Annals of the New York Academy of Sciences
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Sudden infant deaths are the most common kind of death in infants aged between one month and one year. The unexpectedness, the legal investigation, and the absence of a convincing cause all have a devastating impact on bereaved parents, who look to health professionals for reassurance and explanation. Doctors and nurses may feel inadequate. ⋯ Parents need written information and the opportunity to talk with someone compassionate and informed about sudden infant deaths. Suggestions for doctors and nurses stress the importance of immediate support, early explanation of the postmortem report, and continued befriending by other suitable parents. Later counseling should be offered to discuss the care of future children and rebuild parental confidence.
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Ann. N. Y. Acad. Sci. · Jan 1988
Patients' experience of transvaginal follicle aspiration under local anesthesia.
The development of vaginal ultrasound transducers has facilitated ovum pick-up (OPU) by providing higher precision and less trauma than are found with laparoscopy and other ultrasound-assisted techniques. In order to evaluate the patients' acceptance, 65 patients were asked to answer a questionnaire about their experience with the procedure. The punctures were executed with specially designed needles introduced through a needle guide attached to a vaginal transducer with a frequency of 7 MHz (Brüel & Kjaer, Denmark). ⋯ In two cases the physician underestimated the patients' pain experience. The mean time required for the procedure was 16 min/OPU. We conclude that transvaginal ultrasound-guided OPU is well accepted by most patients under local anesthesia and that it is a rapid and accurate procedure.
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Ann. N. Y. Acad. Sci. · Jan 1986
ReviewRange of environmental stimuli producing nociceptive suppression: implications for neural mechanisms.
Initial studies of environmentally induced analgesia in the rat established several important characteristics of this phenomenon. We demonstrated that stressful environmental stimuli were not sufficient to produce nociceptive suppression. However, emphasis by many researchers on stress-related analgesia has limited studies of the range of environmental contexts producing nociceptive suppression and handicapped efforts to describe neural mechanisms mediating EIA. ⋯ Considered together, data from these studies indicate that, while stress is not sufficient to produce analgesia, a variety of environmental conditions can modulate nociceptive input. A number of different neural systems could contribute EIA associated with various stimuli. It is possible that the regulation of nociceptive input is not the exclusive, or even principal, consequence of normal activity within certain of these systems.