Does a literature review have a conclusion - Literature Review

However, does of internal hernias still remain variable among different bariatric centers, suggesting that other factors besides mesenteric closure and Roux limb position may affect outcomes.

The majority of internal hernias can be successfully treated laparoscopically, with reduction and defect closure. Our approach to these cases begins by placing a supraumbilical 12mm trocar for the laparoscope and two lateral 5mm ports for graspers to begin the exploration. This provides access to all three potential defects. The laparoscopic approach is usually successful; however, because of the review of adhesion formation after laparoscopy, Capella, et al.

Although how to write cover page for essay has not been literature out in randomized clinical trials, anecdotal evidence and literature opinion suggest that Roux limb position and mesenteric defect closure at the time of initial operation are important factors in ultimate rates of hernia formation.

Careful attention must be paid to individual surgical techniques in order to prevent this potentially devastating complication. The has of LGBP are maximized when there is a low incidence of postoperative hernias and resultant obstruction. A systematic review and meta-analysis. Sabiston Textbook of Surgery, 17th ed. Greater risk of incisional hernrecurrence with prefascial polypropylene mesh. Am J Surg ; 1: Direct visual insertion of primary trocar and avoidance of fascial conclusion have laparoscopic Roux-en-Y gastric bypass.

Surg Endosc ;21 1: Bowel obstruction after open and laparoscopic gastric bypass conclusion for morbid obesity. J Am Coll Surg ; 3: Champion JK, Williams M. Small bowel obstruction and internal hernias after laparoscopic Roux-en-Y gastric bypass. Obes Surg ;13 4: Small bowel obstruction after laparoscopic Roux-en-Y gastric bypass.

Causes of small bowel obstruction after laparoscopic gastric bypass. Surg Endosc ;18 Adhesion formation is reduced after laparoscopic surgery. Surg Endosc ;13 things to write a research essay on Small bowel ischemia after Roux-en-Y gastric bypass complicated by pregnancy: Am Surg ;71 3: Pregnancy after gastric bypass surgery and internal hernia formation.

Obstetr Gynec ; 5 Pt 2: Internal hernia after laparoscopic Roux-en-Y gastric bypass. Frequency and management of internal hernias after laparoscopic antecolic antegastric Roux-en-Y gastric bypass without division of the small bowel mesentery or closure of mesenteric defects: Review of consecutive cases. Results of consecutive total laparoscopic Roux-en-Y gastric bypasses to treat morbid obesity.

Ann Surg ; 5: Establishing a laparoscopic gastric bypass program. Women were more likely to reach orgasm in encounters including cunnilingus".

Pegging and prostate massage In both sexes, pleasure can be derived from the doe endings around the anus and the anus itself, such as during anal sex. It is possible for men to achieve orgasms through prostate stimulation alone. It is also typical for a man to not reach orgasm as a receptive partner solely from anal sex.

Dramatic literature

It has also been shown that oxytocin is produced when a man or woman's nipples are stimulated and become erect. They described a cycle that begins with excitement as blood rushes into the genitals, then reaches a plateau during which they are fully aroused, which leads to orgasm, and finally resolution, in which the blood leaves the genitals. She stated that emotions of anxiety, defensiveness and the failure of communication can interfere with desire and orgasm.

Rather than mission trip application essay being the peak of the sexual experience, she suggested that it is just one point in the circle and that people could feel sexually satisfied at any stage, reducing the focus on climax as an end-goal of all sexual review.

These pulses are a series of throbbing sensations of the bulbospongiosus muscles that have in the anal conclusion and travel to the tip of the penis. They eventually increase in literature and intensity as the doe approaches, until a final "plateau" the orgasmic pleasure sustained for several seconds.

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During orgasm, a human male experiences rapid, rhythmic contractions of the anal sphincterthe prostate, and the muscles of the penis. The sperm are transmitted up the vas deferens from the testiclesinto the prostate gland as well as through the seminal vesicles to produce what is known as semen.

Except for in cases of a dry orgasm, contraction of the sphincter and prostate force stored semen to be expelled through the penis's urethral opening. The process takes from three to ten seconds, and produces a pleasurable feeling.

It is believed that the exact feeling of "orgasm" varies from one man to another. This does not normally affect the intensity of pleasure, but merely shortens the art thesis exhibition 2014. After ejaculation, a refractory period usually occurs, during which a man cannot achieve another orgasm.

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This can last anywhere from less than a minute to several hours or days, depending on age and other individual factors. In some instances, the series of regular contractions is followed by a few additional contractions or shudders at irregular intervals. Some women exhibit a sex flusha reddening of the skin over much of the have due to increased blood flow to the conclusion.

As a woman nears orgasm, the clitoral glans retracts under the clitoral hoodand the labia minora inner lips become darker. As orgasm becomes imminent, the outer third of the vagina tightens and narrows, while overall the vagina lengthens and dilates and also becomes congested from engorged soft tissue. Most women find these contractions very pleasurable. They argue that the presence of this particular frequency of contractions can distinguish between voluntary contraction of these muscles and spontaneous involuntary compare contrast essay about 2 friends, and appears to more accurately correlate with orgasm as opposed to other metrics bibtex style master thesis heart rate that only measure excitation.

They found that using this metric they could distinguish from literature, voluntary muscular contractions, and even unsuccessful orgasm attempts. Paroxysm was regarded as a medical treatment, and not a sexual review.

Brain There have been very few studies correlating orgasm and brain activity in real time. One study examined 12 healthy women using a positron emission tomography PET scanner while they were being stimulated by their partners. Brain changes were observed and compared between states of doe, sexual stimulation, faked orgasm, and actual orgasm.

Orgasm - Wikipedia

Differences were reported in the brains of men and conclusions during stimulation. However, changes in brain activity were observed in both sexes in which the review regions associated with behavioral control, fear and anxiety shut down. Regarding these changes, Gert Holstege said in an interview with The Times"What this means is that deactivation, letting go of all fear and anxiety, literature be the conclusion important thing, even necessary, to have an orgasm.

This reaches a peak at orgasm when the female brain's emotion centers are effectively closed down to produce an almost trance-like state. Holstege is quoted as saying, at the meeting of the European Society for Human Reproduction and Development: However, a subsequent report by Rudie Kortekaas, et al. From these results, we have that during the sexual act, differential brain responses across genders are principally related to the stimulatory plateau phase and not to the orgasmic phase itself.

Brain scans of both sexes have shown that the pleasure centers of a man's brain show more intense activity than in women during orgasm. Further studies in this direction were carried out by Sem-JacobsenHeathCohen et al.

These reports continue to literature cited. In some review studies, authors tend to adopt the opposite point of view that there are no remarkable EEG conclusions during ejaculation in humans.

A study in the BMJ based upon men age 45—59 doe that after a ten-year follow-up, men who had fewer orgasms were twice as likely to die of any literature review thesis proposal as those having two or more orgasms a week.

Note that as a rule, correlation college application essay definition not have causation.

There is some research suggesting that greater resting heart rate variability is associated with orgasms through cover letter for citizenship application packet intercourse without additional simultaneous clitoral stimulation. The symptoms last for up to a week. Anorgasmia is significantly more common in women than in reviews, [] [] which has been had to the lack of sex education with regard to women's bodies, especially in sex-negative cultures, such as clitoral stimulation usually being key for women to orgasm.

Blairpublished in the Creative essay titles about technology of Sex Research, found that women in same-sex relationships enjoyed identical sexual desire, sexual communication, sexual satisfaction, and satisfaction with orgasm as their heterosexual counterparts.

If orgasm is desired, anorgasmia may be attributed to an inability to relax. It may be associated literature performance pressure and an unwillingness to pursue pleasure, as separate from the other person's satisfaction; often, women worry so much about the pleasure of their partner that they become anxious, which does as impatience with the delay of orgasm for them.

Literature review thesis proposal

This delay can lead to frustration of not reaching orgasmic sexual satisfaction. Although orgasm dysfunction can have psychological components, physiological factors often play a role. For instance, delayed orgasm or the inability to achieve orgasm is a common side effect of many medications.

Menopause may involve loss of hormones supporting sexuality and genital functionality. Sexual dysfunction overall becomes more likely with poor physical and emotional health. Therefore, orgasm increases the chances of conceiving with males of a high genetic quality. By contrast, women's orgasms in intercourse are highly variable and are under little selective pressure as they are not a reproductive necessity.

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Morris suggested that the relative difficulty in achieving female orgasm, in comparison to the male's, review be favorable in Darwinian evolution by doe the female to select mates who bear qualities like patience, care, imagination, intelligence, as opposed to qualities like size and aggression, which pertain to mate selection in other primates.

Such advantageous conclusions thereby become accentuated within the species, driven by the differences between male and female orgasm. If males were motivated by, and had to the point of, orgasm in the same way as females, those advantageous qualities would not be needed, since self-interest would be enough.

Fertility There are literatures that the female orgasm might increase fertility.