Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 28
Filtrar
1.
J Small Anim Pract ; 61(8): 494-503, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32725907

RESUMO

OBJECTIVES: To assess the impact of the WSAVA Global Nutrition Committee's work in promoting nutrition as the fifth vital assessment and enhancing knowledge of nutrition. Further objectives were to ascertain use of existing Global Nutrition Committee assessment tools, identify potential new tools and determine which members of the veterinary health care team are responsible for carrying out nutrition assessments, planning and intervention in practice. MATERIALS AND METHODS: A 16-question online questionnaire on the awareness, use and frequency of nutritional assessment was completed by 2740 veterinary health care team members. Statistical association was tested between the reported frequency of nutritional assessment in practice and the likely establishment of normal dietary regime, calculation of energy requirements and creation of nutritional plans. RESULTS: Most respondents (95%) currently had responsibility for providing small animal nutrition education, yet only 27% were aware of the WSAVA guidelines. Over half (64%) recognised nutritional evaluation as the fifth vital assessment. Only 4% consistently used WSAVA tools to perform a systematic nutritional assessment. Veterinarians and veterinary nurses/technicians were the most frequent source of nutritional advice in practice, with the consultation recognised as the most important contact point with clients. CLINICAL SIGNIFICANCE: Awareness of nutritional assessment is apparent, yet implementation in practice is inconsistent. These findings will help the WSAVA Global Nutrition Committee prioritise future activities to support the veterinary health care team and pet owners with nutrition-related knowledge, tools and resources.


Assuntos
Avaliação Nutricional , Médicos Veterinários , Fenômenos Fisiológicos da Nutrição Animal , Animais , Atitude , Humanos , Equipe de Assistência ao Paciente
2.
Mol Phylogenet Evol ; 101: 286-293, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27126185

RESUMO

The West Indian fruit fly, Anastrepha obliqua (Diptera: Tephritidae), is an economically important pest that inhabits areas of South and Central America, Mexico and the Caribbean with occasional infestations in the southern United States. We examine intra-specific relationships within A. obliqua as well as interspecific relationships to other Anastrepha species using a multi-locus data set comprising nine loci (seven nuclear, two mitochondrial) with 105 operational taxonomic units. The results based on a concatenated set of nuclear loci strongly support the monophyly of A. obliqua and most of the other species previously identified by morphology. A split between Peruvian A. obliqua samples and those from other locations was also identified. These results contrast with prior findings of relationships within A. obliqua based on mitochondrial data, as we found a marked discrepancy between nuclear and mitochondrial loci. These analyses suggest that introgression, particularly between A. obliqua and fraterculus species, may be one explanation for the discrepancy and the high mitochondrial diversity reported for A. obliqua could be the result of incomplete lineage sorting.


Assuntos
Filogenia , Tephritidae/classificação , Animais , Teorema de Bayes , Frutas , Loci Gênicos , Análise de Sequência de DNA , Especificidade da Espécie , Índias Ocidentais
3.
Transbound Emerg Dis ; 63(4): 408-15, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25414096

RESUMO

Rabies remains a significant problem throughout much of the developing world. An estimated 69 000 people die annually from exposure to rabies. Most of these deaths are the result of being bitten by a rabid dog. Mass vaccination campaigns targeting dogs have been implemented around the world in an attempt to control or eliminate canine rabies. We analysed the vaccination and cost data for a campaign in the KwaZulu-Natal province of South Africa; we found that the cost per dog vaccinated to be $6.61 for mass campaigns and $5.41 for local campaigns. We also estimated the cost of human post-exposure prophylaxis (PEP). The cost of PEP is approximately $64.50 on average per patient, and $333 on average for the 9% of patients who receive RIG. We also found that the districts that vaccinated the most dogs per capita experienced the highest rates of human treatment and thus had the highest PEP costs.


Assuntos
Mordeduras e Picadas , Doenças do Cão/prevenção & controle , Promoção da Saúde , Vacina Antirrábica/economia , Raiva/prevenção & controle , Animais , Cães , Humanos , África do Sul , Vacinação/economia
4.
Int J Emerg Ment Health ; 16(1): 223-31, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25345234

RESUMO

Much is known about the negative impact of emergency services work, but no studies, to date, have investigated its long-term consequences. This cross-sectional study assesses the possible long-term effects on quality of life, of trauma exposure and emergency work in a sample of retirees from the Irish emergency services (n = 169) and a comparison group of non-emergency service retirees (n = 140). A multi-questionnaire postal survey was administered to assess quality of life (QoL; WHOQOL-BREF), experiences of trauma, and trauma symptoms (PSS-SR). QoL was significantly better in non-emergency retirees, whilst this group also had significantly fewer trauma symptoms. Incidents involving children were identified by a large proportion of emergency retirees as being particularly difficult to manage. The findings address a significant gap in our knowledge around the possible longer-term effects of emergency services work in an often neglected sub-group. Factors associated with increased QoL and reduced symptoms of PTSD are discussed, as are some possible recommendations for the future.


Assuntos
Socorristas/psicologia , Qualidade de Vida/psicologia , Aposentadoria , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/psicologia , Idoso , Ambulâncias , Estudos Transversais , Feminino , Bombeiros , Inquéritos Epidemiológicos , Humanos , Irlanda , Acontecimentos que Mudam a Vida , Masculino , Pessoa de Meia-Idade , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Inquéritos e Questionários
5.
Mol Psychiatry ; 15(6): 647-56, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18957941

RESUMO

Personality traits are summarized by five broad dimensions with pervasive influences on major life outcomes, strong links to psychiatric disorders and clear heritable components. To identify genetic variants associated with each of the five dimensions of personality we performed a genome-wide association (GWA) scan of 3972 individuals from a genetically isolated population within Sardinia, Italy. On the basis of the analyses of 362 129 single-nucleotide polymorphisms we found several strong signals within or near genes previously implicated in psychiatric disorders. They include the association of neuroticism with SNAP25 (rs362584, P=5 x 10(-5)), extraversion with BDNF and two cadherin genes (CDH13 and CDH23; Ps<5 x 10(-5)), openness with CNTNAP2 (rs10251794, P=3 x 10(-5)), agreeableness with CLOCK (rs6832769, P=9 x 10(-6)) and conscientiousness with DYRK1A (rs2835731, P=3 x 10(-5)). Effect sizes were small (less than 1% of variance), and most failed to replicate in the follow-up independent samples (N up to 3903), though the association between agreeableness and CLOCK was supported in two of three replication samples (overall P=2 x 10(-5)). We infer that a large number of loci may influence personality traits and disorders, requiring larger sample sizes for the GWA approach to confidently identify associated genetic variants.


Assuntos
Predisposição Genética para Doença/genética , Estudo de Associação Genômica Ampla , Personalidade/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Genótipo , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Determinação da Personalidade , Polimorfismo de Nucleotídeo Único , Reprodutibilidade dos Testes
6.
Med Hypotheses ; 72(6): 723-8, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19231088

RESUMO

Anabolic steroid-induced hypogonadism (ASIH) is the functional incompetence of the testes with subnormal or impaired production of testosterone and/or spermatozoa due to administration of androgens or anabolic steroids. Anabolic-androgenic steroid (AAS), both prescription and nonprescription, use is a cause of ASIH. Current AAS use includes prescribing for wasting associated conditions. Nonprescription AAS use is also believed to lead to AAS dependency or addiction. Together these two uses account for more than four million males taking AAS in one form or another for a limited duration. While both of these uses deal with the effects of AAS administration they do not account for the period after AAS cessation. The signs and symptoms of ASIH directly impact the observation of an increase in muscle mass and muscle strength from AAS administration and also reflect what is believed to demonstrate AAS dependency. More significantly, AAS prescribing after cessation adds the comorbid condition of hypogonadism to their already existing chronic illness. ASIH is critical towards any future planned use of AAS or similar compound to effect positive changes in muscle mass and muscle strength as well as an understanding for what has been termed anabolic steroid dependency. The further understanding and treatments that mitigate or prevent ASIH could contribute to androgen therapies for wasting associated diseases and stopping nonprescription AAS use. This paper proposes a unified hypothesis that the net effects for anabolic steroid administration must necessarily include the period after their cessation or ASIH.


Assuntos
Anabolizantes/efeitos adversos , Anabolizantes/metabolismo , Hipogonadismo/induzido quimicamente , Hipogonadismo/metabolismo , Modelos Biológicos , Esteroides/efeitos adversos , Esteroides/metabolismo , Simulação por Computador , Humanos
7.
Dev Biol ; 300(1): 366-84, 2006 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-17097629

RESUMO

Metazoan genomes contain large numbers of genes that participate in responses to environmental stressors. We surveyed the sea urchin Strongylocentrotus purpuratus genome for homologs of gene families thought to protect against chemical stressors; these genes collectively comprise the 'chemical defensome.' Chemical defense genes include cytochromes P450 and other oxidases, various conjugating enzymes, ATP-dependent efflux transporters, oxidative detoxification proteins, and transcription factors that regulate these genes. Together such genes account for more than 400 genes in the sea urchin genome. The transcription factors include homologs of the aryl hydrocarbon receptor, hypoxia-inducible factor, nuclear factor erythroid-derived 2, heat shock factor, and nuclear hormone receptors, which regulate stress-response genes in vertebrates. Some defense gene families, including the ABCC, the UGT, and the CYP families, have undergone expansion in the urchin relative to other deuterostome genomes, whereas the stress sensor gene families do not show such expansion. More than half of the defense genes are expressed during embryonic or larval life stages, indicating their importance during development. This genome-wide survey of chemical defense genes in the sea urchin reveals evolutionary conservation of this network combined with lineage-specific diversification that together suggest the importance of these chemical stress sensing and response mechanisms in early deuterostomes. These results should facilitate future studies on the evolution of chemical defense gene networks and the role of these networks in protecting embryos from chemical stress during development.


Assuntos
Genoma , Inativação Metabólica/genética , Ouriços-do-Mar/fisiologia , Aclimatação/genética , Animais , Meio Ambiente , Humanos , Filogenia , Ouriços-do-Mar/classificação , Ouriços-do-Mar/genética , Transdução de Sinais/genética , Fatores de Transcrição/genética
8.
J S Afr Vet Assoc ; 77(4): 175-8, 2006 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17458340

RESUMO

Pigmented serum, usually due to free haemoglobin and/or bilirubin, is a common finding in dogs with babesiosis, resulting in interference with all biochemical tests that rely on photochemistry. This is particularly true of urea and creatinine determinations, complicating the diagnosis of acute renal failure, which is a serious complication of babesiosis. A disproportionately raised serum urea concentration of unknown origin occurs in severely anaemic canine babesiosis patients and gives rise to an increased serum urea:creatinine ratio. The assay for cystatin-C, an excellent measure of glomerular filtration rate, is unaffected by free serum haemoglobin, and due to its different intrinsic origins, is free of influence by the metabolic derangements and organ pathology, other than renal disease, encountered in canine babesiosis. Serum cystatin-C was used to compare the concentrations of serum urea and serum creatinine in dogs with the severely anaemic form of canine babesiosis as well as a canine babesiosis-free reference group. Mean serum urea and mean serum urea:creatinine ratio were significantly elevated in the babesia-infected group relative to the reference population in this study. Mean serum creatinine and mean serum cystatin-C were within the reference ranges. Therefore an elevated urea:creatinine ratio in canine babesiosis in the presence of a normal serum creatinine concentration is considered to be caused by an elevated serum urea concentration and is most likely of non-renal origin. Serum creatinine was therefore as specific a measure of renal function as serum cystatin-C in canine babesiosis in this study. The sensitivity of serum creatinine as a measure of renal function was not established by this study. Serum urea, however, proved to be of little use compared to serum cystatin-C and serum creatinine. Serum urea should therefore not be used to diagnose renal failure in canine babesiosis.


Assuntos
Babesiose/veterinária , Creatinina/sangue , Doenças do Cão/sangue , Ureia/sangue , Animais , Babesiose/sangue , Babesiose/complicações , Babesiose/diagnóstico , Estudos de Casos e Controles , Cistatina C , Cistatinas/sangue , Diagnóstico Diferencial , Doenças do Cão/diagnóstico , Cães , Nefropatias/diagnóstico , Nefropatias/etiologia , Nefropatias/veterinária , Estudos Prospectivos , Valores de Referência
9.
J S Afr Vet Assoc ; 75(3): 121-4, 2004 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-15628803

RESUMO

Serum urea and creatinine are extensively used as parameters to screen for azotaemia. Their reciprocal plots roughly correlate with glomerular filtration rate (GFR). They are, however, subject to influence by non-renal factors and to increase their specificity they are often tested concurrently. In renal disease they are expected to behave similarly, with both parameters increasing as GFR decreases. Haemolysis, as it occurs in canine babesiosis, may cause non-renal elevations in serum urea, possibly due to ammonia loading. Furthermore, haemolysis with its related elevations in serum bilirubin and serum haemoglobin, may negatively bias the measurement of serum creatinine due to interference of these substances with the chemical analysis of serum creatinine. This negative bias occurs when the alkaline picrate method, or when direct enzymatic methods based on the measurement of hydrogen peroxide, are used. In order to investigate the significance of these perturbations in canine babesiosis, paired values of serum urea and serum creatinine from Babesia canis-negative, non-haemolysis dogs (Group 1), were used to establish a relationship between urea and creatinine over a range of azotaemia by linear regression analysis. This relationship was then used to predict serum creatinine values from actual serum urea values in B. canis-positive dogs (Group 2). The mean of the predicted serum creatinine values for Group 2 (237.03 micromol/l) was then compared with the mean of the actual serum creatinine values for Group 2 (131.31 micromol/l). For Group 2, the mean actual serum creatinine demonstrated a significant negative bias relative to the mean predicted creatinine value. There was also a higher correlation between serum urea and serum creatinine in Group 1 than in Group 2. These findings may have been caused by either nonrenal elevations of serum urea values or by interference with the measurement of serum creatinine. Therefore, although it is possible that some Group 2 dogs with B. canis with high serum urea and normal, low, or zero values for serum creatinine were not azotaemic, it is also possible that other Group 2 dogs with these biochemical findings did in fact have azotaemia. This study concluded that urea and creatinine do not behave in a similar and predictable manner over a range of azotaemia in canine babesiosis and are therefore not ideally suited for the detection of renal disease in this clinical setting.


Assuntos
Babesiose/veterinária , Creatinina/sangue , Doenças do Cão/sangue , Ureia/sangue , Uremia/veterinária , Animais , Babesiose/sangue , Babesiose/complicações , Estudos de Casos e Controles , Doenças do Cão/diagnóstico , Cães , Taxa de Filtração Glomerular/veterinária , Modelos Lineares , Estudos Retrospectivos , Uremia/diagnóstico , Uremia/etiologia
10.
J S Afr Vet Assoc ; 75(3): 150-2, 2004 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-15628808

RESUMO

Primary ciliary dyskinesia (PCD) is a diverse group of inherited structural and functional abnormalities of the respiratory and other cilia, which results in recurrent respiratory tract infections. Primary ciliary dyskinesia was diagnosed in a 14-week old Staffordshire bull terrier that had a history of respiratory disease from 7 weeks of age. Pneumonia was diagnosed on thoracic radiographs and transtracheal aspirate. Transmission electron microscopy of the bronchi and trachea indicated the presence of both primary and secondary ciliary dyskinesia. The most prominent primary defects consisted of absent inner dyneim arms, absent radial spokes and absence of the central microtubules. These defects accounted for 62% of the total number of cross-sections screened. Non-specific ciliary abnormalities encountered most often were compound cilia, swollen cilia, addition/deletion of peripheral doublets and disorganised axonemes (26%). To the authors' knowledge, this is the first case of PCD described in the Staffordshire bull terrier and the first report of PCD in South Africa.


Assuntos
Transtornos da Motilidade Ciliar/veterinária , Doenças do Cão/diagnóstico , Animais , Brônquios/patologia , Brônquios/ultraestrutura , Cílios/patologia , Cílios/ultraestrutura , Transtornos da Motilidade Ciliar/diagnóstico , Transtornos da Motilidade Ciliar/patologia , Doenças do Cão/patologia , Cães , Evolução Fatal , Masculino , Radiografia Torácica/veterinária , Traqueia/patologia , Traqueia/ultraestrutura
11.
J S Afr Vet Assoc ; 73(4): 219-21, 2002 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-12665138

RESUMO

The metacestode of Taenia solium, Cysticercus cellulosae, was recovered from the brain of a cat showing central nervous clinical signs ante mortem. This is the first record of cerebral cysticercosis in a cat in South Africa.


Assuntos
Encefalopatias/veterinária , Doenças do Gato/diagnóstico , Neurocisticercose/veterinária , Animais , Encéfalo/parasitologia , Encefalopatias/diagnóstico , Encefalopatias/parasitologia , Encefalopatias/patologia , Doenças do Gato/parasitologia , Doenças do Gato/patologia , Gatos , Cysticercus/isolamento & purificação , Eutanásia Animal , Masculino , Neurocisticercose/diagnóstico , Neurocisticercose/patologia , África do Sul , Taenia solium/isolamento & purificação
12.
Science ; 294(5550): 2348-51, 2001 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-11743200

RESUMO

Molecular phylogenetic studies have resolved placental mammals into four major groups, but have not established the full hierarchy of interordinal relationships, including the position of the root. The latter is critical for understanding the early biogeographic history of placentals. We investigated placental phylogeny using Bayesian and maximum-likelihood methods and a 16.4-kilobase molecular data set. Interordinal relationships are almost entirely resolved. The basal split is between Afrotheria and other placentals, at about 103 million years, and may be accounted for by the separation of South America and Africa in the Cretaceous. Crown-group Eutheria may have their most recent common ancestry in the Southern Hemisphere (Gondwana).


Assuntos
Teorema de Bayes , Mamíferos/classificação , Mamíferos/genética , Filogenia , África , Animais , Pareamento de Bases , Evolução Biológica , Núcleo Celular/genética , Ecossistema , Fósseis , Genes , Genes de RNAr , Funções Verossimilhança , Cadeias de Markov , Marsupiais/classificação , Marsupiais/genética , Mitocôndrias/genética , Método de Monte Carlo , Placenta , Probabilidade , Análise de Sequência de DNA , América do Sul
14.
Nature ; 409(6820): 610-4, 2001 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-11214318

RESUMO

Higher level relationships among placental mammals, as well as the historical biogeography and morphological diversification of this group, remain unclear. Here we analyse independent molecular data sets, having aligned lengths of DNA of 5,708 and 2,947 base pairs, respectively, for all orders of placental mammals. Phylogenetic analyses resolve placental orders into four groups: Xenarthra, Afrotheria, Laurasiatheria, and Euarchonta plus Glires. The first three groups are consistently monophyletic with different methods of analysis. Euarchonta plus Glires is monophyletic or paraphyletic depending on the phylogenetic method. A unique nine-base-pair deletion in exon 11 of the BRCA1 gene provides additional support for the monophyly of Afrotheria, which includes proboscideans, sirenians, hyracoids, tubulidentates, macroscelideans, chrysochlorids and tenrecids. Laurasiatheria contains cetartiodactyls, perissodactyls, carnivores, pangolins, bats and eulipotyphlan insectivores. Parallel adaptive radiations have occurred within Laurasiatheria and Afrotheria. In each group, there are aquatic, ungulate and insectivore-like forms.


Assuntos
Evolução Biológica , Mamíferos/classificação , Animais , DNA , Humanos , Mamíferos/genética , Filogenia , Alinhamento de Sequência
15.
J Clin Microbiol ; 38(3): 953-9, 2000 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-10698979

RESUMO

PCR amplifications of the 16S rRNA gene were performed on 46 specimens obtained from 43 dogs with canine leproid granuloma syndrome to help determine its etiology. Sequence capture PCR was applied to 37 paraffin-embedded specimens from 37 dogs, and nested PCR was attempted on DNA from 9 fresh tissue specimens derived from 3 of the 37 aforementioned dogs and from an additional 6 dogs. Molecular analyses of the paraffin-embedded tissues and fresh tissue specimen analyses were performed at separate institutions. PCR products with identical sequences over a 350-bp region encompassing variable regions 2 and 3 of the 16S rRNA gene were obtained from 4 of 37 paraffin-embedded specimens and from all 9 specimens of fresh tissue originating from 12 of the 43 dogs. Identical sequences were determined from amplicons obtained from paraffin-embedded and fresh specimens from one dog. The consensus DNA sequence, amplified from paraffin-embedded tissue and represented by GenBank accession no. AF144747, shared highest nucleotide identity (99.4% over 519 bp) with mycobacterial strain IWGMT 90413 but did not correspond exactly to any EMBL or GenBank database sequence. With a probe derived from the V2 region of the novel canine sequence, reverse cross blot hybridization identified an additional four paraffin-embedded specimens containing the same novel sequence. In total, molecular methodologies identified the proposed novel mycobacterial sequence in 16 of 43 dogs with canine leproid granuloma syndrome, indicating that the species represented by this sequence may be the principal etiological agent of canine leproid granuloma syndrome.


Assuntos
Doenças do Cão/microbiologia , Granuloma/veterinária , Infecções por Mycobacterium/veterinária , Mycobacterium/classificação , RNA Ribossômico 16S/genética , Dermatopatias Bacterianas/veterinária , Animais , Sequência de Bases , Bovinos , Primers do DNA , DNA Bacteriano/genética , DNA Bacteriano/isolamento & purificação , DNA Ribossômico/genética , Doenças do Cão/patologia , Cães , Granuloma/microbiologia , Granuloma/patologia , Dados de Sequência Molecular , Mycobacterium/genética , Mycobacterium/isolamento & purificação , Infecções por Mycobacterium/microbiologia , Infecções por Mycobacterium/patologia , Reação em Cadeia da Polimerase , Dermatopatias Bacterianas/microbiologia , Dermatopatias Bacterianas/patologia , Síndrome
16.
Nature ; 403(6766): 188-92, 2000 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-10646602

RESUMO

Bats (order Chiroptera) are one of the few orders of mammals that echolocate and the only group with the capacity for powered flight. The order is subdivided into Microchiroptera and Megachiroptera, with an array of characteristics defining each group, including complex laryngeal echolocation systems in microbats and enhanced visual acuity in megabats. The respective monophylies of the two suborders have been tacitly assumed, although microbat monophyly is uncorroborated by molecular data. Here we present a phylogenetic analysis of bat relationships using DNA sequence data from four nuclear genes and three mitochondrial genes (total of 8,230 base pairs), indicating that microbat families in the superfamily Rhinolophoidea are more closely related to megabats than they are to other microbats. This implies that echolocation systems either evolved independently in rhinolophoids and other microbats or were lost in the evolution of megabats. Our data also reject flying lemur (order Dermoptera) as the bat sister group, indicating that presumed shared derived characters for flying lemurs and bats are convergent features that evolved in association with gliding and flight, respectively.


Assuntos
Evolução Biológica , Quirópteros/fisiologia , Ecolocação/fisiologia , Voo Animal/fisiologia , Animais , Núcleo Celular/genética , Quirópteros/classificação , Quirópteros/genética , Humanos , Mitocôndrias/genética , Filogenia
18.
Am J Obstet Gynecol ; 144(7): 841-8, 1982 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-7148906

RESUMO

Although hysterectomy was the most frequently performed major surgical procedure among women of reproductive age during the past decade, few recent studies have been conducted to determine the risk of complications. We examined data from the Collaborative Review of Sterilization, a prospective, multicenter, observational study coordinated by the Centers for Disease Control, to assess the comparative risks of complications among women undergoing hysterectomy by the abdominal and vaginal approaches. Between September, 1978, and August, 1981, 1,851 women from nine institutions were included in the study. Women who underwent vaginal hysterectomy experienced significantly fewer complications than women who had undergone abdominal hysterectomy. The difference was probably attributable to the prevalence and efficacy of prophylactic antibiotic use among the former group. Vaginal hysterectomy was associated with more unintended major surgical procedures but less febrile morbidity, bleeding requiring transfusion, hospitalization, and convalescence than abdominal hysterectomy. Vaginal hysterectomy with prophylactic antibiotics should be strongly considered for those women of reproductive age for whom either surgical approach is clinically appropriate.


PIP: Although hysterectomy was the most frequently performed major surgical procedure among women of reproductive age during the past decade, few recent studies have been conducted to determine the risk of complications. We examined data from the Collaborative Review of Sterilization, a prospective, multicenter, observational study coordinated by the Centers for Disease Control, to assess the comparative risks of complications among women undergoing hysterectomy by the abdominal and vaginal approaches. Between September 1978-August 1981, 1851 women from 9 institutions were included in the study. Women who underwent vaginal hysterectomy experienced significantly fewer complications than women who had undergone abdominal hysterectomy. The difference was probably attributable to the prevalence and efficacy of prophylactic antibiotic use among the former group. Vaginal hysterectomy was associated with more unintended major surgical procedures but less febrile morbidity, bleeding requiring transfusion, hospitalization, and convalescence than abdominal hysterectomy. Vaginal hysterectomy with prophylactic antibiotics should be strongly considered for those reproductive age women for whom either surgical approach is clinically appropriate.


Assuntos
Histerectomia Vaginal/efeitos adversos , Histerectomia/efeitos adversos , Complicações Pós-Operatórias , Adolescente , Adulto , Fatores Etários , Feminino , Humanos , Estudos Prospectivos , Risco
19.
JAMA ; 248(3): 323-7, 1982 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-7087126

RESUMO

An estimated 3.5 million women aged 15 to 44 years in the United States underwent hysterectomy (excluding radical procedures) between 1970 and 1978. Data from the National Center for Health Statistics were used to study the influence of age, race, and geographic region on hysterectomy rates, surgical approach, and concurrent oophorectomy. The number and rate of hysterectomies increased between 1970 and 1972 but remained stable thereafter. Hysterectomy rates increased with age, and rates for black women slightly exceeded the rates for whites. Rates were consistently highest for women in the South and lowest for women in the Northeast. Women undergoing hysterectomy in the Northeast had the lowest percentage performed by a vaginal approach and the highest percentage performed in conjunction with bilateral oophorectomy. Women having a hysterectomy in the West had the highest percentage performed by a vaginal approach.


Assuntos
Histerectomia/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , População Negra , Castração/estatística & dados numéricos , Feminino , Humanos , Histerectomia/métodos , Histerectomia Vaginal/estatística & dados numéricos , Estados Unidos , População Branca
20.
JAMA ; 245(7): 714-8, 1981 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-6450842

RESUMO

We analyzed factors affecting the length of hospital stay for tubal sterilization in 1970 and 1975, using data from the National Center for Health Statistic's Hospital Discharge Survey. The average hospital stay for tubal sterilization declined from 6.5 nights in 1970 to 4.0 nights in 1975. Pregnancy status, region of residence, and race were important determinants of the length of hospital stay. One technological innovation, the use of the laparoscope for tubal sterilization, accounted for 39% of the total length-of-stay reduction from 1970 to 1975. General changes in medical care from 1970 to 1975, combined with the introduction of laparoscopy, averted 1,363,000 nights of hospitalization for tubal sterilization in 1975. Conservatively, this resulted in a savings of more than $200 million. About $80 million of this savings was directly attributable to laparoscopy. Even greater savings could have been achieved if sterilization techniques requiring shorter hospital stays had been more widely used.


Assuntos
Controle de Custos , Tempo de Internação , Esterilização Tubária , População Negra , Feminino , Hospitalização/economia , Humanos , Laparoscopia/economia , Gravidez , Encaminhamento e Consulta , Estados Unidos , População Branca
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...