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Biomedical subjects

L Cardozo

Publications and source records attributed to L Cardozo.

At least 55 records · Page 3Linked to original sources
PubMed2000

Current trends in management of ectopic pregnancy in the United Kingdom.

The potential advantages of laparoscopic management of ectopic pregnancy include lower morbidity, faster return to work, and less impact on reproductive health. This study aimed to investigate the current management of ectopic pregnancy in the United Kingdom. Thirty-five per cent of ectopic pregnancies are currently managed laparoscopically. Units that tended to operate laparoscopically were more likely to attempt to preserve the fallopian tube at surgery. Ninety per cent of units in the UK feel that they potentially could manage ectopic pregnancies laparoscopically but in practice only 60% managed any of the last three ectopic pregnancies by this technique.

Journal Article↗
PubMed2000

Genuine stress incontinence: colpocystourethropexy versus sling procedures.

Both colpocystourethropexy (colposuspension) and sling operations have been shown to be effective in treating female stress incontinence. The present review discusses the literature available and compares the results and complications of both procedures. Colposuspension can give excellent results as both primary and secondary surgery. Slings also give excellent results, but are prone to complications relating to the sling material and postoperative voiding difficulties. Slings are arguably best reserved for women in whom vaginal scarring makes colposuspension impossible. Colposuspension remains the gold standard operation against which new techniques should be compared.

Female↗
PubMed2000

[Coxitis due to multidrug resistant Mycobacterium tuberculosis in a HIV negative patient].

A case of an HIV negative female patient with coxofemoral arthritis of tuberculous etiology, multidrug-resistant strain, and connective tissue disease associated to glucocorticoid therapy is reported. The patient was treated with cycloserine, ethambutol, p-aminosalicylic acid and ofloxacin, with improvement of the joint lesions. Previous publications on this subject are reviewed.

Adult↗
PubMed1999

Imaging the urethral sphincter with three-dimensional ultrasound.

OBJECTIVE: To image the striated urethral sphincter (rhabdosphincter) using three-dimensional ultrasound and to compare its size in women with genuine stress incontinence and continent controls. METHODS: Women with no previous continence or prolapse surgery had transvaginal sonography using a 7.5-MHz mechanical sector endoprobe with real-time and three-dimensional facilities. Three perpendicular planes were displayed simultaneously on the screen. Manipulation of the stored images allowed detailed morphologic assessment of the urethra at different levels using several parallel cross-sectional planes along its length. The length, thickness, and volume of the rhabdosphincter were measured. RESULTS: Forty-six women with genuine stress incontinence (27-73 years, mean 48) and 48 continent controls (23-76 years, mean 49) were studied. In the transverse plane, the inner part of the urethra, which consists of urothelium and smooth muscle, appeared hyperechogenic compared with the outer hypoechogenic ring of striated muscle. The two groups studied were not different in age and parity. Women with genuine stress incontinence, compared with continent controls, had a significantly shorter (mean +/- standard deviation 16.9 +/- 1.9 mm compared with 19.2 +/- 3.6 mm; P = .001), thinner (2.1 +/- 0.5 mm compared with 2.5 +/- 0.4 mm; P < .001), and smaller volume (0.8 +/- 0.2 mL compared with 1.2 +/- 0.2 mm; P < .001) of the striated urethral sphincter. There was a close correlation between the urethral sphincter volume and the degree of incontinence assessed on videocystourethrography (r = -.65, P < .001). CONCLUSION: Three-dimensional ultrasound allowed examination of the female urethra in planes that could not be visualized by conventional sonography. The rhabdosphincter had a smaller volume in women with genuine stress incontinence than in continent women.

Adult↗
PubMed1999

Colposuspension after previous failed incontinence surgery: a prospective observational study.

OBJECTIVE: To evaluate the outcome of colposuspension for genuine stress incontinence in women who had previously undergone bladder neck surgery. DESIGN: Prospective observational study. SETTING: Tertiary referral urogynaecology unit. PARTICIPANTS: Fifty-two consecutive women with recurrent genuine stress incontinence operated on by one surgeon. MAIN OUTCOME MEASURES: Subjective and objective cure of stress incontinence. Complications of surgery. RESULTS: The mean age of the women was 51 years (range 28-72) and weight 72.7 kg (range 53-112). Sixty-five continence procedures had been performed previously, with 13 women (25%) having had more than one operation. Nine months post-operatively the subjective cure rate was 80% and objective cure rate 78%. Intraoperative complications were few but included two bladder injuries and one rectus muscle tear which required repair. Seven women (13%) developed voiding difficulties which required clean intermittent self-catheterisation, but only one needed to continue this for six months. None of the women developed detrusor instability. CONCLUSIONS: In this setting colposuspension after previous bladder neck surgery offers a high rate of success. However, long term follow up is needed to see if this effect is maintained.

Adult↗
PubMed1999

Lower urinary tract symptoms and their impact on women with anorexia nervosa.

Anorexia nervosa is a condition which is associated with extremely low body weight and endocrine problems including persistent anovulation and a hypo-oestrogenic state. As the lower urinary tract is oestrogen sensitive, it is possible that women suffering from anorexia nervosa may experience similar distressing urinary problems. Of 29 anorexic women assessed, the majority had significant irritative urinary symptoms of which frequency, urgency and nocturia were the most common. These symptoms also had an unfavorable impact on their quality of life.

Adolescent↗
PubMed1999

Urinary incontinence in middle aged women: childhood enuresis and other lifetime risk factors in a British prospective cohort.

STUDY OBJECTIVE: To investigate the prevalence and lifetime risk factors for urinary incontinence in middle aged women. DESIGN: Nationally representative birth cohort study with prospective data on childhood enuresis, measured adult height and weight, childbearing histories and measures of socioeconomic status updated at regular contacts, and measures of menopausal status, symptomatology and health care in midlife. SETTING: England, Scotland and Wales. PARTICIPANTS: General population sample of 1333 women aged 48 years. MAIN RESULTS: Fifty per cent reported symptoms of stress incontinence and 22% reported symptoms of urge incontinence in the previous year. Eight per cent had severe symptoms. Women who at age 6 years had wet in the day or several nights a week were more likely to suffer severe incontinence and report urge symptoms but occasional bedwetting was not associated with an increased risk in adult life. Those who were older at the birth of their children and who had vaginal deliveries had an excess risk of stress symptoms. Heavier adult body weight was also a risk factor for these symptoms and for severe incontinence. Postmenopausal women were less likely to report stress symptoms. These risk factors remained significant after taking account of the increased reporting of incontinence among women with high levels of general symptomatology and general practitioner visits, and of stress symptoms among better educated women. CONCLUSIONS: Urinary incontinence is a common problem among middle aged women. This is the first prospective study of a general population sample to support the postulated link between childhood enuresis and adult incontinence. Child-bearing has long term adverse effects, particularly for older mothers. Overweight is a common risk factor.

Child↗
PubMed1998

Videocystourethrography with a ring pessary in situ. A clinically useful preoperative investigation for continent women with urogenital prolapse?

The aim of the study was to evaluate the use of a vaginal pessary in the detection of genuine stress incontinence (GSI) in women with urogenital prolapse undergoing urodynamic investigation. Continent women with urogenital prolapse, with or without associated urinary symptoms, were studied. All underwent videocystourethrography using a standardized protocol. None had evidence of incontinence on provocative testing in the upright position. A well-fitting vaginal ring pessary was inserted to reduce the prolapse and mimic a vaginal repair. The provocative tests were then repeated while the bladder was screened. Seventy women with a mean age 59.0 years (range 34-83) were recruited over a 21-month period: 15 women complained of prolapse alone and 55 had concurrent urinary symptoms; 19 women (27%) developed GSI only following the insertion of a vaginal pessary. The women who became incontinent were significantly older (mean age 63.9 years) than those who remained continent (mean age 56.8 years) (P < 0.020). The use of a vaginal pessary increases the detection rate of GSI in continent women with urogenital prolapse undergoing videocystourethrography. These findings are important because women with prolapse and coexisting incontinence should be offered a continence procedure rather than a simple vaginal repair.

Female↗
PubMed1998

Meta-analysis of estrogen therapy in the management of urogenital atrophy in postmenopausal women: second report of the Hormones and Urogenital Therapy Committee.

OBJECTIVE: To evaluate the efficacy of estrogen therapy in the treatment of postmenopausal women with symptoms and signs associated with urogenital atrophy, by meta-analysis of available data. METHODS: We searched the literature (Excerpta Medica, Biosis, MEDLINE, and hand search) for studies published between January 1969 and April 1995. Criteria for inclusion were English-language articles, peer-reviewed original publications, and urogenital atrophy assessed by at least one of the following outcomes: patient symptoms, physician report, pH, or cytologic change. Data had to allow comparison between treated and control groups in controlled trials or an estimated change from baseline in uncontrolled series. Meta-analytic methods were applied separately to controlled clinical trials and uncontrolled studies. RESULTS: Of the 77 relevant articles reviewed, nine contained ten randomized controlled trials. Meta-analysis of these using the Stouffer method revealed a statistically significant benefit of estrogen therapy for all outcomes studied. In 54 uncontrolled case series, the patient symptoms were treated by 24 different treatment modalities. All routes of administration appeared to be effective and maximum benefit was obtained between 1 and 3 months after the start of treatment. As expected, the least systemic absorption of estrogen was seen with estriol (administered orally or vaginally), then vaginal estradiol as measured by pretherapy and posttherapy serum estradiol and estrone. CONCLUSION: Estrogen is efficacious in the treatment of urogenital atrophy and low-dose vaginal estradiol preparations are as effective as systemic estrogen therapy in the treatment of urogenital atrophy in postmenopausal women.

Atrophy↗
PubMed1998

Cryptic speciation in Triatoma sordida (Hemiptera:Reduviidae) from the Bolivian Chaco.

Eight natural Bolivian populations of two closely related species of Triatominae, Triatoma sordida and T. guasayana, were analysed by multilocus enzyme electrophoresis at 20 loci. Both species were readily separated and no natural hybrid was observed. Among the silvatic sample of T. sordida, strong departure from panmixia within and between loci was detected in two sites of the Chaco, suggesting two reproductively separate populations easily recognized at Idh2 and Mdh2 loci. Genetic distance between them was in agreement with the hypothesis of distinct species. However, the detection of 3% of putative hybrids suggested a recent evolutionary divergence.

Alleles↗