted this study to find out whether the peak-to-peak pulsatility index (PPI) predicted graft failure and which factors affected the PPI.Methods. Color-duplex sonography was used to take 520 scans of 74 infrainguinal bypasses, 62 of which were femoropopliteal bypasses and 12 of which were femorocrural bypasses. Vessel diameter and velocity waveform were measured in the graft as well as in the proximal and distal arteries.Results. There were 13 cases of graft failure. The PPI in the mid-graft was significantly different in the normal group (12.30 ± 8.77) and the graft failure group (4.17 ± 1.79). A PPI of less than 7.0 in the mid-graft was defined as graft failure, with a sensitivity of 96.0% and a specificity of 77.6%. There was no correlation between the graft diameter and the PPI. The average mode frequency was inversely correlated with the PPI (PPI = 44.8 × Mode F–1 + 3.50, correlation co-efficient: 0.78).Conclusion. One point measurement of the PPI in the mid-graft could be a simple and useful parameter for diagnosing graft failure, based on our finding that the waveform was very similar in the proximal artery, the entire graft, and the distal artery. PPI was inversely correlated with average mode frequency because reverse flow decreased or diminished when a significant stenosis existed. 相似文献
79.
内镜中心创新模式的建立 总被引:2,自引:0,他引:2
为促进学科间协调发展、优化资源配量,该院将消化科内镜室、普通外科内窥镜室、纤维支气管镜室和膀胱镜检查室整合为内镜中心,实现了内镜检查的中心化、一体化管理。文章通过阐述内镜中心的发展思路、管理模式与主要结构,介绍该院内镜中心的工作模式与管理体会。 相似文献
80.
Renal Prognosis in Alport's and Related Syndromes: Influence of the Mode of Inheritance 总被引:3,自引:2,他引:1
Pochet J.-M.; Bobrie G.; Landais P.; Goldfarb B.; Grunfeld J.-P. 《Nephrology, dialysis, transplantation》1989,4(12):1016-1021
Progressive hereditary nephritis is subdivided into Alport'ssyndrome (with extrarenal involvement) and hereditary nephritiswithout deafness. Three modes of inheritance have been described:X-linked dominant, autosomal dominant, and autosomal recessive.We reviewed the mode of inheritance in 48 kindred with hereditarynephritis (41 with Alport's syndrome and 7 with hereditary nephritiswithout deafness). It was presumed X-linked dominant in 34 Alport'ssyndrome and 6 hereditary nephritis without deafness, autosomaldominant in five hereditary nephritis and one hereditary nephritiswithout deafness, and autosomal recessive in two Alport's syndrome.We studied the cumulative renal survival of 149 patients, 128(76 males, 52 females) with Alport's syndrome and 21 (10 males,and 11 females) with hereditary nephritis without deafness.Major prognostic factors were the patient's sex (median renalsurvival in males and females being respectively 32 versus 61years in Alport's syndrome and 34 versus 57 years in hereditarynephritis without deafness), and the mode of inheritance (medianrenal survival in males being 25 years in X-linked dominantAlport's syndrome versus 51 years in autosomal dominant Alport'ssyndrome). The presence of hearing loss in the kindred or inthe patient himself did not appear as a significant prognosticfactor. We conclude that Alport's syndrome and hereditary nephritiswithout deafness are predominantly X-linked dominant diseaseswith the same renal outcome, and that in Alport's syndrome thepatient's sex and the mode of inheritance are two independentprognostic factors. 相似文献