No abstract

Although it is commonly believed that recovery from subtotal abdominal hysterectomy (SH) is associated with fewer complications and less pelvic organ dysfunction than total abdominal hysterectomy (TH), there is little data supporting this belief in the literature. Previous studies have found no difference in the postoperative recovery time between these procedures. Overall recovery after hysterectomy depends on treatment of postoperative physical symptoms and complications. Some studies have shown that recovery also depends on preoperative psychological well being and postoperative overall well being. The impact of these factors on the postoperative day-by-day recovery has not been investigated.This prospective randomized, controlled, open, multicenter study assessed possible differences between SH and TH in the day-by-day postoperative recovery, and also analyzed factors associated with postoperative recovery and sick leave. The study was conducted at 7 hospitals and 1 private gynecological clinic in Sweden between 1998 and 2004. The study subjects were 200 women who were scheduled for hysterectomy because of benign gynecological conditions. Of the 178 patients who completed the study, 94 were randomized to a SH group and 84 to a TH group. Assessment of day-by-day recovery of general well being was made using a patient diary with daily entries initiated at 1 week before surgery and continuing until the 35th postoperative day; the results were calculated on a visual analogue scale. Psychometric measurements included depression and anxiety; general psychological well being was also assessed. The primary study outcome measures were the associations between day-by-day recovery of general well being and duration of sick leave with mode of hysterectomy.The data showed no significant difference in the SH and TH groups for the day-by-day recovery of general well being in the preoperative and postoperative periods. A strong association was found between both postoperative day-by-day recovery of general well being and the duration of sick leave, with the occurrence of minor complications, but there was no significant association for major complications. The postoperative day-by-day recovery of general well being and duration of sick leave were strongly associated with the level of preoperative psychological well being.These findings show no difference in the speed of day-by-day recovery of general well being between the 2 procedures, but demonstrate an association between postoperative recovery of general well being and the duration of sick leave with preoperative psychological well being. Strong determinants for a prolonged sick leave include minor postoperative complications and a low preoperative level of psychological well being. GYNECOLOGY Volume 65, Number 6 OBSTETRICAL AND GYNECOLOGICAL SURVEY ABSTRACTPrevious studies have shown that the new minimally invasive mid-urethral tape procedures are as effective or even more effective in curing female stress urinary incontinence (SUI) than the traditional methods. An esse...

Second University of Naples.

Coronavirus disease has disrupted tuberculosis services globally. Data from 33 centers in 16 countries on 5 continents showed that attendance at tuberculosis centers was lower during the first 4 months of the pandemic in 2020 than for the same period in 2019. Resources are needed to ensure tuberculosis care continuity during the pandemic.

Introduction: Several recent case reports have described common early chest imaging findings of lung pathology caused by 2019 novel Coronavirus (SARS-COV2) which appear to be similar to those seen previously in SARS-CoV and MERS-CoV infected patients. Objective: We present some remarkable imaging findings of the first two patients identified in Italy with COVID-19 infection travelling from Wuhan, China. The follow-up with chest X-Rays and CT scans was also included, showing a progressive adult respiratory distress syndrome (ARDS). Results: Moderate to severe progression of the lung infiltrates, with increasing percentage of high-density infiltrates sustained by a bilateral and multi-segmental extension of lung opacities, were seen. During the follow-up, apart from pleural effusions, a tubular and enlarged appearance of pulmonary vessels with a sudden caliber reduction was seen, mainly found in the dichotomic tracts, where the center of a new insurgent pulmonary lesion was seen. It could be an early alert radiological sign to predict initial lung deterioration. Another uncommon element was the presence of mediastinal lymphadenopathy with short-axis oval nodes. Conclusions: Although only two patients have been studied, these findings are consistent with the radiological pattern described in literature. Finally, the pulmonary vessels enlargement in areas where new lung infiltrates develop in the follow-up CT scan, could describe an early predictor radiological sign of lung impairment.