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At least 1,585 records · Page 88Linked to original sources
PubMed2005

Fallopian tube prolapse after laparoscopic resection of pelvic endometriosis.

BACKGROUND: Fallopian tube prolapse is an unusual but often reported complication after hysterectomy. This problem has not yet been reported in a patient undergoing laparoscopy but not hysterectomy. CASE: Fallopian tube prolapse was diagnosed in a patient after laparoscopic excision of pelvic endometriosis, without hysterectomy. The prolapsed fallopian tube was preserved by laparoscopic retrieval from the vagina and closure of the vaginoperitoneal fistula. CONCLUSION: Laparoscopic surgery, when associated with the creation of a vaginoperitoneal fistula, is a risk factor for fallopian tube prolapse. This problem can be diagnosed and safely managed with a laparoscopic approach.

Adult↗
PubMed2005

[Group B streptococcus colonization during pregnancy and prevention of early onset of disease].

Group B Streptococcus (GBS) is the most frequent cause of early onset of neonatal sepsis. Case-fatality rate is 6-20% for newborns. Neurological sequel occurs in 30% of survivors. In 1996, the Centers for Disease Control and Prevention (CDC), the American College of Obstetricians and Gynecologists, and the American Academy of Pediatrics recommended that obstetrics providers should adopt either a culture-based or a risk-based approach for the prevention of this disease. The aim of this prospective study was to determine the colonization rate of GBS in our population of pregnant women between July 1st 2001 and December 31st 2002, and to introduce a culture-based strategy to prevent early onset neonatal GBS disease. From a population of 1756 pregnant women, 1228 were screened with rectal and vaginal swabs (69.9%). Maternal colonization rate was 1.4% (17 patients). There was one case of early-onset neonatal sepsis consistent with GBS disease (0.6%) in a patient with negative cultures. From the colonized patients, only one presented risk factors. Because most of the colonized women did not present intrapartum risk factors, the results of this study suggest that the culture-based approach should be used for the prevention of early-onset GBS disease in our population. Cost-benefit studies are needed in our country to determine if this prevention strategy is able to be implemented in all the settings of Argentina.

Adolescent↗
PubMed1990

[Storage of spermatozoa in the oviducts of birds: morphologic, histologic and functional approach].

This paper reviews the studies devoted to the anatomical, histological and functional aspects of sperm storage in the oviduct of domestic birds (hen, turkey). Despite the presence of substances, such as lipids and mucopolysaccharides, in the cytoplasm of the cells encompassing the utero-vaginal glands (site of residence of spermatozoa in the oviduct after intra-vaginal inseminations), the absence of organelles involved in protein synthesis questions the existence of a secretory cycle in these glands. In the absence of such a cycle, the microvilli bordering the lumen of the utero-vaginal glands could participate in the purification of this micro-environment, thus allowing prolonged survival of spermatozoa in this region. Recent observations indicate that the mechanism controlling the penetration and/or storage of spermatozoa in the utero-vaginal glands is of an immuno-dependent nature and is closely related to the functional integrity of the glycocalyx surrounding the spermatozoon. A quantitative study of the kinetics of the storage of spermatozoa with or without alteration of their glycocalyx might help to explain its role (recognition of spermatozoa by the utero-vaginal glands or agglutination of spermatozoa within these glands). This type of experiment might also contribute to understanding the mechanism underlying the prolonged storage of spermatozoa in the utero-vaginal glands of birds.

Animals↗
PubMed1987

A suprapubic retroperitoneal operative approach to solitary paravaginal tumors.

Five cases of paravaginal tumors including a neurolemmoma, neurofibroma, lipoma, and desmoid tumors are presented. These tumors were approached through a modified Cherney incision. The rectus muscle was removed from the pubic symphysis and the pubococcygeus muscle was divided. This approach allowed good visualization of the paravaginal space, reasonable blood loss, and avoidance of entry into the peritoneal cavity. Although paravaginal tumors are rare, gynecologic surgeons should be aware of the suprapubic approach to the paravaginal space.

Adult↗
PubMed1997

[Clinical analysis of 15 patients with primary malignant melanoma in the genital tract].

OBJECTIVE: To analyse the clinical characteristics and prognosis of primary malignant melanoma in female genital tract. METHODS: Clinical data of 15 patients with primary malignant genital melanoma were analysed retrospectively. The tumors occurred in the vulva (4 patients), in vagina (9) and in uterine cervix (2). 11 of them were treated by surgery combined with chemotherapy and immunotherapy, the remaining 4 by chemotherapy and immunotherapy only. RESULTS: All cases except one were followed up. The survival periods were shorter than 1 year in 5 patients, shorter than 2 years in 7. Two were alive for more than 3 years and 1 for more than 19 years. CONCLUSIONS: The prognosis of primary malignant melanoma is rather poor. Surgery combined of chemotherapy and immunotherapy is the main therapeutic approach.

Adult↗
PubMed2024

Vaginal Lactobacillus fatty acid response mechanisms reveal a metabolite-targeted strategy for bacterial vaginosis treatment.

Bacterial vaginosis (BV), a common syndrome characterized by Lactobacillus-deficient vaginal microbiota, is associated with adverse health outcomes. BV often recurs after standard antibiotic therapy in part because antibiotics promote microbiota dominance by Lactobacillus iners instead of Lactobacillus crispatus, which has more beneficial health associations. Strategies to promote L. crispatus and inhibit L. iners are thus needed. We show that oleic acid (OA) and similar long-chain fatty acids simultaneously inhibit L. iners and enhance L. crispatus growth. These phenotypes require OA-inducible genes conserved in L. crispatus and related lactobacilli, including an oleate hydratase (ohyA) and putative fatty acid efflux pump (farE). FarE mediates OA resistance, while OhyA is robustly active in the vaginal microbiota and enhances bacterial fitness by biochemically sequestering OA in a derivative form only ohyA-harboring organisms can exploit. OA promotes L. crispatus dominance more effectively than antibiotics in an in vitro BV model, suggesting a metabolite-based treatment approach.

Vaginosis, Bacterial↗
PubMed2003

Biotechnological approaches to the production of idiotypic vaccines and antiidiotypic antibiotics.

The potential therapeutic activity of a killer toxin produced by the yeast Pichia anomala (PaKT) characterized by its wide spectrum of antimicrobial activity has been exploited through the simulation of its interaction with the specific cell wall receptor (KTR) of PaKT-sensitive microorganisms by the idiotypic network. Killer antiidiotypes (PaKTantiId) produced by idiotypic vaccination with a PaKT-neutralizing monoclonal antibody have proven to confer active and passive immunoprotection in experimental models of systemic and vaginal candidiasis. PaKTantiId-like human anti-KTR antibodies are naturally produced in infections caused by PaKT-sensitive microorganisms. PaKTantiId in its monoclonal and recombinant formats as well as expressed on human commensal bacteria have shown microbicidal activity in vitro and a therapeutic effect in experimental models of infection caused by PaKT-sensitive microorganisms. New perspectives of idiotypic vaccination and antiidiotypic antibiotic therapy and biotechnological approaches to the production of trandisease idiotypic vaccines and wide-spectrum antiidiotypic antibiotics (killer mimotopes) will be discussed as effective tools to fight epidemiologically important mucosal and systemic microbial infections.

Animals↗
PubMed1997

Birth trauma causing nasal vestibular stenosis.

Nasal vestibular stenosis is caused by a disruption of the nasal vestibular lining with secondary proliferation of granulation and fibrous tissue. It is most commonly the result of significant nasal trauma of foreign body reaction. In the pediatric population, it is exceedingly rare, with only a few cases reported in the literature. We report the first case, to our knowledge, of complete stenosis caused by traumatic vaginal delivery. This case demonstrates the profound effect nasal vestibular stenosis can have on the developing nose. Correction can be difficult because of the tendency of wound contracture and recurrence. A new approach is presented, using a hard palate mucosal graft. This graft is tough, resilient, and easily harvested. Its ability to resist contracture obviates the need for postoperative stenting, which is especially useful in the pediatric population.

Birth Injuries↗
PubMed1987

Postoperative perineal hernia.

Eight patients (seven male and one female) with symptomatic postoperative perineal hernias treated at the Cleveland Clinic Foundation from 1975 to 1986 are reviewed. The patients ranged in age from 43 to 68 years (mean, 61 years). Seven had previous abdominoperineal resections of the rectum and one had a pelvic exenteration. The first two patients underwent repair via a perineal approach and both had recurrences of their hernias. These recurrences, as well as the presenting hernias in the six later patients, were repaired with mesh placed through an abdominal approach. Of these, there was one recurrence, which was repaired via an abdominal approach. There was no operative mortality. Based on experience, the authors believe that the best method of repair for this uncommon problem, involves placement of Marlex mesh across the pelvic inlet through an abdominal approach. This allows attachment of the mesh to the lateral musculature and posterior sacral periosteum under direct vision. The anterior borders of the mesh can be secured to the apex of the vaginal or prostatic tissue. The placement of metallic clips to the edges of the mesh allows for confirmation of the mesh position by radiographic examination during follow-up.

Aged↗
PubMed1988

Monitoring of ovulation in the assessment of reproductive hazards in the workplace.

If women are exposed to reproductive hazards in the workplace, some disturbances of ovulation are expected. Assessment of ovulation requires monitoring to distinguish normal and abnormal ovarian cycles. Menstrual interval and basal body temperature charts are inadequate for identifying many abnormal cycles. A late-luteal endometrial biopsy or a single mid-luteal morning progesterone level each appears to be only 80% accurate in distinguishing normal and abnormal cycles. The complete "cycle profile" of daily ovarian ultrasonic scans and daily serum levels of reproductive hormones appears to be a definitive approach to characterizing ovarian cycles, but this demanding regimen would not be applicable to monitoring large populations in the workplace. An ovarian cycle monitoring protocol consisting of daily measurement of salivary or vaginal electrical resistance, mid-cycle urine testing for the luteinizing hormone surge, and daily luteal phase salivary progesterone levels would provide a practical comprehensive corroborative assessment of ovarian cycles in such populations of women. This monitoring of ovarian cycles would aid in the early detection of reproductive hazards and medical conditions that might present as an ovulatory disturbance.

Female↗
PubMed2004

Puerperal sepsis and maternal mortality: what role can new technologies play?

OBJECTIVE: To identify new and underutilized technologies to reduce maternal mortality related to puerperal sepsis in developing countries. METHOD: Review of current medical literature. RESULT: The literature indicates that infection-control protocols and evidence-based procedures--including prophylactic antibiotics for cesarean section or preterm rupture of membranes, and updated antibiotic regimens--should be widely adopted. Devices such as hand rubs, needle-disposal systems, and rapid microbiological diagnostic tests can improve compliance and efficiency. Operational research on promising developments like vaginal cleansing with antiseptics, vitamin A supplementation, and prophylactic antibiotics in high-risk women is needed. CONCLUSION: Sepsis management continues to depend on good implementation of established technologies. Program-based approaches are required to improve uptake.

Female↗
PubMed1988

A new surgical approach for the correction of female stress urinary incontinence.

A new surgical approach for the correction of female urinary stress incontinence has been devised. The retropubic space is entered through a dome-shaped incision in front of the urethral meatus in the anterior vaginal vestibule. The incision does not extend beyond the lower edge of the symphysis pubis. With the tip of the hemostat or scissors the incision is opened longitudinally, and the lower legs of the incision are opened and freed up from the bulbocavernosus muscles. The bleeders are controlled. The layers of the genitourinary diaphragm are opened beginning from behind the symphysis pubis and the retropubic cavity is exposed. Then, the vesical neck and urethra are sutured to the back of the symphysis pubis in the midline. With this procedure there is no abdominal incision. The vesical neck and urethra are well exposed. The back of the symphysis pubis can be visualized with the patient in an exaggerated Trendelenburg position. All except 1 patient were cured. Hospitalization and postoperative recovery times were markedly reduced. The procedure affords easy access for drainage of the retropubic space. A new avenue is provided for insertion of an artificial sphincter to achieve urinary continence and for vesical neck colposuspension.

Adult↗
PubMed1999

Axial penile buckling forces vs Rigiscan radial rigidity as a function of intracavernosal pressure: why Rigiscan does not predict functional erections in individual patients.

AIM: An improved understanding of the relationship between radial and axial rigdity values would enable better appreciation of the clinical usefulness of RigiScantrade mark, the most widely utilized determination of erectile rigidity testing. Previous studies have shown that axial rigidity (measured by buckling forces) correlated well with radial rigidity (measured by RigiScantrade mark) for radial rigidity values below 60%. For radial rigidity exceeding 60%, there was poor correlation. Heretofore, there has been no physiologic explanation of this phenomenon. METHODS: During dynamic pharmacocavernosometry in 36 impotent patients, we investigated the relationship between axial buckling forces and RigiScan radial rigidity and, for the first time, how they both vary with pressure, (which we varied over over a wide functional range). In addition, we recorded multiple penile length and diameter values enabling us to relate, also for the first time, axial and radial rigidity to individual mechanical erectile tissue and penile geometric properties. RESULTS: Marked differences were found in the manner RigiScan radial rigidity units and axial buckling force magnitudes increased with increases in intracavernosal pressure values in each individual. The former asymptotically approached a maximum finite value while the latter increased continuously towards infinity. Based on data in this study, RigiScan radial rigidity values greater than 55% may be considered a necessary criteria for vaginal intromission capability in all partners but it is not a sufficient one. CONCLUSIONS: Axial and radial rigidity share a common dependency upon intracavernosal pressure, however, they are also dependent upon other unique physical determinants. For axial rigidity, additional dependent variables include cavernosal erectile tissue properties and penile geometry, while for radial rigidity, this may include tunical surface wall tension properties. Clinical devices which assess functional penile rigidity should utilize axial and not radial rigidity testing.

Equipment Design↗
PubMed2003

MR imaging diagnosis of uterovaginal anomalies: current state of the art.

Uterovaginal anomalies are associated with a high incidence of decreased fertility and multiple obstetric problems. These anomalies are caused by alterations in development or fusion of the müllerian ducts. Uterovaginal anomalies are classified into three types: dysgenesis, vertical or lateral fusion defects, and unusual configurations. Systematic analysis of magnetic resonance (MR) images allows accurate morphologic demonstration and classification of uterovaginal anomalies, thereby indicating the appropriate treatment. The following parameters are recorded in MR images: uterine size, external fundal contour, intercornual distance, zonal anatomy, and presence of uterine or vaginal septa. Associated pelvic lesions or renal anomalies are to be reported. MR imaging allows diagnosis of obstructive uterovaginal anomalies; determining the site of obstruction is imperative for planning the proper surgical approach. MR imaging techniques, including planes, sequences, and the application of more recent advances, are discussed. Pelvic phase-array coils and endovaginal coils provide detailed images and can be problem-solving tools in complex anomalies. MR imaging findings associated with a variety of uterovaginal anomalies are shown. The author suggests a five-step approach for diagnosing uterovaginal anomalies with MR imaging.

Female↗
PubMed1999

Evaluation of prostate-specific antigen (PSA) membrane test assays for the forensic identification of seminal fluid.

Prostate specific antigen (PSA, also known as p30), a glycoprotein produced by the prostatic gland and secreted into seminal plasma, is a marker used for demonstrating the presence of seminal fluid. Methods for the detection of PSA include Ouchterlony double diffusion, crossover electrophoresis, rocket immuno-electrophoresis, radial immunodiffusion, and ELISA. The extremely sensitive ELISA technique can detect PSA in concentrations as low as approximately 4 ng/mL. However, all these techniques are cumbersome and time consuming to perform in forensic laboratories, especially when only a few samples per week are processed. Various membrane tests are currently used in clinical settings to screen a patient's serum for the presence of PSA at levels greater than 4 ng/mL. In this study we evaluated three immunochromatographic PSA membrane tests by analyzing semen stains stored at room temperature for up to 30 years, post-coital vaginal swabs taken at different time after intercourse, semen-free vaginal swabs, and various female and male body fluids, including urine. The data demonstrate that PSA membrane test assays offer the same sensitivity as ELISA-based tests and provide a rapid approach for the forensic identification of seminal fluid. Furthermore, when the supernatant from a DNA extraction is used for the assay, there is essentially no DNA consumption for determining the presence of PSA in a forensic sample.

Animals↗
PubMed2002

New strategies for treatment of Candida vaginal infections.

New strategies for treatment of vaginal candidiasis have been recently exploited, due to widespread occurrence of this disease, in particular as recurrent infections, limitations of safe and efficacious antifungals as well as the lack of reliable preventative approaches. In this review new chemotherapeutic and immunotherapeutic strategies, based on the improved understanding of the immunopathogenesis of this prevalent human infection, will be discussed. The role of killer antibodies (or their molecular derivatives), i.e. antibodies that show antibiotic activity bearing the internal image of a yeast killer toxin (KT), characterized by a wide spectrum of microbicidal activity, and of the specific cell wall KT receptor as putative new therapeutic agents and preventative or therapeutic vaccines, respectively, will be particularly outlined.

Journal Article↗
PubMed2004

The transobturator sling: newest tension-free suburethral sling for treatment of stress urinary incontinence.

T his innovative sling system places the sling between the obturator foramens using a perineal approach while preserving an intact retropubic space. Potential complications associated with tension-free sling systems that use needle-carrier placement through the retropubic space, such as the tension-free vaginal tape (TVT, Gynecare, Ethicon, Somerville, NJ, USA), are eliminated and routine cystoscopy is not required. The procedure is effective and safe for the primary treatment of stress urinary incontinence in patients with urethral hypermobility, intrinsic sphincter deficiency, or both. It is equally efficient in treatment of recurrent and mixed urinary incontinence. Short-term results are similar to those of the retropubic tension-free slings.

Aged↗
PubMed1989

Complications of pelvic lymphadenectomy in patients with endometrial adenocarcinoma.

The complications of surgical treatment in 193 cases of endometrial adenocarcinoma, subdivided into two groups, were analyzed: 58 without lymphadenectomy and 135 with systematic pelvic lymphadenectomy before total abdominal hysterectomy and bilateral salpingo-oophorectomy with vaginal cuff. The only significant differences concern the number of patients requiring transfusions and the length of the postoperative stay. It is suggested that lymphadenectomy should always be performed when an abdominal approach is chosen.

Adenocarcinoma↗