scholarly journals Etiology, staging, and management of cystocele

2022 ◽  
Author(s):  
Sheema Sabahath ◽  
Abdullah Haitham Bogis ◽  
Taif Shabib Al Mutairi ◽  
Hasan Yousef Alshahabi ◽  
Hussain Ahmed Al Sayhab ◽  
...  
Keyword(s):  
Urinary Bladder ◽  
Treatment Plan ◽  
Current Treatment ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall ◽  
Treatment Modalities ◽  
Management Approach ◽  
Sacral Colpopexy ◽  
Suitable Treatment ◽  
Associated Risk Factors

A cystocele is usually found to protrude the urinary bladder through the vaginal wall. Various causes have been reported in the literature for the pathogenesis and development of cystocele. These can cumulatively lead to a remarkable weakness in the muscular and connective tissue layers related to the urinary bladder and anterior vaginal wall. The present study discusses the etiology, staging, and management of patients with cystocele. Evidence indicates that a defect within the pelvic-floor supporting system can significantly lead to the development of cystocele. Parity, increasing age, and obesity are the main associated risk factors for developing these events. Staging is important to decide the most suitable treatment plan, which might be conservative or surgical. Some patients do not require any management approach, being asymptomatic, and refuse the current treatment modalities. Surgery has been associated with enhanced outcomes and can be conducted via two different approaches, including anterior colporrhaphy and sacral colpopexy. 

scholarly journals Mesh Exposure and Associated Risk Factors in Women Undergoing Transvaginal Prolapse Repair with Mesh

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Elizabeth A. Frankman ◽  
Marianna Alperin ◽  
Gary Sutkin ◽  
Leslie Meyn ◽  
Halina M. Zyczynski
Keyword(s):  
Risk Factors ◽  
Retrospective Chart Review ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall ◽  
Repair System ◽  
Mesh Exposure ◽  
Prolapse Repair ◽  
Increased Risk ◽  
Independent Risk Factors ◽  
Associated Risk Factors

Objective. To determine frequency, rate, and risk factors associated with mesh exposure in women undergoing transvaginal prolapse repair with polypropylene mesh.Methods. Retrospective chart review was performed for all women who underwent Prolift Pelvic Floor Repair System (Gynecare, Somerville, NJ) between September 2005 and September 2008. Multivariable logistic regression was performed to identify risk factors for mesh exposure.Results. 201 women underwent Prolift. Mesh exposure occurred in 12% (24/201). Median time to mesh exposure was 62 days (range: 10–372). When mesh was placed in the anterior compartment, the frequency of mesh exposure was higher than that when mesh was placed in the posterior compartment (8.7% versus 2.9%,P=0.04). Independent risk factors for mesh exposure were diabetes (AOR = 7.7, 95% CI 1.6–37.6;P=0.01) and surgeon (AOR = 7.3, 95% CI 1.9–28.6;P=0.004).Conclusion. Women with diabetes have a 7-fold increased risk for mesh exposure after transvaginal prolapse repair using Prolift. The variable rate of mesh exposure amongst surgeons may be related to technique. The anterior vaginal wall may be at higher risk of mesh exposure as compared to the posterior vaginal wall.

scholarly journals Office-Based Sedation/General Anesthesia for COPD Patients, Part II

2019 ◽  
Vol 66 (1) ◽  
pp. 44-51
Author(s):  
Kristin Chino ◽  
Steven Ganzberg ◽  
Kristopher Mendoza
Keyword(s):  
General Anesthesia ◽  
Treatment Plan ◽  
Current Treatment ◽  
Multiple Organ ◽  
Treatment Modalities ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Anxiety Control ◽  
Dental Office ◽  
Organ Systems

The safe treatment of patients with chronic obstructive pulmonary disease (COPD) in dental office office-based settings can be quite complex without a current understanding of the etiology, course, severity, and current treatment modalities of the disease. The additional concerns of providing sedation and/or general anesthesia to patients with COPD in settings outside of a hospital demand thorough investigation of individual patient presentation and realistic development of planned treatment that patients suffering from this respiratory condition can tolerate. Along with other co-morbidities, such as advanced age and potential significant cardiovascular compromise, the dental practitioner providing sedation or general anesthesia must tailor any treatment plan to address multiple organ systems and mitigate risks of precipitating acute respiratory failure from inadequate pain and/or anxiety control. Part I of this article covered the epidemiology, etiology, and pathophysiology of COPD. Patient considerations in the preoperative period were also reviewed. Part II will cover which patients are acceptable for sedation/general anesthesia in the dental office-based setting as well as sedation/general anesthesia techniques that may be considered. Postoperative care will also be reviewed.

906: Pelvicol Implants for Prevention of Anterior Vaginal wall Prolapse: Randomized Multicenter Study

2006 ◽  
Vol 175 (4S) ◽  
pp. 293-293
Author(s):  
Ervin Kocjancic ◽  
Paolo Pifarotti ◽  
Fabio Magatti ◽  
Francesco Bernasconi ◽  
Diego Riva ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall ◽  
Anterior Vaginal Wall Prolapse

The Use of Mesenchymal Stem Cells and their Derived Extracellular Vesicles in Cardiovascular Disease Treatment

2020 ◽  
Vol 15 (7) ◽  
pp. 623-638
Author(s):  
Saeideh Gholamzadeh Khoei ◽  
Fateme Karimi Dermani ◽  
Sara Malih ◽  
Nashmin Fayazi ◽  
Mohsen Sheykhhasan
Keyword(s):  
Cardiovascular Disease ◽  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Extracellular Vesicles ◽  
Adult Stem Cells ◽  
Heart Diseases ◽  
Therapeutic Option ◽  
Current Treatment ◽  
Treatment Modalities ◽  
Cellular Source

Background: Cardiovascular disease (CVD), including disorders of cardiac muscle and vascular, is the major cause of death globally. Many unsuccessful attempts have been made to intervene in the disease's pathogenesis and treatment. Stem cell-based therapies, as a regeneration strategy, cast a new hope for CVD treatment. One of the most well-known stem cells is mesenchymal stem cells (MSCs), classified as one of the adult stem cells and can be obtained from different tissues. These cells have superior properties, such as proliferation and highly specialized differentiation. On the other hand, they have the potential to modulate the immune system and anti-inflammatory activity. One of their most important features is the secreting the extracellular vesicles (EVs) like exosomes (EXOs) as an intercellular communication system mediating the different physiological and pathophysiological affairs. Methods: In this review study, the importance of MSC and its secretory exosomes for the treatment of heart disease has been together and specifically addressed and the use of these promising natural and accessible agents is predicted to replace the current treatment modalities even faster than we imagine. Results: MSC derived EXOs by providing a pro-regenerative condition allowing innate stem cells to repair damaged tissues successfully. As a result, MSCs are considered as the appropriate cellular source in regenerative medicine. In the plethora of experiments, MSCs and MSC-EXOs have been used for the treatment and regeneration of heart diseases and myocardial lesions. Conclusions: Administration of MSCs has been provided a replacement therapeutic option for heart regeneration, obtaining great attention among the basic researcher and the medical doctors.

Utility of anterior vaginal wall length measurement in vaginal reconstructive surgery

2016 ◽  
Vol 28 (8) ◽  
pp. 1197-1200 ◽  
Author(s):  
Amy F Collins ◽  
Paula J Doyle ◽  
Smitha Vilasagar ◽  
Gunhilde M Buchsbaum
Keyword(s):  
Reconstructive Surgery ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall ◽  
Length Measurement ◽  
Vaginal Reconstructive Surgery

scholarly journals Management of extra-abdominal fibromatosis in a musculoskeletal tumour centre in Hong Kong

2021 ◽  
pp. 221049172198908
Author(s):  
Lam Wei Sze Yvette ◽  
Fong Sin Tak ◽  
Mak Ka Lok
Keyword(s):  
Watchful Waiting ◽  
Surgical Excision ◽  
Treatment Modalities ◽  
Management Approach ◽  
Conservative Approach ◽  
Management Options ◽  
Musculoskeletal Tumour ◽  
Female Predominance ◽  
Tumour Location ◽  
Marginal Status

Introduction: Fibromatosis is a benign disease yet prone to recurrence. The best treatment option remains controversial. The purpose of this study was to analyse the management approach in our musculoskeletal tumour centre. Materials and Methods: Thirty-four patients with extra-abdominal fibromatosis referred to our centre between 2000 to 2018 were included. Patients’ demographics, tumour location and size, year of diagnosis, treatment modalities, surgical margins, recurrence, and subsequent management were analysed. Results: Patients mostly presented in the second and third decade, with female predominance. Twenty-seven patients underwent excision. Other management options included ‘watchful waiting’, pharmacological treatment and radiotherapy. Recurrence rate was 51.9%. There was no statistically significant relationship between marginal status and recurrence. Conclusion: We report our experiences on management of fibromatosis, with strategy shifted from early excision to a conservative approach over the years. Surgical excision is still indicated in some situations. Tumour recurrence is not rare but second excision is not always necessary.

scholarly journals Challenges and opportunities for ovarian cancer management in the epidemic of Covid-19: lessons learned from Wuhan, China

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Zhilan Chen ◽  
Chun Zhang ◽  
Jiu Yin ◽  
Xin Xin ◽  
Hemei Li ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Large Scale ◽  
Treatment Plan ◽  
Clinical Care ◽  
Gynecologic Cancer ◽  
Treatment Phase ◽  
Tumor Stage ◽  
Current Treatment ◽  
Lessons Learned ◽  
Cancer Management

AbstractChina and the rest of the world are experiencing an outbreak of the 2019 novel coronavirus disease (COVID-19). Patients with cancer are more susceptible to viral infection and are more likely to develop severe complications, as compared to healthy individuals. The growing spread of COVID-19 presents challenges for the clinical care of patients with gynecological malignancies. Ovarian debulking surgery combined with the frequent need for chemotherapy is most likely why ovarian cancer was rated as the gynecologic cancer most affected by COVID-19. Therefore, ovarian cancer presents a particular challenging task. Concerning the ovarian cancer studies with confirmed COVID-19 reported from large-scale general hospitals in Wuhan, we hold that the treatment plan was adjusted appropriately and an individualized remedy was implemented. The recommendations discussed here were developed mainly based on the experience from Wuhan. We advise that the management strategy for ovarian cancer patients should be adjusted in the light of the local epidemic situation and formulated according to the pathological type, tumor stage and the current treatment phase. Online medical service is an effective and convenient communication platform during the pandemic.

scholarly journals Infective Aortic Valve Endocarditis Causing Embolic Consecutive ST-Elevation Myocardial Infarctions

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Kanksha Peddi ◽  
Alexander L. Hsu ◽  
Tomas H. Ayala
Keyword(s):  
Myocardial Infarction ◽  
Infective Endocarditis ◽  
Aortic Valve ◽  
Index Case ◽  
Current Treatment ◽  
Myocardial Infarctions ◽  
Treatment Modalities ◽  
The Past ◽  
First Case ◽  
St Elevation

ST-elevation myocardial infarction (STEMI) is a rare and potentially fatal complication of infective endocarditis. We report the ninth case of embolic native aortic valve infective endocarditis causing STEMI and the first case to describe consecutive embolisms leading to infarctions of separate coronary territories. Through examination of this case in the context of the previous eight similar documented cases in the past, we find that infective endocarditis of the aortic valve can and frequently affect more than a single myocardial territory and can occur consecutively. Further, current treatment modalities for embolic infective endocarditis causing acute myocardial infarction are limited and unproven. This index case illustrates the potential severity of complications and the challenges in developing standardized management for such patients.

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