<strong>Objective: </strong><span><span><span style="font-family:""><span style="font-family:Verdana;">The purpose of this study was to analyze the opinions...<strong>Objective: </strong><span><span><span style="font-family:""><span style="font-family:Verdana;">The purpose of this study was to analyze the opinions of gynecologists, midwives, and interns/Specialist students practicing in Senegal about the use of IUD, and to assess factors that stand as obstacles to IUD prescribing. </span><b><span style="font-family:Verdana;">Patients and methods: </span></b><span style="font-family:Verdana;">An online questionnaire was developed to assess providers’ IUD practices and attitudes. The questionnaire was based on the one used in a Swiss study on the same topic. The platform used was Google forms. The questionnaire was shared in associative platforms involving gynecologists, midwives and interns/Specialist students. </span><b><span style="font-family:Verdana;">Results and comments: </span></b><span style="font-family:Verdana;">We received 292 feedbacks. Gynecologists represented 13.7% of the sample, interns and specialist students 11.3% and midwives 76%. Parity is a determining factor in IUD selection. The care-providers were concerned about the followings, which might have prevented the use of IUD, even </span><span style="font-family:Verdana;">though it </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">was</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> indicated: infections (75.7%), pelvic pain (61.3%), expulsion (48.3%), increased risk of perforation (46.9%), women’s appreciation </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">(45.2%), ectopic pregnancy (33.9%) and sexual behavior (28.4%). </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Our study reveals that providers’ apprehensions and concerns severely limit the availability of IUDs. These concerns are often unfounded, based on personal experiences and not on official recommendations. Parity is a major obstacle.</span></span></span></span>展开更多
Objective:To explore the pattern of medication used in the treatment of dysmenorrhea by famous Chinese gynecologists based on the data mining method.Method:The electronic search of the Chinese journal full-text databa...Objective:To explore the pattern of medication used in the treatment of dysmenorrhea by famous Chinese gynecologists based on the data mining method.Method:The electronic search of the Chinese journal full-text database CNKI,WIP database,Wanfang database,and biomedical database was used to download the experience awareness of famous Chinese gynecologists on the literature of dysmenorrhea treatment,including the self-experience introduction of Chinese gynecologists and the experience summary of students.Conduct a manual search to extract relevant literature on dysmenorrhea treatment.An Excel sheet was used to create a statistical summary table from which all data collected were classified into dysmenorrhea,TCM diagnosis,Western medicine diagnosis,TCM evidence differentiation,and high-frequency pharmacological gender classification.Statistical methods were used to perform frequency statistics for all syndromes,formulations and herbal medicines and to apply association rules to mine potential connections between two diseases,syndromes,prescriptions and herbal medicines to summarize the pharmacological patterns of TCM gynecology treatment of dysmenorrhea.The method was used to provide evidence for differentiation and drug ideas and to improve the efficacy of the clinical treatment of dysmenorrhea.Results:Among the 50 gynecologists in The Experience of Famous Chinese Gynecologists,153 journal articles and 22 monographs that met the requirements were collected,and the total number of prescriptions finally collected was 715.A total of 294 medical cases were included,and the high-risk age group for the onset of dysmenorrhea was concentrated between 27–36 years old.The types of dysmenorrhea can be categorized into eight types,and the number of occurrences in descending order:Qi stagnation and blood stasis,cold clotting and blood stasis,kidney deficiency and blood stasis,heat burning and blood stasis,Qi and blood deficiency,damp-heat stasis,Qi deficiency and blood stasis,and liver and kidney deficiency.Famous TCM gynecologists used 296 kinds of herbs for treating dysmenorrhea,with a total drug frequency of 8020 times,of which the total frequency of the top 100 herbs was 7355 times,accounting for 91.71%of the total frequency.Conclusion:(1)Famous Chinese gynecologists treat dysmenorrhea with the guiding principle of"if it does not pass,it hurts;if it does not glory,it hurts".Blood stasis is the main type of dysmenorrhea,and the method of activating blood stasis is the main treatment for dysmenorrhea.(2)Dysmenorrhea is mainly caused by real evidence,among which primary dysmenorrhea can be caused by real evidence,deficiency evidence and mixed evidence of deficiency and real,and the prescriptions used are mainly sutra prescriptions;secondary dysmenorrhea is mainly caused by real evidence and mixed evidence of deficiency and real,and the prescriptions used are mainly empirical prescriptions and are often used together with drugs to disperse nodules.(3)Commonly used herbal medicines for treating dysmenorrhea include Danggui,Baishao,Chuanxiong,Xiangfu,Yanhusuo,Chishao,Gancao and Wulingzhi.Common classic formulas include Siwu Tang,Wenjing Tang,Shixiao San,Shaofuzhuyu Tang,Sini San,Jinlingzi San,and Xiaoyao San.Typical experienced formulas:Neiyi 1 Fang,Neiyi 2 Fang,Neiyi 3 Fang,Jiaweimojie Tang,Bailiansanjie Tang,Neiyizhitong Tang,Huoxuequyuhuazheng Tang,etc.展开更多
BACKGROUND Ureteral injury is a known complication of hysterectomies.Recent studies have attempted to correlate surgeon volume and experience with incidence of urinary tract injuries during hysterectomies.Some studies...BACKGROUND Ureteral injury is a known complication of hysterectomies.Recent studies have attempted to correlate surgeon volume and experience with incidence of urinary tract injuries during hysterectomies.Some studies have reported that as surgeon volume increases,urinary tract injury rates decrease.To our knowledge,no studies have assessed the relationship between surgeon subspecialty and the rate of urinary tract injury rates during minimally invasive hysterectomy.AIM To determine the incidence of urinary tract injury between urogynecologists,gynecologic oncologists,and general gynecologists.METHODS The study took place from January 1,2016 to December 1,2021 at a large comm-unity hospital in Detroit,Michigan.We conducted a retrospective chart review of adult patients who underwent minimally invasive hysterectomy.After we identified eligible patients,the surgeon subspecialty was identified and the surgeon’s volume per year was calculated.Patient demographics,medical history,physician-dictated operative reports,and all hospital visits postoperatively were reviewed.RESULTS Urologic injury occurred in four patients(2%)in the general gynecologist group,in one patient(1%)in the gynecologic oncologist group,and in one patient(1%)in the urogynecologist group.When comparing high and low-volume surgeons,there was no statistically significant difference in urinary tract injury(1%vs 2%)or bowel injury(1%vs 0%).There were more complications in the low-volume group vs the high-volume group excluding urinary tract,bowel,or major vessel injury.High-volume surgeons had four(1%)patients with a complication and low-volume surgeons had 12(4%)patients with a complication(P=0.04).CONCLUSION Our study demonstrated that there was no difference in the urinary tract injury rate in general gynecologists vs subspecialists,however our study was underpowered.展开更多
<strong>Background:</strong> Cervical cancer is one of the most common cancers, requiring a precise complementary assessment. The aim of this study was to contribute to the improvement of the management of...<strong>Background:</strong> Cervical cancer is one of the most common cancers, requiring a precise complementary assessment. The aim of this study was to contribute to the improvement of the management of cervical cancer by describing the MRI aspects of cervical cancer according to the IFOG-MRI classification. <strong>Material and Methods:</strong> This was a cross-sectional study, conducted in patients who came for clinical suspicion, extension assessment of histologically confirmed cervical cancer, from October 2020 to March 2021, in Yaoundé (Cameroon). <strong>Results:</strong> 54 patients were selected, with an average age of 50.4 years. Genital hemorrhage was the most frequent symptom (92%). The mean tumor size was 52.9 mm. According to IFOG staging, stages Ia, Ib, IIa, IIb, IIIa, IIIb, and IV accounted for 9.10%, 10.20%, 12.50%, 29.50%, 5.70%, 12.50%, and 20% respectively. No patient had known metastasis at the time of examination. <strong>Conclusion:</strong> MRI allows non-invasive, satisfactory tumor staging examination by providing information on tumor size, parametrium invasion, adjacent organ involvement, and the presence of lymph node metastasis.展开更多
The process of medicalization of abortion in Poland began when pregnancy termination procedures were legalized in 1956.The context in which that was possible is important:it happened under the communist rule as part o...The process of medicalization of abortion in Poland began when pregnancy termination procedures were legalized in 1956.The context in which that was possible is important:it happened under the communist rule as part of the Soviet bloc.The main goal of communism was to promote scientific approach to medicine and to eliminate popular folk medicine.The communist rule was also characterized by state feminism,which involved mass employment of women in industry and other occupations.The positive side to the changes was the fact that health care was free of charge.However,the system excluded the care of village healers and abortionists who were replaced by obstetricians-gynecologists,usually men.According to the official propaganda,an abortion that was not performed by a medical professional was dangerous for a woman’s health and could cause her death.Indeed,abortion-related mortality decreased,but the rate of abortion itself did not fall;it gradually increased.This is typical for countries with no free market,including communist ones,where access to contraceptive pills is very limited with abortion being the primary method of birth control.After the fall of communism in Poland,access to abortion was severely restricted;nevertheless,contraceptive pills and morning-after pills are available on prescription from pharmacies.The total fertility rate decreased in comparison to the period of communism and its broad access to abortion.Therefore,I maintain that the process of medicalization of abortion has not ended despite the partial disenfranchisement of women.展开更多
Background： Preeclarnpsia （PE） is a serious idiopathic disease posing a threat to both mothers and fetuses＇ lives during pregnancy, whose main diagnostic criteria include hypertension with proteinuria. However, Am...Background： Preeclarnpsia （PE） is a serious idiopathic disease posing a threat to both mothers and fetuses＇ lives during pregnancy, whose main diagnostic criteria include hypertension with proteinuria. However, American College of Obstetricians and Gynecologists （ACOG） updated the diagnostic criteria for PE and redtlced the diagnostic value of proteinuria for patients with PE. Qualitative analysis of the diagnostic value of 24-h proteinuria for patients with PE in China was conducted to evaluate the diagnostic criteria value in the latest ACOG guideline. Methods： Complete clinical data of 65 patients with hypertensive disorder in pregnancy （HDP） were collected. All patients were delivered to and hospitalized in Renji Hospital. Adverse outcome was defined in case of the emergence of any serious complication for a mother or the fetus. A retrospective study was conducted according to ACOG guideline, to analyze the relationship between each diagnostic criteria of ACOG guideline and maternal and perinatal outcomes. Spearman correlation test was used to detect the association between each diagnostic criterion, its corresponding value, and the adverse pregnancy outcome. Logistic regression was performed to verily the result of Spearman correlation test. Results： Of 65 HDP patients, the percentage of adverse pregnancy outcome was 63.1%. Adverse pregnancy outcomes constitute diversification. There were 55 cases with 24-h proteinuria value ≥0.3 g, of which the adverse outcome rate was 74.5%. While adverse pregnancy outcomes did not appear in the rest 10 HDP patients with proteinuria 〈0.3 /24 h. The statistic difference was significant （P = 0.000）. However, no significant difference was tbund in other criteria groups （impaired liver function： P = 0.417; renal insufficiency： P = 0.194; thrombocytopenia： P - 0.079： and cerebral or visual symptoms： P = 0.296）. The correlation coefficient between 24-h proteinuria ≥0.3 g and adverse pregnancy outcomes was 0.557 （P 〈 0.005）. hnpaired liver function （P = 0.180）, renal insufficiency （P =0.077） and cerebral or visual symptoms （P = 0.118） were not related to adverse outcomes, The 24-h proteinuria value （HDP： r= 0.685; PE： r= 0.521）, liver enzyme value （HDP： r= 0.519; PE： r= 0.501）, and creatinine value （HDP： r= 0.511; PE： r= 0.398） were associated with adverse pregnancy outcomes both in PE and HDP, and the corresponding logistic regression equation can be produced. Conclusions： The 24-h proteinuria value is still an important diagnostic criterion for PE, and deletion of 24-h proteinuria value from diagnostic criteria for severe PE was not recommended. The diagnostic criteria in ACOG guideline need to be verified in Chinese women.展开更多
文摘<strong>Objective: </strong><span><span><span style="font-family:""><span style="font-family:Verdana;">The purpose of this study was to analyze the opinions of gynecologists, midwives, and interns/Specialist students practicing in Senegal about the use of IUD, and to assess factors that stand as obstacles to IUD prescribing. </span><b><span style="font-family:Verdana;">Patients and methods: </span></b><span style="font-family:Verdana;">An online questionnaire was developed to assess providers’ IUD practices and attitudes. The questionnaire was based on the one used in a Swiss study on the same topic. The platform used was Google forms. The questionnaire was shared in associative platforms involving gynecologists, midwives and interns/Specialist students. </span><b><span style="font-family:Verdana;">Results and comments: </span></b><span style="font-family:Verdana;">We received 292 feedbacks. Gynecologists represented 13.7% of the sample, interns and specialist students 11.3% and midwives 76%. Parity is a determining factor in IUD selection. The care-providers were concerned about the followings, which might have prevented the use of IUD, even </span><span style="font-family:Verdana;">though it </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">was</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> indicated: infections (75.7%), pelvic pain (61.3%), expulsion (48.3%), increased risk of perforation (46.9%), women’s appreciation </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">(45.2%), ectopic pregnancy (33.9%) and sexual behavior (28.4%). </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Our study reveals that providers’ apprehensions and concerns severely limit the availability of IUDs. These concerns are often unfounded, based on personal experiences and not on official recommendations. Parity is a major obstacle.</span></span></span></span>
文摘Objective:To explore the pattern of medication used in the treatment of dysmenorrhea by famous Chinese gynecologists based on the data mining method.Method:The electronic search of the Chinese journal full-text database CNKI,WIP database,Wanfang database,and biomedical database was used to download the experience awareness of famous Chinese gynecologists on the literature of dysmenorrhea treatment,including the self-experience introduction of Chinese gynecologists and the experience summary of students.Conduct a manual search to extract relevant literature on dysmenorrhea treatment.An Excel sheet was used to create a statistical summary table from which all data collected were classified into dysmenorrhea,TCM diagnosis,Western medicine diagnosis,TCM evidence differentiation,and high-frequency pharmacological gender classification.Statistical methods were used to perform frequency statistics for all syndromes,formulations and herbal medicines and to apply association rules to mine potential connections between two diseases,syndromes,prescriptions and herbal medicines to summarize the pharmacological patterns of TCM gynecology treatment of dysmenorrhea.The method was used to provide evidence for differentiation and drug ideas and to improve the efficacy of the clinical treatment of dysmenorrhea.Results:Among the 50 gynecologists in The Experience of Famous Chinese Gynecologists,153 journal articles and 22 monographs that met the requirements were collected,and the total number of prescriptions finally collected was 715.A total of 294 medical cases were included,and the high-risk age group for the onset of dysmenorrhea was concentrated between 27–36 years old.The types of dysmenorrhea can be categorized into eight types,and the number of occurrences in descending order:Qi stagnation and blood stasis,cold clotting and blood stasis,kidney deficiency and blood stasis,heat burning and blood stasis,Qi and blood deficiency,damp-heat stasis,Qi deficiency and blood stasis,and liver and kidney deficiency.Famous TCM gynecologists used 296 kinds of herbs for treating dysmenorrhea,with a total drug frequency of 8020 times,of which the total frequency of the top 100 herbs was 7355 times,accounting for 91.71%of the total frequency.Conclusion:(1)Famous Chinese gynecologists treat dysmenorrhea with the guiding principle of"if it does not pass,it hurts;if it does not glory,it hurts".Blood stasis is the main type of dysmenorrhea,and the method of activating blood stasis is the main treatment for dysmenorrhea.(2)Dysmenorrhea is mainly caused by real evidence,among which primary dysmenorrhea can be caused by real evidence,deficiency evidence and mixed evidence of deficiency and real,and the prescriptions used are mainly sutra prescriptions;secondary dysmenorrhea is mainly caused by real evidence and mixed evidence of deficiency and real,and the prescriptions used are mainly empirical prescriptions and are often used together with drugs to disperse nodules.(3)Commonly used herbal medicines for treating dysmenorrhea include Danggui,Baishao,Chuanxiong,Xiangfu,Yanhusuo,Chishao,Gancao and Wulingzhi.Common classic formulas include Siwu Tang,Wenjing Tang,Shixiao San,Shaofuzhuyu Tang,Sini San,Jinlingzi San,and Xiaoyao San.Typical experienced formulas:Neiyi 1 Fang,Neiyi 2 Fang,Neiyi 3 Fang,Jiaweimojie Tang,Bailiansanjie Tang,Neiyizhitong Tang,Huoxuequyuhuazheng Tang,etc.
文摘BACKGROUND Ureteral injury is a known complication of hysterectomies.Recent studies have attempted to correlate surgeon volume and experience with incidence of urinary tract injuries during hysterectomies.Some studies have reported that as surgeon volume increases,urinary tract injury rates decrease.To our knowledge,no studies have assessed the relationship between surgeon subspecialty and the rate of urinary tract injury rates during minimally invasive hysterectomy.AIM To determine the incidence of urinary tract injury between urogynecologists,gynecologic oncologists,and general gynecologists.METHODS The study took place from January 1,2016 to December 1,2021 at a large comm-unity hospital in Detroit,Michigan.We conducted a retrospective chart review of adult patients who underwent minimally invasive hysterectomy.After we identified eligible patients,the surgeon subspecialty was identified and the surgeon’s volume per year was calculated.Patient demographics,medical history,physician-dictated operative reports,and all hospital visits postoperatively were reviewed.RESULTS Urologic injury occurred in four patients(2%)in the general gynecologist group,in one patient(1%)in the gynecologic oncologist group,and in one patient(1%)in the urogynecologist group.When comparing high and low-volume surgeons,there was no statistically significant difference in urinary tract injury(1%vs 2%)or bowel injury(1%vs 0%).There were more complications in the low-volume group vs the high-volume group excluding urinary tract,bowel,or major vessel injury.High-volume surgeons had four(1%)patients with a complication and low-volume surgeons had 12(4%)patients with a complication(P=0.04).CONCLUSION Our study demonstrated that there was no difference in the urinary tract injury rate in general gynecologists vs subspecialists,however our study was underpowered.
文摘<strong>Background:</strong> Cervical cancer is one of the most common cancers, requiring a precise complementary assessment. The aim of this study was to contribute to the improvement of the management of cervical cancer by describing the MRI aspects of cervical cancer according to the IFOG-MRI classification. <strong>Material and Methods:</strong> This was a cross-sectional study, conducted in patients who came for clinical suspicion, extension assessment of histologically confirmed cervical cancer, from October 2020 to March 2021, in Yaoundé (Cameroon). <strong>Results:</strong> 54 patients were selected, with an average age of 50.4 years. Genital hemorrhage was the most frequent symptom (92%). The mean tumor size was 52.9 mm. According to IFOG staging, stages Ia, Ib, IIa, IIb, IIIa, IIIb, and IV accounted for 9.10%, 10.20%, 12.50%, 29.50%, 5.70%, 12.50%, and 20% respectively. No patient had known metastasis at the time of examination. <strong>Conclusion:</strong> MRI allows non-invasive, satisfactory tumor staging examination by providing information on tumor size, parametrium invasion, adjacent organ involvement, and the presence of lymph node metastasis.
文摘The process of medicalization of abortion in Poland began when pregnancy termination procedures were legalized in 1956.The context in which that was possible is important:it happened under the communist rule as part of the Soviet bloc.The main goal of communism was to promote scientific approach to medicine and to eliminate popular folk medicine.The communist rule was also characterized by state feminism,which involved mass employment of women in industry and other occupations.The positive side to the changes was the fact that health care was free of charge.However,the system excluded the care of village healers and abortionists who were replaced by obstetricians-gynecologists,usually men.According to the official propaganda,an abortion that was not performed by a medical professional was dangerous for a woman’s health and could cause her death.Indeed,abortion-related mortality decreased,but the rate of abortion itself did not fall;it gradually increased.This is typical for countries with no free market,including communist ones,where access to contraceptive pills is very limited with abortion being the primary method of birth control.After the fall of communism in Poland,access to abortion was severely restricted;nevertheless,contraceptive pills and morning-after pills are available on prescription from pharmacies.The total fertility rate decreased in comparison to the period of communism and its broad access to abortion.Therefore,I maintain that the process of medicalization of abortion has not ended despite the partial disenfranchisement of women.
文摘Background： Preeclarnpsia （PE） is a serious idiopathic disease posing a threat to both mothers and fetuses＇ lives during pregnancy, whose main diagnostic criteria include hypertension with proteinuria. However, American College of Obstetricians and Gynecologists （ACOG） updated the diagnostic criteria for PE and redtlced the diagnostic value of proteinuria for patients with PE. Qualitative analysis of the diagnostic value of 24-h proteinuria for patients with PE in China was conducted to evaluate the diagnostic criteria value in the latest ACOG guideline. Methods： Complete clinical data of 65 patients with hypertensive disorder in pregnancy （HDP） were collected. All patients were delivered to and hospitalized in Renji Hospital. Adverse outcome was defined in case of the emergence of any serious complication for a mother or the fetus. A retrospective study was conducted according to ACOG guideline, to analyze the relationship between each diagnostic criteria of ACOG guideline and maternal and perinatal outcomes. Spearman correlation test was used to detect the association between each diagnostic criterion, its corresponding value, and the adverse pregnancy outcome. Logistic regression was performed to verily the result of Spearman correlation test. Results： Of 65 HDP patients, the percentage of adverse pregnancy outcome was 63.1%. Adverse pregnancy outcomes constitute diversification. There were 55 cases with 24-h proteinuria value ≥0.3 g, of which the adverse outcome rate was 74.5%. While adverse pregnancy outcomes did not appear in the rest 10 HDP patients with proteinuria 〈0.3 /24 h. The statistic difference was significant （P = 0.000）. However, no significant difference was tbund in other criteria groups （impaired liver function： P = 0.417; renal insufficiency： P = 0.194; thrombocytopenia： P - 0.079： and cerebral or visual symptoms： P = 0.296）. The correlation coefficient between 24-h proteinuria ≥0.3 g and adverse pregnancy outcomes was 0.557 （P 〈 0.005）. hnpaired liver function （P = 0.180）, renal insufficiency （P =0.077） and cerebral or visual symptoms （P = 0.118） were not related to adverse outcomes, The 24-h proteinuria value （HDP： r= 0.685; PE： r= 0.521）, liver enzyme value （HDP： r= 0.519; PE： r= 0.501）, and creatinine value （HDP： r= 0.511; PE： r= 0.398） were associated with adverse pregnancy outcomes both in PE and HDP, and the corresponding logistic regression equation can be produced. Conclusions： The 24-h proteinuria value is still an important diagnostic criterion for PE, and deletion of 24-h proteinuria value from diagnostic criteria for severe PE was not recommended. The diagnostic criteria in ACOG guideline need to be verified in Chinese women.
