RESUMO
OBJECTIVE: There is controversy as to whether maternal body mass index (BMI) influences the contractility of human myometrium in pregnancy. The aim of this study was to examine spontaneous contractile activity of human pregnant myometrium in vitro, with respect to maternal BMI. STUDY DESIGN: Myometrial tissue specimens were obtained at cesarean delivery from 74 women with BMI values ranging from 19 to 50.1 kg m-2. By recording in vitro from eight strips per donor (590 strips in total), several parameters of spontaneous contractile activity were monitored. The relationship between BMI and contractility was evaluated using linear regression analysis. RESULTS: There was a significant correlation between maximum amplitude (P=0.007) and mean contractile force (P=0.001) with increasing BMI. However, the time to onset of contractions (P=0.009), and time taken to reach maximal amplitude (P=0.020) also increased with increasing BMI. No significant correlation was observed with BMI for other parameters studied. The mean maximum amplitude value for spontaneous contractions was 37±1 mN, the mean contractile force for spontaneous contractions was 4.1±0.1 mN, the average time to the first spontaneous contraction was 11.3±0.6 min and the average frequency of contractions was 6.5±0.2 per hour. CONCLUSIONS: These results suggest that the time to onset of contractions is increased with increasing maternal BMI, but that the force developed is greater. In all other respects, human uterine contractility is unaffected by increasing BMI. These findings underline the complexity of regulation of uterine contractility in labor with elevated maternal BMI.
Assuntos
Índice de Massa Corporal , Miométrio/fisiologia , Contração Uterina/fisiologia , Adulto , Cesárea , Feminino , Humanos , Irlanda , Modelos Lineares , Gravidez , Técnicas de Cultura de TecidosRESUMO
The role development of assistive personnel has become more important in rural hospitals because of the limited professional nursing supply. St. Mary's Hospital has fostered interdepartmental collaboration to reallocate duties to personnel who are best qualified to perform them. The dyad model, uniquely tailored to this hospital's needs, has resulted in the more efficient and effective use of personnel.
Assuntos
Hospitais Rurais , Assistentes de Enfermagem/estatística & dados numéricos , Humanos , Maryland , Modelos de Enfermagem , Admissão e Escalonamento de Pessoal/tendências , Recursos HumanosRESUMO
Until nurses at St. Mary's Hospital took the lead in establishing an outpatient infusion unit, oncology patients had to travel up to 100 miles to receive chemotherapy. Today, they need travel only ten minutes to receive the best and latest of a variety of high-tech services.
