However, the treatment effect is small which suggests that acupressure may be most effective Cefaloridine
during the initial phase of labor. ""Objective. To study short- and long-term improvement in obstetric anal incontinence after secondary overlapping sphincteroplasty and repeat repairs. Design. A prospective analysis based on incontinence scores and patient satisfaction. Setting. Department of Gastroenterological Surgery, Oslo University Hospital, a tertiary unit also dealing with sphincter repair. Population. Of 40 obstetric patients operated consecutively from February 1996 to April 2004, 33 (83%) patients with median age of 36 years were eligible for evaluation. Methods. Wexner's and St. Mark's incontinence score, clinical examination, anal ultrasonography and manometry, and neurophysiological examination when indicated. Patient satisfaction to treatment was recorded. The patients had anterior overlapping sphincteroplasty. Five had repeat operations, four sphincteroplasty and two post-anal repair. Main outcome measures. Anal incontinence, patient satisfaction. Results. The 33 patients were examined after median 7 (range 2�C62) months and 103 (62�C162) months. Median incontinence scores preoperatively http://www.selleckchem.com/
and after short- and long-term follow-up were 12 (5�C20), 7 (5�C20) (p < 0.01) and 9 (0�C18) (p < 0.05), respectively. Three patients (9%) had normalized anal incontinence (score ��1) after short- and long-term follow-up. Corresponding numbers for improved anal incontinence were 22 (67%) and 16 (49%), respectively. Improvement in incontinence scores and patients' satisfaction were concordant. Symptom duration (n = 7), pudendal neuropathy (n = 6), repeat repair (n = 5) and instrument delivery (n = 3) were associated www.selleckchem.com
with adverse outcome. Conclusions. Improvement in anal incontinence at short-term follow-up is attenuated at long-term follow-up. Stoma formation, sacral nerve stimulation and neo-sphincter formation must be considered in compliant patients. ""Objectives. To examine the association between the psychosocial construct of race-related stress and smoking among pregnant African-American women. Design. Inferential statistical analyses were performed. Setting. Participants were recruited primarily at a medical clinic as well as through word-of-mouth consistent with the snowball sampling technique. Population. Seventy pregnant self-identified African-American women (32 smokers and 38 non-smokers) 18 years or older participated in the study. Methods. Participants completed self-report measures of the Index of Race-Related Stress and an investigator-developed demographic and smoking questionnaire. Main outcome measures. Smoking status of each participant was established through self-report. Results. Significant associations were found between the smoking status of pregnant African-American women and the frequency and perceptions of overall race-related stress (p < 0.03 and 0.