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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Diseases of the colon & rectum 40 (1997), S. 172-178 
    ISSN: 1530-0358
    Keywords: Imagery ; Relaxation ; Anxiety ; Colorectal surgery ; Pain
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: Guided imagery uses the power of thought to influence psychologic and physiologic states. Some studies have shown that guided imagery can decrease anxiety, analgesic requirements, and length of stay for surgical patients. This study was designed to determine whether guided imagery in the perioperative period could improve the outcome of colorectal surgery patients. METHODS: We conducted a prospective, randomized trial of patients undergoing their first elective colorectal surgery at a tertiary care center. Patients were randomly assigned into one of two groups. Group 1 received standard perioperative care, and Group 2 listened to a guided imagery tape three days preoperatively; a music-only tape during induction, during surgery, and postoperatively in the recovery room; a guided imagery tape during each of the first six postoperative days. Both groups had postoperative patient-controlled analgesia. All patients rated their levels of pain and anxiety daily, on a linear analog scale of 0 to 100. Total narcotic consumption, time to first bowel movement, length of stay, and number of patients with complications were also recorded. RESULTS: Groups were similar in age and gender distribution, diagnoses, and surgery performed. Median baseline anxiety score was 75 in both groups. Before surgery, anxiety increased in the control group but decreased in the guided imagery group (median change, 30; P 〈 0.001). Postoperatively, median increase in the worst pain score was 72.5 for the control group and 42.5 for the imagery group (P 〈0.001). Least pain was also significantly different (P 〈0.001), with a median increase of 30 for controls and 12.5 for the imagery group. Total opioid requirements were significantly lower in the imagery group, with a median of 185 mg vs.326 mg in the control group (P 〈0.001). Time to first bowel movement was significantly less in the imagery group (median, 58 hours) than in the control group (median, 92 hours;P 〈0.001). The number of patients experiencing postoperative complications (nausea, vomiting, pruritus, or ileus) did not differ in the two groups. CONCLUSION: Guided imagery significantly reduces postoperative anxiety, pain, and narcotic requirements of colorectal surgery and increases patient satisfaction. Guided imagery is a simple and low-cost adjunct in the care of patients undergoing elective colorectal surgery.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1573-5168
    Keywords: 17α,20β-P-sulphate ; maturation ; gonadotropin ; rainbow trout
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology
    Notes: Abstract Thein vitro secretion of 17α,20β-dihydroxy-4-pregnen-3-one 20-sulphate (17α,20β-P-sulphate) and the free steroid 17α,20β-dihydroxy-4-pregnen-3-one (17α,20β-P), by rainbow trout (Oncorhynchus mykiss) gonads, in response to gonadotropin (GTH) I and GTH II, were studied during the final stages of sexual maturation. Substantial amounts of 17α,20β-P-sulphate were produced, by both mature ovaries and testes, indicating considerable 20β-hydroxysteroid sulphotransferase (20β-HST) activity within these tissues. In the post-ovulatory ovary the level of 17α,20β-P-sulphate (36.6 ng ml−1) greatly exceeded that of 17α,20β-P (8.59 ng ml−1). The amount of 17α,20β-P-sulphate produced in incubations of both mature ovary and testes was unaffected by either GTH I or GTH II treatment at physiological concentrations up to 100 ng ml−1. Similarly, incubations of maturing ovary and testes, treated with GTH I or GTH II, in the presence of added 17α,20β-P at 100 ng ml−1 of medium, produced levels of 17α,20β-P-sulphate that were similar to those of the controls. In incubations of mature ovarian follicles at the stages of germinal vesicle breakdown and preovulation, both GTHs significantly stimulated secretion of 17α,20β-P, although GTH II was always more potent than GTH I. GTH II significantly elevated the levels of 17α,20β-P in testicular incubations from mature males more than 4-fold relative to GTH I and controls, which did not differ from one another. In conclusion, 20β-HST, the enzyme responsible for the sulphate conjugation of 17α,20β-P, was found to be active in the ovaries and testes of rainbow troutin vitro. However, the levels of this enzyme do not appear to be regulated by either GTH I or GTH II.
    Type of Medium: Electronic Resource
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