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Sample records for abandoned radical hysterectomy

  1. Place of Schauta's radical vaginal hysterectomy.

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    Roy, Michel; Plante, Marie

    2011-04-01

    Women affected by early stage invasive cancer of the cervix are usually treated by surgery. Radical abdominal hysterectomy with pelvic lymphadenectomy is the most widely used technique. Because the morbidity of the abdominal approach can be important, the radical vaginal hysterectomy has gained acceptance in gynaecologic oncology. New instrumentation in laparoscopy also opens the possibility of treating cervical cancer by laparoscopically assisted vaginal radical hysterectomy and also total laparoscopic radical hysterectomy. Before these techniques become widely accepted, it has to be shown that safety and efficacy are comparable with the 'standard' abdominal approach. In this chapter, we review the technique of radical vaginal hysterectomy with pelvic lymphadenectomy and evaluate results of published studies, comparing the abdominal, vaginal and laparoscopic approaches.

  2. Pilot study of radical hysterectomy versus radical trachelectomy on sexual distress.

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    Brotto, Lori A; Smith, Kelly B; Breckon, Erin; Plante, Marie

    2013-01-01

    Radical trachelectomy, which leaves the uterus intact, has emerged as a desirable surgical option for eligible women with early-stage cervical cancer who wish to preserve fertility. The available data suggest excellent obstetrical outcomes with radical trachelectomy, and no differences in sexual responding between radical trachelectomy and radical hysterectomy. There is a need to examine the effect of radical hysterectomy on sexual distress given that it is distinct from sexual function. Participants were 34 women diagnosed with early-stage cervical cancer. The authors report 1-month postsurgery data for 29 women (radical hysterectomy group: n = 17, M age = 41.8 years; radical trachelectomy group: n = 12, M age = 31.8 years), and 6-month follow-up data on 26 women. Whereas both groups experienced an increase in sex-related distress immediately after surgery, distress continued to increase 6 months after surgery for the radical hysterectomy group but decreased in the radical trachelectomy group. There were no between-group differences in mood, anxiety, or general measures of health. The decrease in sex-related distress in the radical trachelectomy but not in the radical hysterectomy group suggests that the preservation of fertility may have attenuated sex-related distress. Care providers should counsel women exploring surgical options for cervical cancer about potential sex distress-related sequelae.

  3. Comparison of Nerve-Sparing Radical Hysterectomy and Radical Hysterectomy: a Systematic Review and Meta-Analysis

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    Zhuowei Xue

    2016-05-01

    Full Text Available Background/Aims: Radical hysterectomy (RH for the treatment of cervical cancer frequently caused pelvic organ dysfunctions. This study aimed to compare the results of pelvic organ function and recurrence rate after Nerve sparing radical hysterectomy (NSRH and RH treatment through systematic review and meta-analysis. Methods: PubMed, Web of Science and China Knowledge Resource Integrated Database were searched from inception to 25 February 2015. Studies of cervical cancer which reported radical hysterectomy or nerve sparing radical hysterectomy were included. The quality of included studies was evaluated using the guidelines of Cochrane Handbook for Systematic Reviews of Interventions. Statistical analysis was performed using Review Manager 5.3 software (Cochrane Collaboration. Results: A total of 20 studies were finally included. Meta-analysis demonstrated that NSRH was associated with less bladder and anorectal dysfunction than RH. The time to bladder and anorectal function recovery after NSRH was shorter than RH. Patients undergoing NSRH also scored higher than patients undergoing RH at Female Sexual Function Index (FSFI. On the other hand, the local recurrence and overall recurrence rate were similar between NSRH and RH. Conclusion: NSRH may be an effective technique for lowering pelvic organ dysfunction and improving the function recovery without increasing the recurrence rate of cervical cancer.

  4. Radical Hysterectomy and Total Abdominal Vaginectomy for Primary Vaginal Cancer.

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    Ozgul, Nejat; Basaran, Derman; Boyraz, Gokhan; Salman, Coskun; Yuce, Kunter

    2016-03-01

    The aim of this surgical video is to demonstrate en bloc radical removal of uterus and vagina in a patient with clinical early-stage vaginal cancer. Surgical treatment was offered to our patient for clinical early-stage primary vaginal cancer. An en bloc radical hysterectomy, systematic pelvic lymphadenectomy, and total abdominal vaginectomy were performed. Postoperative adjuvant radiation or chemotherapy was not recommended for completely resected pathologic stage I disease with no lymph node involvement and negative surgical margins. Radical surgery can be a treatment option for selected patients with primary vaginal cancer. PMID:26825828

  5. Laparoscopic pelvic anatomy of nerve-sparing radical hysterectomy.

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    Park, Nae Yoon; Cho, Young Lae; Park, Il Soo; Lee, Yoon Soon

    2010-03-01

    Many reports regarding nerve-sparing radical hysterectomy have been published. However, most reports have been based on systematic descriptions via laparotomy or cadaver dissection. The aim of this work was to describe the pelvic anatomy of nerve-sparing radical hysterectomy via laparoscopy, with specific focus on the inferior hypogastric plexus. This study is based on 125 patients with FIGO stage IB cervical cancer who had undergone laparoscopic nerve-sparing radical hysterectomies since 1999. The inferior hypogastric plexus was demonstrated via laparoscopy and was comprised of afferent fibers from the sacral root (S2, S3, and S4), sacral sympathetic ganglion, and hypogastric nerve, and efferent fibers forming its vesical, uterovaginal, and rectal branches. During the dissection of the posterior leaf of the vesicouterine ligament, various vesical veins were identified. If the cut edge of an inferior vesical vein was pulled medially with upward traction, the vesical branches of the inferior hypogastric plexus were exposed and these were divided into medial and lateral branches. The magnified view of laparoscopy made it possible to dissect nerves and vessels meticulously and to secure a clear resection margin during the dissection of the deep part of the cardinal ligament, uterosacral ligament, and posterior leaf of the vesicouterine ligament. PMID:20108355

  6. Urological complications after radical hysterectomy: Incidence rates and predisposing factors

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    Likić-Lađević Ivana

    2007-01-01

    Full Text Available Bacground/Aim. Radical hysterectomy is a surgical approach for stage Ib and IIa of cervical cancer. The incidence of intraoperative injuries of the bladder during radical hysterectomy ranges from 0.4-3.7%. The ureter can be crushed, caught in sutures, transsected, obstructed by angulation, or ischemic by the stippling or periureteric fascia. Vesicovaginal and ureterovaginal fistuls are reported to develop in 0.9-2% of patients after radical abdominal hysterectomy. Fistulas usually become manifested or visible at speculum examination within 14 days following the surgery. The aim of this study was to establish the incidence and predisposing factor of urological complications after radical hysterectomy. Methods. The study included a total of 536 patients with invasive stage Ib to IIb cancer of the cervix uteri who had underwent radical hysterectomy. The special elements considered were: the patient’s age; the International Federation of Ginecology and Obstetrics (FIGO stage after pathohistology; duration of operation; the result of preoperative laboratory tests for diabetes, anemia, hypoproteinemia, or disorders of liver or kidney function; ASA status; postoperative surgical infection. Results. The average age of the patients with complications was 48.68 years. All patients with intraoperative ureteric and bladder injuries had statisticaly significant higher stage of disease and operation lasted more than in others without injury. We noticed 1.3% ureteral injuries and 1.49% bladder injuries, more than 50% of the patients with a previously mentioned injuries were operated on more than 3 hours. We found 2.61% vesicovaginal and 2.43% ureterovaginal fistuls. A total of 50% of the patients with bladder injury and vesicovaginal fistuls and 70% of the patients with ureterovaginal fistuls had diabetes mellitus. Postoperative infection of surgical site is a very important factor for the development of fistule. Half of the patients with vesicovaginal

  7. Can radical parametrectomy be omitted inoccult cervical cancer afterextrafascial hysterectomy?

    Institute of Scientific and Technical Information of China (English)

    Huai-WuLu,; JingLi,; Yun-YunLiu,; Chang-HaoLiu,; Guo-CaiXu,; Ling-LingXie,; Miao-FangWu; Zhong-QiuLin

    2015-01-01

    Background:Occult invasive cervical cancer discovered after simple hysterectomy is not common, radical parame‑trectomy (RP) is a preferred option for young women. However, the morbidity of RP was high. The aim of our study is to assess the incidence of parametrial involvement in patients who underwent radical parametrectomy for occult cervical cancer or radical hysterectomy for early‑stage cervical cancer and to suggest an algorithm for the triage of patients with occult cervical cancer to avoid RP. Methods:A total of 13 patients with occult cervical cancer who had undergone RP with an upper vaginectomy and pelvic lymphadenectomy were included in this retrospective study. Data on the clinicopathologic characteristics of the cases were collected. The published literature was also reviewed, and low risk factors for parametrial involvement in early‑stage cervical cancer were analyzed. Results:Of the 13 patients, 9 had a stage IB1 lesion, and 4 had a stage IA2 lesion. There were four patients with grade 1 disease, seven with grade 2 disease, and two with grade 3 disease. The median age of the entire patients was 41years. The most common indication for extrafascial hysterectomy was cervical intraepithelial neoplasia 3. Three patients had visible lesions measuring 10–30mm, in diameter and ten patients had cervical stromal invasions with depths ranging from 4 to 9mm; only one patient had more than 50% stromal invasion, and four patients had lymph‑vascular space invasion (LVSI). Perioperative complications included intraoperative bowel injury, blood transfusion, vesico‑vaginal ifstula, and ileus (1 case for each). Postoperative pathologic examination results did not show residual disease or parametrial involvement. One patient with positive lymph nodes received concurrent radiation therapy. Only one patient experienced recurrence. Conclusions:Perioperative complications following RP were common, whereas the incidence of parametrial involve‑ment was very low

  8. Radical hysterectomy with adjuvant radiotherapy versus radical radiotherapy for FIGO stage IIB cervical cancer

    International Nuclear Information System (INIS)

    The goal of this study was to compare treatment outcomes for Federation of Gynecology and Obstetrics (FIGO) stage IIB cervical carcinoma patients receiving radical surgery followed by adjuvant postoperative radiotherapy versus radical radiotherapy. Medical records of FIGO stage IIB cervical cancer patients treated between July 2008 and December 2011 were retrospectively reviewed. A total of 148 patients underwent radical hysterectomy with pelvic lymph node dissection followed by adjuvant radiotherapy (surgery-based group). These patients were compared with 290 patients that received radical radiotherapy alone (RT-based group). Recurrence rates, progression-free survival (PFS), overall survival (OS), local control rates, and treatment-related complications were compared for these two groups. Similar rates of recurrence (16.89% vs. 12.41%, p = 0.200), PFS (log-rank, p = 0.211), OS (log-rank, p = 0.347), and local control rates (log-rank, p = 0.668) were observed for the surgery-based group and the RT-based group, respectively. Moreover, the incidence of acute grade 3–4 gastrointestinal reactions and late grade 3–4 lower limb lymphedema were significantly higher for the surgery-based group versus the RT-based group. Cox multivariate analyses found no significant difference in survival outcome between the two groups, and tumor diameter and histopathology were identified as significant prognostic factors for OS. Radical radiotherapy was associated with fewer treatment-related complications and achieved comparable survival outcomes for patients with FIGO stage IIB cervical cancer compared to radical hysterectomy followed by postoperative radiotherapy

  9. Application of da Vinci® Robot in simple or radical hysterectomy: Tips and tricks

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    Iavazzo, Christos; Gkegkes, Ioannis D.

    2016-01-01

    The first robotic simple hysterectomy was performed more than 10 years ago. These days, robotic-assisted hysterectomy is accepted as an alternative surgical approach and is applied both in benign and malignant surgical entities. The two important points that should be taken into account to optimize postoperative outcomes in the early period of a surgeon’s training are how to achieve optimal oncological and functional results. Overcoming any technical challenge, as with any innovative surgical method, leads to an improved surgical operation timewise as well as for patients’ safety. The standardization of the technique and recognition of critical anatomical landmarks are essential for optimal oncological and clinical outcomes on both simple and radical robotic-assisted hysterectomy. Based on our experience, our intention is to present user-friendly tips and tricks to optimize the application of a da Vinci® robot in simple or radical hysterectomies. PMID:27403078

  10. Early-stage cervical carcinoma, radical hysterectomy, and sexual function. A longitudinal study

    DEFF Research Database (Denmark)

    Jensen, Pernille T; Groenvold, Mogens; Klee, Marianne C;

    2004-01-01

    BACKGROUND: Limited knowledge exists concerning the impact of radical hysterectomy (RH) alone on the sexual function of patients with early-stage cervical carcinoma. The authors investigated the longitudinal course of self-reported sexual function after RH. METHODS: The current study was comprise...

  11. Adjuvant postoperative radiation therapy following simple hysterectomy and radical hysterectomy in stage IB cancer of the cervix: Analysis of risk factors and patterns of failure

    International Nuclear Information System (INIS)

    Between 1969 and 1980, 242 cases of stage IB cancer of the cervix were referred to the department of radiation oncology for curative radiation therapy. In 186 cases treatment was with radiation therapy alone. In 56 cases treatment included adjuvant postoperative radiation therapy; a minimum follow-up of 5 years has been carried out in this group. In 17 cases radiation therapy followed a simple hysterectomy for an unexpected stage IB cancer of the cervix. In 39 cases radiation therapy was given after a radical hysterectomy for stage IB cancer of the cervix because of positive margins and/or positive pelvic lymph nodes

  12. Complications after radiotherapy and radical hysterectomy in early-stage cervical carcinoma

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    Gerdin, E. [Univ. Hospital, Dept. of Obstetrics and Gynecology, and Gynecologic Oncology, Uppsala (Sweden); Cnattingius, S. [Univ. Hospital, Dept. of Social Medicine, Uppsala (Sweden); Johnson, P. [Univ. Hospital, Dept. of Obstetrics and Gynecology, Uppsala (Sweden)

    1995-08-01

    Objective: To evaluate the overall complications, major as well as minor, in patients treated for early-stage cervical carcinoma as related to treatment parameters. Methods: In this retrospective study, 167 consecutive patients with early-stage cervical carcinoma treated with preoperative radiotherapy and radical hysterectomy were investigated. Clinical data were collected from the medical files. Results: Transient or permanent complications appeared in up to half of all patients. Seven percent exhibited intraoperative complications and 35% suffered from early postoperative urinary tract problems; most frequently urinary tract infection. After one year, the urinary tract complications dominated; voidance difficulties and incontinence being most common. Gastrointestinal complications occurred in 15% of patients. Lymphedema appeared during the first year in 21% of the patients but several of the mild or moderate cases improved after the first year. The relative risk of lymphedema was increased with shorter duration of surgery, extensive preoperative irradiation to the bladder and after external postoperative irradiation. Some form of late sequelae remained in every fifth patient, and every fourth patient, aged 23-44 years, periodically suffered from vasomotor symptoms despite estrogen replacement therapy. Conclusion: The complications after radiotherapy and radical hysterectomy in early stage cervical carcinoma suggest that attempts should be made to evaluate effective treatments designed to minimize risk to the patients. (au) 29 refs.

  13. The anatomical basis and prevention of neurogenic voiding dysfunction following radical hysterectomy.

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    Tong, X K; Huo, R J

    1991-01-01

    The disorder of neurogenic dysfunction is one of the most important complications of radical hysterectomy. In order to prevent this potential complication, the authors have studied the composition and layers of the pelvic paravisceral structures. The nerve branching and distribution of the pelvic plexus of 12 adult female cadavers were analyzed. From lateral to medial the pelvic paravisceral structure is made up of three layers. The lateral layer is the pelvic visceral fascia, the middle, a vascular layer, and the medial one, a nervous one which consists of the pelvic plexus and subsidiary plexuses. The pelvic plexus and subsidiary plexuses are laid closely to the lateral walls of pelvic organs. The ischial spine was taken as the central point and two perpendicular lines penetrating through the ischial spine were used as the longitudinal axis and transverse axis. According to these landmarks, the pelvic plexus could be divided into three parts: behind the longitudinal axis are the roots of the pelvic plexus, near the longitudinal axis is the uterovaginal plexus, and in front of the longitudinal axis are the branches distributed to bladder and urethra. The pelvic plexus and the uterosacral and cardinal ligaments are closely related. The pelvic and subsidiary plexuses can be damaged in radical hysterectomy and voiding dysfunction may then develop. Some anatomic bases are provided to explain and hopefully prevent this from happening. PMID:1925917

  14. Radical Hysterectomy

    Science.gov (United States)

    ... with grief and loss Rebuilding self-esteem Good communication: The key to building a successful sexual relationship Overcoming anxiety about sex Rekindling sexual interest Sexual activity with your partner ...

  15. Adjuvant radiotherapy after radical hysterectomy of the cervical cancer. Prognostic factors and complications

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    Chatani, Masashi; Nose, Takayuki; Masaki, Norie [Osaka Univ. Medical School (Japan). Dept. of Radiation Therapy; Inoue, Toshihiko [Osaka Univ. Medical School (Japan). Dept. of Radiation Oncology

    1998-10-01

    Aim: To investigate prognostic factors and complications after radical hysterectomy followed by postoperative radiotherapy for carcinoma of the uterine cervix. Patients and Methods: One hundred twenty-eight patients with T1b-2b carcinoma of the uterine cervix following radical hysterectomy with bilateral pelvic lymphadenectomy and postoperative radiation therapy were reviewed. Pathologic and treatment variables were assessed by multivariate analysis for local recurrence, distant metastases and cause specific survival. Results: The number of positive nodes (PN) in the pelvis was the strongest predictor of pelvic recurrence and distant metastases. These 2 failure patterns independently affect the cause specific survival. The 5-year cumulative local and distant failure were PN(0): 2% and 12%, PN(1-2): 23% and 25%, PN(2<): 32% and 57%, respectively (p=0.0029 and p=0.0051). The 5-year cause specific survival rates were PN(0): 90%, PN(1-2): 59% and PN(2<): 42% (p=0.0001). The most common complication was lymphedema of the foot experienced by one-half of the patients (5-year: 42%, 10-year: 49%). Conclusion: These results suggest that patients with pathologic T1b-T2b cervix cancer with pelvic lymph node metastases are at high risk of recurrence or metastases after radical hysterectomy with pelvic lymphadenectomy and postoperative irradiation. (orig.) [Deutsch] Ziel: Untersuchung der prognostischen Faktoren und Komplikationen der adjuvanten Radiotherapie nach radikaler Hysterektomie bei Patienten mit Zervixkarzinom. Patienten und Methoden: In dieser Studie wurden 128 Patientinnen mit Zervixkarzinom untersucht, bei denen die pathologische Untersuchung nach radikaler Hysterektomie mit gleichzeitiger bilateraler pelvischer Lymphadenektomie und postoperativer Radiotherapie die Klassifikation als T1b-T2b-Karzinome ergab. Dabei wurden pathologische und therapeutische Parameter auf der behandelten Seite mit Hilfe der Multivarianzanalyse auf lokale Rezidive und Fernmetastasen

  16. Clinical efficacy and safety of paclitaxel plus carboplatin as neoadjuvant chemotherapy prior to radical hysterectomy and pelvic lymphadenectomy for Stage IB2-IIB cervical cancer

    OpenAIRE

    Yang, Lu; Guo, Jianfeng; Shen, Yi; Cai, Jing; Xiong, Zhoufang; Dong, Weihong; Min, Jie; Wang, Zehua

    2015-01-01

    Objective: To assess the efficacy and toxicity of the combination of paclitaxel plus carboplatin as neoadjuvant chemotherapy (NACT) for locally advanced cervical cancer (LACC) prior to radical hysterectomy and pelvic lymphadenectomy. Methods: We reviewed patients with cervical cancer of the International Federation of Gynecology and Obstetrics (FIGO) stage IB2-IIB who underwent neoadjuvant chemotherapy (NACT) with paclitaxel plus carboplatin followed by radical hysterectomy (NACT group) or on...

  17. Morbidity and survival patterns in patients after radical hysterectomy and postoperative adjuvant pelvic radiotherapy

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    Fiorica, J.V.; Roberts, W.S.; Greenberg, H.; Hoffman, M.S.; LaPolla, J.P.; Cavanagh, D. (Univ.ersity of South Florida College of Medicine, Tampa (USA))

    1990-03-01

    Morbidity and survival patterns were reviewed in 50 patients who underwent radical hysterectomy, pelvic lymphadenectomy, and adjuvant postoperative pelvic radiotherapy for invasive cervical cancer. Ninety percent of the patients were FIGO stage IB, and 10% were clinical stage IIA or IIB. Indications for adjuvant radiotherapy included pelvic lymph node metastasis, large volume, deep stromal penetration, lower uterine segment involvement, or capillary space involvement. Seventy-two percent of the patients had multiple high-risk factors. An average of 4700 cGy of whole-pelvis radiotherapy was administered. Ten percent of the patients suffered major gastrointestinal complications, 14% minor gastrointestinal morbidity, 12% minor genitourinary complications, one patient a lymphocyst, and one patient lymphedema. Of the five patients with major gastrointestinal morbidity, all occurred within 12 months of treatment. Three patients required intestinal bypass surgery for distal ileal obstructions and all are currently doing well and free of disease. All of the patients who developed recurrent disease had multiple, high-risk factors. The median time of recurrence was 12 months. All patients recurred within the radiated field. Actuarial survival was 90% and disease-free survival 87% at 70 months. It is our opinion that the morbidity of postoperative pelvic radiotherapy is acceptable, and benefit may be gained in such a high-risk patient population.

  18. Adjuvant radiotherapy following radical hysterectomy for patients with stage IB and IIA cervical cancer

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    Soisson, A.P.; Soper, J.T.; Clarke-Pearson, D.L.; Berchuck, A.; Montana, G.; Creasman, W.T. (Duke Univ. Medical Center, Durham, NC (USA))

    1990-06-01

    From 1971 through 1984, 320 women underwent radical hysterectomy as primary therapy of stage IB and IIA cervical cancer. Two hundred forty-eight patients (78%) were treated with surgery alone and 72 patients (22%) received adjuvant postoperative external-beam radiotherapy. Presence of lymph node metastasis, large lesion (greater than 4 cm in diameter), histologic grade, race (noncaucasian), and age (greater than 40 years) were significant poor prognostic factors for the entire group of patients. Patients treated with surgery alone had a better disease-free survival than those who received combination therapy (P less than 0.001). However, patients receiving adjuvant radiation therapy had a higher incidence of lymphatic metastases, tumor involvement of the surgical margin, and large cervical lesions. Adjuvant pelvic radiation therapy did not improve the survival of patients with unilateral nodal metastases or those who had a large cervical lesion with free surgical margins and the absence of nodal involvement. Radiation therapy appears to reduce the incidence of pelvic recurrences. Unfortunately, 84% of patients who developed recurrent tumor after combination therapy had a component of distant failure. The incidence of severe gastrointestinal or genitourinary tract complications was not different in the two treatment groups. However, the incidence of lymphedema was increased in patients who received adjuvant radiation therapy. Although adjuvant radiation therapy appears to be tolerated without a significant increase in serious complications, the extent to which it may improve local control rates and survival in high-risk patients appears to be limited. In view of the high incidence of distant metastases in high-risk patients, consideration should be given to adjuvant systemic chemotherapy in addition to radiation therapy.

  19. Comparison of remifentanil and fentanyl in patients undergoing modified radical mastectomy or total hysterectomy

    Institute of Scientific and Technical Information of China (English)

    郭向阳; 易杰; 叶铁虎; 罗爱伦; 黄宇光; 任洪智

    2003-01-01

    Objective To compare the efficacy and safety of remifentanil and fentanyl in patients undergoing a modified radical mastectomy or total hysterectomy.Methods Fifty-four patients were evenly randomised into remifentanil group and fentanyl group. Anesthesia was induced by propofol (1-2 mg/kg) and either remifentanil (2 μg/kg) or fentanyl (2.5 μg/kg), and was maintained with inhalation of nitrous oxide in oxygen (2∶1) and continuous infusion of either remifentanil (0.2 μg*kg-1*min-1) or fentanyl(0.03 μg*kg-1*min-1). Results The number of patients exhibiting light anesthesia responses in the remifentanil group during intubation and the maintenance of anesthesia was significantly less than that in the fentanyl group. Both systolic and diastolic blood pressures in the fentanyl group were significantly higher than those in the remifentanil group during intubation, skin incision, maintenance of anesthesia and extubation. The time to opening eyes on command and the time for extubation after surgery was comparable between the two groups. More patients in the remifentanil group (25 patients) required bolus injection of morphine for postoperative pain relief than those in the fentanyl group (5 patients, P<0.05). There was no significant difference between the two groups in terms of side effects.Conclusions Under the condition of this study protocol, the anesthetic and analgesic effects of remifentanil are more potent than those of fentanyl. Remifentanil can offer superior intraoperative hemodynamic stability in comparison with fentanyl, and has no compromising recovery from anesthesia.

  20. Risk model in stage IB1-IIB cervical cancer with positive node after radical hysterectomy

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    Chen Z

    2016-05-01

    Full Text Available Zhilan Chen,1,2,* Kecheng Huang,1,* Zhiyong Lu,1,3 Song Deng,1,4 Jiaqiang Xiong,1 Jia Huang,1 Xiong Li,5 Fangxu Tang,1 Zhihao Wang,6 Haiying Sun,1 Lin Wang,1 Shasha Zhou,1 Xiaoli Wang,1 Yao Jia,1 Ting Hu,1 Juan Gui,7 Dongyi Wan,1 Ding Ma,1 Shuang Li,1 Shixuan Wang11Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Techonology, Wuhan, 2Department of Obstetrics and Gynecology, Wuhan General Hospital of Guangzhou Military Command, Wuhan, 3Hubei Key Laboratory of Embryonic Stem Cell Research, Tai-He Hospital, Hubei University of Medicine, Shiyan, Hubei, 4Department of Obstetrics and Gynecology, University Hospital of Hubei University for Nationalities, Enshi, Hubei, 5Department of Obstetrics and Gynecology, Wuhan Central Hospital, Wuhan, 6Department of Pathology and Pathophysiology, Key Laboratory of Ministry of Education of China for Neurological Disorders, Huazhong University of Science and Techonology, Wuhan, 7Department of Obstetrics and Gynecology, Renmin Hospital, Wuhan University, Wuhan, People’s Republic of China*These authors contributed equally to this workAbstract: The purpose of this study was to identify risk factors in patients with surgically treated node-positive IB1-IIB cervical cancer and to establish a risk model for disease-free survival (DFS and overall survival (OS. A total of 170 patients who underwent radical hysterectomy and bilateral pelvic lymphadenectomy as primary treatment for node-positive International Federation of Gynaecology and Obstetrics (FIGO stage IB1-IIB cervical cancer from January 2002 to December 2008 were retrospectively analyzed. Five published risk models were evaluated in this population. The variables, including common iliac lymph node metastasis and parametrial invasion, were independent predictors of outcome in a multivariate analysis using a Cox regression model. Three distinct prognostic groups (low, intermediate, and high risk

  1. Management of low-risk early-stage cervical cancer: Should conization, simple trachelectomy, or simple hysterectomy replace radical surgery as the new standard of care?

    OpenAIRE

    Ramirez, Pedro T.; Pareja, Rene; Rendón, Gabriel J.; Millan, Carlos; Frumovitz, Michael; Schmeler, Kathleen M.

    2013-01-01

    The standard treatment for women with early-stage cervical cancer (IA2-IB1) remains radical hysterectomy with pelvic lymphadenectomy. In select patients interested in future fertility, the option of radical trachelectomy with pelvic lymphadenectomy is also considered a viable option. The possibility of less radical surgery may be appropriate not only for patients desiring to preserve fertility but also for all patients with low-risk early-stage cervical cancer. Recently, a number of studies h...

  2. Impact of the care provided by gynecologic oncologists on outcomes of cervical cancer patients treated with radical hysterectomy.

    Science.gov (United States)

    Wu, Miao-Fang; Li, Jing; Lu, Huai-Wu; Wang, Li-Juan; Zhang, Bing-Zhong; Lin, Zhong-Qiu

    2016-01-01

    For many malignant diseases, specialized care has been reported to be associated with better outcomes. The purpose of this study is to investigate the influence of gynecologic oncologists on treatment outcomes for cervical cancer patients treated by radical hysterectomy. Records of patients who received radical hysterectomy between January 2005 and June 2010 were reviewed. Perioperative morbidity, recurrence-free survival, and cancer-specific survival were assessed. Cox regression model was used to evaluate gynecologic oncologists as an independent predictor of survival. A total of 839 patients were included. Of these patients, 553 were treated by gynecologic oncologists, while 286 were treated by other subspecialties. With regard to operative outcomes, significant differences in favor of operation by gynecologic oncologists were found in number of patients receiving para-aortic node sampling and dissection (P=0.038), compliance with surgical guidelines (P=0.003), operative time (P<0.0001), estimated blood loss (P<0.0001), transfusion rate (P=0.046), number of removed nodes (P=0.033), and incidences of ureteric injury (P=0.027), cystotomy (P=0.038), and fistula formation (P=0.002). Patients who were operated on by gynecologic oncologists had longer recurrence-free survival (P=0.001; hazard ratio [HR] =0.64; 95% confidence interval [CI] [0.48, 0.84]) and cancer-specific survival (P=0.005; HR=0.64; 95% CI [0.47, 0.87]), and this association remained significant in patients with locally advanced disease. Care by gynecologic oncologists was an independent predictor for improved recurrence-free survival (P<0.0001; HR=0.57; 95% CI [0.42, 0.76]) and cancer-specific survival (P=0.001; HR=0.58; 95% CI [0.42, 0.81]), which was still significant among patients with locally advanced cancer. Given the results, we believe for cervical cancer patients receiving radical hysterectomy, operation by gynecologic oncologists results in significantly improved surgical and survival

  3. Adjuvant chemoradiation after laparoscopically assisted radical vaginal hysterectomy (LARVH) in patients with cervical cancer. Oncologic outcome and morbidity

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    Gruen, Arne; Musik, Thabea; Stromberger, Carmen; Budach, Volker; Marnitz, Simone [Charite Univ. Medicine Berlin, Campus Virchow-Klinikum, Berlin (Germany). Dept. of Radiooncology; Koehler, Christhardt; Schneider, Achim [Charite Univ. Medicine Berlin, Campus Mitte- und Benjamim Franklin, Berlin (Germany). Dept. of Gynaecology; Fueller, Juergen; Wendt, Thomas [Jena Univ. Hospital (Germany). Dept. of Radiooncology

    2011-06-15

    Compared to laparotomic surgery, laparoscopically assisted radical vaginal hysterectomy (LARVH) offers decreased blood loss during surgery and faster convalescence of the patient postoperatively, while at the same time delivering similar oncologic results. However, there is no data on outcome and toxicity of LARVH followed by (chemo)radiation. A total of 55 patients (range 28-78 years) with cervical cancer on FIGO stages IB1-IIIA (Tables 1 and 2) with risk factors were submitted to either external beam radiotherapy alone [EBRT, n = 8 (14%), including paraaortic irradiation, n = 4 (2.2%); EBRT and brachytherapy (BT), n = 33 (60%); BT alone, n = 14 (25.5%)] or chemoradiation after LARVH. At a median follow-up of 4.4 years, the 5-year disease-free survival (DFS) was 81.8% with 84.5% overall survival (OS). Acute grade 3 side effects were seen in 4 patients. These were mainly gastrointestinal (GI) and genitourinary (GU) symptoms. Grade 4 side effects were not observed. With similar oncologic outcome data and mostly mild side effects, LARVH followed by (chemo)radiation is a valid alternative in the treatment of cervical cancer patients. (orig.)

  4. Adjuvant chemoradiation after laparoscopically assisted radical vaginal hysterectomy (LARVH) in patients with cervical cancer. Oncologic outcome and morbidity

    International Nuclear Information System (INIS)

    Compared to laparotomic surgery, laparoscopically assisted radical vaginal hysterectomy (LARVH) offers decreased blood loss during surgery and faster convalescence of the patient postoperatively, while at the same time delivering similar oncologic results. However, there is no data on outcome and toxicity of LARVH followed by (chemo)radiation. A total of 55 patients (range 28-78 years) with cervical cancer on FIGO stages IB1-IIIA (Tables 1 and 2) with risk factors were submitted to either external beam radiotherapy alone [EBRT, n = 8 (14%), including paraaortic irradiation, n = 4 (2.2%); EBRT and brachytherapy (BT), n = 33 (60%); BT alone, n = 14 (25.5%)] or chemoradiation after LARVH. At a median follow-up of 4.4 years, the 5-year disease-free survival (DFS) was 81.8% with 84.5% overall survival (OS). Acute grade 3 side effects were seen in 4 patients. These were mainly gastrointestinal (GI) and genitourinary (GU) symptoms. Grade 4 side effects were not observed. With similar oncologic outcome data and mostly mild side effects, LARVH followed by (chemo)radiation is a valid alternative in the treatment of cervical cancer patients. (orig.)

  5. Sentinel lymph node identification in patients with early stage cervical cancer undergoing radical hysterectomy and pelvic lymphadenectomy

    Institute of Scientific and Technical Information of China (English)

    李斌; 章文华; 刘琳; 吴令英; 张蓉; 李宁

    2004-01-01

    Background In general, sentinel lymph node (SLN) can reflect the whole state of the entire drainage area. The present study evaluated the clinical significance of sentinel lymph node identification in the treatment of early stage cervical cancer.Methods Twenty-eight patients with early stage (Ia-Iia) cervical cancer undergoing radical hysterectomy and pelvic lymphadenectomy were included in this study. At two locations 8 hours before operation, 0.4 ml 37 Mbq technicium-99 labeled dextran was injected intracervically. After that, preoperative lymphoscintigraphy was performed to detect SLNs. During the operation, lymph nodes were detected ex vivo by a γ-counter to identify SLNs. The samples of SLNs and non-SLNs were used for pathological examination separately and compared with the final results. Results SLNs were identified in 27 of 28 (96.4%) patients. A total of 123 SLNs were identified from 814 nodes. Six patients had altogether 11 positive lymph nodes, which were all SLNs. No patient had false-negative sentinel node. Conclusion SLNs can successfully predict the lymphatic metastasis in patients with cervical cancer. The clinical validity of this technique should be evaluated prospectively.

  6. Clinical Behaviors and Outcomes for Adenocarcinoma or Adenosquamous Carcinoma of Cervix Treated by Radical Hysterectomy and Adjuvant Radiotherapy or Chemoradiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Yi-Ting; Wang, Chun-Chieh; Tsai, Chien-Sheng [Department of Radiation Oncology, Chang Gung Memorial Hospital, Lin-Kou, Chang Gung University, Taoyuan, Taiwan (China); Department of Medical Imaging and Radiological Science, Chang Gung University, Taoyuan, Taiwan (China); Lai, Chyong-Huey; Chang, Ting-Chang; Chou, Hung-Hsueh [Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Lin-Kou, Chang Gung University, Taoyuan, Taiwan (China); Lee, Steve P. [Department of Radiation Oncology, University of California, Los Angeles School of Medicine, Los Angeles, CA (United States); Hong, Ji-Hong, E-mail: jihong@adm.cgmh.org.tw [Department of Radiation Oncology, Chang Gung Memorial Hospital, Lin-Kou, Chang Gung University, Taoyuan, Taiwan (China); Department of Medical Imaging and Radiological Science, Chang Gung University, Taoyuan, Taiwan (China)

    2012-10-01

    Purpose: To compare clinical behaviors and treatment outcomes between patients with squamous cell carcinoma (SCC) and adenocarcinoma/adenosquamous carcinoma (AC/ASC) of the cervix treated with radical hysterectomy (RH) and adjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CCRT). Methods and Materials: A total of 318 Stage IB-IIB cervical cancer patients, 202 (63.5%) with SCC and 116 (36.5%) with AC/ASC, treated by RH and adjuvant RT/CCRT, were included. The indications for RT/CCRT were deep stromal invasion, positive resection margin, parametrial invasion, or lymph node (LN) metastasis. Postoperative CCRT was administered in 65 SCC patients (32%) and 80 AC/ASC patients (69%). Patients with presence of parametrial invasion or LN metastasis were stratified into a high-risk group, and the rest into an intermediate-risk group. The patterns of failure and factors influencing survival were evaluated. Results: The treatment failed in 39 SCC patients (19.3%) and 39 AC/ASC patients (33.6%). The 5-year relapse-free survival rates for SCC and AC/ASC patients were 83.4% and 66.5%, respectively (p = 0.000). Distant metastasis was the major failure pattern in both groups. After multivariate analysis, prognostic factors for local recurrence included younger age, parametrial invasion, AC/ASC histology, and positive resection margin; for distant recurrence they included parametrial invasion, LN metastasis, and AC/ASC histology. Compared with SCC patients, those with AC/ASC had higher local relapse rates for the intermediate-risk group but a higher distant metastasis rate for the high-risk group. Postoperative CCRT tended to improve survival for intermediate-risk but not for high-risk AC/ASC patients. Conclusions: Adenocarcinoma/adenosquamous carcinoma is an independent prognostic factor for cervical cancer patients treated by RH and postoperative RT. Concurrent chemoradiotherapy could improve survival for intermediate-risk, but not necessarily high-risk, AC/ASC patients.

  7. Radical hysterectomy in surgical treatment of invasive cervical cancer at the Department of gynecology and obstetrics in Novi Sad in the period 1993-2013.

    Directory of Open Access Journals (Sweden)

    Đurđević Srđan

    2015-01-01

    Full Text Available Introduction. During the period from 1993 - 2013, 175 women with invasive cervical cancer underwent radical hysterectomy sec. Wertheim-Meigs at the Department of Gynecology and Obstetrics, Clinical Center of Vojvodina in Novi Sad. Indications for radical hysterectomy comprise histopathologically confirmed invasive cervical cancer in stages I B 1 - II B according to the International Federation of Gynecology and Obstetrics. Material and Methods. Stage of the disease or extent of the disease spread to the adjacent structures was assessed in accordance with the International Federation of Gynecology and Obstetrics staging system from 2009. Exclusion criteria were all other stages of this disease: I A and stages higher than II B, as well as the absence of definite histological confirmation of the cervical cancer (primary endometrial or vaginal cancer which infiltrates the uterine cervix. Prior the operation, the following had to be done: the imaging of pelvis and abdomen, chest X-ray in two directions, electrocardiography, internist and anesthesiological examination. Results. The patients’ age ranged from 24-79 years (x : 46 years, and the operation duration was 120-300 minutes (x : 210 min.. Stage I B 1 was found in 64.6% of operated patients, 14.8% of the patients were in stage I B 2, 9.1% were in stage II A and 11.4 % were in stage II B. Blood loss during the operation ranged from 50-800 ml (on average 300 ml, and the number of removed lymph nodes per operation was 14-75 (x : 32. Intraoperative and postoperative complications developed in 6.8% of and 17.7% of patients, respectively. Recurrence was reported in 22 (12.5% patients, most often in paraaortic lymph nodes (3.4% and parametria (2.8%, while the overall 5-year survival rate was 87% until 2008. Concluision. Wertheim-Meigs radical hysterectomy is a basic surgical technique for the treatment of initial stages of invasive cervical cancer.

  8. Clinical efficacy and safety of paclitaxel plus carboplatin as neoadjuvant chemotherapy prior to radical hysterectomy and pelvic lymphadenectomy for Stage IB2-IIB cervical cancer

    Science.gov (United States)

    Yang, Lu; Guo, Jianfeng; Shen, Yi; Cai, Jing; Xiong, Zhoufang; Dong, Weihong; Min, Jie; Wang, Zehua

    2015-01-01

    Objective: To assess the efficacy and toxicity of the combination of paclitaxel plus carboplatin as neoadjuvant chemotherapy (NACT) for locally advanced cervical cancer (LACC) prior to radical hysterectomy and pelvic lymphadenectomy. Methods: We reviewed patients with cervical cancer of the International Federation of Gynecology and Obstetrics (FIGO) stage IB2-IIB who underwent neoadjuvant chemotherapy (NACT) with paclitaxel plus carboplatin followed by radical hysterectomy (NACT group) or only received primary radical surgery (PRS group) in our hospital between Jan 2007 and Jan 2012. Toxicity, NACT response, surgery pathological factors and survival data were collected and analyzed. Results: In the NACT group, the overall response rate was 71.3% (82/115). Eighteen (15.7%) patients achieved complete remission. Well differentiated tumors showed a more favorable response to NACT (P=0.011). Myelosuppression was the most common adverse effect (51.7%) and serious adverse effects were rare (3.4%). The median follow-up period was 44 months (range, 6-75). The NACT responders had significantly longer OS and PFS when compared to the non-NACT responders and patients in the PRS group. Conclusion: Patients with LACC can benefit from neoadjuvant chemotherapy with paclitaxel plus carboplatin when they have response to the chemotherapeutic agents. PMID:26550314

  9. LARVH与RAH治疗妇科恶性肿瘤临床疗效的Meta分析%Clinical Efficacy Comparison of Lapararoscopic Assisted Radical Vaginal Hysterectomy and Radical Abdominal Hysterectomy for the Treatment of Gynecologic Malignancies: a Meta-Analysis

    Institute of Scientific and Technical Information of China (English)

    徐玮; 滕银成

    2013-01-01

    目的:通过Meta分析综合评价腹腔镜辅助阴式根治性子宫切除术(LARVH)与经腹根治性子宫切除术(RAH)治疗妇科恶性肿瘤的临床疗效.方法:电子检索Cochrane Library、PubMed、Ovid、EMBASE、中国知网数据库(CNKI)、万方全文数据库、维普中文科技期刊数据库、中国生物医学文献数据库,并辅以手工检索.检索时间截至2012年6月,收集LARVH与RAH临床疗效比较的随机对照试验(RCT)或设计良好的回顾性临床对照试验(CCT).由两名研究者按Cochrane系统评价方法提取有效数据进行Meta分析.结果:共纳入7篇RCT,11篇CCT,共计4046例患者,其中LARVH组2280例,RAH组1766例.结果显示:LARVH与RAH相比,其术中失血量少(MD=-186.00,95% CI-292.48~-79.52,P=0.0006)、住院天数短(MD=-3.37,95% CI-4.23~-2.50,P=0.0000)、术后并发症发生率低(RR =0.60,95%CI0.46—0.79,P=0.0003),但术中并发症发生率高(RR =1.45,95%CI 1.15 ~ 1.82,P=0.0010);而在手术时间、淋巴结活检数、术后总体复发率方面比较,差异均无统计学意义(P>0.01).结论:运用LARVH治疗妇科恶性肿瘤在减少住院时间、降低手术失血量和术后并发症方面比RAH具有一定优势,但应注意降低术中并发症的发生.%Objective:To compare the clinical efficacy of lapararoscopic assisted radical vaginal hysterectomy ( LARVH) and radical abdominal hysterectomy( RAH) for the treatment of gynecologic malignancies by meta-analysis. Methods:Electronic searches of the Cochrane Libaray,PubMed, Ovid, EMBASE.CNKI, Wan-fang Databases,VIP Full-text Databases and CBMdisc Databases,supplemented by manual searches. Retrieval time as of June 2012,the studies included in the references of eligible studies were additionally searched randomized controlled trials (RCTs) or well-designed retrospective controlled clinical trails (CCTs) with the clinical efficacy of LARVH and RAH. All the data were extracted in the same way as Cochrane system

  10. The influence of number of high risk factors on clinical outcomes in patients with early-stage cervical cancer after radical hysterectomy and adjuvant chemoradiation

    Science.gov (United States)

    Lim, Soyi; Lee, Seok-Ho; Park, Chan-Yong

    2016-01-01

    Objective The purpose of this study was to evaluate the prognosis according to the number of high risk factors in patients with high risk factors after radical hysterectomy and adjuvant chemoradiation therapy for early stage cervical cancer. Methods Clinicopathological variables and clinical outcomes of patients with FIGO (International Federation of Gynecology and Obstetrics) stage IB1 to IIA cervical cancer who had one or more high risk factors after radical hysterectomy and adjuvant chemoradiation therapy were retrospectively analyzed. Patients were divided into two groups according to the number of high risk factors (group 1, single high risk factor; group 2, two or more high risk factors). Results A total of 93 patients were enrolled in the present study. Forty nine out of 93 (52.7%) patients had a single high risk factor, and 44 (47.3%) had two or more high risk factors. Statistically significant differences in stage and stromal invasion were observed between group 1 and group 2. However, age, histology, tumor size, and lymphovascular space invasion did not differ significantly between the groups. Distant recurrence occurred more frequently in group 2, and the probability of recurrence and death was higher in group 2. Conclusion Patients with two or more high risk factors had worse prognosis in early stage cervical cancer. For these patients, consideration of new strategies to improve survival may be worthwhile. Conduct of further clinical trials is warranted for development of adjuvant treatment strategies individualized to each risk group. PMID:27200308

  11. Chemoradiation With Paclitaxel and Carboplatin in High-Risk Cervical Cancer Patients After Radical Hysterectomy: A Korean Gynecologic Oncology Group Study

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Taek Sang [Department of Obstetrics and Gynecology, SMG-SNU Boramae Medical Center, Seoul (Korea, Republic of); Kang, Soon Beom, E-mail: tslee70@gmail.com [Department of Obstetrics and Gynecology, Konkuk University Medical Center, Seoul (Korea, Republic of); Kim, Young Tak [Department of Obstetrics and Gynecology, Asan Medical Center, Seoul (Korea, Republic of); Park, Byung Joo [Department of Preventive Medicine, Seoul National University College of Medicine, Seoul (Korea, Republic of); Kim, Yong Man [Department of Obstetrics and Gynecology, Asan Medical Center, Seoul (Korea, Republic of); Lee, Jong Min [Department of Obstetrics and Gynecology, Kyung Hee University Hospital at Gangdong, Seoul (Korea, Republic of); Kim, Seok Mo [Department of Obstetrics and Gynecology, Chonnam National University Medical School, Gwangju (Korea, Republic of); Kim, Young Tae [Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Jae Hoon [Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Seoul (Korea, Republic of); Kim, Kyung Tai [Department of Obstetrics and Gynecology, Hanyang University Medical Center, Seoul (Korea, Republic of)

    2013-06-01

    Purpose: To evaluate the efficacy and toxicity of concurrent chemoradiation with paclitaxel and carboplatin in patients with high-risk cervical cancer. Methods and Materials: Patients after radical hysterectomy for cervical cancer, with at least 1 high-risk characteristic, were administered paclitaxel 135 mg/m{sup 2}, carboplatin area under the curve = 5 every 3 weeks for 3 cycles concomitant with radiation therapy as adjuvant treatment. Results: This prospective study enrolled 71 consecutive patients. Sixty-six patients (93%) completed the planned treatment. The majority of grade 3/4 neutropenia or nonhematologic toxicities were usually self-limited. Diarrhea grades 3/4 were observed in 4 patients (5.6%). One patient developed anaphylactic shock after infusion of paclitaxel. With a median follow-up of 57 months, recurrences occurred in 16 patients. Multivariable analysis indicated that common iliac lymph node involvement is an independent risk factor for disease recurrence (odds ratio 13.48; 95% confidence interval 2.93-62.03). In the intent-to-treat population (n=71), the estimated 5-year disease-free survival and overall survival rates were 77.3% and 80.3% respectively. In the per-protocol population (n=62), disease-free survival was 78.9% and overall survival was 83.9%. Conclusions: Concurrent chemoradiation with paclitaxel/carboplatin is well tolerated and seems to be effective for patients who undergo radical hysterectomy. Therefore, a prospective, randomized controlled study should be designed to evaluate efficacy of this approach for patients with high-risk cervical cancer.

  12. Quality of life and sexuality in disease-free survivors of cervical cancer after radical hysterectomy alone: A comparison between total laparoscopy and laparotomy.

    Science.gov (United States)

    Xiao, Meizhu; Gao, Huiqiao; Bai, Huimin; Zhang, Zhenyu

    2016-09-01

    The aim of the present study was to evaluate the possible differences between total laparoscopy and laparotomy regarding their impact on postoperative quality of life and sexuality in disease-free cervical cancer survivors who received radical hysterectomy (RH) and/or lymphadenectomy alone and were followed for >1 year.We reviewed all patients with cervical cancer who had received surgical treatment in our hospital between January 2001 and March 2014. Consecutive sexually active survivors who received RH and/or lymphadenectomy for early stage cervical cancer were enrolled and divided into 2 groups based on surgical approach. Survivors were interviewed and completed validated questionnaires, including the European Organization for Research Treatment of Cancer Quality-of-Life Core Questionnaire including 30 items, the Cervical Cancer-Specific Module of European Organization for Research Treatment of Cancer Quality-of-Life Questionnaire including 24 items (EORTC QLQ-CX24), and the Female Sexual Function Index (FSFI).In total, 273 patients with histologically confirmed cervical cancer were retrospectively reviewed. However, only 64 patients had received RH and/or lymphadenectomy alone; 58 survivors meeting the inclusion criteria were enrolled, including 42 total laparoscopy cases and 16 laparotomy cases, with an average follow-up of 46.1 and 51.2 months, respectively. The survivors in the 2 groups obtained good and similar scores on all items of the European Organization for Research Treatment of Cancer Quality-of-Life Core Questionnaire including 30 items and Cervical Cancer-Specific Module of European Organization for Research Treatment of Cancer Quality-of-Life Questionnaire including 24 items, without significant differences after controlling for covariate background characteristics. To the date of submission, 21.4% (9/42) of cases in the total laparoscopy group and 31.2% (5/16) of cases in the laparotomy group had not resumed sexual behavior after RH. Additionally

  13. 早期宫颈癌(Ⅰb-Ⅱa期)预后相关因素的回顾性分析%Clinical outcome following radical hysterectomy and pelvic lymphadenectomy for early-stage cervical cancer

    Institute of Scientific and Technical Information of China (English)

    Hongbo Wang; Suhui Wu; Zehua Wang

    2008-01-01

    Objective: To estimate the impact of parametrial infiltration and lymph node metastasis on clinical outcome in women with early-stage cervical cancer following radical hysterectomy and pelvic lymphadenectomy. Methods: Clinical re-cords and pathologic slides of 532 patients with early-stage cervical cancer (330 Ib and 202 Ila) treated with radical hyster-ectomy and pelvic lymphadenectomy were reviewed. The study group comprised 520 patients with squamous cell carcinoma and 12 patients with adenocarcinoma of the cervix. Median follow-up time was 67 months. The association among the various histopathologic predictors of outcome was determined with analysis. The influence of the predictors on outcome was exam-ined with log rank survival methods and the Cox regression model. Results: FIGO stage, histologic type, tumor size, depth of invasion, parametrial infiltration, lymph node metastasis, and remote metastasis were identified as significantly biologically relevant and therefore were included as candidate predictors in multivariate analysis. In particular, parametrial infiltration and lymph node metastasis were found to be simultaneous predictors of death on multivariate analysis (P < 0.05). After controlling for these two factors, the other variables considered were not statistically significant up to a two-way interaction. Conclusion: Presence of parametrial infiltration and/or lymph node metastasis in women with early-stage cervical cancer is an indepen-dent poor prognostic factor. In addition, the relatively poor survival of women with more than one lymph nodes identified with cancer cells.

  14. Current Issues with Hysterectomy.

    Science.gov (United States)

    Barker, Matthew A

    2016-09-01

    Hysterectomy is one of the most common gynecologic surgeries. Early adoption of surgical advancements in hysterectomies has raised concerns over safety, quality, and costs. The risk of potential leiomyosarcoma in women undergoing minimally invasive hysterectomy led the US Food and Drug Administration to discourage the use of electronic power morcellator. Minimally invasive hysterectomies have increased substantially despite lack of data supporting its use over other forms of hysterectomy and increased costs. Health care reform is incentivizing providers to improve quality, improve safety, and decrease costs through standardized outcomes and process measures. PMID:27521886

  15. Current Issues with Hysterectomy.

    Science.gov (United States)

    Barker, Matthew A

    2016-09-01

    Hysterectomy is one of the most common gynecologic surgeries. Early adoption of surgical advancements in hysterectomies has raised concerns over safety, quality, and costs. The risk of potential leiomyosarcoma in women undergoing minimally invasive hysterectomy led the US Food and Drug Administration to discourage the use of electronic power morcellator. Minimally invasive hysterectomies have increased substantially despite lack of data supporting its use over other forms of hysterectomy and increased costs. Health care reform is incentivizing providers to improve quality, improve safety, and decrease costs through standardized outcomes and process measures.

  16. 腹腔镜宫颈癌根治术中腹膜阴道延长术的应用%The application of vaginal extension with peritoneum in the laparoscopic radical hysterectomy

    Institute of Scientific and Technical Information of China (English)

    杨尚武; 王小婕; 梦灵; 仲勇; 李莉芳; 黄浩

    2013-01-01

    Objective To explore the value of vaginal extension with peritoneum in the laparoscopic radical hysterectomy with the preservation of pelvic autonomic nerve .Methods Seven cases with cervical carcinoma at the stage of the Ⅰb-Ⅱa had the laparoscopic radical hysterectomy with the preservation of pelvic autonomic nerve and the operation of vaginal extension with peritoneum at the same time.Post-operative vaginal length and sexual life status of the patients were studied .Results The length of vagina 3 months after the operation was 8 to 11cm, with the average length of 8.8 ±2.2cm.No obvious side effect on sex life was found after the surgery . Conclusion It is feasible and advisable that the patients with cervical carcinoma have vaginal extension with peritoneum to ensure their life quality while they have laparoscopic radical hysterectomy with the preservation of the pelvic autonomic nerve .%目的探讨腹膜阴道延长术在腹腔镜下保留盆腔自主神经广泛子宫切除术中的价值。方法对7例Ⅰb~Ⅱa宫颈癌患者在行保留盆腔自主神经广泛性子宫切除术的同时行腹膜阴道延长术,研究患者术后阴道长度、性生活的情况。结果术后3个月测量阴道长度为8~11cm,平均长度为8.8±2.2cm。性生活质量术后与术前相比无明显影响。结论宫颈癌患者在行腹腔镜下保留盆腔自主神经的同时,采用腹膜进行阴道延长是可行的,保证了患者术后的生活质量,值得推广。

  17. Clinical analysis on laparoscopic nerve sparing radical hysterectomy in malignant uterine cancer%腹腔镜保留盆腔神经的广泛子宫切除治疗子宫肿瘤

    Institute of Scientific and Technical Information of China (English)

    王文翔; 海静; 高玉霞; 段树锋; 杨静; 马瑞霞; 陈彩霞; 董学彩

    2016-01-01

    目的:回顾性分析腹腔镜下保留盆腔自主神经的广泛子宫切除术在子宫肿瘤患者治疗中的可行性。方法选择2013年8月至2015年6月在新乡市中心医院接受手术治疗的早期宫颈癌及Ⅱ期子宫内膜癌患者95例,其中43例患者接受腹腔镜保留盆腔神经的广泛子宫切除术+盆腔淋巴结清扫术( A组),52例患者行经腹广泛子宫切除+盆腔淋巴结清扫术( B组)。总结两组的手术时间、术中出血量、切除宫旁组织及阴道长度、淋巴结数量,以及术后膀胱、直肠及性功能恢复情况。结果两组的手术时间、切除范围及淋巴结数量差异无统计学意义(P>0.05);两组的术中出血量,以及术后膀胱、直肠及性功能评估治疗比较[(180±55)ml vs (340±75)ml,(51.2±10.3)h vs (74.9±12.8) h,(11.6±2.1) d vs (18.3±2.9) d,19.9分 vs 23.4分],差异有统计学意义(P<0.05)。结论腹腔镜下保留盆腔神经的广泛子宫切除术在子宫肿瘤中是安全可行的,与传统术式相比更有利于膀胱直肠功能恢复,提高生命质量。%Objective To explore the efficacy of laparoscopic nerve sparing radical hysterectomy for malignant uterine cancer. Methods Nighty-five patients with early cervical cancer and endometrial cancer received surgery from Aug. 2013 to Jun. 2015 in Central Hospital of Xinxiang, 43 cases underwent laparo-scopic nerve sparing radical hysterectomy pelvic lymphadenectomy, 52 cases underwent radical hysterectomy combined pelvic lymphadenectomy. The data of operating time, blood loss, excision extent, numbers of lymph node, the postoperative function of bladder, rectal and sexual were assessed. Results There were not remarkable difference in terms of operating time, excision extent, number of lymph node, duration of hospital stays. The data of blood loss, the postoperative function of bladder, rectal and sexual reached statis-tical difference [(180±55)ml vs (340±75)ml, (51. 2±10. 3)h vs (74. 9±12. 8

  18. Chronic pain after hysterectomy

    DEFF Research Database (Denmark)

    Brandsborg, B.; Nikolajsen, L.; Kehlet, H.;

    2008-01-01

    BACKGROUND: Chronic pain is a well-known adverse effect of surgery, but the risk of chronic pain after gynaecological surgery is less established. METHOD: This review summarizes studies on chronic pain following hysterectomy. The underlying mechanisms and risk factors for the development of chronic...... post-hysterectomy pain are discussed. RESULTS AND CONCLUSION: Chronic pain is reported by 5-32% of women after hysterectomy. A guideline is proposed for future prospective studies Udgivelsesdato: 2008/3...

  19. Chronic pain after hysterectomy

    DEFF Research Database (Denmark)

    Brandsborg, B; Nikolajsen, L; Kehlet, Henrik;

    2008-01-01

    BACKGROUND: Chronic pain is a well-known adverse effect of surgery, but the risk of chronic pain after gynaecological surgery is less established. METHOD: This review summarizes studies on chronic pain following hysterectomy. The underlying mechanisms and risk factors for the development of chronic...... post-hysterectomy pain are discussed. RESULTS AND CONCLUSION: Chronic pain is reported by 5-32% of women after hysterectomy. A guideline is proposed for future prospective studies. Udgivelsesdato: 2008-Mar...

  20. 腹腔镜下宫颈癌根治术32例临床分析%Clinical Analysis of 32 Cases of Laparoscopic Radical Hysterectomy for Cervical Cancer

    Institute of Scientific and Technical Information of China (English)

    倪琴; 米鑫; 张风格

    2015-01-01

    Objective:To explore the clinical efficacy of laparoscopic radical hysterectomy in the treatment of cervical cancer.Method:A retrospective chart review identified stageⅠa2 toⅡa cervical cancer patients who underwent laparoscopic radical hysterectomy and pelvic lymph node dissection and abdominal aorta lymph node dissection from January 2011 to November 2014,the treatment effect was observed.Result:All the 32 cases were successfully treated by laparoscopic surgery,no one turned to undergo laparotomy.The mean operative time was (240.06±31.99)min.The average intraoperative blood loss was (245.31±102.45)ml.The average pelvic lymph node resected and abdominal aorta lymph node resected were (23.41±1.72) and (4.13±0.94).Postoperative anal exhaust time was (42.63±5.98)h,and bladder function recovery time was (16.78±4.72)d.One case complicated with external iliac vein injury.All cases of vaginal stump and cutting edge were negative.Seven cases received supplementary postoperative radiotherapy and chemotherapy.32 cases followed up 1 to 48 months postoperatively no recurrence.Conclusion:Laparoscopic radical hysterectomy for cervical cancer is safe and feasible,and has satisfactory result,but the surgeon must have skilled operation technique and treatment experience of operation complication.%目的:探讨腹腔镜下宫颈癌根治术的临床疗效。方法:回顾性分析笔者所在医院32例Ⅰa2~Ⅱa期宫颈癌患者腹腔镜下广泛子宫切除术及盆腔淋巴结和腹主动脉旁淋巴结清扫术的临床资料,观察腹腔镜手术治疗效果。结果:32例患者手术均成功,无一例中转开腹。手术时间(240.06±31.99)min,术中出血量(245.31±102.45)ml,切除盆腔淋巴结(23.41±1.72)枚,切除腹主动脉旁淋巴结(4.13±0.94)枚,术后肛门排气时间(42.63±5.98)h,膀胱功能恢复时间(16.78±4.72)d;1例髂外静脉损伤;所有病例断端及阴道切缘均阴性,术后7例补充放疗、化疗。32

  1. Total versus subtotal hysterectomy

    DEFF Research Database (Denmark)

    Gimbel, Helga; Zobbe, Vibeke; Andersen, Anna Birthe;

    2005-01-01

    The aim of this study was to compare total and subtotal abdominal hysterectomy for benign indications, with regard to urinary incontinence, postoperative complications, quality of life (SF-36), constipation, prolapse, satisfaction with sexual life, and pelvic pain at 1-year postoperative. Eighty...... women chose total and 105 women chose subtotal abdominal hysterectomy. No significant differences were found between the 2 operation methods in any of the outcome measures at 12 months. Fourteen women (15%) from the subtotal abdominal hysterectomy group experienced vaginal bleeding and three women had...

  2. "STUDY OF CONCURRENT CISPLATIN AND EXTERNAL RADIOTHERAPY PRIOR TO RADICAL HYSTERECTOMY AND LYMPHADENECTOMY IN PATIENTS WITH STAGE IB-IIB CERVICAL CANCER"

    Directory of Open Access Journals (Sweden)

    M. Modares Gilani

    2004-06-01

    Full Text Available The purpose of this study was to describe the feasibility of a combined preoperative chemoradiation program Ib-IIa, bulky and suspicious IIb by radical surgery in patients with stage Ib-IIb cervical cancer. From September 1999 to April 2002, 30 patients with carcinoma of the cervix were treated with preoperative external beam radiotherapy of 45 Gy in 5 weeks. Patients received concurrent continuous infusion of cisplatin 50 mg/m2 for one day in week during 5 weeks of radiation. Radical surgery was performed 4-6 weeks after completion of the preoperative treatment. Toxicity with chemoradiation was usually mild. Two patients developed vesicovaginal fistula, and four developed long-term hydronephrosis that needed ureteral stenting. Clinical response was observed in 100% of the patients (23.7% complete response. The analysis of the surgical specimens revealed complete pathological response in 43.3% of the cases and partial pathological response in 56.7%. The degree of pathological response was not predictable by the degree of clinical response. Thirty months disease-free survival and overall survival were 66.3% and 77.31%, respectively. Patients with complete and partial pathological response were not significantly different in terms of disease-free survival (p= 0.08 and overall survival (p= 0.3. Cisplatin in preoperative chemoradiation is effective and usually welltolerated in bulky cervical cancer and parametrial invasion, inducing a high rate of clinical and pathological complete responses. When this therapy is followed by radical surgery, disease-free and overall survival rates are higher. The latter may be possible only through extensive surgical resection with a parallel increase in complication rates.

  3. Efficacy of biofeedback combined with electrical stimulation therapy for retention after radical hysterectomy%生物反馈联合电刺激治疗宫颈癌根治术后尿潴留的疗效分析

    Institute of Scientific and Technical Information of China (English)

    傅琦博; 吕坚伟; 蒋晨; 吕婷婷; 李震东; 邱丰; 黄翼然

    2015-01-01

    ABSTRACT:Objective To investigate the efficacy of biofeedback combined with electrical stimulation therapy for reten‐tion after radical hysterectomy .Methods A total of 38 cases with retention after radical hysterectomy treated during June 2012 to May 2014 were randomly divided into two groups .The trial group was treated with pelvic floor biofeedback with elec‐trical stimulation AM800B for 20 to 30 minutes once daily for a week ,while the control group was treated with traditional blad‐der training .Results After one week of trement ,the effective rate for the trial group was 89 .47% (17/19) ,which was higher than 52 .63% (10/19) ,the rate for the control group (P0 .05 ) .Conclusions Pelvic floor biofeedback with electrical stimulation therapy can improve the urinary function effectively within a short period of time .It is worth clinical application .%目的:评估生物反馈联合电刺激治疗宫颈癌根治术后尿潴留的疗效。方法2012年6月至2014年5月共收治38例宫颈癌根治术后尿潴留患者,随机分成2组,治疗组采用生物反馈治疗仪进行生物反馈联合电刺激治疗,治疗时间约为20~30 min ,1次/d ,疗程1周;对照组采用传统膀胱功能训练进行治疗,对比两组间的疗效。结果1周后疗效比较,治疗组有效率89.47%(17/19),对照组52.63%(10/19),治疗组疗效明显优于对照组( P<0.05);2周后疗效比较,治疗组有效率达到94.74%(18/19),对照组89.47%(17/19),两组间统计学无明显差异( P>0.05)。结论采用生物反馈联合电刺激治疗宫颈癌根治术后尿潴留能明显缩短恢复患者排尿功能的时间,且创伤小,无明显不良反应,容易被患者接受,值得临床推广。

  4. Emergency peripartum hysterectomy

    DEFF Research Database (Denmark)

    Jakobsson, Maija; Tapper, Anna-Maija; Colmorn, Lotte Berdiin;

    2015-01-01

    hysterectomy. The number of stillbirths was substantially high (70/1000), but the case fatality rate stood at 0.47% (one death, maternal mortality rate 0.17/100 000 deliveries). CONCLUSIONS: A combination of prospective data collected from clinicians and information gathered from register-based databases can...

  5. Emergency peripartum hysterectomy

    Directory of Open Access Journals (Sweden)

    Mehmet Sıddık Evsen

    2009-03-01

    Full Text Available The aim of the present study was to determine the incidence, indications and maternal characteristics of emergency peripartum hysterectomy (EPH.Medical records belong to 49 patients, that undergone EPH at Diyarbakır Gynecology and Obstetrics Hospital, between September 2005 and August 2008 were retrospectively reviewed. During three years, from 63463 deliveries, hysterectomy was performed to 49 patients (0.77/1000 due to obstetrical hemorrhage. Indications for EPH were uterine atony (49.6%, uterine rupture (42.9% and placenta accreata (8.2%. The mean age of patients was 34.6±5.7 years, and mean gravida was 5.5±2.4. Subtotal hysterectomy was performed to 31 (63.3% patients and total hysterectomy to 18 (36.7% of them. Bilateral hypogastric artery ligation was performed to 8 (16.3% and unilateral ooferectomy to 7 (14.3%. Two of our patients died secondary to uncontrolled uterine bleeding.In conclusion, uterine atony and uterine rupture were the most frequent causes of EPH. Emergent and appropriate management of these patients is the most important life saving procedure.

  6. Transformation of Abandonment

    DEFF Research Database (Denmark)

    Krag, Mo Michelsen Stochholm

    2015-01-01

    “Transformation of abandonment, a new critical practice” Abstract. While the major cities in Denmark are experiencing growth in population and economy, the surrounding rural areas face abandoned villages and increasing decay. This research focuses on the abandoned houses, seeking an alternative...... a new critical practice based on a series of full-scale transformations of abandoned buildings . These transformations, hereinafter referred to as actions, are the core of the research. The actions are implemented as physical interventions, each of which involves an abandoned building. The interventions...... are of such a radical manner it will not be possible to re-establish the former function of the building. The aim of the actions is to develop and test full-scale transformation prototypes in varying rural village environments. Interaction with local people and their response to the prototypes can be seen as real life...

  7. Multivariate analysis of the prognostic factors of squamous cell cervical cancer treated by radical hysterectomy or combined radiation therapy; Carcinoma espinocelular do colo uterino submetido a cirurgia radical isolada ou em combinacao com radioterapia

    Energy Technology Data Exchange (ETDEWEB)

    Coelho, Francisco Ricardo Gualda; Kowalski, Luiz Paulo; Abrao, Fauzer Simao [Fundacao Antonio Prudente, Sao Paulo, SP (Brazil). Hospital A.C. Camargo; Franco, Eduardo Luiz [McGill Univ., Montreal, PQ (Canada). Dept. of Oncology; Zeferino, Luiz Carlos [Universidade Estadual de Campinas, SP (Brazil). Faculdade de Medicina; Brentani, Maria Mitzi [Sao Paulo Univ., SP (Brazil). Faculdade de Medicina

    1996-04-01

    Six hundred and nine cases of invasive squamous cell carcinoma of the cervix uteri in a retrospective analysis (1953-1982) at the A.C. Camargo Hospital, Antonio Prudente Foundation, Sao Paulo, Brazil. The patients were submitted to radical surgery and radiation therapy, individually or in combination. A multivariate analysis of the different variables were performed according to the Cox`s regression method. The variables of prognosis value, in decreasing order of importance, were: the decade of patient`s admission, the modality of therapy employed, the presence of residual tumor in the surgical specimens and the clinical stage of the disease. Other variables like ethnic group, age of first menstrual flux, menopause, number of pregnancy, kind of delivery, number and kind of abortion, were found to be of no prognostic importance. The decade of admission was of independent prognostic significance. The presence of residual tumor in the surgical specimens was more important than lymph nodes spreading, but the overall survival was affected by the increase in the number of positive lymph nodes. Patient`s age was a weak prognostic factor accounting for a reduction in the survival time among cases with age upper to 45 years old. Radiation therapy sterilizes a considerable number of lymph nodes but not all of them in every patient. There are a specific group of patients where the radical surgery is necessary in order to carry a complete debulking of the disease. (author) 82 refs., 10 figs.

  8. Depression, anxiety, hostility and hysterectomy.

    Science.gov (United States)

    Ewalds-Kvist, S Béatrice M; Hirvonen, Toivo; Kvist, Mårten; Lertola, Kaarlo; Niemelä, Pirkko

    2005-09-01

    Sixty-five women (aged 32 - 54 yrs) were assessed at 2 months before to 8 months after total abdominal hysterectomy on four separate occasions. Beck's Depression Inventory (BDI), Taylor's Manifest Anxiety Scale (TMAS), the Buss-Durkee Hostility Inventory (BDHI), Measurement of Masculinity-Femininity (MF), Likert scales and semantic differentials for psychological, somatic and sexual factors varied as assessment tools. High-dysphoric and low-dysphoric women were compared with regard to hysterectomy outcomes. Married nulliparae suffered from enhanced depression post-surgery. Pre-surgery anxiety, back pain and lack of dyspareunia contributed to post-surgery anxiety. Pre-surgery anxiety was related to life crises. Pre- and post-surgery hostility occurred in conjunction with poor sexual gratification. Post-hysterectomy health improved, but quality of sexual relationship was impaired. Partner support and knowledge counteracted hysterectomy aftermath. Post-hysterectomy symptoms constituted a continuum to pre-surgery signs of depression, anxiety or hostility.

  9. Subtotal versus total abdominal hysterectomy

    DEFF Research Database (Denmark)

    Andersen, Lea Laird; Ottesen, Bent; Alling Møller, Lars Mikael;

    2015-01-01

    , constipation, pain, sexuality, quality of life (Short Form-36 questionnaire), hospital contacts, and vaginal bleeding. RESULTS: The questionnaire was answered by 197 of 304 women (64.8%) (subtotal hysterectomy [n = 97] [63.4%]; total hysterectomy [n = 100] [66.2%]). Mean follow-up time was 14 years and mean...... hysterectomy. All women enrolled in the trial from 1996 to 2000 who were still alive and living in Denmark (n = 304) were invited to answer the validated questionnaire used in prior 1 and 5 year follow-ups. Hospital contacts possibly related to hysterectomy from 5 to 14 years postoperatively were registered......, randomized clinical trial without blinding. Eleven gynecological departments in Denmark contributed participants to the trial. Women referred for benign uterine diseases who did not have contraindications to subtotal abdominal hysterectomy were randomized to subtotal (n = 161) vs total (n = 158) abdominal...

  10. Sexuality after total vs. subtotal hysterectomy

    DEFF Research Database (Denmark)

    Zobbe, Vibeke Bahn; Gimbel, Helga Margrethe Elisabeth; Andersen, Birthe Margrethe;

    2004-01-01

    The effect of hysterectomy on sexuality is not fully elucidated and until recently total and subtotal hysterectomies have only been compared in observational studies.......The effect of hysterectomy on sexuality is not fully elucidated and until recently total and subtotal hysterectomies have only been compared in observational studies....

  11. Laparoscopic Radical Trachelectomy

    OpenAIRE

    Rendón, Gabriel J.; Ramirez, Pedro T.; Frumovitz, Michael; Schmeler, Kathleen M.; Pareja, Rene

    2012-01-01

    Introduction: The standard treatment for patients with early-stage cervical cancer has been radical hysterectomy. However, for women interested in future fertility, radical trachelectomy is now considered a safe and feasible option. The use of minimally invasive surgical techniques to perform this procedure has recently been reported. Case Description: We report the first case of a laparoscopic radical trachelectomy performed in a developing country. The patient is a nulligravid, 30-y-old fem...

  12. Preoperative teaching and hysterectomy outcomes.

    Science.gov (United States)

    Oetker-Black, Sharon L; Jones, Susan; Estok, Patricia; Ryan, Marian; Gale, Nancy; Parker, Carla

    2003-06-01

    This study used a theoretical model to determine whether an efficacy-enhancing teaching protocol was effective in improving immediate postoperative behaviors and selected short- and long-term health outcomes in women who underwent abdominal hysterectomies. The model used was the self-efficacy theory of Albert Bandura, PhD. One hundred eight patients in a 486-bed teaching hospital in the Midwest who underwent hysterectomies participated. The participation rate was 85%, and the attrition rate was 17% during the six-month study. The major finding was that participants in the efficacy-enhancing teaching group ambulated significantly longer than participants in the usual care group. This is an important finding because the most prevalent postoperative complications after hysterectomy are atelectasis, pneumonia, paralytic ileus, and deep vein thrombosis, and postoperative ambulation has been shown to decrease or prevent all of these complications. This finding could affect the overall health status of women undergoing hysterectomies. PMID:12817743

  13. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Medline Plus

    Full Text Available ... as follows: I’ll begin with some historical information regarding hysterectomy, and then we’ll show a ... perform the hysterectomy procedure; however I believe the information that we present and discuss tonight will be ...

  14. Peripartum hysterectomy: an evolving picture.

    LENUS (Irish Health Repository)

    Turner, Michael J

    2012-02-01

    Peripartum hysterectomy (PH) is one of the obstetric catastrophes. Evidence is emerging that the role of PH in modern obstetrics is evolving. Improving management of postpartum hemorrhage and newer surgical techniques should decrease PH for uterine atony. Rising levels of repeat elective cesarean deliveries should decrease PH following uterine scar rupture in labor. Increasing cesarean rates, however, have led to an increase in the number of PHs for morbidly adherent placenta. In the case of uterine atony or rupture where PH is required, a subtotal PH is often sufficient. In the case of pathological placental localization involving the cervix, however, a total hysterectomy is required. Furthermore, the involvement of other pelvic structures may prospectively make the diagnosis difficult and the surgery challenging. If resources permit, PH for pathological placental localization merits a multidisciplinary approach. Despite advances in clinical practice, it is likely that peripartum hysterectomy will be more challenging for obstetricians in the future.

  15. 子宫切除联合阴道延长手术对Ⅰb1~Ⅰb2期宫颈癌患者婚姻质量的影响%Quality of marriage and sexual function of cervical cancer patients following radical hysterectomy and vaginal extension

    Institute of Scientific and Technical Information of China (English)

    陈红; 张友忠

    2015-01-01

    Objective To investigate the quality of marriage and sexual function of cervical cancer patients following radical hysterectomy and vaginal extension.Methods Case-control and questionnairebased methods were used in this study.Forty patients of early-stage (Ⅰ b 1 ~ Ⅰ b2) cervical cancer who had undergone vaginal extension following classic radical hysterectomy were included in the observation group,while 40 patients with matching factors and radical hysterectomy only during the same period were included in the control group.The quality of marriage and sexual function were compared with OLSON marriage prolapse and incontinence sexual function questionnaire Shon Fonn (PISQ-12).Results The operation time and postoperative vaginal length in the observation group were higher than those in the control group (P < 0.05 or P < 0.01).The emotional,physical,and total scores during postoperation were lower than those during preoperation (P < 0.01).The emotional,physical,and total scores in the control group were lower than those in the observation group (P < 0.01).The marital satisfaction,husband and wife communication,conflict resolution methods,extracurricular activities and sex scores in the observation group were higher than those in the control group (P < 0.05 or P < 0.01).Conclusions Patients with peritoneovaginoplasty following radical hysterectomy had much longer vagina and less self-perceived short vagina.Vaginal extension following radical hysterectomy does not worsen the pelvic floor symptoms.%目的 探讨子宫切除联合阴道延长手术对Ⅰb1~Ⅰb2期宫颈癌患者婚姻质量、生活质量及性生活的影响.方法 选择本院住院经宫腔细胞学及宫颈活组织病理学确诊的Ⅰb1~Ⅰb2期宫颈癌患者80例为研究对象,采用随机数字表法分为观察组和对照组,每组40例,两组分别给予腹腔镜子宫切除联合阴道延长手术与单独腹腔镜子宫切除手术治疗.观察患者术

  16. The decline of hysterectomy for benign disease.

    LENUS (Irish Health Repository)

    Horgan, R P

    2012-01-31

    Hysterectomy is one of the most common gynaecological surgical procedures performed but there appears to be a decline in the performance of this procedure in Ireland in recent times. We set out to establish the extent of the decline of hysterectomy and to explore possible explanations. Data for hysterectomy for benign disease from Ireland was obtained from the Hospital In-Patient Enquiry Scheme (HIPE) section of the Economic and Social Research Institute for the years 1999 to 2006. The total number of hysterectomies performed for benign disease showed a consistent decline during this time. There was a 36% reduction in the number of abdominal hysterectomy procedures performed.

  17. Peripartum hysterectomy in Denmark 1995-2004

    DEFF Research Database (Denmark)

    Sakse, Abelone Elisabeth; Weber, Tom; Nickelsen, Carsten Nahne Amtoft;

    2007-01-01

    BACKGROUND: Severe postpartum hemorrhage (PPH) is a potentially life-threatening situation that sometimes requires a hysterectomy. We examined the national incidence, risk factors, indications, outcomes and complications of peripartum hysterectomy following vaginal and caesarean delivery. METHODS......: Peripartum hysterectomy was defined as a hysterectomy after birth until 1 month after delivery using the codes for hysterectomy from the NOMESCO classification (1995). National data from the period 1995-2004 were extracted from the Danish Medical Birth Register and linked to the Danish National Hospital...... Register followed by registration of relevant data from the medical records of all the patients. RESULTS: We found 152 hysterectomies corresponding to an incidence of 0.24/1,000 deliveries. The risk of peripartum hysterectomy increased 11-fold following caesarean compared to vaginal delivery. Placenta...

  18. TOTAL LAPAROSCOPIC HYSTERECTOMY VERSUS TOTAL ABDOMINAL HYSTERECTOMY: A RETROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Virupaksha

    2015-10-01

    Full Text Available BACKGROUND: Hysterectomy is a common gynaecological surgery which can be done by abdominal, vaginal or laparoscopic routes or with robotic assistance. Although there were concerns regarding the safety of laparoscopic surgery, a newer technique when compared with abdominal hysterectomy, it is now being reco gnized as a safe procedure in the hands of an experienced surgeon. AIMS: This study was done to compare the intra - operative and post - operative parameters of abdominal and laparoscopic hysterectomy. SETTINGS AND DESIGN: This study was done at JSS Hospital, Mysore between June 2013 and September 2014. It is a retrospective study . MATERIALS AND METHOD S: Patients admitted in the Department of Obstetrics and Gynaecology at JSS Hospital, JSS University, Mysore, with an indication for total abdominal hysterectomy( TAH or total laparoscopic hysterectomy(TLH for benign pathology from June 2013 to September 2014 were included in the study. Exclusion criteria were suspicion of malignancy, vaginal prolapse higher than first degree and those undergoing laparoscopic assi sted vaginal hysterectomy. Baseline characteristics, intraoperative and postoperative parameters were compared between the two groups. STATISTICAL ANALYSIS : The data were analyzed using independent T test, Chi square test and Mann Whitney test. A p value o f <0 . 05 was accepted as significant. RESULTS: The mean time taken to perform TLH was significantly longer, i.e. 113.46 minutes compared with TAH, i.e. 70.44 minutes, with the p value being <0.0001. But the duration of stay in the hospital was shorter for t he women undergoing TLH, mean duration being 3.74 days as opposed to 7.65 days in women undergoing TAH. This difference was also statistically significant with p value being <0.0001. Also, women undergoing TAH required more analgesic doses (mean 3.29 than those undergoing TLH (mean 1.36 and this difference was also statistically significant. CONCLUSION: Although TLH took a

  19. Socioeconomic factors may influence the surgical technique for benign hysterectomy

    DEFF Research Database (Denmark)

    Daugbjerg, Signe B; Ottesen, Bent; Diderichsen, Finn;

    2012-01-01

    Owing to significantly improved outcomes, vaginal hysterectomy is the recommended standard approach when feasible in preference to abdominal hysterectomy. It is, however, not clear whether the use of vaginal hysterectomy varies with the women's socioeconomic background....

  20. Lower urinary tract symptoms after subtotal versus total abdominal hysterectomy

    DEFF Research Database (Denmark)

    Andersen, Lea Laird; Møller, Lars Mikael Alling; Gimbel, Helga

    2015-01-01

    INTRODUCTION AND HYPOTHESIS: Lower urinary tract symptoms (LUTS) are common after hysterectomy and increase after menopause. We aimed to compare subtotal with total abdominal hysterectomy regarding LUTS, including urinary incontinence (UI) subtypes, 14 years after hysterectomy. Main results from ...

  1. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Medline Plus

    Full Text Available ... t know if I feel comfortable doing that.” Well I believe our presentation will be different. I’m confident that after this evening ... this? Why do OB-GYNs prefer abdominal hysterectomy? Well the vaginal hysterectomy ... Inherent with that may be some fear that will have some injury to ...

  2. 腹腔镜下广泛全子宫及盆腹腔淋巴结切除手术6例泌尿系损伤临床分析%Clinical analysis on 6 cases of urinary system injury in peritoneoscope radical hysterectomy and abdomi-nopelvic cavity lymph node excision

    Institute of Scientific and Technical Information of China (English)

    陶玲; 于春霞; 李霞; 周琦

    2015-01-01

    目的:探讨我科腹腔镜广泛全子宫及盆腔淋巴结切除手术中泌尿系损伤的发生情况、处理方式以及预防的方法。方法:回顾性分析5年间我科腹腔镜广泛全子宫+盆腔淋巴结切除手术中发生泌尿系损伤患者的临床资料、疾病类型、盆腔情况、损伤、诊治情况及预后。结果:385例妇科腹腔镜手术中,共发生泌尿系损伤6例,发生率为1.56%,其中膀胱损伤2例,输尿管损伤4例。5例均有盆腔粘连,4例有盆腹腔手术史,1例合并盆腔子宫内膜异位症,2例子宫均有增大(6~10周)。2例膀胱损伤及 2例输尿管损伤均在术中发现。另 2例输尿管损伤于术后发现,其中 1例为术后复习录制手术视频时发现;1例为术后第5天行静脉肾盂造影确诊。2例膀胱损伤术中发现者均行腹腔镜下膀胱修补术。2例术中发现输尿管损伤者在术中行腹腔镜下输尿管吻合术+支架置入术及膀胱镜下输尿管支架置入术。2例术后发现者其中 1例行腹腔镜输尿管修补术及支架置入术,1例在膀胱镜下行输尿管支架置入术,预后均较好。结论:妇科腹腔镜手术泌尿系损伤是妇科腹腔镜手术少见而严重的并发症,如果注意预防损伤常可避免。术前须仔细评估患者的病情,应严格掌握腹腔镜手术指征,术中应仔细操作,术中术后尽早发现膀胱或输尿管损伤,尽可能采取及时、有效的方式减少损害。%Objectives:To discuss the occurrence rate,causes,treatment and prevention methods of urina-ry system injury in peritoneoscope radical hysterectomy and abdominopelvic cavity lymph node excision.Methods:A retrospective analysis on the clinical material,disease type,pelvic cavity condition,damage,diagnosis and treat-ment condition and prognosis of the patients suffering from urinary system injury in peritoneoscope radical hysterecto-my and abdominopelvic cavity lymph

  3. Abandoned vehicles

    CERN Multimedia

    Relations with the Host States Service

    2004-01-01

    The services in charge of managing the CERN site have recently noted an increase in the number of abandoned vehicles. This poses a risk from the point of view of safety and security and, on the eve of several important events in honour of CERN's fiftieth anniversary, is detrimental to the Organization's image. Owners of vehicles that have been left immobile for some time on the CERN site, including on the external car park by the flags, are therefore invited to contact the Reception and Access Control Service (service-parking-longterm@cern.ch) before 1st October 2004 and, where appropriate, move their vehicle to a designated long-term parking area. After this date, any vehicle whose owner has failed to respond to this request and which is without a number plate, has been stationary for several weeks or is out of service, may be impounded at the owner's risk and expense. Relations with the Host States Service Tel. 72848

  4. Hysterectomy

    Science.gov (United States)

    ... in the pelvic area). You may still get pregnant after myolysis. Treatments to shrink fibroids without surgery. These treatments include uterine artery embolization (UAE) and magnetic resonance (MR)-guided focused ultrasound (MR[f]US). UAE puts ...

  5. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Medline Plus

    Full Text Available ... know that all the patients in this particular analysis had supercervical hysterectomies. So back to that slide, ... patient recovery. I would say that, again, statistical analysis tells us that we’re not comfortable doing ...

  6. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Medline Plus

    Full Text Available ... Illinois. I practice with North Shore University Health Systems at Highland Park Hospital. I’m joined tonight ... as follows: I’ll begin with some historical information regarding hysterectomy, and then we’ll show a ...

  7. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Medline Plus

    Full Text Available Expanding Patient Options: Minilaparotomy for Hysterectomy Covidien Energy Based Devices Concord, California May 26, 2010 Welcome to this OR Live program presented by Covidien energy-based devices. Good evening, and thank ...

  8. Laparoscopic hysterectomy in the treatment of endometrial cancer: NCI experience

    International Nuclear Information System (INIS)

    The standard treatment for women with endometrial cancer is total abdominal hysterectomy and pelvic lymphadenectomy for surgical staging. Total laparoscopic radical hysterectomy (TLH) is an alternative approach providing surgical and patient related advantages to laparoscopy. Methods: Twenty female patients with early stage endometrial cancer were operated upon by TLH and pelvic lymphadenectomy, aiming to assess the safety and efficacy of TLH. Results: The mean operative time was 296.8 min conversion to laparotomy was done in one patient due to bleeding from the uterine vessels. The mean blood loss was 517.5 cc. The uterus was removed transvaginally in 18 patients (90%) and via a small Pfannenstiel incision in two patients (10%). The mean number of pelvic lymph nodes retrieval was 21.2. Postoperative bleeding occurred in one patient (5%) which necessitated exploration. One patient (5%) suffered a pulmonary embolism. Four patients (20%) developed pyrexia, and one patient (5%) suffered from a chest infection. One patient (5%) had wound infection. The mean hospital stay was 4.5 days (range 3-10). Conclusion: TLH with pelvic lymphadenectomy is a safe and effective approach in the treatment of early endometrial carcinoma.

  9. [Is hysterectomy indicated during prolapsus treatment?].

    Science.gov (United States)

    Fatton, B; Amblard, J; Jacquetin, B

    2007-06-01

    Hysterectomy remains a usual procedure in vaginal reconstructive pelvic surgery. However, it may seem illogical, given our improved knowledge of the pathologic pelvic anatomy, to begin pelvic repair by a removal procedure. The question about uterine preservation during vaginal reconstructive surgery is crucial. Although some authors have proposed some arguments on this topic, we don't have, at present, any rigorous prospective and randomized studies able to prove the superiority of hysterectomy or uterine preservation, on long-term anatomic results. Nevertheless, in reconstructive surgery with synthetic mesh, hysterectomy exposes to an increased risk of mesh exposure. Consequently, it increases blood lost, surgical duration and hospitalisation stay. On the other hand, uterine preservation imposes constant gynaecologic follow-up. Subsequently, if a hysterectomy is needed for benign or malignant diseases, the surgery is often difficult because of prior uterine fixation. Subtotal hysterectomy which prevents endometrial cancer can be a possible alternative but, at the moment, no study was able to demonstrate that uterine cervix has a role in pelvic static. Functional results, influenced by biological individual characteristics and by the number of associated procedures, are even more difficult to analyse. Sexual life after hysterectomy has been the subject of numerous publications of unequal scientific quality. Among correctly evaluated and informed patients, hysterectomy do not seem to produce negative consequences on sexuality; it can even improve, in some circumstances, the sexual life. We can admit that cervical conservation in some women may have a role in terms of pleasure, more from sexual fantasies and ballistic reasons than in relation with organic and physiologic reasons. Since no rigorous and specifically oriented works on that topic have been published until now, it seems justified today to promote prospective and randomized studies, advice against

  10. Laparoscopic hysterectomy with morcellation versus abdominal hysterectomy for presumed fibroids in premenopausal women: a decision analysis

    Science.gov (United States)

    SIEDHOFF, Matthew T.; WHEELER, Stephanie B.; RUTSTEIN, Sarah E.; GELLER, Elizabeth J.; DOLL, Kemi M.; WU, Jennifer M.; CLARKE-PEARSON, Daniel L.

    2016-01-01

    Objective To model outcomes in laparoscopic hysterectomy with morcellation compared to abdominal hysterectomy for the presumed fibroid uterus, examining short-and long-term complications, as well as mortality. Study Design A decision tree was constructed to compare outcomes for a hypothetical cohort of 100,000 premenopausal women undergoing hysterectomy for presumed fibroids over a 5-year time horizon. Parameter and quality of life utility estimates were determined from published literature for postoperative complications, leiomyosarcoma incidence, death related to leiomyomsarcoma, and procedure-related death. Results The decision analysis predicted fewer overall deaths with laparoscopic hysterectomy compared to abdominal hysterectomy (98 vs. 103 per 100,000). While there were more deaths from leiomyosarcoma following laparoscopic hysterectomy (86 vs. 71 per 100,000), there were more hysterectomy-related deaths with abdominal hysterectomy (32 vs. 12 per 100,000). The laparoscopic group had lower rates of transfusion (2,400 vs. 4,700 per 100,000), wound infection (1,500 vs 6,300 per 100,000), venous thromboembolism (690 vs. 840 per 100,000) and incisional hernia (710 vs. 8,800 per 100,000), but a higher rate of vaginal cuff dehiscence (640 vs. 290 per 100,000). Laparoscopic hysterectomy resulted in more quality-adjusted life years (499,171 vs. 490,711 over five years). Conclusion The risk of leiomyosarcoma morcellation is balanced by procedure-related complications associated with laparotomy, including death. This analysis provides patients and surgeons with estimates of risk and benefit, upon which patient-centered decisions can be made. PMID:25817518

  11. Guam Abandoned Vessel Inventory

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Guam. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral habitats...

  12. Florida Abandoned Vessel Inventory

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Florida. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  13. Abandoned Shipwreck Act

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Abandoned Shipwreck Act of 1987 (ASA) affirms the authority of state governments to claim ownership to, protect, and manage abandoned shipwrecks on state...

  14. Low adherence to cervical cancer screening after subtotal hysterectomy

    DEFF Research Database (Denmark)

    Andersen, Lea Laird; Møller, Lars Mikael Alling; Gimbel, Helga Margrethe

    2015-01-01

    INTRODUCTION: A reason for not recommending subtotal hysterectomy is the risk of cervical pathology. We aimed to evaluate cervical cancer screening and to describe cervical pathology after subtotal and total hysterectomy for benign indications. METHODS: Data regarding adherence to screening.......7% were not screened. We found a minimum of one abnormal test in 28 (10.8%) after subtotal hysterectomy and one after total hysterectomy. No cervical cancers were found. CONCLUSIONS: Adherence to cervical cancer screening after subtotal hysterectomy in a Danish population is suboptimal and some patients...... have unnecessary tests performed after total hysterectomy. Clarification of the use of cervical/vaginal smears after hysterectomy is needed to identify women at risk of cervical dysplasia or cancer. FUNDING: Research Foundation of Region Zealand, University of Southern Denmark, Nykøbing Falster...

  15. Cutting inoperable bodies: particularizing rural sociality to normalize hysterectomies in Balochistan, Pakistan.

    Science.gov (United States)

    Towghi, Fouzieyha

    2012-01-01

    Drawing on 15 months of ethnographic research in Balochistan, Pakistan (2005 -2006), I explore Panjguri midwives' (dïnabogs, kawwās, or balloks) narrative links between routine injections of prostaglandins around childbirth and the increasing number of hysterectomies. These techno-medical interventions reflect the postcolonial biomedicalization of women's bodies and reproductive health care, and are reinforced by shifts in Pakistan's public health policy against maternal mortality in a context where about 90 percent of births occur outside of hospitals. Transnational campaigns against maternal mortality further biomedicalize women's lives. Interviews with doctors, midwives, and women, and analysis of women's experiences, illustrate the practical considerations that were used to normalize radical hysterectomies over less invasive procedures.

  16. Enhanced recovery programme in gynaecology: outcomes of a hysterectomy care pathway.

    Science.gov (United States)

    Mukhopadhyay, Debjani

    2015-01-01

    There was a wide variation in the peri-operative management of women undergoing hysterectomy for both benign and malignant disease at Southend University Hospital NHS Foundation Trust prior to 2010. The median length of stay following a hysterectomy and more radical gynaecological oncology surgery was five days and seven days respectively. The NHS East of England Strategic Health Authority commissioned the development of Enhanced Recovery Programme (ERP) in various surgical specialties including gynaecology and the pathway was implemented from 2012 onward. Dedicated specialist nurses collected data prospectively. The median length of stay was shortened to three days. This difference was statistically significant with a P value = 0.0001. We describe the successful implementation of an ERP in Southend Hospital resulting with no difference in measurable morbidity and mortality, a shorter length of stay, and a high patient satisfaction scores and outcomes. PMID:26734443

  17. A comparison of abdominal and vaginal hysterectomies in Benghazi, Libya.

    Science.gov (United States)

    Agnaeber, K; Bodalal, Z

    2013-08-01

    We performed a comparative study between abdominal and vaginal hysterectomies using clinical data from Al-Jamhouria hospital (one of the largest maternity hospitals in Eastern Libya). Various parameters were taken into consideration: the rates of each type (and their subtypes); average age of patients; indications; causes; postoperative complications; and duration of stay in the hospital afterwards. Conclusions and recommendations were drawn from the results of this study. In light of the aforementioned parameters, it was found that: (1) abdominal hysterectomies were more common than vaginal hysterectomies (p < 0.001); (2) patients admitted for abdominal hysterectomies are younger than those admitted for vaginal hysterectomies (p < 0.001); (3) the most common indication for an abdominal hysterectomy was menstrual disturbances, while for vaginal hysterectomies it was vaginal prolapse; (4) the histopathological cause for abdominal and vaginal hysterectomies were observed and the most common were found to be leiomyomas and atrophic endometrium; (5) there was no significant difference between the two routes in terms of postoperative complications; (6) patients who were admitted for abdominal hysterectomies spent a longer amount of time in the hospital (p < 0.01). It was concluded that efforts should be made to further pursue vaginal and laparoscopic hysterectomies as a viable option to the more conventional abdominal route.

  18. HYSTERECTOMY: CHANGING TRENDS IN A TERTIARY CARE CENTER

    OpenAIRE

    Abha; Smrity; Anchala

    2015-01-01

    BACKGROUND: Hysterectomy is the most common gynec operation worldwide. It leads to significant morbidity and mortality hence there must be justifiable indication before procedure is undertaken. There is a lack of comprehensive data and too much variability from place to place, even in India. OBJECTIVE: To analyze the changing trends in hysterectomy in past 6 years. METHOD: A retrospective study of all women undergoing hysterectomy that were done in Dr. B.R.A.M. Hospital, Medic...

  19. Analysis of a Standardized Technique for Laparoscopic Cuff Closure following 1924 Total Laparoscopic Hysterectomies.

    Science.gov (United States)

    O'Hanlan, Katherine A; Emeney, Pamela L; Peters, Alfred; Sten, Margaret S; McCutcheon, Stacey P; Struck, Danielle M; Hoang, Joseph K

    2016-01-01

    Objective. To review the vaginal cuff complications from a large series of total laparoscopic hysterectomies in which the laparoscopic culdotomy closure was highly standardized. Methods. Retrospective cohort study (Canadian Task Force Classification II-3) of consecutive total and radical laparoscopic hysterectomy patients with all culdotomy closures performed laparoscopically was conducted using three guidelines: placement of all sutures 5 mm deep from the vaginal edge with a 5 mm interval, incorporation of the uterosacral ligaments with the pubocervical fascia at each angle, and, whenever possible, suturing the bladder peritoneum over the vaginal cuff edge utilizing two suture types of comparable tensile strength. Four outcomes are reviewed: dehiscence, bleeding, infection, and adhesions. Results. Of 1924 patients undergoing total laparoscopic hysterectomy, 44 patients (2.29%) experienced a vaginal cuff complication, with 19 (0.99%) requiring reoperation. Five patients (0.26%) had dehiscence after sexual penetration on days 30-83, with 3 requiring reoperation. Thirteen patients (0.68%) developed bleeding, with 9 (0.47%) requiring reoperation. Twenty-three (1.20%) patients developed infections, with 4 (0.21%) requiring reoperation. Three patients (0.16%) developed obstructive small bowel adhesions to the cuff requiring laparoscopic lysis. Conclusion. A running 5 mm deep × 5 mm apart culdotomy closure that incorporates the uterosacral ligaments with the pubocervical fascia, with reperitonealization when possible, appears to be associated with few postoperative vaginal cuff complications. PMID:27579179

  20. Establishment of a national Danish hysterectomy database: preliminary report on the first 13,425 hysterectomies

    DEFF Research Database (Denmark)

    Hansen, Charlotte T; Møller, Charlotte; Daugbjerg, Signe;

    2008-01-01

    2%, the rate of bleeding complications from 8 to 6%, the reoperation rate from 5 to 4%, and the readmission rate from 7 to 5%. CONCLUSIONS: Clinical performance indicators, audit meetings and nationwide collaboration are useful in monitoring and improving outcome after hysterectomy on a national...

  1. Comparative study of vaginal hysterectomy and abdominal hysterectomy for enlarged uterus

    Directory of Open Access Journals (Sweden)

    Chandrika S.

    2016-09-01

    Conclusions: Bulk reducing techniques were used to remove the moderately enlarged uterus through vaginal route. Vaginal hysterectomy is invasive route, safe and feasible in cases with enlarged uteri up to 14 weeks due to benign causes. [Int J Reprod Contracept Obstet Gynecol 2016; 5(9.000: 3116-3120

  2. Abandoned Texas oil fields

    Energy Technology Data Exchange (ETDEWEB)

    1980-12-01

    Data for Texas abandoned oil fields were primarily derived from two sources: (1) Texas Railroad Commission (TRRC), and (2) Dwight's ENERGYDATA. For purposes of this report, abandoned oil fields are defined as those fields that had no production during 1977. The TRRC OILMASTER computer tapes were used to identify these abandoned oil fields. The tapes also provided data on formation depth, gravity of oil production, location (both district and county), discovery date, and the cumulative production of the field since its discovery. In all, the computer tapes identified 9211 abandoned fields, most of which had less than 250,000 barrel cumulative production. This report focuses on the 676 abandoned onshore Texas oil fields that had cumulative production of over 250,000 barrels. The Dwight's ENERGYDATA computer tapes provided production histories for approximately two-thirds of the larger fields abandoned in 1966 and thereafter. Fields which ceased production prior to 1966 will show no production history nor abandonment date in this report. The Department of Energy hopes the general availability of these data will catalyze the private sector recovery of this unproduced resource.

  3. 42 CFR 50.207 - Sterilization by hysterectomy.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Sterilization by hysterectomy. 50.207 Section 50... GENERAL APPLICABILITY Sterilization of Persons in Federally Assisted Family Planning Projects § 50.207 Sterilization by hysterectomy. (a) Programs or projects to which this subpart applies shall not perform...

  4. 42 CFR 441.255 - Sterilization by hysterectomy.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Sterilization by hysterectomy. 441.255 Section 441.255 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Sterilizations § 441.255 Sterilization by hysterectomy. (a) FFP is not available in expenditures for...

  5. A new approach to simplify surgical colpotomy in laparoscopic hysterectomy

    NARCIS (Netherlands)

    Van den Haak, L.; Rhemrev, J.P.; Bikkendaal, M.D.; Luteijn, A.C.; Van den Dobbelsteen, J.J.; Driessen, S.R.; Jansen, F.W.

    2016-01-01

    New surgical techniques and technology have simplified laparoscopic hysterectomy and have enhanced the safety of this procedure. However, the surgical colpotomy step has not been addressed. This study evaluates the surgical colpotomy step in laparoscopic hysterectomy with respect to difficulty and d

  6. Lower urinary tract symptoms after total and subtotal hysterectomy

    DEFF Research Database (Denmark)

    Gimbel, Helga; Zobbe, Vibeke; Andersen, Birthe Jakobsen;

    2005-01-01

    The aim of this Danish multicenter trial was to compare the proportion of women with lower urinary tract symptoms after total abdominal hysterectomy (TAH) and subtotal abdominal hysterectomy (SAH) for benign uterine disorders. A total of 319 women were randomized to TAH (n = 158) or SAH (n = 161)...

  7. Total abdominal hysterectomy versus minimal-invasive hysterectomy: a systemic review and meta-analysis

    International Nuclear Information System (INIS)

    INTRODUCTION. At the present time three types of hysterectomies are used: the vaginal hysterectomy and the minimal-invasive hysterectomy (MIH). The objective of present research was to compare the MIH and the total abdominal hysterectomy (TAH) in women presenting with benign uterine diseases. METHODS. A systemic review was made and a meta-analysis from the following databases: MEDLINE, EBSCO HOST AND The Cochrane Central Register of Controlled Trials. Only the controlled and randomized studies were selected. The data of all studies were combined and also the relative risk (RR) with a 95% CI was used with the Mantel-Haenszel method as an effect measure for dichotomy variables. For the analysis of continuing variables the mean difference was used. In all the comparisons performed the results were obtained with the fix effect and randomized forms. RESULTS. A total of 53 transoperative complications were registered in the MIH hysterectomy versus 17 in the TAH group (RR: 1,78; 95% CI: 1,04-3.05). Postoperative complications evolved in a similar way in both groups without significant differences from the statistical point of view. The blood losses, the hospital stay and the patient's reincorporation to usual and work activities were lesser in the laparoscopy group; however, the operative time is higher when it is compared with TAH (mean difference: 37,36; 95% CI: 34,36-39,93). CONCLUSIONS. Both techniques have advantages and disadvantages. The indication of MIH must to be individualized according to the clinical situation of each patient and these not to be performed in those centers without a properly trained surgical staff and with experience in advanced minimal invasive surgery. (author)

  8. Are hysterectomies necessary? Racial-ethnic differences in women's attitudes.

    Science.gov (United States)

    Dillaway, Heather E

    2016-01-01

    There is a dearth of comparative information about how women from diverse social locations think about, talk about, and experience the various types of reproductive aging. In this article I analyze racial-ethnic differences in attitudes toward surgically induced menopause (hysterectomy) utilizing data from an interview study of 130 menopausal women. African American women in this study were more suspect of doctors' initial offers of hysterectomies than European American women, with the former group of interviewees still fearing a legacy of racial-ethnic discrimination within medical institutions. Only after seeking a second opinion or finding a trustworthy doctor did African American women feel comfortable accepting a hysterectomy. European American interviewees were not as wary as their African American counterparts and sometimes reported wishing for a hysterectomy. I argue that attitudes toward hysterectomy must be contextualized within women's experiences of racial-ethnic oppression and privilege to be fully understood. PMID:27045199

  9. Surgeon volume and outcomes in benign hysterectomy.

    Science.gov (United States)

    Doll, Kemi M; Milad, Magdy P; Gossett, Dana R

    2013-01-01

    Annual surgeon case volume has been linked to patient outcome in a variety of surgical fields, although limited data focus on gynecologic surgery performed by general gynecologists. Herein we review the literature addressing the associations between intraoperative injury, postoperative morbidity, and resource use among surgeons performing a low vs high volume of hysterectomies. Although study design and populations differ, individual and composite morbidity outcomes consistently favored high-volume surgeons. Given the growing emphasis on competency-based evaluation in surgery, gynecology departments may soon consider volume requirements a component of privileging. PMID:23622760

  10. Emergency peripartum hysterectomy: Incidence, indications, risk factors and outcome

    Directory of Open Access Journals (Sweden)

    Lovina S.M. Machado

    2011-01-01

    Full Text Available Background: Peripartum hysterectomy is a major operation and is invariably performed in the presence of life threatening hemorrhage during or immediately after abdominal or vaginal deliveries. Material and Methods: A Medline search was conducted to review the recent relevant articles in English literature on emergency peripartum hysterectomy. The incidence, indications, risk factors and outcome of emergency peripartum hysterectomy were reviewed. Results: The incidence of emergency peripartum hysterectomy ranged from 0.24 to 8.7 per 1000 deliveries. Emergency peripartum hysterectomy was found to be more common following cesarean section than vaginal deliveries. The predominant indication for emergency peripartum hysterectomy was abnormal placentation (placenta previa/accreta which was noted in 45 to 73.3%, uterine atony in 20.6 to 43% and uterine rupture in 11.4 to 45.5 %. The risk factors included previous cesarean section, scarred uterus, multiparity, older age group. The maternal morbidity ranged from 26.5 to 31.5% and the mortality from 0 to 12.5% with a mean of 4.8%. The decision of performing total or subtotal hysterectomy was influenced by the patient′s condition. Conclusion: Emergency peripartum hysterectomy is a most demanding obstetric surgery performed in very trying circumstances of life threatening hemorrhage. The indication for emergency peripartum hysterectomy in recent years has changed from traditional uterine atony to abnormal placentation. Antenatal anticipation of the risk factors, involvement of an experienced obstetrician at an early stage of management and a prompt hysterectomy after adequate resuscitation would go a long way in reducing morbidity and mortality.

  11. Having views, abandoning views

    DEFF Research Database (Denmark)

    Sobisch, Jan-Ulrich

    2013-01-01

    In the bKa' brgyud tradition of Tibetan Buddhism, holding a philosophical view cannot produce an understanding of ultimate reality. The article contains some arguments why views must ultimately be abandoned....

  12. Abandoning wells working group

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-03-01

    The primary objective of this working group is to identify major technical, regulatory, and environmental issues that are relevant to the abandonment of offshore wellbores. Once the issues have been identified, the working group also has the objective of making recommendations or providing potential solutions for consideration. Areas for process improvement will be identified and {open_quotes}best practices{close_quotes} will be discussed and compared to {open_quotes}minimum standards.{close_quotes} The working group will primarily focus on wellbore abandonment in the Gulf of Mexico. However, workshop participants are encouraged to discuss international issues which may be relevant to wellbore abandonment practices in the Gulf of Mexico. The Abandoning Wells Group has identified several major areas for discussion that have concerns related to both operators and service companies performing wellbore abandonments in the Gulf of Mexico. The following broad topics were selected for the agenda: (1) MMS minimum requirements and state regulations. (2) Co-existence of best practices, new technology, and P & A economics. (3) Liability and environmental issues relating to wellbore abandonment.

  13. HYSTERECTOMY: CHANGING TRENDS IN A TERTIARY CARE CENTER

    Directory of Open Access Journals (Sweden)

    Abha

    2015-11-01

    Full Text Available BACKGROUND: Hysterectomy is the most common gynec operation worldwide. It leads to significant morbidity and mortality hence there must be justifiable indication before procedure is undertaken. There is a lack of comprehensive data and too much variability from place to place, even in India. OBJECTIVE: To analyze the changing trends in hysterectomy in past 6 years. METHOD: A retrospective study of all women undergoing hysterectomy that were done in Dr. B.R.A.M. Hospital, Medical College, Raipur for 6yrs from 2009 to 2014. RESULTS: A total of 1032 hysterectomies were done during the study period. Most common age group was from 41-50 years. The commonest indication was symptomatic fibroid (33.52%. Vaginal and abdominal hysterectomy were done equally. A declining trend of incidence of hysterectomy was observed over the years from 14.9 to 9.61 per 1000 women per year, which is significant (p value- 0.008. CONCLUSION: This study shows changing scenario of hysterectomy in terms of age, oophorectomy and rate. A shift towards minimal invasive techniques is also evident

  14. Single-incision total laparoscopic hysterectomy

    Directory of Open Access Journals (Sweden)

    Sinha Rakesh

    2011-01-01

    Full Text Available Single-incision laparoscopic surgery is an alternative to conventional multiport laparoscopy. Single-access laparoscopy using a transumbilical port affords maximum cosmetic benefits because the surgical incision is hidden in the umbilicus. The advantages of single-access laparoscopic surgery may include less bleeding, infection, and hernia formation and better cosmetic outcome and less pain. The disadvantages and limitations include longer surgery time, difficulty in learning the technique, and the need for specialized instruments. Ongoing refinement of the surgical technique and instrumentation is likely to expand its role in gynecologic surgery in the future. We perform single-incision total laparoscopic hysterectomy using three ports in the single transumbilical incision.

  15. Gender and power: the Irish hysterectomy scandal.

    Science.gov (United States)

    McCarthy, Joan; Murphy, Sharon; Loughrey, Mark

    2008-09-01

    In April 2004 the Irish Government commissioned Judge Maureen Harding Clark to compile a report to ascertain the rate of caesarean hysterectomies at Our Lady of Lourdes Hospital in Drogheda, Republic of Ireland. The report came about as a result of complaints by midwives into questionable practices that were mainly (but not solely) attributed to one particular obstetrician. In this article we examine the findings of this Report through a feminist lens in order to explore what a feminist reading of the Report and the events that led to the inquiry will bring to light. We consider how sex and gender feature in the Lourdes case, draw attention to the deeply gendered asymmetries of power and privilege that existed between the men and women at the centre of this inquiry, and explore the impact such asymmetries had on this particular situation. PMID:18687818

  16. Obstetric hysterectomy: a retrospective study at a tertiary care centre

    Directory of Open Access Journals (Sweden)

    Anjali Kanhere

    2013-08-01

    Conclusions: Obstetric hysterectomy is a lifesaving procedure. The outcome depends on timely decision, good clinical judgement and professional surgical technique. It reduces maternal morbidity and mortality. [Int J Reprod Contracept Obstet Gynecol 2013; 2(4.000: 562-565

  17. Effect of hysterectomy on anorectal and urethrovesical physiology.

    Science.gov (United States)

    Prior, A; Stanley, K; Smith, A R; Read, N W

    1992-02-01

    To investigate whether vaginal or total abdominal hysterectomy is associated with changes in anorectal and urethrovesical physiology, 26 women were studied before operation and six weeks and six months afterwards. The results showed a postoperative increase in both rectal and vesical sensitivity (p less than 0.01). Similar results were observed irrespective of the type of hysterectomy. No significant changes in rectal or bladder compliance were noted, and anal pressure and urethral pressure and length were unchanged after surgery. Whole gut transit was not affected by hysterectomy. Urinary symptoms occurred de novo in 6/26 women and gastrointestinal symptoms in 2/26 women. These results show that significant changes in rectal and vesical sensitivity occur after hysterectomy for benign disease. These persist for at least six months postoperatively but are not always associated with development of urinary or gastrointestinal symptoms.

  18. Total laparoscopic hysterectomy via suture and ligation technique

    OpenAIRE

    Kang, Hye Won; Lee, Ji Won; Ho Yeon KIM; Kim, Bo Wook; Moon, Chong Soo

    2016-01-01

    Objective The term 'total laparoscopic hysterectomy (TLH) with classical suture method' refers to a surgical procedure performed using only sutures and ligations with intracorporeal or extracorporeal ties, without using any laser or electronic cauterization devices during laparoscopic surgery as in total abdominal hysterectomy. However, the method is not as widely used as electric coagulation equipment for TLH because further advances in technology and surgical technique are required and oper...

  19. The effect of hysterectomy on ano-rectal physiology.

    LENUS (Irish Health Repository)

    Kelly, J L

    2012-02-03

    Hysterectomy is associated with severe constipation in a subgroup of patients, and an adverse effect on colonic motility has been described in the literature. The onset of irritable bowel syndrome and urinary bladder dysfunction has also been reported after hysterectomy. In this prospective study, we investigated the effect of simple hysterectomy on ano-rectal physiology and bowel function. Thirty consecutive patients were assessed before and 16 weeks after operation. An abdominal hysterectomy was performed in 16 patients, and a vaginal procedure was performed in 14. The parameters measured included the mean resting, and maximal forced voluntary contraction anal pressures, the recto-anal inhibitory reflex, and rectal sensation to distension. In 8 patients, the terminal motor latency of the pudendal nerve was assessed bilaterally. Pre-operatively, 8 patients were constipated. This improved following hysterectomy in 4, worsened in 2, and was unchanged in 2. Symptomatology did not correlate with changes in manometry. Although, the mean resting pressure was reduced after hysterectomy (57 mmHg-53 mmHg, P = 0.0541), the maximal forced voluntary contraction pressure was significantly decreased (115 mmHg-105 mmHg, P = 0.029). This effect was more pronounced in those with five or more previous vaginal deliveries (P = 0.0244, n = 9). There was no significant change in the number of patients with an intact ano-rectal inhibitory reflex after hysterectomy. There was no change in rectal sensation to distension, and the right and left pudendal nerve terminal motor latencies were unaltered at follow-up. Our results demonstrate that hysterectomy causes a decrease in the maximal forced voluntary contraction and pressure, and this appears to be due to a large decrease in a small group of patients with previous multiple vaginal deliveries.

  20. Emergency peripartum hysterectomy in a tertiary hospital in southern Nigeria

    OpenAIRE

    Abasiattai, Aniekan Monday; Umoiyoho, Aniefiok Jackson; Utuk, Ntiense Maurice; Inyang-Etoh, Emmanuel Columba; Asuquo, Otobong Peter

    2013-01-01

    Introduction Emergency peripartum hysterectomy, a maker of severe maternal morbidity and near miss mortality is an inevitable surgical intervention to save a woman's life when uncontrollable obstetric haemorrhage complicates delivery. This study was conducted in order to determine the incidence, types, indications and maternal complications of emergency peripartum hysterectomy at the University of Uyo Teaching Hospital, Uyo, Nigeria. Methods The case records of all women who underwent emergen...

  1. Fallopian tube prolapse after hysterectomy: a systematic review.

    Directory of Open Access Journals (Sweden)

    Lobna Ouldamer

    Full Text Available BACKGROUND: Prolapse of the fallopian tube into the vaginal vault is a rarely reported complication that may occur after hysterectomy. Clinicians can miss the diagnosis of this disregarded complication when dealing with post-hysterectomy vaginal bleeding. OBJECTIVES: We performed a systematic review in order to describe the clinical presentation, therapeutic management and outcome of fallopian tube prolapse occurring after hysterectomy. SEARCH STRATEGY: A systematic search of MEDLINE and EMBASE references from January 1980 to December 2010 was performed. We included articles that reported cases of fallopian tube prolapse after hysterectomy. Data from eligible studies were independently extracted onto standardized forms by two reviewers. RESULTS: Twenty-eight articles including 51 cases of fallopian tube prolapse after hysterectomy were included in this systematic review. Clinical presentations included abdominal pain, dyspareunia, post- coital bleeding, and/or vaginal discharge. Two cases were asymptomatic and diagnosed at routine checkup. The surgical management reported comprised partial or total salpingectomy, with vaginal repair in some cases combined with oophorectomy using different approaches (vaginal approach, combined vaginal-laparoscopic approach, laparoscopic approach, or laparotomy. Six patients were initially treated by silver nitrate application without success. CONCLUSIONS: This systematic review provided a precise summary of the clinical characteristics and treatment of patients presenting with fallopian tube prolapse following hysterectomy published in the past 30 years. We anticipate that these results will help inform current investigations and treatment.

  2. Cervical removal at hysterectomy for benign disease. Risks and benefits.

    Science.gov (United States)

    Hasson, H M

    1993-10-01

    An assessment of the risks and benefits of total and subtotal hysterectomy for benign disease was performed using the published literature, including a MEDLINE search, on all studies dealing with hysterectomy and related topics from 1946 to 1992. The shift from subtotal to total hysterectomy occurred before cytologic screening was accepted. Currently, SIL is diagnosed by cytology, evaluated by colposcopy and treated preferentially with cone biopsy. Prophylactic removal of the cervix does not eliminate the risk of cancer: it may shift the risk to the vaginal epithelium. The cervix has a role in sexual arousal and orgasm, probably due to stimulation of the Frankenhauser uterovaginal plexus. Bladder and bowel dysfunction following total hysterectomy may be related to loss of nerve ganglia closely associated with the cervix. Increased operative and postoperative morbidity, vaginal shortening, vault prolapse, abnormal cuff granulations and oviductal prolapse are other disadvantages of total hysterectomy. The cervix is not a useless organ and should not be removed during hysterectomy without a proper indication. PMID:8263867

  3. Hawaii Abandoned Vessel Inventory, Lanai

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Lanai. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral habitats...

  4. Hawaii Abandoned Vessel Inventory, Molokai

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Molokai, Hawaii. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of...

  5. CNMI Abandoned Vessel Inventory, Tinian

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Tinian. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  6. CNMI Abandoned Vessel Inventory, Saipan

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Saipan. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  7. Hawaii Abandoned Vessel Inventory, Kauai

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Kauai. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral habitats...

  8. Hawaii Abandoned Vessel Inventory, Oahu

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Oahu, Hawaii. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  9. Hawaii Abandoned Vessel Inventory, Maui

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Maui. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral habitats...

  10. CNMI Abandoned Vessel Inventory, Rota

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Rota. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral habitats...

  11. Puerto Rico Abandoned Vessel Inventory

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Puerto Rico. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  12. American Samoa Abandoned Vessel Inventory

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for American Samoa. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  13. Pelvic organ prolapse (POP) surgery among Danish women hysterectomized for benign conditions: age at hysterectomy, age at subsequent POP operation, and risk of POP after hysterectomy

    DEFF Research Database (Denmark)

    Lykke, Rune; Blaakær, Jan; Ottesen, Bent;

    2015-01-01

    INTRODUCTION AND HYPOTHESIS: The aim of this study was to describe the incidence of pelvic organ prolapse (POP) surgery after hysterectomy from 1977 to 2009, the time interval from hysterectomy to POP surgery, and age characteristics of women undergoing POP surgery after hysterectomy and to estim......INTRODUCTION AND HYPOTHESIS: The aim of this study was to describe the incidence of pelvic organ prolapse (POP) surgery after hysterectomy from 1977 to 2009, the time interval from hysterectomy to POP surgery, and age characteristics of women undergoing POP surgery after hysterectomy...... women was high the first 2 years of the follow-up period with almost 800 women operated yearly. More than one third (n = 2,872) of all women operated for POP were operated less than 5 years after the hysterectomy with a median of 8.6 years. The cumulated incidence of POP surgery after hysterectomy...... with follow-up of up to 32 years was 12 %; 50 % (n = 5,451) of all POP surgeries were in the posterior compartment. The mean age of women undergoing a first POP surgery after hysterectomy was 60 years. CONCLUSIONS: POP after hysterectomy occurs as a long-term complication of hysterectomy; 12...

  14. 精准-间隙解剖技术在腹腔镜广泛性子宫切除术+腹腔镜下盆腔淋巴结切除术中预防并发症的临床价值%Clinical value of precise-fascia space dissection technique in prevention of complications in laparoscopic radical hysterectomy combined with laparoscopic pelvic lymphadenectomy

    Institute of Scientific and Technical Information of China (English)

    李平军; 嵇振岭; 孟惠吉; 朱委巧; 李霞; 崔晓勇; 李丹; 张新梅; 刘嵩颖

    2014-01-01

    Objective To research the clinical value of precise-fascia space dissection technique in laparoscopic radical hysterectomy (LRH) combined with laparoscopic pelvic lymphadenectomy (LPL).Methods A retrospective analysis for 30 cases with early uterine malignancy operated by LRH + LPL were conducted,each patient was used for precise-fascia space dissection technique.Results All cases were successfully performed LRH + LPL under laparoscopy.The operative time was (253.2 ± 30.5) min,the blood loss in operation was (180.3 ± 83.2) ml,the amount of the excised lymph nodes was (13.2 ± 4.0) pieces,the time of gastrointestinal tract functional rehabilitation was (2.5 ± 0.9) d,the time of keeping urinary catheter was (13 ± 5) d.Three cases occurred lymphatic leakage and recovered after fasting and intravenous nutrition.None occurred ureter,bladder and vascular injury.Followed up for 6-72 months,none occurred recurrence or death.Conclusion LRH + LPL using precise-fascia space dissection technique can avoid ureter,bladder and vascular injury.%目的 探讨精准-间隙解剖技术在腹腔镜广泛性子宫切除术(LRH)+腹腔镜下盆腔淋巴结切除术(LPL)中预防并发症的临床价值.方法 回顾性分析采用精准-间隙解剖技术施行LRH+ LPL治疗的30例早期子宫恶性肿瘤患者的临床资料.结果 30例患者全部成功施行LRH+ LPL,手术时间(253.2±30.5) min,术中出血量(180.3±83.2) ml,切除盆腔淋巴结(13.2士4.0)枚,术后肠功能恢复时间(2.5±0.9)d,术后留置尿管时间(13±5)d;术后发生淋巴漏3例,经禁食和静脉营养治疗痊愈;无输尿管、膀胱及大血管损伤.30例术后随访6 ~ 72个月,未发现复发患者.结论 采用精准-间隙解剖技术施行LRH+ LPL,按层次解剖、间隙分离,可避免输尿管、膀胱及大血管损伤等严重并发症.

  15. Vaginal hysterectomy or laparoscopic assisted vaginal hysterectomy for enlarged myomatous uterus: a randomized clinical trial

    Institute of Scientific and Technical Information of China (English)

    Fan Rong; Zhu Lan; Lang Jing-he; Shi Hong-hui; Gong Xiao-ming

    2011-01-01

    Objective:To compare the intraoperative condition and short-term outcomes of vaginal hysterectomy (VH) and laparoscopic assisted vaginal hysterectomy (LAVH) for enlarged myomatous uterus.Methods:Fifty patients from Peking Union Medical College Hospital (PUMCH) were randomly assigned to two treatment groups:VH (n=23) and LAVH (n=27).All procedures were performed by a single senior surgeon to maintain homogeneity.Results:The baseline characteristics of the two groups were comparable.The operative time for LAVH was significantly longer than for VH (76.7±23.2 vs.57.6±23.5 min,P<0.05),and LAVH costs more money than VH (6,923.07±622.96 vs.5,974.46±1,408.08 RMB,P<0.05).Major complications,uterine weight and the length of hospital stay were comparable between VH and LAVH group.One case of VH was converted to LAVH due to adhesion.Conclusions:Compared with LAVH,VH is a time- and cost-saving operative technique for enlarged myomatous uterus.VH should be the primary method for uterine removal,but LAVH may have advantages when adhesion is present.

  16. Analysis of histopathological examination of the hysterectomy specimens in a north Indian teaching institute

    Directory of Open Access Journals (Sweden)

    Deepti Verma

    2016-11-01

    Conclusions: Justification of hysterectomy is proved when the HPE report is compatible with the preoperative diagnosis; hence HPE of all hysterectomy specimens should be done and analyzed. [Int J Res Med Sci 2016; 4(11.000: 4753-4758

  17. Five-year follow up of a randomised controlled trial comparing subtotal with total abdominal hysterectomy

    DEFF Research Database (Denmark)

    Andersen, L L; Zobbe, V; Ottesen, B;

    2015-01-01

    OBJECTIVES: To compare the rates of urinary incontinence (UI) and other complications of subtotal abdominal hysterectomy (SAH) with total abdominal hysterectomy (TAH) at 5 years after surgery. DESIGN: Randomised clinical trial with central, computer-generated randomisation. SETTING: Danish multi-...

  18. Analysis of 46 Hysterectomies Performed for Obstetric Indications

    Directory of Open Access Journals (Sweden)

    Mahmut Erdemoğlu

    2006-01-01

    Full Text Available We analyzed retrospectively 52 cases of emergency peripartum hysterectomy that were performed at our clinic from January 1998 to December 2004. Fifty two patients of emergency peripartum hysterectomy were identified amoung 11098 deliveries.The mean age was 32.66±6.74, gravida 7.09±3.37, parity 6.12±3.11 , gestational weeks. 84.61% patients were underwent subtotal hysterectomy. The emergency peripartum hysterectomy was done 51.92% of the cases during cesarean section or later. The indications of hysterectomy were identified as (55.76% uterine atony, uterine rupture (15.38%, pelviperitonitis and acute abdomen (9.61%, anormal placentation (15.38%, uterine myoma (1.92%, and cervical cancer (1.92% respectively. The overall (23.07% patients developed disseminated intravascular coagulopathy (DIC, two cases had ureter injury,one case had bladder injury. Bilateral hypogastric artery ligation were performed in 30.76% of the patients and relaparatomy was performed in 5 (9.61% patients due to the intraabdominal hemorrhage. Maternal mortality occured in four cases.

  19. Extrafascial hysterectomy in IB2 cervical cancer after radio chemotherapy

    International Nuclear Information System (INIS)

    Aim: To evaluate overall and disease free survival in cervical cancer IB2 patients with concomitant chemoradiotherapy and posterior extrafascial hysterectomy treatment. Methods: Between July 2005 to December 2009, a total of 31 eligible patients with IB2 cervical cancer were treated with chemoradiotherapy and posterior hysterectomy in the Carlos Van Buren Hospital Oncology Unit. Radiotherapy consisted in external pelvic radiation and a utero-vaginal brachytherapy with low rate doses to get preoperatory doses between 70 and 75 Gy to the A point and a concomitant Cisplatin based chemotherapy. After this treatment, the patients received extrafascial hysterectomy 4 to 6 weeks completed chemoradiotherapy. Results: The mean age was 41 ± 8 years. 81% of the patients had an spinocelular carcinoma. The extrafascial hysterectomy was made between 4 to 6 weeks post-radiation in 85% of the patients. 79% and 13% of the patients received 5 and 4 chemotherapy cycles respectively. The median follow up was 38 months. The 5 years overall survival and disease free survival estimates were 86% and 79% respectively. There was a significant difference between subgroups of patients with and without macroscopic residual disease in the operatory specimen (p<0.001). Conclusion: Our survival is similar to published results with the same treatment. The presence of macroscopic residual disease in the hysterectomy specimen could be a factor of prognostic value

  20. Robotic Trachelectomy After Supracervical Hysterectomy for Benign Gynecologic Disease

    Science.gov (United States)

    Aoun, Joelle; Hanna, Rabbie; Papalekas, Eleni; Schiff, Lauren; Theoharis, Evan; Eisenstein, David

    2016-01-01

    Background and Objectives: A renewed interest in the supra cervical approach to hysterectomy has created a cohort of patients with a retained cervix at risk of persistent symptoms requiring a subsequent trachelectomy. The objective of this study was to evaluate the efficacy of robotic trachelectomy after a previous supracervical hysterectomy. Methods: This is a retrospective chart review of women who had robotic trachelectomy after supracervical hysterectomy for benign gynecologic disease from January 2009 through October 2014. Results: Eleven patients underwent robotic trachelectomy for benign conditions during the observed period. Prior supracervical hysterectomy had been performed for pelvic pain (8/11, 73%), abnormal uterine bleeding (7/11, 64%), and dysmenorrhea (5/11, 45%). In 10 of 11 patients, the symptoms leading to robotic trachelectomy were the same as those leading to supracervical hysterectomy. The time from hysterectomy to recurrence of symptoms ranged from 0.5 to 26 months (median, 6), whereas the time interval from previous surgery to robotic trachelectomy ranged from 1 to 57 months (median, 26). Mean age and body mass index at robotic trachelectomy were 42 ± 5.4 years and 32 ± 6.1 kg/m2. Mean length of surgery was 218 ± 88 minutes (range, 100–405). There was 1 major postoperative complication involving bladder perforation and subsequent vesicovaginal fistula (VVF). Endometriosis was seen in 27% of pathologic specimens and cervicitis in another 27%; 45% showed normal tissue histology. In 6 (55%) cases, symptoms leading to trachelectomy resolved completely after surgery, and the other 5 (45%) patients reported a significant improvement. Conclusions: Although trachelectomy can be a challenging surgery, our experience suggests that the robotic approach may be a valuable means of achieving safe and reproducible outcomes. PMID:27493470

  1. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Medline Plus

    Full Text Available ... entire piece. We’re going to use the technology of LigaSure, which has radically changed our ability ... so we’re going to need to use technology to help us, and that technology with the ...

  2. ASYMPTOMATIC MISSING INTRAUTERINE CONTRACEPTIVE DEVICE FOUND INCIDENTALLY DURING VAGINAL HYSTERECTOMY

    Directory of Open Access Journals (Sweden)

    Reena

    2015-06-01

    Full Text Available Incidence of missing IUCD iy is 0.5% - 2%. U s ually the cause is either expulsion or perforation of uterus. Sometimes the perforated IUCD remains asymptomatic for years together and found incidentally later on. We hereby presenting a case of 55 yrs female presenting with prolapsed uterus , planned for vaginal hysterectomy. During vaginal hysterectomy asymptomatic missing IUCD was detected which was found on the anterior surface of body of uterus with omentum adherent to it. KEY WORDS: M issing Cu T , IUCD , O mentum , P erforation .

  3. The Essential Elements of a Robotic-Assisted Laparoscopic Hysterectomy.

    Science.gov (United States)

    Simpson, Khara M; Advincula, Arnold P

    2016-09-01

    Robotic-assisted laparoscopic hysterectomies are being performed at higher rates since the da Vinci Surgical System (Intuitive Surgical, Inc, Sunnyvale, CA, USA) received US Food and Drug Administration approval in 2005 for gynecologic procedures. Despite the technological advancements over traditional laparoscopy, a discrepancy exists between what the literature states and what the benefits are as seen through the eyes of the end-user. There remains a significant learning curve in the adoption of safe and efficient robotic skills. The authors present important considerations when choosing to perform a robotic hysterectomy and a step-by-step technique. The literature on perioperative outcomes is also reviewed. PMID:27521880

  4. Effect of socioeconomic position on patient outcome after hysterectomy

    DEFF Research Database (Denmark)

    Daugbjerg, Signe B; Cesaroni, Giulia; Ottesen, Bent;

    2014-01-01

    AND POPULATION: The study included nearly all Danish women (n = 22 150) registered with a benign elective hysterectomy in the Danish Hysterectomy Database in 2004-2008. METHODS: Data were analyzed using logistic regression models estimating the odds ratio with 95% confidence intervals. MAIN OUTCOME MEASURES...... and employed women. Furthermore, unemployed women had higher odds of hospitalization >4 days than women in employment. Lifestyle factors (smoking and body mass index) and co-morbidity status seemed to explain most of the social differences. However, an association between women with less than high school...

  5. Risk factors associated with emergency peripartum hysterectomy

    Institute of Scientific and Technical Information of China (English)

    Jin Rong; Guo Yuna; Chen Yan

    2014-01-01

    Background Use of an emergency peripartum hysterectomy (EPH) as a lifesaving measure to manage intractable postpartum hemorrhage (PPH) appears to be increasing recently around the world,and the indications for EPH have changed.The object of this study is to identify risk factors associated with EPH.Methods We conducted a case-control study of 21 patients who underwent EPH because of intractable PPH between January 1,2005 and June 30,2013,at the International Peace Maternity and Child Health Hospital Shanghai Jiao Tong University,School of Medicine (IPMCH).The parametric t-test,chi-square tests and Logistic regression models were used for analysis to identify the risk factors.The results were considered statistically significant when P<0.05.Results There were 89 178 deliveries during the study period.Twenty-one women had an EPH,with an incidence of 24 per 100 000 deliveries.The loss of blood during postpartum hemorrhage of the EPH group was (5 060.7±3 032.6)ml,and that of the control group was (2 040.8±723.5) ml.There was a significant difference of PHH between the EHP group and the control group (P=0.001).Independent risk factors for EPH from a logistic regression model were:disseminated intravascular coagulation (DIC) (OR:9.9,95% CI 2.8-34,P=0.003),previous cesarean section (OR:5.27;95% CI:1.48-17.9,P=0.009),placenta previa (OR:6.9; 95% CI 1.6-2.9,P=0.008),the loss of PPH (OR:1.001; 95% CI 1.001-1.002,P=0.002),placenta accreta (OR:68; 95% CI 10-456,P=0.004),the use of tocolytic agents prenatally (OR:6.55,95%CI 1.34-32.1,P=0.049),and fetal macrosomia (OR:6.9,95% CI 1.25-38,P=0.049).Conclusion Significant risk factors of EPH are DIC,placenta previa,PPH,previous cesarean delivery,and placenta accrete,the use of tocolytic agents prenatally,and fetal macrosomia.

  6. Histopathological audit of 373 nononcological hysterectomies in a teaching hospital.

    Science.gov (United States)

    Tiwana, Kanwardeep Kaur; Nibhoria, Sarita; Monga, Tanvi; Phutela, Richa

    2014-01-01

    Hysterectomy, the most common gynecological surgery, provides a definitive cure to various diseases like DUB (dysfunctional uterine bleeding), leiomyoma, adenomyosis, chronic pelvic pain, prolapse, and malignancy. However, with advent of effective medical and conservative treatment modalities for nononcological causes it is now posing question mark on justification of hysterectomy. Therefore, an audit is required to assess the correlation between preoperative diagnosis and histopathological examination of specimen for justification of the procedure. In this study over period of one year (April 2013 to March 2014) 373 hysterectomies specimens were received in the department of pathology for nononcological causes. The age of patients ranged from 22 to 85 years with mean 45 ± 9.2 years. All cases were divided into five categories on the basis of age and audit was done. In this study the most common finding was leiomyoma (43.7%) followed by adenomyosis (19.3%). Almost 50% of hysterectomies causes were justified as preoperative diagnosis matched with histopathology. Cohen kappa statistics were used to measure agreement between preoperative and postoperative histopathological diagnosis which was found to be fair with κ value being 0.36. This study highlights that regular audit of surgeries can help improve quality of health care services and provide safe conservative option to patients.

  7. Abandoned vehicles - Reminder

    CERN Multimedia

    Relations with the Host States Service

    2004-01-01

    The services in charge of managing the CERN site have recently noted an increase in the number of abandoned vehicles. This poses a risk from the point of view of safety and security and, on the eve of several important events in honour of CERN's fiftieth anniversary, is detrimental to the Organization's image. Owners of vehicles that have been left immobile for some time on the CERN site, including on the external car park by the flags, are therefore invited to contact the Reception and Access Control Service (service-parking-longterm@cern.ch) before 1st October 2004 and, where appropriate, move their vehicle to a designated long-term parking area. After this date, any vehicle whose owner has failed to respond to this request and which is without a number plate, has been stationary for several weeks or is out of service, may be impounded at the owner's risk and expense. Relations with the Host States Service Tel. 72848

  8. Abandonned vehicles - REMINDER

    CERN Multimedia

    Relations with the Host States Service

    2004-01-01

    The services in charge of managing the CERN site have recently noted an increase in the number of abandoned vehicles. This poses a risk from the point of view of safety and security and, on the eve of several important events in honour of CERN's fiftieth anniversary, is detrimental to the Organization's image. Owners of vehicles that have been left immobile for some time on the CERN site, including on the external car park by the flags, are therefore invited to contact the Reception and Access Control Service (service-parking-longterm@cern.ch) before 1st October 2004 and, where appropriate, move their vehicle to a designated long-term parking area. After this date, any vehicle whose owner has failed to respond to this request and which is without a number plate, has been stationary for several weeks or is out of service, may be impounded at the owner's risk and expense. Relations with the Host States Service Tel. 72848

  9. Abandoned vehicles REMINDER

    CERN Multimedia

    Relations with the Host States Service

    2004-01-01

    The services in charge of managing the CERN site have recently noted an increase in the number of abandoned vehicles. This poses a risk from the point of view of safety and security and, on the eve of several important events in honour of CERN's fiftieth anniversary, is detrimental to the Organization's image. Owners of vehicles that have been left immobile for some time on the CERN site, including on the external car park by the flags, are therefore invited to contact the Reception and Access Control Service (service-parking-longterm@cern.ch) before 1st October 2004 and, where appropriate, move their vehicle to a designated long-term parking area. After this date, any vehicle whose owner has failed to respond to this request and which is without a number plate, has been stationary for several weeks or is out of service, may be impounded at the owner's risk and expense. Relations with the Host States Service Tel. 72848

  10. Water pollution from abandoned mines

    OpenAIRE

    Iversen, E.; Johannessen, M.

    1987-01-01

    The report provides a country-wide overview of abandoned pyrite mines where operations have been fairly extensive. The water pollution situation is assessed on the basis of reported investigations, inspections and chemical analyses from the individual areas. In cases where larger watercourses (Orkla, Gaula), and the upper stretch of the Glåma are affected the situation appears to be adequately described. However abandoned mine areas may also cause local pollution problems, and here documentat...

  11. 23 CFR 752.10 - Abandoned vehicles.

    Science.gov (United States)

    2010-04-01

    ... 23 Highways 1 2010-04-01 2010-04-01 false Abandoned vehicles. 752.10 Section 752.10 Highways... ROADSIDE DEVELOPMENT § 752.10 Abandoned vehicles. (a) Abandoned motor vehicles may be removed from the... collection of abandoned motor vehicles from within the right-of-way must be a development project and not...

  12. Postpartum Prolapsed Leiomyoma with Uterine Inversion Managed by Vaginal Hysterectomy

    Directory of Open Access Journals (Sweden)

    Kelly L. Pieh-Holder

    2014-01-01

    Full Text Available Background. Uterine inversion is a rare, but life threatening, obstetrical emergency which occurs when the uterine fundus collapses into the endometrial cavity. Various conservative and surgical therapies have been outlined in the literature for the management of uterine inversions. Case. We present a case of a chronic, recurrent uterine inversion, which was diagnosed following spontaneous vaginal delivery and recurred seven weeks later. The uterine inversion was likely due to a leiomyoma. This late-presenting, chronic, recurring uterine inversion was treated with a vaginal hysterectomy. Conclusion. Uterine inversions can occur in both acute and chronic phases. Persistent vaginal bleeding with the appearance of a prolapsing fibroid should prompt further investigation for uterine inversion and may require surgical therapy. A vaginal hysterectomy may be an appropriate management option in select populations and may be considered in women who do not desire to maintain reproductive function.

  13. Influence of alcohol intake on postoperative morbidity after hysterectomy

    DEFF Research Database (Denmark)

    Felding, C; Jensen, L M; Tønnesen, H

    1992-01-01

    Postoperative morbidity after hysterectomy was prospectively studied in 229 consecutive patients in our departments. The incidence of alcohol abuse (greater than 60 gm of alcohol daily) and social drinking (between 25 and 60 gm of alcohol daily) was 6.5% for each. When compared with the social...... drinkers and the control group, the alcohol abuse group had significantly more complications (80% vs 27% and 80% vs 13%, respectively)....

  14. Clinical study of emergency peripartum hysterectomy for postpartum hemorrhage

    Directory of Open Access Journals (Sweden)

    Amudha S.

    2016-04-01

    Conclusions: PPH is unpredictable in onset, duration and etiology and it remains a major life threatening complication of any delivery. The most common causes of hemorrhage in these women are placental abnormalities and uterine atony. When conservative treatment is not feasible or has failed, prompt peripartum hysterectomy is performed failing which the delay would contribute to the maternal morbidity and mortality. [Int J Reprod Contracept Obstet Gynecol 2016; 5(4.000: 1171-1173

  15. EMERGENCY PERIPARTUM HYSTERECTOMY AT A TERTIARY CARE HOSPITAL IN KASHMIR VALLEY

    Directory of Open Access Journals (Sweden)

    Sameena

    2015-01-01

    Full Text Available OBJECTIVE: To determine the incidence , indications , maternal and perinatal outcome of emergency peripartum hysterectomy. METHOD: A prospective observational study of all patients who underwent peripartum hysterectomy was conducted from June 2011 to November 2012 in the Department of Obstetrics and Gynecology , Lalla Ded Hospital , an associated hospital of Government Medical College , Srinagar , Kashmir. Data , specifically on the incidence of emergency peripartum hysterectomy , the total number of deliveries , the maternal parameters , the indications of peripartum hysterectomy and associated maternal morbidity and mortality were recorded on a proforma. RESULTS: There were 87 cases of peripartum hysterectom y ( 75 caesarean hysterectomies , 86.2% and 12 postpartum hysterectomies , 13.8% , making an incidence of 2.56/1000 deliveries. Most of the patients were para 3 , 32 ( 36.8% , were mostly in age group of 35 - 39 years 38 ( 43.7% and belonged to rural areas . Overa ll , the most common indication for emergency peripartum hysterectomy was morbidly adherent placenta with placenta previa 39( 44.8% followed by uterine rupture 24 ( 27.6 % , uterine atony 13 (14.9% and accidental haemorrhage 6 (6.9%. In 38 (43.7% patients total abdominal hysterectomy was performed while 49 (56.3% patients required subtotal hysterectomy. There were 9 (10.3% maternal and 40 (46% perinatal deaths; all were due to severity of conditions necessitating hysterectomy. CONCLUSION: Emergency perip artum hysterectomy is potentially a lifesaving procedure associated with significant maternal morbidity and mortality. Morbidly adherent placenta with placenta previa was the commonest indication for emergency peripartum hysterectomy. Previous scar , multip arity and abnormal placentation were the significant risk factors.

  16. Analysis of Risk Factors for Post-Hysterectomy Vaginal Vault Prolapse

    Directory of Open Access Journals (Sweden)

    Mahmut Kuntay kuntay Kokanali

    2015-03-01

    Conclusions: Vault prolapse after hysterectomy is a relatively rare complication. Elderly age, obesity, chronic obstructive lung diseases, prior genital prolapse sugery, vaginal hysterectomy, genital prolapse as indication of hysterectomy and the number of vaginal delivery and #8805;2 increase vault prolapse risk. Identification of these risk factors is important to prevent this complication. [Cukurova Med J 2015; 40(1.000: 63-71

  17. Obstetric Hysterectomy: Retrospective analytical study at P D U Medical College, Rajkot

    OpenAIRE

    Parmar, Prakash; Goswami, K. D.; Dudhrejiya, Kavita M; Jain, Mahima

    2014-01-01

    Objective: To find out indications of obstetrics hysterectomy, related complications and associated maternal morbidity and mortality.Methods:  A Retrospective Analytical Study was performed at Dept of obs & gynec P D U Medical College, Rajkot over a period of 3 yrs during 2011-2013.Evaluation of Maternal age, parity, SE status, booking status, obstetric risk factors, duration of hospital stay, indications of hysterectomy, type of hysterectomy, intra-op and post-operative complications, bl...

  18. EM ERGENCY PERIPARTUM HYSTERECTOMY: A FIVE YEAR STUDY

    Directory of Open Access Journals (Sweden)

    Saritha

    2015-10-01

    Full Text Available Emergency peripartum hysterectomy is performed as a life saving measure in uncontrolled PPH. OBJECTIVES: T o examine incidence, risk factors, indications, outcome and complications of emergency peripartum hysterectomy in a teaching hospital. METHODS: A 5 ye ar prospective study conducted between January 2010 to December 2014. Demographic data, detailed history, clinical examination and relevant investigations obtained. RESULTS: The incidence of EPH in present study was 0.6 per 1000 deliveries. Most of these p atients were young, mean age of 22.67 years, para 1 and 2, 84.21% were unbooked with no antenatal visits and delivered outside. Rupture of uterus was the commonest indication (42.10% for EPH, followed by uterine atony (26.32% and abnormal placentation (2 6.32%. Both total or subtotal hysterectomy were performed as a life saving measure after conservative measures failed. Maternal mortality in this study was 15.79%. Other complications noted were febrile illness, anaemia, coagulopathy, renal failure, wound infection. CONCLUSION: EPH performed for uncontrolled PPH is associated with significant mortality and morbidity. Its incidence can be reduced by regular antenatal check - ups, early detection and referral of high risk patients and updating knowledge and skill of doctors working in peripheral centres.

  19. C.I.S.H. Laparoscopic Hysterectomy: The Experience at the "Centro Materno Infantil"

    Science.gov (United States)

    Decunto; Traverso; Gibelli; Harpe

    1994-08-01

    Laparoscopic hysterectomy has been established firmly as a surgical alternative to standard abdominal hysterectomy around the world. In Argentina, we had introduced operative laparoscopy at the Hospital Aleman in May 1993, with a major change from basic diagnostic laparoscopy to advanced operative laparoscopy. A total of 180 major laparoscopic cases have been performed from May 1993 to January 1994, including laparoscopic hysterectomies. Of our first five C.I.S.H. laparoscopic hysterectomies, all had excellent outcomes, with greatly diminished hospital stay and less usage of analgesics postoperatively. The average length of stay was 2.5 days. No major complications occurred.

  20. Long-term cancer risk after hysterectomy on benign indications: Population-based cohort study.

    Science.gov (United States)

    Altman, Daniel; Yin, Li; Falconer, Henrik

    2016-06-01

    Hysterectomy on benign indications is associated with an increased risk for adverse health effects. However, little is known about the association between hysterectomy and subsequent cancer occurrence later in life. The purpose of this study was to assess the effect of hysterectomy on the incidence of cancer. In this population-based cohort study, we used data on 111,595 hysterectomized and 537,9843 nonhysterectomized women from nationwide Swedish Health Care registers including the Inpatient Register, the Cancer Register and the Cause of Death Register between 1973 and 2009. Hysterectomy with or without concomitant bilateral salpingo-ophorectomy (BSO) performed on benign indications was considered as exposure and incidence of primary cancers was used as outcome measure. Rare primary cancers (cancer was observed for women with previous hysterectomy and for those with hysterectomy and concurrent BSO (HR 0.93, 95% CI 0.91-0.95 and HR 0.92, 95% CI 0.87-0.96, respectively). Compared to nonhysterectomized women, significant risks were observed for thyroid cancer (HR 1.76, 95% CI 1.45-2.14). For both hysterectomy and hysterectomy with BSO, an association with brain cancer was observed (HR 1.48, 95% CI 1.32-1.65 and HR 1.45, 95% CI 1.15-1.83, respectively). Hysterectomy, with or without BSO, was not associated with breast, lung or gastrointestinal cancer. We conclude that hysterectomy on benign indications is associated with an increased risk for thyroid and brain cancer later in life. Further research efforts are needed to identify patient groups at risk of malignancy following hysterectomy.

  1. Comparative study of abdominal, vaginal and laparoscopic assisted vaginal hysterectomies with special reference to immediate sequel, late sequel and complications

    Directory of Open Access Journals (Sweden)

    Pujitha Devi Suraneni

    2016-02-01

    Conclusions: Preference for laparoscopic assisted vaginal hysterectomy or vaginal hysterectomy depends on expertise of doctor and selections of patients. [Int J Reprod Contracept Obstet Gynecol 2016; 5(2.000: 402-406

  2. Bursectomy at radical gastrectomy

    Institute of Scientific and Technical Information of China (English)

    Cuneyt; Kayaalp

    2015-01-01

    Radical gastrectomy with extended lymph node dissec tion and prophylactic resection of the omentum, peri toneum over the posterior lesser sac, pancreas and/o spleen was advocated at the beginning of the 1960 s in Japan. In time, prophylactic routine resections of the pancreas and/or spleen were abandoned because of the high incidence of postoperative complications. However omentectomy and bursectomy continued to be standard parts of traditional radical gastrectomy. The bursaomentalis was thought to be a natural barrier against invasion of cancer cells into the posterior part of the stomach. The theoretical rationale for bursectomy was to reduce the risk of peritoneal recurrences by eliminating the peritoneum over the lesser sac, which might include free cancer cells or micrometastases. Over time, the indication for bursectomy was gradually reduced to only patients with posterior gastric wall tumors penetrating the serosa. Despite its theoretical advantages, its benefit for recurrence or survival has not been proven yet. The possible reasons for this inconsistency are discussed in this review. In conclusion, the value of bursectomy in the treatment of gastric cancer is still under debate and large-scale randomized studies are necessary. Until clear evidence of patient benefit is obtained, its routine use cannot be recommended.

  3. [A review of 445 cases of laparoscopic hysterectomy: benefits and outcome].

    Science.gov (United States)

    Malzoni, M; Perniola, G; Hannuna, K; Iuele, T; Fruscella, M L; Basili, R; Ebano, V; Marziani, R

    2004-01-01

    Hysterectomy is a major procedure indicated for women with gynaecologic pathologies. After reporting the first laparoscopic hysterectomy (Reich 1989), this technique has recently been considered as a safe and efficient alternative to traditional abdominal hysterectomy in the management of benign uterine pathologies when vaginal route is contraindicated. The laparoscopic approach should not be held to compete with vaginal hysterectomy. From 1995 to 2001 in our institute, the proportion of laparoscopic hysterectomy has increased and laparotomic hysterectomy has decreased. Between January 1999 and January 2001 we carried out 445 total laparoscopic hysterectomies. There were 5 laparotomy conversions for large uterus. The average haemoglobin drop was 1,36 g/dl. Median operative time was 95 +/- 27 min. The mean in postoperative stay was 2.7 +/- 0.8 gg. The postoperative complications were minimal. Laparoscopic approach is less painful, is associated to less blood loss, shorter hospital stay, more rapid recovery and a better assumption by affected women. Some disadvantages are reported too, such as larger operating time, high rate of complication and experience required for performing laparoscopy including a learning curve. A training period is necessary to standardize the operating procedure, to put in place methods of avoiding complication and to reach a plateau of surgical skill. The purpose of this study was to show the role of total laparoscopic hysterectomy and how it can be performed safely with a minimal morbidity after a period of training in which we worked out shrewdness to get a standardized technique with the most effective outcome.

  4. Age at hysterectomy as a predictor for subsequent pelvic organ prolapse repair

    DEFF Research Database (Denmark)

    Lykke, Rune; Blaakær, Jan; Ottesen, Bent;

    2016-01-01

    INTRODUCTION AND HYPOTHESIS: The aim of this study was to investigate the association between patient age at the time of hysterectomy and subsequent pelvic organ prolapse (POP) surgery. METHODS: We gathered data on all benign hysterectomies and POP surgeries performed in Denmark on Danish women...

  5. The transversus abdominis plane block provides effective postoperative analgesia in patients undergoing total abdominal hysterectomy.

    LENUS (Irish Health Repository)

    Carney, John

    2008-12-01

    Patients undergoing total abdominal hysterectomy suffer significant postoperative pain. The transversus abdominis plane (TAP) block is a recently described approach to providing analgesia to the anterior abdominal wall. We evaluated the analgesic efficacy of the TAP block in patients undergoing total abdominal hysterectomy via a transverse lower abdominal wall incision, in a randomized, controlled, double-blind clinical trial.

  6. Objective comparison of subtotal vs. total abdominal hysterectomy regarding pelvic organ prolapse and urinary incontinence

    DEFF Research Database (Denmark)

    Andersen, Lea L; Alling Møller, Lars M; Gimbel, Helga M

    2015-01-01

    prolapse, 3 day voiding diary and also filled out the pelvic floor distress inventory (PFDI-20) questionnaire. RESULTS: We included 100/304 (32.9%) women (subtotal hysterectomy: 53, total hysterectomy: 47) in the clinical examinations. The study questionnaire was answered by 197 (64.8%) (subtotal: 97......OBJECTIVE: To compare subtotal and total abdominal hysterectomy regarding objective assessment of pelvic organ prolapse, urinary incontinence and voiding function 14 years after hysterectomy for benign diseases. STUDY DESIGN: Long-term follow-up of a randomized clinical trial of subtotal vs. total...... abdominal hysterectomy with objective outcomes. All randomized women still alive and living in Denmark (n=304) were invited to answer a questionnaire and come for clinical examination consisting of 20-min pad weighing test, urinary flow, measurement of residual urine, POP-Q measurement for pelvic organ...

  7. Global epidemiology of hysterectomy: possible impact on gynecological cancer rates

    DEFF Research Database (Denmark)

    Hammer, Anne; Rositch, Anne; Kahlert, Johnny Abildgaard;

    2015-01-01

    Despite the fact that hysterectomy is the most common surgical procedure worldwide in gynecology, national reporting of the incidence rate of gynecological cancers rarely removes the proportion no longer at risk of the disease from the population-at-risk-denominator (ie. women who have had...... of gynecological cancer incidence rates, performed via removing the proportion of hysterectomized or oophorectomized women from the population-at-risk-denominator, the impact of prevention strategies may be masked or misinterpreted. Furthermore, since national cervical cancer screening guidelines are at least...

  8. [Pre- and postoperative complaints in women with total hysterectomy].

    Science.gov (United States)

    Rha, J G; Lee, J H

    1973-01-01

    A study was conducted at St. Mary's Hospital in Seoul, Korea, to determine levels of complaints before and after total hysterectomy. 113 women who underwent the operation from January 1968 to June 1972 were questioned as to medical, mental, and sexual complaints both pre- and postoperative. The total number of complaints decreased from 35.2% before to 30.2% after the operation. Each category of complaint decreased following the operation. Pelvic inflammatory disease and myom ata complaint rates decreased significantly. High rates of depression were common following the operation. PMID:12307215

  9. Port-site metastasis following robotic-assisted radical hysterectomy for squamous cell cervical cancer

    OpenAIRE

    Bolles, Olivia; Borowsky, Mark

    2011-01-01

    ► Port-site metastases can occur following treatment for cervical cancer. ► Port-site metastases can occur following robotic assisted laparoscopic surgery. ► The pathogenesis of port-site metastases is poorly understood.

  10. Longitudinal study of uro-gynecological morbidity and quality of life after radical hysterectomy

    DEFF Research Database (Denmark)

    Jensen, Pernille Tine

    with scores from an age-matched control group from the general population. Results: Compared with the control group, patients reported long-term pain and urological adverse effects: frequent voiding, bladder insensitivity for micturition, and burning sensation or pain during micturition for 6 to 12 months...... on the patients’ level of functioning. Methods: 173 lymph node-negative, early stage cervical cancer patients who had undergone RH and pelvic lymphadenectomy alone, were assessed prospectively using validated self-assessment questionnaires at 5 weeks and 3, 6, 12, 18, and 24 months after RH. Results were compared...... of problems attributable to the surgery. Conclusion: RH for early stage cervical cancer is associated with both short and long term urological and pain symptomatology besides having a short-term negative impact on many aspects of the patients’ level of functioning. The latter suggests that, over time...

  11. Hawaii Abandoned Vessel Inventory, Hawaii Island

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Hawaii Island. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  12. Hawaii Abandoned Vessel Inventory, Maro Reef, NWHI

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Maro Reef, NWHI. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of...

  13. Hawaii Abandoned Vessel Inventory, Midway Island, NWHI

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Midway Island, NWHI. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of...

  14. US Virgin Islands Abandoned Vessel Inventory

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for US Virgin Islands. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of...

  15. Hawaii Abandoned Vessel Inventory, Kure, NWHI

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Kure, NWHI. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  16. Hawaii Abandoned Vessel Inventory, Lisianski Island, NWHI

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Lisianski Island, NWHI. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction...

  17. Who abandons embryos after IVF?

    LENUS (Irish Health Repository)

    Walsh, A P H

    2010-04-01

    This investigation describes features of in vitro fertilisation (IVF) patients who never returned to claim their embryos following cryopreservation. Frozen embryo data were reviewed to establish communication patterns between patient and clinic; embryos were considered abandoned when 1) an IVF patient with frozen embryo\\/s stored at our facility failed to make contact with our clinic for > 2 yrs and 2) the patient could not be located after a multi-modal outreach effort was undertaken. For these patients, telephone numbers had been disconnected and no forwarding address was available. Patient, spouse and emergency family contact\\/s all escaped detection efforts despite an exhaustive public database search including death records and Internet directory portals. From 3244 IVF cycles completed from 2000 to 2008, > or = 1 embryo was frozen in 1159 cases (35.7%). Those without correspondence for > 2 yrs accounted for 292 (25.2%) patients with frozen embryos; 281 were contacted by methods including registered (signature involving abandoned embryos did not differ substantially from other patients. The goal of having a baby was achieved by 10\\/11 patients either by spontaneous conception, adoption or IVF. One patient moved away with conception status unconfirmed. The overall rate of embryo abandonment was 11\\/1159 (< 1%) in this IVF population. Pre-IVF counselling minimises, but does not totally eliminate, the problem of abandoned embryos. As the number of abandoned embryos from IVF accumulates, their fate urgently requires clarification. We propose that clinicians develop a policy consistent with relevant Irish Constitutional provisions to address this medical dilemma.

  18. [Has ketamine preemptive analgesic effect in patients undergoing abdominal hysterectomy?].

    Science.gov (United States)

    Karaman, Semra; Kocabaş, Seden; Zincircioğlu, Ciler; Firat, Vicdan

    2006-07-01

    The aim of this study was to determine if preemptive use of the NMDA receptor antogonist ketamine decreases postoperative pain in patients undergoing abdominal hystrectomy. A total of 60 patients admitted for total abdominal hysterectomy were included in this study after the approval of the ethic committee, and the patients were randomly classified into three groups. After standart general anaesthesia, before or after incision patients received bolus saline or ketamine. Group S received only saline while Group Kpre received ketamine 0.4 mg/kg before incision and saline after incision, and Group Kpost received saline before incision and 0.4 mg/kg ketamine after incision. Postoperatif analgesia was maintained with i.v. PCA morphine. Pain scores were assessed with Vizüal Analog Scale (VAS), Verbal Rating Scale (VRS) at 1., 2, 3., 4., 8., 12. ve 24. hours postoperatively. First analgesic requirement time, morphine consumption and side effects were recorded. There were no significant differences between groups with respect to VAS / VRS scores, the time for first analgesic dose, and morphine consumption ( p>0.05). Patients in Group S had significantly lower sedation scores than either of the ketamine treated groups ( pketamin had no preemptive analgesic effect in patients undergoing abdominal hysterectomy, but further investigation is needed for different operation types and dose regimens.

  19. Radical Evil

    Directory of Open Access Journals (Sweden)

    Carlos Manrique

    2007-12-01

    Full Text Available There is an aporia in Kant’s analysis of evil: he defines radical evilas an invisible disposition of the will, but he also demands an inferential connection between visible evil actions and this invisible disposition. This inference,however, undermines the radical invisibility of radical evil according to Kant’s own definition of the latter. Noting how this invisibility of moral worth is a distinctive feature of Kant’s approach to the moral problem, the paper then asks why, in the Groundwork, he nonetheless forecloses a question about evil that seems to be consistent with this approach. It is argued that to account for this aporia and this foreclosure, one has to interrogate the way in which the category of religion orients Kant’s incipient philosophy of history in Die Religion.

  20. A RETROSPECTIVE STUDY OF EMERGENCY HYSTERECTOMY PERFORMED IN LAST 5 YEARS AT KRISHNA HOSPITAL, KARAD

    Directory of Open Access Journals (Sweden)

    Nikunj

    2016-05-01

    Full Text Available OBJECTIVE Study is to determine the incidence, indications of obstetric hysterectomy, maternal morbidity and maternal mortality associated with emergency obstetric hysterectomy at a tertiary hospital, Karad. This will help to highlight the lack of availability and inadequate utilisation of antenatal services. This will help to identify avoidable factors and stress factors; those need to organise health care services so as to improve maternal and foetal outcome. MATERIAL AND METHODS A retrospective analysis of 30 cases of emergency hysterectomies done for obstetric indications from JULY 2010 to JUNE 2015 was done. Indications for hysterectomy and causes of maternal morbidity and mortality were studied. RESULTS There were 30 cases of emergency hysterectomies amongst 19,635 deliveries during the period of study giving an incidence 0.15%, i.e. 1 in 654 deliveries. CONCLUSION The presence of risk factors like placenta previa, accreta, previous LSCS should facilitate referral or transfer of patients to a tertiary care hospital. When conservative measures like haemostatic sutures, internal iliac artery ligation, embolization is not feasible or has failed obstetric hysterectomy is performed without delay, in which delay would contribute to the maternal morbidity and in unfortunate cases mortality. Special provisions of blood components, dialysis facility and ventilator support associated with availability of experienced obstetrician, anaesthetist, neonatologist, physician and surgical services are necessary round the clock. Training of obstetrician in obstetric hysterectomy is very much necessary to reduce morbidity and mortality.

  1. THE ROLE OF HYSTERECTOMY IN THE THERAPY OF GESTATIONAL TROPHOBLASTIC TUMOR

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective.To evaluate the role of hysterectomy for patients with gestational trophoblastic tumor.Methods.We retrospectively analyzed 68 cases of gestational trophoblastic neoplasia treated by hysterectomy from 1985~1997 at PUMC hospital. Thirty-eight cases were diagnosed of choriocarcinoma and 30 were invasive mole.Results.Twenty-three elder patients who didn't desire to preserve fertility were selected for hysterectomy after shorter courses of chemotherapy, 22 of them had a complete remission(95.6%), the total aver-age courses of chemotherapy was 4.2. Of twenty-seven chemorefractory cases who were suspected of a refractory isolated lesion in the uterus, delayed hysterectomy as an adjunct to chemotherapy was performed, 20 of them got a complete remission(74.1%), the total average courses of chemotherapy were 9.4. Emergency hysterectomy is indicated in 18 patients with uterine perforation or life-threatening hemorrhage, 17 cases had a complete remission(94.4%), the total average courses of chemotherapy were 7.6.Conclusion.Although the development of effective chemotherapy has resulted in improved survival of patients with gestational trophoblastic tumor, hysterectomy remains an important adjuncts in the treatment of a selected subset of patients; in order to operate more completely and prevent recurrence, it's better to perform extended hysterectomy for the indicated patients.

  2. Localized Detection of Abandoned Luggage

    Directory of Open Access Journals (Sweden)

    Jing-Ying Chang

    2010-01-01

    Full Text Available Abandoned luggage represents a potential threat to public safety. Identifying objects as luggage, identifying the owners of such objects, and identifying whether owners have left luggage behind are the three main problems requiring solution. This paper proposes two techniques which are “foreground-mask sampling” to detect luggage with arbitrary appearance and “selective tracking” to locate and to track owners based solely on looking only at the neighborhood of the luggage. Experimental results demonstrate that once an owner abandons luggage and leaves the scene, the alarm fires within few seconds. The average processing speed of the approach is 17.37 frames per second, which is sufficient for real world applications.

  3. Assessment of selected perioperative parameters in patients undergoing laparoscopic and abdominal supracervical hysterectomy

    Science.gov (United States)

    Skręt-Magierło, Joanna; Kluz, Tomasz; Barnaś, Edyta; Sobolewski, Marek; Raś, Renata; Skręt, Andrzej

    2015-01-01

    Introduction Subtotal hysterectomy is a method of treatment of patients with mild changes in the uterine body. Laparoscopic methods are increasingly used in surgical gynaecology. One of the limitations of laparoscopy is the proper level of operating surgeon's training, which may be assessed with the use of the learning curve. The aim of the study was to compare data regarding the perioperative period in patients who underwent subtotal hysterectomy with the two methods, and to establish a learning curve for laparoscopic subtotal hysterectomy. Material and methods One hundred and twenty-seven patients qualified for subtotal hysterectomy due to mild disturbances in the uterine body participated in the study. The study was conducted at the Clinical Department of Gynaecology and Obstetrics of Fryderyk Chopin Provincial Specialist Hospital in Rzeszów in 2012-2013. Results The time of laparoscopic subtotal hysterectomy is longer than that of the classical surgical procedure. Uterine myomas are the main indication for subtotal hysterectomy. Laparoscopic operation results in lower blood loss compared to the classical surgical method. The mean age of the patients operated due to mild changes in the uterine body is similar in both groups. Patients who are obese or have undergone Caesarean sections are more frequently qualified for the classical surgery. The study revealed a reduction in time of laparoscopic subtotal hysterectomy by ca. 31 minutes (33%). Conclusions Laparoscopic subtotal hysterectomy is a method chosen by operating surgeons for patients with a lower perioperative risk. The period of the study made it possible to determine a learning curve for laparoscopic subtotal hysterectomy. PMID:26848296

  4. Histopathological Distribution of Ovarian Masses Occurring After Hysterectomy: A Five-Year Assay in Iranian Patients

    Directory of Open Access Journals (Sweden)

    Lalooei

    2016-01-01

    Full Text Available Background Ovarian cancer, the third most important genital cancer and fifth cause of cancer-related death in women, is diagnosed at terminal stages in 70% of cases. Therefore, it is imperative to know the possible risk factors associated with ovarian cancer. Only a few studies have discussed the histopathological features of ovarian masses occurring after hysterectomy. Objectives The study aimed to investigate the five-year prevalence and histopathological distribution of ovarian masses after hysterectomy in Iranian patients and to determine the need for prophylactic salpingo-oophorectomy. Patients and Methods This descriptive cross-sectional study enrolled all patients with ovarian masses and a history of hysterectomy for benign conditions who were visiting the gynecology clinic of Baqiyatallah Hospital, Tehran, between May 2009 and May 2014. Demographic information, pathological features of ovarian masses, family history, the time between hysterectomy and ovarian mass surgery, and method of hysterectomy were recorded in a predesigned checklist. The level of tumor markers such as CA125 and alpha-fetoprotein (α-FP were measured. Results Of the 1052 patients with ovarian masses, 45patients (mean age, 53.11 ± 9.56 years who had undergone abdominal hysterectomy underwent analysis. The study participants had a mean age of 47.92 ± 1.58 years at the time of hysterectomy. The mean time interval between hysterectomy and diagnosis of ovarian mass was 5.38 ± 4.15 years. Based on pathological reports, serous cystadenoma was the most frequent (43.2% pathological diagnosis, followed by mucinous cystadenoma (17.5%. Conclusions A majority of ovarian masses, especially those diagnosed within a short duration after hysterectomy, are benign. Iranian patients with such ovarian masses when asymptomatic and associated with negative tumor markers could be followed up, and prophylactic oophorectomy may not be necessary.

  5. Brent Spar abandonment - impact hypothesis

    International Nuclear Information System (INIS)

    This report describes the predicted fate of the Brent Spar storage and offloading platform following its proposed deep sea abandonment. Based on the characteristics of the Brent Spar and the contents of the buoy this ''Impact Hypothesis'' uses currently available knowledge of the North East Atlantic deep sea environment. Three scenarios based on possible outcomes are considered, incllcuding the release of metals into the water following corrosion of the structure. (UK)

  6. Placenta previa percreta left in situ - management by delayed hysterectomy: a case report

    Directory of Open Access Journals (Sweden)

    Stefanovic Vedran

    2011-08-01

    Full Text Available Abstract Introduction Placenta percreta is an obstetric emergency often associated with massive hemorrhage and emergency hysterectomy. Case presentation We present the case of a 30-year-old African woman, gravida 7, para 5, with placenta percreta managed by an alternative approach: the placenta was left in situ, methotrexate was administered, and a delayed hysterectomy was successfully performed. Conclusions Further studies are needed to develop the most appropriate management option for the most severe cases of abnormal placentation. Delayed hysterectomy may be a reasonable strategy in the most severe cases.

  7. Mexican beliefs and attitudes toward hysterectomy and gender-role ideology in marriage.

    Science.gov (United States)

    Marván, Ma Luisa; Quiros, Vanessa; López-Vázquez, Esperanza; Ehrenzweig, Yamilet

    2012-01-01

    One hundred and sixty-one Mexican respondents completed a questionnaire that measured beliefs and attitudes toward hysterectomy and another that measured gender-role ideology in marriage (GRIMQ). The participants were divided into two groups according to the GRIMQ: "high machismo/marianismo" and "low machismo/marianismo" groups. The participants belonging to the first group showed the most negative attitudes toward hysterectomy. In this group, men showed more negative attitudes toward hysterctomy and were less likely than women to believe that hysterectomy has positive aspects. The findings are discussed in light of male dominance and female subordination that prevail in certain cultural groups of Mexico.xs.

  8. Radical prostatectomy

    DEFF Research Database (Denmark)

    Fode, Mikkel; Sønksen, Jens; Jakobsen, Henrik

    2014-01-01

    OBJECTIVE: The aim of this study was to compare oncological and functional outcomes between robot-assisted laparoscopic radical prostatectomy (RALP) and retropubic radical prostatectomy (RRP) during the initial phase with RALP at a large university hospital. MATERIAL AND METHODS: Patient and tumour...... surgery and at follow-up and they were asked to report their use of pads/diapers. Potency was defined as an IIEF-5 score of at least 17 with or without phosphodiesterase-5 inhibitors. Patients using up to one pad daily for security reasons only were considered continent. Positive surgical margins, blood...... loss and functional outcomes were compared between groups. RESULTS: Overall, 453 patients were treated with RRP and 585 with RALP. On multivariate logistic regression analyses, the type of surgery did not affect surgical margins (p = 0.96) or potency at 12 months (p = 0.7). Patients who had undergone...

  9. Perimenopausal invasive hyadatidiform mole treated by total abdominal hysterectomy followed by chemotherapy

    Science.gov (United States)

    Nakashima, Ayaka; Miyoshi, Ai; Miyatake, Takashi; Kazuhide, Ogita; Takeshi, Yokoi

    2016-01-01

    Gestational trophoblastic neoplasias (GTNs) are rare tumors that constitute mole of the uterus with metastasis to the right ovary and labium minus treated by total abdominal hysterectomy followed by chemotherapy. PMID:27651108

  10. Is Previous Tubal Ligation a Risk Factor for Hysterectomy because of Abnormal Uterine Bleeding?

    Directory of Open Access Journals (Sweden)

    Sanam Moradan

    2012-07-01

    Full Text Available Objectives: Post tubal ligation syndrome (PTLS is a term used to describe a variety of post tubal ligation side effects or symptoms. These include increased menstrual bleeding and hysterectomy. Whether or not post tubal syndrome is a real entity, it has been a subject of controversy in the medical literature for decades. Numerous studies have reported conflicting conclusions about these symptoms. In this study the incidence of hysterectomy for bleeding disorders among sterilized women was compared with the incidence of hysterectomy for bleeding disorders among non-sterilized female population of the same age.Methods: This study was carried out on 160 women, 38-52 years, who underwent hysterectomy in Amir University Hospital, Semnan, Iran, from September 2008 to September 2011. After gathering of data from medical records, in this study, the incidence of hysterectomy for bleeding disorders among sterilized women was compared with the incidence of hysterectomy for bleeding disorders among nonsterilized female population for the same age.Results: The mean age of the study group was 44/4±5/7 and the mean age of the control group was 45/2±5/3, (p=0.424.The mean parity of the study group was 3/8±1/8 and the mean parity of the control group was 3/5±1/4, (p=0.220. So, in regard to age and parity, two groups were matched. Hysterectomies were performed for 160 cases and abnormal uterine bleeding was the cause of hysterectomy in 67 cases. Among 67 cases, 19 cases (37.3% had previous tubal sterilization + hysterectomy (study group and 48 cases (44% were not undergoing tubal sterilization but had hysterectomy for abnormal bleeding causes (control group. Statistical analyses showed that there were not significant differences between two groups, (RR=0.85; 95% CI: 0.56-1.28; p=0.418.Conclusion: The result of this study showed that previous tubal sterilization is not a risk factor for undergoing hysterectomy because of abnormal uterine bleeding.

  11. Unexpected premalignant gynecological lesions in women undergoing vaginal hysterectomy for utero-vaginal prolapse

    OpenAIRE

    Assem A.M. Elbiaa; Abdelazim, Ibrahim A.; Farghali, Mohamed M.; Hussain, M.; Omu, A.E.

    2015-01-01

    Aim of the study Aim of the study was to estimate the incidence of unexpected premalignant gynecological lesions in women undergoing vaginal hysterectomy for utero-vaginal prolapse. Material and methods Eighty women with asymptomatic utero-vaginal prolapse were included in this prospective study for vaginal hysterectomy after preoperative preparation and after written informed consent. Women included in this study were screened preoperatively by high vaginal swab, Pap smear, endometrial biops...

  12. Mini laparotomy versus conventional laparotomy for abdominal hysterectomy: A comparative study

    Directory of Open Access Journals (Sweden)

    Sharma Jai

    2004-05-01

    Full Text Available BACKGROUND: Less traumatizing measures for hysterectomies are searched for to improve the recovery from surgery. AIM: Comparison of minilaparotomy abdominal hysterectomy with conventional abdominal hysterectomy in respect to per-operative and post-operative outcome and complications. SETTING AND DESIGN: In a medical college hospital patients undergoing abdominal hysterectomy were enrolled. It was a concomitant comparative study. METHODS AND MATERIAL: We are presenting our comparative data of 100 cases of minilaparotomy abdominal hysterectomy (group I, incision =< 6 cm performed over last 4 years from January 1998 to December 2002 and comparing the outcome with 99 cases of abdominal hysterectomy (group II, incision > 6 cm done by traditional method over the same duration. STATISTICAL ANALYSIS USED: Chi-square and Fischer test with significance of p value being taken at 0.05 were used for categorical data, while student′s t test was used for continuous data. RESULTS: Mean age and parity of patients were similar in the two groups. Incision was transverse in 100% cases in-group I and 22.2% cases in-group II. Estimated blood loss was significantly higher (354 ml in group II in contrast to group I (240 ml. Blood transfusion was also required more commonly (22.2% in-group II than in-group I (9%. Mean operative time was significantly more in-group II (90 minutes than in group I (41 minutes. Mean hospital stay, day of mobility, starting oral diet and days of injectable analgesics required were higher in group II than in group I. Major complications were rare in both the groups, but minor complications were significantly higher in group II (40.4% than in group I (26%. CONCLUSION: Minilaparotomy abdominal hysterectomy appears to be an attractive alternative to traditional abdominal hysterectomy with fewer complications.

  13. Mood Symptoms After Natural Menopause and Hysterectomy With and Without Bilateral Oophorectomy Among Women in Midlife

    Science.gov (United States)

    Gibson, Carolyn J.; Joffe, Hadine; Bromberger, Joyce T.; Thurston, Rebecca C.; Lewis, Tené T.; Khalil, Naila; Matthews, Karen A.

    2012-01-01

    Objective To examine whether mood symptoms increased more for women in the years after hysterectomy with or without bilateral oophorectomy relative to natural menopause. Methods Using data from the Study of Women’s Health Across the Nation (n=1,970), depression and anxiety symptoms were assessed annually for up to 10 years with the Center for Epidemiological Studies Depression Index and four anxiety questions, respectively. Piecewise hierarchical growth models were used to relate natural menopause, hysterectomy with ovarian conservation, and hysterectomy with bilateral oophorectomy to trajectories of mood symptoms before and after the final menstrual period or surgery. Covariates included educational attainment, race, menopausal status, age the year prior to final menstrual period or surgery, and time-varying body mass index, self-rated health, hormone therapy, and antidepressant use. Results By the 10th annual visit, 1,793 (90.9%) women reached natural menopause, 76 (3.9%) reported hysterectomy with ovarian conservation, and 101 (5.2%) reported hysterectomy with bilateral oophorectomy. For all women, depressive and anxiety symptoms decreased in the years after final menstrual period or surgery. These trajectories did not significantly differ by hysterectomy or oophorectomy status. The Center for Epidemiological Studies Depression Index means were .72 standard deviations lower, and anxiety symptoms .67 standard deviations lower, five years after final menstrual period or surgery. Conclusion In this study, mood symptoms continued to improve after the final menstrual period or hysterectomy for all women. Women who undergo a hysterectomy with or without bilateral oophorectomy in midlife do not experience more negative mood symptoms in the years after surgery. PMID:22525904

  14. Chronic plasma cell endometritis in hysterectomy specimens of HIV-infected women: a retrospective analysis.

    OpenAIRE

    Kerr-Layton, J A; Stamm, C. A.; Peterson, L. S.; McGregor, J A

    1998-01-01

    OBJECTIVE: Abnormal uterine bleeding is a common and troublesome problem in human immunodeficiency virus (HIV)-infected women. We sought to evaluate endometrial pathology among HIV-infected women requiring hysterectomy to explore if endometritis may be common among these patients. METHODS: We performed a retrospective analysis of uterine pathology specimens obtained from HIV-infected and control patients requiring hysterectomy in two urban hospitals between 1988 and 1997 matched for age, surg...

  15. Chronic Plasma Cell Endometritis in Hysterectomy Specimens of HIV-Infected Women: A Retrospective Analysis

    OpenAIRE

    Kerr-Layton, J A; Stamm, C. A.; Peterson, L. S.; McGregor, J A

    1998-01-01

    Objective: Abnormal uterine bleeding is a common and troublesome problem in human immunodeficiency virus (HIV)-infected women. We sought to evaluate endometrial pathology among HIVinfected women requiring hysterectomy to explore if endometritis may be common among these patients.Methods: We performed a retrospective analysis of uterine pathology specimens obtained from HIV-infected and control patients requiring hysterectomy in two urban hospitals between 1988 and 1997 matched for age, surgic...

  16. Multiple factors drive regional agricultural abandonment.

    Science.gov (United States)

    Osawa, Takeshi; Kohyama, Kazunori; Mitsuhashi, Hiromune

    2016-01-15

    An understanding of land-use change and its drivers in agroecosystems is important when developing adaptations to future environmental and socioeconomic pressures. Agricultural abandonment occurs worldwide with multiple potentially positive and negative consequences; however, the main factors causing agricultural abandonment in a country i.e., at the macro scale, have not been identified. We hypothesized that socio-environmental factors driving agricultural abandonment could be summarized comprehensively into two, namely "natural" and "social", and the relative importance of these differs among regions. To test this postulate, we analyzed the factors currently leading to agricultural abandonment considering ten natural environment variables (e.g., temperature) and five social variables (e.g., number of farmers) using the random forest machine learning method after dividing Japan into eight regions. Our results showed that agricultural abandonment was driven by various socio-environmental factors, and the main factors leading to agricultural abandonment differed among regions, especially in Hokkaido in northern Japan. Hokkaido has a relatively large area of concentrated farmland, and abandonment might have resulted from the effectiveness of cultivation under specific climate factors, whereas the other regions have relatively small areas of farmland with many elderly part-time farmers. In such regions, abandonment might have been caused by the decreasing numbers of potential farmers. Thus, two different drivers of agricultural abandonment were found: inefficient cultivation and decreasing numbers of farmers. Therefore, agricultural abandonment cannot be prevented by adopting a single method or policy. Agricultural abandonment is a significant problem not only for food production but also for several ecosystem services. Governments and decision-makers should develop effective strategies to prevent further abandonment to ensure sustainable future management of agro

  17. An audit of indications, complications, and justification of hysterectomies at a teaching hospital in India.

    Science.gov (United States)

    Pandey, Deeksha; Sehgal, Kriti; Saxena, Aashish; Hebbar, Shripad; Nambiar, Jayaram; Bhat, Rajeshwari G

    2014-01-01

    Objective. Aim of this audit was to analyze indications, complications, and correlation of preoperative diagnosis with final histopathology report of all hysterectomies, performed in a premier teaching hospital. Methods. Present study involved all patients who underwent hysterectomy at a premier university hospital in Southern India, in one year (from 1 January, 2012, to 31 December, 2012). Results. Most common surgical approach was abdominal (74.7%), followed by vaginal (17.8%), and laparoscopic (6.6%) hysterectomy. Most common indication for hysterectomy was symptomatic fibroid uterus (39.9%), followed by uterovaginal prolapse (16.3%). Overall complication rate was 8.5%. Around 84% had the same pathology as suspected preoperatively. Only 6 (5 with preoperative diagnosis of abnormal uterine bleeding and one with high grade premalignant cervical lesion) had no significant pathology in their hysterectomy specimen. Conclusion. Hysterectomy is used commonly to improve the quality of life; however at times it is a lifesaving procedure. As any surgical procedure is associated with a risk of complications, the indication should be carefully evaluated. With the emergence of many conservative approaches to deal with benign gynecological conditions, it is prudent to discuss available options with the patient before taking a direct decision of surgically removing her uterus.

  18. Roaming Radicals

    Science.gov (United States)

    Bowman, Joel M.; Shepler, Benjamin C.

    2011-05-01

    Roaming is a recently verified unusual pathway to molecular products from unimolecular dissociation of an energized molecule. Here we present the evidence for this pathway for H2CO and CH3CHO. Theoretical analysis shows that this path visits the plateau region of the potential energy surface near dissociation to radical products. It is not clear whether roaming is a distinct isolated pathway, in addition to the conventional one via the well-known molecular saddle-point transition state. Evidence is presented to suggest that the two pathways may originate from a single, but highly complicated, dividing surface. Other examples of unusual reaction dynamics are also reviewed.

  19. Postpartal hysterectomy performed the consequence of chronic myometritis

    Directory of Open Access Journals (Sweden)

    Jovanović Božidar

    2008-01-01

    Full Text Available Introduction. As a diffuse chronic inflammation, myometritis is very rere and usually follows after postpartal placenta remains or postabortion infections, but it can be also associated with endometrial or ascendent infection. Chronic myometritis is often followed by profuse bleeding, though in most cases it cannot be recognized as it is asymptomatic. Histologically, that chronic process is characterized by the presence of fibriosis within the muscles and mononuclear cells (lymphoplasmocytic and histiocytic infiltration. Case report. A 24 old woman's second child was delivered per vias naturalis but the next day the profuse bleeding occured which would not stop even after repeated curretages and suspecting a case of placenta accreta and uterus atony, subtotal hysterectomy was performed. Histologically, the disappearance of the regular arrangement of the smooth muscles and stroma could be seen with the devastation of myometrium due to the diffuse reduction of its smooth muscle bundles and cells, as well as their atrophy, necrobiosis and apoptosis with the minimal preservation of the muscle bundles and little cell groups of the myometrium, an abundant presence of the fibrocollagene and myxoid transformed connective tissue, group cells similar to the mesenchymal tissue and adipocytes. Discussion It was not possible to find this variant of the changes on the myometrium in the available literature. The present case is about the clinically unknown asymptomatic myometritis, possibly developed in the postpartal period of the previous pregnancy. It is our opinion that it is most probably an autoagressive process directed towards the smooth muscle cells of the myometrium, as shown by their reduction and inflammatory cells composition, which plays an important role in the immune reactions (lymphocytes, plasma cells, eosinophilis, histocytes. Conclusion. A subtotal hysterectomy was performed on a woman, 24 years old, who gave birth to her second child and

  20. 32 CFR 636.31 - Abandoned vehicles.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Abandoned vehicles. 636.31 Section 636.31... CRIMINAL INVESTIGATIONS MOTOR VEHICLE TRAFFIC SUPERVISION (SPECIFIC INSTALLATIONS) Fort Stewart, Georgia § 636.31 Abandoned vehicles. (a) Any MP or DOD police officer who finds or has knowledge of a...

  1. Hysterectomy at a Canadian tertiary care facility: results of a one year retrospective review

    Directory of Open Access Journals (Sweden)

    Gorwill R Hugh

    2004-11-01

    Full Text Available Abstract Background The purpose of this study was to investigate the indications for and approach to hysterectomy at Kingston General Hospital (KGH, a teaching hospital affiliated with Queen's University at Kingston, Ontario. In particular, in light of current literature and government standards suggesting the superiority of vaginal versus abdominal approaches and a high number of concurrent oophorectomies, the aim was to examine the circumstances in which concurrent oophorectomies were performed and to compare abdominal and vaginal hysterectomy outcomes. Methods A retrospective chart audit of 372 consecutive hysterectomies performed in 2001 was completed. Data regarding patient characteristics, process of care and outcomes were collected. Data were analyzed using descriptive statistics, t-tests and linear and logistic regression. Results Average age was 48.5 years, mean body mass index (BMI was 28.6, the mean length of stay (LOS was 5.2 days using an abdominal approach and 3.0 days using a vaginal approach without laparoscopy. 14% of hysterectomies were performed vaginally, 5.9% were laparoscopically assisted vaginal hysterectomies and the rest were abdominal hysterectomies. The most common indication was dysfunctional or abnormal uterine bleeding (37%. The average age of those that had an oophorectomy (removal of both ovaries was 50.8 years versus 44.3 years for those that did not (p Conclusions A significant reduction in LOS was found using the vaginal approach. Both the patient and the health care system may benefit from the tendency towards an increased use of vaginal hysterectomies. The audit process demonstrated the usefulness of an on-going review mechanism to examine trends associated with common surgical procedures.

  2. NON–DESCENT VAGINAL HYSTERECTOMY FOR BENIGN GYNAECOLOGICAL DISEASE – A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Thulasi

    2016-04-01

    Full Text Available OBJECTIVE To assess safety and feasibility of non-descent vaginal hysterectomy for benign gynaecological disease. METHODS A prospective study was conducted at the Department of Obstetrics and Gynaecology of P K Das Institute of Medical Sciences from January 2013 to December 2013. An effort was made to perform hysterectomies vaginally in women with benign or premalignant conditions in the absence of prolapse. A suspected adnexal pathology, endometriosis, immobility of uterus, uterus size more than 16 weeks was excluded from the study. Vaginal hysterectomy was done in usual manner. In bigger size uterus, morcellation techniques like bisection, debulking, coring, myomectomy, or combination of these were used to remove the uterus. Data regarding age, parity, uterine size, estimated blood loss, length of operation, intraoperative and postoperative complications and hospital stay were recorded. RESULTS A total of 100 cases were selected for non-descent vaginal hysterectomy. Among them, 97 cases successfully underwent nondescent vaginal hysterectomy. Majority of the patients (55% were in age group 40-45 yrs. Four patients were nulligravida and eight patients had previous LSCS. Uterine size was ≤ 12 weeks in 84 cases and > 12-16 weeks in 16 cases. Commonest indication was leiomyoma of uterus (43%. Mean duration of surgery was 70±20.5 minutes. Mean blood loss was 150±65 mL. Reasons for failure to perform NDVH was difficulty in opening pouch of Douglas in two cases because of adhesions and in one case there was difficulty in reaching the fundal myoma which prevented the uterine descent. Intra–operatively, one case had bladder injury (1% that had previous 2 LSCS. Postoperatively, complications were minimal which included postoperative fever (11%, UTI (8% and vaginal cuff infection was (4%. Mean hospital stay was 3.5 days. CONCLUSION Vaginal hysterectomy is safe, feasible in most of the women requiring hysterectomy for benign conditions with less

  3. Changing trends in peripartum hysterectomy over the last 4 decades.

    LENUS (Irish Health Repository)

    Flood, Karen M

    2012-02-01

    OBJECTIVE: The purpose of this study was to identify changing trends in peripartum hysterectomy (PH) in a single large obstetric population over the last 40 years. STUDY DESIGN: A retrospective cohort study was performed from 1966-2005 of patients who had PH in any of the 3 Dublin obstetric hospitals. Cases were identified, and details were obtained from the combined patient databases of each hospital. RESULTS: There were 872,379 deliveries during the study period, among which 358 women underwent PH (0.4\\/1000 deliveries). In a comparison of the study decades 1966-1975 with 1996-2005, PH decreased from 0.9 per 1000 deliveries to 0.2 of 1000 deliveries. Although the overall cesarean delivery rate has increased from 6-19% during these 2 decades, the percentage of PH that occurs in the setting of a previous cesarean delivery has increased from 27-57% (P < .00001). Indications for PH have changed significantly in this time period, with "uterine rupture" as the indication for PH decreasing from 40.5-9.3% (P < .0001) and placenta accreta as the indication increasing significantly from 5.4-46.5% (P < .00001). CONCLUSION: PH has decreased over the last 4 decades. However, alongside the rising cesarean delivery rate, there has been a marked increase in the incidence of placenta accreta.

  4. Pattern and frequency of uterine pathologies among hysterectomy specimens in rural part of northern India: a retrospective secondary data analysis

    Directory of Open Access Journals (Sweden)

    Vineet Chaturvedi

    2014-03-01

    Full Text Available Background: Hysterectomy is the most commonly performed gynecological surgery throughout the world.  Over the last several years reported cases of hysterectomy was increasing in numbers. However, similar studies from Etawah district with high prevalence of hysterectomy are lacking. Therefore, we have conducted this study to identify the pattern of pathologies identified in hysterectomy specimen and to correlate the pathological findings with the age group of the patient along with frequency of benign, malignant pathologies identified. Material and method:  This   study was conducted on 870 hysterectomy specimen who reported to pathology department .They were compared in terms of age of the patients and pathology of hysterectomy specimens. Result: Out of the hysterectomy specimens, pathological findings were seen in 850 hysterectomies.  Most common lesion was   leiomyoma (22.47% followed by Adenomyosis (21.76% ,Endometrial hyperplasia (14.00 %, ovarian cyst (9.29%, Endometrial atrophy (8.70%, Endometritis (7.76 %, Endo cervical polyp (5.64, Carcinoma intra epithelial neoplasm (3.52%, Endometrial polyp (3.17%, Carcinoma cervix (1.17%, Carcinoma ovary (1.05%, Benign ovarian tumor (0.58%,Carcinoma endometrium(0.35%, Myometritis (0.35%, Chorio carcinoma (0.11% The most common age group was (40-49 years. Conclusion:  Our data suggest that leiomyoma was the most common pathology seen in hysterectomy .The common age group for hysterectomy was (40 -49 years. Benign pathologies are more frequent in hysterectomy than malignant. Histopathology is mandatory for ensuring diagnosis and thus management, in particular of malignant disease.         

  5. Obstetric hysterectomy, still a life saving tool in modern day obstetrics: a five year study

    Directory of Open Access Journals (Sweden)

    Neetu Singh

    2014-06-01

    Results: During the study period, 105 emergency obstetric hysterectomies were performed giving an incidence of 0.54% .The incidence of hysterectomy following vaginal delivery was 0.54% and that of caesarean hysterectomy was 2.08%. It was most common in the age group 26-35 years (66.66% and in women of parity 3-4 (71.42%.Rupture uterus was the most common indication accounting for 59.04% cases followed by Atonic PPH (18.09%. Febrile illness and wound infection were the two most common co-morbidities. Maternal mortality was 5.71%. Conclusions: Emergency obstetric hysterectomy is potentially a life saving procedure which every obstetrician must be familiar with in cases of catastrophic rupture uterus and intractable haemorrhage. With the help of prostaglandins, modern policies of active management of labor, timely performance of caesarean section, internal iliac artery ligation, compression sutures etc. obstetric hysterectomy should be made a more rare procedure. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 540-543

  6. Ignorance Radicalized

    Directory of Open Access Journals (Sweden)

    Gergo Somodi

    2009-12-01

    Full Text Available The aim of this paper is twofold. I criticize Michael Devitt's linguistic---as opposed to Chomsky's psychological---conception of linguistics on the one hand, and I modify his related view on linguistic intuitions on the other. I argue that Devitt's argument for the linguistic conception is in conflict with one of the main theses of that very conception, according to which linguistics should be about physical sentence tokens of a given language rather than about the psychologically real competence of native speakers. The basis of this conflict is that Devitt's view on language, as I will show, inherits too much from the criticized Chomskian view. This is also the basis of Devitt's strange claim that it is the linguist, and not the ordinary speaker, whose linguistic intuition should have an evidential role in linguistics. I will argue for the opposite by sketching a view on language that is more appropriate to the linguistic conception. That is, in criticizing Devitt, I am not defending the Chomskian approach. My aim is to radicalize Devitt's claims.

  7. A Marked Increase in Obstetric Hysterectomy for Placenta Accreta

    Institute of Scientific and Technical Information of China (English)

    Xiao-Yu Pan; Yu-Ping Wang; Zheng Zheng; Yan Tian; Ying-Ying Hu; Su-Hui Han

    2015-01-01

    Background:Obstetric hysterectomy (OH) as a lifesaving measure to manage uncontrolled uterine hemorrhage appears to be increasing recently.The objective of this study was to determine the etiology and changing trends of OH and to identify those at particular risk of OH to enhance the early involvement of multidisciplinary intensive care.Methods:A retrospective study was carried out in patients who had OH in China-Japan Friendship Hospital from 2004 to 2014.Maternal characteristics,preoperative evaluation,operative reports,and prenatal outcomes were studied in detail.Results:There were 19 cases of OH among a total of 18,838 deliveries.Comparing the study periods between 2004-2010 and 2011-2014,OH increased from 0.8/1000 (10/12,890) to 1.5/1000 (9/5948).Indications for OH have changed significantly during this study period with uterine atony decreasing from 50.0% (5/10) to 11.1% (1/9) (P < 0.05),and placenta accreta as the indication for OH has increased significantly from 20.0% (2/10) to 77.8% (7/9) (P < 0.05).Ultrasonography and magnetic resonance imaging (MRI) have been used to make an exact antepartum diagnosis of placenta accreta.A multidisciplinary management led to improved outcomes for patients with placenta accreta.Conclusion:As the multiple cesarean delivery rates have risen,there has been a dramatic increase in OH for placenta accreta.An advance antenatal diagnosis of ultrasonography,and MRI,and a multidisciplinary teamwork can maximize patients' safety and outcome.

  8. Complications after hysterectomy. A Danish population based study 1978-1983

    DEFF Research Database (Denmark)

    Andersen, T F; Loft, A; Brønnum-Hansen, Henrik;

    1993-01-01

    We studied complications after hysterectomy among all women in the Danish population who had a simple hysterectomy in the period 1978-81 based on data obtained from the Danish National Hospital Registry. Among patients, with neither diagnosed cancer nor major co-surgery (n = 23,386), we identified...... all the complications which occurred during hospital admission from the time of surgery up to six years from that point. Within 30 days of hysterectomy 2.6% of the patients had been diagnosed in hospitals as having complications according to our definition. The corresponding figures at 90 days and two...... years after the operation were 3.7% and 9.4%. The most frequently observed complications were post operative wound infections and bleeding, each affecting about 2% of all operated women. Logistic regression and Cox regression were used to identify prognostic indicators of readmission with complications...

  9. Hysterectomy and its impact on the calculated incidence of cervical cancer and screening coverage in Denmark

    DEFF Research Database (Denmark)

    Lam, Janni Uyen Hoa; Lynge, Elsebeth; Njor, Sisse Helle;

    2015-01-01

    BACKGROUND: The incidence rates of cervical cancer and the coverage in cervical cancer screening are usually reported by including in the denominator all women from the general population. However, after hysterectomy women are not at risk anymore of developing cervical cancer. Therefore, it makes...... sense to determine the indicators also for the true at-risk populations. We described the frequency of total hysterectomy in Denmark and its impact on the calculated incidence of cervical cancer and the screening coverage. MATERIAL AND METHODS: With data from five Danish population-based registries......, the incidence rate of cervical cancer and the screening coverage for women aged 23-64 years on 31 December 2010 were calculated with and without adjustments for hysterectomies undertaken for reasons other than cervical cancer. They were calculated as the number of cases divided by 1) the total number of woman...

  10. Grinding Properties of Abandoned Concrete

    Institute of Scientific and Technical Information of China (English)

    ZHENG Fang-yu; WANG Li-jiu; LI Qiang

    2007-01-01

    The grinding properties of abandoned concrete, which consists primarily of hardened cement, limestone aggregate and river sand, are studied. Theoretical models of grinding are used to explain the experimental observation. The results show that 1) The principle disintegration mechanism of hardened cement and river sand is volumetric grinding, although at later stages grinding of cement becomes difficult because of its flaked structure; 2) The limestone grinding process can be divided into two steps. First, volumetric grinding, with an obvious component of surface grinding, followed by primarily surface grinding as the micro-particle content increases; 3) Initially, the principle mechanism of grinding limestone and river sand is volumetric grinding, albeit less efficient grinding than if these components were ground separately, and; 4) After 10 to 20 min of grinding the grinding bottleneck phenomenon appears and after 20 min of grinding the content of micro-particles is large and surface grinding is the main mechanism while the particle size of the mixture is smaller than that of separately ground river sand and cement but bigger than that of separately ground limestone.

  11. Even free radicals should follow some rules: a guide to free radical research terminology and methodology.

    Science.gov (United States)

    Forman, Henry Jay; Augusto, Ohara; Brigelius-Flohe, Regina; Dennery, Phyllis A; Kalyanaraman, Balaraman; Ischiropoulos, Harry; Mann, Giovanni E; Radi, Rafael; Roberts, L Jackson; Vina, Jose; Davies, Kelvin J A

    2015-01-01

    Free radicals and oxidants are now implicated in physiological responses and in several diseases. Given the wide range of expertise of free radical researchers, application of the greater understanding of chemistry has not been uniformly applied to biological studies. We suggest that some widely used methodologies and terminologies hamper progress and need to be addressed. We make the case for abandonment and judicious use of several methods and terms and suggest practical and viable alternatives. These changes are suggested in four areas: use of fluorescent dyes to identify and quantify reactive species, methods for measurement of lipid peroxidation in complex biological systems, claims of antioxidants as radical scavengers, and use of the terms for reactive species.

  12. Coal Mines, Abandoned - AML Inventory Sites 201601

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This data set portrays the approximate location of Abandoned Mine Land Problem Areas containing public health, safety, and public welfare problems created by past...

  13. Coal Mines, Abandoned - AML Points Feature

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This data set portrays the approximate location of Abandoned Mine Land Problem Areas containing public health, safety, and public welfare problems created by past...

  14. Coal Mines, Abandoned - AML Polygons Feature

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This data set portrays the approximate location of Abandoned Mine Land Problem Areas containing public health, safety, and public welfare problems created by past...

  15. Continued distress among abandoned dogs in Fukushima.

    Science.gov (United States)

    Nagasawa, Miho; Mogi, Kazutaka; Kikusui, Takefumi

    2012-01-01

    In Fukushima, Japan, a prolonged refugee situation caused by a major nuclear incident after the earthquake of March 11, 2011 has led to the unintentional abandonment of many pets. We received stray or abandoned dogs from rescue centers in Fukushima Prefecture. During re-socialization training and health care, we accessed the behavioral characteristics and the urine cortisol level of each dog and compared them with those of other abandoned dogs not involved in this earthquake. The dogs from Fukushima showed significantly lower aggression toward unfamiliar people, trainability, and attachment to their caretakers; also, urine cortisol levels in the dogs from Fukushima were 5-10-fold higher than those in abandoned dogs from another area of Japan. These results suggested that the dogs from Fukushima suffered through an extremely stressful crisis. PMID:23061007

  16. Incidence of postpartum post-cesarean hysterectomy at the Institute of gynecology and obstetrics, Clinical center of Serbia, Belgrade

    Directory of Open Access Journals (Sweden)

    Sparić Radmila

    2007-01-01

    Full Text Available Introduction. Postpartum hysterectomy means hysterectomy at least 6 weeks after delivery or cesarean section. It is usually performed in life-threatening situations. Incidence of postpartum hysterectomy varies from 0.02% to 0.3% of total number of deliveries. Objective. The aim of this study was to show and compare the incidence of postpartum hysterectomy after the cesarean section at the Institute of Gynecology and Obstetrics, Clinical Center of Serbia. We compared two five-year periods: the first period 1987-1982 and the second 2000-2004. Method. The retrospective study analyzed all patients treated at the Institute of Gynecology and Obstetrics who had had hysterectomy until six weeks after vaginal delivery or cesarean section. We analyzed the number of deliveries and the number of postpartum hysterectomies. Results. There were 50,467 deliveries (3,542 cesarean sections and 91 postpartum hysterectomies (70 or 76.92% after cesarean section in the first period. In the second period, there were 34,035 deliveries (7,105 cesarean sections and 64 hysterectomies (39 or 60.94 % after cesarean section. The overall incidence of postpartum hysterectomy was 1.98/1,000 in the first and 1.88/1,000 deliveries in the second period. The incidence of post-cesarean hysterectomy decreased from 19.76/1,000 in the first period to 5.49/1,000 in the second period. Conclusion. It is crucial for each obstetrician to cautiously distinguish and reach an appropriate decision about the exact indications for cesarean delivery having in mind growing incidence of cesarean sections, which is the main risk factor for puerperal morbidity and mortality. .

  17. Invasive mole of the uterus: A description of two cases managed by hysterectomy

    Directory of Open Access Journals (Sweden)

    Ahmed Samy El-agwany

    2015-12-01

    Full Text Available Gestational trophoblastic disease (GTD is a term used for a group of pregnancy-related tumors. Gestational trophoblastic neoplasia (GTN, is recognized as the most curable gynecologic malignancy. However, many cases are resistant to first line chemotherapy. We present cases of invasive mole. They were diagnosed as a vesicular mole on ultrasonography and underwent suction and evacuation but vaginal bleeding recurred with plateau and rising B-hcg with intramyometrial vascular lesion. Hysterectomy was done that indicated invasive mole. Patients were cured of their symptoms. Surgical therapy (hysterectomy with chemotherapy has shown to achieve remission in these cases especially with resistance to chemotherapy and in perimenopause.

  18. [Life threatening postpartal haemorrhage after rupture of the vagina, uterine cervix, caesarean section or hysterectomy].

    Science.gov (United States)

    Kozovski, I; Radoinova, D

    2010-01-01

    The authors discuss 10 cases--seven after vaginal and cervical rupture, 2 after Caesarean section and 1 after hysterectomy. Six of them died--5 after rupture of the vagina and cervix and one after Caesarean section. The lethal issue was avoidable in all cases because it was a result of untimely done or not done at all hysterectomy and other interventions, e.g., ligation of the hypogastric arteries, as well as of faulty surgical performance. Basic principles of surgical behavior in such cases are postulated.

  19. The indication for hysterectomy as a risk factor for subsequent pelvic organ prolapse repair

    DEFF Research Database (Denmark)

    Lykke, Rune; Blaakær, Jan; Ottesen, Bent;

    2015-01-01

    , the HR for POP was 6.57 (95% confidence interval 5.91 - 7.30). The HR for abnormal uterine bleeding (AUB), pain, endometriosis, and "other indications" was significantly higher than the reference. POP surgery was performed predominantly in the posterior compartment for all indications except benign...... ovarian tumors. CONCLUSIONS: POP as the indication for hysterectomy was associated with the highest cumulative incidence of subsequent POP surgery 32 years after hysterectomy. But the indications AUB, pain, endometriosis, and "other indications" were associated with a higher risk of subsequent POP surgery...

  20. 30 CFR 77.215-4 - Refuse piles; abandonment.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Refuse piles; abandonment. 77.215-4 Section 77... MINES Surface Installations § 77.215-4 Refuse piles; abandonment. When a refuse pile is to be abandoned... refuse pile shall be abandoned in accordance with a plan submitted by the operator and approved by...

  1. The Serbian Radical movement 1881-1903: A historical aspect

    Directory of Open Access Journals (Sweden)

    Protić Milan St

    2005-01-01

    Full Text Available Focusing on the initial stage (until 1903 of the Serbian Radical movement the paper attempts to delineate and explicate the main phases of its political maturation. In its initial stage Serbian Radicalism passed through several significant phases. The earliest phase (1869-80 may be named the period of rudimentary Radicalism. The movement was unorganized and oscillated between the ideas of socialism, anarchism and peasant democracy. The year 1881 saw the founding of the Radical Party as the first organized political party in Serbia with its own internal structure and programme. It opened the second phase, known as a period of militant Radicalism (1881-86 marked by its organized and uncompromising opposition to the existing system and the personal regime of king Milan Obrenović, culminating in the Timok rebellion in 1883. The period of pragmatic Radicalism (1886-94 saw a recuperation and reorganization of the movement, its inclusion as a legitimate political force into the existing order, the passing in 1888 of a new constitution predominantly influenced by Radical political views and the Party’s first compromises with other factors on the domestic political scene. Finally, there was a period of overpowered Radicalism (1894-1903. Without abandoning their fundamental ideological tenets, the Radicals were forced to make some serious political compromises and moderate their political programme in order to remain in the race for power.

  2. More Wounding Than Wounds: Hysterectomy, Phenomenology, and the Pain(s of Excorporation

    Directory of Open Access Journals (Sweden)

    Heather Hill-Vásquez

    2016-06-01

    Full Text Available Focusing on the pain experience of hysterectomy, this article applies and interrogates the foundational descriptive process on which phenomenology is based and suggests that feminism and phenomenology are more compatible than previously asserted. Building upon the work of feminist philosophers who have also explored how feminist and phenomenological approaches share similar methods and intentions—especially in connection with the former’s significant attention to lived experience as a source for the theory feminism employs—the article engages with the philosophies of Maurice Merleau-Ponty and Samuel Mallin who maintain a consistent attention to the body in their phenomenological approaches. Arguing that Mallin’s method of “body hermeneutics” is especially valuable for constructing a feminist phenomenological approach, the article applies Mallin’s theories to the hysterectomy experience, thus revealing how other female-coded experiences of pain, intrusion, shame, and vulnerability are intertwined with hysterectomy. Moreover, the article posits the pain experience of hysterectomy as a particularly emphatic form of phenomenological excorporation in which hidden and habituated assumptions—in this case, the previously unnoticed and unexamined association of a woman’s womb with what it means to be a woman—are painfully brought to light. As the womb becomes more present in the notion and reality of its absence, what does this mean for the many women who experience the shared phenomenon of hysterectomy—including feminist women who enter the experience with a more explicit understanding of themselves as gendered subjects?

  3. Inflammatory response in patients undergoing uterine artery embolization as compared to patients undergoing conventional hysterectomy

    DEFF Research Database (Denmark)

    Brøchner, A C; Mygil, B; Elle, B;

    2009-01-01

    BACKGROUND: Uterine fibroids are benign tumors seen in 20-40% of women of childbearing age, and these fibroids are usually treated by hysterectomy. During the last decade, embolization of the uterine arteries with polyvinyl alcohol microparticles has become an alternative treatment. PURPOSE: To...

  4. Prediction of peripartum hysterectomy and end organ dysfunction in major obstetric haemorrhage.

    LENUS (Irish Health Repository)

    O'Brien, D

    2010-12-01

    The aims of this study are to determine the incidence and aetiology of major obstetric haemorrhage (MOH) in our population, to examine the success rates of medical and surgical interventions and to identify risk factors for peripartum hysterectomy and end organ dysfunction (EOD).

  5. Single-port access laparoscopic hysterectomy: a new dimension of minimally invasive surgery.

    Science.gov (United States)

    Liliana, Mereu; Alessandro, Pontis; Giada, Carri; Luca, Mencaglia

    2011-01-01

    The fundamental idea is to have all of the laparoscopic working ports entering the abdominal wall through the same incision. Single-incision laparoscopic surgery is an alternative to conventional multiport laparoscopy. Single-access laparoscopy using a transumbilical port affords maximum cosmetic benefits because the surgical incision is hidden in the umbilicus and reduces morbidity of minimally invasive surgery. The advantages of single-access laparoscopic surgery may include less bleeding, infection, and hernia formation and better cosmetic outcome and less pain. The disadvantages and limitations include longer surgery time, difficulty in learning the technique, and the need for specialized instruments. This review summarizes the history of SPAL hysterectomy (single-port access laparoscopy), and emphasizes nomenclature, surgical technique, instrumentation, and perioperative outcomes. Specific gynecological applications of single-port hysterectomy to date are summarized. Using the PubMed database, the English-language literature was reviewed for the past 40 years. Keyword searches included scarless, scar free, single-port/trocar/incision, single-port access laparoscopic hysterectomy. Within the bibliography of selected references, additional sources were retrieved. The purpose of the present article was to review the development and current status of SPAL hysterectomy and highlight important advances associated with this innovative approach. PMID:22442528

  6. Peripartum hysterectomy in the first decade of the 21st century.

    LENUS (Irish Health Repository)

    Tadesse, W

    2012-02-01

    We reviewed the role of peripartum hysterectomy (PH) in the first decade of the 21st century. The study was confined to women who delivered a baby weighing 500 g or more between 2000 and 2009, and who required a hysterectomy within 72 h of delivery for obstetric reasons. Individual case records were reviewed. There were 19 cases of PH in 78,961 deliveries giving an incidence of 1 in 4,156 (0.02%). Of the 19 cases, 95% were delivered by caesarean section and 89% had one or more prior sections. The indications were placental bed pathology (79%), uterine atony (16%) and uterine trauma (5%). Of the 19 hysterectomies, 16 (84%) were total and a gynaecological oncologist was involved in nine (56%) of these cases. There were no maternal or fetal deaths, but a mother required an average blood transfusion of 10 units. The overall rate of PH was remarkably low compared with other studies but it is likely to increase in the future because of the strong association between increasing caesarean section rates and placental bed pathology. The potential involvement of the cervix and other pelvic structures by placental pathology means that PH in the future will be more challenging, and the hysterectomy will need to be total rather than subtotal.

  7. A six year review of hysterectomy for benign gynaecological conditions at the Federal Medical Centre, Owerri

    Directory of Open Access Journals (Sweden)

    Duke A. Onyeabochukwu

    2014-04-01

    Conclusions: Hysterectomy for benign gynaecological conditions is relatively common and safe in our centre, but there is need for improvement on the high post-operative morbidity rate. [Int J Reprod Contracept Obstet Gynecol 2014; 3(2.000: 352-356

  8. Emergency peripartum hysterectomy in a tertiary hospital in Upper Egypt: six years analysis

    Directory of Open Access Journals (Sweden)

    Ahmed M. Abbas

    2016-04-01

    Conclusions: The incidence of EPH in Upper Egypt is high. Uterine atony is the major indication for EPH in our hospital. Late referral and delayed decisions to perform hysterectomy contributes in the high mortality rate. [Int J Reprod Contracept Obstet Gynecol 2016; 5(4.000: 953-958

  9. Prophylactic antibiotics for hysterectomy and cesarean section: amoxicillin-clavulanic acid versus cefazolin

    Directory of Open Access Journals (Sweden)

    Jyoti Malik

    2016-04-01

    Conclusions: Broad spectrum amoxicillin-clavulanic acid was not superior to cefazolin in prevention of post-operative infection when given as prophylaxis in hysterectomy and elective cesarean section. [Int J Reprod Contracept Obstet Gynecol 2016; 5(4.000: 980-983

  10. [The capacities of ultrasound study and magnetic resonance imaging of small pelvic masses after hysterectomy].

    Science.gov (United States)

    Boldyreva, O G; Briukhanov, A V

    2012-01-01

    The purpose of the study was to develop the ultrasound study (USS) and magnetic resonance imaging (MRI) semiotics of small pelvic masses after hysterectomy, to comprehensively use USS and MRI for the diagnosis of these masses, and to define indications for MRI. One hundred and seventy-five female patients with small pelvic masses after hysterectomy were examined. For the specification of the pattern of small pelvic masses and their differential diagnosis, USS and MRI were carried out in 175 and 72 patients, respectively. Four groups of the masses were identified; of them there were tumor-like masses of the uterine appendages in 67 (38.2%) patients, ovarian tumors in 31 (17.7%), other additional masses of the small pelvis in 27 (15.4%), and a mixed variant of its masses in 50 (28.5%). The findings suggest that it is reasonable to concurrently use USS and MRI in the diagnosis of small pelvic masses following hysterectomy for the specification of their pattern and their differential diagnosis. The benefit of MRI is that information images of the basic structures of the small pelvis can be obtained in patients with a marked commissural process after hysterectomy in the absence of limitations in large mass sizes. Practical guidelines were proposed to comprehensively use USS and MRI for the diagnosis of small pelvic pathology.

  11. History of abandoned infants in Greece

    Directory of Open Access Journals (Sweden)

    Maria Athanasopoulou

    2010-01-01

    Full Text Available It is since mythology to classical ages in Greece, since Medieval Ages to the end of the 19th century in Smyrna and in Athens, that history indicates the abandonment of the infants as a phenomenon always existing. A time flashback and the research of the phenomenon through the historic examples contribute unequivocally to the remonstrance of the social facts in each era.Aim: The aim of this study was to critically review all the historical data and the evidence from the international and Greek literature and to explore the factors that are accountable for to the infant’s abandonment and especially in Greece.Method: A critical literature search was performed using of MEDLINE and CINAHL (1990-2008 databases. The literature review referred to historical data related to the care of the abandoned infants since ancient Greek times.Conclusion: The literature review leads to the conclusion that the detection of the historical sources combines a “mosaic” which reflects the multiple needs of the Greek society, with target to encounter the infant abandonment. The ways used each time in order the phenomenon to be faced, not rarely were doubted. Still they stand as the salutary solutions for the abandoned infants and they are explained and established through the social background of each era and through the needs serviced each time.

  12. Effects of Weather Variability on Crop Abandonment

    Directory of Open Access Journals (Sweden)

    Kelvin Mulungu

    2015-03-01

    Full Text Available In Zambia, every year some parts of the maize fields are abandoned post-planting. Reasons for this are not clearly known. In this paper, we examine the influence of soil and climatic factors on crop abandonment using a six-year (2007–2012 panel data by modeling the planted-to-harvested ratio (a good indicator of crop abandonment using a fractional and linear approach. Therefore, for the first time, our study appropriately (as supported by the model specification tests that favour fractional probit over linear models the fractional nature of crop abandonment. Regression results, which are not very different between the two specifications, indicate that, more than anything, high rainfall immediately after planting and inadequate fertilizer are the leading determinants of crop abandonment. In the agro-ecological region where dry planting takes place, low temperature during planting months negatively affects the harvested area. The results have implications on the sustainability of farming systems in the face of a changing climate.

  13. Pattern of mental ill health morbidities following hysterectomy for benign gynaecological disorders among Nigerian women

    Directory of Open Access Journals (Sweden)

    Morhason-Bello Imran O

    2009-07-01

    Full Text Available Abstract Objective to compare the pre and post hysterectomy mental ill health (MIH status and also, to determine whether there is any association with the surgical indication. Methodology An observational study, conducted among women scheduled for hysterectomy at the University College Hospital, Ibadan from January till June 2005. The MIH morbidities were assessed using a validated general health questionnaire (GHQ before and after the surgery by trained research assistant. The score of 4 and above was used as the cut off. Cross tabulations were performed to detect any association and also to compare pre and post hysterectomy mental health status. The level of statistical significance was set at P Results Of the 50 women recruited, 45 participated in the study. The age range of the participants was 35 to 63 years with a mean of 48.6 (SD = 0.6 years. Anxiety related disorder was present in 20 (44.4%, and depression in 3 (6.7% before hysterectomy. Post surgery, there was significant increase in those with anxiety by 6.8% and a reduction in the proportion of depressive illness by 2.3%. Uterine fibroid as a preoperative diagnosis, had significant association among those with anxiety related disorder (68.4% and depression (10.5%. Conclusion This study suggests that mental ill health may complicates hysterectomy for benign uterine pathology among Nigerian women, and that anxiety related disorders increases after operation with the highest proportion in those with clinical diagnosis of Uterine Fibroid. We recommend adequate preoperative counseling using properly trained psychologists when affordable to minimize these morbidities.

  14. Can We Be Less Radical with Surgery for Early Cervical Cancer?

    Science.gov (United States)

    Macdonald, Madeleine C; Tidy, John A

    2016-03-01

    Although a rare cancer in the developed world due to the success of cervical screening programmes, cervical cancer remains one of the most common cancers diagnosed in women under the age of 35 years old. Radical hysterectomy and more recently radical trachelectomy have been highly effective in curing the majority of women with early stage disease. Many, however, are left with long-term 'survivorship' issues including bowel, bladder and sexual dysfunction. In view of these chronic co-morbidities, many clinicians now consider whether a less radical approach to surgery may be an option for some women. This review focuses on the current evidence for the safety of conservative surgery for early stage cervical cancer with regard to cure rates in comparison to standard management, as well as any improvement in short and long-term morbidity associated with a more conservative approach. PMID:26838586

  15. Infanticide and illegal infant abandonment in Malaysia.

    Science.gov (United States)

    Razali, Salmi; Kirkman, Maggie; Ahmad, S Hassan; Fisher, Jane

    2014-10-01

    Infant abandonment and infanticide are poorly understood in Malaysia. The information available in the public arena comes predominantly from anecdotal sources. The aim of this study was to describe the prevalence and characteristics of infanticide and illegal infant abandonment in Malaysia and to estimate annual rates for the most recent decade. Summaries of data about infanticide and illegal infant abandonment were gathered from police records; the annual number of live births was ascertained from the national registry. The estimated inferred infanticide rates for Malaysia were compared with the infanticide rates among countries of very high, high, medium, and low rankings on the Human Development, Gender Inequality, and Gini indices. From 1999 to 2011, 1,069 cases of illegal infant abandonment were recorded and 1,147 people were arrested as suspected perpetrators. The estimated inferred infanticide rate fluctuated between 4.82 and 9.11 per 100,000 live births, a moderate rate relative to the infanticide rates of other countries. There are substantial missing data, with details undocumented for about 78-87% of cases and suspected perpetrators. Of the documented cases, it appeared that more boys than girls were victims and that suspected perpetrators were predominantly Malays who were women, usually mothers of the victim; the possibility of arrest bias must be acknowledged. Economic and social inequality, particularly gender inequality, might contribute to the phenomena of infanticide and abandonment. Strategies to reduce rates of infanticide and illegal infant abandonment in Malaysia will require strengthening of the surveillance system and attention to the gender-based inequalities that underpin human development.

  16. Infanticide and illegal infant abandonment in Malaysia.

    Science.gov (United States)

    Razali, Salmi; Kirkman, Maggie; Ahmad, S Hassan; Fisher, Jane

    2014-10-01

    Infant abandonment and infanticide are poorly understood in Malaysia. The information available in the public arena comes predominantly from anecdotal sources. The aim of this study was to describe the prevalence and characteristics of infanticide and illegal infant abandonment in Malaysia and to estimate annual rates for the most recent decade. Summaries of data about infanticide and illegal infant abandonment were gathered from police records; the annual number of live births was ascertained from the national registry. The estimated inferred infanticide rates for Malaysia were compared with the infanticide rates among countries of very high, high, medium, and low rankings on the Human Development, Gender Inequality, and Gini indices. From 1999 to 2011, 1,069 cases of illegal infant abandonment were recorded and 1,147 people were arrested as suspected perpetrators. The estimated inferred infanticide rate fluctuated between 4.82 and 9.11 per 100,000 live births, a moderate rate relative to the infanticide rates of other countries. There are substantial missing data, with details undocumented for about 78-87% of cases and suspected perpetrators. Of the documented cases, it appeared that more boys than girls were victims and that suspected perpetrators were predominantly Malays who were women, usually mothers of the victim; the possibility of arrest bias must be acknowledged. Economic and social inequality, particularly gender inequality, might contribute to the phenomena of infanticide and abandonment. Strategies to reduce rates of infanticide and illegal infant abandonment in Malaysia will require strengthening of the surveillance system and attention to the gender-based inequalities that underpin human development. PMID:25048164

  17. Radical prostatectomy - discharge

    Science.gov (United States)

    ... prostatectomy - discharge; Laparoscopic radical prostatectomy - discharge; LRP - discharge; Robotic-assisted laparoscopic prostatectomy - discharge ; RALP - discharge; Pelvic lymphadenectomy - ...

  18. Pregabalin and dexamethasone in combination with paracetamol for postoperative pain control after abdominal hysterectomy. A randomized clinical trial

    DEFF Research Database (Denmark)

    Rasmussen, M L; Dierking, G; Lech, K;

    2008-01-01

    BACKGROUND: Multimodal analgesia may be important for optimal postoperative pain treatment and facilitation of early mobilization and recovery. We investigated the analgesic effect of pregabalin and dexamethasone in combination with paracetamol after abdominal hysterectomy. METHODS: One hundred a...

  19. Integrated interventions for improving negative emotions and stress reactions of young women receiving total hysterectomy.

    Science.gov (United States)

    Wang, Fen; Li, Chun-Bo; Li, Shenghua; Li, Quan

    2014-01-01

    50% of women had obvious abnormal emotions before hysterectomy and hysterectomy can cause strong mental stress reaction. This study was to investigate the impact of psychological health education based integrated interventions on the preoperative negative emotions and stress of patients younger than 45 years receiving total hysterectomy. Forty patients undergoing total hysterectomy were randomly divided into psychological intervention (PI) group and control group (n=20 per group). Patients in PI received peri-operative psychological intervention (supportive psychotherapy, health education, individual depth psychotherapy, family and society supportive care, education on anesthesia and surgery etc.); Interventions were not used in control group. Hamilton Anxiety Scale and Hamilton Depression Rating Scale were used to evaluate patients in two groups on admission (T1) and before surgery (T2; after interventions in PI group). Serum levels of cortisol and IL-6 were detected at T1, T2 and the second day after surgery (T3). Results showed that 1) Patients had obvious anxiety and depression symptoms before and after total hysterectomy. For patients in PI group, the Hamilton Anxiety Scale (HAMA) score decreased from 14.4±5.9 to 9.1±4.2 and the Hamilton Depressing Scale (HAMD) score from 17.8±3.5 to 9.4±6.8 after interventions; 2) In PI group, the serum cortisol was 13.4±3.9 μg/dl at T2 and 14.2±4.8 μg/dl at T3 which were significantly lower than that at T1 (16.6±4.0 μg/dl) and that in the control group at T2 (13.4±3.9/15.5±4.3 μg/dl, t=2.10, P<0.05). Thus, preoperative integrated intervention based on psychological health education can improve peri-operative negative emotions and psychological stress in young patients undergoing hysterectomy. PMID:24482729

  20. Comparison of ramosetron's and ondansetron's preventive anti-emetic effects in highly susceptible patients undergoing abdominal hysterectomy

    OpenAIRE

    Lee, Jae-Woo; Park, Hye Jin; Choi, Juyoun; Park, So Jin; Kang, Hyoseok; Kim, Eu-Gene

    2011-01-01

    Background This study compared the preventive effects of ramosetron and ondansetron on postoperative nausea and vomiting (PONV) in highly susceptible patients undergoing abdominal hysterectomy. Methods In a prospective, randomized, double-blinded study, a total of 120 highly susceptible women (nonsmokers, those receiving opioid-based IV patient-controlled analgesia [PCA]) undergoing abdominal hysterectomy were included in the study. Patients were divided into 2 groups and each group received ...

  1. Hawaii Abandoned Vessel Inventory, Pearl & Hermes Atoll, NWHI

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for , Pearl & Hermes, Atoll, NWHI. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical...

  2. Hawaii Abandoned Vessel Inventory, French Frigate Shoals, NWHI

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for French Frigate Shoals. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction...

  3. 18 CFR 157.216 - Abandonment.

    Science.gov (United States)

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Abandonment. 157.216 Section 157.216 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT... firm contract; or (2) A facility that did or could now qualify for automatic authorization as...

  4. Quarries - QUARRIES_ABANDONED_IN: Abandoned Quarries in Indiana (Indiana Geological Survey, Point Shapefile)

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — QUARRIES_ABANDONED_IN was derived from a comma-delimited text file named "QUALOC.TXT" contained on the following CD-ROM publication: Hasenmueller, W.A., and Ault,...

  5. Radical theory of rings

    CERN Document Server

    Gardner, JW

    2003-01-01

    Radical Theory of Rings distills the most noteworthy present-day theoretical topics, gives a unified account of the classical structure theorems for rings, and deepens understanding of key aspects of ring theory via ring and radical constructions. Assimilating radical theory's evolution in the decades since the last major work on rings and radicals was published, the authors deal with some distinctive features of the radical theory of nonassociative rings, associative rings with involution, and near-rings. Written in clear algebraic terms by globally acknowledged authorities, the presentation

  6. Nurses' Attitudes and Knowledge of Their Roles in Newborn Abandonment

    OpenAIRE

    Cesario, Sandra K.

    2003-01-01

    The practice of abandoning newborns shortly after birth has always existed. Occurring in primitive and contemporary societies, the motivations for newborn abandonment are varied and dependent upon the social norms of a specific geographic region at a given point in time. Because the desire to abandon an infant has had no support system in American society, such unwanted infants have been abandoned in a manner leading to their deaths. In response, many states have passed safe-haven legislation...

  7. [Lavoisier and radicals].

    Science.gov (United States)

    Lafont, Olivier

    2007-01-01

    Lavoisier and his co-workers (Guyton de Morveau, Bertholet, Fourcroy) considered that acids were constituted of oxygen and of something else that they called radicals. These radicals were known in some cases, i.e. nitrogen for nitrous acid, carbon for carbonic acid, phosphorus for phosphoric acid. In the case of sulfur, the sulfuric radical could be associated with different quantities of oxigen leading to sulfuric or sulfurous acids. In other cases radicals remained unknown at the time i.e. muriatic radical for muriatic acid, or benzoyl radical for benzoic acid. It is interesting to notice that Lavoisier evoked the case of compound radicals constituted of different substances such as carbon and hydrogen.

  8. 30 CFR 57.4011 - Abandoned electric circuits.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Abandoned electric circuits. 57.4011 Section 57.4011 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL... and Control § 57.4011 Abandoned electric circuits. Abandoned electric circuits shall be...

  9. 30 CFR 56.4011 - Abandoned electric circuits.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Abandoned electric circuits. 56.4011 Section 56.4011 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL... Control § 56.4011 Abandoned electric circuits. Abandoned electric circuits shall be deenergized...

  10. 30 CFR 256.56 - Lease-specific abandonment accounts.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Lease-specific abandonment accounts. 256.56... OF SULPHUR OR OIL AND GAS IN THE OUTER CONTINENTAL SHELF Bonding § 256.56 Lease-specific abandonment accounts. (a) The Regional Director may authorize you to establish a lease-specific abandonment account...

  11. Fiber Optical Improvements for a Device Used in Laparoscopic Hysterectomy Surgery

    Science.gov (United States)

    Hernández Garcia, Ricardo; Vázquez Mercado, Liliana; García-Torales, G.; Flores, Jorge L.; Barcena-Soto, Maximiliano; Casillas Santana, Norberto; Casillas Santana, Juan Manuel

    2006-09-01

    Hysterectomy removes uterus from patients suffering different pathologies. One of the most common techniques for performing it is the laparoscopically-assisted vaginal hysterectomy (LAVH). In the final stage of the procedure, surgeons face the need to unambiguously identify the vaginal cuff before uterus removal. The aim of this research is to adapt a local source of illumination to a polymer cup-like device adapted to a stainless steel shaft that surgeons nowadays use to manipulate the uterus in LAVH. Our proposal consists in implementing a set of optical fiber illuminators along the border of the cup-like device to illuminate the exact vaginal cupola, using an external light source. We present experimental results concerning temperature increases in quasi adiabatic conditions in cow meat under different light intensity illumination.

  12. Utility of endometrial sampling prior to risk-reducing hysterectomy in a patient with Lynch syndrome

    Science.gov (United States)

    Frey, Melissa K; David-West, Gizelka; Mittal, Khushbakhat R; Muggia, Franco M; Pothuri, Bhavana

    2016-01-01

    Occult endometrial cancer is occasionally discovered in women with Lynch syndrome undergoing risk-reducing hysterectomy. The case presented here demonstrates that preoperative endometrial sampling can help detect these occult cancers; however, there are currently no recommendations for this preoperative intervention. A 50-year-old woman with Lynch syndrome underwent endometrial sampling prior to planned risk-reducing hysterectomy and bilateral salpingo-oophorectomy. The endometrial biopsy demonstrated a serous endometrial cancer. The patient was counselled regarding the diagnosis and revised operative plan, which now included staging, prior to surgery. Although the prevalence of occult endometrial cancer at the time of risk-reducing surgery in women with Lynch syndrome remains unknown, preoperative endometrial sampling may allow for improved patient counselling and surgical planning in this population, and can help avoid a subsequent surgery for staging. PMID:26823682

  13. Emergency Peripartum Hysterectomies at a District General Hospital in United Kingdom: 10-Year Review of Practice

    Directory of Open Access Journals (Sweden)

    J. Chester

    2016-01-01

    Full Text Available Peripartum haemorrhage is an obstetric emergency which requires effective and timely management. A retrospective analysis was conducted at a single centre district hospital, over a 10-year period to describe factors that would lead to a peripartum hysterectomy. We sought to establish intraoperative and postoperative risks and review outcomes and complications associated with the procedure. A total of 29 cases (incidence 0.8 per 1000 were reviewed over 2001–2011. The mean parity was 1.8 and the mean maternal age was 33 years. Uterine atony was the most common indication for hysterectomy (12/29 followed by placenta praevia and accreta (4/29 and 5/29 cases, resp.. The commonest postoperative complications were sepsis and paralytic ileus. EPH most commonly occurs due to uterine atony but remains difficult to predict. Hospitals should continue to have robust systems and the necessary resources available to perform EPH where clinically indicated.

  14. Acute Colonic Pseudo-Obstruction (Ogilvie's Syndrome) Following Total Laparoscopic Hysterectomy.

    Science.gov (United States)

    Cebola, Monique; Eddy, Eliza; Davis, Suzanne; Chin-Lenn, Laura

    2015-01-01

    Rapid identification of acute colonic pseudo-obstruction (ACPO), or Ogilvie's syndrome, is paramount in the management of this condition, which, if unresolved, can progress to bowel ischemia and perforation with significant morbidity and mortality. We present the first case report, to our knowledge, of ACPO following total laparoscopic hysterectomy. We describe the presentation and management of ACPO in a patient who underwent uncomplicated total laparoscopic hysterectomy to treat menorrhagia and dysmenorrhea after declining conservative treatment. Following initial conservative management, the patient rapidly deteriorated and required laparotomy for clinically suspected cecal ischemia. Cecal resection, colonic decompression, and end ileostomy formation were performed. A brief review of the current literature is presented with respect to the case report. PMID:26164536

  15. LigaSure versus Conventional Suture Ligature for Vaginal Hysterectomy: a Randomized Controlled Trial

    OpenAIRE

    Mohamed Abd Elzaher, a, b, Ashraf Moawad, a, c and Hanaa Abu-Ria

    2011-01-01

    Introduction: Vaginal hysterectomy is considered to be the method of choice for removal of the uterus. Of particular concern for the vaginal surgeon is the ability to access, visualize, and legate structures while maintaining adequate hemostasis. Surgical hemostasis can be secured by a variety of methods, including mechanical means (sutures) or vessel coagulation (diathermy). Electro-surgical vessel sealing (LigaSure) is a new hemostatic system based on the combination of pressure and bipolar...

  16. Development of Transvaginal Uterus Amputation Device for Laparoscopic Hysterectomies in Gynecologic Surgeries

    Directory of Open Access Journals (Sweden)

    Serkan DİKİCİ

    2015-01-01

    Full Text Available Hysterectomy, that is removal of uterus, is one of the most common major operations in gynecologic surgeries. Laparoscopy technique is preferred in hysterectomy because of its advantages such as lower intra-operative blood loss, decreased surrounding tissue/organ damage, less operating time, lower postoperative infection and frequency of fever, shorter duration of hospitalization and post-operative returning time to normal activity. During total laparoscopic hysterectomy, first uterine vessels and ligaments are cauterized respectively, and then cervicovaginal connections are cauterized and coagulated to remove uterus completely. Uterine manipulators are used during laparoscopy to maximize the endoscopic vision of surgeons by moving related organs. However, conventional uterine manipulators have important drawbacks particularly to move uterus in three dimensions and to show cervicovaginal landmark during laparoscopic circular cauterization and amputation of the uterine cervix. A new transvaginal uterine manipulator may overcome these two important drawbacks of these currently available devices. For this reason, a3D scanned technique was used to get uterus sizes and computer aided design software is used in designing of the new manipulator and then 3D printer was used in prototyping. Special light emitting diodes (LEDs were mounted on the cervical cap of the manipulator to guide light beams from inside of cervicovaginal tissue to abdominal cavity to facilitate the visualization of tissue landmarks. Moreover, performances of different caps and LED systems will be evaluated. Furthermore, after integration of self-cutting and self-suturing mechanisms into our system, final prototype will be produced by using titanium which is biologically and mechanically appropriate. Therefore, aim of this study was to design and produce a new uterine manipulator with three dimensional movements, LED illumination, self-cutting and self-suturing systems to facilitate

  17. A prospective study of risk factors for pain persisting 4 months after hysterectomy

    DEFF Research Database (Denmark)

    Brandsborg, Birgitte; Dueholm, Margit; Nikolajsen, Lone;

    2009-01-01

    OBJECTIVES: Chronic pain after hysterectomy is reported by 5% to 32% of women, but it is unknown whether the pain is a result of surgery or can be attributable to other factors such as preoperative and postoperative pain, physical, and psychosocial status. The aim of this prospective study was...... most often related to preoperative factors and acute postoperative pain. The relative contribution of surgery itself is small....

  18. Profound bilateral visual loss after hysterectomy indicated for severe postpartum haemorrhage

    DEFF Research Database (Denmark)

    Ostri, Christoffer; Zibrandtsen, Nathalie; Larsen, Michael;

    2014-01-01

    We present a case of a patient with bilateral posterior ischaemic optic neuropathy in the previously unreported setting of hysterectomy indicated for severe postpartum haemorrhage. The diagnosis was based on clinical and paraclinical examinations, including MRI of the head, electroretinography (ERG....... The diagnosis of perioperative posterior ischaemic optic neuropathy is mostly a clinical diagnosis. However, MRI plays a major role in excluding other causes of visual loss, and VEP, ERG and OCT are valuable supplemental diagnostic tools....

  19. Effect of preoperative flupirtine on postoperative morphine sparing in patients undergoing total abdominal hysterectomy

    OpenAIRE

    Thapa, D; Ahuja, V; C Dass; S Gombar; Huria, A.

    2016-01-01

    Background: Flupirtine is a unique non-opioid, centrally acting analgesic with muscle relaxant properties. So far no study has evaluated, use of preoperative flupirtine on postoperative morphine sparing effect in patients undergoing total abdominal hysterectomy (TAH). Materials and Methods: We performed a prospective, controlled, and randomized study in 50 female patients of American Society of Anesthesiologists physical status I-II, aged between 30 and 60 years scheduled for TAH under ge...

  20. Transvaginal Laparoscopic Appendectomy Simultaneously with Vaginal Hysterectomy: Initial Experience of 10 Cases

    OpenAIRE

    Tian, Yu; Wu, Shuo-Dong; Chen, Ying-Han; Wang, Dan-Bo

    2014-01-01

    Background Natural orifice transluminal endoscopic surgery (NOTES) involves the introduction of instruments through a natural orifice into the peritoneal cavity to perform surgical interventions. The vagina is the most widely used approach to NOTES. We report the utilization of the vaginal opening at the time of vaginal hysterectomy as a natural orifice for laparoscopic appendectomy. Material/Methods We reviewed cases of 10 patients with chronic appendicitis who underwent transvaginal laparos...

  1. Analgesic effect of ultrasound-guided transversus abdominis plane block after total abdominal hysterectomy

    DEFF Research Database (Denmark)

    Røjskjaer, Jesper O; Gade, Erik; Kiel, Louise B;

    2015-01-01

    OBJECTIVE: To assess the effect of bilateral ultrasound-guided transversus abdominis plane block with ropivacaine compared with placebo as part of a multimodal analgesic regimen. DESIGN: A randomized, double-blind, placebo-controlled trial following the CONSORT criteria. SETTING: Hvidovre...... ultrasound-guided transversus abdominis plane block in women undergoing total abdominal hysterectomy. As part of a multimodal regimen the transversus abdominis plane block showed some effect on pain scores at rest only in the early postoperative period....

  2. Emergency peripartum hysterectomy, physical and mental consequences: a 6-year study

    Directory of Open Access Journals (Sweden)

    Denisa-Oana Bălălău

    2016-04-01

    Full Text Available Emergency peripartum hysterectomy (EPH is performed for massive postpartum hemorrhage following a cesarean delivery or vaginal delivery, in order to save the patient’s life. The current study was performed on a sample of 13.162 patients, which underwent cesarean or vaginal delivery during a period of 6 years, from 2010 to 2015, in Bucur Maternity Hospital. There were two subsequential groups consisting in: 6593 patients with cesarean operations and 6569 patients with vaginal delivery. In 12 cases occurred one or more of the risk factors that lead to EPH, divided equally across the two groups above. The main two types of surgery are a more frequent subtotal hysterectomy, which is the preferred type of EPH as it takes less time and is associated with fewer complications, and a total hysterectomy. The majority of procedures were performed at patients over 35 years old (9 of 12, with a median age of 31,16 (ranging from 21 to 44 years old. The most important risk factor present across the lot was multiparity (11 from 12, with cicatricial uterus being the second one (4 of 12. ICU median time was 4,5 days (ranging from 3 to 15 days, with a median blood transfusion necessity of around 2,4 I.U per patient. There were no mother or newborn reported deaths, neither PTSD following EPH.EPH is a procedure performed as last-resort, life-saving surgery, leaving no time for mental preparation of the patients. This may predispose to negative psychological outcomes, especially because they are not part of decision-making process due to the emergency character of hysterectomy.

  3. Emergency peripartum hysterectomy, physical and mental consequences: a 6-year study

    OpenAIRE

    Denisa-Oana Bălălău; Romina Marina Sima; Nicolae Bacalbașa; Liana Pleș; Anca Daniela Stănescu

    2016-01-01

    Emergency peripartum hysterectomy (EPH) is performed for massive postpartum hemorrhage following a cesarean delivery or vaginal delivery, in order to save the patient’s life. The current study was performed on a sample of 13.162 patients, which underwent cesarean or vaginal delivery during a period of 6 years, from 2010 to 2015, in Bucur Maternity Hospital. There were two subsequential groups consisting in: 6593 patients with cesarean operations and 6569 patients with vaginal delivery. In 12 ...

  4. Chronic plasma cell endometritis in hysterectomy specimens of HIV-infected women: a retrospective analysis.

    Science.gov (United States)

    Kerr-Layton, J A; Stamm, C A; Peterson, L S; McGregor, J A

    1998-01-01

    OBJECTIVE: Abnormal uterine bleeding is a common and troublesome problem in human immunodeficiency virus (HIV)-infected women. We sought to evaluate endometrial pathology among HIV-infected women requiring hysterectomy to explore if endometritis may be common among these patients. METHODS: We performed a retrospective analysis of uterine pathology specimens obtained from HIV-infected and control patients requiring hysterectomy in two urban hospitals between 1988 and 1997 matched for age, surgical indication, and history of gonadotropin-releasing hormone (GnRH) use. Cases were evaluated for the presence of plasma cells and assigned a grade between 0 and 3. RESULTS: Indications included cervical dysplasia (4), carcinoma in situ (2), abnormal uterine bleeding (3), and adnexal mass (3). Some degree of abnormal uterine bleeding occurred in all cases. Plasma cell endometritis was twice as common in HIV-infected women compared to HIV-negative specimens (11/11 versus 11/22) (P < 0.05). Plasma cell endometritis was also of a higher grade in specimens from HIV-infected women than in controls (P = 0.001). CONCLUSION: Chronic endometritis was common and of a higher grade among HIV-infected women requiring hysterectomy in our series. Diagnosis and treatment of endometritis should be considered in HIV-infected women with uterine bleeding and/or tenderness. We speculate that antiretroviral and/or antimicrobial treatment for endometritis may effectively treat endometritis and eliminate the need for surgery in some HIV-infected women. We suggest that consideration and treatment of endometritis in HIV-1 infected women being evaluated for possible hysterectomy has the potential to reduce costs and morbidity for patients and providers who may be exposed during surgical procedures. PMID:9812252

  5. The impact of nonclinical factors on practice variations: the case of hysterectomies.

    OpenAIRE

    Geller, S E; Burns, L R; Brailer, D J

    1996-01-01

    OBJECTIVE: This study investigates the role of nonclinical factors (physician characteristics) in explaining variations in hysterectomy practice patterns. DATA SOURCES AND STUDY SETTING: Patient discharge data are obtained from the Arizona state discharge database for the years 1989-1991. Physician data are obtained from the Arizona State Medical Association. The analyses are based on 36,104 cases performed by 339 physicians in 43 hospitals. STUDY DESIGN: This article measures the impact of p...

  6. A COMPARISON OF KETOROLAC, DICLOFENAC AND PARACETAMOL FOR POSTOPERATIVE ANALGESIA FOLLOWING ABDOMINAL HYSTERECTOMY

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    Gaurav

    2015-11-01

    Full Text Available BACKGROUND Abdominal hysterectomy is associated with moderate-to-severe postoperative pain. Among non-opioid analgesics diclofenac, paracetamol and ketorolac are most commonly used. OBJECTIVES: The aim of this study was to compare the analgesic duration, efficacy and side effect profile of paracetamol, diclofenac and ketorolac administered intravenously in patients who underwent abdominal hysterectomy. METHODS In a prospective double-blinded study, in which 90 women undergoing elective abdominal hysterectomy under spinal anesthesia were randomly selected and divided into 3 groups to receive 1ml (75mg Diclofenac (Group D, 1ml (30mg Ketorolac (Group K and 100ml (1000mg Paracetamol (Group P. Two hours post spinal anesthesia, irrespective of completion of surgery study drug was administered intravenously. In post-operative ward analgesic, efficacy was assessed hourly using a visual analog scale (VAS, duration of motor blockade due to spinal anesthesia (Modified Bromage scale, time for rescue analgesia (VAS>4 were compared and occurrence of adverse effects noted. STATICS Collected data was analyzed using ANOVA. RESULTS The time taken to administer the first dose of rescue analgesic was significantly (P <0.05 delayed in the group K (276mins. Overall, mean postoperative VAS scores were significantly better with (Group K and VAS scores were not significantly different between other (Group P and (Group D. CONCLUSION Ketorolac was a better post-operative analgesic compared to diclofenac and paracetamol.

  7. Unexpected premalignant gynecological lesions in women undergoing vaginal hysterectomy for utero-vaginal prolapse

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    Assem A.M. Elbiaa

    2015-09-01

    Full Text Available Aim of the study was to estimate the incidence of unexpected premalignant gynecological lesions in women undergoing vaginal hysterectomy for utero-vaginal prolapse. Material and methods : Eighty women with asymptomatic utero-vaginal prolapse were included in this prospective study for vaginal hysterectomy after preoperative preparation and after written informed consent. Women included in this study were screened preoperatively by high vaginal swab, Pap smear, endometrial biopsy and trans-vaginal ultrasound. Surgically removed uteri and ovaries were sent for histopathological examination. Results of histopathological examination as gold standard were compared with conventional gynecological screening methods. Results : Histopathological examination of surgically removed uteri and ovaries after vaginal hysterectomy for uterovaginal prolapse showed abnormal findings in 61.25% (49/80 of studied cases (10 chronic cervicitis; 20 cervical intra-epithelial neoplasia-1 [CIN-1]; 5 CIN-2; 2 CIN-3; 10 simple endometrial hyperplasia without atypia and 2 simple serous ovarian cyst. Also, histopathological examination showed premalignant changes in 33.75% (27/80 of studied cases (20 CIN-1; 5 CIN-2 and 2 CIN-3, which mean 50% sensitivity of pre-operative Pap smear to detect premalignant cervical changes. Conclusions : Asymptomatic women with utero-vaginal prolapse may have associated premalignant lesions which may not be detected by conventional screening methods, and this should be explained preoperatively for women undergoing surgery, especially if conservative management was considered.

  8. Transversus abdominis plane (TAP) block after robot-assisted laparoscopic hysterectomy

    DEFF Research Database (Denmark)

    Torup, H; Bøgeskov, M; Hansen, E G;

    2015-01-01

    BACKGROUND: Transversus abdominis plane (TAP) block is widely used as a part of pain management after various abdominal surgeries. We evaluated the effect of TAP block as an add-on to the routine analgesic regimen in patients undergoing robot-assisted laparoscopic hysterectomy. METHODS: In a pros...... and Nonsteroidal anti-inflammatory drugs (NSAID) treatment, had no effect on morphine consumption, VAS pain scores, or frequency of nausea and vomiting after robot-assisted laparoscopic hysterectomy compared with paracetamol and NSAID alone.......BACKGROUND: Transversus abdominis plane (TAP) block is widely used as a part of pain management after various abdominal surgeries. We evaluated the effect of TAP block as an add-on to the routine analgesic regimen in patients undergoing robot-assisted laparoscopic hysterectomy. METHODS...... on top of paracetamol and ibuprofen or diclofenac. For the first 24 post-operative hours, we monitored PCA morphine consumption and pain scores with visual analogue scale (VAS) at rest and while coughing. Post-operative nausea and number of vomits (PONV) were recorded. RESULTS: Sixty-five patients...

  9. Effects of institutional changes on land use: agricultural land abandonment during the transition from state-command to market-driven economies in post-Soviet Eastern Europe

    Science.gov (United States)

    Prishchepov, Alexander V.; Radeloff, Volker C.; Baumann, Matthias; Kuemmerle, Tobias; Müller, Daniel

    2012-06-01

    Institutional settings play a key role in shaping land cover and land use. Our goal was to understand the effects of institutional changes on agricultural land abandonment in different countries of Eastern Europe and the former Soviet Union after the collapse of socialism. We studied ˜273 800 km2 (eight Landsat footprints) within one agro-ecological zone stretching across Poland, Belarus, Latvia, Lithuania and European Russia. Multi-seasonal Landsat TM/ETM + satellite images centered on 1990 (the end of socialism) and 2000 (one decade after the end of socialism) were used to classify agricultural land abandonment using support vector machines. The results revealed marked differences in the abandonment rates between countries. The highest rates of land abandonment were observed in Latvia (42% of all agricultural land in 1990 was abandoned by 2000), followed by Russia (31%), Lithuania (28%), Poland (14%) and Belarus (13%). Cross-border comparisons revealed striking differences; for example, in the Belarus-Russia cross-border area there was a great difference between the rates of abandonment of the two countries (10% versus 47% of abandonment). Our results highlight the importance of institutions and policies for land-use trajectories and demonstrate that radically different combinations of institutional change of strong institutions during the transition can reduce the rate of agricultural land abandonment (e.g., in Belarus and in Poland). Inversely, our results demonstrate higher abandonment rates for countries where the institutions that regulate land use changed and where the institutions took more time to establish (e.g., Latvia, Lithuania and Russia). Better knowledge regarding the effects of such broad-scale change is essential for understanding land-use change and for designing effective land-use policies. This information is particularly relevant for Northern Eurasia, where rapid land-use change offers vast opportunities for carbon balance and biodiversity

  10. Preoperative povidone-iodine vaginal gel in abdominal hysterectomy: a randomized clinical trial

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    Beigi A

    2007-09-01

    Full Text Available Background: Infectious complications of hysterectomy remain common despite the use of antibiotic. The usual existing methods of preoperative antisepsis do not control the vaginal bacteria that are the primary cause of contamination at the surgical site. Our goal was to assess whether febrile morbidity after total abdominal hysterectomy is decreased by the addition of povidone-iodine gel at the vaginal apex after the routine vaginal preparation with povidone-iodine solution.Methods: We carried out a prospective randomized trial on women admitted for elective abdominal hysterectomy. Inclusion criteria included planned abdominal hysterectomy for benign or malignant gynecologic conditions. Exclusion criteria consisted of emergency surgery, current treatment for pelvic infection, and known povidone-iodine allergy. A total of 168 patients were randomized to either the control group or the intervention group, who received 20 cc povidone-iodine gel placed at the vaginal apex immediately before the operation. Both groups received the routine preoperative preparation of antimicrobial prophylaxis, abdominal and vaginal scrubbing with povidone-iodine solution prior to the operation. The primary outcome was post-operative febrile morbidity. Other outcomes included abdominal wound infection, vaginal cuff cellulitis or pelvic abscess. Data was analyzed using Fisher's exact test. p<0.05 was considered statistically significant.Results: The overall rate of febrile morbidity was 20.5%. Febrile morbidity occurred in ten of 80 (12.5% women receiving the povidone-iodine gel preparation and 24 of 86 (27.9% women not receiving the gel (p<0.05. The rate of abdominal wound infection was 18.6% (16 in the control group, and 5% (4 in the gel group (p<0.05. Vaginal cuff cellulitis was seen in three patients from the control group versus one woman from the gel group (p>0.05. Pelvic abscess was diagnosed in one patient from the control group and in no patients from the

  11. Variation in NHS utilisation of vault smear tests in women post-hysterectomy: A study, using routinely collected datasets

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    Wilson Sue

    2008-03-01

    Full Text Available Abstract Background 20% of women living in the UK have a hysterectomy during their lifetime, levels are higher in the USA, making it one of the most commonly performed major surgical procedures. Understanding of the indications for hysterectomy and of the rationale for follow-up of women post hysterectomy is currently limited. Guidelines concerning follow-up by means of vaginal vault cytology tests exist but these are not based on 'gold standard' evidence. Furthermore, the extent to which current practice reflects these guidelines is unclear. This study aims to determine the factors associated with variability in hysterectomy rates and subsequent follow-up after surgery by use of the vaginal vault smear cytology test. Methods/Design All women resident in the West Midlands region, of the United Kingdom, who had a hysterectomy operation between 1st April 2002 and 30th March 2003 will be identified from the Hospital Episodes Statistics database which also contains proxy data on deprivation status, derived from postcode and self declared ethnicity. These data will be linked to regional cervical screening records for each woman and histopathology laboratory records from the relevant hospitals. Study objectives are to describe: Indications for the hysterectomy operation, histology at hysterectomy, subsequent follow-up by use or non-use of vaginal vault cytology tests and variation between histological groups. Additionally the data will be categorised according to a woman's cytology screening history prior to surgery (i.e. always normal, borderline, resolved abnormalities, CIN etc and these different groups compared. Variations in these outcomes according to age, deprivation and ethnic group will also be examined. Analysis will be undertaken using SPSS. Discussion This study will clarify patterns of current practice in one large English region and determine whether this practice reflects existing guidelines. The study will also strengthen the evidence

  12. Laparoscopic radical cystectomy

    OpenAIRE

    Fergany, Amr

    2012-01-01

    Objective Laparoscopic radical cystectomy (LRC) has emerged as a minimally invasive alternative to open radical cystectomy (ORC). This review focuses on patient selection criteria, technical aspects and postoperative outcomes of LRC. Methods Material for the review was obtained by a PubMed search over the last 10 years, using the keywords ‘laparoscopic radical cystectomy’ and ‘laparoscopic bladder cancer’ in human subjects. Results Twenty-two publications selected for relevance and content we...

  13. Schoenberg and the Radical Economies of Harmonielehre

    Directory of Open Access Journals (Sweden)

    Murray Dineen

    2009-06-01

    Full Text Available This article examines Schoenberg’s Harmonielehre as a text shaped by the influence of Central European science and politics. In accord with a severely economical approach to his subject, Schoenberg’s critique of figured bass and chorale harmonization is compared with Ernst Mach’s writings on scientific method. In support of this comparison, the article addresses the role played in Schoenberg’s political development by the Leftist editor and organizer, David J. Bach, one of Schoenberg’s closest childhood friends and a student of Mach. The comparison between Schoenberg and Mach, then, is drawn not only in terms of scientific method but also in light of the radical politics of the Austrian Left at the time, a politics for which both Mach and Schoenberg held sympathies. It should not be overlooked that later, however, they ceased to acknowledge these sympathies explicitly, and Schoenberg would appear to have abandoned them entirely.

  14. Negative attitudes and affect do not predict elective hysterectomy: A prospective analysis from the Study of Women's Health Across the Nation

    Science.gov (United States)

    Gibson, Carolyn J.; Bromberger, Joyce T.; Weiss, Gerson E.; Thurston, Rebecca C.; Sowers, MaryFran; Matthews, Karen A.

    2010-01-01

    Objective Cross-sectional studies suggest an association between hysterectomy and negative affect. Using prospective data, we examined the associations of negative affect, attitudes toward aging and menopause, premenstrual symptoms and vasomotor symptoms with elective hysterectomy in midlife. Methods Data were from the Study of Women's Health Across the Nation, a multi-site community-based prospective cohort study of the menopausal transition (n=2,818). Annually reported hysterectomy at visits 2-9 was verified with medical records when available (71%). Anxiety, perceived stress, depressive symptoms, attitudes toward aging and menopause, vasomotor symptoms, and premenstrual symptoms were assessed at baseline using standardized questions. Cox proportional hazards models were used to relate these variables to subsequent elective hysterectomy. Covariates included demographic variables, menstrual bleeding problems, body mass index, hormone levels, and self-rated health, also assessed at baseline. Results Elective hysterectomy was reported by 6% of participants (n=168) over an 8-year period. Women with hysterectomy were not higher in negative affect or negative attitudes toward aging and menopause compared to women without hysterectomy. Vasomotor symptoms (HR 1.44, 95% CI 1.03-2.01, p=.03) and positive attitudes toward aging and menopause (HR 1.74, 95% CI 1.04-2.93) at baseline predicted hysterectomy over the 8-year period, controlling for menstrual bleeding problems, site, race/ethnicity, follicle stimulating hormone, age, education, body mass index, and self-rated health. Menstrual bleeding problems at baseline were the strongest predictor of hysterectomy (HR 4.30, 95% CI 2.05-9.05). Conclusions In this prospective examination, negative affect and attitudes were not associated with subsequent hysterectomy. Menstrual bleeding problems were the major determinant of elective hysterectomy. PMID:21228728

  15. Physiology of free radicals

    Directory of Open Access Journals (Sweden)

    Stevanović Jelka

    2011-01-01

    Full Text Available Free radicals imply that every atom, molecule, ion, group of atoms, or molecules with one or several non-paired electrons in outer orbital. Among these are: nitrogenoxide (NO•, superoxide-anion-radical (O2•-, hydroxyl radical (OH•, peroxyl radical (ROO•, alcoxyl radical (RO• and hydroperoxyl radical (HO2•. However, reactive oxygen species also include components without non-paired electrons in outer orbital (so-called reactive non-radical agents, such as: singlet oxygen (1O2, peroxynitrite (ONOO-, hydrogen-peroxide (H2O2, hypochloric acid (eg. HOCl and ozone (O3. High concentrations of free radicals lead to the development of oxidative stress which is a precondition for numerous pathological effects. However, low and moderate concentrations of these matter, which occur quite normally during cell metabolic activity, play multiple significant roles in many reactions. Some of these are: regulation of signal pathways within the cell and between cells, the role of chemoattractors and leukocyte activators, the role in phagocytosis, participation in maintaining, changes in the position and shape of the cell, assisting the cell during adaption and recovery from damage (e.g.caused by physical effort, the role in normal cell growth, programmed cell death (apoptosis and cell ageing, in the synthesis of essential biological compounds and energy production, as well as the contribution to the regulation of the vascular tone, actually, tissue vascularization.

  16. Orgasm after radical prostatectomy

    NARCIS (Netherlands)

    Koeman, M; VanDriel, MF; Schultz, WCMW; Mensink, HJA

    1996-01-01

    Objective To evaluate the ability to obtain and the quality of orgasm after radical prostatectomy, Patients and methods The orgasms experienced after undergoing radical prostatectomy were evaluated in 20 men (median age 65 years, range 56-76) using a semi-structured interview and a self-administered

  17. Effect of different anesthesia methods on inflammation and oxidative stress in patients with laparoscopic hysterectomy

    Institute of Scientific and Technical Information of China (English)

    Xiao-Guang Wang; Ge-Hui Li; Xiao-Fei Qi; Dan-Yong Liu

    2016-01-01

    Objective:To analyze the effect of different anesthesia methods on inflammation and oxidative stress in patients with laparoscopic hysterectomy.Methods: A total of 75 cases who received laparoscopic hysterectomy in our hospital from September 2012 to February were included in the research and divided into simple general anesthesia group 40 cases and combined general and epidural anesthesia group 35 cases according to different anesthesia methods. Peripheral venous blood was drawn from patients to detect the differences in inflammation-related indexes, immune molecule-related indexes, cerebral oxygen metabolism as well as cerebral blood flow and oxidative stress-related indexes, etc in it.Results: Postoperative MBP, MCP-1, HMGB1 and LBP values of observation group were lower than those of control group while Ins value was higher than that of control group (P<0.05);postoperative CD25,CD14, CD4+CD25+T,CD8+CD28-T and Th1 cell percentage of observation group were higher than those of control group while Th2 cell, Th17 cell percentage were lower than those of control group (P<0.05); CaO2, CjvO2 and CajvDO2 values of observation group 30 min before the end of operation and after operation were higher than those of control group (P<0.05); serum 5-HT, TH and MAOA values of observation group after treatment were lower than those of control group while GSH-Px and T-AOC values were higher than those of control group (P<0.05). Conclusions: Combined general and epidural anesthesia for patients with laparoscopic hysterectomy can effectively inhibit body's inflammatory and oxidative stress state and maintain stable immune state, and it has positive clinical significance.

  18. Adenomyosis:Pathologies associated in a set of patients underwent hysterectomy

    Institute of Scientific and Technical Information of China (English)

    Luis Humberto Sordia-Hernandez; Julio Herrero; Arturo Morales Martinez; Jose Mara Gris; Donato Saldivar Rodriguez; Oscar Vidal Gutierrez; Celina Castro

    2012-01-01

    Objective:To determine if a relationship exists between the histopathological diagnosis of adenomyosis and the clinical conditions and pathologies that are more commonly related to it in patients undergoing hysterectomy. Methods:Retrospective, comparative, case-control study was conducted. With previous approval by ethics committee, we included 794 patients undergoing hysterectomy at a University Hospital. The Medical records and pathology reports of patients undergoing hysterectomy over a two-year period were reviwed. Clinical conditions and associated pathologies, in patients with and without adenomyosis, were reviewed and compared. Statistical analysis was done using the Chi-square test. Results:Adenomyosis was reported in 140 out of 794 patients, 17.6%(95%CI:15.1-20.4). No differences in adenomyosis prevalence were found among patients with or without uterine fibroids, 20.2%(75/371) vs. 15.5%(65/423);endometrial polyps, 9.7%(6/62) vs. 18.3%(134/732);and the presence or lack of endometrial hyperplasia 13.9%(5/36) vs. 17.4%(135/758). The prevalence of adenomyosis among patients with endometriosis was 40.7%(11/27), and among those without this diagnosis, 16.8%(129/767). This difference was significant (P=0.001). A history of two or more curettages was also positively related to adenomyosis. Conclusions:There was a statistically significant difference in the prevalence of adenomyosis in women with endometriosis when compared to women without endometriosis. A higher incidence of adenomyosis was found in patients with a history of two or more curettages. Trauma to the endometrium could explain the higher incidence of adenomyosis in both conditions.

  19. Postoperative Nausea and Vomiting: Palonosetron with Dexamethasone vs. Ondansetron with Dexamethasone in Laparoscopic Hysterectomies

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    Anish N. G. Sharma

    2015-07-01

    Full Text Available Objectives: Postoperative nausea and vomiting (PONV is the most common complication seen following laparoscopic surgery. Our study sought to evaluate the efficacy of the newer drug palonosetron with that of ondansetron, in combination with dexamethasone, for PONV in patients undergoing laparoscopic hysterectomies. Methods: A total of 90 patients, aged between 30–50 years old, posted for elective laparoscopic hysterectomies under general anesthesia belonging to the American Society of Anesthesiologist (ASA physical status I and II were included in the study. Patients were randomly divided into one of two groups (n=45. Before induction, patients in the first group (group I received 0.075mg palonosetron with 8mg dexamethasone and patients in the second group (group II received 4mg ondansetron with 8mg dexamethasone. Postoperatively, any incidences of early or delayed vomiting, requirement of rescue antiemetic, and side effects were recorded. Patient’s hemodynamics were also monitored. Statistical analysis was done using Student’s t-test, chi-square test, and Fisher’s exact test. Results: Preoperative, intraoperative, and postoperative heart rate, mean arterial pressure, peripheral capillary oxygen saturation were statistically not significant (p>0.050 in either group. In group II, eight patients had nausea in the first two hours and three patients had nausea in the two to six-hour postoperative period. In group I, three patients experienced nausea in the first six hours period. Eight patients in group II had vomited in the first two-hour period compared to one patient in group I (p=0.013. The requirement of rescue antiemetic was greater in group II than group I (20% vs. 4%. No side effects of antiemetic use were observed in either group. Conclusion: The combination of palonosetron with dexamethasone is more effective in treating early, delayed, and long term PONV compared to ondansetron with dexamethasone in patients undergoing

  20. A randomized controlled trial to compare pregabalin with gabapentin for postoperative pain in abdominal hysterectomy

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    Anju Ghai

    2011-01-01

    Full Text Available Background: Pregabalin is a potent ligand for alpha-2-delta subunit of voltage-gated calcium channels in the central nervous system, which exhibits potent anticonvulsant, analgesic and anxiolytic activity. The pharmacological activity of pregabalin is similar to that of gabapentin and shows possible advantages. Although it shows analgesic efficacy against neuropathic pain, very limited evidence supports its postoperative analgesic efficacy. We investigated its analgesic efficacy in patients experiencing acute pain after abdominal hysterectomy and compared it with gabapentin and placebo. Methods: A randomized, double-blind, placebo-controlled study was conducted in 90 women undergoing abdominal hysterectomy who were anaesthetized in a standardized fashion. Patients received 300 mg pregabalin, 900 mg gabapentin or placebo, 1-2 hours prior to surgery. Postoperative analgesia was administered at visual analogue scale (VAS ≥3. The primary outcome was analgesic consumption over 24 hours and patients were followed for pain scores, time to rescue analgesia and side effects as secondary outcomes. Results: The diclofenac consumption was statistically significant between pregabalin and control groups, and gabapentin and control groups; however, pregabalin and gabapentin groups were comparable. Moreover, the consumption of tramadol was statistically significant among all the groups. Patients in pregabalin and gabapentin groups had lower pain scores in the initial hour of recovery. However, pain scores were subsequently similar in all the groups. Time to first request for analgesia was longer in pregabalin group followed by gabapentin and control groups. Conclusion: A single dose of 300 mg pregabalin given 1-2 hours prior to surgery is superior to 900 mg gabapentin and placebo after abdominal hysterectomy. Both the drugs are better than placebo.

  1. Outcome analysis of salvage radiotherapy for occult cervical cancer found after simple hysterectomy

    International Nuclear Information System (INIS)

    The objective was to analyze the outcomes of the patients, who received salvage radiotherapy for incidentally discovered cervical cancer following simple hysterectomy, and to identify the influence of intracavitary radiotherapy on treatment outcomes. Data from 117 patients with occult cervical cancer who underwent simple hysterectomy followed by salvage radiotherapy from September 1979 to November 2010 were collected. All the patients received external beam radiotherapy with (n=45) or without (n=72) intracavitary radiotherapy. Local control, disease-free survival, overall survival and treatment-related toxicity were investigated. The median follow-up time was 75 months. The 5- and 10-year local control/disease-free survival/overall survival rates were 93/87/87% and 90/84/83%, respectively. Among 98 patients who had no residual disease and negative resection margin on surgical specimens, 32 (33%) received intracavitary radiotherapy and 66 (67%) did not. There were no differences in patient and tumor characteristics between patients treated with and without intracavitary radiotherapy. The 5-year local control rate for the non-intracavitary radiotherapy group was 93 versus 94% for the intracavitary radiotherapy group (P=0.564); the disease-free survival rate was 88 versus 94% (P=0.894); the overall survival rate was 95 versus 85% (P=0.106), respectively. Among all patients, there were 5% of Grade 3 or higher late toxicities. Patients with occult invasive cervical cancer discovered following simple hysterectomy could be treated safely and effectively with salvage radiotherapy. For patients with no residual disease and negative resection margin, intracavitary radiotherapy could be omitted. (author)

  2. Uterine compression suture technique in the management of severe postpartum haemorrhage as an alternative to hysterectomy

    Directory of Open Access Journals (Sweden)

    Stanojević Dušan

    2009-01-01

    Full Text Available Introduction. One of the most dramatic conditions in obstetrics is definitely bleeding from the uterus which fails to compress. This condition is known as postpartum atony. When such a condition is diagnosed, the obstetrician has a choice of several conservative methods to stimulate the uterus to contract and several surgical methods to stop the bleeding. The most extreme measure used to save the patient's life and stop the bleeding is hysterectomy. This surgery is characterized by high morbidity, primarily by the loss of woman's fertility. In order to avoid hysterectomy, several authors have introduced the compressive uterine suture technique into gynaecological practice. Objective. The aim of the paper is to demonstrate the technique of applying compressive uterine suture after delivery to stop excessive bleeding, and to present results obtained by this technique. Methods. The paper explains the technique of applying compressive suture to the atonic uterus in cases when all other procedures to stop excessive bleeding after delivery fail. Since uterine atony is the main reason for excessive and uncontrollable bleeding after childbirth, the need to perform such surgery is rather common. Authors demonstrate the technique of applying four compressive sutures which prevent uterus dilation and thus stop the bleeding. Results. Compressive suture technique was used by the authors eight times, seven of which during caesarean section and one after spontaneous delivery. All patients had normal postpartum period and normal involution of the uterus. Conclusion. Although this surgery requires a skilful and experienced obstetrician, the authors find it rather easy to perform and it is suggested to be applied in all cases of uterine atony when excessive bleeding cannot be stopped by other any other method except hysterectomy. This surgical procedure saves the uterus and facilitates quick and easy patient's recovery.

  3. Risk factors for urinary retention after vaginal hysterectomy for pelvic organ prolapse

    Science.gov (United States)

    Chong, Chul; Kim, Hye Sung; Suh, Dong Hoon

    2016-01-01

    Objective To evaluate the risk factors for postoperative urinary retention in women who underwent vaginal hysterectomy for symptomatic pelvic organ prolapse. Methods The medical records of 221 women who underwent vaginal hysterectomy with anterior and posterior colporrhapy were reviewed. Urinary retention after catheter removal was defined as the presence of at least one of the following three conditions: 1) failure of first voiding trial necessitating catheterization, 2) first residual urine volume after self-voiding ≥150 mL, and 3) Foley catheter re-insertion. Results Urinary retention occurred in 60 women (27.1%). Multivariate and receiver operating characteristic curve analysis revealed that age (>63 years) and early postoperative day of catheter removal (day 1) was independent predictor for postoperative urinary retention. The incidence of urinary retention was significantly higher in women who removed indwelling catheter at day 1 (35.2%) than those at day 2 (12.0%, P=0.024), or day 3 (21.3%, P=0.044), but was similar to those at day 4 (25.0%, P=0.420). In women ≤63 years, urinary retention rate was not associated with the time of catheter removal after surgery; however, in women >63 years, the rate was significantly higher in day 1 removal group than day 2 to 4 removal group. Conclusion Age and postoperative day of catheter removal appear to be associated with postoperative urinary retention in women undergoing vaginal hysterectomy for pelvic organ prolapse. Keeping urinary catheter in situ at least for one day after vaginal prolapse surgery could be recommended, especially, in women older than 63 years. PMID:27004205

  4. Histopathology findings in patients presenting with menorrhagia: A study of 100 hysterectomy specimen

    Directory of Open Access Journals (Sweden)

    Nilima G Sawke

    2015-01-01

    Full Text Available Background: Menorrhagia, by definition, is heavy cyclical blood loss in excess of 80 ml/month of menstrual period lasting longer than 7 days. There are many possible causes of heavy menstrual bleeding which include hormonal imbalance, fibroids, miscarriage or ectopic pregnancy, nonhormonal intrauterine device, adenomyosis, pelvic inflammatory disease, and rarely uterine, ovarian, or cervical cancer. Treatment depends on the causes of the menorrhagia. Hysterectomy is one of the several surgical procedures as definitive treatment. Objective: To determine the histopathologic spectrum of lesions associated with menorrhagia in different age groups. Study Design: This prospective descriptive study was conducted at the Department of Pathology, People′s College of Medical Sciences and Research Centre, Bhopal. During the study period, 100 hysterectomy specimens were taken which were performed for the treatment of menorrhagia. Patients with menorrhagia in the age group of 30-50 years were selected after detailed history and fulfilling the inclusion criteria. Result: In our study, it was observed that maximum number of cases were in the age group of 41-50 years (n = 35 followed by the age group of 31-40 (n = 30. Out of 100 cases, 31% cases (n = 31 showed adenomyosis followed by leiomyomas 25% (n = 25, endometrial hyperplasia 23% (n = 23, and endometrial polyp 4% (n = 4. 11% cases (n = 11 showed dual pathology consisting of both adenomyosis and endometrial hyperplasia and 6% cases (n = 6 of leiomyoma with adenomyosis. Conclusion: Uterine adenomyosis and leiomyoma are the most common benign conditions found in hysterectomy specimens with peak incidence at 31-50 years. Patients having menorrhagia above 40 years should be screened for any endometrial pathology. Histopathology is mandatory for confirming diagnosis and the key to effective therapy and optimal outcome.

  5. Costs and effects of abdominal versus laparoscopic hysterectomy: systematic review of controlled trials.

    Directory of Open Access Journals (Sweden)

    Claudia B M Bijen

    Full Text Available OBJECTIVE: Comparative evaluation of costs and effects of laparoscopic hysterectomy (LH and abdominal hysterectomy (AH. DATA SOURCES: Controlled trials from Cochrane Central register of controlled trials, Medline, Embase and prospective trial registers. SELECTION OF STUDIES: Twelve (randomized controlled studies including the search terms costs, laparoscopy, laparotomy and hysterectomy were identified. METHODS: The type of cost analysis, perspective of cost analyses and separate cost components were assessed. The direct and indirect costs were extracted from the original studies. For the cost estimation, hospital stay and procedure costs were selected as most important cost drivers. As main outcome the major complication rate was taken. FINDINGS: Analysis was performed on 2226 patients, of which 1013 (45.5% in the LH group and 1213 (54.5% in the AH group. Five studies scored > or =10 points (out of 19 for methodological quality. The reported total direct costs in the LH group ($63,997 were 6.1% higher than the AH group ($60,114. The reported total indirect costs of the LH group ($1,609 were half of the total indirect in the AH group ($3,139. The estimated mean major complication rate in the LH group (14.3% was lower than in the AH group (15.9%. The estimated total costs in the LH group were $3,884 versus $3,312 in the AH group. The incremental costs for reducing one patient with major complication(s in the LH group compared to the AH group was $35,750. CONCLUSIONS: The shorter hospital stay in the LH group compensates for the increased procedure costs, with less morbidity. LH points in the direction of cost effectiveness, however further research is warranted with a broader costs perspective including long term effects as societal benefit, quality of life and survival.

  6. Phase-in, abandonment, and cost disallowances

    International Nuclear Information System (INIS)

    The major regulatory challenge to the electric utility industry appears to be coming from the financial side with its bookkeeping and financial reporting requirements. The author describes the accounting procedures and problems associated with straightforward phase-in rate treatment, abandonment, excess capacity, cost allowances, etc. She concludes that the available options to the Financial Accounting Standards Board are to adopt either the proposed exposure draft or a modification of the draft, to drop the proposed draft of amendments to Statement No. 71, or issue a whole new exposure draft

  7. Should executive stock options be abandoned?

    OpenAIRE

    Choe, Chongwoo; Yin, Xiangkang

    2006-01-01

    Recent corporate scandals around the world have led many to single out executive stock options as one of the main culprits. More corporations are abandoning stock options and reverting to restricted stock. This paper argues that such a change is not entirely justifiable. We first provide a critical review of the pros and cons of executive stock options. We then compare option-based contracts with stock-based contracts using a simple principal-agent model with moral-hazard. In a general enviro...

  8. Mercury distribution in an abandoned metallurgical plant

    OpenAIRE

    Millán R.; Sierra M. J.; Schmid T.; Carrasco Gil S.; Sánchez Ledesma D. M.; Díaz Puent F. J.

    2013-01-01

    The aim of the work is to evaluate the spatial distribution of Hg in the soil-plant system within an area where intense activity of Hg was dominant over a long period. An abandoned metallurgical plant from the 17th-18th centuries was chosen as the study area. It is situated in Almadenejos within the Almadén mining district (Spain) that constitutes the largest and most unusual concentration of mercury in the world and has provided a third of the entire world production of mercury (Hg). Nowaday...

  9. Transmural penetration of sigmoid colon and rectum by retained surgical sponge after hysterectomy.

    Science.gov (United States)

    Shin, Woo Young; Im, Chan Hyuk; Choi, Sun Keun; Choe, Yun-Mee; Kim, Kyung Rae

    2016-03-14

    Gossypiboma is a surgical sponge that is retained in the body after the operation. A 39-year-old female presented with vague lower abdominal pain, fever, and rectal discharge 15 mo after hysterectomy. The sponge remaining in the abdomen had no radiopaque marker. Therefore a series of radiographic evaluations was fruitless. The surgical sponge was found in the rectosigmoid colon on colonoscopy. The sponge penetrated the sigmoid colon and rectum transmurally, forming an opening on both sides. The patient underwent low anterior resection and was discharged without postoperative complications. PMID:26973401

  10. INTERNAL ILIAC ARTERY LIGATION AFTER CAESERIAN HYSTERECTOMY IN POST - PARTUM HAEMORRHAGE LIFE SAVING PROCEDURE

    Directory of Open Access Journals (Sweden)

    Vijayalakshmi

    2015-07-01

    Full Text Available Internal iliac artery (Hypogastric supplies the pelvic viscera. Bilateral ligation of the internal iliac arteries is a safe, rapid and very effective method of controlling bleeding from genital tract. It is also helpful in massive broad ligament hematoma, in torn vessels retracted within th e broad ligament, and even in postoperative hemorrhage after abdominal or vaginal hysterectomy where there are no definitive bleeding points detectable. Bilateral ligation of internal iliac arteries is also helpful in life threatening hemorrhagic condition s like postpartum hemorrhage, placenta previa, cervical and vaginal tear, cervical pregnancy and uterine rupture etc.

  11. URETER INJURY PRESENTIN G AS ASCITES AFTER HYSTERECTOMY: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Venugopalan

    2015-04-01

    Full Text Available Urinary bladder injury or injury to ureter is a recognized complication of lower abdominal surgery and it is the most common organ injured during gynecological procedures. We report here, history of a 48 year old female developing ascites and respiratory distress on 3 rd postoperative day of abdominal hysterectomy for fibroid ut e rus. Ultrasound guided abdominal tap showed urine. Computed tomography of abdomen revealed double ureter and injury to one of the left ureters. It was re implanted and bladder site repaired throug h emergency lap a rotomy. The key to the diagnosis of ureter injury is awareness of this clinical entity.

  12. Anaesthetic management of a patient with Liddle's syndrome for emergency caesarean hysterectomy.

    LENUS (Irish Health Repository)

    Hayes, N E

    2011-04-01

    We describe the anaesthetic management of a patient with Liddle\\'s syndrome during caesarean section and emergency hysterectomy for placenta accreta associated with significant intrapartum haemorrhage. Liddle\\'s syndrome is a rare autosomal dominant disorder characterised by early onset arterial hypertension and hypokalaemic metabolic alkalosis. Additional issues were the presence of short stature, limb hypertonicity and preeclampsia. Initial management with a low-dose combined spinal-epidural technique was subsequently converted to general anaesthesia due to patient discomfort. The management of Liddle\\'s syndrome in the setting of neuraxial and general anaesthesia in a patient undergoing caesarean section is discussed.

  13. Anaesthetic management of a patient with Liddle's syndrome for emergency caesarean hysterectomy.

    LENUS (Irish Health Repository)

    Hayes, N E

    2012-02-01

    We describe the anaesthetic management of a patient with Liddle\\'s syndrome during caesarean section and emergency hysterectomy for placenta accreta associated with significant intrapartum haemorrhage. Liddle\\'s syndrome is a rare autosomal dominant disorder characterised by early onset arterial hypertension and hypokalaemic metabolic alkalosis. Additional issues were the presence of short stature, limb hypertonicity and preeclampsia. Initial management with a low-dose combined spinal-epidural technique was subsequently converted to general anaesthesia due to patient discomfort. The management of Liddle\\'s syndrome in the setting of neuraxial and general anaesthesia in a patient undergoing caesarean section is discussed.

  14. The effect of a preoperative single-dose methylprednisolone on postoperative pain after abdominal hysterectomy:

    DEFF Research Database (Denmark)

    Aabakke, Anna J M; Holst, Lars B; Jørgensen, Jørgen C;

    2014-01-01

    OBJECTIVE: Methylprednisolone has been shown to have analgesic effects after orthopedic surgery. The objective of this trial was to compare the effect of 125 mg methylprednisolone with placebo on postoperative pain after abdominal hysterectomy. STUDY DESIGN: In this randomized double-blinded...... models. RESULTS: Forty-nine cases were analyzed (methylprednisolone n=25, placebo n=24). Pain scores were significantly higher in the methylprednisolone group compared to the placebo group during mobilization (0.79 [95% confidence intervals (CI) 0.07-1.50] P=0.03) but not at rest (0.55 [95% CI: -0...

  15. Perioperative use of etoricoxib reduces pain and opioid side-effects after total abdominal hysterectomy

    DEFF Research Database (Denmark)

    Viscusi, Eugene R; Frenkl, Tara L; Hartrick, Craig T;

    2012-01-01

    Abstract Objective: To evaluate the effects of two different doses of etoricoxib delivered perioperatively compared with placebo and standard pain management on pain at rest, pain with mobilization, and use of additional morphine/opioids postoperatively. Research design and methods: In this double...... as primary endpoints. Conclusion: In patients undergoing total abdominal hysterectomy, etoricoxib 90 and 120 mg dosed preoperatively and then continued postoperatively significantly reduces both resting and movement-related pain, as well as reduced opioid (morphine) consumption that led to more rapid bowel...

  16. Combined epidural-spinal opioid-free anaesthesia and analgesia for hysterectomy

    DEFF Research Database (Denmark)

    Callesen, T; Schouenborg, Lars Øland; Nielsen, D;

    1999-01-01

    Postoperative nausea and vomiting (PONV) are major problems after gynaecological surgery. We studied 40 patients undergoing total abdominal hysterectomy, allocated randomly to receive opioid-free epidural-spinal anaesthesia or general anaesthesia with continuous epidural bupivacaine 15 mg h-1...... or continuous bupivacaine 10 mg h-1 with epidural morphine 0.2 mg h-1, respectively, for postoperative analgesia. Nausea, vomiting, pain and bowel function were scored on 4-point scales for 3 days. Patients undergoing general anaesthesia had significantly higher nausea and vomiting scores (P ....01) but significantly lower pain scores during rest (P anaesthesia received antiemetics (13 vs five; P epidural-spinal anaesthesia...

  17. Radical chemistry of artemisinin

    Energy Technology Data Exchange (ETDEWEB)

    Denisov, Evgenii T; Solodova, S L; Denisova, Taisa G [Institute of Problems of Chemical Physics, Russian Academy of Sciences, Chernogolovka, Moscow Region (Russian Federation)

    2010-12-29

    The review summarizes physicochemical characteristics of the natural sesquiterpene peroxide artemisinin. The kinetic schemes of transformations of artemisinin radicals under anaerobic conditions are presented and analyzed. The sequence of radical reactions of artemisinin in the presence of oxygen is considered in detail. Special emphasis is given to the intramolecular chain oxidation resulting in the transformation of artemisinin into polyatomic hydroperoxide. The kinetic characteristics of elementary reaction steps involving alkyl, alkoxyl, and peroxyl radicals generated from artemisinin are discussed. The results of testing of artemisinin and its derivatives for the antimalarial activity and the scheme of the biochemical synthesis of artemisinin in nature are considered.

  18. Radical cystectomy in eldery

    OpenAIRE

    Bančević Vladimir; Aleksić Predrag; Milović Novak; Spasić Aleksandar; Kovačević Božidar; Toševski Perica; Čampara Zoran; Milošević Radovan; Cerović Snežana

    2015-01-01

    Background/Aim. Radical cystectomy is the method of choice for the treatment of muscle invasive bladder cancer. This major surgery is associated with many complications, especially in older patients. The aim of this study was to analyze preoperative comorbidity, and intraoperative and postoperative complicatons in patients older than 75 years. Methods. This clinical, retrospective study included 46 patients over 75 years, who underwent radical cystectomy. I...

  19. Abdominal Radical Trachelectomy

    OpenAIRE

    Căpîlna, Mihai Emil; Ioanid, Nicolae; Scripcariu, Viorel; Gavrilescu, Madalina Mihaela; Szabo, Bela

    2014-01-01

    Objective Abdominal radical trachelectomy (ART) is one of the fertility-sparing procedures in women with early-stage cervical cancer. The published results of ART, in comparison with vaginal radical trachelectomy, so far are limited. Materials and Methods This retrospective study comprises all cases of female patients referred to ART with early-stage cervical cancer from 2 gynecologic oncology centers in Romania. Results A total of 29 women were referred for ART, but subsequently, fertility c...

  20. Histerectomias: estudo retrospectivo de 554 casos Hysterectomies: a retrospective study of 554 cases

    Directory of Open Access Journals (Sweden)

    Eddie Fernando Cândido Murta

    2000-10-01

    Full Text Available OBJETIVO: A histerectomia é uma operação muito realizada, entretanto há poucos trabalhos na literatura nacional sobre suas indicações, técnica e complicações. O objetivo deste trabalho é avaliar estes procedimentos realizados na Disciplina de Ginecologia e Obstetrícia da Faculdade de Medicina do Triângulo Mineiro. MÉTODO: Estudo retrospectivo de 470 histerectomias abdominais e 84 vaginais foi conduzido analisando as indicações, tempo de cirurgia e internação, tipo de incisão e morbidez. RESULTADOS: As principais indicações foram o mioma uterino e o prolapso uterino para as histerectomias abdominais e vaginais, respectivamente. As complicações intra-operatórias aconteceram em 3,4% e as pós-operatórias em 2,4% do total de casos. Nenhuma diferença estatística foi encontrada no número de complicações em relação ao tipo de incisão (vertical ou transversal. O tempo de cirurgia e o de hospitalização foram estatisticamente maiores nas incisões verticais. A hemorragia foi a mais freqüente complicação intra-operatória e a infecção da incisão operatória foi a mais freqüente no pós-operatório. CONCLUSÕES: A histerectomia é um procedimento de baixo risco, no entanto, a realização de revisões sobre indicações e complicações, e a pesquisa de melhores técnicas cirúrgicas são necessárias para torná-la cada vez mais segura.OBJECTIVE: Hysterectomy is a frequently performed surgery, but national literature gives limited information regarding indications, technique and complications. The aim of this study is to evaluate our results with this operation performed by the Discipline of Gynecology and Obstetrics of the Faculty of Medicine of "Triângulo Mineiro". METHODS: A retrospective study of 470 abdominal and 84 vaginal hysterectomies was conducted in which the indications, operation time, abdominal approach, hospitalization time, and morbidity were analyzed. RESULTS: Uterine myoma and uterine prolapse

  1. 49 CFR 195.59 - Abandonment or deactivation of facilities.

    Science.gov (United States)

    2010-10-01

    ... operator of that facility must file a report upon abandonment of that facility. (a) The preferred method to... System (NPMS) in accordance with the NPMS “Standards for Pipeline and Liquefied Natural Gas Operator... the NPMS-required attributes, operators must submit the date of abandonment, diameter, method...

  2. Incidence and Treatment Abandonment in Teen And Young Adult Cancers

    Directory of Open Access Journals (Sweden)

    Prakash Chitalkar

    2016-03-01

    Results- On analyzing data of three years ,hematolymphoid malignancy(28% cases are the most common cases seen followed by Breast (10% and head and neck (10%,cervix(6%,CNS(5% ,Bone( 4%. 38% TYA cancer patients abandoned treatment . Telephonic tracking, financial support, counseling of whole family are methods employed in reducing abandonment. [Natl J Med Res 2016; 6(1.000: 77-79

  3. Free Radical Reactions in Food.

    Science.gov (United States)

    Taub, Irwin A.

    1984-01-01

    Discusses reactions of free radicals that determine the chemistry of many fresh, processed, and stored foods. Focuses on reactions involving ascorbic acid, myoglobin, and palmitate radicals as representative radicals derived from a vitamin, metallo-protein, and saturated lipid. Basic concepts related to free radical structure, formation, and…

  4. THE ESTIMATION OF DIMENSION AND FACTORS OF SCHOOL ABANDON

    Directory of Open Access Journals (Sweden)

    Andreea Iluzia IACOB

    2011-12-01

    Full Text Available During the transition period, in Romania, the dimension of school abandon had risen. The main goals of the study are: to estimate the school abandon rate by each educational level in Romania, to identify the factors which affect school abandon on urban and rural areas and at development regions level; to analyze the causes of earlier school abandon. In the same time, the analysis had also followed the temporal component, by including in the database the last decade statistical information. The school abandon was measured as the difference between the numbers of pupils/students found at the end of the school year and the same category enrolled at the beginning of the same year.

  5. Meanings of Consumption and Abandonment: Understanding Smoking Cessation Symbolism

    Directory of Open Access Journals (Sweden)

    Maribel Carvalho Suarez

    2014-04-01

    Full Text Available In consumption studies, very little attention has been focused on investigating abandonment and, more specifically, its symbolic dimension. The present study aims to investigate how meanings are created and negotiated through the abandonment of cigarettes. This study used a qualitative methodology to collect and analyze the data generated by one-on-one semi-structured in-depth interviews with 15 Brazilian ex-smokers. Results suggest that abandonment of cigarettes can be offered as a connection, gift, or sacrifice that makes relations special and even magical. As regards abandonment, the present study evidences the interactions and movements of positive and negative meanings related to the consumption and non-consumption of a category. The study proposes a framework that highlights the cooling, decontamination, reinforcement and defensive symbolical movements, thus constructing a tool for analyzing abandonment, offering possible paths of intervention for organizations that are interested in this issue.

  6. Heavy metals biogeochemistry in abandoned mining areas

    Directory of Open Access Journals (Sweden)

    Favas P. J. C.

    2013-04-01

    Full Text Available Plants growing on the abandoned Portuguese mines, highly contaminated with W, Sn, As, Cd, Cu, Zn and Pb, have been studied for their biogeochemical indication/prospecting and mine restoration potential. The results of analysis show that the species best suited for biogeochemical indicating are: aerial tissues of Halimium umbellatum (L. Spach, for As and W; leaves of Erica arborea L. for Bi, Sn, W and mostly Pb; stems of Erica arborea L. for Pb; needles of Pinus pinaster Aiton and aerial tissues of Pteridium aquilinum (L. Kuhn for W; and leaves of Quercus faginea Lam. for Sn. The aquatic plant studied (Ranunculus peltatus Schrank can be used to decrease the heavy metals, and arsenic amounts into the aquatic environment affected by acid mine drainages.

  7. A 12-year cavern abandonment test

    Directory of Open Access Journals (Sweden)

    Brouard B.

    2010-06-01

    Full Text Available In 1997-1998, an abandonment test was performed in a 950-m deep, 8000-m3 salt cavern operated by GDF SUEZ at Etrez, France. In this relatively small brine-filled cavern, which had been kept idle for 15 years before the test, thermal equilibrium was reached. A special system was designed to monitor leaks, which proved to be exceedingly small. In these conditions, brine permeation and cavern creep closure are the only factors to play significant roles in pressure evolution. This test strongly suggested that obtaining an equilibrium pressure such that the effects of these two factors were exactly equal would be reached in the long term. Four years later, pressure monitoring in the closed cavern resumed. Pressure evolution during the 2002-2009 period confirmed that cavern brine pressure will remain constant and significantly smaller than geostatic pressure in the long term, precluding any risk of fracturing and brine seepage to the overburden layers.

  8. The role of interventional radiology in reducing haemorrhage and hysterectomy following caesarean section for morbidly adherent placenta

    International Nuclear Information System (INIS)

    Aim: To report experience of prophylactic occlusion balloon catheters (POBCs) in both internal iliac arteries before caesarean section, with or without embolization, to preserve the uterus and reduce haemorrhage. Methods and materials: Twenty-seven women diagnosed with morbidly adherent placenta (MAP) and with suspected placenta percreta underwent POBC placement before caesarean section. The balloons were inflated immediately after delivery of the baby. The patients' case notes were reviewed retrospectively for histological grading of MAP, blood loss, transfusion, requirement of uterine artery embolization (UAE), or hysterectomy, radiation dose, and infant or maternal morbidity and mortality. Results: MAP was confirmed histologically as percreta in 17, accreta in eight, and increta in two women. Mean blood loss was 1.92 l (range 0.5–12 l). Postpartum haemorrhage (PPH) occurred in nine patients. Eight were referred for UAE, which was successful in six. Immediate peri-partum hysterectomy was performed in one patient. Three women in total required hysterectomy, two after recurrent haemorrhage after UAE. No foetal morbidity or mortality occurred. No maternal mortality occurred. There was one case of iliac artery thrombosis, which resolved with conservative therapy. Conclusion: POBC, with or without UAE, contributes to reduction of blood loss and preservation of the uterus in women with MAP. - Highlights: • Management of morbidly adherent placenta requires a multidisciplinary team approach. • Prophylactic occlusion balloon catheters reduce blood loss and help avoid hysterectomy. • Protocols ensure correct management of placenta percreta patients and minimise risk

  9. Trocar-guided total tension-free vaginal mesh repair of post-hysterectomy vaginal vault prolapse.

    NARCIS (Netherlands)

    Milani, A.L.; Withagen, M.I.J.; Vierhout, M.E.

    2009-01-01

    INTRODUCTION AND HYPOTHESIS: The objective of this study was to report 1 year anatomical and functional outcomes of trocar-guided total tension-free vaginal mesh (Prolift) repair for post-hysterectomy vaginal vault prolapse with one continuous piece of polypropylene mesh. METHODS: We conducted a pro

  10. The effect of menopause and hysterectomy on systemic vascular endothelial growth factor in women undergoing surgery for breast cancer

    International Nuclear Information System (INIS)

    Vascular endothelial growth factor (VEGF) is a potent angiogenic cytokine produced physiologically by the uterus. Pathological secretion by tumours promotes growth and metastasis. High circulating VEGF levels potentially have a deleterious effect on breast cancer by promoting disease progression. The aims of this study were to investigate circulating VEGF levels in breast cancer patients and assess the effect of menopause or hysterectomy on systemic VEGF. Patients undergoing primary surgery for breast cancer and controls matched for age, menopausal and hysterectomy status were prospectively recruited. Serum VEGF, FSH, LH, estrogen, progesterone and platelet levels were measured. Serum VEGF was corrected for platelet load (sVEGFp) to provide a biologically relevant measurement of circulating VEGF. SVEGFp levels were analyzed with respect to tumor characteristics, menopausal status and hysterectomy status. Two hundred women were included in the study; 89 breast cancer patients and 111 controls. SVEGFp levels were significantly higher in breast cancer patients compared to controls (p = 0.0001), but were not associated with clinico-pathological tumor characteristics. Systemic VEGF levels reduced significantly in the breast cancer patients following tumor excision (p = 0.018). The highest systemic VEGF levels were observed in postmenopausal breast cancer patients. Postmenopausal women who had had a previous hysterectomy had significantly higher VEGF levels than those with an intact postmenopausal uterus (p = 0.001). This study identifies an intact postmenopausal uterus as a potential means of reducing circulating levels of VEGF which could confer a protective effect against breast cancer metastatic potential

  11. Transfusion rate and prevalence of unexpected red blood cell alloantibodies in women undergoing hysterectomy for benign disease

    DEFF Research Database (Denmark)

    Thoestesen, Lisbeth M; Rasmussen, Kjeld L; Lauszus, Finn F;

    2011-01-01

    To determine transfusion rates, risk factors for transfusion and the prevalence of unexpected red blood cell alloantibodies in women undergoing hysterectomy for benign disease. In addition, we aimed to evaluate the necessity of the pretransfusion testing for red blood cell alloantibodies....

  12. Absent organs—Present selves: Exploring embodiment and gender identity in young Norwegian women's accounts of hysterectomy

    Directory of Open Access Journals (Sweden)

    Kari Nyheim Solbrække

    2015-04-01

    Full Text Available In this paper, we explore how younger women in Norway construct their embodiment and sense of self after hysterectomy. To do this, we conducted in-depth interviews with eight ethnic Norwegian women aged between 25 and 43 who had undergone hysterectomy. In line with a broad phenomenological approach to illness, the study was designed to explore the trajectories of the women's illness with a specific focus on concrete human experience and identity claims from a subjective point of view. In analysing the stories, we encountered feelings of suffering due to the loss of the uterus as well as profound side-effects, such as menopause. However, we also found evidence of relief from being treated for heavy bleeding and serious illness. In order to accentuate the individual voices in these illness stories, we chose a case-oriented analysis in line with Radley and Chamberlain (2001 and Riessman (2008. From this, two main seemingly contradictory storylines stood out: They have removed what made me a woman versus Without a uterus, I feel more like a woman. We also identified heteronormativity as an unstated issue in both these storylines and in the research data as a whole. Acknowledging diversity in the way women experience hysterectomy is important for a better understanding of the ways in which hysterectomy may affect women as humans as well as for developing more cultural competent healthcare services for this group.

  13. Timing of heparin prophylaxis and bleeding complications in hysterectomy a nationwide prospective cohort study of 9,949 Danish women

    DEFF Research Database (Denmark)

    Hansen, Charlotte T; Kehlet, Henrik; Møller, Charlotte;

    2008-01-01

    's experience, route and type of hysterectomy and additional surgery, and stratification on assistant's experience, peri-operative pain prophylaxis with NSAID and daily use of Acetyl Salicylic Acid (ASA)/NSAID. RESULTS: 9,051 women (92%) received thromboprophylaxis with heparin, initiated pre-operatively in 48...

  14. Abandoning pipelines working group regulatory issues

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-03-01

    The history of hydrocarbon development in Louisiana and off its coast is one of the interdependence of technological innovation, entrepreneurial risk-taking, resource management, judicial decisions, legislation, marketing, employee good will, infrastructure and support services, coupled with favorable geologic structures that made early exploration and development relatively easy. Mariners sailing off the coast of Louisiana and Texas in the 1600`s recorded one of the earliest known natural oil seeps. They shrugged it off as unimportant, as there was no market for the substance they witnessed. The seepage, however, provided a tiny clue to the vast storehouse of hydrocarbons trapped in the earth`s crust extending from the uplands, through Louisiana`s swamps and marshes, and into the subaqueous habitats of the Gulf of Mexico-the world`s ninth largest body of water. In all cases, each move into a new geographic province required considerable change in operation philosophy and in the science supporting the exploration and development activity. As technology changed, or was developed to meet the industry`s needs, new frontiers were explored. However, with time-as is the case with any nonrenewable resource-fields and wells lost their productive life. They had to be abandoned. In fact, the Minerals Management Service suggests that within the next 10 years the offshore industry will remove 150 platforms per year, or nearly half of the current number of production units. The industry will be asked to dispose of nearly one unit every 2.4 days. If this is the case, abandonment issues are going to continue to surface.

  15. Interval Between Hysterectomy and Start of Radiation Treatment Is Predictive of Recurrence in Patients With Endometrial Carcinoma

    International Nuclear Information System (INIS)

    Purpose: Adjuvant radiation therapy (RT) has been shown to improve local control in patients with endometrial carcinoma. We analyzed the impact of the time interval between hysterectomy and RT initiation in patients with endometrial carcinoma. Methods and Materials: In this institutional review board-approved study, we identified 308 patients with endometrial carcinoma who received adjuvant RT after hysterectomy. All patients had undergone hysterectomy, oophorectomy, and pelvic and para-aortic lymph node evaluation from 1988 to 2010. Patients' demographics, pathologic features, and treatments were compared. The time interval between hysterectomy and the start of RT was calculated. The effects of time interval on recurrence-free (RFS), disease-specific (DSS), and overall survival (OS) were calculated. Following univariate analysis, multivariate modeling was performed. Results: The median age and follow-up for the study cohort was 65 years and 72 months, respectively. Eighty-five percent of the patients had endometrioid carcinoma. RT was delivered with high-dose-rate brachytherapy alone (29%), pelvic RT alone (20%), or both (51%). Median time interval to start RT was 42 days (range, 21-130 days). A total of 269 patients (74%) started their RT <9 weeks after undergoing hysterectomy (group 1) and 26% started ≥9 weeks after surgery (group 2). There were a total of 43 recurrences. Tumor recurrence was significantly associated with treatment delay of ≥9 weeks, with 5-year RFS of 90% for group 1 compared to only 39% for group 2 (P<.001). On multivariate analysis, RT delay of ≥9 weeks (P<.001), presence of lymphovascular space involvement (P=.001), and higher International Federation of Gynecology and Obstetrics grade (P=.012) were independent predictors of recurrence. In addition, RT delay of ≥9 weeks was an independent significant predictor for worse DSS and OS (P=.001 and P=.01, respectively). Conclusions: Delay in administering adjuvant RT after

  16. Sexuality Following Radical Prostatectomy

    DEFF Research Database (Denmark)

    Fode, Mikkel; Serefoglu, Ege C; Albersen, Maarten;

    2016-01-01

    INTRODUCTION: Radical prostatectomies can result in urinary incontinence and sexual dysfunction. Traditionally, these issues have been studied separately, and the sexual problem that has received the most focus has been erectile dysfunction. AIM: To summarize the literature on sexually related side...... effects and their consequences after radical prostatectomy and focus on the occurrence and management of problems beyond erectile dysfunction. METHODS: The literature on sexuality after radical prostatectomy was reviewed through a Medline search. Original research using quantitative and qualitative...... methodologies was considered. Priority was given to studies exploring aspects of sexuality other than erectile function. MAIN OUTCOME MEASURES: The prevalence, predictive factors, and management of post-prostatectomy sexual problems beyond erectile dysfunction. RESULTS: Most patients will develop urinary...

  17. Gangs, Terrorism, and Radicalization

    Directory of Open Access Journals (Sweden)

    Scott Decker

    2011-01-01

    Full Text Available What can street gangs tell us about radicalization and extremist groups? At first glance, these two groups seem to push the boundaries of comparison. In this article, we examine the important similarities and differences across criminal, deviant, and extremist groups. Drawing from research on street gangs, this article explores issues such as levels of explanation,organizational structure, group process, and the increasingly important role of technology and the Internet in the context of radicalization. There are points of convergence across these groups, but it is important to understand the differences between these groups. This review finds little evidence to support the contention that American street gangs are becoming increasingly radicalized. This conclusion is based largely on organizational differences between gangs and terror groups.

  18. Adnexectomy Versus Ovarian Conservation During Total Hysterectomy for Benign Conditions. A Difficult Dilemma

    Directory of Open Access Journals (Sweden)

    Ion Păun

    2014-09-01

    Full Text Available Introduction: Bilateral adnexectomy is a surgical procedure that is frequently associated with total hysterectomy performed for benign uterine conditions. Given the relatively wide range of indications for the aforementioned type of salpingo-ooforectomy which in it self is not devoid of potential risks the patients' and physicians' decision-making should take into account several parameters (most helpful to individualize treatment such as published ratio of removal versus conservation of uterine adnexae, patients' age, pre/postmenopausal status at the time of surgery, relevant family and personal history including current use of hormonal replacement therapy. Material and Method: This retrospective cohort study was conducted among 457 women aged 18 years or older who underwent abdominal total hysterectomies for benign uterine conditions between 2000 and 2011. The study patients were stratified by age for better characterization and according to recent publications. Results: Uni- or bilateral oophorectomy was performed in 50% of the subgroup of hysterectomized women younger than 35 years old whereas in the other half of the same age category of patients the uterine adnexas were conserved. Among the study patients aged between 35 and 45 years in 50.5% of the cases the unilateral type of oophorectomy was undertaken while for the other 49.5% of women the bilateral adnexectomy was the rule. Finally, in all patients older than age 45 years the bilateral salpingo-oophorectomy was the procedure of choice. Moreover, out of the 55 study patients in which at least one ovary was preserved, 30.9% of cases underwent the removal of the remaining adnexa when affected de novo by malignant (n=3 or benign (n=14 pathology. Last but not least, in order to reduce both cancer risks and early menopause hazards, our analysis based on recent literature attempted to identify patient characteristics (relevant factors associated with or without bilateral oophorectomy at the

  19. LigaSure versus Conventional Suture Ligature for Vaginal Hysterectomy: a Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Mohamed Abd Elzaher, a, b, Ashraf Moawad, a, c and Hanaa Abu-Ria

    2011-07-01

    Full Text Available Introduction: Vaginal hysterectomy is considered to be the method of choice for removal of the uterus. Of particular concern for the vaginal surgeon is the ability to access, visualize, and legate structures while maintaining adequate hemostasis. Surgical hemostasis can be secured by a variety of methods, including mechanical means (sutures or vessel coagulation (diathermy. Electro-surgical vessel sealing (LigaSure is a new hemostatic system based on the combination of pressure and bipolar electrical energy and is able to seal vessels up to 7 mm in diameter. Objective: To assess the safety and efficacy of using the LigaSure vessel sealing system for securing the pedicles during vaginal hysterectomy in comparison with the conventional method of securing the pedicles by suture ligation. Design: Prospective randomized controlled trial. Setting: Obstetrics and Gynecology departments (Al-Kharj University Hospital- KSA, Enjab Hospital - UAE and Gulf Medical College and Research Centre- UAE. Methods: 80 patients undergoing vaginal hysterectomy for benign conditions were randomized to either LigaSure group (n=40 or Suture group (n=40. Main outcome measures: The primary outcome measures were the operative time and blood loss while the secondary outcome measures were the hospital stay and intra- and post-operative complications. Results: Patients in the LigaSure group had a significantly reduced operating time (37.1 ± 8.9 min vs. 63.8 ± 10.9 min; P < 0.001, operative blood loss (125.5 ± 33.2 mL vs. 264.6 ± 70.4 mL; P < 0.001, requirement of surgical sutures(1.2 ± 0.4 units vs. 8.2 ± 0.4 units; p < 0.001, pain status (2.0 ± 0.6 vs. 3.7 ± 0.7; P < 0.001, and hospital stay (30.3 ± 2.5 h vs. 45.7 ±10.5 h; P < 0.001 compared to the control group. The overall complication rate in the study was 10 % (8/80, and did not differ between patients of the LigaSure and control group. Conclusion: The use of LigaSure device can reduce operative time. It allows

  20. Pharma TARP: A Troubled Asset Relief Program for Novel, Abandoned Projects in the Pharmaceutical Industry

    Directory of Open Access Journals (Sweden)

    Tamas Bartfai

    2011-01-01

    Full Text Available Within days of each other, Pfizer, Merck, and GlaxoSmithKline announced that they will focus on a few therapeutic areas only and abandon others entirely. Pfizer alone will close well over a hundred drug development projects that have reached two-thirds of the way to launch. The programs are deemed to be too risky and not lucrative enough for Big Pharma in the current climate. Society has a real need for the drugs that are no longer going to be developed for, among others, drug-resistant epilepsy, neuropathic and cancer pain, type-2 diabetes, obesity, and schizophrenia. The authors propose a radical response by the U.S. government and the National Institutes of Health to rescue these abandoned projects, and to continue selected programs for drug approval by the U.S. Food and Drug Administration and the European Medicines Agency. The investment required is small compared to the Troubled Asset Relief Program bank bail out, but the return on investment in financial terms and in satisfying societal needs makes this proposal attractive.

  1. Transfer Out Patient Not Abandon The Patient

    Directory of Open Access Journals (Sweden)

    Deepak Gupta

    2015-12-01

    Full Text Available Physician-patient relationship is unique in some aspects and not-so-unique in other aspects when compared to other human interactions. Until-unless for the sake of health promotional activities, this relationship is almost always conceived in the times of human sufferings and consequently culminated when those sufferings have subsided as well as sought out happiness has ensued/been achieved. However, not all physician-patient relationships follow the normal course and/or meet the natural ends. These abnormal relationships are not inconsequential in terms of numbers and/or their effects (short-term and long term on both patients and physicians. Every country has its own baggage in the wake of why, how and what about these abnormal ends to physician-patient relationships; however, the most common causes are the patients’ inability to pay their medical bills, the conflicting goals of physicians and their patients in regards to patients’ sufferings’ management and finally the behavioral issues (patients’ and/or physicians’ interfering these relationships. Irrespective of any cause, the physicians should never forget that the patient can always discharge their physicians and discontinue their relationship with their physicians without any reason (until unless the physicians deem those patients either incapable/non-consentable to do so and/or potential threat to their own personal safety or other people’s safety. Contrarily, physicians can also discharge patients from their care but cannot abandon these patients (1-3 which mean that physicians have to ensure their discharged patients either are referred to or have sought another physician within appropriate time frame post-relationship-discontinuation. Each country has their own medico-legal liabilities that vary in terms of penalties imposed; however, irrespective of the feared legal concerns, the physicians should not forget that ethical essence of medicine is the art of healing that

  2. Robotic-assisted laparoscopic hysterectomy seems safe in women with early-stage endometrial cancer

    DEFF Research Database (Denmark)

    Herling, Suzanne Forsyth; Havemann, Maria Cecilie; Palle, Connie;

    2015-01-01

    INTRODUCTION: Robotic surgery is increasingly used in the management of endometrial cancer; and although it is known that minimally invasive surgery reduces post-operative morbidity, the outcomes of this novel treatment should be monitored carefully. The aim of this study was to examine...... the incidence of complications according to the Clavien-Dindo scale after robotic-assisted laparoscopic hysterectomy (RALH) for early-stage endometrial cancer and atypical complex hyperplasia. The Clavien-Dindo scale grades the severity of complications. METHODS: This was a retrospective, descriptive cohort...... study of 235 women with endometrial cancer or atypical complex hyperplasia who had RALH. Surgeries were stratified into two groups: with or without pelvic lymphadenectomy. RESULTS: A total of 6% developed a grade 3 or higher complication with no significant difference (p = 0.24) between the groups...

  3. Postoperative shoulder pain after laparoscopic hysterectomy with deep neuromuscular blockade and low-pressure pneumoperitoneum

    DEFF Research Database (Denmark)

    Madsen, Matias V; Istre, Olav; Staehr-Rye, Anne K;

    2015-01-01

    BACKGROUND: Postoperative shoulder pain remains a significant problem after laparoscopy. Pneumoperitoneum with insufflation of carbon dioxide (CO2) is thought to be the most important cause. Reduction of pneumoperitoneum pressure may, however, compromise surgical visualisation. Recent studies......-pressure pneumoperitoneum (12 mmHg) and moderate NMB (single bolus of rocuronium 0.3 mg kg with spontaneous recovery) would reduce the incidence of shoulder pain and improve recovery after laparoscopic hysterectomy. DESIGN: A randomised, controlled, double-blinded study. SETTING: Private hospital in Denmark. PARTICIPANTS...... was the incidence of shoulder pain during 14 postoperative days. Secondary endpoints included area under curve VAS scores for shoulder, abdominal, incisional and overall pain during 4 and 14 postoperative days; opioid consumption; incidence of nausea and vomiting; antiemetic consumption; time to recovery...

  4. Laparoscopic hysterectomy with bilateral orchidectomy for Persistent Mullerian duct syndrome with seminoma testes: Case report

    Directory of Open Access Journals (Sweden)

    Senthilnathan Palanisamy

    2015-01-01

    Full Text Available Persistent Mullerian duct syndrome (PMDS is one of the three rare intersex disorders caused by defective anti-mullerian hormone or its receptor, characterized by undescended testes with presence of underdeveloped derivatives of mullerian duct in genetically male infant or adult with normal external genitals and virilization. This population will essentially have normal, 46(XY, phenotype. We hereby present a case of PMDS, presented with incarcerated left inguinal hernia associated with cryptorchidism and seminoma of right testes. Patient underwent laparoscopic hernia repair with bilateral orchidectomy and hysterectomy with uneventful postoperative recovery. Here we highlight the importance of minimal access approach for this scenario in terms of better visualization, less blood loss, combining multiple procedures along with early return to work and excellent cosmetic outcome.

  5. Metastatic low-grade endometrial stromal sarcoma of the sigmoid colon three years after hysterectomy

    Institute of Scientific and Technical Information of China (English)

    Yuki Asada; Hajime Isomoto; Fumitaka Akama; Noriko Nomura; Chun-Yang Wen; Haruhiko Nakao; Ikuo Murata; Kan Toriyama; Shigeru Kohno

    2005-01-01

    A 49-year-old woman, who had undergone hysterectomy for low-grade endometrial stromal sarcoma (ESS) 3 years ago, presented with a 2-wk history of lower abdominal pain. Barium enema and sigmoidoscopy disclosed a polypoid submucosal tumor. Histopathologic features of biopsy specimens from the lesion were similar to those of the resected uterine ESS. Under the diagnosis of metastatic ESS of the sigmoid colon, sigmoidectomy was performed. Microscopic examination demonstrated dense proliferation of spindle cells with little nuclear atypia, which were sometimes arranged in whorled pattern around abundant arterioles. Mitotic count is below 1 in 10 highpower fields. Immunohi-stochemically, the neoplastic cells were strongly positive for vimentin, estrogen receptor and progesterone receptor but negative for α-smooth muscle actin, S-100 protein and CD34. Thus, a final diagnosis of low-grade ESS metastasis to the sigmoid colon was made.Her postoperative course was uneventful and hormonal therapy with progestational agents is entertained.

  6. The value of random biopsies, omentectomy, and hysterectomy in operations for borderline ovarian tumors

    DEFF Research Database (Denmark)

    Kristensen, Gitte Schultz; Schledermann, Doris; Mogensen, Ole;

    2014-01-01

    OBJECTIVE: Borderline ovarian tumors (BOTs) are treated surgically like malignant ovarian tumors with hysterectomy, salpingectomy, omentectomy, and multiple random peritoneal biopsies in addition to removal of the ovaries. It is, however, unknown how often removal of macroscopically normal-appearing...... Hospital from 2007 to 2011 were eligible for this study. Data were extracted from electronic records. Intraoperative assessment of tumor spread (macroscopic disease) and the microscopic evaluation of removed tissues were the main outcome measures. RESULTS: The study included 75 patients, 59 (78.7%) in...... surgeon's identification of macroscopic tumor spread to the contralateral ovary and the peritoneum had a sensitivity of 88% and 69.2% and a specificity of 90.2% and 92.5%, respectively. The macroscopic assessment of the uterine surface, the omentum, and the pelvic and para-aortal lymph nodes was not a...

  7. Body mass and risk of complications after hysterectomy on benign indications

    DEFF Research Database (Denmark)

    Osler, Merete; Daugbjerg, Signe; Frederiksen, Birgitte Lidegaard;

    2011-01-01

    between 25 and 30 kg/m(2) (classified as overweight) and 17.5% with a BMI = 30 kg/m(2) (categorized as obese). The overall rate of complications was 17.6%, with bleeding being the most common specific complication (6.8%). After adjustment for age, ethnicity, education, indication for surgery, uterus...... referrals for benign indications in Denmark from 2004 to 2009. Logistic regression was used to investigate relationship between BMI and complications reported at surgery or during the first 30 days after surgery. RESULTS; Of the 20 353 women with complete data, 6.0% had a BMI ... weight, use of prophylaxis, American Society of Anaesthesiologists classification, co-morbidity status and route of hysterectomy, obesity was associated with an increased risk of heavy bleeding during surgery [odds ratio (OR) = 3.64 (2.90-4.56)], all bleeding complications [OR = 1.27 (1...

  8. Iatrogenic Lower Extremity Subcutaneous Emphysema after Prolonged Robotic-Assisted Hysterectomy

    Directory of Open Access Journals (Sweden)

    Monica Hagan Vetter

    2015-01-01

    Full Text Available Subcutaneous emphysema is a known complication of carbon dioxide insufflation, an essential component of laparoscopy. The literature contains reports of hypercarbia, pneumothorax, or pneumomediastinum. However, isolated lower extremity subcutaneous emphysema remains a seldom-reported complication. We report a case of unilateral lower extremity subcutaneous emphysema following robotic-assisted hysterectomy, bilateral salpingooophorectomy, staging, and anterior/posterior colporrhaphy for carcinosarcoma and vaginal prolapse. On postoperative day 1, the patient developed tender crepitus and bruising of her right ankle. Radiography confirmed presence of subcutaneous air. Vital signs and laboratory findings were unremarkable. Her symptoms spontaneously improved over time, and she was discharged in good condition on day 2. In stable patients with postoperative extremity swelling or pain with crepitus on exam, the diagnosis of iatrogenic subcutaneous emphysema must be considered.

  9. Stability analysis of abandoned drift for alternative utilization

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bo-Hyun; Yoo, In-Kol; Kim, Moon-Seob; Kim, Ryang-Hee [Korea Resources Corp., Seoul(Korea); Yang, Hyung-Sik [Chonnam National University, Kwangju(Korea); Lee, Hi-Keun [Seoul National University, Seoul(Korea); Kim, Jae-Dong [Kangwon National University, Chuncheon(Korea)

    2000-04-30

    This study was performed to find the way that is alternative utilization of the drift that had been abandoned by coal industry promotion. To determine whether abandoned drift would be maintained without supports or not, the safety inspection that consists of drift survey, laboratory tests, rock mass classification and numerical analysis was performed. According to the result, there were discontinuity sets those had unfavorable orientation to the drift and rock mass around the drift had generally poor condition. So, it would be much difficult that abandoned drift is maintained without supports. (author). 15 refs., 8 tabs., 7 figs.

  10. Mapping abandoned agriculture with multi-temporal MODIS satellite data

    DEFF Research Database (Denmark)

    Alcantara, Camilo; Kuemmerle, Tobias; Prishchepov, Alexander;

    2012-01-01

    Agriculture is expanding and intensifying in many areas of the world, but abandoned agriculture is also becoming more widespread. Unfortunately, data and methods to monitor abandoned agriculture accurately over large areas are lacking. Remote sensing methods may be able to fill this gap though...... when used in conjunction with NDVI time series by more than 8% over the use of NDVI data alone. The approach that we identified here is promising and suggests that it is possible to map abandoned agriculture at broad scales, which is relevant to gain a better understanding of this important land use...

  11. Radically enhanced molecular recognition

    KAUST Repository

    Trabolsi, Ali

    2009-12-17

    The tendency for viologen radical cations to dimerize has been harnessed to establish a recognition motif based on their ability to form extremely strong inclusion complexes with cyclobis(paraquat-p-phenylene) in its diradical dicationic redox state. This previously unreported complex involving three bipyridinium cation radicals increases the versatility of host-guest chemistry, extending its practice beyond the traditional reliance on neutral and charged guests and hosts. In particular, transporting the concept of radical dimerization into the field of mechanically interlocked molecules introduces a higher level of control within molecular switches and machines. Herein, we report that bistable and tristable [2]rotaxanes can be switched by altering electrochemical potentials. In a tristable [2]rotaxane composed of a cyclobis(paraquat-p-phenylene) ring and a dumbbell with tetrathiafulvalene, dioxynaphthalene and bipyridinium recognition sites, the position of the ring can be switched. On oxidation, it moves from the tetrathiafulvalene to the dioxynaphthalene, and on reduction, to the bipyridinium radical cation, provided the ring is also reduced simultaneously to the diradical dication. © 2010 Macmillan Publishers Limited. All rights reserved.

  12. Violent Radicalization in Europe

    DEFF Research Database (Denmark)

    Dalgaard-Nielsen, Anja

    2010-01-01

    When, why, and how do people living in a democracy become radicalized to the point of being willing to use or directly support the use of terrorist violence against fellow citizens? This question has been at the center of academic and public debate over the past years as terrorist attacks...

  13. Homegrown religious radicalization

    DEFF Research Database (Denmark)

    Khawaja, Iram

    and their families. Existing literature and ways of thinking about the social psychological process of radicalization will be reviewed, such as social identity theory and transformative learning theory, and a theoretical framework based on a focus on belonging, recognition and the sense of community will be proposed...

  14. Radical School Reform.

    Science.gov (United States)

    Gross, Beatrice, Ed.; Gross, Ronald, Ed.

    This book provides a comprehensive examination of the nature of the school crisis and the ways in which radical thinkers and educators are dealing with it. Excerpts from the writings of Jonathan Kozol, John Holt, Kenneth Clark, and others are concerned with the realities of education in ghettos and suburbs. Paul Goodman, Marshall McLuhan, Sylvia…

  15. Radical Financial Innovation

    OpenAIRE

    Robert J. Shiller

    2004-01-01

    Radical financial innovation is the development of new institutions and methods that permit risk management to be extended far beyond its former realm, covering important new classes of risks. This paper compares past such innovation with potential future innovation, looking at the process that produced past success and the possibilities for future financial innovation.

  16. On Radical Feminism

    Institute of Scientific and Technical Information of China (English)

    翟良锴

    2015-01-01

    <正>All men are created equal.For centuries,human have been struggling for their rights.Women,as a special social force,are fighting vigorously for their equal rights with men.According to an introduction to feminism,there are three main types of feminism:socialist,reformist and radical(Feminism 101).In order

  17. Comparison between Preoperative Rectal Diclofenac Plus Paracetamol and Diclofenac Alone for PostoperativePain of Hysterectomy.

    Directory of Open Access Journals (Sweden)

    Saghar Samimi Sede

    2014-09-01

    Full Text Available To detect whether the preoperative combined administration of rectal diclofenac and paracetamol is superior to placebo or rectal diclofenac alone for pain after abdominal hysterectomy.Ninety female patients (American Society of Anesthesiologists (ASA physical status I-II, scheduled for abdominal hysterectomy were recruited to this double blind trial and were randomized to receive one of three modalities before surgery: rectal combination of diclofenac and paracetamol, rectal diclofenac alone or rectal placebo alone which were given as a suppository one hour prior to surgery. The primary outcomes were visual analogue pain scores measured at 0, 0.5, 2, 4, 8, 16 and 24 hours after surgery and the time of first administration and also total amount of morphine used in the first 24 hour after surgery. A 10 cm visual analog scale (VAS was used to assess pain intensity at rest.In patients receiving the combination of diclofenac and paracetamol total dose of morphine used in the first 24 hour after surgery was significantly lower (13.9 ± 2.7 mg compared to diclofenac group (16.8± 2.8 mg and placebo group (20.1 ± 3.6 mg (p<0.05. VAS pain score was significantly lower in combination group compared to other groups all time during first 24 hours (p<0.05. There had been a significant difference between combination group and the two other groups in terms of the first request of morphine (p<0.05.According to our study Patients who receive the rectal diclofenac-paracetamol combination experience significantly a lower pain scale in the first 24 hour after surgery compared with patients receiving diclofenac or placebo alone. Their need to supplementary analgesic is significantly later and lower compared to placebo and diclofenac alone.

  18. Free radical transfer in polymers

    International Nuclear Information System (INIS)

    For the present study of free-radical transfer in polymers pulse radiolysis and product studies have been carried out in aqueous solutions using thus far only the water-soluble polymers polyacrylic acid, polymethacrylic acid and polyvinyl alcohol. When OH radicals, generated in the radiolysis of N2O-saturated aqueous solutions, react with polymers the lifetime of the polymer radical thus created very much depends on the number of radicals per polymer chain. When there are a large number of radicals per chain their bimolecular decay may be faster than the corresponding (diffusion controlled) decay of monomeric radicals, but when the macromolecule contains only few or even just one radical their lifetime is considerably prolonged. Highly charged polymers such as polyacrylic acid at high pH attain a rod-like conformation which again favors a long lifetime of the radicals. Under such conditions, radical transfer reactions can occur. For example, in polyacrylic acid OH radicals generate two kinds of radicals side by side. The radical in β-position to the carboxylate group converts into the thermodynamically more stable α-radicals by an H-transfer reaction as can be followed by spectrophotometry. Besides radical transfer reactions β-fragmentation reactions occur causing chain scission. Such reactions can be followed in a pulse radiolysis experiment by conductometry, because counter ions are released upon chain scission. Such a process is especially effective in the case of polymethacrylic acid, where it results in a chain depolymerization. An intramolecular H-abstraction is also observed in the γ-radiolysis of polyacrylic acid with the corresponding peroxyl radicals. This causes a chain reaction to occur. The resulting hydroperoxides are unstable and decarboxylate given rise to acetylacetone-like products. In polyvinyl alcohol the peroxyl radicals in α-position to the alcohol function undergo HO2-elimination. This prevents a scission of the polymer chain in the

  19. Anti-hemorrhagic effect of prophylactic tranexamic acid in benign hysterectomy-a double-blinded randomized placebo-controlled trial

    DEFF Research Database (Denmark)

    Topsoee, Märta Fink; Bergholt, Thomas; Ravn, Pernille;

    2016-01-01

    and in 2004, 8% of all women in Denmark undergoing benign hysterectomy experienced a bleeding complication. Tranexamic acid is an antifibrinolytic agent that has shown to effectively reduce bleeding complications within other surgical and medical areas. However, knowledge about the drug's effect in relation...... to benign hysterectomy is still missing. OBJECTIVE: To investigate the antihemorrhagic effect of prophylactic tranexamic acid in elective benign hysterectomy. STUDY DESIGN: A double-blinded randomized placebo-controlled trial was conducted at 4 gynecological departments in Denmark from April 2013 to October...... 2014. A total of 332 women undergoing benign abdominal, laparoscopic, or vaginal hysterectomy were included in the trial, randomized to either 1 g of intravenous tranexamic acid or placebo at start of surgery. Chi-square test and Student t test statistical analyses were applied. RESULTS: The primary...

  20. Robust Abandoned Object Detection Using Dual Foregrounds

    Directory of Open Access Journals (Sweden)

    Tetsuji Haga

    2007-11-01

    Full Text Available As an alternative to the tracking-based approaches that heavily depend on accurate detection of moving objects, which often fail for crowded scenarios, we present a pixelwise method that employs dual foregrounds to extract temporally static image regions. Depending on the application, these regions indicate objects that do not constitute the original background but were brought into the scene at a subsequent time, such as abandoned and removed items, illegally parked vehicles. We construct separate long- and short-term backgrounds that are implemented as pixelwise multivariate Gaussian models. Background parameters are adapted online using a Bayesian update mechanism imposed at different learning rates. By comparing each frame with these models, we estimate two foregrounds. We infer an evidence score at each pixel by applying a set of hypotheses on the foreground responses, and then aggregate the evidence in time to provide temporal consistency. Unlike optical flow-based approaches that smear boundaries, our method can accurately segment out objects even if they are fully occluded. It does not require on-site training to compensate for particular imaging conditions. While having a low-computational load, it readily lends itself to parallelization if further speed improvement is necessary.

  1. Mercury distribution in an abandoned metallurgical plant

    Directory of Open Access Journals (Sweden)

    Millán R.

    2013-04-01

    Full Text Available The aim of the work is to evaluate the spatial distribution of Hg in the soil-plant system within an area where intense activity of Hg was dominant over a long period. An abandoned metallurgical plant from the 17th-18th centuries was chosen as the study area. It is situated in Almadenejos within the Almadén mining district (Spain that constitutes the largest and most unusual concentration of mercury in the world and has provided a third of the entire world production of mercury (Hg. Nowadays, this study area is covered with cinnabar mine tailings and village habitants use it for livestock. The area has elevated Hg concentrations of natural origin and from human activities. Soil parameters are similar throughout the study area; however, data reveal high variability in total and available Hg concentrations in soils, making it difficult to establish a tendency. Marrubium vulgare L.has been studied due to its high presence in the field plot, and there is no evidence of phenological toxicity. Furthermore, in spite of elevated Hg concentrations, a good biological activity is tested in the soil samples. All these characteristics, spatial variation, high Hg concentration, good biological activity, enhance the peculiarity of the study area for studies involving Hg.

  2. Observational evaluation of preoperative, intraoperative, and postoperative characteristics in 117 Brazilian women without uterine prolapse undergoing vaginal hysterectomy

    Directory of Open Access Journals (Sweden)

    Osako MT

    2012-09-01

    Full Text Available Claudio Sergio Batista,1 Takasi Osako,2 Eliana Mara Clemente,2 Fernanda Carvalhido Antonio Batista,3 Maurício Takeshi Janiques Osako41Department of Gynecology and Obstetrics of Faculty of Medicine of Petropolis, Petropolis, Rio de Janeiro, Brazil; 2Gynecology and Obstetrics, Casa Providencia Hospital, Petropolis, Rio de Janeiro, Brazil; 3School of Medicine of Technical Educational Foundation Souza Marques, Rio de Janeiro, Brazil; 4School of Medicine of University Gama Filho, Rio de Janeiro, BrazilBackground: Despite the introduction of minimally invasive approaches for various benign uterine problems, hysterectomy is often still performed abdominally, but the vaginal route should be used whenever possible. The aim of this study was to identify the preoperative, intraoperative, and postoperative characteristics of women undergoing vaginal hysterectomy in the absence of uterine prolapse.Methods: A prospective, descriptive, quantitative, noncomparative study was conducted in 117 women between August 2009 and February 2011 in Petropolis, Rio de Janeiro, Brazil. The women included had a uterine indication for hysterectomy, their surgeries were performed by the same team, and they were followed up for 12 months. An adapted Pelvic Organ Prolapse Quantification system was used to check for uterine prolapse.Results: The age range of the women was 33–59 years, uterine volume was 300–900 mL, and 73.50% has undergone prior cesarean section. The main indication for hysterectomy was uterine myoma (64.95%, with a surgery time of 30–60 minutes in 55 (59.82% and 19 (15.98% cases, respectively. Uterine volume reduction was performed in 41 (35.05% cases, salpingectomy was the most common associated surgery (81.19%, and anesthesia was subdural (68.37%. Common intraoperative complications included bladder lesions (8.54%, with conversion to the abdominal route being necessary in one case (1.28%, and the most common postoperative complication being vaginal

  3. 7 CFR 97.104 - Application or certificate abandoned.

    Science.gov (United States)

    2010-01-01

    ... 97.104 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) COMMODITY... abandoned certificates shall be published in the Official Journal, indicating that the variety has...

  4. Abandoned mines at Little Pend Oreille National Wildlife Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The objectives of the study were: 1) Determine whether abandoned mines on LPO were impacting aquatic biota, 2) Determine whether mines were safety or liability...

  5. Determinants of the exclusive breastfeeding abandonment: psychosocial factors

    OpenAIRE

    Mariana Campos Martins Machado; Karine Franklin Assis; Fabiana de Cássia Carvalho Oliveira; Andréia Queiroz Ribeiro; Raquel Maria Amaral Araújo; Alexandre Faisal Cury; Silvia Eloiza Priore; Sylvia do Carmo Castro Franceschini

    2014-01-01

    OBJECTIVE To assess the determinants of exclusive breastfeeding abandonment. METHODS Longitudinal study based on a birth cohort in Viçosa, MG, Southeastern Brazil. In 2011/2012, 168 new mothers accessing the public health network were followed. Three interviews, at 30, 60, and 120 days postpartum, with the new mothers were conducted. Exclusive breastfeeding abandonment was analyzed in the first, second, and fourth months after childbirth. The Edinburgh Postnatal Depression Scale was applied...

  6. Identification of Risks Pertaining to Abandoned Housing Projects in Malaysia

    OpenAIRE

    Hamzah Abdul-Rahman; Chen Wang; Nur Hamizah Ariffin

    2015-01-01

    Housing industry is one of the most dynamic, risky, and challenging industries. In Malaysia, this industry has a poor reputation for managing risks, with many major projects failing to be completed within the allotted time. Due to the inherent risks involved in construction projects, it is essential to recognize the risks that cause problems associated with abandoned housing projects. Therefore, this study aims to identify the risks that contribute to issues of abandoned housing projects and ...

  7. Brent spar experience haunts N. Sea platform abandonments

    International Nuclear Information System (INIS)

    This paper reviews the environmental conflicts that oil and gas industry officials have recently encountered in their attempts to abandon offshore platforms. It reviews the various governmental policies which are in effect in the North Sea area and the effect these policies have had on removal or deepsea disposal of these facilities. It provides a prospectus of soon to be abandoned facilities in the North Sea countries and a summary of removal operations in recent history

  8. 19 CFR 158.42 - Abandonment by importer within 30 days after entry.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Abandonment by importer within 30 days after entry..., OR EXPORTED Destroyed, Abandoned, or Exported Merchandise § 158.42 Abandonment by importer within 30... which the merchandise being abandoned appears. (b) Application within 30 days. The importer shall...

  9. 49 CFR 1105.12 - Sample newspaper notices for abandonment exemption cases.

    Science.gov (United States)

    2010-10-01

    ... 20423, a notice of exemption under 49 CFR 1152 Subpart F—Exempt Abandonments permitting the (abandonment... 49 Transportation 8 2010-10-01 2010-10-01 false Sample newspaper notices for abandonment exemption... OF ENVIRONMENTAL LAWS § 1105.12 Sample newspaper notices for abandonment exemption cases. In...

  10. Radical substitution with azide

    DEFF Research Database (Denmark)

    Pedersen, Christian Marcus; Marinescu, Lavinia Georgeta; Bols, Mikael

    2005-01-01

    and the substrate. A primary deuterium kinetic isotope effect was found for the azidonation of benzyl ethers both with TMSN3-PhI(OAc)2 and with IN3. Also a Hammett free energy relationship study of this reaction showed good correlation with sigma+ constants giving with rho-values of -0.47 for TMSN3-PhI(OAc)2 and -0.......39 for IN3. On this basis a radical mechanism of the reaction was proposed....

  11. Laparoscopic radical cystectomy with orthotopic ileal neobladder in the female: report of 14 cases

    Institute of Scientific and Technical Information of China (English)

    LIN Tian-xin; YIN Xin-bao; HUANG Jian; ZHANG Cai-xia; XU Ke-wei; HUANG Hai; JIANG Chun; HAN Jin-li; YAO You-sheng; GUO Zheng-hui; XIE Wen-lian

    2008-01-01

    Background Bladder carcinoma is the most common malignant urological tumor in China. We present our preliminary experience and results of laparoscopic radical cystectomy (LRC) with orthotopic ileal neobladder in female patients with bladder carcinoma.Methods From February 2003 to February 2008, 14 female patients with bladder carcinoma underwent LRC with orthotopic ileal neobladder. Nine of these patients underwent hysterectomy and ovariectomy, and the other 5 had preservation of the uterus and ovarian appendage. Standard bilateral pelvic lymphadenectomy was followed by radical cystectomy that was completed laparoscopically with hysterectomy and ovariectomy when needed. The tumor was removed by a 4-5 cm lower midline abdominal incision, followed by the construction of ileal neobladder and the extracorporeal anastomosis of ureter-neobladder. The neobladder was anastomosed to the urethral stump under a laparoscope.Results The mean operative time and blood loss in the 14 patients were 350.2 minutes and 349.8 ml, respectively.Postoperative complications included uretero-pouch anastomotic stricture in 1 patient and pouch-vaginal fistula in 1 patient. Follow-up time of all patients ranged from 3 to 60 months, and 12 patients were followed up for more than 6 months and achieved micturition in half a year. One patient had occasional day-time urinary incontinence and 2 had night-time incontinence. Two patients who had undergone hystectomy and ovariectomy had voiding difficulties after one year, which was treated by intermittent self-catheterization. The mean volume of the neobladder and the residual urine were 333.6 ml and 31.2 ml, respectively. Surgical margins were tumor free for all patients. One patient had bone metastasis and died 11 months after the operation.Conclusions LRC with orthotopic ileal neobladder in female patients is a technically feasible, safe and mini-invasive procedure with a low morbidity and acceptable neobladder function. Long-term follow-up is

  12. THERMOCHEMISTRY OF HYDROCARBON RADICALS

    Energy Technology Data Exchange (ETDEWEB)

    Kent M. Ervin, Principal Investigator

    2004-08-17

    Gas phase negative ion chemistry methods are employed to determine enthalpies of formation of hydrocarbon radicals that are important in combustion processes and to investigate the dynamics of ion-molecule reactions. Using guided ion beam tandem mass spectrometry, we measure collisional threshold energies of endoergic proton transfer and hydrogen atom transfer reactions of hydrocarbon molecules with negative reagent ions. The measured reaction threshold energies for proton transfer yield the relative gas phase acidities. In an alternative methodology, competitive collision-induced dissociation of proton-bound ion-molecule complexes provides accurate gas phase acidities relative to a reference acid. Combined with the electron affinity of the R {center_dot} radical, the gas phase acidity yields the RH bond dissociation energy of the corresponding neutral molecule, or equivalently the enthalpy of formation of the R{center_dot} organic radical, using equation: D(R-H) = {Delta}{sub acid}H(RH) + EA(R) - IE(H). The threshold energy for hydrogen abstraction from a hydrocarbon molecule yields its hydrogen atom affinity relative to the reagent anion, providing the RH bond dissociation energy directly. Electronic structure calculations are used to evaluate the possibility of potential energy barriers or dynamical constrictions along the reaction path, and as input for RRKM and phase space theory calculations. In newer experiments, we have measured the product velocity distributions to obtain additional information on the energetics and dynamics of the reactions.

  13. [Radical prostatectomy - pro robotic].

    Science.gov (United States)

    Gillitzer, R

    2012-05-01

    Anatomical radical prostatectomy was introduced in the early 1980s by Walsh and Donker. Elucidation of key anatomical structures led to a significant reduction in the morbidity of this procedure. The strive to achieve similar oncological and functional results to this gold standard open procedure but with further reduction of morbidity through a minimally invasive access led to the establishment of laparoscopic prostatectomy. However, this procedure is complex and difficult and is associated with a long learning curve. The technical advantages of robotically assisted surgery coupled with the intuitive handling of the device led to increased precision and shortening of the learning curve. These main advantages, together with a massive internet presence and aggressive marketing, have resulted in a rapid dissemination of robotic radical prostatectomy and an increasing patient demand. However, superiority of robotic radical prostatectomy in comparison to the other surgical therapeutic options has not yet been proven on a scientific basis. Currently robotic-assisted surgery is an established technique and future technical improvements will certainly further define its role in urological surgery. In the end this technical innovation will have to be balanced against the very high purchase and running costs, which remain the main limitation of this technology.

  14. Robot-Assisted Laparoscopic Hysterectomy,Gonadal Biopsy, and Orchiopexies in an Infant with Persistent Mullerian Duct Syndrome

    OpenAIRE

    Wu, Jonathan A.; Hsieh, Michael H.

    2013-01-01

    An infant born with hypospadias and no palpable gonads was diagnosed with persistent mullerian duct syndrome (PMDS) based on history, physical examination, laboratory testing, and radiologic imaging. A robot-assisted laparoscopic hysterectomy, right gonadal biopsy, and bilateral orchiopexies were performed without incident. Final pathology confirmed the diagnosis of PMDS. To our knowledge, this is only the second report of PMDS managed through a robot-assisted laparoscopic approach.

  15. Robot-assisted laparoscopic hysterectomy, gonadal biopsy, and orchiopexies in an infant with persistent mullerian duct syndrome.

    Science.gov (United States)

    Wu, Jonathan A; Hsieh, Michael H

    2014-04-01

    An infant born with hypospadias and no palpable gonads was diagnosed with persistent mullerian duct syndrome (PMDS) based on history, physical examination, laboratory testing, and radiologic imaging. A robot-assisted laparoscopic hysterectomy, right gonadal biopsy, and bilateral orchiopexies were performed without incident. Final pathology confirmed the diagnosis of PMDS. To our knowledge, this is only the second report of PMDS managed through a robot-assisted laparoscopic approach. PMID:24246315

  16. Railroad Lines - RAIL_SYSTEM_ACTIVE_ABANDONED_INDOT_IN: Active and Abandoned Rail System in Indiana, 2005 (Indiana Department of Transportation, 1:1200, Line Shapefile)

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — RAIL_SYSTEM_ACTIVE_ABANDONED_INDOT_IN is a line shapefile that contains all active and abandoned rail lines in Indiana, provided by personnel of Indiana Department...

  17. Total versus subtotal Laparoscopic Hysterectomy: A comparative study in Arash Hospital

    Directory of Open Access Journals (Sweden)

    Samiei H

    2009-09-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 st1":*{behavior:url(#ieooui } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Over the past 50 years, subtotal or supracervical hysterectomy has come to be viewed as a suboptimal procedure reserved for those rare instances in which when concern over blood loss or anatomic distortion dictates limiting the extent of dissection, the aim of this study was to compare total and subtotal laparoscopic hysterectomy. "n"nMethods: The patients who were candidates for hysterectomy with benign disease, with no contraindication for laparoscopic surgery entered the study in Arash Hospital, from March 2007 to April 2009. By simple randomization 45 patients (25 for TLH and 20 for SLH were selected. Demographic Details and intra and post operative complications, were recorded by the staff and were compared between two groups."n"nResults: The average time for TLH operations look significantly longer than SLH operation (148.6±29.7 minutes; 128.5±25.64 minutes, p=0.03. Although, the hemoglobin (gr/dl drop in TLH was significantly higher than SLH (1.54 Versus 0.9, p<0.05 Blood transfusion were common in SLH (1 case Versus 3 Cases. The total length of hospital stay, was significantly shorter after SLH than TLH (3.6±1.47 day and 2.85±0.59, p=0.04. The drug requirements to

  18. Who Says There Is No Life after Abandonment? A Grounded Theory on the Coping of Abandoned Filipino Elderly in Nursing Homes

    Science.gov (United States)

    de Guzman, Allan B.; Lacorte, Jeremy C.; Lacsamana, Andrea Keith G.; Lagac, Mark Lawrence M.; Laguador, Jobel M.; Lapid, Jazminn Jessica R.; Lee, Lyndcie Miriele C.

    2012-01-01

    Cases of abandoned elderly are increasing worldwide. By and large, this group struggles with the sudden change in living arrangement as well as abandonment by their families. Consequently, many elderly are forced into living in nursing homes for the remainder of their lives. Abandonment among these elderly negatively affects how they view…

  19. Catalysis of Radical Reactions: A Radical Chemistry Perspective.

    Science.gov (United States)

    Studer, Armido; Curran, Dennis P

    2016-01-01

    The area of catalysis of radical reactions has recently flourished. Various reaction conditions have been discovered and explained in terms of catalytic cycles. These cycles rarely stand alone as unique paths from substrates to products. Instead, most radical reactions have innate chains which form products without any catalyst. How do we know if a species added in "catalytic amounts" is a catalyst, an initiator, or something else? Herein we critically address both catalyst-free and catalytic radical reactions through the lens of radical chemistry. Basic principles of kinetics and thermodynamics are used to address problems of initiation, propagation, and inhibition of radical chains. The catalysis of radical reactions differs from other areas of catalysis. Whereas efficient innate chain reactions are difficult to catalyze because individual steps are fast, both inefficient chain processes and non-chain processes afford diverse opportunities for catalysis, as illustrated with selected examples.

  20. Community members’ responses to the elective hysterectomy of an intellectually disabled girl

    Directory of Open Access Journals (Sweden)

    Carol Hamilton

    2011-06-01

    Full Text Available Abstract The United Nations Convention on the Rights of People with Disabilities (2007 guarantees all intellectually disabled women the right to full bodily integrity. However, non-therapeutic sterilisations continue to be proposed as a means of managing the support needs of some members of this group. The opinions of community members, and whether men and women's views differ in relation to this topic, are rarely canvassed. Yet these views are significant as what constitutes acceptable social practice is ultimately set and contested at community level. This article reviews comments posted by male and female contributors to a BBC Have Your Say website about a mother's request for a hysterectomy for her 'severely disabled' daughter. Comments suggest the majority of posters endorse the request, however a marked difference by gender in reasons for support is evident. Gender differences are also noted in remarks about the social implications of requests of this kind and in the gender of contributors who thought this topic to be unsuitable for discussion in public forum. The difficulty some posters had with comments made from a rights-based advocacy position is briefly discussed as are possible limitations involved in using rights when debating the issue of non-therapeutic sterilisation. Keywords: intellectual disability, sterilisation, gender, community, rights

  1. Placenta Increta Complicating Persistent Cesarean Scar Ectopic Pregnancy following Failed Excision with Subsequent Preterm Cesarean Hysterectomy.

    Science.gov (United States)

    Malik, M F; Hoyos, L R; Rodriguez-Kovacs, J; Gillum, J; Johnson, S C

    2016-01-01

    Introduction. Cesarean scar pregnancies (CSPs) are one of the rarest forms of ectopic pregnancy. Given their rarity, there is lack of consensus regarding the management and natural course of CSPs. Case. A 37-year-old G10 P3063 female with a history of two prior cesarean deliveries was diagnosed with her second CSP at 6 weeks and 5 days in her tenth pregnancy. The patient underwent vertical hysterotomy, excision of a gestational sac implanted in the cesarean sac, and bilateral salpingectomy via a laparotomy incision. The histopathology report confirmed immature chorionic villi. The patient returned 10 weeks later and was found to be still pregnant. Obstetric ultrasound confirmed a viable fetus of 19 weeks and 4 days of gestational age with a thin endometrium and an anteroposterior and right lateral placenta with multiple placental lakes. The patient ruptured her membranes at 31 weeks of gestation and pelvic MRI revealed an anterior placenta invading the myometrium and extending to the external serosal surface consistent with placenta increta. Following obstetric interventions, a live female infant was delivered by cesarean hysterectomy (because of placenta increta) at 32 weeks of gestation. Conclusion. Development of standardized guidelines for management of CSPs, as well as heightened vigilance for possible complications, is required for proper care and avoidance of potential morbidity and mortality. PMID:27375911

  2. Placenta Increta Complicating Persistent Cesarean Scar Ectopic Pregnancy following Failed Excision with Subsequent Preterm Cesarean Hysterectomy

    Directory of Open Access Journals (Sweden)

    M. F. Malik

    2016-01-01

    Full Text Available Introduction. Cesarean scar pregnancies (CSPs are one of the rarest forms of ectopic pregnancy. Given their rarity, there is lack of consensus regarding the management and natural course of CSPs. Case. A 37-year-old G10 P3063 female with a history of two prior cesarean deliveries was diagnosed with her second CSP at 6 weeks and 5 days in her tenth pregnancy. The patient underwent vertical hysterotomy, excision of a gestational sac implanted in the cesarean sac, and bilateral salpingectomy via a laparotomy incision. The histopathology report confirmed immature chorionic villi. The patient returned 10 weeks later and was found to be still pregnant. Obstetric ultrasound confirmed a viable fetus of 19 weeks and 4 days of gestational age with a thin endometrium and an anteroposterior and right lateral placenta with multiple placental lakes. The patient ruptured her membranes at 31 weeks of gestation and pelvic MRI revealed an anterior placenta invading the myometrium and extending to the external serosal surface consistent with placenta increta. Following obstetric interventions, a live female infant was delivered by cesarean hysterectomy (because of placenta increta at 32 weeks of gestation. Conclusion. Development of standardized guidelines for management of CSPs, as well as heightened vigilance for possible complications, is required for proper care and avoidance of potential morbidity and mortality.

  3. Total laparoscopic hysterectomy in cases of very large uteri: a retrospective comparative study.

    Science.gov (United States)

    Fiaccavento, Andrea; Landi, Stefano; Barbieri, Fabrizio; Zaccoletti, Riccardo; Tricolore, Carlo; Ceccaroni, Marcello; Pomini, Paola; Bruni, Francesco; Soriano, David; Stepniewska, Ania; Selvaggi, Luigi; Zanolla, Luisa; Minelli, Luca

    2007-01-01

    In this review, we assessed the feasibility of total laparoscopic hysterectomy (TLH) in cases of very large uteri weighting more than 500 grams. We compared surgical outcomes and short term follow-up in 149 patients with the uterus weighing less than 350 g (group A: 40-350 g) and 100 patients with the uterus weighing more than 500 g (group B: 500-1550 g). We discovered no statistical difference between the 2 groups in terms of intraoperative complications (group A: 0%; group B: 2%) and postoperative stay (group A: 3.05 +/- 1.89 days; group B: 3.2 +/- 1.28 days). There were statistically significant differences between the 2 groups in terms of operative time (group A: 101.3 +/- 34.3 min; group B: 149.1 +/- 57.2 min.; p <.0001) and postoperative hospital stay length (group A: 2.8 +/- 0.7 days; group B: 3.5 +/- 1.7 days; p <.0001). No major complications occurred in either group. Postoperative minor complications were more frequent in group B (group A: 8.7%; group B: 18%; p = .03). Median time to well-being was comparable in both groups. In conclusion, TLH is a feasible surgical technique also in cases of very large uteri. An increase in operative time, intraoperative blood loss, hospital stay length, and postoperative minor complications can be expected as the uterine weight increases. PMID:17848315

  4. A rare case of arteriovenous malformation following hysterectomy in a case of choriocarcinoma

    Directory of Open Access Journals (Sweden)

    Suchitra R

    2015-10-01

    Full Text Available A uterine arteriovenous malformation (AVM is a rare cause of uterine bleeding. It may have varied presentations ranging from being completely asymptomatic; to features of congestive heart failure, to vaginal bleeding which may at times life be threatening. Clinical findings in such cases are often un-reliable; requiring a high index of suspicion to make the diagnosis. We report a case of a 46-year-old lady who presented with heavy vaginal bleeding. She has undergone hysterectomy with a histopathology of choriocarcinoma one and half months back. She has received chemotherapy and 8 fractions of radiotherapy for the same. AVM was diagnosed following a CT angiogram and was managed by embolization. We also discuss in brief about this uncommon but serious condition which the radiologist/gynaecologist may encounter in their practice. AV Malformation is a rare but potentially life-threatening cause of vaginal bleeding which must be kept in the differential diagnosis of sudden and massive vaginal bleeding. It requires a high index of clinical suspicion. Despite its rarity, early recognition of an AVM is imperative to enable timely diagnosis and intervention. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1561-1564

  5. Infusion of hypertonic saline before elective hysterectomy: effects on cytokines and stress hormones

    DEFF Research Database (Denmark)

    Kølsen-Petersen, Jens Aage; Bendtzen, Klaus; Tønnesen, Else Kirstine

    2008-01-01

    BACKGROUND: Infusion of hypertonic saline provides early haemodynamic benefits and may affect the immune system. It is unknown if infusion of hypertonic saline affects plasma cytokines and stress hormones after surgery. METHODS: Sixty-two women undergoing abdominal hysterectomy were randomized...... in a double-blind study to infusion of NaCl 7.5% (HS), NaCl 0.9% (NS4), both 4 ml kg(-1), or NaCl 0.9% 32 ml kg(-1) (NS32) over 20 min. Blood was collected at baseline, 1, 4, and 24 h after surgery (n=34) for the determination of interleukin (IL)-1beta, IL-6, IL-8, IL-10, IL-12, IL-1ra, and tumour necrosis...... factor-alpha. Serum cortisol and vasopressin were measured at these time points and 48 h after operation. Epinephrine and norepinephrine (n=26) were quantified at baseline, after infusion, 25 min after incision, 1, and 4 h after surgery. Finally, C-reactive protein was measured at baseline, 24, and 48 h...

  6. Investigation of abandoned surface settling ponds

    International Nuclear Information System (INIS)

    One of the problems that may appear during the ground reclamation of surface settling ponds of underground mines is enhanced radon exhalation from bottom sediments. This problem becomes more important when the concentration of radium isotopes in sediments is enhanced due to the discharge of radium-bearing waters into the pond. For investigations, special radon accumulation chambers have been designed and constructed. The concentration of radon in these chambers can be measured with the application of Lucas cells or activated charcoal detectors. In the latter method, radon is extracted from charcoal into a liquid scintillator and the sample is measured in a liquid scintillation spectrometer. Therefore the lower limit of detection (LLD) of the second method is as low as 0.1 mBq·m-2s-1, while the LLD for Lucas cells is 1.5 mBq·m-2s-1. The above-mentioned methods for the measurement of radon exhalation have been applied to investigations of a surface settling pond of one Polish coal mine, abandoned and emptied at the beginning of 2002. An agreement between the mine management and the local authority was to make the ground reclamation of the pond. A thick layer of sediments with an enhanced concentration of radium isotopes covers the bottom of the pond. The maximum concentration of radium isotopes in these sediments is as high as 2000 Bq/kg for 226Ra and up to 4000 Bq/kg for 228Ra. Two years after the complete release of brines from the pond, bottom sediments are still soaked with water. Therefore, measurements of radon in soil gas were not possible. On the other hand, in some parts of the pond investigations of radon exhalation coefficient were done. The preliminary results of measurements, conducted in 2002, showed that radon exhalation rates in specific parts of the pond were higher than the highest values of radon exhalation from the ground in the Upper Silesia region. Values of exhalation coefficient up to 200 mBq·m-2s-1 were found. It must be pointed out that

  7. A radical publishing collective: the Journal of Radical Librarianship

    Directory of Open Access Journals (Sweden)

    Simon Barron

    2015-03-01

    Full Text Available In Brief: the Journal of Radical Librarianship is a new open-access journal publishing scholarly work in the field of radical librarianship. The focus on critical approaches to librarianship and anti-marketisation of information is reflected not only in our subject matter but in our publishing model, our licensing model, and our organisational practices. We hope to […

  8. Radical cystectomy in eldery

    Directory of Open Access Journals (Sweden)

    Bančević Vladimir

    2015-01-01

    Full Text Available Background/Aim. Radical cystectomy is the method of choice for the treatment of muscle invasive bladder cancer. This major surgery is associated with many complications, especially in older patients. The aim of this study was to analyze preoperative comorbidity, and intraoperative and postoperative complicatons in patients older than 75 years. Methods. This clinical, retrospective study included 46 patients over 75 years, who underwent radical cystectomy. Indications for surgery, and complications during and after the surgery were followed up. Results. Preoperatively, anemia caused by hematuria was registered in 76% of the patients. In 52% of the patients urine derivation was performed by ileal conduit, in 35% by ureterocutaneostomy and in 13% orthotopic ileal neobladder was created. The average duration of surgery was 190 (120-300 min. A total of 76% of the patients were treated by blood supstitution intraoperatively, average 630 (310-1230 mL. Concerning pathological stage of transitional cell carcinoma of urinary bladder, 26% of the patients had T2, 4% T3a, 52% T3b, and 14% T4a stage. In one case, planocellular carcinoma was diagnosed by patohistological examination, and in 2 cases prostate carcinoma was incidentally found. The average duration of hospitalization was 16 (8-35 days. Conclusion. The main reason for cystectomy in patients over 70 and 80 years was gross hematuria caused by bladder cancer, with consecutive anemia which could not be solved using endoscopic treatment or blood supstitution. As expected, a prolonged stay in hospital after cystectomy, and a higher rate of complications were recorded in this population.

  9. Anti-social behaviour, community and radical moral communitarianism

    Directory of Open Access Journals (Sweden)

    Roger Hopkins-Burke

    2015-12-01

    Full Text Available This article offers an insight into the lives of individuals who are repeat victims of antisocial behaviour (ASB. Drawing on data derived from 15 case studies, the authors demonstrate the plight that such victims endure on a daily basis. The research reveals that a number of victims feel abandoned by their communities and the authorities and, how for many, there is an overwhelming sense of being “trapped” within their own homes. The article also offers evidence to support previous claims that police crime data only captures a small proportion of the actual number of incidents of ASB that occur. We conclude by proposing an emphasis on individual and community responsibility and suggest that by adopting a radical moral communitarian approach ASB could be reduced as part of rebuilding communities.

  10. Laparoscopic hysterectomy and transabdominal hysterectomy complication comparative study%腹腔镜全子宫切除术与经腹全子宫切除术并发症比较研究

    Institute of Scientific and Technical Information of China (English)

    黄巧玲

    2015-01-01

    Objective To compare the laparoscopic hysterectomy and transabdominal hysterectomy complications, and to explore effective prevention method summary.Method select 2011 July -2013 year in July to 108 cases of laparoscopic hysterectomy patients in our hospital (laparoscopic group) and 92 cases by abdominal hysterectomy patients (laparotomy group) as the research object, the two groups were observed after operation complications.Results the patients in the laparoscopic group postoperative urinary tract infection in 10 cases (9.26%), 9 cases of cesarean section group (9.78%); 11 cases of vaginal stump hemorrhage (10.19%), 9 cases of cesarean section group (9.78%),P0.05;腹腔镜组患者术后出现腹部切口愈合不良3例(2.78%),剖腹组11例(11.96%),P<0.05。长期随访后发现腹腔镜组患者出现阴道干涩和性欲下降13例(12.04%),而剖腹组47例(51.09%),P<0.05。两组患者围绝经期症状差异无统计学意义,腹腔镜组患者出现宫颈残鞘囊肿的比率为27例(25.0%)。结论腹腔镜全子宫切除术治疗子宫肌瘤具有创口小、出血少,患者手术后恢复快、并发症少等特点,是临床上一种效果较好的全子宫切除术,手术医师掌握手术指征,具有娴熟的手术技巧是减少患者出现并发症的关键。

  11. Muoniated acyl and thioacyl radicals

    Energy Technology Data Exchange (ETDEWEB)

    McKenzie, Iain [TRIUMF and Department of Chemistry, 8888 University Drive, Simon Fraser University, Burnaby B.C., V5A 1S6 (Canada); Brodovitch, Jean-Claude [TRIUMF and Department of Chemistry, 8888 University Drive, Simon Fraser University, Burnaby B.C., V5A 1S6 (Canada); Ghandi, Khashayar [TRIUMF and Department of Chemistry, 8888 University Drive, Simon Fraser University, Burnaby B.C., V5A 1S6 (Canada); Percival, Paul W. [TRIUMF and Department of Chemistry, 8888 University Drive, Simon Fraser University, Burnaby B.C., V5A 1S6 (Canada)]. E-mail: percival@sfu.ca

    2006-03-31

    The product of the reaction of muonium with tert-butylisocyanate was previously assigned as the muoniated tert-butylaminyl radical (I. McKenzie, J.-C. Brodovitch, K. Ghandi, S. Kecman, P. W. Percival, Physica B 326 (2003) 76). This assignment is incorrect since the muon and {sup 14}N hyperfine-coupling constants (hfcc) of this radical would have the opposite sign, which is in conflict with the experimental results. The radical is now reassigned as the muoniated N-tert-butylcarbamoyl radical, based on the similarities between the experimental muon and {sup 14}N hfcc and hfcc calculated at the UB3LYP/6-311G(d,p)//UB3LYP/EPR-III level. The large zero-point energy in the N-Mu bond results in the dissociation barrier of the muoniated N-tert-butylcarbamoyl radical being above the combined energy of the reactants, in contrast to the N-tert-butylcarbamoyl radical where the dissociation barrier lies below the combined energy of the reactants. The reaction of muonium with tert-butylisothiocyanate produced both conformers of the muoniated N-tert-butylthiocarbamoyl radical and their assignment was based on the similarities between the experimental and calculated muon hfcc. These are the first acyl and thioacyl radicals to be directly detected by muon spin spectroscopy.

  12. Vaginal Motion and Bladder and Rectal Volumes During Pelvic Intensity-Modulated Radiation Therapy After Hysterectomy

    International Nuclear Information System (INIS)

    Purpose: To evaluate variations in bladder and rectal volume and the position of the vaginal vault during a 5-week course of pelvic intensity-modulated radiation therapy (IMRT) after hysterectomy. Methods and Materials: Twenty-four patients were instructed how to fill their bladders before simulation and treatment. These patients underwent computed tomography simulations with full and empty bladders and then underwent rescanning twice weekly during IMRT; patients were asked to have full bladder for treatment. Bladder and rectal volumes and the positions of vaginal fiducial markers were determined, and changes in volume and position were calculated. Results: The mean full and empty bladder volumes at simulation were 480 cc (range, 122–1,052) and 155 cc (range, 49–371), respectively. Bladder volumes varied widely during IMRT: the median difference between the maximum and minimum volumes was 247 cc (range, 96–585). Variations in rectal volume during IMRT were less pronounced. For the 16 patients with vaginal fiducial markers in place throughout IMRT, the median maximum movement of the markers during IMRT was 0.59 cm in the right–left direction (range, 0–0.9), 1.46 cm in the anterior–posterior direction (range, 0.8–2.79), and 1.2 cm in the superior–inferior direction (range, 0.6–2.1). Large variations in rectal or bladder volume frequently correlated with significant displacement of the vaginal apex. Conclusion: Although treatment with a full bladder is usually preferred because of greater sparing of small bowel, our data demonstrate that even with detailed instruction, patients are unable to maintain consistent bladder filling. Variations in organ position during IMRT can result in marked changes in the position of the target volume and the volume of small bowel exposed to high doses of radiation.

  13. Decidual transformation in adenomyosis during pregnancy as an indication for hysterectomy

    Directory of Open Access Journals (Sweden)

    Jovanović Božidar

    2009-01-01

    Full Text Available Introduction. Incidence of adenomyosis is estimated on 20% in all of extracted uteruses. Clinically, it usually exists asymptomatically, but could be followed with dysmenorrhoea, menorrhagia and pelvic pain. One third of patients with adenomyosis are sterile, however in other two thirds, conception and pregnancy could have normal development, with delivery without complications. One of possible complications related to adenomyosis is rupture of uterus during delivery. Case report. A pregnant woman at the end of the 10th lunar month of pregnancy, showed minimal labour contractions, following amnion rupture and the delivery was terminated by section ceasar. Subtotal hysterectomy was performed because of concominant profuse bleeding. Myometrium was occupied with decidual cells in trabecular arrangement, among which elongated endometrial glands were placed. Surrounding muscle fascicles showed atrophic, apoptic, and occasionally necrotic changes. Myometrial stroma was edematous, and infiltrated with mesenchymal cells, as well as with adipose cells, which were extending toward serosa. Discussion. The patient had been receiving treatment, for a long period, because of sterility without clear etiological factor. A small number of similar cases ends with complications. Here, it is evident that abundant decidual transformation of stromal cells in adenomiosis leads to atrophy and necrosis of muscle cells. Teh reduction of uterine muscle mass causes atony and threating rupture, through separation of muscle cells, and therefore the absence of their synchronized contractions. Conclusion. Atony of uterine muscle could be caused by decidual transformation in adenomyosal fields, atrophy of muscle fascicles, edema of the stroma, mesenchymal transformation, and fibrosis. This leads to a decrease in myometrial contractions, and prolonged postpartal bleeding.

  14. 76 FR 76104 - Arkansas Regulatory Program and Abandoned Mine Land Reclamation Plan

    Science.gov (United States)

    2011-12-06

    ... their regulatory program and abandoned mine land plan, make grammatical changes, correct punctuation... revise substantial portions of their regulatory program and abandoned mine land plan, make grammatical changes, correct punctuation, revise dates, and add citations. The proposed amendment consists...

  15. Into the Woods Again: Three Recent Young Adult Novels of Parental Abandonment.

    Science.gov (United States)

    Munde, Gail

    1997-01-01

    Takes a look at three recent young adult novels that are stories of children abandoned by their parents, and shows how each retains the essential features of the Hansel and Gretel folktale, a prototype of abandonment stories. (SR)

  16. Abandoning uranium mining in Germany. Rehabilitation of the Wismut site

    International Nuclear Information System (INIS)

    After the unification of Germany in 1989, the Government decided to abandon uranium mining in two lands of the former Eastern Germany, in Saxonia and Thuringia. The closing of the mines and the reclamation and rehabilitation of the site cost more than 10 billion USD. The rehabilitation of the Wismut site is described in detail. (R.P.)

  17. Standardized Discharge Information After Short-Stay Hysterectomy and Relationships With Self-Care Confidence, Perceived Recovery, and Satisfaction.

    Science.gov (United States)

    Lynch, Kate M; LeFort, Sandra M

    2016-01-01

    We report on the development and investigation of standardized, nurse-delivered discharge information to women after same-day hysterectomy, including the relationships among discharge information, self-care confidence, perceived recovery, and satisfaction. Fifty-one women reported high levels of self-care confidence and various levels of perceived recovery 48 to 72 hours after surgery. They were satisfied to highly satisfied with their experiences and with the discharge information provided. The important role of standardized patient discharge information is highlighted.

  18. Emergency peripartum hysterectomy- a study in tertiary care centre and medical college in Hubli, North Karnataka, India

    Directory of Open Access Journals (Sweden)

    Sahaja Kittur

    2016-04-01

    Conclusions: Hysterectomy is a lifesaving procedure to control postpartum hemorrhage, but is associated with significant maternal morbidity and mortality. Uterine atony, uterine ruptures, also due to prior caesarean delivery, placenta previa were identified as risk factors. The incidence in this part of Karnataka was found to be significantly high due to referral cases from neighboring 5 government district hospitals. Hence only proper awareness, timely referral and correction of anemia are the key factors to be addressed to this part of the state. [Int J Reprod Contracept Obstet Gynecol 2016; 5(4.000: 1097-1101

  19. Emergency Hysterectomy in Obstetric Risk Factors%产科急症子宫切除相关危险因素分析

    Institute of Scientific and Technical Information of China (English)

    袁文艳

    2013-01-01

      目的:分析产科急症子宫切除术的相关危险因素,为降低子宫切除率的措施提出科学依据.方法:收集45例的产科急症行子宫切除患者和100例剖宫产产后出血但未行子宫切除术的患者临床资料进行病例对照分析,探索相关危险因素.结果:胎盘早剥、术前凝血指标异常、子宫破裂、产后总出血量超过2000ml、出现DCI、子宫肌瘤可使子宫切除的风险增高(P<0.05).结论:结合上述危险因素,开展有针对性的危险性预测及干预,有利于提高生殖健康水平,降低剖宫产子宫切除率.%Objective:To analyze hospita1 emergency hysterectomy in obstetric risk factors,and reduce the hysterectomy rate of possible measures.Methods:58 cases emergency obstetric hysterectomy patients and 100 cases of postpartum hemorrhage after caesarean sections not undergoing obstetric hysterectomy were retrospectively analyzed.Results:The cause of postpartum hemorrhage risk factors for emergency hysterectomy were placental abruption,preoperative coagulation abnormalities,uterine rupture,blood loss increased,DIC and myoma of uterus (P<0.05).Conclusion:To be combination with these risk factors would benefit for controlling the rate of emergency hysterectomy.

  20. Abandonment, Ecological Assembly and Public Health Risks in Counter-Urbanizing Cities

    OpenAIRE

    Alexandra Gulachenski; Ghersi, Bruno M.; Amy E. Lesen; Michael J Blum

    2016-01-01

    Urban landscapes can be transformed by widespread abandonment from population and economic decline. Ecological assembly, sometimes referred to as “greening”, following abandonment can yield valuable ecosystem services, but also can pose a risk to public health. Abandonment can elevate zoonotic vector-borne disease risk by favoring the hyperabundance of commensal pests and pathogen vectors. Though greater biodiversity in abandoned areas can potentially dilute vector-borne pathogen transmission...

  1. Determinants of the exclusive breastfeeding abandonment: psychosocial factors

    Directory of Open Access Journals (Sweden)

    Mariana Campos Martins Machado

    2014-12-01

    Full Text Available OBJECTIVE To assess the determinants of exclusive breastfeeding abandonment. METHODS Longitudinal study based on a birth cohort in Viçosa, MG, Southeastern Brazil. In 2011/2012, 168 new mothers accessing the public health network were followed. Three interviews, at 30, 60, and 120 days postpartum, with the new mothers were conducted. Exclusive breastfeeding abandonment was analyzed in the first, second, and fourth months after childbirth. The Edinburgh Postnatal Depression Scale was applied to identify depressive symptoms in the first and second meetings, with a score of ≥ 12 considered as the cutoff point. Socioeconomic, demographic, and obstetric variables were investigated, along with emotional conditions and the new mothers’ social network during pregnancy and the postpartum period. RESULTS The prevalence of exclusive breastfeeding abandonment at 30, 60, and 120 days postpartum was 53.6% (n = 90, 47.6% (n = 80, and 69.6% (n = 117, respectively, and its incidence in the fourth month compared with the first was 48.7%. Depressive symptoms and traumatic delivery were associated with exclusive breastfeeding abandonment in the second month after childbirth. In the fourth month, the following variables were significant: lower maternal education levels, lack of homeownership, returning to work, not receiving guidance on breastfeeding in the postpartum period, mother’s negative reaction to the news of pregnancy, and not receiving assistance from their partners for infant care. CONCLUSIONS Psychosocial and sociodemographic factors were strong predictors of early exclusive breastfeeding abandonment. Therefore, it is necessary to identify and provide early treatment to nursing mothers with depressive symptoms, decreasing the associated morbidity and promoting greater duration of exclusive breastfeeding. Support from health professionals, as well as that received at home and at work, can assist in this process.

  2. Radical Surgery for Endometriosis: Analysis of Quality of Life and Surgical Procedure

    Science.gov (United States)

    De la Hera-Lazaro, Cristina M.; Muñoz-González, Jose L.; Perez, Reyes Oliver; Vellido-Cotelo, Rocío; Díez-Álvarez, Alvaro; Muñoz-Hernando, Leticia; Alvarez-Conejo, Carmen; Jiménez-López, Jesús S.

    2016-01-01

    OBJECTIVE The main aim of this study is to determine the improvement in quality of life in patients who have undergone radical surgery because of severe endometriosis. PATIENTS AND METHODS This nonrandomized interventional study (quasi experimental) was carried out between January 2009 and September 2014. A total of 46 patients with diagnosis of severe endometriosis were included. Radical surgery, including hysterectomy, was performed. Acting as their own control group, the patients were asked to fill in a validated questionnaire of quality of life [Endometriosis Health Profile-5 (EHP-5)] and a visual analog scale of pain at the moment of the preoperative visit (one month prior to surgery) and six months after the surgery. RESULTS Radical surgery for endometriosis was performed in 46 patients at our center over the period of six years. Among the patients, 73.9% of them had undergone previous surgery for endometriosis. In 82.6% of cases, a complete laparoscopic resection was carried out. Gastrointestinal tract resection was performed in 21.7%, and urinary tract resection was necessary in 8.7%. The mean age of the patients was 38.6 years. The rate of complications was 30.4%. Six months after the surgery, all items of the EHP-5 questionnaire had a lower score, which means an improvement in all aspects of quality of life related to endometriosis. The difference obtained between the scores before and after the surgery was statistically significant. The mean visual analog scale score before the surgery was 8.5, whereas it decreased to 1.4 after the surgery (P < 0.001). CONCLUSION Performing a radical surgery is a difficult decision to make; however, it can provide optimal results in terms of improvement of quality of life and, therefore, should be considered when conservative therapy fails. PMID:26966396

  3. 77 FR 51614 - CSX Transportation, Inc.-Abandonment Exemption-in Niagara County, NY

    Science.gov (United States)

    2012-08-24

    ... Abandonments to abandon a 0.1-mile rail line on its Northern Region, Albany Division, Niagara Subdivision, between milepost QDN 28.0 near North Avenue to the end of the track at milepost QDN 28.1, in Niagara Falls... Surface Transportation Board CSX Transportation, Inc.--Abandonment Exemption--in Niagara County, NY...

  4. Shot to Death: The Fate of Abandoned Places in the Hands of Artists

    Directory of Open Access Journals (Sweden)

    Nezaket Tekin

    2015-08-01

    Full Text Available This essay discusses the use of abandoned places by photographers. I review this subject from a perspective of remembering and forgetting. Giving examples of artists, especially photographer’s works whose subjects are abandoned places in Izmir and Detroit, I interpret photographs of abandoned places in the context of hauntology and ghost-metaphors.

  5. The Abandonment of an Active Lifestyle Within University Students: Reasons for Abandonment and Expectations of Re-Engagement

    Directory of Open Access Journals (Sweden)

    Manuel Gómez-López

    2011-08-01

    Full Text Available The objective of this research is to analyse in detail the barriers that make university students abandon the practice of physical activity and adopt a sedentary lifestyle. In order to do so, a questionnaire on the analysis of sports habits and lifestyles was administered to 795 students who stated not having done any physical and/or sports activity for at least one year at the moment of the field-work. A factorial, descriptive and correlation analysis was carried out. The results reveal that university students abandon a healthy lifestyle mainly due to external barriers particularly because of lack of time. On the one hand, women appear to be the ones who, to a great extent, adopt a sedentary lifestyle. On the other hand, men are the ones who refer more to abandoning the practice of physical activity due to internal barriers. The majority of the university students gave up practicing sport before entering university alluding to external barriers as their reason for the abandonment. A greater part of the sedentary university students expressing that they will be active in the future, left the practice of sport due to internal barriers.

  6. Guest Editorial: Processes of Radicalization and De-Radicalization

    Directory of Open Access Journals (Sweden)

    Donatella Della Porta

    2012-05-01

    Full Text Available The study of radicalization and de-radicalization, understood as processes leading towards the increased or decreased use of political violence, is central to the question of how political violence emerges, how it can be prevented, and how it can be contained. The focus section of this issue of the International Journal of Conflict and Violence addresses radicalization and de-radicalization, seeking to develop a more comprehensive understanding of the processes, dynamics, and mechanisms involved and taking an interdisciplinary approach to overcome the fragmentation into separate disciplines and focus areas. Contributions by Pénélope Larzillière, Felix Heiduk, Bill Kissane, Hank Johnston, Christian Davenport and Cyanne Loyle, Veronique Dudouet, and Lasse Lindekilde address repressive settings, legitimacy, institutional aspects, organizational outcomes, and dynamics in Europe, Asia, Africa, and North and South America.

  7. Surgical and Pathologic Outcomes of Fertility-Sparing Radical Abdominal Trachelectomy for FIGO Stage IB1 Cervical Cancer

    Science.gov (United States)

    Abu-Rustum, Nadeem R.; Neubauer, Nikki; Sonoda, Yukio; Park, Kay J.; Gemignani, Mary; Alektiar, Kaled M.; Tew, William; Leitao, Mario M.; Chi, Dennis S.; Barakat, Richard R.

    2016-01-01

    Objectives To describe the surgical and pathologic findings of fertility-sparing radical abdominal trachelectomy using a standardized surgical technique, and report the rate of post-trachelectomy adjuvant therapy that results in permanent sterility Methods A prospectively maintained database of all patients with FIGO stage IB1 cervical cancer admitted to the operating room for planned fertility-sparing radical abdominal trachelectomy was analyzed. Sentinel node mapping was performed via cervical injection of Technetium and blue dye. Results Between 6/2005 and 5/2008, 22 consecutive patients with FIGO stage IB1 cervical cancer underwent laparotomy for planned fertility-sparing radical abdominal trachelectomy. Median age was 33 years (range 23–43). Histology included 13 (59%) with adenocarcinoma and 9 (41%) with squamous carcinoma. Lymph-vascular invasion was seen in 9 (41%) cases. Only 3 (14%) needed immediate completion radical hysterectomy due to intraoperative findings (2 for positive nodes, 1 for positive endocervical margin). Median number of nodes evaluated was 23 (range 11–44); and 6 (27%) patients had positive pelvic nodes on final pathology – all received postoperative chemoradiation. Sixteen (73%) patients agreed to participate in sentinel node mapping which yielded a detection rate of 100%, sensitivity of 83%, specificity of 100% and false negative rate of 17%. Eighteen of 19 (95%) patients who completed trachelectomy had a cerclage placed, and 9/22 (41%) patients had no residual cervical carcinoma on final pathology. Median time in the operating room was 298 minutes (range 180–425). Median estimated blood loss was 250 ml (range 50–700), and median hospital stay was 4 days (range 3–6). No recurrences were noted at the time of this report. Conclusions Cervical adenocarcinoma and lymph-vascular invasion are common features of patients selected for radical abdominal trachelectomy. The majority of patients can undergo the operation successfully

  8. Investigate the Nursing Care after Hysterectomy%探讨全子宫切除术后的护理

    Institute of Scientific and Technical Information of China (English)

    粱慧

    2014-01-01

    Objective To analyze the clinical nursing measures after hysterectomy. Methods After the surgery for patients with provide basic nursing, psychological nursing, diet nursing and health guidance. Results For 42 patients after careful nursing, severe complications, no 1 patients al recovered from, length of hospital stay between 4 d ~ 10 d, average (5.2 + 1.7) d. Conclusion comprehensive after total hysterectomy and cor esponding clinical nursing intervention is helpful to improve the prognosis of patients, should pay at ention to promote the use in clinical.%目的:分析全子宫切除术后的临床护理措施。方法在手术完成后为患者提供基础护理、心理护理、饮食护理及健康指导。结果为42例患者提供精心的护理后,无1例患者产生严重并发症,均康复出院,住院时间在4~10d,平均(5.2±1.7)d。结论在全子宫切除术后进行全面及对应的临床护理干预有助于改善患者的预后状况,在临床中应重视推广使用。

  9. Conservative management of postmenopausal woman with prolonged use of the dislocated intrauterine device which was also unnoticed while hysterectomy

    Directory of Open Access Journals (Sweden)

    Mustafa Gazi Ucar

    2015-10-01

    Full Text Available The objectives of this study are to identify and compare the treatment options of woman with uterine perforation caused by intrauterine device (IUD. A 74-years-old woman presented with irritable voiding symptoms and a dislocated IUD into the peritoneal cavity was discovered incidentally during radiologic imaging. While a Lippes loop IUD had been inserted 35 years previously, she had a history of hysterectomy 10 years after an IUD insertion. Not only the patient had forgotten the presence of the IUD, but also it was unnoticed during hysterectomy. Patient has remained asymptomatic for over the 25 years, with the prolonged use of dislocated IUD. The patient managed conservatively and no need for surgical intervention. Once a gynaecologist is faced with the dilemma of whether it is necessary to remove a dislocated IUD or not, patients should undergo an individualized management, balancing both risks and benefits of surgical intervention. Asymptomatic elderly patients with comorbidities may benefit from conservative management with close monitoring. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1565-1567

  10. Redox Properties of Free Radicals.

    Science.gov (United States)

    Neta, P.

    1981-01-01

    Describes pulse radiolysis as a useful means in studing one-electron redox potentials. This method allows the production of radicals and the determination of their concentration and rates of reaction. (CS)

  11. Ecoporn, Irrationalities and Radical Environmentalism

    OpenAIRE

    Măntescu, Liviu

    2016-01-01

    This study explores the ‘irrationalities’ of deep ecology activism in the context of radical environmentalism by using the empirical example of ecoporn. Fuck For Forest is an environmental Non-Governmental Organisation which undertakes fund-raising for re-forestation and forest protection by means of pornography. Following twelve months of ethnographic fieldwork, this study presents first research results on a radical environmental project which does not promote democratic and established pro...

  12. Abandoned coal mine tunnels: Future heating/power Supply centers

    Institute of Scientific and Technical Information of China (English)

    Luo Pingjia; Chen Ning

    2011-01-01

    We have studied three plans for re-use of the abandoned mine roadway tunnels as an energy center.These are the thermostat plan,the thermal accumulator plan,and the CAES plan.Calculations show that the thermostat plan can provide over 15,000 m2 of building air-conditioning/heating load for each kilometer of roadway,but electric power is needed to run the system.Numerical research proved that the accumulation of hot water in the roadway for seasonal heating purposes (a temperature swing from 90 to 54 ℃) is a viable possibility.The CAES plan proposes using the discarded coal mine tunnel as a peaking power station with an energy storage density over 7000 kJ/m3.It can be concluded that presently abandoned coal mines could be reformed into future energy centers for a city.

  13. The problem of abandoned uranium tailings in northern Saskatchewan

    International Nuclear Information System (INIS)

    Two Saskatchewan tailings sites, Lorado and Gunnar, covering approximately 89 ha., were abandoned in the early 1960s leaving untreated tailings in lakes and depressions. This report reviews the literature on environmental conditions in abandoned uranium tailings and available managmenet and mitigation options, and identifies research requirements essential for proper treatment of these two sites. The recommended management plan includes isolation of the exposed tailings area from surface waters, stabilization of the exposed tailings surfaces, diversion of runoff around tailings, treatment of overflow water before release, and implementation of an environmental monitoring program. Revegetation appears to be a promising stabilization measure, but research is needed into propagation methods of appropriate native species. Studies of the existing geological and hydrological conditions at both sites, detailed characterization of the wastes, field testing of different surface treatment methods, and nutrient cycling investigations are also needed

  14. A Critique of Block on Abortion and Child Abandonment

    Directory of Open Access Journals (Sweden)

    Jakub Bożydar Wiśniewski

    2010-05-01

    Full Text Available The present paper offers a critique of Block on the issues of abortion and child abandonment. Block regards aborting a fetus or abandoning a child as an instance of exercising one’s libertarian right of expelling trespassers from one’s private property. I argue that the above reasoning is flawed due to the lack of the appreciation of the fact that if one voluntarily initiates the causal chain which leads to someone else ending up on his property, the latter person cannot be considered a trespasser. Furthermore, in the light of the above observation, any direct effects resulting from that person’s eviction should be considered the responsibility of the property’s owner. All of this follows from the simple logical fact that in all links of the causal chain under consideration the owner is the ultimate causal agent.

  15. Television method of controlling stowing of abandoned workings

    Energy Technology Data Exchange (ETDEWEB)

    Zimny, W.

    1978-01-01

    This method describes a method of monitoring stowing of an underground abandoned working by means of a television camera lowered through a drillhole from the surface. The method was used in Poland for the first time in the period from 1974 to 1976. The camera had been previously used to check the technical state of underground sewage systems. The sAV 18 camera can be lowered to a maximum depth of 400 m, it is explosion proof and can be used under conditions of explosion hazard. A scheme of the equipment is given. A method of determining size of old workings using the camera (with light source) is explained. Examples of photos made by the camera (on videotape) of the abandoned working being stowed with a sand-water mixture through a drillhole from the surface are also given. (In Polish)

  16. Abandoned Highway Sections: an Opportunity for Requalification Landscape Projects

    Directory of Open Access Journals (Sweden)

    Lucia Moretti

    2014-12-01

    Full Text Available With technology constantly improving, modern highways can nowadays be built through terrains where construction used to be either technically infeasible or too costly. While this results in faster connections and shorter commuting times, it leaves the abandoned historic routes behind without any use. This workshop was aimed at developing solutions for the requalification of abandoned highway sections, focusing on the example of the Autostrada del Sole which bypasses the little town of Vado, Bologna. A concept of converting the section into a Sole Park - a park which offers both relaxation and amusement elements - was developed in order to attract visitors from the neighboring villages and the high-speed highway. Within this context, potential locations for lookouts were identified, giving stunning vistas of the Tuscan-Emilian landscape.

  17. Should High-Frequency Ventilation in the Adult Be Abandoned?

    Science.gov (United States)

    Nguyen, Albert P; Schmidt, Ulrich H; MacIntyre, Neil R

    2016-06-01

    High-frequency oscillatory ventilation (HFOV) can improve ventilation-perfusion matching without excessive alveolar tidal stretching or collapse-reopening phenomenon. This is an attractive feature in the ventilation of patients with ARDS. However, two recent large multi-center trials of HFOV failed to show benefits in this patient population. The following review addresses whether, in view of these trails, HFOV should be abandoned in the adult population? PMID:27235314

  18. Characterization of abandoned rocket body families for active removal

    Science.gov (United States)

    Pardini, Carmen; Anselmo, Luciano

    2016-09-01

    A new ranking index was developed and applied to a wide set of rocket body families, characterized by stage dry masses greater than 500 kg and by the presence of at least 5 stages abandoned in LEO. The upper stages selected accounted for more than 80% of the unclassified rocket bodies in LEO and nearly 95% of the associated dry mass. The detailed results obtained for 657 objects clearly identified the most critical altitude-inclination bands and stage models, to be targeted first if and when a debris remediation strategy including the active removal of intact abandoned objects were deemed necessary. Apart from the evaluation of the criticality regarding the long-term evolution of the debris environment, resulting in a priority listing for optimal active removal, the application of the new ranking index is not limited to debris remediation. In fact, if applied before launch to spacecraft and rocket bodies to be disposed in orbit, at the end of mission, it would provide an additional debris mitigation analysis tool for evaluating competing disposal options. Concerning the rocket bodies abandoned in LEO, 274 resulted to have a criticality equal or larger than the average intact object abandoned in an 800 km sun-synchronous orbit. Among them, 243 belonged to the Russian Federation and Ukraine, 25 to China, 5 to Europe and 1 to Japan. In addition to being concentrated in relatively few and narrow altitude-inclinations bands, the most numerous rocket body families often present a quite uniform distribution in right ascension of the ascending node, which is especially convenient for multiple target removal missions.

  19. A randomized trial of prophylactic uterosacral ligament suspension at the time of hysterectomy for Prevention of Vaginal Vault Prolapse (PULS): design and methods.

    Science.gov (United States)

    Alperin, Marianna; Weinstein, Milena; Kivnick, Seth; Duong, Thinh H; Menefee, Shawn

    2013-07-01

    The primary aim of this randomized trial is to evaluate whether a standardized uterosacral ligament suspension colpopexy (USLSC), added to a planned hysterectomy for an indication other than pelvic organ prolapse (POP), decreases the rate of subsequent vaginal vault prolapse in women without preoperative symptomatic POP. Secondary aims include comparison of perioperative complications, urinary, bowel and sexual functions between subjects with and without concomitant USLSC. If shown to be beneficial, the cost-effectiveness of prophylactic USLSC at the time of hysterectomy will be evaluated. This trial will be performed at 4 centers across the United States. The data will be analyzed by the data-coordinating center of the Southern California Kaiser Permanente. Standardized questionnaires and objective measurements will be obtained. The patients and providers performing assessments are masked to treatment assignment. The primary outcome, defined as absence of POP at/distal to the hymen on Pelvic Organ Prolapse Quantitative examination, will be determined 12 months post-operatively. Secondary outcomes include: no prolapse symptoms by questionnaires, and no treatment for POP besides the prophylactic study intervention. Additional follow-up occurs annually for a total of 5 years. Accrual is projected to take 3 years. Given cost and morbidity of surgical repair of post-hysterectomy prolapse, preventive strategies are of outmost importance. The risks and benefits of prophylactic USLSC have never been studied prospectively. This trial is designed to determine if USLSC is an appropriate clinical adjunct at the time of hysterectomy, with subsequent reduction of symptomatic POP. PMID:23587538

  20. Incidental placenta increta at the time of prophylactic hysterectomy for Lynch syndrome: Insights into individualized decision-making and surgical timing

    OpenAIRE

    Nielsen, Tara A.; David, Stephanie N.; Desouki, Mohamed M; Crispens, Marta A.; Dineo Khabele

    2015-01-01

    Highlights • Increta in a prophylactic hysterectomy specimen for Lynch syndrome is rare. • Individualizing risk-reducing procedures after childbearing is important. • Shared decision making should include the timing of prophylactic surgery. • Minimizing surgical risks in the postpartum period should be discussed.

  1. "I no longer believe": did Freud abandon the seduction theory?

    Science.gov (United States)

    Ahbel-Rappe, Karin

    2006-01-01

    Recent accounts of the seduction theory and the question of its abandonment have emphasized the continuity of Freud's work before and after the seduction theory, claiming that Freud did not abandon his concern with the event of seduction but rather came to appreciate that an understanding of fantasy was also essential. This claim is challenged. It is shown that Freud did abandon the passionate concerns of his seduction theory for the most part; that he left behind his early interest in reconstructing unconscious infantile incest and focused instead on later, conscious seduction; that he at times clearly reduced apparent paternal incest to fantasy; that he turned away from the phenomenology of incest he had begun to develop; and that he theoretically nullified the value of the difference between real and fantasied seduction. It is also shown that, contrary to a persistent concern in psychoanalytic history, attention to actual seduction need not detract from the essential psychoanalytic concern with fantasy and infantile sexuality. Thinking about incest specifically illuminates the capacity for fantasizing, the core of the Freudian psyche. In this way the intuition of the seduction theory that there is something of distinctive psychoanalytic significance about incest finds support.

  2. Identification of Risks Pertaining to Abandoned Housing Projects in Malaysia

    Directory of Open Access Journals (Sweden)

    Hamzah Abdul-Rahman

    2015-01-01

    Full Text Available Housing industry is one of the most dynamic, risky, and challenging industries. In Malaysia, this industry has a poor reputation for managing risks, with many major projects failing to be completed within the allotted time. Due to the inherent risks involved in construction projects, it is essential to recognize the risks that cause problems associated with abandoned housing projects. Therefore, this study aims to identify the risks that contribute to issues of abandoned housing projects and to propose mitigation strategies. The methodologies used in this study are combination of qualitative and quantitative methods of literature review, questionnaire survey, and interview. The results show that many risks are involved in housing project, including risks related to environmental impacts, construction, politics, law, management, finance, materials, and economy, of which the probability of risks from unexpected ground condition, project delays, bureaucracy, contractual disputes between developer and landlord, weakness in management by inexperience developer, and financial crisis is very high. It was also found that all relevant parties involved in housing industry are required to have extensive cooperation in advance and should perform systematic risk management strategies in order to mitigate the risks leading to problems associated with abandoned housing projects.

  3. Secondary Forests from Agricultural Abandonment in Amazonia 2000-2009

    Science.gov (United States)

    Morton, Douglas

    2010-01-01

    Ongoing negotiations to include reducing emissions from tropical deforestation and forest degradation (REDD+) in a post-Kyoto climate agreement highlight the critical role of satellite data for accurate and transparent accounting of forest cover changes. In addition to deforestation and degradation, knowledge of secondary forest dynamics is essential for full carbon accounting under REDD+. Land abandonment to secondary forests also frames one of the key tradeoffs for agricultural production in tropical forest countries-whether to incentivize secondary forest growth (for carbon sequestration and biodiversity conservation) or low-carbon expansion of agriculture or biofuels production in areas of secondary forests. We examined patterns of land abandonment to secondary forest across the arc of deforestation in Brazil and Bolivia using time series of annual Landsat and MODIS data from 2000-2009. Rates of land abandonment to secondary forest during 2002-2006 were less than 5% of deforestation rates in these years. Small areas of new secondary forest were scattered across the entire arc of deforestation, rather than concentrated in any specific region of the basin. Taken together, our analysis of the satellite data record emphasizes the difficulties of addressing the pool of new secondary forests in the context of REDD+ in Amazonia. Due to the small total area of secondary forests, land sparing through agricultural intensification will be an important element of efforts to reduce deforestation rates under REDD+ while improving agricultural productivity in Amazonia.

  4. 剖宫产子宫切除术相关情况分析%The Analysis of Cesarean Hysterectomy during Caesarean Section

    Institute of Scientific and Technical Information of China (English)

    李湛

    2014-01-01

    Objective To investigate the related factors of cesarean hysterectomy during caesarean section. Methods From January 2003 to December 2012,a total of 14 601 women had delivery at department of obstetrical and gynecology in Bei-jing Chaoyang Hospital,among whom 7 178 momen received cesarean section,13 cases received cesarean hysterectomy during cesarean section,the general information,postpartum blood lossing,postoperative complications,and prognosis of mother and infant were analyzed retrospectively. Results Among 7 178 momen who received cesarean section during past 10 years,there were totally 13 cases who received cesarean hysterectomy,the incidence was 0. 18% ,10 cases received total hysterectomy,3 cases received subtotal hysterectomy. The indications of operation include placental factor(9 cases),hemorrhage and dissemi-nated intravascular coagulation(3 cases),and uterine atony(1 case). The postpartum hemorrhage was 600 to 12 600 ml(av-erage 3 800 ml). The postpartum hemorrhage,post - operative hospitalization duration,the proportion of cases with postopera-tive complications,and the proportion of cases who were transferred to ICU after operation of cases whose quantity of blood lossing≤1 500 ml when making the hysterectomy decision were significantly less than those of cases whose quantity of blood lossing >1 500 ml when making the hysterectomy decision(P 1500 ml 者产后出血量、术后住院日减少,术后并发症发生率及转 ICU 比例降低(P <0.05)。2例产妇分别于孕20周及孕24周因瘢痕子宫胎盘因素大量出血急诊行剖宫产术终止妊娠,其余11例进入围生期。13例产妇均治愈出院;11例围生儿中,早产儿7例,胎死宫内2例,新生儿重度窒息1例家属放弃抢救后死亡,轻度窒息1例。结论剖宫产子宫切除术胎盘因素是主要手术指征,剖宫产术中各种止血措施无效时应及时切除子宫。

  5. Age at Menarche, Level of Education, Parity and the Risk of Hysterectomy: A Systematic Review and Meta-Analyses of Population-Based Observational Studies.

    Directory of Open Access Journals (Sweden)

    Louise F Wilson

    Full Text Available Although rates have declined, hysterectomy is still a frequent gynaecological procedure. To date, there has been no systematic quantification of the relationships between early/mid-life exposures and hysterectomy. We performed a systematic review and meta-analyses to quantify the associations between age at menarche, education level, parity and hysterectomy.Eligible studies were identified by searches in PubMed and Embase through March 2015. Study-specific estimates were summarised using random effects meta-analysis. Heterogeneity was explored using sub-group analysis and meta-regression.Thirty-two study populations were identified for inclusion in at least one meta-analysis. Each year older at menarche was associated with lower risk of hysterectomy-summary hazard ratio 0.86 (95% confidence interval: 0.78, 0.95; I2 = 0%; summary odds ratio 0.88 (95% confidence interval: 0.82, 0.94; I2 = 61%. Low education levels conferred a higher risk of hysterectomy in the lowest versus highest level meta-analysis (summary hazard ratio 1.87 (95% confidence interval: 1.25, 2.80; I2 = 86%, summary odds ratio 1.51 (95% confidence interval: 1.35, 1.69; I2 = 90% and dose-response meta-analysis (summary odds ratio 1.17 (95% confidence interval: 1.12, 1.23; I2 = 85% per each level lower of education. Sub-group analysis showed that the birth cohort category of study participants, the reference category used for level of education, the year the included article was published, quality of the study (as assessed by the authors and control for the key variables accounted for the high heterogeneity between studies in the education level meta-analyses. In the meta-analyses of studies of parity and hysterectomy the results were not statistically significant.The present meta-analyses suggest that the early life factors of age at menarche and lower education level are associated with hysterectomy, although this evidence should be interpreted with some caution due to variance

  6. The games radicals play : special issue on free radicals and radical ions

    OpenAIRE

    Walton, John C; Ffrancon Williams

    2015-01-01

    Chemistry and Physics have aptly been described as “most excellent children of Intellect and Art” [1]. Both these “children” engage with many playthings, and molecules rank as one of their first favorites, especially radicals, which are amongst the most lively and exciting. Checking out radicals dancing to the music of entropy round their potential energy ballrooms is surely both entertaining and enlightening. Radicals’ old favorite convolutions are noteworthy, but the new styles, modes and a...

  7. Clinical Analysis of 110 Cases of Emergency Hysterectomy%急诊子宫切除110例临床分析

    Institute of Scientific and Technical Information of China (English)

    郭孝涵

    2015-01-01

    Objective To evaluate the incidence, risk factors, surgical indications, postoperative complications and maternal mortality rate of patients undergoing emergency hysterectomy from January 2004 to December 2014. Methods A retrospective analysis was performed on 110 patients who underwent emergency hysterectomy for 10 years. Results The incidence rate of emergency hysterectomy was 0.082% in 10 years. Hysterectomy was performed in 91 patients after cesarean, 19 cases of emergency hysterectomy after vaginal delivery. Mainly refers to the emergency hysterectomy syndrome is abnormal placenta, followed by uterine atony, uterine rupture and amniotic fiuid embolism. The main risk factors of emergency hysterectomy was the number of abortion, the twins, the giant, pregnancy complicated with uterine myoma. A previous history of cesarean section and the cesarean section operation increased incidence rate of emergency hysterectomy. A previous history of cesarean section also significantly increased the risk of placental implantation. Conclusion Placental abnormality is the most important indication of emergency hysterectomy, and emergency hysterectomy is still an important cause of maternal mortality.%目的:评估2004年1月至2014年12月在本院行急诊子宫切除患者的发病率、危险因素、手术指征、术后并发症及产妇死亡率。方法回顾性分析10年间110例行急诊子宫切除术的患者。结果10年间本院急诊子宫切除发生率为0.082%,91例患者剖宫产后行子宫切除术,阴道分娩后行急诊子宫切除术者19例。急诊子宫切除的主要指征是胎盘异常,其次为宫缩乏力、子宫破裂和羊水栓塞。流产次数多、双胎、巨大儿、妊娠合并子宫肌瘤也是急诊子宫切除的主要危险因素。前次剖宫产史及本次剖宫产手术都增加急诊子宫切除的发病率。前次剖宫产史也使胎盘植入的风险明显增加。结论胎盘异常是急诊子宫切除的最主

  8. Crystalline bipyridinium radical complexes and uses thereof

    Science.gov (United States)

    Fahrenbach, Albert C.; Barnes, Jonathan C.; Li, Hao; Stoddart, J. Fraser; Basuray, Ashish Neil; Sampath, Srinivasan

    2015-09-01

    Described herein are methods of generating 4,4'-bipyridinium radical cations (BIPY.sup..cndot.+), and methods for utilizing the radical-radical interactions between two or more BIPY.sup..cndot.+ radical cations that ensue for the creation of novel materials for applications in nanotechnology. Synthetic methodologies, crystallographic engineering techniques, methods of physical characterization, and end uses are described.

  9. Peroxy radical partitioning during the AMMA radical intercomparison exercise

    Directory of Open Access Journals (Sweden)

    M. D. Andrés-Hernández

    2010-04-01

    Full Text Available Peroxy radicals were measured onboard two scientific aircrafts during the AMMA (African Monsoon Multidisciplinary Analysis campaign in summer 2006. This paper reports results from the flight on 16 August 2006 during which measurements of HO2 by laser induced fluorescence spectroscopy at low pressure (LIF-FAGE and total peroxy radicals (RO2*=HO2+ΣRO2, R= organic chain by two similar instruments based on the peroxy radical chemical amplification (PerCA technique were subject of a blind intercomparison. The German DLR-Falcon and the British FAAM-BAe-146 flew wing tip to wing tip for about 30 min making concurrent measurements on 2 horizontal level runs at 697 and 485 hPa over the same geographical area in Burkina Faso. A full set of supporting measurements comprising photolysis frequencies, and relevant trace gases like CO, NO, NO2, NOy, O3 and a wider range of VOCs were collected simultaneously.

    Results are discussed on the basis of the characteristics and limitations of the different instruments used. Generally, no data bias are identified and the RO2* data available agree quite reasonably within the instrumental errors. The [RO2*]/[HO2] ratios, which vary between 1:1 and 3:1, as well as the peroxy radical variability, concur with variations in photolysis rates and in other potential radical precursors. Model results provide additional information about dominant radical formation and loss processes.

  10. Comparison of the effect of laparoscopic hysterectomy and abdominal hysterectomy on ovarian function%腹腔镜与开腹全子宫切除术对女性卵巢功能影响的比较

    Institute of Scientific and Technical Information of China (English)

    姜琦; 朱福梅

    2014-01-01

    目的:探讨腹腔镜下与开腹全子宫切除术对中青年女性卵巢功能的影响。方法选择60例未绝经的子宫良性疾病并需行子宫切除术的中青年患者,随机分为腹腔镜组和开腹组,每组各30例,比较两组患者围手术期指标、性激素水平及围绝经期综合征情况。结果腹腔镜组术中出血量、术后肛门排气时间均显著少于开腹组,差异有统计学意义( t值分别为4.27和3.11,P<0.05);术后6个月,两组患者卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、孕酮(P)水平相比,差异均无统计学意义(t值分别为0.69、0.95、0.67、-0.33,均P>0.05);术后12个月两组患者FSH、LH、E2、P水平差异也均无统计学意义(t值分别为0.88、-0.21、1.65、0.20,均P>0.05);两组患者术后围绝经期综合征发生率比较差异无统计学意义(χ2=0.10,P>0.05)。结论腹腔镜子宫切除术具有对机体创伤小、术后恢复快的优点,与传统子宫切除术相比不会增加对卵巢功能的损伤。%Objective To investigate the effect of laparoscopic hysterectomy ( LH) and abdominal hysterectomy ( AH) on ovarian function of young and middle-aged women.Methods Totally 60 young and middle-aged premenopausal patients with benign uterine disease were going to undergo hysterectomy .They were randomly divided into LH group and AH group with 30 cases in each .The perioperative indexes , sexual hormone level and perimenopausal syndrome were compared between two groups .Results The blood loss and postoperative flatus in LH group were significantly less than AH group , and the differences were significant (t value was 4.27 and 3.11, respectively, both P0.05).There were not significant differences in the serum levels of FSH , LH, E2 and P in 12 months after surgery ( t value was 0.88, -0.21, 1.65 and 0.20, respectively, all P >0.05 ).The incidence of

  11. Standard Electrode Potentials Involving Radicals in Aqueous Solution: Inorganic Radicals

    Energy Technology Data Exchange (ETDEWEB)

    Armstrong, David A.; Huie, Robert E.; Koppenol, Willem H.; Lymar, Sergei V.; Merenyi, Gabor; Neta, Pedatsur; Ruscic, Branko; Stanbury, David M.; Steenken, Steen; Wardman, Peter

    2015-12-01

    Recommendations are made for standard potentials involving select inorganic radicals in aqueous solution at 25 °C. These recommendations are based on a critical and thorough literature review and also by performing derivations from various literature reports. The recommended data are summarized in tables of standard potentials, Gibbs energies of formation, radical pKa’s, and hemicolligation equilibrium constants. In all cases, current best estimates of the uncertainties are provided. An extensive set of Data Sheets is appended that provide original literature references, summarize the experimental results, and describe the decisions and procedures leading to each of the recommendations

  12. Radical formation by heavy metals

    Energy Technology Data Exchange (ETDEWEB)

    Beuter, W.

    1982-09-01

    Certain reduced heavy metal ions can convert oxygen to a ''reactive oxygen species'' by donation of an electron. The reactive oxygen then attacks structures susceptible to oxidation, in particular unsaturated fatty acids, and peroxidizes them in a radical reaction. This process is inhibited by the presence of vitamin E and by other means. Peroxidized lipids decay forming free radicals in the process which themselves can peroxidise neighbouring lipids in a radical chain reaction. This decay is, moreover, catalysed by reduced heavy metal ions but on the other hand retarded by selenium-containing glutathione peroxidase. Radical formation by heavy metals is considerably involved in (i) the production of parenteral iron poisoning of the piglet (ii) haemolytic crisis occurring in ruminants through chronic copper poisoning (iii) the production of lead poisoning in ruminants and other animals. These types of poisonings are made worse by a deficiency of vitamin E and/or selenium. Factors which increase the bio-availability of the free heavy metal ion or reduce the redox potential thereof can aid radical formation as well as factors which lead to a reduction of the heavy metal ion e.g. cysteine, ascorbic acid or glucose.

  13. Epistemological barriers to radical behaviorism

    Science.gov (United States)

    O'Donohue, William T.; Callaghan, Glenn M.; Ruckstuhl, L. E.

    1998-01-01

    The historian and philosopher of science Gaston Bachelard proposed the concept of epistemological barriers to describe the intellectual challenges encountered by scientists in their work. In order to embrace novel ways of approaching a problem in science, scientists must overcome barriers or obstacles posed by their prior views. For example, Einsteinian physics presents scientists with claims that space is curved and that time and space are on the same continuum. We utilize Bachelard's concept of epistemological barriers to describe the differences between the intellectual journeys students pursuing advanced studies face when attempting to accept cognitive psychology or radical behaviorism. We contend that the folk psychological beliefs that students typically hold when entering these studies pose less challenge to cognitive psychology than to radical behaviorism. We also suggest that these barriers may also partly be involved in the problematic exegesis that has plagued radical behaviorism. In close, we offer some suggestions for dealing with these epistemological barriers. PMID:22478314

  14. Health-related quality of life after robotic-assisted laparoscopic hysterectomy for women with endometrial cancer

    DEFF Research Database (Denmark)

    Herling, Suzanne Forsyth; Møller, Ann M; Palle, Connie;

    2016-01-01

    OBJECTIVE: The aim of this prospective cohort study using patient-reported outcome measures (PROMs) was to detect short term changes in functioning, symptoms and health-related quality of life (HRQoL) after robotic-assisted laparoscopic hysterectomy (RALH) for endometrial cancer or atypical complex...... postoperatively, but back to baseline level at 5 weeks. Ability to perform work or hobbies and change of taste were still affected at 5 weeks. CONCLUSIONS: HRQoL and postoperative symptoms were overall back to the preoperative level 5 weeks after RALH. These findings indicate fatigue, pain, constipation......, gastrointestinal symptoms, appetite, ability to perform work and hobbies, change of taste and sexually related problems should be addressed in future research and in the pre- and postoperative care for women undergoing RALH....

  15. Vaginal radical trachelectomy: an update.

    Science.gov (United States)

    Plante, Marie

    2008-11-01

    The vaginal radical trachelectomy has emerged as a valuable fertility-preserving treatment option for young women with early-stage disease. Cancer-related infertility is associated with feelings of depression, grief, stress, and sexual dysfunction. Data have shown that the overall oncological outcome is safe and that the obstetrical outcome is promising. In this article, we analyze the data on the vaginal radical trachelectomy published over the last 10 years in the context of what we have learned, what issues remain unclear, and what the future holds.

  16. Radical democratic politics and feminism

    Directory of Open Access Journals (Sweden)

    Martínez Labrin, Soledad

    2006-05-01

    Full Text Available In the article I present a reflection around the radical democratic project proposed by Chantal Mouffe and Ernesto Laclau. Specifically, I examine the application of the project in the context of the “new social movements” and especially, of feminist movement. I state the need of drawing attention to universalism and essentialism as the main obstacles to generate a collective proposal without margins. Nevertheless, doubts remind about the possibility of building up a feminism tailored by the radical democratic project, in a stage in which the political action of such a movement is characterized by categories that are closed and crystallized

  17. Patterns and drivers of post-socialist farmland abandonment in Western Ukraine

    DEFF Research Database (Denmark)

    Baumann, Matthias; Kuemmerle, Tobias; Elbakidze, Marine;

    2011-01-01

    Farmland abandonment restructures rural landscapes in many regions worldwide in response to gradual industrialization and urbanization. In contrast, the political breakdown in Eastern Europe and the former Soviet Union triggered rapid and widespread farmland abandonment, but the spatial patterns...... substantial spatial variation in abandonment rates. However, many of our a priori hypotheses about the direction of variable influence were rejected. Most importantly, abandonment rates were higher in the plains and lower in marginal areas. The growing importance of subsistence farming in the transition...... period, as well as off-farm income and remittances likely explain these patterns. The breakdown of socialism appears to have resulted in fundamentally different abandonment patterns in the Western Ukraine, where abandonment was a result of the institutional and economic shock, compared to those in Europe...

  18. Measures of Vegetation Restoration in Abandoned Mined Lands

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    By 2004, the occupied and disturbed land area had reached 3.393 million ha by mining, of which forest land took 532 000 ha; In addition, mining also caused 3.721 million -5.316 million ha of degraded forests and woodlands. The impact of mining on environment is multi-fold and deep. Thus it is necessary and significant to approach effective methods to speed up vegetation restoration in abandoned mined lands. Phytoremediation is a relatively new technology (in the lastest decade) and the numbers of plant spec...

  19. Brent Spar abandonment - Best Practicable Environmental Option (BPEO) assessment

    International Nuclear Information System (INIS)

    Possible methods of abandoning or re-using the Brent Spar storage and tanker offloading facility following its decommissioning in 1991 are discussed. The report assesses six of the thirteen possible methods, including horizontal dismantling and onshore disposal, vertical dismantling and onshore disposal, in-field disposal, deep water disposal, refurbishment and re-use, and continued maintenance, in order to determine the Best Practicable Environmental Option (BPEO). The BPEO covers technical feasibility risks to health and safety of the work force, environmental impacts, public acceptability and costs. (UK)

  20. Abandonment Fears in Persons with Alzheimer's at Adult Day Care Centers

    OpenAIRE

    Judkins, Wayne A

    1999-01-01

    In my research, I examined abandonment fears in persons with Alzheimerâ s disease at the Salem Veterans Affairs adult day care center. I observed fifty hours at the center, and conducted open-ended interviews with two of the participants and their respective caregivers. These two participants (Ellen and Opel) at the center expressed abandonment fears much more frequently than any of the other participants. I found that most of the time, these two women would express their abandonment f...

  1. Direct measurements of methane emissions from abandoned oil and gas wells in Pennsylvania

    OpenAIRE

    Kang, Mary; Kanno, Cynthia M.; Reid, Matthew C.; Zhang, Xin; Mauzerall, Denise L.; Celia, Michael A.; Chen, Yuheng; Onstott, Tullis C.

    2014-01-01

    Recent studies indicate that greenhouse gas emission inventories are likely missing methane emission sources. We conducted the first methane emission measurements from abandoned oil and gas wells and found substantial emissions, particularly from high-emitting abandoned wells. These emissions are not currently considered in any emissions inventory. We scaled methane emissions from our direct measurements of abandoned wells in Pennsylvania and calculate that they represent 4–7% of current tota...

  2. Detecting Social Polarization and Radicalization

    DEFF Research Database (Denmark)

    Qureshi, Pir Abdul Rasool; Memon, Nasrullah; Wiil, Uffe Kock;

    2011-01-01

    This paper proposes a novel system to detect social polarization and to estimate the chances of violent radicalization associated with it. The required processes for such a system are indicated; it is also analyzed how existing technologies can be integrated into the proposed system to fulfill the...

  3. Kinetics of nitroxyl radical reactions

    International Nuclear Information System (INIS)

    Absolute rate-constants for the reaction of the nitroxyl free radicals TAN and TMPN with radiation-chemically-formed radicals and ions have been determined. k(TAN + X) (in M-1 sec-1) = 4.0 x 109 (for X =OH), 2.9 x 1010(esub(aq)-), 8.0 x 109 (H), 7.2 x 108 (CH2OH), 4.0 x 108 (CH3CHOH), 4.3 x 108 ((CH3)2COH), 2.8 x 108 (CH2(CH3)2COH), 5.9 x 107 (glucose radical), 4.0 x 108 (c-C5H9), and k(TMPN + X) = 3.4 x 109 (OH), 7.8 x 109 (esub(aq)-), 4.9 x 109 (H), 4.4 x 108 (CH2OH), 4.9 x 108 (CH3CHOH), 3.6 x 108 ((CH3)2COH), 1.5 x 108 (CH2(CH3)2COH), 4.9 x 107 (glucose radical), 4.3 x 108 (c-C5H9). Direct measurements by means of a pulse-radiolysis conductivity technique were based on the formation and destruction of charged species in these reactions within certain pH ranges. It is indicated that the radiosensitizing nitroxyles undergo both redox and addition reactions. (author)

  4. Remembering Dutch-Moluccan radicalism

    DEFF Research Database (Denmark)

    Marselis, Randi Lorenz

    2016-01-01

    This article examines memory politics in relation to radical actions of young Dutch-Moluccans, more specifically a train hijacking in 1977 at the village of De Punt in the Netherlands. The article examines how these historical events were remembered in the drama-documentary television film, De Punt...

  5. Wild radical square zero algebras

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    It is shown that a radical square zero algebra is wild, if and only if it is of Corner's type, and it is strictly wild if and only if it is Endo-wild. This gives a negative answer to a problem posed by Simson.

  6. Exploring the Theories of Radicalization

    Directory of Open Access Journals (Sweden)

    Maskaliūnaitė Asta

    2015-12-01

    Full Text Available After the London bombings in July 2005, the concern of terrorism scholars and policy makers has turned to “home-grown” terrorism and potential for political violence from within the states. “Radicalization” became a new buzz word. This article follows a number of reviews of the literature on radicalization and offers another angle for looking at this research. First, it discusses the term “radicalization” and suggests the use of the following definition of radicalization as a process by which a person adopts belief systems which justify the use of violence to effect social change and comes to actively support as well as employ violent means for political purposes. Next, it proposes to see the theories of radicalization focusing on the individual and the two dimensions of his/her motivation: whether that motivation is internal or external and whether it is due to personal choice or either internal (due to some psychological traits or external compulsion. Though not all theories fall neatly within these categories, they make it possible to make comparisons of contributions from a variety of different areas thus reflecting on the interdisciplinary nature of the study of terrorism in general and radicalization as a part of it.

  7. Cervicovaginal human papillomavirus (HPV)-infection before and after hysterectomy: evidence of different tissue tropism for oncogenic and nononcogenic HPV types in a cohort of HIV-positive and HIV-negative women.

    Science.gov (United States)

    D'Souza, Gypsyamber; Burk, Robert D; Zhong, Ye; Minkoff, Howard; Massad, L Stewart; Xue, Xiaonan; Watts, D Heather; Anastos, Kathryn; Palefsky, Joel M; Levine, Alexandra M; Colie, Christine; Castle, Philip E; Strickler, Howard D

    2012-09-15

    Human papillomavirus (HPV) is detected in nearly all cervical cancers and approximately half of vaginal cancers. However, vaginal cancer is an order of magnitude less common than cervical cancer, not only in the general population but also among women with HIV/AIDS. It is interesting therefore that recent studies found that HPV was common in both normal vaginal and cervical tissue, with higher prevalence of nononcogenic HPV types in the vagina. In our investigation, we prospectively examined HPV infection in 86 HIV-positive and 17 HIV-negative women who underwent hysterectomy during follow-up in a longitudinal cohort. Cervicovaginal lavage specimens were obtained semi-annually and tested for HPV DNA by polymerase chain reaction. To address possible selection biases associated with having a hysterectomy, subjects acted as their own comparison group--before versus after hysterectomy. The average HPV prevalence was higher in HIV-positive than HIV-negative women both before (59% vs. 12%; p < 0.001) and after hysterectomy (56% vs. 6%; p < 0.001). Multivariate random effects models (within-individual comparisons) demonstrated significantly lower HPV prevalence [odds ratio (OR) = 0.71; 95% confidence interval (CI) = 0.59-0.85) after hysterectomy. The association of HPV prevalence with hysterectomy was similar among HIV-positive and HIV-negative women. However, hysterectomy had greater effects on oncogenic (OR = 0.48; 95% CI = 0.35-0.66) than nononcogenic HPV types (OR = 0.89; 95% CI = 0.71-1.11; P(interaction) = 0.002). Overall, we observed greater reductions in oncogenic than nononcogenic HPV prevalence after hysterectomy. If correct, these data could suggest that oncogenic HPV have greater tropism for cervical compared to vaginal epithelium, consistent with the lower incidence of vaginal than cervical cancer.

  8. Fiscal year 1996 well plugging and abandonment program Y-12 Plant, Oak Ridge, Tennessee

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-04-01

    This report is a synopsis of the progress of the well plugging and abandonment program at the Oak Ridge Y-12 Plant, Oak Ridge, Tennessee, from August 1995 through August 1996. A total of 27 wells, piezometers, and borings were plugged and abandoned during the period of time covered in this report. All wells and borings were plugged and abandoned in accordance with the Monitoring Well Plugging and Abandonment Plan for the U.S. Department of Energy, Y-12 Plant, Oak Ridge, Tennessee (HSW, Inc. 1991).

  9. Preoperative radium therapy and radical hysterectomy in the treatment of cervical cancer stage IB, IIA, and initial IIB.; Radiumterapia pre-operatoria e histerectomia radical no tratamento do cancer do colo uterino IB, IIA e IIB inicial

    Energy Technology Data Exchange (ETDEWEB)

    Salum, Resalla; Lopes, Edison R.; Souza, Maria A.H. de [Faculdade de Medicina do Triangulo Mineiro, Uberaba, MG (Brazil). Hospital Escola

    1995-07-01

    Patients with IB, IIa and in initial IIb cervical cancer were randomized for combined therapy, consisting of one or two radium insertion followed by Wertheim Meigs operation performed 40 days later. We look for the early and late complications of the treatment, residual cancer after radiotherapy and survival without recurrence. The project begin in 1965 and ended in 1986. All the operations were done by one of the investigators and 116 patients were analysed. The age ranged from 21 to 75 years with an average of 4.18 years. During the operations 31 (26.72%) patients needed 1.500 cc or greater amount of blood transfusion and we have 3 iliac veins lesions. Managing the ureters, we do our best to leave the posterior fascia as intact as possible. Post operative complications ranged from minor (fever, localised pelvic infections, temporary popliteal nerve paralysis) to evisceration (3 patients) deep venous thrombosis (3 patients) and two early urinary fistulas. Late complications were seen in patients submitted to sequential teletherapy irradiation. One uretrovaginal fistula occurred 10 month after treatment, another one, 7 years later and the third one 24 years later. One patient develop hydronefrosis and enterocolite after 7.000 rads of teletherapy and another one rectovaginal fistula 13 years after initial therapy. The shortening of the vagina making impossible the intercourse was seen in 7 patients. By the histological examination, the cervix was sterilized in 73.3 % of the patients. Residual cancer was found according the original size of the tumour and the stage of the disease. Studying different combinations between the existence of residual cervical cancer with positive or negative limphnodes and making a correlation with survival, we found the critical points is to have positive cervix and positive lymphonodes. The five years survival (life table methodology) for stage 1 lesion was 96%; stage II, 67%. At ten years survival was slighted different. With positive lymphnodes the survival was 47.38%. We believe the combined therapy has an important place in the treatment of cervical cancer stage I,IIA and initial IB. (author). 31 refs., 8 figs., 10 tabs.

  10. [Postoperative radiotherapy in patients with invasive uterine cervix cancer treated previously with simple hysterectomy. Results from the Hospital de Oncología, Centro Médico Nacional SXXI. ].

    Science.gov (United States)

    Huerta Bahena, Judith; Labastida Almendaro, Sonia; Cortez Arroyo, Héctor; Calva, Angel

    2003-06-01

    Invasive carcinoma found after simple hysterectomy for several causes is an increasing clinical condition. That situation results in the necessity for further therapy: re-operation or radiotherapy. The purpose of this review is to analyze our results with postoperative radiotherapy for these patients. In 1998, 59 patients were submitted to postoperative radiotherapy at the Oncology Hospital, Medical Cancer Center for invasive cervical cancer found after simple hysterectomy for several causes. All patients had postoperative radiotherapy, the dose depended of the magnitude of residual disease after surgery (range 10-80 Gy). After surgery 27 patients had gross residual disease; and no residual disease or microscopic disease was present in 32 patients. Three years overall survival rate was 59% for the whole group. With the results of the univariate analysis, prognostic factors found that significantly affect disease free survival were interval between hysterectomy and radiotherapy of more than 6 months, radiotherapy dose less than 50 Grays and histology. With multivariate analysis only presence of gross residual disease affect significantly disease free survival p = 0.0000. Postoperative radiotherapy results in patients with invasor cervical cancer incidentally found in hysterectomy specimens with minimal residual disease are excellent. However with the presence of more extensive residual disease the results in disease free survival are worse than those obtained in patients with similar stages who had not been treated with hysterectomy. A well established diagnostic procedure must be done in all patients candidates to simple hysterectomy.

  11. From Radical Translation to Radical Interpretation and Back

    Directory of Open Access Journals (Sweden)

    António Zilhão

    2003-12-01

    Full Text Available Both Quine and Davidson put forth programs of empirical semantics satisfying the conditions that characterize the so-called “standpoint of interpretation.” Quine’s less ambitious program of radical translation rests upon two buttresses: causality and empathy. Davidson’s more ambitious program of radical interpretation replaces causality with truth and empathy with rationality. Although the replacement of causality with intersubjective truth seems to me to be a fully justified move, I nevertheless contend that it is more realistic to develop the work of interpretation drawing upon Quine’s less ambitious requirement of empathy than upon Davidson’s view of human agency as rational agency. In order to substantiate this contention, I present an argument to the effect that Davidson’s characterization of human agency as rational is not compatible with his other requirement that truth should pro-vide the essential link connecting speech with environment and action.

  12. Reaction between protein radicals and other biomolecules

    DEFF Research Database (Denmark)

    Østdal, Henrik; Davies, Michael Jonathan; Andersen, Henrik J

    2002-01-01

    The present study investigates the reactivity of bovine serum albumin (BSA) radicals towards different biomolecules (urate, linoleic acid, and a polypeptide, poly(Glu-Ala-Tyr)). The BSA radical was formed at room temperature through a direct protein-to-protein radical transfer from H(2)O(2......)-activated immobilized horseradish peroxidase (im-HRP). Subsequently, each of the three different biomolecules was separately added to the BSA radicals, after removal of im-HRP by centrifugation. Electron spin resonance (ESR) spectroscopy showed that all three biomolecules quenched the BSA radicals....... Subsequent analysis showed a decrease in the concentration of urate upon reaction with the BSA radical, while the BSA radical in the presence of poly(Glu-Ala-Tyr) resulted in increased formation of the characteristic protein oxidation product, dityrosine. Reaction between the BSA radical and a linoleic acid...

  13. 全子宫切除术后阴道微生态状况分析%Vaginal micro ecological condition analysis after total hysterectomy

    Institute of Scientific and Technical Information of China (English)

    宋世静; 牛战琴

    2015-01-01

    目的:了解全子宫切除术后患者阴道微生态的恢复情况,探讨全子宫切除术后阴道微生态评价的临床意义。方法:选取40例全子宫切除术后2个月复查的患者,取阴道分泌物进行微生态评价,以同期40例体检妇女作为对照。结果:全子宫切除术后阴道优势菌以乳酸杆菌为主的者占41%;菌群密集度多为(++)~(+++),占50%;菌群多样性多为(++)~(+++),占42.5%;pH≤4.5,占35%;外因阴道假丝酵母菌(VVC)阳性率为5%;阴道毛滴虫阳性率为2.5%;细菌性阴道病(BV)阳性率为25%;微生态失调的发生率为67.5%。结论:全子宫切除术后,阴道微生态失调发生率明显增高;全子宫切除术后阴道微生态的失调与全子宫切除手术范围、卵巢去留等无关;全子宫切除术后细菌性阴道病的发病率增高;评价全子宫切除术后阴道微生态环境的状况,对预防与治疗术后生殖道感染具有重要指导意义。%Objective:To understand the recovery of patients after total hysterectomy vaginal microecological,investigate clinical significance of vaginal micro ecological evaluation after hysterectomy. Methods:Methods:The vaginal secretions of 40 cases of total hysterectomy two months later were microecology evaluated. 40 cases of physical examination of women as a con-trol. Results:After total hysterectomy vaginal advantage bacterium is given priority to with lactic acid bacteria,accounting for 41% . Bacteria concentration in( + + )~( + + + ),accounted for 50% . Flora diversity in( + + )~( + + + ),accounted for 42. 5% ;pH 4. 5 or less,accounting for 35% . VVC positive rate is 5% . Trichomonas vaginalis positive rate is 2. 5% . BV posi-tive rate is 25% . The incidence of micro ecological imbalance accounted for 67. 5% . Conclusion:After total hysterectomy,vagi-nal microecological imbalance rate increased obviously. The vaginal

  14. Leiomioma benigno metastatizante de veia cava inferior: rara complicação tardia de histerectomia Benign metastasizing leiomyoma of inferior vena cava: a rare condition following hysterectomy

    Directory of Open Access Journals (Sweden)

    Marcos Filgueiras

    2008-08-01

    Full Text Available Large vessel tumors diagnosis is usually difficult. Benign metastasizing leiomyoma is a rare condition occurring inside peripheral vessels. There are few publications about this tumor inside inferior vena cava. A 54 years old female patient is presented with a previous hysterectomy for myomas. She complained of no specific symptoms 18 months after surgery. Computer tomography revealed a 7.5 x 3.5 x 4.0 cm mass at inferior vena cava and right psoas muscle. After surgical management and immunohistochemical screening biopsy, the diagnosis was benign metastasizing leiomyoma of inferior vena cava. The patient recovery was uneventful. Benign metastasizing leiomyoma of inferior vena cava is a very rare condition, and must be suspected in patients with primary leiomyosarcoma, especially in women previously submitted to hysterectomy for leiomyomatosis.

  15. Electron attachment to fluorocarbon radicals

    Science.gov (United States)

    Shuman, Nicholas

    2014-10-01

    Most plasma environments contain populations of short-lived species such as radicals, the chemistry of which can have significant effects on the overall chemistry of the system. However, few experimental measurements of the kinetics of electron attachment to radicals exist due to the inherent difficulties of working with transient species. Calculations from first principles have been attempted, but are arduous and, because electron attachment is so sensitive to the specifics of the potential surface, their accuracy has not been established. Electron attachment to small fluorocarbon radicals is particularly important, as the data are needed for predictive modeling of plasma etching of semiconductor materials, a key process in the industrial fabrication of microelectronics. We have recently developed a novel flowing afterglow technique to measure several types of otherwise difficult to study plasma processes, including thermal electron attachment to radicals. Variable Electron and Neutral Density Attachment Mass Spectrometry (VENDAMS) exploits dissociative electron attachment in a weakly ionized plasma as a radical source. Here, we apply VENDAMS to a series of halofluorocarbon precursors in order to measure the kinetics of thermal electron attachment to fluorocarbon radicals. Results are presented for CF2, CF3, C2F5,C2F3,1-C3F7, 2-C3F7, and C3F5 from 300 K to 900 K. Both the magnitude and the temperature dependences of rate coefficients as well as product branching between associative and dissociative attachment are highly system specific; however, thermal attachment to all species is inefficient, never exceeding 5% of the collision rate. The data are analyzed using a recently developed kinetic modeling approach, which uses extended Vogt-Wannier theory as a starting point, accounts for dynamic effects such as coupling between the electron and nuclear motions through empirically validated functional forms, and finally uses statistical theory to determine the fate of

  16. Post-Soviet cropland abandonment and carbon sequestration in European Russia, Ukraine, and Belarus

    Science.gov (United States)

    Schierhorn, Florian; Müller, Daniel; Beringer, Tim; Prishchepov, Alexander V.; Kuemmerle, Tobias; Balmann, Alfons

    2013-12-01

    Widespread cropland abandonment occurred after the collapse of socialism across the former Soviet Union, but the rates and spatial patterns of abandoned lands are not well known. As a result, the potential of this region to contribute to global food production and estimates of the carbon sink developing on currently idle lands are highly uncertain. We developed a spatial allocation model that distributes yearly and subnational sown area statistics to the most agriculturally suitable plots. This approach resulted in new, high-resolution (1 km2) annual time series of cropland and abandoned lands in European Russia, Ukraine, and Belarus from 1990 to 2009. A quantitative validation of the cropland map confirms the reliability of this data set, especially for the most important agricultural areas of the study region. Overall, we found a total of 87 Mha of cropland and 31 Mha of abandoned cropland in European Russia, Ukraine, and Belarus combined, suggesting that abandonment has been severely underestimated in the past. The abandonment rates were highest in European Russia. Feeding our new map data set into the dynamic vegetation model LPJmL revealed that cropland abandonment resulted in a net carbon sink of 470 TgC for 1990 to 2009. Carbon sequestration was generally slow in the early years after abandonment, but carbon uptake increased significantly after approximately 10 years. Recultivation of older abandoned lands would be associated with high carbon emissions and lead to substantial amounts of carbon not being sequestered in vegetation formations currently developing on idle croplands. Our spatially and temporally explicit cropland abandonment data improve the estimation of trade-offs involved in reclaiming abandoned croplands and thus in increasing agricultural production in this globally important agricultural region.

  17. 20 cases of Postpartum Hemorrhage Hysterectomy Treatment Study%产后出血子宫切除20例诊疗探讨

    Institute of Scientific and Technical Information of China (English)

    石恒; 刘利; 陈圣莲

    2013-01-01

    目的探讨产后出血子宫切除的病因及处理措施。方法回顾性分析20例产科子宫切除病例的病因及诊治过程。结果产后出血子宫切除的主要有宫缩乏力、胎盘因素(早剥、粘连、植入、嵌顿等)、产道裂伤、凝血功能障碍四大病因[1];产后出血子宫切除发生率与产前检查、孕产次、产科并发症的诊治水平密切相关。结论加强围生期保健,密切观察产程,防治产科并发症、积极处理,保守治疗无效时立即切除子宫,可有效治疗急性产后大出血,挽救产妇生命。降低孕产妇死亡率。%Objective To investigate the cause of postpartum hemorrhage hysterectomy and treatment measures. Methods A retrospective analysis of 20 cases of obstetric hysterectomy cases the cause and treatment process. Results postpartum hemorrhage hysterectomy are uterine inertia, placenta (abruption, adhesions, implants, incarcerated, etc.), birth canal laceration, four major causes coagulation dysfunction [1]; hysterectomy incidence of postpartum hemorrhage and productivity before the examination, motherhood, diagnosis and treatment of obstetric complications are closely related. Conclusion Strengthening perinatal care, close observation of the birth process, preventing obstetric complications, active treatment, conservative treatment fails Immediate removal of the uterus, which can ef ectively treat acute postpartum hemorrhage, save maternal life. Reducing maternal mortality.

  18. Radical carbonylations using a continuous microflow system

    Directory of Open Access Journals (Sweden)

    Takahide Fukuyama

    2009-07-01

    Full Text Available Radical-based carbonylation reactions of alkyl halides were conducted in a microflow reactor under pressurized carbon monoxide gas. Good to excellent yields of carbonylated products were obtained via radical formylation, carbonylative cyclization and three-component coupling reactions, using tributyltin hydride or TTMSS as a radical mediator.

  19. Oxygen free radicals in rheumatoid arthritis

    NARCIS (Netherlands)

    P. Biemond (Pieter)

    1986-01-01

    textabstractCurrent knowledge strongly suggests that oxygen free radicals are involved in the pathogenesis of RA. Additional information about the mechanism of free radical attack is necessary in order to find out if interaction with the mechanism of free radical damage can be used in the treatment

  20. The Prognosis of Patients with Stage Ib-IIb Node-Positive Cervical Carcinoma after Radical Surgery

    Institute of Scientific and Technical Information of China (English)

    XiCheng; ShumoCai; ZitingLi; MeiqinTang; MuquanXue; RongyuZang

    2004-01-01

    OBJECTIVE To investigate the influence of positive lymph nodes on the prognosis for patients with stage Ib-IIb cervical carcinoma.METHODS Sixty-six patients with stage Ib-IIb cervical carcinoma who underwent a radical hysterectomy and pelvic lymphadenectomy were analyzed retrospectively. The potential prognostic factors were calculated by the Cox proportional hazard model.RFSULTS The 5-year survival of metastasis was 40.7%. The Coxthe patients with pelvic lymph node proportional hazard model analysis showed that cellular differentiation, the number of positive nodes and adjuvant therapy were independent prognostic factors (PO.05). The 5-year survival of the patients who had no adjuvant therapy (12.6%) was much lower than that(53.7%) of those with adjuvant therapy (P0.05).CONCLUSION The prognosis of patients with stage Ib-IIb node-positive cervical carcinoma who underwent radical surgery was poor. Adjuvant therapy can increase the survival rate, decrease the pelvic recurrence and distant metastasis.

  1. DNA binding hydroxyl radical probes

    Energy Technology Data Exchange (ETDEWEB)

    Tang, Vicky J.; Konigsfeld, Katie M.; Aguilera, Joe A. [Department of Radiology, University of California at San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0610 (United States); Milligan, Jamie R., E-mail: jmilligan@ucsd.edu [Department of Radiology, University of California at San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0610 (United States)

    2012-01-15

    The hydroxyl radical is the primary mediator of DNA damage by the indirect effect of ionizing radiation. It is a powerful oxidizing agent produced by the radiolysis of water and is responsible for a significant fraction of the DNA damage associated with ionizing radiation. There is therefore an interest in the development of sensitive assays for its detection. The hydroxylation of aromatic groups to produce fluorescent products has been used for this purpose. We have examined four different chromophores, which produce fluorescent products when hydroxylated. Of these, the coumarin system suffers from the fewest disadvantages. We have therefore examined its behavior when linked to a cationic peptide ligand designed to bind strongly to DNA. - Highlights: > Examined four aromatic groups as a means to detect hydroxyl radicals by fluorescence. > Coumarin system suffers from the fewest disadvantages. > Characterized its reactivity when linked to a hexa-arginine peptide.

  2. Free radicals and Dupuytren's contracture.

    OpenAIRE

    Murrell, G. A.; Francis, M. J.; Bromley, L.

    1987-01-01

    The concentration of substrate expressed as hypoxanthine capable of reacting with xanthine oxidase to release superoxide free radicals (O2-) was measured in control and Dupuytren's contracture palmar fascia. In Dupuytren's contracture palmar fascia the concentration of hypoxanthine was six times that of control and was greatest in "nodular" areas. Xanthine oxidase activity was also detected in Dupuytren's contracture palmar fascia. These results suggest a greater potential for hypoxanthine-xa...

  3. Geoscientists and the Radical Middle

    Science.gov (United States)

    Tinker, S. W.

    2015-12-01

    Addressing the great challenges facing society requires industry, government, and academia to work together. I call this overlap space, where compromises are made and real solutions determined, the Radical Middle. Radical because it can appear at times as if the loudest and most publicly influential voices lie outside of the actual solution space, content to provoke but not problem-solve. One key area where geoscientists can play a lead role in the Radical Middle is in the overlap between energy, the environment, and the economy. Globally, fossil fuels still represent 85% of the aggregate energy mix. As existing conventional oil and natural-gas reservoir production continues to slowly decline, unconventional reservoirs, led today by shale and other more expensive resources, will represent a growing part of the oil and gas production mix. Many of these unconventional reservoirs require hydraulic fracturing. The positive economic impact of hydraulic fracturing and associated natural gas and oil production on the United States economy is well documented and undeniable. Yet there are environmental concerns about fracking, and some states and nations have imposed moratoria. This energy-environment-economy space is ideal for leadership from the geosciences. Another such overlap space is the potential for geoscience leadership in relations with China, whose economy and global presence continue to expand. Although China is building major hydropower and natural-gas power plants, as well as nuclear reactors, coal is still king—with the associated environmental impacts. Carbon sequestration—onshore in brine and to enhance oil recovery, as well as offshore—could prove viable. It is vital that educated and objective geoscientists from industry, government, and academia leave their corners and work together in the Radical Middle to educate the public and develop and deliver balanced, economically sensible energy and environmental strategies.

  4. Why do leaf-tying caterpillars abandon their leaf ties?

    Directory of Open Access Journals (Sweden)

    Michelle Sliwinski

    2013-09-01

    Full Text Available Leaf-tying caterpillars act as ecosystem engineers by building shelters between overlapping leaves, which are inhabited by other arthropods. Leaf-tiers have been observed to leave their ties and create new shelters (and thus additional microhabitats, but the ecological factors affecting shelter fidelity are poorly known. For this study, we explored the effects of resource limitation and occupant density on shelter fidelity and assessed the consequences of shelter abandonment. We first quantified the area of leaf material required for a caterpillar to fully develop for two of the most common leaf-tiers that feed on white oak, Quercus alba. On average, Psilocorsis spp. caterpillars consumed 21.65 ± 0.67 cm2 leaf material to complete development. We also measured the area of natural leaf ties found in a Maryland forest, to determine the distribution of resources available to caterpillars in situ. Of 158 natural leaf ties examined, 47% were too small to sustain an average Psilocorsis spp. caterpillar for the entirety of its development. We also manipulated caterpillar densities within experimental ties on potted trees to determine the effects of cohabitants on the likelihood of a caterpillar to leave its tie. We placed 1, 2, or 4 caterpillars in ties of a standard size and monitored the caterpillars twice daily to track their movement. In ties with more than one occupant, caterpillars showed a significantly greater propensity to leave their tie, and left sooner and at a faster rate than those in ties as single occupants. To understand the consequences of leaf tie abandonment, we observed caterpillars searching a tree for a site to build a shelter in the field. This is a risky behavior, as 17% of the caterpillars observed died while searching for a shelter site. Caterpillars that successfully built a shelter traveled 110 ± 20 cm and took 28 ± 7 min to find a suitable site to build a shelter. In conclusion, leaf-tying caterpillars must frequently

  5. Impact of uranium mines closure and abandonment on groundwater quality.

    Science.gov (United States)

    Rapantova, Nada; Licbinska, Monika; Babka, Ondrej; Grmela, Arnost; Pospisil, Pavel

    2013-11-01

    The aim of the study is to assess the evolving mine water quality of closed uranium mines (abandoned between 1958 and 1992) in the Czech Republic. This paper focuses on the changes in mine water quality over time and spatial variability. In 2010, systematic monitoring of mine water quality was performed at all available locations of previous uranium exploitation. Gravity flow discharges (mine adits, uncontrolled discharges) or shafts (in dynamic state or stagnating) were sampled. Since the quality of mine water results from multiple conditions-geology, type of sample, sampling depth, time since mine flooding, an assessment of mine water quality evolution was done taking into account all these conditions. Multivariate analyses were applied in order to identify the groups of samples based on their similarity. Evaluation of hydrogeochemical equilibrium and evolution of mine waters was done using the Geochemist's Workbench and PHREEQC software. The sampling proved that uranium concentrations in mine waters did not predominantly exceed 0.45 mg/L. In case of discharges from old adits abandoned more than 40 years ago, uranium concentrations were below the MCL of US Environmental Protection Agency for uranium in drinking water (0.03 mg/L). Higher concentrations, up to 1.23 mg/L of U, were found only at active dewatered mines. Activity concentration of 226Ra varied from 0.03 up to 1.85 Bq/L except for two sites with increased background values due to rock formation (granites). Radium has a typically increasing trend after mine abandonment with a large variability. Concerning metals in mine water, Al, Co and Ni exceeded legislative limits on two sites with low pH waters. The mine water quality changes with a focus on uranium mobility were described from recently dewatered mines to shafts with water level maintained in order to prevent outflows to surface water and finally to stagnating shafts and discharges of mine water from old adits. The results were in good agreement

  6. Impacts of Land Abandonment on Vegetation: Successional Pathways in European Habitats

    NARCIS (Netherlands)

    Prévosto, B.; Kuiters, A.T.; Bernhardt-Römermann, M.; Dölle, M.; Schmidt, W.; Hoffmann, M.; Uytvanck, Van J.; Bohner, A.; Kreiner, D.; Stadler, J.; Klotz, S.; Brandl, R.

    2011-01-01

    Changes in traditional agricultural systems in Europe in recent decades have led to widespread abandonment and colonization of various habitats by shrubs and trees. We combined several vegetation databases to test whether patterns of changes in plant diversity after land abandonment in different hab

  7. 78 FR 66988 - Minnesota Northern Railroad, Inc.-Abandonment Exemption-in Polk County, Minn.

    Science.gov (United States)

    2013-11-07

    ... Line).\\1\\ The Line traverses United States Postal Service Zip Code 56517. \\1\\ Upon abandonment, MNN... abandonment of rail service and salvage of the Line, the Line may be suitable for other public use, including... Herzig, Clearance Clerk. BILLING CODE 4915-01-P...

  8. Inhomogeneous CTMC Model of a Call Center with Balking and Abandonment

    OpenAIRE

    Burak, Maciej Rafal

    2015-01-01

    This paper considers a nonstationary multiserver queuing model with abandonment and balking for inbound call centers. We present a continuous time Markov chain (CTMC) model which captures the important characteristics of an inbound call center and obtain a numerical solution for its transient state probabilities using uniformization method with steady-state detection. Keywords: call center, transient, Markov processes, numerical methods, uniformization, abandonment, balking

  9. Technical standardization of oil well abandonment: a review of current standards and technologies

    Energy Technology Data Exchange (ETDEWEB)

    Suzart, J. Walter P.; Pessoa, Laudemar; Paiva, Maria [Halliburton Energy Services (HES), Duncan, OK (United States)

    2008-07-01

    The objective of this study is to provide a new methodology for well abandonment. This practice is becoming more and more important because of the increasing number of production fields being abandoned. We strongly recommend a study of cement slurries properties for specific use in temporary and permanent abandonment plugs based on the estimation of the cement slurry hardened when placed in the well. By using specific additives, it is possible to achieve very stable slurries. For example, when permeability is reduced, formation fluid migration can be blocked and chemical reactions between the fluid and the slurry may be inhibited. With this objective, we present a laboratory investigation model and an example of slurry testing recommendation. During the abandonment operation, all records of the well characteristics should be maintained to include the reason for the abandonment, and location of fresh water, brine, and hydrocarbon zones that may exist. This documentation will also allow the analysis of solutions for the problems that originally caused the abandonment of the well. This data could be important for future use by environmental protection commissions to reopen or to drill an adjacent well. Given the high price of oil, it may now be economically feasible to reopen the well, if the reason for abandonment was low productivity. This way, a critical analysis of the current conditions of well and field abandonment in the country is presented. Based on this information, a review of the current standards is suggested. (author)

  10. A Lower Rhine flood chronology based on the sedimentary record of an abandoned channel fill

    NARCIS (Netherlands)

    Toonen, W.H.J.; Winkels, T.G.; Prins, M.A.; de Groot, L.V.; Bunnik, F.P.; Cohen, K.M.

    2012-01-01

    The Bienener Altrhein is an abandoned channel of the Lower Rhine (Germany). Following a late 16th century abandonment event, the channel was disconnected from the main stream and the oxbow lake gradually filled with 8 meters of flood deposits. This process still continues today. During annual floods

  11. An exploratory analysis of land abandonment drivers in areas prone to desertification

    NARCIS (Netherlands)

    Kosmas, C.; Kairis, O.; Karavitis, C.; Hessel, R.; Ritsema, C.J.

    2015-01-01

    The abandonment of land is a global problemwith environmental and socioeconomic implications. An approach to assess the relationship between land abandonment and a large set of indicators was illustrated in the present study by using data collected in the framework of the European Union DESIRE resea

  12. COMPARISON OF ANTIEMETIC EFFICACY OF ONDANSETRON, GRANISETRON AND PALONOSETRON IN HIGH-RISK PATIENTS UNDERGOING ABDOMINAL HYSTERECTOMY UNDER GENERAL ANAESTHESIA

    Directory of Open Access Journals (Sweden)

    Rakesh Kumar

    2016-03-01

    Full Text Available BACKGROUND Postoperative nausea and vomiting is (PONV a very distressing complication and preventive measures are justified when the risk of PONV is very high. Ondansetron is the first 5-HT3 antagonist used alone or in combination for prophylaxis of PONV due to its lower cost. Granisetron and palonosetron are recently introduced 5-HT3 antagonists with greater affinity for 5-HT3 receptor and having longer half-life. Aim of the present study is to compare the antiemetic efficacy of ondansetron, granisetron and palonosetron in high-risk patients undergoing abdominal hysterectomy under general anaesthesia. METHODS After obtaining Institutional Ethical Committee approval and written informed consent from all the participants, 150 patients of ASA grade I & II, aged between 20-50 years and weight between 30-60 kg undergoing abdominal hysterectomy under general anaesthesia were assigned randomly in to three groups of 50 patients each using random number table receiving either ondansetron 4 mg (Group O or granisetron 2 mg (Group G or palonosetron 0.75 mg (Group P intravenously just before the induction of anaesthesia. Incidence and severity of nausea and frequency of retching and vomiting were recorded in each group at the end of 2-hour and then at 24-hour and 48-hour intervals. RESULTS The incidence of nausea during first two hours postoperatively was found to be 14(28% in Group O, which was found to be significantly higher than 6(12% in group G and 4(8% in group P (p value = 0.016. The incidence of vomiting was found to be 6(12% in group O, which was found to be significantly higher than 2(4% in both group G and group P (p value = 0.018. Number of complete responders was significantly higher in Group P and group G as compared to group O. Number of patients requiring rescue antiemetic treatment was significantly high in group O{10(20%} as compared to 3(6% in both the group G and group P. CONCLUSIONS Newly introduced 5-HT3 antagonists, granisetron and

  13. Radioactive pollution investigation and disposal of abandoned uranium mines in Jiangsu province

    International Nuclear Information System (INIS)

    The environment influence of five abandoned uranium mines in Jiangsu province from 1950s to 1960s is introduced. By monitoring air absorbed dose rate of external exposure γ radiation, it is found that the pollution scope of No.1 abandoned uranium mine is the biggest in five abandoned uranium mines. The No. 2 and No. 3 mine areas has achieved the limit use after they were desposed. The radioactivity and the gamma nuclein in solid samples(slag, soil, silt) and liquid samples (the surface water, the well water)of No. 1 abandoned uranium mine were further analyzed and measured, the measured values are higher. The pollution of abandoned uranium mines still exists and diffuses after 30 years. According to the monitoring results and the analysis of pollution present situation, suggestions and measures are proposed for the pollution control. (authors)

  14. Long-term ecological behaviour of abandoned uranium mill tailings

    International Nuclear Information System (INIS)

    Semi-aquatic and terrestrial areas on abandoned or inactive uranium mill tailings in Ontario were studied in order to identify the growth characteristics of the naturally invading species dominating these areas. Semi-aquatic areas of tailings sites have been invaded by cattails. These species formed wetland communities which varied in size, but all were essentially monocultures of Typha latifolia, T. angustifolia, or of the hybrids T. glauca. Sedges, Scripus cyperinus (wool-grass) and Phragmites australis (reed-grass), were found in transition zones between the cattail stand and the dry section of the tailings site. The expansion of the cattail stands appeared to be controlled by the hydrological conditions on the site, rather than the chemical characteristics of the tailings

  15. Should fine needle aspiration cytology in breast assessment be abandoned?

    Energy Technology Data Exchange (ETDEWEB)

    Litherland, Janet C

    2002-02-01

    Fine needle aspiration cytology (FNAC) has been used extensively in the U.K. for the diagnosis of breast lesions over the past 15 years. More recently, large gauge needle biopsy has been used to address many of the problems which have been encountered with fine needle aspiration. This paper reviews the evolution of the use of these procedures and the advantages and disadvantages of each. In considering whether to abandon the use of fine needle aspiration cytology in breast assessment, each individual unit should make a decision based upon their own audited results. However, even if FNAC is retained, it is important to be able to complement cytological diagnosis with core biopsy as there are indisputable advantages, e.g. in the diagnosis of mammographically detected microcalcification. As always, a multi-disciplinary approach is ultimately essential for effective patient management. Litherland, J.C. (2002)

  16. Should fine needle aspiration cytology in breast assessment be abandoned?

    Science.gov (United States)

    Litherland, Janet C

    2002-02-01

    Fine needle aspiration cytology (FNAC) has been used extensively in the U.K. for the diagnosis of breast lesions over the past 15 years. More recently, large gauge needle biopsy has been used to address many of the problems which have been encountered with fine needle aspiration. This paper reviews the evolution of the use of these procedures and the advantages and disadvantages of each. In considering whether to abandon the use of fine needle aspiration cytology in breast assessment, each individual unit should make a decision based upon their own audited results. However, even if FNAC is retained, it is important to be able to complement cytological diagnosis with core biopsy as there are indisputable advantages, e.g. in the diagnosis of mammographically detected microcalcification. As always, a multi-disciplinary approach is ultimately essential for effective patient management. PMID:11977938

  17. Childhood lead poisoning: the promise and abandonment of primary prevention.

    Science.gov (United States)

    Needleman, H L

    1998-12-01

    In 1991, the Public Health Service published the Strategic Plan for the Elimination of Childhood Lead Poisoning. This document marked a fundamental shift in federal policy from finding and treating lead-poisoned children to authentic primary prevention. It spelled out a 15-year strategy to achieve this goal and provided a cost-benefit analysis showing that the monetized benefits far exceeded the costs of abatement. A strong national effort to eliminate the disease developed. Now, 7 years after publication of the plan, primary prevention of lead exposure has been abandoned. This article examines the role of some prevailing attitudes and institutions in derailing the effort. Some institutions--the lead industry, real estate interests, and insurance interests--behaved as anticipated. Others, including private pediatricians, the American Academy of Pediatrics, some federal agencies, and a public interest group ostensibly dedicated to eliminating lead poisoning, also played an unexpected part in derailing the plan. PMID:9842392

  18. Key site abandonment steps in CO2 storage

    Science.gov (United States)

    Kühn, M.; Wipki, M.; Durucan, S.; Deflandre, J.-P.; Lüth, S.; Wollenweber, J.; Chadwick, A.; Böhm, G.

    2012-04-01

    CO2CARE is an EU funded project within FP7-research, which started in January 2011 with a funding period of three years. The project objectives will be achieved through an international consortium consisting of 23 partners from Europe, USA, Canada, Japan, and Australia, belonging to universities, research institutes, and energy companies. According to the EC Guidance Document 3, the lifetime of a CO2 storage site can be generally subdivided into 6 phases: 1. assessment, 2. characterisation, 3. development, 4. operation, 5. post-closure/pre-transfer, and 6. post transfer. CO2CARE deals with phases 5 and 6. The main goals of the project are closely linked to the three high-level requirements of the EU Directive 2009/31/EC, Article 18 for CO2 storage which are: (i) absence of any detectable leakage, (ii) conformity of actual behaviour of the injected CO2 with the modelled behaviour, and (iii) the storage site is evolving towards a situation of long-term stability. These criteria have to be fulfilled prior to subsequent transfer of responsibility to the competent authorities, typically 20 or 30 years after site closure. CO2CARE aims to formulate robust procedures for site abandonment which will meet the regulatory requirements and ensure long-term integrity of the storage complex. We present key results from the first year of the project via a report on international regulatory requirements on CO2 geological storage and site abandonment that includes a general overview on the current state-of-the art in abandonment methodologies in the oil and gas industry worldwide. Due to the long time-frames involved in CO2 storage (in the range of several thousands of years), the behaviour of a system with respect to, for example, long-term well stability can be demonstrated only by using long-term predictive modelling tools to study potential leakage pathways. Trapping mechanisms for CO2 are of high interest concerning a quantitative estimation of physically captured, capillary

  19. Alternative utilization of underground spaces with abandoned mine openings

    Energy Technology Data Exchange (ETDEWEB)

    Chung, So Keul; Cho, Won Jai; Han, Kong Chang; Choi, Sung Oong [Korea Institute of Geology Mining and Materials, Taejon (Korea)

    1998-12-01

    Utilization of the openings of the abandoned mines could be planned by the principal parameters such as location and geotechnical impact. The local governments have not only to lead the each stage of the utilization project from the very beginning of conceptual design up to the construction stage, but also to promote the project for the development of public purpose. The possible tentative candidates for the utilization of the abandoned mine openings which are supported by the local governments could be summarized as follows. a. The Gahak mine of Kwangmyung, Kyunggi: The mine caverns which have been served as the storage of the pickled fishes, could be reexcavated by taking into consideration the geotechnical parameters for the public use such as: 1) Training center for the youth, 2) Fermentation and storehouse of marine products, 3) Sightseeing resort, 4) Sports and leisure complex, 5) Underground parking lot, 6) Underground shopping mall and chilled room storage, 7) Library, concert hall and museum. b. Hamtae mine of Taebaek, Kangwon: The Hambaek main haulage way and its shaft should be investigated in detail in order to find out a possible use as the underground challenging park of the coal mining operation. c. Mines of Boryung and Hongsung, Chungnam: Lots of mine caverns have been used as the storehouse for the pickled shrimp. However, they have to be promoted to a large scale industries. d. Imgok mine of Kwangju and Palbong mine of Jeongeup, Chunbuk: Mine caverns which have been used as the storehouse of pickles, need a detailed investigation for alternative promotion. e. Yongho mine of Pusan Dalsung mine of Taegu: Both of the mines are located near metropolitan communities. Reconstruction of the old mine caverns of the Yongho mine is highly recommended for a public use. The caverns of the Dalsung mine could be utilized as the storage facilities. Detailed geotechnical survey and sit investigation could be suggested to design the recommended facilities for both

  20. Abandoned Rice Fields Make Streams Go Dry in Upland Landscapes

    Science.gov (United States)

    Jayawickreme, D.

    2015-12-01

    In South Asia, new economic realities are driving many rural rice farmers out of agriculture. With increasing neglect, abandonment, and rising conversions of centuries old rice fields into other uses, ecological and environmental consequences of these transitions are becoming progressively clear. Field observations in Sri Lanka's central highlands suggest that small shifts in rice to non-rice land uses in headwater watersheds can have a domino effect on the productivity and viability of rice fields and other ecological systems downstream by inflicting groundwater recharge reductions, lowering groundwater yields, and causing other hydrological changes. Preliminary analysis shows that although rice itself is a very water intensive crop, the presence of rain-fed upland rice-fields is hugely beneficial to the watersheds they reside. In particular, water benefits of rice appear to be derived from ponded conditions (3-5 inches of standing water) in which rice is grown, and the contribution rice fields makes to enhance water retention and storage capacity of their watersheds during the monsoon season that coincide with the cropping season. In the absence of well managed rice-fields, hilly upland landscapes produce more runoff and retain little rainwater during the wet season. Furthermore, after centuries of intensive use, much of South Asia's rice fields are nutrient poor and minimally productive without fertilizer applications and other interventions. Consequently, when abandoned, soil erosion and other impacts that affect aquatic ecosystems and watershed health also emerge. Despite these multiple concerns however, little research is currently done to better understand the environmental significance of rice cultivations that are a dominant land-use in many South Asian landscapes. The aim of this presentation is to stir interest among the scientific community to engage more broadly in rice, water, and environmental change research in the face of new economic realities in

  1. Hydropedologic patterns of escalic soils in cultivated and abandoned vineyards

    Science.gov (United States)

    Schmaltz, Elmar; Rellini, Ivano; Scopesi, Claudia; Tassistro, Martina; Märker, Michael

    2016-04-01

    The construction of vineyard terraces was conducted extensively for many centuries in the Mediterranean area. However, the use of this technique has direct influences on a hillslope environment. Both artificial topographic transformation and frequently agricultural use have a strong impact on terrace soils. Hydromechanical properties have been scarcely investigated. They can change due to several terrace construction techniques, ploughing and particularly abandonment. These changes can cause the collapse of terrace walls due to modifications in the inner drainage behaviour of the terrace and increase the susceptibility to failure of a terraced slope. To determine differencies in hydropedological water fluxes of escalic soils, infiltration and saturated hydraulic conductivity in 25cm, 50cm and 100cm were measured on defined Unique Condition Units (UCU) in the Vernazza catchment in Cinque Terre, Italy. The determination of soil texture and soil skeleton supported the information of the hydropedologic information. Moreover, shear strength of the soil in the three depths was estimated with a light torvane device and compared with the texture and the hydrological values. The results of our study indicate that escalic soils in vineyards in a Mediterranean torrential catchment show certain hydropedologic patterns under different substratum and distinct agricultural land cover conditions. The latter is defined by both species-related coverage of distinct crop plants and status of cultivation or abandonment respectively. These results depict the fundament for the application of physically-based landslide susceptibility modelling on the terraced landscape of the Vernazza catchment. The hydropedologic patterns determined in our study are expected to represent the conditions of water fluxes in the soil better and make the results of landslide susceptibility models more reliable.

  2. GROWING NIPA PALM FOR RESTORATION OF ABANDONED SHRIMP PONDS

    Institute of Scientific and Technical Information of China (English)

    Noparat Bamroongrugsa; Chorthip Purintavarakul

    2006-01-01

    Rapid increase in the production of marine shrimps in the coastal zone has resulted in large - scale conversion of mangrove forests to shrimp ponds. Productions of the shrimps in some regions have been unstable. Consequently, a number of ponds are left idle. Restoring environmental conditions within the pond site by planting a suitable mangrove species considered an option. The experiment herein was carried out to explore the effect of planting methods on growth of Nipa palm in abandoned shrimp ponds in the Southern Thailand. Economically, coastal villagers in this area earn their income from the palm in several ways, the most importantly in Nipa sugar production. Most seedlings were planted on top of furrows were constructed in the pond to avoid flooding, except for some seedlings which were planted in the pond base where additional pond sludge were slightly filled up to compare their growth rates. The results showed that planting seedlings with attached rhizomes had the best growth rate and without seedling death at 14 months after planting. At this stage, however, the height of seedlings grown from the fallen fruits was similar to those growth from bare rooted seedlings (70 cm tall). Also, seedling mortality was not observed when growth from fallen fruits whereas about6% mortality was experienced by the bare rooted ones. Among the bare rooted seedling treatments, however no significant differences in growth rates were found when applying the soil with chemical fertilizers or farm manure or liming with CaCO3. In addition, it was found that seedling growth measured at 40 months after planting for those growths in pond base was almost 100% greater than those grown on the furrows. Therefore, this finding may be applied for the restoration of abandoned shrimp ponds by growing Nipa palm.

  3. LETTING GO: DE-RADICALIZATION IN EGYPT

    Directory of Open Access Journals (Sweden)

    Zeynep Kaya

    2016-03-01

    Full Text Available The literature on the causes of how terrorist organizations are formed and how counter terrorism measures can be more effective is immense. What is novel in terrorism literature is de-radicalization in terrorist organizations. This paper hopes to shed light on the de-radicalization process in terrorist organizations based in Egypt. In order to achieve that goal, the first part of the paper will deal with the de-radicalization process. The second part will briefly describe the major radical terrorist organizations that are effective in Egypt. The last part will combine the two parts and bring in suggestions on the de-radicalization process itself. Terrorism and de-radicalization are complicated threats to nearly all societies. Therefore, it is important to go beyond security and intelligence approaches and take proactive measures. It is best to view what is de-radicalization and how it can be achieved.

  4. Oxidative stress, free radicals and protein peroxides.

    Science.gov (United States)

    Gebicki, Janusz M

    2016-04-01

    Primary free radicals generated under oxidative stress in cells and tissues produce a cascade of reactive secondary radicals, which attack biomolecules with efficiency determined by the reaction rate constants and target concentration. Proteins are prominent targets because they constitute the bulk of the organic content of cells and tissues and react readily with many of the secondary radicals. The reactions commonly lead to the formation of carbon-centered radicals, which generally convert in vivo to peroxyl radicals and finally to semistable hydroperoxides. All of these intermediates can initiate biological damage. This article outlines the advantages of the application of ionizing radiations to studies of radicals, with particular reference to the generation of desired radicals, studies of the kinetics of their reactions and correlating the results with events in biological systems. In one such application, formation of protein hydroperoxides in irradiated cells was inhibited by the intracellular ascorbate and glutathione.

  5. 急症产科子宫切除36例临床分析%Clinical Analysis on 36 Cases of Emergency Hysterectomy

    Institute of Scientific and Technical Information of China (English)

    陈国伟; 陈江鸿

    2013-01-01

    To analyze the cause of the obstetrical acute hysterectomy,and study the possibility of decreasing the incidence of obstetrical hysterectomy,a retrospective analysis was performed on 36 cases of the obstetrical acute hysterectomy between Jan 2006 and Jan 2012.Results show the placental factor have 20 cases,account for 55.6%,uterine atony account for 27.8%%,amniotic fluid embolism accout for 5.6 %,uterine rupture account for 8.3 %,late postpartum hemorrhage accout for 2.8 %.The obstetrical acute hysterectomy after Cesarean accounting for 0.39 % of the number of cesarean delivery 31,vaginal delivery accounting for 0.05 %,with 5 acute hysterectomy.Prevention of the occurrence of obstetrical complication will be beneficial to decrease the incidence of cesarean section.%分析导致产科临床急症子宫切除的原因,探讨降低产科子宫切除的可能性方法.回顾分析我院产科2006年1月~2012年1月间36例急症子宫切除病例,胎盘因素占55.6%,子宫收缩乏力占27.8%,羊水栓塞占5.6%,子宫破裂占8.3%,晚期产后出血占2.8%.剖宫产术后行子宫切除31例,占剖宫产人数的0.39%;阴道分娩后5人行子宫切除,占阴道分娩总数的0.05%.为减少产后出血的发生,应严格掌握剖宫产指征,降低剖宫产率.

  6. Late Onset of CSF Rhinorrhea in a Postoperative Transsphenoidal Surgery Patient Following Robotic-Assisted Abdominal Hysterectomy

    Directory of Open Access Journals (Sweden)

    Justin T. Dowdy MD

    2014-01-01

    Full Text Available Cerebrospinal fluid (CSF leak is the most commonly encountered perioperative complication in transsphenoidal surgery for pituitary lesions. Direct closure with a combination of autologous fat, local bone, and/or synthetic grafts remains the standard of care for leaks encountered at the time of surgery as well as postoperatively. The development of the vascularized nasoseptal flap as a closure technique has increased the surgeon’s capacity to correct even larger openings in the dura of the sella as well as widely exposed anterior skull base defects. Yet these advances in the technical nuances for management of post-transsphenoidal CSF leak are useless without the ability to recognize a CSF leak by physical examination, clinical history, biochemical testing, or radiographic assessment. Here, we report a case of a patient who developed a CSF leak 28 years after transsphenoidal surgery, precipitated by a robotic-assisted hysterectomy during which increased intra-abdominal pressure and steep Trendelenberg positioning were both factors. Given the remote nature of the patient’s transsphenoidal surgery and relative paucity of data regarding such a complication, the condition went unrecognized for several months. We review the available literature regarding risk and pathophysiology of CSF leak following abdominal surgery and propose the need for increased vigilance in identification of such occurrences with the increasing acceptance and popularity of minimally invasive abdominal and pelvic surgeries as standards in the field.

  7. Fontan's circulation with dextrocardia, recent pulmonary embolism, and inferior vena cava filter: Anesthetic challenges for urgent hysterectomy.

    Science.gov (United States)

    Singh, Preet Mohinder; Borle, Anuradha; Ramachandran, Rashmi; Trikha, Anjan; Goudra, Basavana Gouda

    2016-01-01

    Fontan's circulation is a unique challenge for the anesthesiologist. Venous pressure is the only source of blood flow for the pulmonary circulation. Patients with such circulation are extremely sensitive to progression of cyanosis (decreased pulmonary blood flow) or circulatory failure. Any major venous compression can compromise the pulmonary blood flow worsening cyanosis; simultaneously, an increased afterload can precipitate circulatory failure. We present a rare patient of surgically corrected Ivemark syndrome with Fontan's physiology with dextrocardia who developed a large uterine fibroid compressing inferior vena cava (IVC). As a result of compression, not only the pulmonary circulation was compromised but she also developed stasis-induced venous thrombosis in the lower limbs that lead to pulmonary embolism (PE) (increased afterload). In addition to oral anticoagulation an IVC filter was inserted to prevent ongoing recurrent PE. Further, to prevent both circulatory compromise and deep venous thrombosis an urgent myomectomy/hysterectomy was planned. In the present case, we discuss the issues involved in the anesthetic management of such patients and highlight the lacunae in the present guidelines for managing perioperative anticoagulation these situations.

  8. Fontan′s circulation with dextrocardia, recent pulmonary embolism, and inferior vena cava filter: Anesthetic challenges for urgent hysterectomy

    Directory of Open Access Journals (Sweden)

    Preet Mohinder Singh

    2016-01-01

    Full Text Available Fontan′s circulation is a unique challenge for the anesthesiologist. Venous pressure is the only source of blood flow for the pulmonary circulation. Patients with such circulation are extremely sensitive to progression of cyanosis (decreased pulmonary blood flow or circulatory failure. Any major venous compression can compromise the pulmonary blood flow worsening cyanosis; simultaneously, an increased afterload can precipitate circulatory failure. We present a rare patient of surgically corrected Ivemark syndrome with Fontan′s physiology with dextrocardia who developed a large uterine fibroid compressing inferior vena cava (IVC. As a result of compression, not only the pulmonary circulation was compromised but she also developed stasis-induced venous thrombosis in the lower limbs that lead to pulmonary embolism (PE (increased afterload. In addition to oral anticoagulation an IVC filter was inserted to prevent ongoing recurrent PE. Further, to prevent both circulatory compromise and deep venous thrombosis an urgent myomectomy/hysterectomy was planned. In the present case, we discuss the issues involved in the anesthetic management of such patients and highlight the lacunae in the present guidelines for managing perioperative anticoagulation these situations.

  9. Long-term intermittent pharmacological therapy of uterine fibroids – a possibility to avoid hysterectomy and its negative consequences

    Directory of Open Access Journals (Sweden)

    Anita Olejek

    2016-03-01

    Full Text Available Uterine fibroids are found in almost 20-40% of women of reproductive age. For each woman an individualised treatment method should be applied because the hysterectomy procedure is not a good option in every case. The uterus is an organ necessary not only in reproduction. Its removal may result in: pelvic floor dysfunction and stress urinary incontinence, negative impair on life quality, depressive disorders, increased risk of cardiovascular and neurodegenerative diseases, and higher incidence of neoplastic disease. According to the last scientific reports, selective progesterone receptor modulators are the effective therapeutic option in uterine fibroids in women of reproductive age because progesterone is an important factor in their pathogenesis. Ulipristal acetate (UPA is a progesterone receptor antagonist. It inhibits cell proliferation and angiogenesis in uterine fibroids and also reduces collagen deposits in extracellular matrix. Significant data concerning ulipristal acetate efficacy have been provided by scientific research, especially from the consecutive PEARL studies. Oral ulipristal acetate effectively and safely controls bleeding and pain in patients with symptomatic fibroids. It reduces fibroid volume and restores quality of life. The results of UPA long-term intermittent treatment are largely maintained during the off-treatment periods.

  10. Online radicalization: the net or the netizen?

    Directory of Open Access Journals (Sweden)

    Femi Richard Omotoyinbo

    2014-10-01

    Full Text Available Purpose - Radicalization has gained some unusual prominence in the academic circles; maintaining a generic existence not only in the political sector. And with the advent of the Information Communication Technology (ICT, radicalization has begun to have some virtual dimension even in the remotest of human communities. This study seeks to mobilize a universal awareness on the collective urgency to oppose Online Radicalization (a radicalization that happens through the internet due to its propensity to engendering conflicts. It also aims at identifying the principal cause of online radicalization and steer a clear course for a practical reversal in the systems of online radicalization.Design/methodology/approach - The study is divided into three primary parts. The general notion of radicalization is the focus of the first part; which is further analysed into the levels of online radicalization with its accompanying developments and segments. The second part utilizes analytic and historical method to pinpoint the principal cause of online radicalization amidst the suspected causal factors (the Net and the Netizen. The final part analytically focuses on the Netizen (a user/citizen of the internet as the primary cause of online radicalization, and how the global community can bring about a corresponding change in the Net by the application of some measures on the Netizen.Findings - By virtue of the analytic plus historical methods employed by this study; it was initially identified that radicalization is basically having two versions which are online and offline. Further emphasis on the online version reveals that its existence is only made possible by the availability of the internet (the Net. Since the Net is a global phenomenon online radicalization is considered to be worldwide: a menace of globalization. However, the study later indicated that the Net is a facilitator and a cause of online radicalization. A view was deduced that the Netizen is

  11. Radical conservatism and Danish imperialism

    DEFF Research Database (Denmark)

    2013-01-01

    on the basis of a close reading of their imperialist program in the pamphlet Danmark Udslettes! from 1918. Rige had been a vague term for the larger Danish polity that originated in a pre-national conceptualization of the polity as a realm. The article suggests that rige-as-realm was translated by the radical...... to signify the ambition of being a great power, the spiritual elevation of the nation through the transcendence of the decaying liberal modernity. The program addressed the tension between a conservative political attitude and modernity and thus signified a kind of reactionary modernism, which rejected...

  12. Aromatic-radical oxidation chemistry

    Energy Technology Data Exchange (ETDEWEB)

    Glassman, I.; Brezinsky, K. [Princeton Univ., NJ (United States)

    1993-12-01

    The research effort has focussed on discovering an explanation for the anomalously high CO{sub 2} concentrations observed early in the reaction sequence of the oxidation of cyclopentadiene. To explain this observation, a number of plausible mechanisms have been developed which now await experimental verification. One experimental technique for verifying mechanisms is to probe the reacting system by perturbing the radical concentrations. Two forms of chemical perturbation of the oxidation of cyclopentadiene were begun during this past year--the addition of NO{sub 2} and CO to the reacting mixture.

  13. Laser spectroscopy of hydrocarbon radicals

    Energy Technology Data Exchange (ETDEWEB)

    Chen, P. [Harvard Univ., Cambridge, MA (United States)

    1993-12-01

    The author reports the application of supersonic jet flash pyrolysis to the specific preparation of a range of organic radicals, biradicals, and carbenes in a skimmed molecular beam. Each species was produced cleanly and specifically, with little or no secondary reactions by the thermal dissociation of appropriately designed and synthesized organic precursors. Photoelectron spectra of the three isomeric C{sub 3}H{sub 2} carbenes, ortho-benzyne, and the {alpha},3-dehydrotoluene biradical, were used to establish adiabatic ionization potentials for use in thermochemical determinations.

  14. Free radical kinetics of irradiated durum wheat

    Science.gov (United States)

    Korkmaz, M.; Polat, M.

    2000-04-01

    In the present work, a detailed ESR investigation of characteristic features and kinetic behaviors at three different temperatures of free radicals produced in a species of durum wheat cultivated in Turkey and irradiated at doses of up to 5 kGy by a γ source, is reported. Unirradiated wheat samples exhibit a weak, single-line ESR signal originating from a radical of unknown structure called radical III in this work. Irradiation produces two more radicals identified as hydroxyalkyl (I) and aldehydalkyl (II) radicals beside radical III. The radicals (I, II and III) follow complicated kinetics. Species I and II initially decay very fast after the irradiation followed by slower decay. Radical half-life times depend on whether they were induced in the crystalline or amorphous fractions of the wheat starch. Activation energy values of the radicals were found to follow the order Ea(III)> Ea(II)> Ea(I). ESR parameters of the radical species were determined by simulating experimental spectra recorded following the irradiation. Room temperature dose-response curves and variations of different spectral parameters between 120 and 390 K were also studied.

  15. Radical constructivism: Between realism and solipsism

    Science.gov (United States)

    Martínez-Delgado, Alberto

    2002-11-01

    This paper criticizes radical constructivism of the Glasersfeld type, pointing out some contradictions between the declared radical principles and their theoretical and practical development. These contradictions manifest themselves in a frequent oscillation between solipsism and realism, despite constructivist claims to be an anti-realist theory. The paper also points out the contradiction between the relativism of the radical constructivist principles and the constructivist exclusion of other epistemological or educational paradigms. It also disputes the originality and importance of the radical constructivist paradigm, suggesting the idea of an isomorphism between radical constructivist theory and contemplative realism. In addition, some pedagogical and scientific methodological aspects of the radical constructivist model are examined. Although radical constructivism claims to be a rational theory and advocates deductive thinking, it is argued that there is no logical deductive connection between the radical principles of constructivism and the radical constructivist ideas about scientific research and learning. The paper suggests the possibility of an ideological substratum in the construction and hegemonic success of subjective constructivism and, finally, briefly advances an alternative realist model to epistemological and educational radical constructivism.

  16. Detection of a secondary muoniated radical

    Energy Technology Data Exchange (ETDEWEB)

    McCollum, Brett M.; Brodovitch, Jean-Claude [TRIUMF and Department of Chemistry, Simon Fraser University, Burnaby, BC, V5A 1S6 (Canada); Clyburne, Jason A.C. [Department of Chemistry, Saint Mary' s University, Halifax, NS, B3H 3C3 (Canada); Percival, Paul W., E-mail: percival@sfu.c [TRIUMF and Department of Chemistry, Simon Fraser University, Burnaby, BC, V5A 1S6 (Canada); West, Robert [Organosilicon Research Center, University of Wisconsin, Madison, WI 53706 (United States)

    2009-04-15

    Muoniated free radicals are formed by addition of muonium to unsaturated molecules. Successful detection by transverse-field muon spin rotation (muSR) usually requires pure or highly concentrated samples and a muonium reaction rate in excess of 10{sup 9} M{sup -1}s{sup -1} to ensure that the muon spin polarization is coherently transferred to the radical. For this reason muoniated radicals reported to date are all the primary radical products of Mu reaction. Thus, it was expected that Mu addition to a silylene would result in detection of a silyl radical. However, the muon hyperfine constant determined by experiment is much smaller than the value predicted by density functional calculations. Instead, it is consistent with a disilanyl radical, the secondary radical formed by reaction of the initially formed silyl radical with a second silylene molecule. From an analysis of the signal amplitude it was deduced that the second-order rate constant for reaction of the muoniated silyl radical with the parent silylene is 5.7x10{sup 8} M{sup -1}s{sup -1}. This work represents the first example of direct detection of a secondary radical product by transverse-field muSR.

  17. Study on Impact of Laparoscopic Triangle Hysterectomy on Ovarian Function%腹腔镜下子宫体三角形切除术对卵巢功能影响研究

    Institute of Scientific and Technical Information of China (English)

    劳金美; 王庆一; 温晟姝; 熊永崂

    2012-01-01

    Objective To explore the effect of laparoscopic triangle hysterectomy on ovarian function. Methods We prospectively and randomly collected 40 patients underwent laparoscopic triangle hysterectomy and 40 patients underwent total hysterectomy due to dysfunctional uterine bleeding hospitalized in Zhuhai Municipal Maternal and Child Health Hospital from January 2007 to December 2010. Follicle - stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), inhibin B and anti — mullerian hormone (AMH) were detected and compared before and three months after the surgery. Results No statistically significant difference was found in FSH, LH, E2, inhibin B and AMH of laparoscopic triangle hysterectomy group between before and after the surgery. Three months after the surgery, FSH and E2 in total hysterectomy group were significantly increased, while inhibin B and AMH were significantly decreased. As compared with total hysterectomy group, FSH and E2 of laparoscopic triangle hysterectomy group were significantly decreased, while inhibin B and AMH were significantly increased three months after the surgery. Conclusions Laparoscopic triangle hysterectomy is superior to total hysterectomy in the protection of ovarian function.%目的 探讨腹腔镜下子宫体三角形切除术对卵巢功能的影响. 方法 前瞻性收集2007年1月- 2010年12月本院因功血行腹腔镜下子宫体三角形切除术40例,随机选取因功血腹腔镜下子宫体全切40例,比较术前和术后三个月基础卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、抑制素B(inhibin B)和抗苗勒管因子(AMH). 结果 腹腔镜下子宫体三角形切除术术前术后FSH、LH、E2、Inhibin B和AMH差异无统计学意义,腹腔镜下子宫体切除术术后FSH、E2明显升高,Inhibin B、AMH明显降低,术后三个月腹腔镜下三角形切除术与腹腔镜下子宫体全切术相比FSH、E2明显降低,tnhibin B、AMH明显升高. 结论 腹腔镜下子宫体三角

  18. Cost effectiveness of endometrial ablation with the NovaSure® system versus other global ablation modalities and hysterectomy for treatment of abnormal uterine bleeding: US commercial and Medicaid payer perspectives

    Directory of Open Access Journals (Sweden)

    Miller JD

    2015-01-01

    Full Text Available Jeffrey D Miller,1 Gregory M Lenhart,1 Machaon M Bonafede,1 Cindy M Basinski,2 Andrea S Lukes,3 Kathleen A Troeger4 1Truven Health Analytics, Cambridge, MA, 2Basinski, LLC, Newburgh, IN, 3Carolina Women’s Research and Wellness Center, Durham, NC, 4Hologic, Inc, Marlborough, MA, USA Objectives: Abnormal uterine bleeding (AUB interferes with physical, emotional, and social well-being, impacting the quality of life of more than 10 million women in the USA. Hysterectomy, the most common surgical treatment of AUB, has significant morbidity, low mortality, long recovery, and high associated health care costs. Global endometrial ablation (GEA provides a surgical alternative with reduced morbidity, cost, and recovery time. The NovaSure® system utilizes unique radiofrequency impedance-based GEA technology. This study evaluated cost effectiveness of AUB treatment with NovaSure ablation versus other GEA modalities and versus hysterectomy from the US commercial and Medicaid payer perspectives. Methods: A health state transition (semi-Markov model was developed using epidemiologic, clinical, and economic data from commercial and Medicaid claims database analyses, supplemented by published literature. Three hypothetical cohorts of women receiving AUB interventions were simulated over 1-, 3-, and 5-year horizons to evaluate clinical and economic outcomes for NovaSure, other GEA modalities, and hysterectomy. Results: Model analyses show lower costs for NovaSure-treated patients than for those treated with other GEA modalities or hysterectomy over all time frames under commercial payer and Medicaid perspectives. By Year 3, cost savings versus other GEA were $930 (commercial and $3,000 (Medicaid; cost savings versus hysterectomy were $6,500 (commercial and $8,900 (Medicaid. Coinciding with a 43%–71% reduction in need for re-ablation, there were 69%–88% fewer intervention/reintervention complications for NovaSure-treated patients versus other GEA modalities

  19. A Novel Abandoned Object Detection System Based on Three-Dimensional Image Information

    Directory of Open Access Journals (Sweden)

    Yiliang Zeng

    2015-03-01

    Full Text Available A new idea of an abandoned object detection system for road traffic surveillance systems based on three-dimensional image information is proposed in this paper to prevent traffic accidents. A novel Binocular Information Reconstruction and Recognition (BIRR algorithm is presented to implement the new idea. As initial detection, suspected abandoned objects are detected by the proposed static foreground region segmentation algorithm based on surveillance video from a monocular camera. After detection of suspected abandoned objects, three-dimensional (3D information of the suspected abandoned object is reconstructed by the proposed theory about 3D object information reconstruction with images from a binocular camera. To determine whether the detected object is hazardous to normal road traffic, road plane equation and height of suspected-abandoned object are calculated based on the three-dimensional information. Experimental results show that this system implements fast detection of abandoned objects and this abandoned object system can be used for road traffic monitoring and public area surveillance.

  20. Microbial Nitrogen-Cycle Gene Abundance in Soil of Cropland Abandoned for Different Periods.

    Directory of Open Access Journals (Sweden)

    Huhe

    Full Text Available In Inner Mongolia, steppe grasslands face desertification or degradation because of human overuse and abandonment after inappropriate agricultural management. The soils in these abandoned croplands exist in heterogeneous environments characterized by widely fluctuating microbial growth. Quantitative polymerase chain reaction analysis of microbial genes encoding proteins involved in the nitrogen cycle was used to study Azotobacter species, nitrifiers, and denitrifiers in the soils from steppe grasslands and croplands abandoned for 2, 6, and 26 years. Except for nitrifying archaea and nitrous oxide-reducing bacteria, the relative genotypic abundance of microbial communities involved in nitrogen metabolism differed by approximately 2- to 10-fold between abandoned cropland and steppe grassland soils. Although nitrogen-cycle gene abundances varied with abandonment time, the abundance patterns of nitrogen-cycle genes separated distinctly into abandoned cropland versus light-grazing steppe grassland, despite the lack of any cultivation for over a quarter-century. Plant biomass and plant diversity exerted a significant effect on the abundance of microbial communities that mediate the nitrogen cycle (P < 0.002 and P < 0.03, respectively. The present study elucidates the ecology of bacteria that mediate the nitrogen cycle in recently abandoned croplands.

  1. Abandonment terraced hillside and answer of the fire system: some results from Mediterranean old fields

    Energy Technology Data Exchange (ETDEWEB)

    Llovet Lopez, J.; Ruiz Varela, M.; Josa March, R.; Vallejo Calzada, V. R.

    2009-07-01

    The abandonment of agricultural lands promotes temporal changes both in soil characteristics (i.e., increasing organic matter and other quality indicators) and in plant community (i.e., changing its composition and structure, and increasing the fuel load). As a consequence, we can expect differences in the resilience to fire as succession progresses. The aim of this work is to analyse the capacity of an ecosystem to return to pre-fire conditions as a function of the stage of abandonment of old agricultural lands. The study was carried out in the north of Alicante province (E Spain). In long-term abandoned lands, post-fire modulated plant response, which in turn determined soil crusting, runoff and erosion dynamics. In recently-abandoned lands, the plant community seemed less dependent on ratio to recover. Results show a large increase in soil surface crusting in the short term after the fire and it remained high at medium term in long-abandoned lands colonised by pine forest. Fire scarcely modified runoff and erosion in recently-abandoned lands whereas in forest lands the post-fire values increased by some orders of magnitude and remained highly dependent on rain characteristics in the short and medium term after the fire. The results obtained show evidence of increased vulnerability to fire in long-abandoned lands colonised by pine forests. (Author) 4 refs.

  2. Identification and assessment of trace contaminants associated with oil and gas pipelines abandoned in place

    Energy Technology Data Exchange (ETDEWEB)

    Thorne, W.E.R.; Basso, A.C.; Dhol, S.K. [Biophilia Inc., Calgary, Alberta (Canada)

    1996-12-31

    As more Alberta oil and gas fields become depleted, attention is being given to development of economically and environmentally sound abandonment procedures. The objective of this study was to identify and assess residual internal and external contaminants associated with abandoned pipelines, particularly those to be abandoned in place. Circumstances which might increase the risk of contaminant release, and other issues relating to residual pipeline contaminants, were also identified. It was found that there are thousands of different substances which could potentially be associated with abandoned pipelines. A wide range in the potential quantities of residual contaminants was also found. Of the issues identified, the effectiveness of pipeline pigging and cleaning procedures prior to abandonment was the most critical determinant of the potential quantities of residual contaminants. However, a number of trace contaminants, such as PCBs (Polychlorinated Biphenyls) and NORMs (Naturally Occurring Radioactive Materials) may remain after thorough cleaning. A brief review of the legislation and regulations from a number of jurisdictions shows that pipeline abandonment has only recently become an issue of concern. Regulations specific to abandonment are lacking, and more general regulations and guidelines are being applied on a contaminant-specific basis, or in terms of waste disposal requirements.

  3. Abandonment terraced hillside and answer of the fire system: some results from Mediterranean old fields

    International Nuclear Information System (INIS)

    The abandonment of agricultural lands promotes temporal changes both in soil characteristics (i.e., increasing organic matter and other quality indicators) and in plant community (i.e., changing its composition and structure, and increasing the fuel load). As a consequence, we can expect differences in the resilience to fire as succession progresses. The aim of this work is to analyse the capacity of an ecosystem to return to pre-fire conditions as a function of the stage of abandonment of old agricultural lands. The study was carried out in the north of Alicante province (E Spain). In long-term abandoned lands, post-fire modulated plant response, which in turn determined soil crusting, runoff and erosion dynamics. In recently-abandoned lands, the plant community seemed less dependent on ratio to recover. Results show a large increase in soil surface crusting in the short term after the fire and it remained high at medium term in long-abandoned lands colonised by pine forest. Fire scarcely modified runoff and erosion in recently-abandoned lands whereas in forest lands the post-fire values increased by some orders of magnitude and remained highly dependent on rain characteristics in the short and medium term after the fire. The results obtained show evidence of increased vulnerability to fire in long-abandoned lands colonised by pine forests. (Author) 4 refs.

  4. Microbial Nitrogen-Cycle Gene Abundance in Soil of Cropland Abandoned for Different Periods.

    Science.gov (United States)

    Huhe; Borjigin, Shinchilelt; Buhebaoyin; Wu, Yanpei; Li, Minquan; Cheng, Yunxiang

    2016-01-01

    In Inner Mongolia, steppe grasslands face desertification or degradation because of human overuse and abandonment after inappropriate agricultural management. The soils in these abandoned croplands exist in heterogeneous environments characterized by widely fluctuating microbial growth. Quantitative polymerase chain reaction analysis of microbial genes encoding proteins involved in the nitrogen cycle was used to study Azotobacter species, nitrifiers, and denitrifiers in the soils from steppe grasslands and croplands abandoned for 2, 6, and 26 years. Except for nitrifying archaea and nitrous oxide-reducing bacteria, the relative genotypic abundance of microbial communities involved in nitrogen metabolism differed by approximately 2- to 10-fold between abandoned cropland and steppe grassland soils. Although nitrogen-cycle gene abundances varied with abandonment time, the abundance patterns of nitrogen-cycle genes separated distinctly into abandoned cropland versus light-grazing steppe grassland, despite the lack of any cultivation for over a quarter-century. Plant biomass and plant diversity exerted a significant effect on the abundance of microbial communities that mediate the nitrogen cycle (P bacteria that mediate the nitrogen cycle in recently abandoned croplands. PMID:27140199

  5. Radical Reactions and Its Synthetic Application

    Institute of Scientific and Technical Information of China (English)

    Takeaki Naito

    2005-01-01

    @@ 1Introduction Strategies involving radical reactions have become preeminent tools in organic synthesis. Free radical-mediated cyclization has developed as a powerful method for preparing various types of cyclic compounds via carbon-carbon bond-forming processes. In order to develop effective and convenient methods for the synthesis of biologically active cyclic amines, we have focused our efforts on radical reactions using aldehydes, ketones,and C-C multiple bonds as a radical precursor and/or an oxime ether, hydrazone, and nitrone as a radical acceptor. In this lecture, I would like to talk on radical addition-cyclization of oxime ether and its application to the synthesis of martinellines.

  6. Comparison of Clinical Effects Between Vaginal Hysterectomy and Laparoscopically Assisted Vaginal Hysterectomy%阴式子宫切除术与腹腔镜辅助阴式子宫切除术的术式比较

    Institute of Scientific and Technical Information of China (English)

    鲁春雁

    2011-01-01

    Objective To evaluate clinical effects between vaginal hysterectomy (TVH) and laparoscopic assisted vaginal hysterectomy (LAVH). Methods From January to December 2010, a total of 86 patients with TVH (TVH group) and 92 patients with LAVH (LAVH group) were recruited into this study. Their clinical data before and after the operation were statistically analyzed. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Luoyang No. 3 People s Hospital. Informed consent was obtained from all participants. There were no statistical difference on pelvic operation history, gravidity, parity, anemia during pregnancy, and hysterauxesis (P^>0. 05). Results The operation time, blood loss volume and operation cost of TVH group was shorter, less, and lower than those of LAVH group (P 0. 05). None of serious complication was occurred. Conclusion Compared with LAVH, TVH has the advantage of shorter operative time, less blood loss and lower cost, but it is more adapted to whom the uterus is in 4-month pregnancy and without pelvic adhesions. LAVH expanded TVH s adaptation. We should choose appropriate way according to different clinical conditions for the best therapeutic effects.%目的 探讨阴式子宫切除术(TVH)和腹腔镜辅助阴式子宫切除术(LAVH)的临床效果及应用价值.方法 回顾性分析2007年1月至2010年12月在本院行TVH的86例患者(TVH组)与同期行LAVH的92例患者(LAVH组)的临床资料,对两组患者术中、术后情况进行统计学分析(本研究遵循的程序符合本院人体试验委员会制定的伦理学标准,得到该委员会批准,并与其签署临床研究知情同意书).两组患者既往盆腔手术史、孕次、产次,合并贫血及子宫增大(相应孕周)情况比较,差异无统计学意义(P>0.05).结果 TVH组患者手术时间、术中出血量及手术费用均较LAVH组短、少和低,两组比较,差异有统计学意义(P0.05).所有患者无一例中转开腹及

  7. The impact of land abandonment on species richness and abundance in the Mediterranean Basin

    DEFF Research Database (Denmark)

    Plieninger, Tobias; Hui, Cang; Gaertner, Mirijam;

    2014-01-01

    the effect of land abandonment on species richness and abundance is pronounced; (3) whether previous land use and current protected area status affect the magnitude of changes in the number and abundance of species; and (4) how prevailing landforms and climate modify the impacts of land abandonment. After...... identifying 1240 potential studies, 154 cases from 51 studies that offered comparisons of species richness and abundance and had results relevant to our four areas of investigation were selected for meta-analysis. Results are that land abandonment showed slightly increased (effect size = 0.2109, P,0...... management at these scales can have a powerful impact on biodiversity. ...

  8. Management of mining-related damages in abandoned underground coal mine areas using GIS

    International Nuclear Information System (INIS)

    The mining-related damages such as ground subsidence, acid mine drainage (AMD), and deforestation in the abandoned underground coal mine areas become an object of public concern. Therefore, the system to manage the mining-related damages is needed for the effective drive of rehabilitation activities. The management system for Abandoned Underground Coal Mine using GIS includes the database about mining record and information associated with the mining-related damages and application programs to support mine damage prevention business. Also, this system would support decision-making policy for rehabilitation and provide basic geological data for regional construction works in abandoned underground coal mine areas. (authors)

  9. Preliminary characterization of abandoned septic tank systems. Volume 2: Appendix D

    International Nuclear Information System (INIS)

    In an effort to support remedial investigations of abandoned septic tanks by US DOE, this report contains the results of chemical analyses of the contents of these abandoned tanks. Analytical data are presented for the following: volatile/TCLP volatile organics; semivolatile/TCLP semivolatile organics; PCB organics; total petroleum hydrocarbons; and total metals. The abandoned systems potentially received wastes or effluent from buildings which could have discharged non-domestic, petroleum hydrocarbons, hazardous, radioactive and/or mixed wastes. The 20 sites investigated are located on the Nevada Test Site

  10. Land abandonment, fire recurrence and soil carbon content in the Macizo del Caroig, Eastern Spain

    Science.gov (United States)

    Cerdá, A.; González Peñaloza, F.; Santín, C.; Doerr, S. H.

    2012-04-01

    During the last 50 years two main forces have driven the fate of Mediterranean landscapes: land abandonment and forest fires (MacDonald et al., 2000; Moreira et al., 2001). Due to the economical changes suffered by the of the Mediterranean countries after the Second World War, the population migrated from the rural to the urban areas, and from South to North Europe. The land abandonment allowed the vegetation to recover and, as a consequence, an increase in forest fire took place. The soils of the abandoned land recovered the vegetation and litter layers, and consequently changes in soil properties have being found. One of these changes is the increase of soil carbon content, which is due both to vegetation recovery and to fire occurrence that increases the ash and pyrogenic carbon content in soils. Twenty plots were selected in the Macizo del Caroig in Eastern Spain on soils developed on limestone. The period of abandonment and the forest fires that had affected each plot were determined by interviews with the owners, farmers and shepherds. In addition, six (three + three) plots were selected as forest (no plough) and cultivated control plots. Each plot was sampled (10 random samples) and the organic carbon content determined. The results show that the cultivated plots have organic matter contents of 1.02 %, and the forest (Quercus ilex sp.) plots reach the highest value: 14.98 %. Within those we found values that range from 2.34 %, in the recently abandoned plots (10 year abandonment), to values of 8.23 % in the 50 year old abandoned fields.The results demonstrate that there is a recovery of the organic carbon in abandoned soils and that the forest fires do no affect this trend. The increase of soil organic matter after abandonment is a result of the recovery of vegetation(Debussche et al., 2001), which is the consequence of the end of the disturbance of forest that have affected the Mediterranean for millennia (Barbero et al., 1990). The colonization of the

  11. Successional trends in Sonoran Desert abandoned agricultural fields in northern Mexico

    Science.gov (United States)

    Castellanos, A.E.; Martinez, M.J.; Llano, J.M.; Halvorson, W.L.; Espiricueta, M.; Espejel, I.

    2005-01-01

    Excessive ground-water use and saline intrusion to the aquifer led, in less than three decades, to an increase in abandoned agricultural fields at La Costa de Hermosillo, within the Sonoran Desert. Using a chronosequence from years since abandonment, patterns of field succession were developed. Contrary to most desert literature, species replacement was found, both in fields with and without saline intrusion. Seasonal photosynthetic capacity as well as water and nitrogen use efficiencies were different in dominant early and late successional plant species. These ecological findings provided a framework for a general explanation of species dominance and replacement within abandoned agricultural fields in the Sonoran Desert. ?? 2004 Elsevier Ltd. All rights reserved.

  12. Radicalization In Pakistan And The Spread Of Radical Islam In Pakistan

    Directory of Open Access Journals (Sweden)

    Bahir ahmad

    2015-08-01

    Full Text Available ABSTRACT It is pertinent to mention that radicalism is not intrinsic to Islam and radical interpretations of the religion or for that matter may occur within any way of life and religion Saikal 2003 and yet the question remains as to why Muslims in certain geographical regions have more radical approaches towards their religion and also that what are the causes of such radicalization. Becoming a radical Muslim is not even a matter of a day nor is it a sudden process. There are several reasons behind making a person radical peaceful angry smiling or tolerant. For knowing the reason behind radicalization or radicals persons one has to understand the causes. Tracing these causes is one of the ways to eliminate such behavior. The first step in the elimination of the radical sentiments in a person is to develop peace in his personality Fair Malhotra amp Shapiro 2010. The chapter which has been addressed here is going to shed light on the roots and symptoms of the radicalism. There will be a brief discussion on how the roots of radicalism can be traced and can be eliminated. The assessment and discussion will be conducted on the parameters of the economy media politics and theology from social cultural point of view. According to the analysis of Ahrari 2000 political factor is one of the major and direct factors which have resulted in causing of the radicalism. These factors however intertwine with one another. Radical actions cannot take place only because of the political factors.

  13. Involvement of free radicals in breast cancer

    OpenAIRE

    Ríos-Arrabal, Sandra; Artacho-Cordón, Francisco; León, Josefa; Román-Marinetto, Elisa; del Mar Salinas-Asensio, María; Calvente, Irene; Núñez, Maria Isabel

    2013-01-01

    Researchers have recently shown an increased interest in free radicals and their role in the tumor microenvironment. Free radicals are molecules with high instability and reactivity due to the presence of an odd number of electrons in the outermost orbit of their atoms. Free radicals include reactive oxygen and nitrogen species, which are key players in the initiation and progression of tumor cells and enhance their metastatic potential. In fact, they are now considered a hallmark of cancer. ...

  14. Quantitative determination of atmospheric hydroperoxyl radical

    Energy Technology Data Exchange (ETDEWEB)

    Springston, Stephen R. (Upton, NY); Lloyd, Judith (Westbury, NY); Zheng, Jun (Stony Brook, NY)

    2007-10-23

    A method for the quantitative determination of atmospheric hydroperoxyl radical comprising: (a) contacting a liquid phase atmospheric sample with a chemiluminescent compound which luminesces on contact with hydroperoxyl radical; (b) determining luminescence intensity from the liquid phase atmospheric sample; and (c) comparing said luminescence intensity from the liquid phase atmospheric sample to a standard luminescence intensity for hydroperoxyl radical. An apparatus for automating the method is also included.

  15. EPR spin trapping of protein radicals

    DEFF Research Database (Denmark)

    Davies, Michael Jonathan; Hawkins, Clare L

    2004-01-01

    Electron paramagnetic resonance (EPR) spin trapping was originally developed to aid the detection of low-molecular-mass radicals formed in chemical systems. It has subsequently found widespread use in biology and medicine for the direct detection of radical species formed during oxidative stress...... and via enzymatic reactions. Over the last 15 years this technique has also found increasing use in detecting and identifying radicals formed on biological macromolecules as a result of either radical reactions or enzymatic processes. Though the EPR signals that result from the trapping of large, slowly...

  16. Near-Ring Radicals and Class Pairs

    Institute of Scientific and Technical Information of China (English)

    L.Godloza; N.J.Groenewald; W.A.Olivier

    2005-01-01

    For near-ring ideal mappings p1 and p2, we investigate radical theoretical properties of and the relationship among the class pairs (p1: p2), (Sp2: Sp1) and (Rp2:Rp1). Conditions on p1 and p2 are given for a general class pair to form a radical class of various types. These types include the Plotkin and KA-radical varieties. A number of examples are shown to motivate the suitability of the theory of Hoehnke-radicals over KA-radicals when radical pairs of near-rings are studied. In particular, it is shown that (pc: P3) forms a KA-radical class, where Pc denotes the class of completely prime nearrings and P3 the class of 3-prime near-rings. This gives another near-ring generalization of the 2-primal ring concept. The theory of radical pairs are also used to show that in general the class of 3-semiprime near-rings is not the semisimple class of the 3-prime radical.

  17. The Games Radicals Play: Special Issue on Free Radicals and Radical Ions

    Directory of Open Access Journals (Sweden)

    John C. Walton

    2015-02-01

    Full Text Available Chemistry and Physics have aptly been described as “most excellent children of Intellect and Art” [1]. Both these “children” engage with many playthings, and molecules rank as one of their first favorites, especially radicals, which are amongst the most lively and exciting. Checking out radicals dancing to the music of entropy round their potential energy ballrooms is surely both entertaining and enlightening. Radicals’ old favorite convolutions are noteworthy, but the new styles, modes and arrangements appearing on the scene are even more interesting. Some of these are ephemeral and enjoy only a brief appearance, others are retro-types reappearing in new guises, still others are genuinely new and “go viral” in the scientific world. This Special Issue of Molecules contains the observations and reflections of a select group of chemists and physicists fascinated by this spectacle. It contains an eclectic mix reflecting on new modes and advances as well as on permutations and combinations that revive mature themes. [...

  18. Water pollution - control of pollution regulations: water pollution from abandoned mines; pre-notification of mine abandonment consultation paper and draft regulations

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-02-01

    The paper contains proposals to specify the content of the pre-abandonment notices which UK mine operators will be required to give in the future. The proposals are designed to enhance the Environment Agency`s ability to tackle water pollution from abandoned mines. They set out the precise contents of the notification, which mine operators will have to send to the Agency at least six months in advance of any intended abandonment. The regulations will cover coal and non-coal mines. Estimated compliance costs to business have been drawn up following consultation with the Department of Trade and Industry, the Health and Safety Executive, the Coal Authority and the Environment Agency. The regulations are due in late spring 1998.

  19. Psychoanalysis and the brain - why did freud abandon neuroscience?

    Science.gov (United States)

    Northoff, Georg

    2012-01-01

    Sigmund Freud, the founder of psychoanalysis, was initially a neuroscientist but abandoned neuroscience completely after he made a last attempt to link both in his writing, "Project of a Scientific Psychology," in 1895. The reasons for his subsequent disregard of the brain remain unclear though. I here argue that one central reason may be that the approach to the brain during his time was simply not appealing to Freud. More specifically, Freud was interested in revealing the psychological predispositions of psychodynamic processes. However, he was not so much focused on the actual psychological functions themselves which though were the prime focus of the neuroscience at his time and also in current Cognitive Neuroscience. Instead, he probably would have been more interested in the brain's resting state and its constitution of a spatiotemporal structure. I here assume that the resting state activity constitutes a statistically based virtual structure extending and linking the different discrete points in time and space within the brain. That in turn may serve as template, schemata, or grid for all subsequent neural processing during stimulus-induced activity. As such the resting state' spatiotemporal structure may serve as the neural predisposition of what Freud described as "psychological structure." Hence, Freud and also current neuropsychoanalysis may want to focus more on neural predispositions, the necessary non-sufficient conditions, rather than the neural correlates, i.e., sufficient, conditions of psychodynamic processes.

  20. Reclaiming abandoned mining sites: Reurbanization concepts and examples

    International Nuclear Information System (INIS)

    The Ruhr District in Germany, one of the oldest and largest hard coal mining regions in Europe, has been in a process of constant change over the last 40 years. Since the end of the World War II, the coal industry has been declining. There have been a number of successful attempts to establish new industries in the Ruhr District. However, the initiation of new industries depends strongly on the availability of space. Since the Ruhr District is a rather populated region, the only chance to gain space is to reclaim the areas formerly used by now obsolete industries. The remediation of former mining sites in the ruhr District and the reestablishment of alternative industries have now become both a challenge for city planners and a prestigious attribute for ambitious politicians. It has become the declared goal of the German government to convert the Ruhr District into the greenest industrial region in the world. This paper discusses geotechnical techniques, as well as economical risks involved, in the recycling of abandoned mining sites. To demonstrate remediation techniques used in Germany, a recent remediation project is described and analyzed

  1. Opiate written behavioral agreements: a case for abandonment.

    Science.gov (United States)

    Helft, Paul R; Williams, Jessica R; Bandy, Robin J

    2014-01-01

    Written behavioral agreements (WBAs) are gaining popularity as part of the effort to manage the alarming increase in prescription drug abuse. The rationale for increased use of WBAs in managing patients with chronic pain is that they are believed to increase adherence to agreed-upon behaviors, reduce addiction to or diversion of prescription drugs, and satisfy informed consent requirements. However, there are no high-quality data to support their widespread use in any of these areas. The evidence used to support the use of WBAs is insufficient to justify their unfairness and the high risk of harm they pose to the doctor-patient relationship. Instead, we contend that WBAs are being used to provide leverage for severing relationships with some of our most challenging patients. We propose that physicians treating patients for chronic pain abandon the use of WBAs. Alternatives include open communication, detailed informed consent processes, carefully documented discussions, and most important, commitment to ongoing relationships even with difficult patients.

  2. Abandoned coal mine refuse areas: their reclamation and use

    Energy Technology Data Exchange (ETDEWEB)

    Zellmer, S. D.; Carter, R. P.

    1977-01-01

    There are over 4,000 abandoned deep coal mine refuse areas in Illinois ranging in size from a few acres to as large as 160 acres. These sites produce quantities of pollutants which affect the environment, have no real land value, and are a scar on the landscape. The Staunton 1 Site Reclamation Demonstration Project addressess these problems. It also is developing and evaluating new cost-effective methods for reclaiming refuse areas of this type. The program involved determining the final land use for the site, development of detailed engineering plans and specifications for the reclamation effort, a prereclamation environmental inventory, and implementation. Post-construction evaluation is now in process to determine the effectiveness of the reclamation effort. Detailed investigations are being conducted to determine surface water quality improvement, the amount of suitable surface cover and amendments required for revegetation, and field evaluation of candidate vegetation species for revegetation. Other research is examining soil microbial populations, soil fauna reactions, and changes in surface material characteristics at the reclamation site. Surveys are being conducted on groundwater quality, effects on the aquatic ecosystem, and wildlife use of the area. An economic evaluation is underway to determine the cost effectiveness of the total effort and of individual reclamation procedures. Preliminary results from the first year's environmental evaluation of various method tested will be described in detail. An economic assessment, including cost effectiveness, of the first year's work is given.

  3. Inhibitory effects of chitosan on superoxide anion radicals and lipid free radicals

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    With the electron spin resonance (ESR) technique, the inhibitory effects of chitosan on superoxide anion radicals and linoleic acid lipid radicals were found. The inhibitory ratio E for these two kinds of radicals is in proportion to the concentration of chitosan. It was also observed that E for linoleic acid lipid radicals increased with the increase of the degree of deacetylation and decreased with the increase of the molecular weight of chitosan.

  4. Effect of adding dexamethasone to bupivacaine on transversus abdominis plane block for abdominal hysterectomy: A prospective randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Amany S Ammar

    2012-01-01

    Full Text Available Purpose: Different adjuvants have been used to improve the quality and increase the duration of local anesthetics during various nerve block techniques. The current study was aimed to evaluate the effect of adding dexamethasone to bupivacaine on the quality and duration of transversus abdominis plane (TAP block. Methods: Sixty adult patients undergoing elective open abdominal hysterectomy were randomly allocated to receive TAP block using 20 mL of bupivacaine hydrochloride 0.25% + 2 mL saline 0.9% (control group, n=30 or 20 mL of bupivacaine hydrochloride 0.25% + 2 mL dexamethasone "8 mg" (dexamethasone group, n=30. The primary outcome was postoperative pain, as evaluated by visual analog scale (VAS for pain scoring at 1, 2, 4, 12, 24 and 48 h postoperatively, whereas the secondary outcomes were time to first analgesia (TFA, morphine consumption and the occurrence of nausea, vomiting or somnolence. Results: The pain VAS score was significantly lower at the postoperative 2 h (4.9 vs. 28.1, P=0.01, 4 h (12.2 vs. 31.1, P=0.01 and 12 h (15.7 vs. 25.4, P=0.02. Furthermore, TFA was significantly longer in the dexamethasone group (459.8 vs. 325.4 min, P=0.002, with lesser morphine requirements in the postoperative 48 h (4.9 vs. 21.2 mg, P=0.003 and lower incidence of nausea and vomiting (6 vs. 14, P=0.03. No complications attributed to the block were recorded. Conclusion: Addition of dexamethasone to bupivacaine in TAP block prolonged the duration of the block and decreased the incidence of nausea and vomiting.

  5. Is Radical Innovation Management Misunderstood?

    DEFF Research Database (Denmark)

    Kristiansen, Jimmi Normann; Gertsen, Frank

    2015-01-01

    This paper poses a critical view on radical innovation (RI) management research and practice. The study investigates how expected RI performance influences firms’ under- standing of their RI capability. RI performance is often based on output measures such as market shares or fiscal return....... On the contrary, RI capability building advocates for ex- ploration, learning, and accepting uncertainty. Hence, RI capability building often focuses on the processes of the firms, and not the outcome. Thus, it is argued that the RI capability- building and RI performance expectations are based on different...... managerial orientations. Coupling a discussion of the literature with case findings from four large international firms, this paper identifies a discrepancy between RI capability-building and RI perfor- mance within literature and practice. This is regarded to be a major contributing factor to RI program...

  6. Photoionisation of the tropyl radical

    Directory of Open Access Journals (Sweden)

    Kathrin H. Fischer

    2013-04-01

    Full Text Available We present a study on the photoionisation of the cycloheptatrienyl (tropyl radical, C7H7, using tunable vacuum ultraviolet synchrotron radiation. Tropyl is generated by flash pyrolysis from bitropyl. Ions and electrons are detected in coincidence, permitting us to record mass-selected photoelectron spectra. The threshold photoelectron spectrum of tropyl, corresponding to the X+ 1A1’ ← X 2E2” transition, reveals an ionisation energy of 6.23 ± 0.02 eV, in good agreement with Rydberg extrapolations, but slightly lower than the value derived from earlier photoelectron spectra. Several vibrations can be resolved and are reassigned to the C–C stretch mode ν16+ and to a combination of ν16+ with the ring breathing mode ν2+. Above 10.55 eV dissociative photoionisation of tropyl is observed, leading to the formation of C5H5+ and C2H2.

  7. Students' Ideas and Radical Constructivism

    Science.gov (United States)

    Sánchez Gómez, Pedro J.

    2016-08-01

    In this article, I study, from the point of view of the analytic philosophy of mind, the compatibility of students' ideas studies (SIS) with radical constructivism (RC). I demonstrate that RC is based on a psychology of narrow mental states; that is, the idea that the mental content of an individual can be fully characterised without any reference external to her or him. I show that this fact imposes some severe restrictions to SIS to be incorporated into RC. In particular, I argue that only qualitative studies can comply with the requirement of narrowness. Nevertheless, I propose that quantitative works can be employed as sources of types in order to study token actual students. I use this type-token dichotomy to put forward an outline of a theory of the relation between school contents and mental contents. In this view, token mental contents regarding a given topic can be defined, and probed, only by resorting to typical school contents.

  8. Iron and iron derived radicals

    Energy Technology Data Exchange (ETDEWEB)

    Borg, D.C.; Schaich, K.M.

    1987-04-01

    We have discussed some reactions of iron and iron-derived oxygen radicals that may be important in the production or treatment of tissue injury. Our conclusions challenge, to some extent, the usual lines of thought in this field of research. Insofar as they are born out by subsequent developments, the lessons they teach are two: Think fastexclamation Think smallexclamation In other words, think of the many fast reactions that can rapidly alter the production and fate of highly reactive intermediates, and when considering the impact of competitive reactions on such species, think how they affect the microenvironment (on the molecular scale) ''seen'' by each reactive molecule. 21 refs., 3 figs., 1 tab.

  9. Supporting radical front end innovation

    DEFF Research Database (Denmark)

    Aagaard, Annabeth; Gertsen, Frank

    2011-01-01

    ). Pharmaceutical innovation is unique, as it opposed to most other industries’ product development is science-driven and not customer-driven. In addition, the pharmaceutical FEI, as represented by research, lasts up to 5 years and the entire R&D process constitutes a period of 10-12 years, which is highly...... regulated by external authorities, e.g. The American Food and Drug Administration (FDA). The research aim of this paper is: to contribute to the field of FEI by studying how FEI can be actively supported within the industry specific context of the pharmaceutical industry, and through a conceptual discussion...... of FEI, pharmaceutical FEI and radical innovation. Based on this understanding, empirical research through exploratory and inductive case studies is analyzed. The value added and the contribution of this article to the existing FEI literature is in the study of the theoretical fields of research...

  10. Effectiveness of cervical conization versus simple total hysterectomy, patients with in situ cervix cancer, Instituto Oncologico Nacional Dr. Juan Tanca Marengo Guayaquil 1996-1998

    International Nuclear Information System (INIS)

    The cancer in the cervix is the main cause of oncologic disease in the women in Ecuador. This investigation tries to find out the more adequate surgical treatment used in the patients with early cervix cancer, in agreed with the cost benefit relationship. This work has not been before done in the ION SOLCA, because of that, there is only information reports of other countries. We make a bibliographic review of previous reports about the surgical treatments of the cancer in situ of the cervix, that is the cervical conization and the simple total hysterectomy, likewise, we analyse the results of the efficacy of both treatments in the patients attended during three years in the National Oncologic Institute SOLCA, by means of a 5 years follow up. In this retrospective study, it was compared the efficacy between the cervical conization and the simple total hysterectomy in the treatment of patients with in situ cancer of cervix who went to the service of surgery of the Oncologic National Institute SOLCA Guayaquil during 1996, 1997 and 1998 and whom were followed up during 5 years. This is a bibliographic documental investigation, in which, we got information about the object of study from the department of statistics in the ION SOLCA; the techniques used were the analysis and the documental statistic collection. We revised 246 clinical histories of patients with cancer in situ of cervix, of which, 128 were included and 118 were excluded. The reasons for exclusion were the lack of posttreatment controls and data record. The data collection was accomplished by formularies. The 128 clinical histories were classified in three groups: the group in which it was done only the conization. The group in which it was done only the simple total hysterectomy. The group in which it was done both treatment. (The author)

  11. Outcomes of vaginal hysterectomy and constricting colporrhaphy with concurrent levator myorrhaphy and high perineorrhaphy in women older than 75 years of age

    Directory of Open Access Journals (Sweden)

    Töz E

    2015-06-01

    Full Text Available Emrah Töz, Aykut Özcan, Nesin Apaydin, İbrahim Uyar, Betül Kocakaya, Gülin Okay Department of Gynecology and Obstetrics, Tepecik Education and Research Hospital, İzmir, Turkey Objectives: We performed constricting anterior and posterior colporrhaphy, levator myorrhaphy, and high perineorrhaphy with concurrent hysterectomy, and investigated the intraoperative complications, and short-term outcomes of these constricting procedures in patients aged 75 years or older.Methods: We searched our hospital database for cases, between January 2011 and January 2014, of women aged over 75 years who underwent surgery for pelvic organ prolapse of stage 2 or higher, via vaginal hysterectomy, constricting anterior and posterior colporrhaphy, levator myorrhaphy, and high perineorrhaphy, with or without treatment of urinary incontinence. All volunteers were evaluated via pelvic examination using the pelvic organ prolapse quantification system, the modified Decision Regret Scale–Pelvic Floor Disorders form, the Satisfaction Decision Scale–Pelvic Floor Disorders form, and the Pelvic Floor Distress Inventory form.Results: Fifty-four patients were included in the study. The mean follow-up time was 24.4 months after constricting surgery (range: 8–44 months. There were four cases (7% of de novo urge incontinence (the symptoms resolved upon prescription of anticholinergic medication. Two patients developed de novo stress urinary incontinence after the procedure and were treated via transobturator sling surgery using Safyre T® polypropylene monofilament slings. No anatomical or subjective recurrence of prolapse was noted during the follow-up period. No patient required additional surgery for recurrence of prolapse.Conclusion: Constricting anterior and posterior colporrhaphy, levator myorrhaphy, and high perineorrhaphy with concurrent hysterectomy is a feasible, safe, and effective surgical option in elderly patients at low anesthesiological risk. The decision

  12. Decrease in symptoms, blood loss and uterine size with nafarelin acetate before abdominal hysterectomy: a placebo-controlled, double-blind study.

    Science.gov (United States)

    Ylikorkala, O; Tiitinen, A; Hulkko, S; Kivinen, S; Nummi, S

    1995-06-01

    To evaluate the efficacy and safety of nafarelin before hysterectomy in a prospective placebo-controlled trial, we randomized 188 pre-menopausal women with uterine fibroids (n = 111), menometrorrhagia (n = 58) or pelvic pain (n = 19) to receive either nafarelin (200 micrograms twice daily as a nasal spray) or a placebo for 3 months before abdominal hysterectomy. The data analysis could be performed in 166 women, of whom 107 received nafarelin and 59 a placebo. Nafarelin led to a rise in blood haemoglobin (5.5 g/l) and to a decrease in uterine volume (23.7%). This, however, gave no objective benefit during surgery (similar operative durations and blood losses). The uteri from patients treated with nafarelin (255.5 +/- 12.6 g, mean +/- SD) were significantly lighter (P = 0.029) than those from patients treated with a placebo (346.2 +/- 35.7 g). Histological examination of the fibroids or uteri revealed changes typical for hypo-oestrogenism, but no specific histological pattern could be established. The endometrium was proliferative in 56% and showed mild hyperplastic features in 10% of patients given nafarelin, whereas the respective figures for the placebo group were 41 and 0%. Hot flushes were the most common side-effects, being reported by 61% in the nafarelin group and 35% in the placebo group. Nafarelin can be useful as a pre-surgical adjunct in a patient scheduled for abdominal hysterectomy if there is a need to raise the haemoglobin concentration or to reduce the size of the uterus. PMID:7593517

  13. Abandoned Uranium Mine (AUM) Enforcement Action Mine Points, Navajo Nation, 2016, US EPA Region 9

    Data.gov (United States)

    U.S. Environmental Protection Agency — This GIS dataset contains point features that represent abandoned uranium mines with EPA enforcement actions as of March 2016 in Navajo Nation. Attributes include...

  14. Abandoned Uranium Mines (AUM) Site Screening Map Service, 2016, US EPA Region 9

    Data.gov (United States)

    U.S. Environmental Protection Agency — As described in detail in the Five-Year Report, US EPA completed on-the-ground screening of 521 abandoned uranium mine areas. US EPA and the Navajo EPA are using...

  15. Abandoned Uranium Mine (AUM) Priority Mine Areas, Navajo Nation, 2016, US EPA Region 9

    Data.gov (United States)

    U.S. Environmental Protection Agency — This GIS dataset contains polygon features representing priority abandoned uranium mines in Navajo Nation, as determined by the US EPA and the Navajo Nation. USEPA...

  16. Abandoned Uranium Mine (AUM) Points, Navajo Nation, 2016, US EPA Region 9

    Data.gov (United States)

    U.S. Environmental Protection Agency — This GIS dataset contains point features of all Abandoned Uranium Mines (AUMs) on or within one mile of the Navajo Nation. Points are centroids developed from the...

  17. Abandoned Uranium Mine (AUM) Priority Mine Points, Navajo Nation, 2016, US EPA Region 9

    Data.gov (United States)

    U.S. Environmental Protection Agency — This GIS dataset contains point features representing priority abandoned uranium mines in Navajo Nation, as determined by the US EPA and the Navajo Nation. USEPA...

  18. Abandoned Uranium Mine (AUM) Surface Areas, Navajo Nation, 2016, US EPA Region 9

    Data.gov (United States)

    U.S. Environmental Protection Agency — This GIS dataset contains polygon features that represent all Abandoned Uranium Mines (AUMs) on or within one mile of the Navajo Nation. Attributes include mine...

  19. Asymptotic inference for waiting times and patiences in queues with abandonment

    DEFF Research Database (Denmark)

    Gorst-Rasmussen, Anders; Hansen, Martin Bøgsted

    Motivated by applications in call center management, we propose a framework based on empirical process techniques for inference about the waiting time and patience distribution in multiserver queues with abandonment. The framework rigorises heuristics based on survival analysis of independent...

  20. Asymptotic inference for waiting times and patiences in queues with abandonment

    DEFF Research Database (Denmark)

    Gorst-Rasmussen, Anders; Hansen, Martin Bøgsted

    2009-01-01

    Motivated by applications in call center management, we propose a framework based on empirical process techniques for inference about waiting time and patience distributions in multiserver queues with abandonment. The framework rigorises heuristics based on survival analysis of independent...