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At least 865 records · Page 48Linked to original sources
PubMed1987

Endometrial morphology after 6 months of continuous treatment with a new gonadotropin-releasing hormone superagonist for contraception.

Light and electron microscopic studies were performed on endometrial curettage specimens from 27 women after 6 months of contraceptive treatment with continuous intranasal gonadotropin hormone-releasing hormone (GnRH) superagonist. The GnRH superagonist nafarelin acetate (D-Nal[2]6-GnRH) was used in single daily doses of 125 or 250 micrograms. Ovulation was inhibited during all but one of the 159 treatment months. No pregnancies occurred. In 6 women with fairly regular bleedings, the endometrium displayed weak to normal proliferation. Twenty women developed oligomenorrhea or amenorrhea, 16 of them had inactive endometrium, 1 had weakly proliferative endometrium, and 3 endometrial biopsies were too sparse for adequate evaluation. One woman reported repeated episodes of heavy uterine bleedings. The endometrial biopsy from this woman showed weak proliferation. No signs of endometrial hyperplasia were observed. Generally, the electron microscopy showed signs of low metabolic activity and weak protein synthesis. Thus, long-term continuous treatment with nafarelin acetate for inhibition of ovulation does not appear to have untoward effects on the endometrium.

Administration, Intranasal↗
PubMed2004

Safety and efficacy of ERCP in pregnancy.

BACKGROUND: Choledocholithiasis during pregnancy increases the risk of morbidity and mortality for both fetus and mother because of cholangitis and pancreatitis. ERCP has been advocated as safe and effective in pregnant women, but fetal radiation exposure is not routinely monitored. The aim of this study was to record fetal exposure to ionizing radiation during ERCP and to assess outcome. METHODS: Seventeen ERCPs were performed in pregnant women between January 1995 and August 2003. Techniques to minimize fluoroscopy were used, and fluoroscopy times were recorded. Thermoluminescent dosimeters affixed to the skin of the mother were used to estimate fetal radiation exposure. OBSERVATIONS: Mean gestational age was 18.6 (8.9) weeks (range 5-33 weeks). Mean fluoroscopy time was 14 (13) seconds (range 1-48 seconds). Estimated fetal radiation exposure was 40 (46) mrad (range 1-180 mrad). There was a correlation between fluoroscopy time and radiation exposure, but there was a wide range of radiation exposure for individual fluoroscopy times. Complications included post-sphincterotomy bleeding in one patient (controlled by hemoclip placement) and post-ERCP pancreatitis in one patient that necessitated 3 days of hospitalization. Two women developed third-trimester preeclampsia, and labor was induced in both. Thirteen of the 15 patients who delivered were contacted and they confirmed that their child was in good health. CONCLUSIONS: ERCP with modified techniques is safe during pregnancy. Dosimetry should be routinely recorded.

Adolescent↗
PubMed2000

Vaginal pain caused by laparoscopic colposuspension with tacks.

BACKGROUND: Laparoscopic colposuspension is a popular surgical procedure for stress incontinence. To simplify the laparoscopic approach, many physicians have replaced laparoscopic suturing with mesh, secured with staples or tacks. CASES: Two women developed severe, shooting vaginal pain after laparoscopic colposuspension with mesh and tacks. The tacks could be palpated vaginally in both, reproducing the pain. Tack removal relieved their pain, but one had recurrent cystocele. CONCLUSION: Laparoscopic colposuspension with tacks might produce shooting vaginal pain, possibly unique to tacks versus staples or sutures.

Adult↗
PubMed2001

Group A streptococcal puerperal sepsis preceded by positive surveillance cultures.

BACKGROUND: Screening of pregnant women for vaginal and rectal carriage of group B streptococci may also identify group A streptococcal carriers. The clinical significance of prenatal group A streptococcal carriage is unknown. CASES: Two women developed group A streptococcal puerperal sepsis after delivery at one hospital 15 months apart. The first patient required hysterectomy and suffered complications including subcapsular hepatic hematoma, pleural effusion, and prolonged ileus. She recovered after a 35-day hospitalization. The second patient had endometritis and recovered. Both had had group A streptococci isolated from vaginal and rectal cultures taken for prenatal group B streptococcal screening. The acute sepsis isolates were both M-type 28, but pulsed-field gel electrophoresis determined that the strains were unrelated. CONCLUSIONS: Finding group A streptococci on prenatal culture may presage serious postpartum infection.

Female↗
PubMed2003

Characterization of the relationship between joint laxity and maternal hormones in pregnancy.

OBJECTIVE: To evaluate peripheral joint laxity during pregnancy and to correlate changes with serum cortisol, estradiol, progesterone, and relaxin. METHODS: Forty-six women with first-trimester singleton gestations consented to participate in this longitudinal observational study. Bilateral wrist laxity measurements (flexion-extension and medial-lateral deviation) were made using a clinical goniometer, and serum levels of cortisol, estradiol, progesterone, and relaxin were determined during each trimester of pregnancy and postpartum. Patients were also screened for subjective joint complaints. Statistical analysis included Student t test, analysis of variance, and linear regression analysis. RESULTS: Eleven women (24%) were excluded from the study after spontaneous first-trimester pregnancy loss. Fifty-four percent (19 of 35) demonstrated increased laxity (10% or higher) in either wrist from the first to the third trimester. Although serum levels of cortisol, estradiol, progesterone, and relaxin were significantly elevated during pregnancy, no significant differences in these levels were noted between those who became lax during gestation and those who did not. Linear regression analysis of wrist joint laxity and level of serum estradiol, progesterone, and relaxin demonstrated no significant correlation. Wrist flexion-extension laxity, however, did significantly correlate with level of maternal cortisol (r = 0.18, P =.03). Fifty-seven percent of women developed subjective joint pain during pregnancy, which was not associated with increased joint laxity, but was associated with significantly increased levels of estradiol and progesterone. CONCLUSION: Peripheral joint laxity increases during pregnancy; however, these changes do not correlate well with maternal estradiol, progesterone, or relaxin levels.

Adult↗
PubMed1998

Plasma active renin, angiotensin I, and angiotensin II during pregnancy and in preeclampsia.

OBJECTIVE: To evaluate the activity of the renin-angiotensin-aldosterone system in the circulation during the three trimesters of normal pregnancy and in women with preeclampsia. METHODS: Normal pregnant volunteers (n = 7) were studied throughout pregnancy, and women with preeclampsia (n = 8) were studied in the third trimester. Plasma active renin and aldosterone were measured by radioimmunoassay. Angiotensin I and angiotensin II were determined by radioimmunoassay after separation of the peptides by high-performance liquid chromatography. RESULTS: Active renin concentration increased in the first trimester of normal pregnancy, whereas angiotensin I, angiotensin II, and aldosterone remained at a level comparable to the postpartum values. Highest activity of the renin-angiotensin-aldosterone system was observed during the third trimester with increased levels of angiotensin I, angiotensin II, and aldosterone. In contrast, in patients with preeclampsia, despite a slight increase of active renin levels, the other parameters of the renin-angiotensin-aldosterone system were low compared with the third trimester of normal pregnancy and were comparable to postpartum data. CONCLUSION: Our results suggest that during the first trimester of normal pregnancy, active renin concentration in the plasma is increased and that renin is not the factor that limits angiotensin II synthesis. These results also confirm decreased activity of the renin-angiotensin-aldosterone system in preeclampsia. This could contribute to the diminished hemodynamic control observed in pregnant women developing preeclampsia.

Adult↗
PubMed1999

Edema of pregnancy: a comparison of water aerobics and static immersion.

OBJECTIVE: To compare the edema-relieving effects of static immersion with water aerobics. METHODS: Eighteen healthy women between 20 and 33 weeks' gestation were studied standing on land, immersed to the axilla, and participating in a water aerobics class, each for 30 minutes. RESULTS: Water aerobics and the static immersion led to a similar diuresis, 187 and 180 mL, respectively. Both were significantly greater than standing 30 minutes on land, 65 mL (P < .01). The dilutional effect as measured by a decline in urine specific gravity was also similar between static immersion and water aerobics and greater than standing on land (P < .01). Standing on land led to a small increase in leg volume compared with water aerobics or static immersion (P < .01). CONCLUSION: Water aerobics had diuretic and edema-relieving effects similar to static immersion. When women develop edema of pregnancy, water aerobics classes may be used as a potential treatment.

Adult↗
PubMed2004

[Progressive intra-acetabular dislocation of bipolar hip prostheses: four cases].

Certain complications, such as acetabular erosion or cup dissociation, are specific to bipolar prostheses. Progressive intra-acetabular dislocation has not been reported to date. We report 4 cases. Four elderly women developed progressive intra-acetabular dislocation after implantation of a bipolar prosthesis for femoral neck fractures. The metal-backed cup verticalized progressively and the ball gradually dislocated into the acetabulum, eroding it. Revision was undertaken with a hemispheric bone ingrowth cup and partial grafting. Follow-up was then uneventful. This phenomenon is different from the acute intra-acetabular dislocation that may occur after rupture of the anti-dissociation mechanism (polyethylene ring) incorporated in the design of new implant models, or after dissociation between the ball and the cup during closed reduction of a dislocation, the cup catching on the acetabular rim. It is not due to a variation in the neck-head angles (we observed varus, valgus, and neutral angles) nor to a problem between the modular head and the neck (at the morse cone taper). For us, the cause of this progressive intra-acetabular dislocation is poor cup design associated with a weak retention system. If the centers of the inner and outer spheres are superimposed, the cup has a natural tendency to drop into varus because of its weight. This becomes even worse if the center of the outer sphere is medial to the ball center. The cup should be designed so that the center of the outer sphere (bipolar cup) lies lateral to the center of the inner sphere (ball) creating a valgus torque for the cup. Designing a bipolar cup is not as a simple matter as it may seem. We emphasize the importance of the position of the rotation centers.

Acetabulum↗
PubMed2006

[Rapid sensory motor neuropathy after gastric restriction surgery].

INTRODUCTION: Central and peripheral neurological complications have been described in association with bariatric surgery over the last 20 years. CASE REPORT: A 40 year-old women developed a sensory motor neuropathy 3 months after a gastric restriction operation followed by a 30 kilograms weight loss. No specific vitamin or mineral deficiency was detected but she improved after multivitamin and minerals supplementation. CONCLUSION: Acute or subacute neuropathy may develop in 1 to 2p.cent of patients who undergo bariatric surgery. Its pathogenesis is not very clear but the most commonly associated factors are rapid weight loss and non-supplementation with vitamins and minerals post-operatively.

Adult↗
PubMed1996

Maternal varicella during pregnancy: correlation of maternal history and fetal outcome with placental histopathology.

The authors examined the records from 73 women diagnosed with varicella during pregnancy to correlate placental findings with maternal history and fetal outcome. Fifty-eight of the mothers delivered at the authors' institution, and 19 placentas were available for review. The onset of symptoms of varicella occurred from 27 weeks before delivery to 1 day postpartum. Only on e of the newborns delivered at the authors' institution was diagnosed with probable varicella at birth; the remainder had no unequivocal evidence of infection; however, serological studies were not performed on most of the newborns. The placenta from the newborn with probable varicella showed extensive basal chronic villitis with a lymphohistiocytic infiltrate and occasional multinucleated giant cells. Two other placentas showed rare foci of chronic villitis, and the remainder showed no villitis or other viral-associated changes. Twenty-four (33%) of the 73 women developed varicella pneumonia, and one woman died. Although varicella during pregnancy is associated with high maternal morbidity, fetal disease is uncommon. Most placentas show no virus-associated lesions; however, chronic villitis with multinucleated giant cells in association with a recent history of maternal varicella may be predictive of neonatal infection.

Chickenpox↗
PubMed1997

Randomised study of radical surgery versus radiotherapy for stage Ib-IIa cervical cancer.

BACKGROUND: Stage Ib and IIa cervical carcinoma can be cured by radical surgery or radiotherapy. These two procedures are equally effective, but differ in associated morbidity and type of complications. In this prospective randomised trial of radiotherapy versus surgery, our aim was to assess the 5-year survival and the rate and pattern of complications and recurrences associated with each treatment. METHODS: Between September, 1986, and December, 1991, 469 women with newly diagnosed stage Ib and IIa cervical carcinoma were referred to our institute. 343 eligible patients were randomised: 172 to surgery and 171 to radical radiotherapy. Adjuvant radiotherapy was delivered after surgery for women with surgical stage pT2b or greater, less than 3 mm of safe cervical stroma, cut-through, or positive nodes. The primary outcome measures were 5-year survival and the rate of complications. The analysis of survival and recurrence was by intention to treat and analysis of complications was by treatment delivered. FINDINGS: 170 patients in the surgery group and 167 in the radiotherapy group were included in the intention-to-treat analysis; scheduled treatment was delivered to 169 and 158 women, respectively, 62 of 114 women with cervical diameters of 4 cm or smaller and 46 of 55 with diameters larger than 4 cm received adjuvant therapy. After a median follow-up of 87 (range 57-120) months, 5-year overall and disease-free survival were identical in the surgery and radiotherapy groups (83% and 74%, respectively, for both groups), 86 women developed recurrent disease: 42 (25%) in the surgery group and 44 (26%) in the radiotherapy group. Significant factors for survival in univariate and multivariate analyses were: cervical diameter, positive lymphangiography, and adeno-carcinomatous histotype. 48 (28%) surgery-group patients had severe morbidity compared with 19 (12%) radiotherapy-group patients (p = 0.0004). INTERPRETATION: There is no treatment of choice for early-stage cervical carcinoma in terms of overall or disease-free survival. The combination of surgery and radiotherapy has the worst morbidity, especially urological complications. The optimum therapy for each patient should take account of clinical factors such as menopausal status, age, medical illness, histological type, and cervical diameter to yield the best cure with minimum complications.

Adult↗
PubMed2005

[Pellagra and panniculitis induced by chronic bacterial colonisation of the small intestine].

INTRODUCTION: Pellagra is an exceptional disorder in France. The classical description of pellagra associates a photoinduced rash with neurological impairment and intestinal dysfunction. Without adapted treatment, the progression is fatal. CASE REPORT: A 62 year-old women developed a photoinduced rash, composed of circular and erythematous elements with pustular edges. She also had panniculitis, peripheral neuropathy, depressive mood and diarrhea. Her medical past was marked by epilepsy treated with sodium valproate and hydantoin. Biological exams revealed lowered plasma levels of vitamins PP, B1, B6 and zinc, secondary to intestinal impairment induced by bacteria proliferating in the small intestine. The rash resolved with vitamin PP and zinc supplementation. The bacterial colonisation was improved by long-term, sequential antibiotics. DISCUSSION: We report a rare clinical form of pellagroid rash. The rash was induced by chronic malabsorption resulting from excessive bacterial proliferation in the diverticules of the small intestine. The antiepileptic treatment could have facilitated vitamin PP et zinc deficiency. Panniculitis was related to the bacterial proliferation. We discuss in this paper the relationship between some vitamin deficiencies, their clinical manifestations and the direct role of intestinal bacterial proliferation in the cutaneous manifestations.

Anti-Bacterial Agents↗
PubMed1999

Left ventricular geometry and function in patients with aortic stenosis: gender differences.

BACKGROUND: Gender differences in cardiac size have been described in normal and pathological conditions in human and animals. Sex determination of a pattern of hypertrophy as a response to pressure overload has not been extensively evaluated and is still poorly understood in humans. METHODS AND RESULTS: To investigate the influence of gender in the left ventricle remodelling and preservation of the left ventricle function 195 adults (140 men and 55 women) with isolated aortic stenosis were evaluated. The mean age was 52 +/- 11 years for men and 53 +/- 13 years for women. All the patients had similar degree of aortic stenosis finally treated with valve replacement, similar clinical status and no signs of coronary artery disease in coronary angiograms. On echocardiography the left ventricle of women had a smaller the end systolic (30.5 +/- 7.8 vs. 39.4 +/- 11.2, P<0.001) and the end diastolic (49.4 +/- 9 vs. 57.3 +/- 11, P<0.001) chamber size. The female left ventricle generated a higher relative wall thickness (0.65 +/- 0.21 vs. 0.52 +/- 0.12, P<0.01), a greater fractional shortening (35.3 +/- 8.5 vs. 32.0 +/- 9.0, P<0.01) and a higher ejection fraction (64.4 +/- 12.7 vs. 57.5 +/- 14.6, P<0.001). The left ventricle posterior wall thickness and the septal thickness indexes were similar in both groups. There were also significant differences between the two groups in the left ventricle mass index. CONCLUSIONS: Gender has an important influence on the left ventricle adaptation pattern to pressure overload due to aortic stenosis. Women developed a greater degree of left ventricle hypertrophy documented as changes in left ventricle geometry (increased relative wall thickness, left ventricular mass) and left ventricle function (fractional shortening and ejection fraction).

Aortic Valve Stenosis↗
PubMed1987

Pirprofen-associated hepatic injury.

Four cases of hepatic injury attributed to the use of pirprofen (Rengasil) were reported to the Monitoring Centres for Adverse Reactions of Belgium, The Netherlands and the German Medical Association. One man and three women developed severe hepatic injury between 3 1/2 and 6 1/2 months after starting treatment with 400-1200 mg pirprofen daily. Histology showed acute hepatocellular damage, often with bridging necrosis. Two patients died. The other two patients made an incomplete recovery. It is possible that this severe type of hepatic injury is due to a metabolic idiosyncrasy to pirprofen, as this reaction seems to be rare and unpredictable but is not associated with immunoallergic signs.

Adult↗
PubMed2000

Lipid-mediated endothelial dysfunction: a common factor to preeclampsia and chronic vascular disease.

Preeclampsia is a complex pathophysiological state where regulatory systems of inflammation and endothelial function are stimulated beyond the physiological limits of normal pregnancy. Different lines of evidence indicate that abnormal lipid metabolism is not a mere manifestation but is also involved in the pathogenesis of the disease. Lipid-mediated oxidative stress is likely to contribute to endothelial hyperstimulation leading to dysfunction and damage. Maternal predisposing factors seem to be essential to explain why some pregnant women develop a systemic syndrome such as preeclampsia and why others do not. Preliminary evidence suggests that abnormal lipid metabolism could be one of these factors. In this review the evidence for the contribution of lipid oxidation in the pathogenesis of preeclampsia, the similarities between preeclampsia and lipid-mediated chronic vascular disease will be summarized, and the reasons to believe that constitutional lipid abnormalities could be one of the maternal predisposing factors for developing the disease will be examined and will be discussed.

Endothelium↗
PubMed1981

"Seal finger".

Two young women developed septic arthritis in an interphalangeal joint following a seal bite. One patient was cured with tetracycline: the other required joint arthrodesis. This entity known as "seal finger" is common among sealers. Although the infection may be cured with tetracycline, in late treated or untreated cases joint destruction may occur. No causative organism has been isolated.

Adult↗
PubMed2001

Comparative effects of aging in men and women on the properties of the arterial tree.

OBJECTIVES: We measured the properties of the arterial tree, seeking differences between men and women as they aged. BACKGROUND: There are many differences between men and women, besides menopause, which might account for such disparities. These include body height, heart rate, stroke volume and smaller arterial diameters. Any gender differences in arterial stiffness could influence pulse pressure (PP), now recognized as a cardiovascular risk factor. METHODS: A total of 530 patients (347 men and 183 women) were classified by age into quartiles: < or = 40, 41-47, 48-54 and > or = 55 years. The middle groups represented the menopausal years. Studies included brachial artery blood pressure (BP), aortic pulse wave velocity (PWV), B-mode ultrasonography and wave form analysis of the common carotid artery (CCA), with its conversion to the aortic wave formin. Standard echocardiography provided left ventricular dimensions and flows. Calculated values included CCA compliance and distensibility, systemic compliance, stroke volume and peripheral resistance. RESULTS: At all ages, women had higher heart rates but lower BP than men. Pulse pressure, however, was lower in young women and higher in older women. Measurements influenced by body size, such as CCA diameter, compliance and systemic compliance, were lower in women. Those related to arterial wall properties, such as CCA and aortic distensibility, were the same. Although aortic PWV rose similarly with aging, PWV had more of an influence on PP in women than did mean BP. The reverse was true in men. CONCLUSIONS: Despite lower mean BP and similar arterial distensibilitvy, women develop a higher degree of pulsatility with aging, as compared with men. This is mainly due to their smaller physical characteristics, independent of the role of menopause and its related hormonal changes.

Adult↗