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Query: UMLS:C0277787 (stigma)
 13,352 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To reduce the maternal mortality associated with obstructed labor, the World Health Organization recommended (1986) more widespread use of cesarean section. However, this procedure is itself associated with significant mortality and morbidity risks in health facilities in rural areas of developing countries where obstructed labor due to cephalopelvic disproportion is most prevalent. In some cases of obstructed labor, symphysiotomy--the artificial separation of the symphysis pubis with a scalpel to enlarge the pelvic diameter--is a viable alternative to cesarean section. The maternal mortality associated with this procedure is negligible. In a series of 1752 symphysiotomies in Africa, there were 3 deaths (0.2% mortality rate), and none of these deaths was related to the procedure itself. This compares with a mortality rate for cesarean section in African hospitals of 1.8%. Complications of symphysiotomy can be virtually eliminated if the procedure is performed only when 1/3 or more of the fetal head has entered the pelvic brim, the fetal head is not felt prominent in from of the symphysis, and the cervix is dilated beyond 7 cm. Since this procedure does not scar the uterus, the concern of future uterine rupture that exists with cesarean section is not a factor. The vaginal delivery rate after previous symphysiotomy is 87% compared to 44% after cesarean section for disproportion. Moreover, the need for blood transfusion--with the attendant risk of human immunodeficiency virus infection--is far less in symphysiotomy. Finally, symphysiotomy is more culturally acceptable in developing countries where cesarean section delivery is viewed with stigma as a failure to achieve "natural" vaginal birth.
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PMID:Safe motherhood: cesarean section or symphysiotomy? 237 30

The volume of peritoneal fluid was measured after laparoscopic aspiration in 303 women. Contamination with blood was estimated at 4.2 per cent by haemoglobin assay. In 120 women with regular menstrual cycles, the volume of peritoneal fluid increased progressively during the follicular phase, was highest during the early luteal phase (20.0 +/- 6.3 ml) and declined thereafter. In 89 women with moderate and mild endometriosis the amounts of peritoneal fluid were similar, but 9 women with severe endometriosis had lower (P less than 0.05) volumes during the luteal phase. Women with inactive ovaries had uniformly low amounts of peritoneal fluid: 4.2 +/- 2.3 ml in 31 women taking combined oral contraceptive pills; 4.7 +/- 5.8 ml in 17 women taking 5 mg of lynoestrenol daily and 1.2 +/- 1.9 ml in 20 postmenopausal women with an inactive endometrium. In contrast, two postmenopausal women with proliferative endometrium had 7 and 10 ml of peritoneal fluid. Women with active ovaries, 5 with absent or distally occluded Fallopian tubes and 7 without a uterus had normal amounts of peritoneal fluid. The volume of peritoneal fluid was not affected by pelvic varicose veins, a visible corpus luteum or an ovulation stigma. Peritoneal fluid appears to be predominantly an ovarian exudate, neither an exudate from the pelvic peritoneum nor a tubal secretion.
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PMID:Origin of peritoneal fluid in women: an ovarian exudation product. 738 17

Constantly shifting cultural views influence public perceptions of psychiatric diagnoses, sometimes accommodated by changes in diagnostic terminology. Evolving scientific knowledge of the era is at times used to justify and support mental illnesses. Too often, however, remasked nomenclatures fail to alter social stigma, in part because political arguments are used. Scientific validations of variant behaviors as symptoms with a pathologic status are unfortunately overshadowed. Examples of cultural bias effects on recurring diagnostic challenges illustrate a need for scientific validation. Renaming fails to improve stigma or diagnostic clarity. For example, neurasthenia, or nervous exhaustion, was attributed to fast-paced urban life through the late 1970s. Its symptoms are now largely, to no real advantage, retitled as chronic fatigue syndrome. Diagnoses like "hysteria" have evolved into histrionic personality disorder and somatoform spectrum disorders, although less as a result of demonic possession or a "wandering uterus." Decriminalized and depathologized homosexuality remains a political football, where religious "sin" conceptualizations have not been displaced by studies documenting healthy adjustments among groups with diverse sexual orientations and preferences. Each of these remains severely socially stigmatized. The pseudoscience of "drapetomania," once used to rationalize and pathologize a slave's freedom, is perceived now as psychiatric incarcerations of mentally healthy individuals, more commonly in totalitarian regimes-a politicization of stigma. Research reviews and funding efforts need to emphasize a sound basis for individuals caught in perpetuated diagnostic challenges, not remedied by simple shifts in nomenclature.
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PMID:Modern-Day Relics of Psychiatry. 3146 83