19112406 OR Fetal pain Dotaz Zobrazit nápovědu
The fetus reacts to nociceptive stimulations through different motor, autonomic, vegetative, hormonal, and metabolic changes relatively early in the gestation period. With respect to the fact that the modulatory system does not yet exist, the first reactions are purely reflexive and without connection to the type of stimulus. While the fetal nervous system is able to react through protective reflexes to potentially harmful stimuli, there is no accurate evidence concerning pain sensations in this early period. Cortical processes occur only after thalamocortical connections and pathways have been completed at the 26th gestational week. Harmful (painful) stimuli, especially in fetuses have an adverse effect on the development of humans regardless of the processes in brain. Moreover, pain activates a number of subcortical mechanisms and a wide spectrum of stress responses influence the maturation of thalamocortical pathways and other cortical activation which are very important in pain processing.
- MeSH
- bolest patofyziologie MeSH
- centrální nervový systém embryologie fyziologie MeSH
- financování organizované MeSH
- gestační stáří MeSH
- krysa rodu rattus MeSH
- lidé MeSH
- nervové dráhy embryologie fyziologie MeSH
- percepce fyziologie MeSH
- plod fyziologie MeSH
- práh bolesti fyziologie MeSH
- těhotenství MeSH
- vývoj plodu MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- MeSH
- bolest MeSH
- lidé MeSH
- měření bolesti MeSH
- nociceptory fyziologie MeSH
- novorozenec * MeSH
- percepce bolesti * MeSH
- plod * MeSH
- Check Tag
- lidé MeSH
- novorozenec * MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- bolest embryologie MeSH
- lidé MeSH
- percepce fyziologie MeSH
- plod fyziologie inervace MeSH
- Check Tag
- lidé MeSH
AIMS: To assess the use of skin conductance as an objective measure of pain in infants of different gestational age. A secondAIM was to investigate the relationship between skin conductivity and selected physiological and behavioural variables (oxygen saturation, heart rate and behavioural state). METHODS: Infants were divided according to gestational age into the following 3 groups; group A: 25+0-31+6 weeks (13 infants), group B: 32+0-35+6 weeks (25 infants), group C: 36+0-41+6 weeks (19 infants). The pain stimulus was blood sampling. RESULTS: The most sensitive parameter for describing changes in skin conductance related to pain was peak per second. No other parameter correlated with the physiological variables chosen. The results showed that the inability to determine basal skin conductance is a crucial disadvantage to practical application. The lack of correlation between conductance parameters and gestational age is surprising. CONCLUSION: We conclude that the Peak per Second is the best parameter for evaluating skin conductance in infants and it is not influenced by gestational age. Peaks per Second correlate only with Prechtl's Scale of behavioural state and not with the physiological parameters chosen.
- MeSH
- chování kojenců fyziologie MeSH
- galvanická kožní odpověď fyziologie MeSH
- gestační stáří MeSH
- kojenec MeSH
- lidé MeSH
- měření bolesti metody MeSH
- spotřeba kyslíku fyziologie MeSH
- srdeční frekvence fyziologie MeSH
- Check Tag
- kojenec MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Introduction: Pregnancy, independently of its multiplicity, always presents a challenge for a woman: it is a strong stressor for a woman's body and labor is a source of severe pain. It can also be an arduous, critical and traumatic experience. Thus it is important to conduct longitudinal research and look for variables which reduce both labor stress and pain. Aim: The aim of the research was to assess labor pain as well as the intensity of labor stress and their modificators for patients in labor. Material and method: The research was conducted using the method of a diagnostic questionnaire, a questionnaire technique and such instruments as: an authorship questionnaire, the Numerical Rating Scale (NRS) to rate pain and the Cambridge Worry Scale (CWS) to rate labor stress. 68 respondents took part in the research. They were admitted for labor at the obstetrics ward of Klinika Ginekologii i Położnictwa CM UJ w Krakowie. Results: In the group of respondents, the average stress rate for all the respondents was below the middle point on the CWS, which shows a low stress level of the women in labor. The average intensity of pain rated by means of the NRS at the peak of pain was great and really great – above the middle point on the scale. Retrospective rating after labor showed that for over a half of the respondents their pain was greater than anticipated. Conclusions: The variables which significantly modified labor pain turned out to be: education, place of residence, partner's support, fetal presentation, newborn's length and suturing of episiotomised perineum. No significant relation was detected among the researched variables and labor stress.
- MeSH
- dospělí MeSH
- lidé MeSH
- manželé psychologie MeSH
- měření bolesti statistika a číselné údaje MeSH
- mladiství MeSH
- porod psychologie MeSH
- porodní bolesti epidemiologie psychologie MeSH
- porodní děj psychologie MeSH
- průřezové studie statistika a číselné údaje MeSH
- průzkumy a dotazníky MeSH
- psychický stres epidemiologie psychologie MeSH
- sociální opora MeSH
- statistika jako téma MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- ženské pohlaví MeSH
Bolesti břicha a podbřišku patří mezi nejčastější symptomy v pediatrii a dětské gynekologii. Stanovit správnou diagnózu může být v některých případech obtížné, zvláště u velmi malých dětských pacientů jsou s ohledem na jejich věkem omezenou schopnost spolupráce mnohdy problematicky ověřitelné parametry bolesti jako např. intenzita, lokalizace, charakter nebo doba trvání. Definitivní diagnóza bývá ve většině případů výsledkem multioborové spolupráce (nejčastěji specialistů z oboru chirurgie, onkologie, gynekologie, interny, infekčního lékařství, neurologie, nefrologie). V dětské gynekologii je však nezřídka přínosem také vyšetření dalších specializací, jejichž obor nemusí s dutinou břišní zdánlivě souviset.
The low abdominal pain is one of the most common complaints of child patients. To establish the proper diagnosis might be often difficult. Due to their age children are not able to specify the intensity of pain, its localization, character and duration. Therefore, the final diagnosis is often based on the results of examinations by others specialists: (surgeons, oncologists, nephrologists, neurologists etc.; even doctors from branches that are not directly focused on the abdomen may contribute to set the proper diagnosis.
- MeSH
- bolesti břicha * diagnóza etiologie klasifikace MeSH
- diferenciální diagnóza * MeSH
- dítě MeSH
- dysmenorea patologie terapie MeSH
- endometrióza diagnóza MeSH
- gynatrézie MeSH
- gynekologické vyšetření metody MeSH
- lidé MeSH
- mladiství MeSH
- nádory vaječníků diagnóza klasifikace MeSH
- pánevní zánět MeSH
- vrozené vady MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- ženské pohlaví MeSH
- Publikační typ
- přehledy MeSH
Although in vitro studies have shown that cortisol concentrations in human and animal hair respond to environmental stressors, few data have been reported regarding the in vivo variability of hair cortisol to brief pain stressors. As an extension of a previous study, hair was collected and assayed for cortisol concentrations from each of three sites (elbow, mid-forearm, wrist) before and after participants immersed their hand in ice water for 1 min. Results showed that the “localization” boundary of hair cortisol responses previously reported was able to be reduced to only 250 mm between sites. Furthermore, all participants showed considerable variability in hair cortisol across the three sites at each collection period, although consistency across participants in overall responsivity of hair cortisol to the pain stressor was observed.
Cíl studie: Upozornit na vzácnou komplikaci těhotenství. Typ studie: Kazuistika. Název a sídlo pracoviště: Gynekologicko-porodnická klinika 1. LF UK a VFN Praha. Předmět a metoda studie: Uvedený případ popisuje symptomy náhlé příhody břišní imitující apendicitidu, které překrývaly probíhající rupturu děložní. Závěr: Ruptura děložní je vzácná komplikace těhotenství. V současné době, se zvyšujícím se počtem císařských řezů a prenatálních operativních výkonů na děloze, je nutno více pomýšlet na popisovanou komplikaci.
Objective: To give attention to the rare complication of pregnancy. Design: Case report. Settings: Dept. of Obstetric and Gynecology, 1st Faculty of Medicine, Charles University and General Faculty Hospital Prague. Methods: Description of acute abdominal pain which immitated the appendicitis in case of the uterine rupture. Conclusion: The uterine rupture is the rare and very dangerous complication of pregnancy. In the time of increasing number of the cesarean section and the operation on the uterine wall, we must thing on the uterine rupture.
- Klíčová slova
- náhlá příhoda břišní,
- MeSH
- akutní bolest břicha etiologie MeSH
- císařský řez MeSH
- dospělí MeSH
- hysterektomie MeSH
- hysteroskopie škodlivé účinky MeSH
- komplikace těhotenství MeSH
- lidé MeSH
- narození mrtvého plodu MeSH
- odumření plodu MeSH
- ruptura dělohy diagnóza chirurgie ultrasonografie MeSH
- těhotenství MeSH
- třetí trimestr těhotenství MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Sympathetic nervous system (SNS) undergoes a prolonged period of fetal and neonatal development and maturation during which is vulnerable to a variety of influences (e.g. painful experiences). Thus, we aimed to evaluate SNS activity at rest and in response to stressful stimulus (pain) within the earliest postnatal life in healthy term neonates using electrodermal activity (EDA) measures. In twenty eutrophic healthy term neonates EDA was recorded within the first two hours after birth (measurement 1 - M1) and 72 h after birth (measurement 2 - M2) at rest and in response to pain (M1 - intramuscular K vitamin administration; M2 - heel stick). Evaluated parameters were skin conductance level (SCL), non-specific skin conductance responses (NS.SCRs), skin SCL 10 s before pain stimulus (SCL_10 before pain), skin conductance response (SCR) peak after pain stimulus, SCL 10 s after pain stimulus (SCL_10 after pain), SCR magnitude, latency, SCR rise/decline time, SCR half recovery time. SCL was significantly decreased at rest during M2 compared to M1 (p=0.010). SCL_10 before pain, SCR peak after pain, and SCL_10 after pain stimulus were significantly decreased in M2 compared to M1 (p=0.014, p=0.020, p=0.011, respectively). SCL was significantly decreased and NS.SCRs were significantly higher in the recovery period after the pain stimulus during M2 compared to M1 (p=0.015, p=0.032, respectively). Our results indicate EDA parameters sensitive to detect sympathetic changes during the earliest postnatal life reflecting its potential in early diagnosis of the autonomic maturation - linked pathological states in neonates.
- MeSH
- autonomní nervový systém MeSH
- bolest diagnóza MeSH
- galvanická kožní odpověď * MeSH
- lidé MeSH
- novorozenec MeSH
- reakční čas MeSH
- sympatický nervový systém * fyziologie MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- Publikační typ
- časopisecké články MeSH