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

It was the aim of this study to evaluate the obstetric performance of Ethiopian Jewish immigrants in comparison to the general Jewish obstetric population. The study was performed at the Soroka Medical Center, Beer Sheva, which manages the busiest delivery ward in Israel. Between 1988 and 1991 a total of 20,047 non-Ethiopian women (Group N) and 431 parturients of Ethiopian origin (group E) delivered at the Soroka Medical Center. Group E included a significantly higher percentage of grandmultiparous women than group N. Among diseases complicating pregnancy there was a statistically significant higher incidence of severe pregnancy-induced hypertension (PIH) in group E than in group N. Mild PIH and chronic hypertension were of comparable prevalence in both groups. The prevalence of class A diabetes mellitus was significantly lower in group E than in group N; the same trend was also observed for diabetes class B but without reaching statistical significance. There was no significant difference between the groups in the prevalence of polyhydramnios, postdatism and poor obstetric history, or fetal distress, s/p cesarean section, and prolapse of cord. Statistical analysis indicated a tendency towards significance for higher prevalence of premature rupture of membranes in group N. Malpresentations and malpositions were of similar prevalence in both groups. The incidence of premature delivery in group E showed a higher relative risk, suggesting a tendency of significance. The incidence of meconium-stained amniotic fluid in group E was significantly higher than in group N. There was no significant difference in the prevalence rates of placental complications such as placenta previa and abruption of placenta between the groups. The mode of delivery, the prevalence of complications during the third stage of labor, birthweight of infants and perinatal mortality were similar for both groups. In conclusion, the obstetric performance in Ethiopian Jewish immigrants is surprisingly similar to that of Israeli Jewish parturients. The only prominent pathology that does not seem to be related to life-style and nutrition is pregnancy-induced hypertension.
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PMID:Obstetric performance in Ethiopian immigrants compared with Israeli parturients. 834 62

The prevalence of gynecological and related morbidity in a rural Egyptian community was assessed as part of the Program of Research and Technical Consultation in Family Resources. Child Survival, and Reproductive Health. A medical examination was conducted on a sample of 509 ever-married, nonpregnant women from November 1989 to July 1990. A logistic regression using Generalized Linear Interactive Modeling was performed for each type of morbidity. For gynecological morbidities, genital prolapse was diagnosed in 56%, reproductive tract infections in 52%, and abnormal cervical cell changes in 11% of the women. For related morbidities, anemia was present in 63% of the women, followed by obesity (43%), hypertension (19%), and urinary tract infection (14%). Most of the women were suffering from at least 1 morbidity, with only 3% free of all the morbidity conditions considered. Gynecological morbidity, together with urinary tract infection and syphilis, showed that 35% of the women had 1 morbidity, 34% had 2, and 17% had 3 or more morbidities. Regression analysis of risk factors demonstrated that social conditions and medical factors contributed to these diseases. Reproductive tract infections occurred more frequently with uterovaginal prolapse, IUD use, presence of husband (regular sexual activity), and unhygienic behavior. Genital prolapse increased with age and number of deliveries. Age, recent pregnancy, education, socioeconomic class, and workload revealed significant associations with related morbidity conditions. The risk of anemia was significantly related to age and to a pregnancy within the previous 2 years. With every increase of 1 year of age, the risk of hypertension increased by 9%. For every increase of 1 year of age, the risk of obesity increased by 7%. Women with the highest level of education had a 3 times greater risk of urinary tract infection than did uneducated women, while women of low-middle socioeconomic status had almost 4 times the risk of women in the lowest class.
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PMID:A community study of gynecological and related morbidities in rural Egypt. 835 98

Ophthalmic surgery is one of the most valuable indications for ambulatory anaesthesia (AA). Respecting the usual recommendations for AA and the specificity of ophthalmic surgery, AA has very few problems. In USA it concerns about 90% of ophthalmic surgery. Most of the patients are very young or very old. Adults are often poly-medicamented: diabetes and arterial hypertension are the most frequent pathologies. A lot of multivisceral pathologies are responsible of ocular diseases and can complicate anaesthesia. It is necessary to diagnose them before anaesthesia. Maligna hyperthermia risk is increased during strabismus and ptosis surgery. Some ocular treatments have systemic repercussion and require to be stopped before anaesthesia. Most of ophthalmic surgery can be practiced under any types of local anaesthesia. In postoperative of strabismus and retinal detachment repair, pain, nausea, vomiting are frequently observed. Their prevention is not very well known. The atropine used for cardiac reflex treatment may be responsible of an acute urine retention or a disorientation in elderly patients and delays the home readiness. Paper and pencil tests after general anaesthesia are very difficult to do, because requesting a good vision. The postoperative complications are essentially surgical complications.
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PMID:[Characteristic problems posed to the anesthetist by ambulatory surgery in ophthalmology]. 840 83

The purpose of this study was to demonstrate the special features of cardiovascular effects in connective tissue disorders through a group of fifteen cases observed over a period of ten years. The group consisted of eleven cases of Marfan syndrome (or Marfan-like syndrome), two cases of pseudoxanthoma elasticum and two cases of Ehlers-Danlos disease. The cardiovascular lesions were as follows: 1) dissection of the ascending aorta which was confirmed and had been treated surgically in 2 cases; 2) aneurysmal dilatation of the ascending aorta in 5 cases; 3) moderate mitral valve prolapse, which was isolated in 2 other cases; 4) distention of the mitral valve in 2 cases; 5) mitral valve prolapse combined with tricuspid valve prolapse in 1 case; the mitral incompetence was severe and made it necessary to carry out mitral valve replacement; 6) moderate aortic valve prolapse combined with tricuspid prolapse in a case of type-I Ehlers-Danlos disease; 7) Fallot's tetralogy combined with Marfan's syndrome and treated surgically in one case; 8) severe hypertension with abnormalities of the iliac and renal arteries in one case of elastic pseudoxanthoma elasticum. In three cases complications occurred leading to death, extension of the dissection of the abdominal aorta and global recalcitrant heart failure respectively. The outcome in the other 12 cases, with a mean follow-up time of 3 and one half years (range: 3 years to 7 years) was not marked by complications.
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PMID:[Cardiovascular manifestations of hereditary dysplasias of connective tissue]. 851 93

Genital prolapse is associated to a greater concurrence of repeat urinary infections, stress urinary incontinence, arterial hypertension and obstructive uropathy with a higher or lower degree of renal impairment. Incidence of uropathy in the genital prolapse setting ranges between 4 and 13%. This paper presents a female patient with renal insufficiency secondary to bilateral obstructive uropathy caused by a concomitant genital prolapse. A brief revision is made of the pathophysiological, diagnostic and therapeutic aspects in the literature. The need to perform both prone and standing urographic studies is emphasized; also a study of the renal function should be performed in these patients in order to establish the appropriate treatment and avoid major complications and renal function impairment.
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PMID:[Obstructive uropathy secondary to genitourinary prolapse]. 865 84

Raeder's paratrigeminal syndrome is an uncommon neurologic disorder characterized by oculosympathetic paralysis, including ptosis and miosis. In the ED, this syndrome can be easily confused with Horner's syndrome, although with Raeder's syndrome trigeninal nerve irritation and preservation of facial sweating are noted. This report reviews a case of a 62-year-old man who presented to the ED with signs and symptoms consistent with Raeder's syndrome. MRI with angiography revealed a carotid artery dissection, and the patient was admitted and anticoagulated. The syndrome has been associated with head trauma, hypertension, vasculitis, migraine headaches, parasellar mass lesions, and internal carotid artery dissections. Hence, treatment of the patient who has Raeder's syndrome is dependent on the specific underlying lesion.
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PMID:Raeder's paratrigeminal syndrome: a case report. 887 Jul 59

The medical record linkage system for the Rochester Epidemiology Project provided the means to identify 1,444 incidence cases of ischemic stroke and age- and sex-matched controls from the population from 1960 to 1984 to conduct a case-control study nested in the population. A multiple logistic-regression model permitted the estimation of odds ratios of ischemic stroke for each risk factor while adjusting for confounding variables. The final model, in addition to age and date of stroke, included transient ischemic attacks, hypertension, current smoking, atrial fibrillation, ischemic heart disease, mitral valve disease (other than prolapse), and diabetes mellitus. The process identified interactions showing that ischemic stroke incidence for persons with transient ischemic attacks was higher in women than in men and that the risk decreased with increasing age; that the risk of stroke with hypertension and also with current cigarette smoking decreased with increasing age; and that the risk of ischemic stroke with intermittent or persistent atrial fibrillation was similar when hypertension was present, but without hypertension the risk of stroke was more than seven times greater with persistent than with intermittent atrial fibrillation. None of the odds ratios differed over the five quinquennia of the study, and no effect of antihypertensive treatment on stroke incidence could be demonstrated in the population.
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PMID:A population-based model of risk factors for ischemic stroke: Rochester, Minnesota. 896 Jul 21

Atrial septal aneurysm is a localized "saccular" deformity, generally at the level of the fossa ovalis, which protrudes to the right or the left atrium or both. For 39 months we prospectively analyzed 205 consecutive patients in whom atrial septal aneurysm was diagnosed echocardiographically. The direction and movement of atrial septal aneurysms were carefully studied in multiple views, and, according to our findings, we now propose a new classification: type 1R if the bulging is in the right atrium only, type 2L if the bulging is in the left atrium only, type 3RL if the major excursion bulges to the right atrium and the lesser excursion bulges toward the left, type 4LR if the maximal excursion of the atrial septal aneurysm is toward the left atrium with a lesser excursion toward the right atrium, type 5 if the atrial septal aneurysm movement is bidirectional and equidistant to both atria during the cardiorespiratory cycle. We found an incidence of 1.9%, a mean age of 63 years (25 to 97 years), a female/male ratio of 2:1, valvular regurgitation 74%, hypertension 64%, left ventricular hypertrophy 38%, coronary heart disease 32%, patent foramen ovale 32%, pulmonary hypertension 31%, stroke 20%, dysrhythmias 16%, valvular prolapse 15%, and atrial septal defect 3%. No differences were found between mobile and motionless types of atrial septal aneurysm. However, differences were found between predominantly left bulging or right bulging atrial septal aneurysm (134 versus 57 patients), as well as other variables. All types of atrial septal aneurysm have particular clinical or echocardiographic characteristics. The new classification is a complete, simple, and practical form. Atrial septal aneurysm is associated with congenital and acquired heart diseases but also can present as an isolated abnormality.
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PMID:Atrial septal aneurysm: a new classification in two hundred five adults. 928 54

We report a 62-year-old man who developed coma and died in a fulminant course. The patient was well until May 1, 1996 when he noted chillness, tenderness in his shoulders, and he went to bed without having his lunch and dinner. In the early morning of May 2, his families found him unresponsive and snoring; he was brought into the ER of our hospital. He had histories of hypertension, gout, and hyperlipidemia since 42 years of the age. On admission, his blood pressure was 120/70, heart rate 102 and regular, and body temperature 36.3 degrees C. His respiration was regular and he was not cyanotic. Low pitch rhonchi was heard in his right lower lung field. Otherwise general physical examination was unremarkable. Neurologic examination revealed that he was somnolent and he was only able to respond to simple questions such as opening eyes and grasping the examiner's hand, but he was unable to respond verbally. The optic discs were flat; the right pupil was slightly larger than the left, but both reacted to light. He showed ptosis on the left side, conjugate deviation of eyes to the left, and right facial paresis. The oculocephalic response and the corneal reflex were present. His right extremities were paralyzed and did not respond to pain Deep tendon reflexes were exaggerated on the right side and the plantar response was extensor on the right. No meningeal signs were present. Laboratory examination revealed the following abnormalities; WBC 18,400/ml, GOT 131 IU/l GPT 50 IU/l, CK616 IU/l, BUN 30 mg/dl, Cr 2.1 mg/ dl, glucose 339 mg/dl, and CRP 27.4 mg/dl. ECG showed sinus tachycardia and ST elevation in II, III and a VF leads and abnormal q waves in I, V5, and V6 leads. Chest X-ray revealed cardiac enlargement but the lung fields were clear. Cranial CT scan revealed low density areas in the left middle cerebral and left posterior cerebral artery territories. The patient was treated with intravenous glycerol infusion and other supportive measures. At 2: 10 AM on May 3, he developed sudden hypotension and cardiopulmonary arrest. He was pronounced dead at 3:45 AM. The patient was discussed in a neurological CPC, and the chief discussant arrived at the conclusion that the patient had acute myocardial infarction involving the inferior and the true posterior walls and left internal carotid embolism from a mural thrombus. Post mortem examination revealed occlusion of the circumflex branch of the left coronary artery due to atherom plaque rupture and myocardial infarction involving the posterior and the lateral wall with a rupture in the postero-lateral wall. Marked atheromatous changes were seen in the left internal carotid, the middle cerebral and the basilar arteries; the left internal carotid and the middle cerebral arteries were almost occluded by thrombi and blood coagulate. The territories of the left middle cerebral and the occipital arteries were infarcted; but the left thalamic area was spared. The neuropathologist concluded that the infarction was thrombotic origin not an embolic one as the atherosclerotic changes were severe. Cardiac rupture appeared to be the cause of terminal sudden hypotension and cardiopulmonary arrest. It appears likely that a vegetation which had been attached to the aortic valve induced thromboembolic occlusion of the left internal carotid artery which had already been markedly sclerotic by atherosclerosis. It is also possible that the vegetations in the aortic valve came from mural thrombi at the site of acute myocardial infarction, as no bacteria were found in those vegetations.
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PMID:[A 62-year-old man with an acute onset of consciousness disturbances]. 945 48

Lippia multiflora (L.m.) is a verbenacea used in Congo as conventional tea decoction. No traditional indication is known in this country. Nevertheless, in Ghana the plant is used for the treatment of arterial hypertension. The aim of this study is to investigate the psychotropic activity of the aqueous extract of L.m. using the classical tests of experimental psychopharmacology. The extract of L.m. is constituted by lyophilisated powder obtained from an infusion of dried leaves. Different doses are prepared: 200, 400, 600, 800, 1,000 and 1,200 mg/kg dissolved in 1 ml of NaCl 0.9%. L.m. is administered by intraperitoneal or oral route. The wistar rats of both sexes, weighing between 150-200 g, are used. Animal's behaviour is observed macroscopically. The spontaneous motor activity is appreciated by using the number of squares crossed by animal with the four paws in ten minutes (Martin and al. method slightly modified). The rectal temperature is measured. The effect of L.m. on stereotypies induced by apomorphin and anesthesia induced by phenobarbital are studied. The traction test is used to investigate the muscle relaxant effect of L.m. and analgesic activity is evaluated by using acetic acid and hot plate methods by comparison with diazepam 2 and 4 mg/kg. Fischer-t test is used for the statistical analysis of results. L.m. is well tolerated by rats. No mortality is observed with the doses used. So the doses of 200, 400 and 600 mg/kg were selected for experiments. At theses doses L.m. caused: a precocious ataxia, a sedation, a ptosis and a yellow coloration of urines, these effects are dose dependent; a significant reduction of spontaneous motor activity: control 61.60 +/- 6.48, L.m. 200: 16.40 +/- 5.68 (P < 0.01), L.m. 400: 12.20 +/- 2.01 and L.m. 600: 9.60 +/- 1.90 (P < 0.01); no modification of rectal temperature and apomorphin stereotypies; a reduction of sleep latence: control 22.40 +/- 1.89 min, L.m. 200: 17.20 +/- 2.74 min (P < 0.01), L.m. 400: 13.80 +/- 1.81 min (P < 0.01) and L.m. 600: 13.40 +/- 2.16 min (P < 0.01); a potentiation of phenobarbital anesthesia: L.m. 200: 209.80 +/- 29.58 min (N.S.), L.m. 400: 336.40 +/- 22.23 min (P < 0.01), L.m. 600: 342.20 +/- 16.28 min (P < 0.01) and control: 199.40 +/- 2.90 min; an increase at the dose of 400 mg/kg of the time necessary for the restoration of the paws to the metallic bar in the traction test: control; 0.8 +/- 0.1 s, L.m. 400: 7.04 +/- 2.29 s (P < 0.05); a reduction of abdominal cramps induced by acetic acid. This number is respectively 18.40 +/- 4.49 (P < 0.05); 15.00 +/- 2.90 (P < 0.01), 14.20 +/- 3.89 (P < 0.01), 11.60 +/- 4.75 (P < 0.01), 13.00 +/- 2.00 (P < 0.01) and 33.80 +/- 5.04 for L.m. 200 mg/kg, L.m. 400 mg/kg, L.m. 600 mg/kg, Diazepam 2 and 4 mg/kg and control; an increase of reaction time on the hot plate: L.m. 200: 3.26 +/- 0.46 s (N.S.), L.m. 400: 4.50 +/- 0.80 s (P < 0.01), L.m. 600: 10.50 +/- 1.56 s (P < 0.001), diazepam 2 mg/kg: 2.90 +/- 0.51 s (N.S.), diazepam 4 mg/kg: 5.90 +/- 1.09 s (P < 0.01) and control 2.10 +/- 0.26 s. Those results demonstrated that L.m. possess a tranquilizer and analgesic activities as Diazepam. But, anticonvulsant and anxiolytic tests are necessary to confirm the psychopharmacological profile of this medicinal plant.
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PMID:[Psychopharmacologic properties of Lippia multiflora]. 985 Aug 19


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