[Topografičeskaâ karta 1:42000]. XIII-41, XIII-42, XII-41, XII-42, Vyb. gub., Vil'manstrand. i Kûmensk. uězd.

1:42000.

[Topografičeskaâ karta 1:42000]. XIII-43, XIII-44, XII-43, XII-44, Vyborg. gub., Kûmen. i Vil'manstrand. uězd / snimal" i c̆ertil" Anaevskìj.

1:42000.

[Topografičeskaâ karta 1:42000]. XIII-45, XIII-46, XII-45, XII-46, Vyborg. gub., Vil'manstr., Kûmen. i Strand. uěz.

1:42000.

[Topografičeskaâ karta 1:42000]. XIII-49, XIII-50, XII-49, XII-50, Vyborg. gub., Âskis", Stranda i Èurâpâ uězdov.

1:42000.

[Topografičeskaâ karta 1:42000]. XIII-51, XIII-52, XII-51, XII-52, Vyborg. gub., Âskis" uězd / snimal" i c̆ertil" Gûbìev".

1:42000.

[Topografičeskaâ karta 1:42000]. XIII-55, XIII-56, XII-55, XII-56, Vyborg. gub., Keksgol'msk. uězd / snimali Rozonoer", Bogdanov" i Nikol'skìj i čertili Rozonoer" i Nikol'skìj.

1:42000.

[Topografičeskaâ karta 1:42000]. IX-37, IX-38, Finl. Nûland. i Vyborg. gub., Finl. Vyborgs. gub.

1:42000.

The effect of epidural and general anesthesia on newborn rectal temperature at elective cesarean section

Both epidural and general anesthesia can impair thermoregulatory mechanisms during surgery. However, there is lack of information about the effects of different methods of anesthesia on newborn temperature. The purpose of this study was to determine whether there are differences in newborn rectal temperature related to type of anesthesia. Sixty-three pregnant women were randomly assigned to receive general or epidural anesthesia. Maternal core temperature was measured three times with a rectal probe just before anesthesia, at the beginning of surgery and at delivery. In addition, umbilical vein blood was sampled for pH. The rectal temperatures of the babies were recorded immediately after delivery, and Apgar scores were determined 1, 5, and 10 min after birth. The duration of anesthesia and the volume of intravenous fluid given during the procedure (833 ± 144 vs 420 ± 215 mL) were significantly higher in the epidural group than in the general anesthesia group (P < 0.0001). Maternal rectal temperatures were not different in both groups at all measurements. In contrast, newborn rectal temperatures were lower in the epidural anesthesia group than in the general anesthesia group (37.4 ± 0.3 vs 37.6 ± 0.3°C; P < 0.05) immediately after birth. Furthermore, the umbilical vein pH value (7.31 ± 0.05 vs 7.33 ± 0.01; P < 0.05) and Apgar scores at the 1st-min measurement (8.0 ± 0.9 vs 8.5 ± 0.7; P < 0.05) were lower in the epidural anesthesia group than in the general anesthesia group. Since epidural anesthesia requires more iv fluid infusion and a longer time for cesarean section, it involves a risk of a mild temperature reduction for the baby which, however, did not reach the limits of hypothermia.

Clustering of psychiatric and somatic illnesses in the general population: multimorbidity and socioeconomic correlates

The distribution of psychiatric disorders and of chronic medical illnesses was studied in a population-based sample to determine whether these conditions co-occur in the same individual. A representative sample (N = 1464) of adults living in households was assessed by the Composite International Diagnostic Interview, version 1.1, as part of the São Paulo Epidemiological Catchment Area Study. The association of sociodemographic variables and psychological symptoms regarding medical illness multimorbidity (8 lifetime somatic conditions) and psychiatric multimorbidity (15 lifetime psychiatric disorders) was determined by negative binomial regression. A total of 1785 chronic medical conditions and 1163 psychiatric conditions were detected in the population concentrated in 34.1 and 20% of respondents, respectively. Subjects reporting more psychiatric disorders had more medical illnesses. Characteristics such as age range (35-59 years, risk ratio (RR) = 1.3, and more than 60 years, RR = 1.7), being separated (RR = 1.2), being a student (protective effect, RR = 0.7), being of low educational level (RR = 1.2) and being psychologically distressed (RR = 1.1) were determinants of medical conditions. Age (35-59 years, RR = 1.2, and more than 60 years, RR = 0.5), being retired (RR = 2.5), and being psychologically distressed (females, RR = 1.5, and males, RR = 1.4) were determinants of psychiatric disorders. In conclusion, psychological distress and some sociodemographic features such as age, marital status, occupational status, educational level, and gender are associated with psychiatric and medical multimorbidity. The distribution of both types of morbidity suggests the need of integrating mental health into general clinical settings.