Labhardt’s colpoperineocleisis: subjective results of an alternative treatment for genital prolapse in patients who are not sexually active—2-year follow-up

Background:Idiopathic inflammatory myopathies (IIM) are essentially treated aiming improvement of muscle function and extra muscular disease manifestations. The backbone of the treatment is corticosteroids enhancing the survival and patient quality of life. The lack of consensus on target-specific immunosuppressive treatment highlights the need for further studies evaluating alternative treatment methods. Rituximab is potentially a glucocorticoid-sparing agent which was reviewed in multiple studies with small sample sizes due to the rarity of the disease.Objectives:Higher statistical power can enhance the trustworthiness of alternative treatment methods yielding the main objective of this study.Methods:This retrospective study was conducted at a tertiary rheumatology center. Patients were diagnosed with an idiopathic inflammatory myopathy (dermatomyositis [DM], polymyositis [PM]) and were treated with rituximab in order to be included in this study. Clinical signs and symptoms of the presentation were noted during the first patient encounter as well as the follow-up. Parameters of disease activity including acute phase reactants, muscle enzyme levels, and disease-specific autoantibodies were analyzed.Results:The study includes 28 patients (20 DM, 8 PM). The age of diagnosis was 43.44 ± 15.77 years, follow-up duration was 60.7 ± 70.7 months. The presenting signs and symptoms of the patients are shown in Figure 1. The parameters of disease activity before and after treatment are summarized in Table 1. The mean corticosteroid dose decreased from 31.429 ±23.934 mg to 10.278 ±12.001 (p=0.001). Other treatment methods were methotrexate (n=18), Intravenous Immunoglobulin (IVIG) (n=7), and cyclophosphamide (n=2). There were not any deaths during the follow-up. Two patients were lost to follow-up.Table 1.The Parameters of Disease Activity Before and After TreatmentBefore TreatmentAfter TreatmentP ValueCPK, mean ± std (U/L)1426 ± 2049.92263.44 ± 265.630.004LDH, mean ± std (U/L)557.5 ± 365379.78 ± 192.10.03AST, mean ± std (U/L)62.52 ± 5930.16 ± 27.590.01ALT, mean ± std (U/L)56.48 ± 49.2127.64 ± 24.520.008ESR, mean ± std (mm/hour)26.38 ± 28.9820.39 ± 18.760.36CRP, mean ± std (mg/L)19.23 ± 46.1512.53 ± 26.670.5RF, mean ± std (U/mL)0 (0)N/AN/AANA, n (%)3 (10.71)N/AN/AFigure 1.The Presenting Signs and Symptoms of the PatientsConclusion:Rituximab is shown to be effective in treating myositis along with corticosteroids as well as a corticosteroid-sparing agent in retrospective studies and open-label clinical trials; however, lack of statistical power should be underlined. Long term decrease in steroid use and decrease in disease activity markers hints the effective use of rituximab as a glucocorticoid sparing agent as well as its safety with minimal side effects.Disclosure of Interests:None declared

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Conservative approach to a giant mandibular myxoma: an alternative treatment - 5 years follow up

International Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.ijom.2019.03.271 ◽

2019 ◽

Vol 48 ◽

pp. 89-90

Author(s):

C.C.R. Cerqueira ◽

D.S. De Paula ◽

R.B. Aguiar

Keyword(s):

Alternative Treatment ◽

Conservative Approach

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A COMPARISON BETWEEN SYNTHETIC AND BIOSYNTHETIC MESHES IN THE SURGICAL TREATMENT OF SEVERE GENITAL PROLAPSE: RESULTS AND COMPLICATIONS

Urogynaecologia ◽

10.4081/uij.2009.3.21 ◽

2010 ◽

Vol 23 (3) ◽

pp. 21

Author(s):

S. Dati ◽

V. De Lellis ◽

P. Palermo ◽

G. Carta

Keyword(s):

Genital Prolapse ◽

Pelvic Organ ◽

Wilcoxon Test ◽

Type I ◽

Replacement Surgery ◽

Group A ◽

Group B ◽

Work Up

The effectiveness, tolerability and complications of two surgical procedures using prosthetic materials with different physical and structural properties were assessed with a full Urogynecology work-up, through a retrospective study of 158 patients with severe genital prolapse (POP-Q staging III-IV) selected from November 2006 to April 2009. Eighty-six patients underwent fascial replacement surgery with ProliftTM System with a dual transobturator access in the anterior district and a transperineal posterior access with a synthetic polypropylene type I mesh (Group A). Seventy-two patients who underwent pelvic organ prolapse surgery with Avaulta/Avaulta PlusTM System with a dual transobturator access in the anterior district and a dual transperineal posterior access with a biosynthetic polypropylene type I mesh coated with a film of hydrophilic porcine collagen were placed in Group B. There were no intra and postoperative complications. Results of mean 20.8 month follow-up showed an effective anatomical cure rate of 89.5% in group A and 86.1% in group B and a low percentage of erosive complications, 8.1% and 5.6% respectively. Validated questionnaires for prolapse, the UDI 6 s.f., the IIQ7 s.f. and the PISQ-12 all showed a statistically significant improvement of quality of life in patients undergoing the two procedures (Wilcoxon test: P<0.001).

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Female Genital Schistosomiasis and HIV-1 incidence in Zambian women: a retrospective cohort study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab349 ◽

2021 ◽

Author(s):

Amy S Sturt ◽

Emily L Webb ◽

Comfort R Phiri ◽

Maina Mudenda ◽

Joyce Mapani ◽

...

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Poisson Regression ◽

Retrospective Cohort ◽

Statistical Evidence ◽

Sexually Active ◽

Hiv Seroconversion ◽

Hiv 1 ◽

Female Genital

Abstract Background Female genital schistosomiasis (FGS) has been associated with prevalent HIV-1. We estimated the incidence of HIV-1 infection in Zambian women with and without FGS. Methods Women (aged 18-31, non-pregnant, sexually active) were invited to participate in this study in January-August 2018 at final follow-up of the HPTN 071 (PopART) Population Cohort. HIV-1 negative participants at enrolment (n=492) were included in this analysis with testing to confirm incident HIV-1 performed in HPTN 071 (PopART). Association of incident HIV-1 infection with FGS (Schistosoma DNA detected by PCR in any genital specimen) was assessed with exact Poisson regression. Results Incident HIV-1 infections were observed in 4.1% (20/492) participants. Women with FGS were twice as likely to seroconvert as women without FGS but with no statistical evidence for a difference (aRR 2.16, 95%CI[0.21–12.30], p=0.33). Exploratory analysis suggested an association with HIV-1 acquisition among women with ≥2 positive genital PCR specimens (RR 6.02, [0.58–34.96]), p=0.13). Conclusions Despite higher HIV seroconversion rates in women with FGS, there was no statistical evidence of association, possibly due to low power. Further longitudinal studies should investigate this association in a setting with higher schistosomiasis endemicity.

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EXPERIENCE OF USING SYNTHETIC PROSTHESES PROLIFT ® (GYNECARE) FOR CORRECTION OF GENITAL PROLAPSE

Clinical Practice ◽

10.17816/clinpract1332-37 ◽

2010 ◽

Vol 1 (3) ◽

pp. 32-37

Author(s):

S A Levakov ◽

N S Wanke ◽

O R Shablovskiy ◽

A G Kedrova ◽

V N Shirshov ◽

...

Keyword(s):

Pelvic Organ Prolapse ◽

Prospective Observational Study ◽

Vaginal Surgery ◽

Genital Prolapse ◽

Pelvic Organ ◽

Safe Procedure ◽

Prolapse Repair ◽

Specific Outcome ◽

One Year

The aim was to evaluated anatomical and symptom specific outcome measures of prolapse repair with PROLIFT ® (Gynecare). In this longitudinal prospective observational study we collected data on a total of 85 women with pelvic organ prolapse stage 2 or more. Objective success rate was 85.9% at 6 months respectively. Patients required a blood more 500 ml - 7,1% and need transfusion. The mesh erosion rate or the displacement of the mesh were 3,5%. Vaginal surgery with prolift mesh® is an effective and safe procedure to correct pelvic organ prolapse over one year follow up.

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Asymptomatic Penile HPV Infection: A Prospective Study

International Journal of STD & AIDS ◽

10.1177/095646240001100203 ◽

2000 ◽

Vol 11 (2) ◽

pp. 80-84 ◽

Cited By ~ 16

Author(s):

A Wikström ◽

C Popescu ◽

O Forslund

Keyword(s):

Hpv Infection ◽

Sexually Active ◽

Hpv Dna ◽

Persistent Infections ◽

Repeated Sampling ◽

Pcr Method ◽

Hpv Types ◽

Polymerase Chain ◽

A Prospective Study

The occurrence of human papillomavirus (HPV) among males was analysed with the polymerase chain reaction (PCR) method. Penile brush samples were taken once from 147 males attending for a control or for HPV non-related reasons, and consecutive samples were collected from 88 males re-attending the clinic. Of the males attending once, 13% (19/147) were HPV DNA positive and among the re-attenders 14% (12/88) were initially positive as compared with 33% (29/88) who were positive at least at one visit. Totally, 22 different HPV types were detected of which HPV 16 was most common, found in 6.4% (15/235), followed by HPV 42 found in 3.8% (9/235). Among 14 HPV-positive males with at least one follow-up, 7 had persistent infections with at least one HPV type, and transient HPV types were observed in 9; but in 5 of them new types appeared at follow-up. Among sexually-active males subclinical/latent HPV infection is common and repeated sampling increases its prevalence.

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Prevalence of Cervical Intra Epithelial Neoplasia (CIN) among the Sexually Active Married Women by Colposcopy at Rajshahi Division

TAJ Journal of Teachers Association ◽

10.3329/taj.v31i2.41581 ◽

2019 ◽

Vol 31 (2) ◽

pp. 1-5

Author(s):

Sahela Jesmin ◽

Monira Najnin ◽

Ashrafunnesa ◽

Romana Afroz ◽

Mousumi Sarkar ◽

...

Keyword(s):

Squamous Metaplasia ◽

Population Based ◽

Married Women ◽

Sexually Active ◽

Cross Sectional ◽

Socioeconomic Condition ◽

Normal Cervix ◽

Chronic Cervicitis ◽

Good Number

Objective: To determine the prevalence of cervical intra epithelial neoplasia (CIN) among sexually active married women in Rajshahi division of Bangladesh. Study Design: It is a prospective cross sectional type descriptive study. Place and Duration: This study is population based & carried out in 4 selected Upazilla from 4 different districts of Rajshahi Division. Total 1050 patient were enrolled in the study. Study period was 6 months from 1st December 2014 to 31st May 2015. Subject and Method: All sexually active woman between age group 25 to 55 years in selected Upazilla. In UHC of preselected Upazilla who fulfilled the inclusion criteria enrolled in the study after taking the consent. Frequency & risk factors for CIN were analyzed after entering in predesigned proforma. Result: During study period of 6 months among 1050 enrolled patients 90 patient were VIA positive and 91 patients were colposcopically abnormal and among these 33 patients were CIN positive & 58 patients had chronic cervicitis with or without squamous metaplasia. Mean age of CIN positive were 36.75 years, 92.2% patient were housewife & 7.8% patient were service holder and in 64.6% patients education level up to XII class, in 55.5% patients husband was day labour from poor socioeconomic condition. Conclusion: VIA and Colposcopy can differentiate a normal cervix from a precancerous cervix with reasonable accuracy. Till now, a good number of studies had been carried out in different countries of world & it is now well established that sensitivity of the test is very good. From the present study we can conclude that it will give very good information about the prevalence of CIN in our country and by follow up study this might help us in reducing the incidence of carcinoma cervix. TAJ 2018; 31(2): 1-5

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Aggressive angiomyxoma of the perineal region

SAGE Open Medical Case Reports ◽

10.1177/2050313x19843391 ◽

2019 ◽

Vol 7 ◽

pp. 2050313X1984339 ◽

Cited By ~ 1

Author(s):

Clémence Raptin ◽

Jean-Philippe Lucot ◽

Alfred Bassil ◽

Edouard Poncelet ◽

Jean-François Prolongeau ◽

...

Keyword(s):

Case Report ◽

Surgical Treatment ◽

High Risk ◽

Genital Prolapse ◽

Aggressive Angiomyxoma ◽

Rare Tumour ◽

Long Term Follow Up ◽

Perineal Region

Aggressive angiomyxoma is a rare tumour that frequently involves the perineal region with a high risk of local recurrence. This is a case report of a 24-year-old female patient with a genital prolapse. We performed a surgical treatment. Histological examination found an aggressive angiomyxoma. The tumour recurred 1 year after surgery. Long-term follow-up is necessary.

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