ABSTRACT
Minimally invasive surgical techniques are becoming increasingly common in gynecologic surgery. However, traditional laparoscopy can be challenging. A robotic surgical system gives several advantages over traditional laparoscopy and has been incorporated into reproductive gynecological surgeries. The objective of this article is to review recent publications on robotically-assisted laparoscopy for reproductive surgery. Recent clinical research supports robotic surgery as resulting in less post-operative pain, shorter hospital stays, faster return to normal activities, and decreased blood loss. Reproductive outcomes appear similar to alternative approaches. Drawbacks of robotic surgery include longer operating room times, the need for specialized training, and increased cost. Larger prospective studies comparing robotic approaches with laparoscopy and conventional open surgery have been initiated and information regarding long-term outcomes after robotic surgery will be important in determining the ultimate utility of these procedures.
Subject(s)
Gynecologic Surgical Procedures/adverse effects , Gynecologic Surgical Procedures/methods , Robotics/methods , Endometriosis/surgery , Female , Fertility Preservation/methods , Humans , Leiomyoma/surgery , Minimally Invasive Surgical Procedures/adverse effects , Minimally Invasive Surgical Procedures/methods , Organ Sparing Treatments/methods , Pregnancy , Sterilization Reversal/adverse effects , Sterilization Reversal/methods , Urinary Bladder Neoplasms/surgery , Uterine Neoplasms/surgeryABSTRACT
AIM: Endometriosis is a leading cause of pelvic pain and infertility. Implantation of endometrial cells to the peritoneal surface can lead to a spectrum of disease severity with the most severe causing extensive pelvic adhesions and anatomic distortion. Infertility can result from anatomic abnormalities as well proinflammatory cellular and immune factors. Treatment options for women seeking pregnancy include surgical removal and/or in vitro fertilization. The aim of this study was to review current literature on the pathogenesis of endometriosis and treatment options for infertility. METHODS: Recent published articles regarding infertility and endometriosis have been reviewed analyzing PubMed and Cochrane databases. RESULTS: In vitro fertilization (IVF) is a valid option for patients after surgical management has not restored fertility. IVF may be offered sooner to older patients or to those with more severe disease. It is unclear if prior surgical treatment has deleterious effects on IVF outcomes. It does appear, however, that surgical removal of endometriomas may lead to decreased ovarian reserve. This may not affect fertility outcomes. CONCLUSION: Endometriosis is a leading cause of pelvic pain and infertility. The most accepted theory of how endometriosis develops is the retrograde transplant theory by Sampson, but a constellation of numerous other factors are involved. The gold standard for diagnosis is operative; therefore, the true prevalence of this disease is uncertain. Many women with endometriosis will seek fertility treatment. In this case if endometriosis is found, it should be treated.
Subject(s)
Endometriosis/epidemiology , Endometriosis/physiopathology , Fertilization in Vitro/statistics & numerical data , Adult , Female , Humans , Pain/epidemiology , PregnancyABSTRACT
It has been suggested that manifestations of mental illnesses have been changing during the last decades. Thus, the catatonic form of schizophrenia is scarcely observed nowadays and should be about to disappear. Changes in both catatonic schizophrenia prevalence, and catatonic symptoms are analyzed according to revisions dated 1964, and 1984, of the clinical records to be found at the Psychiatric Clinic, University of Chile. A diminution of schizophrenia catatonic forms in 1984 records was found out when comparing with 1964 records. A diminution of catatonic symptons--usually associated to severe forms of schizophrenia--was also noticeable. In both groups, however, such variations have no relation whatever with the extent of the evolutive period prior to institutionalization.
Subject(s)
Hospitalization/statistics & numerical data , Schizophrenia, Catatonic/epidemiology , Adolescent , Adult , Chile/epidemiology , Educational Status , Female , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
It has been suggested that manifestations of mental illnesses have been changing during the last decades. Thus, the catatonic form of schizophrenia is scarcely observed nowadays and should be about to disappear. Changes in both catatonic schizophrenia prevalence, and catatonic symptoms are analyzed according to revisions dated 1964, and 1984, of the clinical records to be found at the Psychiatric Clinic, University of Chile. A diminution of schizophrenia catatonic forms in 1984 records was found out when comparing with 1964 records. A diminution of catatonic symptons--usually associated to severe forms of schizophrenia--was also noticeable. In both groups, however, such variations have no relation whatever with the extent of the evolutive period prior to institutionalization.
ABSTRACT
Se presenta un caso clínico de Paranoia de Renta, describiendo los elementos psicopatológicos que permiten hacer el diagnóstico
Subject(s)
Adult , Humans , Male , Paranoid Disorders/diagnosis , Neurotic Disorders/diagnosis , Occupational Diseases , Diagnosis, DifferentialABSTRACT
The Authors describe the effects of CB 154 (2.5 mg, per os) and naloxone (0.4 mg, i.m) on GH levels in normal man serum. Preliminary results point to a clear potentiation of GH release when the opiate receptor blockade is added to a dopamine receptor stimulation.
