scholarly journals Sonographic Evaluation of Obstetric Anal Injuries

2015 ◽  
Vol 9 (3) ◽  
pp. 266-274
Author(s):  
Aris Antsaklis ◽  
Themos Grigoriadis ◽  
Sylvia-Christina Mylona ◽  
George Giannoulis ◽  
Stavros Athanasiou
Keyword(s):  
Anal Sphincter ◽  
Obstet Gynecol ◽  
Perineal Pain ◽  
Obstetric Anal Sphincter Injuries ◽  
Short Term ◽  
Detection Rates ◽  
Sonographic Evaluation ◽  
Endoanal Sonography ◽  
Vaginal Deliveries

ABSTRACT Intrapartum damage to the anal sphincter is an important factor in fecal incontinence. Obstetric anal sphincter injuries (OASIS) vary from 1 to 18% of vaginal deliveries, including instrumental deliveries. The severity of anal sphincter injuries vary from superficial lacerations to deep injuries that can extend to the epithelium. Obstetric anal sphincter injuries are associated with both short-term complications (heavy bleeding, difficulties in recovery, increased incidence of infections, increased perineal pain) and long-term complications (rectovaginal fistulae or facal incontinence). A significant number of these anal sphincter injuries can be detected promptly after a good clinical examination, but still that does not exclude the possibility of these women suffering long-term complications. What is more when some of these so called ‘occult tears’ go undetected further increase the morbidity of the woman. Sonography of the perineum and the anal sphincter appears to offer a better diagnosis and detection of these injuries after vaginal delivery, which allows a timely and better treatment with less complications, with endoanal sonography offering the best detection rates so far. How to cite this article Grigoriadis T, Mylona SC, Giannoulis G, Athanasiou S, Antsaklis A. Sonographic Evaluation of Obstetric Anal Injuries. Donald School J Ultrasound Obstet Gynecol 2015;9(3):266-274.

scholarly journals Incidence and Risk Factors of Obstetric Anal Sphincter Injuries after Various Modes of Vaginal Deliveries in Chinese Women

2015 ◽  
Vol 128 (18) ◽  
pp. 2420-2425 ◽  
Author(s):  
Tung Chi Wai ◽  
Cheon Willy Cecilia ◽  
Tong Wai Mei Anny ◽  
Leung Hau Yee
Keyword(s):  
Risk Factors ◽  
Anal Sphincter ◽  
Chinese Women ◽  
Obstetric Anal Sphincter Injuries ◽  
Vaginal Deliveries

Sa1670 – Long Term Clinical and Physiological Consequences of Obstetric Anal Sphincter Injuries (OASIS)

2019 ◽  
Vol 156 (6) ◽  
pp. S-360-S-361
Author(s):  
Rose Q. Trieu ◽  
Christine Verdon ◽  
Yoav Mazor ◽  
Gillian Prott ◽  
Michael P. Jones ◽  
...  
Keyword(s):  
Anal Sphincter ◽  
Obstetric Anal Sphincter Injuries

A comparative study of obstetric anal sphincter injuries in vaginal deliveries of twins and singleton pregnancies

2018 ◽  
Vol 37 (8) ◽  
pp. 2717-2723
Author(s):  
Stergios K. Doumouchtsis ◽  
Youstina Fahmay ◽  
Philip Sedgwick ◽  
Constantin M. Durnea
Keyword(s):  
Comparative Study ◽  
Anal Sphincter ◽  
Obstetric Anal Sphincter Injuries ◽  
Vaginal Deliveries ◽  
Singleton Pregnancies

scholarly journals Long-term outcome of sphincteroplasty with separate suturing of the internal and the external anal sphincter

2019 ◽  
Vol 23 (12) ◽  
pp. 1163-1172 ◽  
Author(s):  
M. R. Berg ◽  
H. Gregussen ◽  
Y. Sahlin
Keyword(s):  
Anal Sphincter ◽  
Anal Incontinence ◽  
Internal Anal Sphincter ◽  
External Anal Sphincter ◽  
Internal Sphincter ◽  
Long Term Outcome ◽  
Obstetric Injury ◽  
Endoanal Sonography

Abstract Background Sphincteroplasty is one of the treatment options for anal incontinence following obstetric injury. The aim of the study was to evaluate the long-term effect of sphincteroplasty with separate suturing of the internal and the external anal sphincter on anal continence. Methods A retrospective study was conducted on women who had sphincteroplasty for treatment of anal incontinence following obstetric injury. Women operated between January 1, 2011 and December 31, 2014 at Sykehuset Innlandet Hospital Trust Hamar, were invited to answer a questionnaire and participate in a clinical examination, including endoanal sonography. Results 111 (86.7%) women participated. Median postoperative follow-up was 44.5 months, and 63.8% of the participants experienced an improvement of at least three points in the St. Mark’s incontinence score. Fecal urgency and daily fecal leakage persisted in 39.4% and 6.4% of the participants, respectively. The internal anal sphincter improvement persisted in 61.8% of the participants, and there was a median reduction of their St. Mark’s score of 6.0 points between the preoperative value and the value at long-term follow-up. There was no significant change in the St. Mark’s score of patients with persistent dehiscence of the internal anal sphincter. Conclusions Sphincteroplasty, with separate suturing of the internal sphincter resulted in continence for stool maintained for at least 3 years in the majority of the patients, while there was an improvement in continence in nearly two-thirds.

scholarly journals Do observer fatigue and taxon bias compromise visual encounter surveys for small vertebrates?

2019 ◽  
Vol 46 (2) ◽  
pp. 127 ◽  
Author(s):  
Björn Lardner ◽  
Amy A. Yackel Adams ◽  
Adam J. Knox ◽  
Julie A. Savidge ◽  
Robert N. Reed
Keyword(s):  
Distance Sampling ◽  
Data Interpretation ◽  
Short Term ◽  
Survey Period ◽  
Detection Rates ◽  
Visual Survey ◽  
Survey Results ◽  
Visual Searches ◽  
Standard Animal

Context Visual encounter surveying is a standard animal inventory method, modifications of which (e.g. distance sampling and repeated count surveys) are used for modelling population density. However, a variety of factors may bias visual survey counts. Aims The aim of the present study was to evaluate three observer-related biases: (1) whether fatigue compromises detection rate as a survey occasion progresses; (2) whether long-term fatigue or boredom compromise detection rates over the course of a survey period; and (3) whether observers exhibit biases in detection rates of different animal taxa. Methods We analysed >2.3 × 104 observations of lizards and small mammals from nocturnal pedestrian visual encounter surveys, each 4 h in duration, conducted by a pool of 29 observers, each of whom surveyed for up to 31 nights. Key results Detections of sleeping (diurnal) emerald tree skinks (Lamprolepis smaragdina) exhibited a small but statistically verified decline as the evening progressed, whereas detections of sleeping (diurnal) green anoles (Anolis carolinensis) increased as the evening progressed. Detections of nocturnal geckos (several species pooled) showed a weak and non-significant declining trend. Small mammal sightings (rats, shrews and mice pooled) declined strongly over the course of an evening. The participants saw greater or equal numbers of animals the more nights they surveyed. Most participants exhibited statistically significant, and often strong, taxonomic detection bias compared with the pool of peer observers. The skills of some observers appeared to be consistently above average; others consistently below average. Conclusions Data on sleeping lizards suggest that neither short-term nor long-term observer fatigue is of much concern for 4-h visual searches. On the contrary, differences among observers in taxonomic bias and overall detection skills pose a problem for data interpretation. Implications By comparing temporal detection patterns of immobile (e.g. sleeping) with actively moving animal taxa, sampling biases attributable to searcher fatigue versus the animals’ circadian rhythm can be disentangled and, if need be, statistically corrected for. Observer skill differences and observer-specific taxonomic biases may hamper efforts to statistically evaluate survey results, unless explicitly included as covariates in population models.

Long-Term Sexual Function After Obstetric Anal Sphincter Injuries

2018 ◽  
Vol 24 (2) ◽  
pp. 82-86 ◽  
Author(s):  
Michele S. OʼShea ◽  
Christina Lewicky-Gaupp ◽  
Dana R. Gossett
Keyword(s):  
Sexual Function ◽  
Anal Sphincter ◽  
Obstetric Anal Sphincter Injuries

scholarly journals Postpartum Perineal Pain in the Absence of Obstetric Anal Sphincter Injuries: A Prospective Observational Study

2013 ◽  
Vol 4 (1) ◽  
pp. 69-74
Author(s):  
Shiqin Xu
Keyword(s):  
Logistic Regression ◽  
Anal Sphincter ◽  
Rating Scale ◽  
Short Form ◽  
Postnatal Period ◽  
Early Postnatal Period ◽  
Perineal Pain ◽  
Multivariate Logistic Regression Model ◽  
Multivariate Logistic Regression ◽  
Obstetric Anal Sphincter Injuries

OBJECTIVE The purpose of this study was to identify the prevalence of perineal pain at early postnatal period and to assess the association between maternal, obstetric or neonatal variables and perineal pain. METHODS Three hundred and six women were followed up for perineal pain with present pain intensity (PPI) and visual rating scale (VRS) components of the validated short-form McGill pain scale. Multivariate logistic regression was performed to identify which characteristics of the patients and neonates were independent determinants of perineal pain. RESULTS The incidence of perineal pain at days 1 and 7 postpartum was 88.2% and 24.9%, respectively. PPI was mild 63.1% (day 1) and 23.9% (day 7), moderate 24.2% and 1.1%, and severe 1% and 0%. VRS score was 2 (1-3) at day 1 and 0 (0-1) at day 7 postpartum, respectively. Perineal pain was more common in primiparous women with higher BMI, more maternal weight gain, received epidural analgesia, and use of episiotomy. In a multivariate logistic regression model, only episiotomy predicted the pain at day 1 postpartum (RR=2.05, 95% CI 0.95-4.42) suggesting that women with mediolateral episiotomy experienced more intense pain than women with median episiotomy. CONCLUSIONS In the absence of obstetric anal sphincter injuries, although perineal pain during the early postnatal period is prevalent, the intensity is slight. Moreover, the use of episiotomy is associated with more perineal pain than other perineal trauma.

Conceptual short-term memory (CSTM) supports core claims of Christiansen and Chater

2016 ◽  
Vol 39 ◽  
Author(s):  
Mary C. Potter
Keyword(s):  
Working Memory ◽  
Rapid Serial Visual Presentation ◽  
Language Comprehension ◽  
Short Term Memory ◽  
Visual Presentation ◽  
Long Term Memory ◽  
Short Term ◽  
Term Memory ◽  
Use Of Knowledge

AbstractRapid serial visual presentation (RSVP) of words or pictured scenes provides evidence for a large-capacity conceptual short-term memory (CSTM) that momentarily provides rich associated material from long-term memory, permitting rapid chunking (Potter 1993; 2009; 2012). In perception of scenes as well as language comprehension, we make use of knowledge that briefly exceeds the supposed limits of working memory.

Ultrastructural investigations of MDL 19,660-induced effects on the canine platelet and megakaryocyte

1990 ◽  
Vol 48 (3) ◽  
pp. 374-375
Author(s):  
D.E. Loudy ◽  
J. Sprinkle-Cavallo ◽  
J.T. Yarrington ◽  
F.Y. Thompson ◽  
J.P. Gibson
Keyword(s):  
Antidepressant Drug ◽  
Beagle Dogs ◽  
Long Term Effects ◽  
Short Term ◽  
Platelet Counts ◽  
Toxicological Studies ◽  
Induced Aggregation ◽  
Internal Architecture

Previous short term toxicological studies of one to two weeks duration have demonstrated that MDL 19,660 (5-(4-chlorophenyl)-2,4-dihydro-2,4-dimethyl-3Hl, 2,4-triazole-3-thione), an antidepressant drug, causes a dose-related thrombocytopenia in dogs. Platelet counts started to decline after two days of dosing with 30 mg/kg/day and continued to decrease to their lowest levels by 5-7 days. The loss in platelets was primarily of the small discoid subpopulation. In vitro studies have also indicated that MDL 19,660: does not spontaneously aggregate canine platelets and has moderate antiaggregating properties by inhibiting ADP-induced aggregation. The objectives of the present investigation of MDL 19,660 were to evaluate ultrastructurally long term effects on platelet internal architecture and changes in subpopulations of platelets and megakaryocytes.Nine male and nine female beagle dogs were divided equally into three groups and were administered orally 0, 15, or 30 mg/kg/day of MDL 19,660 for three months. Compared to a control platelet range of 353,000- 452,000/μl, a doserelated thrombocytopenia reached a maximum severity of an average of 135,000/μl for the 15 mg/kg/day dogs after two weeks and 81,000/μl for the 30 mg/kg/day dogs after one week.

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