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Sökning: L773:0029 7828

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  • Arnbjörnsson, E. (författare)
  • Relationship between the removal of the nonacute appendix and the menstrual cycle
  • 1984
  • Ingår i: Obstetrical and Gynecological Survey. - 0029-7828. ; 39:10, s. 658-660
  • Tidskriftsartikel (refereegranskat)abstract
    • The present author has investigated the frequency with which normal appendices are found at appendectomy in different phases of the menstrual cycle. The study is based on 504 female patients, 15–45 years of age, who were perated on for suspected acute appendicitis during the period from 1976 to 1982. The results are shown in Tables 1 and 2. The frequency of acute appendicitis in the luteal phase of the menstrual.
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  • Bauer, Ann Z., et al. (författare)
  • Paracetamol Use During Pregnancy-A Call for Precautionary Action
  • 2022
  • Ingår i: Obstetrical and Gynecological Survey. - : Lippincott Williams & Wilkins. - 0029-7828 .- 1533-9866. ; 77:3, s. 133-134
  • Tidskriftsartikel (refereegranskat)abstract
    • Paracetamol, otherwise known as acetaminophen, is the active ingredient in over 600 prescription and nonprescription analgesic and antipyretic medications. Worldwide and in the United States, more than 50% and 65% of pregnant women use acetaminophen, respectively. Currently, acetaminophen is considered to be of minimal risk and appropriate for use during pregnancy by the US Food and Drug Administration and European Medicines Agency. Despite this, there exists concern that environmental exposure to pharmaceuticals including acetaminophen during fetal life may contribute to the increased rates of neurological, urogenital, and reproductive disorders.This consensus statement aimed to provide an evidence-based summary of the literature relating to neurological, urogenital, and reproductive outcomes that have been associated with maternal and perinatal use of acetaminophen. This consensus statement was created by an international multidisciplinary group consisting of experts in neurology, obstetrics/gynecologists, pediatrics, epidemiology, toxicology, endocrinology, reproductive medicine, and neurodevelopment. A literature review was conducted for studies published between 1995 and 2020, including only those with acetaminophen as an independent exposure. There is a limitation in the existing epidemiological literature addressing these questions, and future efforts are required.This consensus statement and systematic review finds evidence of significant neurodevelopmental and reproductive adverse effects of acetaminophen prenatal exposure, particularly with long-term use. It is recommended by this document that acetaminophen be used by pregnant women cautiously at the lowest effective dose for the shortest possible time and longer or higher-dose use be discussed with a health professional. It is also advised that packaging display warning labels related to the evidence discussed here.
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  • Borendal Wodlin, Ninnie (författare)
  • Intraoperative Cervical Treatment Does Not Affect the Prevalence of Vaginal Bleeding 1 Year Postoperatively After Subtotal Hysterectomy: A Register Study From the Swedish National Register for Gynecological Surgery
  • 2018
  • Ingår i: Obstetrical and Gynecological Survey. - : LIPPINCOTT WILLIAMS & WILKINS. - 0029-7828 .- 1533-9866. ; 73:2, s. 88-89
  • Tidskriftsartikel (refereegranskat)abstract
    • A subtotal hysterectomy implies retaining the cervix. Women who undergo this procedure are more likely to present with persistent vaginal bleeding (PVB) after surgery. To prevent subsequent vaginal bleeding, intraoperative cervical treatment (electrosurgical cauterization or resection) has been recommended. However, there is insufficient evidence demonstrating the efficacy of this treatment. The aims of this retrospective register study were to (1) establish the prevalence of PVB 1 year after subtotal hysterectomy, (2) analyze the effect of intraoperative cervical treatment during the subtotal hysterectomy on the occurrence of PVB, and (3) assess the impact of PVB on the patients self-reported assessment of her medical condition and satisfaction with the hysterectomy 1 year after surgery. Data were obtained fromthe SwedishNational Register for Gynecological Surgery for a cohort of women who underwent subtotal hysterectomy for benign conditions between January 2004 and June 2016. Preoperative and perioperative forms were collected to obtain demographic and clinical data. The 1-year inquiry form was used to collect data on occurrence of PVB, rating of medical condition, and satisfaction with surgical results. Multivariate logistic regression analyses were used to assess outcome measures. The prevalence of PVB following subtotal hysterectomy was 18.6%. Intraoperative treatment of the cervix at the time of the subtotal hysterectomy did not affect the frequency of PVB; the adjusted odds ratio (aOR) was 1.48, with a 95% confidence interval (CI) of 0.93 to 2.37. Althoughmore than 90% of women were satisfied or very satisfied with the surgical results, those experiencing bleeding episodes 1 year after the subtotal hysterectomy were significantly less content with the result of the surgery (aOR, 0.42; 95% CI, 0.26-0.67). There was no difference in self-perception of the medical condition 1 year after the surgery between women with and without PVB; the aOR was 1.16 with a 95% CI of 0.33 to 4.12. These data show that nearly 2 in 10 women may expect PVB following subtotal hysterectomy and that intraoperative cervical treatment does not affect the prevalence of bleeding. Although more than 90% of patients are satisfied with the results of surgery, women with PVB are less content. When choosing hysterectomy technique, information on the risk of PVB may be important. Subtotal hysterectomy may not be an option for women not willing to accept this risk.
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  • Brand, J. S., et al. (författare)
  • Diabetes and Onset of Natural Menopause : Results From the European Prospective Investigation Into Cancer and Nutrition EDITORIAL COMMENT
  • 2015
  • Ingår i: Obstetrical and Gynecological Survey. - 0029-7828 .- 1533-9866. ; 70:8, s. 507-508
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • The age at natural menopause (ANM) in the Western world ranges from 40 to 60 years, with an average onset of 51 years. The exact mechanisms underlying the timing of ANM are not completely understood. Both genetic and environmental factors are involved. The best-established environmental factor affecting ANM is smoking; menopause occurs 1 to 2 years earlier in smokers. In addition to genetic and environmental factors, chronic metabolic diseases may influence ANM. Some evidence suggests that diabetes may accelerate menopausal onset. With more women of childbearing age receiving a diagnosis of diabetes, it is important to examine the impact of diabetes on reproductive health. This study was designed to determine whether ANM occurs at an earlier age among women who have diabetes before menopause than in women without diabetes. Data were obtained from the European Prospective Investigation into Cancer and Nutrition (EPIC) study, a large multicenter prospective cohort study investigating the relationship between diet, lifestyle, and genetic factors and the incidence of cancer and other chronic diseases. A cohort of 519,978 men and women, mostly aged 27 to 70 years, were recruited primarily from the general population between 1992 and 2000. A total of 367,331 women participated in the EPIC study. After exclusions, 258,898 of these women met study inclusion criteria. Diabetes status at baseline and menopausal age were based on self-report and were obtained through questionnaires. Participants were asked if they had ever been diagnosed with diabetes and if so at what age. Associations of diabetes and age at diabetes diagnosis with ANM were estimated using time-dependent Cox regression analyses, with stratification by center and adjustments for age, smoking, reproductive, and known diabetes risk factors including smoking and with age from birth to menopause or censoring as the underlying time scale. Overall, there was no statistically significant lower risk of becoming menopausal among women with diabetes than women with no diabetes; the hazard ratio (HR) was 0.94, with a 95% confidence interval (CI) of 0.89 to 1.01. However, compared with women with no diabetes, women with diabetes before the age of 20 years had an earlier menopause (10-20 years [HR, 1.43; 95% CI, 1.02-2.01] and <10 years [HR, 1.59; 95% CI, 1.03-2.43]), whereas women with diabetes at age 50 years or older had a later menopause (HR, 0.81; 95% CI, 0.70-0.95). No association with ANM was found for diabetes onset between the ages 20 and 50 years. Strengths of the study include its large sample size and the measurement of a broad set of potential confounders. However, there were several limitations. First, results may have been underestimated because of survival bias. Second, the sequence of menopause and diabetes in women with a late age at diabetes is uncertain, as both events occur in a short period, and both diabetes and menopause status were based on self-report, not verified by medical records. Third, no distinction was made between types 1 and 2 diabetes. Although there is no overall association between diabetes and age at menopause, the data suggest that early-onset diabetes may accelerate menopause. The delaying effect of late-onset diabetes on ANM is not in agreement with other studies suggesting the opposite association.
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  • Bryman, Inger, et al. (författare)
  • Pregnancy Rate and Outcome in Swedish Women With Turner Syndrome EDITORIAL COMMENT
  • 2011
  • Ingår i: Obstetrical and Gynecological Survey. - 0029-7828 .- 1533-9866. ; 66:12, s. 756-757
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • The rate of spontaneous pregnancies in women with Turner syndrome (TS) is low (2% to 5%). Oocyte donation is an option for these women and enables many to become pregnant. Some investigators question the use of pregnancy induction in TS because of the high risk for aortic dissection or other serious cardiac events. A cardiac evaluation is recommended before pregnancy is planned in TS. Among patients with TS who use their own oocytes to become pregnant, 45% suffered a miscarriage. The aim of this study was to assess pregnancy rate and outcome in a population of Swedish women with spontaneous pregnancies or who were induced using donated oocytes. Cytogenetic karyotype also was examined; mosaicism was defined as the presence of more than 5% 46, XX cells. The study subjects were 482 women with TS who had participated in a voluntary screening program conducted at Swedish Turner Centers. Among the 482 women with TS, 57 (12%) had pregnancies, including spontaneous pregnancies. The live-born rate was 67 of 124 (54%). The patient's own oocytes were used in 27 (47%) of the pregnancies and oocyte donation in 30 (53%) of pregnancies. Spontaneous pregnancies occurred in 23 of 57 women (40%) with TS. Most pregnancies using the patient's own oocytes occurred in those with 45, X/46, XX mosaic karyotype. The miscarriage rate was 26% after oocyte donation and 45% with the use of the patient's own oocytes. Five liveborns (7%) had birth defects or a serious illness; 4 of these were born after spontaneous pregnancies. Only 1 live-born had coarctation of the aorta.
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