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

Total colectomy with mucosal protectomy and ileal pouchoanal anastomosis (IPAA) is a promising surgical development for the treatment of ulcerative colitis and familial polyposis. It avoids the need for an ostomy to the exterior, removes all affected tissue and maintains reasonable bowel control by the anal sphincter. 58 patients who underwent IPAA (Group A) were compared with 40 who underwent total proctocolectomy with Kock's pouch (KP) or Brooke's ileostomy (BI), or ileorectostomy (Group B). The indications for surgery were intractable disease, recurrent acute colitis, nonresolving acute colitis, dysplasia, toxic megacolon, perforation, hemorrhage and malnutrition. In Groups A and B duration of operation was, respectively, 6.9 and 5 hours (p less than 0.001); postoperative complications were intestinal obstruction (8 cases versus 14, p less than 0.05), pelvic inflammation (4 vs 3), pouchitis (4 vs 2), and wound infection (3 vs 1). Additional complications in Group A were pouchovaginal fistula (2), and single cases of transient brachial plexus palsy, anastomal stenosis, and rectal prolapse. There were no sexual or urinary complications, no cases in which pouch resection was necessary, nor was there any postoperative mortality. Additional complications in Group B were pouchocutaneous fistula (3) and neurogenic bladder (1?). Among those with KP, there were 9 cases of nipple slippage and 2 cases needed total pouch resection. Among those with BI there were 3 cases of ileostomal prolapse. Mortality in Group B was 4. Total hospital stay in groups A and B, respectively, were 30 and 56 days (p less than 0.0005). Fecal output was 6.3 and 5.9 movements per day in Groups A and B, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Treatment of ulcerative colitis and familial polyposis]. 166 68

One case of oculopharyngeal muscular dystrophy is reported, in a 75 year old white male with manifest family history of palpebral ptosis. He displayed bilateral ptosis and dysphagia. Diagnosis was carried out after clinical, electrical and bioptic procedures. Data obtained have been discussed with previous reports in the literature. It was necessary to perform a cricopharyngeal myotomy to overcome the malnutrition secondary to his swallowing problem.
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PMID:[Clinicopathological study of a case of oculopharyngeal muscular dystrophy]. 180 38

There are two types of rectal prolapse viz, complete or procidentia and occult. Aetiology and management are usually different in children and adults. Control of prolapse by various methods of rectopexies, re-education of bowel habit and correction of sphincter dysfunction are the three phases of treatment in adults. Correction of malnutrition, digital reposition of the prolapse, submucous injection of 5% phenol in almond oil under general anaesthesia and lastly the Thiersch's operation are the methods of correction in children.
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PMID:Management of complete rectal prolapse. 270 May 79

A case of oculopharyngeal muscular dystrophy in an elderly woman of French-Canadian background presenting with dysphagia is discussed. Typical features of the clinical presentation include bilateral ptosis and dysphagia with significant potential for morbid outcomes of aspiration pneumonia and malnutrition. Although relatively uncommon, this diagnosis should be considered in an elderly person with dysphagia, a history of ptosis, and the proper family background. Surgical treatment appears to improve the signs and symptoms of this disease.
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PMID:Oculopharyngeal muscular dystrophy as a cause of dysphagia in the elderly. 394 5

Two different conditions are contrasted: mucosal prolapse in children aged between 2 and 5 years and total prolapse, which is very rare. Mucosal prolapse has become very rare in industrialised countries because of the excellent improvement in nutrition since the war, while this remains a very serious condition in under-developed countries. It is rapidly cured, provided the therapeutic errors are avoided, in particular cerclage. Sclerosis with quinine-urea is indicated in this situation. The various causes are discussed: in particular, the abnormal fixation of the rectum and the absence of the sacral curvature. The predisposing factors are essentially prolonged time spent on the pot, constipation and prolonged diarrhoea and, most importantly, malnutrition and prematurity. Total prolapse in very rare; it is about 15 centimetres long curved posteriorly and often incoercible. It occurs in younger infants and even neonates. It is often irreducible and therefore requires surgery in certain cases. It frequently disappears after the age of 8 years. There are a number of very different causes, not only malnutrition and prematurity and, in this clinical context, strain plays an important role and may be due to a vesical or urethral stone or to a congenital abnormality of these organs, but also abnormalities of the rectal segment with disorders of innervation, connective tissue diseases, any diseases affecting the internal sphincter, in particular congenital abnormalities. Abnormalities of the intrinsic rectal innervation with loss of sensitivity are frequent and can be due to denervations caused by a surgical operation (Hirschsprung's operation, for example). Abnormalities of the baso-receptors have also been observed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Anal prolapse in the child]. 409 98

The author reports on four patients (one male, three females) from the same kindred with a newly recognized autosomal recessive condition involving striated and smooth muscle that has been designated oculogastrointestinal muscular dystrophy. It is characterized by ptosis, ophthalmoplegia, and progressive intestinal pseudo-obstruction leading to malnutrition and death before 30 y. Autopsy studies in two cases showed a severe primary myopathy of smooth muscles of the stomach and intestine with intact myenteric plexus and vagus nerves. The proposita notably had myopathic changes of striated muscles but also involvement of the peripheral nerves and central nervous system characterized by demyelinating and axonal neuropathy and focal spongiform degeneration of the posterior columns.
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PMID:Oculogastrointestinal muscular dystrophy. 685 10

Two cachectic, obtunded patients were seen with unilateral periorbital emphysema resembling ptosis as a primary manifestation of pneumothorax. Speculation is made as to the possible role of malnutrition in this unusual manifestation. Spontaneous pneumothorax should be considered in the obtunded patient with ptosis that is poorly explained by other neurologic findings.
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PMID:Ptosis associated with iatrogenic pneumothorax: a false lateralizing sign. 705 15

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

A 59-year-old woman had chronic hyponatremia from inappropriate secretion of antidiuretic hormone (SIADH) and malnutrition after recurrent cholecystitis for 2 months. She developed dysarthria, dysphagia, bilateral ptosis, clonic convulsions and delayed onset Parkinsonian features. Magnetic resonance imaging showed increased signal density in the central pons on T2-weighted images. She was also later diagnosed as having systemic lupus erythematosus (SLE). This case is reported because central pontine myelinolysis (CPM) developed in chronic hyponatremia without correction, and manifested with atypical, delayed-onset Parkinsonian features. The patient recovered well from her neurological illness, unlike the poor outcome in previously reported cases of CPM. In addition, the coincidence of CPM and SLE has not, to knowledge, been reported before.
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PMID:Central pontine myelinolysis in chronic hyponatremic patient: a case report. 771 99

Helminth and schistosome infections occur in the same geographical areas as does malnutrition. These parasitic infections can occur already in malnourished persons. Hookworm infections reduces food intake and/or increase nutrient wastage via vomiting, diarrhea, or blood loss. These effects exasperate protein energy malnutrition, anemia, and other nutrient deficiencies. Hookworm infection reduces the work capacity and productivity of children and adults; increases maternal and fetal morbidity, premature delivery, and low birth weight, as well as the susceptibility to other infections; and reduces the rate of cognitive development. These social and economic consequences in turn reduce the ability of people and families to raise crops or earn enough money to buy food and other essentials. As many as 90% of the children in some areas of the developed world are infected with roundworm. More than 100,000 deaths in 1987 resulted from complications of roundworm infection (e.g., intestinal obstruction). Roundworm infection reduces the body's ability to use protein and to absorb fat, which worsens protein energy malnutrition. Other nutrient effects of roundworm infection are exacerbation of vitamin A deficiency and lactose and milk intolerance. Whipworm infection can effect prolapse of the rectum and nutritional problems. Treatment of children with whipworm improves hematocrit, growth rates and anthropometry, and serum albumin, and reduces diarrhea and bacterial and protozoan infections in the bowel. Schistosomiasis causes nutritional effects similar to those of helminths. Studies in Kenya show that, in children, 1 treatment against worm, infections improves growth and fitness within 4 months. Other studies in Kenya show that treating children for worms or anemia improves weight gains per month at least as much as and usually more than school feeding programs, a more labor intensive, complicated, and expensive effort. Deworming programs should operate in areas where undernutrition exceeds 25% and worms are prevalent.
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PMID:Helminth parasites, a major factor in malnutrition. 801 83


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