Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In southern India, obstetricians conducted a retrospective study of 33 destructive obstetric operations performed between 1981 and 1991 at Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) in Pondicherry. The mothers were all under 40 years old. The operations included 27 craniotomies, 2 decapitations, 3 eviscerations, and 1 cleidotomy (surgical division of the fetus' clavicle to facilitate delivery). Women with shoulder presentation and hand or cord prolapse tended to arrive at the hospital before full cervical dilatation so obstetricians preferred performing a cesarean section, regardless of viability of the fetus, explaining the low rate of decapitation and evisceration. Yet, obstetricians and primary health center physicians referred most women with cephalic presentation rather late in labor with indications of an important rupture or ruptured uterus. Reasons for craniotomy were hydrocephalus (52%), obstructed labor (19%), arrest of aftercoming head (7%), cord prolapse (5%), persistent meuto-transverse position (4%), and placental abruption (4%). 3 cases had to undergo Cesarean section after other procedures failed. 6% of the women suffered vaginal laceration. 3% experienced fever, urinary tract infection, episiotomy, wound infections, or paralytic ileus. 1 woman died from postpartum hemorrhage and another died from severe postoperative shock after undergoing lower segment cesarean section. The incidence rate of destructive operations was lower than that of other Indian hospitals (all deliveries, .094% vs. .24-.283%). These findings suggested that obstetricians and primary healthy center physicians need to be trained in doing confidentially performed craniotomy, decapitation, or evisceration in rural areas so they do not refer mothers at high risk of ruptured uterus and subsequent death while in transmit to a referral center.
 ...
PMID:Destructive operations in modern obstetrics in a developing country at tertiary level. 794 38

Itraconazole is particularly attractive in fungal prophylaxis for cancer patients due to its broad spectrum, including Candida and Aspergillus. It is generally well tolerated. However, its efficacy in preventing invasive aspergillosis could not be demonstrated. A 3-year-old boy diagnosed with acute lymphoblastic leukemia received induction chemotherapy. On day 14, itraconazole solution at a dose of 5 mg/kg was begun. Ten days after itraconazole was started, he developed paralytic ileus, neurogenic bladder, mild left ptosis, and absence of deep reflexes, with severe paralysis of the lower extremities and mild weakness of the upper extremities. Itraconazole withdrawal was followed by rapid improvement, with neurologic examination returning to normal within 6 weeks. Nineteen cases of unusual enhanced vincristine neurotoxicity related to itraconazole have been reported in children. Although the manifestations are the same as those usually associated with the use of vincristine, in these cases the severity appears remarkable. The authors suggest that in the absence of any proven benefit of itraconazole prophylaxis, and given the interaction of this drug with vincristine leading to severe and even potentially fatal toxicities, the combination use of these drugs should be avoided.
 ...
PMID:Itraconazole-related increased vincristine neurotoxicity: case report and review of literature. 1601 30

Introduction: Diverting ostomy is a commonly perfomed procedure but may be associated to its own morbidity (early or late complications). Colostomy-related evisceration is a rare but potentially life threatening condition (requiring emergency surgery), relatively undocumented for its mechanisms. Case report: A male aged 84 was admited for chronic low digestive occlusion due to a locally advanced, stenosing, rectal adenocarcinoma. Prior to neoadjuvant therapy, a loop sigmoidostomy was indicated using a left iliac open aproach, with no preparation of the colic content. The sigmoid was loaded with hard stools. The parietal breach was reaproximated by 2 monofilament nylon sutures, fascial and colocutaneus fixation. Colostomy was opened two days later, but was not functional (postoperative paralytic ileus). Parastomal evisceration of ileum in day 3, dehiscence of parietal suture. Emergency operation, using the same aproach. Results: Favourable outcome. Thoraco-abdominal CT scan: N0,M0. Pelvic MRI: proliferative mass of inferior and middle rectum, involving mesorectum fascia, levator ani and a few regional lymphatic nodes. Radio-chemotherapy and abdomino-perineal resection. Pathologic result: colorectal adenocarcinoma, G2, ypT1ypN0, ICD-O: 8140/3. Conclusions: We rewiewed 8 case reports published since 2011, equally distributed as late or early complications. There was no connection with the princeps indication (colorectal cancer in half of cases); neither related to topography (transverse or sigmoid) or type of colostomy (loop or end). Occurence of the complication is not time-dependent (5 to18 months in late, 3 to 12 days for early eviscerations). The main premise is colostomy itself (a place of reduced parieto-abdominal resistence), stressed by increassed intra-abdominal pressure (eg. bronchopulmonary disease, digestive obstruction). Predisposing factors for late evisceration seems to be related to spontaneous rupture of parastomal hernia/colostomy prolapse. As for early evisceration, both technical details and surgical strategy must be considered (indequate fixation; creation of a larger than necessary colostomy aperture).
 ...
PMID:Paracolostomy Evisceration: Short Review and a New Case Report. 3215 4