RESUMO
Laparoscopic female sterilization is still the leading method of family planning for patients who have completed their family. Mechanical methods include clips and rings and are preferred because they are safe and efficient and can be used on a day case basis. Appropriate training ensures improved results with fewer complications. Clips and rings have an improved reversal potential.
Assuntos
Laparoscopia , Esterilização Tubária/métodos , Serviços de Planejamento Familiar/métodos , Feminino , Humanos , Laparoscopia/mortalidade , Gravidez , Gravidez Ectópica/mortalidade , Gravidez Ectópica/cirurgia , Esterilização Tubária/mortalidade , Taxa de Sobrevida , Estados Unidos/epidemiologiaRESUMO
This review aims to describe the development of the no-scalpel technique and to summarize the available results. An attempt is made to simplify the training of surgeons in the no-scalpel vasectomy technique. This technique uses the method described by Dr Li Shunqiang, utilizing a dedicated vas-grasping forceps; a sharp dedicated dissecting forceps, scissors and sutures are all that are required in addition. In a simple comparative study in Bangkok involving 1203 patients, it was found that the no-scalpel technique was faster. In the 19 cases of complications of symphysis and hemorrhage, 16 occurred using the standard technique (3.1 per 100 patients) and three from the no-scalpel technique (0.4 per 100 patients). The no-scalpel technique is probably more difficult to learn but requires fewer resources. The operation is nearly twice as fast as the standard technique with approximately one-eighth of its complications.
Assuntos
Dissecação/métodos , Vasectomia/métodos , Competência Clínica , Dissecação/instrumentação , Humanos , Masculino , Hemorragia Pós-Operatória/etiologia , Infecção da Ferida Cirúrgica/etiologia , Técnicas de Sutura , Fatores de Tempo , Vasectomia/efeitos adversos , Vasectomia/instrumentaçãoRESUMO
Serotonin, known for its beneficial action on mood and well-being, is also involved in cardiovascular functions. Thus the current work was undertaken to study the effect of hormone replacement therapy on serotonin turnover in postmenopausal women. Eighteen women received estradiol transdermally and 17 women estradiol valerate orally for 4 weeks. The serotonin metabolite 5-hydroxyindole acetic acid (5-HIAA) was determined in the urine before, and after 2 and 4 weeks' estradiol treatment. With both administration routes estradiol produced a significant increase in urinary 5-HIAA excretion, greatest with transdermal estradiol after 28 days of treatment. The enhancement of serotonin turnover may contribute not only to an improvement of mood and well-being but also to a cardioprotective effect of estradiol observed after hormone substitution in postmenopausal women.