RESUMO
Microlaparoscopes have been evaluated for minimally invasive laparoscopy using minimal anaesthesia or analgesia since our preliminary report on microlaparoscopy in 1993. This international multicentre report of safety and efficacy of diagnostic and operative microlaparoscopy was completed to evaluate the role of microlaparoscopy in a wide spectrum of gynaecological indications, diagnoses of pelvic and tubal disease, tubal occlusion and assisted reproduction. A total of 408 patients from seven centres around the world were included in this report. Of the 164 patients who underwent microlaparoscopy under local analgesia only three patients (1.8%) converted to i.v. sedation because of pain intolerance. All 71 patients who underwent microlaparoscopy under i.v. sedation as planned tolerated the procedure with acceptable pain level perception. Only one abdominal wall minor bleeding and one uterine wall minor bleeding were recorded in the remaining 173 patients who underwent microlaparoscopy under general anaesthesia. Visualization of the pelvic organs was sufficient in all 408 cases for diagnosis and treatment of selected pelvic pathology. We concluded, based on this sizeable microlaparoscopy series, that this outpatient procedure can replace large diameter laparoscopy for diagnosis and treatment of various pelvic conditions. Microlaparoscopy can safely replace large diameter laparoscopy in motivated patients who require minor operative procedures such as tubal occlusion, minor adhesiolysis, tubal gamete or embryo transfers and fulguration of endometriotic implants. This series demonstrated that operative microlaparoscopy can be carried out under general anaesthesia, reducing to nil the potential damage of a large diameter tracer. Future improvements in i.v. sedation in combination with i.p. local anaesthesia will potentially eliminate the need for general anaesthesia in some of the patients undergoing minor operative microlaparoscopy.
Assuntos
Laparoscopia , Microcirurgia/métodos , Estudos de Viabilidade , Feminino , Doenças dos Genitais Femininos/cirurgia , Humanos , Laparoscopia/efeitos adversos , Reprodutibilidade dos Testes , Estudos RetrospectivosRESUMO
Study was carried out to find the existence, form of presentation and commonalities and individual differences in the mental representation of natural whole numbers (REMENEN). The design used was an ex-post-factor exploratory and descriptive field study. A questionnaire was developed and administered to a sample of 153 senior students at the Universidad Católica Andres Bello (UCAB). The hypotheses were: a) that REMENEN exists in all individuals, b) that REMENEN are individual, c) that there are intergroup differences and intragroup similarities in REMENEN according to major field of study and sex. The existence of REMENEN in the great majority of individuals was demonstrated as well as their individuality in all subjects. There were no significant differences according to major or sex, and no significant intragroup similarities. The present study opens the field for a new line of research and allows a relationship between isolated statements regarding numbers made by Galton, Jung and some cognitive psychologists.
Assuntos
Inteligência , MatemáticaRESUMO
A series of 30 microlaparoscopies performed under local anaesthesia and sedation are presented. The visualization of the pelvic organs was acceptable and the patients reported mild discomfort only. Microlaparoscopy may potentially replace macrolaparoscopy in selected cases.
Assuntos
Doenças dos Genitais Femininos/diagnóstico , Laparoscopia/métodos , Microcirurgia/métodos , Adulto , Feminino , Doenças dos Genitais Femininos/terapia , HumanosRESUMO
OBJECTIVE: To evaluate publications that introduced novel diagnostic and therapeutic transcervical procedures on the fallopian tubes. DESIGN: Major studies that conceptually changed the therapeutic approach to the fallopian tubes were reviewed. Minor publications were also included if they introduced a new concept or contributed to the topic. Clinical publications were selected if they involved transcervical diagnosis and treatment of fallopian tubes. RESULTS: Transcervical tubal catheterization procedures for diagnosis of tubal disease, tubal obliteration, tubal recanalization, and tubal medication are minimally invasive procedures that can improve our understanding and diagnostic accuracy of tubal disease. These procedures allow transcervical treatment of proximal tubal occlusion. Further improvements in equipment and methodology are promising. Transcervical tubal occlusion, gamete and embryo deposition, and treatment of ectopic pregnancy may all be performed using the transcervical approach. CONCLUSION: Transcervical tubal catheterization can replace microsurgery and IVF in selected patients with proximal tubal occlusion, improve the diagnostic accuracy of tubal disease, and deliver medications to the fallopian tubes. Cumulative knowledge suggests that transcervical tubal catheterization should become a universally accepted, taught, and practiced approach in the diagnosis and treatment of the fallopian tubes.
Assuntos
Cateterismo , Tubas Uterinas , Ginecologia/tendências , Cateterismo/métodos , Colo do Útero , Endoscopia , Doenças das Tubas Uterinas/diagnóstico , Doenças das Tubas Uterinas/terapia , Tubas Uterinas/diagnóstico por imagem , Tubas Uterinas/patologia , Feminino , Humanos , Histerossalpingografia , Técnicas Reprodutivas , Esterilização Tubária , Ultrassom , UltrassonografiaRESUMO
The puberal development of the mammary glands is the result of a final increase of serum estradiol. Having observed that the relationship with the father can affect the concentration of estradiol in the serum, the authors studied the relationship between the intensity of that interaction and the morphological development of the breasts, a standing witness in a woman's body of the concentration of estradiol in the serum during the pubertal stage. The study had two parts: 1) The review of the clinical histories of 145 nulliparous women between 18 and 25 years of age. 57.3% lived with their fathers, while 42.6% had no father, either because of death or separation. The difference between both groups in breast size as well as in the width of the areola was significant. There was also a significant difference depending on whether the separation occurred before or after the girl was 9 years old. 2) The administration of a questionnaire to 90 nulliparous women between the ages of 18 and 25, to establish the intensity of the father/daughter relationship. The results showed significant differences between the intensity of the father/daughter relationship, breast size and width of the areola. There was no significant correlation between the intensity of the relationship and the pigmentation of the areola in either of the two phases.
Assuntos
Mama/crescimento & desenvolvimento , Relações Pai-Filho , Puberdade/psicologia , Adolescente , Adulto , Estradiol/sangue , Feminino , Humanos , Masculino , Mamilos/crescimento & desenvolvimento , Estudos Prospectivos , Estudos Retrospectivos , Pigmentação da PeleRESUMO
Se realiza un estudio prospectivo entre diciembre de 1988 y junio de 1989, que comprende una serie de treinta y ocho mujeres embarazadas después de una procreación médicamente asistida. Se analizan los eventos del principio de la gestación con la ayuda de la ecografía transvaginal y los valores de gonadotropina coriónica humana (HCG). En vista de los pocos resultados hasta ahora publicados, este estudio preliminar podría ser de gran interés para definir lo más precozmente posible el diagnóstico, el pronóstico y la conducta a seguir en caso de embarazo