The structure of somatic dysfunctions in women with a nodular form of uterine myoma

2020 ◽  
pp. 29-40
Author(s):  
G. N. Chebotaeva ◽  
D. S. Lebedev
Keyword(s):  
Local Level ◽  
Randomized Study ◽  
Random Number Generator ◽  
Uterine Fibroids ◽  
Reproductive Function ◽  
Uterine Myoma ◽  
Dynamic Monitoring ◽  
Control Group ◽  
Gynecological Examination ◽  
The Impact

Introduction. Uterine myoma (leiomyoma) occupies one of the first placesin the structure of gynecological diseases.This disease negatively affects both the state of health and the reproductive function of women. Now the problem of the effective methods for the treatment of leiomyoma (including non-medicinal methods, one of which is the osteopathic correction of somatic dysfunctions) is still acutedespite some progress in understanding the mechanisms of this disease pathogenesis. However, the structure of these functional disorders has not been practically studied.The goal of research — to investigate the structure of somatic dysfunctions (SD) in women with uterine myoma before and after osteopathic correction and its relationship with the severity of subjective indicators.Materials and methods. A simple longitudinal randomized study was conducted in 2018–2019 on the basis of a women’s consultation in Kirov, it included 30 women aged 35 to 44 years being under the medical supervision of an obstetrician-gynecologist, with a diagnosis of intramural uterine myoma, nodular form. All women with intramural nodular leiomyoma were divided into 2 groups of 15 people, comparable in age, presence of comorbidities and duration of the disease, using a simple randomization method (a random number generator was used). The main group received osteopathic treatment, and for patients of the control group it was carried out dynamic monitoring. According to the scheme, all patients underwent a clinical gynecological examination, a clinical osteopathic examination, and the dynamics of the severity of subjective manifestations (complaints) was evaluated.The collected data was processed by nonparametric statistics.Results. In the course of osteopathic diagnostics in women with uterine fibroids the following SD were identified: the somatic dysfunctions of the pelvic region dominated among the regional SD, and the most common among the local SD were the somatic dysfunctions of the segment С0–СI and the thoracic diaphragm. As the result of osteopathic correction of diagnosed SD in patients with leiomyoma, the decrease of the total number of SD (p<0,05) and the change of their structure has occurred (before treatment the SD at the regional level prevailed, after treatment there was a reduction in their number, and the increasing of the number of SD local level due to the carried out correction of most existing regional violations); and the severity of subjective symptom (algodismenorrhea) has decreased (p<0,05).Conclusion. In women with uterine myoma (leiomyoma), SD can manifest at different levels. Osteopathic correction of SD in women with uterine myomasignificantly reduces the severity of subjective manifestations (algodismenorrhea), which allows us to continue the research in studying of the impact of the SD osteopathic correction in the complex treatment of women with intramural nodular form of uterine myoma. 

A Randomized Study to Assess the Impact of Pharmacist Counseling of Employer-Based Health Plan Beneficiaries With Diabetes

2011 ◽  
Vol 25 (2) ◽  
pp. 169-179 ◽  
Author(s):  
Dale F. Kraemer ◽  
Wayne A. Kradjan ◽  
Theresa M. Bianco ◽  
Judi A. Low
Keyword(s):  
Diabetes Management ◽  
Statistical Significance ◽  
Glycosylated Hemoglobin ◽  
Randomized Study ◽  
Intervention Group ◽  
Control Group ◽  
Counseling Intervention ◽  
Care Plans ◽  
Pharmacist Counseling ◽  
The Impact

Objective: To assess the impact of pharmacist counseling on empowering people with diabetes to better self-care. Introduction: Community-based pharmacists can play a key role in educating and empowering people in such programs. Methods: A randomized trial compared the effects of pharmacist counseling (intervention group) with printed materials (control group) in diabetic beneficiaries of several employer-based health care plans. All participants also received waiver of out-of-pocket expenses for diabetic-related medications and supplies. Clinical, humanistic, and claim outcomes were evaluated at baseline and at 1 year follow-up. Results: Sixty-seven beneficiaries participated in this study. The 0.50% decrease from baseline in glycosylated hemoglobin (A1c) was statistically significant ( P = .0008) in the intervention group and the difference between the groups approached statistical significance ( P = .076). Beneficiaries in both groups had greater claim costs for diabetic-related medications and supplies during the study year. Both groups also improved in ability to manage their diabetes with the counseling group showing a significantly better understanding of diabetes ( P = .0024). Conclusion: There was a trend toward improvement in A1c in patients counseled by pharmacist with an increased utilization of diabetes-related medications and supplies. Counseling also improved diabetes knowledge and empowered patients to better diabetes management.

scholarly journals OBSTETRICIANS’ TACTICS IN THE DELIVERY BY PATIENTS WITH BREECH POSITION OF THE FOETUS AFFECTED BY THE UTERINE MYOMA

2018 ◽  
pp. 118-121
Author(s):  
O. M. Krupnyk
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Clinical Manifestations ◽  
Uterine Fibroids ◽  
Statistical Processing ◽  
Uterine Myoma ◽  
Control Group ◽  
Full Time ◽  
Obstetric Delivery ◽  
Microsoft Office

The aim of the study – improvement of pregnancy outcomes in women with pelvic presentation on the background of uterine myoma by developing optimal obstetric delivery tactics. Materials and Methods. In order to achieve the stated goal, a prospective analysis of cases of first- and second-time delivering patients with full-term one fetus pregnancy in pelvic presentation (incomplete and complete) amid the uterine myoma – the main group (MG) – (n = 30) was conducted. Into the control group (CG) – (n = 30) were included the first- and second-time bearing women without fetal myoma with full-time pregnancy and the pelvic presentation. Statistical processing of the results was performed using the Microsoft Office Excel 2017 software. Results and Discussion. The analysis of the presented data shows that among pregnant women with pelvic prevalence of fetuses on the background of uterine fibroids, more frequent cases are registered: clinical manifestations of the threat of interruption of pregnancy MG – 26 (86.7 %), CG – 9 (30 %) and pre-eclampsia MG – 8 (26.7 %), CG – 3 (10 %) (p < 0.05). Raising the risk of complications of pregnancy and the expected birth of the uterine myoma requires pre-planning for the most part the operational method of delivery of MG – 19 (63.3 %). Exception, in the absence of other contraindications, there may be women with single myomatous nodes in sizes up to 5 cm – 11 (36.7 %). Only the extension of the cesarean section requires only pregnant women with uterine myoma 7 (36.8 %), and most of these interventions occur during precarious surgical delivery 4 (20 %). Conclusion. Consequently, the presented data indicate the expediency and validity of taking into account the presence of uterine myoma at BP in order to develop an optimal obstetric tactic for the delivery of such patients in order to improve their pregnancy outcomes.

scholarly journals Current trends in the pharmacotherapy of uterine myoma, associated with heavy menstrual bleeding and anemia: review

2020 ◽  
Author(s):  
Z. V. Revazova ◽  
L. V. Adamyan ◽  
O. N. Loginova ◽  
L. M. Manukyan ◽  
K. N. Arslanyan
Keyword(s):  
Uterine Fibroids ◽  
Reproductive Function ◽  
Uterine Myoma ◽  
Reproductive Age ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Cochrane Library ◽  
Pharmacological Agents ◽  
Surgical Interventions ◽  
Current Trends

Aim: to summarize results of up-to-date world researches on the current trends of symptomatic myoma treatment.Materials and Мethods. A search of publications was carried out in the main international databases in Russian and English languages: PubMed/MEDLINE, The Cochrane Library, Embase, eLibrary. The analysis included studies published over the past 10 years examining the clinical efficacy and safety of various groups of pharmacological agents for the treatment of uterine myoma combined with heavy menstrual bleeding in women of reproductive age.Results. Currently, the treatment of uterine fibroids is divided into three main methods: surgical, minimally invasive organ-preserving methods, and pharmacotherapy. Until now, surgical intervention remains the main method of treatment, and, unfortunately, is often carried out in the volume of hysterectomy. However, today it is important to have a personalized approach to the management of a patient with symptomatic uterine myoma, taking into account her desire to preserve reproductive function. The development of the possibilities of drug therapy made a great contribution to the optimization of managing such patients.Conclusion. The global trend is to decrease the number of radical interventions, as well as the development and improvement of new methods of treating symptomatic uterine fibroids. Currently, pharmacotherapy of leiomyoma can significantly improve the quality of life of patients, reduce radical surgical interventions, optimize surgical treatment, and in certain situations, completely eliminate the need for surgery.

scholarly journals A randomized control trial of the impact of an electronic application on resident responses to simulated in-flight medical emergencies (Preprint)

2018 ◽  
Author(s):  
Nur-Ain Nadir ◽  
Courtney J Cook ◽  
Raymond E Bertino ◽  
Marc D Squillante ◽  
Cameron Taylor ◽  
...  
Keyword(s):  
Randomized Study ◽  
Healthcare Providers ◽  
Smartphone Application ◽  
Control Group ◽  
Success Rates ◽  
Ground Support ◽  
Global Ratings ◽  
Medical Emergencies ◽  
Simulation Center ◽  
The Impact

BACKGROUND Healthcare providers are often called to respond to in-flight medical emergencies (IFMEs), but lack familiarity with expected supplies, interventions, and ground medical control support. OBJECTIVE The objective of this study was to determine whether a smartphone application (airRx) improves responses to simulated IFMEs. METHODS This was a randomized study of volunteer, non-emergency resident physician subjects who managed simulated IFMEs with or without the app. Simulations took place in a mock-up cabin in the simulation center. Standardized participants (SPs) played the patient, family member, and flight attendant roles. Live, non-blinded rating was used with occasional video review for data clarification. Subjects participated in two simulated IFMEs (shortness of breath-SOB, syncope-SYN) and were evaluated with checklists (CL) and global ratings scales (GRS). CL item success rates, key critical action times, GRS, and pre-post simulation confidence in managing IFMEs were compared. RESULTS There were 29 subjects in each arm (app versus control) of the study. Mean percentages of completed CL items for the app versus control groups were 56.1 ± 10.3 vs. 49.4 ± 7.4 for SOB (p < 0.05) and 58 ± 8.1 vs. 49.8 ± 7.0 for SYN (p < 0.05). The GRS improved with the app for SYN case (3.14 ± 0.89 vs control 2.6 ± 0.97, p < 0.05), but not the SOB case (2.90 ± 0.97 vs control 2.81 ± 0.80, p = 0.43). For timed checklist items, the app group contacted ground support faster for both cases, but the control group was faster to complete vitals and basic exam. Both groups indicated higher confidence in their post-simulation surveys, but the app group demonstrated a greater increase in this measure. CONCLUSIONS Use of the airRx app prompted some actions, but delayed others. Simulated performance and feedback suggest the app is a useful adjunct for managing IFMEs. CLINICALTRIAL Not applicable

Abstract 2462: Obstructive Sleep Apnea Treatment Improves the Blood Pressure Behavior in Normotensive Patients: A Randomized Study

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Luciano F Drager ◽  
Patrícia M Diniz ◽  
Luzia Diegues-Silva ◽  
Roberta B Couto ◽  
Rodrigo P Pedrosa ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Randomized Study ◽  
Control Group ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
The Impact ◽  
Current Guidelines ◽  
Concomitant Hypertension

Introduction: Obstructive sleep apnea (OSA) promotes significant alterations on blood pressure during sleep. In patients with concomitant hypertension, the treatment with continuous positive airway pressure (CPAP) promotes significant reductions on blood pressure. However, the impact of CPAP on 24 hour blood pressure in normotensive patients is poorly understood. Methods: We included 22 apparently healthy patients with severe OSA defined by polysomnography (apnea/hypopnea index (AHI) >30 events/hour). We excluded hypertension according current guidelines by office measurements. They were randomized to no treatment (control) or CPAP for 3 months. At baseline and at the end of the protocol, we performed 24 hour blood pressure (BP) monitoring evaluating daytime and nighttime BP as well as the morning surge (average of systolic BP during the 2 hours after awakening minus the average of systolic BP during the 1 hour that included the lowest nighttime BP) and highest systolic nighttime BP (mean of 3 BP measurements, centered on the highest nighttime reading). Results: After 3 months, patients randomized to CPAP (mean CPAP usage: 6 hours) presented a significant reduction on daytime (80.3±6.3 to 75.3±6.9 mmHg; P=0.02) and nighttime diastolic BP (67.8±9.5 to 61.4±7.5 mmHg; P=0.03). In addition, we observed a significant reduction on highest nighttime systolic BP (120.0±13.6 to 112.0±.9 mmHg; P=0.02) with a trend for a reduction on morning surge (22.3±9.2 to 17.3±.4 mmHg; P=0.08). No significant alterations occurred in the control group. Conclusion: Even in the absence of established hypertension, CPAP therapy improved the behavior of 24 hour BP in patients with severe OSA.

scholarly journals ВПЛИВ МІКРОЕЛЕМЕНТІВ ТА ГУМІЛІДУ НА ВІДТВОРНУ ФУНКЦІЮ ТЕЛИЦЬ УКРАЇНСЬКОЇ М’ЯСНОЇ ПОРОДИ

2016 ◽  
Vol 18 (2(66)) ◽  
pp. 44-48
Author(s):  
V. Gryban ◽  
D. Mylostiva ◽  
E. Pecheniy
Keyword(s):  
Trace Elements ◽  
Physiological State ◽  
Reproductive Function ◽  
Protein Composition ◽  
Biologically Active ◽  
Control Group ◽  
Group I ◽  
Group Ii ◽  
The Impact ◽  
Experimental Group

The article presents research data on the impact of deficient dietary microelements (cobalt and selenium) and biologically active supplement Humilid  on the indicators of the reproductive function of heifers after the first calving. We have found out that Humilid and trace elements influence on the physiological state of reproductive organs and stimulate the sexual heat of animals. Regarding the duration of the period from calving to fertilized insemination, the difference between the control and experimental groups is more visible. Thus, the service period in the experimental group I (under the influence of Humilid) was 293.2 days, which is 2.6 days less than in the control group. In the experimental group II (under the influence of cobalt and selenium), it was, respectively, by 3.9 days less than in the control one. This may indicate that the minerals and dietary supplements contribute to more rapid recovery of the ovarian cycle. Protein composition of blood serum was investigated in the study of the biochemical spectrum of blood. Balancing the nutrition of animals with deficient dietary microelements and adding Humilid increase the concentration of protein molecules, which is visible from the indicator of crude protein and its components - albumen and globulin.In comparison with animals in the control group, a total protein level of heifers in the experimental group I was higher by 8.8% (P <0.05), and in the experimental group II - by 8.6% (P <0.05). This may indicate the increased intensity of synthetic and redox processes in heifers’ bodies in preovulatory period which serve best for the insemination.The level of albumen was also higher by 8.0 and 7.3% respectively under the influence of Humilid and trace elements in relation to the control group, indicating the improvement of transport of substances, in our case estradiol.As far as globulin is concerned, the growth of this class of proteins was marked by 9.4 and 9.6%, indicating the improvement of the level of resistance of the organism. Thus, the increase in blood biochemical parameters creates certain conditions in heifers’ body to improve their insemination.

scholarly journals Rational and Design of the SIMULATOR Study: A Multicentre Randomized Study to Assess the Impact of SIMULation-bAsed Training on Transoesophageal echocardiOgraphy leaRning for Cardiology Residents

2021 ◽  
Vol 8 ◽  
Author(s):  
Théo Pezel ◽  
Anne Bernard ◽  
Yoan Lavie Badie ◽  
Julien Dreyfus ◽  
Etienne Audureau ◽  
...  
Keyword(s):  
Randomized Study ◽  
Intervention Group ◽  
Medical Residents ◽  
Control Group ◽  
Traditional Teaching ◽  
Single Center ◽  
Simulation Based ◽  
Simulator Study ◽  
And Performance ◽  
The Impact

Introduction: Simulation-based training in transesophageal echocardiography (TEE) seems promising. However, data are limited to non-randomized or single-center studies. To assess the impact of simulation-based vs. traditional teaching on TEE knowledge and performance for medical residents in cardiology.Materials and Methods: Nationwide prospective randomized multicenter study involving 43 centers throughout France allowing for the inclusion of &gt;70% of all French cardiology residents. All cardiology residents naive from TEE will be included. Randomization with stratification by center will allocate residents to either a control group receiving theoretical knowledge by e-learning only, or to an intervention group receiving two simulation-based training sessions on a TEE simulator in addition.Results: All residents will undergo both a theoretical test (0–100 points) and a practical test on a TEE simulator (0–100 points) before and 3 months after the training. Satisfaction will be assessed by a 5-points Likert scale. The primary outcomes will be to compare the scores in the final theoretical and practical tests between the two groups, 3 months after the completion of the training.Conclusion: Data regarding simulation-based learning in TEE are limited to non-randomized or single-center studies. The randomized multicenter SIMULATOR study will assess the impact of simulation-based vs. traditional teaching on TEE knowledge and performance for medical residents in cardiology, and whether such an educational program should be proposed in first line for TEE teaching.

Reproductive function in patients with uterine myoma

1985 ◽  
Vol 66 (2) ◽  
pp. 105-107
Author(s):  
I. M. Mazitov ◽  
T. I. Timofeeva ◽  
N. I. Raimova ◽  
I. M. Bogolyubova
Keyword(s):  
Sexual Function ◽  
Uterine Fibroids ◽  
Reproductive Function ◽  
Uterine Myoma

The concept of the role of sexual function in the development of uterine fibroids is still controversial.

Emergency Room Utilization in the First 15 Months of Life: A Randomized Study

PEDIATRICS ◽  
1979 ◽  
Vol 63 (3) ◽  
pp. 486-490 ◽  
Author(s):  
Nigel Paneth ◽  
Deborah Bell ◽  
Ruth E.K. Stein
Keyword(s):  
Primary Care ◽  
Emergency Room ◽  
Randomized Study ◽  
Group Analysis ◽  
Care Program ◽  
Pediatric Care ◽  
Control Group ◽  
Municipal Hospital ◽  
Primary Care Program ◽  
The Impact

The impact of a system of primary pediatric care on emergency room use in a municipal hospital was measured by comparing that use in two randomly selected populations. The population that was offered participation in a primary care program consistently used the emergency room less than did the control group. Analysis of the pattern of utilization revealed that the differences were limited to patients who actually participated in the program, and to weekday use of the emergency room. Unusually heavy (greater than ten visits per year) use of the emergency room was virtually eliminated among participants in the primary care program.

scholarly journals Pupillometry pain index decreases intraoperative sufentanyl administration in cardiac surgery: a prospective randomized study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Vivien Berthoud ◽  
Maxime Nguyen ◽  
Anouck Appriou ◽  
Omar Ellouze ◽  
Mohamed Radhouani ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Cardiac Surgery ◽  
Primary Outcome ◽  
Randomized Study ◽  
Intervention Group ◽  
Prospective Randomized Study ◽  
Control Group ◽  
Standard Group ◽  
Postoperative Course ◽  
The Impact

AbstractPupillometry has proven effective for the monitoring of intraoperative analgesia in non-cardiac surgery. We performed a prospective randomized study to evaluate the impact of an analgesia-guided pupillometry algorithm on the consumption of sufentanyl during cardiac surgery. Fifty patients were included prior to surgery. General anesthesia was standardized with propofol and target-controlled infusions of sufentanyl. The standard group consisted of sufentanyl target infusion left to the discretion of the anesthesiologist. The intervention group consisted of sufentanyl target infusion based on the pupillary pain index. The primary outcome was the total intraoperative sufentanyl dose. The total dose of sufentanyl was lower in the intervention group than in the control group and (55.8 µg [39.7–95.2] vs 83.9 µg [64.1–107.0], p = 0.04). During the postoperative course, the cumulative doses of morphine (mg) were not significantly different between groups (23 mg [15–53] vs 24 mg [17–46]; p = 0.95). We found no significant differences in chronic pain at 3 months between the 2 groups (0 (0%) vs 2 (9.5%) p = 0.49). Overall, the algorithm based on the pupillometry pain index decreased the dose of sufentanyl infused during cardiac surgery.Clinical trial number: NCT03864016.

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