Incidence and risk factors for chronic pain after elective caesarean delivery under spinal anaesthesia in a Chinese cohort: a prospective study.

BACKGROUND: China has one of the highest rates of caesarean delivery in the world. The aim of this study was to investigate the incidence and risk factors for chronic pain after caesarean delivery in a Chinese cohort. METHODS: Patients undergoing elective caesarean delivery with a Pfannenstiel incision under spinal anaesthesia were recruited prospectively at a Chinese tertiary women's hospital. The State Trait Anxiety Inventory was measured before surgery. Postoperative analgesia was provided by intravenous patient-controlled analgesia for 48 hours. Postoperative acute pain scores and analgesic consumption were assessed. After 3, 6 and 12 months, patients were interviewed by telephone regarding whether pain was present, and if present, the intensity, frequency, location and impact of the pain. RESULTS: In total 786 patients completed this study. The incidence of pain at 3, 6 and 12 months was 12.2%, 3.8% and 0.8% respectively. Of patients with pain at 3 months, most patients experienced pain daily (43.7%) or with intervals of a day or more between pain (41.7%), with intensity overall described as mild to moderate. The most common sites of pain were the incision or nearby (56.3%), and the low back (36.4%). Risk factors for pain at 3 months included previous caesarean delivery and higher analgesic consumption at 24 h and 48 h postoperatively. CONCLUSION: Chronic pain after elective caesarean delivery under spinal anaesthesia occurs infrequently, especially in the long-term, in a Chinese population. Patients with a previous caesarean delivery and higher analgesic use were at increased risk.

Subjective symptoms of medical students exposed to formaldehyde during a gross anatomy dissection course.

The purpose of this study is to investigate the safety of and to try to find the best plan to cope with exposure to FA for students during a gross anatomy dissection course. The FA exposure level and subjective symptoms was estimated. The relationship between exposure to FA and subjective symptoms of irritation were discussed for times; before, in the beginning period, in the middle period, and upon completion of the Anatomy Dissection Course. The geometric means of FA concentration were 32.7 micrograms/m3 (before), 891.3 micrograms/m3 (beginning), 763.3 micrograms/m3 (middle), and 238.9 micrograms/m3 (completion), respectively. Among them, FA-related symptoms were observed in 61.1 percent; 28.0 percent fell strong stress during the course, and 27.4 percent complained that their normal life situation was affected. Our results indicate that such subjective symptoms during the anatomy dissection course were related to the period spent in the anatomy dissection room. Our study suggests that shortening the time of each anatomy dissection practical class and reduction of the number of cadaver tables could help to reduce symptoms.

[A Japanese language version of the health-promoting lifestyle profile].

The development and initial psychometric evaluation of a Japanese version of the Health-Promoting Lifestyle Profile II (HPLP II) is described. The 52-item instrument was translated into Japanese and was found to be culturally relevant and reliable in a pilot study. The Japanese version was then administered to adiverse but predominantly Japanese group of 337 subjects residing in northern Japan. The Japanese version of the HPLP II was evaluated using factor analysis and reliability measurement. Six factors similar to those isolated previously during psychometric assessment of the English language version were extracted. Those six dimensions comprise the HPLP II subscales of: 1. Health responsibility, 2. Spiritual growth, 3. Physical activity, 4. Interpersonal relations, 5. Nutrition, and 6. Stress management. The alpha reliability coefficient for the total scale was 0.94 and the 2-week retest reliability was 0.91; the alpha coefficients for the subscales ranged from 0.70 to 0.87. The Japanese language version of the HPLP II appears to have sufficient validity and reliability for use by researchers who wish to describe the health-promoting components of lifestyle among the Japanese population and to explore differences and similarities in the health-promoting lifestyle of Japanese and American subjects or those of other ethnic groups. Further evaluations of measurement with different populations appears warranted. This instrument will enable researchers to investigate patterns and determinants of health-promoting lifestyle, as well as the effects of interventions to alter the lifestyle.

Specific desensitization of the epidermal growth factor receptor by pp60v-src.

BALB/c 3T3 cells infected with a temperature-sensitive mutant (LA90) of RSV have been used to investigate possible heterologous interactions between the pp60v-src tyrosyl kinase and the epidermal growth factor (EGF) and bradykinin receptors. The LA90 pp60v-src exhibits a very rapid activation t1/2 (less than 5 min) of protein kinase activity on decreasing the temperature from 40 degrees C to 35 degrees C. This change in temperature was also found to induce a very rapid decrease in the affinity for 125I-EGF of receptors on the RSV-LA90-infected cells but not of those on control parental cells. However, no significant changes were detected in the binding of 3H-bradykinin to either cell line. Two separable processes control the desensitization of the EGF receptor by pp60v-src, both of which are independent of protein kinase C. The first is rapid and transient, while the second is sensitive to cycloheximide and persists long after inactivation of pp60v-src.