Sample records for abandoned radical hysterectomy

  1. Place of Schauta's radical vaginal hysterectomy.

    Roy, Michel; Plante, Marie


    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. Nerve plane-sparing radical hysterectomy: a simplified technique of nerve-sparing radical hysterectomy for invasive cervical cancer

    LI Bin; LI Wei; SUN Yang-chun; ZHANG Rong; ZHANG Gong-yi; YU Gao-zhi; WU Ling-ying


    Background In order to simplify the complicated procedure of nerve-sparing radical hysterectomy, a novel technique characterized by integral preservation of the autonomic nerve plane has been employed for invasive cervical cancer. The objective of this study was to introduce the nerve plane-sparing radical hysterectomy technique and compare its efficacy and safety with that of nerve-sparing radical hysterectomy.Methods From September 2006 to August 2010, 73 consecutive patients with International Federation of Gynecology and Obstetrics stage IB to IIA cervical cancer underwent radical hysterectomy with two different nerve-sparing approaches. Nerve-sparing radical hysterectomy was performed for the first 16 patients (nerve-sparing radical hysterectomy group). The detailed autonomic nerve structures were identified and separated by meticulous dissection during this procedure. After January 2008, the nerve plane-sparing radical hysterectomy procedure was developed and performed for the next 57 patients (nerve plane-sparing radical hysterectomy group). During this modified procedure, the nerve plane (meso-ureter and its extension) containing most of the autonomic nerve structures was integrally preserved. The patients' clinicopathologic characteristics, surgical parameters, and outcomes of postoperative bladder function were compared between the two groups.Conclusion Nerve plane-sparing radical hysterectomy Is a reproducible and simplified modification of nerve-sparing radical hysterectomy, and may be preferable to nerve-sparing radical hysterectomy for treatment of early-stage invasive cervical cancer.

  3. Robotic radical hysterectomy in the management of gynecologic malignancies.

    Pareja, Rene; Ramirez, Pedro T


    Robotic surgery is being used with increasing frequency in gynecologic oncology. To date, 44 cases were reported in the literature of radical hysterectomy performed with robotic surgery. When comparing robotic surgery with laparoscopy or laparotomy in performing a radical hysterectomy, the literature shows that robotic surgery offers an advantage over the other 2 surgical approaches with regard to operative time, blood loss, and length of hospitalization. Future studies are needed to further elucidate the equivalence or superiority of robotic surgery to laparoscopy or laparotomy in performing a radical hysterectomy.

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

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


    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.

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

    Zhuowei Xue


    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.

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

    Likić-Lađević Ivana


    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?

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


    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. Laparoscopic, robotic and open method of radical hysterectomy for cervical cancer: A systematic review

    Puliyath Geetha


    Full Text Available Background : Over the last two decades, numerous studies have indicated the feasibility of minimally invasive surgery for early cervical cancer without compromising the oncological outcome. Objective : Systematic literature review and meta analysis aimed at evaluating the outcome of laparoscopic and robotic radical hysterectomy (LRH and RRH and comparing the results with abdominal radical hysterectomy (ARH. Search Strategy : Medline, PubMed, Embase, Cochrane library and Reference lists were searched for articles published until January 31 st 2011, using the terms radical hysterectomy, laparoscopic radical hysterectomy, robotic radical hysterectomy, surgical treatment of cervical cancer and complications of radical hysterectomy. Selection Criteria : Studies that reported outcome measures of radical hysterectomy by open method, laparoscopic and robotic methods were selected. Data collection and analysis: Two independent reviewers selected studies, abstracted and tabulated the data and pooled estimates were obtained on the surgical and oncological outcomes. Results : Mean sample size, age and body mass index across the three types of RH studies were similar. Mean operation time across the three types of RH studies was comparable. Mean blood loss and transfusion rate are significantly higher in ARH compared to both LRH and RRH. Duration of stay in hospital for RRH was significantly less than the other two methods. The mean number of lymph nodes obtained, nodal metastasis and positive margins across the three types of RH studies were similar. Post operative infectious morbidity was significantly higher among patients who underwent ARH compared to the other two methods and a higher rate of cystotomy in LRH. Conclusions : Minimally invasive surgery especially robotic radical hysterectomy may be a better and safe option for surgical treatment of cervical cancer. The laparoscopic method is not free from complications. However, experience of surgeon may

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

    Iavazzo, Christos; Gkegkes, Ioannis D


    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.

  10. Robotic versus total laparoscopic radical hysterectomy with pelvic lymphadenectomy for the treatment of early cervical cancer

    Jagdishwar G Goud


    Conclusions: According to our experience, robotic radical hysterectomy appears to be safe and effective therapeutic procedure for managing early-stage cervical cancer without significant differences when compared to TLRH, with respect to operative time, blood loss, hospital stay. Regarding the oncological outcome, Robotic radical hysterectomy is superior in terms of number of lymph nodes and parametrial bulk; although multicenter randomized clinical trials with longer follow-up are necessary to evaluate the overall oncologic outcome. [Int J Reprod Contracept Obstet Gynecol 2014; 3(1.000: 34-39

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

    Jensen, Pernille Tine

    Background: Radical hysterectomy (RH) and pelvic lymphadenectomy is widely used as the primary treatment for lymph node negative early stage cervical cancer. Little knowledge exists concerning the impact of RH on self-assessed urological and gynecological adverse effects as well as the impact of ...

  12. Acupuncture for Preventing Complications after Radical Hysterectomy: A Randomized Controlled Clinical Trial

    Wei-min Yi


    Full Text Available We aimed to investigate the preventive effects of acupuncture for complications after radical hysterectomy. A single-center randomized controlled single-blinded trial was performed in a western-style hospital in China. One hundred and twenty patients after radical hysterectomy were randomly allocated to two groups and started acupuncture from sixth postoperative day for five consecutive days. Sanyinjiao (SP6, Shuidao (ST28, and Epangxian III (MS4 were selected with electrical stimulation and Zusanli (ST36 without electrical stimulation for thirty minutes in treatment group. Binao (LI14 was selected as sham acupuncture point without any stimulation in control group. The main outcome measures were bladder function and prevalence of postoperative complications. Compared with control group, treatment group reported significantly improved bladder function in terms of maximal cystometric capacity, first voiding desire, maximal flow rate, residual urine, and bladder compliance, and decreased bladder sensory loss, incontinence, and urinary retention on fifteenth and thirtieth postoperative days. Treatment group showed significant advantage in reduction of urinary tract infection on thirtieth postoperative day. But no significant difference between groups was observed for lymphocyst formation. By improving postoperative bladder function, early intervention of acupuncture may provide a valuable alternative method to prevent bladder dysfunctional disorders and urinary tract infection after radical hysterectomy.

  13. Early stage cervical cancer, radical hysterectomy and sexual function: a longitudinal study

    Jensen, Pernille Tine

    Background: Limited knowledge exists regarding the impact of treatment on the sexual function of early stage cervical cancer patients. We investigated the longitudinal course of self-reported sexual function after radical hysterectomy (RH) alone. Methods: 173 patients with lymph node-negative early......-surgery, the patients completed an extended version of the questionnaire with additional items assessing the patient’s perception of changes in sexual function compared with before the cancer diagnosis. Results: Compared with control women, patients experienced severe orgasmic problems and uncomfortable sexual...

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

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


    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 comprised...... with an age-matched control group from the general population. RESULTS: Compared with control women, patients experienced severe orgasmic problems and uncomfortable sexual intercourse due to a reduced vaginal size during the first 6 months after RH, severe dyspareunia during the first 3 months, and sexual...

  15. Radical Hysterectomy

    ... than 1 in 10 women noticed problems with lubrication and pain during sex. Almost 8 in 10 ... News and Stories Glossary For Health Care Professionals Programs & Services Breast Cancer Support TLC Hair Loss & Mastectomy ...

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

    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)


    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.

  17. Radical abdominal hysterectomy using the ENDO-GIA stapler: report of 150 cases and literature review.

    Patsner, B


    Over a seven-year period from 1990-1997 150 consecutive patients underwent Type III radical abdominal hysterectomy using the ENDO-GIA stapler on the cardinal and uterosacral ligaments. Compared to prior patients operated on with standard suturing methods, the stapler patients had shorter operating times, lower blood loss and infection rates, and shorter hospital stays without any increase in recurrence rate. The equipment failure rate was 3%. Although not all improvements in surgical and post-operative morbidity are likely due to use of the ENDO-GIA stapler, the use of the stapler clearly lowered operating times, blood loss, surgical morbidity, hospital stay with no adverse effect on patient survival.

  18. A retrospective study of neoadjuvant chemotherapy plus radical hysterectomy versus radical hysterectomy alone in patients with stage II cervical squamous cell carcinoma presenting as a bulky mass

    Takatori E


    Full Text Available Eriko Takatori, Tadahiro Shoji, Anna Takada, Takayuki Nagasawa, Hideo Omi, Masahiro Kagabu, Tatsuya Honda, Fumiharu Miura, Satoshi Takeuchi, Toru Sugiyama Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan Objective: In order to evaluate the usefulness of neoadjuvant chemotherapy (NAC for stage II cervical squamous cell carcinoma with a bulky mass, we retrospectively compared patients receiving NAC followed by radical hysterectomy (RH; NAC group with patients who underwent RH without NAC (Ope group. Patients and methods: The study period was from June 2002 to March 2014. The subjects were 28 patients with a stage II bulky mass in the NAC group and 17 such patients in the Ope group. The chi-square test was used to compare operative time, volume of intraoperative blood loss, use of blood transfusion, and time from surgery to discharge between the two groups. Moreover, the log-rank test using the Kaplan–Meier method was performed to compare disease-free survival (DFS and overall survival (OS between the groups. Results: There were no statistically significant differences between the two groups in operative time, volume of intraoperative blood loss, or use of blood transfusion. However, the time from surgery to discharge was 18 days (14–25 days in the NAC group and 25 days (21–34 days in the Ope group; the patients in the NAC group were discharged earlier (P=0.032. The hazard ratio for DFS in the NAC group as compared with that in the Ope group was 0.36 (95% CI 0.08–0.91, and the 3-year DFS rates were 81.2% and 41.0%, respectively (P=0.028. Moreover, the hazard ratio for OS was 0.39 (95% CI 0.11–1.24, and the 3-year OS rates were 82.3% and 66.4%, respectively (P=0.101. Conclusion: NAC with cisplatin and irinotecan was confirmed to prolong DFS as compared with RH alone. The results of this study suggest that NAC might be a useful adjunct to surgery in the treatment of stage II squamous

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

    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


    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

  20. Total Laparoscopic Radical Hysterectomy for Treatment of Uterine Malignant Tumors:Analysis of Short-term Therapeutic Efficacy

    沈怡; 王泽华


    To investigate the efficacy and the clinical value of total laparoscopic radical hysterectomy(TLRH) for the treatment of uterine malignancies,we performed a retrospective review of 87 patients with cervical cancer and 23 patients with endometrial carcinoma who underwent TLRH at Union hospital between June 2008 and September 2009.Data collected included operative time,estimated blood loss,lymph node count,time for the recovery of normal temperature and time to resumption of normal bladder function,intraopera...

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

    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))


    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.

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

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


    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.

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

    郭向阳; 易杰; 叶铁虎; 罗爱伦; 黄宇光; 任洪智


    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.

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

    Chen Z


    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

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

    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


    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.)

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

    李斌; 章文华; 刘琳; 吴令英; 张蓉; 李宁


    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.

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

    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: [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)


    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.

  8. Brachytherapy versus radical hysterectomy after external beam chemoradiation: a non-randomized matched comparison in IB2-IIB cervical cancer patients

    Flores Vladimir


    Full Text Available Abstract Background A current paradigm in the treatment of cervical cancer with radiation therapy is that intracavitary brachytherapy is an essential component of radical treatment. This is a matched retrospective comparison of the results of treatment in patients treated with external beam chemoradiation (EBRT-CT and radical hysterectomy versus those treated with identical chemoradiation followed by brachytherapy. Methods In this non-randomized comparison EBRT-CT protocol was the same in both groups of 40 patients. In the standard treated patients, EBRT-CT was followed by one or two intracavitary Cesium (low-dose rate applications within 2 weeks of finishing external radiation to reach a point A dose of at least 85 Gy. In the surgically treated patients, radical hysterectomy with bilateral pelvic lymph node dissection and para-aortic lymph node sampling were performed within 7 weeks after EBRT-CT. Response, toxicity and survival were evaluated. Results A total of 80 patients were analyzed. The patients receiving EBRT-CT and surgery were matched with the standard treated cases. There were no differences in the clinicopathological characteristics between groups or in the delivery of EBRT-CT. The pattern of acute and late toxicity differed. Standard treated patients had more chronic proctitis while the surgically treated had acute complications of surgery and hydronephrosis. At a maximum follow-up of 60 months, median follow-up 26 (2–31 and 22 (3–27 months for the surgery and standard therapy respectively, eight patients per group have recurred and died. The progression free and overall survival are the same in both groups. Conclusion The results of this study suggest that radical hysterectomy can be used after EBRT-CT without compromising survival in FIGO stage IB2-IIB cervical cancer patients in settings were brachytherapy is not available. A randomized study is needed to uncover the value of surgery after EBRT-CT.

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

    Đurđević Srđan


    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.

  10. Lower limb compartment syndrome by reperfusion injury after treatment of arterial thrombosis post-laparoscopic radical hysterectomy and pelvic lymph node dissection for cervical cancer

    Yeon, Jihee; Jung, Ye Won; Yang, Shin Seok; Kang, Byung Hun; Lee, Mina; Ko, Young Bok; Yang, Jung Bo; Lee, Ki Hwan


    Compartment syndrome is a clinical condition associated with decreased blood circulation that can lead to swelling of tissue in limited space. Several factors including lithotomy position, prolonged surgery, intermittent pneumatic compressor, and reperfusion after treatment of arterial thrombosis may contribute to compartment syndrome. However, compartment syndrome rarely occurs after gynecologic surgery. In this case, the patient was diagnosed as compartment syndrome due to reperfusion injury after treatment of arterial thrombosis, which occurred after laparoscopic radical hysterectomy and pelvic lymph node dissection for cervical cancer. Despite its rarity, prevention and identifying the risk factors of complication should be performed perioperatively; furthermore, gynecologist should be aware of the possibility of complications. PMID:28344966

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

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


    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

  12. Incidence of pelvic organ prolapse repair subsequent to hysterectomy

    Lykke, Rune; Blaakær, Jan; Ottesen, Bent


    INTRODUCTION AND HYPOTHESIS: The aim of this study was to compare the incidence of subsequent pelvic organ prolapse (POP) repair in women following radical hysterectomy versus total abdominal hysterectomy. METHODS: From the Danish National Patient Registry, we collected data on all radical...... and hazard ratio (HR). RESULTS: In all, 5279 women underwent radical hysterectomy, and 63 of these underwent subsequent POP surgery. In the same period, 149,920 women underwent total abdominal hysterectomy, and 6107 of these had POP surgery subsequent to the hysterectomy. The cumulative incidence of POP...... compartments was the same for the two types of hysterectomy. CONCLUSIONS: This study found a significantly lower incidence of subsequent POP operations among women who undergo radical hysterectomy than total abdominal hysterectomy....

  13. Hysterectomy (image)

    Hysterectomy is surgical removal of the uterus, resulting in inability to become pregnant. This surgery may be done for a variety of reasons including, but not restricted to, chronic pelvic inflammatory disease, uterine fibroids and ...

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

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


    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

  15. Current Issues with Hysterectomy.

    Barker, Matthew A


    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. Chronic pain after hysterectomy

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


    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...

  17. Chronic pain after hysterectomy

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


    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...


    M. Modares Gilani


    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.

  19. 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

    傅琦博; 吕坚伟; 蒋晨; 吕婷婷; 李震东; 邱丰; 黄翼然


    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。

  20. Total versus subtotal hysterectomy

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


    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...

  1. 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

    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


    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.

  2. Subtotal versus total abdominal hysterectomy

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


    a multiple imputation analysis, this difference disappeared (relative risk, 1.36; 95% confidence interval, 0.86-2.13; P = .19). No differences were seen in any of the secondary outcomes. CONCLUSION: Subtotal abdominal hysterectomy was not superior to total abdominal hysterectomy on any outcomes. More women...

  3. Emergency peripartum hysterectomy

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


    peripartum hysterectomies reached 211, yielding an incidence rate of 3.5/10 000 (95% confidence interval 3.0-4.0) births. Finland had the highest prevalence (5.1) and Norway the lowest (2.9). Primary indications included an abnormally invasive placenta (n = 91, 43.1%), atonic bleeding (n = 69, 32.......7%), uterine rupture (n = 31, 14.7%), other bleeding disorders (n = 12, 5.7%), and other indications (n = 8, 3.8%). The delivery mode was cesarean section in nearly 80% of cases. Previous cesarean section was reported in 45% of women. Both preterm and post-term birth increased the risk for emergency peripartum...

  4. Depression, anxiety, hostility and hysterectomy.

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


    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.

  5. Sexuality after total vs. subtotal hysterectomy

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


    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....

  6. Preoperative teaching and hysterectomy outcomes.

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


    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.

  7. Peripartum hysterectomy in Denmark 1995-2004

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


    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...

  8. Peripartum hysterectomy: an evolving picture.

    Turner, Michael J


    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.

  9. The decline of hysterectomy for benign disease.

    Horgan, R P


    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.

  10. 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

    陈红; 张友忠


    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

  11. Hysterectomy does not cause constipation

    Roovers, Jan-Paul; van der Bom, Johanna G.; van der Vaart, C. Huub


    PURPOSE: This study was designed to evaluate the risk on development and persistence of constipation after hysterectomy. METHODS: We conducted a prospective, observational, multicenter study with three-year follow-up in 13 teaching and nonteaching hospitals in the Netherlands. A total of 413 females

  12. Peripartum hysterectomy in Denmark 1995-2004

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


    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...




    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

  14. 子宫颈癌患者广泛子宫切除术后下泌尿道尿动力学特点%The low urethra urethral dynamics characteristics after cervical cancer radical hysterectomy postoperative

    戴森戈; 雷鸣; 詹丽飞


    Objective To investigate a wide range of uterine cervical cancer after hysterectomy for lower urinary tract urinary dynamics characteristics.Methods Cervical cancer Ib Ⅱ a via ablominal extensive hysterectomy in 25 cases were analyzed retrospectively,which had the type of operation in 7 cases,type Ⅲ Procedures for 18 cases,respectively,at 1 month after operation and 1 urethral urodynamic studies.Results The patients showed varying degrees of voiding dysfunction and urine storage dysfunction,maximum urinary flow rate decreased significantly (10.01 ml/min),the average decrease in urinary flow rate(6.44ml/min),voiding time 77.63s,residual urine volume 103.16ml,maximum bladder capacity 288.68ml,postoperative beard had the aid of abdominal pressure urination.Conclusion Extensive hysterectomy can occur after different degree of voiding dysfunction and urine storage dysfunction,and duration is longer,the main manifestation of impaired detrusor function,bladder sensory dysfunction,urethral dynamics can contribute to early diagnosis,early treatment,to prevent serious complications of the urinary system.%目的 探讨子宫颈癌广泛子宫切除术后下泌尿道尿动力学的特点.方法 回顾性分性因子宫颈癌Ib~Ⅱa期行经腹广泛子宫切除术的患者25例,其中Ⅱ型术式7例、Ⅲ型术式18例,分别于术后1个月至1年间行尿道动力学检查.结果 患者术后均显示不同程度的排尿功能障碍及储尿功能障碍,最大尿流率明显下降(10.01 ml/min),平均尿流率下降(6.44 ml/min),排尿时间77.63 s,残余尿量103.16 ml,最大膀胱容量288.68ml,术后须借助腹压排尿.结论 广泛子宫切除术后可发生不同程度的排尿功能障碍及储尿功能障碍,且持续时间较久,其主要表现为逼尿肌功能受损、膀胱感觉功能减退,尿道动力学可有助于早期诊断、早期治疗,以预防严重的泌尿系统并发症.

  15. Effect of epidural anesthesia combined with remifentanil-propofol in radical hysterectomy for cervical cancer%硬膜外阻滞复合雷米芬太尼-丙泊酚应用于宫颈癌根治术的效果观察

    李秀满; 王立祥


    目的 探讨硬膜外麻醉复合雷米芬太尼-丙泊酚应用于宫颈癌根治术的麻醉效果.方法 56例ASAⅠ~Ⅱ行宫颈癌根治术患者随机分成雷米芬太尼组(R组,n=28)和杜氟合剂组(D组,n=28),R组在硬膜外麻醉后缓慢静注丙泊酚1 mg/kg后用丙泊酚2.0 mg/kg.h+雷米芬太尼0.1ug/kg.min靶控输注,D组用杜冷丁50 mg+氟哌啶2.5 mg后,靶控输注丙泊酚2.0 mg/kg.h.记录5个时间点的血压和心率;记录术中体动反应及术毕呼之睁眼时间,恶心呕吐等评级及患者满意度.结果 ①两组在给药后SBP、DBP、HR较给药前降低(P<0.05〉,切皮时有增高,但D组升高较R组明显(P<0.05〉;②术后D组眩晕、头痛、躁动及患者满意度与R组相比,差异有统计学意义(P<0.05〉.结论 硬膜外复合雷米芬太尼适合在宫颈癌根治术中使用,与复合杜氟合剂相比较,在苏醒程度上更为优良,患者更为舒适.%Objective To explore clinical effect of cpidural anesthesia combined with remifentanil-propofol undergoing radical hysterectomy in patients with cervical cancer. Methods 56 ASA Ⅰ~Ⅱ cases with radical hysterectomy were randomly divided into two groups, Remifentanil group (group R, n= 28), target controlled infusion (TCI) propofol 2.0 mg/kg.h concentration + Remifentanil 0.1 ug/kg. Min after lmg/kg propofol injected slowly by the intraverous route, and Dolantin- droperidol mixture group (group D, n= 28), VCI propofol 2.0 mg/kg.h concentration after Dolantin50mg + droperidol 2.5mg injected slowly by the intravenous route. All patients were oxygenated by nasal cannula. The HR and BP were recorded at five time points respectively. Body reaetion of interoperation, the time of opening eyes, nausea and vomiting rating and patient satisfaction of post operation were observed respectively. Results ① In both groups, patients' HR dropped after drug intravenous injection and inereased when operation was started (P< 0.05 ), in which HR in group

  16. Abandoned vehicles

    Relations with the Host States Service


    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 ( 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

  17. Potentially Avoidable Peripartum Hysterectomies in Denmark

    Colmorn, Lotte Berdiin; Krebs, Lone; Langhoff-Roos, Jens


    to minimize the number of unnecessary peripartum hysterectomies, obstetricians and anesthesiologists should investigate individual cases by structured clinical audit, and disseminate and discuss the results for educational purposes. An international collaboration is warranted to strengthen our recommendations......OBJECTIVE: To audit the clinical management preceding peripartum hysterectomy and evaluate if peripartum hysterectomies are potentially avoidable and by which means. MATERIAL AND METHODS: We developed a structured audit form based on explicit criteria for the minimal mandatory management...

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

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


    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....

  19. The Feasibility of Societal Cost Equivalence between Robotic Hysterectomy and Alternate Hysterectomy Methods for Endometrial Cancer

    Neel T. Shah


    Full Text Available Objectives. We assess whether it is feasible for robotic hysterectomy for endometrial cancer to be less expensive to society than traditional laparoscopic hysterectomy or abdominal hysterectomy. Methods. We performed a retrospective cohort analysis of patient characteristics, operative times, complications, and hospital charges from all (=234 endometrial cancer patients who underwent hysterectomy in 2009 at our hospital. Per patient costs of each hysterectomy method were examined from the societal perspective. Sensitivity analysis and Monte Carlo simulation were performed using a cost-minimization model. Results. 40 (17.1% of hysterectomies for endometrial cancer were robotic, 91 (38.9%, were abdominal, and 103 (44.0% were laparoscopic. 96.3% of the variation in operative cost between patients was predicted by operative time (=0.963, <0.01. Mean operative time for robotic hysterectomy was significantly longer than other methods (<0.01. Abdominal hysterectomy was consistently the most expensive while the traditional laparoscopic approach was consistently least expensive. The threshold in operative time that makes robotic hysterectomy cost equivalent to the abdominal approach is within the range of our experience. Conclusion. It is feasible for robotic hysterectomy to be less expensive than abdominal hysterectomy, but unlikely for robotic hysterectomy to be less expensive than traditional laparoscopy.

  20. On the measurement of recovery following hysterectomy

    Kluivers, K.B.


    Hysterectomy is the most frequently performed major gynaecologic surgical procedure, with millions of procedures performed annually throughout the world. Hysterectomy can be performed by a vaginal, abdominal or laparoscopic approach, and there is an overlap in indications for either choice. In gener

  1. Clinical assessment for three routes of hysterectomy

    ZHU Lan; LANG Jing-he; LIU Chun-yan; SHI Hong-hui; SUN Zhi-jing; FAN Rong


    Background Hysterectomy is a very common surgery in gynecology. Ideal surgery for hysterectomy is microinvasive with few complications. There are three major routes of hysterectomy that are currently used. The aim of this study was to identify the differences of peri-operative outcome among the patients who underwent the three different approaches.Methods One hundred and one women undergoing hysterectomy for myoma had the procedure performed by laparoscopic assisted vaginal hysterectomy (LAVH), total vaginal hysterectomy (TVH) or total abdominal hysterectomy (TAH) in a randomized study. We compared the course of peri-operative and post-operative outcome for the three different approaches. Results were evaluated by linear regression analysis, Fishers exact test and Student's t test for independent samples.Results The operation time among the three procedures was not significantly different (P >0.05). The amount of blood loss in the TVH group was less than in the LAVH and TAH groups (P<0.05). The pain score 3 hours after operation in the LAVH group was significantly lower than in the TAH and TVH groups (P<0.001). The pain scores in the LAVH and TVH groups were lower than in the TAH group at 24 and 48 hours after operation (P<0.01). The women who underwent LAVH and TVH had a shorter hospitalization stay (P <0.001). The highest body temperature after operation in the TAH group was higher than that in LAVH and TVH groups (P <0.001).Conclusions LAVH and TVH are better procedures for women requiring hysterectomy. The peri-operative and post-operative courses of TVH are better than LAVH, excluding the pain score 3 hours after operation. Vaginal hysterectomy is the most cost-effective approach but the final choice for the route of hysterectomy can depend on many factors such as gynecological disease, patients' health status and experiences of the gynecologist.

  2. Elective cesarean hysterectomy vs elective cesarean section followed by remote hysterectomy: reassessing the risks.

    Bost; Rising; Bost


    Objective: The purpose of this study was to compare the risks of elective cesarean hysterectomy with the risks of elective cesarean section followed by remote hysterectomy.Methods: A census of elective cesarean hysterectomies (n = 31) and a random sample of 200 cesarean sections and 200 hysterectomies performed by the authors between 1987 and 1996 were evaluated. Only elective repeat and primary cesarean section patients without labor were selected for study (n = 86). Total abdominal hysterectomies were drawn from the sample (n = 60), excluding cancer cases, patients over 50 years old, and those with ancillary procedures other than adnexectomy and lysis of adhesions. General probability theory was used to calculate a predicted complication rate of cesarean section followed by TAH from the complication rates of the component procedures done independently. This predicted combined complication rate was then compared to the observed rate of complications from cesarean hysterectomy to evaluate the risks of the two alternative treatment regimens.Results: Elective cesarean section and total abdominal hysterectomy had complication rates of 12.8% and 13.4%, respectively. The predicted combined complication rate for elective cesarean section followed by TAH was 24.5%. The observed rate of complications for elective cesarean hysterectomy was much lower (16.1%). Although bleeding complications were similar for the two regimens, the rate of transfusion was higher for cesarean hysterectomy (13.0%) than for cesarean section (0%) and TAH (3.4%) alone. Eighty percent of the cesarean hysterectomy patients would have been candidates for autologous blood donation, had it been available.Conclusions: Elective cesarean hysterectomy has a lower risk of complications than elective cesarean section followed by remote abdominal hysterectomy and should be preferred. Transfusion risks are higher for cesarean hysterectomy but can be decreased by the use of autologous blood.

  3. Hysterectomy

    ... site Find a Health Center Near: Enter a city, ZIP code (such as 20002), address, state, or ... you have symptoms of depression, including feelings of sadness, a loss of interest in food or things ...

  4. Hysterectomy

    ... cuts in the belly, in order to perform robotic surgery You and your doctor will decide which type ... through the vagina using a laparoscope or after robotic surgery. When a larger surgical cut (incision) in the ...

  5. Guam Abandoned Vessel Inventory

    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...

  6. Abandoned Shipwreck Act

    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...

  7. Florida Abandoned Vessel Inventory

    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...

  8. Effects of Hysterectomy on Sexual Function

    Lonnée-Hoffmann, Risa; Pinas, Ingrid


    Hysterectomy remains the most common major gynecological surgery. Postoperative sexual function is a concern for many women and their partners. In this respect, a beneficial effect of hysterectomy for benign disease independent of surgical techniques or removal of the cervix has been demonstrated in the past decade by the majority of studies. For about 20 % of women, deteriorated sexual function has been reported and current research is attempting to identify mechanisms and predictive factors...

  9. Hysterectomy and Lower Urinary Tract Symptoms : A Nonrandomized Comparison of Vaginal and Abdominal Hysterectomy

    Lakeman, M. M. E.; van der Vaart, C. H.; Roovers, J. P. W. R.


    Common adverse effects of hysterectomy include lower urinary tract symptoms (LUTS), especially urinary incontinence. A difference in the prevalence of LUTS between patients who have undergone vaginal and abdominal hysterectomy may be an additional factor in the choice between these 2 surgical approa

  10. Randomised controlled trial of total compared with subtotal hysterectomy with one-year follow up results

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


    To compare total abdominal hysterectomy and subtotal abdominal hysterectomy performed for benign uterine diseases.......To compare total abdominal hysterectomy and subtotal abdominal hysterectomy performed for benign uterine diseases....

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

    Fatton, B; Amblard, J; Jacquetin, B


    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

  12. Single-port laparoscopic hysterectomy: preliminary results

    Renata Assef Tormena


    Full Text Available Summary Objective: to describe the initial results of a laparoscopic single port access hysterectomy and also to evaluate the feasibility and safety of this access. Methods: a prospective study was performed at a tertiary university medical center (Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo between March 2013 and June 2014. A total of 20 women, referred for hysterectomy due to benign uterine disease, were included in the study after they had signed an informed consent. Outcome measures, including operating time, blood loss, rate of complications, febrile morbidity, visual analogical pain score and length of hospital stay were registered. Results: mean patient age and body mass index (BMI were 47.8 years and 27.15 kg/m2, respectively. Mean operating time was 165.5 min. Blood loss was minimal, with no blood transfusion. All procedures but one were successfully performed via a single incision and no post-operative complications occurred. We experienced one conversion to multiport laparoscopic hysterectomy due to extensive pelvic adhesions. There was no conversion to “open” total abdominal hysterectomy. None of the patients required narcotics or NSAD post-operatively. Conclusion: single-port hysterectomy is a feasible and safe technique, with no major complications.

  13. 腹腔镜下保留盆腔自主神经平面根治性子宫切除术的初步临床研究%Preliminary clinical study of laparoscopic pelvic autonomic nerve-plane sparing radical hysterectomy

    卢艳; 姚德生; 莫凌昭; 李菲; 潘忠勉


    目的 探讨保留盆腔自主神经平面的腹腔镜下根治性子宫切除术的技术要点、可行性及其对降低术后膀胱功能障碍的作用.方法 将2010年1月至2011年5月30例宫颈癌患者分为两组,一组(15例)根据盆腔自主神经的标志性结构行保留“神经平面”法,于腹腔镜下保留盆腔自主神经的根治性子宫切除术(LNSRH),另一组(15例)行腹腔镜下根治性子宫切除术(LRH)作为对照.结果 LNSRH组15例患者中2例因出血较多保留单侧神经,1例为ⅡA期选择性保留病灶对侧盆腔神经,其余成功保留了双侧神经.全组30例患者均顺利完成手术,LNSRH组的手术时间为(301.8±47.6) min,长于LRH组的(178.3±17.0) min(P <0.05).术中出血量、术后肠道恢复时间、切除盆腔淋巴结的数目、宫旁和阴道切除范围两组比较差异无统计学意义(P>0.05).术后LNSRH组的住院时间为(10.9±2.0)d,明显少于LRH组的(15.1±0.8)d(P<0.05).LNSRH组术后拔除尿管的平均时间为(10.8±3.2)d,明显短于LRH组的(17.4±3.2)d(P <0.05).随访3~19个月,全组无复发和转移病例.结论 LNSRH在技术上安全、可行,可明显减少术后膀胱功能障碍,既不降低根治性标准,又有利于患者术后恢复及生活质量提高.%Objective To study the feasibility of laparoscopic pelvic autonomic nerve-plane sparing radical hysterectomy (LN-SRH) technique and its effect on decreasing postoperative bladder dysfunction. Methods From February 2010 to May 2011, 30 consecutive patients with cervical cancer were divided into LNSRH group and laparoscopic radical hysterectomy (LRH) group. We performed 15 LNSRH with the fascia space dissection technique and according to the basic anatomic landmarks of pelvic autonomic nerves and the operating time, operating bleeding and the postoperative recovery of bladder function were assayed. The other 15 patients were in control group under LRH. Results In LNSRH group, 2 cases reserved

  14. The long-term efficacy of neoadjuvant chemotherapy followed by radical hysterectomy compared with concurrent chemoradiotherapy on locally advanced uterine cervix cancer%新辅助化疗后根治性手术与同步放化疗在局部晚期宫颈癌的远期疗效评价

    印明柱; 娄阁; 陈秀玮; 顾泰华


    目的 本研究的目的 是比较ⅠB2~ⅡB期局部晚期宫颈癌新辅助化疗后根治性手术与同步放化疗的远期生存情况. 方法 回顾性分析从2000年1月-2004年12月间ⅠB2~ⅡB期局部晚期宫颈癌共222例,将其分为二组:新辅助化疗+根治性全子宫切除术+盆腔淋巴结切除术共155例;同步放化疗组67例.所有患者最长随访时间为114个月,最短随访时间为54个月,中位随访时间为72.6个月.且对所有可能影响无瘤生存时间和总生存时间的高危因素进行评估. 结果 本研究中位随访时间为72.6个月,新辅助化疗后根治性手术组和同步放化疗组5年无瘤生存率分别是88.39%和70.94%,两组比较有统计学意义(P=0.006);而5年总生存率分别为88.52%和72.91%,两组比较有统计学意义(P=0.0004).在Cox风险回归模型中,调整宫颈癌患者的年龄、病理分型后,结果显示:接受新辅助化疗后根治性手术组和同步放化疗组治疗的宫颈癌患者5年无瘤生存时间有明显差异(HR=2.765,95%CI:1.446~5.288,P=0.0021);在5年总生存时间上也有显著性差异(HR=3.516,95%CI:1.822~6.784,P=0.0002). 结论 本研究ⅠB2~ⅡB期局部晚期宫颈癌新辅助化疗后根治性手术组在无瘤生存时间和总生存时间方面显著优于同步放化疗组.%Objective The purpose of this study is to compare long - term survival of neoadjuvant chemotherapy followed by radical hysterectomy with concurrent chemoradiotherapy in locally advanced cervical cancer.Methods A total of 222 stage Ⅰ B2 - Ⅱ B locally advanced cervical cancer cases from January 2000 to December 2004 were analyzed retrospectivly. All the cases were divided into two groups:155 cases of neoadjuvant chemotherapy followed by radical hysterectomy with pelvic lymph node dissection( NACT + RS group );67 cases of concurrent chemoradiotherapy group( CCRT group ). Patients were followed up from 54 to 114 months. NACT group patients were followed up for

  15. Abandoned Texas oil fields


    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.




    A randomized double-blind prospective study on the efficacy of single-dose antibiotic prophylaxis compared cefuroxime versus metronidazole versus the combination of both agents in vaginal hysterectomy. Overall antibiotic prophylaxis was effective in abscess prevention (one abscess in 68 patients). I

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

    Towghi, Fouzieyha


    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.

  18. Having views, abandoning views

    Sobisch, Jan-Ulrich


    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....

  19. Impact on survival and quality of life of laparoscopic radical hysterectomy and pelvic lymphadenectomy to patients with early-stage cervical cancer%腹腔镜下广泛性子宫切除术治疗早期子宫颈癌的疗效及对患者预后和生命质量的影响

    阳志军; 陈艳丽; 姚德生; 张洁清; 李菲; 李力


    Objective To compare intraoperative,pathologic,postoperative outcomes and quality of life of laparoscopic radical hysterectomy and pelvic lymphadenectomy ( LRH + LPL) with abdominal radical hysterectomy and pelvic lymphadenectomy ( ARH + APL) for patients with early-stage cervical cancer.Methods The consecutive cases with International Federation of Gynecology and Obstetrics (FIGO) stages Ⅰ a2 - Ⅱ a cervical cancer who underwent surgery from Jan.1,2002 to Jan.1,2011 were documented,including 85 patients underwent LRH + LPL,and 85 patients underwent ARH + APL as control group.The clinical data of intraoperative,pathologic,postoperative outcomes and quality of life were compared between two groups.Survival data were estimated using Kaplan-Meier survival curves and compared with the log-rank test.Cox proportional hazards model was used for multivariate analysis.Results All but 2 surgical procedures were completed laparoscopically because of right common ihac vein vessel injuries.Mean operative time,it was longer for LRH + LPL than that for ARH + APL [ (242 ±74) minutes vs.( 190 ±61 ) minutes,P =0.000 ].Mean recovery time of intestines function was less for LRH + LPL than that for ARH + APL [ (45 ± 7 ) hours vs.(63 ± 1 1 ) hours,P =0.000 ].Mean estimated blood loss was less for LRH + LPL than that for ARH + APL[ (367 ±252) ml vs.(460 ±220) ml,P =0.006].Mean recovery time of urinary function was less that for LRH + LPL than that for ARH + APL [ ( 19 ±4) days vs.(21 ±4) days,P =0.000 ].There were no significant difference in numbers of the pelvic lymph nodes resected,the extent of parametrial tissue,vaginal cuff,negative margins obtained and complications.The median follow-up was 32 months (range 4 to 105 months),there was no significant difference in the recurrence rate (7% vs.5%,P=0.540) and mortality rate (7% vs.5%,P=0.540),5 years disease-free survival(90% vs.94%,P =0.812),5 years over survival ( 90% vs.95%,P =0.532 ).There were not

  20. Abandoning wells working group



    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.

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

    Agnaeber, K; Bodalal, Z


    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.

  2. Robotic-assisted hysterectomy: patient selection and perspectives

    Smorgick, Noam


    Minimally invasive hysterectomy via the laparoscopic or vaginal approach is beneficial to patients when compared with laparotomy, but has not been offered in the past to all women because of the technical difficulties and the long learning curve required for laparoscopic hysterectomy. Robotic-assisted hysterectomy for benign indications may allow for a shorter learning curve but does not offer clear advantages over conventional laparoscopic hysterectomy in terms of surgical outcomes. In addition, robotic hysterectomy is invariably associated with increased costs. Nevertheless, this surgical approach has been widely adopted by gynecologic surgeons. The aim of this review is to describe specific indications and patients who may benefit from robotic-assisted hysterectomy. These include hysterectomy for benign conditions in cases with high surgical complexity (such as pelvic adhesive disease and endometriosis), hysterectomy and lymphadenectomy for treatment of endometrial carcinoma, and obese patients. In the future, additional evidence regarding the benefits of single-site robotic hysterectomy may further modify the indications for robotic-assisted hysterectomy. PMID:28356774

  3. Low adherence to cervical cancer screening after subtotal hysterectomy

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


    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......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...... and pathology results from the national Danish registry (Patobank) were obtained on women from a randomised clinical trial and an observational study of subtotal versus total abdominal hysterectomy from the time of surgery until 2014. RESULTS: We included 501 women (259 subtotal hysterectomies and 242 total...

  4. Supracervical versus total hysterectomy in women undergoing hysterectomy for benign gynaecological disease - a new danish recommendation

    Sloth, Sigurd Beier; Jørgensen, Annemette; Schroll, Jeppe Bennekou

    Background In May 2015 we published a national clinical guideline on hysterectomy for benign gynaecological conditions in cooperation with the Danish Health and Medicines Authority. One of nine investigated areas of interest was whether to perform total or supracervical hysterectomy in women...... undergoing hysterectomy for benign gynaecological disease. Methods A guideline panel of gynaecologists predefined critical and important outcomes for the assessment. The critical outcomes were defined as reoperation, urinary incontinence, sexual function, pelvic organ prolapse and cervical dysplasia...... we looked for existing guidelines in the Guidelines International Network, the National Institute for Health and Care Excellence, the National Guideline Clearinghouse, the Scottish Intercollegiate Guidelines Network, the Health Technology Assessment Database, the Cochrane Library, MEDLINE, EMBASE...

  5. ACOG Committee Opinion No. 444: choosing the route of hysterectomy for benign disease.


    Hysterectomies are performed vaginally, abdominally, or with laparoscopic or robotic assistance. When choosing the route and method of hysterectomy, the physicians should take into consideration how the procedure may be performed most safely and cost-effectively to fulfill the medical needs of the patient. Evidence demonstrates that, in general, vaginal hysterectomy is associated with better outcomes and fewer complications than laparoscopic or abdominal hysterectomy. When it is not feasible to perform a vaginal hysterectomy, the surgeon must choose between laparoscopic hysterectomy,robot-assisted hysterectomy, or abdominal hysterectomy. Experience with robot-assisted hysterectomy is limited at this time; more data are necessary to determine its role in the performance of hysterectomy. The decision to electively perform a salpingoophorectomy should not be influenced by the chosen route of hysterectomy and is not a contraindication to performing a vaginal hysterectomy.

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

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


    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...... prior to hysterectomy, local estrogen treatment, and body mass index (BMI) > 25 kg/m(2). High BMI was primarily associated with mixed UI (MUI) and urgency symptoms. Predictors of bothersome LUTS were UI and incomplete bladder emptying. CONCLUSIONS: The difference in the frequency of subjectively...

  7. Robot-assisted hysterectomy for endometrial and cervical cancers: a systematic review.

    Nevis, Immaculate F; Vali, Bahareh; Higgins, Caroline; Dhalla, Irfan; Urbach, David; Bernardini, Marcus Q


    Total and radical hysterectomies are the most common treatment strategies for early-stage endometrial and cervical cancers, respectively. Surgical modalities include open surgery, laparoscopy, and more recently, minimally invasive robot-assisted surgery. We searched several electronic databases for randomized controlled trials and observational studies with a comparison group, published between 2009 and 2014. Our outcomes of interest included both perioperative and morbidity outcomes. We included 35 observational studies in this review. We did not find any randomized controlled trials. The quality of evidence for all reported outcomes was very low. For women with endometrial cancer, we found that there was a reduction in estimated blood loss between the robot-assisted surgery compared to both laparoscopy and open surgery. There was a reduction in length of hospital stay between robot-assisted surgery and open surgery but not laparoscopy. There was no difference in total lymph node removal between the three modalities. There was no difference in the rate of overall complications between the robot-assisted technique and laparoscopy. For women with cervical cancer, there were no differences in estimated blood loss or removal of lymph nodes between robot-assisted and laparoscopic procedure. Compared to laparotomy, robot-assisted hysterectomy for cervical cancer showed an overall reduction in estimated blood loss. Although robot-assisted hysterectomy is clinically effective for the treatment of both endometrial and cervical cancers, methodologically rigorous studies are lacking to draw definitive conclusions.

  8. Evaluation of postoperative bladder function and prognosis after modified nerve sparing radical hysterectomy%改良型保留盆腔自主神经的子宫颈癌根治性手术对患者膀胱功能及预后的影响

    王文文; 李斌; 佐晶; 张功逸; 杨页多; 曾红梅; 李晓光; 吴令英


    者的复发率分别为10.8%(11/102)、12.2%(25/204),两组比较,差异无统计学意义(P =0.707);3年无复发生存率(RFS)分别为88.5%及91.1%,3年总生存率(OS)分别为93.7%及96.3%,两组分别比较,差异均无统计学意义(P>0.05).(4)预后影响因素分析:单因素分析显示,病理类型、淋巴结转移和淋巴脉管间隙受侵是影响患者3年RFS和3年OS的危险因素(P<0.05),而保留神经平面与否对患者3年RFS和3年OS无明显影响(P>0.05);多因素分析显示,病理类型、淋巴结转移是影响患者3年RFS的独立危险因素(P<0.05),淋巴结转移也是影响患者3年OS的独立危险因素(P=0.001).结论 NPSRH治疗能明显改善了患者术后的膀胱功能,且不影响患者的预后.%Objective To compare the nerve plane sparing radical hysterectomy (NPSRH) with conventional radical hysterectomy (CRH) in terms of postoperative bladder function and prognosis.Methods One hundred and two patients with International Federation of Gynecology and Obstetrics (FIGO) stage Ⅰ b1-Ⅱa2 cervical cancer were treated by open NPSRH (study group) from January 2008 to March 2013.During the same time periods,two hundred and four patients who underwent open CRH were randomly selected as the control group.Age,pathological type and FIGO stage were matched.Results The median operation time in NPSRH group and CRH group were 268.8 and 242.4 minutes,respectively (P < 0.01).The median hospital stay were 14.6 and 17.2 days (P < 0.01).The median volume of blood loss in the two groups were respectively 394 and 450 ml (P > 0.05).The blood transfusion rate was respectively 46.1% (47/102) and 41.7% (85/204; P > 0.05).The rate of postoperative complications were not significantly difference [14.7% (15/102) vs 11.8% (24/204),P > 0.05].The median duration of catheterization was 9.1 and 15.2 days between two groups (P <0.01).Eighty-five patients in NPSRH group and one hundred and sixty-seven patients in CRH group completed

  9. Transformation on Abandonment

    Krag, Mo Michelsen Stochholm


    were undertaken contemporaneously after the earthquake in the Belice Valley in 1968. In short, previous studies on consequences of depopulation mainly focused on creating economic development in rural areas; this study seeks to explore, identify, and subsequently activate embedded values in abandoned...

  10. Hawaii Abandoned Vessel Inventory, Maui

    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...

  11. Hawaii Abandoned Vessel Inventory, Oahu

    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...

  12. CNMI Abandoned Vessel Inventory, Rota

    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...

  13. CNMI Abandoned Vessel Inventory, Tinian

    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 habitats...

  14. CNMI Abandoned Vessel Inventory, Saipan

    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 habitats...

  15. Hawaii Abandoned Vessel Inventory, Kauai

    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...

  16. Hawaii Abandoned Vessel Inventory, Molokai

    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 coral...

  17. American Samoa Abandoned Vessel Inventory

    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...

  18. Puerto Rico Abandoned Vessel Inventory

    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...

  19. Hawaii Abandoned Vessel Inventory, Lanai

    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...

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

    Chandrika S.


    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

  1. Lower urinary tract symptoms after total and subtotal hysterectomy

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


    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...... quality of life scores than continent women...

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

    Lovina S.M. Machado


    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.

  3. Reflex anuria affecting both kidneys following hysterectomy

    Gholyaf Mahmoud


    Full Text Available In situations when there is unilateral ureteral obstruction, the contralateral kidney retains its normal function. In rare instances however, it has been reported that unilateral ureteral obstruction can lead to reflex anuria (RA and acute renal failure (ARF. Even more unusually, RA with ARF can occur without organic obstruction due to ureteric manipulation during pelvic surgery. We report a 78- year-old woman, who underwent hysterectomy because of endometrial carcinoma. She developed ARF evidenced by anuria of 120-hours duration, and gradual rise of serum creatinine levels to 11.8 mg/dL on the fifth day after hysterectomy. Ultrasound study of the urinary tract revealed bilateral moderate hydronephrosis. Detailed evaluation did not reveal any organic obstruc-tion. She was managed with hemodialysis, control of hypertension and correction of fluid and elec-trolyte imbalances. By the sixth day, diuresis was established, and the blood urea and serum crea-tinine levels decreased to normal by the sixteenth day. The patient was finally discharged on the eighteenth day. Our case suggests that urologists and nephrologists should consider RA as one of the causes of anuria and ARF.

  4. [The meaning of hysterectomy for a group of Chilean men partners of women who have undergone hysterectomy].

    Gutiérrez, Alejandra Araya; Soto, María-Teresa Urrutia; Suazo, Daniel Jara; Solovera, Sergio Silva; Salas, María Jesús Lira; Espinoza, Claudia Flores


    The objective of this study was to understand the meaning of hysterectomy according to a group of Chilean men, partners of women who have undergone the procedure (MPWH). This qualitative study was performed with in-depth interviews. A total of 15 men, partners of women who have undergone hysterectomy, were interviewed between May and September of 2010, under the approval of the Ethics Committees. Data analysis was performed using the phenomenological perspective proposed by Giorgi, and content analysis was performed according to Krippendorff. The Crestwell criteria were used to evaluate the trustworthiness of the analysis and guarantee descriptive validity. Five dimensions emerged, which represented unique aspects of hysterectomy according to the men: symptoms, comments, the attributions of the uterus, concerns and changes in sexuality. It is essential to educate MPWH in terms of the support required by women undergoing hysterectomy. Therefore they should be included in the care plan designed for women undergoing hysterectomy.

  5. 早期子宫颈癌患者行子宫广泛性切除联合阴道延长术后的生命质量和性生活状态的评估%Quality of life and sexual function of cervical cancer patients following radical hysterectomy and vaginal extension

    叶双; 杨佳欣; 曹冬焱; 朱兰; 郎景和; 沈铿


    便相关症状的发生风险.所有患者术后均存在性功能障碍问题,应重视患者术后性功能的改善和恢复.%Objective To investigate the quality of life and sexual function of cervical cancer patients following radical hysterectomy (RH) and vaginal extension.Methods Case-control and questionnaire-based method was employed in this study.Thirty-one patients of early-stage (Ⅰ b1-Ⅰ b2) cervical cancer who had undergone vaginal extension following classic RH in Peking Union Medical College Hospital from December 2008 to September 2012 were included in study group,while 28 patients with matching factors and RH only during the same period were allocated to control group.There was no significant difference between two groups in terms of clinical and demographic variables including age at diagnosis,tumor stage and follow-up time (P>0.05).Patients were assessed retrospectively by validated selfreported questionnaires the European Organization for Research and Treatment of Cancer Cervix Cancer Module Questionnaire (EORTC QLQ-CX24) mainly for quality of life and sexual function for cervical cancer patients; the Sexual Function and Vaginal Changes Questionnaire (SVQ) further investigates sexual function and vaginal changes of patients with gynecologic malignancy at least 6 months after treatment.Results Vaginal length acquired by pelvic examination by gynecologic oncologists during follow-up visits was (10.0±1.3) cm and (5.9± 1.0) cm in study group and control group respectively (P=0.000).Sixty-eight percent (21/31) of cases in study group and 64% (18/28) of cases in control group had resumed sexual activity at the time of interview,and the time interval between treatment and regular sexual activity was mean 6 months (range 3-20 months) and mean 5 months (range 1-12 months) in study and control group respectively,in which there was not statistical significance (P>0.05).No difference was observed regarding pelvic floor symptoms (P>0.05) while

  6. 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

    Lykke, Rune; Blaakær, Jan; Ottesen, Bent


    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...

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

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


    -appearing tissues leads to the finding of microscopic disease. To evaluate the value of random biopsies, omentectomy, and hysterectomy in operations for BOT, the macroscopic and microscopic findings in a cohort of these patients were reviewed retrospectively. MATERIALS: Women treated for BOT at Odense University.......7%) in International Federation of Gynecology and Obstetrics stage I, 9 (12%) in stage II, and 7 (9.3%) in stage III. The histologic subtypes were serous (68%), mucinous (30.7%), and Brenner type (1.3%). Macroscopically radical surgery was performed in 62 patients (82.7%), and 46 (61.3%) received complete staging...... was not a good predictor of microscopic disease. During follow-up, 4 patients (5.3%) relapsed with no relation to surgical radicality or the extent of staging procedures. CONCLUSIONS: Ovaries and peritoneal surfaces with a macroscopically normal appearance rarely contain a microscopic focus of BOT....

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

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


    are registered prospectively by the surgeons involved in the treatment. Data is reported using the Danish National Patient Registry (LPR) and feedback is provided as clinical indicators with well-defined goals. The DHD concept includes annual plenary meetings, elaboration of national clinical guidelines...... and parallel causal studies. MAIN OUTCOME MEASURES: Completeness, data validation and department-identifiable clinical indicators (surgical volume, method of hysterectomy, use of antibiotic and thromboembolic prophylaxis, postoperative hospitalization and bleeding complications, surgical infections......%, 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 level...

  9. Sequelae of tubal ligation: an analysis of 75 consecutive hysterectomies.

    Stock, R J


    Seventy-five consecutive patients undergoing hysterectomy subsequent to elective sterilization were studied regarding the occurrence of the post-tubal-ligation syndrome of pelvic pain and/or menorrhagia. Twenty patients were clinically considered to have the syndrome. In none of the patients operated on specifically for menstrual abnormalities could the findings be remotely attributed to the sterilization procedure. Five of the 20 patients had pelvic varicosities and one had pelvic adhesions that may have been a consequence of previous sterilization and conceivably the cause for the pelvic pain for which the patients were undergoing hysterectomy. I question the legitimacy of the post-tubal-ligation syndrome as a reason for hysterectomy.

  10. Single-incision total laparoscopic hysterectomy

    Sinha Rakesh


    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.

  11. Cost-analysis of robotic-assisted laparoscopic hysterectomy versus total abdominal hysterectomy for women with endometrial cancer and atypical complex hyperplasia

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


    INTRODUCTION: The aim of this study was to analyse the hospital cost of treatment with robotic-assisted laparoscopic hysterectomy and total abdominal hysterectomy for women with endometrial cancer or atypical complex hyperplasia and to identify differences in resource use and cost. MATERIAL...... AND METHODS: This cost analysis was based on two cohorts: women treated with robotic-assisted laparoscopic hysterectomy (n = 202) or with total abdominal hysterectomy (n = 158) at Copenhagen University Hospital, Herlev, Denmark. We conducted an activity-based cost analysis including consumables and healthcare...... in Danish kroner between total abdominal hysterectomy and robotic-assisted laparoscopic hysterectomy. RESULTS: The average cost of consumables was 12,642 Danish kroner more expensive per patient for robotic-assisted laparoscopic hysterectomy than for total abdominal hysterectomy (2014 price level: 1€ = 7...

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

    Anjali Kanhere


    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

  13. Effect of socioeconomic position on patient outcome after hysterectomy

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


    OBJECTIVE: To investigate the association between socioeconomic position (assessed by education, employment and income) and complications following hysterectomy and assess the role of lifestyle, co-morbidity and clinical conditions on the relationship. DESIGN: Register-based cohort study. SETTING...

  14. Effect of hysterectomy on anorectal and urethrovesical physiology.

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


    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.

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

    Kelly, J L


    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.

  16. Histopathological Analysis of 422 Nononcological Hysterectomies in a University Hospital

    Seda Ates


    Full Text Available Aim: The aim of the study was to evaluate the surgical indications, routes of surgery and the correlation between preoperative diagnosis and histopathological examination of hysterectomy specimens. Material and Method: Medical records and histopathological findings were reviewed and analyzed retrospectively, in 422 consecutive women who underwent hysterectomy over a two-year period from 2011 to 2014. Those with confirmed malignancy before operation were excluded. Cohen kappa statistics were used to measure agreement between preoperative clinical and postoperative histopathological diagnosis which was found to be fair with %u043A value being 0.4. Results: The mean age of our patients was 51.5 ± 8 years. The abdominal route was used in 378 cases (85.5%, the vaginal route in 55 patients (12.4% and the laparoscopic-assisted vaginal hysterectomy in 9 cases (2%. Abnormal uterine bleeding (28.9 % was the most common indication for hysterectomy. The histopathology of the endometrium prior to hysterectomy was reported in 75% of the cases and the most common finding was a secretory or proliferative endometrium. Leiomyomatous uterus was the most frequently encountered pathology (43.7% followed by coexistence of leiomyoma and adenomyosis (17.4% in hysterectomy specimens. Hysterectomy specimens may be unremarkable histopathologically, most of which are vaginal hysterectomies done for uterine prolapsed (kappa=0,407. Discussion: The correlation between the preoperative clinical and the pathological diagnosis were poor in cases with abdominal pain, abnormal uterine bleeding and fibroids. But there was a high correlation in cases with adnexial mass.

  17. Vaginal vault suspension during hysterectomy for benign indications

    Bonde, Lisbeth; Noer, Mette Calundann; Møller, Lars Alling


    INTRODUCTION AND HYPOTHESIS: Several suspension methods are used to try to prevent pelvic organ prolapse (POP) after hysterectomy. We aimed to evaluate agreement on terminology and surgical procedure of these methods. METHODS: We randomly chose 532 medical records of women with a history of hyste......INTRODUCTION AND HYPOTHESIS: Several suspension methods are used to try to prevent pelvic organ prolapse (POP) after hysterectomy. We aimed to evaluate agreement on terminology and surgical procedure of these methods. METHODS: We randomly chose 532 medical records of women with a history...... of hysterectomy from the Danish Hysterectomy and Hysteroscopy Database (DHHD). Additionally, we video-recorded 36 randomly chosen hysterectomies. The hysterectomies were registered in the DHHD. The material was categorized according to predefined suspension methods. Agreement compared suspension codes in DHHD...... (gynecologists' registrations) with medical records (gynecologists' descriptions) and with videos (reviewers' categorizations) respectively. Whether the vaginal vault was suspended (pooled suspension) or not (no suspension method + not described) was analyzed, in addition to each suspension method. RESULTS...

  18. Abandoned vehicles REMINDER

    Relations with the Host States Service


    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 ( 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

  19. Abandonned vehicles - REMINDER

    Relations with the Host States Service


    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 ( 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

  20. Abandoned vehicles - Reminder

    Relations with the Host States Service


    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 ( 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

  1. The impact of socioeconomic and clinical factors on purchase of prescribed analgesics before and after hysterectomy on benign indication

    Daugbjerg, Signe Bennedbæk; Brandsborg, Birgitte; Ottesen, Bent Smedegaard;


    OBJECTIVE:: Pelvic pain is a primary symptom of women referred for hysterectomy. This study identified risk factors for purchase of prescribed analgesics before and after hysterectomy and examined purchase changes after hysterectomy, specifically focusing on socioeconomic effects. METHODS:: Nearly...

  2. Experience with irrigation analgesia after abdominal hysterectomy

    R. V. Garyaev


    Full Text Available A prospective randomized clinical trial was performed in 100 patients who underwent abdominal hysterectomy under endotracheal anesthesia based on sevoflurane and fentanyl. Intraoperatively, ketorolac 30 mg was administered intramuscularly after induction of anesthesia and paracetamol 1 g was injected intravenously 30–40 minutes prior to surgical termination in a control group (n = 25. For postoperative anal- gesia, promedol, tramadol, and ketorolac were used intramuscularly and paracetamol was given intravenously. Three study groups (n = 2 in each differed from the control group in that during wound suturing a multiperforated catheter was placed above the peritoneum over a length of 15 cm, through which a 10-ml bolus of 0.75 % ropivacaine was first administered, followed by continuous infusion of 0.2 % ropivacaine at a rate of 8 ml/hour for 36 hours. In one irrigation group, ketorolac 30 mg was injected intramuscularly t.i.d. for 2 days; in another group, the agent was added to a ropivacaine solution calculated with reference to 180 mg for 2 days; in the third group, ketoprofen 100 mg instead of ketorolac was used b.i.d. for 2 days. Pain level (by digital rating scale, 0–10 and the need for analgesics were measured. There was no sta- tistical significant difference in the level of pain and the need for analgesics between the wound irrigation and control groups.

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

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


    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.

  4. A different technique in gasless laparoendoscopic single-site hysterectomy.

    Demirayak, Gökhan


    The aim of this study was to show a different technique for a gasless laparoendoscopic single-site (LESS) hysterectomy and to present advantages and limitations of this technique. Women undergoing gasless LESS hysterectomy with a different technique were evaluated. A total of 14 LESS hysterectomies were performed using this gasless technique and rigid laparoscopic instruments by one surgeon. The mean age of the patients was 48.6 (±4.6). The average blood loss was 80 ± 35 ml. The average time between an umbilical incision and starting hysterectomy was 5 (±2,1) min. The time between starting hysterectomy and umbilical incision closure was 120 (±24) min in the laparoscopic suture group and 88 (±16) min in the vaginal suture group. The mean uterus weight was 188 (±95) g. In conclusion, this different technique is feasible and low cost, especially in non-obese patients. But further studies with large participants are needed to elucidate the safety. Impact statement Conventional CO2 pneumoperitoneum has many adverse effects on cardiopulmonary function, haemodynamic, metabolic and neurologic systems due to high-intraperitoneal pressure. The usage of gasless technique eliminates these adverse effects and postoperative shoulder pain. The satisfaction of patients is higher in laparoendoscopic single-site (LESS) hysterectomy due to improved cosmesis and reduced postoperative analgesic requirements. In the literature, there are a few studies showing techniques combining LESS and gasless laparoscopy for hysterectomy. In this study, a different approach for creating operational space in gasless laparoscopy is described. Creation of intraabdominal operational space is convenient and takes a short time in this technique. The average time between an umbilical incision and starting a hysterectomy is five minutes. Additional training is not needed for experienced surgeons in LESS. Also, cost-effectiveness is one of important advantages. It is quite safe, no possibility of

  5. Obstetric hysterectomy: trend and outcome in Ile-Ife, Nigeria.

    Badejoko, O O; Awowole, I O; Ijarotimi, A O; Badejoko, B O; Loto, O M; Ogunniyi, S O


    Worldwide, the incidence of obstetric hysterectomy is expected to be on the decline due to improvements in obstetric care. This hospital-based 10-year review (2001-10) was performed to determine its incidence and outcome in Ile-Ife, Nigeria. The trend was determined by comparing the current incidence with that from two previous studies from the same centre. There were 58 obstetric hysterectomies and 15,194 deliveries during the review period, giving a rate of 3.8/1,000 deliveries. A rising trend was observed in the obstetric hysterectomy rate in Ile-Ife over two decades (1990-2010). Uterine rupture was the commonest indication (60%). Postoperative complications such as sepsis, vesico-vaginal fistula and renal failure affected 34.5% of the patients. Maternal and fetal case fatality rates were 18.2% and 43.6%, respectively. The obstetric hysterectomy rate in Ile-Ife is high and the trend is rising. Universal access to skilled birth attendance is advocated to reduce uterine rupture and consequently obstetric hysterectomy.

  6. 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

    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


    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.

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

    Deepti Verma


    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

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

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


    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...... a hysterectomy). The incidence rate of gynecological cancers is thus likely underestimated. Since hysterectomy, as well as oophorectomy, incidence varies across countries, age, and over time, meaningful comparison of gynecological cancer incidence rates may be compromised. Without accurate estimates...... 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...

  9. 23 CFR 752.10 - Abandoned vehicles.


    ... 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...

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

    Lykke, Rune; Blaakær, Jan; Ottesen, Bent


    INTRODUCTION AND HYPOTHESIS: The aim of this study was to investigate whether the indication for hysterectomy was itself a risk factor for subsequent pelvic organ prolapse (POP) in Danish women who underwent hysterectomy from 1977 to 2009. METHODS: Data from 154,882 women who underwent hysterectomy...

  11. Psychological meaning of a woman with a hysterectomy among Mexican physicians and women.

    Marván, Maria Luisa; Catillo-López, Rosa Lilia; Ehrenzweig, Yamilet; Palacios, Pedro


    The psychological meaning of women who have had a hysterectomy, and attitudes toward them, were explored in 121 Mexican gynecologists, 155 women who had undergone a hysterectomy, and 115 women who had not had a hysterectomy. The surveys were completed between January and May 2011. Both groups of women defined a woman who had had a hysterectomy using words with positive meanings (healthy, happy, reassured, and complete), as well as words with negative meanings (sad, incomplete, and irritable). However, the participants who had not had a hysterectomy defined a woman who had had a hysterectomy using more negative words and showed more negative attitudes toward such a woman with a hysterectomy than those women who had undergone a hysterectomy. Among participants who had undergone a hysterectomy, those who were premenopausal prior to the surgery and those who had undergone bilateral salpingo-oophorectomy defined a woman who had had a hysterectomy in a more negative manner and showed the most negative attitudes. The gynecologists did not use words with emotional content regarding women who had had a hysterectomy and showed more neutral attitudes toward such a woman than did both groups of women. These findings could be helpful in designing support programs for women facing a hysterectomy.

  12. Hysterectomy with ovarian conservation: effect on bone mineral density

    Lareon, G.; Baillon, L. [Westmead Hospital, Westmead, NSW, (Australia). Department of Nuclear Medicine and Ultrasound


    Full text: There are conflicting data on the long-term effects of hysterectomy with ovarian conservation on bone mineral density (BMD). Accordingly, we performed a cross-sectional study on 58 women with premenopausal hysterectomy and ovarian conservation (group 1) and 59 women with natural menopause (group 2). No subjects had disorders or medications known to interfere with bone metabolism. Patients underwent bone densitometry of the lumbar spine and hip using a Norland XR-36. By chi-squared and one-way ANOVA, there were no differences in age: 55.4{+-} 11.0 y (1)v 57.6{+-} 9.8 y (2); exercise, alcohol or smoking consumption, family history of osteoporosis, height: 1.61 {+-} 0.08m (1) v 1.61 {+-} 0.08m (2); weight 67.7 {+-} 11.3kg (1) v 68.3 kg {+-} 12.5 kg (2); body mass index: 30.95 (1 ) v 26.26 (2). Lumbar spine BMD was also similar for the two groups [0.95 {+-} 0.18g/cm{sup 2} (1) v 0.94{+-} 0.21 g/cm{sup 2} (2)]. However, hysterectomy patients had a significantly lower hip BMD: 0.63 {+-} 0.16 g/cm{sup 2} v 0.76 {+-} 0.18 g/cm{sup 2} (p>0.001). Multivariate logistic regression showed that spine BMD was influenced by age, family history, height and weight (R{sup 2} = 0.37), but not prior hysterectomy. Hip BMD was related to age, hysterectomy, smoking and weight (R{sup 2} = o 45). We conclude that prior hysterectomy with ovarian conservation has an adverse effect on hip but not spine BMD.

  13. Trachelectomy for cancer of the cervix: dargent's operation. Vaginal hysterectomy for early cancer of the cervix stage IA1 and CIN III

    Ottosen, Christian


    Radical vaginal trachelectomy is today an established method of treating selected women with cervical cancer stage IA2 and IB1, with tumour size less than 2cm without precluding future childbearing. This technique has been used for more than 20 years with reassuring oncological safety and excellent...... as figures for radical hysterectomy. Rate of second trimester miscarriage is 8-10%, and that of preterm delivery 20-30%. More than 900 cases with 200 children are now reported in the published literature....

  14. Risk factors associated with emergency peripartum hysterectomy

    Jin Rong; Guo Yuna; Chen Yan


    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.

  15. Comparison between microwave endometrial ablation and total hysterectomy

    LIN Hua


    Background Microwave endometrial ablation (MEA) is a new form of minimal invasive surgical procedure for menorrhagia. It has been widely adopted clinically in many countries. In this study, we compare the outcome of MEA and total hysterectomy for menorrhagia.Methods Sixty patients with menorrhagia were divided into MEA group or total hysterectomy (control) group (30 in each). The intra operative blood loss, operating time, either preserving the uterus or not, and length of recovery time in the two groups were compared. The independent samples t test was used to analyse our data in the study.Results In comparing the MEA group and the control group, the effective rates were 96% (29/30) and 100%(30/30,x2 = 0, P = 1.0). The operating time was (4.0± 1.1) minutes and (68.3 ± 1.9) minutes (t =-160.42,P = 0.00). The mean blood loss was 0 ml and 50 ml, respectively.Conclusions The curative effect of MEA is similar to that of total hysterectomy. When considering preservation of the uterus and postoperative recovery, MEA is obviously superior to total hysterectomy.

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

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


    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.

  17. Concurrent puerperal hysterectomy with Ascaris lumbricoides infestation: coincidence or consequence?

    Zapardiel, Ignacio; Peiretti, Michele; Godoy-Tundidor, Sonia


    The most common etiology of postpartum hemorrhage is uterine atony, although hematologic disorders may be present. A 36-year-old nulliparous woman underwent puerperal hysterectomy caused by uncontrolled postpartum hemorrhage. One day after discharge, she vomited in the emergency room a 24-cm long Ascaris lumbricoides. Infestation during gestation may cause hematologic disorders that could complicate pregnancy outcome.

  18. The Evaluation Of Histopathological Diagnosis In Hysterectomy Materials

    Cigdem Kunt isguder


    Results: The mean age of the patients was 50.48+/-7.50 (min:38, max:74. Leiomyoma with 77 case (%45.3 was the most hysterectomy indicated disease. Thereafter, dysfunctional uterine bleeding in 50 (%29.49, and endometrial hyperplasia 22 (%12.9 were detected. The other clinical indications were uterine prolapse in 17 patients (%10, chronic pelvic pain in 2 (%1.2 and adenomyosis in 2 (%1.2. The results of histopathological reports belong to hysterectomy materials indicated that leiomyoma was the most common pathological finding with 87 cases (%51.2, subsequently adenomyosis in 35 cases (% 20.5 and endometrial hyperplasia in 31 (18.3 was detected. Endometrial polyp was found in 10 cases (%5.9 and atrophic endometrium in 7 cases (%4.1. Combined pathology was defined in 44 hysteterctomy materials. Leiomyoma and endometrial hyperplasia were detected as the most common combination with a ratio of %50. In addition, chronic cervicitis was seen in %64.7 of cervical examinations of hysterectomy materials. Conclusion: Adenomyosis should be kept in mind while planning the diagnosis and treatment of patients whose admitted with compliants of menometrorrhagia, seconder dysmenorrhea and chronic pelvic pain in 4th and 5th decade. Endometrial sampling caused by the co-existence of leiomyoma and endometrial hyperplasia must be necessary in hysterectomy planned cases for leiomyoma those already have menometrorrhagia. [J Contemp Med 2016; 6(2.000: 87-91

  19. Short-term Clinical Outcomes of Laparoscopic Fertility-preserving Radical Hysterectomy in the Management of Early-stage Cervical Cancer%腹腔镜下保留生育功能宫颈癌根治术治疗早期子宫颈癌的近期临床疗效

    刘开江; 刘青; 韩娜娜; 王娟; 李培全; 茹明芳


    Objective To investigate the feasibility and effectiveness of laparoscopic radical trache-lectomy and lymphadenectomy in the treatment of early-stage cervical cancer. Methods The clinical data of 6 patients ( stage I a2 to I bl) , who underwent laparoscopic fertility-preserving radical operation for cervical cancer in our department from February 2009 to October 2010, were retrospectively analyzed in terms of operation duration, intra-operative blood loss, postoperative pathology, complications, and pregnancy. Results Both radical resection of cervical and pelvic lymph node dissection were completed under laparoscopy, and only the cervical and vaginal cuffs were closed from vagina. The operation duration ranged 155-210 min ( mean; 185 min) and the intra-operative blood loss was approximately 60-120 ml (mean: 105 ml). The average length of hospital stay was 18 days without complications, postoperative infection, and bleeding. Postoperative pathology showed no lymph node metastasis, and no ligament, blood vessels, vaginal cutting margin, or upper part of cervix was invaded by tumor cells. During the 8-20-month follow-up, 1 patient had become pregnant for 4 months and no case experienced tumor recurrence. Conclusion Laparoscopic fertility-preserving lymphadenectomy and radical trachelectomy is feasible for patients with early-stage cervical cancer who have strong wish to have a child.%目的 探讨腹腔镜下根治性子宫颈切除术和盆腔淋巴结切除术治疗早期子宫颈癌的可行性和效果.方法 回顾分析6例Ⅰa2~Ⅰb1期行腹腔镜下保留生育功能子宫颈癌根治术患者的临床资料,分析手术时间、出血量、手术后病理、并发症、妊娠情况等.结果 根治性子官颈切除术和盆腔淋巴结清扫术均在腹腔镜下完成,仅宫颈和阴道断端缝合经阴道完成.手术时间155 ~210 min,平均185 min;术中出血量约60~120ml,平均105 ml.术中及术后均无并发症.术后病理学检查未

  20. The Impact of Individual Surgeon Volume on Hysterectomy Costs

    Shepherd, Jonathan P.; Kantartzis, Kelly L.; Lee, Ted; Bonidie, Michael J.


    Background and Objective: Hysterectomy is one of the most common surgical procedures women will undergo in their lifetime. Several factors affect surgical outcomes. It has been suggested that high-volume surgeons favorably affect outcomes and hospital cost. The objective is to determine the impact of individual surgeon volume on total hospital costs for hysterectomy. Methods: This is a retrospective cohort of women undergoing hysterectomy for benign indications from 2011 to 2013 at 10 hospitals within the University of Pittsburgh Medical Center System. Cases that included concomitant procedures were excluded. Costs by surgeon volume were analyzed by tertile group and with linear regression. Results: We studied 5,961 hysterectomies performed by 257 surgeons: 41.5% laparoscopic, 27.9% abdominal, 18.3% vaginal, and 12.3% robotic. Surgeons performed 1–542 cases (median = 4, IQR = 1–24). Surgeons were separated into equal tertiles by case volume: low (1–2 cases; median total cost, $4,349.02; 95% confidence interval [CI] [$3,903.54–$4,845.34]), medium (3–15 cases; median total cost, $2,807.90; 95% CI [$2,693.71–$2,926.93]) and high (>15 cases, median total cost $2,935.12, 95% CI [$2,916.31–$2,981.91]). ANOVA analysis showed a significant decrease (P < .001) in cost from low-to-medium– and low-to-high–volume surgeons. Linear regression showed a significant linear relationship (P < .001), with a $1.15 cost reduction per case with each additional hysterectomy. Thus, if a surgeon performed 100 cases, costs were $115 less per case (100 × $1.15), for a total savings of $11,500.00 (100 × $115). Conclusion: Overall, in our models, costs decreased as surgeon volume increased. Low-volume surgeons had significantly higher costs than both medium- and high-volume surgeons.

  1. Comparison of vaginal hysterectomy and laparoscopically assisted vaginal hysterectomy in women with benign uterine disease: a retrospective study

    Sathiyakala Rajendran


    Conclusions: This study shows lesser operative time in VH group when compared to LAVH group and there is no added advantage in performing LAVH other than shorter hospital stay. Hence it is concluded that whenever feasible VH should be the preferred route of hysterectomy. [Int J Reprod Contracept Obstet Gynecol 2016; 5(11.000: 3915-3918

  2. Who abandons embryos after IVF?

    Walsh, A P H


    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.

  3. US Virgin Islands Abandoned Vessel Inventory

    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...

  4. Hawaii Abandoned Vessel Inventory, Kure, NWHI

    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...

  5. Hawaii Abandoned Vessel Inventory, Maro Reef, NWHI

    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 coral...

  6. Hawaii Abandoned Vessel Inventory, Lisianski Island, NWHI

    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...

  7. Hawaii Abandoned Vessel Inventory, Hawaii Island

    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...

  8. Hawaii Abandoned Vessel Inventory, Midway Island, NWHI

    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...

  9. Elective cesarean hysterectomy for treatment of cervical neoplasia. An update.

    Hoffman, M S; Roberts, W S; Fiorica, J V; Angel, J L; Finan, M A; Cavanagh, D


    From January 1, 1979, to March 31, 1991, 37 patients underwent elective cesarean hysterectomy for early cervical neoplasia. Thirty-four patients had cervical intraepithelial neoplasia III, and three patients had stage IA-1 squamous cell carcinoma of the cervix. Twenty-eight were primary cesarean sections; nine had obstetric indications. The mean operative time was 128 minutes; mean estimated blood loss was 1,400 mL. One patient experienced an intraoperative hemorrhage (3,500 mL). There were no other recognized intraoperative complications. Four significant postoperative complications included a vaginal cuff abscess, a wound dehiscence and pelvic abscess, one patient with febrile morbidity and an ileus and ligation with partial transection of a ureter. Patients were discharged on a mean of postoperative day 5.7. Although significant complications occurred, we believe that the noncompliant nature of our patient population justifies elective cesarean hysterectomy for treatment of cervical neoplasia.

  10. [En block hysterectomy. Institutional experience of 6 years].

    Bonfante Ramírez, E; Bolaños Ancona, R; Ambas Argüelles, M; Juárez García, L; Castelazo Morales, E


    On block hysterectomy is defined as the removal of the gravid uterus with its gestational content in situ. The described indications for the realization of this procedure are neoplastic process as the most frequent cause; septic process, persistent trophoblastic diseases, and hemorrhage due to anomalous placentation. This is a retrospective, descriptive study of twelve cases of on block hysterectomy collected from January 1989 to December 1994 at Instituto Nacional de Perinatología. An average age of 33.4 years was found. The number of pregnancies for this patients in average was found to be 4.1. The gestational age was established between 9 to 29 weeks. Four patients with a 4 or more previous miscarriage background. There were two reported cases having a multiple gestation. Among the complications found, there were three cases of hipovolemic shock and one with abcess of vaginal cupula. The average days of hospitalization was 5.3 days. We found no mortality at all in this study, and the histopathologic correlation accorded in 100% of the cases. In this five year review, 12 cases of on block hysterectomy were found, being the most frequent reason for it's realization the persistent trophoblastic diseases; severe hemorrhage in second place, and serious infection process in third. The observed complications were derived from the hemodynamic compromise of each patient. Even though on block hysterectomy is one rarely seen procedure, it most be in mind as an alternative therapeutical instance it most be carried out in third level institutions, with technology and human resources capable of solving any complication derived from this kind of surgery.

  11. Clinical study of emergency peripartum hysterectomy for postpartum hemorrhage

    Amudha S.


    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

  12. Influence of alcohol intake on postoperative morbidity after hysterectomy

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


    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)....

  13. Localized Detection of Abandoned Luggage

    Jing-Ying Chang


    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.




    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.

  15. Hematuria at laparoscopic hysterectomy: a 9-year review at Sydney West Advanced Pelvic Surgery, Australia.

    Wilson, Matthew; Merkur, Harry


    The aim of this study was to estimate the prevalence and significance of hematuria during laparoscopic hysterectomy for benign uterine disease. The review assessed its incidence, risk factors, site of associated urinary tract injuries, methods of diagnosis, management strategies, and most likely intraoperative point at which hematuria occurred during laparoscopic hysterectomies. A retrospective review of 755 cases of laparoscopic-assisted and total laparoscopic hysterectomies from January 1998 through December 2006 was undertaken at Sydney West Advanced Pelvic Surgery, Sydney, Australia.

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

    Mahmut Kuntay kuntay Kokanali


    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. Danish gynecologists' opinion about hysterectomy on benign indication: results of a survey

    Gimbel, Helga; Ottesen, Bent; Tabor, Ann


    WAS: 73%. For women aged > or = 50 years meno-metrorrhagia and symptomatic fibroids seemed to be important for hysterectomy recommendations, and for those aged pelvic pain seemed important for recommendation of other treatments. Employment, gender...... of postmenopausal metrorrhagia, while disagreement was found in cases of asymptomatic leiomyomas and unexplained pelvic pain. The gynecologists preferred the abdominal route and the subtotal hysterectomy method. Certain attributes of the gynecologists were found to be important to the recommendation of hysterectomy...

  18. 化疗前血红蛋白及血小板水平对子宫颈癌新辅助化疗后手术患者化疗疗效及预后的影响%Effects of pre-chemotherapy hemoglobin and platelet levels in patients with stage Ⅰ b2 - Ⅱ b cervical cancer treated with neoadjuvant chemotherapy followed by radical hysterectomy

    王丹; 吴鸣; 任彤; 万希润; 冯凤芝; 黄惠芳; 杨佳欣; 沈铿; 向阳


    论 对于接受新辅助化疗后手术治疗的宫颈癌患者,化疗前血红蛋白及血小板水平与化疗疗效无明显相关性,也不能作为独立预后因素.%Objective To investigate the role of pre-chemotherapy hemoglobin and platelet levels in the effect of chemotherapy and prognostic outcome in patients with International Federation of Gynecology and Obstetrics(FIGO) stage Ⅰ b2 - Ⅱb cervical cancer treated with neoadjuvant chemotherapy followed by radical hysterectomy.Methods From January 1999 to December 2010,111 patients with FIGO stage Ⅰ b2 - Ⅱ b who underwent chemosurgical treatment at the department of obstetrics and gynecology in Peking Union Medical College Hospital were reviewed.The median age of patients was 42 years (range:21 -68 years).The median level of prechemotherapy hemoglobin and platelet levels was 127 g/L and 266 ×109/L,respectively.Chemotherapy response was evaluated according to the WHO criteria,including complete response (CR),partial response (PR),arable disease (SD) and progressive disease (PD).Patients who achieved CR or PR were defined as responder.Rates of clinical response were compared with the clinicalpathological variables using chi-square test.Multiple logistic regression was carried out to evaluate the relationship among the probability of achieving an optimal clinical response and the variables.The log-rank test was used to compare the homogeneity of progression-free survival and overall survival functions across strata defined by categories of prognostic variables.The Cox proportional hazard model was used to assess the significance of potential prognostic factors for progression-free survival and overall survival.Results All patients received one to three cycles of chemotherapy.After the neoadjuvant chemotherapy,9 patients achieved CR,77 patients PR,23 patients SD, 2 patients PD.The overall response rate was 77.5%(86/111).By univariate analysis,the clinical response rate was associated with tumor grade( P


    Dobrosława L. Sikora-Szczęśniak


    Full Text Available Intruduction: Hysterectomy is one of major surgeries. Pregnancy, delivery and postpartum period make the operation even more difficult as it is forced and complicated by various pathological conditions that develop over that time. Objective: The purpose of study was to analyze the frequency of hysterectomy, indications to undertake it and complications associated with the removal of the uterus in pregnancy and during perinatal and postpartum period. The study analyzed the cases of hysterectomies in perinatal and postpartum period performed over the 17-year clinical material from the Department of Gynaecology and Obstetrics, SZOZ, Lipsko in the years 1985–2001. Material and methods : The material for analysis were medical records of 15 women who developed complications in pregnancy, perinatal and postpartum period, which were absolute indication to perform hysterectomy. The following parameters were analyzed: patient’s age, number of deliveries, the way pregnancies were terminated, the way present pregnancy was terminated, complications, indications to Caesarean section and perinatal and postpartum hysterectomy, type of hysterectomy performed, other associated procedures and complications. Results : In total 15 hysterectomies were performed in the period of study which accounts for 0.10% all deliveries. The material revealed the following causes for hysterectomy: placental pathologies (46.7%, inflammatory conditions of internal sex organs (20.0%, uterine atonia after delivery (13.3%, injuries of sex organs (13.3%. Elective hysterectomy in that period was performed in one patient (6.7%. The risk factors predisposing to complications resulting in hysterectomy were history of Caesarean sections in 10 patients (66.7% and multiple spontaneous deliveries. Complications associated with hysterectomy which enforced additional operations were noted in two cases (13.3%. Total hysterectomy was performed in 8 patients (53.3% including hysterectomy with

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

    Decunto; Traverso; Gibelli; Harpe


    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.

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

    Altman, Daniel; Yin, Li; Falconer, Henrik


    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.

  2. Laparoscopic treatment of post-hysterectomy colovaginal fistula in diverticular disease. Case report.

    Finco, C; Sarzo, G; Parise, P; Savastano, S; De Lazzari, F; Polato, F; Merigliano, S


    Colonic diverticular disease is a benign condition typical of the Western world, but it is not rare for even the 1st episode of diverticulitis to carry potentially fatal complications. The evolution of a peridiverticular process generally poses problems for medical treatment and exposes patients to repeated episodes of diverticulitis, making surgical treatment necessary in approximately 30% of symptomatic patients. One of the most worrying complications of diverticulosis is internal fistula. The most common types of fistula are colovesical and colovaginal, against which the uterus can act as an important protective factor. The symptoms and the clinical and instrumental management of patients with diverticular fistulas are much the same as for patients with episodes of acute diverticulitis. Staging of the disease (according to Hinchey) should be done promptly so that the necessary action can be taken prior to surgery, implementing total parenteral nutrition (TPN), nasogastric aspiration and broad-spectrum antibiotic treatment. The best surgical approach to adopt in patients with diverticulitis complicated by fistula is still not entirely clear, though the 3-step strategy is currently tending to be abandoned due to its high morbidity and mortality rates. There is a widespread conviction, however, that the 2-step strategy (Hartmann, or resection with protective stomy) and the 1-step alternative should be reserved, respectively, for patients in Hinchey stages 3, 4 and 1, 2 with a situation of attenuated local inflammation. The 1-step approach seems to be safe and effective. This report describes a case of colovaginal fistula in a patient with colonic diverticulosis who had recently undergone hysterectomy, but who, unlike such cases in the past, was treated in a single step using a laparoscopic technique.

  3. Optimization of subarachanoid block by oral pregabalin for hysterectomy

    Monica Kohli


    Full Text Available Background: 80% of patients undergoing surgical procedures experience postoperative pain 1 and requires adequate pain relief. Nowadays drugs like COX2 inhibitors and calcium channel modulators (Pregabalin and Gabapentin are been increasingly used for postoperative pain management effectively. We conducted this study to find whether preoperative pregabalin has any effect in postoperative analgesic requirement in patients undergoing hysterectomy under spinal anaesthesia. Patients & Methods: This randomized, double-blind, placebo-controlled trial was conducted in 150 patients undergoing hysterectomy under spinal anaesthesia, divided in three groups - Group I (PO - Control group, Group II (P150 received 150 mg pregabalin and Group III (P300 received 300 mg pregabalin. We used VAS for anxiety, Ramsay sedation scale and VAS for patient satisfaction regarding pain relief. Results: There was significant reduction in anxiety in groups P (150 and P (300 than placebo group P (0 during intraoperative and postoperative period than preoperative period. There was significant sedation seen in groups P (150 and P (300 than placebo group P (0. First rescue analgesia in group P (300 was202.42±6.77 and in group P (150 was176.38±4.80on average, group P (0 was131.38±5.15. Dizziness was 44.44% in group P (300, 36.11% in group P (150, and 19.44% in group P (0. Patient satisfaction was better in P (300 group than other two groups. Conclusions: Pregabalin being an oral drug which would be easy for the patients to take and also its prolongation of the neuraxial block helps in immediate postoperative analgesia and further reduction of other parentral analgesics. Pregabalin 150mg would be the optimal preemptive dose for hysterectomy under spinal anaesthesia.

  4. Hysterectomy on benign indication in Denmark 1988-1998. A register based trend analysis

    Gimbel, H; Settnes, A; Tabor, A


    BACKGROUND: The aims of the study were to describe the trends in Danish hysterectomy rates from 1988 to 1998 for operations done on benign indication. METHODS: Data from all women (n=67,096) undergoing hysterectomy from 1988 to 1998 were obtained from the Danish National Patient Register. Data on...

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

    Lykke, Rune; Blaakær, Jan; Ottesen, Bent


    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...

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

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


    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.

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

    Carney, John


    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.

  8. Single port robotic hysterectomy technique improving on multiport procedure

    John R Lue


    Full Text Available The benefits of laparoscopic surgery over conventional abdominal surgery have been well documented. Reducing postoperative pain, decreasing postoperative morbidity, hospital stay duration, and postoperative recovery time have all been demonstrated in recent peer-review literature. Robotic laparoscopy provides the added dimension of increased fine mobility and surgical control. With new single port surgical techniques, we have the added benefit of minimally invasive surgery and greater patient aesthetic satisfaction, as well as all the other benefits laparoscopic surgery offers. In this paper, we report a successful single port robotic hysterectomy and the simple process by which this technique is performed.

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

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


    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...

  10. [Is a hysterectomy justifiable to prevent post-tubal ligation syndrome?].

    Maheux, R; Fugère, P


    Among 2057 tubal ligations performed between 1971-75 in "Hopital Saint-Luc" in Montreal, 78 patients had to be readmitted for hysterectomy. The main indication for hysterectomy among these patients was for menstrual disorders (65%). These menstrual disorders were present at the moment of the tubal ligation in about half of the patients. Among the patients who had to be reoperated for hysterectomy for menstrual disorders and who were asymptomatic at the momemt of their tubal ligation, 88% were using oral contraceptives for a mean period of 5.8 years. The low incidence of hysterectomy post-tubal ligation (3.8%) does not seem to justify a total hysterectomy to prevent what has been described as the "post tubal ligation syndrome" in the patients who are asymptomatic and desire a permanent sterilization. (Author's modified)

  11. Bursectomy at radical gastrectomy

    Cuneyt; Kayaalp


    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.

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

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


    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.

  13. 32 CFR 636.31 - Abandoned vehicles.


    ... 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...



    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.




    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.

  16. An audit of indications and complications associated with elective hysterectomy at SVMCH and RC, Ariyur, Pondicherry

    Nidhi Bansal, Hiremath PB, Meenal C, Vishnu Prasad


    Full Text Available Background: Hysterectomy is the most common gynaecological surgery performed worldwide Menorrhagia secondary to uterine fibroids and abnormal menstrual bleeding are the two most common indications for hysterectomy. An important factor impacting on the incidence of complications of hysterectomy, apart from the indication for surgery, is the surgical approach. Most surgeons perform up to 80% of procedures by the abdominal route. The incidence of LAVH performed for benign lesions has progressively increased in recent years. Methods : Surgical indications and details, histological findings, and postoperative course were reviewed and analysed for 340 patients who underwent hysterectomy in 2011 and 2012.Results : In our study, fibroid uterus (27.9 % was the leading indication for performing hysterectomies followed by a DUB (22.9% and uterovaginal prolapse (UVP-21.8%. During the study period (2011-2012, most hysterectomies were performed abdominally (54.4%. Overall post operative complications including major and minor, are significantly higher in the abdominal surgery group as compared to the vaginal and laparoscopic group ( p value= 0.001 . Conclusion: We need to ensure that trainees acquire competency in performing hysterectomies vaginally, which is clearly safer than the abdominal approach.

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

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


    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

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



    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.

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

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


    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.

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

    Stefanovic Vedran


    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.

  1. Grinding Properties of Abandoned Concrete

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


    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.

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

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


    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

  3. Diagnostic value of hysteroscopy: correlation with histological findings after dilatation and curettage and hysterectomy.

    Piccolboni, G; Arlacchi, E; Cattani, P; Zardini, R; Lavanda, E; Zardini, E


    The Authors carried out a comparative assessment of hysteroscopy diagnosis and histological findings obtained by dilatation and curettage and hysterectomy. Analysis of the data shows a good correlation between hysteroscopic diagnosis and histological findings obtained with dilatation and curettage.

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

    Brøchner, A C; Mygil, B; Elle, B;


    : To investigate whether uterine artery embolization generates a reduced inflammatory response as compared with conventional hysterectomy. MATERIAL AND METHODS: 40 women, 20 in each group, entered this prospective, non-randomized study. The two groups were comparable concerning age, comorbidity, and body......-mass index (BMI). RESULTS: We found a significant difference between the inflammatory responses in women undergoing embolization compared with the inflammatory response in women having an abdominal hysterectomy. Women undergoing embolization were subjected to a much smaller inflammatory burden, their total...... morphine consumption was lower, and their return to work was faster than women subjected to conventional hysterectomy. CONCLUSION: Uterine artery embolization generates a reduced inflammatory response compared with conventional hysterectomy....

  5. Randomized trial of suturing versus electrosurgical bipolar vessel sealing in abdominal hysterectomy

    Sameer Darwade


    Conclusions: The use of bipolar vessel sealing during abdominal hysterectomy for benign conditions appears to be associated with reduced blood loss, postoperative pain and faster recovery. [Int J Reprod Contracept Obstet Gynecol 2016; 5(6.000: 1778-1783

  6. Electrosurgical bipolar vessel sealing versus conventional clamping and suturing for total abdominal hysterectomy: a randomized trial.

    Lakeman, M.; Kruitwagen, R.F.P.M.; Vos, M.C.; Roovers, J.P.


    STUDY OBJECTIVE: To compare the effects of bipolar vessel sealing versus conventional clamping and suturing in women undergoing total abdominal hysterectomy. DESIGN: A randomized controlled trial was performed. Patients were randomized to vessel sealing or conventional surgery. Postoperative pain wa

  7. Coal Mines, Abandoned - AML Points Feature

    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...

  8. Coal Mines, Abandoned - AML Polygons Feature

    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...

  9. Coal Mines, Abandoned - AML Inventory Sites 201601

    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...

  10. Why General Intelligence Assessment Should Be Abandoned

    Beck, Clive


    The author argues that general intelligence assessment should be abandoned on moral and theoretical grounds, but that the conceptualization, testing, and identification of specific intellectual abilities is both defensible and worthwhile. (MB)

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

    Sanam Moradan


    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.



    Intruduction: Hysterectomy is one of major surgeries. Pregnancy, delivery and postpartum period make the operation even more difficult as it is forced and complicated by various pathological conditions that develop over that time. Objective: The purpose of study was to analyze the frequency of hysterectomy, indications to undertake it and complications associated with the removal of the uterus in pregnancy and during perinatal and postpartum period. The study analyzed the cases of hyst...

  13. Hysterectomy for dysfunctional uterine bleeding in women with previous tubal sterilization

    Hethyshi Ranganna; Nirmala Shivlingiaha


    Background: Post tubal ligation syndrome has been a topic of debate with various studies concluding contradictory results. Hysterectomy can be considered as a continuum of the post ligation syndrome due to prolonged menstrual complaints. The present study was done to evaluate any association of tubal sterilization with hysterectomy in patients presenting with dysfunctional uterine bleeding. Methods: The study was conducted in a medical college hospital. Analysis of case files of patients...

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

    Sanam Moradan; Raheb Gorbani


    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 co...

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

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


    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.

  16. 30 CFR 77.215-4 - Refuse piles; abandonment.


    ... 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...

  17. Radical prostatectomy

    Fode, Mikkel; Sønksen, Jens; Jakobsen, Henrik


    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...

  18. Postpartal hysterectomy performed the consequence of chronic myometritis

    Jovanović Božidar


    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

  19. History of abandoned infants in Greece

    Maria Athanasopoulou


    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.

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

    Flood, Karen M


    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.




    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

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

    Gorwill R Hugh


    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.

  3. Soil microbial community of abandoned sand fields.

    Elhottová, D; Szili-Kovács, T; Tríska, J


    Microbiological evaluation of sandy grassland soils from two different stages of secondary succession on abandoned fields (4 and 8 years old fallow) was carried out as a part of research focused on restoration of semi-natural vegetation communities in Kiskunság National Park in Hungary. There was an apparent total N and organic C enrichment, stimulation of microbial growth and microbial community structure change on fields abandoned by agricultural practice (small family farm) in comparison with native undisturbed grassland. A successional trend of the microbial community was found after 4 and 8 years of fallow-lying soil. It consisted in a shift of r-survival strategy to more efficient C economy, in a decrease of specific respiration and metabolic activity, forced accumulation of storage bacterial compounds and increased fungal distribution. The composition of microbial phospholipid fatty acids mixture of soils abandoned at various times was significantly different.

  4. Infanticide and illegal infant abandonment in Malaysia.

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


    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.

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

    Neetu Singh


    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. Histopathological Study of Hysterectomy Operations in A University Clinic in Tehran From 2005 to 2009

    Mahmoud Khaniki


    Full Text Available Objective: We intended to determine causes and histological pattern of hysterectomies in an Iranianpopulation.Materials and methods: Archived reports of pathology department of a university hospital dated March2005 to March 2009 were retrospectively reviewed. Age, chief complaint, type of operation includingabdominal, vaginal and subtotal hysterectomy, the indication of the operation and the pathology of thespecimen were retrieved from the records.Results: The average rate of hysterectomy was 219 per year. The average age of the patients was49.6±11.3. About 40% of cases aged 45-54 years. The main chief compliant was abnormal uterinebleeding (62.2%. The leading preoperative indication for hysterectomy operations were uterineleiomyoma (24.8% and then abnormal uterine bleeding and abdominal/pelvic mass. The most frequentpathologic findings were leiomyoma (22.0% and adenomyosis (12.1%. In 11.8% of hysterectomyspecimens no pathologic lesion was found.Conclusion: The hysterectomy is rather common in Iran with age dependent pattern of indications andcorresponding pathologies.

  7. Influence of total laparoscopic hysterectomy on the blood viscosity and erythrocyte immune state in patients

    Li Lin; Hong-yan Xu


    Objective:To investigate and study the influenced state of total laparoscopic hysterectomy for the blood viscosity and erythrocyte immune state of patients.Methods:A total of 58 patients who were treated with total hysterectomy in our hospital from June 2013 to February 2015 were the study subjects, the 29 cases in the control group were treated with routine open hysterectomy operation according to the operation types, the 29 cases in the observation group were treated with laparoscopic hysterectomy operation, then the preoperative and postoperative blood viscosity and erythrocyte immune state indexes of two groups were compared.Results:The blood viscosity indexes of the observation group at different postoperative time were all lower than the indexes of the control group, the erythrocyte immune state indexes were all better than those of the control group, and the detection results of two groups at the third day after the operation were all obviously worse than those at other times, their differences were statistically significant.Conclusions:The bad influence of total laparoscopic hysterectomy for the blood viscosity and erythrocyte immune state of patients are relatively smaller, and those postoperative indexes in recovery of patients are faster.

  8. A Marked Increase in Obstetric Hysterectomy for Placenta Accreta

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


    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.

  9. 18 CFR 157.216 - Abandonment.


    ... OF ENERGY REGULATIONS UNDER NATURAL GAS ACT APPLICATIONS FOR CERTIFICATES OF PUBLIC CONVENIENCE AND... in § 157.203(b), provided the certificate holder obtains the written consent of each customer served... abandon: (1) Any receipt or delivery point if all of the existing customers of the pipeline served...

  10. Towards Understanding Methane Emissions from Abandoned Wells

    Reconciliation of large-scale top-down methane measurements and bottom-up inventories requires complete accounting of source types. Methane emissions from abandoned oil and gas wells is an area of uncertainty. This presentation reviews progress to characterize the potential inv...

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

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


    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 prospective blinded study, 70 patients scheduled for elective robot-assisted laparoscopic hysterectomy were randomised to receive either TAP block (ropivacaine 0.5%, 20 ml on each side) or sham block (isotonic saline 0.9%, 20 ml on each side). All patients had patient-controlled analgesia (PCA) with morphine...... 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....

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

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


    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 placebo-controlled trial women scheduled for elective abdominal hysterectomy (n=59) were randomized to preoperatively receive either 125 mg methylprednisolone or saline intravenously. Primary outcome was postoperative pain measured on a 0.0-10.0 visual analog scale and assessed at rest and during...... group (P=0.01). CONCLUSIONS: This trial showed no beneficial effect of methylprednisolone on postoperative pain after abdominal hysterectomy. Methylprednisolone significantly lowered postoperative CRP levels. CLINICAL TRIAL REGISTRATION: NCT01106547....

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

    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 of...

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

    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...

  15. Vaginal hysterectomy for benign uterine disease in the laparoscopically confirmed frozen pelvis.

    Pelosi, M A; Pelosi, M A


    Extensive pelvic adhesions present difficulty with access to the uterus, but they may not account for significant symtomatology, although their dissection may account for a significant deal of morbidity. Results of this study are based on a retrospective analysis of operations by a single surgical team. Eight patients with benign uterine pathology and frozen pelvis diagnosed laparoscopically underwent vaginal hysterectomy. The surgeries were accomplished uneventfully and without significant perioperative morbidity. This approach appears to be an efficient surgical option for hysterectomy, which by-passes the need for and the potential morbidity of an extensive intra-abdominal adhesiolysis by laparotomy or laparoscopy.

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

    Kozovski, I; Radoinova, D


    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.

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

    Ahmed Samy El-agwany


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

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


    University Hospital. PATIENTS: Forty-six women scheduled for total abdominal hysterectomy. INTERVENTION: Women received either ropivacaine 0.75%, 20 mL (n = 24) or 0.9% saline, 20 mL (n = 24) in the transversus abdominis plane on each side. MAIN OUTCOME MEASURES: Primary outcome was the 24-h postoperative...... an 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....

  19. Ignorance Radicalized

    Gergo Somodi


    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.

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

    Sparić Radmila


    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. .

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

    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


    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.

  2. 30 CFR 256.56 - Lease-specific abandonment accounts.


    ... 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...

  3. 19 CFR 18.44 - Abandonment of exportation.


    ... Control Exported Under Cover of A Tir Carnet § 18.44 Abandonment of exportation. In the event that exportation is abandoned at any time after merchandise has been placed under cover of a TIR carnet, the... 19 Customs Duties 1 2010-04-01 2010-04-01 false Abandonment of exportation. 18.44 Section...

  4. 30 CFR 56.4011 - Abandoned electric circuits.


    ... 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...

  5. 30 CFR 57.4011 - Abandoned electric circuits.


    ... 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...

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

    Protić Milan St


    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.

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

    Duke A. Onyeabochukwu


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

    Heather Hill-Vásquez


    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?

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

    O'Brien, D


    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).

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

    Jyoti Malik


    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

  11. Metastatic adenocarcinoma after laparoscopic supracervical hysterectomy with morcellation: A case report.

    Turner, Taylor; Secord, Angeles Alvarez; Lowery, William J; Sfakianos, Gregory; Lee, Paula S


    •Uterine morcellation is common in minimally invasive hysterectomy but should be performed with caution due to risk of unsuspected malignancy.•Intraoperative techniques should be considered to minimize dissemination of endometrial tissue during morcellation.•Strategies to ensure accurate pathologic evaluation of morcellated specimens and to improve preoperative risk stratification before morcellation procedures are necessary.

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

    Tadesse, W


    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.

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

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


    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...

  14. Comparison of robotic surgery and laparoscopy to perform total hysterectomy with pelvic adhesions or large uterus

    Li-Hsuan Chiu


    Full Text Available Background: Currently, benefits of robotic surgery in patients with benign gynecological conditions remain unclear. In this study, we compared the surgical outcome of robotic and laparoscopic total hysterectomies and evaluated the feasibility of robotic surgery in cases with pelvic adhesions or large uterus. Materials and Methods: A total of 216 patients receiving total hysterectomy via robotic or laparoscopic approach were included in this study. Of all 216 patients, 88 underwent robotic total hysterectomy and 128 underwent laparoscopic total hysterectomy. All cases were grouped by surgical type, adhesion score, and uterine weight to evaluate the interaction or individual effect to the surgical outcomes. The perioperative parameters, including operation time, blood loss, postoperative pain score, time to full diet resumption, length of hospital stay, conversion rate, and surgery-related complications were compared between the groups. Results: Operation time and blood loss were affected by both surgical type and adhesion score. For cases with severe adhesions (adhesion score greater than 4, robotic surgery was associated with a shortened operation time (113.9 ± 38.4 min versus 164.3 ± 81.4 min, P = 0.007 and reduced blood loss (187.5 ± 148.7 mL versus 385.7 ± 482.6, P=0.044 compared with laparoscopy. Moreover, robotic group showed a lower postoperative pain score than laparoscopic group, as the effect was found to be independent of adhesion score or uterine weight. The grade-II complication rate was also found to be lower in the robotic group. Conclusions: Comparing to laparoscopic approach, robotic surgery is a feasible and potential alternative for performing total hysterectomy with severe adhesions.

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

    Morhason-Bello Imran O


    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.

  16. A retrospective study of emergency obstetric hysterectomy in a tertiary care center for a period of 5 years

    Bhawna Sharma


    Conclusions: Emergency obstetric hysterectomy is a potentially lifesaving procedure which often puts obstetrician in dilemma at the time of decision making. [Int J Reprod Contracept Obstet Gynecol 2016; 5(11.000: 3778-3781

  17. A radical approach to radical innovation

    Deichmann, Dirk; van der Ende, Jan


    textabstractInnovation pays. Amazon, Apple, Facebook, Google – nearly every one of today’s most successful companies has a talent for developing radical new ideas. But how best to encourage radical initiative taking from employees, and does their previous success or failure at it play a role?

  18. Crimes and misdemeanours: the case of child abandonment.

    Giordano, S


    In 2002, a child was abandoned in a Burger King restaurant in Amsterdam by a Chinese woman, who hoped that the baby would be picked up by someone able to give the child a better life. She was convicted for child abandonment and imprisoned. Whereas some forms of child abandonment are criminalised, others are socially accepted and not even on the ethics agenda. This paper is an invitation to reflect on the inconsistency in the ways in which we prosecute, punish or try to correct some forms of child abandonment and yet make allowances for others.

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

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


    , especially with the frequent observations provided by coarser-resolution sensors and new classification techniques. Past efforts to map abandoned agriculture relied mainly on Landsat data, making it hard to map large regions, and precluding the use of phenology information to identify abandoned agriculture...... with Support Vector Machines (SVM). Training data were derived from several Landsat classifications of agricultural abandonment in the study area. A validation was conducted based on independently collected data. Our results showed that it is possible to map abandoned agriculture for large areas from MODIS...

  20. Comparison of Perioperative Outcomes of Total Laparoscopic and Robotically Assisted Hysterectomy for Benign Pathology during Introduction of a Robotic Program

    Gokhan Sami Kilic


    Full Text Available Study Objective. Prospectively compare outcomes of robotically assisted and laparoscopic hysterectomy in the process of implementing a new robotic program. Design. Prospectively comparative observational nonrandomized study. Design Classification. II-1. Setting. Tertiary caregiver university hospital. Patients. Data collected consecutively 24 months, 34 patients underwent laparoscopic hysterectomy, 25 patients underwent robotic hysterectomy, and 11 patients underwent vaginal hysterectomy at our institution. Interventions. Outcomes of robotically assisted, laparoscopic, and vaginal complex hysterectomies performed by a single surgeon for noncancerous indications. Measurements and Main Results. Operative times were 208.3±59.01 minutes for laparoscopic, 286.2±82.87 minutes for robotic, and 163.5±61.89 minutes for vaginal (<.0001. Estimated blood loss for patients undergoing laparoscopic surgery was 242.7±211.37 cc, 137.4±107.50 cc for robotic surgery, and 243.2±127.52 cc for vaginal surgery (=0.05. The mean length of stay ranged from 1.8 to 2.3 days for the 3 methods. Association was significant for uterine weight (=0.0043 among surgery methods. Conclusion. Robotically assisted hysterectomy is feasible with low morbidity, a shorter hospital stay, and less blood loss. This suggests that robotic assistance facilitates a minimally invasive approach for patients with larger uterine size even during implementing a new robotic program.

  1. Total laparoscopic hysterectomy: A case report from ILE-IFE, Nigeria.

    Badejoko, Olusegun O; Ajenifuja, Kayode O; Oluborode, Babawale O; Adeyemi, Adebanjo B


    Total laparoscopic hysterectomy (TLH) is an advanced gynecological laparoscopic procedure that is widely performed in the developed world. However, its feasibility in resource-poor settings is hampered by obvious lack of equipments and/or skilled personnel. Indeed, TLH has never been reported from any Nigerian hospital. We present a 50-year-old multipara scheduled for hysterectomy on account of pre-malignant disease of the cervix, who had TLH with bilateral salpingo-oophorectomy in the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, southwestern Nigeria and was discharged home on the first post-operative day. She was seen in the gynecology clinic a week later in stable condition and she was highly pleased with the outcome of her surgery. This case is presented to highlight the attainability of operative gynecological laparoscopy, including advanced procedures like TLH in a resource-constrained setting, through the employment of adequate local adaptation and clever improvisation.

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

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


    -blind, placebo-controlled, randomized clinical trial, we evaluated postoperative pain following total abdominal hysterectomy over 5 days in patients receiving placebo or etoricoxib administered 90 min prior to surgery and continuing postoperatively. Patients were randomly assigned to receive either placebo (n...... 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......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...

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

    Denisa-Oana Bălălău


    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.

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

    Serkan DİKİCİ


    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

  5. [Pyelovenous fistula revealed by repeated thromboembolic events after emergency peripartum hysterectomy].

    Sauvanaud, C; Boillot, B; Sergent, F; Long, J A; Pernod, G; Rambeaud, J J


    We report the case of a 51-year old woman presenting pyelovenous fistula revealed by recurrent and serious thromboembolic events after ureteral ligation during emergency peripartum hysterectomy. Imaging reported a complete left ureteral obstruction, a fistula between the upper calix and the left renal vein and a renal function preserved. Uretero-vesical reimplantation was performed. The patient was well doing after 12 months. The authors wonder if pyelovenous fistula is responsible for prothrombotic state and maintaining renal function.

  6. Prophylactic salpingectomy in women undergoing hysterectomy for benign gynaecological disease - a new Danish recommendation

    Sloth, Sigurd Beier; Gimbel, Helga; Jørgensen, Annemette

    of Recommendations Assessment, Development and Evaluation (GRADE). Results The systematic literature search produced 269 hits for existing guidelines, 407 hits for systematic literature and 476 hits for primary literature. One randomized controlled trial (RCT, n = 30) and three observational studies (OS, n = 540...... with concomitant bilateral salpingectomy compared to women undergoing hysterectomy without bilateral salpingectomy. Based on the available evidence, the balance between benefits and harms and patient values and preferences, the guideline panel gave a weak recommendation for concomitant bilateral salpingectomy...

  7. Novel Port Placement and 5-mm Instrumentation for Robotic-Assisted Hysterectomy

    Nezhat, Ceana H.; Katz, Adi; Dun, Erica C; Kho, Kimberly A.; Wieser, Friedrich A.


    Background and Objectives: The value of robotic surgery for gynecologic procedures has been critically evaluated over the past few years. Its drawbacks have been noted as larger port size, location of port placement, limited instrumentation, and cost. In this study, we describe a novel technique for robotic-assisted laparoscopic hysterectomy (RALH) with 3 important improvements: (1) more aesthetic triangular laparoscopic port configuration, (2) use of 5-mm robotic cannulas and instruments, an...

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

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


    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...

  9. Patient and Staff (doctors and nurses) Experiences of Abdominal Hysterectomy in Accelerated Recovery Programme

    Wagner, Lis; Carlslund, Anne Mette; Møller, Charlotte


    the experiences of the women operated and the staff involved. Material and methods: The study is exploratory and descriptive, using qualitative methods. Seventeen women, with good health status, were consecutively selected from August to September 2001. The women were observed and ten were interviewed twice...... of information relay and dialogue between staff and patients/family members. A nursing care ambulatory unit is recommended to support with information for women prior to and following hysterectomy in the ARP....




    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.

  11. Learning Curve Analysis of Different Stages of Robotic-Assisted Laparoscopic Hysterectomy

    Tang, Feng-Hsiang


    Objective. To analyze the learning curves of the different stages of robotic-assisted laparoscopic hysterectomy. Design. Retrospective analysis. Design Classification. Canadian Task Force classification II-2. Setting. Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. Patient Intervention. Women receiving robotic-assisted total and subtotal laparoscopic hysterectomies for benign conditions from May 1, 2013, to August 31, 2015. Measurements and Main Results. The mean age, body mass index (BMI), and uterine weight were 46.44 ± 5.31 years, 23.97 ± 4.75 kg/m2, and 435.48 ± 250.62 g, respectively. The most rapid learning curve was obtained for the main surgery console stage; eight experiences were required to achieve duration stability, and the time spent in this stage did not violate the control rules. The docking stage required 14 experiences to achieve duration stability, and the suture stage was the most difficult to master, requiring 26 experiences. BMI did not considerably affect the duration of the three stages. The uterine weight and the presence of adhesion did not substantially affect the main surgery console time. Conclusion. Different stages of robotic-assisted laparoscopic hysterectomy have different learning curves. The main surgery console stage has the most rapid learning curve, whereas the suture stage has the slowest learning curve. PMID:28373977

  12. Radical theory of rings

    Gardner, JW


    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

  13. [Lavoisier and radicals].

    Lafont, Olivier


    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.

  14. A 12-year cavern abandonment test

    Brouard B.


    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.

  15. Heavy metals biogeochemistry in abandoned mining areas

    Favas P. J. C.


    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.

  16. What About Our Responsibility Toward the Abandoned Elderly?

    Donahue, Wilma T.


    The deinstitutionalization policy has excluded older people from the mental health system and has resulted in abandoning many of them. Causes of this failure are discussed. Suggestions are made for rescuing the abandoned elderly. Presented at the Gerontological Society meeting, November, 1977, San Francisco. (Author/JEL)

  17. 77 FR 74063 - Amendments to the Abandoned Plan Regulations


    ... account plans may be considered ``abandoned'' and procedures by which financial institutions (so-called... theory that such plans are effectively being abandoned by the sponsor as a result of the liquidation... financial institutions and other asset custodians described in section 7701(a)(37) of the Code to...

  18. 37 CFR 2.68 - Express abandonment (withdrawal) of application.


    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Express abandonment (withdrawal) of application. 2.68 Section 2.68 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND... Action by Applicants § 2.68 Express abandonment (withdrawal) of application. (a) Written...

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

    Prakash Chitalkar


    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

  20. 32 CFR 644.494 - Donation, abandonment or destruction.


    ... 32 National Defense 4 2010-07-01 2010-07-01 true Donation, abandonment or destruction. 644.494 Section 644.494 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL... Land) § 644.494 Donation, abandonment or destruction. (a) General. Improvements may be...

  1. Dislocation of an infected and abandoned pacemaker lead.

    Kostopoulou, Anna G; Kyrzopoulos, Stamatios D; Livanis, Efthimios G


    We present a case of pacemaker lead dislodgment in an 83-year-old patient with a pacemaker infection. Initially, the generator and the proximal part of the leads were removed, and the remaining leads were severed and abandoned. Twenty-five days later, dislodgment of both abandoned leads and systemic infection were documented. The leads were then surgically removed without further complications.

  2. 49 CFR 195.59 - Abandonment or deactivation of facilities.


    ... 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...

  3. Abandoning pipelines working group regulatory issues



    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.

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

    Maribel Carvalho Suarez


    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.

  5. Preliminary characterization of abandoned septic tank systems. Volume 1



    This report documents the activities and findings of the Phase I Preliminary Characterization of Abandoned Septic Tank Systems. The purpose of the preliminary characterization activity was to investigate the Tiger Team abandoned septic systems (tanks and associated leachfields) for the purpose of identifying waste streams for closure at a later date. The work performed was not to fully characterize or remediate the sites. The abandoned systems potentially received wastes or effluent from buildings which could have discharged non-domestic, petroleum hydrocarbons, hazardous, radioactive and/or mixed wastes. A total of 20 sites were investigated for the preliminary characterization of identified abandoned septic systems. Of the 20 sites, 19 were located and characterized through samples collected from each tank(s) and, where applicable, associated leachfields. The abandoned septic tank systems are located in Areas 5, 12, 15, 25, and 26 on the Nevada Test Site.

  6. 经阴道与经腹子宫切除术临床效果对比分析%A Retrospective Analyzation on Clinical.Effects of Vaginal Hysterectomy and Transabdominal Hysterectomy

    马亚宁; 李玉杰


    [Objective]To evaluate the clinical effects of vaginal hysterectomy and transabdominal hysterectomy in treatment of uterine benign diseases.[Methods]A retrospective study was performed on 121 cases of hysterectomy (58 cases conducted vaginal hysterectomy, 63 cases conducted transabdominal hysterectomy due to the benign pathological changes of uterus during May 2006 - June 2008. Operation time, bleeding volume, postoperative period of hospitalization, postoperative period of exhaust, postoperative analgesic usage, postoperative morbidity, and postoperative complications of the 2 groups were compared.[Results]The differences of operation time and bleeding volume between the 2 groups were not significant (P>0.05); in vaginal hysterectomy group the postoperative periods of exhaust and hospitalization were short, the postoperative usages of analgesics and morbidity were lower than those of patients with transabdominal hysterectomy(P<0.05).[Conclusion] Compared with transabdominal hysterectomy, vaginal hysterectomy has the advantage of short recovery time and less trauma ,which accords with the view of minimally invasive.%目的 评价经阴道与经腹子宫切除术在子宫良性病变中的临床效果.方法 对2006年5月-2008年6月因子宫良性病变需行子宫切除术的121例病例进行回顾性分析,其中经阴道子宫切除术58例(阴式组),经腹子宫切除术63例(开腹组),主要对比2组手术时间、术中出血量、术后住院时间、术后排气时间、术后镇痛药使用率、术后病率、术后并发症等.结果 2组手术时间,术中出血量比较差异无统计学意义(P>0.05);阴式组术后排气早、住院时间短、术后镇痛药使用率及术后病率低与开腹组比较差异有统计学意义(P<0.05).结论 经阴道子宫切除术较经腹子宫切除术具有创伤小,恢复快的优点,符合微创观点.

  7. Contemporary Radical Prostatectomy

    Qiang Fu


    Full Text Available Purpose. Patients diagnosed with clinically localized prostate cancer have more surgical treatment options than in the past. This paper focuses on the procedures' oncological or functional outcomes and perioperative morbidities of radical retropubic prostatectomy, radical perineal prostatectomy, and robotic-assisted laparoscopic radical prostatectomy. Materials and Methods. A MEDLINE/PubMed search of the literature on radical prostatectomy and other new management options was performed. Results. Compared to the open procedures, robotic-assisted radical prostatectomy has no confirmed significant difference in most literatures besides less blood loss and blood transfusion. Nerve sparing is a safe means of preserving potency on well-selected patients undergoing radical prostatectomy. Positive surgical margin rates of radical prostatectomy affect the recurrence and survival of prostate cancer. The urinary and sexual function outcomes have been vastly improved. Neoadjuvant treatment only affects the rate of positive surgical margin. Adjuvant therapy can delay and reduce the risk of recurrence and improve the survival of the high risk prostate cancer. Conclusions. For the majority of patients with organ-confined prostate cancer, radical prostatectomy remains a most effective approach. Radical perineal prostatectomy remains a viable approach for patients with morbid obesity, prior pelvic surgery, or prior pelvic radiation. Robot-assisted laparoscopic prostatectomy (RALP has become popular among surgeons but has not yet become the firmly established standard of care. Long-term data have confirmed the efficacy of radical retropubic prostatectomy with disease control rates and cancer-specific survival rates.

  8. The effects of hysterectomy on body image, self-esteem, and marital adjustment in Turkish women with gynecologic cancer.

    Pinar, Gul; Okdem, Seyda; Dogan, Nevin; Buyukgonenc, Lale; Ayhan, Ali


    The purpose of this research was to investigate the differences in the effect of hysterectomy on body image, self-esteem, and marital adjustment in Turkish women with gynecologic cancer based on specific independent variables, including age, education, employment, having or not having children, and income. This cross-sectional study compared a group of women who underwent a hysterectomy (n = 100) with a healthy control group (n = 100). The study findings indicate that women who had a hysterectomy were found in worse conditions in terms of body image, self-esteem, and dyadic adjustment compared to healthy women. In terms of dyadic adjustment and body image among women who had undergone a hysterectomy, those with lower levels of income and education were found in poorer conditions. The study's findings show that hysterectomies have negative effects on body image, self-esteem, and dyadic adjustment in women affected by gynecologic cancer. Nursing assessment of self-esteem and marital adjustment indicators and implementation of strategies to increase self-confidence and self-esteem are needed for high-risk women.

  9. Women's sexual behavior, body image and satisfaction with surgical outcomes after hysterectomy: a comparison of vaginal and abdominal surgery.

    Gütl, P; Greimel, E R; Roth, R; Winter, R


    The aim of this study was to investigate the impact of vaginal and abdominal hysterectomy on women's sexual behavior, sexual dysfunction, body image and satisfaction with surgery. A prospective study was conducted on 90 women to evaluate the outcomes of hysterectomy. Data were collected prior to surgery, three months and two years after surgery, using self-report questionnaires. The results showed significant differences in women's sexual behavior and sexual dysfunction before and after hysterectomy, independent of the surgical procedure performed. Women in both groups reported improvements in sexual desire, sexual activity and sexual intercourse three months and two years after surgery. Sexual dysfunction such as dyspareunia, vaginismus, lack of orgasm and loss of sexual interest diminished significantly after surgery. Regression analyses revealed that postmenopausal status, severity of gynecological complaints and frequency of sexual intercourse were the most important factors for improved sexual outcomes. Women in the abdominal group were dissatisfied with their body image because of the abdominal scar, experienced more pain and had a longer period of recovery from surgery compared to women in the vaginal group. According to the results, sexual behavior alone is not an important factor in choosing vaginal or abdominal hysterectomy. However, sexual behavior was important in both groups when evaluating outcomes after hysterectomy.

  10. Transfer Out Patient Not Abandon The Patient

    Deepak Gupta


    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

  11. Schoenberg and the Radical Economies of Harmonielehre

    Murray Dineen


    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.

  12. Forgotten Radicals in Biology


    Redox reactions play key roles in intra- and inter-cellular signaling, and in adaptative processes of tissues towards stress. Among the major free radicals with essential functions in cells are reactive oxygen species (ROS) including superoxide anion (O2 •-), hydroxyl radical (•OH) and reactive nitrogen species (RNS) such as nitric oxide (•NO). In this article, we review the forgotten and new radicals with potential relevance to cardiovascular pathophysiology. Approximately 0.3% of O2 •- pres...

  13. Nurses' attitudes and knowledge of their roles in newborn abandonment.

    Cesario, Sandra K


    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 to save the lives of unwanted newborns. The laws typically specify a mother's ability to "abandon" her child to a medical service provider. However, judgmental attitudes and a lack of accurate information may impede a health care provider's ability to carry out a safe-haven law. The study described here examines a sample of nurses in a state with a safe-haven law. The study revealed no significant correlation between a nurse's knowledge, attitude, and self-perception of preparedness to manage a newborn abandonment event. owever, the outcomes highlight the negative attitudes and lack of knowledge many nurses possess regarding newborn abandonment and the women who commit this act. Educational programs for all health care providers and the community are essential to the efficacy of the legislation that currently exists. Continued multidisciplinary strategizing and general awareness are needed to serve as catalysts to build supports for unwanted newborns and their safe assimilation into the community.

  14. Crimes and misdemeanours: the case of child abandonment


    In 2002, a child was abandoned in a Burger King restaurant in Amsterdam by a Chinese woman, who hoped that the baby would be picked up by someone able to give the child a better life. She was convicted for child abandonment and imprisoned. Whereas some forms of child abandonment are criminalised, others are socially accepted and not even on the ethics agenda. This paper is an invitation to reflect on the inconsistency in the ways in which we prosecute, punish or try to correct some forms of c...

  15. Robust Abandoned Object Detection Using Dual Foregrounds

    Tetsuji Haga


    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.

  16. Mercury distribution in an abandoned metallurgical plant

    Millán R.


    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.

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

    Anju Ghai


    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.

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

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


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

    Nilima G Sawke


    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.

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

    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.

  1. Associations of Premenopausal Hysterectomy and Oophorectomy With Breast Cancer Among Black and White Women: The Carolina Breast Cancer Study, 1993-2001.

    Robinson, Whitney R; Nichols, Hazel B; Tse, Chiu Kit; Olshan, Andrew F; Troester, Melissa A


    Black women experience higher rates of hysterectomy than other women in the United States. Although research indicates that premenopausal hysterectomy with bilateral oophorectomy decreases the risk of breast cancer in black women, it remains unclear how hysterectomy without ovary removal affects risk, whether menopausal hormone therapy use attenuates inverse associations, and whether associations vary by cancer subtype. In the population-based, case-control Carolina Breast Cancer Study of invasive breast cancer in 1,391 black (725 cases, 666 controls) and 1,727 white (939 cases, 788 controls) women in North Carolina (1993-2001), we investigated the associations of premenopausal hysterectomy and oophorectomy with breast cancer risk. Compared with no history of premenopausal surgery, bilateral oophorectomy and hysterectomy without oophorectomy were associated with lower odds of breast cancer (for bilateral oophorectomy, multivariable-adjusted odds ratios = 0.60, 95% confidence interval: 0.47, 0.77; for hysterectomy without oophorectomy, multivariable-adjusted odds ratios = 0.68, 95% confidence interval: 0.55, 0.84). Estimates did not vary by race and were similar for hormone receptor-positive and hormone receptor-negative cancers. Use of estrogen-only menopausal hormone therapy did not attenuate the associations. Premenopausal hysterectomy, even without ovary removal, may reduce the long-term risk of hormone receptor-positive and hormone receptor-negative breast cancers. Varying rates of hysterectomy are a potentially important contributor to differences in breast cancer incidence among racial/ethnic groups.

  2. The Experience of Robotic-Assisted Laparoscopic Hysterectomy for Women Treated for Early-Stage Endometrial Cancer

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


    BACKGROUND: An increasing number of women are offered robotic-assisted laparoscopic hysterectomy as treatment for early-stage endometrial cancer in the developed world. OBJECTIVE: The aim of this study was to explore how women diagnosed with early-stage endometrial cancer experienced robotic......-assisted laparoscopic hysterectomy. METHODS: Semistructured interviews were carried out with 12 women, and interview data were analyzed by qualitative content analysis. RESULTS: Four overarching themes emerged: "surgery was a piece of cake," "recovering physically after surgery," "going from being off guard to being...... on guard," and "preparing oneself by seeking information." The women had confidence in the robotic technique and experienced fast recovery after robotic-assisted laparoscopic hysterectomy; however, they had uncertainties and unanswered questions concerning the postoperative course. Shortly after discharge...

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

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


    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...... 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...... with the other groups (Pstress...

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

    Hayes, N E


    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.

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

    Hayes, N E


    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.




    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.

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

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


    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

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

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


    years after surgery. Complications of hysterectomy were further examined by scrutinising registered discharge summaries following hospitalisation. Intention-to-treat and per-protocol analyses were conducted. Potential bias caused by missing data was handled using multiple imputation. MAIN OUTCOME...... of respondents had urinary incontinence 5 years after SAH 34/113 (30.1%) than TAH 21/119 (17.6%) (RR 1.71, 95% confidence interval 1.06-2.75, P = 0.026). This difference reduced after multiple imputation to account for missing data (RR 1.37, 95% confidence interval 0.99-1.89, P = 0.052). Eleven of the 101 women...

  9. Total vaginal hysterectomy (TVH: outcome analysis of 108 cases at a tertiary centre

    Monika Ramola


    Conclusions: TVH should be promoted as the route of choice for all benign gynaecological conditions. It is safe to do TVH in patients who are at poor general anaesthesia risk. In a state like Uttarakhand where medical facilities are hard to avail due to difficult geographic terrain, TVH has a special role. In lack of endoscopic facility, trained medical and paramedical staff and lack of postoperative monitoring instead of; there is a need to promote TVH. To top it all, TVH is the most cost effective route of hysterectomy. It is truly the natural orifice scarless surgery. [Int J Reprod Contracept Obstet Gynecol 2016; 5(11.000: 3679-3682

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

    Tamas Bartfai


    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.

  11. Orgasm after radical prostatectomy

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


    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

  12. The Radicalization Puzzle [video

    Mohammed Hafez; Center for Homeland Defense and Security Naval Postgraduate School


    This 20 minute lecture, by Dr. Mohammad Hafez of the Naval Postgraduate School examines the driving factors behind the process of radicalization, turning seemingly ordinary men and women into potential terrorists. The lecture is based on the article "The Radicalization Puzzle: A Theoretical Synthesis of Empirical Approaches to Homegrown Extremism" in Studies in Conflict and Terrorism, by Mohammad Hafez and Creighton Mullins.

  13. 7 CFR 97.104 - Application or certificate abandoned.


    ... 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...

  14. "The Giver" and "Shade's Children": Future Views of Child Abandonment and Murder.

    Gross, Melissa


    Examines reasons for child abandonment and murder and how it relates to abandonment in traditional literature. Considers new views of child abandonment and murder (focusing not on overcoming their abandonment, but changing and restructuring their entire society) presented in "The Giver" and "Shade's Children." Discusses the…

  15. 19 CFR 158.42 - Abandonment by importer within 30 days after entry.


    ... 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...

  16. Cervical koilocytosis in hysterectomy specimens of Israeli residents and new immigrants.

    Abramov, D; Fintsi, Y; Zakut, H; Menczer, J


    There is an impression that the prevalence of cervical squamous cell carcinoma (SCC) among new immigrants from the former Soviet Union, is higher than among Israeli residents. Etiologically, SCC is associated with human papilloma virus infection (HPV). The purpose of the present study was to assess the prevalence of cervical HPV infection in new immigrants from the Soviet Union and in Israeli residents as indicated by the presence of koilocytosis in hysterectomy specimens. The study group consisted of 304 women (60 new immigrants and 244 Israeli residents who underwent hysterectomy for benign reasons). The original histological slides of the cervix were reviewed with special attention to the presence of koilocytosis. The two study subgroups differed, as expected, with regard to some characteristics, but koilocytosis was not present in any of the cervical specimens of new immigrants nor of residents. Although the study subgroups may be too small or selective, our findings do not support a possible higher HPV infection rate among new immigrants, yet may indicate a low reservoir of HPV in new immigrants and residents, in line with the low SCC incidence in Israeli women.

  17. Salvage robotic radical prostatectomy

    Samuel D Kaffenberger


    Full Text Available Failure of non-surgical primary treatment for localized prostate cancer is a common occurrence, with rates of disease recurrence ranging from 20% to 60%. In a large proportion of patients, disease recurrence is clinically localized and therefore potentially curable. Unfortunately, due to the complex and potentially morbid nature of salvage treatment, radical salvage surgery is uncommonly performed. In an attempt to decrease the morbidity of salvage therapy without sacrificing oncologic efficacy, a number of experienced centers have utilized robotic assistance to perform minimally invasive salvage radical prostatectomy. Herein, we critically evaluate the existing literature on salvage robotic radical prostatectomy with a focus on patient selection, perioperative complications and functional and early oncologic outcomes. These results are compared with contemporary and historical open salvage radical prostatectomy series and supplemented with insights we have gained from our experience with salvage robotic radical prostatectomy. The body of evidence by which conclusions regarding the efficacy and safety of robotic salvage radical prostatectomy can be drawn comprises fewer than 200 patients with limited follow-up. Preliminary results are promising and some outcomes have been favorable when compared with contemporary open salvage prostatectomy series. Advantages of the robotic platform in the performance of salvage radical prostatectomy include decreased blood loss, short length of stay and improved visualization. Greater experience is required to confirm the long-term oncologic efficacy and functional outcomes as well as the generalizability of results achieved at experienced centers.

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

    Eddie Fernando Cândido Murta


    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

  19. Radical chemistry of artemisinin

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


    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.

  20. Radical chemistry of artemisinin

    Denisov, Evgenii T.; Solodova, S. L.; Denisova, Taisa G.


    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.

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

    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...

  2. Magnitude of Treatment Abandonment in Childhood Cancer.

    Paola Friedrich

    Full Text Available Treatment abandonment (TxA is recognized as a leading cause of treatment failure for children with cancer in low-and-middle-income countries (LMC. However, its global frequency and burden have remained elusive due to lack of global data. This study aimed to obtain an estimate using survey and population data.Childhood cancer clinicians (medical oncologists, surgeons, and radiation therapists, nurses, social workers, and psychologists involved in care of children with cancer were approached through an online survey February-May 2012. Incidence and population data were obtained from public sources. Descriptive, univariable, and multivariable analyses were conducted.602 responses from 101 countries were obtained from physicians (84%, practicing pediatric hematology/oncology (83% in general or children's hospitals (79%. Results suggested, 23,854 (15% of 155,088 children 6% were outside the capital. Lower national income category, higher reliance on out-of-pocket payments, and high prevalence of economic hardship at the center were independent contextual predictors for TxA ≥ 6% (p<0.001. Global survival data available for more developed and less developed regions suggests TxA may account for at least a third of the survival gap between HIC and LMC.Results show TxA is prevalent (compromising cancer survival for 1 in 7 children globally, confirm the suspected high burden of TxA in LMC, and illustrate the negative impact of poverty on its occurrence. The present estimates may appear small compared to the global burden of child death from malnutrition and infection (measured in millions. However, absolute numbers suggest the burden of TxA in LMC is nearly equivalent to annually losing all kids diagnosed with cancer in HIC just to TxA, without even considering deaths from disease progression, relapse or toxicity-the main causes of childhood cancer mortality in HIC. Results document the importance of monitoring and addressing TxA as part of childhood

  3. Radical prostatectomy - discharge

    ... to 6 months. You will learn exercises (called Kegel exercises) that strengthen the muscles in your pelvis. ... Radical prostatectomy Retrograde ejaculation Urinary incontinence Patient Instructions Kegel exercises - self-care Suprapubic catheter care Urinary catheters - ...

  4. The Possible Correlation between the Patient's Immune Tolerance Level During Cesaerean Section and the Incidence of Subsequent Emergency Peripartum Hysterectomy

    Lukasz Wicherek


    Full Text Available Introduction. Cesarean section is an independent risk factor for peripartum hysterectomy. As a method of delivery, cesarean section may interfere with a number of molecular changes that occur at the maternal-fetal interface during the course of labor. Methods. The level of CD3, CD56, CD25, and CD69 antigen immunoreactivity was assessed by immunohistochemistry in 26 decidual tissue samples. The tissue samples were obtained from 18 women who underwent cesarean sections at term and from 8 women who underwent cesarean hysterectomies. Results. An increase in the activity and infiltration of immune cells in the decidua sampled during the spontaneous beginning of labor was observed. The further progression of labor was accompanied by a decrease in the number and activity of immune cells. The number of CD56+ and CD3+ cells in the decidua was statistically significantly lower in patients who had undergone cesarean hysterectomies than in those who had had cesarean sections at term. Conclusion. Abnormal immune response during labor may increase the risk for peripartum hysterectomy.

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

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


    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

  6. Massive Hematometra due to Congenital Cervicovaginal Agenesis in an Adolescent Girl Treated by Hysterectomy: A Case Report

    Turki Gasim


    Full Text Available A case of massive hematometra with a bicornuate uterus in a 14-year-old mentally handicapped girl complicated by vaginal agenesis and absent cervix is presented. She was managed by abdominal hysterectomy and right salpingo-oophorectomy that included the ovarian cystadenoma. The left ovary was conserved. This treatment was considered appropriate for this patient.

  7. Comparison of Robotic vs. Standard Surgical Procedure on Postoperative Nursing Care of Women Undergoing Total Abdominal Hysterectomy.

    Best, Janie; Day, Luanne; Ingram, Lori; Musgrave, Barbara; Rushing, Holli; Schooley, Brenda


    This exploratory study was conducted to determine if the postoperative course is different for women undergoing robotic-assisted total abdominal hysterectomy (TAH) compared to women undergoing traditional (open) TAH. This study adds to the evidence regarding potential benefits and complications of robotic-assisted gynecologic surgery, and identifies specific areas for further research.

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

    Kari Nyheim Solbrække


    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.

  9. Statewide collaboration to evaluate the effects of blood loss and transfusion on surgical site infection after hysterectomy.

    Young, Heather; Berumen, Crystal; Knepper, Bryan; Miller, Amber; Silverman, Morgan; Gilmartin, Heather; Wodrich, Elizabeth; Alexander, Sandy; Price, Connie S


    We used mandatory public reporting as an impetus to perform a statewide study to define risk factors for surgical site infection. Among women who underwent abdominal hysterectomy, blood transfusion was a significant risk factor for surgical site infection in patients who experienced blood loss of less than 500 mL.


    Gunavathi Kandappan


    Full Text Available AIM OF THE STUDY To evaluate whether Gabapentin when given orally preoperatively at a dose of 300 mg has an effect on postoperative pain and analgesic requirement in patients undergoing total abdominal hysterectomy under spinal anaesthesia. The study also evaluates the side effects associated with administration of Gabapentin. METHODOLOGY This is a prospective, randomised, single blinded case controlled study. This study was conducted in total of 60 patients who underwent elective abdominal hysterectomy in our institute over a period of four months. Patients were randomly allocated into two groups: Group G (Gabapentin Group and Group P (Placebo Group. Patients in Group G received Gabapentin 300 mg orally and Group P patients received placebo capsules with sips of water two hours before surgery. Time since spinal anaesthesia to first requirement of analgesic (T, total analgesic requirement in first 24 hours, visual analogue scale (VAS scores at rest and movement, Ramsay sedation score, side effects of the drug like somnolence, dizziness, confusion, nausea, vomiting were recorded in first 24 hours postoperatively. RESULT Single oral dose of Gabapentin 300 mg when given preoperatively reduces the postoperative pain scores and total tramadol consumption in patients undergoing abdominal hysterectomy under spinal anaesthesia. Sedation was the only significant side effect observed with the Gabapentin usage. Thus, Gabapentin can be considered as an adjunct in treating postoperative pain. CONCLUSION Oral Gabapentin 300 mg given preoperatively as preemptive analgesic is effective in total abdominal hysterectomy patients under spinal anaesthesia without any significant complications.

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

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


    '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...

  12. Evolution of the complications of laparoscopic hysterectomy after a decade: a follow up of the Monash experience.

    Tan, Jason J; Tsaltas, Jim; Hengrasmee, Pattaya; Lawrence, Anthony; Najjar, Haider


    A retrospective review of medical records was performed to assess the incidence and types of significant complications encountered during laparoscopic hysterectomy which would affect the use of a laparoscopic approach versus other routes of hysterectomy. A total of 526 consecutive patients' medical data between January 1994 and August 2007 were reviewed. Two hundred and thirty-two laparoscopic-assisted vaginal hysterectomies and 294 total laparoscopic hysterectomies were performed at Monash Medical Centre, a Melbourne tertiary public hospital, and three Melbourne private hospitals, by or under the supervision of three surgeons. Sixteen significant complications occurred. There were two cases of ureteric fistula, two bladder injuries, two bowel obstructions, four postoperative haematomas, one case of a bladder fistula, four conversions to laparotomy and one superficial epigastric artery injury. Inpatient stay ranged from two to six days. Our complication and inpatient stay rates are consistent with the previously reported rates, although there has been a reduction of incidence of visceral injuries with experience and introduction of new equipment.

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

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


    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....

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

    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.


    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…

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

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


    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

  16. Combined spinal and general anesthesia is better than general anesthesia alone for laparoscopic hysterectomy

    Poonam S Ghodki


    Full Text Available Context: Spinal anesthesia (SA was combined with general anesthesia (GA for achieving hemodynamic stability in laparoscopic hysterectomy. Aims: The aim of our study was to evaluate the impact of SA combined with GA in maintaining hemodynamic stability in laparoscopic hysterectomy. The secondary outcomes studied were requirement of inhaled anesthetics, vasodilators, and recovery profile. Settings and Design: We conducted a prospective, randomized study in ASAI/II patients posted for laparoscopic hysterectomy, who were willing to participate in the study. Materials and Methods: Patients were randomly assigned to receive SA with GA (group SGA or plain GA (group GA. Group SGA received 10 mg bupivacaine (heavy for SA. GA was administered using conventional balanced technique. Maintenance was carried out with nitrous oxide, oxygen, and isoflurane. Comparison of hemodynamic parameters was carried out during creation of pneumoperitoneum and thereafter. Total isoflurane requirement, need of vasodilators, recovery profile, and regression of SA were studied. Statistical analysis used: Descriptive statistics in the form of mean, standard deviation, frequency, and percentages were calculated for interval and categorical variables, respectively. One-way analysis of variance (ANOVA was applied for noting significant difference between the two groups, with chi-square tests for categorical variables and post-hoc Bonferroni test for interval variables. Comparison of heart rate (HR, mean arterial pressure (MAP, SPO2, and etCO2 was done with Student′s t-test or Mann-Whitney test, wherever applicable. Results: Patients in group SGA maintained stable and acceptable MAP values throughout pneumoperitoneum. The difference as compared to group GA was statistically significant (P < 0.01. Group GA showed additional requirement of metoprolol (53.33% and higher concentration of isoflurane (P < 0.001 to combat the increased MAP. Recovery was early and quick in group SGA as

  17. The detection of abandoned mine shafts in the Netherlands

    Mooijman, O.P.M.; Vanderkruk, J.; Roest, J.P.A. [Delft University of Technology, Delft (Netherlands). Faculty of Applied Earth Sciences


    In the Old Coal Mine District of East Limburg, in the south of the Netherlands, a number of abandoned mine shafts exist of which the exact coordinates are uncertain. The area is now densely populated, and the majority of the shafts are located near or underneath roads and/or houses. Some of these shafts urgently need to be secured for reasons related to a recent rise in deep ground water levels. This paper describes preliminary investigations for abandoned mine shafts by means of aerial photographs and georadar. Inspection of various photo series indicates that the chances of finding clues for abandoned mine shafts are reasonable, and that digital techniques facilitate identification and exact determination of shaft coordinates. In a densely populated survey environment, such as the area in which the abandoned shafts are located, georadar is a suitable shallow geophysical method for mine shaft detection. In these circumstances, shielded antennae give a clearer subsurface image than unshielded antennae. Signal penetration in the loess-rich deposits commonly found in the area is limited, but the results of a trial survey over a known abandoned shaft accurately confirm the geometry of a collapse zone surrounding the shaft center.

  18. Geophysical methods for locating abandoned wells

    Frischknecht, Frank C.; Muth, L.; Grette, R.; Buckley, T.; Kornegay, B.


    A preliminary study of the feasibility of using geophysical exploration methods to locate abandoned wells containing steel casing indicated that magnetic methods promise to be effective and that some electrical techniques might be useful as auxiliary methods. Ground magnetic measurements made in the vicinity of several known cased wells yielded total field anomalies with peak values ranging from about 1,500 to 6,000 gammas. The anomalies measured on the ground are very narrow and, considering noise due to other cultural and geologic sources, a line spacing on the order of 50 feet (15.2 m) would be necessary to locate all casings in the test area. The mathematical model used to represent a casing was a set of magnetic pole pairs. By use of a non-linear least squares curve fitting (inversion) program, model parameters which characterize each test casing were determined. The position and strength of the uppermost pole was usually well resolved. The parameters of lower poles were not as well resolved but it appears that the results are adequate for predicting the anomalies which would be observed at aircraft altitudes. Modeling based on the parameters determined from the ground data indicates that all of the test casings could be detected by airborne measurements made at heights of 150 to 200 feet (45.7-61.0 m) above the ground, provided lines spaced as closely as 330 feet (100 m) were used and provided noise due to other cultural and geologic sources is not very large. Given the noise levels of currently available equipment and assuming very low magnetic gradients due to geologic sources, the detection range for total field measurements is greater than that for measurements of the horizontal or vertical gradient of the total intensity. Electrical self-potential anomalies were found to be associated with most of the casings where measurements were made. However, the anomalies tend to be very narrow and, in several cases, they are comparable in magnitude to other small

  19. Free Radical Reactions in Food.

    Taub, Irwin A.


    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…

  20. Single-field sterile-scrub, preparation, and dwell for laparoscopic hysterectomy.

    O'Hanlan, Katherine A; McCutcheon, Stacey Paris; McCutcheon, John G; Charvonia, Beth E


    Type VII laparoscopic hysterectomy is classified as a "clean-contaminated" procedure because the surgery involves contact with both the abdominal and vaginal fields. Because the vulva has traditionally been perceived as a separate but contaminated field, operating room guidelines have evolved to require that surgeons gloved and gowned at the abdominal field either avoid contact with the urethral catheter, the uterine manipulator, and the introitus or change their gloves and even re-gown after any contact with those fields. In the belief that the perception of the vaginal field as contaminated stems from inadequate preoperative preparation instructions, we have developed a rigorous abdomino-perineo-vaginal field preparation technique to improve surgical efficiency and prevent surgical site infections. This thorough scrub, preparation, and dwell technique enables the entire abdomino-perineo-vaginal field to be safely treated as a single sterile field while maintaining a low rate of surgical site infection, and should be further investigated in randomized studies.

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

    Senthilnathan Palanisamy


    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.

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

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


    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...

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

    Monica Hagan Vetter


    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.

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

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


    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...

  5. Postoperative recovery profile after elective abdominal hysterectomy: a prospective, observational study of a multimodal anaesthetic regime

    Jensen, Kenneth; Kehlet, Henrik; Lund, Claus M


    BACKGROUND AND OBJECTIVE: To evaluate the applicability, effectiveness, immediate postoperative complaints and requirements for a postanaesthesia care unit stay after elective abdominal hysterectomy under a well defined, multimodal anaesthetic regime. METHODS: Observational study of 145 consecutive...... patients scheduled for the procedure at a major university hospital in Denmark. Perioperative treatments and postoperative complaints were recorded continuously until discharge from the postanaesthesia care unit. Main outcome measures were treatment regimen adherence, pain, nausea and vomiting, respiratory...... epidural analgesia (bupivacaine, morphine) was feasible in more than 90% of all patients. In the postanaesthesia care unit, 64% did not require opioids, but 25% experienced severe pain. Mean length of stay was 2 h with a mean discharge readiness of 80 min. Half the patients required supplemental oxygen...

  6. Time course of subjective pain ratings, and wound and leg tenderness after hysterectomy

    Møiniche, S; Dahl, J B; Erichsen, C J;


    BACKGROUND: Little information is available on time course of wound tenderness and relationship to subjective pain ratings following surgery. Furthermore, it is not clarified whether surgical procedures may induce hyperalgesia to mechanical stimulation outside the area of the surgical incision. We...... have therefore assessed postoperative pain and pressure pain thresholds (PPT) adjacent to and remote from the surgical incision in 16 patients undergoing hysterectomy. METHODS: Pressure pain threshold was assessed with pressure algometry preoperatively, 4 and 6 and 1, 4 and 8 d after surgery...... on the abdominal wall 0.05, 5, 10 and 15 cm perpendicular to the wound, and on the anterior surface of the left thigh and tuberositas tibia. Furthermore, pain was assessed on a visual analogue scale (VAS) at rest and during cough. RESULTS: PPT decreased significantly 0.5, 5, 10 and 15 cm from skin incision up...

  7. Effect of systematic local infiltration analgesia on postoperative pain in vaginal hysterectomy

    Hristovska, Ana-Marija; Kristensen, Billy B; Rasmussen, Marianne A;


    MEASURES: Pain, nausea, vomiting and opioid requirements were assessed for 32 h as well as time spent in the post-anesthesia care unit and time to first mobilization. RESULTS: Pain at rest was significantly reduced after one, four and eight hours in the ropivacaine group (p ≤ 0.001-0.01). Pain during...... coughing was significantly reduced after one and four hours (p ≤ 0.001 and p ≤ 0.003), and pain during movement was significantly reduced after four hours (p ≤ 0.02). Opioid requirements and time spent in the post-anesthesia care unit were significantly reduced in the ropivacaine group (p ....001, respectively), as well as the time to first mobilization (p operative systematic local infiltration analgesia reduces postoperative pain in patients undergoing vaginal hysterectomy, facilities mobilization and improves early recovery....

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

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


    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...

  9. The Manchester procedure versus vaginal hysterectomy in the treatment of uterine prolapse

    Tolstrup, Cæcilie Krogsgaard; Lose, Gunnar; Klarskov, Niels


    INTRODUCTION AND HYPOTHESIS: Uterine prolapse is a common health problem and the number of surgical procedures is increasing. No consensus regarding the surgical strategy for repair of uterine prolapse exists. Vaginal hysterectomy (VH) is the preferred surgical procedure worldwide, but uterus......-preserving alternatives including the Manchester procedure (MP) are available. The objective was to evaluate if VH and the MP are equally efficient treatments for uterine prolapse with regard to anatomical and symptomatic outcome, quality of life score, functional outcome, re-operation and conservative re......-intervention rate, complications and operative outcomes. METHODS: We systematically searched Embase, PubMed, the Cochrane databases, Clinicaltrials and Clinical trials register using the MeSh terms "uterine prolapse", "uterus prolapse", "vaginal prolapse" "pelvic organ prolapse", "prolapsed uterus", "Manchester...

  10. Novel Port Placement and 5-mm Instrumentation for Robotic-Assisted Hysterectomy

    Katz, Adi; Dun, Erica C.; Kho, Kimberly A.; Wieser, Friedrich A.


    Background and Objectives: The value of robotic surgery for gynecologic procedures has been critically evaluated over the past few years. Its drawbacks have been noted as larger port size, location of port placement, limited instrumentation, and cost. In this study, we describe a novel technique for robotic-assisted laparoscopic hysterectomy (RALH) with 3 important improvements: (1) more aesthetic triangular laparoscopic port configuration, (2) use of 5-mm robotic cannulas and instruments, and (3) improved access around the robotic arms for the bedside assistant with the use of pediatric-length laparoscopic instruments. Methods: We reviewed a series of 44 women who underwent a novel RALH technique and concomitant procedures for benign hysterectomy between January 2008 and September 2011. Results: The novel RALH technique and concomitant procedures were completed in all of the cases without conversion to larger ports, laparotomy, or video-assisted laparoscopy. Mean age was 49.9 years (SD 8.8, range 33–70), mean body mass index was 26.1 (SD 5.1, range 18.9–40.3), mean uterine weight was 168.2 g (SD 212.7, range 60–1405), mean estimated blood loss was 69.7 mL (SD 146.9, range 20–1000), and median length of stay was <1 day (SD 0.6, range 0–2.5). There were no major and 3 minor peri- and postoperative complications, including 2 urinary tract infections and 1 case of intravenous site thrombophlebitis. Mean follow-up time was 40.0 months (SD 13.6, range 15–59). Conclusion: Use of the triangular gynecology laparoscopic port placement and 5-mm robotic instruments for RALH is safe and feasible and does not impede the surgeon's ability to perform the procedures or affect patient outcomes. PMID:24960478

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

    Saghar Samimi Sede


    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.

  12. Effect of intraoperative intravenous lidocaine on pain and plasma interleukin-6 in patients undergoing hysterectomy

    Caio Marcio Barros de Oliveira


    Full Text Available BACKGROUND AND OBJECTIVES: Interleukin-6 is a predictor of trauma severity. The purpose of this study was to evaluate the effect of intravenous lidocaine on pain severity and plasma interleukin-6 after hysterectomy. METHOD: A prospective, randomized, comparative, double-blind study with 40 patients, aged 18-60 years. G1 received lidocaine (2 mg kg-1 h-1 or G2 received 0.9% saline solution during the operation. Anesthesia was induced with O2/isoflurane. Pain severity (T0: awake and 6, 12, 18 and 24 h, first analgesic request, and dose of morphine in 24 h were evaluated. Interleukin-6 was measured before starting surgery (T0, 5 h after the start (T5, and 24 h after the end of surgery (T24. RESULTS: There was no difference in pain severity between groups. There was a decrease in pain severity between T0 and other measurement times in G1. Time to first supplementation was greater in G2 (76.0 ± 104.4 min than in G1 (26.7 ± 23.3 min. There was no difference in supplemental dose of morphine between G1 (23.5 ± 12.6 mg and G2 (18.7 ± 11.3 mg. There were increased concentrations of IL-6 in both groups from T0 to T5 and T24. There was no difference in IL-6 dosage between groups. Lidocaine concentration was 856.5 ± 364.1 ng mL-1 in T5 and 30.1 ± 14.2 ng mL-1 in T24. CONCLUSION: Intravenous lidocaine (2 mg kg-1 h-1 did not reduce pain severity and plasma levels of IL-6 in patients undergoing abdominal hysterectomy.

  13. Gangs, Terrorism, and Radicalization

    Scott Decker


    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.

  14. Sexuality Following Radical Prostatectomy

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


    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...

  15. Quality of life, urogynecological morbidity, and lymphedema after radical vaginal trachelectomy for early-stage cervical cancer

    Frøding, Ligita Paskeviciute; Ottosen, Christian; Mosgaard, Berit Jul


    OBJECTIVE: Radical vaginal trachelectomy (RVT) offers a possibility for future childbearing for young women with early-stage cervical cancer. However, the literature on quality of life and self-reported morbidity in patients undergoing RVT is scarce. The aim of this study was to prospectively...... assess quality of life after RVT with focus on urogynecological morbidity and lymphedema. Furthermore, the aim of this study was to compare results with those in women treated with radical abdominal hysterectomy (RAH) and with age-matched control women from the general population. METHODS AND MATERIALS......, whereas an age-matched control group of 30 healthy women was assessed once. RESULTS: Fifty percent of the RVT group and 41% of the RAH reported any grade of incomplete bladder emptying problems at 1 year postsurgery assessment. Eleven percent of the RVT patients and 12.5% of the RAH patients reported...

  16. Inventory of Tank Farm equipment stored or abandoned aboveground

    Hines, S.C.; Lakes, M.E.


    This document provides an inventory of Tank Farm equipment stored or abandoned aboveground and potentially subject to regulation. This inventory was conducted in part to ensure that Westinghouse Hanford Company (WHC) does not violate dangerous waste laws concerning storage of potentially contaminated equipment/debris that has been in contact with dangerous waste. The report identifies areas inventoried and provides photographs of equipment.

  17. Artesian Well Abandonment at Launch Complex 39A

    Morgan, Lindsay; Johansen, Deda


    The artesian well tasked for abandonment was located on the LOX side (northwest area) of the launch complex. The exact date of well installation is unknown. The well was no longer in use at the time of the abandonment request, but was previously utilized under St. Johns River Water Management District (SJRWMD) consumptive use permit (No. 50054) for the Floridian Aquifer. The exact construction details of the LOX artesian well were also unknown; however, a similar-type artesian well was previously located on the LH2 side of the site, which was abandoned in 2012. Based on discussions with the NASA RPM and review of the LH2 artesian well abandonment completion report, the LH2 artesian well was reported to be an 8-inch diameter, 330-foot deep well. The NASA RPM communicated that the LOX artesian well was likely to be an 8-inch diameter, 380-foot deep well. This information was used for scoping, and was subsequently confirmed to be substantially accurate. No additional information could be found for the LOX artesian well using the NASA Remediation Information System (RIS).

  18. Soil food web structure during ecosystem development after land abandonment

    Holtkamp, R.; Kardol, P.; Van der Wal, A.; Dekker, S.C.; Van der Putten, W.H.; de Ruiter, P.C.


    The re-establishment of natural species rich heathlands on abandoned agricultural land is a common land use change in North-West Europe. However, it can take several decades to re-establish natural species rich heathland vegetation. The development rate has found to depend both on soil food web comp

  19. Beyond Radical Educational Cynicism.

    Wood, George H.


    An alternative is presented to counter current radical arguments that the schools cannot bring about social change because they are instruments of capitalism. The works of Samuel Bowles, Herbert Gintis, and Louis Althusser are discussed. Henry Giroux's "Ideology, Culture and the Process of Schooling" provides an alternative to cynicism.…

  20. Radically enhanced molecular recognition

    Trabolsi, Ali


    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.

  1. Electromeric rhodium radical complexes

    Puschmann, F.F.; Harmer, J.; Stein, D.; Rüegger, H.; de Bruin, B.; Grützmacher, H.


    Radical changes: One single P-Rh-P angle determines whether the odd electron in the paramagnetic complex [Rh(trop2PPh)(PPh3)] is delocalized over the whole molecule (see picture, blue) or is localized on the P—Rh unit (red). The two energetically almost degenerate electromers exist in a fast equilib

  2. Violent Radicalization in Europe

    Dalgaard-Nielsen, Anja


    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...

  3. Radical School Reform.

    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…

  4. Homegrown religious radicalization

    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...

  5. On Radical Feminism



    <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

  6. Determinants of the exclusive breastfeeding abandonment: psychosocial factors

    Mariana Campos Martins Machado


    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.

  7. Modelling the rate of secondary succession after farmland abandonment in a Mediterranean mountain area

    Beguería, S.; Pueyo, Y.


    Secondary succession after farmland abandonment has become a common process in north Mediterranean countries, especially in mountain areas. In this paper a methodology is tested which combines Markov chains and logistic multivariate regression to model secondary succession after farmland abandonment

  8. Fiscal Year 1993 Well Plugging and Abandonment Program Summary Report Y-12 Plant, Oak Ridge, Tennessee



    This report is a synopsis of the progress of the well plugging and abandonment program at the Y-12 Plant, Oak Ridge, Tennessee, from October 1993 through August 1994. A total of 57 wells 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.

  9. Fiscal year 1993 well plugging and abandonment program, Y-12 Plant, Oak Ridge, Tennessee


    This report is a synopsis of the progress of the well plugging and abandonment program at the Y-12 Plant, Oak Ridge, Tennessee, from December 1992 through August 20, 1993. A total of 70 wells 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 US Department of Energy, Y-12 Plant, Oak Ridge, Tennessee (HSW, Inc. 1991).




    Full Text Available Post - partum hemorrhagic complication is a critical situation for an anesthesiologist, which requires timely and skillful anesthetic management. A massive post - partum bleeding leading to severe hypovolemic shock may result in life threatening cardio - pulmonary arrest. Here is a case report of 25 year old with atonic post - partum hemorrhage resulting in hypovolemic shock & impending cardiac arrest and successful anesthetic management for emergency peripartum hysterectomy to save the life of the patient.

  11. Adoption and Abandonment of Dual Exchange Rate Systems Adoption and Abandonment of Dual Exchange Rate Systems

    Jose Saul Lizondo


    Full Text Available Adoption and Abandonment of Dual Exchange Rate Systems When facing persistent balance of payments problems, some countries have resorted to a dual exchange rate system as an alternative to a uniform exchange rate adjustment. Typically, under the dual system, certain selected transactions take place at a fixed official exchange rate, while there remaining transactions are effected at a more depreciated rate, which is usually determined by market forces. This paper examines the circumstances that lead to the adoption of a dual system, and the conditions under which the foreign exchange market can be unified successfully or a later stage. In this paper, the adoption of the dual system is linked to the unsustainability of a crawling peg (or a fixed exchange rate system in the presence of large budgret deficits. We show that the initiai spiral between the financial at the commercial exchange rates and the extent of capital flight largely depends on whether the switch in regime is anticipated or unanticipated. Although the dual system improves the external position of the economy, to the extent that there is no change in domestic noticies the country will continue to experience a deficit in the balance of payments. A correction of these policies is the only enduring solution to the external imbalance, and a precondition for a successful unification of the foreirg exchange market. If the economv unifies the foreign exchange market into a crawling peg, the financial exchahnge rate could be an adequate indicator of the initlal level of which the new exchange rate should be set if a capital outflow is to be avoided. If the economy instead moves to a flexible exchange rate system, the initial value of the exchange rate could be higher or lower than the prevailing financial exchange rate.

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

    Samiei H


    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

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

    Nezaket Tekin


    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.

  14. 77 FR 51614 - CSX Transportation, Inc.-Abandonment Exemption-in Niagara County, NY


    ... 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...

  15. Deradicalization or Disengagement : A Framework for Encouraging Jihad Abandonment


    strive to implement a holistic approach , avoid focusing too singularly on security matters, but also invoke the social and religious leverage which...SUBJECT TERMS De-radicalization, Disengagement, Terrorism, Soft Power, Islam, Radical, Ideology 16. SECURITY CLASSIFICATION OF: 17. LIMITATION...8 Defining Success 9 Case Selection Rationale 12 Limitations of Case Studies 14 Chapter 3 – Case #1: Saudi Arabian Counseling

  16. Probability and radical behaviorism

    Espinosa, James M.


    The concept of probability appears to be very important in the radical behaviorism of Skinner. Yet, it seems that this probability has not been accurately defined and is still ambiguous. I give a strict, relative frequency interpretation of probability and its applicability to the data from the science of behavior as supplied by cumulative records. Two examples of stochastic processes are given that may model the data from cumulative records that result under conditions of continuous reinforcement and extinction, respectively. PMID:22478114

  17. Probability and radical behaviorism

    Espinosa, James M.


    The concept of probability appears to be very important in the radical behaviorism of Skinner. Yet, it seems that this probability has not been accurately defined and is still ambiguous. I give a strict, relative frequency interpretation of probability and its applicability to the data from the science of behavior as supplied by cumulative records. Two examples of stochastic processes are given that may model the data from cumulative records that result under conditions of continuous reinforc...

  18. Radical chic, javisst!

    Hartle, J.F.


    Det är lätt att raljera över engagerade människor, i synnerhet när engagemanget framstår som ytligt och chict snarare än grundläggande och autentiskt. Men vad ligger bakom ett sådant avfärdande? Johan Frederik Hartle läser om Tom Wolfes klassiska essä "Radical Chic" och visar hur Wolfe −− genom att

  19. Women and radicalization

    Badran, Margot


    The paper focuses on women and radicalization within the context of Muslim societies (majority, minority, and half Muslim) societies and groups, mainly in Asia and Africa. The basic argument advanced in this paper is that Islamic feminism with its gender-egalitarian discourse and practices has a major role to play in the empowerment of Muslim women—and of men and society as a whole—and should be brought to bear in devising policy, strategy, and tools.

  20. Radical substitution with azide

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


    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....


    Kent M. Ervin, Principal Investigator


    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.

  2. [Radical prostatectomy - pro robotic].

    Gillitzer, R


    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.

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

    Suchitra R


    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

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

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


    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 incid......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....... CONCLUSION: The types and frequency of complications observed in this study resemble those reported in similar studies of RALH for malignant gynaecologic conditions. Health-care professionals treating and caring for women with early-stage endometrial cancer should know of the types and frequency of post...

  5. A woman with diabetes presenting with pyomyoma and treated with subtotal hysterectomy: a case report

    Fletcher Horace


    Full Text Available Abstract Introduction Pyomyoma (suppurative leiomyoma of the uterus is a rare condition resulting from infarction and infection of a leiomyoma. It is more usual in pregnant women or postmenopausal women who have vascular disease. The condition is usually fatal unless treated with appropriate antibiotics and surgical intervention. Case presentation We report a case of a 44-year-old Afro-Caribbean woman with diabetes who presented with recurrent episodes of abdominal pain and fever over a period of five months. Her problem proved to be a diagnostic dilemma mimicking cholecystitis, pyelonephritis and ovarian cancer. Her blood cultures were positive on one occasion for methicillin-resistant Staphylococcus epidermidis. An ultrasound scan suggested uterine fibroids but a computed tomography scan suggested an ovarian malignancy because the mass appeared heterogeneous with fluid filled areas. She was treated with several courses of antibiotics and eventually at laparotomy, she was found to have a large pyomyoma which was successfully removed by subtotal hysterectomy with immediate and complete resolution of her symptoms. Conclusion The diagnosis of pyomyoma should be considered in perimenopausal women with large fibroids and pyrexia of unknown origin.

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

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


    of abandonment and its drivers are not well understood. Our goal was to map post-socialist farmland abandonment in Western Ukraine using Landsat images from 1986 to 2008, and to identify spatial determinants of abandonment using a combination of best-subsets linear regression models and hierarchical partitioning...... 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...

  7. Cheetah do not abandon hunts because they overheat.

    Hetem, Robyn S; Mitchell, Duncan; de Witt, Brenda A; Fick, Linda G; Meyer, Leith C R; Maloney, Shane K; Fuller, Andrea


    Hunting cheetah reportedly store metabolic heat during the chase and abandon chases because they overheat. Using biologging to remotely measure the body temperature (every minute) and locomotor activity (every 5 min) of four free-living cheetah, hunting spontaneously, we found that cheetah abandoned hunts, but not because they overheated. Body temperature averaged 38.4°C when the chase was terminated. Storage of metabolic heat did not compromise hunts. The increase in body temperature following a successful hunt was double that of an unsuccessful hunt (1.3°C ± 0.2°C versus 0.5°C ± 0.1°C), even though the level of activity during the hunts was similar. We propose that the increase in body temperature following a successful hunt is a stress hyperthermia, rather than an exercise-induced hyperthermia.

  8. Listing causes of risk of vulnerability and abandonment

    María Luisa Santamaría Pérez


    Full Text Available In a state of law, a citizen must live under the protection of their fundamental rights. Therefore, when authorities makes an intervention in a family nucleus and separates children from their parents for alleged protection purposes, it should be noted that if the decision was misguided, during the time that the separation remains, fundamental rights of the whole family are being infringed, especially for children, as stated in Article 9 of the CRC. With these premises, this article reveals that the reasons of risk and abandonment of a child should be typified in order to ensure the full success of the decisions of family separation. In addition, following a declaration of abandonment of a child, a lawsuit should be arise, whose procedural aspects would ensure fully adequate protection of the fundamental rights of the child in question, regardless of their parents' litigator ability.

  9. A Critique of Block on Abortion and Child Abandonment

    Jakub Bożydar Wiśniewski


    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.

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

    Luo Pingjia; Chen Ning


    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.

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

    Lucia Moretti


    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.

  12. Characterization of abandoned rocket body families for active removal

    Pardini, Carmen; Anselmo, Luciano


    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.

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

    Ahbel-Rappe, Karin


    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.

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

    Hamzah Abdul-Rahman


    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.

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

    Morton, Douglas


    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.

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

    Studer, Armido; Curran, Dennis P


    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.

  17. Pedagogic approach in the surgical learning: The first period of “assistant surgeon” may improve the learning curve for laparoscopic robotic-assisted hysterectomy.

    Angeline Favre


    Full Text Available Background: Hysterectomy is the most frequently surgery done with robotic assistance in the world and has been widely studied since its emergence. The surgical outcomes of the robotic hysterectomy are similar to those obtained with other minimally invasive hysterectomy techniques (laparoscopic and vaginal and appear as a promising surgical technique in gynaecology surgery. The aim of this study was to observe the learning curve of robot-assisted hysterectomy in a French surgical center, and was to evaluate the impact of the surgical mentoring.Methods: We retrospectively collected the data from the files of the robot-assisted hysterectomies with the Da Vinci® Surgical System performed between March 2010 and June 2014 at the Foch hospital in Suresnes (France. We first studied the operative time according to the number of cases, independently of the surgeon to determine two periods: the initial learning phase (Phase 1 and the control of surgical skills phase (Phase 2. The phase was defined by mastering the basic surgical tasks. Secondarily we compared these two periods for operative time, blood losses, Body Mass Index (BMI, days of hospitalisations and uterine weight. We finally studied the difference of the learning curve between an experimented surgeon (S1 who practised the first the robot-assisted hysterectomies and a less experimented surgeon (S2 who first assisted S1 and then operated on his own patients.Results: 154 robot-assisted hysterectomies were analysed. 20 procedures were necessary to access to the control of surgical skills phase. There was a significant decrease of the operative time between the learning phase (156.8 minutes compared to the control of surgical skills phase (125.8 minutes, p=0.003. No difference between these two periods for blood losses, BMI, days of hospitalisations and uterine weight were demonstrated. The learning curve of S1 showed 20 procedures to master the robot-assisted hysterectomies with a significant

  18. Gnosticism and Radical Feminism

    Cahana, Jonathan


    and place demand an explanation; my attempt to do so also takes into account the important differences between the gnostic and the radical feminist postures, notably the latter belief in progress and the former nostalgia for an ungendered era. Both the similarities and the differences, however, may offer...... support for approaching Gnosticism as first and foremost a cultural phenomenon (albeit exhibiting religious “symptoms”), and I attempt to show that such an approach can help to solve the recurrent problem of defining Gnosticism....

  19. Radically innovative steelmaking technologies

    Szekely, Julian


    The steel industry is faced with serious problems caused by the increasing cost of energy, labor and capital and by tough overseas competition, employing new highly efficient process plants. The very high cost of capital and of capital equipment renders the construction of new green field site plants, exemplifying the best available technology economically unattractive. For this reason, over the long term the development radically innovative steelmaking technologies appears to be the only satisfactory resolution of this dilemma. The purpose of this article is to present a critical review of some of the radically innovative steelmaking technologies that have been proposed during the past few years and to develop the argument that these indeed do deserve serious consideration at the present time. It should be stressed, however, that these innovative technologies can be implemented only as part of a carefully conceived long range plan, which contains as a subset short term solutions, such as trigger prices improved investment credits, and so forth and intermediate term solutions, such as more extensive use of continuous casting, external desulfurization and selective modernization in general.

  20. 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



    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。

  1. Anatomic Considerations for Radical Retropubic Prostatectomy in an Achondroplastic Dwarf

    Dennis Gyomber


    Full Text Available This is the first report of a radical retropubic prostatectomy (RRP in an achondroplastic dwarf. We highlight the pelvic anatomy, precluding laparoscopic or robotic prostatectomy, and making open surgery extremely difficult. We review relevant literature regarding general, urological, and orthopedic abnormalities of achondroplasia (ACH and present a clinical case. No reports of RRP in achondroplastic dwarfs exist, with only one case of an abandoned RRP due to similar pelvic anatomy in a patient with osteogenesis imperfecta. Significant lumbar lordosis found in ACH results in a short anteroposterior dimension, severely limiting access to the prostate. We present a case of a 62-year-old achondroplastic dwarf who had Gleason 3+4 disease on transrectal ultrasound-guided biopsy in four from 12 cores. Surgery was difficult due to narrow anteroposterior pelvic dimension, but achievable. Histological analysis revealed multifocal prostate cancer, with negative surgical margins and no extraprostatic extension. RRP in ACH patients, although possible, should be approached with caution due to the abnormal pelvic dimensions, and discussions regarding potential abandonment of surgery should be included during informed consent. This case highlights the preoperative use of computed tomography to assist in the surgical planning for patients with difficult pelvic anatomy.

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

    Roger Hopkins-Burke


    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.

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

    Jovanović Božidar


    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.

  4. Oxycodone versus fentanyl for intravenous patient-controlled analgesia after laparoscopic supracervical hysterectomy

    Kim, Nan Seol; Lee, Jeong Seok; Park, Su Yeon; Ryu, Aeli; Chun, Hea Rim; Chung, Ho Soon; Kang, Kyou Sik; Chung, Jin Hun; Jung, Kyung Taek; Mun, Seong Taek


    Abstract Background: Oxycodone, a semisynthetic thebaine derivative opioid, is widely used for the relief of moderate to severe pain. The aim of this study was to compare the efficacy and side effects of oxycodone and fentanyl in the management of postoperative pain by intravenous patient-controlled analgesia (IV-PCA) in patients who underwent laparoscopic supracervical hysterectomy (LSH). Methods: The 127 patients were randomized to postoperative pain treatment with either oxycodone (n = 64, group O) or fentanyl group (n = 63, group F). Patients received 7.5 mg oxycodone or 100 μg fentanyl with 30-mg ketorolac at the end of anesthesia followed by IV-PCA (potency ratio 75:1) for 48 hours postoperatively. A blinded observer assessed postoperative pain based on the numerical rating scale (NRS), infused PCA dose, patient satisfaction, sedation level, and side effects. Results: Accumulated IV-PCA consumption in group O was less (63.5 ± 23.9 mL) than in group F (85.3 ± 2.41 mL) during the first 48 hours postoperatively (P = 0.012). The NRS score of group O was significantly lower than that of group F at 4 and 8 hours postoperatively (P dizziness, and drowsiness was significantly higher in group O than in group F. Patient satisfaction was lower in group O than in group F during the 48 hours after surgery (P dizziness, and drowsiness, suggests that the doses used in this study were not equipotent. PMID:28272250

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

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


    BACKGROUND: Hysterectomy is one of the most frequently performed major gynecological surgical procedures. Even when the indication for the procedure is benign, relatively high complication rates have been reported. Perioperative bleeding seems to represent the most common cause of complications...... 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...... 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...

  6. Synchronous single-port access laparoscopic right hemicolectomy and laparoscopic-assisted vaginal hysterectomy with bilateral salpingo-oophorectomy

    Ybañez-Morano, Jessica; Tiu, Andrew C.


    Laparoscopic surgery through a single incision is gaining popularity with different stakeholders. The advantages of improved cosmetics, decreased postoperative pain and blood loss continue to attract patients from different surgical fields. Multidisciplinary approach to different surgical entities through a single incision has just been introduced. We report the first case of a synchronous single-port access (SPA) laparoscopic right hemicolectomy and laparoscopic-assisted vaginal hysterectomy with bilateral salpingo-oophorectomy through a single incision above the umbilicus in a 48-year-old female with ascending colon mass and uterine mass with good postoperative outcomes. SPA laparoscopic surgery is feasible for multidisciplinary approach in resectable tumors. PMID:28096321

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

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


    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...... level in a diary during the first 5 weeks after surgery. RESULTS: We found a clinically relevant decrease in HRQoL after 1 week. At 5 weeks postoperatively, HRQoL was again at the preoperative level. Fatigue, pain, constipation, gastrointestinal symptoms, and appetite were all negatively affected 1 week...

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

    Lynch, Kate M; LeFort, Sandra M


    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.

  9. Adenocarcinoma arising from vaginal stump: unusual vaginal carcinogenesis 7 years after hysterectomy due to cervical intraepithelial neoplasia.

    Shibata, Takashi; Ikura, Yoshihiro; Iwai, Yasuhiro; Tokuda, Hisato; Cho, Yuka; Morimoto, Noriyuki; Nakago, Satoshi; Oishi, Tetsuya


    Primary vaginal adenocarcinomas are one of the rarest malignant neoplasms, which develop in the female genital tract. Because of the extremely low incidence, their clinical and pathologic characteristics are still obscure. Recently, we experienced a case of vaginal adenocarcinoma that appeared 7 yr after hysterectomy because of cervical intraepithelial neoplasia. The patient, a 65-yr-old obese woman, was diagnosed as having adenocarcinoma in the vaginal stump and was treated by simple tumor excision and radiation. Immunohistochemical and molecular biologic examinations indicated a potential association with human papilloma virus infection in the development of the vaginal adenocarcinoma. There has been no evidence of recurrence for 3 yr after the operation.

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



      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.

  11. Radicals in Berkeley?

    Linn, Stuart


    In a previous autobiographical sketch for DNA Repair (Linn, S. (2012) Life in the serendipitous lane: excitement and gratification in studying DNA repair. DNA Repair 11, 595-605), I wrote about my involvement in research on mechanisms of DNA repair. In this Reflections, I look back at how I became interested in free radical chemistry and biology and outline some of our bizarre (at the time) observations. Of course, these studies could never have succeeded without the exceptional aid of my mentors: my teachers; the undergraduate and graduate students, postdoctoral fellows, and senior lab visitors in my laboratory; and my faculty and staff colleagues here at Berkeley. I am so indebted to each and every one of these individuals for their efforts to overcome my ignorance and set me on the straight and narrow path to success in research. I regret that I cannot mention and thank each of these mentors individually.

  12. Measures of Vegetation Restoration in Abandoned Mined Lands


    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...

  13. A knowledge base system for ground control over abandoned mines

    Nazimko, V.V.; Zviagilsky, E.L. [Donetsk State Technical University, Donetsk (Ukraine)


    The knowledge of engineering systems has been developed to choose optimal technology for subsidence prevention over abandoned mines. The expert system treats a specific case, maps consequences of actions and derives relevant technology (or a set of technologies) that should be used to prevent ground subsidence. Input parameters that characterise the case are treated using fuzzy logic and are then fed to a neural network. The network has been successfully trained by a backpropagation algorithm on the basis of three fuzzy rules. 5 refs., 2 figs., 3 tabs.

  14. 腹式筋膜内子宫切除术与传统全子宫切除术200例临床比较%Clinical comparison of abdominal intrafascial hysterectomy and traditional hysterectomy in 200 cases

    柳雪莲; 陈玉姣; 李艳华


    Objective:To explore the clinical effect of abdominal intrafascial hysterectomy traditional hysterectomy.Methods:200 patients with hysterectomy were selected from 2008 to 2013.100 cases were given abdominal intrafascial hysterectomy,and 100 cases were given traditional hysterectomy.We compared two groups of operative effect.Results:In 100 cases with abdominal intrafascial hysterectomy,there were no serious complications in operaion;operation steps were simplified;the operation time was short;the amount of bleeding was less;after surgery,vaginal hemorrhage,stump polyps,defecation discomfort was not obvious,and sexual life condition was not obvious change.After operation,the patients were followed up for 12 to 24 months,there was no significant effect on daily physical activity,life of husband and wife and somatosensory.In 100 cases with traditional hysterectomy, 2 cases had bladder injury;1 case had ureteral injury;after operation,patients were followed up for 12 to 24 months,2 cases had vaginal stump polyps;heavy physical activity was obviously limited,due to the lack of the pelvic floor support,heavy psychological burden,complicated with different degrees of anal bulge and the lower abdomen to drop bilge feeling,bowel dysfunction,and the sexual satisfaction was significantly decreased.Conclusion:Abdominal intrafascial hysterectomy is a new generation of modified operation.The operation can not only simplify the operation steps,but also retain most of pelvic nerve and blood vessel.It can not only treat the diseases,but also does not affect the life quality of the patients.It is a worthy of popularizing operation way.%目的:探讨腹式筋膜内子宫切除术与传统全子宫切除术的临床比较。方法:2008-2013年收治行子宫切除术患者200例,其中筋膜内子宫切除术100例,传统腹式全子宫切除术100例,比较两组的手术效果。结果:筋膜内子宫切除术患者100例,术中均无严重并发症发生,加之手

  15. Radical chic? Yes we are!

    Hartle, J.F.


    Ever since Tom Wolfe in a classical 1970 essay coined the term "radical chic", upper-class flirtation with radical causes has been ridiculed. But by separating aesthetics from politics Wolfe was actually more reactionary than the people he criticized, writes Johan Frederik Hartle.

  16. Muoniated acyl and thioacyl radicals

    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:


    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.

  17. Melatonin scavenges phenylglyoxylic ketyl radicals.

    Sersen, F; Vencel, T; Annus, J


    The antioxidant properties of melatonin were tested in this work by EPR technique. It was found that melatonin scavenges phenylglyoxylic ketyl radicals. Its effectiveness was 10-times lower than that of vitamin C. A new method of generation of phenylglyoxylic ketyl radicals by spontaneous decomposition of D,L-2,3-diphenyltartaric acid in propan-2-ol was used.

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



    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).

  19. 48 CFR 45.603 - Abandonment, destruction or donation of excess personal property.


    ... and does not require demilitarization. (b) Plant clearance officers may abandon sensitive property that does not require demilitarization, with contractor consent, provided appropriate instructions...

  20. 48 CFR 45.604-2 - Abandonment, destruction, or donation of surplus property.


    ... does not require demilitarization. (b) Plant clearance officers may abandon sensitive property that does not require demilitarization, with contractor consent, provided appropriate instructions...

  1. The Oedipus complex revisited: Oedipus abandoned, Oedipus adopted.

    Quinodoz, D


    The author considers that the Oedipus of Sophocles' drama, who kills his biological father and marries his biological mother, is an illustration of the failure to work through the complex named after him. She draws attention to the contrast between the obscurity that surrounds the hero's adoptive parents and the notoriety of their biological counterparts arguing that the former are equally important in the universal oedipal fantasy. In her view the fact that Oedipus has two sets of parents--abandoning and adopting respectively--is significant in that the resulting dichotomisation of the parental imago enables him seemingly to avoid a conflict of ambivalence in relation to a single object. The author further contends that the plague of Thebes represents the symptomatic return of repressed or disavowed aggression. Three clinical examples reveal the parental imago's division to be an unconscious defence against oedipal anxieties and the sense of solitude vis-à-vis the intimacy of the parental couple. The working through of the Oedipus complex is stated to require the synthesis of love and hate and of the abandoning and adoptive aspects of the parents whereby the formerly sadistic superego becomes protective. The author also argues that a useful distinction can be made between splitting and dichotomisation.

  2. Toxocariasis: seroprevalence in abandoned-institutionalized children and infants.

    Archelli, Susana; Santillan, Graciela I; Fonrouge, Reinaldo; Céspedes, Graciela; Burgos, Lola; Radman, Nilda


    Toxocariasis is an infection that has worldwide distribution. Toxocara canis is the most relevant agent due to its frequent occurrence in humans. Soil contamination with embryonated eggs is the primary source of T. canis. This study aimed to determine the seroprevalence of toxocariasis in 10-month to 3 year-old abandoned infants, considered to be at high risk because of their orphanhood status and early age. Blood samples were collected from 120 children institutionalized in an orphanage in the city of La Plata. In this study, we observed 38.33% of seropositive cases for T. canis by ELISA and 45% by Western blot techniques; significant differences among groups A (2 years) were also found. In research group A, children presented a seropositivity rate of 23.91%, in group B of 42.85% and in group C of 56%, which indicates an increase in frequency as age advances, probably because of greater chances of contact with infective forms of the parasite since canines and soil are frequently infected with T. canis eggs. Abandoned children come from poor households, under highly unsanitary conditions resulting from inadequate or lack of water supply and sewer networks, and frequent promiscuity with canines, which promotes the occurrence of parasitic diseases. These children are highly vulnerable due to their orphanhood status and age.

  3. Single dose oral clonidine premedication does not enhance postoperative, single low dose epidural morphine analgesia in hysterectomy patients.

    Oofuvong, Maliwan; Chanvej, Laksamee; Thongsuksai, Paramee


    In this randomized, double blind placebo controlled study, the authors evaluated the effects of oral clonidine premedication on very low dose epidural morphine analgesia in 50 hysterectomy patients. Patients were randomized to receive a single oral clonidine 300 microg (n = 25) or a placebo (n = 25) 90 minutes before insertion of the epidural catheter. 3 ml of 2% lidocaine with adrenaline (5 microg ml(-1) mixed with 2 mg morphine were injected via epidural, followed by an additional volume of 2% lidocaine with adrenaline (5 microg ml(-1)) titrated to T6 block height before commencing general anesthesia. The postoperative analgesia regimen was 2 mg of intravenous morphine every 10 minutes for the first 48 hr and 1 gm of oral acetaminophen every 4-6 hr after initiation of oral diet at 24-48 hr as required. Morphine consumption, acetaminophen, pain scores, and side effects were recorded thoughout 48 hr after surgery. The results show patients in the clonidine and placebo groups were not different in terms of local anesthetics dose (p = 0.27), total morphine and acetaminophen requirement (p = 0.34, p = 0.1) respectively. Pain scores at rest and movement were also not different in both groups (p = 0.83, p = 0.64) respectively. No serious adverse effects were noted. The authors concluded that oral clonidine approximately 6 microg kg(-1) does not enhance the analgesic effect of epidural morphine 2 mg after hysterectomy.

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

    Mustafa Gazi Ucar


    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

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



    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。




    Full Text Available BACKGROUND: Various adjuvants are being used with local anaesthetics in spinal anaesthesia for prolongation of intraoperative and post-operative analgesia. Dexmedetomidine, a highly selective α2 adrenergic agonist is a new neuroaxial adjuvant gaining popularity. AIMS: To evaluate the onset and duration of sensory and motor block, hemodynamic effect, post-operative analgesia and adverse effects of dexmedetomidine given intrathecally with hyperbaric 0.5% bupivacaine. METHODOLOGY: A study was carried out in 30 adult female patients aged 18-55 yrs of ASA grade I and II in each group scheduled for Total abdominal hysterectomy under spinal anaesthesia. Group B received 2.5ml of 0.5% hyperbaric bupivacaine with 0.5ml of normal saline. Group D received 2.5ml of 0.5% hyperbaric bupivacaine with 10µg of dexmedetomidine in 0.5ml of normal saline. The onset time to reach peak sensory and motor level, regression time of sensory and motor block, rescue analgesia, hemodynamic changes and side effects were recorded. STATISTICAL ANALYSIS USED: Data obtained were tabulated and analyzed using statistical package for social science (SPSS 16.0 evaluation version to calculate the sample size. Descriptive data are presented as Mean ± SD and Continuous data are analyzed by unpaired’t’ test. P<0.05 was considered statistically significant. RESULTS: Patients in dexmedetomidine group (group D had a significantly longer sensory and motor block than patients in bupivacaine group (group B. The mean time of sensory regression to S1 was (323 ± 31 min in group D and (191 ± 15min in group B. The regression time of motor block to reach Bromage 0 was (314 ± 30 min in group D and (163 ± 15 min in group B. The time to rescue analgesia was significantly longer in group D (383 ± 38 min as compared to group B (228.6 ± 15 min. CONCLUSION: Intrathecal dexmedetomidine as adjuvant to spinal bupivacaine is associated with prolonged sensory and motor block, hemodynamic stability

  7. Free radicals and male reproduction.

    Agarwal, Ashok; Allamaneni, Shyam S R


    Male factor accounts for almost 50% cases of infertility. The exact mechanism of sperm dysfunction is not known in many cases. Extensive research in the last decade has led to the identification of free radicals (reactive oxygen species) as mediators of sperm dysfunction in both specific diagnoses and idiopathic cases of male infertility. Elevated levels of reactive oxygen species are seen in up to 30-80% of men with male infertility. The role of free radicals has been studied extensively in the process of human reproduction. We know now that a certain level of free radicals is necessary for normal sperm function, whereas an excessive level of free radicals can cause detrimental effect on sperm function and subsequent fertilisation and offspring health. Oxidative stress develops when there is an imbalance between generation of free radicals and scavenging capacity of anti-oxidants in reproductive tract. Oxidative stress has been shown to affect both standard semen parameters and fertilising capacity. In addition, high levels of free radicals have been associated with lack of or poor fertility outcome after natural conception or assisted reproduction. Diagnostic techniques to quantify free radicals in infertile patients can assist physicians treating patients with infertility to plan for proper treatment strategies. In vivo anti-oxidants can be used against oxidative stress in male reproductive tract. Supplementation of in vitro anti-oxidants can help prevent the oxidative stress during sperm preparation techniques in assisted reproduction.

  8. Post-Soviet cropland abandonment and carbon sequestration in European Russia, Ukraine, and Belarus

    Schierhorn, Florian; Müller, Daniel; Beringer, Tim; Prishchepov, Alexander V.; Kuemmerle, Tobias; Balmann, Alfons


    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.

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

    Donatella Della Porta


    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.

  10. Why do leaf-tying caterpillars abandon their leaf ties?

    Michelle Sliwinski


    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


    Bambang Gunadi


    Full Text Available One of main problems in freshwater aquaculture development in Indonesia, especially in Java, is unavailability of developing zone. It is important to find an underutilized area that meets for industrial scale freshwater aquaculture, i.e. sufficient water supply, wide area, and located in one area or zone. The abandoned mining (sand, tin, etc. pools distributed along the country might be the potential area for freshwater aquaculture business. For example, there are at least 13 water pools with total surface area of 250 ha at 15 km side of Citarum River in Karawang District (West Java Province. This study was conducted to obtain preliminary data about the prospect and potency of fish culture (tilapia, clariid catfish, and ‘patin’ catfish in abandoned sand-mining pools in Karawang District. Mini floating net cages of 1 x 1 x 1.5 m3 size were used for culturing fish, i.e. patin catfish (Pangasianodon hypophthalmus, nile tilapia (Oreochromis niloticus, and clariid catfish (Clarias gariepinus, separately. Patin catfish were stocked at a size of 2 g with a density of 300 fish per cage, tilapia were stocked at a size of 6 g with a density of 400 fish per cage, while  the clariid catfish were stocked at a size of 1.4 g with a density of 980 fish per cage. A floating commercial feed (30%—32% protein, 3%—5% fat was used at a daily rate of 9% biomass weight at the beginning and reduced gradually to 3% at the final culture period. Observed data showed that patin catfish grew from the initial size of 2.08 g to the final size 299.59 g in 5 months, nile tilapia grew from individual initial size of 5.92 g to the final size of 247.12 g in 14 weeks, and clariid catfish grew from initial size of 1.39 g to the final size of 73.10 g in 8 weeks. These three species were technically prospective for aquaculture development in the abandoned sand-mining pools.

  12. Deradicalization or Disengagement : A Framework for Encouraging Jihad Abandonment


    process or for enforcement. The group- disengagement achieved in Northern Ireland did not rely on family dynamics , but rather diplomatic agreement...38 Practical Support Measures 40 The Family as a Unit of Analysis 41 Chapter 7 – Recommendations and Conclusions 43 Bibliography...application of social/ family pressure to discourage recidivism. The United States should focus its efforts on crafting an effective de- radicalization

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



    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。

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

    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


    Yu. P. Sernyak


    Full Text Available Objective: to evaluate the impact of dissection of the dorsal venous complex without pre-ligation, suturing, or coagulation during radical prostatectomy (RPE in patients with localized prostate cancer (PC on the quality of surgery and the function of urinary retention.Subjects and methods. The data of 42 patients who had undergone posterior and anterior anatomical repair and vesicourethral anastomosis using a V-lock suture after prostatectomy were analyzed. All the patients were divided into 2 groups. Group 1 consisted of 22 patients in whom the dorsal venous complex was closed using a 3-0 vicryl suture before urethral dissection. Group 2 included 20 patients in whom the urethra was dissected without suturing the venous complex.Results. In group 1, complete urinary retention after catheter removal was noted in 9 (40.9 % and 15 (68 % patients within 24 hours and after 3 months, respectively. Following 12 months, two (9 % patients were observed to have partial mild urinary incontinence (as many as 2 pads per day. Group 2 patients showed complete urinary retention in 17 (85 % cases on the first day after catheter removal; all the patients retained urine 3 months later.Conclusion. In patients with localized PC, dissection of the dorsal venous complex without presuturing during laparoscopic RPE exerts a considerable impact on the preservation of urinary retention, namely 45% more of the patients reported complete urinary retention in early periods and 10 % more did this in later periods. At the same time, there was no statistically significant increase in intraoperative blood loss (p > 0.05, the number of positive edges, or biochemical recurrences.


    Yu. P. Sernyak


    Full Text Available Objective: to evaluate the impact of dissection of the dorsal venous complex without pre-ligation, suturing, or coagulation during radical prostatectomy (RPE in patients with localized prostate cancer (PC on the quality of surgery and the function of urinary retention.Subjects and methods. The data of 42 patients who had undergone posterior and anterior anatomical repair and vesicourethral anastomosis using a V-lock suture after prostatectomy were analyzed. All the patients were divided into 2 groups. Group 1 consisted of 22 patients in whom the dorsal venous complex was closed using a 3-0 vicryl suture before urethral dissection. Group 2 included 20 patients in whom the urethra was dissected without suturing the venous complex.Results. In group 1, complete urinary retention after catheter removal was noted in 9 (40.9 % and 15 (68 % patients within 24 hours and after 3 months, respectively. Following 12 months, two (9 % patients were observed to have partial mild urinary incontinence (as many as 2 pads per day. Group 2 patients showed complete urinary retention in 17 (85 % cases on the first day after catheter removal; all the patients retained urine 3 months later.Conclusion. In patients with localized PC, dissection of the dorsal venous complex without presuturing during laparoscopic RPE exerts a considerable impact on the preservation of urinary retention, namely 45% more of the patients reported complete urinary retention in early periods and 10 % more did this in later periods. At the same time, there was no statistically significant increase in intraoperative blood loss (p > 0.05, the number of positive edges, or biochemical recurrences.

  17. 'Moral distress'--time to abandon a flawed nursing construct?

    Johnstone, Megan-Jane; Hutchinson, Alison


    Moral distress has been characterised in the nursing literature as a major problem affecting nurses in all healthcare systems. It has been portrayed as threatening the integrity of nurses and ultimately the quality of patient care. However, nursing discourse on moral distress is not without controversy. The notion itself is conceptually flawed and suffers from both theoretical and practical difficulties. Nursing research investigating moral distress is also problematic on account of being methodologically weak and disparate. Moreover, the ultimate purpose and significance of the research is unclear. In light of these considerations, it is contended that the notion of moral distress ought to be abandoned and that concerted attention be given to advancing inquiries that are more conducive to improving the quality and safety of moral decision-making, moral conduct and moral outcomes in nursing and healthcare domains.

  18. Contamination from abandoned mine tailings: the geochemical approach

    Fanfani, L. [Cagliari Univ. (Italy). Dipt. di Scienze della Terra


    The oxidation of sulphide minerals in flotation tailings and waste materials in the main source of chemical contamination at abandoned mine sites. Pyrite and the other iron-bearing sulphide minerals are responsible for acid mine drainage which leads to the weathering of other sulphides and mobilizes toxic metals such as Cd, Pb and As. An environment rich in earth-alkaline carbonates buffers the ph close to neutrality and mitigates chemical pollution, but liming is insufficient to control pollution. Prevention has to be based essentially on fighting sulphide oxidation with water covers or organic matter covers impermeable to atmospheric oxygen. Remediation strategies are to be addressed to the application of soft biological technologies.

  19. Key site abandonment steps in CO2 storage

    Kühn, M.; Wipki, M.; Durucan, S.; Deflandre, J.-P.; Lüth, S.; Wollenweber, J.; Chadwick, A.; Böhm, G.


    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

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



    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

  1. 78 FR 66988 - Minnesota Northern Railroad, Inc.-Abandonment Exemption-in Polk County, Minn.


    ... 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...

  2. 40 CFR 144.63 - Financial assurance for plugging and abandonment.


    ... abandonment. 144.63 Section 144.63 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER... the trustee's most recent annual valuation of the trust fund. If the value of the fund is less than... plugging and abandonment cost estimates; (C) Annual valuations as required by the trust agreement; and...

  3. An exploratory analysis of land abandonment drivers in areas prone to desertification

    Kosmas, C.; Kairis, O.; Karavitis, C.; Hessel, R.; Ritsema, C.J.


    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

  4. 40 CFR 147.3011 - Plugging and abandonment of Class III wells.


    ... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Plugging and abandonment of Class III... abandonment of Class III wells. To meet the requirements of § 146.10(d) of this chapter, owners and operators of Class III uranium projects underlying or in aquifers containing up to 5,000 mg/l TDS which...

  5. Inhomogeneous CTMC Model of a Call Center with Balking and Abandonment


    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

  6. Biodiversity of soil biota and plants in abandoned arable fields and grasslands under restoration management

    Brussaard, L.; Bakker, J.P.; Olff, H.


    The currently widespread abandoning of agricultural land use in Western Europe offers new opportunities for ecological restoration and nature conservation. This is illustrated for abandoned arable fields and for permanent grasslands cut for hay after the cessation of fertilizer application. Although

  7. Identification of vulnerable areas for gully erosion under different scenarios of land abandonment in Southeast Spain

    Lesschen, J.P.; Global Change Commission,


    Abandonment of agricultural land is the result of interacting processes of global change and human behaviour. Due to changing European policies, urbanisation, desertification and climate change land abandonment has become one of the main changes in land use in Mediterranean countries. The consequenc

  8. 75 FR 7303 - Union Pacific Railroad Company-Abandonment Exemption-in Polk County, IA


    ...--Exempt Abandonments to abandon .20 miles of a line of railroad on the Ankeny Industrial Lead from milepost 10.50 in Ankeny to milepost 10.70 in Ankeny, in Polk County, IA. The line traverses United States Postal Service Zip Code 50021. UP has certified that: (1) No local traffic has moved over the line for...

  9. 78 FR 17468 - Alabama Railroad Co.-Abandonment Exemption-in Monroe County, AL


    ... Abandonments to abandon approximately 7.42 miles of rail line between milepost 655.20 (east of Route 21 at Tunnel Springs) and milepost 662.62 (west of Main Street in Beatrice), in Monroe County, Ala. The line traverses United States Postal Service Zip Codes 36425 and 36471. ALAB has certified that: (1) No...

  10. 76 FR 2445 - BNSF Railway Company-Abandonment Exemption-in Rolette and Towner Counties, ND


    ... F--Exempt Abandonments to abandon 17.75 miles of rail line between milepost 30.00, north of Bisbee and milepost 47.75 at Rolla, in Rolette and Towner Counties, N.D.\\1\\ The line traverses United States Postal Service Zip Codes 58317, 58363, and 58367. \\1\\ On December 23, 2010, the Rollo Job...

  11. 76 FR 59770 - BNSF Railway Company-Abandonment Exemption-in Boulder County, CO


    ... Abandonments to abandon 1.37 miles of rail line extending between milepost 20.80 and milepost 22.17 at Lafayette, in Boulder County, CO (the Line). The Line traverses United States Postal Service Zip Code 80026 and includes no stations. BNSF has certified that: (1) No local traffic has moved over the Line for...

  12. 77 FR 16585 - Arkansas Midland Railroad Company, Inc.-Abandonment Exemption-in Phillips County, AK


    ..., in Phillips County, Ark. The line traverses United States Postal Service Zip Codes 72342 and 72390. AKMD has certified that: (1) No local traffic has moved over the line for at least 2 years; (2) there... CFR part 1152 subpart F-Exempt Abandonments to abandon an approximately 2.66-mile rail line known...

  13. 77 FR 35751 - Wisconsin Central Ltd.-Abandonment Exemption-in Manitowoc County, WI


    ...--Exempt Abandonments to abandon 6.8 miles of rail line extending from milepost 69.0 in Newton to milepost 62.2 in Cleveland in Manitowoc County, WI. The line traverses United States Postal Service Zip Codes 53015 and 53063, and there are no stations on the line. WCL has certified that: (1) No local traffic...

  14. 75 FR 7302 - Union Pacific Railroad Company-Abandonment Exemption-in Polk County, IA


    ... Polk County, IA. The line traverses United States Postal Service Zip Codes 50317, 50032, 50021, 50009, and 50035. UP has certified that: (1) No local traffic has moved over the line for at least 2 years...--Exempt Abandonments to abandon a portion of its line of railroad known as the Bondurant Industrial...

  15. 78 FR 57681 - Norfolk Southern Railway Company-Abandonment Exemption-in Polk County, Iowa


    ... Postal Service Zip Codes 50309 and 50317. \\1\\ According to NSR, the line segments are part of the same... subpart F--Exempt Abandonments to abandon approximately 0.6 miles of non-contiguous rail line segments in Des Moines, Polk County, Iowa, as follows: (1) Approximately 0.3 miles of rail line extending...

  16. 78 FR 79726 - Norfolk Southern Railway Company-Abandonment Exemption-in Gaston County, NC


    ...-Exempt Abandonments to abandon approximately 0.5 miles of rail line between milepost HG 37.50 (near the line's crossing of Brooks Road) and milepost HG 38.00 (north of Robinson Road), in Crowders (Gastonia), Gaston County, N.C.\\1\\ The line traverses United States Postal Service Zip Code 28052. \\1\\ NSR...

  17. 78 FR 54512 - Illinois Central Railroad Company-Abandonment Exemption-in Hinds County, Miss.


    ... part 1152 subpart F--Exempt Abandonments to abandon approximately 0.16 miles of rail line between mileposts 0.36 and 0.20, in Jackson, Hinds County, Miss. The line traverses United States Postal Service Zip... that: (1) No local traffic has moved over the line for at least two years; (2) there is no...

  18. 78 FR 11733 - Norfolk Southern Railway Company-Abandonment Exemption-in Calhoun County, AL


    ... County, Ala. The line traverses United States Postal Service Zip Code 36201. NSR has certified that: (1) No local traffic has moved over the line for at least two years; (2) no overhead traffic has moved.... 1152 subpart F-Exempt Abandonments to abandon approximately 1.81 miles of rail line extending...

  19. 78 FR 48931 - Norfolk Southern Railway Company-Abandonment Exemption-in Lucas County, Ohio


    ... 300.3 (near the intersection of Douglas Rd. and Dorr St.) in Toledo, Lucas County, Ohio (the Line). The Line traverses United States Postal Service Zip Codes 43606 and 43607. NSR has certified that: (1.... 1152 subpart F--Exempt Abandonments to abandon approximately 1.0 miles of rail line extending...

  20. 76 FR 82348 - Norfolk Southern Railway Company-Abandonment Exemption-in Marietta, Lancaster County, PA


    ... County, Pa. The line traverses United States Postal Service Zip Code 17547. NSR has certified that: (1) No local traffic has moved over the line for at least 2 years; (2) no overhead traffic has moved over... 49 CFR part 1152 subpart F--Exempt Abandonments to abandon 2.0 miles of rail line extending...

  1. 75 FR 7151 - CSX Transportation, Inc.-Abandonment Exemption-in Lucas County, OH


    ..., OH. The line traverses United States Postal Service Zip Codes 43607, 43606, 43613, and 43612, and includes no stations. CSXT has certified that: (1) No local traffic has moved over the line for at least 2... Abandonments to abandon approximately 4.15 miles of rail line on its Northern Region, Chicago Division,...

  2. 75 FR 73161 - Delta Southern Railroad, Inc.-Abandonment Exemption-In East Carroll Parish, LA


    ....\\1\\ The line traverses United States Postal Service Zip Code 71254. \\1\\ On November 16, 2010, DSR supplemented its notice of exemption. DSR has certified that: (1) No local traffic has moved over the line for... subpart F-Exempt Abandonments to abandon 8 miles of rail line extending from milepost 463.0, near...

  3. 78 FR 20714 - Union Pacific Railroad Company-Abandonment Exemption-in Dunn County, WI.


    ... F-Exempt Abandonments to abandon a 0.58-mile line of railroad on its Menomonie Industrial Lead from milepost 0.32 near Cedar Falls Road to the end of the line at milepost 0.90 near Oak Avenue, in Menomonie, Dunn County, Wis. (the Line). The Line traverses United States Postal Service Zip Code 54751. UP...

  4. 75 FR 35514 - Union Pacific Railroad Company-Abandonment Exemption-in Yakima County, WA


    ... Abandonments to abandon a 0.8-mile line of railroad, on the Yakima Industrial Lead, from milepost 62.75 to milepost 63.55 near Midvale, in Yakima County, Wash.\\1\\ The line traverses United States Postal Service Zip... over the line for at least 2 years; (2) there is no overhead traffic on the line; (3) no...

  5. 75 FR 32535 - Elgin, Joliet & Eastern Railway Company-Abandonment Exemption-in Lake County, IN.


    ... CFR part 1152 subpart F-Exempt Abandonments to abandon its line of railroad between milepost 46.10 and milepost 48.28, a distance of 2.18 miles, in Hammond, Lake County, Ind. The line traverses United States Postal Service Zip Code 46320. EJ&E has certified that: (1) No local traffic has moved over the line...

  6. 76 FR 51469 - CSX Transportation, Inc.-Abandonment Exemption-in Beaver County, PA


    ... Abandonments to abandon an approximately 2.39-mile rail line on its Northern Region, Pittsburg Subdivision, between milepost PLK 0.0 and milepost PLK 2.39, in Koppel, Beaver County, Pa. The line traverses United States Postal Service Zip Code 16136 and includes no stations. CSXT has certified that: (1) No...

  7. 78 FR 66801 - Norfolk Southern Railway Company-Abandonment Exemption-in St. Joseph County, Ind.


    ... Line). The Line traverses United States Postal Service Zip Codes 46613 and 46614. NSR has certified that: (1) No local traffic has moved over the Line for at least two years; (2) no overhead traffic has... 1152 subpart F-Exempt Abandonments to abandon a total of approximately 1.5 miles of rail line...

  8. 77 FR 21154 - BNSF Railway Company-Abandonment Exemption-in Oklahoma County, OK


    ... Abandonments to abandon 1.22 miles of rail line extending between milepost 541.69 and milepost 542.91 in Oklahoma City, Oklahoma County, Okla. (the Line).\\1\\ The Line traverses United States Postal Service Zip Codes 73108 and 73109 and includes no stations. \\1\\ The Line previously was part of a larger BNSF...

  9. 78 FR 21494 - Union Pacific Railroad Company-Abandonment Exemption-in Washington County, Idaho


    .... 1152 subpart F--Exempt Abandonments to abandon 0.28 miles of rail line (New Meadows Industrial Lead), between mileposts 0.22 and 0.50 at Weiser, in Washington County, Idaho. The line traverses United States Postal Service Zip Code 83672. UP has certified that: (1) No local traffic has moved over the line for...

  10. Impacts of Land Abandonment on Vegetation: Successional Pathways in European Habitats

    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.


    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

  11. Technical standardization of oil well abandonment: a review of current standards and technologies

    Suzart, J. Walter P.; Pessoa, Laudemar; Paiva, Maria [Halliburton Energy Services (HES), Duncan, OK (United States)


    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)

  12. 18 CFR 157.18 - Applications to abandon facilities or service; exhibits.


    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Applications to abandon facilities or service; exhibits. 157.18 Section 157.18 Conservation of Power and Water Resources FEDERAL..., Concerning Any Operation, Sales, Service, Construction, Extension, Acquisition or Abandonment §...


    Noparat Bamroongrugsa; Chorthip Purintavarakul


    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.

  14. Alternative utilization of underground spaces with abandoned mine openings

    Chung, So Keul; Cho, Won Jai; Han, Kong Chang; Choi, Sung Oong [Korea Institute of Geology Mining and Materials, Taejon (Korea)


    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

  15. Abandoned Rice Fields Make Streams Go Dry in Upland Landscapes

    Jayawickreme, D.


    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

  16. Penile rehabilitation after radical prostatectomy

    Fode, Mikkel; Ohl, Dana A; Ralph, David;


    The pathophysiology of erectile dysfunction after radical prostatectomy (RP) is believed to include neuropraxia, which leads to temporarily reduced oxygenation and subsequent structural changes in penile tissue. This results in veno-occlusive dysfunction, therefore, penile rehabilitation programm...

  17. Redox Properties of Free Radicals.

    Neta, P.


    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)

  18. 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

    姜琦; 朱福梅


    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

  19. Drivers, constraints and trade-offs associated with recultivating abandoned cropland in Russia, Ukraine and Kazakhstan

    Meyfroidt, Patrick; Schierhorn, Florian; Prishchepov, Alexander;


    with recultivating abandoned cropland to assess the potentially available cropland in European Russia, western Siberia, Ukraine and Kazakhstan—the region where the vast majority of post-Soviet cropland abandonment took place. Using spatial panel regressions, we characterized the socio-economic determinants...... of cropland abandonment and recultivation. We then used recent maps of changes in cropland to (i) spatially characterize the socio-economic, accessibility and soil constraints associated with the recultivation of abandoned croplands and (ii) investigate the environmental trade-offs regarding carbon stocks......-economic constraints suggested that the remaining 30.6 (25.7– 30.6) Mha of abandoned croplands were unlikely to provide important contributions to future crop production at current wheat prices but could provide various ecosystem services, and some could support extensive livestock production. Political...

  20. Repeated use of an abandoned vehicle by nesting Turkey vultures (Cathartes aura)

    Igl, L.D.; Peterson, S.L.


    Turkey Vultures (Cathartes aura) lay their eggs on an existing substrate in the dark recesses of a variety of natural sites (Kirk and Mossman 1998). Although an important requirement of Turkey Vulture nest-site selection is isolation from human disturbances (Kirk and Mossman 1998), their nests have been reported in abandoned buildings since at least the early 1800s (Nuttall 1832). Depopulation of rural areas in North America in recent decades has resulted in many abandoned buildings within the Turkey Vulture's breeding range (Peck 2003). Increased use of abandoned buildings by nesting Turkey Vultures has been implicated in the species' recent northward range expansion (Peck 2003, Nelson et al. 2005, Houston et al. 2007). Although abandoned or inoperative vehicles also are widespread in rural areas, we found no published literature documenting Turkey Vultures' use of these potential nest sites. Herein, we summarize the first documented incidence of a Turkey Vulture nesting in an abandoned vehicle.

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

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


    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...... and sixteen patients were randomly assigned to either group A (paracetamol+placebo x 2), group B (paracetamol+pregabalin+placebo) or group C (paracetamol+pregabalin+dexamethasone). According to randomization and preoperatively, patients received paracetamol 1000 mg, pregabalin 300 mg, dexamethasone 8 mg...... or placebo. General anaesthesia was performed. Postoperative pain treatment was paracetamol 1000 mg x 4 and patient-controlled intravenous morphine, 2.5 mg bolus. Nausea was treated with ondansetron. Morphine consumption, pain score (visual analogue scale) at rest and during mobilization, nausea, sedation...

  2. The effect of Reiki on pain and anxiety in women with abdominal hysterectomies: a quasi-experimental pilot study.

    Vitale, Anne T; O'Connor, Priscilla C


    The purpose of this pilot study was to compare reports of pain and levels of state anxiety in 2 groups of women after abdominal hysterectomy. A quasi-experimental design was used in which the experimental group (n = 10) received traditional nursing care plus three 30-minute sessions of Reiki, while the control group (n = 12) received traditional nursing care. The results indicated that the experimental group reported less pain and requested fewer analgesics than the control group. Also, the experimental group reported less state anxiety than the control group on discharge at 72 hours postoperation. The authors recommend replication of this study with a similar population, such as women who require nonemergency cesarian section deliveries.

  3. Peroxy radical partitioning during the AMMA radical intercomparison exercise

    M. D. Andrés-Hernández


    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.

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

    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


    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

  5. Identification and assessment of trace contaminants associated with oil and gas pipelines abandoned in place

    Thorne, W.E.R.; Basso, A.C.; Dhol, S.K. [Biophilia Inc., Calgary, Alberta (Canada)


    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.

  6. A Novel Abandoned Object Detection System Based on Three-Dimensional Image Information

    Yiliang Zeng


    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.

  7. Abandonment terraced hillside and answer of the fire system: some results from Mediterranean old fields

    Llovet Lopez, J.; Ruiz Varela, M.; Josa March, R.; Vallejo Calzada, V. R.


    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.

  8. Microbial Nitrogen-Cycle Gene Abundance in Soil of Cropland Abandoned for Different Periods.


    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.

  9. Radical formation by heavy metals

    Beuter, W.


    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.

  10. Epistemological barriers to radical behaviorism.

    O'Donohue, W T; Callaghan, G M; Ruckstuhl, L E


    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.

  11. Epistemological barriers to radical behaviorism

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


    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

  12. Successional trends in Sonoran Desert abandoned agricultural fields in northern Mexico

    Castellanos, A.E.; Martinez, M.J.; Llano, J.M.; Halvorson, W.L.; Espiricueta, M.; Espejel, I.


    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.

  13. Management of mining-related damages in abandoned underground coal mine areas using GIS

    Lee, U.J.; Kim, J.A.; Kim, S.S. [Coal Industry Promotion Board, Seoul (Korea, Republic of); Kim, W.K.; Yoon, S.H.; Choi, J.K. [Ssangyong Information and Communication Corp., Seoul (Korea, Republic of)


    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)

  14. The impact of land abandonment on species richness and abundance in the Mediterranean Basin

    Plieninger, Tobias; Hui, Cang; Gaertner, Mirijam;


    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. ...

  15. 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.

    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


    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.

  16. Opiate written behavioral agreements: a case for abandonment.

    Helft, Paul R; Williams, Jessica R; Bandy, Robin J


    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.

  17. Design Parameters for Abandoned Dumpsite Soil as Liner Material

    Adefemi Afeez BELLO


    Full Text Available This paper presents the findings of laboratory tests that were carried out on abandoned dumpsite soil from Orita-Aperin, Ibadan, and Southwestern Nigeria, to determine its potentiality as hydraulic barrier. Three soil samples were collected (labeled AB1 - AB3 and compacted at –2, 0, 2 and 4% of optimum moisture content using four compactive energy levels namely reduced Proctor (RP, Standard Proctor (SP, West African Standard (WAS and modified Proctor (MP. The design parameters namely: hydraulic conductivity, volumetric shrinkage and unconfined compressive strength showed appreciable variations in their respective values as moulding water contents and compactive efforts were varied. The soil samples studied had hydraulic conductivity that was less than or equal to 1 x 10-7cm/s provided that: the initial dry unit weight is greater than or equal to 16.48 kN/m3; the initial degree of saturation is greater than or equal to 85%; compaction is carried out at a compactive effort greater than or equal to that of the standard Proctor. Hence, the samples can be used as hydraulic barrier in waste containment structure.

  18. How adoption speed affects the abandonment of cultural tastes.

    Berger, Jonah; Le Mens, Gaël


    Products, styles, and social movements often catch on and become popular, but little is known about why such identity-relevant cultural tastes and practices die out. We demonstrate that the velocity of adoption may affect abandonment: Analysis of over 100 years of data on first-name adoption in both France and the United States illustrates that cultural tastes that have been adopted quickly die faster (i.e., are less likely to persist). Mirroring this aggregate pattern, at the individual level, expecting parents are more hesitant to adopt names that recently experienced sharper increases in adoption. Further analysis indicate that these effects are driven by concerns about symbolic value: Fads are perceived negatively, so people avoid identity-relevant items with sharply increasing popularity because they believe that they will be short lived. Ancillary analyses also indicate that, in contrast to conventional wisdom, identity-relevant cultural products that are adopted quickly tend to be less successful overall (i.e., reduced cumulative adoption). These results suggest a potential alternate way to explain diffusion patterns that are traditionally seen as driven by saturation of a pool of potential adopters. They also shed light on one factor that may lead cultural tastes to die out.

  19. Restoration of contaminated soils in abandoned mine areas (Tuscany, Italy)

    Bini, Claudio; Wahsha, Mohammad


    In Italy ore research and exploitation have been nearly exhausted since the end of the last century, and have left on the land a huge amount of mine waste, therefore provoking evident environmental damage including surface and groundwater, soils, vegetation and the food chain, and a potential threat to human health. The main processes occurring at these sites are: rock disgregation, fragments migration, dust dispersion, oxidation (Eh>250mV), acidification (pHlevels. The results obtained suggest that the abandoned mine sites represent actual natural laboratories where to experiment new opportunities for restoration of anthropogenically contaminated areas, and to study new pedogenetic trends from these peculiar parent materials. Moreover, plants growing on these substrates are genetically adapted to metal-enriched soils, and therefore may be utilized in phytoremediation of contaminated sites. Furthermore, the institution of natural parks in these areas could enhance their educational and scientific value, contributing in the meantime to general population amusement and recreation. Finally, it is the occasion for soil scientists to submit to the scientific community new classification proposals of this new kind of soils. Key-words: mine waste, heavy metals, phytoremediation, soil genesis, soil classification

  20. Psychoanalysis and the brain - why did freud abandon neuroscience?

    Northoff, Georg


    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.

  1. Groundwater flow modelling of an abandoned partially open repository

    Bockgaard, Niclas (Golder Associates AB (Sweden))


    As a part of the license application, according to the nuclear activities act, for a final repository for spent nuclear fuel at Forsmark, the Swedish Nuclear Fuel and Waste Management Company (SKB) has undertaken a series of groundwater flow modelling studies. These represent time periods with different hydraulic conditions and the simulations carried out contribute to the overall evaluation of the repository design and long-term radiological safety. The modelling study presented here serves as an input for analyses of so-called future human actions that may affect the repository. The objective of the work was to investigate the hydraulic influence of an abandoned partially open repository. The intention was to illustrate a pessimistic scenario of the effect of open tunnels in comparison to the reference closure of the repository. The effects of open tunnels were studied for two situations with different boundary conditions: A 'temperate' case with present-day boundary conditions and a generic future 'glacial' case with an ice sheet covering the repository. The results were summarized in the form of analyses of flow in and out from open tunnels, the effect on hydraulic head and flow in the surrounding rock volume, and transport performance measures of flow paths from the repository to surface

  2. Radical democratic politics and feminism

    Martínez Labrin, Soledad


    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

  3. Vaginal radical trachelectomy: an update.

    Plante, Marie


    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.

  4. 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

    Salum, Resalla; Lopes, Edison R.; Souza, Maria A.H. de [Faculdade de Medicina do Triangulo Mineiro, Uberaba, MG (Brazil). Hospital Escola


    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.

  5. [Postoperative radiotherapy in patients with invasive uterine cervix cancer treated previously with simple hysterectomy. Results from the Hospital de Oncología, Centro Médico Nacional SXXI. ].

    Huerta Bahena, Judith; Labastida Almendaro, Sonia; Cortez Arroyo, Héctor; Calva, Angel


    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.

  6. Leiomioma benigno metastatizante de veia cava inferior: rara complicação tardia de histerectomia Benign metastasizing leiomyoma of inferior vena cava: a rare condition following hysterectomy

    Marcos Filgueiras


    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.

  7. 改进阴式子宫切除术的临床研究%Clinic study of improved transvaginal hysterectomy

    吴美艳; 郭艳军; 邓岳红


    Objective To contrast the intraoperative and postoperative effect of improved transvaginal hysterectomy and conventional transvaginal hysterectomy , evaluate two different methods of transvaginal hysterectomy , and study the surgical technique of transvaginal hysterectomy . Methods A retrospective analysis was made for 62 cases of transvaginal hysterectomy. In these cases, 32 were treated by improved transviganl hysterectomy , and 30 were treated by conventional transvaginal hysterectomy . Some indicators were recorded ,including blood loss ,operating time,the recovery time of postoperative fever ,rate of complications, farting time, the time of urinary catheter extraction , analgesics application and antibiotic consumption,and statistical anaylsis were made. Results (1) Comparison of patient's conditions in perioperative period: CD intraoperative conditions : there were statistic significances between the improved group and the conventional group on average operating time and blood loss (P 0. 05). (2 ) Comparison of long-term follow-up effects: there were no statistic significances between two groups on cases of follow up , incidence of granulation tissues in vaginal residual segment , incidence of vaginal stump thrum, cases of recover to normal life in one month after operation ( P > 0.05 ). Conclusions Improved transvaginal hysterectomy has fewer operating process , reduce surgical injury and blood loss,shorten operating time and is more easier to master ,it worths popularizing.%目的 本研究通过对改进阴式子宫切除术与常规阴式子宫切除术的术中及术后情况进行比较,评价改进式效果,进而探讨非脱垂子宫阴式切除的手术方法技巧及效果,提高手术水平.方法 回顾性分析2002年5月至2010年3月我院对非脱垂子宫良性病变行阴式子宫切除术62例患者的临床资料,其中改进式32例、传统式30例,对围手术期及术后随访情况的一些指标(术中出

  8. Robotic-assisted laparoscopic hysterectomy for women with endometrial cancer - complications, women´s experiences, quality of life and a health economic evaluation

    Herling, Suzanne Forsyth


    . These changes should be addressed in the preoperative information and at the post-operative follow-up. It is difficult imagining a RCT of robotic-assisted laparoscopic hysterectomy being conducted in the future due to reluctance towards randomisation to open surgery. However, it would be advisable continuously...... to monitor relevant surgical and patient-reported outcomes as indications for robotic surgery may alter, experiences may develop and further technical advances may change robotic surgery for women with endometrial cancer in the future.......This thesis contains four studies all focusing on women with endometrial cancer undergoing robotic-assisted laparoscopic hysterectomy (RALH). Women with endometrial cancer are typically elderly with co-morbidities. RALH is a relatively new treatment option which has been introduced and adopted over...




    Full Text Available The paper in hand mainly addresses the issue of abandoned industrial and commercial sites. The results of a survey form the central content and regards the method of investigation of this survey of abandoned sites in the province of Carinthia, including experiences and recommendations. The survey started with a number of more than 10,000 businesses. After the different steps of the survey (research phase, exploration phase, clarification phase and evaluation phase 444 sites had to be attributed an increased potential for danger. After these steps followed an evaluation which concerned the priority in regard to the securing and/ or remediation of the abandoned sites. On the basis of certain gathered values, future surveys of abandoned industrial and commercial sites can be calculated fairly exactly.

  10. Contaminants in bats roosting in abandoned mines at Imperial National Wildlife Refuge, Arizona, 1998-1999

    US Fish and Wildlife Service, Department of the Interior — This report documents levels and potential effects of trace element and organochlorine pesticide concentrations in four bats species collected from four abandoned...

  11. Abandoned Uranium Mine (AUM) Enforcement Action Mine Areas, Navajo Nation, 2016, US EPA Region 9

    U.S. Environmental Protection Agency — This GIS dataset contains polygon features that represent abandoned uranium mines with EPA enforcement actions as of March 2016 in the Navajo Nation. Attributes...

  12. Abandoned Uranium Mine (AUM) Surface Areas, Navajo Nation, 2016, US EPA Region 9

    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...

  13. Abandoned Uranium Mines (AUM) Site Screening Map Service, 2016, US EPA Region 9

    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 the...

  14. Abandoned Uranium Mine (AUM) Priority Mine Points, Navajo Nation, 2016, US EPA Region 9

    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 and...

  15. Abandoned Vessels and Barges, Geographic NAD83, LOSCO (1996) [barge_LOSCO_1996

    Louisiana Geographic Information Center — This is a point dataset with two accompanying 'sample tables' [vabfldsmpap96] and [vablabsmpap96] that summarize the results of the study to inventory abandoned...

  16. Asymptotic inference for waiting times and patiences in queues with abandonment

    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 waiting time and patience distributions in multiserver queues with abandonment. The framework rigorises heuristics based on survival analysis of independent...

  17. 45 CFR 3.5 - Lost and found, and abandoned property.


    ... Services Administration regulations (41 CFR part 101-48). Abandoned, or other unclaimed property and, in... Office and sold and the proceeds deposited in accordance with 41 CFR 101-45.304 and 101-48.305....

  18. 76 FR 43374 - CSX Transportation, Inc.; Abandonment Exemption; in Hardin County, OH


    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF TRANSPORTATION Surface Transportation Board CSX Transportation, Inc.; Abandonment Exemption; in Hardin County, OH CSX... Street and Champion Court, in Kenton, Hardin County, Ohio. The line traverses United States...

  19. The public health effects of abandoned coal mine workings on residents in South Wellington, Nanaimo

    Biagioni, K. [Victoria Univ., BC (Canada)


    Abandoned coal mine groundwater frequently contains depressed pH levels and elevated levels of hydrogen sulphide, iron, aluminium and nitrates. Abandoned coal mine groundwater is also usually high in copper, zinc, mercury, and lead. Groundwater from abandoned mines can seriously affect public health through the discharge of non-point source pollution. This paper presents information on a research project regarding the possible impacts of abandoned coal mines and its effects on groundwater as it relates to the health of residents in South Wellington, Nanaimo, British Columbia. The purpose of the project is to determine which illnesses are more common in South Wellington, Nanaimo and in the control area. The paper provides a discussion of the Nanaimo coal field and three major seams; the Wellington, Newcastle and Douglas which are most likely to have a significant impact on groundwater in South Wellington. 27 refs.

  20. Abandoned Uranium Mine (AUM) Regions, Navajo Nation, 2016, US EPA Region 9

    U.S. Environmental Protection Agency — This GIS dataset contains polygon features representing the boundaries of the six Abandoned Uranium Mines (AUM) Regions, including the: Central, Eastern, Northern,...