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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-one patients with polymyositis were prospectively examined with echocardiography, phonocardiography and electrocardiography. Cardiac performance, estimated with echocardiography, was enhanced as shown by a significant (P less than 0.01) increase in ejection phase indexes of left ventricular function compared with values in a matched control group. Known causes of the high output state, such as anemia or thyrotoxicosis, were not clinically evident. There was no evidence of left ventricular enlargement, left ventricular wall hypertrophy, or left atrial enlargement in the echocardiogram or chest X-ray film. The echocardiogram showed systolic mitral valve prolapse in 11 of 17 patients (65 percent) with an adequately imaged mitral valve; midsystolic clicks were present in 7 of these. One patient, who did not have prolapse, had echocardiographic evidence of a small pericardial effusion. Electrocardiographic abnormalities were present in 11 of 21 patients (52 percent) and included evidence of atrioventricular conduction disturbances, atrial and ventricular arrhythmias and left atrial abnormality. The pathophysiology of mitral valve prolapse and increased systolic left ventricular function in polymyositis remains uncertain; however, the spectrum of cardiac abnormalities, detected noninvasively in 16 of 21 of our patients (76 percent) may represent a high frequency rate of cardiac involvement in this disease.
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PMID:Cardiac manifestations in polymyositis. 66 23

Prolapse of the gastric mucosa into the duodenum must be considered when a round soft tissue mass is seen in the right upper quadrant on scout abdominal film. Gastric prolapse may mimic tumor in the duodenum when the prolapse is large. Examination with barium meal is necessary to exclude prolapse of the gastric mucosa into the duodenum as a cause of epigastric pain and vomiting. Medical treatment is suggested for patients with mild symptoms, but patients with severe symptoms, repeated hemorrhage, anemia, severe intermittent epigastric pain and vomiting due to ball-valve syndrome should have operation.
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PMID:Duodenal pseudotumor with ball-valve syndrome. 72 37

Four patients with infective endocarditis caused by Actinobacillus actinomycetemcomitans seen at the National Taiwan University Hospital between January 1985 and December 1990 are reported. There were two men and two women with a mean age of 40 years. Three had had a xenograft replacement, the other one had prolapse of mitral valve. Carious teeth were noted in two. The most common presenting symptoms were fever, cough, dyspnoea, and weight loss and the duration of symptoms before diagnosis varied from 2 weeks to 2 months. Peripheral stigmata of endocarditis were not present in any patient. Laboratory investigation revealed haematuria and anaemia in three patients, and elevated erythrocyte sedimentation rates in all four. None had leucocytosis. Echocardiography was performed more than once for each patient and vegetation was demonstrated in only one. Blood culture became positive after 7-10 days of incubation. One of the isolates was resistant to penicillin. The diagnosis was delayed due to the indolent clinical course, non-specific presentation, and the slow growth of the organism. However, all patients were cured clinically and bacteriologically after 6 weeks of intravenous antibiotic therapy which included penicillin, cefamandole, chloramphenicol, or aztreonam, with or without an aminoglycoside. All patients were free of evidence of recurrence after 6-25 months of follow-up.
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PMID:Actinobacillus actinomycetemcomitans endocarditis: a report of four cases and review of the literature. 180 Oct 59

A rare case of ischemic stroke related to Herpes zoster infection of the eye and documented arteritis in an HIV-positive patient is analyzed. The woman, aged 32, who was born in Angola and lived in Zaire, was diagnoses at the Hospital Universitario de Santa Maria, Lisbon. She presented with a 5-month history of sudden hemiplegia, 4 months after onset of herpes zoster ophthalmicus. Among extensive diagnosis tests, she was positive for HIV by ELISA and Western blot, hepatomegaly, and generalized lymphadenopathy. She has left Herpes zoster ophthalmicus with ptosis bulbi and mottled discoloration of the skin over the distribution of the 1st division of the left trigeminal nerve, and right spastic hemiparesis. Her helper T-cell count was 952/cubic mm, and her T-cell ratio was 0.9. She had anemia, hypoalbuminemia, positive serology for cytomegalovirus, Herpes simplex, Epstein Barr virus, and hepatitis B. She had no bacterial infections, but her stool contained Trichuris trichiura eggs and giardia lamblia cysts. Her cardiovascular system and cerebrovascular fluid were negative. Computed tomography of the head showed an old left capsular infarct. Cerebral angiography showed arteritis of the left choroidal artery with occlusion. She was treated with metronidazole and mebendazole, and had surgery for removal of the left eye with a prosthetic replacement. Strokes are common in AIDS patients, resulting from fungal infections, endocarditis, infectious or non-infectious emboli, or arteritis from herpes zoster infections. This is the 1st published case of hemiplegia and Herpes zoster in a European or African patient with HIV-1.
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PMID:Herpes zoster and controlateral hemiplegia in an African patient infected with HIV-1. 186 23

Over a six-year period (1982-1987), 36 cases of vaginal trauma at sexual intercourse managed in the gynaecological unit of the University of Ilorin Teaching Hospital are presented. The serious nature of this accident is stressed. The frequent involvement of the posterior fornix of the vagina, accounting for 50% of the cases is shown. Perforation of the pouch of Douglas with possible intestinal prolapse, and involvement of the urinary bladder resulting in vesicovaginal fistula are not common in Ilorin. The predisposing factors like rough coitus, first sexual intercourse, puerperium, surgical alteration of the vagina, peno-vaginal disproportion and multiparity are discussed. The importance of adequately preparing the women emotionally and physically for coitus, a matter which certain males tend to ignore, is emphasized. The necessity for thorough digital as well as speculum examination in all cases of vaginal bleeding is made. There was no death recorded, while the morbidity was mainly hypovolaemic shock with haemorrhagic anaemia.
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PMID:Vaginal trauma at sexual intercourse in Ilorin, Nigeria. An analysis of 36 cases. 248 1

Between January 1982 and December 1985, 355 fiberoptic pouchoscopies were performed in 123 patients with a continent ileostomy. These examinations have been reviewed to determine the effectiveness of the technique as a diagnostic and therapeutic tool. The Olympus GIF-XP pediatric endoscope was used after pouch lavage, and the afferent loop of ileum, the pouch, and (by retroflexion) the nipple valve were examined on each occasion. There were 63 males and 60 females, with a median age of 35 years (range, 16 to 71 years). The median length of follow-up after pouch construction was 36 months (range, 6 to 120 months), and an average of three examinations were performed per patient (range, 1 to 12). Of 127 examinations performed in asymptomatic patients, the pouch was normal in 117 cases, and there was mesh erosion into the pouch in 10 cases. The remaining 228 examinations were for symptoms that included pouchitis (56), difficulty in intubation (47), incontinence (35), follow-up of treated pouchitis (18), parastomal sepsis (22), blood in the stool (13), anemia (8), excess mucus discharge (6), valve prolapse (4), and purulent discharge from the stoma (1). Eighty-four examinations were normal; 144 revealed a likely cause for the symptoms and led to appropriate treatment, which in 45 patients was surgical. Fiberoptic endoscopy was therapeutic in 6 patients in whom it was used on 10 occasions to intubate a pouch with a slipped valve. Radiographic studies were seldom used, with pouchograms being carried out in 16 patients and fistulograms in 5. Only the fistulograms contributed to the assessment of each patient.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The role of fiberoptic endoscopy in the management of the continent ileostomy. 359 85

We report 3 patients with severe and persistent iron deficiency anemia who were found to have gastric antral vascular ectasia. Endoscopically, the patients presented with a characteristic antral appearance so distinctive as to be diagnostic: longitudinal rugal folds traversing the antrum and converging on the pylorus, each containing a visible convoluted column of vessels, the aggregate resembling the stripes on a watermelon; and, less prominently, evidence of mucosal prolapse. In 2 of these patients, with uncontrollable anemia, antrectomy and Billroth I anastomosis were performed; their hemoglobin levels have subsequently remained normal over the following 2 yr. In the third patient, who was achlorhydric, prednisone therapy substantially reduced the rate of bleeding. In all patients, endoscopic biopsy specimens showed dilatation of mucosal capillaries, with focal thrombosis and fibromuscular hyperplasia of the lamina propria; the resected specimens, additionally, show thickened mucosa with tortuous submucosal venous channels. The importance of the condition lies in its recognition.
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PMID:Gastric antral vascular ectasia: the watermelon stomach. 633 57

We report a case of juvenile polyposis coli in a 13 year old girl who initially complained of rectal bleeding and prolapse of polyps. Tube feeding with an elemental or a low residue diet and total parenteral nutrition were prescribed to treat the hypoproteinemia and anemia. A modified Soave's operation was successfully performed. The polyps appeared in several different stages of development. A single dilated gland of the colonic mucosa, which was not grossly visible, was presumed to be the site of the initial lesion which developed into a typical juvenile polyp. Adenomatous tubules were found in some juvenile polyps. In this case of immunologic deficiency, it is not clear whether such was a primary or secondary phenomenon.
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PMID:Juvenile polyposis coli. A case report. 712 Jul 7

Health planners and policymakers in India had virtually no information about reproductive morbidity and its determinants on which to base efforts to improve the reproductive health of women and the acceptance of family planning programs. Thus, a study of self-reported symptoms of reproductive morbidity was undertaken in 1993 in the state of Karnataka as part of a larger research project investigating the pathways through which maternal education affects child survival. Data were gathered through a cross-sectional survey of women living in one subdistrict who were younger than 35 and had at least one child younger than five. Eligibility was limited to 3600 women living in the town and 48 villages with a population over 500. Experienced female interviewers achieved a more than 95% response rate. Disorders associated with the reported symptoms included: menstrual disorders, dyspareunia, hemorrhoids, prolapse, fistula, lower reproductive tract infection (RTI), urinary tract infection, acute pelvic inflammatory disease (PID), infertility, and anemia. Bivariate analysis revealed the significant variations in reports made by women of different socioeconomic, cultural, and demographic backgrounds; a parallel analysis was performed on the proportions seeking treatment for each condition; and logistic regression analysis estimated the net effect of each factor on the likelihood of reporting specific symptoms and the probability of seeking treatment. Independent variables were composed of socioeconomic background, demographic, last live birth and contraceptive usage, and cognitive and behavioral factors. A third of the women reported symptoms of at least one gynecological morbidity, and about half of these sought treatment. A tenth of menstruating women reported menstrual problems, a sixth reported symptoms of lower RTI, 5% reported symptoms indicative of acute PID, and 23% reported symptoms of anemia. Morbidity was influenced by the presence of complications during the pregnancy, delivery, or postpartum period of the last live birth; the location of the last delivery, with less problems reported by those who delivered in a private institution; and whether or not a woman had undergone tubectomy, which increased reporting of all symptom categories except menstrual problems. This points to the urgent need for longterm follow-up studies of sterilized women. Since most women sought private medical treatment, the primary health care facilities should be subject to a radical review and the private sector should undergo systematic evaluation.
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PMID:Self-reported symptoms of gynecological morbidity and their treatment in south India. 748 78

According to a 3-year collaborative study estimating maternal mortality rates from 41 hospitals affiliated with teaching centers in India, maternal mortality was 721 per 100,000 live births. Community studies in rural areas of Sirur, Pachod, and Ambula reported maternal mortality as 210-253 per 100,000. Cohort studies conducted by the Indian Council of Medical Research reported maternal mortality as 530 per 100,000 based on data from rural areas of Varanasi, 460 per 100,000 in urban Delhi, and 450 per 100,000 in urban Madras. The Ministry of Health gave the rate as 460 per 100,000 in 1984, while UNICEF gave a figure of 400 per 100,000 for 1980-91. India has 1 out of 4 of the world's maternal deaths, or 1 every 6 minutes. The risk of maternal death has been calculated to be one in 64. Risk is unevenly distributed geographically. Risk is low in Kerala compared to Uttar Pradesh or Madya Pradesh. In 1992 maternal mortality was calculated to be 1320 per 100,000 births based on 5 district hospitals. The cause of maternal deaths was anemia in 25% of cases. 75% of cases were accounted for by eclampsia, sepsis, hemorrhage, and abortion. Anemia (pre-existing the pregnancy) is acerbated by the demands of pregnancy and causes congestive heart failure and death. Blood losses of greater than 150 ml (due to hemorrhages of pregnancy and labor) can be fatal. During 1982-89 anemia was responsible for 17-24% of all maternal deaths in rural areas. Morbidity from pregnancy-related causes included obstetric fistulae, pelvic inflammatory disease, anemia, genital prolapse, and urinary incontinence. Quality of maternal care is an important factor in reducing maternal mortality and morbidity. Societal factors such as illiteracy and malnutrition, early marriage, poorly supervised pregnancies, and lack of transportation during emergencies are other determinants of mortality and morbidity. About 10% of maternal deaths are attributed to unsafe abortion. The government aim for the year 2000 of 100% prenatal care and care during delivery will require professional commitment and thousands more midwives in rural areas.
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PMID:How safe motherhood in India is. 765 33


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