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Title: Spontaneous vesicovaginal fistula caused by genitourinary aspergillosis.
Author: Agarwal N; Seth A; Kulshrestha V; Kochar S; Kriplani A
Source: International Journal of Gynaecology and Obstetrics. 2009 Apr;105(1):63-4.
Abstract: Genitourinary aspergillosis is rare in patients who are not immunocompromised. A 39-year-old woman presented with vaginal urinary leakage with no history of previous trauma, procedure, or fever. The patient's last delivery had been by cesarean 12 years previously and she had no history of difficult labor. Six months prior to presenting, the patient had been scheduled to undergo abdominal hysterectomy for menorrhagia along with repair of a surgical hernia; only the hernia was repaired at that time as dense adhesions prevented the hysterectomy. The patient had been amenorrheic since that surgery and her incontinence began 6 days prior to presentation. (excerpt)
Language: English
Keywords:
INDIA | SUMMARY REPORT | CASE HISTORIES | CLIENTS | FISTULA | AMENORRHEA | VAGINAL ABNORMALITIES | SURGERY | BACTERIAL AND FUNGAL DISEASES | UROGENITAL EFFECTS | Asia, Southern | Asia | Developing Countries | Data Collection | Research Methodology | Program Activities | Programs | Organization and Administration | Diseases | Menstruation Disorders | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Infections | Urogenital System | Physiology | Biology
Document Number: 341383

Title: Early diagnosis, follow-up, and prenatal treatment of a case of TRAP sequence occurring in a dichorionic triamniotic triplet pregnancy.
Author: Cavoretto P; Serafini A; Valsecchi L; Lanna M; Rustico MA
Source: Journal of Clinical Ultrasound. 2009 Jul-Aug;37(6):350-3.
Abstract: We are reporting a case of twin reversed arterial perfusion (TRAP) sequence occurring in a dichorionic triamniotic triplet pregnancy with successful percutaneous prenatal treatment and excellent neonatal outcome. TRAP sequence was diagnosed at 11 weeks in a spontaneous dichorionic-triamniotic triplet. Sonographic assessment showed persistent arterial flow and development of hydrops in the acardiac twin. Percutaneous cord interstitial laser coagulation was performed, and the co-twin subsequently developed growth restriction. The 9-month-old twins have a normal developmental course. This report confirms that fetal intervention is indicated in cases of TRAP sequence in which the acardiac twin presents a significant enlargement on follow-up sonographic examinations.
Language: English
Keywords:
ITALY | SUMMARY REPORT | CASE HISTORIES | PREGNANT WOMEN | FETUS | MULTIPLE BIRTH | FETAL MEMBRANES | VASCULAR DISEASES | GROWTH | EXAMINATIONS AND DIAGNOSES | ULTRASONICS | AMNIOCENTESIS | PREGNANCY OUTCOMES | Developed Countries | Europe, Southern | Europe | Data Collection | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Diseases | Child Development | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Genetic Techniques | Laboratory Examinations and Diagnoses
Document Number: 342793

4.
Peer Reviewed

Title: Pregnancy-related deaths in rural Rajasthan, India: exploring causes, context, and care-seeking through verbal autopsy.
Author: Iyengar K; Iyengar SD; Suhalka V; Dashora K
Source: Journal of Health, Population, and Nutrition. 2009 Apr;27(2):293-302.
Abstract: In 2002-2003, all deaths (n=156) of women aged 15-49 years in a block of southern Rajasthan were investigated to determine the cause of death and care-seeking behaviour. Family members of 156 (98%) of 160 deceased women were interviewed following the comprehensive listing of all deaths among women of reproductive age. Of the 156 deaths, 31 (20%) were pregnancy-related; 77% of these women died during the postpartum period, and 74% of the deaths occurred in the home. Direct and indirect obstetric causes were responsible for 58% and 29% of the deaths respectively; 12% were injury-related deaths. Medical care was sought for 65% of the women, and 29% were hospitalized. Family perception of not being able to afford treatment at distant hospitals was a major barrier to seeking care, and 60% of those who sought care had to borrow money for treatment. Lack of skilled attendance and immediate postpartum care were major factors contributing to deaths. Improved access to emergency obstetric care facilities in rural areas and steps to eliminate costs at public hospitals would be crucial to prevent pregnancy-related deaths.
Language: English
Keywords:
INDIA | RURAL AREAS | RESEARCH REPORT | CASE HISTORIES | LOW LITERATES | MATERNAL MORTALITY | PREGNANCY COMPLICATIONS | AUTOPSY | CAUSES OF DEATH | RURAL HEALTH SERVICES | MATERNAL HEALTH SERVICES | UTILIZATION OF HEALTH CARE | OBSTACLES | Asia, Southern | Asia | Developing Countries | Geographic Factors | Population | Data Collection | Research Methodology | Educational Status | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Mortality | Population Dynamics | Demographic Factors | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Maternal-Child Health Services | Primary Health Care | Organization and Administration
Document Number: 341928

Title: Spontaneous hepatic hemorrhage secondary to prolonged use of oral contraceptives.
Author: Jaffar R; Pechet L; Whalen GF; Banner BF
Source: Pathology, Research and Practice. 2009 Jul 3;
Abstract: Oral contraceptive pills (OCP) are the most commonly used form of contraception throughout the United States of America. The prolonged usage of oral contraceptives leads to a variety of complications, ranging from subclinical modifications of liver function tests to the development of benign and malignant tumors of the liver. Spontaneous hepatic hemorrhage secondary to oral contraceptive use was only reported once in the early 1980s. We report a case of spontaneous hepatic hemorrhage secondary to prolonged ingestion of combined OCPs followed by multiple pulmonary emboli without underlying thrombophilia.
Language: English
Keywords:
UNITED STATES OF AMERICA | SUMMARY REPORT | CASE HISTORIES | ORAL CONTRACEPTIVES, SIDE EFFECTS | ADMINISTRATION AND DOSAGE | HEPATIC EFFECTS | BLEEDING | HEMATOMA | PULMONARY EMBOLISM | SURGERY | Developed Countries | North America | Americas | Data Collection | Research Methodology | Contraceptive Safety | Safety | Public Health | Health | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Physiology | Biology | Signs and Symptoms | Diseases | Embolism | Vascular Diseases
Document Number: 341974

Title: Acute Renal Vein Thrombosis, Oral Contraceptives, and Protein S Deficiency: A Successful Catheter-Directed Thrombolysis.
Author: Kim HK; Choi HH; Lee JM; Huh S
Source: Annals of Vascular Surgery. 2009 Jul 22;
Abstract: Acute renal vein thrombosis (RVT) is a rare but noteworthy form of venous thromboembolism. Traditional management has been systemic anticoagulation with heparin, followed by warfarin. We report a case of acute RVT with multiple pulmonary emboli that occurred in a 40-year-old woman who was taking oral contraceptives and was subsequently found to have protein S deficiency. The patient was treated with catheter-directed thrombolysis, and complete resolution of the RVT was achieved. This case suggests that oral contraceptive use in a patient with protein S deficiency may interact in a synergistic manner in the pathogenesis of thrombosis. Also, we believe that catheter-directed thrombolysis is warranted in selective cases in the absence of overriding contraindications.
Language: English
Keywords:
REPUBLIC OF KOREA | SUMMARY REPORT | CASE HISTORIES | CLIENTS | RENAL EFFECTS | THROMBOSIS | TREATMENT | ORAL CONTRACEPTIVES | SERUM PROTEIN EFFECTS | RISK FACTORS | BLOOD COAGULATION EFFECTS | Asia, Eastern | Asia | Developed Countries | Data Collection | Research Methodology | Program Activities | Programs | Organization and Administration | Urogenital Effects | Urogenital System | Physiology | Biology | Thromboembolism | Embolism | Vascular Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Methods | Contraception | Family Planning | Hematological Effects | Hemic System
Document Number: 342328

Title: Transvaginal endoscopic tubal sterilization.
Author: Kondo W; Noda RW; Branco AW; Rangel M; Branco Filho AJ
Source: Journal of Laparoendoscopic and Advanced Surgical Techniques. Part A. 2009 Feb;19(1):59-61.
Abstract: BACKGROUND: Tubal sterilization is one of the most widely used options for female contraception. It can be performed by laparotomy, minilaparotomy, colpotomy, laparoscopy, and hysteroscopy. In this paper, we report the use of the transvaginal endoscopic approach to perform tubal ligation. CASE: The access to the abdomen was obtained by a 1.5-cm colpotomy. The flexible endoscope was introduced into the peritoneal cavity, and carbon dioxide was instilled to get the pneumoperitoneum. Fallopian tubes were identified and electrocauterized with a 40-W coagulation current. Total procedure time was 45 minutes. A single dose of intravenous dypirone was administered for pain. She was discharged 10 hours after the procedure. CONCLUSION: Transvaginal endoscopic tubal ligation is feasible and can be considered an alternative approach to perform female sterilization.
Language: English
Keywords:
BRAZIL | SUMMARY REPORT | CASE HISTORIES | CLIENTS | TUBAL LIGATION | COLPOTOMY | ENDOSCOPY | South America, Eastern | South America | Latin America | Americas | Developing Countries | Data Collection | Research Methodology | Program Activities | Programs | Organization and Administration | Female Sterilization | Sterilization, Sexual | Family Planning | Gynecologic Surgery | Urogenital Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Physical Examinations and Diagnoses | Examinations and Diagnoses
Document Number: 341431

Title: IUS producing a TAC [letter]
Author: Lipscombe SL
Source: Journal of Family Planning and Reproductive Health Care. 2009 Apr;35(2):132.
Abstract: I recently saw a very unusual patient in whom an intrauterine system (IUS) appeared to produce a trigeminal autonomic cephalgia (TAC). The patient, a 39-year-old woman, was fortunate never to have had a headache until the events reported here. In early 2007, the patient started to complain of severe menorrhagia. Her periods were heavy and lasted 14 days, and necessitated the use of 15-20 sanitary pads a day. Tranexamic acid 1000 mg qds was tried initially for 8 weeks but the heavy bleeding continued. Next a therapeutic trial of norethisterone 5 mg tds was tried for many months resulting in a mild improvement. In desperation, the patient was referred to a gynaecologist who felt that the next step was to insert a levonorgestrel-releasing IUS. This was duly done. Within 6 hours of inserting the IUS the attacks started. All the patient's attacks (averaging 5-7 attacks/day) were similar. All were left sided and lasted 15-30 minutes. An attack started with pain to the side of the left eye that the patient described as unbearable, like the worst toothache ever. Associated with the pain was profuse tearing mainly from the left eye, although the pain was so bad the patient also cried with her right eye. Her palpabral fissure narrowed, her nose ran and her eye became pink. Her face felt strange and numb though painful. Touching her face, or brushing her hair or her teeth, did not trigger an attack. The attacks continued daily for 4 weeks until the patient came to see me. As she entered the room, an attack started. Following the attack I removed the patient's IUS very easily and gave her a zolmitriptan nasal spray in case she had further attacks. I arranged to see her 7 days later, at which time she appeared to be a completely different person. She had suffered one further attack some 6 hours after the IUS was removed and so had used the nasal spray. After this her attacks had totally stopped. At that clinic visit, in order to help her menorrhagia, which still raged, I started the patient on norethisterone again. Eighteen months later she is still totally free of attacks, and although her bleeding is still very heavy, she is not prepared to even consider allowing me to reinsert an intrauterine device/system, with or without hormones. She says the pain was the worst pain she could ever imagine and as a result she would never, even for the purposes of research, have an IUS inserted again. This woman appeared to develop a TAC, which approximated most closely to a cluster headache, though some attacks lasted only 15 minutes. It might be argued that it was not the IUS itself, but the hormone present in the IUS, which triggered the attacks, however this seems unlikely. The patient had already had very large doses of progestogen prior to IUS insertion with no ill effects and has also had large doses following IUS removal. The progesterone dose in the IUS is effective locally and is unlikely to have reached a high level after only 6 hours. Conversely, if the problem were the hormone in the IUS, its removal would be unlikelyto cause the hormone level to decrease significantly in 6 hours. In summary, on the face of it this would appear to be a simple case of a woman having an IUS inserted and developing a TAC, which was rapidly cured by removing the device. I would be delighted to discover if any of the Journal's readers have observed a similar case. (full-text)
Language: English
Keywords:
UNITED KINGDOM | SUMMARY REPORT | CASE HISTORIES | CLIENTS | IUD, HORMONE RELEASING | LEVONORGESTREL | IUD SIDE EFFECTS | HEADACHE | MENORRHAGIA | Developed Countries | Europe, Western | Europe | Data Collection | Research Methodology | Program Activities | Programs | Organization and Administration | IUD | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Signs and Symptoms | Diseases | Menstruation Disorders
Document Number: 341645

10.

Title: Yasmin and venous thromboembolism: new case reports.
Author: Lopez M; Vaya A; Martinez Triguero ML; Contreras MT; Todoli J; Ricart A; Laiz B
Source: Clinical Hemorheology and Microcirculation. 2009;42(1):65-9.
Abstract: It is not yet known whether Yasmin involves a higher thrombotic risk compared with other contraceptives. We present a serie of eight new cases of women who developed thrombotic events early after starting on Yasmin who were sent to our Thrombosis and Hemostasis Unit for a thrombophilia work-up in the last five years. Only two of them were heterozygous carriers of the prothrombin G20210A mutation and three were obese while none of them were smoker. These new cases provide information about the characteristics of the thrombotic events and the concomitant risk factors, indicating that this pill may not be as safe as had been previously thought, and suggest that new studies regarding safety profile of Yasmin are required to explain the association with venous thrombotic events.
Language: English
Keywords:
SPAIN | SUMMARY REPORT | CASE HISTORIES | CLIENTS | THROMBOEMBOLISM | RISK FACTORS | ORAL CONTRACEPTIVES, COMBINED | CONTRACEPTIVE SAFETY | PULMONARY EMBOLISM | GENETICS | OBESITY | Developed Countries | Europe, Southwestern | Europe | Data Collection | Research Methodology | Program Activities | Programs | Organization and Administration | Embolism | Vascular Diseases | Diseases | Health | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Safety | Public Health | Biology | Body Weight | Physiology
Document Number: 342317

11.

Peer Reviewed

Title: Coexistent lithopedion and live abdominal ectopic pregnancy.
Author: Massinde AN; Rumanyika R; Im HB
Source: Obstetrics and Gynecology. 2009 Aug;114(2 Pt 2):458-60.
Abstract: BACKGROUND:: Abdominal pregnancy is a rare, life-threatening variant of ectopic pregnancy, and thus its diagnosis and management remain controversial. CASE:: A multigravida was admitted for complaints of abdominal swelling that had been occurring for 2 years and symptoms of pregnancy in the 3 months before admission. Radiologic studies revealed a live intraabdominal pregnancy at 15 weeks of gestation with a concurrent lithopedion of advanced gestation. The patient underwent laparotomy, removing both fetuses; the placenta was left in situ. She was discharged 1 week later in good condition. CONCLUSION:: The case of a concurrent lithopedion of advanced gestation and a live intraabdominal ectopic pregnancy was successfully managed.
Language: English
Keywords:
TANZANIA | SUMMARY REPORT | CASE HISTORIES | CLIENTS | PREGNANCY, ABDOMINAL | PREGNANCY, ECTOPIC | EXAMINATIONS AND DIAGNOSES | PRODUCTS OF CONCEPTION, RETENTION | LAPAROTOMY | ULTRASONICS | FETAL MEMBRANES | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Data Collection | Research Methodology | Program Activities | Programs | Organization and Administration | Pregnancy Complications | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Surgery | Treatment | Fetus | Pregnancy | Reproduction
Document Number: 342273

12.

13.

Peer Reviewed

Title: Management of severe cervical stenosis after conization by detention of nylon threads tied up to intrauterine contraceptive device.
Author: Nasu K; Narahara H
Source: Archives of Gynecology and Obstetrics. 2009 Aug 12;
Abstract: PURPOSE: To investigate the efficacy of the insertion of intrauterine contraceptive device (IUCD) tied up with nylon threads for the treatment of cervical stenosis after conization. METHODS: Dilatation of the cervical canal and insertion of IUCD tied up with nylon threads was performed in four patients with symptomatic cervical stenosis after conization. After three courses of regular menstruation, the IUCD with nylon threads was removed. RESULTS: Total relief of symptoms was achieved in all four patients without any management-related complications. There was no evidence of recurrent cervical stenosis at follow-up in any of the patients. CONCLUSIONS: Detention of nylon threads tied up to IUCD provides an easy and reliable conservative management technique for post-conization cervical stenosis.
Language: English
Keywords:
JAPAN | SUMMARY REPORT | CASE HISTORIES | CLIENTS | CERVIX | MEDICAL PROCEDURES | GYNECOLOGY | HISTOLOGY | COMPLICATIONS | CERVICAL EFFECTS | SIGNS AND SYMPTOMS | TREATMENT | IUD | Asia, Eastern | Asia | Developed Countries | Data Collection | Research Methodology | Program Activities | Programs | Organization and Administration | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Medicine | Health Services | Delivery of Health Care | Health | Diseases | Contraceptive Methods | Contraception | Family Planning
Document Number: 342488

14.

15.

Title: Serious morbidity with long-term IUD retention [letter]
Author: Pillai M; Van de Venne M; Shefras J
Source: Journal of Family Planning and Reproductive Health Care. 2009 Apr;35(2):131-2; author reply 132.
Abstract: This letter to the editor examines serious health problems resulting from long-term IUD retention in women experiencing menopause and in the years following. It recommends that current guidelines be revised to include some emphasis on the importance of timely removal of an IUD once its contraceptive properties are no longer required for the IUD user.
Language: English
Keywords:
UNITED KINGDOM | SUMMARY REPORT | CASE HISTORIES | CLIENTS | IUD, COPPER RELEASING | IUD COMPLICATIONS | TIME FACTORS | PELVIC INFECTIONS | Developed Countries | Europe, Western | Europe | Data Collection | Research Methodology | Program Activities | Programs | Organization and Administration | IUD | Contraceptive Methods | Contraception | Family Planning | Population Dynamics | Demographic Factors | Population | Infections | Diseases
Document Number: 341648

17.

19.

Title: Informed consent for IUD fitting [letter]
Author: Stillwell S; Searle S
Source: Journal of Family Planning and Reproductive Health Care. 2009 Apr;35(2):132-3.
Abstract: Perforation of the uterus is a rare complication of intrauterine device (IUD) fitting. It is quoted as occurring in up to 2 in 1000 IUD fittings. Risk factors for perforation include previous caesarean section and postpartum insertion up to 6 months after delivery. Perforation may occur during the sounding of the uterus or the device itself may perforate the uterus. This can lead to the device being free in the abdominal cavity, necessitating removal by laparoscopy or laparotomy. Faculty Guidance tells IUD fitters that they should explain the risk of perforation to women considering an IUD and document this discussion in the clinical record. This fits with General Medical Council (GMC) guidance on informed consent. I dealt with a complaint from a woman who had a perforation of the uterus following an IUD change; this lady required laparoscopy to remove a missing IUD. The perforation was diagnosed at her IUD check, when the threads were found to be missing. Despite a clinical record showing "perf" followed by a tick this lady alleged that she had not been made aware of the risk of perforation and that if she had been aware she would not have had an IUD fitted. Dealing with this complaint led me to review my own clinical practice and to seek the opinions of other IUD fitters. Using a questionnaire, 15 instructing doctors were asked about the manner in which they (1) explain perforation risk to women and their confidence doing this and (2) assess their patients' understanding of the risk of perforation. These doctors all explained the risk of perforation to all women on their first IUD fitting but only 80% did on subsequent fittings. They commonly used an explanation along the lines of: "There is a small chance -1 in a 1000 -of perforation. This means making a hole in the wall of the womb. This is not serious but if the IUD goes into the tummy outside the womb it has to be removed with keyhole surgery". An explanation such as this would meet GMC consent guidance (i.e. you must tell patients if an investigation or treatment might result in a serious adverse outcome, even if the likelihood is very small). Although 50% of doctors found perforation easy to explain only 20% felt that their patients had understood the risk of perforation. If this is the case then this would not meet guidance that "you should check that a patient understands the terms that you use, particularly when describing the seriousness, frequency and likelihood of an adverse outcome". No doctor felt that patients were deterred from having an IUD fitted by the risk of perforation. More than 50% of the doctors felt that they would like further training in the discussion of risk of perforation of the uterus and of explanation of risk in general. It sometimes takes a review of everyday practice to identify a learning need. In this case it was prompted by a complaint from a woman who unfortunately did experience uterine perforation following an IUD change. All the doctors questioned did discuss the risk of perforation at a first IUD fitting but not all did at a subsequent IUD change. We should not assume that a woman will remember the potential complications of IUD fitting from a previous consultation. The management of this particular complaint and the results of this survey have changed the way in which I discuss perforation risk with women, and I now incorporate this into a fuller explanation of how the device is introduced and why a problem might occur potentially leading to perforation. (full-text)
Language: English
Keywords:
UNITED KINGDOM | SUMMARY REPORT | CASE HISTORIES | INFORMED CONSENT | IUD COMPLICATIONS | INSERTION | UTERINE PERFORATION | PHYSICIAN-PATIENT RELATIONS | Developed Countries | Europe, Western | Europe | Data Collection | Research Methodology | Health Services | Delivery of Health Care | Health | IUD | Contraceptive Methods | Contraception | Family Planning | Treatment | Medical Procedures | Medicine | Perforations | Diseases | Interpersonal Relations | Behavior
Document Number: 341646

20.

21.
Title: Ineffective attempt to preserve fertility with a levonorgestrel-releasing intrauterine device in a young woman with endometrioid endometrial carcinoma: a case report and review of the literature.
Author: Vandenput I; Van Eygen K; Moerman P; Vergote I; Amant F
Source: European Journal of Gynaecological Oncology. 2009;30(3):313-6.
Abstract: BACKGROUND: The treatment of endometrial cancer in young women who want to preserve their fertility is challenging. CASE: A 25-year-old woman (A0P0G0) was diagnosed with grade 1 endometrioid endometrial carcinoma (EEC). Imaging studies including transvaginal ultrasound (TVS), computed tomography and magnetic resonance imaging (MRI) could not detect myometrial invasion or metastatic disease. The immunohistochemical expression of the estrogen and progesterone receptor in the tumor was strongly positive, whereas p53 staining was negative. After extensive counseling, we decided to use a levonorgestrel-releasing intrauterine device to preserve her fertility. Follow-up was organized every three months and consisted of serum CA125 levels, TVS, endometrial biopsy and MRI. The tumor regressed after ten months and the intrauterine device was removed. However, nine months later, recurrent EEC was diagnosed and a hysterectomy performed. Pathological examination confirmed Stage Ia EEC. CONCLUSION: Despite the presence of favorable prognostic factors of EEC as determined by grade and immunohistochemistry, the levonorgestrel-releasing intrauterine device was unable to preserve fertility.
Language: English
Keywords:
BELGIUM | SUMMARY REPORT | LITERATURE REVIEW | CASE HISTORIES | CLIENTS | ENDOMETRIAL CANCER | TREATMENT | FECUNDITY | IUD, HORMONE RELEASING | LEVONORGESTREL | ULTRASONICS | HYSTERECTOMY | Europe, Western | Europe | Developed Countries | Data Collection | Research Methodology | Program Activities | Programs | Organization and Administration | Cancer | Neoplasms | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Reproduction | IUD | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Gynecologic Surgery | Urogenital Surgery | Surgery
Document Number: 342780

22.

Peer Reviewed

Title: Chronic fatigue syndrome: a hormonal origin? A rare case of dysmenorrhea membranacea.
Author: Veldman J; Van Houdenhove B; Verguts J
Source: Archives of Gynecology and Obstetrics. 2009 May;279(5):717-20.
Abstract: BACKGROUND: Membranous dysmenorrhea is a rare entity involving expulsion of fragments of endometrium retaining the shape of the uterus. The condition is often linked to high progesterone levels. An association with a chronic fatigue syndrome was never described. CASE: A 44-year-old woman with a chronic fatigue syndrome (CFS), presented with membranous dysmenorrhea after taking an oral contraceptive pill containing ethinylestradiol 0.02 mg and desogestrel 0.15 mg for 3 months in a continuous regimen as treatment for dysfunctional bleeding. Oral contraception was discontinued and she resumed normal menstruations. Remarkably, she mentioned complete disappearance of the CFS since expulsion of the tissue and started working again. CONCLUSION: The occurrence of membranous dysmenorrhea with a dissolving chronic fatigue syndrome is very rare and was never described before. This case suggests a hormonal dysfunction as a possible cause of chronic fatigue syndrome. A review of the literature on membranous dysmenorrhea is presented.
Language: English
Keywords:
BELGIUM | SUMMARY REPORT | LITERATURE REVIEW | CASE HISTORIES | CLIENTS | FATIGUE | DYSMENORRHEA | HORMONES | EXAMINATIONS AND DIAGNOSES | ORAL CONTRACEPTIVES | Europe, Western | Europe | Developed Countries | Data Collection | Research Methodology | Program Activities | Programs | Organization and Administration | Signs and Symptoms | Diseases | Menstruation Disorders | Endocrine System | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Methods | Contraception | Family Planning
Document Number: 341663

23.

Peer Reviewed

Title: Migration of an intrauterine device into the bladder: a rare case.
Author: Yensel U; Bezircioglu I; Yavuzcan A; Baloglu A; Cetinkaya B
Source: Archives of Gynecology and Obstetrics. 2009 May;279(5):739-42.
Abstract: INTRODUCTION: Intrauterine device (IUD) application has been used for over 30 years and is a widely accepted contraception method among women because of its low-complication rates. The use of intrauterine devices may cause complications but migration of the IUD into an adjacent organ is rarely encountered. CASE: In the present report, we present a 26-year-old patient to whom IUD had been applied 2 years ago and whose examination performed due to pain and urinary complaints revealed migration of the uterine device into the bladder. CONCLUSION: Patients with pelvic pain and chronic irritative urinary symptoms whose vaginal examination and ultrasonography reveal a dislocated IUD should be carefully examined for the migration of the IUD into the bladder. In order to avoid this rare complication, patient should be evaluated physically and ultrasonographically for uterine position, thinness of the uterine wall and inflammatory disease before the insertion. The patient should be evaluated with sonographyimmediately after insertion and periodically.
Language: English
Keywords:
TURKEY | SUMMARY REPORT | CASE HISTORIES | CLIENTS | IUD MIGRATION | UROGENITAL EFFECTS | EXAMINATIONS AND DIAGNOSES | UTERINE PERFORATION | ULTRASONICS | Europe, Southeastern | Europe | Developing Countries | Data Collection | Research Methodology | Program Activities | Programs | Organization and Administration | IUD | Contraceptive Methods | Contraception | Family Planning | Urogenital System | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Perforations | Diseases
Document Number: 341662

24.

Peer Reviewed

Title: Nonvenereal transmission of syphilis in infancy by mouth-to-mouth transfer of prechewed food.
Author: Zhou P; Qian Y; Lu H; Guan Z
Source: Sexually Transmitted Diseases. 2009 Apr;36(4):216-7.
Abstract: Early recognition of acquired syphilis in childhood is vital. Children may acquire syphilis as a consequence of kissing, breast-feeding, or handling. We report 2 cases of infantile syphilis transmitted by mouth-to-mouth feeding from actively infected relatives. Syphilis should be suspected in children presenting with atypical rashes accompanied by headache, sore throat, and adenitis, especially if family members are affected by active syphilis.
Language: English
Keywords:
CHINA | SUMMARY REPORT | CASE HISTORIES | INFANT | SYPHILIS | TRANSMISSION | FOOD AND BEVERAGE | SIGNS AND SYMPTOMS | Asia, Eastern | Asia | Developing Countries | Data Collection | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Nutrition | Health
Document Number: 341441

25.

Peer Reviewed

Title: Social costs of skilled attendance at birth in rural Ghana.
Author: Bazzano AN; Kirkwood B; Tawiah-Agyemang C; Owusu-Agyei S; Adongo P
Source: International Journal of Gynecology and Obstetrics. 2008 Jul;102(1):91-94.
Abstract: The objective of this study was to examine the social costs to women of skilled attendance at birth in rural Ghana. Ethnographic data were obtained through participant observation, interviews, case histories, and focus groups and were analyzed alongside data from a birth cohort of 2878 singletons born in the Kintampo study district between July 2003 and June 2004. Most women delivered at home. Home delivery raises a woman's status in her community, while seeking skilled attendance lowers it.Women feel that seeking assistance in childbirth wastes other people's timeand they value secrecy in labor. Negative treatment by health providers and expensive supplies needed for delivery also act as barriers. The social costs of obtaining skilled attendance at birth must be offset by community level strategies such as mobilization of older women and husbands, and ensuring health providers extend professional, humane care to laboring women. (author's)
Language: English
Keywords:
GHANA | RESEARCH REPORT | INTERVIEWS | FOCUS GROUPS | CASE HISTORIES | WOMEN | CHILDBIRTH | MATERNAL HEALTH SERVICES | QUALITY OF HEALTH CARE | UTILIZATION OF HEALTH CARE | WOMEN'S STATUS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Data Collection | Research Methodology | Demographic Factors | Population | Pregnancy Outcomes | Pregnancy | Reproduction | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration | Socioeconomic Factors | Economic Factors
Document Number: 327055

26.

Peer Reviewed

Title: Sexually transmissible infection management practices among primary care physicians in Singapore.
Author: Chan RK; Tan HH; Chio MT; Sen P; Ho KW; Wong ML
Source: Sexual Health. 2008 Aug;5(3):265-271.
Abstract: Primary care physicians manage a significant number of sexually transmissible infections (STI); however, there has not been a survey to assess the standard of medical care, completeness of notifications, provision of counselling and contact tracing by primary care physicians in Singapore. An anonymous postal survey was conducted in which 1557 questionnaires were mailed out to general practitioners (GP), and government primary care and emergency department doctors. In all, 736 questionnaires (47.3%) were returned, and the majority of respondents were graduates from the local medical school, worked in solo or group practices and were males. One hundred and thirty doctors (17.7%) indicated they had received training attachments or postings in dermato-venereology departments. Almost one-third (30.8%) had been working as doctors for fewer than 10 years and 87.8% reported that they managed STI in their practice. Almost half did not investigate genital discharge patients, and one-third would still use ciprofloxacin to treat discharges. In the management of ulcers, over half indicated that they would order syphilis serology, and a significant minority would use parenteral penicillin. Most doctors provided history taking, screening for other STI, testing for HIV infection and STI counselling. A small minority of doctors undertook contact tracing, and there was incomplete notification of many STI. Overall medical management of STI by primary care physicians was acceptable. Skills in contact tracing and reminders on disease notification are areas that need particular attention.
Language: English
Keywords:
SINGAPORE | RESEARCH REPORT | KAP SURVEYS | PHYSICIANS | SEXUALLY TRANSMITTED DISEASES | PRIMARY HEALTH CARE | COUNSELING | NOTIFICATION | SEX FACTORS | ACADEMIC TRAINING | TIME FACTORS | PHYSICAL EXAMINATIONS AND DIAGNOSES | LABORATORY EXAMINATIONS AND DIAGNOSES | TESTING | CASE HISTORIES | Developed Countries | Asia, Southeastern | Asia | Surveys | Sampling Studies | Studies | Research Methodology | Health Personnel | Delivery of Health Care | Health | Reproductive Tract Infections | Infections | Diseases | Health Services | Clinic Activities | Program Activities | Programs | Organization and Administration | Political Factors | Sociocultural Factors | Population Characteristics | Demographic Factors | Population | Training Programs | Education | Population Dynamics | Examinations and Diagnoses | Medical Procedures | Medicine | Measurement | Data Collection
Document Number: 322920

27.

Peer Reviewed

Title: Chronic isolated torsion of the left fallopian tube: A diagnostic dilemma.
Author: Schollmeyer T; Soyinka AS; Mabrouk M; Jonat W; Mettler L
Source: Archives of Gynecology and Obstetrics. 2008 Jan;277(1):87-90.
Abstract: Chronic tubal torsion is a rare clinical entity. A 15-year-old adolescent presented with an 18-month history of intermittent lower abdominal pain at our outpatient department after various preceding consultations with different physicians. She was asymptomatic and showed no abnormality on physical examination. Ultrasound findings revealed a cystic structure adjacent to the left ovary. Diagnostic laparoscopy showed a twisted and dilated left fallopian tube with thickened wall and adherence to the pelvic sidewall. Following detorsion, there was no evidence of reperfusion. Consequently, a left salpingectomy was performed. Chronic tubal torsion is a rare but possible differential diagnosis of current lower abdominal pain. Physicians should have a high index of suspicion. (author's)
Language: English
Keywords:
GERMANY | SUMMARY REPORT | CASE HISTORIES | FALLOPIAN TUBES | TUBAL EFFECTS | PAIN | EXAMINATIONS AND DIAGNOSES | ORAL CONTRACEPTIVES, COMBINED | ULTRASONICS | LAPAROSCOPY | SURGERY | Europe, Central | Europe | Developed Countries | Data Collection | Research Methodology | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Signs and Symptoms | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Endoscopy | Physical Examinations and Diagnoses | Treatment
Document Number: 322619

28.

Peer Reviewed

Title: Primary carcinoid tumor of the ovary: A case report.
Author: Somak R; Shramana M; Vijay S; Nita K
Source: Archives of Gynecology and Obstetrics. 2008 Jan;277(1):79-82.
Abstract: Carcinoid tumors commonly occur in the gastrointestinal tract and lungs. However, carcinoid tumors of the ovary are rare, primary carcinoid tumors being even rarer, forming 0.3% of all carcinoid tumors. We present a case of a 55-year-old woman presented with symptoms of abdominal discomfort, weakness and fatigue. Pelvic ultrasound revealed a left-sided lobulated ovarian mass, which was solid with occasional internal scattered fluid areas. No other abnormality was detected on pelvic and abdominal ultrasonography. The findings of biochemical investigations were within normal limits. The patient underwent total abdominal hysterectomy and bilateral salphingo-oophorectomy for a clinical suspicion of ovarian tumor. Gross examination revealed a large tumor completely replacing the ovary, which was predominantly solid with few cystic areas and yellowish in color. Microscopically, the tumor was composed of uniform population of polygonal cells with abundant granular cytoplasm, arranged in small acini, solid sheets, ribbons and trabecular pattern. No teratomatous component was seen either grossly or microscopically. The tumor cells showed the strong expression of Chromogranin A and synaptophysin on immunohistochemistry. On the basis of this, a diagnosis of primary ovarian carcinoid was made. We conclude that it is important to be aware of this entity in the pathological diagnosis of ovarian tumors, even in the absence of any clinical indicator of carcinoid tumor/syndrome, as it carries a markedly better prognosis and clinical outcome in comparison with most other malignant ovarian tumors. (author's)
Language: English
Keywords:
INDIA | SUMMARY REPORT | CASE HISTORIES | NEOPLASMS | OVARIAN CANCER | EXAMINATIONS AND DIAGNOSES | HYSTERECTOMY | HISTOLOGY | ULTRASONICS | Developing Countries | Asia, Southern | Asia | Data Collection | Research Methodology | Diseases | Cancer | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Gynecologic Surgery | Urogenital Surgery | Surgery | Treatment | Biology
Document Number: 322618

29.

Peer Reviewed

Title: Aggressive mixed type endometrial carcinoma in a young woman with rapid progression and fatal outcome.
Author: Taskin EA; Taskin S; Berker B; Erol E; Dunder I
Source: Archives of Gynecology and Obstetrics. 2008 Jan;277(1):71-73.
Abstract: Endometrial carcinoma in young ages is uncommon and tends to be a well differentiated endometrioid type and has an excellent prognosis. Nevertheless, in this report mixed type endometrial cancer including serous, clear cell and endometrioid components in a young patient with rapid progression and fatal outcome is presented. A 26-year-old virgin female was admitted with menometrohagia lasting for 9 months, leading to severe anemia. Transabdominal ultrasonography demonstrated 30 x 27 mm intramural mass consistent with leiomyoma in uterine corpus posterior. The patient did not permit any vaginal intervention including endometrial sampling, therefore laparotomy was decided. Mixed type endometrial carcinoma was diagnosed and she was treated with comprehensive surgery plus adjuvant chemotherapy. After 7 months of surgery she deceased. We suggest that persistent uterine bleeding associated with severe anemia should be evaluated for malignancy even in young women to avoid delay in diagnosis. Imaging studies especially magnetic resonance imaging may be helpful when endometrial sampling cannot be done. (author's)
Language: English
Keywords:
TURKEY | SUMMARY REPORT | CASE HISTORIES | ENDOMETRIAL CANCER | BLEEDING | ANEMIA | ULTRASONICS | LAPAROTOMY | HISTOLOGY | SURGERY | DRUGS | Europe, Southeastern | Europe | Developing Countries | Data Collection | Research Methodology | Cancer | Neoplasms | Diseases | Signs and Symptoms | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Treatment | Biology
Document Number: 322616

30.


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