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1.
Artigo em Inglês | MEDLINE | ID: mdl-33403738

RESUMO

AIM: To investigate the safety and feasibility of taking low-concentration carbohydrate solution at 2 h before induction of anesthesia for gestational diabetes mellitus (GDM) patients. METHODS: GDM patients undergoing cesarean section were randomly assigned to experimental group (n = 43) and control group (n = 42). Two hours before induction of anesthesia, participants in experimental group orally received 300 mL low-concentration carbohydrate solution, while those in control group received equivalent warm water. Blood glucose and serum insulin were measured at 2 h before induction of anesthesia, right before induction of anesthesia, and the morning of postoperative day 1. Neonatal blood glucose level was monitored at birth. Maternal gastrointestinal function and well-being were assessed perioperatively. RESULTS: The levels of blood glucose and serum insulin right before induction of anesthesia in the experimental group were significantly higher than those in the control group. There were four cases with hypoglycemia in the experimental group and 19 cases in the control group right before induction of anesthesia (9.3% vs 45.2%, p < 0.001). The incidence of neonatal hypoglycemia was 2.3% in the experimental group and 7.1% in the control group with no significance. Hunger score of the participants between the two groups right before induction of anesthesia was significantly different. No aspiration, nausea, and vomiting occurred in both groups before, during, and after surgery. No significant difference was found in the time to the first flatus and abdominal distension between the two groups. CONCLUSION: Taking low-concentration carbohydrate solution is safe and feasible for patients with GDM undergoing elective cesarean section.

2.
J Gynecol Obstet Hum Reprod ; 50(8): 102068, 2021 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-33484932

RESUMO

OBJECTIVE: Many women experience pelvic floor dysfunction (PFD) during the perinatal period. Knowledge of PFD among women is poor, which may reflect inadequate provision of information by healthcare workers. The aim of this study was to explore obstetrical healthcare workers' knowledge, attitude, and practice regarding PFD. MATERIAL AND METHODS: This study had a cross-sectional design. We developed a 65-question survey to explore obstetrical healthcare workers' knowledge, attitude, and practice regarding PFD. An electronic version of the questionnaire was distributed to healthcare workers from 31 provinces in the People's Republic of China by convenience sampling in July and August 2019. This research complied with the guidelines of the Strengthening of the Reporting of Observational Studies in Epidemiology checklist. RESULTS: In total, 1545 valid questionnaires were collected. The mean scores for the knowledge, attitude, and practice of obstetrical healthcare workers were 23.67 ± 4.70 out of 30, 31.91 ± 6.68 out of 40, and 47.88 ± 9.17 out of 65, respectively. Approximately 50 % of the respondents reported providing practical pelvic floor muscle training (PFMT) guidance and evaluation of its correct performance only "sometimes" or even "never". Nearly 30 % of respondents denied asking patients about PFD-related symptoms. Respondents' PFD-related practice were affected not only by their knowledge and attitude but also by their age, treatment or nursing experience of PFD, own PFD history and that of relatives or friends, and the PFD-related departmental setup of their hospital (P < 0.001). CONCLUSION: Most obstetrical healthcare workers have knowledge of PFD and hold a positive attitude but fail to routinely provide PFD counseling and mentoring to patients. Many factors affect the respondents' PFD-related practice.

3.
J Int Med Res ; 48(6): 300060520931319, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32552122

RESUMO

Cases of urogenital sinus malformation with a huge calculus are complex and rare. Improper nursing care of these cases can lead to a series of problems. We report here a 23-year-old married woman who was admitted to hospital because of primary amenorrhea and failed sexual intercourse for 5 years. Through combined diagnosis and treatment of radiology, ultrasound, urology, gynecology, and other disciplines, the patient was diagnosed with urogenital sinus malformation, a vaginal calculus, and primary amenorrhea. After full preparation, the patient underwent an operation for extraction of the vaginal calculus, urethroplasty, vaginoplasty, and hysteroscopy. The calculus of the patient was removed and the vagina was returned to its normal anatomy. Patients with urogenital sinus malformation and a huge calculus have complex care requirements and experience a particular state of vulnerability during the diagnostic phase. By establishing good communication with patients and providing proper perioperative nursing, physiological and psychological rehabilitation of these patients can be achieved.

4.
Int J Nurs Stud ; 104: 103527, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32058140

RESUMO

BACKGROUND: Stress urinary incontinence is a distressing and burdensome condition affecting approximately one third of pregnant women and pelvic floor muscle training is recommended as the first-line treatment. Convenient and cost-effective regimen of pelvic floor muscle training is required to facilitate the treatment of stress urinary incontinence and improve the adherence to treatment in pregnant women. OBJECTIVE: To determine the effectiveness of app-based audio guidance pelvic floor muscle training on the treatment of stress urinary incontinence in primiparas. DESIGN: The study was a two-arm, parallel, randomized controlled clinical trial. SETTING: The study was conducted in the obstetric clinic of a tertiary maternity hospital in Hangzhou, China. PARTICIPANTS: A total of 108 eligible primiparas were enrolled from January to April 2018. METHODS: Participants were randomly allocated (1:1) to the audio group or the control group. Primary outcomes included severity of stress urinary incontinence and adherence to pelvic floor muscle training assessed by the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form and the Broome Pelvic Muscle Self-Efficacy Scale, respectively. Secondary outcomes included pelvic floor muscle strength, bladder neck mobility and sexual function measured by vaginal palpation and pelvic floor muscle surface electromyography, perineal ultrasound and Female Sexual Function Index, respectively. Data analysis followed the intention-to-treat principle. Generalized estimation equation model, t-test and chi-square test were used to examine intervention effect on primary outcomes and secondary outcomes, respectively. RESULTS: Participants showed significant improvement in symptom severity across the study, which was most significant at 6 weeks postpartum (ß = -4.245, p < 0.001). No significant difference was found in symptom severity between groups (ß = -0.344, p = 0.168). The interaction effect between intervention and time on adherence was significant. Compared with the control group, greater self-efficacy was shown in the audio group at 6 weeks (ß = 4.425, p = 0.009), 3 months (ß = 3.204, p < 0.001) and 6 months (ß = 4.457, p < 0.001) postpartum. Participants in the audio group indicated less bladder neck descent (16.5 vs. 19.5, p = 0.020) at 6 weeks postpartum, better pelvic floor muscle strength (12.5% vs. 34.0%, p = 0.012; 4.2% vs. 18.0%, p = 0.030) and sexual function (22.2 vs. 17.3, p = 0.007) at 6 months postpartum. CONCLUSIONS: The app-based audio guidance pelvic floor muscle training was more effective and much easier to comply for treatment of stress urinary incontinence in primiparas than the conventional home-based pelvic floor muscle training.

5.
Oncotarget ; 8(43): 75264-75271, 2017 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-29088863

RESUMO

Complete hydatidiform mole (CHM) is a rare pregnancy-related disease with invasive potential. The genetics underlying the sporadic form of CHM have not been addressed previously, but maternal genetic variants may be involved in biparental CHM. We performed whole-exome sequencing of 51 patients with CHM and 47 healthy women to identify genetic variants associated with CHM. In addition, candidate variants were analyzed using single base extension and Matrix Assisted Laser Desorption/Ionization-Time of Flight Mass Spectrometry in 199 CHM patients and 400 healthy controls. We validated candidate variants using Sanger sequencing in 250 cases and 652 controls, including 205 new controls. Two single nucleotide polymorphisms, c.G48C(p.Q16H) inERC1 and c.G1114A(p.G372S) in KCNG4, were associated with an increased risk of CHM (p<0.05). These variants may contribute to the pathogenesis of CHM and could be used to screen pregnant women for this genetic abnormality.

6.
J Clin Nurs ; 26(19-20): 3156-3163, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27875017

RESUMO

AIM AND OBJECTIVES: To evaluate the effects of gum chewing combined with a semi-liquid diet on patients after gynaecologic laparoscopic surgery. BACKGROUND: Previous studies suggested that chewing gum before traditional postoperative care promotes the postoperative recovery of bowel motility and function after open and laparoscopic surgery. However, gum chewing combined with a semi-liquid diet has not been reported in postoperative care of patients following gynaecologic laparoscopic surgery. DESIGN: A prospective randomised study. METHODS: Total 234 patients were randomly assigned after elective gynaecologic laparoscopic surgery to a gum chewing and semi-liquid diet group, a semi-liquid only diet group or a liquid diet group. The gum chewing and semi-liquid diet group chewed sugar-free gum with an oral intake of a semi-liquid diet six hours postoperatively. The semi-liquid only diet and liquid diet groups received a semi-liquid diet or a liquid diet, respectively. The time to first bowel sounds, time to first regular postoperative bowel sounds, time to first passage of flatus, time to first defecation, serum gastrin and incidences of hunger, nausea, vomiting and abdominal distension were recorded. Hunger and gastrointestinal sensations were assessed using a four-point scale. Serum gastrin was assayed pre- and postoperatively using a gastrin radioimmunoassay kit. RESULTS: The gum chewing and semi-liquid diet group had first bowel sounds, first regular bowel sounds, first passage of flatus and first defecation earlier than the semi-liquid only and liquid groups. Increased serum gastrin was observed in the gum chewing and semi-liquid diet group. Incidences of nausea, vomiting and abdominal distention were not significantly different between these groups. CONCLUSION: Chewing gum combined with an oral intake of a semi-liquid diet is safe and accelerates the postoperative recovery of bowel function. It might be recommended as a better postoperative care regimen for patients after gynaecologic laparoscopic surgery. RELEVANCE TO CLINICAL PRACTICE: This study developed a new postoperative diet regimen to improve the postoperative care of patients undergoing laparoscopic gynecologic surgery.


Assuntos
Goma de Mascar , Dieta/métodos , Motilidade Gastrointestinal , Procedimentos Cirúrgicos em Ginecologia , Cuidados Pós-Operatórios/métodos , Recuperação de Função Fisiológica , Procedimentos Cirúrgicos Eletivos , Feminino , Humanos , Laparoscopia , Pessoa de Meia-Idade , Período Pós-Operatório , Estudos Prospectivos
7.
Ther Clin Risk Manag ; 11: 851-6, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26056463

RESUMO

BACKGROUND: The purpose of this study was to determine the clinicopathologic predictors of residual disease in patients with high-grade cervical intraepithelial neoplasia (CIN) and margin involvement after initial conization. METHODS: Data from 145 patients who underwent subsequent surgery for high-grade CIN with positive margins were retrospectively analyzed. RESULTS: After subsequent surgery, residual disease was diagnosed in 47 (34.2%) patients, of whom five had invasive cervical carcinoma, 31 had CIN 3, nine had CIN 2, and two had CIN 1. Multivariate analysis revealed that only age ≥35 years (P=0.033), major abnormal cytology (P=0.002), and pre-cone high-risk human papillomavirus load ≥300 relative light units (P=0.011) were significant factors associated with residual disease. CONCLUSION: Age ≥35 years, major abnormal cytology, and pre-cone high-risk human papillomavirus load ≥300 relative light units were the only significant factors predicting post-cone residual disease. Appropriate application of these predictive factors may avoid delayed treatment and overtreatment.

8.
Int J Nurs Pract ; 21(1): 102-6, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24758197

RESUMO

To explore suitable scales to assess psychological status of pregnant women whose fetuses have grave deformities, a face-to-face interview guided by the Triage Assessment System (TAS) was conducted. Also, a questionnaire of the Impact of Event Scale-Revised (IES-R) was obtained in 44 pregnant women diagnosed with a fetal deformity. Percentages and non-parametric Spearman correlations were used to analyse the scores of the two scales. The total score of TAS ranged from 3 to 26, with a mean of 9.93; and the total score of IES-R ranged from 5 to 63, with a mean of 40.36. The total score and the two subscales of each scale were significantly correlated (P < 0.05). The TAS subscale of emotion and IES-R subscale of intrusion were not significantly correlated, with r = 0.24 (P = 0.11). Combined use of TAS and IES-R can make up for each other's deficiencies and guide the clinician to make individual interventions during screening and treatment.


Assuntos
Anormalidades Congênitas/psicologia , Gestantes/psicologia , Inquéritos e Questionários , Triagem , Adulto , China , Feminino , Humanos , Gravidez
9.
Asia Pac J Public Health ; 24(3): 522-31, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-21807623

RESUMO

To explore women's knowledge of human papillomavirus (HPV) and attitudes toward the HPV vaccine in Zhejiang, China, women attending the checkup clinics were invited to participate. A questionnaire-guided interview was conducted with a representative sample of 1490 women, and 1432 effective questionnaires were obtained. The authors found 39.1% of women in urban areas and 27.1 % in rural areas had heard of HPV, whereas 23.7% and 15.1%, respectively, had heard of the HPV vaccine. The mean score of HPV knowledge was 3.75 in urban areas and 3.18 in rural areas, with a significant difference (P = .016). Of the sample who had heard of the HPV vaccine, the supportive mean score was 2.59 and 2.11, with a significant difference (P = .003). Women with more HPV knowledge were more likely to support the HPV vaccination (r = 0.50 and r = 0.61). The authors conclude that inadequate knowledge and misconceptions about HPV are common. Attitudes toward HPV vaccine are unsatisfactory. Education campaigns targeting different populations are needed prior to the introduction of an HPV vaccine.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus , Adulto , China , Feminino , Humanos , Pessoa de Meia-Idade , População Rural/estatística & dados numéricos , Inquéritos e Questionários , População Urbana/estatística & dados numéricos , Adulto Jovem
10.
Zhonghua Fu Chan Ke Za Zhi ; 45(11): 813-6, 2010 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-21211277

RESUMO

OBJECTIVE: To analyze the association of serum CA(125) level at the different phases with recurrence and survival, for providing simple and efficient methods about predicting recurrence and prognosis in epithelial ovarian cancer. METHODS: The clinical-pathological data from 151 patients were collected, who were histologically confirmed as primary ovarian cancer between Jan 2002 and Dec 2005. All the patients were followed up. The relationship between serum CA(125) level at different phases and clinical-pathological data were analyzed, including prognostic associated factors, 2-year or 5-year recurrent rate, 5-year survival rate, progression-free survival times, and overall survival times. RESULTS: Serum CA(125) level at pre-surgery and the end of 3-course chemotherapy were associated with most of the clinical-pathological parameters, included stage, pathological grade, amount of ascites, residual tumor size, type of recurrence, 2-year and 5-year recurrent rate, and 5-year survival rate (all P < 0.05). Progression-free survival and overall survival times were shorter in the patients with higher CA(125) level at pre-surgery or abnormal CA(125) level at the end of 3-course chemotherapy (P < 0.01). There was no relationship between the ratio of CA(125) level at pre- and post-surgery and recurrence or prognosis (all P > 0.05). CONCLUSION: Serum CA(125) level at pre-surgery and the end of 3-course chemotherapy can be used for predicting the recurrence and prognosis of epithelial ovarian cancer.


Assuntos
Adenocarcinoma/sangue , Antígeno Ca-125/sangue , Neoplasias Ovarianas/sangue , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/mortalidade , Adenocarcinoma/patologia , Adolescente , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biomarcadores Tumorais/sangue , Terapia Combinada , Intervalo Livre de Doença , Feminino , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Ovarianas/mortalidade , Neoplasias Ovarianas/patologia , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Análise de Sobrevida , Taxa de Sobrevida , Fatores de Tempo , Adulto Jovem
11.
Cancer Nurs ; 31(3): 209-13, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18453877

RESUMO

To explore and evaluate the safety and efficacy of early oral intake following major abdominal gynecological oncology surgery. During an 11-month period, 60 gynecological oncology patients undergoing major intra-abdominal surgery were enrolled in a randomized controlled clinical trial of semiliquid diet (experimental group) compared with clear feeds (control group) 6 hours after operation. Patients were evaluated for nausea, vomiting, bowel sound, passage of flatus, body weight difference before and after operation, urine acetone, fasting blood sugar, and prealbumin level, and need for nasogastric tube decompression. There were significantly higher incidences of nausea, shorter time of regular diet resumption, and higher level of prealbumin on postoperative day 7 in patients from the experimental group than those from the control group (P < .05). No significant differences were found in vomiting, the time to development of bowel sound and passage of flatus, body weight difference before and after operation, urine acetone and fasting blood sugar on postoperative day 1, and prealbumin level on postoperative day 2 between the 2 groups. Early oral intake with semiliquid diet 6 hours after major intra-abdominal gynecological oncology surgery is safe and well tolerated.


Assuntos
Neoplasias dos Genitais Femininos/cirurgia , Estado Nutricional , Enfermagem Oncológica , Cuidados Pós-Operatórios , Adulto , Feminino , Neoplasias dos Genitais Femininos/enfermagem , Humanos , Pessoa de Meia-Idade , Fatores de Tempo
12.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 25(4): 414-7, 2003 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-12974085

RESUMO

OBJECTIVE: To investigate the efficacy and toxicity of methotrexate (MTX) give intravenously in the primary treatment of gestational trophoblastic tumor (GTT). METHODS: A total of 37 patients with low-risk GTT was primarily treated by single MTX in Women's Hospital, School of Medicine, Zhejiang University. Data on the patients' age, clinical stage, WHO classification criteria, antecedent pregnancy, presenting level of human chorionic gonadotropin, courses of chemotherapy required to achieve complete remission, and toxicity related to chemotherapy treatments were collected. RESULTS: Thirty-seven patients with low-risk GTT totally received 137 cycles of MTX between Oct. 1999 and Sep. 2002, 34 patients (91.9%) achieved complete remission. Twenty-nine patients received multiple courses of MTX, complete remission was induced in 26 patients (89.7%). The complete response rates of I stage and III stage were 100.0% and 70.0% (P = 0.03) respectively in patients who were received multiple courses of MTX. However, eight patients received single course of chemotherapy, 7 patients achieved complete remission, and 1 achieved complete remission after another additional course of MTX was conducted. Grade III side effects (WHO criteria) only appeared in 7 courses (5.1%) during MTX treatment. Follow-up data showed that only one patient with single course of chemotherapy relapsed after 6 months. CONCLUSION: Single MTX chemotherapy may be effective and well tolerated for low-risk GTT.


Assuntos
Antimetabólitos Antineoplásicos/administração & dosagem , Doença Trofoblástica Gestacional/tratamento farmacológico , Metotrexato/administração & dosagem , Neoplasias Uterinas/tratamento farmacológico , Adolescente , Adulto , Coriocarcinoma/tratamento farmacológico , Esquema de Medicação , Feminino , Humanos , Gravidez
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