RESUMO
Physiological changes in the bladder that occur during pregnancy predispose women to develop symptomatic retention of urine during the first hours to days after birth (Saultz et al 1991, Lose et al 1992). A basic definition of postpartum urinary retention (PUR) is the lack of spontaneous micturition six hours after vaginal birth or after removing an indwelling catheter (Humburg 2008). PUR after vaginal birth is a relatively common event, with the reported incidence ranging from 1.7 per cent to 17.9 per cent (Carley et al 2002, Ching-Chung et al 2002, Glavind and Bjørk 2003, Yip et al 2004). When examining why PUR occurs following vaginal birth research often states that instrument-assisted birth and regional analgesia are both independently associated (MacLennan 2002, Groutz 2001,Teo et al 2007). Other common risk factors include primiparity, prolonged first and second stage, perineal damage and oxytocin use (MacLennan 2002, Glavind and Bjørk 2003, Humburg 2008, Groutz et al 2001, Teo et al 2007). Unrecognised urinary retention and mismanagement may lead to recurrent urinary tract infections, upper urinary tract damage and permanent voiding difficulties (Groutz et al 2001). Humburg (2008) suggests that, overall, the lack of guidelines is one of the major problems in treating women with PUR. Careful questioning and examination from the midwife should always be performed to avoid any complication.
Assuntos
Tocologia/métodos , Relações Enfermeiro-Paciente , Padrões de Prática em Enfermagem , Transtornos Puerperais/enfermagem , Retenção Urinária/enfermagem , Feminino , Humanos , Papel do Profissional de Enfermagem , Diagnóstico de Enfermagem/métodos , Período Pós-Parto , Transtornos Puerperais/diagnóstico , Transtornos Puerperais/prevenção & controle , Fatores de Risco , Retenção Urinária/diagnóstico , Retenção Urinária/prevenção & controle , Urodinâmica , Saúde da MulherAssuntos
Intervenção em Crise/métodos , Depressão Pós-Parto/prevenção & controle , Tocologia/métodos , Papel do Profissional de Enfermagem , Relações Enfermeiro-Paciente , Cuidado Pós-Natal/métodos , Aconselhamento/métodos , Feminino , Humanos , Recém-Nascido , Mães/psicologia , Pesquisa em Avaliação de Enfermagem , Gravidez , Transtornos de Estresse Pós-Traumáticos/prevenção & controleRESUMO
Chronic myeloid leukaemia is a condition that affects around 600 people a year in the UK. The only curative intervention to date has been bone-marrow transplantation. A combined drug therapy featuring interferon and a new drug called imatinib has shown encouraging results in recent trials. In one trial of 532 patients, 60% achieved a major cytogenetic response, while in 41% no leukaemia could be detected using normal cytogenetic techniques. This article provides background on the nature of chronic myeloid leukaemia, and discusses the imatinib trial results and indications for future treatments.