Waiting time and pain during office hysteroscopy Carta, Gaspare; Palermo, Patrizia; Marinangeli, Franco ...
Journal of minimally invasive gynecology,
05/2012, Letnik:
19, Številka:
3
Journal Article
Recenzirano
To find a correlation between the waiting time between counseling about and performance of office hysteroscopy and the perception of pain.
Observational study (Canadian Task Force classification ...II-2).
Academic environment.
Two hundred eighty-four women undergoing hysteroscopy.
Diagnostic hysteroscopy with endometrial biopsy.
Before examination, patients were asked to complete 2 forms, the STAI-S (State-Trait Anxiety Inventory, State) and STAI-T (State-Trait Anxiety Inventory, Trait) anxiety scales, for evaluation of their usual anxiety state and their state of anxiety during the examination. Patients were asked to quantify on a visual analog scale the pain felt during the examination. A statistically significant positive correlation, even if weak, was demonstrated between pain and waiting time (r = 0.45; p < .01) but not with the values for the anxiety state (r = 0.06; p = .56) and anxiety trait (r = -0.05; p = .66). Pain (≥4) was significantly associated with waiting time (≥60 minutes) (odds ratio OR, 5.21; 95% confidence interval CI, 1.29-35.50), age (OR, 1.57; 95% CI, 0.40-5.87) and menopause (OR, 2.81; 95% CI, 1.10-7.40) but not with STAI-S level (≥34) (OR, 0.87; 95% CI, 0.26-3.12) or STAI-T level (≥34) (OR, 0.65; 95% CI, 0.19-2.32).
Office hysteroscopy is associated with a level of anxiety that can affect patient tolerability of the procedure. However, factors such as reducing waiting time may have a positive effect on patient compliance, making hysteroscopy easier and thereby increasing its diagnostic and therapeutic potential.
Pain in terminally ill patients with cancer can be often hard to manage, due to the unpredictable kinetics of drugs caused by progressive kidney and liver dysfunction. Plasma concentrations of active ...metabolites-also a cause of dangerous side effects--could be difficult to estimate. This case report holds the idea that buprenorphine, a partial agonist of m-receptors, even at high dosage, may be effective and safe to use in terminally ill patients with significant liver and kidney impairment.
Objective: The present study was designed specifically to assess the relationship between brain morphology and outcome in schizophrenia. Methods: Fifty‐six schizophrenic patients and a matched group ...of 32 healthy subjects were studied with magnetic resonance (MR) imaging scans. Clinical assessment included the Krawiecka–Manchester Scale (K‐MS) and the Outcome scale by Strauss and Carpenter. Results: Along several neuromorphological measures the patients differed from controls only for right and left ventricular volumes. The ‘poor outcome’ patients had a left and right ventricular enlargement when compared to the ‘good outcome’ patients and healthy controls. A regression analysis showed that right ventricle volume, left temporal lobe volume and left hippocampal volume entered into the regression equation, accounting for a 27% of the outcome measure. Conclusion: The outcome does not seem to be predicted by one particular morphological site but involves different brain regions; however, the ventricular enlargement identifies a subgroup of patients with poor outcome.
Abstract Objective The organization of a homogeneous medical emergency system was developed in Italy in 1999. Currently, 104 stations manage medical emergencies with ambulances and 47 ...helicopter-capable bases for more difficult missions. The current study describes the organization of the helicopter emergency system in Italy. Methods Data were collected from questionnaires filled in by each base commander. Results Six hundred twenty-seven physicians are enrolled in helicopter-capable base emergency teams. Of those physicians, 89.5% are specialists in anesthesiology. Professional nurses are enrolled in 46 bases. Twenty-six bases specialize in search-and-rescue (SAR) missions (which take place in geographically unfriendly terrain), where a mountain rescue technician (CNSAS) is part of the team. Twenty-one bases are for missions in geographically friendly terrain (HEMS bases). Eight bases provide 24-hour service. Specialized training is given to physicians and nurses: it is considered of first level (high standard) in 21 bases, of second level (intermediary) in 17 bases, and of third level (low) in nine bases. In the mountain bases (Alps and Apennines), the more widely used helicopters are the AB412 and the BK117C1. During 2004, there were 20,660 primary interventions and 7,790 secondary interventions. From 1999 to 2004 there was a 33% increase of activity for primary and 35% for secondary interventions. Conclusions The data show the activity of the helicopter-ambulance service, the role of anesthetists within the helicopter-based Advanced Cardiac Life Support (ACLS) team, and the diverse organization of training for medical staff in different regions of Italy.
Scopo - Il presente studio ha lo scopo di verificare la validità di costrutto della versione italiana del questionario Parental Bonding Instrument (PBI) che misura lo stile genitoriale come ricordato ...dal figlio. Materiali e metodi - Il questionario è stato somministrato ad un gruppo di 102 studenti dell'Università degli Studi de L'Aquila (62 maschi e 40 femmine) ed a 128 pazienti (76 maschi e 52 femmine) consecutivamente ricoverati in un reparto di psichiatria per un episodio indice. Nel gruppo dei pazienti ed in quello degli studenti sono state confrontate le medie dei valori delle due dimensioni («cura» e «protezione») per ciascun genitore in ogni gruppo, con un t-test per campioni indipendenti. Dopo la verifica della consistenza interna degli item del questionario calcolando il valore dell'alfa di Cronbach, è stata effettuata un'analisi fattoriale esplorativa per studenti e pazienti separatamente per individuare i fattori latenti del questionario e un'analisi fattoriale confermatoria nel gruppo di studenti per valutare l'adeguatezza dei dati reali rispetto ai modelli proposti in letteratura. Risultati - La versione italiana del PBI, ha dimostrato di differenziare i 2 gruppi e di possedere una buona consistenza interna degli item. L'analisi fattoriale esplorativa condotta nel gruppo degli studenti identificava due fattori che spiegavano il 44.6% ed il 44.3% della varianza per le scale del PBI della madre e del padre rispettivamente, mentre nel gruppo dei pazienti identificava due fattori che spiegavano il 49.3% ed il 46.6% della varianza per le scale del PBI rispettivamente della madre e del padre. Conclusioni - I pazienti affetti da patologie psichiatriche evidenziano una bassa «cura»/alta «protezione» rispetto agli studenti, confermando l'associazione tra un pattern affettivo di affectionless control e la presenza di un disturbo psichiatrico. Objective - The aim of this study was to verify the construct validity of the Italian version of Parental Bonding Instrument (PBI) a questionnaire which estimates the parental style as reported by the son or daughter. Method - The questionnaire was administered to a group of 102 students (62 males and 40 females) attending University of L'Aquila and to a sample of 128 patients (76 males and 52 females) consecutively admitted to a psychiatric unit for an index episode. We compared the means of the two factors (care, protection) separately for each parent in the two groups using a t-test for indipendent samples. After having estimated the internal consistency of items of each scale by calculating Cronbach's coefficient α, a factor analysis was performed for students and patients to find the structural factors of the questionnaire; then, we conducted a confirmatory factor analysis of the PBI items, for the students only, to evaluate the fit of the real items to models proposed in the literature. Results - The Italian version of the Parental Bonding Instrument, demonstrated the ability to discriminate between patients and controls; it showed an high internal consistency. The factor analysis identified a two factors solution which accounted for 44.6% and 44.3% of the variance of the mother's and father's PBI scores respectively for the group of students and it identified two factors which accounted for 49.3% and 46.6% of the variance in the group of patients. Conclusions - The psychiatric patients showed a low «care»-high «protection » confirming an association between the «affectionless control» pattern and psychiatric disorders.
The objective was to examine trends in pulse (dry beans, dry peas, chickpeas and lentils) intake over a 10-year period and to compare nutrient intakes of pulse consumers and non-consumers to better ...understand the impact of pulse consumption on diet quality in the US population. NHANES 2003–2014 data for respondents (≥19 years) with 2 days of intake was used to evaluate trends in pulse intake. Pulse consumers were identified as those NHANES respondents who consumed pulses on one or both days. Differences in energy adjusted nutrient intakes between non-consumers and consumers were assessed. There were no significant trends in pulse intakes for the total population or for pulse consumers over the 10-year period. In 2013–2014, approximately 27% of adults consumed pulses with an intake of 70.9 ± 2.5 g/day over 2 days, just slightly <0.5 cup equivalents/day. At all levels of consumption, consumers had higher (p < 0.01) energy adjusted intakes of fiber, folate, magnesium. Higher energy adjusted intakes for potassium, zinc, iron and choline and lower intakes of fat were observed for consumers than for non-consumers at intakes ≥69.4 ± 1.01 g/day. These data suggest that pulse consumption in the US population may result in better diet quality with diets that are more nutrient dense than those without pulses.
Pulses are dry leguminous crops consisting of beans, lentils, chickpeas, and peas. They are a broad category of food that are often aggregated when their contribution to healthy dietary patterns are ...disseminated. However, the different genera and varieties of pulses vary in composition and are consumed in different amounts, largely dictated by geographic region and ethnicity. Given the number of pulse-derived components, including fibre, that have the capacity to alter the composition of the gut microbiome, the objective of this study was to systematically review dietary pulses and pulse-derived ingredients as a broader food group, to determine their effect on gut microbiota in humans. Major scientific databases were used to conduct the search, which spanned from 1990 until February 2019. The search strategy identified 2,444 articles and five studies were included in this analysis. Two studies used whole pulses (chickpeas and pinto beans), one study used cooked navy bean powder, and the two remaining studies used pulse-derived fibre (lupin or yellow pea hulls). Although inconsistent, some studies demonstrated that whole pulses (pinto beans and chickpeas), cooked navy bean powder, and pulse-derived fibre (lupin kernel fibre), did impose changes to the microbiota that inhabit the human large intestine. However, there was considerable variability concerning the methodologies and endpoints used to decipher the observed effects on the abundance, diversity, and/or richness of specific microbiota or the microbiome. More extensive human studies that directly link the effects of specific types of pulses on the gastrointestinal microbial environment to health outcomes in the host are required.
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