Východiská: V súčasnej dobe neexistuje dostatok štúdií, ktoré by porovnávali šírku linea alba u žien po pôrode so stresovou inkontinenciou moču a bez. Primárnym cieľom práce bolo porovnanie šírky (IRD – inter recti distance) u žien po pôrode so symptómami stresovej inkontinencie moču (SUI – stress urinary incontinence) a bez SUI. Sekundárnym cieľom práce bolo porovnanie morfometrie svalov panvového dna u žien po pôrode so symptómami SUI a bez. Metódy: Vyšetrenie IRD vzdialenosti bolo merané lineárnou sondou prostredníctvom 2D USG. Symptómy úniku moču boli hodnotené Dotazníkom medzinárodnej konzultácie o inkontinencii (ICIQ – UI SF). Symptómy hyperaktívneho močového mechúra boli hodnotené Krátkym dotazníkom príznakov urgentnej inkontinencie moču (OAB-q). Funkčný stav svalov panvového dna bol vyšetrený manometrom a morfometria svalov panvového dna bola vyšetrená prostredníctvom 3D/4D USG. Záver: Porovnávali sme IRD vzdialenosť so symptómami SUI a bez u žien po pôrode. Skupina pacientok so stresovou inkontinenciou moču mala väčšiu IRD vzdialenosť v pokoji a pri záťaži v porovnaní so ženami bez stresovej inkontinencie moču. Nebola zistená horšia funkcia a morfometria svalov panvového dna u žien so SUI v porovnaní so ženami bez SUI.
Background: Currently, there are not enough studies comparing the width of the linea alba in women with and without stress urinary incontinence in postpartum women. The primary aim of the study was to compare the width (IRD) in postpartum women with and without symptoms of stress urinary incontinence (SUI). The secondary aim of the study was to compare pelvic floor muscle morphometry in postpartum women with and without SUI symptoms. Methods: IRD distance was measured with a linear probe via 2D US. Urinary leakage symptoms were assessed by the International Consultation on Incontinence Questionnaire (ICIQ – UI SF). Symptoms of overactive bladder were assessed by the Brief Urge Urinary Incontinence Symptoms Questionnaire (OAB-q). The functional status of the pelvic floor muscles was examined by manometry and pelvic floor muscle morphometry was examined by 3D/4D US. Conclusion: We compared IRD distance with and without SUI symptoms in postpartum women. The group of patients with stress urinary incontinence had a greater IRD distance at rest and during exercise compared to women without stress urinary incontinence. No worse pelvic floor muscle function and morphometry was found in women with SUI compared to women without SUI.
Východiská: Vyšetrenie na prítomnosť diastázy priameho brušného svalu a vyšetrenie celej postúry je veľmi dôležité u žien po pôrode. V súčasnosti sa používa vyšetrenie prostredníctvom 2D ultrazvukom, caliprom a palpáciou. Vyšetruje sa v pokoji a pri záťažových testoch. Metódy: Prípadová štúdia pacientky s diastázou priameho brušného svalu po prvom spontánnom nekomplikovanom pôrode vo veku 32 rokov. Vyšetrenie na potvrdenie diastázy priameho brušného svalu – meranie šírky linea alba bola meraná lineárnou sondou 2D ultrazvukom 4,5 cm nad pupkom, v jeho oblasti a 4,5 cm pod pupkom. V ľahu na chrbte v pokoji, a pri elevácii dolných končatín. Miera závažnosti bola klasifikovaná do štyroch stupňov. Bolo realizované štandardné fyzioterapeutické vyšetrenie postúry. Intervenciou bolo individuálne cvičenie s aktiváciou m. transversus abdominis na redukciu diastázy priameho brušného svalu. Súčasťou cvičebného programu bola úprava postúry, úprava stereotypu a kvality dýchania, aktivácia svalov panvového dna. Realizované bolo aj cvičenie na redukciu bolesti ligamentózneho aparátu a nácvik správnej ergonómie. Dávkovanie cvičenia bolo v 1. týždni liečby 15 min denne, 2.–4. týždeň liečby 20 min denne, 5.–12. týždeň liečby 30 min denne, 5 dni v týždni, počas 12 týždňov. Záver: Efekt cvičenia s aktiváciou m. transversus abdominis na redukciu diastázy priameho brušného svalu u pacientky po pôrode bol objektívne dokázaný prostredníctvom vyššie uvedených objektivizačných metód.
Background: Examination for the presence of diastasis of the rectus abdominis muscle and examination of the entire posture is very important in postpartum women. Currently, examination by 2D ultrasound, caliper and palpation is used. It is examined at rest and during stress tests. Methods: Case study of a patient with diastasis of the direct abdominal muscle after a first spontaneous uncomplicated delivery at the age of 32 years. Examination to confirm diastasis of the rectus abdominis muscle – the width of linea alba was measured with a 2D linear probe by ultrasound 4.5 cm above the umbilicus, in the region of the umbilicus and 4.5 cm below the umbilicus. Lying on the back at rest, and with elevation of the lower limbs. The degree of severity was classified into four grades. A standard physiotherapy postural examination was performed. A part of the intervention was individual exercise with activation of the m. transversus abdominis to reduce diastasis of the direct abdominal muscles. The exercise program included postural adjustment, modification of breathing stereotype and quality, and activation of pelvic floor muscles. Exercises to reduce pain in the ligamentous apparatus and training in correct ergonomics were also performed. The dosage of exercise was 15 min per day in the 1st week of treatment, 2–4 week of treatment 20 min per day, 5–12 week of treatment 30 min per day, 5 days per week, for 12 weeks. Conclusion: The effect of exercise with activation of m. transversus abdominis on the reduction of diastasis of the direct abdominal muscle in the postpartum patient was objectively proven by the above mentioned objectification methods.
- MeSH
- cvičení MeSH
- diastáza svalů * rehabilitace MeSH
- dospělí MeSH
- lidé MeSH
- musculus rectus abdominis patologie MeSH
- poporodní období MeSH
- techniky fyzikální terapie MeSH
- terapie cvičením * MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Cieľ: Cieľom práce bolo sledovanie vzťahu diastázy m. rectus abdominis (DRA) a bolesti chrbta u žien po pôrode. Desing štúdie: observačná prospektívna štúdia. Konečný súbor pozostával zo 118 žien po pôrode s DRA s priemerným vekom 33,11 rokov. Metodológia: Vyšetrenie diastázy – inter recti distance meraná lineárnou 2D ultrazvukovou sondou, 4,5 cm nad pupkom, v jej oblasti a 4,5 cm pod pupkom. V ľahu na chrbte v pokoji a počas záťažového testu (elevácia dolných končatín). Bolesti chrbta boli hodnotené dotazníkom Oswestry (ODI – Owestry Disability Index). Výsledky: Korelovali sme diastázu m. rectus abdominis nad pupkom, v oblasti pupka a pod ním bez záťaže a pri záťaži s jednotlivými sekciami dotazníka ODI pre hodnotenie bolesti pri aktivitách každodenného života. V sekciách sedenie, státie, sexuálny život, spoločenský život, cestovanie a celkové skóre sme identifikovali niekoľko miernych signifikantných korelácií. Najviac pri diastáze nad pupkom pri záťaži. Následne pri diastáze nad pupkom bez záťaže. Jedna signifikantná korelácia bola zaznamenaná pri diastáze v oblasti pupka. Záver: Intenzita bolesti a bolesť pri aktivitách každodenného života v sledovanom súbore bola minimálna. Bolo potvrdené, že ženy s diastázou majú negatívne pocity pre diastázu pri sexuálnom živote, ale aj v rámci cestovania a spoločenského života, z dôvodu toho, že je to problém aj estetického charakteru.
Aim: The aim of the work was to monitor the relationship between rectus abdominis diastasis and back pain in women after childbirth. Study design: observational prospective study. The final cohort consisted of 118 postpartum women with diastasis m. rectus abdominis (DRA) with a mean age of 33.11 years. Methods: Examination of diastasis – inter recti distance (IRD) measured with a linear 2D ultrasound probe, 4.5 cm above the navel, in its area and 4.5 cm below the navel. Lying on the back at rest, and during the stress test (elevation of the lower limbs), back pain was assessed by the Oswestry Disability Index (ODI). Results: We correlated diastasis m. rectus abdominis above the umbilicus, in the area of the umbilicus and below it with and without weight with individual sections of the ODI questionnaire for the assessment of pain during activities of daily living. In the sitting, standing, sex life, social life, travel and total score sections, we identified several moderate significant correlations; mostly with diastasis above the navel during weight bearing, and subsequently with diastasis above the navel without weight. One significant correlation was recorded for diastasis in the navel area. Conclusion: Pain intensity and pain during activities of daily living in the observed group was minimal. It has been confirmed that women with diastasis have negative feelings about diastasis in their sexual life, but also in travel and social life due to the fact that it is also a problem of aesthetic nature.
BACKGROUND: The aim of this study was to explore the personal views of female gynecologists regarding the management of POP with a particular focus on the issue of uterine sparing surgery. METHODS: A questionnaire based survey of practicing female gynecologists in the Czech Republic, Slovenia and Slovakia. RESULTS: A total of 140 female gynecologists from 81 units responded to our questionnaire. The majority of respondents stated they would rely on a urogynecologist to aid them with their choice of POP management options. The most preferred options for POP management were sacrocolpopexy and physiotherapy. Almost 2/3 of respondents opted for a hysterectomy together with POP surgery, if they were menopausal, even if the anatomical outcome was similar to uterine sparing POP surgery. Moreover, 81.4% of respondents, who initially opted for a uterine sparing procedure, changed their mind if the anatomical success of POP surgery with concomitant hysterectomy was superior. Discussing uterine cancer risk in relation to other organs had a less significant impact on their choices. CONCLUSIONS: The majority of female gynecologists in our study opted for hysterectomy if they were postmenopausal at the time of POP surgery. However, variation in information provision had an impact on their choice.
- MeSH
- chirurgické síťky MeSH
- hysterektomie metody statistika a číselné údaje MeSH
- léčba šetřící orgány metody statistika a číselné údaje MeSH
- lidé středního věku MeSH
- lidé MeSH
- porodnické chirurgické výkony škodlivé účinky metody MeSH
- prolaps pánevních orgánů chirurgie MeSH
- průzkumy a dotazníky MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Slovinsko MeSH
BACKGROUND: This study describes the effect of rapid tumor growth of patients suffering from various grades of malignant ductal breast carcinoma associated with the gene expression of ECM protein emilin 1, in correlation with the number of gene copies of emilin 1 and degradation of tumor tissue proteins. METHODS: A total of 40 examined patients participated in the experiment (controls, n = 10, grades GI-GIII, each n = 10). After isolation of total mRNA, transcription of mRNA into the cDNA was performed. Quantification of gene expression changes was detected by the real-time PCR method. Analysis at the protein level was performed via Western blot method. RESULTS: During the detection of changes at the mRNA level, a significantly decreased level of emilin 1 in tumor tissues with grade II (about 54 ± 8 % lower than control) was identified. Protein-level analysis indicated an increased level of emilin 1 in tumors with grade I in comparison with control samples (about 10 ± 3 %). CONCLUSION: Obtained results demonstrated that the suppressive role of emilin 1 is related to the grade of growing breast tumors, and associated with increased hypoxia in the tumor microenvironment followed by elevated unfolding and degradation of tissue proteins.
- MeSH
- duktální karcinom prsu genetika metabolismus MeSH
- exprese genu MeSH
- genová dávka MeSH
- komplementární DNA genetika metabolismus MeSH
- kvantitativní polymerázová řetězová reakce MeSH
- lidé MeSH
- membránové glykoproteiny biosyntéza genetika MeSH
- messenger RNA genetika metabolismus MeSH
- nádory prsu genetika metabolismus MeSH
- studie případů a kontrol MeSH
- stupeň nádoru MeSH
- western blotting MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Plodová voda predstavuje biologickú tekutinu, ktorá v určitých medziach odráža metabolický stav plodu, preto štúdium jej zložiek a ich zmien v jednotlivých týždňoch tehotenstva poskytuje užitočné informácie o raste a dozrievaní plodu za fyziologických, ale aj patologických podmienok. Koncentrácia glukózy v plodovej vode je prediktívny marker hmotnosti vyvíjajúceho sa plodu, marker intrauterinnej infekcie, ktorý odráža zrelosť plodu, metabolický stav matky, ale môže súvisieť aj s niektorými vrodenými poruchami. V našej štúdii sme pomocou diagnostických prúžkov v plodovej vode v rôznych týždňoch tehotenstva sledovali rôzne parametre ako špecifická hmotnosť, proteíny, nitrity, pH, leukocyty, a hladinu glukózy. Veľmi zaujímavé výsledky sme získali pri semikvantitatívnom vyhodnotení koncentrácie glukózy. Za fyziologických podmienok koncentrácia glukózy negatívne koreluje s týždňom gravidity, na základe čoho možno predvídať potenciálne využitie rýchlych strip testov aj v klinickej praxi v prípade dostupnosti plodovej vody.
Amniotic fluid represent a biological fluid, which reflect metabolic state of the fetus, the study of its components and their changes in different gestational weeks provide useful information about the growth and maturation of the fetus under physiological, as well as pathological conditions. Concentration of glucose in amniotic fluid is considered as predictive marker of fetus weight, of intrauterine infection, it reflects the fetal maturity, maternal metabolic state, but is also connected with some births defects. In our study, we focused on the detection of specific gravity, proteins, nitrites, pH, leukocytes and glucose level in amniotic fluid, in different weeks of pregnancy by diagnostic strips. Very interesting results were obtained in the semi-quantitative evaluation of glucose concentration. Under physiological conditions the glucose concentration in amniotic fluid progressively decreases with weeks of pregnancy, on the basis of which it is foreseeable potential use of rapid-strip tests and in clinical practice, where available amniotic fluid.
