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PubMed2004

The effect of labor and/or ovariectomy on rodent continence mechanism--the neuronal changes.

Many women develop stress urinary incontinence (SUI) after childbirth, but the exact neuronal changes are largely unknown. This study is designed to identify the neuronal changes associated with pregnancy, delivery and ovariectomy. A total of 10 virgin and 48 pregnant rats were used. Cystometry and stress/sneeze tests were performed in the virgin once and the pregnant rats at certain time points. Postpartum the rats were equally grouped as follows: group I: delivery, group II: delivery + ballooning, group III: delivery + ovariectomy, group IV: delivery + ballooning + ovariectomy. Tissues from bladder, bladder neck, and urethra were analyzed by immunostaining for PGP 9.5, CGRP, SP, NPY, VIP, TH, n-NOS. We found complex innervation changes in the different tissue samples. Since the bladder neck and the mid-urethra play an important role in the continence mechanism the neuronal changes in these areas contribute to the observed functional changes.

Animals↗
PubMed2001

Inflammatory bowel disease and pregnancy.

The peak age ranges for pregnancy and inflammatory bowel disease (IBD) coincide, and many women develop IBD during their reproductive years. This contribution reviews the major studies on the subject, and is sub-divided into two broad considerations: the effects of the disease on fertility, pregnancy and other factors related to the puerperium, and, conversely, the effects of pregnancy and childbirth on the disease: its natural history and recent surgical treatment options, namely pouch anatomy and function. A systematic review of the literature from 1950 to the present was undertaken using Medline and the keywords inflammatory bowel disease and pregnancy.

Adrenal Cortex Hormones↗
PubMed1997

[Pregnancy in patients with transposition of great vessels corrected by the Mustard procedure. Report of a case and review of reported cases].

BACKGROUND: In patients after atrial switch operation (Mustard or Senning procedure) for transposition of the great arteries (TGA), the anatomic right (anterior) ventricle works as the systemic ventricle. Although this is associated with an increased rate of congestive heart failure, the prognosis for long-term survival is good. Therefore a large proportion of these patients has reached their reproductive years and consult cardiologists and obstetricians because they plan a pregnancy or are already pregnant. Because of the substantial hemodynamic changes and the increase in cardiac output during pregnancy, potential risk factors and complications have to be considered. PATIENTS: Initiated by the presentation of a pregnant patient with TGA after surgery in our hospital, we analyzed the information referenced in MEDLINE. Including our patient, there were reports on 27 patients after the Mustard procedure with a total of 39 pregnancies. FETAL OUTCOME: Three abortions occurred during the first trimenon, another one was electively induced because of maternal cardiac deterioration. One late abortion occurred in the 23rd week of pregnancy. 35 babies (one twinpair) were born healthy without cardiovascular anomalies. MATERIAL OUTCOME: No maternal deaths occurred. Eight women developed clinical signs of systemic (= right) heart failure including all three patients with former complex TGA. Four of these patients recovered after delivery, four showed persistent reduction of physical abilities or signs of heart failure. Further complications were supraventricular tachycardias (five patients) and a high incidence of hypertension and pre-eclampsia (22% of patients). CONCLUSION: Overall, the outcome for mothers after Mustard procedure for TGA and their children is good, but there is need for intensive and specialized follow-up.

Adult↗
PubMed2000

Quaternary ammonium compounds and occupational asthma.

OBJECTIVE: Quaternary ammonium compounds, among which benzalkonium chloride is one of the best-known, are commonly used as antiseptics, disinfectants, detergents and preservatives. They can cause occupational asthma, which however, has been rarely reported so far, despite wide use of these products. We report three such cases. Possible mechanisms causing asthma are discussed, taking into account their characteristics. METHODS AND RESULTS: Our patients, all female nurses, manifested asthma symptoms upon handling disinfectant solutions containing benzalkonium chloride. Work-related fall in PEFR was observed in all of them. The diagnosis was confirmed by challenge tests where the patients were exposed, in a closed chamber, to suspected disinfectant contained in a tray. All of the women developed early or delayed symptoms upon exposure. Similar challenge tests to placebo or other disinfectants devoid of quaternary ammonium compound were negative. CONCLUSION: These three cases, in addition to others reported in the literature, point out an as yet poorly known etiology of occupational asthma to quaternary ammonium compounds in hospital employees. The exact mechanism of the action remains unexplained.

Adult↗
PubMed2006

BRCA1 and BRCA2: chemosensitivity, treatment outcomes and prognosis.

BRCA1 and BRCA2 are important breast and ovarian cancer susceptibility genes, and mutations in these two genes confer lifetime risks of breast cancer of up to 80% and ovarian cancer risks of up to 40%. Clinico-pathological studies have identified features that are specific to BRCA1-related breast cancer, but this has been more difficult for BRCA2-related breast cancer. Ovarian cancers due to BRCA1 or BRCA2 mutations cannot usually be distinguished from their non-hereditary counterparts on morphological grounds, but micro-array data suggest that differences do exist. Prognostic studies have shown that breast cancer in a BRCA1 mutation carrier is likely to have a similar, or worse, outcome than that occurring in a BRCA2- or non-carrier of the same age. By contrast, most studies indicate that women developing a BRCA1/2-related ovarian cancer have an improved survival compared with non-carriers, particularly if they receive platinum-based therapy. In support of this, in vitro chemo-sensitivity studies have found that human cells lacking BRCA1 may be particularly sensitive to cisplatinum and to other drugs that cause double-strand breaks in DNA. Nevertheless, in breast cancer, little is known regarding clinically important differences in response to chemotherapy between BRCA1/2 mutation carriers and non-carriers, and between different chemotherapeutic regimens within existing series of BRCA1/2 mutation carriers. There are no published prospective studies. It is hoped that, in the near future, randomised controlled trials will be started with the aim of answering these important clinical questions.

Breast Neoplasms↗
PubMed2004

Antidiabetic actions of estrogen: insight from human and genetic mouse models.

There is increasing evidence both in humans and rodents linking the endogenous estrogen 17b-estradiol (E2) to the maintenance of glucose homeostasis. Postmenopausal women develop visceral obesity and insulin resistance and are at increased risk for type 2 diabetes mellitus, but hormone replacement therapy leads to a reduction in the incidence of diabetes. In various spontaneous rodent models of type 2 diabetes, female rodents are protected against hyperglycemia unless they are ovariectomized, and E2 perfusion reverses diabetes in male rodents. Finally, the study of transgenic mice and mice with genetic alteration of E2 secretion or E2 action has shed light on the antidiabetic properties of E2 at a tissue-specific level. Thus, E2 secretion and action in rodents seems to be implicated 1) in adipose tissue biology and the prevention of obesity, 2) in the stimulation of liver fatty acid metabolism and suppression of hepatic glucose production, and 3) in the protection of pancreatic b-cell function/survival and insulin secretion in conditions of oxidative stress.

Animals↗
PubMed2002

Post-traumatic stress disorder in women: current concepts and treatments.

In the US, 13% of women develop post-traumatic stress disorder (PTSD) during their lifetime. An accurate diagnosis of PTSD requires screening for trauma and symptoms of PTSD. Current research in the neurobiologic and psychologic responses to traumatic stress supports the use of pharmacologic and psychosocial interventions. Selective serotonin reuptake inhibitors are the current first-line pharmacotherapy. Efficacious psychosocial interventions include exposure therapy and cognitive processing therapy.

Brain↗
PubMed1987

Fibrinogen, cigarette smoking, and risk of cardiovascular disease: insights from the Framingham Study.

During the tenth biennial examination, 1315 Framingham study participants free of cardiovascular disease had fibrinogen measured along with other major cardiovascular risk factors including cigarette smoking. The fibrinogen values were significantly higher in smokers than in nonsmokers, increased with the amount smoked in each sex, and exsmokers had values as low as those of nonsmokers. Over 10 years of follow-up, 165 men and 147 women developed cardiovascular disease, the risk in both sexes increasing progressively in relation to antecedent fibrinogen values over the 180 to 450 mg/dl range. Risk gradients for cardiovascular disease in men diminished with advancing age. In men, risk of cardiovascular disease was related to cigarette smoking. This was true in the multivariate case taking all standard risk factors into account. As for fibrinogen, the impact diminished with advancing age. Regression coefficients were actually larger in the multivariate than in the univariate case because of a negative correlation between smoking and blood pressure. Fibrinogen contributed to cardiovascular disease, risk taking into account both cigarette smoking and other risk factors. When fibrinogen is added to the multivariate model for prediction of cardiovascular disease the coefficient for smoking becomes much reduced and is no longer statistically significant. However, each independently contributed to risk in cross-sectional analysis. These data provide another mechanism whereby cigarette smoking influences the occurrence of atherocardiovascular disease and also another reason for prohibiting cigarette use.

Aged↗
PubMed1980

Conservative management of preterm premature rupture of the fetal membranes in a low socioeconomic population.

The management of rupture of the membranes associated with a premature gestation (PROM) is controversial. Some authors advise immediate delivery while others counsel delay in the hope of decreasing the morbidity and mortality rates associated with prematurity. A retrospective chart review of 90 pregnancies with this obstetric complication treated conservatively was performed to delineate the relative risk factors in a low socioeconomic population. All patients were placed at bed rest until either labor or amnionitis prompted delivery. Amnionitis was a significant problem, occurring in 27% of patients. The percentage of women developing amnionitis did not increase with increasing duration of PROM. Respiratory distress syndrome (RDS) was the significant cause of neonatal illness and death. No relationship between the duration of PROM and incidence of RDS could be demonstrated, but there was a significant relationship between birth weight and RDS. The smaller the infant, the more likely it would be to develop RDS. Our data indicate that a possible course of therapy would be to accelerate fetal lung maturity medically and then deliver the infant. A randomized prospective study could answer this question.

Adolescent↗
PubMed1975

Krukenberg's spindles.

Forty-three patients who initially presented with Krikenberg's spindles but with no glaucomatous field defects were observed for an average of 5.8 years in an attempt to evaluate the prognostic implication of spindle presence. Twenty-two of the patients had been followed for a minimum of five years. Analysis of the study population revealed that there were more women than men, (26 vs. 17), the women were older than the men, and more women had positive glucose tolerance tests (25% vs. 0). Only two of the patients, both women, developed glaucomatous field defects during the period of observation. Thus, the presence of a Krukenberg's spindle in a patient with no visual field defect is not a particularly ominous sign.

Administration, Topical↗
PubMed1976

Blindness caused by photoreceptor degeneration as a remote effect of cancer.

Three postmenopausal women developed photoreceptor degeneration one to four months preceding or following discovery of an anaplastic tumor. Two patients had transitory visual obscurations and bizarre visual sensations. Ring scotomas progressed to severe visual field loss. Retinal arteries were markedly narrowed. Electroretinograms revealed almost total absence of response in one patient, and another complained of the recent onset of night blindness. In all three patients severe degeneration of the photoreceptor cells associated with melanophagic activity was shown histologically. In two patients neuropathologic examination from the retinal bipolar cells to the occipital cortex revealed no significant alterations.

Aged↗
PubMed1977

Papilledema in endemic typhus.

A 21-year-old women developed severe bilateral papilledema during an acute febrile disease. Her optic disk margins were blurred and the disks were elevated up to 5 diopters. Splinter hemorrhages, cotton-wool exudates, cytoid bodies, and sheathing of veins were also present. The pyrexia was caused by murine typhus diagnosed by serologic tests. These tests revealed that Proteus OX-19 agglutination titer rose to 1:12800, and a positive complement fixation test titer was 1:640 with Rickettsia mooseri antigens. Neurological examination results, skull roentgenograms, brain scan, electroencephalogram, and the cerebrospinal fluid were all within normal range, thereby excluding intracranial hypertension. After the patient's recovery from the rickettsial disease, the papilledema abated gradually until her fundi reverted to normal.

Adult↗
PubMed1981

Acquired cyclic esotropia in an adult.

A 67-year-old women developed periodic alternate-day esotropia, documented with videotape, 16-mm film, and quantitative eye-movement recordings, after retinal detachment surgery. The eye movements suggested that central reprocessing and adaptation to a peripheral defect was in part responsible for this adult form of acquired cyclic esotropia.

Adult↗
PubMed1988

Maternal orbital hematoma associated with labor.

We examined two women with orbital hematomas that occurred during labor. Both women developed sudden diplopia, proptosis, and orbital pain. The location of the hematoma was confirmed by orbital echography and computed tomography. The patients were observed without surgical intervention. Neither patient developed clinical or echographic signs of compressive optic neuropathy. Clinical resolution occurred during the following two weeks. Serial standardized orbital echographic examinations documented resolution of the hematomas.

Adult↗
PubMed1981

Acute acalculous cholecystitis.

Sixty-three patients, 49 men and 14 women, developed acute cholecystitis without gallbladder stones. Only eight patients had a history suggestive of gallbladder disease. In 17 patients cholecystitis developed in the postoperative period, and cholecystitis occurred in 7 patients who had extensive trauma. The signs and symptoms did not differ markedly from those found when acute cholecystitis is associated with cholelithiasis. Pain and tenderness in the right upper abdominal quadrant, vomiting, abdominal distention, decreased bowel sounds, jaundice and fever were common. Thirty (47.6 percent) gallbladder specimens had gangrene, and perforation occurred in five instances. Bacteria were cultured from 28 of 43 bile specimens. E. coli was the most common organism. A high incidence of acalculous gallbladders is found when acute cholecystitis occurs in the postoperative period or after trauma and in children. Decreased blood flow to the gallbladder, cystic duct obstruction and concentrated bile are necessary to produce experimental cholecystitis. These factors are probably necessary in humans also. Decreased gallbladder perfusion caused by shock, congestive heart failure and arteriosclerosis probably contributed to the development of acute acalculous cholecystitis in these patients.

Acute Disease↗
PubMed1980

Toxic polyneuropathy due to n-hexane.

Three women developed a predominantly motor polyneuropathy following industrial exposure to an adhesive agent containing 80.4% of n-hexane as a volatile substance. Histological and electron-microscopic studies were carried out on sural nerve and on soleus muscle. In the nerve, there were polymorphous changes in both myelin sheaths and axons of large diameter fibres. Irregular and swollen myelin sheaths and segmental swelling of axons with dissolution of neurotubules and evident increase of neurofilaments were frequently observed. Polymorphous inclusion bodies were often present in Schwann cell cytoplasm. The small myelinated and unmyelinated fibres did not show significant changes. The muscles showed denervation atrophy and focal degenerative myopathic changes, with presence of lymphocytic infiltrates and phagocytosis. This study confirms the noxious effect of n-hexane on the peripheral nerve, with development, in our cases, of a toxic polyneuropathy and denervation muscular atrophy with consistent myopathic changes.

Adolescent↗
PubMed1988

Microangiopathy with encephalopathy, hearing loss and retinal arteriolar occlusions: two new cases.

Two young women developed encephalopathy, hearing loss and retinal arteriolar occlusions. Their behaviour became immature and cognitive functions were severely impaired. One of the patients underwent brain biopsy, which showed several microinfarcts in both white and grey matter and microangiopathic changes, with thickened arteriolar segments staining intensely for laminin and fibronectin. These findings support the concept of a new type of microangiopathy involving the brain, inner ear and retina.

Adult↗
PubMed1984

Completely thrombosed giant aneurysm of the angular artery.

An unusual case of a completely thrombosed giant aneurysm arising from the angular artery is reported. A 69-year-old women developed a subarachnoid hemorrhage with a large intracranial hematoma. Computed tomography scans and cerebral angiography could not detect the aneurysm. The rarity of aneurysms in this position is stressed and the difficulty of diagnosis in this case is discussed.

Aged↗