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91.
Introduction and hypothesis To prospectively evaluate anorectal symptoms, quality of life (QoL), sphincter integrity and function after subsequent childbirth
following previous obstetric anal sphincter injuries (OASIS).
Methods A validated Manchester Health Questionnaire, endoanal sonography and manometry were performed during the third trimester and
13 weeks postpartum. Women without objective compromise of anal function were recommended a vaginal delivery and the others
a caesarean section.
Results Seventy-three consecutive women with previous OASIS were seen during a subsequent pregnancy of whom 59 were reviewed 13 weeks
following delivery. Anal manometry findings did not change significantly following a subsequent vaginal delivery or caesarean
section. Only one new defect (internal sphincter) occurred after a vaginal delivery. There was no significant change in symptoms
or QoL. Three (6.8%) sustained repeat OASIS.
Conclusions Women who have no antenatal evidence of objective compromise of anal sphincter function can be reassured that a vaginal delivery
is not associated with any significant deterioration in function or QoL.
This paper was presented at the 36th Annual meeting of the International Continence Society in Christchurch, New Zealand and
a preliminary abstract is published in: Neurourology Urodynamics 2006;25(6):512–513. 相似文献
92.
Stress urinary incontinence 3 years after pregnancy: correlation to mode of delivery and parity 总被引:1,自引:0,他引:1
Viviane Herrmann Katia Scarpa Paulo Cesar Rodrigues Palma Cassio Zanettini Riccetto 《International urogynecology journal》2009,20(3):281-288
The aim was to estimate the incidence of stress urinary incontinence 3 years after delivery and its correlation to mode of
delivery and parity. A longitudinal cohort study was conducted with 120 women at the Antenatal Clinic at the State University
of Campinas. There was a significant difference in the incidence of postpartum stress urinary incontinence (SUI) among patients
with SUI during pregnancy (p > 0.0001). Women that were asymptomatic during pregnancy and had vaginal delivery developed SUI 2.4 times more frequently
than after c-section (19.2% and 8.0%, respectively). The incidence of SUI after delivery dropped significantly in the primiparous
(p = 0.0073) and multiparous 2–3 (p < 0.0001), but not in the multiparous with four or more deliveries (66.7% to 60.0%) (p = 0.5637). A significant correlation has been observed between parity and SUI (p = 0.0299). Pregnancy possibly predisposes to SUI 3 years after delivery as well as parity. No significant correlation has
been demonstrated between mode of delivery and SUI. 相似文献
93.
编制大学生学习状况调查问卷(信度0.688,效标效度为0.775),以北京中医药大学中药学院本科生和研究生为抽样框,收集389份有效问卷。运用频数、相关系数和非参数差异比较检验等统计分析方法。对大学生的学习状况满意度和相关的学习心理素质进行调查分析。研究结果显示:50.5%的被调查学生对自己目前的学习状况感到不满意,约占被调查学生的一半,这个比例大大超过了一般社会现象正态分布中两端分布约各为I/3的分布比例。同时,这个分布比例与笔者在新疆医科大学的调查结论相似;在学习思维模式上,学生并没有形成有利于专业学科学习的客观思维模式;75.0%的学生并不感受到学习问题所带来的学习压力,55.1%的学生体验到强烈的社会压力. 相似文献
94.
The clinical course of early squamous cell carcinoma of oral tongue (OTSCC) is unpredictable and various histopathologic parameters of the primary tumour have been suggested as prognostic factors to be used in clinical decision-making. We reviewed clinicopathologic data of 73 patients diagnosed with Stage I–II OTSCC. Predictive value of pathological T-stage, depth of infiltration, grade, and mode of invasion with respect to local recurrences, occult cervical metastases, and disease specific survival (DSS) was analysed. Depth of infiltration and pT-stage significantly predicted occult nodal disease, while only pT-stage predicted local recurrence. Specific cut-off value for depth of infiltration separating high-risk and low-risk patients was not found. Significant correlations between the histopathologic parameters and DSS were not found. We conclude that depth of infiltration predicted occult nodal disease but its value in clinical decision-making is limited because of poor specificity when using a cut-off value that offers reasonable sensitivity for finding the patients with occult nodal disease. The risk for occult metastases and local recurrence was high in patients with pT2 tumours. 相似文献
95.
Arsenic in drinking water, a mixture of arsenite and arsenate, is associated with increased skin and other cancers in Asia and Latin America, but not the United States. Arsenite alone in drinking water does not cause skin cancers in experimental animals; therefore, it is not a complete carcinogen in skin. We recently showed that low concentrations of arsenite enhanced the tumorigenicity of solar UV irradiation in hairless mice, suggesting arsenic cocarcinogenesis with sunlight in skin cancer and perhaps with different carcinogenic partners for lung and bladder tumors. Cocarcinogenic mechanisms could include blocking DNA repair, stimulating angiogenesis, altering DNA methylation patterns, dysregulating cell cycle control, induction of aneuploidy and blocking apoptosis. Arsenicals are documented clastogens but not strong mutagens, with weak mutagenic activity reported at highly toxic concentrations of inorganic arsenic. Previously, we showed that arsenite, but not monomethylarsonous acid (MMA[III]), induced delayed mutagenesis in HOS cells. Here, we report new data on the mutagenicity of the trivalent methylated arsenic metabolites MMA(III) and dimethylarsinous acid [DMA(III)] at the gpt locus in Chinese hamster G12 cells. Both methylated arsenicals seemed mutagenic with apparent sublinear dose responses. However, significant mutagenesis occurred only at highly toxic concentrations of MMA(III). Most mutants induced by MMA(III) and DMA(III) exhibited transgene deletions. Some non-deletion mutants exhibited altered DNA methylation. A critical discussion of cell survival leads us to conclude that clastogenesis occurs primarily at highly cytotoxic arsenic concentrations, casting further doubt as to whether a genotoxic mode of action (MOA) for arsenicals is supportable. 相似文献
96.
目的:讨论全程护理干预对降低初产妇负性分娩体验以及分娩方式的影响。方法:选择2022年1月至2022年6月来我院产科分娩的400例初产妇,随机分组各200例,对照组施以常规产科护理,研究组施以全程护理,观察两组的干预结局。结果:研究组的自然分娩率(66.00%)高于对照组(48.00%),P<0.05。干预前两组HAMA与HAMD评分相匹配,P>0.05。干预后HAMA与HAMD评分比干预前低,P<0.05。干预后研究组的HAMA与HAMD评分比对照组低,P<0.05。研究组的不良妊娠发生率(2.00%)低于对照组(7.00%),P<0.05。研究组的护理依从率(98.00%)高于对照组(90.50%),P<0.05。结论:全程护理干预可改善初产妇的负性分娩体验与分娩方式、妊娠结局,值得应用推广。 相似文献
97.
听障生作为一个特殊的群体,他们有着强烈的求知欲,也会对异性的身体与行为产生幻想与冲动,多方位探究听障生性健康教育模式,正确引导听障生的思想和行为,促进其顺利地度过青春期,具有非常重要的意义.心理健康研究课题组设计出四种性教育模式,通过社会、学校、家庭三位一体相互配合,来达到对听障生性教育的示范与引导的作用,以促进特教事业的发展. 相似文献
98.
广州市番禺区第二人民医院 《中国卫生质量管理》2023,(1):075-79
隔离酒店是对感染高危人员进行医学观察的定点场所。开展课题研究型品管圈活动,从综合协调组、医疗组、安保组、酒店组4个方面展开现状水平分析,挖掘攻坚点,拟定并筛选方策,包括构建工作人员管理体系、提高医学观察服务水平、全面加强感染防控力度,规范了新冠肺炎疫情下隔离酒店的综合管理。 相似文献
99.
PBL教学作为一种新的教学模式与医学伦理学的教学目标、教学设计相契合,有助于增强医学伦理学的教学实效性,从而激发医学生医德理论认知的兴趣;有利于培养医学生的职业情感;有利于锻炼学生的伦理思维和伦理决策能力。医学伦理学中PBL的实施过程包括:围绕主题,设置情境;根据问题进行分工;共同协商,解决问题;集中汇报,成果交流;进行评价,集中反馈。医学伦理学PBL教学中应注意教师教学观念的转变、恰当选择问题、注重组织和引导。 相似文献
100.
《The journal of maternal-fetal & neonatal medicine》2013,26(10):1106-1113
Objective.?This randomised trial was designed to study the psychological status and morbidity during and after delivery among women with a previous cesarean section (CS) who were randomised to planned vaginal birth (VBAC) or planned CS.Methods.?Two hundred and ninety-eight women with one previous lower segment CS were randomised to either planned VBAC or planned CS. Women were asked to complete psychometric scales during their pregnancy till 6 months after confinement. The primary outcome studied was the differences in psychometric scores between the two study groups.Results.?There were no differences in anxiety, depression, psychological well-being or satisfaction scores between the two groups. Significantly more women in planned VBAC (27/123) requested to change to elective CS, compared to those who were randomised to planned CS (15/135) initially requested to change to planned VBAC (OR: 2.25; 95% CI: 1.13–4.47). Subgroup analyses showed that women who changed from planned CS to VBAC had lower satisfaction at delivery [Client Satisfaction Score: 24.0 (23.0–24.3), 23.0 (22.0–24.0); p?=?0.009] compared to women who did not change their plan for elective CS.Conclusions.?The planned mode of delivery, either elective CS or VBAC, in pregnant women who had one previous CS did not influence the psychological dynamic during the course of or after the pregnancy. VBAC was not associated with higher psychological morbidity and therefore should be encouraged. 相似文献