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Reproduction, Nutrition, Development 1998Diet-induced undernutrition causes deleterious changes in the structure and function of the diaphragm muscle. Diseases associated with somatic washing cause atrophy of... (Review)
Review
Diet-induced undernutrition causes deleterious changes in the structure and function of the diaphragm muscle. Diseases associated with somatic washing cause atrophy of the respiratory muscles. In cachectic subjects, the diaphragm muscle mass and thickness are reduced in proportion to the reduction in body weight. In addition, respiratory muscle strength and endurance are reduced more dramatically than the weight loss. This finding suggests that malnutrition induces a reduction in muscular mass which is associated with a decrease in contractility. Diaphragmatic weakness may increase the risk of respiratory failure in patients with chronic obstructive pulmonary disease (COPD). The primary goal of a successful nutritional programme is to improve the diaphragm strength by correcting the mineral, electrolyte and energetic disturbances at the muscular level, the latter being responsible for the decreased contractability associated with malnutrition.
Topics: Animals; Diaphragm; Humans; Nutrition Disorders; Nutritional Status; Physical Endurance
PubMed: 9638791
DOI: 10.1051/rnd:19980204 -
The Cochrane Database of Systematic... 2001The diaphragm is usually used with a spermicide. However, some practitioners have suggested that spermicides offer no additional contraceptive protection and have... (Review)
Review
BACKGROUND
The diaphragm is usually used with a spermicide. However, some practitioners have suggested that spermicides offer no additional contraceptive protection and have advocated alternative guidelines for the use of diaphragms.
OBJECTIVES
The objective of this review was to compare the effectiveness, safety and acceptability of the diaphragm with and without spermicide.
SEARCH STRATEGY
We searched MEDLINE, EMBASE, POPLINE, CINAHL, the Cochrane Controlled Trials Register, and reference lists of relevant articles. In addition, we contacted experts in the field to identify unpublished studies.
SELECTION CRITERIA
Randomized controlled trials comparing women of reproductive age using the diaphragm with and without spermicide as the sole contraceptive method that reported clinical outcomes.
DATA COLLECTION AND ANALYSIS
Two reviewers independently extracted data on outcomes and trial characteristics and any discrepancies were resolved by consensus or by consultation with the third reviewer. The results of the one identified study are presented descriptively.
MAIN RESULTS
We identified only one study. No significant difference was found in the pregnancy rates (with typical use or consistent use) or discontinuation rates between the diaphragm-with-spermicide and diaphragm-without-spermicide groups. There was a trend towards higher pregnancy rates in the diaphragm-without-spermicide group. However, this study failed to recruit the planned number of participants and was consequently underpowered.
REVIEWER'S CONCLUSIONS
As only one underpowered study was identified, we cannot distinguish between the contraceptive effectiveness of the diaphragm with and without spermicide. We cannot draw any conclusion at this point, further research is needed.
Topics: Contraception; Contraceptive Devices, Female; Female; Humans; Pregnancy; Randomized Controlled Trials as Topic; Spermatocidal Agents
PubMed: 11406025
DOI: 10.1002/14651858.CD002031 -
The European Journal of Contraception &... Apr 2017The European Society of Contraception Expert Group on Abortion identified as one of its priorities to disseminate up-to-date evidence-based information on postabortion...
The European Society of Contraception Expert Group on Abortion identified as one of its priorities to disseminate up-to-date evidence-based information on postabortion contraception to healthcare providers. A concise communication was produced which summarises the latest research in an easy-to-read format suitable for busy clinicians. Information about individual methods is presented in boxes for ease of reference.
Topics: Aftercare; Contraception; Contraceptive Agents; Contraceptive Agents, Female; Contraceptive Devices, Female; Europe; Family Planning Services; Female; Gynecology; Humans; Obstetrics; Practice Guidelines as Topic; Pregnancy; Pregnancy, Unplanned
PubMed: 28256918
DOI: 10.1080/13625187.2017.1287352 -
Taiwanese Journal of Obstetrics &... Mar 2023We aimed to investigate whether there is a relationship between diaphragm thickness and disease severity in Covid-19 pregnant subgroups.
OBJECTIVE
We aimed to investigate whether there is a relationship between diaphragm thickness and disease severity in Covid-19 pregnant subgroups.
MATERIAL AND METHODS
In this prospective study 100 pregnant patients were enrolled. Thickness of the diaphragm muscle at end-expiration was measured using B-Mode US. Hemoglobin,WBC, NLR, procalcitonin and LDH levels were measured.
RESULTS
There was a statistically significant difference between the groups in terms of diaphragm thickness, and the diaphragm thickness was thinner in the severe disease group (p < 0.001). There was no statistically significant difference between the groups with mild to moderate disease severity (p = 0.708).
CONCLUSION
Covid-19 patients who developed serious infection has thinner diaphragms than those who did not. Low diaphragm muscle thickness at the outset of Covid-19 disease, may predispose to poor clinical outcomes. Diaphragmatic ultrasound may be a promising tool to evaluate the risk of Covid-19 disease severity.
Topics: Humans; Pregnancy; Female; Diaphragm; Prospective Studies; COVID-19; Ultrasonography
PubMed: 36965895
DOI: 10.1016/j.tjog.2022.10.008 -
Journal of General Internal Medicine Nov 2009Women who have survived cancer may need guidance in choosing a method of contraception. This paper reviews the evidence supporting the safety and efficacy of available... (Review)
Review
Women who have survived cancer may need guidance in choosing a method of contraception. This paper reviews the evidence supporting the safety and efficacy of available methods of contraception for cancer survivors and concludes that the Copper T380A intrauterine device (IUD), a highly effective, reversible, long-acting, hormone-free method should be considered a first-line contraceptive option for women with a history of a hormonally mediated cancer. However, the levonorgestrel-containing IUD may be preferable for women being treated with tamoxifen and women who have survived non-hormonally mediated cancers. Women with IUDs can undergo all forms of imaging, including computed tomography and magnetic resonance imaging.
Topics: Contraception; Contraceptive Agents, Female; Female; Humans; Intrauterine Devices, Copper; Intrauterine Devices, Medicated; Neoplasms; Survivors
PubMed: 19838839
DOI: 10.1007/s11606-009-1023-8 -
The Journal of Clinical Investigation May 1985
Review
Topics: Adult; Animals; Biomechanical Phenomena; Body Weight; Diaphragm; Disease Models, Animal; Energy Metabolism; Humans; Muscle Contraction; Muscle Relaxation; Muscular Diseases; Physical Exertion; Respiration; Time Factors
PubMed: 3889054
DOI: 10.1172/JCI111841 -
Asian Journal of Surgery Dec 2022
Topics: Humans; Fibromatosis, Aggressive; Diaphragm
PubMed: 35835675
DOI: 10.1016/j.asjsur.2022.06.104 -
Medical Science Monitor : International... Mar 2017BACKGROUND The aims of this study are to investigate the difference between the diaphragm thickness at end expiration and the thickness at total lung capacity (TLC), and...
BACKGROUND The aims of this study are to investigate the difference between the diaphragm thickness at end expiration and the thickness at total lung capacity (TLC), and to examine differences in inspiratory muscle function between stroke patients and healthy individuals. MATERIAL AND METHODS Forty-five stroke patients and 49 healthy volunteers were included in this study. Diaphragm thickness was measured at end expiration and at TLC by ultrasonography. The maximal inspiratory pressure (MIP), peak inspiratory flow (PIF), vital capacity (VC), and inspiratory muscle endurance (IME) were assess to evaluate inspiratory muscle function. RESULTS In stroke patients, the diaphragm was significantly thinner on the affected side than the less affected side at end expiration and at TLC. The change between the thickness at end expiration and at TLC were also significant on both sides. Between groups, the difference in diaphragm thickness at end expiration was not significant, but at TLC, the diaphragms were significantly thicker in healthy individuals than on either side in stroke patients, and the change in diaphragm thickness was significantly greater for healthy individuals. Inspiratory muscle functions were also significantly greater in healthy individuals. MIP, PIF, and VC were positively correlated with the change in thickness in healthy individuals, and MIP was positively correlated with the change in thickness and IME in stroke patients. CONCLUSIONS Stroke patients showed decreases in the thickening ability of the diaphragm at TLC and in inspiratory muscle function. The change between the diaphragm thickness at end expiration and at TLC was positively correlated with MIP, PIF, and VC.
Topics: Adult; Case-Control Studies; Chronic Disease; Diaphragm; Female; Humans; Male; Middle Aged; Respiratory Mechanics; Respiratory Muscles; Stroke; Tidal Volume; Total Lung Capacity
PubMed: 28284044
DOI: 10.12659/msm.900529 -
The Cochrane Database of Systematic... 2002The cervical cap and the diaphragm are vaginal barrier contraceptive methods that prevent pregnancy by covering the cervix. The two devices also act as a reservoir for... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The cervical cap and the diaphragm are vaginal barrier contraceptive methods that prevent pregnancy by covering the cervix. The two devices also act as a reservoir for spermicide. The cervical cap is smaller and can remain in place longer than the diaphragm. Two types of cervical caps, the Prentif cap and the FemCap, have been compared to the diaphragm in randomized controlled trials.
OBJECTIVES
The review seeks to evaluate the contraceptive efficacy, safety, discontinuation, and acceptability of the cervical cap with that of the diaphragm.
SEARCH STRATEGY
We searched MEDLINE, Popline, Cochrane Controlled Trials Register, EMBASE, and LILACS for randomized controlled trials of cervical caps, and we reviewed the references of the included publications. Also, we wrote to the manufacturers and known investigators to request information about any other published or unpublished trials not found in our search.
SELECTION CRITERIA
All randomized controlled trials in any language comparing a cervical cap with a diaphragm were eligible for inclusion.
DATA COLLECTION AND ANALYSIS
All titles and abstracts located in the literature searches were assessed, and articles identified for inclusion were independently abstracted by two reviewers. Data were entered and analyzed with RevMan 4.1, and a second reviewer verified the data entered. Outcome measures include contraceptive efficacy, safety, discontinuation, and acceptability. Outcomes were calculated as Peto odds ratios with 95 percent confidence intervals using women as the denominators. Life-table and Kaplan-Meier cumulative rate ratios for selected measures were also presented in "Additional Tables."
MAIN RESULTS
The Prentif cap was comparable to the diaphragm in preventing pregnancy, but the FemCap was not as effective in preventing pregnancy as its comparison diaphragm. The curves for the life-table cumulative pregnancy rates through 24 months for the Prentif cap and the diaphragm were not statistically significantly different (p-value of 0.39). However, the six-month Kaplan-Meier cumulative pregnancy rates for the FemCap and the diaphragm did not meet the a priori definition of clinical equivalence. The Prentif cap had a higher proportion of Class I to Class III cervical cytologic conversions at the three-month visit than the diaphragm; the odds ratio was 2.3 (95% CI, 1.0-5.1). The FemCap trial did not find differences in Papanicolaou smear results between the cap and diaphragm groups. Prentif cap users had a lower odds ratio of vaginal ulcerations or lacerations (0.3; 95% CI, 0.1-0.7) than diaphragm users. FemCap users had a higher odds ratio of blood in the device on removal (2.3; 95% CI, 1.3-4.1), but a lower odds ratio of urinary tract infections (0.6; 95% CI, 0.4-1.0) than those in the diaphragm group. In the FemCap trial, similar proportions of women reported liking their assigned device "somewhat" or "a lot" at the two-week interview. However, FemCap users were less likely than the diaphragm users to state that they were "probably" or "definitely" likely to use the device alone after completing the trial (odds ratio of 0.5; 95% CI, 0.3-0.7) or that they would recommend it to a friend (odds ratio of 0.5; 95% CI, 0.3-0.8).
REVIEWER'S CONCLUSIONS
The Prentif cap was as effective as its comparison diaphragm in preventing pregnancy, but the FemCap was not. Both cervical caps appear to be medically safe.
Topics: Adult; Contraception; Female; Humans; Intrauterine Devices; Randomized Controlled Trials as Topic
PubMed: 12519602
DOI: 10.1002/14651858.CD003551 -
Asian Journal of Surgery Oct 2022
Topics: Colon; Diaphragm; Humans; Infant
PubMed: 35440392
DOI: 10.1016/j.asjsur.2022.03.132