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Physiotherapy as a Way to Maintain Vaginal Health during Menopause

Advances in Sexual Medicine 2017年第2期7卷 97-104页

作者： Mercedes Blanquet Rochera Cristina Salar Andreu Yolanda Castellano Madrid Karima Bouallalene enrique montero pau IM Clinic Fisio 7 Rehabilitation Centre University of Manresa Manresa Spain CEU Cardenal Herrera University Valencia Spain Autonomous University of Barcelona Barcelona Spain Fisio 7 Rehabilitation Centre Manresa Spain A Punto Clinic Valencia Spain

The majority of women will experience some or most of the menopause symptoms in their life. Thais time in women’s life is associated with a reduction in estrogen levels which leads to physiological changes that affect different organ systems. In the urogenital tract, these changes usually cause vulvar and vaginal atrophy, affecting a vaginal health of women and decreasing their quality of life. Also, there is a reduction in vaginal moisture and loss of tissue elasticity. Besides, other organ systems are involved and they can also negatively impact normal vaginal physiology. These evolutional changes frequently lead to bothersome symptoms that can negatively impact a woman’s vaginal health and the quality of life. The role of pelvic floor physiotherapy is to improve the tone and strength of the muscle fibres in order to achieve the increase of motor units, improve muscle elasticity and to increase the muscle mass which will help to alleviate menopause symptoms.

关键词： Menopause Vaginal Health Physiotherapy Pelvic Floor

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Geomechanical modelling of cold heavy oil production with sand

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Petroleum 2022年第1期8卷 66-83页

作者： Assef Mohamad-Hussein Pablo enrique Vargas Mendoza Paolo Francesco Delbosco Claudia Sorgi Vincenzo De Gennaro Surej Kumar Subbiah Qinglai Ni Jose Maria Segura Serra MRLakshmikantha Jos Alvarellos Iglesias Rebecca Daniels Schlumberger Geomechanics Center of Excellence Gatwick AirportUnited Kingdom Schlumberger Calle Alvarez de Baena 4Planta Baja28006MadridSpain Schlumberger Av.A.NobelZI NordPau64000France Schlumberger 45th Floor Tornado TowerWest BayMajlis Al TaawonDohaQatar Repsol Technology Center MostolesMadridSpain

The contribution of geomechanics to provide a rigorous quantification of porosity changes and associated permeability changes is often neglected when considering hydrocarbon ***,it often has significant effects on production rates and ultimate *** the cold heavy oil production with sand(CHOPS)technique,geomechanics is the key for reservoir simulations and promoting successful *** fact,the technique employed in CHOPS significantly affects the stress state within the reservoir by inducing“on-purpose”formation *** is not only vital to comprehend the behaviour of the reservoir during production,but it is crucial to identify how to harness that behaviour to improve *** order to simulate the mechanical behaviour of unconsolidated sand material,an elastoplastic damage model was ***-flow-geomechanical modelling was then performed for predicting individual well behaviour and overall field *** combined effect of fluid-flow and geomechanics improved predictions with respect to oil,water,and gas production rates at key *** rates matched satisfactorily most of the *** addition,the onset and propagation of equivalent wormhole networks were quantified throughout the production *** enabled quantification of the volume of produced sand at individual *** comparisons between the measured and simulated sand volume rate at well locations showed reasonable *** calibrated models can then be used for the placement of new wells to optimize production.

关键词： CHOPS Numerical simulation Sanding Geomechanics

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The effect of broadening the definition of generalized anxiety disorder on healthcare resource utilization and related costs in outpatient psychiatric clinics

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Open Journal of Psychiatry 2013年第1期3卷 158-167页

作者： José M. Olivares José L. Carrasco enrique álvarez María Perez Vanessa López-Gómez Javier Rejas Department of Psychiatry Hospital de la Santa Creu i San Pau Universitat Autónoma de Barcelona Centro de Investigación Biomédica En Red de SAlud Mental (CIBERSAM) Barcelona Spain Department of Psychiatry Hospital Meixoeiro Complejo Hospitalario Universitario Vigo Spain Department of Psychiatry Instituto de Investigación Sanitaria Hospital Clínico San Carlos Centro de Investigación Biomédica En Red de SAlud Mental (CIBERSAM) Madrid Spain Health Economics and Outcomes Research Department Pfizer S.L.U. Madrid Spain Medical Unit Pfizer S.L.U. Madrid Spain

Background: Patients with generalized anxiety disorder (GAD) are among the highest users of healthcare resources. The broadening of the DSM-IV criteria for GAD has been a subject of controversy in the literature, but its consequences have not been analyzed to date. Objective: The purpose of this study was to analyze how the broadening of the DSM-IV criteria affects healthcare resource utilization and related costs. Methods: A multicentre, prospective, observational study was conducted in randomly selected outpatient psychiatric clinics between October 2007 and April 2008. Patients diagnosed according to DSM-IV or broader criteria (1 month of excessive or non-excessive worry and only 2 associated DSM-IV symptoms) for the first time were consecutively enrolled. Socio-demographic data, healthcare resources and corresponding costs were collected over a 6-month period. Results: A total of 3549 patients were systematically recruited, 1815 in the DSM-IV criteria group (DG) and1264 inthe broad criteria group (BG). Treatments prescribed were similar for antidepressants in both groups (77.0% in the DG vs. 75.3% in the BG, p = 0.284), and slightly higher in the DG for benzodiazepines (71.5% vs. 67.2% respectively, p = 0.011) and anticonvulsants (72.1% vs. 67.0% respectively, p = 0.002). Healthcare resource utilization was statistically reduced to a similar extent in both groups as a consequence of treatment, yielding a reduction in the cost of illness of €1196 (SD = 1158) and €1112 (SD = 874) respectively;p = 0.304, over a 6-month period. Conclusion: The broadening of the GAD criteria could lead to earlier diagnosis not necessarily associated with an increase in healthcare resource utilization or costs to the National Health System in the six-month follow-up.

关键词： Generalized Anxiety Disorder Diagnosis DSM-IV Criteria Healthcare Resource Utilization Costs

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