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[PMID]:29336418
[Au] Autor:Katwal PC; Karki NR; Sharma P; Tamrakar SR
[Ad] Endereço:Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Science, Dhulikhel, Kavre, Nepal.
[Ti] Título:Dysmenorrhea and Stress among the Nepalese Medical Students.
[So] Source:Kathmandu Univ Med J (KUMJ);14(56):318-321, 2016 Oct.-Dec..
[Is] ISSN:1812-2078
[Cp] País de publicação:Nepal
[La] Idioma:eng
[Ab] Resumo:Background Dysmenorrhea is the most common gynecological disorder in women of reproductive age with implications as reduced quality of life and school absenteeism. Mental stress is possibly the most important known predisposing factor for primary dysmenorrhea. Objective This study aims to assess the relationship between stress and dysmenorrhea amongst the Nepalese medical students. Method This is cross-sectional descriptive study, conducted from 1st Dec. 2012 to 31st Jan. 2013. The study was conducted in Kathmandu University School of Medical Sciences. A total of 184 participants consented for this study and each one was given a questionnaire to complete. This study included only unmarried nulliparous, healthy (all through first to final years) female medical students, in age group of 16 to 24 years. Result The mean age of the participants was 19.43(±3.9) years. Among them, 67% of the participants experienced dysmenorrhea. Of them, 85% experienced increase in frequency and severity of dysmenorrhea after joining medical college. Similarly, 65% of participants considered medical education to be stressful. Of participants experiencing dysmenorrhea, 29.45% missed classes and 17.39% participants had positive family history of dysmenorrhea in first and second degree relatives. Conclusion The present study indicated a positive relationship between psychological stress and dysmenorrhea. Dysmenorrhea is the leading cause of recurrent short-term school absence in young ladies; this issue certainly needs to be addressed.
[Mh] Termos MeSH primário: Dismenorreia/epidemiologia
Estresse Psicológico/epidemiologia
Estudantes de Medicina/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Estudos Transversais
Feminino
Seres Humanos
Prevalência
Qualidade de Vida
Inquéritos e Questionários
Universidades
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180129
[Lr] Data última revisão:
180129
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180117
[St] Status:MEDLINE


  2 / 2903 MEDLINE  
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[PMID]:28456617
[Au] Autor:Pundir J; Omanwa K; Kovoor E; Pundir V; Lancaster G; Barton-Smith P
[Ad] Endereço:Centre for Reproductive Medicine, St Bartholomew's Hospital, West Smithfield, London, United Kingdom. Electronic address: jyotsnapundir@yahoo.com.
[Ti] Título:Laparoscopic Excision Versus Ablation for Endometriosis-associated Pain: An Updated Systematic Review and Meta-analysis.
[So] Source:J Minim Invasive Gynecol;24(5):747-756, 2017 Jul - Aug.
[Is] ISSN:1553-4669
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of this study was to update the evidence on the surgical management of endometriosis-associated pain. Does laparoscopic excision offer any benefits over laparoscopic ablation? This is a systematic review and meta-analysis in which we searched MEDLINE, Embase, Institute for Scientific Information conference proceedings, the International Standard Randomised Controlled Trial Number registry, the Register and Meta-register for randomized controlled trials, the World Health Organization trials search portal, the Cochrane Library, and the British Library of electronic theses. Three randomized controlled trials were included, which enrolled 335 participants with a sample size per study ranging from 24 to 178 participants. Of these 3 studies, data from 2 could be pooled for meta-analysis. The primary outcome measure was the reduction in the visual analog scale score for dysmenorrhea. The secondary outcome measures included the reduction in the visual analog scale score for dyspareunia, dyschezia, and chronic pelvic pain and the reduction in Endometriosis Health Profile-30 core pain scores. The meta-analysis showed that the excision group had a significantly greater reduction in symptoms of dysmenorrhea (mean difference [MD] = 0.99; 95% confidence interval [CI], -0.02 to 2.00; p = .05) and dyschezia (MD = 1.31; 95% CI, 0.33-2.29; p = .009) compared with ablation. The symptoms of dyspareunia showed a nonsignificant benefit with excision (MD = 0.96; 95% CI, -0.07 to 1.99; p = .07). Data from 1 study showed a significant reduction in chronic pelvic pain (MD = 2.57; 95% CI, 1.27-3.87; p = .0001) and Endometriosis Health Profile-30 core pain scores (MD = 13.20; 95% CI, 3.70-22.70; p = .006) with the excision group compared with the ablation group. The limited available evidence shows that at 12 months postsurgery, symptoms of dysmenorrhea, dyschezia, and chronic pelvic pain secondary to endometriosis showed a significantly greater improvement with laparoscopic excision compared with ablation.
[Mh] Termos MeSH primário: Técnicas de Ablação Endometrial/métodos
Endometriose/cirurgia
Laparoscopia/métodos
Distúrbios do Assoalho Pélvico/cirurgia
Dor Pélvica/cirurgia
[Mh] Termos MeSH secundário: Dor Crônica/etiologia
Dor Crônica/cirurgia
Dismenorreia/etiologia
Dismenorreia/cirurgia
Dispareunia/etiologia
Dispareunia/cirurgia
Técnicas de Ablação Endometrial/efeitos adversos
Endometriose/complicações
Feminino
Seres Humanos
Laparoscopia/efeitos adversos
Terapia a Laser/efeitos adversos
Terapia a Laser/métodos
Distúrbios do Assoalho Pélvico/complicações
Dor Pélvica/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170501
[St] Status:MEDLINE


  3 / 2903 MEDLINE  
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[PMID]:29205027
[Au] Autor:Suvitie P
[Ti] Título:Dysmenorrhea in teenagers.
[So] Source:Duodecim;133(3):285-91, 2017.
[Is] ISSN:0012-7183
[Cp] País de publicação:Finland
[La] Idioma:eng
[Ab] Resumo:Dysmenorrhea affects quality of life, but is often inadequately treated in teenagers. The mainstay of treatment is NSAID, which must be started pre-emptively and in adequate dose. If NSAID provides insufficient pain relief, or when contraception is required, combined oral contraceptives can be prescribed concomitantly. Hormonal IUD can also be used in teenagers. If dysmenorrhea persists despite appropriate treatment, the patient must be referred to a gynecologist. Endometriosis, the most common cause of severe dysmenorrhea, can manifest already during adolescence.
[Mh] Termos MeSH primário: Anti-Inflamatórios não Esteroides/uso terapêutico
Anticoncepcionais Orais/uso terapêutico
Dismenorreia/complicações
Dismenorreia/tratamento farmacológico
Endometriose/complicações
Manejo da Dor/métodos
[Mh] Termos MeSH secundário: Adolescente
Feminino
Seres Humanos
Qualidade de Vida
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents, Non-Steroidal); 0 (Contraceptives, Oral)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE


  4 / 2903 MEDLINE  
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[PMID]:28885348
[Au] Autor:Bai HY; Bai HY; Yang ZQ
[Ad] Endereço:aDepartment of Gynecology, The People's Hospital of Yan'an bDepartment of Reproductive Medicine, Maternal and Child Health Hospital of Yan'an cDepartment of Chinese Medicine, The People's Hospital of Yan'an, Yan'an, China.
[Ti] Título:Effect of transcutaneous electrical nerve stimulation therapy for the treatment of primary dysmenorrheal.
[So] Source:Medicine (Baltimore);96(36):e7959, 2017 Sep.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: This study aimed to investigate the effect and safety of transcutaneous electrical nerve stimulation (TENS) therapy for relieving pain in women with primary dysmenorrhea (PD). METHODS: In this study, 134 participants with PD were randomly divided into the intervention group and the sham group, with 67 participants in each group. Participants in the intervention group received TENS, whereas those in the sham group received sham TENS. The primary outcome was measured by the Numeric Rating Scale (NRS). The secondary outcomes were measured by the duration of relief from dysmenorrheal pain, number of ibuprofen tablets taken, and the World Health Organization quality of life (WHOQOL)-BREF score, as well as the adverse events. RESULTS: A total of 122 participants completed the study. Compared to sham TENS, TENS showed a greater effect in pain relief with regard to the NRS (P < .01), duration of relief from dysmenorrheal pain (P < .01), and number of ibuprofen tablets taken (P < .01). However, no significant differences in the quality of life, measured by the WHOQOL-BREF score, were found between 2 groups. The adverse event profiles were also similar between 2 groups. CONCLUSION: TENS was efficacious and safe in relieving pain in participants with PD.
[Mh] Termos MeSH primário: Dismenorreia/terapia
Estimulação Elétrica Nervosa Transcutânea
[Mh] Termos MeSH secundário: Adulto
Analgésicos não Entorpecentes/uso terapêutico
Dismenorreia/psicologia
Feminino
Seres Humanos
Ibuprofeno/uso terapêutico
Manejo da Dor
Medição da Dor
Qualidade de Vida
Método Simples-Cego
Estimulação Elétrica Nervosa Transcutânea/efeitos adversos
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Analgesics, Non-Narcotic); WK2XYI10QM (Ibuprofen)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170909
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007959


  5 / 2903 MEDLINE  
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[PMID]:28859645
[Au] Autor:Xu Y; Zhao W; Li T; Bu H; Zhao Z; Zhao Y; Song S
[Ad] Endereço:Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China.
[Ti] Título:Effects of acupoint-stimulation for the treatment of primary dysmenorrhoea compared with NSAIDs: a systematic review and meta-analysis of 19 RCTs.
[So] Source:BMC Complement Altern Med;17(1):436, 2017 Aug 31.
[Is] ISSN:1472-6882
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Primary dysmenorrhoea (PD), defined as painful menses in women with normal pelvic anatomy, is one of the most common gynaecological syndromes. Acupoint-stimulation could potentially be an effective intervention for PD. Our aim was to determine the effectiveness of acupoint-stimulation compared with Non-Steroidal Anti-Inflammatory Drugs (NASIDs) in the treatment of PD. METHODS: Six databases were searched to December 2014. Sixteen studies involving 1679 PD patients were included. We included randomized controlled trials that compared acupoint-stimulation with NASIDs for the treatment of PD. The main outcomes assessed were clinical effectiveness rate, symptom score, visual analogue score, variation in peripheral blood prostaglandin F2α (PGF2α) and side effects. All analyses were performed using Comprehensive Meta-Analysis statistical software. RESULTS: (1) The total efficacy was better than control group: odds ratio = 5.57; 95% confidence interval (95% CI) = 3.96, 7.83; P < 0.00001; (2) The effect of intervention was positive in relieving the severity of PD symptoms: mean difference (MD) = 2.99; 95%CI = 2.49, 3.49; P < 0.00001; (3) No statistical difference existed between two groups in terms of a reduction in the VAS: MD = 1.24; 95%CI = -3.37, 5.85; P = 0.60; (4) The effect of intervention on the variation in peripheral blood PGF2α between two groups was positive: MD = 7.55; 95%CI = 4.29,10.82; P < 0.00001; (5) The side effects of control groups was more than the acupoint-stimulation group: OR = 0.03; 95%CI =0.00,0.22; P = 0.0005. CONCLUSIONS: According to this article, acupoint-stimulation can relieve pain effectively in the treatment of PD and offers advantages in increasing the overall effectiveness.
[Mh] Termos MeSH primário: Terapia por Acupuntura
Anti-Inflamatórios não Esteroides/administração & dosagem
Dismenorreia/terapia
[Mh] Termos MeSH secundário: Pontos de Acupuntura
Dismenorreia/tratamento farmacológico
Feminino
Seres Humanos
Masculino
Ensaios Clínicos Controlados Aleatórios como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents, Non-Steroidal)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170908
[Lr] Data última revisão:
170908
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170902
[St] Status:MEDLINE
[do] DOI:10.1186/s12906-017-1924-8


  6 / 2903 MEDLINE  
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[PMID]:28830511
[Au] Autor:Chen Y; Tian S; Tian J; Shu S
[Ad] Endereço:Changhai Hospital of Traditional Chinese Medicine, Second Military Medical University, 168 Changhai Road, Yangpu District, Shanghai, China.
[Ti] Título:Wrist-ankle acupuncture (WAA) for primary dysmenorrhea (PD) of young females: study protocol for a randomized controlled trial.
[So] Source:BMC Complement Altern Med;17(1):421, 2017 Aug 22.
[Is] ISSN:1472-6882
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Primary dysmenorrhea (PD) is one of the most common health complaints all over the world, specifically among young females. Acupuncture has been employed to relieve the pain-based symptoms and to avoid the side effects of conventional medication, and wrist-ankle acupuncture (WAA) has confirmed analgesic efficacy for various types of pain. The aim of this study is to evaluate the immediate analgesia effect of WAA on PD of young females. METHODS/DESIGN: This study will carry out a randomized parallel controlled single-blind trial to observe the immediate analgesia effect of WAA in PD of young females. Sixty participants who meet inclusion criteria will be recruited from September 2016 to September 2017 in Changhai hospital of China. They are randomly assigned to WAA therapy or sham acupuncture groups (30 patients for each group), and then receive real or sham acupuncture treatment, respectively. In this trial, the primary outcome measure is simple form of McGill pain questionnaire (SF-MPQ), while expectation and treatment credibility scale (ETCS), safety assessment, the COX menstrual symptom scale (CMSS), questionnaire about the feeling of being punctured are included in the secondary outcomes. DISCUSSION: This trial will be the first study protocol designed to evaluate the immediate analgesia effect of WAA in PD of young females. The strengths in methodology, including rigorous randomized, sham-controlled, participants-blinded and assessors-blinded, will guarantee the quality of this study. WAA doesn't require any needling sensation, so non-penetrating sham acupuncture can serve as an effective placebo intervention in this trial. TRIALS REGISTRATION: Chinese Clinical Trial Registry (identifier: ChiCTR-IOR-16008546 ; registration date: 27 May 2016).
[Mh] Termos MeSH primário: Terapia por Acupuntura/métodos
Tornozelo/fisiologia
Dismenorreia/terapia
Punho/fisiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Feminino
Seres Humanos
Projetos de Pesquisa
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170824
[St] Status:MEDLINE
[do] DOI:10.1186/s12906-017-1923-9


  7 / 2903 MEDLINE  
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[PMID]:28700680
[Au] Autor:Armour M; Dahlen HG; Zhu X; Farquhar C; Smith CA
[Ad] Endereço:The National Institute of Complementary Medicine, Western Sydney University, Sydney, Australia.
[Ti] Título:The role of treatment timing and mode of stimulation in the treatment of primary dysmenorrhea with acupuncture: An exploratory randomised controlled trial.
[So] Source:PLoS One;12(7):e0180177, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: We examined the effect of changing treatment timing and the use of manual, electro acupuncture on the symptoms of primary dysmenorrhea. METHODS: A randomised controlled trial was performed with four arms, low frequency manual acupuncture (LF-MA), high frequency manual acupuncture (HF-MA), low frequency electro acupuncture (LF-EA) and high frequency electro acupuncture (HF-EA). A manualised trial protocol was used to allow differentiation and individualized treatment over three months. A total of 74 women were randomly assigned to one of the four groups (LF-MA n = 19, HF-MA n = 18, LF-EA n = 18, HF-EA n = 19). Twelve treatments were performed over three menstrual cycles, either once per week (LF groups) or three times in the week prior to menses (HF groups). All groups received a treatment in the first 48 hours of menses. The primary outcome was the reduction in peak menstrual pain at 12 months from trial entry. RESULTS: During the treatment period and nine month follow-up all groups showed statistically significant (p < .001) reductions in peak and average menstrual pain compared to baseline but there were no differences between groups (p > 0.05). Health related quality of life increased significantly in six domains in groups having high frequency of treatment compared to two domains in low frequency groups. Manual acupuncture groups required less analgesic medication than electro-acupuncture groups (p = 0.02). HF-MA was most effective in reducing secondary menstrual symptoms compared to both-EA groups (p<0.05). CONCLUSION: Acupuncture treatment reduced menstrual pain intensity and duration after three months of treatment and this was sustained for up to one year after trial entry. The effect of changing mode of stimulation or frequency of treatment on menstrual pain was not significant. This may be due to a lack of power. The role of acupuncture stimulation on menstrual pain needs to be investigated in appropriately powered randomised controlled trials.
[Mh] Termos MeSH primário: Terapia por Acupuntura/métodos
Dismenorreia/terapia
[Mh] Termos MeSH secundário: Terapia por Acupuntura/efeitos adversos
Adulto
Estimulação Elétrica/efeitos adversos
Estimulação Elétrica/métodos
Feminino
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170713
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0180177


  8 / 2903 MEDLINE  
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[PMID]:28686000
[Au] Autor:Lee JM; Kim KH
[Ad] Endereço:Department of Computer and Electron Communication, Yanbian Jilin China, Yanbian University of Science and Technology, Yanji City, Jilin Province, China.
[Ti] Título:Effect of near-infrared rays on female menstrual pain in Korea.
[So] Source:Nurs Health Sci;19(3):366-372, 2017 Sep.
[Is] ISSN:1442-2018
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:Most Korean women who experience menstrual pain have reported taking pain medicine and making use of complementary alternative therapies. However, because some interventions may cause side effects, more effective pain-relieving measures need to be identified. This study using a non-equivalent group design, evaluated the effects of near-infrared rays on dysmenorrhea among Korean women. The experimental group wore a near-infrared ray abdominal belt for the duration of one menstrual cycle until the end of the menstrual period, while the control group used hot packs. The level of menstrual pain, menstrual pain duration, and pain medicine use were measured. The menstrual pain, average menstrual pain duration, and use of analgesics were reduced in the near-infrared rays group. The results of this study indicate that the near-infrared ray LED belt was effective in reducing menstrual pain, menstrual pain duration compared to the use of analgesics in Korean women with dysmenorrhea. Therefore, near-infrared rays may be used to relieve menstrual pain and improve the quality of life of women with dysmenorrhea in Korea.
[Mh] Termos MeSH primário: Dismenorreia/radioterapia
Raios Infravermelhos/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Analgésicos/uso terapêutico
Estudos de Casos e Controles
Feminino
Seres Humanos
Medição da Dor
Qualidade de Vida
República da Coreia
Inquéritos e Questionários
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Analgesics)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:IM; N
[Da] Data de entrada para processamento:170708
[St] Status:MEDLINE
[do] DOI:10.1111/nhs.12356


  9 / 2903 MEDLINE  
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[PMID]:28623918
[Au] Autor:Kim KI; Nam HJ; Kim M; Lee J; Kim K
[Ad] Endereço:Department of Clinical Korean Medicine, College of Korean Medicine, Kyung Hee University, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea.
[Ti] Título:Effects of herbal medicine for dysmenorrhea treatment on accompanied acne vulgaris: a study protocol for a randomized controlled trial.
[So] Source:BMC Complement Altern Med;17(1):318, 2017 Jun 17.
[Is] ISSN:1472-6882
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The incidence of preadolescent acne among women is increasing. Acne deteriorates the quality of life; conventional treatment options are limited and have not been effective against acne, particularly acne associated with menstruation. Despite evidence that acne associated with menstruation abnormalities naturally improves when menstruation recovers to normal, there have only been few studies on the effects of dysmenorrhea treatment on acne. Therefore- we designed this study to assess the effects of gyejibokryung-hwan (GBH) and dangguijagyag-san (DJS), which are widely used in dysmenorrhea treatment, on acne associated with menstruation cycle. METHODS: This is a protocol for a randomized, double-blind, parallel-group, placebo-controlled and multicenter trial. One hundred and sixteen participants with dysmenorrhea accompanied by acne vulgaris will be recruited at three centers and randomized into two groups, the herbal treatment group and placebo group. The participants will receive GBH or DJS based on pattern identification or placebo granules thrice daily for 8 weeks, with an 8-week follow up. The primary outcome will be the mean percentage change in the count of inflammatory acne lesions. The secondary outcomes would be based on dysmenorrhea numeric rating scale, verbal multidimensional scoring system for dysmenorrhea, acne numeric rating scale, investigator's static global assessment scale of facial acne vulgaris, and safety testing. Adverse events will also be reported. DISCUSSION: The effects of GBH or DJS used in dysmenorrhea treatment on acne associated with the menstrual cycle will be evaluated. The findings of this trial will provide evidence regarding the effect of herbal medicine in improving acne vulgaris associated with menstruation in women. TRIAL REGISTRATION: Korean Clinical Trial Registry ( http://cris.nih.go.kr ; registration number: KCT0002259). Date of registration: March 10, 2017.
[Mh] Termos MeSH primário: Acne Vulgar/tratamento farmacológico
Dismenorreia/tratamento farmacológico
Medicina Herbária
Extratos Vegetais/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Protocolos Clínicos
Método Duplo-Cego
Feminino
Seres Humanos
Fitoterapia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Plant Extracts)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170821
[Lr] Data última revisão:
170821
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170619
[St] Status:MEDLINE
[do] DOI:10.1186/s12906-017-1813-1


  10 / 2903 MEDLINE  
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[PMID]:28578175
[Au] Autor:Katon JG; Gray K; Callegari L; Gardella C; Gibson C; Ma E; Lynch KE; Zephyrin L
[Ad] Endereço:Health Services Research and Development Center of Innovation for Veteran-Centered and Value Driven Care, US Department of Veterans Affairs, Veterans Affairs Puget Sound Healthcare System, Seattle, WA; Department of Health Services, University of Washington School of Public Health, Seattle, WA. Elec
[Ti] Título:Trends in hysterectomy rates among women veterans in the US Department of Veterans Affairs.
[So] Source:Am J Obstet Gynecol;217(4):428.e1-428.e11, 2017 Oct.
[Is] ISSN:1097-6868
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Prior studies demonstrate a higher prevalence of hysterectomy among veterans compared with nonveterans. While studies identify overall decreasing hysterectomy rates in the United States, none report rates of hysterectomy among women veterans. Given the increasing numbers of women veterans using Veterans Affairs health care, there is an ongoing need to ensure high-quality gynecology care. Therefore, it is important to examine current hysterectomy trends, including proportion of minimally invasive surgeries, among veterans using Veterans Affairs health care. OBJECTIVE: Our objective was to describe hysterectomy trends and utilization of minimally invasive hysterectomy in the Veterans Affairs healthcare system. STUDY DESIGN: This longitudinal study used Veterans Affairs clinical and administrative data from fiscal year 2008 to 2014 to identify hysterectomies provided or paid for by Veterans Affairs. Crude and age-adjusted hysterectomy rates were calculated by indication (benign or malignant), mode (abdominal, laparoscopic, vaginal, robotic assisted, unspecified), and source of care (provided vs paid for by Veterans Affairs). Mode and indication for hysterectomy were classified using International Classification of Diseases, ninth revision, codes. The distribution of hysterectomy mode in each year was calculated by indication and source of care. RESULTS: Between fiscal year 2008 and fiscal year 2014, the total hysterectomy rate decreased from 4.0 per 1000 to 2.6 per 1000 unique women veteran Veterans Affairs users. Age-adjusted rates of abdominal hysterectomy for benign indications decreased over the study period from 1.54 per 1000 (95% confidence interval, 1.40-1.69) to 0.77 per 1000 (95% confidence interval, 0.69-0.85) for procedures provided by Veterans Affairs and 0.77 per 1,000 (95% confidence interval, 0.69-0.85) to 0.29 per 1,000 (95% confidence interval, 0.23-0.34) for those paid for by Veterans Affairs. Among hysterectomies for benign indications provided by (n = 5296) or paid for (n = 2610) by Veterans Affairs, the percentage of hysterectomies performed abdominally decreased from 67.2% to 46.8% and from 68.9% to 57.6%, respectively. CONCLUSION: These findings suggest that gynecology care provided within Veterans Affairs has kept pace with national trends in reducing hysterectomy rates and increasing utilization of minimally invasive surgical techniques.
[Mh] Termos MeSH primário: Histerectomia/tendências
Veteranos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Distribuição por Idade
Idoso
Dismenorreia/cirurgia
Feminino
Doenças Urogenitais Femininas/cirurgia
Seres Humanos
Histerectomia/métodos
Laparoscopia/tendências
Estudos Longitudinais
Meia-Idade
Procedimentos Cirúrgicos Robóticos/tendências
Estados Unidos/epidemiologia
United States Department of Veterans Affairs
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170605
[St] Status:MEDLINE



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