Articles: treatment.
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The benefits of surgical treatment for patients with congenital heart disease in relation to pregnancy are still controversial. We studied 48 pregnant women (mean age = 25 years) with surgically-corrected congenital heart diseases (Group 1). This included 15 cyanotic diseases: Fallot's tetralogy (11 cases); Ebstein's anomaly (2 cases); transposition of the great arteries (1 case); and double outlet of the right ventricle (1 case). ⋯ Spontaneous abortion (4 vs. 10 percent), Caesarean deliveries (48 vs. 66 percent) or growth retardation (13 vs. 28 percent) did not present any significant differences between these groups. Surgical treatment in patients with heart diseases is associated with a better maternal and fetal prognosis. Therefore, surgery must be considered when counseling patients with congenital heart diseases.
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Low back pain ist frequently associated with malposition of the pelvis due to an imbalance of the postural muscles. In these patients functional malposition of both the sacrum and the ileum can be observed, resulting in differences in the length of the legs. We investigated whether the return to a normal position correlated with pain relief. ⋯ Differences in the length of the legs can be successfully treated by manual therapy at C0/C1 or C2/C3 in the majority of patients with pelvic malposition. However, infiltration of the iliosacral joints is often required as additional therapy for short-term and long-term pain relief. Treatment with NSAIDs alone is only seldom effective in cases of pelvic malposition and rarely affords long-term pain relief.
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A multimodal treatment program is presented in cases of functional restoration for chronic low back pain. The study comprises four parts. Part I gives an overview of the different results of the study. Part II focuses on the medical and functional examination in comparison with persons who do not suffer from back pain. Part III describes psychosocial aspects (depression, complaints, ways of coping, disability) and psychotherapy. In part IV prognostic factors and their reliability for predicting treatment outcome (return to work, pain intensity, self-assessment of success by patients) are examined. In addition the relevant effects of the program on social and health care systems are also addressed. ⋯ The results demonstrate the effectiveness of the multimodal program of functional restoration, not only concerning positive changes in somatic, psychological and physical variables, but also with respect to the number of patients who returned to work. Our methods are also compared with the discrepant results of multimodal treatment in the United States and Scandinavia.
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Self-treatment for sexually transmitted diseases (STD) is common, but little studied, in Thailand, and its influence on human immunodeficiency virus (HIV) infection is unknown. ⋯ These men are attempting to prevent HIV and STDs. Self-treatment with antibiotics may lower HIV risks associated with bacterial STD in a high-prevalence population.
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Am. J. Obstet. Gynecol. · Jul 1996
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of misoprostol with and without laminaria tents for induction of second-trimester abortion.
Our purpose was to determine whether intracervical placement of laminaria tents would improve the effectiveness of the prostaglandin analog misoprostol for the elective termination of pregnancies in the second trimester. ⋯ Laminaria tents inserted concurrently with the first dose of misoprostol do not significantly improve the abortifacient effect of vaginal misoprostol in the second trimester of pregnancy.