International Journal of Gynecology & Obstetrics
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Radiation therapy duration influences overall survival in patients with cervical carcinoma
International Journal of Gynecology & Obstetrics - Tập 57 - Trang 295-303 - 1997
Use of in vitro method to predict response of human ovarian carcinoma cells to chemotherapeutic agents Abstract In vitro tissue culture and sensitivity tests were carried out on 16 cases of ovarian cancer to select the right anticancer drug(s) on an individual basis. The predictive accuracy of the in vitro drug sensitivity tests were 81.8%. The drug(s) suggested by in vitro tests did not reveal any correlation to the type of ovarian cancer. The drug sensitivity of cells from primary growth was different from that of secondary growth. The in vitro screening test also provided the choice of the next best drug(s), once the tumor had become resistant to a particular drug(s). Thus, the overall prognosis of patients at an advanced stage of malignancy could be improved with the help of in vitro predictive tests.
International Journal of Gynecology & Obstetrics - Tập 22 - Trang 371-374 - 1984
Long‐term results of prolapse recurrence and functional outcome after vaginal hysterectomy Abstract Objective To evaluate the incidence of prolapse and prolapse‐related symptoms following vaginal hysterectomy. Methods Data were reviewed from women who underwent vaginal hysterectomy between 1988, and 1995, at St George's Hospital, London, UK, and attended long‐term follow‐up. Outcome measures included a questionnaire for prolapse, urinary, bowel, and sexual symptoms; and a vaginal examination. Results Among 94 women attending long‐term evaluation, the mean follow‐up time was 100.7 months (range 67.0–156.0 months). Before vaginal hysterectomy, urgency was noted among 23 (24.5%), urge incontinence among 11 (11.7%), and stress incontinence among 8 (8.5%) women. At follow‐up, these symptoms were observed among 23 (24.5%), 13 (13.8%), and 6 (6.4%) women, respectively. De novo urge incontinence and de novo stress incontinence were observed among 3 (3.2%) and 2 (2.1%) women, respectively. Vaginal examination data were compared for 70 women, of whom 18 (25.7%) had grade 1, 40 (57.1%) had grade 2, and 6 (8.6%) had grade 3 uterine prolapsed before surgery. Postoperatively, vaginal vault prolapse occurred in 7 (10.0%) women and correlated with degree of posterior prolapse (P = 0.007), but not with severity of uterine descent (P = 0.205) or previous prolapse surgery (P = 0.573). Conclusion The incidence of post‐hysterectomy vault prolapse correlated with the degree of preoperative rectocele.
International Journal of Gynecology & Obstetrics - Tập 120 - Trang 57-60 - 2013
Evolution of malaria in pregnancy control: Jhpiego's 10‐year contribution Abstract Malaria continues to be a life‐threatening illness throughout Sub‐Saharan Africa, with pregnant women and children being particularly vulnerable and an estimated 10 000 women and 200 000 newborns dying each year as a result of malaria in pregnancy (MIP). Since 2004, WHO has supported a three‐pronged MIP approach: (1) intermittent preventive treatment with sulfadoxine‐pyrimethamine; (2) use of insecticide‐treated bed nets; and (3) effective case management. The present article identifies benchmarks in Jhpiego's 10‐plus years of MIP experience at the regional and national levels that have contributed to its global MIP leadership and aligned programs and policies with global approaches toward malaria elimination. As countries continue to develop and expand MIP programming, support will continue to be essential in the following eight MIP program areas: integration, policy, capacity development, community engagement, quality assurance, commodities, monitoring and evaluation, and financing.
International Journal of Gynecology & Obstetrics - Tập 130 - Trang S62-S67 - 2015
Task shifting in maternal and newborn health care: Key components from policy to implementation Abstract Task shifting in various forms has been adopted extensively around the world in an effort to expand the reach of lifesaving services to the women, newborns, and families who need them. The emerging global literature, as well as Jhpiego's field experiences, supports the importance of addressing several key components that facilitate effective task shifting in maternal and newborn health care. These components include: (1) policy and regulatory support; (2) definition of roles, functions, and limitations; (3) determination of requisite skills and qualifications; (4) education and training; and (5) service delivery support, including management and supervision, incentives and/or remuneration, material support (e.g. commodities), and referral systems. Jhpiego's experiences with task shifting also provide illustrations of the complex interplay of these key components at work in the field. Task shifting should be considered as a part of the larger health system that needs to be designed to equitably meet the needs of mothers, newborns, children, and families.
International Journal of Gynecology & Obstetrics - Tập 130 - Trang S25-S31 - 2015
Implementation of the Standards‐Based Management and Recognition approach to quality improvement in maternal, newborn, and child health programs in low‐resource countries Abstract The Standards‐Based Management and Recognition (SBM‐R; Jhpiego, Baltimore, MD, USA) approach to quality improvement was developed by Jhpiego to respond to common challenges faced by health systems in low‐resource settings, including poor pre‐service education, lack of resources for conventional supervisory models, and weak health information systems. Since its introduction in Brazil in 1997, SBM‐R has been implemented in approximately 30 countries and continues expanding to new places and service delivery areas. The present article: (1) describes key steps in the SBM‐R methodology focusing on provider performance assessment using evidence‐based standards; and (2) presents examples of improvements in provider performance in maternal, newborn, and child health care following SBM‐R implementation derived from routine program data, quasi‐experimental evaluations, and in‐depth case studies. SBM‐R incorporates evidence‐based methods that are known to have positive effects on healthcare quality, including audit and feedback, educational outreach visits, and checklist usage; however, further rigorous research is needed to document the population‐level impacts of the SBM‐R approach.
International Journal of Gynecology & Obstetrics - Tập 130 - Trang S17-S24 - 2015
Perinatal outcome in pregnancies complicated by pulmonary tuberculosis
International Journal of Gynecology & Obstetrics - Tập 44 - Trang 119-124 - 1994
Comparison of dienogest versus combined oral contraceptive pills in the treatment of women with adenomyosis: A randomized clinical trial Abstract Objective To compare the efficacy and safety of dienogest with combined oral contraceptives (COCs) for treating adenomyosis‐associated symptoms. Methods This was a randomized clinical trial including women with symptomatic adenomyosis conducted from March 1, 2019 to August 1, 2020 at Assiut Woman's Health Hospital, Egypt. Participants were randomly assigned to the dienogest group or COCs group. The primary outcome was the level of adenomyosis‐associated pain from before to 6 months after treatment measured by a visual analog scale (VAS). Changes in the uterine bleeding pattern, uterine volume, and uterine artery blood flow were also reported. Results The VAS score of pain was significantly decreased in both groups; however, the decreased rate was more pronounced in the dienogest group (3.21 ± 1.18) in comparison with the COCs group (4.92 ± 1.22). Bleeding pattern was improved greatly; uterine volume and uterine artery blood flow decreased significantly in the dienogest group. However, women in the dienogest group reported a higher rate of side effects. Conclusion Dienogest and COCs are effective in treating adenomyosis‐associated symptoms after 6 months of use but dienogest is more effective. The decrease in uterine volume and uterine artery blood flow may be the cause of the treatment effect. Dienogest carries a higher risk of side effects. Clinical trial.gov: NCT03890042.
International Journal of Gynecology & Obstetrics - Tập 154 Số 2 - Trang 263-269 - 2021
Treatment of symptomatic adenomyosis with the levonorgestrel‐releasing intrauterine system Abstract Objective To determine the long‐term effects of using the levonorgestrel‐releasing intrauterine system (LNG ‐IUS ) to treat symptomatic adenomyosis. Method A prospective longitudinal study was conducted among 1100 women who received the LNG ‐IUS at a tertiary teaching hospital in China between December 10, 2006, and December 24, 2014. All participants had symptomatic adenomyosis (visual analogue scale [VAS ] ≥7 and/or pictorial blood loss assessment chart [PBAC ] score >100) diagnosed by transvaginal sonography. Follow‐up was at 3, 6, 12, 24, 36, 48, and 60 months after LNG ‐IUS placement. The primary outcome was symptom relief. Secondary outcomes included LNG ‐IUS retention status; changes in uterine volume; serum levels of cancer antigen 125 (CA 125); menstruation pattern; and adverse events. Results In all, 374 (33.7%) participants completed 60 months of LNG ‐IUS treatment. The VAS , verbal rating scale, PBAC score, hemoglobin level, uterine volume, and serum CA 125 level all showed marked improvements at this time point when compared with baseline (P <0.05 for all comparisons). The cumulative retention rate of LNG ‐IUS was 56.2%. Changes in menstruation pattern at 60 months included amenorrhea (n=97, 25.9%) and shortened periods (n=82, 21.9%). The incidence of adverse events was <10% and not considered notable. Conclusions Long‐term use of LNG ‐IUS was effective and acceptable for the treatment of symptomatic adenomyosis. Registered at clinicaltrials.gov (NCT 03027648).
International Journal of Gynecology & Obstetrics - Tập 146 Số 3 - Trang 357-363 - 2019
Triptorelin for the treatment of adenomyosis: A multicenter observational study of 465 women in Russia Abstract Objective To evaluate the effectiveness of triptorelin for the treatment of adenomyosis, the benign invasion of endometrial tissue into the myometrium, as a fertility‐preserving alternative to the gold standard hysterectomy. Methods In this multicenter, open‐label, observational study in Russia, performed from November 3, 2011, to August 24, 2015, we assessed the efficacy and safety of triptorelin 3.75 mg administered intramuscularly every 28 days in Russian women who were gonadotropin‐releasing hormone agonist treatment‐naïve, aged 25–40 years, and had a diagnosis of endometriosis or adenomyosis with heavy menstrual bleeding. We performed a medical record review, interviews to assess symptom severity, and pelvic assessments including transvaginal ultrasound. Data were obtained at first injection of triptorelin (visit 1), on the day of last injection (visit 2), 6 months after last injection (visit 3), and 9 months after last injection (visit 4). Significance was assessed by Wilcoxon signed rank test. Results A total of 465 women were included. There was a significant improvement from baseline in severity of heavy menstrual bleeding in 390/463 (84.2%) of women 6 months after last injection (P <0.0001). Severity of dysmenorrhea, abnormal uterine bleeding, and pelvic pain was decreased at visit 3 compared with baseline (P <0.0001). Endometriosis symptoms stopped in 253/262 (96.6%) of women at visit 2 and in 243/263 (92.4%) of women at visit 3. Pregnancy was reported in 116/465 (24.9%) women within 9 months following the end of treatment. Conclusion Triptorelin has a favorable safety profile, is highly efficacious in treating clinical symptoms of adenomyosis, and improves reproductive function. ClinicalTrials.gov registration number: A‐38‐52014‐191, registered October 2011.
International Journal of Gynecology & Obstetrics - Tập 151 Số 3 - Trang 347-354 - 2020
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