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Sample records for pregnancy-related pelvic girdle

  1. Etiology and prognosis of pregnancy-related pelvic girdle pain; design of a longitudinal study

    Directory of Open Access Journals (Sweden)

    Kroese Mariëlle EAL

    2005-01-01

    Full Text Available Abstract Background Absence of knowledge of pregnancy-related pelvic girdle pain (PPGP has prompted the start of a large cohort study in the Netherlands. The objective of this study was to investigate the prevalence and incidence of PPGP, to identify risk factors involved in the onset and to determine the prognosis of pregnancy-related pelvic girdle pain. Methods/design 7,526 pregnant women of the southeast of the Netherlands participated in a prospective cohort study. During a 2-year period, they were recruited by midwives and gynecologists at 14 weeks of pregnancy. Participants completed a questionnaire at baseline, at 30 weeks of pregnancy, at 2 weeks after delivery, at 6 months after delivery and at 1 year after delivery. The study uses extensive questionnaires with questions ranging from physical complaints, limitations in activities, restriction in participation, work situation, demographics, lifestyle, pregnancy-related factors and psychosocial factors. Discussion This large-scale prospective cohort study will provide reliable insights in incidence, prevalence and factors related to etiology and prognosis of pregnancy-related pelvic girdle pain.

  2. Women's experiences of pregnancy related pelvic girdle pain: A systematic review.

    Science.gov (United States)

    Mackenzie, Jo; Murray, Esther; Lusher, Joanne

    2018-01-01

    to systematically review the available studies which relay the experience of pregnancy related pelvic girdle pain and how this affects women psychologically and emotionally. a systematic review and meta-synthesis of the experiences of pregnancy related pelvic girdle pain was conducted for qualitative studies dated between 2005 and 2016. Predefined terms were used to search nine central databases and hand searches of two reference lists of identified studies were carried out. 614 records were identified, eight studies met the inclusion criteria for review. Pain from pelvic girdle pain impacted on women's daily lives both at home and the workplace. This had a negative emotional and psychological impact on women as it took away their feeling of independence. Women reported feelings of frustration, guilt, irritability and upset at being unable to carry out their normal roles. Pelvic girdle pain also affected the women's sense of identity and ability to care for their children. Health professionals working with pregnant and postnatal women need to be aware of the anger, frustration and negative emotions resulting from PGP. These women may become socially isolated and there is a risk they could abuse analgesics in attempt to manage the pain especially if they do not have the social support. For women with young children, it is important to be aware of safety issues they face with carrying babies and controlling toddlers. It is therefore important that health professionals recognise PGP as a serious health issue, approach this condition sensitively and refer to appropriate treatment as soon as PGP is suspected. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  3. The use of complementary and alternative medicine (CAM) for pregnancy related low back and/ or pelvic girdle pain: An online survey.

    Science.gov (United States)

    Hughes, Ciara M; Liddle, S D; Sinclair, Marlene; McCullough, Julie E M

    2018-05-01

    Low back and pelvic girdle pain (LBPGP) is a common complaint among pregnant women, which increases throughout pregnancy and women use various complementary and alternative medicine (CAM) therapies to manage their pain. Using an online survey, CAM treatments used by pregnant women in the UK and their perceptions of these therapies to relieve LBPGP were investigated. 191 women completed the survey and 70% experienced LBPGP lasting more than one week. Over half of women who sought treatment from a GP or physiotherapist were dissatisfied. 25% of participants used CAM during pregnancy, the most popular being aromatherapy (21%), acupuncture (21%), and reflexology (15%). 81% of women used CAM to manage their LBPGP and 85% found it useful for pregnancy symptoms. Women experience high levels of pain during pregnancy with limited treatment options. Research into effective CAM treatments for LBPGP is required to allow women to make informed decisions regarding treatment options. Copyright © 2018 Elsevier Ltd. All rights reserved.

  4. Treatment of pregnancy-related pelvic girdle and/or low back pain after delivery design of a randomized clinical trial within a comprehensive prognostic cohort study [ISRCTN08477490

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    Klabbers Aldegonda BA

    2004-12-01

    Full Text Available Abstract Background Pregnancy-related pelvic girdle and/or low back pain is a controversial syndrome because insight in etiology and prognosis is lacking. The controversy relates to factors eliciting pain and some prognostic factors such as the interpretation of pain at the symphysis. Recent research about treatment strategies also reflects those various opinions, in fact suggesting there is professional uncertainty about the optimal approach. Currently, physiotherapists often prescribe a pain-contingent treatment regime of relative rest and avoiding several day-to-day activities. Additionally, treatment more often includes an exercise program to guide rectification of the muscle imbalance and alignment of the pelvic girdle. Effectiveness of those interventions is not proven and the majority of the studies are methodologically flawed. Investigators draw particular attention to biomedical factors but there is growing evidence that important prognostic issues such as biopsychosocial factors appear to be even more important as point of action in a treatment program. Methods/design This pragmatic randomized controlled trial is designed to evaluate the effectiveness of a tailor-made treatment program with respect to biopsychosocial factors in primary care. The effect of the experimental intervention and usual care are evaluated as they are applied in primary health care. The trial is embedded in a cohort study that is designed as a longitudinal, prospective study, which studies prevalence, etiology, severity and prognosis during pregnancy until one year after delivery. The present paper focuses on choices regarding recruitment procedures, in-/exclusion criteria and the development of a well-timed intervention. Discussion This section briefly discusses the actions taken to minimize bias in the design, the proper time-window for the experimental intervention and the contrast between the experimental intervention and usual care.

  5. Physical exercise and pelvic girdle pain in pregnancy

    DEFF Research Database (Denmark)

    Andersen, Linda Kahr; Backhausen, Mette; Hegaard, Hanne Kristine

    2015-01-01

    OBJECTIVE: Pelvic girdle pain is a frequent cause of sick leave among pregnant women in Denmark. Studies regarding prevention of pelvic girdle pain are sparse. The aim of this study was to examine the association between physical exercise and pelvic girdle pain in pregnancy. STUDY DESIGN: A nested...... case-control study within the Danish National Birth Cohort (n = 5304). METHODS: This study used self-reported data on pelvic girdle pain obtained from an interview six months after childbirth. Information on physical exercise was obtained from the pregnancy interview around gestational week 16....... The association was estimated using logistic regression analysis. RESULTS: Physical exercise in pregnancy was associated with decreased risk of overall pelvic girdle pain (OR = 0.87; 95% CI: 0.77-0.99, p = 0.028). Tests for trend indicated decreasing odds for pelvic girdle pain with increasing number of hours per...

  6. Fractures due to insufficient pelvic girdle

    International Nuclear Information System (INIS)

    Garcia Aguayo, F.J.; Martinez Almagro, A.

    1995-01-01

    Eleven cases are presented of postmenopausal women with a total of 37 fractures due to insufficient pelvic girdle: 15 located in sacrum, ten in the pubic rami, four in ilium proximal to the sacroiliac joint, three in iliac fossa, two in iliac tuberosity and three in the public body. Eight of the patients were diagnosed over a period of six years when seeking medical attention for bone pain. The other three were diagnosed retrospectively among a group of 33 cancer patients (the majority having having breast cancer) who presented positive pelvic radionuclide bone scan. CT was superior to conventional radiology in detecting fractures of this type, especially those of sacrum and ilium. Radionuclide bone scan was highly sensitive but its specificity was low, requiring back-up radiology and above all CT to establish the differential diagnosis with respect to other types of lesions, especially metastases. (Author) 14 refs

  7. Age at menarche and pregnancy-related pelvic pain

    DEFF Research Database (Denmark)

    Kirkeby, Mette J; Biering, Karin; Olsen, Jørn

    2013-01-01

    AIM: Menarcheal age is a predictor of several complications related to pregnancy and diseases later in life. We aimed to study if menarcheal age is a risk factor for pregnancy-related pelvic pain. MATERIAL AND METHODS: A nested case-control study was conducted within the Danish National Birth...

  8. Triple pelvic ring fixation in patients with severe pregnancy-related low back and pelvic pain.

    NARCIS (Netherlands)

    Zwienen, C.M. van; Bosch, E.W. van den; Snijders, C.J.; Vugt, A.B. van

    2004-01-01

    STUDY DESIGN: Single-group prospective follow-up study. OBJECTIVES: To assess the functional outcome of internal fixation of the pelvic ring in patients with severe pregnancy-related low back and pelvic pain (PLBP) in whom all other treatments failed. BACKGROUND DATA: More than half of all pregnant

  9. CLINICAL TESTS FOR THE ASSESSMENT OF THE PELVIC GIRDLE PAIN IN PREGNANCY AND POSTPARTUM

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    Darija Šćepanović

    2018-02-01

    Full Text Available Background: Pregnancy-related pelvic girdle pain (PGP refers to the pain in the lumbosacral region, the sacroiliac joints and the symphysis pubis joint. The results of the high methodological quality studies indicate that the point prevalence of pregnant women suffering from PGP is about 20 %. Pregnancy-related PGP requires a comprehensive physiotherapy assessment in order to make or confirm a diagnosis, plan the treatment and evaluate the patient’s condi- tion. Physiotherapy assessment includes clinical diagnostic tests which should satisfy the criteria of safety, feasibility, reliability, sensitivity, specificity and validity. The aim of the present paper was to systematically review the literature on clinical diagnostic tests of PGP in order to determine which clinical tests meet the necessary criteria and are appropriate for clinical examination of PGP in pregnancy and postpartum. Methods: PubMed, Cinahl, Embase, Index Medicus databases and the Cochrane controlled trials reg- ister from 1980 to 2008 were searched using the key words, pregnancy/pelvic girdle pain, pregnancy/clinical tests/sacroiliac joint/symphysis pubis. Only the articles/texts in English and Slovene were reviewed unless translated abstract was available. Additional manual searches of the reference lists in books and review articles were undertaken. Along with the randomized clinical studies the literature search encompassed also the basic studies. Results: Nine studies evaluating the tests for clinical examination of the pregnancy-related PGP met the criteria for inclusion in this review. The studies evaluated and analysed six provocation tests for the sacroiliac joint, namely, the Posterior pelvic pain provocation test (P4, Patrick’s Faber test, palpation of the long dorsal ligament, compression test, separation test, Menell’s test as well as two provocation tests for the symphysis pubis joint (pain palpation and a modified Trendelenburg test and one functional

  10. Mobility of the pelvic joints in pregnancy-related lumbopelvic pain : a systematic review

    NARCIS (Netherlands)

    Mens, Jan M A; Pool-Goudzwaard, A.L.; Stam, H

    2009-01-01

    About 45% of all pregnant women and 25% of all women postpartum suffer from pelvic girdle pain and/or low back pain (PLPP). It has been suggested that increased motion of the three joints in the pelvic ring is one of the causes of PLPP. However, in spite of the availability of high technology the

  11. Pregnancy Related Low Back and Pelvic Pain: a surgical approach

    NARCIS (Netherlands)

    C.M.A. Zwienen

    2005-01-01

    textabstractMore than half of all pregnant women experience low back and/or pelvic pain of whom one-third has severe complaints. In most cases the pelvic pain disap­pears within a few months after delivery, either spontaneously or after con­servative treatment. In a minority of patients the pain

  12. Pelvic girdle pain affects the whole life--a qualitative interview study in Norway on women's experiences with pelvic girdle pain after delivery.

    Science.gov (United States)

    Engeset, Jorun; Stuge, Britt; Fegran, Liv

    2014-10-03

    The aim of this study was to explore how pelvic girdle pain after delivery influences women's daily life in Norway. Knowledge about living with post-partum pelvic girdle pain is lacking. A phenomenological-hermeneutical design with qualitative semi-structured interviews was used. A strategic selection procedure was chosen to recruit participants from physiotherapy clinics and a regional hospital in Norway. Five women with clinically verified pelvic girdle pain after delivery were included. Data were imported into NVivo9 and analysed in three steps: naïve reading, structural analysis and comprehensive understanding of the text. Three themes influencing the women's daily life were identified: 1) activity and pain, 2) lack of acknowledgment of pain and disability, and 3) changed roles. A daily life with pain and limited physical activity was difficult to accept and made some of the women feel discouraged, isolated and lonely. Despite this, the women had a positive attitude to their problems, which may have positively increased their ability to cope. The findings also revealed the importance of a reciprocal influence between the woman and her environment, and that social support was crucial. Pelvic girdle pain may influence women's lives for months and years after delivery. Health care professionals should appreciate and focus on the patient's knowledge and skills. Understanding the daily experiences of women with pelvic girdle pain might help improve rehabilitation strategies for these patients.

  13. The prognostic value of asymmetric laxity of the sacroiliac joints in pregnancy-related pelvic pain.

    NARCIS (Netherlands)

    Damen, L.; Buyruk, H.M.; Guler-Uysal, F.; Lotgering, F.K.; Snijders, C.J.; Stam, H.J.

    2002-01-01

    STUDY DESIGN: Prospective cohort study. OBJECTIVE: To determine the prognostic value of asymmetric laxity of the sacroiliac joints during pregnancy on pregnancy-related pelvic pain postpartum. SUMMARY OF BACKGROUND DATA: In a previous study, we observed a significant relation between asymmetric

  14. Pregnancy-related pelvic pain is more frequent in women with increased body mass index

    DEFF Research Database (Denmark)

    Biering, K; Nohr, EA; Olsen, J

    2011-01-01

    Objective. To investigate the association between pre-pregnancy overweight/obesity and pregnancy-related pelvic pain. Design: Nested case-control study. Setting and population. The Danish National Birth Cohort, a cohort of pregnant women and their children recruited 1996–2002. Methods. The women...

  15. Predictors for postpartum pelvic girdle pain in working women: the Mom@Work cohort study

    NARCIS (Netherlands)

    Stomp-van den Berg, G.M.; Hendriksen, I.J.M.; Bruinvels, D.J.; Twisk, J.W.R.; Mechelen, W. van; Poppel, M.N.M. van

    2012-01-01

    The objective of this study was to examine which factors during pregnancy and postpartum predict pelvic girdle pain (PGP) at 12 weeks postpartum among working women. A total of 548 Dutch pregnant employees were recruited in 15 companies, mainly health care, child care, and supermarkets. The

  16. HEMIPELVECTOMY AND INTRAOPERATIVE RADIOTHERAPY FOR BONE AND SOFT-TISSUE SARCOMAS OF THE PELVIC GIRDLE

    NARCIS (Netherlands)

    HOEKSTRA, HJ; SINDELAR, WF; SZABO, BG; KINSELLA, TJ

    1995-01-01

    Current treatment of locally advanced bone and soft tissue sarcomas of the pelvic girdle are associated with a high local and distant failure rate, and local tumor control after hemipelvectomy can be a significant problem. IORT has been used in conjunction with hemipelvectomy, both conventional

  17. External and internal hemipelvectomy for sarcomas of the pelvic girdle : consequences of limb-salvage treatment

    NARCIS (Netherlands)

    Ham, SJ; Veth, RPH; van Horn, [No Value; Eisma, WH; Hoekstra, HJ; Schraffordt Koops, H.

    1997-01-01

    The outcome of different Limb-saving treatment modalities for pelvic girdle sarcoma is controversial. The oncological and functional results after 11 external and 10 internal hemipelvectomies and the consequences of limb-salvage treatment were studied in 21 consecutive patients with primary bone (19

  18. Bone anatomy of the pelvic girdle, the thigh and the leg of Myrmecophaga tridactyla (Myrmecophagidae: Pilosa

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    Lucas de Assis Ribeiro

    2013-11-01

    Full Text Available The giant anteater (Myrmecophaga tridactyla is the largest anteater species in the world. It is an animal of terrestrial habits, however, it has some ability to climb tall trees and termite mounds. The hard skeletal structures are of crucial importance, since they join and protect the soft organs and help support the body, shape, and get involved in movement. The appendicular skeleton is an important part of the locomotor apparatus, whose anatomical information in wild species is scarce, making it difficult to interpret data on these bones. This paper aims to describe the pelvic girdle, the thigh, and the leg skeleton in the giant anteater. We used two specimens of Myrmecophaga tridactyla Linnaeus (1758, fixed in a 3.7% aqueous formaldehyde solution. At first, the limbs were disjointed and we removed the skin, viscera, and muscles associated to the bones of the pelvic girdle, the thigh, and the leg in the specimens. Then, they were macerated in boiling water, and, subsequently, placed in a hydrogen peroxide solution. Once clean and dry, the bones were identified and described. The pelvic girdle skeleton in the giant anteater consists of the hip bone, formed by the ilium, pubis, and ischium bones; the thigh consists of the femur bone, and the leg consists of the tibia and fibula bones. In the knee joint region there is the patella, a relatively small sesamoid bone, considering the large size of this animal. The giant anteater have osteological features of the pelvic girdle, the thigh, and the leg similar to those in domestic carnivores, however, some morphological differences are made evident, something which may reflect differences in locomotor patterns.

  19. Determining the prevalence of patterns of pregnancy-induced pelvic girdle pain and low back pain in urban and rural populations: A cross-sectional study

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    Arati Mahishale

    2016-01-01

    Full Text Available Background: Biomechanical changes during pregnancy impose postural deviations, leading to various musculoskeletal pain syndromes. Commonly noted pain syndromes are the pelvic girdle pain (PGP and low back pain (LBP, which were experienced by pregnant women globally. There is a prevalence of pregnancy-related PGP (PPGP and pregnancy-related LBP (PLBP in Western population. Data of the same in Indian pregnant population lack evidence. Objective: To find the rates of incidence and prevalence of different patterns of PPGP and PLBP in the urban and rural pregnant women. Materials and Methods: A total of 580 pregnant women were screened for inclusion criteria. Confirmation of diagnosis of PGP and LBP was done for 457 subjects using Modified Oswestry Disability Index (MODI questionnaire and the pelvic girdle questionnaire (PGQ. Once diagnosed, all participants were subjected to nine clinical tests to differentiate the site of pain and to classify them accordingly into three different groups, namely group A (LBP, group B [posterior pelvic pain (PPP], and group C [anterior pelvic pain (APP]. Results: The point prevalence of pain in group A (LBP was 31%, in group B (PPP was 65%, and in group C (APP was 15%. The prevalence of PGP and LBP was 75% in the urban pregnant population and 25% in the rural pregnant population. Conclusion: The prevalence rate of PPP (65% is higher than that of LBP (31% and APP (15%. Also PPP is reported to be highest in primiparous with gestational age of 38 weeks. The urban population showed 75% and rural population showed 25% of PGP and LBP.

  20. The pelvic fin and girdle of Panderichthys and the origin of tetrapod locomotion.

    Science.gov (United States)

    Boisvert, Catherine A

    2005-12-22

    One of the most marked transformations in the vertebrate transition to land was that of fins to limbs. This transformation involved not only the generation of morphological novelties (digits, sacrum) but also a shift in locomotory dominance from the pectoral to the pelvic appendage. Despite its importance, the transformation from pelvic fin to hindlimb is the least studied and least well-documented part of this transformation, which is bracketed by the osteolepiform Eusthenopteron and the early tetrapods Ichthyostega and Acanthostega, but is not directly illuminated by any intermediate form. Panderichthys is the closest tetrapod relative currently represented by complete fossils, but its pelvic fin skeleton has not been described. Here, I present the only known articulated pelvic fin endoskeleton and associated partial pelvis of Panderichthys. The pelvic girdle is even less tetrapod-like than that of the osteolepiform Eusthenopteron, but the pelvic fin endoskeleton shares derived characteristics with basal tetrapods despite being more primitive than the pectoral fin of Panderichthys. The evolution of tetrapod locomotion appears to have passed through a stage of body-flexion propulsion, in which the pelvic fins played a relatively minor anchoring part, before the emergence of hindlimb-powered propulsion in the interval between Panderichthys and Acanthostega.

  1. Internal hemipelvectomy with intraoperative and external beam radiotherapy in the limb-sparing treatment of a pelvic girdle chondrosarcoma

    NARCIS (Netherlands)

    Hoekstra, HJ; Szabo, BG

    The case of a patient with an extensive pelvic girdle chondrosarcoma treated with internal hemipelvectomy and intraoperative radiotherapy, followed by adjuvant high-dose external beam radiotherapy, with a successful attempt in achieving long-term local tumor control and limb-sparing treatment is

  2. Variation in the pelvic and pectoral girdles of Australian Oligo–Miocene mekosuchine crocodiles with implications for locomotion and habitus

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    Michael D. Stein

    2017-06-01

    Full Text Available Australian Oligo–Miocene mekosuchines (Crocodylia; Crocodyloidea display wide diversity in cranial shape and inferred hunting strategies. Terrestrial habitus has been inferred for these distinctive predators. A direct morphological signal for locomotion can be expected in the postcrania, particularly the pelvic and pectoral girdles. Here we describe fossil materials of the girdles, which chart their morphological variation in the subfamily from Eocene through to Middle Miocene. Over this period, both girdles undergo significant morphological changes. Notably, an enclosed, ventrally orientated acetabulum in the ilium is developed in one lineage. This recapitulates the erect parasagittal configuration of the pelvic limb seen in many Mesozoic crocodylomorph lineages, suggesting consistent use of erect high-walking in these mekosuchines. Other pelves from the same Oligo–Miocene deposits display morphology closer to modern crocodilians, suggesting a partitioning of locomotory strategy among sympatric mekosuchines. Plesiomorphic and derived pelvic girdles are distinguishable by parsimony analysis, and the earliest examples of the mekosuchine pelvis more closely resemble gavialids and alligatorids while latter forms converge on crown group crocodylids in the morphology of the iliac crest. This suggests that a revaluation of the base relationship of Mekosuchinae within Eusuchia is necessary.

  3. Asymmetries of the shoulder and pelvic girdles in girls with scoliosis and scoliotic posture

    Directory of Open Access Journals (Sweden)

    Jacek Wilczyński

    2013-08-01

    Full Text Available Aim of the research: To evaluate the asymmetries of the shoulder and pelvic girdles in girls aged 7–18 with scoliosis and scoliotic posture. Material and methods: The children were enrolled at the Międzyszkolny Ośrodek Gimnastyki Korekcyjnej i Kompensacyjnej (Interschool Corrective and Compensatory Gymnastics Centre in Starachowice. The research was carried out in June 2011. 3D digital photogrammetry using the moiré effect was adopted in the research. Depending on the conformity of the variables’ distributions with the normal distribution, and the values of skewness and kurtosis, parametric or non-parametric tests were adopted. The variables were verified in terms of normal distribution with the Shapiro-Wilk test. A screening analysis of the parameters of physiological curvatures of the spine in age groups was also carried out. The relation between the frequency and type of disorders in the frontal plane and age was determined using the χ 2 test. Value of p ≤ 0.05 was assumed as the level of significance. Results: Based on the size of the angle of the curvature of the spine the following were singled out scoliotic posture (1–9° and idiopathic scoliosis (≥ 10°. There were 21 (75% children with the scoliotic posture and 7 (25% with idiopathic scoliosis. The frequency and type of disorders in the frontal plane does not depend on the age of the examined. Asymmetry of the shoulders and shoulder blades was found in all of the examined. The left shoulder along with the left shoulder blade were raised more often. The right side of the pelvis was lowered in most of the examined. Posterior rotation of the left hip bone occurred more often. Conclusions: The values of WBM, WBK and WBC asymmetry coefficients confirm the asymmetry of the shoulder and hip girdles. Analysis of variance did not show any significant relations of asymmetry of the shoulder and hip girdles and the age of the examined.

  4. Relevance of discrete traits in forensic anthropology: From the first cervical vertebra to the pelvic girdle.

    Science.gov (United States)

    Verna, Emeline; Piercecchi-Marti, Marie-Dominique; Chaumoitre, Kathia; Adalian, Pascal

    2015-08-01

    In forensic anthropology, identification begins by determining the sex, age, ancestry and stature of the individuals. Asymptomatic variations present on the skeleton, known as discrete traits, can be useful to identify individuals, or at least contribute to complete their biological profile. We decided to focus our work on the upper part of the skeleton, from the first vertebra to the pelvic girdle, and we chose to present 8 discrete traits (spina bifida occulta, butterfly vertebra, supraclavicular nerve foramen, coracoclavicular joint, os acromiale, suprascapular foramen, manubrium foramen and pubic spine), because they show a frequency lower than 10%. We examined 502 anonymous CT scans from polytraumatized individuals, aged 15 to 65 years, in order to detect the selected discrete traits. Age and sex were known for each subject. Thin sections in the axial, coronal and sagittal planes and 3D volume rendering images were created and examined for the visualization of the selected discrete traits. Supraclavicular foramina were found only in males and only on the left clavicle. Coracoclavicular joints were observed only in males. The majority of individuals with a suprascapular foramen were older than 50 years of age. Pubic spines were observed mostly in females. Other traits did not present significant association with sex, age and laterality. No association between traits was highlighted. Better knowledge of human skeletal variations will help anthropologists come closer to a positive identification, especially if these variations are rare, therefore making them more discriminant. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  5. Gorham-Stout syndrome of the pelvic girdle treated by radiation therapy. A case report

    International Nuclear Information System (INIS)

    Heyd, Reinhard; Tselis, Nikolaos; Zamboglou, Nikolaos; Rabeneck, Daniela; Universitaetsklinikum Frankfurt, Frankfurt am Main; Doernenburg, Oliver

    2011-01-01

    The Gorham-Stout syndrome (GSS) is a rare, benign idiopathic and progressive disorder causing massive osteolysis due to a vascular hyperproliferation replacing the bony structure. Clinical experience concerning the efficacy of radiation therapy (RT) is limited to about 50 of an overall 200 cases reported worldwide. Case Report: A 24-year-old bedridden woman had histologically proven GSS with destruction of the anterior pelvic girdle and received RT for a total dose of 45.0 Gy applied in 5 weekly fractions of 1.8 Gy. In addition, the patient received intravenously 4 mg zoledronic acid once a month. One year after the combined treatment, complete pain relief occurred, and the patient was able to walk without the use of appliances. Imaging studies revealed no progression of the osteolysis but only minimal signs of remineralization. Conclusion: Combined treatment with RT and bisphosphonate administration can prevent the progression of osteolysis in GSS. Total doses of 40-45 Gy are recommended. (orig.)

  6. Gorham-Stout syndrome of the pelvic girdle treated by radiation therapy. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Heyd, Reinhard; Tselis, Nikolaos; Zamboglou, Nikolaos [Klinikum Offenbach, Offenbach am Main (Germany). Strahlenklinik; Rabeneck, Daniela [Klinikum Offenbach, Offenbach am Main (Germany). Strahlenklinik; Universitaetsklinikum Frankfurt, Frankfurt am Main (Germany). Klinik fuer Strahlentherapie und Onkologie; Doernenburg, Oliver [Klinikum Offenbach, Offenbach am Main (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie

    2011-02-15

    The Gorham-Stout syndrome (GSS) is a rare, benign idiopathic and progressive disorder causing massive osteolysis due to a vascular hyperproliferation replacing the bony structure. Clinical experience concerning the efficacy of radiation therapy (RT) is limited to about 50 of an overall 200 cases reported worldwide. Case Report: A 24-year-old bedridden woman had histologically proven GSS with destruction of the anterior pelvic girdle and received RT for a total dose of 45.0 Gy applied in 5 weekly fractions of 1.8 Gy. In addition, the patient received intravenously 4 mg zoledronic acid once a month. One year after the combined treatment, complete pain relief occurred, and the patient was able to walk without the use of appliances. Imaging studies revealed no progression of the osteolysis but only minimal signs of remineralization. Conclusion: Combined treatment with RT and bisphosphonate administration can prevent the progression of osteolysis in GSS. Total doses of 40-45 Gy are recommended. (orig.)

  7. The health-seeking behaviours of first-time mothers with persistent pelvic girdle pain after childbirth in Ireland: A descriptive qualitative study.

    Science.gov (United States)

    Wuytack, Francesca; Curtis, Elizabeth; Begley, Cecily

    2015-11-01

    to explore the health-seeking behaviours of primiparous women with pelvic girdle pain persisting for more than three months post partum. a descriptive qualitative design involving face-to-face semi-structured interviews following institutional ethical approval. Transcripts were analysed using thematic analysis. an urban hospital in Ireland. a purposive sample of 23 consenting first-time mothers with pelvic girdle pain persisting for at least three months post partum. 'they didn't ask, I didn't tell' was a key theme, which included emerging categories of a perceived lack of follow-up post partum, and feeling ignored by healthcare professionals. The theme 'Seeking advice and support' describes women's role of talking to others, and triggers and barriers to getting help. 'Coping strategies' was the third theme emerging from the interviews, whereby participants described different strategies they used to deal with their symptoms, although many expressed uncertainty about what to do or who to see. our findings show the importance of appropriate information and follow-up care for women with pelvic girdle pain and highlight barriers they encounter in seeking help. They also question the duration of postnatal care as participants felt that postnatal care was stopped too early. The findings may assist maternity care providers in addressing mothers' expectations and needs related to persistent pelvic girdle pain. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. The association between pelvic girdle pain and sick leave during pregnancy; a retrospective study of a Norwegian population.

    Science.gov (United States)

    Malmqvist, Stefan; Kjaermann, Inger; Andersen, Knut; Økland, Inger; Larsen, Jan Petter; Brønnick, Kolbjørn

    2015-10-05

    The incidence of pelvic girdle pain (PGP) in pregnancy is wide ranged depending on definition, the utilised diagnostic means, and the design of the studies. PGP during pregnancy has negative effects on activities of daily living and causes long sick leave, which makes it a major public health issue. Our objectives were to explore the frequency of sick leave in pregnancy due to PGP, assess the relationship between different types of pain-related activities of daily living, examine physical workload, type of work in relation to sick leave, and to explore factors that make women less likely to take sick leave for PGP. All women giving birth at the maternity ward of Stavanger University Hospital, Norway, were asked to participate and complete a questionnaire on demographic features, PGP, pain-related activities of daily living, sick leave in general and for PGP, frequency of exercising before and during pregnancy. Drawings of pelvic girdle and low back area were used for the localization of pain. PGP intensity was then rated retrospectively on a numerical rating scale. Non-parametric tests, multinomial logistic regression and sequential linear regression analysis were used in the statistical analysis. PGP is a frequent and major cause of sick leave during pregnancy among Norwegian women, which is also reflected in activities of daily living as measured with scores on all Oswestry disability index items. In the multivariate analysis of factors related to sick leave and PGP we found that work satisfaction, problems with lifting and sleeping, and pain intensity were risk factors for sick leave. In addition, women with longer education, higher work satisfaction and fewer problems with sitting, walking and standing, were less likely to take sick leave in pregnancy, despite the same pain intensity as women being on sick leave. A coping factor in pregnant women with PGP was discovered, most likely dependant on education, associated with work situation and/or work posture

  9. Life's pregnant pause of pain: pregnant women's experiences of pelvic girdle pain related to daily life: a Swedish interview study.

    Science.gov (United States)

    Elden, Helen; Lundgren, Ingela; Robertson, Eva

    2013-03-01

    Pelvic girdle pain (PGP) is a universally disabling condition affecting three of 10 pregnant women. Qualitative studies on the subject are lacking. To describe pregnant women's experiences of PGP as related to daily life. In all, 27 women with PGP participating in a randomised controlled study were interviewed during 2010-2011. Qualitative content analysis was used. Five main categories emerged: PGP affects the ability to cope with everyday life; Coping with motherhood; Relationships between partners often reached the breaking point; Questioning one's identity as defined by profession and work, and Lessons learned from living with PGP. The categories illustrate how women's everyday lives were interrupted. Their inability to meet their own and others' expectations put a strain on their lives causing disappointment, sadness and frustration. It made them question and doubt their roles and identities as mothers, partners and professionals, and kept them from looking forward to future pregnancies, in the absence of effective treatment for PGP. Knowledge gained was that women with PGP should seek help immediately, listen to their bodies, and acknowledge their limitations. PGP severely affects pregnant women's everyday lives. There appears to be a lack of knowledge and awareness in general, as well as among caregivers and employers of PGP that needs to be highlighted and rectified. There is also a great need to learn how to support those suffering from it. Appropriate support during this important and rare phase in a woman's life is highly warranted. Copyright © 2012 Elsevier B.V. All rights reserved.

  10. The automatic pelvic floor muscle response to the active straight leg raise in cases with pelvic girdle pain and matched controls.

    Science.gov (United States)

    Stuge, Britt; Sætre, Kaja; Ingeborg Hoff, Brækken

    2013-08-01

    The active straight leg raise (ASLR) test has been proposed as a clinical test for the assessment of pelvic girdle pain (PGP). Little is known about the activation of the pelvic floor muscles (PFM) during ASLR. The main aim of this study was to examine the automatic PFM contraction during ASLR. Specific aims were to compare automatic contraction to rest and to voluntary contraction, to compare PFM contraction during ASLR with and without compression and to examine whether there were any differences in PFM contraction between women with and without clinically diagnosed PGP during ASLR. Forty-nine pairs of women participated in a cross-sectional study with individual, one-to-one matched cases and controls. PFM was assessed by reliable and valid 3D ultrasound at rest, during voluntary and automatic contraction. Test-retest data for the levator hiatus during ASLR showed good repeatability. Significantly automatic PFM contractions occurred when ASLR tests were performed. There was a strong positive correlation between voluntary and automatic PFM contractions. Manual compression reduced the automatic PFM contraction during ASLR by 62-66%. There were no significant differences between cases and controls in reduction of levator hiatus or muscle length from rest to automatic contractions during ASLR. Interestingly, a significantly smaller levator hiatus was found in women with PGP than in controls, at rest, during an automatic contraction with ASLR and during voluntary contraction. In conclusion, a significant automatic PFM contraction occurred during ASLR, both in cases and in controls. Women with PGP had a significantly smaller levator hiatus than controls. Copyright © 2012 Elsevier Ltd. All rights reserved.

  11. Exercise level before pregnancy and engaging in high-impact sports reduce the risk of pelvic girdle pain: a population-based cohort study of 39 184 women.

    Science.gov (United States)

    Owe, Katrine Mari; Bjelland, Elisabeth K; Stuge, Britt; Orsini, Nicola; Eberhard-Gran, Malin; Vangen, Siri

    2016-07-01

    To examine whether an association exists between exercise levels pre-pregnancy and pelvic girdle pain in pregnancy. Pelvic girdle pain in pregnancy has been associated with physical inactivity, a risk factor for adverse pregnancy outcomes. We used data from a population-based cohort study including 39 184 nulliparous women with a singleton pregnancy enrolled in the Norwegian Mother and Child Cohort study. Pre-pregnancy exercise frequency and types were assessed by questionnaire in pregnancy week 17. Pelvic girdle pain, defined as combined pain in the anterior pelvis and in the posterior pelvis bilaterally, was self-reported in pregnancy week 30. Multivariable Poisson regression estimated risks of pelvic girdle pain associated with pre-pregnancy exercise. We examined a dose-response association of prepregnancy exercise frequency using restricted cubic splines. A test for non-linearity was also conducted. Final models were adjusted for pre-pregnancy BMI, age, education, history of low back pain and history of depression. 4069 women (10.4%) reported pelvic girdle pain in pregnancy and the prevalence among women who were non-exercisers prepregnancy was 12.5%. There was a non-linear association for pre-pregnancy exercise and risk of pelvic girdle pain (test for non-linearity, p=0.003). Compared to non-exercisers, women exercising 3-5 times weekly pre-pregnancy had a 14% lower risk of developing pelvic girdle pain in pregnancy (aRR 0.86, 95% CI 0.77 to 0.96). Taking part in high-impact exercises such as running, jogging, orienteering, ballgames, netball games and high-impact aerobics were associated with less risk of pelvic girdle pain. Women who exercise regularly and engage in high-impact exercises before the first pregnancy may have a reduced risk of pelvic girdle pain in pregnancy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  12. CT scan-guided percutaneous osteosynthesis of a complex, multifocal fracture of the pelvic girdle in a 14-year-old adolescent

    International Nuclear Information System (INIS)

    Gagne, Pierre-Thomas; Bertrand, Anne-Sophie; Caudal, Amandine; El Hayek, Tony; Amoretti, Nicolas

    2014-01-01

    We report on a 14-year-old girl with minimally displaced pelvic girdle and acetabular roof fracture following motor vehicle trauma, treated percutaneously under CT and C-arm fluoroscopic guidance by an interventional radiologist. After informed consent from the patient's parents, under surgical aseptic conditions and under general anesthesia, three screws were positioned adequately under dual guidance by a radiologist and without immediate or long-term complication. The patient was mobilized 48 h after the procedure and resumed normal activities after 1 month. Even though the technique has been described before on adults, to our knowledge this is the first time it has been described on a pediatric patient. (orig.)

  13. Radiosteriometric analysis of movement in the sacroiliac joint during a single-leg stance in patients with long-lasting pelvic girdle pain.

    Science.gov (United States)

    Kibsgård, Thomas J; Røise, Olav; Sturesson, Bengt; Röhrl, Stephan M; Stuge, Britt

    2014-04-01

    Chamberlain's projections (anterior-posterior X-ray of the pubic symphysis) have been used to diagnose sacroiliac joint mobility during the single-leg stance test. This study examined the movement in the sacroiliac joint during the single-leg stance test with precise radiostereometric analysis. Under general anesthesia, tantalum markers were inserted into the dorsal sacrum and the ilium of 11 patients with long-lasting and severe pelvic girdle pain. After two to three weeks, a radiostereometric analysis was conducted while the subjects performed a single-leg stance. Small movements were detected in the sacroiliac joint during the single-leg stance. In both the standing- and hanging-leg sacroiliac join, a total of 0.5 degree rotation was observed; however, no translations were detected. There were no differences in total movement between the standing- and hanging-leg sacroiliac joint. The movement in the sacroiliac joint during the single-leg stance is small and almost undetectable by the precise radiostereometric analysis. A complex movement pattern was seen during the test, with a combination of movements in the two joints. The interpretation of the results of this study is that, the Chamberlain examination likely is inadequate in the examination of sacroiliac joint movement in patients with pelvic girdle pain. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. CT scan-guided percutaneous osteosynthesis of a complex, multifocal fracture of the pelvic girdle in a 14-year-old adolescent

    Energy Technology Data Exchange (ETDEWEB)

    Gagne, Pierre-Thomas; Bertrand, Anne-Sophie; Caudal, Amandine; El Hayek, Tony; Amoretti, Nicolas [Centre Hospitalier Universitaire de Nice, Nice (France)

    2014-08-15

    We report on a 14-year-old girl with minimally displaced pelvic girdle and acetabular roof fracture following motor vehicle trauma, treated percutaneously under CT and C-arm fluoroscopic guidance by an interventional radiologist. After informed consent from the patient's parents, under surgical aseptic conditions and under general anesthesia, three screws were positioned adequately under dual guidance by a radiologist and without immediate or long-term complication. The patient was mobilized 48 h after the procedure and resumed normal activities after 1 month. Even though the technique has been described before on adults, to our knowledge this is the first time it has been described on a pediatric patient. (orig.)

  15. Differential muscular myosin heavy chain expression of the pectoral and pelvic girdles during early growth in the king penguin (Aptenodytes patagonicus) chick.

    Science.gov (United States)

    Erbrech, Aude; Robin, Jean-Patrice; Guérin, Nathalie; Groscolas, René; Gilbert, Caroline; Martrette, Jean-Marc

    2011-06-01

    Continuous growth, associated with a steady parental food supply, is a general pattern in offspring development. So that young chicks can acquire their locomotor independence, this period is usually marked by a fast maturation of muscles, during which different myosin heavy chain (MyHC) isoforms are expressed. However, parental food provisioning may fluctuate seasonally, and offspring therefore face a challenge to ensure the necessary maturation of their tissues when energy is limited. To address this trade-off we investigated muscle maturation in both the pectoral and pelvic girdles of king penguin chicks. This species has an exceptionally long rearing period (1 year), which is prolonged when parental food provisioning is drastically reduced during the sub-Antarctic winter. Approximately 1 month post hatching, chicks acquire a functional pedestrian locomotion, which uses pelvic muscles, whereas swimming, which uses the pectoral muscles, only occurs 1 year later. We therefore tested the hypothesis that the MyHC content of the leg muscles reaches a mature state before those of the pectoral muscles. We found that leg muscle MyHC composition changed with the progressive acquisition of pedestrian locomotion, whereas pectoral muscle fibres reached their mature MyHC profile as early as hatching. Contrary to our predictions, the acquisition of the adult profile in pectoral muscles could be related to an early maturation of the contractile muscular proteins, presumably associated with early thermoregulatory capacities of chicks, necessary for survival in their cold environment. This differential maturation appears to reconcile both the locomotor and environmental constraints of king penguin chicks during growth.

  16. Chronic sacroiliac joint and pelvic girdle dysfunction in a 35-year-old nulliparous woman successfully managed with multimodal and multidisciplinary approach.

    Science.gov (United States)

    Jonely, Holly; Brismée, Jean-Michel; Desai, Mehul J; Reoli, Rachel

    2015-02-01

    Sacroiliac joint pain and dysfunction affect 15-25% of patients reporting low back pain, including reports of spontaneous, idiopathic, traumatic, and non-traumatic onsets. The poor reliability and validity associated with diagnostic clinical and imaging techniques leads to challenges in diagnosing and managing sacroiliac joint dysfunction. A 35-year-old nulliparous female with a 14-year history of right sacroiliac joint dysfunction was managed using a multimodal and multidisciplinary approach when symptoms failed to resolve after 2 months of physical therapy. The plan of care included four prolotherapy injections, sacroiliac joint manipulation into nutation, pelvic girdle belting, and specific stabilization exercises. The patient completed 20 physical therapy sessions over a 12-month period. At 6 months, the patient's Oswestry Disability Questionnaire score was reduced from 34% to 14%. At 1-year follow-up, her score was 0%. The patient's rating of pain on a numeric rating scale decreased to an average of 4/10 at 6 months and 0/10 at 1-year follow-up. A multidisciplinary and multimodal approach for the management of chronic sacroiliac joint dysfunction appeared successful in a single-case design at 1-year follow-up.

  17. Reliability of the Timed Up and Go test and Ten-Metre Timed Walk Test in Pregnant Women with Pelvic Girdle Pain.

    Science.gov (United States)

    Evensen, Natalie M; Kvåle, Alice; Braekken, Ingeborg H

    2015-09-01

    There is a lack of functional objective tests available to measure functional status in women with pelvic girdle pain (PGP). The purpose of this study was to establish test-retest and intertester reliability of the Timed Up and Go (TUG) test and Ten-metre Timed Walk Test (10mTWT) in pregnant women with PGP. A convenience sample of women was recruited over a 4-month period and tested on two occasions, 1 week apart to determine test-retest reliability. Intertester reliability was established between two assessors at the first testing session. Subjects were instructed to undertake the TUG and 10mTWT at maximum speed. One practise trial and two timed trials for each walking test was undertaken on Day 1 and one practise trial and one timed trial on Day 2. Seventeen women with PGP aged 31.1 years (SD [standard deviation] = 2.3) and 28.7 weeks pregnant (SD = 7.4) completed gait testing. Test-retest reliability using the intraclass correlation coefficient (ICC) was excellent for the TUG (0.88) and good for the 10mTWT (0.74). Intertester reliability was determined in the first 13 participants with excellent ICC values being found for both walking tests (TUG: 0.95; 10mTWT: 0.94). This study demonstrated that the TUG and 10mTWT undertaken at fast pace are reliable, objective functional tests in pregnant women with PGP. While both tests are suitable for use in the clinical and research settings, we would recommend the TUG given the findings of higher test-retest reliability and as this test requires less space and time to set up and score. Future studies in a larger sample size are warranted to confirm the results of this study. Copyright © 2015 John Wiley & Sons, Ltd.

  18. Safety and effectiveness of minimally invasive sacroiliac joint fusion in women with persistent post-partum posterior pelvic girdle pain: 12-month outcomes from a prospective, multi-center trial.

    Science.gov (United States)

    Capobianco, Robyn; Cher, Daniel

    2015-01-01

    Postpartum posterior pelvic girdle pain (PPGP) affects nearly 20 % of women who experience back pain in the peripartum period. The sacroiliac joint is a source of this pain in 75 % of women with persistent PPGP. A subset of women will fail to obtain acceptable pain relief from the current array of non-surgical treatment options. The purpose of this study is to assess the safety and effectiveness of minimally invasive sacroiliac (SI) joint fusion in women with chronic SI joint dysfunction whose pain began in the peri-partum period whose symptoms were recalcitrant to non-surgical management. A sub-group analysis of subjects with sacroiliac joint disruption and/or degenerative sacroiliitis enrolled in a prospective, multi-center trial of SI joint fusion was performed. Subjects with PPGP were identified and compared with women without PPGP and with men. Of 172 enrolled subjects, 52 were male, 100 were females without PPGP and 20 females had PPGP. PPGP subjects were significantly younger (43.3 years, vs. 52.8 for females without PPGP and 50.5 for men, p = 0.002). There were no differences in any other demographic or baseline clinical measure. Women with PPGP experienced a significant improvement in pain (-51 mm on VAS), function (-20.6 pts on ODI) and quality of life (SF-36 PCS +10.4, MCS +7.2, EQ-5D +0.31) at 12 months after surgery. These improvements were characteristic of the overall study results; no difference was detected between sub-groups. The sacroiliac joint can be a source of pain in women with persistent PPGP and should be investigated as a pain generator. In this study, women with carefully diagnosed chronic SI joint pain from PPGP recalcitrant to conservative therapies experienced clinically beneficially improvements in pain, disability and quality of life after minimally invasive SI joint fusion using a series of triangular porous plasma spray coated implants.

  19. Unusual Bones Articulating With the Pelvic Girdle

    African Journals Online (AJOL)

    of the coracoid process. Skeletal radiology 2003 32.661-. 664. 4. Joshy S., Iossifidis A. and Ebrahim S. Post-traumatic du- plication of the clavicle. Injury, 2005; 2.: 20. 5. Moore, Keith L. and Arthur F. Dalley. Clinically Oriented. Anatomy, 4th edition.Lippincott Wilkins, 1999, 4th Ed. 6. Stedman's Medical Dictionary, 27th edition.

  20. Evaluation of Limb-Girdle Muscular Dystrophy

    Science.gov (United States)

    2014-03-06

    Becker Muscular Dystrophy; Limb-Girdle Muscular Dystrophy, Type 2A (Calpain-3 Deficiency); Limb-Girdle Muscular Dystrophy, Type 2B (Miyoshi Myopathy, Dysferlin Deficiency); Limb-Girdle Muscular Dystrophy, Type 2I (FKRP-deficiency)

  1. The active straight leg raising test and mobility of the pelvic joints

    OpenAIRE

    Mens, J. M. A.; Vleeming, Andry; Snijders, Chris J.; Stam, Henk J.; Ginai, Abida Z.

    1999-01-01

    Objective signs to assess impairment in patients who are disabled by peripartum pelvic girdle pain hardly exist. The purpose of this study was to develop a clinical test to quantify and qualify disability in these patients. The study examined the relationship between impaired active straight leg raising (ASLR) and mobility of pelvic joints in patients with peripartum pelvic girdle pain, focusing on (1) the reduction of impairment of ASLR when the patient was wearing a pelvic belt, and (2) mot...

  2. Chronic female pelvic pain

    Directory of Open Access Journals (Sweden)

    Gaurab Maitra

    2013-01-01

    Full Text Available Chronic pelvic pain (CPP is defined as nonmalignant pain perceived in the structures related to the pelvis that has been present for more than 6 months or a non acute pain mechanism of shorter duration. Pain in the pelvic region can arise from musculoskeletal, gynaecological, urologic, gastrointestinal and or neurologic conditions. Key gynaecological conditions that contribute to CPP include pelvic inflammatory disease (PID, endometriosis, adnexa pathologies (ovarian cysts, ovarian remnant syndrome, uterine pathologies (leiomyoma, adenomyosis and pelvic girdle pain associated with pregnancy. Several major and minor sexually transmitted diseases (STD can cause pelvic and vulvar pain. A common painful condition of the urinary system is Interstitial cystitis(IC. A second urologic condition that can lead to development of CPP is urethral syndrome. Irritable bowel syndrome (IBS is associated with dysmenorrhoea in 60% of cases. Other bowel conditions contributing to pelvic pain include diverticular disease,Crohn′s disease ulcerative colitis and chronic appendicitis. Musculoskeletal pathologies that can cause pelvic pain include sacroiliac joint (SIJ dysfunction, symphysis pubis and sacro-coccygeal joint dysfunction, coccyx injury or malposition and neuropathic structures in the lower thoracic, lumbar and sacral plexus. Prolonged pelvic girdle pain, lasting more than 6 months postpartum is estimated in 3% to 30% of women. Nerve irritation or entrapment as a cause of pelvic pain can be related to injury of the upper lumbar segments giving rise to irritation of the sensory nerves to the ventral trunk or from direct trauma from abdominal incisions or retractors used during abdominal surgical procedures. Afflictions of the iliohypogastric, ilioinguinal, genitofemoral, pudendal and obturator nerves are of greatest concern in patients with pelvic pain. Patient education about the disease and treatment involved is paramount. A knowledge of the differential

  3. The influence of psychosocial factors on pregnancy related pelvic symptoms

    NARCIS (Netherlands)

    Pol, G. van de

    2006-01-01

    This thesis encloses studies which are separate analyses of the PRIMIS Study. In the PRIMIS Study a cohort of healthy women who expected their first child was followed up from early pregnancy to one year after delivery. Self-report questionnaires regarding psychosocial factors, urogenital symptoms

  4. Limb girdle muscular dystrophies

    DEFF Research Database (Denmark)

    Vissing, John

    2016-01-01

    PURPOSE OF REVIEW: The aim of the study was to describe the clinical spectrum of limb girdle muscular dystrophies (LGMDs), the pitfalls of the current classification system for LGMDs, and emerging therapies for these conditions. RECENT FINDINGS: Close to half of all LGMD subtypes have been...... or are registered in other classification systems for muscle disease. On the contrary, diseases that fulfill classical criteria for LGMD have found no place in the LGMD classification system. These shortcomings call for revision/creation of a new classification system for LGMD. The rapidly expanding gene sequencing...... capabilities have helped to speed up new LGMD discoveries, and unveiled pheno-/genotype relations. Parallel to this progress in identifying new LGMD subtypes, emerging therapies for LGMDs are under way, but no disease-specific treatment is yet available for nonexperimental use. SUMMARY: The field of LGMD...

  5. Pregnancy-related anxiety: A concept analysis.

    Science.gov (United States)

    Bayrampour, Hamideh; Ali, Elena; McNeil, Deborah A; Benzies, Karen; MacQueen, Glenda; Tough, Suzanne

    2016-03-01

    Evidence suggests that pregnancy-related anxiety is more strongly associated with maternal and child outcomes than general anxiety and depression are and that pregnancy-related anxiety may constitute a distinct concept. However, because of its poor conceptualization, the measurement and assessment of pregnancy-related anxiety have been limited. Efforts to analyze this concept can significantly contribute to its theoretical development. The first objective of this paper was to clarify the concept of pregnancy-related anxiety and identify its characteristics and dimensions. The second aim was to examine the items of current pregnancy-related anxiety measures to determine the dimensions and attributes that each scale addresses, noting any gaps between the current assessment and the construct of the concept. A concept analysis was conducted to examine the concept of pregnancy-related anxiety. To obtain the relevant evidence, several databases were searched including MEDLINE, PsycINFO, EBSCO's SocINDEX, Psychological and Behavioral Sciences Collection, CINAHL, SCOPUS, and EMBASE. A modified approach based on Walker and Avant (Strategies for theory construction in nursing. 5th ed; 2011) was used. Qualitative or quantitative studies published in English that explored or examined anxiety during pregnancy or its dimensions prospectively or retrospectively were included. Thirty eight studies provided data for the concept analysis. Three critical attributes (i.e., affective responses, cognitions, and somatic symptoms), three antecedents (i.e., a real or anticipated threat to pregnancy or its outcomes, low perceived control, and excessive cognitive activity, and four consequences (i.e., negative attitudes, difficulty concentrating, excessive reassurance-seeking behavior, and avoidance behaviors) were identified. Nine dimensions for pregnancy-related anxiety were determined, and a definition of the concept was proposed. The most frequently reported dimensions included anxiety

  6. Morphological variation in the girdled

    African Journals Online (AJOL)

    1990-10-18

    Oct 18, 1990 ... A.g.v. corvleueling in hierdie eien- skappe word aparte taksonomiese status vir eksemplare buite die tipelokaliteit nie oorweag nie. Die stel diagnostiese eienskappe vir die spesie word op datum gebring en aanvul- lende ekologiese inligting word verskaf. Mouton (1986) described a new girdled lizard, ...

  7. Reconstrução após ressecção extensa de tumor das cinturas pélvica e escapular: relato de dois casos Reconstruction following extensive tumor resection of the pelvic and scapular girdle: a report of two cases

    Directory of Open Access Journals (Sweden)

    Juliana Corrêa Dallagnol

    2012-02-01

    Full Text Available As cirurgias radicais para tratamento dos tumores da cintura pélvica e escapular (hemipelvectomias e desarticulações interescapulotorácicas constituem-se, em geral, em procedimentos extensos com grandes áreas de perda de substância local após ressecção do tumor. A utilização do retalho que inclui toda a musculatura anterior e posterior da coxa após dissecção do fêmur, pediculado pelos vasos femorais superficiais, foi descrita apenas uma vez na literatura. O retalho similar utilizando toda a musculatura anterior e posterior do braço após dissecção do úmero, pediculado pelos vasos subclávios para reconstrução após desarticulação interescapulotorácica, não apresenta relatos. Descrevemos dois casos - um de hemipelvectomia e outro de desarticulação interescapulotorácica - utilizando estes dois retalhos para fechamento do defeito.Radical surgeries for treatment of scapular and pelvic girdle tumors (hemipelvectomy and interscapulothoracic amputation are generally extended procedures, with large areas of local tissue loss after tumor resection. The use of a flap that includes all the anterior and posterior thigh musculature after femur dissection, pedicled in the superficial femoral vessels, has been described was only once in the medical literature, and there have been no reports on a similar flap using the whole anterior and posterior musculature of the arm after humerus dissection, pedicled in the subclavian vessels, for reconstruction after interscapulothoracic amputation. Here, we describe two cases - one hemipelvectomy and one interscapulothoracicl amputation - using these two the flaps to close the defect.

  8. Treatments for pregnancy-related lumbopelvic pain: a systematic review of physiotherapy modalities.

    Science.gov (United States)

    Gutke, Annelie; Betten, Carola; Degerskär, Kristina; Pousette, Sara; Olsén, Monika Fagevik

    2015-11-01

    To explore the effect of physiotherapeutic interventions on pregnancy-related lumbopelvic pain. Data sources: MEDLINE, Cochrane Central Register of Controlled Trials, PEDro, CINAHL, AMED, and SCOPUS databases were searched up to December 2014 for studies written in English, French, German or Scandinavian languages that evaluated physiotherapeutic modalities for preventing and treating pregnancy-related lumbopelvic pain. For lumbopelvic pain during pregnancy, the evidence was strong for positive effects of acupuncture and pelvic belts. The evidence was low for exercise in general and for specific stabilizing exercises. The evidence was very limited for efficacy of water gymnastics, progressive muscle relaxation, a specific pelvic tilt exercise, osteopathic manual therapy, craniosacral therapy, electrotherapy and yoga. For postpartum lumbopelvic pain, the evidence was very limited for clinic-based treatment concepts, including specific stabilizing exercises, and for self-management interventions for women with severe disabilities. No specific adverse events were reported for any intervention. No meta-analysis could be performed because of study heterogeneity. The levels of evidence were strong for a positive effect of acupuncture and pelvic belts, but weak for an effect of specific exercises. Caution should prevail in choosing other interventions for pregnancy-related lumbopelvic pain. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  9. Radiodiagnosis of pelvic birth injuries and their consequences

    Energy Technology Data Exchange (ETDEWEB)

    Konycheva, E.A.; Loskutova, L.A. (Bashkirskij Meditsinskij Inst. (USSR))

    A study was made of the changes in the pelvic articulations in women with birth injuries 2-5 years following birth on the basis of the clinicoroentgenological findings. Pathological adhesion of birth injuries of the pelvic bones, that manifested itself in the formation of callus and arthrosis of the public and sacroiliac articulations, was noted. The study confirmed incomplete rehabilitation in this group of women. For prognosis of subsequent parturition roentgenopelvimetry is recommended for women with birth injuries of the pelvic girdle.

  10. Pregnancy-related venous thromboembolism and risk of occult cancer

    DEFF Research Database (Denmark)

    Hansen, Anette Tarp; Veres, Katalin; Horváth-Puhó, Erzsébet

    2017-01-01

    The cancer risk during the first year after a pregnancy-related venous thromboembolism episode is higher than expected. An aggressive search for cancer in women with pregnancy-related venous thromboembolism is probably not warranted, due to low absolute risk.......The cancer risk during the first year after a pregnancy-related venous thromboembolism episode is higher than expected. An aggressive search for cancer in women with pregnancy-related venous thromboembolism is probably not warranted, due to low absolute risk....

  11. CT findings of muscular dystrophy; Limb girdle type (LG), myotonic type (MYD) and Duchenne type (DMD)

    Energy Technology Data Exchange (ETDEWEB)

    Saitoh, Hiroshi (Tokushima Univ. (Japan). School of Medicine)

    1991-07-01

    CT scans of muscles in patients with limb girdle type (LG), myotonic type (MYD) and Duchenne type (DMD) dystrophies were obtained at five different body levels: the neck, L3 vertebral body, pelvic girdle, thigh and lower leg. CT numbers, cross sectional areas (CSA) and %CSA of muscle or fat were evaluated in each muscle. The characteristic CT patterns for each type of muscular dystrophy were obtained. Compared with DMD, the gracilis and soleus were more severely damaged in LG and the biceps femoris remained relatively preserved among the hamstrings. In addition, the multifidus of the neck and sternocleidomastoid also were more severely damaged in MYD. This study suggests that CT scan will be useful in the differential diagnosis of these types of muscular dystrophy as well as in planning appropriate rehabilitation and detecting damaged muscles. (author).

  12. Pregnancy-related venous thromboembolism and risk of occult cancer

    DEFF Research Database (Denmark)

    Tarp Hansen, Anette; Veres, Katalin; Horváth-Puhó, Erzsébet

    2017-01-01

    The cancer risk during the first year after a pregnancy-related venous thromboembolism episode is higher than expected.An aggressive search for cancer in women with pregnancy-related venous thromboembolism is probably not warranted, due to low absolute risk.......The cancer risk during the first year after a pregnancy-related venous thromboembolism episode is higher than expected.An aggressive search for cancer in women with pregnancy-related venous thromboembolism is probably not warranted, due to low absolute risk....

  13. Radiodiagnosis of pelvic birth injuries and their consequences

    International Nuclear Information System (INIS)

    Konycheva, E.A.; Loskutova, L.A.

    1984-01-01

    A study was made of the changes in the pelvic articulations in women with birth injuries 2-5 years following birth on the basis of the clinicoroentgenological findings. Pathological adhesion of birth injuries of the pelvic bones, that manifested itself in the formation of callus and arthrosis of the public and sacroiliac articulations, was noted. The study confirmed incomplete rehabilitation in this group of women. For prognosis of subsequent partirition roentgenopelvimetry is recommended for women with birth in uries of the pelvic girdle

  14. Preliminary diffusion tensor imaging studies in limb-girdle muscular dystrophies

    Science.gov (United States)

    Hidalgo-Tobon, S.; Hernandez-Salazar, G.; Vargas-Cañas, S.; Marrufo-Melendez, O.; Solis-Najera, S.; Taboada-Barajas, J.; Rodriguez, A. O.; Delgado-Hernandez, R.

    2012-10-01

    Limb-girdle muscular dystrophies (LGMD) are a group of autosomal dominantly or recessively inherited muscular dystrophies that also present with primary proximal (limb-girdle) muscle weakness. This type of dystrophy involves the shoulder and pelvic girdles, distinct phenotypic or clinical characteristics are recognized. Imaging experiments were conducted on a 1.5T GE scanner (General Electric Medical Systems. Milwaukee. USA), using a combination of two eight-channel coil array. Diffusion Tensor Imaging (DTI) data were acquired using a SE-EPI sequence, diffusion weighted gradients were applied along 30 non-collinear directions with a b-value=550 s/mm2. The connective tissue content does not appear to have a significant effect on the directionality of the diffusion, as assessed by fractional anisotropy. The fibers of the Sartorius muscle and gracilis showed decreased number of tracts, secondary to fatty infiltration and replacement of connective tissue and muscle mass loss characteristic of the underlying pathology. Our results demonstrated the utility of non-invasive MRI techniques to characterize the muscle pathology, through quantitative and qualitative methods such as the FA values and tractrography.

  15. The initial development of the Pregnancy-related Anxiety Scale.

    Science.gov (United States)

    Brunton, Robyn J; Dryer, Rachel; Saliba, Anthony; Kohlhoff, Jane

    2018-05-30

    Pregnancy-related anxiety is a distinct anxiety characterised by pregnancy-specific concerns. This anxiety is consistently associated with adverse birth outcomes, and obstetric and paediatric risk factors, associations generally not seen with other anxieties. The need exists for a psychometrically sound scale for this anxiety type. This study, therefore, reports on the initial development of the Pregnancy-related Anxiety Scale. The item pool was developed following a literature review and the formulation of a definition for pregnancy-related anxiety. An Expert Review Panel reviewed the definition, item pool and test specifications. Pregnant women were recruited online (N=671). Using a subsample (N=262, M=27.94, SD=4.99), fourteen factors were extracted using Principal Components Analysis accounting for 63.18% of the variance. Further refinement resulted in 11 distinct factors. Confirmatory Factor Analysis further tested the model with a second subsample (N=369, M=26.59, SD=4.76). After additional refinement, the resulting model was a good fit with nine factors (childbirth, appearance, attitudes towards childbirth, motherhood, acceptance, anxiety, medical, avoidance, and baby concerns). Internal consistency reliability was good with the majority of subscales exceeding α=.80. The Pregnancy-related Anxiety Scale is easy to administer with higher scores indicative of greater pregnancy-related anxiety. The inclusion of reverse-scored items is a potential limitation with poorer reliability evident for these factors. Although still in its development stage, the Pregnancy-related Anxiety Scale will eventually be useful both clinically (affording early intervention) and in research settings. Copyright © 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  16. An examination of pregnancy- related deaths among adolescents

    African Journals Online (AJOL)

    maternal deaths (direct maternal causes of death) and pregnancy- related deaths (all deaths including ... The study was set in SA, where adolescent pregnancies are high and generally .... reported sexual behaviours of youth, it was found that termination .... engagement and education, especially among adolescents, could.

  17. Pregnancy related biometric changes in the ovaries and uterus of ...

    African Journals Online (AJOL)

    Ovaries and uteri of 40 apparently normal, sexually mature female Sahelian goats (30 pregnant and10 non-pregnant) were obtained and measured, immediately after slaughter, at the Metropolitan abattoir, Maiduguri, Nigeria, over a period of one year. This was with the aim of documenting pregnancy related biometrical ...

  18. Pregnancy related biometric changes in the ovaries and uterus of ...

    African Journals Online (AJOL)

    HP USER

    Pregnancy related biometric changes in the ovaries and uterus of the sahelian goat. AZJaji1* ... (Butterfly Brand) were used to measure length and widths of uteri and ovaries. .... Sahelian goat, being grazed in harsh climate. The uterine horn of ...

  19. Outcome of pregnancy related acute kidney injury requiring ...

    African Journals Online (AJOL)

    Background: Pregnancy related acute kidney injury (AKI) severe enough to require dialysis is now rare in developed countries but is still a significant cause of maternal mortality in many resource constrained countries. However, there is scanty information from many sub-Saharan countries about outcomes of patient who ...

  20. Interobserver reliability of physical examination of shoulder girdle

    NARCIS (Netherlands)

    Nomden, Jettie G.; Slagers, Anton J.; Bergman, Geert; Winters, Jan C.; Kropmans, Thomas J. B.; Dijkstra, Pieter U.

    The object of this study was to assess interobserver reliability in 23 tests concerning physical examination of the shoulder girdle. A physical therapist and a physical therapist/manual therapist independently performed a physical examination of the shoulder girdle in 91 patients with shoulder

  1. Pelvic Pain

    Science.gov (United States)

    ... OLPP) Office of Science Policy, Reporting, and Program Analysis (OSPRA) Division of Extramural Research (DER) Extramural Scientific ... treat my pain? Can pelvic pain affect my emotional well-being? How can I cope with long- ...

  2. Pelvic Exam

    Science.gov (United States)

    ... each step so that nothing comes as a surprise to you. After the pelvic exam After the ... Clinic does not endorse any of the third party products and services advertised. Advertising and sponsorship policy ...

  3. The girdles of the oldest fossil turtle, Proterochersis robusta, and the age of the turtle crown.

    Science.gov (United States)

    Joyce, Walter G; Schoch, Rainer R; Lyson, Tyler R

    2013-12-06

    Proterochersis robusta from the Late Triassic (Middle Norian) of Germany is the oldest known fossil turtle (i.e. amniote with a fully formed turtle shell), but little is known about its anatomy. A newly prepared, historic specimen provides novel insights into the morphology of the girdles and vertebral column of this taxon and the opportunity to reassess its phylogenetic position. The anatomy of the pectoral girdle of P. robusta is similar to that of other primitive turtles, including the Late Triassic (Carnian) Proganochelys quenstedti, in having a vertically oriented scapula, a large coracoid foramen, a short acromion process, and bony ridges that connect the acromion process with the dorsal process, glenoid, and coracoid, and by being able to rotate along a vertical axis. The pelvic elements are expanded distally and suturally attached to the shell, but in contrast to modern pleurodiran turtles the pelvis is associated with the sacral ribs. The primary homology of the character "sutured pelvis" is unproblematic between P. robusta and extant pleurodires. However, integration of all new observations into the most complete phylogenetic analysis that support the pleurodiran nature of P. robusta reveals that this taxon is more parsimoniously placed along the phylogenetic stem of crown Testudines. All current phylogenetic hypotheses therefore support the basal placement of this taxon, imply that the sutured pelvis of this taxon developed independently from that of pleurodires, and conclude that the age of the turtle crown is Middle Jurassic.

  4. Pelvic Actinomycosis

    Directory of Open Access Journals (Sweden)

    Alejandra García-García

    2017-01-01

    Full Text Available Introduction. Actinomycosis is a chronic bacterial infection caused by Actinomyces, Gram-positive anaerobic bacteria. Its symptomatology imitates some malignant pelvic tumours, tuberculosis, or nocardiosis, causing abscesses and fistulas. Actinomycoses are opportunistic infections and require normal mucous barriers to be altered. No epidemiological studies have been conducted to determine prevalence or incidence of such infections. Objective. To analyse the clinical cases of pelvic actinomycosis reported worldwide, to update the information about the disease. Methods. A systematic review of worldwide pelvic actinomycosis cases between 1980 and 2014 was performed, utilising the PubMed, Scopus, and Google Scholar databases. The following information was analysed: year, country, type of study, number of cases, use of intrauterine device (IUD, final and initial diagnosis, and method of diagnosis. Results. 63 articles met the search criteria, of which 55 reported clinical cases and 8 reported cross-sectional studies. Conclusions. Pelvic actinomycosis is confusing to diagnose and should be considered in the differential diagnosis of pelvic chronic inflammatory lesions. It is commonly diagnosed through a histological report, obtained after a surgery subsequent to an erroneous initial diagnosis. A bacterial culture in anaerobic medium could be useful for the diagnosis but requires a controlled technique and should be performed using specialised equipment.

  5. Glu20Ter Variant in PLEC 1f Isoform Causes Limb-Girdle Muscle Dystrophy with Lung Injury

    Directory of Open Access Journals (Sweden)

    Roman V. Deev

    2017-07-01

    Full Text Available Plectinopathies are orphan diseases caused by PLEC gene mutations. PLEC is encoding the protein plectin, playing a role in linking cytoskeleton components in various tissues. In this study, we describe the clinical case of a 26-year-old patient with an early onset plectinopathy variant “limb-girdle muscle dystrophy type 2Q,” report histopathological and ultrastructural findings in m. vastus lateralis biopsy and a novel homozygous likely pathogenic variant (NM_201378.3:c.58G>T, NP_958780.1:p.Glu20Ter in isoform 1f of the gene PLEC. The patient had an early childhood onset with retarded physical development, moderate weakness in pelvic girdle muscles, progressive weakening of limb-girdle muscles after the age of 21, pronounced atrophy of axial muscles, and hypertrophy of the gastrocnemius, deltoid, and triceps muscles, intermittent dyspnea, and no skin involvement. Findings included: non-infectious bronchiolitis and atelectasis signs, biopsy revealed myodystrophal pattern without macrophage infiltration, muscle fiber cytoskeleton disorganization resulted from the plectin loss, incomplete reparative rhabdomyogenesis, and moderate endomysial fibrosis. We have determined a novel likely pathogenic variant in PLEC 1f isoform that causes limb-girdle muscle dystrophy type 2Q and described the third case concerning an isolated myodystrophic phenotype of LGMD2Q with the likely pathogenic variant in PLEC 1f isoform. In addition, we have demonstrated the presence of severe lung injury in a patient and his siblings with the same myodystrophic phenotype and discussed the possible role of plectin deficiency in its pathogenesis.

  6. Intrapartum sacral stress fracture due to pregnancy-related osteoporosis: a case report.

    Science.gov (United States)

    Oztürk, Gülcan; Külcü, Duygu Geler; Aydoğ, Ece

    2013-01-01

    Low back pain (LBP) and hip pain frequently occur during pregnancy and postpartum period. Although pelvic and mechanic lesions of the soft tissues are most responsible for the etiology, sacral fracture is also one of the rare causes. A 32-year-old primigravid patient presented with LBP and right hip pain which started 3 days after vaginal delivery. Although direct radiographic examination was normal, magnetic resonance imaging of the sacrum revealed sacral stress fracture. Lumbar spine and femoral bone mineral density showed osteoporosis as a risk factor. There were no other risk factors such as trauma, excessive weight gain, and strenuous physical activity. It is considered that the patient had sacral fatigue and insufficiency fracture in intrapartum period. The patient's symptoms subsided in 3 months after physical therapy and rest. In conclusion, sacral fractures during pregnancy and postpartum period, especially resulting from childbirth, are very rare. To date, there are two cases in the literature. In cases who even do not have risk factors related to vaginal delivery such as high birth weight infant and the use of forceps, exc., sacral fracture should be considered in the differential diagnosis of LBP and hip pain started soon after child birth. Pregnancy-related osteoporosis may lead to fracture during vaginal delivery.

  7. Internet use by Chinese women seeking pregnancy-related information.

    Science.gov (United States)

    Gao, Ling-ling; Larsson, Margareta; Luo, Shu-yuan

    2013-07-01

    to investigate whether and how Chinese pregnant women used the Internet to retrieve pregnancy-related information. a descriptive, cross-sectional design using a waiting-room questionnaire was employed to obtain information from Chinese pregnant women attending the antenatal clinic of a general hospital in Guangzhou, mainland China from September to October in 2011. a total of 335 Chinese women pregnant at least 32 weeks participated in the study with the response rate 85%. the great majority of the women (91.9%) had access to the Internet. Most of them (88.7%) used it to retrieve health information and began from the beginning of the pregnancy. Fetal development and nutrition in pregnancy were the two most often mentioned topics of interest. More than half of the women regarded the information as reliable. The first most important criterion for judging the trustworthiness of web-based information was if the facts were consistent with information from other sources; the second most important criterion was if references were provided. Most (75.1%) of the women did not discuss the information they retrieved from the Internet with their health professionals. the Internet was a common source for pregnancy related information among Chinese pregnant women, the same as that in the western countries. Health professionals should be able to guide Chinese pregnant women to high-quality, web-based information and then take the opportunity to discuss this information with them during antenatal visits, consultations and childbirth education classes. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. On the homology of the shoulder girdle in turtles.

    Science.gov (United States)

    Nagashima, Hiroshi; Sugahara, Fumiaki; Takechi, Masaki; Sato, Noboru; Kuratani, Shigeru

    2015-05-01

    The shoulder girdle in turtles is encapsulated in the shell and has a triradiate morphology. Due to its unique configuration among amniotes, many theories have been proposed about the skeletal identities of the projections for the past two centuries. Although the dorsal ramus represents the scapular blade, the ventral two rami remain uncertain. In particular, the ventrorostral process has been compared to a clavicle, an acromion, and a procoracoid based on its morphology, its connectivity to the rest of the skeleton and to muscles, as well as with its ossification center, cell lineage, and gene expression. In making these comparisons, the shoulder girdle skeleton of anurans has often been used as a reference. This review traces the history of the debate on the homology of the shoulder girdle in turtles. And based on the integrative aspects of developmental biology, comparative morphology, and paleontology, we suggest acromion and procoracoid identities for the two ventral processes. © 2014 Wiley Periodicals, Inc.

  9. Some pregnancy-related effects of artemether in laboratory animals.

    Science.gov (United States)

    Ejiofor, Janet I; Kwanashie, Helen O; Anuka, Joseph A

    2006-01-01

    Artemether, highly effective in multi-drug-resistant malaria is not routinely available for use in pregnancy due to the lack of adequate research data in animals and man. This study was therefore aimed at investigating some pregnancy-related effects of artemether. Artemether (1.5, 7.5 and 15 mg/kg i.p. daily for 7 days) did not produce changes in rat oestrous cycle. The drug did not prevent or prolong the rate of conception or parturition, cause pre-term delivery and affect litter size. Birth weight and growth rate of pups from artemether-pretreated dams were within the normal range. Artemether (48-480 microg/ml) had no agonist effect on the isolated uterine smooth muscles of both non-pregnant and pregnant rats and guinea pigs. However, the drug (24- 240 microg/ml) reduced oxytocin-induced contraction of uterine tissues concentration-dependently, particularly in pregnant uteri. Copyright (c) 2006 S. Karger AG, Basel.

  10. [Non-Pharmacological Interventions for Pregnancy-Related Sleep Disturbances].

    Science.gov (United States)

    Hung, Hsuan-Man; Chiang, Hsiao-Ching

    2017-02-01

    Most women experience the worse sleep quality of their life during pregnancy and the early postpartum period. Although pregnancy typically accounts for a relatively short part of a woman's life, the related sleep disturbances may have a significant and negative impact on her long-term health. Approximately 78-80% of pregnant women experience sleep disturbances, including interruptions in deep sleep, decreased total sleep time, poor subjective sleep quality, frequent night waking, and reduced sleep efficacy. Sleep disturbances during pregnancy start during the first trimester and become prevalent during the third trimester. Related factors include physiological and psychosocial changes and an unhealthy lifestyle. As non-pharmacological interventions have the potential to improve sleep quality in 70% to 80% of patients with insomnia, this is the main approached that is currently used to treat pregnancy-related sleep disturbances. Examples of these non-pharmacological interventions include music therapy, aerobic exercise, massage, progressive muscle relaxation, multi-modal interventions, and the use of a maternity support belt. The efficacy and safety of other related non-pharmacological interventions such as auricular acupressure, cognitive therapy, tai chi, and aromatherapy remain uncertain, with more empirical research required. Additionally, non-pharmacological interventions do not effectively treat sleep disturbances in all pregnant women.

  11. Incidence and prevalence of pregnancy-related heart disease.

    Science.gov (United States)

    Sliwa, Karen; Böhm, Michael

    2014-03-15

    Worldwide, the numbers of women who have a pre-existing cardiovascular disease or develop cardiac problems during pregnancy are increasing and, due to the lack of evidenced-based data, this provides challenges for the treating physician. Cardiovascular disease in pregnancy is a complex topic as women can present either pre- or post-partum, due to a pre-existing heart disease such as operated on or unoperated on congenital heart disease, valvular heart disease, chronic hypertension, or familial dilated cardiomyopathy. Women often present with symptoms and signs of acute heart failure. On the other hand, there are diseases which are directly related to pregnancy, such as hypertensive disorders of pregnancy and peripartum cardiomyopathy, or where pregnancy increases risk of a disease as, for example, the risk of myocardial infarction. These diseases can have long-term implications to the life of the affected women and their families. There is, in particular, a paucity of data from developing countries of this unique disease pattern and its presentations. This review summarizes the current knowledge of the incidence and prevalence of pregnancy-related cardiovascular disease in women presenting pre- or post-partum.

  12. Pelvic Chondroblastoma

    International Nuclear Information System (INIS)

    Romero Rojas, Alfredo Ernesto; Restrepo Escobar, Ligia Ines; Melo Uribe, Mario Alexander

    2009-01-01

    This article describes the case of a 24-year old woman with a pelvic chondroblastoma localized at the top of the right iliac crest, with six months of evolution and progressive growth. X-rays revealed an osteolytic lesion with heterogeneous density, extending toward soft tissue; the histopathologic study provided evidence of chondroblastoma. Chondroblastomas are benign bone tumors producers of cartilage which appears in the long bone epiphysis of young people. Nearly 75% of such tumors affect the long bones, principally the femur, the tibia, and the humerus; exceptions include those in the flat craniofacial bones and the pelvis bones. Chondroblastomas have distinct radiological and histopathologic characteristics, and despite their benign biological behavior, can cause elevated morbidity among patients due to their localization and being treated exclusively with surgery.

  13. Limb girdle muscular dystrophy due to mutations in POMT2

    DEFF Research Database (Denmark)

    Østergaard, Sofie Thurø; Johnson, Katherine; Stojkovic, Tanya

    2018-01-01

    BACKGROUND: Mutations in the gene coding for protein O-mannosyl-transferase 2 (POMT2) are known to cause severe congenital muscular dystrophy, and recently, mutations in POMT2 have also been linked to a milder limb-girdle muscular dystrophy (LGMD) phenotype, named LGMD type 2N (LGMD2N). Only four...

  14. Pelvic belt effects on pelvic morphometry, muscle activity and body balance in patients with sacroiliac joint dysfunction.

    Directory of Open Access Journals (Sweden)

    Odette Soisson

    Full Text Available The sacroiliac joint (SIJ is frequently involved in low back and pelvic girdle pain. However, morphometrical and functional characteristics related to SIJ pain are poorly defined. Pelvic belts represent one treatment option, but evidence still lacks as to their pain-reducing effects and the mechanisms involved. Addressing these two issues, this case-controlled study compares morphometric, functional and clinical data in SIJ patients and healthy controls and evaluates the effects of short-term pelvic belt application.Morphometric and functional data pertaining to pelvic belt effects were compared in 17 SIJ patients and 17 controls. Lumbar spine and pelvis morphometries were obtained from 3T magnetic resonance imaging. Functional electromyography data of pelvis and leg muscles and center of pressure excursions were measured in one-leg stance. The numerical rating scale was used to evaluate immediate pain-reducing effects.Pelvic morphometry was largely unaltered in SIJ patients and also by pelvic belt application. The angle of lumbar lateral flexion was significantly larger in SIJ patients without belt application. Muscle activity and center of pressure were unaffected by SIJ pain or by belt application in one-leg stance. Nine of 17 patients reported decreased pain intensities under moderate belt application, four reported no change and four reported increased pain intensity. For the entire population investigated here, this qualitative description was not confirmed on a statistical significant level.Minute changes were observed in the alignment of the lumbar spine in the frontal plane in SIJ patients. The potential pain-decreasing effects of pelvic belts could not be attributed to altered muscle activity, pelvic morphometry or body balance in a static short-term application. Long-term belt effects will therefore be of prospective interest.

  15. Pelvic Belt Effects on Pelvic Morphometry, Muscle Activity and Body Balance in Patients with Sacroiliac Joint Dysfunction

    Science.gov (United States)

    Soisson, Odette; Lube, Juliane; Germano, Andresa; Hammer, Karl-Heinz; Josten, Christoph; Sichting, Freddy; Winkler, Dirk; Milani, Thomas L.; Hammer, Niels

    2015-01-01

    Introduction The sacroiliac joint (SIJ) is frequently involved in low back and pelvic girdle pain. However, morphometrical and functional characteristics related to SIJ pain are poorly defined. Pelvic belts represent one treatment option, but evidence still lacks as to their pain-reducing effects and the mechanisms involved. Addressing these two issues, this case-controlled study compares morphometric, functional and clinical data in SIJ patients and healthy controls and evaluates the effects of short-term pelvic belt application. Methods Morphometric and functional data pertaining to pelvic belt effects were compared in 17 SIJ patients and 17 controls. Lumbar spine and pelvis morphometries were obtained from 3T magnetic resonance imaging. Functional electromyography data of pelvis and leg muscles and center of pressure excursions were measured in one-leg stance. The numerical rating scale was used to evaluate immediate pain-reducing effects. Results Pelvic morphometry was largely unaltered in SIJ patients and also by pelvic belt application. The angle of lumbar lateral flexion was significantly larger in SIJ patients without belt application. Muscle activity and center of pressure were unaffected by SIJ pain or by belt application in one-leg stance. Nine of 17 patients reported decreased pain intensities under moderate belt application, four reported no change and four reported increased pain intensity. For the entire population investigated here, this qualitative description was not confirmed on a statistical significant level. Discussion Minute changes were observed in the alignment of the lumbar spine in the frontal plane in SIJ patients. The potential pain-decreasing effects of pelvic belts could not be attributed to altered muscle activity, pelvic morphometry or body balance in a static short-term application. Long-term belt effects will therefore be of prospective interest. PMID:25781325

  16. Pelvic belt effects on pelvic morphometry, muscle activity and body balance in patients with sacroiliac joint dysfunction.

    Science.gov (United States)

    Soisson, Odette; Lube, Juliane; Germano, Andresa; Hammer, Karl-Heinz; Josten, Christoph; Sichting, Freddy; Winkler, Dirk; Milani, Thomas L; Hammer, Niels

    2015-01-01

    The sacroiliac joint (SIJ) is frequently involved in low back and pelvic girdle pain. However, morphometrical and functional characteristics related to SIJ pain are poorly defined. Pelvic belts represent one treatment option, but evidence still lacks as to their pain-reducing effects and the mechanisms involved. Addressing these two issues, this case-controlled study compares morphometric, functional and clinical data in SIJ patients and healthy controls and evaluates the effects of short-term pelvic belt application. Morphometric and functional data pertaining to pelvic belt effects were compared in 17 SIJ patients and 17 controls. Lumbar spine and pelvis morphometries were obtained from 3T magnetic resonance imaging. Functional electromyography data of pelvis and leg muscles and center of pressure excursions were measured in one-leg stance. The numerical rating scale was used to evaluate immediate pain-reducing effects. Pelvic morphometry was largely unaltered in SIJ patients and also by pelvic belt application. The angle of lumbar lateral flexion was significantly larger in SIJ patients without belt application. Muscle activity and center of pressure were unaffected by SIJ pain or by belt application in one-leg stance. Nine of 17 patients reported decreased pain intensities under moderate belt application, four reported no change and four reported increased pain intensity. For the entire population investigated here, this qualitative description was not confirmed on a statistical significant level. Minute changes were observed in the alignment of the lumbar spine in the frontal plane in SIJ patients. The potential pain-decreasing effects of pelvic belts could not be attributed to altered muscle activity, pelvic morphometry or body balance in a static short-term application. Long-term belt effects will therefore be of prospective interest.

  17. Bole girdling affects metabolic properties and root, trunk and branch hydraulics of young ponderosa pine trees.

    Science.gov (United States)

    Domec, Jean-Christophe; Pruyn, Michele L

    2008-10-01

    Effects of trunk girdling on seasonal patterns of xylem water status, water transport and woody tissue metabolic properties were investigated in ponderosa pine (Pinus ponderosa Dougl. ex P. Laws.) trees. At the onset of summer, there was a sharp decrease in stomatal conductance (g(s)) in girdled trees followed by a full recovery after the first major rainfall in September. Eliminating the root as a carbohydrate sink by girdling induced a rapid reversible reduction in g(s). Respiratory potential (a laboratory measure of tissue-level respiration) increased above the girdle (branches and upper trunk) and decreased below the girdle (lower trunk and roots) relative to control trees during the growing season, but the effect was reversed after the first major rainfall. The increase in branch respiratory potential induced by girdling suggests that the decrease in g(s) was caused by the accumulation of carbohydrates above the girdle, which is consistent with an observed increase in leaf mass per area in the girdled trees. Trunk girdling did not affect native xylem embolism or xylem conductivity. Both treated and control trunks experienced loss of xylem conductivity ranging from 10% in spring to 30% in summer. Girdling reduced xylem growth and sapwood to leaf area ratio, which in turn reduced branch leaf specific conductivity (LSC). The girdling-induced reductions in g(s) and transpiration were associated with a decrease in leaf hydraulic conductance. Two years after girdling, when root-to-shoot phloem continuity had been restored, girdled trees had a reduced density of new wood, which increased xylem conductivity and whole-tree LSC, but also vulnerability to embolism.

  18. Pelvic girdle sepsis in childhood. An illustrative case of the difficulty in diagnosis.

    LENUS (Irish Health Repository)

    Street, John

    2012-02-03

    The child who presents with fever, limp and hip pain will often undergo multiple diagnostic procedures before a definitive diagnosis is made. We describe a diagnostically challenging case of a 14-year-old boy presenting with an atraumatic painful limp and pyrexia. Eventually the diagnosis of obturator internus muscle abscess with associated ischial osteomyelitis was made. Of the 19 previous cases reported, four children had associated osteomyelitis and were of an older age. Symptomatology varies, clinical examination is non-specific and the diagnosis can be difficult. Haematological indices are more predictive than in cases of classical osteomyelitis or septic arthritis. Subtle features on conventional radiography and isotope bone scanning should not be overlooked while CT and MRI may be complementary in diagnosis.

  19. An Experimental Comparison of Two Methods on Photosynthesis Driving Soil Respiration: Girdling and Defoliation.

    Science.gov (United States)

    Jing, Yanli; Guan, Dexin; Wu, Jiabing; Wang, Anzhi; Jin, Changjie; Yuan, Fenghui

    2015-01-01

    Previous studies with different experimental methods have demonstrated that photosynthesis significantly influences soil respiration (RS). To compare the experimental results of different methods, RS after girdling and defoliation was measured in five-year-old seedlings of Fraxinus mandshurica from June to September. Girdling and defoliation significantly reduced RS by 33% and 25% within 4 days, and 40% and 32% within the entire treatment period, respectively. The differential response of RS to girdling and defoliation was a result of the over-compensation for RS after girdling and redistribution of stored carbon after defoliation. No significant effect on RS was observed between girdling and defoliation treatment, while the soluble sugar content in fine roots was higher in defoliation than in girdling treatment, indicating that defoliation had less compensation effect for RS after interrupting photosynthates supply. We confirm the close coupling of RS with photosynthesis and recommend defoliation for further studies to estimate the effect of photosynthesis on RS.

  20. Chronic pelvic pain.

    Science.gov (United States)

    Stein, Sharon L

    2013-12-01

    Chronic pelvic pain is pain lasting longer than 6 months and is estimated to occur in 15% of women. Causes of pelvic pain include disorders of gynecologic, urologic, gastroenterologic, and musculoskeletal systems. The multidisciplinary nature of chronic pelvic pain may complicate diagnosis and treatment. Treatments vary by cause but may include medicinal, neuroablative, and surgical treatments. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Serious and life-threatening pregnancy-related infections: opportunities to reduce the global burden.

    Directory of Open Access Journals (Sweden)

    Courtney A Gravett

    Full Text Available Michael Gravett and colleagues review the burden of pregnancy-related infections, especially in low- and middle-income countries, and offer suggestions for a more effective intervention strategy.

  2. Pregnancy-related hemophagocytic lymphohistiocytosis associated with cytomegalovirus infection: A diagnostic and therapeutic challenge

    Directory of Open Access Journals (Sweden)

    Nor Rafeah Tumian

    2015-08-01

    Conclusion: This case highlights the challenges and difficulties involved in the diagnosis and management of pregnancy-related HLH. Immunosuppressive treatment for HLH can precipitate life-threatening opportunistic infections, which need to be promptly diagnosed and treated.

  3. Resistance training in patients with limb-girdle and becker muscular dystrophies

    DEFF Research Database (Denmark)

    Sveen, Marie-Louise; Andersen, Søren P; Ingelsrud, Lina H

    2013-01-01

    In this study we investigated the effect of strength training in patients with limb-girdle muscular dystrophy (LGMD) and Becker muscular dystrophy (BMD).......In this study we investigated the effect of strength training in patients with limb-girdle muscular dystrophy (LGMD) and Becker muscular dystrophy (BMD)....

  4. Cone and seed production of western larch in response to girdling and nitrogen fertilization - an update

    Science.gov (United States)

    Russell T. Graham; Jonalea R. Tonn; Theresa B. Jain

    1995-01-01

    Western larch (Larix occidentalis Nutt.) is a sporadic cone and seed producer. Because the species is such an important component of the -Northern Rocky Mountain forests, methods of increasing seed production are needed. Girdling, fertilizing, and a combination of the two were used on 75-year-old western larch in northern Idaho. Girdling at the base of the live crown...

  5. A tree girdling beetle in Korogwe District: its potential risk to ...

    African Journals Online (AJOL)

    A study was conducted to identify and assess damage of an insect pest girdling young Eucalypts in Korogwe Forest Plantation, Tanga. Purposive sampling was employed to establish 10 plots of 10m by 10m. A total of 90 trees were sampled. Insect pest specimens were collected and girdled trees counted in each plot. The

  6. Clinical and molecular characterization of limb-girdle muscular dystrophy due to LAMA2 mutations

    DEFF Research Database (Denmark)

    Gavassini, Bruno F; Carboni, Nicola; Nielsen, Jørgen E

    2011-01-01

    In this study we describe the clinical and molecular characteristics of limb-girdle muscular dystrophy (LGMD) due to LAMA2 mutations.......In this study we describe the clinical and molecular characteristics of limb-girdle muscular dystrophy (LGMD) due to LAMA2 mutations....

  7. Physiological girdling of pine trees via phloem chilling: proof of concept

    Science.gov (United States)

    Kurt Johnsen; Chris Maier; Felipe Sanchez; Peter Anderson; John Butnor; Richard Waring; Sune Linder

    2007-01-01

    Quantifying below-ground carbon (C) allocation is particularly difficult as methods usually disturb the root– mycorrhizal–soil continuum. We reduced C allocation below ground of loblolly pine trees by: (1) physically girdling trees and (2) physiologically girdling pine trees by chilling the phloem. Chilling reduced cambium temperatures by approximately 18 °C. Both...

  8. Pelvic and acetabular fractures

    International Nuclear Information System (INIS)

    Mears, D.C.; Rubash, H.E.

    1986-01-01

    This treatise focuses primarily on the clinical aspects of diagnosis and treatments of pelvic and acetabular fractures. However, considerable attention is also paid to the radiographic diagnosis of trauma and postoperative effects. The book begins with a succinct review of pelvic and acetabular anatomy and pelvic biomechanics. It continues with a radiographic classification of pelvic injury, which will represent the major source of the book's interest for radiologists. The remainder of the book is concerned with clinical management of pelvic and acetabular trauma, including preoperative planning, surgical approaches, techniques of reduction, internal fixation, eternal fixation, post-operative care, and late problems. Even throughout this later portion of the book there are extensive illustrations, including plain radiographs, computed tomographic (CT) scans, reconstructed three-dimensional CT scans, and schematic diagrams of diverse pelvic and acetabular fractures and the elementary surgical techniques for their repair

  9. An Atraumatic Symphysiolysis with a Unilateral Injured Sacroiliac Joint in a Patient with Cushing’s Disease: A Loss of Pelvic Stability Related to Ligamentous Insufficiency?

    Directory of Open Access Journals (Sweden)

    Andreas Höch

    2016-01-01

    Full Text Available Glucocorticoids are well known for altering bone structure and elevating fracture risk. Nevertheless, there are very few reports on pelvic ring fractures, compared to other bones, especially with a predominantly ligamentous insufficiency, resulting in a rotationally unstable pelvic girdle. We report a 39-year-old premenopausal woman suffering from an atraumatic symphysiolysis and disruption of the left sacroiliac joint. She presented with external rotational pelvic instability and immobilization. Prior to the injury, she received high-dose glucocorticoids for a tentative diagnosis of rheumatoid arthritis over two months. This diagnosis was not confirmed. Other causes leading to the unstable pelvic girdle were excluded by several laboratory and radiological examinations. Elevated basal cortisol and adrenocorticotropic hormone levels were measured and subsequent corticotropin-releasing hormone stimulation, dexamethasone suppression test, and petrosal sinus sampling verified the diagnosis of adrenocorticotropic hormone-dependent Cushing’s disease. The combination of adrenocorticotropic hormone-dependent Cushing’s disease and the additional application of exogenous glucocorticoids is the most probable cause of a rare atraumatic rotational pelvic instability in a premenopausal patient. To the authors’ knowledge, this case presents the first description of a rotationally unstable pelvic ring fracture involving a predominantly ligamentous insufficiency in the context of combined exogenous and endogenous glucocorticoid elevation.

  10. Pregnancy-related Health Behavior of Women with Congenital Heart Disease : Room for Behavioral Change Interventions

    NARCIS (Netherlands)

    Moons, Philip; Budts, Werner; Costermans, Els; Huyghe, Els; Pieper, Petronella G.; Drenthen, Wim

    2009-01-01

    Background. Pregnancy in women with congenital heart disease is associated with maternal and neonatal complications. In order to reduce risks for unfavorable outcomes, pregnant women need to adopt specific health behaviors. We investigated the pregnancy-related health behavior of women with

  11. Maternal and pregnancy-related factors associated with developmental delay in moderately preterm-born children

    NARCIS (Netherlands)

    Kerstjens, Jorien M; de Winter, Andrea F; Sollie, Krystyna M; Bocca-Tjeertes, Inger F; Potijk, Marieke R; Reijneveld, Sijmen A; Bos, Arend F

    OBJECTIVE: To estimate the association between preexisting maternal and pregnancy-related factors and developmental delay in early childhood in moderately preterm-born children. METHODS: We measured development with the Ages and Stages Questionnaire at age 43-49 months in 834 moderately preterm-born

  12. HIV/AIDS and pregnancy-related deaths in Blantyre, Malawi | Lema ...

    African Journals Online (AJOL)

    Background: HIV/AIDS epidemic is one of the major factors affecting women's health and impeding national efforts to improve it especially in sub-Saharan Africa. Current evidence indicates that HIV/ AIDS is increasingly becoming a major cause or contributing factor to pregnancy-related deaths, almost overtaking the ...

  13. Maternal and pregnancy-related death: causes and frequencies in an autopsy study population.

    Science.gov (United States)

    Buschmann, Claas; Schmidbauer, Martina; Tsokos, Michael

    2013-09-01

    Maternal deaths during pregnancy, both from pregnancy-related or other causes, are rare in Western industrialized countries. In this study we report maternal and pregnancy-related deaths in a large autopsy population focusing on medical history, autopsy findings and histological examinations. Medico-legal autopsy files (n = 11,270) from the Institute of Legal Medicine and Forensic Sciences, University Medical Centre Charité, University of Berlin, and the State Institute of Legal and Social Medicine, Berlin, from 2005 to 2010 were reviewed. All female cases between 15 and 49 years were checked for maternal and pregnancy-related death, and deaths of pregnant women from non-natural causes were also included. Fatalities that met the chosen criteria were classified as "direct gestational death," "indirect gestational death" or "non-gestational death." 13 female fatalities (0.12 %) met the chosen criteria (median age 28 years ± 6.87 SD). Eight (61.5 %) women died in-hospital, four (30.8 %) at home, and one woman died in public. Three cases (23.1 %) were "non-gestational deaths," and one case (7.7 %) remained unclear after autopsy and additional examinations. Of the remaining nine cases, six cases (46.5 %) were "direct gestational deaths," and two cases (15.4 %) were "indirect gestational deaths." One case (7.7 %) was not to be defined as "late maternal death," but the cause of death seemed to be directly related to previous gestation ["(very) late maternal death"]. Maternal deaths during pregnancy, both from pregnancy-related or other causes, remain an uncommon event in routine forensic autopsy practice. We report on the collection and analysis of maternal and pregnancy-related deaths in a large autopsy population, with particular attention to the phenomenology of pregnancy, pathophysiological changes in different organ systems and their detection, and the forensic autopsy assessment.

  14. Pregnancy-related sickness absence among employed women in a Swedish county.

    Science.gov (United States)

    Alexanderson, K; Hensing, G; Carstensen, J; Bjurulf, P

    1995-06-01

    The objective of this study was to analyze the variation of pregnancy-related sickness absence among employed women according to age, occupation, and degree of male-female domination within occupations. Data from a prospective study of all new sick-leave spells exceeding 7 d in 1985 and 1986 in the county of Ostergötland, Sweden, were related to the population at risk, through the Swedish Medical Birth Register. The subjects included in the analysis were all 7000 employed women that gave birth in 1985 and 1986, of which some 3000 were sick-listed at least once with pregnancy-related diagnoses. There was little difference in the pregnancy-related sickness absence between the age groups. The age-standardized rate for sick leaves involving pregnancy-related diagnoses differed substantially between occupations. Women in the metal industry had the highest rates; those employed in administration, banking, and insurance had the lowest. White-collar occupations generally had lower rates and blue-collar occupations higher rates, with some exceptions (eg, in saw mills, farming, and the chemical industry). Gender-integrated occupations had the lowest sick-leave rate, while extremely male-dominated jobs had the highest. The latter association remained after adjustment for occupational area. There were considerable differences between occupational groups in the rates of sick leaves involving pregnancy-related diagnoses. Some differences were related to physical load of the jobs being done, but not all. It seems important to consider also male-female domination within a job with respect to such sick leaves.

  15. Current management of pregnancy-related low back pain: a national cross-sectional survey of U.K. physiotherapists.

    Science.gov (United States)

    Bishop, A; Holden, M A; Ogollah, R O; Foster, N E

    2016-03-01

    Pregnancy-related low back pain (LBP) is very common. Evidence from a systematic review supports the use of exercise and acupuncture, although little is known about the care received by women with pregnancy-related back pain in the U.K. To describe current acupuncture and standard care management of pregnancy-related LBP by U.K. physiotherapists. Cross-sectional survey of physiotherapists with experience of treating women with pregnancy-related LBP from three professional networks of the Chartered Society of Physiotherapy. In total, 1093 physiotherapists were mailed a questionnaire. The questionnaire captured respondents' demographic and practice setting information, and experience of managing women with pregnancy-related back pain, and investigated the reported management of pregnancy-related LBP using a patient case vignette of a specific, 'typical' case. The overall response rate was 58% (629/1093). Four hundred and ninety-nine physiotherapists had experience of treating women with pregnancy-related LBP and were included in the analysis. Most respondents worked wholly or partly in the U.K. National Health Service (78%). Most respondents reported that they treat patients with pregnancy-related LBP in three to four one-to-one treatment sessions over 3 to 6 weeks. The results show that a range of management strategies are employed for pregnancy-related LBP, and multimodal management is common. The most common reported treatment was home exercises (94%), and 24% of physiotherapists reported that they would use acupuncture with the patient described in the vignette. This study provides the first robust data on the management of pregnancy-related LBP by U.K. physiotherapists. Multimodal management is common, although exercise is the most frequently used treatment for pregnancy-related LBP. Acupuncture is used less often for this patient group. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. Common recessive limb girdle muscular dystrophies differential diagnosis: why and how?

    Directory of Open Access Journals (Sweden)

    Ana Cotta

    2014-09-01

    Full Text Available Limb girdle muscular dystrophies are heterogeneous autosomal hereditary neuromuscular disorders. They produce dystrophic changes on muscle biopsy and they are associated with mutations in several genes involved in muscular structure and function. Detailed clinical, laboratorial, imaging, diagnostic flowchart, photographs, tables, and illustrated diagrams are presented for the differential diagnosis of common autosomal recessive limb girdle muscular dystrophy subtypes diagnosed nowadays at one reference center in Brazil. Preoperative image studies guide muscle biopsy site selection. Muscle involvement image pattern differs depending on the limb girdle muscular dystrophy subtype. Muscle involvement is conspicuous at the posterior thigh in calpainopathy and fukutin-related proteinopathy; anterior thigh in sarcoglycanopathy; whole thigh in dysferlinopathy, and telethoninopathy. The precise differential diagnosis of limb girdle muscular dystrophies is important for genetic counseling, prognostic orientation, cardiac and respiratory management. Besides that, it may probably, in the future, provide specific genetic therapies for each subtype.

  17. Chemical-Free Cotton Defoliation by; Mechanical, Flame and Laser Girdling

    Directory of Open Access Journals (Sweden)

    Mathew G. Pelletier

    2017-01-01

    Full Text Available A novel new way to achieve chemical-free defoliation of cotton is discussed. The research found that by severing the phloem tissue on the main stalk, via a girdling operation, the operation stimulated the cotton plant to alter its growth into an early senescence pathway that resulted in the plant shedding its leaves and opening up all its bolls, leaving the plant in the perfect state for machine harvesting. Even with follow-up rains, zero regrowth occurred in the treated plants, unlike the untreated control plots where significant regrowth did occur. This report compares the results of greenhouse and field trials where the girdling operation was performed by hand, flame, mechanical and via a CO2 laser to achieve phloem tissue severance. Design parameters for a prototype laser girdling system are also provided. Results suggest that for deficit irrigated cotton, girdling can provide an alternative means to defoliate cotton.

  18. A newly recognized autosomal dominant limb girdle muscular dystrophy with cardiac involvement

    NARCIS (Netherlands)

    van der Kooi, A. J.; Ledderhof, T. M.; de Voogt, W. G.; Res, C. J.; Bouwsma, G.; Troost, D.; Busch, H. F.; Becker, A. E.; de Visser, M.

    1996-01-01

    Sixty-five members of three families with limb girdle muscular dystrophy (LGMD) underwent neurological, cardiological, and ancillary investigations. Thirty-five individuals were diagnosed as having slowly progressive autosomal dominant LGMD. Symmetrical weakness started in the proximal lower limb

  19. Limb-girdle muscular dystrophy in Brazilian children: clinical, histological and molecular characterization

    Directory of Open Access Journals (Sweden)

    Marco A. Veloso Albuquerque

    2014-06-01

    Full Text Available Limb-girdle muscular dystrophies (LGMD are a heterogeneous group of genetic muscular dystrophies, involving 16 autosomal recessive subtypes and eight autosomal dominant subtypes. Autosomal recessive dystrophy is far more common than autosomal dominant dystrophy, particularly in children. The clinical course in this group is characterized by progressive proximal weakness, initially in pelvic and after in shoulder-girdle musculature, varying from very mild to severe degree. Significant overlap of clinical phenotypes, with genetic and clinical heterogeneity, constitutes the rule for this group of diseases. Muscle biopsies are useful for histopathologic and immunolabeling studies, and DNA analysis is the gold standard to establish the specific form of muscular dystrophy. Objectives: The aim of this study was to characterize the clinical, histological and molecular aspects in children with LGMD who attend a big public neuromuscular centre in our country to determine the frequency of different forms. Method: Thirty seven patients were classified as LGMD and included in this analysis. The study period extended from 2009-2012. The female to male ratio was 3:1. The age of onset ranged from two to 13 years, mean 7,5 years. Onset in the first decade was seen in 90%. Results: The initial clinical signs included: frequent falls (22 cases, difficulty in climbing stairs (13 cases, walk on tip toes (2 cases, difficulty in rising from the floor (2 cases and difficulty on walking (1 case. The serum CK levels were high in all cases. Among the 37 patients, 15 (40,5% were classified as sarcoglycanopathies (LGMD2C-F, five (13,5% as dysferlinopathy (LGMD2B, five (13,5% as calpainopathy (LGMD2A. Mutations in LMNA gene (LGMD1B, FKRP gene (LGMDI and caveolin gene (LGMD 1C were identified in two (5,5%, two (5,5% and one patient (2,5%, respectively. In seven of 37 cases (19% it was impossible to determine specific diagnosis. Calf hypertrophy, scapular winging and scoliosis

  20. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... often used to determine the cause of unexplained pain. CT scanning is fast, painless, noninvasive and accurate. ... help diagnose the cause of abdominal or pelvic pain and diseases of the internal organs, small bowel ...

  1. Chronic Pelvic Pain

    Science.gov (United States)

    ... NSAIDs) are helpful in relieving pelvic pain, especially dysmenorrhea . Physical therapy—Acupuncture, acupressure, and nerve stimulation therapies may be useful in treating pain caused by dysmenorrhea. Physical therapy that eases trigger points may give ...

  2. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... test used to help detect diseases of the small bowel, colon and other internal organs and is ... pelvic pain and diseases of the internal organs, small bowel and colon, such as: infections such as ...

  3. Pelvic Organ Prolapse

    Science.gov (United States)

    ... the Treatment Options for Pelvic Organ Prolapse? After obtaining a detailed medical history and completing a thorough ... Food and Drug Administration 10903 New Hampshire Avenue Silver Spring, MD 20993 1-888-INFO-FDA (1- ...

  4. Chronic pelvic floor dysfunction.

    Science.gov (United States)

    Hartmann, Dee; Sarton, Julie

    2014-10-01

    The successful treatment of women with vestibulodynia and its associated chronic pelvic floor dysfunctions requires interventions that address a broad field of possible pain contributors. Pelvic floor muscle hypertonicity was implicated in the mid-1990s as a trigger of major chronic vulvar pain. Painful bladder syndrome, irritable bowel syndrome, fibromyalgia, and temporomandibular jaw disorder are known common comorbidities that can cause a host of associated muscular, visceral, bony, and fascial dysfunctions. It appears that normalizing all of those disorders plays a pivotal role in reducing complaints of chronic vulvar pain and sexual dysfunction. Though the studies have yet to prove a specific protocol, physical therapists trained in pelvic dysfunction are reporting success with restoring tissue normalcy and reducing vulvar and sexual pain. A review of pelvic anatomy and common findings are presented along with suggested physical therapy management. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Pelvic Inflammatory Disease (PID)

    Science.gov (United States)

    ... types of infections. Bacterial Vaginosis: A type of vaginal infection caused by the overgrowth of a number of ... of the uterus at the top of the vagina. Chlamydia: A sexually transmitted infection caused by bacteria that can lead to pelvic ...

  6. Lifetime risk of pregnancy-related death among Zambian women: district-level estimates from the 2010 census

    NARCIS (Netherlands)

    Banda, R.; Fossgard Sandøy, I.; Fylkesnes, K.; Janssen, F.

    The aim of this study was to examine district differentials in the lifetime risk of pregnancy-related death among females aged 15–49 in Zambia. We used data on household deaths collected in the 2010 census to estimate the lifetime risk of pregnancy-related death among females in Zambia. Using

  7. Bethlem myopathy is not allelic to limb-girdle muscular dystrophy type 1A

    Energy Technology Data Exchange (ETDEWEB)

    Speer, M.C.; Yamaoka, L.H.; Stajich, J.; Lewis, K. [and others

    1995-08-28

    The Bethlem myopathy, an autosomal-dominant myopathy, shows a distribution of proximal muscle weakness similar to that observed in dominant limb-girdle muscular dystrophy (LGMD). Yet the Bethlem myopathy differs from most limb-girdle dystrophies in two important regards. First, the Bethlem myopathy presents with joint contractures most commonly observed at the elbows, ankles, and neck. Secondly, disease onset in the Bethlem myopathy is in early childhood, while most dominant LGMDs present with adult onset. 6 refs., 1 fig.

  8. The girdles of the oldest fossil turtle, Proterochersis robusta, and the age of the turtle crown

    OpenAIRE

    Joyce, Walter G; Schoch, Rainer R; Lyson, Tyler R

    2013-01-01

    Background: Proterochersis robusta from the Late Triassic (Middle Norian) of Germany is the oldest known fossil turtle (i.e. amniote with a fully formed turtle shell), but little is known about its anatomy. A newly prepared, historic specimen provides novel insights into the morphology of the girdles and vertebral column of this taxon and the opportunity to reassess its phylogenetic position.Results: The anatomy of the pectoral girdle of P. robusta is similar to that of other primitive turtle...

  9. Pregnant Women Sharing Pregnancy-Related Information on Facebook: Web-Based Survey Study.

    Science.gov (United States)

    Harpel, Tammy

    2018-03-22

    Research indicates expectant and new mothers use the Internet, specifically social media, to gain information and support during the transition to parenthood. Although parents regularly share information about and photos of their child or children on Facebook, researchers have neither explored the use of Facebook to share pregnancy-related information nor investigated factors that influence such sharing. The aim of this study was to address a gap in the literature by exploring the use of Facebook by pregnant women. Specifically, the study examined the use of Facebook to share pregnancy-related information, as well as any association between prenatal attachment and the aforementioned aspects of sharing pregnancy-related information on Facebook. Pregnant women who were at least 18 years of age were recruited for participation in the study through posts and paid advertisements on Facebook and posts to professional organization listservs. Individuals interested in participating were directed to a secure Web-based survey system where they completed the consent form and the survey that focused on their current pregnancy. Participants completed the Maternal Antenatal Attachment Scale and answered questions that assessed how often they shared pregnancy-related information on Facebook, who they shared it with, why they shared it, and what they shared. A total of 117 pregnant women completed the survey. Descriptive statistics indicated that the pregnancy announcement was most commonly shared (75/108, 69.4%), with most women sharing pregnancy-related information on Facebook less than monthly (52/117, 44.4%) with only family and friends (90/116, 77.6% and 91/116, 78.4%, respectively) and for the purpose of involving others or sharing the experience (62/107, 57.9%). Correlation and regression analyses showed that prenatal attachment, in general, was positively and significantly related to all aspects of sharing pregnancy-related information at the PFacebook for a variety of

  10. Extraperitoneal pelvic leiomyosarcoma

    International Nuclear Information System (INIS)

    Santamarina, Mario G.; Baltazar, Alberto D.; Arce, Patricia; Dettano, Veronica; Lopez, Jessica

    2003-01-01

    Extraperitoneal pelvic leiomyosarcoma is a very uncommon neoplasic process. It is a highly aggressive tumor with unfavorable prognosis. Clinical findings are nonspecific; diagnosis is generally made in an advanced stage of the disease. We present a case of a 34 years old female patient with pelvic leiomyosarcoma located at the recto vaginal septum who referred vulvar tumor and disability of the left lower limb. This case report describes the results obtained by ultrasound, Computed Tomography, Magnetic Resonance Imaging and pathology. (author)

  11. Anorectal and Pelvic Pain.

    Science.gov (United States)

    Bharucha, Adil E; Lee, Tae Hee

    2016-10-01

    Although pelvic pain is a symptom of several structural anorectal and pelvic disorders (eg, anal fissure, endometriosis, and pelvic inflammatory disease), this comprehensive review will focus on the 3 most common nonstructural, or functional, disorders associated with pelvic pain: functional anorectal pain (ie, levator ani syndrome, unspecified anorectal pain, and proctalgia fugax), interstitial cystitis/bladder pain syndrome, and chronic prostatitis/chronic pelvic pain syndrome. The first 2 conditions occur in both sexes, while the latter occurs only in men. They are defined by symptoms, supplemented with levator tenderness (levator ani syndrome) and bladder mucosal inflammation (interstitial cystitis). Although distinct, these conditions share several similarities, including associations with dysfunctional voiding or defecation, comorbid conditions (eg, fibromyalgia, depression), impaired quality of life, and increased health care utilization. Several factors, including pelvic floor muscle tension, peripheral inflammation, peripheral and central sensitization, and psychosocial factors, have been implicated in the pathogenesis. The management is tailored to symptoms, is partly supported by clinical trials, and includes multidisciplinary approaches such as lifestyle modifications and pharmacological, behavioral, and physical therapy. Opioids should be avoided, and surgical treatment has a limited role, primarily in refractory interstitial cystitis. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  12. Response of “Red Globe” (Vitis vinifera L. to cane girdling

    Directory of Open Access Journals (Sweden)

    Soltekin Oğuzhan

    2015-01-01

    Full Text Available The effect of cane girdling on skin colour, harvest date, yield, and some quality characteristics of Vitis vinifera L. cv. Red Globe table grape variety, was measured over two growing seasons, 2013–2014, at the facility of Manisa Viticulture Research Station in Turkey. Cane girdling was performed on the spurs after first bud was left from the bottom and 4 mm-wide ring of bark was completely removed with a doubleded knife at veraison period. Statistical analyses showed that total soluble solid content, berry width, berry length, colour parameters, CIRG index and anthocyanin content of the Red Globe was significantly affected by the girdling treatment in both years, 2013 and 2014. In addition it was detected that any effect of girdling treatments cannot be determined statistically significant on total yield, marketable yield, total phenolics, titrable acidity, pH and 50 berry weight. Total and marketable yields of girdled vines had higher value although they weren’t statistically significant. Furthermore it was observed on girdled vines 7 and 11 days earliness compare to the control vines in 2013 and 2014, respectively.

  13. Dual function of the pectoral girdle for feeding and locomotion in white-spotted bamboo sharks.

    Science.gov (United States)

    Camp, Ariel L; Scott, Bradley; Brainerd, Elizabeth L; Wilga, Cheryl D

    2017-07-26

    Positioned at the intersection of the head, body and forelimb, the pectoral girdle has the potential to function in both feeding and locomotor behaviours-although the latter has been studied far more. In ray-finned fishes, the pectoral girdle attaches directly to the skull and is retracted during suction feeding, enabling the ventral body muscles to power rapid mouth expansion. However, in sharks, the pectoral girdle is displaced caudally and entirely separate from the skull (as in tetrapods), raising the question of whether it is mobile during suction feeding and contributing to suction expansion. We measured three-dimensional kinematics of the pectoral girdle in white-spotted bamboo sharks during suction feeding with X-ray reconstruction of moving morphology, and found the pectoral girdle consistently retracted about 11° by rotating caudoventrally about the dorsal scapular processes. This motion occurred mostly after peak gape, so it likely contributed more to accelerating captured prey through the oral cavity and pharynx, than to prey capture as in ray-finned fishes. Our results emphasize the multiple roles of the pectoral girdle in feeding and locomotion, both of which should be considered in studying the functional and evolutionary morphology of this structure. © 2017 The Author(s).

  14. Recurrent pregnancy-related upper airway obstruction caused by intratracheal ectopic thyroid tissue

    DEFF Research Database (Denmark)

    Døssing, H; Jørgensen, K E; Oster-Jørgensen, E

    1999-01-01

    An unusual case of recurrent pregnancy-related thyroid growth stimulation is reported. A 27-year-old euthyroid woman had pulmonary symptoms, thought to be asthma during her first pregnancy, that improved postpartum. Bronchodilatators had no effect and symptoms recurred from gestational week 22...... during her second pregnancy. Her 58-mL multinodular goiter (by ultrasound) was not thought to be responsible for her upper airway symptoms. Therefore, fiber laryngoscopy and computed tomographic (CT) scan were performed and revealed a 20 x 15 x 10 mm intratracheal tumor. After tracheostomy...... developed normally. We believe that this case illustrates the recurrent effect of pregnancy-related thyroid tissue stimulation by a combination of increasing human chorionic gonadotropin (hCG) stimulation and iodine deficiency in a borderline iodine-deficient region. This is the first report on symptomatic...

  15. Pregnancy-related mortality in California: causes, characteristics, and improvement opportunities.

    Science.gov (United States)

    Main, Elliott K; McCain, Christy L; Morton, Christine H; Holtby, Susan; Lawton, Elizabeth S

    2015-04-01

    To compare specific maternal and clinical characteristics and contributing factors among the five leading causes of pregnancy-related mortality to develop focused clinical and public health prevention programs. California pregnancy-related deaths from 2002-2005 were identified with enhanced surveillance using linked birth and death certificates. A multidisciplinary committee reviewed medical records, autopsy reports, and coroner reports to determine cause of death, clinical and demographic characteristics, chance to alter outcome, contributing factors (at health care provider, facility, and patient levels), and quality improvement opportunities. The five leading causes of death were compared with each other and with the overall California birth population. Among the 207 pregnancy-related deaths, the five leading causes were cardiovascular disease, preeclampsia or eclampsia, hemorrhage, venous thromboembolism, and amniotic fluid embolism. Among the leading causes of death, we identified differing patterns for race, maternal age, body mass index, timing of death, and method of delivery. Overall, there was a good-to-strong chance to alter the outcome in 41% of deaths, with the highest rates of preventability among hemorrhage (70%) and preeclampsia (60%) deaths. Health care provider, facility, and patient contributing factors also varied by cause of death. Pregnancy-related mortality should not be considered a single clinical entity. Reducing mortality requires in-depth examination of individual causes of death. The five leading causes exhibit different characteristics, degrees of preventability, and contributing factors, with the greatest improvement opportunities identified for hemorrhage and preeclampsia. These findings provide additional support for hospital, state, and national maternal safety programs.

  16. Pregnancy related causes of deaths in Ghana: a 5-year retrospective study.

    Science.gov (United States)

    Der, E M; Moyer, C; Gyasi, R K; Akosa, A B; Tettey, Y; Akakpo, P K; Blankson, A; Anim, J T

    2013-12-01

    Data on maternal mortality varies by region and data source. Accurate local-level data are essential to appreciate its burden. This study uses autopsy results to assess maternal mortality causes in southern Ghana. Autopsy log books of the Department of Pathology, Korle-Bu Teaching Hospital Mortuary were reviewed from 2004 through 2008 for pregnancy related deaths. Data were entered into a database and analyzed using SPSS statistical software (Version 19). Of 5,247 deaths among women aged 15-49, 12.1% (634) were pregnancy-related. Eighty one percent of pregnancy-related deaths (517) occurred in the community or within 24 hours of admission to a health facility and 18.5% (117) occurred in a health facility. Out of 634 pregnancy-related deaths, 79.5% (504) resulted from direct obstetric causes, including: haemorrhage (21.8%), abortion (20.8%), hypertensive disorders (19.4%), ectopic gestation (8.7%), uterine rupture (4.3%) and genital tract sepsis (2.5%). The remaining 20.5% (130) resulted from indirect obstetric causes, including: infections outside the genital tract, (9.2%), anemia (2.8%), sickle cell disease (2.7%), pulmonary embolism (1.9%) and disseminated intravascular coagulation (1.3%). The top five causes of maternal death were: haemorrhage (21.8%), abortion (20.7%), hypertensive disorders (19.4%), infections (9.1%) and ectopic gestation (8.7%). Ghana continues to have persistently high levels of preventable causes of maternal deaths. Community based studies, on maternal mortality are urgently needed in Ghana, since our autopsy studies indicates that 81% of deaths recorded in this study occurred in the community or within 24 hours of admission to a health facility.

  17. Pregnancy-related anxiety and depressive symptoms are associated with visuospatial working memory errors during pregnancy.

    Science.gov (United States)

    Kataja, E-L; Karlsson, L; Huizink, A C; Tolvanen, M; Parsons, C; Nolvi, S; Karlsson, H

    2017-08-15

    Cognitive deficits, especially in memory and concentration, are often reported during pregnancy. Similar cognitive dysfunctions can also occur in depression and anxiety. To date, few studies have investigated the associations between cognitive deficits and psychiatric symptoms during pregnancy. This field is of interest because maternal cognitive functioning, and particularly its higher-order aspects are related to maternal well-being and caregiving behavior, as well as later child development. Pregnant women (N =230), reporting low (n =87), moderate (n =97), or high (n =46) levels of depressive, general anxiety and/or pregnancy-related anxiety symptoms (assessed repeatedly with EPDS, SCL-90/anxiety subscale, PRAQ-R2, respectively) were tested in mid-pregnancy for their cognitive functions. A computerized neuropsychological test battery was used. Pregnant women with high or moderate level of psychiatric symptoms had significantly more errors in visuospatial working memory/executive functioning task than mothers with low symptom level. Depressive symptoms throughout pregnancy and concurrent pregnancy-related anxiety symptoms were significant predictors of the performance in the task. General anxiety symptoms were not related to visuospatial working memory. Cognitive functions were evaluated only at one time-point during pregnancy precluding causal conclusions. Maternal depressive symptoms and pregnancy-related anxiety symptoms were both associated with decrements in visuospatial working memory/executive functioning. Depressive symptoms seem to present more stable relationship with cognitive deficits, while pregnancy-related anxiety was associated only concurrently. Future studies could investigate, how stable these cognitive differences are, and whether they affect maternal ability to deal with demands of pregnancy and later parenting. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Epidemiologic Tools to Study the Influence of Environmental Factors on Fecundity and Pregnancy-related Outcomes

    Science.gov (United States)

    Slama, Rémy; Ballester, Ferran; Casas, Maribel; Cordier, Sylvaine; Eggesbø, Merete; Iniguez, Carmen; Nieuwenhuijsen, Mark; Philippat, Claire; Rey, Sylvie; Vandentorren, Stéphanie; Vrijheid, Martine

    2014-01-01

    Adverse pregnancy outcomes entail a large health burden for the mother and offspring; a part of it might be avoided by better understanding the role of environmental factors in their etiology. Our aims were to review the assessment tools to characterize fecundity troubles and pregnancy-related outcomes in human populations and their sensitivity to environmental factors. For each outcome, we reviewed the possible study designs, main sources of bias, and their suggested cures. In terms of study design, for most pregnancy outcomes, cohorts with recruitment early during or even before pregnancy allow efficient characterization of pregnancy-related events, time-varying confounders, and in utero exposures that may impact birth outcomes and child health. Studies on congenital anomalies require specific designs, assessment of anomalies in medical pregnancy terminations, and, for congenital anomalies diagnosed postnatally, follow-up during several months after birth. Statistical analyses should take into account environmental exposures during the relevant time windows; survival models are an appropriate approach for fecundity, fetal loss, and gestational duration/preterm delivery. Analysis of gestational duration could distinguish pregnancies according to delivery induction (and possibly pregnancy-related conditions). In conclusion, careful design and analysis are required to better characterize environmental effects on human reproduction. PMID:24363355

  19. A case study of chiropractic management of pregnancy-related heartburn with postulated fetal epigenome implications.

    Science.gov (United States)

    Peterson, Caroline

    2012-01-01

    This case study reports on chiropractic care for pregnancy-related heartburn. The purpose of this article is to relate the benefit of chiropractic treatment for one individual, to contrast chiropractic management with the biomedical standard of care for pregnancy-related heartburn, and to point to potential epigenetic implications of the standard of care. A 32-year-old woman who was 24 weeks pregnant presented with persistent heartburn that she was treating with ranitidine (Zantac®) and calcium carbonate (Tums®) daily at the initiation of chiropractic care. Findings of the initial examination were thoracic intersegmental dysfunction and pain upon palpation of the diaphragm, with hypertonicity noted. Therapy localization was positive for reflexes associated with the esophagus and lower esophageal sphincter, suggesting spasms. Emotional components also were identified in association with the symptoms by the use of a mind-body therapy called NeuroEmotional Technique. The patient was treated by adjusting the thoracic spine, manually releasing the diaphragm spasms, and releasing the esophageal spasm with an activator (a small hand-held instrument that creates a percussive force). The patient was symptom-free and did not use medication after the fifth treatment. She was followed throughout the remainder of her pregnancy and was asymptomatic and required no further treatment. A larger study should investigate the effectiveness of chiropractic care for the treatment of pregnancy-related heartburn. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. Pelvic floor muscle function in women with pelvic floor dysfunction

    DEFF Research Database (Denmark)

    Tibaek, Sigrid; Dehlendorff, Christian

    2014-01-01

    The objectives of this study were to investigate the level of pelvic floor muscle (PFM) function in women with pelvic floor dysfunction (PFD) referred by gynaecologists and urologists for in-hospital pelvic floor muscle training (PFMT), and to identity associated factors for a low level of PFM...

  1. Retroperitoneal and pelvic fibromatosis

    International Nuclear Information System (INIS)

    Lopez de Lacalle, J. M.; Garmendia, G.; Laso, C.; Galardi, A.

    1998-01-01

    We present a case of retroperitoneal and pelvic fibromatosis in a 17-year-old boy who came to the emergency room with sudden onset acute abdominal pain. The initial radiological examination (plain X-ray and ultrasound) disclosed only minimal right hydronephrosis. Subsequent computed tomography revealed the presence of a solid retroperitoneal and pelvic mass involving right ureter and secondary right hydronephrosis. We stress its presentation in the form of acute abdominal pain with initial radiological signs suggestive of a primarily urological disorder. (Author) 8 refs

  2. Optimizing Use of Girdled Ash Trees for Management of Low-Density Emerald Ash Borer (Coleoptera: Buprestidae) Populations.

    Science.gov (United States)

    Siegert, Nathan W; McCullough, Deborah G; Poland, Therese M; Heyd, Robert L

    2017-06-01

    Effective survey methods to detect and monitor recently established, low-density infestations of emerald ash borer, Agrilus planipennis Fairmaire (Coleoptera: Buprestidae), remain a high priority because they provide land managers and property owners with time to implement tactics to slow emerald ash borer population growth and the progression of ash mortality. We evaluated options for using girdled ash (Fraxinus spp.) trees for emerald ash borer detection and management in a low-density infestation in a forested area with abundant green ash (F. pennsylvanica). Across replicated 4-ha plots, we compared detection efficiency of 4 versus 16 evenly distributed girdled ash trees and between clusters of 3 versus 12 girdled trees. We also examined within-tree larval distribution in 208 girdled and nongirdled trees and assessed adult emerald ash borer emergence from detection trees felled 11 mo after girdling and left on site. Overall, current-year larvae were present in 85-97% of girdled trees and 57-72% of nongirdled trees, and larval density was 2-5 times greater on girdled than nongirdled trees. Low-density emerald ash borer infestations were readily detected with four girdled trees per 4-ha, and 3-tree clusters were as effective as 12-tree clusters. Larval densities were greatest 0.5 ± 0.4 m below the base of the canopy in girdled trees and 1.3 ± 0.7 m above the canopy base in nongirdled trees. Relatively few adult emerald ash borer emerged from trees felled 11 mo after girdling and left on site through the following summer, suggesting removal or destruction of girdled ash trees may be unnecessary. This could potentially reduce survey costs, particularly in forested areas with poor accessibility. Published by Oxford University Press on behalf of Entomological Society of America 2017. This work is written by US Government employees and is in the public domain in the US.

  3. Pregnant Women Sharing Pregnancy-Related Information on Facebook: Web-Based Survey Study

    Science.gov (United States)

    2018-01-01

    Background Research indicates expectant and new mothers use the Internet, specifically social media, to gain information and support during the transition to parenthood. Although parents regularly share information about and photos of their child or children on Facebook, researchers have neither explored the use of Facebook to share pregnancy-related information nor investigated factors that influence such sharing. Objective The aim of this study was to address a gap in the literature by exploring the use of Facebook by pregnant women. Specifically, the study examined the use of Facebook to share pregnancy-related information, as well as any association between prenatal attachment and the aforementioned aspects of sharing pregnancy-related information on Facebook. Methods Pregnant women who were at least 18 years of age were recruited for participation in the study through posts and paid advertisements on Facebook and posts to professional organization listservs. Individuals interested in participating were directed to a secure Web-based survey system where they completed the consent form and the survey that focused on their current pregnancy. Participants completed the Maternal Antenatal Attachment Scale and answered questions that assessed how often they shared pregnancy-related information on Facebook, who they shared it with, why they shared it, and what they shared. Results A total of 117 pregnant women completed the survey. Descriptive statistics indicated that the pregnancy announcement was most commonly shared (75/108, 69.4%), with most women sharing pregnancy-related information on Facebook less than monthly (52/117, 44.4%) with only family and friends (90/116, 77.6% and 91/116, 78.4%, respectively) and for the purpose of involving others or sharing the experience (62/107, 57.9%). Correlation and regression analyses showed that prenatal attachment, in general, was positively and significantly related to all aspects of sharing pregnancy-related information

  4. Haemodynamically Unstable Pelvic Fractures

    Science.gov (United States)

    2009-01-01

    through the pubic symphysis, and posteriorlywith the sacrum forming the sacroiliac (SI) joints (Fig. 1). The SI joints are the strongest in the body...Gardner MJ, Kendoff D, Ostermeier S, et al. Sacroiliac joint compression using an anterior pelvic compressor: a mechanical study in synthetic bone. J

  5. Chronic pelvic pain

    African Journals Online (AJOL)

    misdiagnoses, inappropriate or inadequate treatment strategies, and poor patient compliance .... excitation tenderness implies an active pelvic inflammatory process. Pain localising to ... neoplastic process, particularly cervical cancer, must be excluded. .... The dosage should be started at 10 mg at night, and increased by 5 ...

  6. Pelvic Inflammatory Disease (PID)

    Science.gov (United States)

    ... a serious condition, in women. 1 in 8 women with a history of PID experience difficulties getting pregnant. You can prevent PID if you know how to protect yourself. What is PID? Pelvic inflammatory disease is an infection of a woman’s reproductive organs. It is a complication often caused ...

  7. Carbohydrate regulation of photosynthesis and respiration from branch girdling in four species of wet tropical rain forest trees.

    Science.gov (United States)

    Asao, Shinichi; Ryan, Michael G

    2015-06-01

    How trees sense source-sink carbon balance remains unclear. One potential mechanism is a feedback from non-structural carbohydrates regulating photosynthesis and removing excess as waste respiration when the balance of photosynthesis against growth and metabolic activity changes. We tested this carbohydrate regulation of photosynthesis and respiration using branch girdling in four tree species in a wet tropical rainforest in Costa Rica. Because girdling severs phloem to stop carbohydrate export while leaving xylem intact to allow photosynthesis, we expected carbohydrates to accumulate in leaves to simulate a carbon imbalance. We varied girdling intensity by removing phloem in increments of one-quarter of the circumference (zero, one--quarter, half, three-quarters, full) and surrounded a target branch with fully girdled ones to create a gradient in leaf carbohydrate content. Light saturated photosynthesis rate was measured in situ, and foliar respiration rate and leaf carbohydrate content were measured after destructive harvest at the end of the treatment. Girdling intensity created no consistent or strong responses in leaf carbohydrates. Glucose and fructose slightly increased in all species by 3.4% per one-quarter girdle, total carbon content and leaf mass per area increased only in one species by 5.4 and 5.5% per one-quarter girdle, and starch did not change. Only full girdling lowered photosynthesis in three of four species by 59-69%, but the decrease in photosynthesis was unrelated to the increase in glucose and fructose content. Girdling did not affect respiration. The results suggest that leaf carbohydrate content remains relatively constant under carbon imbalance, and any changes are unlikely to regulate photosynthesis or respiration. Because girdling also stops the export of hormones and reactive oxygen species, girdling may induce physiological changes unrelated to carbohydrate accumulation and may not be an effective method to study carbohydrate feedback

  8. Evaluating the perceived effectiveness of pregnancy-related cigarette package health warning labels among different gender/age groups.

    Science.gov (United States)

    Kollath-Cattano, Christy; Osman, Amira; Thrasher, James F

    2017-03-01

    The impact of pregnancy-related health warning labels (HWLs) appearing on cigarette packages on women of reproductive age and other socio-demographic groups is not well understood. The current study analyzes how different age/gender groups respond to pregnancy-related HWLs as compared to non-pregnancy HWLs. Data were analyzed from four waves of an online longitudinal study with adult smokers aged 18-64 in Australia, Canada, Mexico, and the US. Participants were classified into four age\\gender groups: women 40 and under; men 40 and under; women over 40; men over 40. Participants rated one pregnancy-related and several non-pregnancy related labels on worry, believability, and motivation to quit. Country-specific adjusted linear GEE were estimated regressing ratings for each of the three key outcomes for 1) pregnancy-related HWLs and 2) a rating difference score that subtracted the average ratings of the non-pregnancy warning from the rating of the pregnancy warning. All models adjusted for socio-demographics and smoking related variables. In Mexico and Australia, where graphic pregnancy-related HWL imagery is used (i.e., premature infant), women of reproductive age reported stronger believability, worry, and quit motivation than all other groups. Results were similar in the US, where text only HWLs are used. In contrast in Canada, where the pregnancy-related HWL imagery features a pregnant woman, ratings were unassociated with gender/age groups. Stronger effects among women of reproductive age were limited to pregnancy HWLs in each country, except Canada. HWLs that depict graphic effects to illustrate smoking-related pregnancy risks appear to be perceived as particularly effective among women of reproductive age. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. [Pregnancy-related anxiety and subthreshold autism trait in preschool children based a birth cohort study].

    Science.gov (United States)

    Sun, Yanli; Shao, Ting; Yao, Yuyou; Tao, Huihui; Ni, Lingling; Yan, Shuangqin; Gu, Chunli; Cao, Hui; Huang, Kun; Tao, Fangbiao

    2016-02-01

    To analyze the associations between pregnancy-related anxiety and the prevalence of subthreshold autism trait (SAT) in preschool children. Baseline data came from the Ma'anshan Birth Cohort Study, a part of the China-Anhui Birth Cohort Study (C-ABCS). All the participants were enrolled among pregnant women who received prenatal health care in 4 municipal medical centers during Oct. 2008 to Oct. 2010. A total of 5 084 pregnant women were recruited at the beginning and 4 669 singleton live births were included until childbirth. The situation about pregnancy-specific anxiety during trimester and third trimester of women were evaluated by Pregnancy-specific Anxiety Questionnaire (PAQ). Between April 2014 and April 2015, the cohort was followed up again, and the Clancy Autism Behavior Scale (CABRS) filled out by parents was used for telling the SAT children from the healthy children among 3 663 preschool children. Univariate and binary regression model was used to estimate associations between the pregnancy-related anxiety during trimester and third trimester and the subthreshold autism trait in children. During the pregnancy, the detected rates of women with pregnancy-specific anxiety in trimester and the third trimester were 25.5%(935/3 663), 13.9%(501/3 592) respectively, and the detected rate of maternal pregnancy-specific anxiety in both periods was 7.7%(278/3 592). There were 290 positive children with SAT and the detection rate was 7.9%. After controlling possible confounding factors including children's genders, place of residence, supplement folic acid during pregnancy, preterm birth, exposure to second-hand smoke during pregnancy, the father (mother) cultural levels, the father (mother) nature of work and family income, the results of multinomial logistic regression analysis showed that maternal pregnancy-specific anxiety in trimester was the risk factor for SAT in preschool children (OR=1.51, 95% CI: 1.11-2.04), and there was no association between maternal

  10. Management of pelvic chondrosarcoma

    Directory of Open Access Journals (Sweden)

    Florin Groșeanu

    2016-11-01

    Full Text Available The partial or complete excision of the hemipelvis with sparing of the lower limb is an option of the treatment of pelvic chondrosarcoma and a therapeutic alternative of the interilio-abdominal disarticulation. The operation has in principle the same indications as the interilio-abdominal disarticulation and offers a good solution for avoiding a mutilating operation. The 149 cases include: 120 biopsies, 29 excisional biopsies, 6 interilioabdominal disarticulations and 14 resections – reconstruction’s, one of with prosthetic reconstruction. The prognostic score was established by assessing: the surgical stage, the site of the tumor, the surgical margins of the tumor, the functional mobility and the postoperative activity. The wide excision of the tumor, a stable reconstruction and an efficient recovery are essential for a successful treatment of pelvic chondrosarcoma. The limb sparing resection-reconstruction represents a highly surgical demanding procedure, followed up by complications in 60% of the cases, so that should be performed only by high skilled surgeons. Hemipelvectomy still remains a well-established life-saving surgery method for patients suffering from vast oncological extensions, where a pelvic resection is not an option.

  11. Depression, pregnancy-related anxiety and parental-antenatal attachment in couples using preimplantation genetic diagnosis.

    Science.gov (United States)

    Winter, C; Van Acker, F; Bonduelle, M; Van Berkel, K; Belva, F; Liebaers, I; Nekkebroeck, J

    2016-06-01

    Do preimplantation genetic diagnosis (PGD) couples experience higher levels of stress during pregnancy and the perinatal period compared with couples who conceive spontaneously (SC) or with ICSI? PGD couples did not experience more psychological stress during pregnancy and beyond than ICSI or SC couples. Previous studies have shown that assisted reproduction technology (ART) couples are more prone to pregnancy-related anxieties than SC couples, but display depressed feelings to an equal or lesser extent. However, only one study has focused on a female PGD sample, which may be a more vulnerable group than other ART groups, due to the potentially complex hereditary background, adverse childhood experiences and losses. In that study, PGD women experienced a reduction in state anxiety, and maternal-antenatal attachment did not differ from normative data. Unfortunately, no data exist on pregnancy-related anxiety, depression and parental-antenatal attachment. Valuable information from both parents (e.g.: couples) is also lacking. For this longitudinal prospective study questionnaire, data from 185 women and 157 men (157 couples) were collected between February 2012 until April 2014. Data were analysed using multilevel analysis. The couples conceiving after PGD, ICSI or SC were followed from the first trimester of the pregnancy until the third month post-partum. A total of 60 PGD, 58 ICSI and 69 SC couples were initially recruited by various departments of Universitair Ziekenhuis Brussel (UZ Brussel). At each trimester (T1: 12-14 weeks, T2: 20-22 weeks, T3: 30-32 weeks) of pregnancy, depression (EPDS), pregnancy-related anxieties (PRAQ) and parental-antenatal attachment (M/PAAS) were recorded. At T4 (3 months post-partum), depression (EPDS) was assessed again. In the first trimester (T1) broad socio-demographic data and at T4 perinatal health data of both mother and child were recorded. Differences between conception groups over time were analysed using multilevel

  12. Cesarean section after abdominal mesh repair for pregnancy-related desmoid tumor: a case report

    Directory of Open Access Journals (Sweden)

    Ooi S

    2017-07-01

    Full Text Available Sara Ooi, Harry Ngo Obstetrics and Gynaecology Department, Liverpool Hospital, Liverpool, NSW, Australia Abstract: We report the case of a 32-year-old gravida 2 para 1 woman with a background of partially resected desmoid tumor (DT arising from the previous cesarean section (CS scar. This case details the management of her DT by surgical resection and mesh repair and second pregnancy following this. Pregnancy-related DTs are a relatively rare entity, and there is a paucity of literature regarding their management during pregnancy. There are only five reported cases of DTs arising from CS scars. To our knowledge, this is the only report to illustrate that subsequent CS is possible after desmoid resection and abdominal mesh repair. It provides evidence that CS can be safely accomplished following abdominal wall reconstructions and further arguments against elective lower segment CS. Keywords: abdominal wall, cesarean section, complications, desmoid tumor, surgical mesh

  13. Cesarean section after abdominal mesh repair for pregnancy-related desmoid tumor: a case report.

    Science.gov (United States)

    Ooi, Sara; Ngo, Harry

    2017-01-01

    We report the case of a 32-year-old gravida 2 para 1 woman with a background of partially resected desmoid tumor (DT) arising from the previous cesarean section (CS) scar. This case details the management of her DT by surgical resection and mesh repair and second pregnancy following this. Pregnancy-related DTs are a relatively rare entity, and there is a paucity of literature regarding their management during pregnancy. There are only five reported cases of DTs arising from CS scars. To our knowledge, this is the only report to illustrate that subsequent CS is possible after desmoid resection and abdominal mesh repair. It provides evidence that CS can be safely accomplished following abdominal wall reconstructions and further arguments against elective lower segment CS.

  14. Cardiac involvement in patients with limb-girdle muscular dystrophy type 2 and Becker muscular dystrophy

    DEFF Research Database (Denmark)

    Sveen, Marie-Louise; Thune, Jens Jakob; Køber, Lars

    2008-01-01

    OBJECTIVE: To investigate the extent of cardiac involvement in patients with 1 of the 12 groups of recessively inherited limb-girdle muscular dystrophy type 2 (LGMD2A-L) and Becker muscular dystrophy (BMD). DESIGN: Prospective screening. SETTING: Neuromuscular Clinic and Department of Cardiology...

  15. Body weight-supported training in Becker and Limb Girdle 2I muscular dystrophy

    DEFF Research Database (Denmark)

    Jensen, Bente Rona; Berthelsen, Martin Peter; Husu, Edith

    2016-01-01

    INTRODUCTION: We studied the functional effects of combined strength and aerobic anti-gravity training in severely affected patients with Becker and Limb-Girdle muscular dystrophies. METHODS: Eight patients performed 10-week progressive combined strength (squats, calf raises, lunges) and aerobic...

  16. Progression of cardiac involvement in patients with limb-girdle type 2 and Becker muscular dystrophies

    DEFF Research Database (Denmark)

    Petri, Helle; Sveen, Marie-Louise; Thune, Jens Jakob

    2015-01-01

    AIM: To assess the degree and progression of cardiac involvement in patients with limb-girdle type 2 (LGMD2) and Becker muscular dystrophies (BMD). METHODS: A follow-up study of 100 LGMD2 (types A-L) and 30 BMD patients assessed by electrocardiogram (ECG) and echocardiography, supplemented...

  17. Contractile properties are disrupted in Becker muscular dystrophy, but not in limb girdle type 2I

    DEFF Research Database (Denmark)

    Løkken, Nicoline; Hedermann, Gitte; Thomsen, Carsten

    2016-01-01

    We investigated whether a linear relationship between muscle strength and cross-sectional area (CSA) is preserved in calf muscles of patients with Becker muscular dystrophy (BMD, n = 14) and limb-girdle type 2I muscular dystrophy (LGMD2I, n = 11), before and after correcting for muscle fat...

  18. Clinical and genetic spectrum in limb-girdle muscular dystrophy type 2E

    DEFF Research Database (Denmark)

    Semplicini, Claudio; Vissing, John; Dahlqvist, Julia R

    2015-01-01

    OBJECTIVE: To determine the clinical spectrum of limb-girdle muscular dystrophy 2E (LGMD2E) and to investigate whether genetic or biochemical features can predict the phenotype of the disease. METHODS: All LGMD2E patients followed in participating centers were included. A specific clinical protoc...

  19. Attraction of the emerald ash borer to ash trees stressed by girdling, herbicide treatment, or wounding

    Science.gov (United States)

    Deborah McCullough; Therese Poland; David. Cappaert

    2009-01-01

    New infestations of emerald ash borer, Agrilus planipennis Fairmaire, an invasive pest native to Asia, are difficult to detect until densities build and symptoms appear on affected ash (Fraxinus spp). We compared the attraction of A. planipennis to ash trees stressed by girdling (bark and phloem removed...

  20. Assessing health and economic outcomes of interventions to reduce pregnancy-related mortality in Nigeria.

    Science.gov (United States)

    Erim, Daniel O; Resch, Stephen C; Goldie, Sue J

    2012-09-14

    Women in Nigeria face some of the highest maternal mortality risks in the world. We explore the benefits and cost-effectiveness of individual and integrated packages of interventions to prevent pregnancy-related deaths. We adapt a previously validated maternal mortality model to Nigeria. Model outcomes included clinical events, population measures, costs, and cost-effectiveness ratios. Separate models were adapted to Southwest and Northeast zones using survey-based data. Strategies consisted of improving coverage of effective interventions, and could include improved logistics. Increasing family planning was the most effective individual intervention to reduce pregnancy-related mortality, was cost saving in the Southwest zone and cost-effective elsewhere, and prevented nearly 1 in 5 abortion-related deaths. However, with a singular focus on family planning and safe abortion, mortality reduction would plateau below MDG 5. Strategies that could prevent 4 out of 5 maternal deaths included an integrated and stepwise approach that includes increased skilled deliveries, facility births, access to antenatal/postpartum care, improved recognition of referral need, transport, and availability quality of EmOC in addition to family planning and safe abortion. The economic benefits of these strategies ranged from being cost-saving to having incremental cost-effectiveness ratios less than $500 per YLS, well below Nigeria's per capita GDP. Early intensive efforts to improve family planning and control of fertility choices, accompanied by a stepwise effort to scale-up capacity for integrated maternal health services over several years, will save lives and provide equal or greater value than many public health interventions we consider among the most cost-effective (e.g., childhood immunization).

  1. Assessing health and economic outcomes of interventions to reduce pregnancy-related mortality in Nigeria

    Directory of Open Access Journals (Sweden)

    Erim Daniel O

    2012-09-01

    Full Text Available Abstract Background Women in Nigeria face some of the highest maternal mortality risks in the world. We explore the benefits and cost-effectiveness of individual and integrated packages of interventions to prevent pregnancy-related deaths. Methods We adapt a previously validated maternal mortality model to Nigeria. Model outcomes included clinical events, population measures, costs, and cost-effectiveness ratios. Separate models were adapted to Southwest and Northeast zones using survey-based data. Strategies consisted of improving coverage of effective interventions, and could include improved logistics. Results Increasing family planning was the most effective individual intervention to reduce pregnancy-related mortality, was cost saving in the Southwest zone and cost-effective elsewhere, and prevented nearly 1 in 5 abortion-related deaths. However, with a singular focus on family planning and safe abortion, mortality reduction would plateau below MDG 5. Strategies that could prevent 4 out of 5 maternal deaths included an integrated and stepwise approach that includes increased skilled deliveries, facility births, access to antenatal/postpartum care, improved recognition of referral need, transport, and availability quality of EmOC in addition to family planning and safe abortion. The economic benefits of these strategies ranged from being cost-saving to having incremental cost-effectiveness ratios less than $500 per YLS, well below Nigeria’s per capita GDP. Conclusions Early intensive efforts to improve family planning and control of fertility choices, accompanied by a stepwise effort to scale-up capacity for integrated maternal health services over several years, will save lives and provide equal or greater value than many public health interventions we consider among the most cost-effective (e.g., childhood immunization.

  2. The Effect of Topical Rosa damascena (Rose) Oil on Pregnancy-Related Low Back Pain: A Randomized Controlled Clinical Trial.

    Science.gov (United States)

    Shirazi, Mahbobeh; Mohebitabar, Safieh; Bioos, Sodabeh; Yekaninejad, Mir Saeed; Rahimi, Roja; Shahpiri, Zahra; Malekshahi, Farhad; Nejatbakhsh, Fatemeh

    2017-01-01

    The study aimed to assess the efficacy of topical rose oil in women with pregnancy-related low back pain. A randomized controlled clinical trial was conducted on 120 women with pregnancy-related low back pain. Patients were allocated to 3 parallel groups to receive topical rose oil (in the carrier of almond oil), placebo (carrier oil), or no intervention. All groups were followed for 4 weeks. All participants were evaluated by Visual Analog Scale and the Roland-Morris Disability Questionnaires to assess the pain intensity and its impact on daily activities before and after the intervention. Significant decrease in pain intensity compared to carrier oil or no intervention was observed. The rose oil also improves the functional ability of these patients in contrast with no intervention, while its effect on function is not significant compared to carrier oil. Rose oil reduced pregnancy-related low back pain intensity without any significant adverse effect. © The Author(s) 2016.

  3. Pelvic floor physical therapy in urogynecologic disorders.

    Science.gov (United States)

    Kotarinos, Rhonda K

    2003-08-01

    Physical therapists are uniquely qualified to treat pelvic floor dysfunction with conservative management techniques. Techniques associated with incontinence and support functions of the pelvic floor include bladder training and pelvic floor rehabilitation: pelvic floor exercises, biofeedback therapy, and pelvic floor electrical stimulation. Pain associated with mechanical pelvic floor dysfunction can be treated by physical therapists utilizing various manual techniques and modalities. Research documents that conservative management is effective in treating many conditions associated with pelvic floor dysfunction. Research should be conducted to determine if addressing diastasis recti and contracture of the pelvic floor musculature should be a component of the standard physical therapy protocol.

  4. Comparative pelvic development of the axolotl (Ambystoma mexicanum) and the Australian lungfish (Neoceratodus forsteri): conservation and innovation across the fish-tetrapod transition.

    Science.gov (United States)

    Boisvert, Catherine Anne; Joss, Jean Mp; Ahlberg, Per E

    2013-01-23

    The fish-tetrapod transition was one of the major events in vertebrate evolution and was enabled by many morphological changes. Although the transformation of paired fish fins into tetrapod limbs has been a major topic of study in recent years, both from paleontological and comparative developmental perspectives, the interest has focused almost exclusively on the distal part of the appendage and in particular the origin of digits. Relatively little attention has been paid to the transformation of the pelvic girdle from a small unipartite structure to a large tripartite weight-bearing structure, allowing tetrapods to rely mostly on their hindlimbs for locomotion. In order to understand how the ischium and the ilium evolved and how the acetabulum was reoriented during this transition, growth series of the Australian lungfish Neoceratodus forsteri and the Mexican axolotl Ambystoma mexicanum were cleared and stained for cartilage and bone and immunostained for skeletal muscles. In order to understand the myological developmental data, hypotheses about the homologies of pelvic muscles in adults of Latimeria, Neoceratodus and Necturus were formulated based on descriptions from the literature of the coelacanth (Latimeria), the Australian Lungfish (Neoceratodus) and a salamander (Necturus). In the axolotl and the lungfish, the chondrification of the pelvic girdle starts at the acetabula and progresses anteriorly in the lungfish and anteriorly and posteriorly in the salamander. The ilium develops by extending dorsally to meet and connect to the sacral rib in the axolotl. Homologous muscles develop in the same order with the hypaxial musculature developing first, followed by the deep, then the superficial pelvic musculature. Development of the pelvic endoskeleton and musculature is very similar in Neoceratodus and Ambystoma. If the acetabulum is seen as being a fixed landmark, the evolution of the ischium only required pubic pre-chondrogenic cells to migrate posteriorly. It

  5. Pelvic Muscle Rehabilitation: A Standardized Protocol for Pelvic Floor Dysfunction

    Directory of Open Access Journals (Sweden)

    Rodrigo Pedraza

    2014-01-01

    Full Text Available Introduction. Pelvic floor dysfunction syndromes present with voiding, sexual, and anorectal disturbances, which may be associated with one another, resulting in complex presentation. Thus, an integrated diagnosis and management approach may be required. Pelvic muscle rehabilitation (PMR is a noninvasive modality involving cognitive reeducation, modification, and retraining of the pelvic floor and associated musculature. We describe our standardized PMR protocol for the management of pelvic floor dysfunction syndromes. Pelvic Muscle Rehabilitation Program. The diagnostic assessment includes electromyography and manometry analyzed in 4 phases: (1 initial baseline phase; (2 rapid contraction phase; (3 tonic contraction and endurance phase; and (4 late baseline phase. This evaluation is performed at the onset of every session. PMR management consists of 6 possible therapeutic modalities, employed depending on the diagnostic evaluation: (1 down-training; (2 accessory muscle isolation; (3 discrimination training; (4 muscle strengthening; (5 endurance training; and (6 electrical stimulation. Eight to ten sessions are performed at one-week intervals with integration of home exercises and lifestyle modifications. Conclusions. The PMR protocol offers a standardized approach to diagnose and manage pelvic floor dysfunction syndromes with potential advantages over traditional biofeedback, involving additional interventions and a continuous pelvic floor assessment with management modifications over the clinical course.

  6. Women with epilepsy in childbearing age: Pregnancy-related knowledge, information sources, and antiepileptic drugs.

    Science.gov (United States)

    Friedrich, Latica; Sruk, Ana; Bielen, Ivan

    2018-03-01

    Pregnancy-related issues in epilepsy (PRIE) are essential for management of epilepsy in women. We conducted a study among women with epilepsy (WWE) aged 15-45years about their knowledge, sources, and needs for information regarding PRIE, which included their current antiepileptic drugs (AEDs) usage. Women with epilepsy, visitors of Croatian Association for Epilepsy webpage, were offered an online questionnaire, and 200 responses were analyzed. The mean number of correct answers about PRIE was 3.5 out of 5. Main predictors of knowledge on PRIE were a prior consultation with a neurologist and higher usage of books/brochures. A prior neurologist consultation on PRIE was stated by 45% of subjects. As the preferred future mode of being informed on PRIE, majority of women (61%) chooses their neurologist, 22% written materials distributed by a neurologist, and only 13% Internet. Levetiracetam was the most commonly used AED (34.5%). Valproate was used by 26%, and of those 59% stated no previous consultation on PRIE with their neurologist. In summary, we believe our study shows that knowledge of PRIE among WWE in their childbearing age is unsatisfactory, as are the neurologist consultation rates about PRIE. Our results demonstrate that, despite modern technologies, educational activities should be based on neurologist consultations and providing the patients with appropriate written materials. This is especially true for the relatively large proportion of women still taking valproate. Copyright © 2018 Elsevier Inc. All rights reserved.

  7. 11-Year Trends in Pregnancy-Related Health Indicators in Maine, 2000–2010

    Directory of Open Access Journals (Sweden)

    David E. Harris

    2014-01-01

    Full Text Available The objective of this study is to understand health and demographic trends among mothers and infants in Maine relative to the goals of Healthy People 2020. Pregnancy risk assessment monitoring system (PRAMS data from Maine for 2000–2010 were used to determine yearly values of pregnancy-related variables. Means (for continuous variables and percentages (for categorical variables were calculated using the survey procedures in SAS. Linear trend analysis was applied with study year as the independent variable. The slope and significance of the trend were then calculated. Over the study period, new mothers in Maine became better educated but the fraction of households with incomes <$20,000/year remained stagnant. Maternal prepregnancy BMI increased. Average pregnancy weight gain decreased but the number of women whose pregnancy weight gain was within the recommended range was unchanged. The rates of smoking and alcohol consumption (before and during pregnancy increased. The Caesarean section rate rose and the fraction of infants born premature (<37 wks gestation or underweight (<2500 gms remained unchanged. The fraction of infants who were breast-fed increased. These results suggest that, despite some positive trends, Maine faces significant challenges in meeting Healthy People 2020 goals.

  8. Effects of cane girdling on yield, fruit quality and maturation of (Vitis vinifera L. cv. Flame Seedless

    Directory of Open Access Journals (Sweden)

    Soltekin Oguzhan

    2016-01-01

    Full Text Available This study was carried out to determine the effects of cane girdling on coloration, maturation, yield and some quality characteristics of Vitis vinifera L. cv. Flame Seedless table grape variety. Cane girdling practices were treated at pea-size stage (G2 and veraison period (G1 over two growing seasons, 2013–2014, at the facility of Manisa Viticultural Research Institute in Turkey. Cane girdling was performed on the canes after first shoot was left from the bottom and 4 mm-wide ring of bark was completely removed with a doubleded knife. On the other hand control vines were left untouched. Statistical analyses showed that TSS, berry length, colour parameters, CIRG index and anthocyanin content of Flame Seedless was significantly affected by the cane girdling treatments in both years, 2013 and 2014. In addition it was detected that any effect of girdling treatments cannot be determined statistically significant on total yield, marketable yield, titrable acidity and 50 berry weight. Total and marketable yields of girdled vines had higher value than control vines although they were not statistically significant. Furthermore it was observed 9 and 12 days earliness with G2 treatments compare to the control vines in 2013 and 2014, respectively.

  9. Pelvic denervation procedures for dysmenorrhea.

    Science.gov (United States)

    Ramirez, Christina; Donnellan, Nicole

    2017-08-01

    Chronic pelvic pain and dysmenorrhea are common conditions affecting reproductive-age women. Surgical pelvic denervation procedures may be a treatment option for women with midline dysmenorrhea, in which medical management is declined by the patient, ineffective at managing symptoms, or medically contraindicated. This review describes the surgical techniques and complications associated with pelvic denervation procedures as well as the current evidence for these procedures in women with primary dysmenorrhea and dysmenorrhea secondary to endometriosis. Presacral neurectomy is the preferred pelvic denervation procedure in patients with primary dysmenorrhea and midline chronic pelvic pain associated with endometriosis. In patients with endometriosis presacral neurectomy is a useful adjunct to excision or ablation of all endometrial lesions to improve postoperative pain relief. There is no additional patient benefit of performing combined presacral neurectomy and uterine nerve ablation procedures. Pelvic denervation procedures can be performed safely and quickly with a low risk of complication if the surgeon is knowledgeable and skilled in operating in the presacral space. Patients should be adequately counseled on expected success rates and potential complications associated with pelvic denervation procedures.

  10. Post Pelvic Radiotherapy Bony Changes

    Energy Technology Data Exchange (ETDEWEB)

    Huh, Seung Jae [Samsung Medical Center, Seoul (Korea, Republic of)

    2009-03-15

    There has been recent interest in radiation-induced bone injury in clinical conditions, especially for pelvic insufficiency fracture (PIF). A PIF is caused by the effect of normal or physiological stress on bone with demineralization and decreased elastic resistance. Pelvic radiotherapy (RT) can also contribute to the development of a PIF. A PIF has been regarded as a rare complication with the use of megavoltage equipment. However, recent studies have reported the incidence of PIFs as 8.2{approx}20% after pelvic RT in gynecological patients, an incidence that was higher than previously believed. The importance of understanding a PIF lies in the potential for misdiagnosis as a bony metastasis. If patients complain of pelvic pain after whole-pelvis radiation therapy, the presence of a PIF must be considered in the differential diagnosis. The use of multibeam arrangements and conformal RT to reduce the volume and dose of irradiated pelvic bone can be helpful to minimize the risk of fracture. In addition to a PIF, osteonecrosis and avascular necrosis of the femoral head can develop after radiation therapy. Osteoradionecrosis of the pelvic bone is a clinical diagnostic challenge that must be differentiated from an osseous metastasis. A post-radiation bone sarcoma can result as a long-term sequela of pelvic irradiation for uterine cervical cancer.

  11. A new mutation of the fukutin gene causing late-onset limb girdle muscular dystrophy

    DEFF Research Database (Denmark)

    Riisager, Maria; Duno, M; Hansen, Flemming Juul

    2013-01-01

    to aberrations of FKTN is rare, with only eight reported cases of limb girdle phenotype (LGMD2M). We describe the mildest affected patient outside Japan with genetically confirmed LGMD2M and onset of symptoms at age 14. She was brought to medical attention at age 12, not because of muscle weakness, but due...... to episodes of tachycardia caused by Wolff-Parkinson-White syndrome. On examination, she had rigid spine syndrome, a typical limb girdle dystrophy pattern of muscle weakness, cardiomyopathy, and serum CK levels >2000 IU/L (normal G; p.Y306C mutation in the FKTN gene was found. The case confirms FKTN mutations...... as a cause of LGMD2M without mental retardation and expands the phenotypic spectrum for LGMD2M to include cardiomyopathy and rigid spine syndrome in the mildest affected non-Japanese patient reported so far....

  12. Complex surgery for locally advanced bone and soft tissue sarcomas of the shoulder girdle.

    Science.gov (United States)

    Lesenský, Jan; Mavrogenis, Andreas F; Igoumenou, Vasilios G; Matejovsky, Zdenek; Nemec, Karel; Papagelopoulos, Panayiotis J; Fabbri, Nicola

    2017-08-01

    Surgical management of primary musculoskeletal tumors of the shoulder girdle is cognitively and technically demanding. Over the last decades, advances in the medical treatments, imaging and surgical techniques have fostered limb salvage surgery and reduced the need for amputation. Despite well-accepted general principles, an individualized approach is often necessary to accommodate tumor extension, anatomical challenges and patient characteristics. A combination of techniques is often required to achieve optimal oncologic and durable functional outcome. Goal of this article is to review approach and management of patients with locally advanced sarcomas of the shoulder girdle requiring major tumor surgery, to illustrate principles of surgical strategy, outcome and complications, and to provide useful guidelines for the treating physicians.

  13. Radiographic assessment of pelvic trauma

    International Nuclear Information System (INIS)

    Rubenstein, J.D.

    1983-01-01

    Assessment of pelvic fractures requires an understanding of the bony and soft-tissue anatomy of the pelvis. Pelvic injuries may be classified into major and minor groups. Minor fractures usually result from athletic trauma in the young or falls in the elderly and can generally be adequately evaluated with routine radiography. Major fractures are most often caused by motor vehicle accidents, falls from a height or industrial accidents and require more sophisticated examination. However, the investigation of injuries in either category should be directed by a knowledge of the history and physical findings. The classification of pelvic injuries used at Sunnbrook Medical Centre is based on mechanisms of injury

  14. Internet use by pregnant women seeking pregnancy-related information: a systematic review.

    Science.gov (United States)

    Sayakhot, Padaphet; Carolan-Olah, Mary

    2016-03-28

    The Internet has become one of the most popular sources of information for health consumers and pregnant women are no exception. The primary objective of this review was to investigate the ways in which pregnant women used the Internet to retrieve pregnancy-related information. We conducted a systematic review to answer this question. In November 2014, electronic databases: Scopus, Medline, PreMEDLINE, EMBASE, CINAHL and PubMed were searched for papers with the terms "Internet"; "pregnancy"; "health information seeking", in the title, abstract or as keywords. Restrictions were placed on publication to within 10 years and language of publication was restricted to English. Quantitative studies were sought, that reported original research and described Internet use by pregnant women. Seven publications met inclusion criteria and were included in the review. Sample size ranged from 182 - 1347 pregnant women. The majority of papers reported that women used the Internet as a source of information about pregnancy. Most women searched for information at least once a month. Fetal development and nutrition in pregnancy were the most often mentioned topics of interest. One paper included in this review found that women with higher education were three times more likely to seek advice than women with less than a high school education, and also that single and multiparous women were less likely to seek advice than married and nulliparous women. The majority of women found health information on the Internet to be reliable and useful. Most women did not discuss the information they retrieved from the Internet with their health providers. Thus, health providers may not be aware of potentially inaccurate information or mistaken beliefs about pregnancy, reported on the Internet. Future research is needed to address this issue of potentially unreliable information.

  15. Pregnancy Related Complications in Patients with Systemic Lupus Erythematosus, An Egyptian Experience

    Directory of Open Access Journals (Sweden)

    S.F. Hendawy

    2011-01-01

    Full Text Available Background Systemic Lupus Erythematosus (SLE has a tendency to occur in women in their reproductive years, causing complications during pregnancy and labour. Conversely, pregnancy can cause flares of disease activity, often necessitating immediate intervention. Aim of study to study pregnancy related complications in patients with SLE. Patients and methods The study included 48 SLE pregnant females. 27 patients with 38 pregnancies, their data viewed retrospectively from medical records, and 21 patients with 21 pregnancies followed up prospectively. The laboratory data included ANA, DNA, APL antibodies and anti Ro/SSA. The disease activity was calculated according to the Systemic Lupus Activity Measure. Ultrasound was performed to confirm gestational age and assess for the presence of any congenital fetal malformations, and then repeated monthly to detect any abnormality including intrauterine growth restriction. At 30 weeks gestation and onwards, assessment of fetal wellbeing including daily fetal kick chart and once weekly non stress test was performed. Doppler blood flow velocimetry was done for those with abnormal fetal heart rate pattern. After labour, the neonate was examined for complications including complete heart block and neonatal lupus. Results Anti dsDNA was found in 95% of the patients, anti Ro/SSA in 6% and anti APL in 30%. 57% of the patients followed up prospectively had active disease in the 1st trimester, 24% in the 2nd and 62% in the 3rd trimester. The most common maternal complication was preeclampsia 33%, followed by spontaneous abortion 20%. Prematurity was the most common fetal complication 37%, followed by intrauterine growth restriction 29%. 2 neonates were born with congenital heart block and 1 with neonatal lupus. Conclusion Pregnancy in SLE patients is associated with a higher risk of obstetric complications affecting both the mother and the fetus. Preeclampsia was the most common complication followed by prematurity

  16. Pelvic Inflammatory Disease (PID) Statistics

    Science.gov (United States)

    ... Home Page Bacterial Vaginosis (BV) Chlamydia Genital Herpes Gonorrhea Hepatitis HIV/AIDS & STDs Human Papillomavirus (HPV) Pelvic ... last 12 months that they had chlamydia or gonorrhea or have ever been told they have herpes, ...

  17. How Is Pelvic Pain Diagnosed?

    Science.gov (United States)

    ... NICHD Research Information Find a Study More Information Pharmacology Condition Information NICHD Research Information Find a Study ... button to look inside the pelvis 4 Pelvic MRI (magnetic resonance imaging) scan, an imaging test that ...

  18. Stem girdling evidences a trade-off between cambial activity and sprouting and dramatically reduces plant transpiration due to feedback inhibition of photosynthesis and hormone signaling.

    Science.gov (United States)

    López, Rosana; Brossa, Ricard; Gil, Luis; Pita, Pilar

    2015-01-01

    The photosynthesis source-sink relationship in young Pinus canariensis seedlings was modified by stem girdling to investigate sprouting and cambial activity, feedback inhibition of photosynthesis, and stem and root hydraulic capacity. Removal of bark tissue showed a trade-off between sprouting and diameter growth. Above the girdle, growth was accelerated but the number of sprouts was almost negligible, whereas below the girdle the response was reversed. Girdling resulted in a sharp decrease in whole plant transpiration and root hydraulic conductance. The reduction of leaf area after girdling was strengthened by the high levels of abscisic acid found in buds which pointed to stronger bud dormancy, preventing a new needle flush. Accumulation of sugars in leaves led to a coordinated reduction in net photosynthesis (AN) and stomatal conductance (gS) in the short term, but later (gS below 0.07 mol m(-2) s(-1)) AN decreased faster. The decrease in maximal efficiency of photosystem II (FV/FM) and the operating quantum efficiency of photosystem II (ΦPSII) in girdled plants could suggest photoprotection of leaves, as shown by the vigorous recovery of AN and ΦPSII after reconnection of the phloem. Stem girdling did not affect xylem embolism but increased stem hydraulic conductance above the girdle. This study shows that stem girdling affects not only the carbon balance, but also the water status of the plant.

  19. Stem girdling evidences a trade-off between cambial activity and sprouting and dramatically reduces plant transpiration due to feedback inhibition of photosynthesis and hormone signaling

    Directory of Open Access Journals (Sweden)

    Rosana eLópez

    2015-04-01

    Full Text Available The photosynthesis source-sink relationship in young Pinus canariensis seedlings was modified by stem girdling to investigate sprouting and cambial activity, feedback inhibition of photosynthesis, and stem and root hydraulic capacity. Removal of bark tissue showed a trade-off between sprouting and diameter growth. Above the girdle, growth was accelerated but the number of sprouts was almost negligible, whereas below the girdle the response was reversed. Girdling resulted in a sharp decrease in whole plant transpiration and root hydraulic conductance. The reduction of leaf area after girdling was strengthened by the high levels of ABA found in buds which pointed to stronger bud dormancy, preventing a new needle flush. Accumulation of sugars in leaves led to a coordinated reduction in net photosynthesis (AN and stomatal conductance (gS in the short term, but later (gS below 0.07 mol m-2 s-1 AN decreased faster. The decrease in maximal efficiency of photosystem II (FV/FM and the operating quantum efficiency of photosystem II (ΦPSII in girdled plants could suggest photoprotection of leaves, as shown by the vigorous recovery of AN and ΦPSII after reconnection of the phloem. Stem girdling did not affect xylem embolism but increased stem hydraulic conductance above the girdle. This study shows that stem girdling affects not only the carbon balance, but also the water status of the plant.

  20. MR appearance of pelvic hemangiopericytoma

    International Nuclear Information System (INIS)

    Kehagias, D.; Gouliamos, A.; Vlahos, L.

    1999-01-01

    A case of pelvic hemangiopericytoma in a 59-year-old woman is reported. The MR imaging features are presented. The tumor was unresectable and the patient received postoperative irradiation of 4200 cGy on the pelvis. One year after diagnosis, metastasis to a lumbar vertebra was discovered and additional irradiation of 3900 cGy was applied. One year later, CT showed control of the pelvic tumor and its metastasis. (orig.) (orig.)

  1. MR appearance of pelvic hemangiopericytoma

    Energy Technology Data Exchange (ETDEWEB)

    Kehagias, D.; Gouliamos, A.; Vlahos, L. [Dept. of Radiology, University of Athens (Greece)

    1999-02-01

    A case of pelvic hemangiopericytoma in a 59-year-old woman is reported. The MR imaging features are presented. The tumor was unresectable and the patient received postoperative irradiation of 4200 cGy on the pelvis. One year after diagnosis, metastasis to a lumbar vertebra was discovered and additional irradiation of 3900 cGy was applied. One year later, CT showed control of the pelvic tumor and its metastasis. (orig.) (orig.) With 3 figs., 10 refs.

  2. Interventional Management for Pelvic Pain.

    Science.gov (United States)

    Nagpal, Ameet S; Moody, Erika L

    2017-08-01

    Interventional procedures can be applied for diagnostic evaluation and treatment of the patient with pelvic pain, often once more conservative measures have failed to provide relief. This article reviews interventional management strategies for pelvic pain. We review superior and inferior hypogastric plexus blocks, ganglion impar blocks, transversus abdominis plane blocks, ilioinguinal, iliohypogastric and genitofemoral blocks, pudendal nerve blocks, and selective nerve root blocks. Additionally, we discuss trigger point injections, sacroiliac joint injections, and neuromodulation approaches. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. MR Imaging of Brachial Plexus and Limb-Girdle Muscles in Patients with Amyotrophic Lateral Sclerosis.

    Science.gov (United States)

    Gerevini, Simonetta; Agosta, Federica; Riva, Nilo; Spinelli, Edoardo G; Pagani, Elisabetta; Caliendo, Giandomenico; Chaabane, Linda; Copetti, Massimiliano; Quattrini, Angelo; Comi, Giancarlo; Falini, Andrea; Filippi, Massimo

    2016-05-01

    To assess brachial plexus magnetic resonance (MR) imaging features and limb-girdle muscle abnormalities as signs of muscle denervation in patients with amyotrophic lateral sclerosis (ALS). This study was approved by the local ethical committees on human studies, and written informed consent was obtained from all subjects before enrollment. By using an optimized protocol of brachial plexus MR imaging, brachial plexus and limb-girdle muscle abnormalities were evaluated in 23 patients with ALS and clinical and neurophysiologically active involvement of the upper limbs and were compared with MR images in 12 age-matched healthy individuals. Nerve root and limb-girdle muscle abnormalities were visually evaluated by two experienced observers. A region of interest-based analysis was performed to measure nerve root volume and T2 signal intensity. Measures obtained at visual inspection were analyzed by using the Wald χ(2) test. Mean T2 signal intensity and volume values of the regions of interest were compared between groups by using a hierarchical linear model, accounting for the repeated measurement design. The level of interrater agreement was very strong (κ = 0.77-1). T2 hyperintensity and volume alterations of C5, C6, and C7 nerve roots were observed in patients with ALS (P < .001 to .03). Increased T2 signal intensity of nerve roots was associated with faster disease progression (upper-limb Medical Research Council scale progression rate, r = 0.40; 95% confidence interval: 0.001, 0.73). Limb-girdle muscle alterations (ie, T2 signal intensity alteration, edema, atrophy) and fat infiltration also were found, in particular, in the supraspinatus muscle, showing more frequent T2 signal intensity alterations and edema (P = .01) relative to the subscapularis and infraspinatus muscles. Increased T2 signal intensity and volume of brachial nerve roots do not exclude a diagnosis of ALS and suggest involvement of the peripheral nervous system in the ALS pathogenetic cascade. MR

  4. A new species of Silvinichthys (Siluriformes, Trichomycteridae) lacking pelvic fins from mid-elevation localities of the southern Andes, with comments on the genus.

    Science.gov (United States)

    Fernández, L; Sanabria, E A; Quiroga, L B; Vari, R P

    2014-02-01

    Silvinichthys huachi new species, is described from a stream along the lower slope of the Andean Cordillera in the Provincia de San Juan, Argentina. It shares the distinctive modifications characteristic of Silvinichthys, but is distinguished from the four previously described congeners by the combination of a lack of the pelvic fin and the pelvic girdle, details of pigmentation and various meristic and morphometric features. Silvinichthys huachi is apparently endemic to the type locality situated within an arid region of western central Argentina in the Andino Cuyana Province. Major gaps in the range of species of Silvinichthys may indicate that the origin of the genus predates the uplift events that subdivided drainages along the eastern slopes of the Andean Cordillera in west central Argentina. Silvinichthys huachi is hypothesized to be the sister species of Silvinichthys bortayro. © 2014 The Fisheries Society of the British Isles.

  5. Clinical factors associated with readmission for postpartum hypertension in women with pregnancy-related hypertension: a nested case control study.

    Science.gov (United States)

    Hirshberg, A; Levine, L D; Srinivas, S K

    2016-05-01

    To evaluate the association between mode of delivery and length of labor on readmission for postpartum hypertension in women with pregnancy-related hypertension. Nested case control study within a cohort of 99 women with pregnancy-related hypertension who delivered at our institution between 2005 and 2009. Data were abstracted for clinical and labor information. Mode of delivery and length of labor were compared between women with previously diagnosed pregnancy-related hypertension readmitted within 4 weeks post partum (25 cases) and those not readmitted (74 controls). Categorical and continuous variables were compared using χ(2) and T-tests, respectively. Multivariable logistic regression controlled for confounders. Hypertension readmission was not associated with mode of delivery (cases: 10(40%) spontaneous vaginal delivery, 15(60%) cesarean delivery; controls: 38(51%) spontaneous vaginal delivery, 36(49%) cesarean delivery, P=0.33). Length of labor appeared longer in cases, with a trend toward significance (median: 15.5 [7,28] h vs 10.75 [5.8,15.9] h, P=0.12) and was significantly associated with readmission after controlling for delivery mode, induction and parity (adjusted odds ratio=1.06 [1 to 1.12], P=0.048). Readmitted patients were less likely to have initially been started on antihypertensive medications after controlling for age, race and chronic hypertension (adjusted odds ratio=0.23 [0.06 to 0.88], P=0.03). Postpartum readmission for hypertension in women with known pregnancy-related hypertension is not associated with mode of delivery, appears increased in those with longer length of labor and decreased in those initially started on antihypertensive medications. This provides targets for future research to continue to improve transitions of care and reduce preventable readmissions.

  6. Functional anatomy of pelvic floor

    Directory of Open Access Journals (Sweden)

    Salvatore Rocca Rossetti

    2016-03-01

    Full Text Available Generally, descriptions of the pelvic floor are discordant, since its complex structures and the complexity of pathological disorders of such structures; commonly the descriptions are sectorial, concerning muscles, fascial developments, ligaments and so on. On the contrary to understand completely nature and function of the pelvic floor it is necessary to study it in the most unitary view and in the most global aspect, considering embriology, philogenesy, anthropologic development and its multiple activities others than urological, gynaecological and intestinal ones. Recent acquirements succeeded in clarifying many aspects of pelvic floor activity, whose musculature has been investigated through electromyography, sonography, magnetic resonance, histology, histochemistry, molecular research. Utilizing recent research concerning not only urinary and gynecologic aspects but also those regarding statics and dynamics of pelvis and its floor, it is now possible to study this important body part as a unit; that means to consider it in the whole body economy to which maintaining upright position, walking and behavior or physical conduct do not share less than urinary, genital, and intestinal functions. It is today possible to consider the pelvic floor as a musclefascial unit with synergic and antagonistic activity of muscular bundles, among them more or less interlaced, with multiple functions and not only the function of pelvic cup closure.

  7. Explorable three-dimensional digital model of the female pelvis, pelvic contents, and perineum for anatomical education.

    Science.gov (United States)

    Sergovich, Aimée; Johnson, Marjorie; Wilson, Timothy D

    2010-01-01

    The anatomy of the pelvis is complex, multilayered, and its three-dimensional organization is conceptually difficult for students to grasp. The aim of this project was to create an explorable and projectable stereoscopic, three-dimensional (3D) model of the female pelvis and pelvic contents for anatomical education. The model was created using cryosection images obtained from the Visible Human Project, in conjunction with a general-purpose three-dimensional segmentation and surface-rendering program. Anatomical areas of interest were identified and labeled on consecutive images. Each 2D slice was reassembled, forming a three-dimensional model. The model includes the pelvic girdle, organs of the pelvic cavity, surrounding musculature, the perineum, neurovascular structures, and the peritoneum. Each structure can be controlled separately (e.g. added, subtracted, made transparent) to reveal organization and/or relationships between structures. The model can be manipulated and/or projected stereoscopically to visualize structures and relationships from different angles with excellent spatial perception. Because of its ease of use and versatility, we expect this model may provide a powerful teaching tool for learning in the classroom or in the laboratory. (c) 2010 American Association of Anatomists.

  8. Microbiota and Pelvic Inflammatory Disease

    Science.gov (United States)

    Sharma, Harsha; Tal, Reshef; Clark, Natalie A.; Segars, James H.

    2014-01-01

    Female genital tract microbiota play a crucial role in maintaining health. Disequilibrium of the microbiota has been associated with increased risk of pelvic infections. In recent years, culture-independent molecular techniques have expanded understanding of the composition of genital microbiota and the dynamic nature of the microbiota. There is evidence that upper genital tract may not be sterile and may harbor microflora in the physiologic state. The isolation of bacterial vaginosis-associated organisms in women with genital infections establishes a link between pelvic infections and abnormal vaginal flora. With the understanding of the composition of the microbiota in healthy and diseased states, the next logical step is to identify the function of the newly identified microbes. This knowledge will further expand our understanding of the causation of pelvic infections, which may lead to more effective prevention and treatment strategies. PMID:24390920

  9. Computed tomography of pelvic fractures

    Energy Technology Data Exchange (ETDEWEB)

    Kimoto, Makoto; Hashimoto, Keiji; Hiraki, Yoshio

    1984-12-01

    Plain x-ray and computed tomographic (CT) findings were compared in 7 patients with pelvic fractures (2 males and 5 females) aged between 35 and 50 year. Plain x-rays had a higher sensitivity than CT in detecting fractures of the ischiatic and pubic ramuses, and deviation of bone fragments. CT was superior to plain x-rays near the acetabulum and in detecting deviation of bone fragments. Although there were no differences between the two modalities in detecting fractures of the wing of ilium, CT was more useful than plain x-rays in visualizing deviation of bone fragments. CT clearly visualized not only fractures but also injuries of the soft tissues, such as pelvic viscera and muscles, and the presence of hematoma. CT seems to be a useful method for observing the condition and process of pelvic injuries and for deciding treatment protocols.

  10. Comparative analysis of phenotypes features in two common genetic variants of limb-girdle muscular dystrophy

    Directory of Open Access Journals (Sweden)

    I. V. Sharkova

    2015-01-01

    Full Text Available The algorithm of differential diagnosis of the two most common genetic variants the limb-girdle muscular dystrophy (LGMD2A and DMD, developed on the basis of a comprehensive survey of 85 patients with a diagnosis specification using techniques of DNA analysis. It is shown that the accurate diagnosis of LGMD genetic types should be based on the results of the clinical and genealogical, biochemical and molecular genetic analysis. The proposed algorithm will significantly reduces the economic and time costs with expensive DNA testing.

  11. Progressive dysphagia in limb-girdle muscular dystrophy type 2B.

    LENUS (Irish Health Repository)

    Walsh, Richard

    2012-02-01

    Dysphagia has not been reported in genetically confirmed limb-girdle muscular dystrophy type 2B (LGMD2B). A 40-year-old woman reported exercise-induced calf pain at age 34, followed by progressive lower and upper limb weakness. At age 38, progressive dysphagia for solids, and subsequently liquids, ensued. Endoscopic and videofluoroscopic-radiological findings indicated a myopathic swallowing disorder. Molecular genetic analysis confirmed two dysferlin gene mutations consistent with a compound heterozygote state. Progressive dysphagia should be considered as part of the expanding dysferlinopathy phenotype.

  12. Transcriptomes of Arbuscular Mycorrhizal Fungi and Litchi Host Interaction after Tree Girdling.

    Science.gov (United States)

    Shu, Bo; Li, Weicai; Liu, Liqin; Wei, Yongzan; Shi, Shengyou

    2016-01-01

    Trunk girdling can increase carbohydrate content above the girdling site and is an important strategy for inhibiting new shoot growth to promote flowering in cultivated litchi (Litchi chinensis Sonn.). However, girdling inhibits carbohydrate transport to the root in nearly all of the fruit development periods and consequently decreases root absorption. The mechanism through which carbohydrates regulate root development in arbuscular mycorrhiza (AM) remains largely unknown. Carbohydrate content, AM colonization, and transcriptome in the roots were analyzed to elucidate the interaction between host litchi and AM fungi when carbohydrate content decreases. Girdling decreased glucose, fructose, sucrose, quebrachitol, and starch contents in the litchi mycorrhizal roots, thereby reducing AM colonization. RNA-seq achieved approximately 60 million reads of each sample, with an average length of reads reaching 100 bp. Assembly of all the reads of the 30 samples produced 671,316 transcripts and 381,429 unigenes, with average lengths of 780 and 643 bp, respectively. Litchi (54,100 unigenes) and AM fungi unigenes (33,120 unigenes) were achieved through sequence annotation during decreased carbohydrate content. Analysis of differentially expressed genes (DEG) showed that flavonoids, alpha-linolenic acid, and linoleic acid are the main factors that regulate AM colonization in litchi. However, flavonoids may play a role in detecting the stage at which carbohydrate content decreases; alpha-linolenic acid or linoleic acid may affect AM formation under the adaptation process. Litchi trees stimulated the expression of defense-related genes and downregulated symbiosis signal-transduction genes to inhibit new AM colonization. Moreover, transcription factors of the AP2, ERF, Myb, WRKY, bHLH families, and lectin genes altered maintenance of litchi mycorrhizal roots in the post-symbiotic stage for carbohydrate starvation. Similar to those of the litchi host, the E3 ubiquitin ligase complex

  13. Muscle MRI findings in patients with limb girdle muscular dystrophy with calpain 3 deficiency (LGMD2A) and early contractures.

    Science.gov (United States)

    Mercuri, Eugenio; Bushby, Kate; Ricci, Enzo; Birchall, Daniel; Pane, Marika; Kinali, Maria; Allsop, Joanna; Nigro, Vincenzo; Sáenz, Amets; Nascimbeni, Annachiara; Fulizio, Luigi; Angelini, Corrado; Muntoni, Francesco

    2005-02-01

    Limb girdle muscular dystrophy 2A is a common variant secondary to mutations in the calpain 3 gene. A proportion of patients has early and severe contractures, which can cause diagnostic difficulties with other conditions. We report clinical and muscle magnetic resonance imaging findings in seven limb girdle muscular dystrophy 2A patients (four sporadic and three familial) who had prominent and early contractures. All patients showed a striking involvement of the posterior thigh muscles. The involvement of the other thigh muscles was variable and was related to clinical severity. Young patients with minimal functional motor impairment showed a predominant involvement of the adductors and semimembranosus muscles while patients with restricted ambulation had a more diffuse involvement of the posterolateral muscles of the thigh and of the vastus intermedius with relative sparing of the vastus lateralis, sartorius and gracilis. At calf level all patients showed involvement of the soleus muscle and of the medial head of the gastrocnemius with relative sparing of the lateral head. MRI findings were correlated to those found in two patients with the phenotype of limb girdle muscular dystrophy 2A without early contractures and the pattern observed was quite similar. However, the pattern observed in limb girdle muscular dystrophy 2A is different from that reported in other muscle diseases such as Emery-Dreifuss muscular dystrophy and Bethlem myopathy which have a significant clinical overlap with limb girdle muscular dystrophy 2A once early contractures are present. Our results suggest that muscle MRI may help in recognising patients with limb girdle muscular dystrophy 2A even when the clinical presentation overlaps with other conditions, and may therefore, be used as an additional investigation to target the appropriate biochemical and genetic tests.

  14. Biomechanics of the pelvic floor musculature

    NARCIS (Netherlands)

    Janda, S.

    2006-01-01

    The present thesis was motivated by two main goals. The first research goal of the thesis was to understand the complex biomechanical behaviour of the pelvic floor muscles. The second goal was to study the mechanism of the pelvic organ prolapse (genital prolapse). The pelvic floor in humans is a

  15. Early development of the human pelvic diaphragm

    NARCIS (Netherlands)

    Koch, Wijnandus Franciscus Robertus Maria

    2006-01-01

    The last decade an increasing interest in the pelvic floor can be observed in medical sciences. The lack of data on the development of the human pelvic floor is striking. The early development of the human pelvic diaphragm was studied. Materials and methodsUse was made of 38 human embryos and

  16. Relationships Among Smoking, Drinking, Betel Quid Chewing and Pregnancy-Related Nausea and Vomiting in Taiwanese Aboriginal Women

    Directory of Open Access Journals (Sweden)

    Fan-Hao Chou

    2009-02-01

    Full Text Available A cross-sectional survey was conducted to investigate the associations among smoking, drinking, betel quid chewing and pregnancy-related nausea and vomiting (N/V in Taiwanese aboriginal women. A total of 901 aboriginal women from 11 hospitals were recruited into this study. A structured questionnaire on demographic and obstetric information, smoking history, alcohol consumption, betel quid chewing habits, and N/V by checklist was used to collect data. The findings of this study indicated that the prevalence of N/V, maternal smoking, drinking, and betel quid chewing were 75.6% (n = 682, 22.8% (n = 201, 31.9% (n = 287, and 34.7% (n = 313 respectively. Multiple logistic regression with adjustment for age, body mass index and antiemetics use revealed significant relationships between smoking habits and N/V before confirmation of pregnancy and during pregnancy. In comparison with those who did not smoke, women smoking in excess of 10 cigarettes a day before pregnancy were 1.65 times more likely to develop N/V; and women smoking in excess of 10 cigarettes a day during pregnancy were 2.79 times more likely to develop N/V. Based on the findings of this study, smoking was associated, with a dose-response effect, with pregnancy-related N/V. Reducing the intake of cigarettes could decrease the risk of pregnancy-related N/V. Health care providers should help these women decrease their uncomfortable symptoms and improve their experiences of pregnancy and birth outcome during critical times.

  17. Revealing the burden of maternal mortality: a probabilistic model for determining pregnancy-related causes of death from verbal autopsies

    Directory of Open Access Journals (Sweden)

    Desta Teklay

    2007-02-01

    Full Text Available Abstract Background Substantial reductions in maternal mortality are called for in Millennium Development Goal 5 (MDG-5, thus assuming that maternal mortality is measurable. A key difficulty is attributing causes of death for the many women who die unaided in developing countries. Verbal autopsy (VA can elicit circumstances of death, but data need to be interpreted reliably and consistently to serve as global indicators. Recent developments in probabilistic modelling of VA interpretation are adapted and assessed here for the specific circumstances of pregnancy-related death. Methods A preliminary version of the InterVA-M probabilistic VA interpretation model was developed and refined with adult female VA data from several sources, and then assessed against 258 additional VA interviews from Burkina Faso. Likely causes of death produced by the model were compared with causes previously determined by local physicians. Distinction was made between free-text and closed-question data in the VA interviews, to assess the added value of free-text material on the model's output. Results Following rationalisation between the model and physician interpretations, cause-specific mortality fractions were broadly similar. Case-by-case agreement between the model and any of the reviewing physicians reached approximately 60%, rising to approximately 80% when cases with a discrepancy were reviewed by an additional physician. Cardiovascular disease and malaria showed the largest differences between the methods, and the attribution of infections related to pregnancy also varied. The model estimated 30% of deaths to be pregnancy-related, of which half were due to direct causes. Data derived from free-text made no appreciable difference. Conclusion InterVA-M represents a potentially valuable new tool for measuring maternal mortality in an efficient, consistent and standardised way. Further development, refinement and validation are planned. It could become a routine

  18. Complex shoulder girdle injuries following mountain bike accidents and a review of the literature

    Science.gov (United States)

    Lea, Matthew Alexander; Makaram, Navnit; Srinivasan, Makaram S

    2016-01-01

    Background Mountain and road bike accidents are particularly common with the increased popularity of the sport. We reviewed the attendances in our emergency department over a 4-year period looking at cycling injuries to detect the level and grade of these injuries and their outcomes. Method Royal Blackburn Hospital caters for a population of 550 000. A search through the Hospital information system revealed 104 patients with fractures following mountain bike injuries. These were looked at in more detail. We present a series of 5 severe shoulder girdle injuries following mountain bike accidents in this cohort, to highlight the serious level of injury sustained in this sport. We searched MEDLINE and EMBASE databases over the past 10 years using the keywords, mountain, biking and fracture. This yielded 7 papers. We compared our series with the literature. Results 104 fractures following mountain bike accidents between 2008 and 2011. Fractures of the upper limb were the most common (88.5%) with the clavicle being the most commonly fractured bone (28.8%). Conclusions Major scapular injuries with destruction or disruption of the four bar linkage of the shoulder girdle are very common following mountain accidents. Clavicular fractures are the commonest upper limb injury. It is easy to miss a disruption to the four-bar linkage associated with a clavicular injury. This paper highlights the severity of the injuries sustained in mountain bike accidents of the upper limb and requirement of adequate protection in this exhilarating sport. PMID:27900147

  19. Comparison of different patient positioning strategies to minimize shoulder girdle artifacts in head and neck CT.

    Science.gov (United States)

    Wirth, Stefan; Meindl, Thomas; Treitl, Marcus; Pfeifer, Klaus-Jürgen; Reiser, Maximilian

    2006-08-01

    The purpose of this study was to analyze different patient positioning strategies for minimizing artifacts of the shoulder girdle in head and neck CT. Standardized CT examinations of three positioning groups were compared (P: patients pushed their shoulders downwards; D: similar optimization by a pulling device; N: no particular positioning optimization). Parameters analyzed were the length of the cervical spine not being superimposed by the shoulder girdle as well as noise in the supraclavicular space. In groups P and D, the portion of the cervical spine not superimposed was significantly larger than in group N (P: 10.4 cm; D: 10.6 cm; N: 8.5 cm). At the supraclavicular space, noise decreased significantly (P: 12.5 HU; D: 12.1 HU; N: 17.7 HU). No significant differences between the two position-optimized groups (P and D) were detected. Optimized shoulder positioning by the patient increases image quality in CT head and neck imaging. The use of a pulling device offers no additional advantages.

  20. Bone Health and Pelvic Radiotherapy.

    Science.gov (United States)

    Higham, C E; Faithfull, S

    2015-11-01

    Survivors who have received pelvic radiotherapy make up many of the long-term cancer population, with therapies for gynaecological, bowel, bladder and prostate malignancies. Individuals who receive radiotherapy to the pelvis as part of their cancer treatment are at risk of insufficiency fractures. Symptoms of insufficiency fractures include pelvic and back pain and immobility, which can affect substantially quality of life. This constellation of symptoms can occur within 2 months of radiotherapy up to 63 months post-treatment, with a median incidence of 6-20 months. As a condition it is under reported and evidence is poor as to the contributing risk factors, causation and best management to improve the patient's bone health and mobility. As radiotherapy advances, chronic symptoms, such as insufficiency fractures, as a consequence of treatment need to be better understood and reviewed. This overview explores the current evidence for the effect of radiotherapy on bone health and insufficiency fractures and identifies what we know and where gaps in our knowledge lie. The overview concludes with the need to take seriously complaints of pelvic pain from patients after pelvic radiotherapy and to investigate and manage these symptoms more effectively. There is a clear need for definitive research in this field to provide the evidence-based guidance much needed in practice. Copyright © 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  1. Obesity and pelvic organ prolapse

    NARCIS (Netherlands)

    Lee, U.J.; Kerkhof, M.H.; Leijsen, S.A. van; Heesakkers, J.P.F.A.

    2017-01-01

    PURPOSE OF REVIEW: The purpose of this review is to review the data on the relationship of obesity and pelvic organ prolapse (POP). This review is timely and relevant as the prevalence of obesity is increasing worldwide, and it is an important risk factor to consider in counseling women on

  2. MR imaging in female pelvic organs prolapse

    International Nuclear Information System (INIS)

    Capiel, Carlos A. h; Bouzas, Carlos A.

    2003-01-01

    Pelvic floor weakness and consequent organ prolapse may result in a variety of symptoms, including pain, urinary or fecal incontinence and constipation. Diagnosis is made primary on the basis of findings at physical pelvic examination. Imaging is useful in patients in whom findings at physical examination are equivocal. Different imaging techniques (fluoroscopy, ultrasonography), can be useful in evaluating pelvic organs prolapse. MR imaging is a new noninvasive technique that provides a multiplanar global evaluation of the pelvic contents and demonstrates pelvic organs prolapse. Reference points are the pubococcygeal line and puborectalis muscle sling. This pictorial assay illustrates different grades of cystourethrocele, recto-sigmoidocele and hysteroptosis (uterine prolapse) on MR imaging. (author)

  3. The contribution of unimproved water and toilet facilities to pregnancy-related mortality in Afghanistan: analysis of the Afghan Mortality Survey.

    Science.gov (United States)

    Gon, Giorgia; Monzon-Llamas, Laura; Benova, Lenka; Willey, Barbara; Campbell, Oona M R

    2014-12-01

    To estimate the effect of unimproved household water and toilet facilities on pregnancy-related mortality in Afghanistan. The data source was a population-based cross-sectional study, the Afghan Mortality Survey 2010. Descriptive, univariate and multivariate logistic regression analyses were carried out, comparing 69 pregnancy-related deaths (cases) and 15386 surviving women (non-cases) who had a live birth or stillbirth between 2007 and 2010. After adjusting for confounders, households with unimproved water access had 1.91 the odds of pregnancy-related mortality [95% confidence interval (CI) 1.11-3.30] compared to households with improved water access. We also found an association between unimproved toilet facilities and pregnancy-related mortality (OR = 2.25; 95% CI 0.71-7.19; P-value = 0.169), but it was not statistically significant. Unimproved household water access was an important risk factor for pregnancy-related mortality in Afghanistan. However, we were unable to discern whether unimproved water source is a marker of unhygienic environments or socio-economic position. There was weak evidence for the association between unimproved toilet facilities and pregnancy-related mortality; this association requires confirmation from larger studies. © 2014 John Wiley & Sons Ltd.

  4. [Functional aspects of pelvic floor surgery].

    Science.gov (United States)

    Wagenlehner, F M E; Gunnemann, A; Liedl, B; Weidner, W

    2009-11-01

    Pelvic floor dysfunctions are frequently seen in females. The human pelvic floor is a complex structure and heavily stressed throughout female life. Recent findings in the functional anatomy of the pelvic floor have led to a much better understand-ing, on the basis of which enormous improvements in the therapeutic options have arisen. The pelvic floor activity is regulated by three main muscular forces that are responsible for vaginal tension and suspension of the pelvic floor -organs, bladder and rectum. For different reasons laxity in the vagina or its supporting ligaments as a result of altered connective tissue can distort this functional anatomy. A variety of symptoms can derive from these pelvic floor dysfunctions, such as urinary urge and stress incontinence, abnormal bladder emptying, faecal incontinence, obstructive bowel disease syndrome and pelvic pain. Pelvic floor reconstruction is nowadays driven by the concept that in the case of pelvic floor symptoms restoration of the anatomy will translate into restoration of the physiology and ultimately improve the patients' symptoms. The exact surgical reconstruction of the anatomy is there-fore almost exclusively focused on the restoration of the lax pelvic floor ligaments. An exact identification of the anatomic lesions preoperatively is eminently necessary, to allow for an exact anatomic reconstruction with respect to the muscular forces of the pelvic floor. Georg Thieme Verlag Stuttgart * New York.

  5. Mode of delivery and Pelvic floor disorder

    International Nuclear Information System (INIS)

    Noor, R.; Neelam, H.; Bashir, M.S.

    2017-01-01

    Objective: To compare pelvic floor dysfunction in non pregnant women who had delivered vaginally versus those with cesarean delivery. Methodology: The prevalence of pelvic floor disorders among non pregnant women was assesses by using a standardized tool pelvic floor distress inventory short form (PFDI-20). Data was collected from Jinnah Hospital Lahore, Pakistan. Results: Total numbers of participants were 278. 47.12% subjects had moderate, 36.69% miner and 16.19% had severe pelvic floor dysfunction. The symptoms of pelvic organ prolapse were more prevalent (mean value is 59.1876) than Urinary Distress (mean value is 40.5426), while the Colorectal-Anal Distress (mean value is 35.9150) were least prevalent. Conclusion: Pelvic floor disorders are very common among females and are strongly associated with mode of delivery. Although spontaneous vaginal birth was extensively associated with pelvic floor disorders the instrumental delivery affects most. (author)

  6. Studies on the relationship between leptin secretion and several pregnancy-related hormones during pregnancy in the golden hamster

    International Nuclear Information System (INIS)

    Wang Chen; Yang Liguo; Gen Watanabe; Kazuyoshi Taya

    2003-01-01

    Objective: To determine the relationships between leptin secretion and several pregnancy related hormones, the body weight as well as food intaken in the golden hamster during pregnancy and early lactation. Methods: 100 golden hamsters were mated and divided into 16 groups. Blood specimens were taken at 11:00 daily and were determined for plasma leptin, growth hormone (GH), follicular stimulating hormone (FSH), luteinizing hormone (LH), progesterone estradiol and inhibin with RIA. Relationships between leptin level and food intake as well as material body weight were also noted. Results: A plasma leptin peak level occurred on day 12 of the pregnancy. Leptin levels were significantly correlated with levels of gonadal hormones but not with pituitary hormones. Food intake and material total body weight (including the fetus) bore no significant correlationship with plasma leptin throughout the whole pregnancy stage. However, if the fetus weight was subtracted, the net maternal body weight would be significantly correlated with the leptin concentration. Conclusion: These results suggest that leptin-resistance may exits in the golden hamster during pregnancy. Some pregnancy-related hormones, especially gonadal hormones, have regulatory effect on the secretion of leptin. Positive correlation between leptin and net maternal body weight suggests that leptin is still a signal of the body weight to the central nerves system during pregnancy

  7. Pregnancy-related maternal risk factors of attention-deficit hyperactivity disorder: a case-control study.

    Science.gov (United States)

    Amiri, Shahrokh; Malek, Ayyoub; Sadegfard, Majid; Abdi, Salman

    2012-01-01

    Background. The etiology of attention-deficit hyperactivity disorder (ADHD) is complex.This study was conducted to evaluate the pregnancy-related maternal risk factors of ADHD. Methods. 164 ADHD children attending to Child and Adolescent Psychiatric Clinics compared with 166 normal children selected in a random-cluster method from primary schools. ADHD rating scale and clinical interview based on Schedule for Affective disorders and Schizophrenia for School-Aged Children (K-SADS) were used to diagnose ADHD cases and to select the control group. Results. The mean maternal age at pregnancy, duration of pregnancy, and the mean paternal age were alike in two groups. The ADHD children's mothers compared with those of control group had higher frequencies of somatic diseases, psychiatric disorders, and alcohol and cigarette exposure during the pregnancies (P birth by cesarean section was more common among mothers of ADHD children (P < 0.001). These factors plus trauma to the abdomen during pregnancy were significantly predictors of ADHD in children. Conclusions. Some pregnancy-related maternal factors may be considered as environmental risk factors for ADHD. Each of these factors considered in our study as a risk factor needs to be tested and confirmed through next methodologically appropriate researches in this field.

  8. Validation of the Pelvic Floor Distress Inventory-20 and the Pelvic Floor Impact Questionnaire-7 in Danish women with pelvic organ prolapse

    DEFF Research Database (Denmark)

    Due, Ulla; Brostrøm, Søren; Lose, Gunnar

    2013-01-01

    To translate the Pelvic Floor Distress Inventory-20 (PFDI-20) and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7) and to evaluate their psychometric properties in Danish women with symptomatic pelvic organ prolapse....

  9. Effect of giberellic acid (GA4/7) and girdling on induction of reproductive structures in Pinus patula

    Energy Technology Data Exchange (ETDEWEB)

    Vargas-Hernandez, J.J.; Vargas-Abonce, J.I.

    2016-07-01

    Aim of the study. Seed production in forest tree species commonly takes a long time due to the length of the juvenile stage. Even though several treatments have been used to induce early flowering in conifer species, experience on their use in subtropical Pinus species is limited. This study aimed to evaluate the effect of GA4/7 dose (0, 1.27 and 2.54 mg cm-2) and application time (July-October), alone or in combination with partial stem girdling, on male and female strobili production in young Pinus patula Schiede ex Schltdl. et Cham. clones. Area of study: Nine clones with different flowering background of high-elevation Pinus patula growing in a six-year old seed orchard established in Central México (Aquixtla, Puebla) at 2,800 m elevation. Material and methods: Two independent flowering trials (FT1 and FT2) were carried out in the seed orchard during the 2009 and 2010 flowering cycles; similar factors were evaluated at both trials but time of application, clones tested, and experimental design used varied for each of them. Partial stem girdling was done at the base of the trunk and the GA4/7 solution was injected into the xylem above the point of girdling. The following spring, the percentage of trees with strobili and the number of strobili per tree were determined for both male and female structures. Main results: Significant differences (p ≤ 0.05) among clones in flowering capacity were found at both trials. None of the treatments applied in FT1 resulted in an increase of strobili formation, most probably because they were applied too late in the growing season. In FT2, however, application of GA4/7 combined with partial stem girdling increased the percentage of trees with strobili and the number of strobili of both sexes, particularly when applied in early July. Partial stem girdling was more effective on promoting male strobili than female ones in gibberellin-treated grafts. Research highlights: Timing of GA4/7 application and stem girdling was

  10. Interactive influence of leaf age, light intensity, and girdling on green ash foliar chemistry and emerald ash borer development.

    Science.gov (United States)

    Chen, Yigen; Poland, Therese M

    2009-07-01

    Biotic and abiotic environmental factors affect plant nutritional quality and defensive compounds that confer plant resistance to herbivory. Influence of leaf age, light availability, and girdling on foliar nutrition and defense of green ash (Fraxinus pennsylvanica Marsh) was examined in this study. Longevity of the emerald ash borer, Agrilus planipennis Fairmaire (Coleoptera: Buprestidae), adults reared on green ash foliage subjected to these factors was assayed. Mature leaves generally were more nutritious with greater amino acids and a greater ratio of protein to non-structural carbohydrate (P:C) than young leaves, in particular when trees were grown in shade. On the other hand, mature leaves had lower amounts of trypsin and chymotrypsin inhibitors, and total phenolics compared to young leaves. Lower defense of mature leaves alone, or along with higher nutritional quality may lead to increased survival and longevity of emerald ash borer feeding on mature leaves. Sunlight reduced amino acids and P:C ratio, irrespective of leaf age and girdling, and elevated total protein of young foliage, but not protein of mature leaves. Sunlight also dramatically increased all investigated defensive compounds of young, but not mature leaves. Girdling reduced green ash foliar nutrition, especially, of young leaves grown in shade and of mature leaves grown in sun. However emerald ash borer performance did not differ when fed leaves from trees grown in sun or shade, or from girdled or control trees. One explanation is that emerald ash borer reared on lower nutritional quality food may compensate for nutrient deficiency by increasing its consumption rate. The strong interactions among leaf age, light intensity, and girdling on nutrition and defense highlight the need for caution when interpreting data without considering possible interactions.

  11. [Ultrasonography in acute pelvic pain].

    Science.gov (United States)

    Kupesić, Sanja; Aksamija, Alenka; Vucić, Niksa; Tripalo, Ana; Kurjak, Asim

    2002-01-01

    Acute pelvic pain may be the manifestation of various gynecologic and non-gynecologic disorders from less alarming rupture of the follicular cyst to life threatening conditions such as rupture of ectopic pregnancy or perforation of inflamed appendix. In order to construct an algorithm for differential diagnosis we divide acute pelvic pain into gynecologic and non-gynecologic etiology, which is than subdivided into gastrointestinal and urinary causes. Appendicitis is the most common surgical emergency and should always be considered in differential diagnosis if appendix has not been removed. Apart of clinical examination and laboratory tests, an ultrasound examination is sensitive up to 90% and specific up to 95% if graded compression technique is used. Still it is user-depended and requires considerable experience in order to perform it reliably. Meckel's diverticulitis, acute terminal ileitis, mesenteric lymphadenitis and functional bowel disease are conditions that should be differentiated from other causes of low abdominal pain by clinical presentation, laboratory and imaging tests. Dilatation of renal pelvis and ureter are typical signs of obstructive uropathy and may be efficiently detected by ultrasound. Additional thinning of renal parenchyma suggests long-term obstructive uropathy. Ruptured ectopic pregnancy, salpingitis and hemorrhagic ovarian cysts are three most commonly diagnosed gynecologic conditions presenting as an acute abdomen. Degenerating leiomyomas and adnexal torsion occur less frequently. For better systematization, gynecologic causes of acute pelvic pain could be divided into conditions with negative pregnancy test and conditions with positive pregnancy test. Pelvic inflammatory disease may be ultrasonically presented with numerous signs such as thickening of the tubal wall, incomplete septa within the dilated tube, demonstration of hyperechoic mural nodules, free fluid in the "cul-de-sac" etc. Color Doppler ultrasound contributes to more

  12. Pelvic morphology in ischiofemoral impingement

    International Nuclear Information System (INIS)

    Bredella, Miriam A.; Azevedo, Debora C.; Oliveira, Adriana L.; Simeone, Frank J.; Chang, Connie Y.; Torriani, Martin; Stubbs, Allston J.

    2015-01-01

    To assess MRI measures to quantify pelvic morphology that may predispose to ischiofemoral impingement (IFI). We hypothesized that patients with IFI have a wider interischial distance and an increased femoral neck angle compared with normal controls. The study was IRB-approved and complied with HIPAA guidelines. IFI was diagnosed based on clinical findings (hip or buttock pain) and ipsilateral edema of the quadratus femoris muscle on MRI. Control subjects did not report isolated hip/buttock pain and underwent MRI for surveillance of neoplasms or to exclude pelvic fractures. Two MSK radiologists measured the ischiofemoral (IF) and quadratus femoris (QF) distance, the ischial angle as a measure of inter-ischial distance, and the femoral neck angle. The quadratus femoris muscle was evaluated for edema. Groups were compared using ANOVA. Multivariate standard least-squares regression modeling was used to control for age and gender. The study group comprised 84 patients with IFI (53 ± 16 years, 73 female, 11 male) and 51 controls (52 ± 16 years, 33 female, 18 male). Thirteen out of 84 patients (15 %) had bilateral IFI. Patients with IFI had decreased IF and QF distance (p < 0.0001), increased ischial angle (p = 0.004), and increased femoral neck angle (p = 0.02) compared with controls, independent of age and gender. Patients with IFI have increased ischial and femoral neck angles compared with controls. These anatomical variations in pelvic morphology may predispose to IFI. MRI is a useful method of not only assessing the osseous and soft-tissue abnormalities associated with IFI, but also of quantifying anatomical variations in pelvic morphology that can predispose to IFI. (orig.)

  13. Pelvic morphology in ischiofemoral impingement

    Energy Technology Data Exchange (ETDEWEB)

    Bredella, Miriam A.; Azevedo, Debora C.; Oliveira, Adriana L.; Simeone, Frank J.; Chang, Connie Y.; Torriani, Martin [Massachusetts General Hospital, Department of Radiology, Musculoskeletal Imaging and Intervention, Boston, MA (United States); Stubbs, Allston J. [Wake Forest University School of Medicine, Department of Orthopedic Surgery, Division of Sports Medicine, Winston-Salem, NC (United States)

    2014-11-06

    To assess MRI measures to quantify pelvic morphology that may predispose to ischiofemoral impingement (IFI). We hypothesized that patients with IFI have a wider interischial distance and an increased femoral neck angle compared with normal controls. The study was IRB-approved and complied with HIPAA guidelines. IFI was diagnosed based on clinical findings (hip or buttock pain) and ipsilateral edema of the quadratus femoris muscle on MRI. Control subjects did not report isolated hip/buttock pain and underwent MRI for surveillance of neoplasms or to exclude pelvic fractures. Two MSK radiologists measured the ischiofemoral (IF) and quadratus femoris (QF) distance, the ischial angle as a measure of inter-ischial distance, and the femoral neck angle. The quadratus femoris muscle was evaluated for edema. Groups were compared using ANOVA. Multivariate standard least-squares regression modeling was used to control for age and gender. The study group comprised 84 patients with IFI (53 ± 16 years, 73 female, 11 male) and 51 controls (52 ± 16 years, 33 female, 18 male). Thirteen out of 84 patients (15 %) had bilateral IFI. Patients with IFI had decreased IF and QF distance (p < 0.0001), increased ischial angle (p = 0.004), and increased femoral neck angle (p = 0.02) compared with controls, independent of age and gender. Patients with IFI have increased ischial and femoral neck angles compared with controls. These anatomical variations in pelvic morphology may predispose to IFI. MRI is a useful method of not only assessing the osseous and soft-tissue abnormalities associated with IFI, but also of quantifying anatomical variations in pelvic morphology that can predispose to IFI. (orig.)

  14. Contractile properties are disrupted in Becker muscular dystrophy, but not in limb girdle type 2I.

    Science.gov (United States)

    Løkken, Nicoline; Hedermann, Gitte; Thomsen, Carsten; Vissing, John

    2016-09-01

    We investigated whether a linear relationship between muscle strength and cross-sectional area (CSA) is preserved in calf muscles of patients with Becker muscular dystrophy (BMD, n = 14) and limb-girdle type 2I muscular dystrophy (LGMD2I, n = 11), before and after correcting for muscle fat infiltration. The Dixon magnetic resonance imaging technique was used to quantify fat and calculate a fat-free contractile CSA. Strength was assessed by dynamometry. Muscle strength/CSA relationships were significantly lower in patients versus controls. The strength/contractile-CSA relationship was still severely lowered in BMD, but was almost normalized in LGMD2I. Our findings suggest close to intact contractile properties in LGMD2I, which are severely disrupted in BMD. Ann Neurol 2016;80:466-471. © 2016 American Neurological Association.

  15. Diagnosis of tumors in the shoulder girdle by means of MRI

    International Nuclear Information System (INIS)

    Schlecht, I.; Gaffke, G.; Stroszczynski, C.; Felix, R.

    2001-01-01

    The aim of the study was to estimate the value of MRI for evaluation of tumors of the shoulder girdle. We diagnosed respectively 13 patients with lesions in the shoulder region. The imaging has been done with a 'Magnetom SP 63' (Siemens, Erlangen, Germany). The protocol consisted of T1- and T2-based SE-sequences in axial slice orientation, T1-based imaging in coronary respectively in sagittal slice orientation as well as T1-based sequences after application of contrast medium. The evaluation of the tumor expansion within the soft tissue was possible. The exact diagnosis in some individual cases - neurinoma, cyst of the synovia - could be found by MRI. Estimation of the dignity in the case of infiltrative growth was possible in most cases. To assess the exact type of tumor was often difficult. Especially the dignity of the cartilaginous tumors could not be precisely described. (orig.) [de

  16. Limb-girdle muscular dystrophy type 2A in Brazilian children

    Directory of Open Access Journals (Sweden)

    Marco Antônio Veloso de Albuquerque

    2015-12-01

    Full Text Available ABSTRACT Calpainopathy is an autosomal recessive limb girdle muscular dystrophy (LGMD2A caused by mutations in CAPN3 gene. Objective To present clinical and histological findings in six children with a molecular diagnosis of LGMD2A and additionally the MRI findings in two of them. Method We retrospectively assessed medical records of 6 patients with mutation on CAPN3 gene. Results All patients were female (three to 12 years. The mean of age of disease onset was 9 years. All of them showed progressive weakness with predominance in lower limbs. Other findings were scapular winging, joint contractures and calf hypertrophy. One female had a more severe phenotype than her dizygotic twin sister that was confirmed by muscle MRI. Muscle biopsies showed a dystrophic pattern in all patients. Conclusion In this cohort of children with LGMD2A, the clinical aspects were similar to adults with the same disorder.

  17. Gene expression profiling in limb-girdle muscular dystrophy 2A.

    Directory of Open Access Journals (Sweden)

    Amets Sáenz

    Full Text Available Limb-girdle muscular dystrophy type 2A (LGMD2A is a recessive genetic disorder caused by mutations in calpain 3 (CAPN3. Calpain 3 plays different roles in muscular cells, but little is known about its functions or in vivo substrates. The aim of this study was to identify the genes showing an altered expression in LGMD2A patients and the possible pathways they are implicated in. Ten muscle samples from LGMD2A patients with in which molecular diagnosis was ascertained were investigated using array technology to analyze gene expression profiling as compared to ten normal muscle samples. Upregulated genes were mostly those related to extracellular matrix (different collagens, cell adhesion (fibronectin, muscle development (myosins and melusin and signal transduction. It is therefore suggested that different proteins located or participating in the costameric region are implicated in processes regulated by calpain 3 during skeletal muscle development. Genes participating in the ubiquitin proteasome degradation pathway were found to be deregulated in LGMD2A patients, suggesting that regulation of this pathway may be under the control of calpain 3 activity. As frizzled-related protein (FRZB is upregulated in LGMD2A muscle samples, it could be hypothesized that beta-catenin regulation is also altered at the Wnt signaling pathway, leading to an incorrect myogenesis. Conversely, expression of most transcription factor genes was downregulated (MYC, FOS and EGR1. Finally, the upregulation of IL-32 and immunoglobulin genes may induce the eosinophil chemoattraction explaining the inflammatory findings observed in presymptomatic stages. The obtained results try to shed some light on identification of novel therapeutic targets for limb-girdle muscular dystrophies.

  18. Intra-abdominal gout mimicking pelvic abscess

    International Nuclear Information System (INIS)

    Chen, Chia-Hui; Chen, Clement Kuen-Huang; Yeh, Lee-Ren; Pan, Huay-Ban; Yang, Chien-Fang

    2005-01-01

    Gout is the most common crystal-induced arthritis. Gouty tophi typically deposit in the extremities, especially toes and fingers. We present an unusual case of intrapelvic tophaceous gout in a patient suffering from chronic gouty arthritis. CT and MRI of the abdomen and pelvic cavity disclosed calcified gouty tophi around both hips, and a cystic lesion with peripheral enhancement in the pelvic cavity along the course of the iliopsoas muscle. The intra-abdominal tophus mimicked pelvic abscess. (orig.)

  19. Intra-abdominal gout mimicking pelvic abscess

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Chia-Hui; Chen, Clement Kuen-Huang [Kaohsiung Veterans General Hospital, Department of Radiology, Kaohsiung (Taiwan); National Yang-Ming University, School of Medicine, Taipei (Taiwan); Yeh, Lee-Ren; Pan, Huay-Ban; Yang, Chien-Fang [Kaohsiung Veterans General Hospital, Department of Radiology, Kaohsiung (Taiwan)

    2005-04-01

    Gout is the most common crystal-induced arthritis. Gouty tophi typically deposit in the extremities, especially toes and fingers. We present an unusual case of intrapelvic tophaceous gout in a patient suffering from chronic gouty arthritis. CT and MRI of the abdomen and pelvic cavity disclosed calcified gouty tophi around both hips, and a cystic lesion with peripheral enhancement in the pelvic cavity along the course of the iliopsoas muscle. The intra-abdominal tophus mimicked pelvic abscess. (orig.)

  20. Gynecological pelvic pain as emergency pathology.

    Science.gov (United States)

    Rivera Domínguez, A; Mora Jurado, A; García de la Oliva, A; de Araujo Martins-Romeo, D; Cueto Álvarez, L

    Acute pelvic pain is a common condition in emergency. The sources of acute pelvic pain are multifactorial, so it is important to be familiar with this type of pathologies. The purpose of this article is review the main causes of gynecological acute pelvic pain and their radiologic appearances to be able to make an accurate diagnosis and provide objective criteria for patient management. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Magnetic resonance imaging of pelvic floor dysfunction.

    Science.gov (United States)

    Lalwani, Neeraj; Moshiri, Mariam; Lee, Jean H; Bhargava, Puneet; Dighe, Manjiri K

    2013-11-01

    Pelvic floor dysfunction is largely a complex problem of multiparous and postmenopausal women and is associated with pelvic floor or organ descent. Physical examination can underestimate the extent of the dysfunction and misdiagnose the disorders. Functional magnetic resonance (MR) imaging is emerging as a promising tool to evaluate the dynamics of the pelvic floor and use for surgical triage and operative planning. This article reviews the anatomy and pathology of pelvic floor dysfunction, typical imaging findings, and the current role of functional MR imaging. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Contribution of pelvic floor muscles to stiffness of the pelvic ring

    NARCIS (Netherlands)

    Pool-Goudzwaard, A.L.; Hoek van Dijke, G; van Gurp, M; Mulder, P; Snijders, C.J.; Stoeckart, R.

    2004-01-01

    STUDY DESIGN: A biomechanical study in embalmed specimens, on the relation between applied tension in the pelvic floor muscles, stiffness of the pelvic ring and generation of movement in the sacroiliac joints. OBJECTIVE: To gain insight into the effect of tension in the pelvic floor muscles on

  3. Assessment of pelvic floor dysfunctions using dynamic magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Hoda Salah Darwish

    2014-03-01

    Conclusion: Dynamic MRI is an ideal, non invasive technique which does not require patient preparation for evaluation of pelvic floor. It acts as one stop shop for diagnosing single or multiple pelvic compartment involvement in patients with pelvic floor dysfunction.

  4. Retrospective review of pelvic malignancies undergoing total pelvic exenteration

    Directory of Open Access Journals (Sweden)

    Kuhrt Maureen P

    2012-06-01

    Full Text Available Abstract Background In patients with locally advanced or recurrent pelvic malignancies, total pelvic exenteration (TPE may be necessary for curative treatment. Despite improvements in mortality rates since TPE was first described, morbidity rates remain high due to the extensive resection and the aggressiveness of these tumors. We have studied the outcomes of TPE surgery performed at our institution. Methods Fifty-three patients with various pelvic pathologies underwent TPE between 2004 and 2010. Patients were divided into two groups based on pathology: colorectal (n = 36 versus non-colorectal (n = 17 malignancies. Demographics, operative reports, pathology reports, periprocedural events, and outcomes were analyzed. Comparison of the two groups was performed using student’s t-test and Fisher’s exact test. Survival curves were constructed using the Kaplan–Meier method and compared using the log rank test. Results The colorectal and non-colorectal groups were similar in demographics, operative times, length of stay, estimated blood loss, and rates of preoperative and intraoperative radiation use. Chemotherapy use was increased in the colorectal group compared with the non-colorectal group (55.6% vs. 23.5%, P = 0.04. Complication rates were similar: 86% in the colorectal group and 76% in the non-colorectal group. In the colorectal group, 27.8% of patients developed perineal abscesses, whereas no patients developed these complications in the non-colorectal group (P = 0.02. No survival difference was seen in primary versus recurrent colorectal tumors; however, within the colorectal group there was a survival advantage when comparing R0 resection to R1 and R2 resection combined. Median survival rates were 27.3 months for R0 resection and 10.7 months for R1 and R2 resection combined. The median survival was 21.4 months for the colorectal group and 6.9 months for the non-colorectal group (P = 0.002. Conclusions

  5. Perceived social stress, pregnancy-related anxiety, depression and subjective social status among pregnant Mexican and Mexican American women in south Texas.

    Science.gov (United States)

    Fleuriet, K Jill; Sunil, T S

    2014-05-01

    The purpose of this study was to determine differences in subjective social status, perceived social stress, depressive symptoms, and pregnancy-related anxiety between pregnant Mexican American and Mexican immigrant women. Three hundred pregnant Mexican immigrant and Mexican American women in South Texas were surveyed for pregnancy-related anxiety, perceived social stress, depressive symptoms, and subjective social status. Pregnant Mexican immigrant women had higher levels of pregnancy-related anxiety and lower levels of depression and perceived social stress than pregnant Mexican American women. Change in these variables among Mexican immigrant women was relatively linear as time of residence in the United States increased. Mexican immigrant and Mexican American women had significantly different correlations between subjective social status, self-esteem and perceived social stress. Results indicate that subjective social status is an important psychosocial variable among pregnant Hispanic women. Results contribute to ongoing efforts to provide culturally responsive prenatal psychosocial support services.

  6. Reconstructive options in pelvic tumours

    Directory of Open Access Journals (Sweden)

    Mayilvahanan N

    2005-01-01

    Full Text Available Background: Pelvic tumours present a complex problem. It is difficult to choose between limb salvage and hemipelvectomy. Method: Forty three patients of tumours of pelvis underwent limb salvage resection with reconstruction in 32 patients. The majority were chondrosarcomas (20 cases followed by Ewing sarcoma. Stage II B was the most common stage in malignant lesions and all the seven benign lesions were aggressive (B3. Surgical margins achieved were wide in 31 and marginal in 12 cases. Ilium was involved in 51% of cases and periacetabular involvement was seen in 12 patients. The resections done were mostly of types I &II of Enneking′s classification of pelvic resection. Arthrodesis was attempted in 24 patients. Customized Saddle prosthesis was used in seven patients and no reconstruction in 12 patients. Adjuvant chemotherapy was given to all high-grade malignant tumours, combined with radiotherapy in 7 patients. Results: With a mean follow up of 48.5 months and one patient lost to follow up, the recurrence rate among the evaluated cases was 16.6%. Oncologically, 30 patients were continuously disease free with 7 local recurrences and 4 deaths due to disseminated disease and 2 patients died of other causes. During the initial years, satisfactory functional results were achieved with prosthetic replacement. Long-term functional result of 36 patients who were alive at the time of latest follow up was satisfactory in 75% who underwent arthrodesis and in those where no reconstruction was used. We also describe a method of new classification of pelvic resections that clarifies certain shortcomings of the previous systems of classification. Conclusion: Selection of a procedure depends largely on the patient factors, the tumour grade, the resultant defect and the tissue factors. Resection with proper margins gives better functional and oncological results

  7. Assessment of a semiautomated pelvic floor measurement model for evaluating pelvic organ prolapse on MRI.

    Science.gov (United States)

    Onal, S; Lai-Yuen, S; Bao, P; Weitzenfeld, A; Greene, K; Kedar, R; Hart, S

    2014-06-01

    The objective of this study was to assess the performance of a semiautomated pelvic floor measurement algorithmic model on dynamic magnetic resonance imaging (MRI) images compared with manual pelvic floor measurements for pelvic organ prolapse (POP) evaluation. We examined 15 MRIs along the midsagittal view. Five reference points used for pelvic floor measurements were identified both manually and using our semiautomated measurement model. The two processes were compared in terms of accuracy and precision. The semiautomated pelvic floor measurement model provided highly consistent and accurate locations for all reference points on MRI. Results also showed that the model can identify the reference points faster than the manual-point identification process. The semiautomated pelvic floor measurement model can be used to facilitate and improve the process of pelvic floor measurements on MRI. This will enable high throughput analysis of MRI data to improve the correlation analysis with clinical outcomes and potentially improve POP assessment.

  8. Laparoscopic Pelvic Floor Repair Using Polypropylene Mesh

    Directory of Open Access Journals (Sweden)

    Shih-Shien Weng

    2008-09-01

    Conclusion: Laparoscopic pelvic floor repair using a single piece of polypropylene mesh combined with uterosacral ligament suspension appears to be a feasible procedure for the treatment of advanced vaginal vault prolapse and enterocele. Fewer mesh erosions and postoperative pain syndromes were seen in patients who had no previous pelvic floor reconstructive surgery.

  9. 38 CFR 4.67 - Pelvic bones.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Pelvic bones. 4.67 Section 4.67 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS SCHEDULE FOR RATING DISABILITIES Disability Ratings The Musculoskeletal System § 4.67 Pelvic bones. The variability of residuals...

  10. Biomimetic matrices for pelvic floor repair

    NARCIS (Netherlands)

    Vashaghian, M.

    2017-01-01

    Pelvic organ prolapsed (POP) is a dysfunctional disease in female pelvic floor that affects a lot of women worldwide, and reduces their quality of life. Currently, trans-vaginal knitted polypropylene meshes are used as secondary treatment, for anatomical correction of the dysfunctional tissues.

  11. The screening pelvic radiograph in pediatric trauma

    International Nuclear Information System (INIS)

    Rees, M.J.; Aickin, R.; Kolbe, A.; Teele, R.L.

    2001-01-01

    Background. Pelvic radiographs are routinely obtained in adult trauma to optimise early management. In adults, pelvic fractures are associated with high early transfusion requirement, high injury severity scores and an increased incidence of other abdominal and thoracic injuries. It is unclear whether this holds true in children. Objective. To determine whether the screening pelvic radiograph is necessary in paediatric trauma. Materials and methods. The notes of all patients who presented after trauma to the Starship Children's Hospital and were triaged to the resuscitation room during 1997 were reviewed. Results of initial radiography were obtained and correlated with later imaging. Results. Our review of 444 injured children seen over a period of 1 year revealed that of 347 children who had screening pelvic radiographs, only 1 had a pelvic fracture. The fracture in this child was clinically apparent and required no specific treatment. Conclusions. The presence of a pelvic fracture is rare in injured children. By omitting screening pelvic radiographs there are potential benefits, including reduced radiation exposure to children and cost savings. Uninterpretable or abnormal clinical examination or haematuria requires further investigation, but routine screening for pelvic fracture is unnecessary. (orig.)

  12. MANAGEMENT OF PELVIC FRACTURES IN DOG

    African Journals Online (AJOL)

    EDITOR-IN-CHIEF

    Dept. of Surgery and Radiology, College of Veterinary Science and Animal Husbandry,. Birsa Agricultural ... dogs, most of the pelvic fractures recover without surgery. .... management in the dog and cat,. New York: Thieme, pp. 161-199. FOSSUM, T.W. (2007) Pelvic fractures. In: Fossum, T.W., 3rd edn.Small. Animal Surgery.

  13. Gene expression in Citrus sinensis fruit tissues harvested from huanglongbing-infected trees: comparison with girdled fruit.

    Science.gov (United States)

    Liao, Hui-Ling; Burns, Jacqueline K

    2012-05-01

    Distribution of viable Candidatus Liberibacter asiaticus (CaLas) in sweet orange fruit and leaves ('Hamlin' and 'Valencia') and transcriptomic changes associated with huanglongbing (HLB) infection in fruit tissues are reported. Viable CaLas was present in most fruit tissues tested in HLB trees, with the highest titre detected in vascular tissue near the calyx abscission zone. Transcriptomic changes associated with HLB infection were analysed in flavedo (FF), vascular tissue (VT), and juice vesicles (JV) from symptomatic (SY), asymptomatic (AS), and healthy (H) fruit. In SY 'Hamlin', HLB altered the expression of more genes in FF and VT than in JV, whereas in SY 'Valencia', the number of genes whose expression was changed by HLB was similar in these tissues. The expression of more genes was altered in SY 'Valencia' JV than in SY 'Hamlin' JV. More genes were also affected in AS 'Valencia' FF and VT than in AS 'Valencia' JV. Most genes whose expression was changed by HLB were classified as transporters or involved in carbohydrate metabolism. Physiological characteristics of HLB-infected and girdled fruit were compared to differentiate between HLB-specific and carbohydrate metabolism-related symptoms. SY and girdled fruit were smaller than H and ungirdled fruit, respectively, with poor juice quality. However, girdling did not cause misshapen fruit or differential peel coloration. Quantitative PCR analysis indicated that many selected genes changed their expression significantly in SY flavedo but not in girdled flavedo. Mechanisms regulating development of HLB symptoms may lie in the host disease response rather than being a direct consequence of carbohydrate starvation.

  14. Homology of the enigmatic nuchal bone reveals novel reorganization of the shoulder girdle in the evolution of the turtle shell.

    Science.gov (United States)

    Lyson, Tyler R; Bhullar, Bhart-Anjan S; Bever, Gabe S; Joyce, Walter G; de Queiroz, Kevin; Abzhanov, Arhat; Gauthier, Jacques A

    2013-01-01

    The turtle shell represents a unique modification of the ancestral tetrapod body plan. The homologies of its approximately 50 bones have been the subject of debate for more than 200 years. Although most of those homologies are now firmly established, the evolutionary origin of the dorsal median nuchal bone of the carapace remains unresolved. We propose a novel hypothesis in which the nuchal is derived from the paired, laterally positioned cleithra-dorsal elements of the ancestral tetrapod pectoral girdle that are otherwise retained among extant tetrapods only in frogs. This hypothesis is supported by origin of the nuchal as paired, mesenchymal condensations likely derived from the neural crest followed by a unique two-stage pattern of ossification. Further support is drawn from the establishment of the nuchal as part of a highly conserved "muscle scaffold" wherein the cleithrum (and its evolutionary derivatives) serves as the origin of the Musculus trapezius. Identification of the nuchal as fused cleithra is congruent with its general spatial relationships to other elements of the shoulder girdle in the adult morphology of extant turtles, and it is further supported by patterns of connectivity and transformations documented by critical fossils from the turtle stem group. The cleithral derivation of the nuchal implies an anatomical reorganization of the pectoral girdle in which the dermal portion of the girdle was transformed from a continuous lateral-ventral arc into separate dorsal and ventral components. This transformation involved the reduction and eventual loss of the scapular rami of the clavicles along with the dorsal and superficial migration of the cleithra, which then fused with one another and became incorporated into the carapace. © 2013 Wiley Periodicals, Inc.

  15. Imaging pelvic floor disorders. 2. rev. ed.

    International Nuclear Information System (INIS)

    Stoker, Jaap; Taylor, Stuart A.; DeLancey, John O.L.

    2008-01-01

    This volume builds on the success of the first edition of imaging pelvic floor disorders and is aimed at those practitioners with an interest in the imaging, diagnosis and treatment of pelvic floor dysfunction. Concise textual information from acknowledged experts is complemented by high-quality diagrams and images to provide a thorough update of this rapidly evolving field. Introductory chapters fully elucidate the anatomical basis underlying disorders of the pelvic floor. State of the art imaging techniques and their application in pelvic floor dysfunction are then discussed in detail. Additions since the first edition include consideration of the effect of aging and new chapters on perineal ultrasound, functional MRI and MRI of the levator muscles. The closing sections of the book describe the modern clinical management of pelvic floor dysfunction, including prolapse, urinary and faecal incontinence and constipation, with specific emphasis on the integration of diagnostic and treatment algorithms. (orig.)

  16. Occupational lifting and pelvic pain during pregnancy:

    DEFF Research Database (Denmark)

    Larsen, Pernille Stemann; Strandberg-Larsen, Katrine; Juhl, Mette

    2013-01-01

    OBJECTIVES: Pelvic pain during pregnancy is a common ailment, and the disease is a major cause of sickness absence during pregnancy. It is plausible that occupational lifting may be a risk factor of pelvic pain during pregnancy, but no previous studies have examined this specific exposure. The aim...... of this study was to examine the association between occupational lifting and pelvic pain during pregnancy. METHODS: The study comprised 50 143 pregnant women, enrolled in the Danish National Birth Cohort in the period from 1996-2002. During pregnancy, the women provided information on occupational lifting...... (weight load and daily frequency), and six months post partum on pelvic pain. Adjusted odds ratios for pelvic pain during pregnancy according to occupational lifting were calculated by logistic regression. RESULTS: Any self-reported occupational lifting (>1 time/day and loads weighing >10 kg...

  17. Imaging pelvic floor disorders. 2. rev. ed.

    Energy Technology Data Exchange (ETDEWEB)

    Stoker, Jaap [Amsterdam Univ. (Netherlands). Dept. of Radiology; Taylor, Stuart A. [University College Hospital, London (United Kingdom). Dept. of Specialist X-Ray; DeLancey, John O.L. (eds.) [Michigan Univ., Ann Arbor, MI (United States). L4000 Women' s Hospital

    2008-07-01

    This volume builds on the success of the first edition of imaging pelvic floor disorders and is aimed at those practitioners with an interest in the imaging, diagnosis and treatment of pelvic floor dysfunction. Concise textual information from acknowledged experts is complemented by high-quality diagrams and images to provide a thorough update of this rapidly evolving field. Introductory chapters fully elucidate the anatomical basis underlying disorders of the pelvic floor. State of the art imaging techniques and their application in pelvic floor dysfunction are then discussed in detail. Additions since the first edition include consideration of the effect of aging and new chapters on perineal ultrasound, functional MRI and MRI of the levator muscles. The closing sections of the book describe the modern clinical management of pelvic floor dysfunction, including prolapse, urinary and faecal incontinence and constipation, with specific emphasis on the integration of diagnostic and treatment algorithms. (orig.)

  18. Stem girdling affects the quantity of CO2 transported in xylem as well as CO2 efflux from soil.

    Science.gov (United States)

    Bloemen, Jasper; Agneessens, Laura; Van Meulebroek, Lieven; Aubrey, Doug P; McGuire, Mary Anne; Teskey, Robert O; Steppe, Kathy

    2014-02-01

    There is recent clear evidence that an important fraction of root-respired CO2 is transported upward in the transpiration stream in tree stems rather than fluxing to the soil. In this study, we aimed to quantify the contribution of root-respired CO2 to both soil CO2 efflux and xylem CO2 transport by manipulating the autotrophic component of belowground respiration. We compared soil CO2 efflux and the flux of root-respired CO2 transported in the transpiration stream in girdled and nongirdled 9-yr-old oak trees (Quercus robur) to assess the impact of a change in the autotrophic component of belowground respiration on both CO2 fluxes. Stem girdling decreased xylem CO2 concentration, indicating that belowground respiration contributes to the aboveground transport of internal CO2 . Girdling also decreased soil CO2 efflux. These results confirmed that root respiration contributes to xylem CO2 transport and that failure to account for this flux results in inaccurate estimates of belowground respiration when efflux-based methods are used. This research adds to the growing body of evidence that efflux-based measurements of belowground respiration underestimate autotrophic contributions. © 2013 The Authors. New Phytologist © 2013 New Phytologist Trust.

  19. An analysis of pregnancy-related mortality in the KEMRI/CDC health and demographic surveillance system in western Kenya.

    Directory of Open Access Journals (Sweden)

    Meghna Desai

    Full Text Available Pregnancy-related (PR deaths are often a result of direct obstetric complications occurring at childbirth.To estimate the burden of and characterize risk factors for PR mortality, we evaluated deaths that occurred between 2003 and 2008 among women of childbearing age (15 to 49 years using Health and Demographic Surveillance System data in rural western Kenya. WHO ICD definition of PR mortality was used: "the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the cause of death". In addition, symptoms and events at the time of death were examined using the WHO verbal autopsy methodology. Deaths were categorized as either (i directly PR: main cause of death was ascribed as obstetric, or (ii indirectly PR: main cause of death was non-obstetric. Of 3,223 deaths in women 15 to 49 years, 249 (7.7% were PR. One-third (34% of these were due to direct obstetric causes, predominantly postpartum hemorrhage, abortion complications and puerperal sepsis. Two-thirds were indirect; three-quarters were attributable to human immunodeficiency virus (HIV/AIDS, malaria and tuberculosis. Significantly more women who died in lower socio-economic groups sought care from traditional birth attendants (p = 0.034, while less impoverished women were more likely to seek hospital care (p = 0.001. The PR mortality ratio over the six years was 740 (95% CI 651-838 per 100,000 live births, with no evidence of reduction over time (χ(2 linear trend = 1.07; p = 0.3.These data supplement current scanty information on the relationship between infectious diseases and poor maternal outcomes in Africa. They indicate low uptake of maternal health interventions in women dying during pregnancy and postpartum, suggesting improved access to and increased uptake of skilled obstetric care, as well as preventive measures against HIV/AIDS, malaria and tuberculosis among all women of childbearing age may help to reduce pregnancy-related mortality.

  20. The Role of Pelvic Floor Muscles in Male Sexual Dysfunction and Pelvic Pain.

    Science.gov (United States)

    Cohen, Deborah; Gonzalez, Joshua; Goldstein, Irwin

    2016-01-01

    Sexual function is essential to good health and well-being in men. The relationship between male sexual function, pelvic floor function, and pelvic pain is complex and only beginning to be appreciated. The objectives of the current review are to examine these complex relationships, and to demonstrate how pelvic floor physical therapy can potentially improve the treatment of various male sexual dysfunctions, including erectile dysfunction and dysfunction of ejaculation and orgasm. Contemporary data on pelvic floor anatomy and function as they relate to the treatment of various male sexual dysfunctions were reviewed. Examination of evidence supporting the association between the male pelvic floor and erectile dysfunction, ejaculatory/orgasmic dysfunction, and chronic prostatitis/chronic pelvic pain syndrome, respectively. Evidence suggests a close relationship between the pelvic floor and male sexual dysfunction and a potential therapeutic benefit from pelvic floor therapy for men who suffer from these conditions. Pelvic floor physical therapy is a necessary tool in a more comprehensive bio-neuromusculoskeletal-psychosocial approach to the treatment of male sexual dysfunction and pelvic pain. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  1. Factors Affecting Recruitment and Attrition in Randomised Controlled Trials of Complementary and Alternative Medicine for Pregnancy-Related Issues

    Directory of Open Access Journals (Sweden)

    Ciara Close

    2016-01-01

    Full Text Available Background. Randomised controlled trials (RCTs investigating Complementary and Alternative Medicine (CAM for pregnancy-related issues have encountered issues with recruitment and attrition. Little is known about the cause of these issues. Methods. Data was gathered from an antenatal CAM randomised controlled trial. During foetal anomaly appointments, women meeting inclusion criteria were invited to participate in the trial. Numbers of women invited and eligible were recorded. Reasons for noninterest were noted and analysed. Focus groups exploring trial experience of participants were also conducted. Findings. Of the 428 women invited to participate, 376 were eligible and just under a quarter participated. Reasons for nonparticipation included concerns about CAM and lack of interest in participation in research. Other factors negatively affecting recruitment included recruitment timing, competition for participants, limited support from staff, and inadequate trial promotion. Factors encouraging recruitment included being interested in research and seeking pain relief. Reasons for dropping out were time constraints, travel issues, work commitments, and pregnancy issues. Several women in the sham and usual care group dropped out due to dissatisfaction with treatment allocation. Conclusion. CAM researchers must explore problems encountered with recruitment and attrition so that evidence-based implementation strategies to address the issues can be developed.

  2. A postcolonial feminist discourse analysis of urban Aboriginal women's description of pregnancy-related weight gain and physical activity.

    Science.gov (United States)

    Darroch, Francine E; Giles, Audrey R

    2016-02-01

    Excessive weight gain and physical inactivity in pregnancy have been identified as risk factors for negative health outcomes for mothers and fetuses, particularly among Aboriginal women. In this paper we engage with postcolonial feminist theory and critical discourse analysis to examine the question, "how do urban Aboriginal women understand pregnancy-related weight gain and physical activity." We conducted focus groups and semi-structured interviews with 25 urban Aboriginal pregnant or postpartum women between the ages of 16 and 39 in Ottawa, Canada. Three prominent discourses emerged: Aboriginal women have different pregnancies than non-Aboriginal women because Aboriginal women gain more weight and are more likely to develop gestational diabetes; Aboriginal women feel personally responsible for and shameful about excessive weight gain; finally, Aboriginal women need culturally safe pregnancy resources. Our results illuminate the complex and often paradoxical ways in which discourses around weight gain and physical activity are produced and taken-up by Aboriginal women and their healthcare providers. Based on these findings, we argue there is a lack of accessible and culturally safe resources for urban Aboriginal women, specifically concerning weight gain and physical activity in pregnancy. We recommend the development of resources that are created for/by/with Aboriginal women to better address that issues that urban Aboriginal women themselves identify as being of key importance. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  3. Calpain 3 is important for muscle regeneration: Evidence from patients with limb girdle muscular dystrophies

    Directory of Open Access Journals (Sweden)

    Hauerslev Simon

    2012-03-01

    Full Text Available Abstract Background Limb girdle muscular dystrophy (LGMD type 2A is caused by mutations in the CAPN3 gene and complete lack of functional calpain 3 leads to the most severe muscle wasting. Calpain 3 is suggested to be involved in maturation of contractile elements after muscle degeneration. The aim of this study was to investigate how mutations in the four functional domains of calpain 3 affect muscle regeneration. Methods We studied muscle regeneration in 22 patients with LGMD2A with calpain 3 deficiency, in five patients with LGMD2I, with a secondary reduction in calpain 3, and in five patients with Becker muscular dystrophy (BMD with normal calpain 3 levels. Regeneration was assessed by using the developmental markers neonatal myosin heavy chain (nMHC, vimentin, MyoD and myogenin and counting internally nucleated fibers. Results We found that the recent regeneration as determined by the number of nMHC/vimentin-positive fibers was greatly diminished in severely affected LGMD2A patients compared to similarly affected patients with LGMD2I and BMD. Whorled fibers, a sign of aberrant regeneration, was highly elevated in patients with a complete lack of calpain 3 compared to patients with residual calpain 3. Regeneration is not affected by location of the mutation in the CAPN3 gene. Conclusions Our findings suggest that calpain 3 is needed for the regenerative process probably during sarcomere remodeling as the complete lack of functional calpain 3 leads to the most severe phenotypes.

  4. Body weight-supported training in Becker and limb girdle 2I muscular dystrophy.

    Science.gov (United States)

    Jensen, Bente R; Berthelsen, Martin P; Husu, Edith; Christensen, Sofie B; Prahm, Kira P; Vissing, John

    2016-08-01

    We studied the functional effects of combined strength and aerobic anti-gravity training in severely affected patients with Becker and Limb-Girdle muscular dystrophies. Eight patients performed 10-week progressive combined strength (squats, calf raises, lunges) and aerobic (walk/run, jogging in place or high knee-lift) training 3 times/week in a lower-body positive pressure environment. Closed-kinetic-chain leg muscle strength, isometric knee strength, rate of force development (RFD), and reaction time were evaluated. Baseline data indicated an intact neural activation pattern but showed compromised muscle contractile properties. Training (compliance 91%) improved functional leg muscle strength. Squat series performance increased 30%, calf raises 45%, and lunges 23%. Anti-gravity training improved closed-kinetic-chain leg muscle strength despite no changes in isometric knee extension strength and absolute RFD. The improved closed-kinetic-chain performance may relate to neural adaptation involving motor learning and/or improved muscle strength of other muscles than the weak knee extensors. Muscle Nerve 54: 239-243, 2016. © 2016 Wiley Periodicals, Inc.

  5. The Classification, Natural History and Treatment of the Limb Girdle Muscular Dystrophies.

    Science.gov (United States)

    Murphy, Alexander Peter; Straub, Volker

    2015-07-22

    Over sixty years ago John Walton and Frederick Nattrass defined limb girdle muscular dystrophy (LGMD) as a separate entity from the X-linked dystrophinopathies such as Duchenne and Becker muscular dystrophies. LGMD is a highly heterogeneous group of very rare neuromuscular disorders whose common factor is their autosomal inheritance. Sixty years later, with the development of increasingly advanced molecular genetic investigations, a more precise classification and understanding of the pathogenesis is possible.To date, over 30 distinct subtypes of LGMD have been identified, most of them inherited in an autosomal recessive fashion. There are significant differences in the frequency of subtypes of LGMD between different ethnic populations, providing evidence of founder mutations. Clinically there is phenotypic heterogeneity between subtypes of LGMD with varying severity and age of onset of symptoms. The first natural history studies into subtypes of LGMD are in process, but large scale longitudinal data have been lacking due to the rare nature of these diseases. Following natural history data collection, the next challenge is to develop more effective, disease specific treatments. Current management is focussed on symptomatic and supportive treatments. Advances in the application of new omics technologies and the generation of large-scale biomedical data will help to better understand disease mechanisms in LGMD and should ultimately help to accelerate the development of novel and more effective therapeutic approaches.

  6. The effect of squash training on shoulder girdle mobility and frequency of injury among player

    Directory of Open Access Journals (Sweden)

    Mikołaj Gajewski

    2017-05-01

    Full Text Available Introduction: Squash is a relatively new field in the Polish sports market. Its specification is based primarily on dynamic movements, often taking place at the end of its scope. This condition is an increased risk of injury as well as numerous compensations throughout the body. Aim: The aim of the study was to examine the impact of squash training on shoulder mobility of active athletes and to identify factors likely to increase trauma among players. Does squash game cause hypermobility in all dimension? Do long-term breaks in squash training increase the frequency of injuries? Does pre-training warm up affect trauma? Material and method: The study consists 110 active players: 19 women (17% and 91 men (83% age between 17 and 50 years. The research tool was an author’s questionnaire consisting of metrics and closed questions, which examined the problem and testing the mobility of the shoulder girdle using  an inclinometer and functional tests. Descriptive statistics were made. The greatest limitation of the range of motion in the shoulder joint is observed in the sagittal plane - flexion. No injury was associated with a prolonged break from training. Conclusion: Squash players did not have hypomobility in the shoulder joint and even had a limited range of motion. Long-term breaks in squash training do not increase the level of trauma.

  7. Shoulder Girdle Muscles Endurance in Subjects with and without Impingement Syndrome

    Directory of Open Access Journals (Sweden)

    Afsoun Nodehi-Moghadam

    2011-07-01

    Full Text Available Objective: Any minimal alteration in performance and coordination of scapular and glenohumeral muscles has the potential to lead to shoulder joint dysfunction. The impingement syndrome has been reported as is the most common diagnosis of shoulder pain. The purpose of this study was to determine whether endurance deficits could be detected in patients with shoulder impingement. Materials & Methods: By convenient sampling 15 patients with impingement syndrome at average of 45.3 years of age and 15 healthy persons (age 45.8 years through a case–control design participated in the study. Endurance of glenohumeral and scapulothoracic muscles were tested with a hand held dynamometer. Independent t–test was used to statistically analyze different groups. Results: Compared to non–impaired subjects, those with impingement syndrome demonstrated a significantly lower endurance of external rotation, scaption and scapular abduction and upward rotation movements (P<0.05. In impingement syndrome patients, the external–to–internal rotator muscles endurance ratio was significantly lower than the control group (P<0.05. Conclusion: The result of the study suggests that endurance deficit of rotator cuff and scapular upward rotator muscles may be an important aspect of the impingement syndrome. Shoulder girdle muscles endurance should be considered in evaluation and physical therapy of impingement syndrome patients.

  8. Clinical and muscle biopsy findings in Norwegian paediatric patients with limb girdle muscular dystrophy 2I.

    Science.gov (United States)

    Rasmussen, Magnhild; Scheie, David; Breivik, Noralv; Mork, Marit; Lindal, Sigurd

    2014-05-01

    To describe patients diagnosed with limb girdle muscular dystrophy 2I (LGMD2I) in our paediatric departments between 2004 and 2012. The hospital charts of 17 patients presenting for evaluation at a mean age of 7.8 years (range 1-13 years) were retrospectively reviewed. With one exception, all patients were homozygous for the common mutation c.826C>A in the FKRP gene. Three patients experienced transient pronounced weakness as toddlers. Fatigue and muscle pain were most prominent, weakness less so, in children presenting at an older age. The degree of severity varied substantially. In certain cases, increased creatine kinase was an incidental finding. All walked independently by 18 months. When last evaluated at a mean age of 14.3 years (range 3.5-18 years), five patients were part-time wheelchair users. One patient was then treated for a cardiomyopathy. Creatine kinase was consistently increased, except presymptomatic in one patient. Muscle biopsies showed focal acute and chronic myopathic changes and pathological expression of α-dystroglycan. No consistent relationship between clinical function and the degree of morphological pathology was found. LGMD2I is a relevant differential diagnosis when creatine kinase is increased in children presenting with fatigue, muscle pain and sometimes weakness. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  9. Probable high prevalence of limb-girdle muscular dystrophy type 2D in Taiwan.

    Science.gov (United States)

    Liang, Wen-Chen; Chou, Po-Ching; Hung, Chia-Cheng; Su, Yi-Ning; Kan, Tsu-Min; Chen, Wan-Zi; Hayashi, Yukiko K; Nishino, Ichizo; Jong, Yuh-Jyh

    2016-03-15

    Limb-girdle muscular dystrophy type 2D (LGMD2D), an autosomal-recessive inherited LGMD, is caused by the mutations in SGCA. SGCA encodes alpha-sarcoglycan (SG) that forms a heterotetramer with other SGs in the sarcolemma, and comprises part of the dystrophin-glycoprotein complex. The frequency of LGMD2D is variable among different ethnic backgrounds, and so far only a few patients have been reported in Asia. We identified five patients with a novel homozygous mutation of c.101G>T (p.Arg34Leu) in SGCA from a big aboriginal family ethnically consisting of two tribes in Taiwan. Patient 3 is the maternal uncle of patients 1 and 2. All their parents, heterozygous for c.101G>T, denied consanguineous marriages although they were from the same tribe. The heterozygous parents of patients 4 and 5 were from two different tribes, originally residing in different geographic regions in Taiwan. Haplotype analysis showed that all five patients shared the same mutation-associated haplotype, indicating the probability of a founder effect and consanguinity. The results suggest that the carrier rate of c.101G>T in SGCA may be high in Taiwan, especially in the aboriginal population regardless of the tribes. It is important to investigate the prevalence of LGMD2D in Taiwan for early diagnosis and treatment. Copyright © 2016. Published by Elsevier B.V.

  10. Leonardo da Vinci and Andreas Vesalius; the shoulder girdle and the spine, a comparison.

    Science.gov (United States)

    Ganseman, Y; Broos, P

    2008-01-01

    Leonardo Da Vinci and Andreas Vesalius were two important renaissance persons; Vesalius was a surgeon-anatomist who delivered innovative work on the study of the human body, Leonardo da Vinci was an artist who delivered strikingly accurate and beautiful drawings on the human body. Below we compare both masters with regard to their knowledge of the working of the muscles, their method and system of dissection and their system and presentation of the drawings. The investigation consisted of a comparison between both anatomists, in particular concerning their study on the shoulder girdle and spine, by reviewing their original work as well as already existing literature on this subject. The investigation led to the conclusion that the drawings mentioned meant a change in history, and were of high quality, centuries ahead of their time. Both were anatomists, both were revolutionary, only one changed history at the moment itself, while the other changed history centuries later. Leonardo has made beautiful drawings that are at a match with the drawings of today or are even better. Vesalius set the start for medicine as a science as it is until this day. Their lives differed as strongly as their impact. In the light of their time, the achievement they made was extraordinary.

  11. Reconstruction of Complex Post-Traumatic Perineal/Pelvic Defects ...

    African Journals Online (AJOL)

    of the pelvic diaphragm). A composite pedicled. ALT flap was considered adequate for the initial reconstruction and stabilization, with the option of using a free fibular flap later, should the pelvic ring remain unstable. The fascia was used to complete the pelvic ring. It also provided anterior support to the pelvic diaphragm.

  12. Pelvic Mass Due to Transmigrated IUD

    Directory of Open Access Journals (Sweden)

    Nadereh Behtash

    2010-03-01

    Full Text Available Intrauterine device (IUD, a conventional method of contraception is rarely associated with uterine perforation and extra uterine dislocation. A 29 years old woman complaining of vaginal bleeding was referred for pelvic mass identified in ultrasound. The mass was confirmed with CT scan. In laparatomy we found an IUD in cul-de-sac and pelvic mass was apparently an organized hematoma. Transmigrated IUD can induce organized hematomas presenting as a pelvic mass."n© 2010 Tehran University of Medical Sciences. All rights reserved.

  13. Radiology of sport injuries of pelvic apophyses

    Energy Technology Data Exchange (ETDEWEB)

    Heuck, F

    1983-09-01

    Pelvic apophyses are places of insertion of strong muscles and tendons and are therefore places of least resistance at the end of skeletal growth. Avulsions and disruptions of pelvic apophyses can be caused by overstrain during different kinds of sport activity. Typical radiological findings in 8 different cases of ruptures of apophyses, osteochondropathies, and resulting conditions of sport injuries are demonstrated. The difficulties of correct diagnosis and different diagnosis are pointed out. The significance of hormonal impairment of ossification for development and stress factor of pelvic apophyses is exposed. Questions of treatment and follow-up studies are discussed.

  14. Radiology of sport injuries of pelvic apophyses

    International Nuclear Information System (INIS)

    Heuck, F.

    1983-01-01

    Pelvic apophyses are places of insertion of strong muscles and tendons and are therefore places of least resistance at the end of skeletal growth. Avulsions and disruptions of pelvic apophyses can be caused by overstrain during different kinds of sport activity. Typical radiological findings in 8 different cases of ruptures of apophyses, osteochondropathies, and resulting conditions of sport injuries are demonstrated. The difficulties of correct diagnosis and different diagnosis are pointed out. The significance of hormonal impairment of ossification for development and stress factor of pelvic apophyses is exposed. Questions of treatment and follow-up studies are discussed. (orig.)

  15. Recognition and Management of Nonrelaxing Pelvic Floor Dysfunction

    OpenAIRE

    Faubion, Stephanie S.; Shuster, Lynne T.; Bharucha, Adil E.

    2012-01-01

    Nonrelaxing pelvic floor dysfunction is not widely recognized. Unlike in pelvic floor disorders caused by relaxed muscles (eg, pelvic organ prolapse or urinary incontinence, both of which often are identified readily), women affected by nonrelaxing pelvic floor dysfunction may present with a broad range of nonspecific symptoms. These may include pain and problems with defecation, urination, and sexual function, which require relaxation and coordination of pelvic floor muscles and urinary and ...

  16. Pelvic exenteration for locally advanced primary and recurrent pelvic neoplasm: a series of 54 resectable cases

    Directory of Open Access Journals (Sweden)

    Sergio Renato Pais Costa

    2008-09-01

    Full Text Available Objective: To report on a series of 54 patients with pelvic neoplasms submitted to curative pelvic exenteration at a tertiary hospital and describe the results (morbidity, mortality, and long-term survival. Methods: The complete data of 54 patients submitted to pelvic exenteration between 1999 and 2007 were evaluated. Sixteen men and 38 women with a mean age of 65 years and median age of 66 years (36 to 77 were studied. Surgical procedures included total pelvic exenteration (n = 26, anterior pelvic exenteration(n = 5, and posterior pelvic exenteration (n = 23. Rresults: The mean operative time was 402 minutes (280 to 585. The average volume of intraoperative bleeding was 2,013 ml (300 to 5,800. Postoperative mortality was 5% (n = 3. The overall morbidity rate was 46%(n = 25. Histological evaluation demonstrated that 47 resections were R0 (87% while seven were R1 (13%. The overall survival rate in five years was 23.5% (n = 12. Cconclusions: Despite its aggressive nature and high morbidity, pelvic exenteration is still justified in locally advanced pelvic neoplasms or even in isolated pelvic recurrence, since it affords a greater long-term control of the neoplasm.

  17. Use of a caudoventral-craniodorsal oblique radiographic view made at 45° to the frontal plane to evaluate the pectoral girdle in raptors.

    Science.gov (United States)

    Visser, Marike; Hespel, Adrien-Maxence; de Swarte, Marie; Bellah, Jamie R

    2015-11-01

    To evaluate use of a caudoventral-craniodorsal oblique radiographic view made at 45° to the frontal plane (H view) for assessment of the pectoral (thoracic) girdle in raptors. Retrospective cross-sectional analysis. 24 raptors suspected to have a fracture of the thoracic girdle. Standard ventrodorsal and H views were obtained for all birds. Radiographs were evaluated twice by a radiologist blinded to the final diagnosis, with each view first evaluated independently and views then evaluated in combination. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated, with results of surgery or necropsy used as the gold standard. 9 birds had thoracic girdle fractures; fractures were correctly identified in 8 of these 9 birds on the ventrodorsal view alone, 7 of these 9 birds on the H view alone, and all 9 birds on the 2 views in combination. Fifteen birds did not have thoracic girdle fractures; radiographs were correctly classified in 12 of these 15 birds when the ventrodorsal view was evaluated alone, all 15 birds when the H view was evaluated alone, and 14 of these 15 birds when the 2 views were evaluated in combination. Results suggested that the H view or the addition of the H view to the VD view could be useful in raptors suspected to have fractures of the thoracic girdle. Agreement with the gold standard (ie, fracture present or absent) was higher with the H view and combination of views than with the ventrodorsal view alone.

  18. Feasibility of a controlled trial aiming to prevent excessive pregnancy-related weight gain in primary health care

    Directory of Open Access Journals (Sweden)

    Weiderpass Elisabete

    2008-08-01

    Full Text Available Abstract Background Excessive gestational weight gain and postpartum weight retention may predispose women to long-term overweight and other health problems. Intervention studies aiming at preventing excessive pregnancy-related weight gain are needed. The feasibility of implementing such a study protocol in primary health care setting was evaluated in this pilot study. Methods A non-randomized controlled trial was conducted in three intervention and three control maternity and child health clinics in primary health care in Finland. Altogether, 132 pregnant and 92 postpartum women and 23 public health nurses (PHN participated in the study. The intervention consisted of individual counselling on physical activity and diet at five routine visits to a PHN and of an option for supervised group exercise until 37 weeks' gestation or ten months postpartum. The control clinics continued their usual care. The components of the feasibility evaluation were 1 recruitment and participation, 2 completion of data collection, 3 realization of the intervention and 4 the public health nurses' experiences. Results 1 The recruitment rate was slower than expected and the recruitment period had to be prolonged from the initially planned three months to six months. The average participation rate of eligible women at study enrolment was 77% and the drop-out rate 15%. 2 In total, 99% of the data on weight, physical activity and diet and 96% of the blood samples were obtained. 3 In the intervention clinics, 98% of the counselling sessions were realized, their contents and average durations were as intended, 87% of participants regularly completed the weekly records for physical activity and diet, and the average participation percentage in the group exercise sessions was 45%. 4 The PHNs regarded the extra training as a major advantage and the high additional workload as a disadvantage of the study. Conclusion The study protocol was mostly feasible to implement, which

  19. Imaging findings in idiopathic pelvic fibrosis

    International Nuclear Information System (INIS)

    Wiesner, W.; Bongartz, G.; Stoffel, F.

    2001-01-01

    Two patients presented with ureteric obstruction, and voiding symptoms and constipation, respectively, and were examined by means of intravenous urography and computed tomography. One patient was additionally examined by means of MR tomography. After CT (performed in both patients) and MRT (performed in one patient) had shown a diffuse, contrast-enhancing, infiltrating process in the small pelvis with infiltration of adjacent organs and vessels, surgical biopsy proved the diagnosis of idopathic pelvic fibrosis. Extension of retroperitoneal fibrosis below the pelvic rim is very rare. Clinical symptoms of pelvic fibrosis are variable and imaging findings may lead to a broad list of differential diagnoses. We present two patients with idiopathic pelvic fibrosis and discuss radiological findings and differential diagnoses of this rare disease. (orig.)

  20. Magnetic Resonance Imaging (MRI): Dynamic Pelvic Floor

    Science.gov (United States)

    ... to a CD or uploaded to a digital cloud server. Dynamic pelvic floor MRI provides detailed pictures ... with you. top of page What are the benefits vs. risks? Benefits MRI is a noninvasive imaging ...

  1. CT in the evaluation of pelvic trauma

    International Nuclear Information System (INIS)

    Federle, M.P.

    1986-01-01

    Pelvic fractures from motor vehicle accidents are a cause of substantial morbidity and permanent disability, and are the third leading cause of death following blunt trauma. Associated extremity fractures are common, and injury to abdominal and pelvic viscera may occur. Difficulty in establishing the source of hemorrhage may be encountered, especially since pelvic fractures with extraperitoneal bleeding may result in intraperitoneal bleeding through torn fascial planes. The difficulty in properly diagnosing and managing complex fractures of the pelvis and acetabulum is well documented. Prognosis is influenced by the type and extent of pelvic fracture and associated soft tissue injuries. Computed tomography (CT) has proved to be a valuable tool in evaluation of these complex and life-threatening injuries

  2. Pelvic floor electrophysiology patterns associated with faecal ...

    African Journals Online (AJOL)

    Hussein Al-Moghazy Sultan

    2012-12-28

    Dec 28, 2012 ... pelvic floor electrophysiological abnormalities associated with. FI were illustrated in ... detection of a localized anal sphincter defect clinically and ..... Woods R, Voyvodic F, Schloithe A, Sage M, Wattchow D. Anal sphincter ...

  3. Pelvic Inflammatory Disease (PID) Fact Sheet

    Science.gov (United States)

    ... Home Page Bacterial Vaginosis (BV) Chlamydia Genital Herpes Gonorrhea Hepatitis HIV/AIDS & STDs Human Papillomavirus (HPV) Pelvic ... often caused by some STDs, like chlamydia and gonorrhea . Other infections that are not sexually transmitted can ...

  4. Imaging findings in idiopathic pelvic fibrosis

    Energy Technology Data Exchange (ETDEWEB)

    Wiesner, W.; Bongartz, G. [Inst. of Diagnostic Radiology University Hospital Basel (Switzerland); Stoffel, F. [Inst. of Urology, University Hospital Basel (Switzerland)

    2001-04-01

    Two patients presented with ureteric obstruction, and voiding symptoms and constipation, respectively, and were examined by means of intravenous urography and computed tomography. One patient was additionally examined by means of MR tomography. After CT (performed in both patients) and MRT (performed in one patient) had shown a diffuse, contrast-enhancing, infiltrating process in the small pelvis with infiltration of adjacent organs and vessels, surgical biopsy proved the diagnosis of idopathic pelvic fibrosis. Extension of retroperitoneal fibrosis below the pelvic rim is very rare. Clinical symptoms of pelvic fibrosis are variable and imaging findings may lead to a broad list of differential diagnoses. We present two patients with idiopathic pelvic fibrosis and discuss radiological findings and differential diagnoses of this rare disease. (orig.)

  5. Pelvic Surgical Site Infections in Gynecologic Surgery

    Directory of Open Access Journals (Sweden)

    Mark P. Lachiewicz

    2015-01-01

    Full Text Available The development of surgical site infection (SSI remains the most common complication of gynecologic surgical procedures and results in significant patient morbidity. Gynecologic procedures pose a unique challenge in that potential pathogenic microorganisms from the skin or vagina and endocervix may migrate to operative sites and can result in vaginal cuff cellulitis, pelvic cellulitis, and pelvic abscesses. Multiple host and surgical risk factors have been identified as risks that increase infectious sequelae after pelvic surgery. This paper will review these risk factors as many are modifiable and care should be taken to address such factors in order to decrease the chance of infection. We will also review the definitions, microbiology, pathogenesis, diagnosis, and management of pelvic SSIs after gynecologic surgery.

  6. Preoperative evaluation of locally spreaded pelvic tumors

    International Nuclear Information System (INIS)

    Baramia, M.; Todua, F.; Gotsadze, D.; Khutulashvili, N.; Lashkhi, K.; Nadareishvili, A.

    1998-01-01

    Am of the study: preoperative evaluation of patients with locally advanced pelvic tumors subjected to pelvic exenteration. Determine operability to avoid explorative laparatomies, which cause serious complications in these patients. Evaluate condition of urinary system in case of this pathology. Materials and methods: 34 patients with locally advanced pelvic tumors where pelvic exenteration was attempted were studied. Along with other methods of diagnostic CT and MRI were performed. Results: In all patients secondary involvement of the urinary bladder was noted. In 30 patients CT and MR findings were confirmed (88,2%) intraoperatively and different types of pelvic organs exenteration were performed. In 1 case spread of tomoruos infiltrate to the pelvic wall and common iliac vessels was detected intraoperatively (patient had history of radiation therapy). In 2 cases carcinomatosis of the peritoneum was found. In 1 case involvement of urinary bladder was simulated by close attachment of enlarged uterus. Conclusion: Obtained results show, that CT and MR are highly informative methods of disease spread evaluation and thus determining operability. Radiotherapy performed prior to operation sets difficulties in differentiation for tumourous infiltrate and post-radiotherapy changes in pelvis. (Full text)

  7. Pelvic floor and sexual male dysfunction

    Directory of Open Access Journals (Sweden)

    Antonella Pischedda

    2013-04-01

    Full Text Available The pelvic floor is a complex multifunctional structure that corresponds to the genito- urinary-anal area and consists of muscle and connective tissue. It supports the urinary, fecal, sexual and reproductive functions and pelvic statics. The symptoms caused by pelvic floor dysfunction often affect the quality of life of those who are afflicted, worsening significantly more aspects of daily life. In fact, in addition to providing support to the pelvic organs, the deep floor muscles support urinary continence and intestinal emptying whereas the superficial floor muscles are involved in the mechanism of erection and ejaculation. So, conditions of muscle hypotonia or hypertonicity may affect the efficiency of the pelvic floor, altering both the functionality of the deep and superficial floor muscles. In this evolution of knowledge it is possible imagine how the rehabilitation techniques of pelvic floor muscles, if altered and able to support a voiding or evacuative or sexual dysfunction, may have a role in improving the health and the quality of life.

  8. Anatomical basics, variations, and degenerative changes of the shoulder joint and shoulder girdle

    Energy Technology Data Exchange (ETDEWEB)

    Prescher, Andreas E-mail: dkeyserlingk@post.klinikum.rwth-aachen.de

    2000-08-01

    -lesions may occur and at the glenoid rim, where the labrum is often not fixed to the bony margin, avulsions of the labrum may occur. This well-established anatomical condition must not be mistaken for a manifest Bankart-lesion. The glenohumeral ligaments, which are located in the ventral articular capsule, have a stabilizing function for the ventral part of the glenoid labrum. The glenohumeral ligaments lift the articular lip where it crosses the glenoid notch. This 'labrum-lift effect' supports the stabilizing features of the articular lip and the glenohumeral ligaments. The rotator cuff is composed of the tendons of the teres minor, infraspinatus, supraspinatus, and subscapularis muscles. This cuff has a poorly vascularized area, due to mechanical conditions, about 1.5 cm from the major tubercle, which causes degenerative changes and eventually may lead to ruptures. Results of the impingement-syndrome and the osteoarthrotic changes of the shoulder and acromioclavicular joint are also presented and discussed. Finally, the coracoclavicular joint, which probably represents no congenital entity but appears due to a changed, lowered position of the shoulder girdle, is discussed. The paper also presents instructive figures of anatomical preparations that can be used to make more precise radiological and differential diagnoses. All preparations were done by the author and are part of a series of more than 300 preparations of the shoulder joint and girdle.

  9. Effect of pelvic floor rehabilitation technique in preventing the postpartum pelvic floor dysfunction

    Directory of Open Access Journals (Sweden)

    Shi-Qiong Li

    2017-04-01

    Full Text Available Objective: To explore the effect of pelvic floor rehabilitation technique in preventing the postpartum pelvic floor dysfunction and on the sexual life quality. Methods: A total of 286 puerpera with pelvic floor dysfunction who were admitted in our hospital from May, 2014 to May, 2015 42 d after delivery were included in the study, and randomized into the treatment group and the control group with 143 cases in each group. After guidance, the puerpera in the control group were given pelvic floor muscle training by themselves at home. On this basis, the puerpera in the treatment group were treated by the pelvic floor rehabilitation apparatus. The puerpera in the two groups were treated for 4 weeks. The pelvic floor function before treatment, 6 months and 1 year after delivery was detected. The color Doppler ultrasound apparatus was used to detect BSD, PUVA, UVJ-M, and BND 3 months after delivery. Results: BND, PUVA-R, PUVA-S, and UVJ-M 3 months after delivery in the treatment groups were significantly lower than those in the control group, while BSD-S was significantly higher than that in the control group. The improvement of type I and II muscle fiber fatigue (%, POP-Q degree, AP indication point (cm, and vaginal dynamic pressure (cmH2O was significantly superior to that in the control group. The comparison of pelvic floor muscle strength classification before treatment between the two groups was not statistically significant. After treatment, the pelvic floor muscle in the two groups was significantly strengthened, and the proportion of V grade patients was significantly increased when compared with before treatment. Conclusions: The postpartum early pelvic floor rehabilitation technique can effectively enhance the pelvic floor function, and prevent the postpartum pelvic floor dysfunction, with an accurate efficacy; therefore, it deserves to be widely recommended in the clinic.

  10. A comparison between stabilization exercises and pelvic floor muscle training in women with pelvic organ prolapse

    Directory of Open Access Journals (Sweden)

    Nuriye Özengin

    2015-03-01

    Full Text Available Objective: This study aimed to compare the effectiveness of stabilization exercises and pelvic floor muscle training in women with stage 1 and 2 pelvic organ prolapse. Materials and Methods: In a total 38 women with pelvic organ prolapse whose average age was 45.60 years, pelvic floor muscles were evaluated with electromyography, and prolapse with pelvic organ prolapse quantification system, and the quality of life with prolapse quality of life questionnaire. Afterwards, the subjects were divided into two groups; stabilization exercise group (n=19 and pelvic floor muscle training group (n=19. Stabilization exercise group were given training for 8 weeks, 3 times a week. Pelvic floor muscle training group were given eight-week home exercises. Each group was assessed before training and after eight weeks. Results: An increase was found in the pelvic muscle activation response in the 2 groups (p≤0.05. There was no difference in EMG activity values between the groups (p>0.05. A difference was found in the values Aa, Ba and C in subjects of each group (p≤0.05, and the TVL, Ap, Bp and D values of subjects in pelvic floor muscle training group (p≤0.05 in the before and after pelvic organ prolapse quantification system assessment, however, no difference was found between the groups (p≤0.05. A positive difference was found in the effect of prolapse sub parameter in each of the two groups, and in general health perception sub parameter in subjects of stabilization exercise group (p<0.05 in the prolapse quality of life questionnaire. Conclusions: It was concluded that both training programs increased the pelvic floor muscle strength, provided a decline in prolapse stages. Stabilization exercise has increased general health perception unlike home training, thus, these exercises can be added to the treatment of women with prolapse.

  11. Percutaneous CT and Fluoroscopy-Guided Screw Fixation of Pathological Fractures in the Shoulder Girdle: Technical Report of 3 Cases

    Energy Technology Data Exchange (ETDEWEB)

    Garnon, Julien, E-mail: juliengarnon@gmail.com; Koch, Guillaume, E-mail: Guillaume.koch@gmail.com [University Hospital of Strasbourg, Department of Interventional Radiology (France); Ramamurthy, Nitin, E-mail: Nitin-ramamurthy@hotmail.com [Norfolk and Norwich University Hospital, Department of Radiology (United Kingdom); Caudrelier, Jean, E-mail: caudjean@yahoo.fr [University Hospital of Strasbourg, Department of Interventional Radiology (France); Rao, Pramod, E-mail: pramodrao@me.com [University of Strasbourg, ICube (France); Tsoumakidou, Georgia, E-mail: Georgia.tsoumakidou@chru-strasbourg.fr; Cazzato, Roberto Luigi, E-mail: gigicazzato@hotmail.it; Gangi, Afshin, E-mail: Afshin.gangi@chru-strasbourg.fr [University Hospital of Strasbourg, Department of Interventional Radiology (France)

    2016-09-15

    ObjectiveTo review our initial experience with percutaneous CT and fluoroscopy-guided screw fixation of pathological shoulder-girdle fractures.Materials and MethodsBetween May 2014 and June 2015, three consecutive oncologic patients (mean age 65 years; range 57–75 years) with symptomatic pathological shoulder-girdle fractures unsuitable for surgery and radiotherapy underwent percutaneous image-guided screw fixation. Fractures occurred through metastases (n = 2) or a post-ablation cavity (n = 1). Mechanical properties of osteosynthesis were adjudged superior to stand-alone cementoplasty in each case. Cannulated screws were placed under combined CT and fluoroscopic guidance with complementary radiofrequency ablation or cementoplasty to optimise local palliation and secure screw fixation, respectively, in two cases. Follow-up was undertaken every few weeks until mortality or most recent appointment.ResultsFour pathological fractures were treated in three patients (2 acromion, 1 clavicular, 1 coracoid). Mean size of associated lesion was 2.6 cm (range 1–4.5 cm). Technical success was achieved in all cases (100 %), without complications. Good palliation and restoration of mobility were observed in two cases at 2–3 months; one case could not be followed due to early post-procedural oncologic mortality.ConclusionPercutaneous image-guided shoulder-girdle osteosynthesis appears technically feasible with good short-term efficacy in this complex patient subset. Further studies are warranted to confirm these promising initial results.

  12. Percutaneous CT and Fluoroscopy-Guided Screw Fixation of Pathological Fractures in the Shoulder Girdle: Technical Report of 3 Cases

    International Nuclear Information System (INIS)

    Garnon, Julien; Koch, Guillaume; Ramamurthy, Nitin; Caudrelier, Jean; Rao, Pramod; Tsoumakidou, Georgia; Cazzato, Roberto Luigi; Gangi, Afshin

    2016-01-01

    ObjectiveTo review our initial experience with percutaneous CT and fluoroscopy-guided screw fixation of pathological shoulder-girdle fractures.Materials and MethodsBetween May 2014 and June 2015, three consecutive oncologic patients (mean age 65 years; range 57–75 years) with symptomatic pathological shoulder-girdle fractures unsuitable for surgery and radiotherapy underwent percutaneous image-guided screw fixation. Fractures occurred through metastases (n = 2) or a post-ablation cavity (n = 1). Mechanical properties of osteosynthesis were adjudged superior to stand-alone cementoplasty in each case. Cannulated screws were placed under combined CT and fluoroscopic guidance with complementary radiofrequency ablation or cementoplasty to optimise local palliation and secure screw fixation, respectively, in two cases. Follow-up was undertaken every few weeks until mortality or most recent appointment.ResultsFour pathological fractures were treated in three patients (2 acromion, 1 clavicular, 1 coracoid). Mean size of associated lesion was 2.6 cm (range 1–4.5 cm). Technical success was achieved in all cases (100 %), without complications. Good palliation and restoration of mobility were observed in two cases at 2–3 months; one case could not be followed due to early post-procedural oncologic mortality.ConclusionPercutaneous image-guided shoulder-girdle osteosynthesis appears technically feasible with good short-term efficacy in this complex patient subset. Further studies are warranted to confirm these promising initial results.

  13. Botulinum toxin type a injections for cervical and shoulder girdle myofascial pain using an enriched protocol design.

    Science.gov (United States)

    Nicol, Andrea L; Wu, Irene I; Ferrante, F Michael

    2014-06-01

    Myofascial pain syndrome is a regional condition of muscle pain and stiffness and is classically characterized by the presence of trigger points in affected musculature. Botulinum toxin type A (BoNT-A) has been shown to have antinociceptive properties and elicit sustained muscle relaxation, thereby possibly affording even greater relief than traditional strategies. Our goal was to determine whether direct injection of BoNT-A into painful muscle groups is effective for cervical and shoulder girdle myofascial pain. An enriched protocol design was used, wherein 114 patients with cervical and shoulder girdle myofascial pain underwent injection of BoNT-A to determine their response to the drug. Fifty-four responders were then enrolled in a 12-week, randomized, double-blind, placebo-controlled trial. Pain scales and quality of life measures were assessed at baseline and at routine follow-up visits until completion of the study after 26 weeks. Injection of BoNT-A into painful muscle groups improved average visual numerical pain scores in subjects who received a second dose of BoNT-A compared to placebo (P = 0.019 [0.26, 2.78]). Subjects who received a second dose of BoNT-A had a reduced number of headaches per week (P = 0.04 [0.07, 4.55]). Brief Pain Inventory interference scores for general activity and sleep were improved (P = 0.046 [0.038, 3.700] and 0.02 [0.37, 4.33], respectively) in those who received a second dose of BoNT-A. BoNT-A injected directly into painful muscle groups improves average pain scores and certain aspects of quality of life in patients experiencing severe cervical and shoulder girdle myofascial pain.

  14. Cardiac involvement of progressive muscular dystrophy (Becker type, Limb-girdle type and Fukuyama type) evaluated by radionuclide method

    International Nuclear Information System (INIS)

    Nagamachi, Shigeki; Inoue, Kenjiro; Jinnouchi, Seishi; Hoshi, Hiroaki; Ono, Seiji; Ohnishi, Takashi; Futami, Shigemi; Watanabe, Katsushi; Hayashi, Tohru

    1994-01-01

    Tl-201 SPECT and Tc-99m-Human serum albumin (HSA) multigated radionuclide ventriculography were performed on 11 patients with progressive muscular dystrophy (Becker type 2, Fukuyama type 2, Limb-girdle type 7) to evaluate myocardial involvement. Hypoperfusion was detected in 8 patients on Tl-201 SPECT. Decreases in both systolic function (left ventricular ejection fraction; LVEF) and diastolic function (peak filling rate; PFR) were also seen in these patients. A high incidence of myocardial involvement of these kinds of progressive muscular dystrophy was suggested. (author)

  15. Cardiac involvement of progressive muscular dystrophy (Becker type, Limb-girdle type and Fukuyama type) evaluated by radionuclide method

    Energy Technology Data Exchange (ETDEWEB)

    Nagamachi, Shigeki; Inoue, Kenjiro; Jinnouchi, Seishi; Hoshi, Hiroaki; Ono, Seiji; Ohnishi, Takashi; Futami, Shigemi; Watanabe, Katsushi; Hayashi, Tohru [Miyazaki Medical Coll., Kiyotake (Japan)

    1994-02-01

    Tl-201 SPECT and Tc-99m-Human serum albumin (HSA) multigated radionuclide ventriculography were performed on 11 patients with progressive muscular dystrophy (Becker type 2, Fukuyama type 2, Limb-girdle type 7) to evaluate myocardial involvement. Hypoperfusion was detected in 8 patients on Tl-201 SPECT. Decreases in both systolic function (left ventricular ejection fraction; LVEF) and diastolic function (peak filling rate; PFR) were also seen in these patients. A high incidence of myocardial involvement of these kinds of progressive muscular dystrophy was suggested. (author).

  16. Prevalence of myofascial chronic pelvic pain and the effectiveness of pelvic floor physical therapy.

    Science.gov (United States)

    Bedaiwy, Mohamed A; Patterson, Betsy; Mahajan, Sangeeta

    2013-01-01

    To determine the prevalence of myofascial pain and the outcome of transvaginal pelvic floor physical therapy for the treatment of chronic pelvic pain caused by myofascial pelvic pain in a tertiary care facility. A retrospective chart review was performed on all women who presented to our facility between January 2005 and December 2007. Those diagnosed with myofascial pelvic pain and referred for transvaginal pelvic floor physical therapy over this 3-year period were evaluated. Participants with an initial pain score of > or = 4, myofascial pelvic pain on examination, and who attended 2 or more physician visits were included in the analysis. Patient physical examination findings, symptoms, and verbal pain ratings were reviewed. In all, 146 (13.2%) of 1,106 initially screened patients were diagnosed with myofascial pain. Seventy-five (51%) of the 146 patients who were referred for physical therapy were included, and 75% had an initial pain score of > or = 7. Pain scores significantly improved proportional to the number of physical therapy visits completed, with 63% of patients reporting significant pain improvement. Transvaginal physical therapy is an effective treatment for chronic pelvic pain resulting from myofascial pelvic pain.

  17. Lifestyle advice with or without pelvic floor muscle training for pelvic organ prolapse

    DEFF Research Database (Denmark)

    Due, Ulla; Brostrøm, Søren; Lose, Gunnar

    2016-01-01

    INTRODUCTION AND HYPOTHESIS: We evaluated the effect of adding pelvic floor muscle training (PFMT) to a structured lifestyle advice program. METHODS: This was a single-blinded randomized trial of women with symptomatic pelvic organ prolapse (POP) stage ≥ II. Participants were randomized...

  18. [Imaging of pelvic organ prolapse].

    Science.gov (United States)

    Lapray, Jean-François

    2013-01-01

    Colpocystodefecography (CCD) and dynamic MRI with defecography (MRId) allow an alternation between filling and emptying the hollow organs and the maximum abdominal strain offered by the defecation. When applied in imaging these two principles reveal the masked or underestimated prolapses at the time of the physical examination. A rigorous application of the technique guarantees almost equivalent results from the two examinations. The CCD provides voiding views and improved analysis of the anorectal pathology (intussusception, anismus) but involves radiation and a more invasive examination. MRId has the advantage of providing continuous visibility of the peritoneal compartment, and a multiplanar representation, enabling an examination of the morphology of the pelvic organs and of the supporting structures, with the disadvantage of still necessitating a supine examination, resulting sometimes in an incomplete or impossible evacuation. The normal and abnormal results (cystoptosis, vaginal vault prolapse, enterocele, anorectal intussuception, rectocele, descending perineum, urinary and fecal incontinence) and the respective advantages and limits of the various imaging methods are detailed. Dynamic perineal and introital ultrasound remains more limited in the appreciation of posterior colpoceles and especially in anorectal disorders, than CCD or MRId. Endoanal ultrasound is the first line morphological evaluation of the anal sphincter. Transvaginal and introital ultrasound can detect some complications of suburethral tapes and meshes. Morphological and dynamic imaging are essential complementary tools to the physical examination, especially when a precise anatomic assessment is required to understand the functional complaint or when a reintervention is needed.

  19. Short-Term Effects of Kinesio Taping in Women with Pregnancy-Related Low Back Pain: A Randomized Controlled Clinical Trial.

    Science.gov (United States)

    Kaplan, Şeyhmus; Alpayci, Mahmut; Karaman, Erbil; Çetin, Orkun; Özkan, Yasemin; İlter, Server; Şah, Volkan; Şahin, Hanım Güler

    2016-04-18

    BACKGROUND Pregnancy-related low back pain is a common condition during pregnancy. Kinesio tape is a drug-free elastic therapeutic tape used for treating various musculoskeletal problems. The aim of this study was to investigate the short-term effects of lumbar Kinesio taping on pain intensity and disability in women with pregnancy-related low back pain. MATERIAL AND METHODS A total of 65 patients with pregnancy-related low back pain were randomly allocated into either Kinesio taping (n=33) or control (n=32) groups. The intervention group was treated with paracetamol plus Kinesio taping, while the control group received only paracetamol. Kinesio taping was applied in the lumbar flexion position, and four I-shaped bands were used. Two bands were attached horizontally, with space correction technique. The remaining 2 bands, 1 on each side of the lumbar spine, were placed vertically, with inhibition technique. Low back pain intensity was measured on a 10-cm visual analogue scale (VAS), and the Roland-Morris Disability Questionnaire (RMDQ) was used for evaluation of disability. RESULTS Pain intensity and RMDQ scores improved significantly in both groups at 5 days compared with baseline. Considering the degree of treatment effect (the change from baseline to day 5), the Kinesio taping group was significantly superior than the control group in all outcome measures (for all, Plow back pain.

  20. Randomized controlled pilot of a group antenatal care model and the sociodemographic factors associated with pregnancy-related empowerment in sub-Saharan Africa.

    Science.gov (United States)

    Patil, Crystal L; Klima, Carrie S; Leshabari, Sebalda C; Steffen, Alana D; Pauls, Heather; McGown, Molly; Norr, Kathleen F

    2017-11-08

    The links between empowerment and a number of health-related outcomes in sub-Saharan Africa have been documented, but empowerment related to pregnancy is under-investigated. Antenatal care (ANC) is the entry point into the healthcare system for most women, so it is important to understand how ANC affects aspects of women's sense of control over their pregnancy. We compare pregnancy-related empowerment for women randomly assigned to the standard of care versus CenteringPregnancy-based group ANC (intervention) in two sub-Saharan countries, Malawi and Tanzania. Pregnant women in Malawi (n = 112) and Tanzania (n = 110) were recruited into a pilot study and randomized to individual ANC or group ANC. Retention at late pregnancy was 81% in Malawi and 95% in Tanzania. In both countries, individual ANC, termed focused antenatal care (FANC), is the standard of care. FANC recommends four ANC visits plus a 6-week post-birth visit and is implemented following the country's standard of care. In group ANC, each contact included self- and midwife-assessments in group space and 90 minutes of interactive health promotion. The number of contacts was the same for both study conditions. We measured pregnancy-related empowerment in late pregnancy using the Pregnancy-Related Empowerment Scale (PRES). Independent samples t-tests and multiple linear regressions were employed to assess whether group ANC led to higher PRES scores than individual ANC and to investigate other sociodemographic factors related to pregnancy-related empowerment. In Malawi, women in group ANC had higher PRES scores than those in individual ANC. Type of care was a significant predictor of PRES and explained 67% of the variation. This was not so in Tanzania; PRES scores were similar for both types of care. Predictive models including sociodemographic variables showed religion as a potential moderator of treatment effect in Tanzania. Muslim women in group ANC had a higher mean PRES score than those in

  1. Physical activity and the pelvic floor.

    Science.gov (United States)

    Nygaard, Ingrid E; Shaw, Janet M

    2016-02-01

    Pelvic floor disorders are common, with 1 in 4 US women reporting moderate to severe symptoms of urinary incontinence, pelvic organ prolapse, or fecal incontinence. Given the high societal burden of these disorders, identifying potentially modifiable risk factors is crucial. Physical activity is one such potentially modifiable risk factor; the large number of girls and women participating in sport and strenuous training regimens increases the need to understand associated risks and benefits of these exposures. The aim of this review was to summarize studies reporting the association between physical activity and pelvic floor disorders. Most studies are cross-sectional and most include small numbers of participants. The primary findings of this review include that urinary incontinence during exercise is common and is more prevalent in women during high-impact sports. Mild to moderate physical activity, such as brisk walking, decreases both the odds of having and the risk of developing urinary incontinence. In older women, mild to moderate activity also decreases the odds of having fecal incontinence; however, young women participating in high-intensity activity are more likely to report anal incontinence than less active women. Scant data suggest that in middle-aged women, lifetime physical activity increases the odds of stress urinary incontinence slightly and does not increase the odds of pelvic organ prolapse. Women undergoing surgery for pelvic organ prolapse are more likely to report a history of heavy work than controls; however, women recruited from the community with pelvic organ prolapse on examination report similar lifetime levels of strenuous activity as women without this examination finding. Data are insufficient to determine whether strenuous activity while young predisposes to pelvic floor disorders later in life. The existing literature suggests that most physical activity does not harm the pelvic floor and does provide numerous health benefits for

  2. Recessive variants of MuSK are associated with late onset CMS and predominant limb girdle weakness.

    Science.gov (United States)

    Owen, David; Töpf, Ana; Preethish-Kumar, Veeramani; Lorenzoni, Paulo José; Vroling, Bas; Scola, Rosana Herminia; Dias-Tosta, Elza; Geraldo, Argemiro; Polavarapu, Kiran; Nashi, Saraswati; Cox, Daniel; Evangelista, Teresinha; Dawson, John; Thompson, Rachel; Senderek, Jan; Laurie, Steven; Beltran, Sergi; Gut, Marta; Gut, Ivo; Nalini, Atchayaram; Lochmüller, Hanns

    2018-04-28

    Congenital myasthenic syndrome (CMS) is a heterogeneous disorder that causes fatigable muscle weakness. CMS has been associated with variants in the MuSK gene and, to date, 16 patients have been reported. MuSK-CMS patients present a different phenotypic pattern of limb girdle weakness. Here, we describe four additional patients and discuss the phenotypic and clinical relationship with those previously reported. Two novel damaging missense variants are described: c.1742T > A; p.I581N found in homozygosis, and c.1634T > C; p.L545P found in compound heterozygosis with p.R166*. The reported patients had predominant limb girdle weakness with symptom onset at 12, 17, 18, and 30 years of age, and the majority exhibited a good clinical response to Salbutamol therapy, but not to esterase inhibitors. Meta-analysis including previously reported variants revealed an increased likelihood of a severe, respiratory phenotype with null alleles. Missense variants exclusively affecting the kinase domain, but not the catalytic site, are associated with late onset. These data refine the phenotype associated with MuSK-related CMS. © 2018 Wiley Periodicals, Inc.

  3. Muscle recruitment patterns of the subscapularis, serratus anterior and other shoulder girdle muscles during isokinetic internal and external rotations.

    Science.gov (United States)

    Gaudet, Sylvain; Tremblay, Jonathan; Begon, Mickael

    2018-05-01

    The aims of this study were to investigate the differences in peak muscle activity and recruitment patterns during high- and low-velocity, concentric and eccentric, internal and external isokinetic shoulder rotations. Electromyographic activity of the rotator cuff and eight superficial muscles of the shoulder girdle was recorded on 25 healthy adults during isokinetic internal and external shoulder rotation at 60°/s and 240°/s. Peak muscle activity, electromyographic envelopes and peak isokinetic moments were analyzed using three-factor ANOVA and statistical parametric mapping. The subscapularis and serratus anterior showed moderate to high peak activity levels during each conditions, while the middle and posterior deltoids, upper, middle and lower trapezius, infraspinatus and supraspinatus showed higher peak activity levels during external rotations (+36.5% of maximum voluntary activation (MVA)). The pectoralis major and latissimus dorsi were more active during internal rotations (+40% of MVA). Only middle trapezius and pectoralis major electromyographic activity decreased with increasing velocity. Peak muscle activity was similar or lower during eccentric contractions, although the peak isokinetic moment increased by 35% on average. The subscapularis and serratus anterior appear to be important stabilizers of the glenohumeral joint and scapula. Isokinetic eccentric training at high velocities may allow for faster recruitment of the shoulder girdle muscles, which could improve joint stability during shoulder internal and external rotations.

  4. Effect of BAP, ethrel and stem girdling on growth and partitioning of photosynthates in Y-shaped mungbean

    International Nuclear Information System (INIS)

    Panwar, J.D.S.; Abbas, S.; Sita Ram; Sirohi, G.S.

    1988-01-01

    During early vegetative growth, pots grown mungbean (Vigna radiata (L) Wilczek cv. Pusa 105) were forced to develop a Y-shaped stem consisting of two symmetrical branches. At preflowering stage, the plants were treated with 6-benzyl amino purine (BAP-20 ppm) and ethrel (500 ppm). Stem girdling was also done just below the junction of the two symmetrical branches and hormonal application (BAP) was done on one of the branches and its effect was observed on other branch of the same plant. Suitable controls were kept. BAP delayed the leaf senescence, enhanced photosynthetic rate and its duration on the treated as well as untreated leaf, whereas ethrel enhanced leaf senescence, reduced photosynthetic rate and its duration. 14 C studies indicated that the translocation of photosynthates was diverted differentially to other plant parts through hormonal application. Girdling on main stem affected the remote effects of hormones and about 98% 14 C remained on the applied branch itself indicating that growth regulators showed their effect on the other branch through roots only. (author). 4 refs., 4 tabs

  5. Fibrous soft tissue tumor of neck and shoulder girdle: MR and CT characteristics

    International Nuclear Information System (INIS)

    Gu Yajia; Peng Weijun; Wang Peihua; Wang Jian

    2005-01-01

    Objective: To evaluate MR and CT imagings of desmoplastic fibroblastoma (DF) and aggressive fibromatosis (AF) in neck and shoulder girdle, and to emphasis upon the MRI findings with pathological correlation. Methods: MR and CT appearances of DFs (4 cases) and AFS (3 cases) confirmed by surgical and pathologic findings were retrospective analysed, which were correlated to the pathologic features. Four cases of DF were male patients, with a median age at 48 years. Two cases of AF were female (20, 29 years respectively), and another AF patient was male (79 years). Results: (1) Four DFs were round mass located in the inter muscle space of neck, and the margins were mostly well-circumscribed. Envelope was seen in one lesion on MRI. On unenhanced CT, the masses showed homogeneous low attenuation (2 cases) or slightly low attenuation with several heterogeneous areas in it (1 cases). Enhancement was not obvious on post-contrast CT images. MRI studies were done in two patients. Signal intensity (SI) on MR was homogeneous and heterogeneous one lesion respectively on unenhanced T 1 -weighted images. Mixed SI as low or high SI nodes within isointense compared with muscle on T 2 -weighted images. No evident enhancing was noted after administration of gadopentetate dimeglumine. (2) All three lesions of aggressive fibromatosis arose from musculoaponeurotic structures. The masses were irregular margin and appeared elongated, which oriented in the direction of the muscle bundle. On unenhanced CT examination, the masses had poorly defined and isodense relative to adjacent musculature (2 cases). On T 1 -weighted images, three masses consisted of poormargination and isointensity relative to adjacent muscle. On T 2 -weighted images, two lesions were heterogeneity of signal, which predominantly slightly high in SI with strip-or node-shape low SI, and one lesion had homogeneous high SI. On post-contrast T 1 -weighted images, all lesions showed marked enhancement, heterogeneity of signal

  6. Transvaginal Ultrasound-Guided Aspiration of Pelvic Abscesses

    Directory of Open Access Journals (Sweden)

    P. J. Corsi

    1999-01-01

    Full Text Available Objective: To assess the utility of a less invasive approach to the care of women with a pelvic abscess, we retrospectively reviewed the outcome of women with pelvic abscesses managed by transvaginal ultrasound-guided aspiration.

  7. Pelvic Organ Prolapse in Jimma University Specialized Hospital ...

    African Journals Online (AJOL)

    Pelvic Organ Prolapse in Jimma University Specialized Hospital, Southwest Ethiopia. ... and there was a significant association between prolapse and residence area. ... Awareness creation on risk factors of pelvic organ prolapse and use of ...

  8. Symptomatic pelvic organ prolapse: Experience at a tertiary ...

    African Journals Online (AJOL)

    information was recorded after a detailed history, physical examination and completion of a self-administered symptom questionnaire. ... due to anatomical restoration of prolapse in ..... of terminology of female pelvic organ prolapse and pelvic.

  9. Imaging of the posterior pelvic floor

    International Nuclear Information System (INIS)

    Stoker, Jaap; Bartram, Clive I.; Halligan, Steve

    2002-01-01

    Disorders of the posterior pelvic floor are relatively common. The role of imaging in this field is increasing, especially in constipation, prolapse and anal incontinence, and currently imaging is an integral part of the investigation of these pelvic floor disorders. Evacuation proctography provides both structural and functional information for rectal voiding and prolapse. Dynamic MRI may be a valuable alternative as the pelvic floor muscles are visualised, and it is currently under evaluation. Endoluminal imaging is important in the management of anal incontinence. Both endosonography and endoanal MRI can be used for detection of anal sphincter defects. Endoanal MRI has the advantage of simultaneously evaluating external sphincter atrophy, which is an important predictive factor for the outcome of sphincter repair. Many aspects of constipation and prolapse remain incompletely understood and treatment is partly empirical; however, imaging has a central role in management to place patients into treatment-defined groups. (orig.)

  10. Postirradiation changes in the pelvic wall

    International Nuclear Information System (INIS)

    Soevik, E.; Lien, H.H.; Tveit, K.M.

    1993-01-01

    MR images of 45 patients who had received radiation therapy for carcinoma of the anus or recurrent carcinoma of the rectum were reviewed with regard to postirradiation changes of the pelvic wall. High signal intensity in bone marrow on T1-weighted images due to fatty replacement was almost always observed. Presacral edema occurred in 7 of 36 patients who were examined 4 to 6 weeks after the end of irradiation and was more frequent at later studies. The pelvic wall muscles showed high signal intensity on T2-weighted images compatible with edema. This finding was most frequent on studies performed more than 6 weeks after the end of irradiation. The changes subsided more than a year after radiation therapy. To avoid an erroneous diagnosis of tumor infiltration into the pelvic wall, it is important to be familiar with the normal postirradiation changes of the presacral space and the muscles. (orig.)

  11. Imaging of the posterior pelvic floor

    Energy Technology Data Exchange (ETDEWEB)

    Stoker, Jaap [Department of Radiology, Academic Medical Center, University of Amsterdam (Netherlands); Bartram, Clive I.; Halligan, Steve [Intestinal Imaging Centre, St. Mark' s Hospital, London (United Kingdom)

    2002-04-01

    Disorders of the posterior pelvic floor are relatively common. The role of imaging in this field is increasing, especially in constipation, prolapse and anal incontinence, and currently imaging is an integral part of the investigation of these pelvic floor disorders. Evacuation proctography provides both structural and functional information for rectal voiding and prolapse. Dynamic MRI may be a valuable alternative as the pelvic floor muscles are visualised, and it is currently under evaluation. Endoluminal imaging is important in the management of anal incontinence. Both endosonography and endoanal MRI can be used for detection of anal sphincter defects. Endoanal MRI has the advantage of simultaneously evaluating external sphincter atrophy, which is an important predictive factor for the outcome of sphincter repair. Many aspects of constipation and prolapse remain incompletely understood and treatment is partly empirical; however, imaging has a central role in management to place patients into treatment-defined groups. (orig.)

  12. Laparoendoscopic single site in pelvic surgery

    Science.gov (United States)

    Sanchez-Salas, Rafael; Clavijo, Rafael; Barret, Eric; Sotelo, Rene

    2012-01-01

    Laparoendoscopic single site (LESS) has recently gained momentum as feasible techniques for minimal access surgery. Our aim is to describe the current status of laparoendoscopic single site (LESS) in pelvic surgery. A comprehensive revision of the literature in LESS pelvic surgery was performed. References for this manuscript were obtained by performing a review of the available literature in PubMed from 01-01-01 to 30-11-11. References outside the search period were obtained selected manuscript΄s bibliography. Search terms included: pelvic anatomy, less in gynecology, single port colectomy, urological less, single port, single site, NOTES, LESS and single incision. 314 manuscripts were initially identified. Out of these, 46 manuscripts were selected based in their pelvic anatomy or surgical content; including experimental experience, clinical series and literature reviews. LESS drastically limit the surgeon's ability to perform in the operative field and the latter becomes hardened by the lack of space in anatomical location like the pelvis. Potential advantages of LESS are gained with the understanding that the surgical procedure is more technically challenging. Pelvic surgical procedures related to colorectal surgery, gynecology and urology have been performed with LESS technique and information available is mostly represented by case reports and short case series. Comparative series remain few. LESS pelvic surgery remain in its very beginning and due to the very specific anatomical conditions further development of LESS surgery in the mentioned area can be clearly be facilitated by using robotic technology. Standardization ad reproducibility of techniques are mandatory to further develop LESS in the surgical arena.. PMID:22557719

  13. Laparoendoscopic single site in pelvic surgery

    Directory of Open Access Journals (Sweden)

    Rafael Sanchez-Salas

    2012-01-01

    Full Text Available Laparoendoscopic single site (LESS has recently gained momentum as feasible techniques for minimal access surgery. Our aim is to describe the current status of laparoendoscopic single site (LESS in pelvic surgery. A comprehensive revision of the literature in LESS pelvic surgery was performed. References for this manuscript were obtained by performing a review of the available literature in PubMed from 01-01-01 to 30-11-11. References outside the search period were obtained selected manuscript΄s bibliography. Search terms included: pelvic anatomy, less in gynecology, single port colectomy, urological less, single port, single site, NOTES, LESS and single incision. 314 manuscripts were initially identified. Out of these, 46 manuscripts were selected based in their pelvic anatomy or surgical content; including experimental experience, clinical series and literature reviews. LESS drastically limit the surgeon′s ability to perform in the operative field and the latter becomes hardened by the lack of space in anatomical location like the pelvis. Potential advantages of LESS are gained with the understanding that the surgical procedure is more technically challenging. Pelvic surgical procedures related to colorectal surgery, gynecology and urology have been performed with LESS technique and information available is mostly represented by case reports and short case series. Comparative series remain few. LESS pelvic surgery remain in its very beginning and due to the very specific anatomical conditions further development of LESS surgery in the mentioned area can be clearly be facilitated by using robotic technology. Standardization ad reproducibility of techniques are mandatory to further develop LESS in the surgical arena..

  14. Functional imaging of the pelvic floor

    Energy Technology Data Exchange (ETDEWEB)

    Lienemann, Andreas E-mail: andreaslienemann@web.de; Fischer, Tanja

    2003-08-01

    Introduction/Objective: Pelvic floor dysfunction and associated pelvic organ prolapse represent a major problem in our present-day society, mostly afflicting parous women. Magnetic resonance imaging (MRI) is assuming an increasingly important role in the more accurate delineation of the extent of the problem. This article briefly reviews one of the main radiological methods for the dynamic evaluation of the pelvic floor: functional cine MRI. Methods and Material: Out of the literature the smallest common denominator for functional cine MRI can be defined as follows: high field system; patient either in supine or sitting position; fast gradient echo sequence; midsagittal slice orientation; either a stack of slices or repeated measurements at the same slice position with the patient at rest or straining; image analysis using the pubococcygeal reference line. Results: All except two publications stress the usefulness of functional cine MRI in the evaluation of patients with organ descent and prolapse. This well accepted method allows for the visualization of all relevant structures in the anterior, middle and posterior compartment. It is especially useful in the detection of enteroceles, and provides a reliable postoperative follow-up tool. Isolated urinary or stool incontinence are not an indication for functional cine MRI, as is the case in patients with equivocal clinical findings. To date it does not allow for real 3D imaging of the pelvic floor or sufficient determination of fascial defects. Discussion: Functional cine MRI of the pelvic floor is a promising new imaging method for the detection of organ descent and prolapse in patients with equivocal clinical findings. The combination of function and morphology allows for an innovative view of the pelvic floor, and thus adds to our understanding of the various interactions of the structures.

  15. [Quality of life after extensive pelvic surgery].

    Science.gov (United States)

    Levý, M; Lipská, L; Visokai, V; Šimša, J

    Multiorgan resections in the small pelvis are standard procedures in oncosurgery and some indications have no alternative. In advanced pelvic cancer, pelvic exenteration with en bloc resection of the involved organs and structures, including portions of the bony pelvis, is indicated. The 5-year survival rate is fairly good, around 50%, but little is known about the long-term quality of life. The aim was to describe the quality of life of long-term total pelvic exenteration survivors. In total, 63 pelvic exenterations were performed between 2000 to 2015 at the Department of Surgery, Thomayer Hospital, First Faculty of Medicine, Charles University in Prague, mostly for primary or relapsed rectal cancer. In this retrospective cohort study, the quality of life was assessed using the EORTC QLQ-C30 (version 3.0) and the EORTC QLQ-CR29 questionnaires. The completed questionnaires were scored according to EORTC instructions. At the time of this survey, 24 patients after TPE were surviving longer than one year after the surgery. The five-year survival of all patients was 49%, median survival 4.6 years, and median follow-up 15 months. Most of our patients reported a good level of their physical, emotional, cognitive and social functions. Some patients reported a worse body image, and of course a worsening in their sexual life. Regarding symptom-oriented questions, some patients evaluated the necessity of more frequent care of the stomia as slightly problematic; most patients reported impotence (men) or painful sexual intercourse (women). Long-term quality of life in survivors of pelvic exenteration for rectal cancer is comparable with reported results following primary rectal cancer resection with the exception of the sexual function. The quality of life gradually improves in the course of weeks to months from the surgery. pelvic exenteration quality of life.

  16. Are routine pelvic radiographs in major pediatric blunt trauma necessary?

    International Nuclear Information System (INIS)

    Lagisetty, Jyothi; Slovis, Thomas; Thomas, Ronald; Knazik, Stephen; Stankovic, Curt

    2012-01-01

    Screening pelvic radiographs to rule out pelvic fractures are routinely used for the initial evaluation of pediatric blunt trauma. Recently, the utility of routine pelvic radiographs in certain subsets of patients with blunt trauma has been questioned. There is a growing amount of evidence that shows the clinical exam is reliable enough to obviate the need for routine screening pelvic radiographs in children. To identify variables that help predict the presence or absence of pelvic fractures in pediatric blunt trauma. We conducted a retrospective study from January 2005 to January 2010 using the trauma registry at a level 1 pediatric trauma center. We analyzed all level 1 and level 2 trauma victims, evaluating history, exam and mechanism of injury for association with the presence or absence of a pelvic fracture. Of 553 level 1 and 2 trauma patients who presented during the study period, 504 were included in the study. Most of these children, 486/504 (96.4%), showed no evidence of a pelvic fracture while 18/504 (3.6%) had a pelvic fracture. No factors were found to be predictive of a pelvic fracture. However, we developed a pelvic fracture screening tool that accurately rules out the presence of a pelvic fracture P = 0.008, NPV 99, sensitivity 96, 8.98 (1.52-52.8). This screening tool combines eight high-risk clinical findings (pelvic tenderness, laceration, ecchymosis, abrasion, GCS <14, positive urinalysis, abdominal pain/tenderness, femur fracture) and five high-risk mechanisms of injury (unrestrained motor vehicle collision [MVC], MVC with ejection, MVC rollover, auto vs. pedestrian, auto vs. bicycle). Pelvic fractures in pediatric major blunt trauma can reliably be ruled out by using our pelvic trauma screening tool. Although no findings accurately identified the presence of a pelvic fracture, the screening tool accurately identified the absence of a fracture, suggesting that pelvic radiographs are not warranted in this subset of patients. (orig.)

  17. Knowledge of the pelvic floor in nulliparous women

    OpenAIRE

    Neels, Hedwig; Wyndaele, Jean-Jacques; Tjalma, Wiebren A. A.; De Wachter, Stefan; Wyndaele, Michel; Vermandel, Alexandra

    2016-01-01

    [Purpose] Proper pelvic floor function is important to avoid serious dysfunctions including incontinence, prolapse, and sexual problems. The current study evaluated the knowledge of young nulliparous women about their pelvic floor and identified what additional information they wanted. [Subjects and Methods] In this cross-sectional survey, a validated, 36 item questionnaire was distributed to 212 nulliparous women. The questionnaire addressed demography, pelvic floor muscles, pelvic floor dys...

  18. Are routine pelvic radiographs in major pediatric blunt trauma necessary?

    Energy Technology Data Exchange (ETDEWEB)

    Lagisetty, Jyothi [Memorial Hermann Medical Center, Emergency Medicine Department, Houston, TX (United States); Slovis, Thomas [Wayne State University School of Medicine, Department of Radiology, Pediatric Imaging, Children' s Hospital of Michigan, Detroit, MI (United States); Thomas, Ronald [Children' s Hospital of Michigan, Wayne State University of Medicine, Department of Pediatrics, Detroit, MI (United States); Knazik, Stephen; Stankovic, Curt [Wayne State University of Medicine, Division of Emergency Medicine, Children' s Hospital of Michigan, Detroit, MI (United States)

    2012-07-15

    Screening pelvic radiographs to rule out pelvic fractures are routinely used for the initial evaluation of pediatric blunt trauma. Recently, the utility of routine pelvic radiographs in certain subsets of patients with blunt trauma has been questioned. There is a growing amount of evidence that shows the clinical exam is reliable enough to obviate the need for routine screening pelvic radiographs in children. To identify variables that help predict the presence or absence of pelvic fractures in pediatric blunt trauma. We conducted a retrospective study from January 2005 to January 2010 using the trauma registry at a level 1 pediatric trauma center. We analyzed all level 1 and level 2 trauma victims, evaluating history, exam and mechanism of injury for association with the presence or absence of a pelvic fracture. Of 553 level 1 and 2 trauma patients who presented during the study period, 504 were included in the study. Most of these children, 486/504 (96.4%), showed no evidence of a pelvic fracture while 18/504 (3.6%) had a pelvic fracture. No factors were found to be predictive of a pelvic fracture. However, we developed a pelvic fracture screening tool that accurately rules out the presence of a pelvic fracture P = 0.008, NPV 99, sensitivity 96, 8.98 (1.52-52.8). This screening tool combines eight high-risk clinical findings (pelvic tenderness, laceration, ecchymosis, abrasion, GCS <14, positive urinalysis, abdominal pain/tenderness, femur fracture) and five high-risk mechanisms of injury (unrestrained motor vehicle collision [MVC], MVC with ejection, MVC rollover, auto vs. pedestrian, auto vs. bicycle). Pelvic fractures in pediatric major blunt trauma can reliably be ruled out by using our pelvic trauma screening tool. Although no findings accurately identified the presence of a pelvic fracture, the screening tool accurately identified the absence of a fracture, suggesting that pelvic radiographs are not warranted in this subset of patients. (orig.)

  19. Primary Pelvic Involvement of Hydatid Disease

    Directory of Open Access Journals (Sweden)

    Migraci Tosun

    2011-04-01

    Full Text Available Hydatid disease is caused by larval stage of a parasite named as Echinococcus. To diagnose this condition may be challenging without surgery and postoperative pathological examination due to limited value of serological studies but imaging techniques may give a clue when hydatid disease is suspected and hydatid disease shall be considered for differential diagnosis in pelvic mass. In the present case, we present a 75-year-old postmenopausal woman with pelvic hydatosis.

  20. Pelvic radiograph in skeletal dysplasias: An approach

    Directory of Open Access Journals (Sweden)

    Manisha Jana

    2017-01-01

    Full Text Available The bony pelvis is constituted by the ilium, ischium, pubis, and sacrum. The pelvic radiograph is an important component of the skeletal survey performed in suspected skeletal dysplasia. Most of the common skeletal dysplasias have either minor or major radiological abnormalities; hence, knowledge of the normal radiological appearance of bony pelvis is vital for recognizing the early signs of various skeletal dysplasias. This article discusses many common and some uncommon radiological findings on pelvic radiographs along with the specific dysplasia in which they are seen; common differential diagnostic considerations are also discussed.

  1. US and MR imaging of pelvic masses

    International Nuclear Information System (INIS)

    Angtuaco, T.L.; Boyd, C.M.; Mattison, D.R.; Williamson, M.R.; Sanders, M.M.; Bard, D.S.

    1987-01-01

    US and MR imaging were compared in benign and malignant pelvic masses to determine where MR imaging may replace US. With regard to benign masses, MR imaging showed a significant advantage only in the imaging of teratomas. In malignancy, US was better than MR imaging in delineating internal architecture. MR imaging was superior in suggesting the origin and extent of masses, especially in large neoplasms. US remains a reliable tool in the initial evaluation of pelvic masses. When US studies are suboptimal, MR imaging should be performed as complementary study. MR imaging may replace US in the initial examination of large masses where US cannot depict the origin and extent

  2. Correction of Pelvic Tilt and Pelvic Rotation in Cup Measurement after THA - An Experimental Study.

    Science.gov (United States)

    Schwarz, Timo Julian; Weber, Markus; Dornia, Christian; Worlicek, Michael; Renkawitz, Tobias; Grifka, Joachim; Craiovan, Benjamin

    2017-09-01

    Purpose  Accurate assessment of cup orientation on postoperative pelvic radiographs is essential for evaluating outcome after THA. Here, we present a novel method for correcting measurement inaccuracies due to pelvic tilt and rotation. Method  In an experimental setting, a cup was implanted into a dummy pelvis, and its final position was verified via CT. To show the effect of pelvic tilt and rotation on cup position, the dummy was fixed to a rack to achieve a tilt between + 15° anterior and -15° posterior and 0° to 20° rotation to the contralateral side. According to Murray's definitions of anteversion and inclination, we created a novel corrective procedure to measure cup position in the pelvic reference frame (anterior pelvic plane) to compensate measurement errors due to pelvic tilt and rotation. Results  The cup anteversion measured on CT was 23.3°; on AP pelvic radiographs, however, variations in pelvic tilt (± 15°) resulted in anteversion angles between 11.0° and 36.2° (mean error 8.3°± 3.9°). The cup inclination was 34.1° on CT and ranged between 31.0° and 38.7° (m. e. 2.3°± 1.5°) on radiographs. Pelvic rotation between 0° and 20° showed high variation in radiographic anteversion (21.2°-31.2°, m. e. 6.0°± 3.1°) and inclination (34.1°-27.2°, m. e. 3.4°± 2.5°). Our novel correction algorithm for pelvic tilt reduced the mean error in anteversion measurements to 0.6°± 0.2° and in inclination measurements to 0.7° (SD± 0.2). Similarly, the mean error due to pelvic rotation was reduced to 0.4°± 0.4° for anteversion and to 1.3°± 0.8 for inclination. Conclusion  Pelvic tilt and pelvic rotation may lead to misinterpretation of cup position on anteroposterior pelvic radiographs. Mathematical correction concepts have the potential to significantly reduce these errors, and could be implemented in future radiological software tools. Key Points   · Pelvic tilt and rotation influence cup

  3. Anatomy of Shoulder Girdle Muscle Modifications and Walking Adaptation in the Scaly Chinese Pangolin (Manis Pentadactyla Pentadactyla: Pholidota) Compared with the Partially Osteoderm-Clad Armadillos (Dasypodidae).

    Science.gov (United States)

    Kawashima, Tomokazu; Thorington, Richard W; Bohaska, Paula W; Chen, Yen-Jean; Sato, Fumi

    2015-07-01

    Because pangolins are unique mammals with a body and limbs almost entirely sheathed in hard keratinous overlapping scales and with digging and climbing abilities, the shoulder girdle muscles may differ significantly from those of other mammals including the partially osteoderm-clad armadillos. Therefore, we conducted a functional anatomical study of the shoulder girdle muscles in Chinese pangolins (Manis pentadactyla pentadactyla, Pholidota) and some armadillo species (Dasypodidae). Our CT scans revealed that the pangolin's overlapping scales are hard structures completely encasing the limbs. The armadillo's limbs, however, are covered with small relatively soft non-overlapping scales embedded in the skin, and articulate completely free of the hard osteodermal carapace. The attachments of some shoulder girdle muscles in the pangolin have moved from the surrounding edges of the scapula to the spine, and they, therefore, fully cover the scapula. In addition, some pangolin shoulder girdle muscles cross the shoulder joint to insert on the distal humerus, but this does not occur in armadillos. We cannot rule out the possibility that these muscle modifications represent adaptations for digging and/or climbing in pangolins. Our results and previous literature do not establish specific links between them and locomotive modes. However, we propose that the Chinese pangolin may use its derived muscular features when walking to move its armor-restricted forelimbs more effectively by swinging its head from side to side. © 2015 Wiley Periodicals, Inc.

  4. A mitochondrial tRNA(Met) mutation causing developmental delay, exercise intolerance and limb girdle phenotype with onset in early childhood

    DEFF Research Database (Denmark)

    Born, Alfred Peter; Duno, Morten; Rafiq, Jabin

    2015-01-01

    A 10-year-old girl presented with exercise intolerance, learning difficulty, and muscle weakness in a limb girdle distribution. She had delayed achievement of motor milestones and difficulties with social interaction at pre-school age. Muscle biopsy showed no myopathic or dystrophic features...

  5. Pelvic floor function during and after first pregnancy

    NARCIS (Netherlands)

    Brummen, H.J. van

    2006-01-01

    This study evaluated the effects the first pregnancy and childbirth on the pelvic floor. Pregnancy and vaginal delivery can negatively affect pelvic floor function. Micturition symptoms, defecation symptoms and sexual dysfunction are all signs of an impaired pelvic floor function. These symptoms are

  6. Linking women who test HIV-positive in pregnancy-related services to long-term HIV care and treatment services: a systematic review.

    Science.gov (United States)

    Ferguson, Laura; Grant, Alison D; Watson-Jones, Deborah; Kahawita, Tanya; Ong'ech, John O; Ross, David A

    2012-05-01

    To quantify attrition between women testing HIV-positive in pregnancy-related services and accessing long-term HIV care and treatment services in low- or middle-income countries and to explore the reasons underlying client drop-out by synthesising current literature on this topic. A systematic search in Medline, EMBASE, Global Health and the International Bibliography of the Social Sciences of literature published 2000-2010. Only studies meeting pre-defined quality criteria were included. Of 2543 articles retrieved, 20 met the inclusion criteria. Sixteen (80%) drew on data from sub-Saharan Africa. The pathway between testing HIV-positive in pregnancy-related services and accessing long-term HIV-related services is complex, and attrition was usually high. There was a failure to initiate highly active antiretroviral therapy (HAART) among 38-88% of known-eligible women. Providing 'family-focused care', and integrating CD4 testing and HAART provision into prevention of mother-to-child HIV transmission services appear promising for increasing women's uptake of HIV-related services. Individual-level factors that need to be addressed include financial constraints and fear of stigma. Too few women negotiate the many steps between testing HIV-positive in pregnancy-related services and accessing HIV-related services for themselves. Recent efforts to stem patient drop-out, such as the MTCT-Plus Initiative, hold promise. Addressing barriers and enabling factors both within health facilities and at the levels of the individual woman, her family and society will be essential to improve the uptake of services. © 2012 Blackwell Publishing Ltd.

  7. Are routine pelvic radiographs in major pediatric blunt trauma necessary?

    Science.gov (United States)

    Lagisetty, Jyothi; Slovis, Thomas; Thomas, Ronald; Knazik, Stephen; Stankovic, Curt

    2012-07-01

    Screening pelvic radiographs to rule out pelvic fractures are routinely used for the initial evaluation of pediatric blunt trauma. Recently, the utility of routine pelvic radiographs in certain subsets of patients with blunt trauma has been questioned. There is a growing amount of evidence that shows the clinical exam is reliable enough to obviate the need for routine screening pelvic radiographs in children. To identify variables that help predict the presence or absence of pelvic fractures in pediatric blunt trauma. We conducted a retrospective study from January 2005 to January 2010 using the trauma registry at a level 1 pediatric trauma center. We analyzed all level 1 and level 2 trauma victims, evaluating history, exam and mechanism of injury for association with the presence or absence of a pelvic fracture. Of 553 level 1 and 2 trauma patients who presented during the study period, 504 were included in the study. Most of these children, 486/504 (96.4%), showed no evidence of a pelvic fracture while 18/504 (3.6%) had a pelvic fracture. No factors were found to be predictive of a pelvic fracture. However, we developed a pelvic fracture screening tool that accurately rules out the presence of a pelvic fracture P = 0.008, NPV 99, sensitivity 96, 8.98 (1.52-52.8). This screening tool combines eight high-risk clinical findings (pelvic tenderness, laceration, ecchymosis, abrasion, GCS blunt trauma can reliably be ruled out by using our pelvic trauma screening tool. Although no findings accurately identified the presence of a pelvic fracture, the screening tool accurately identified the absence of a fracture, suggesting that pelvic radiographs are not warranted in this subset of patients.

  8. Radiographic cup anteversion measurement corrected from pelvic tilt.

    Science.gov (United States)

    Wang, Liao; Thoreson, Andrew R; Trousdale, Robert T; Morrey, Bernard F; Dai, Kerong; An, Kai-Nan

    2017-11-01

    The purpose of this study was to develop a novel technique to improve the accuracy of radiographic cup anteversion measurement by correcting the influence of pelvic tilt. Ninety virtual total hip arthroplasties were simulated from computed tomography data of 6 patients with 15 predetermined cup orientations. For each simulated implantation, anteroposterior (AP) virtual pelvic radiographs were generated for 11 predetermined pelvic tilts. A linear regression model was created to capture the relationship between radiographic cup anteversion angle error measured on AP pelvic radiographs and pelvic tilt. Overall, nine hundred and ninety virtual AP pelvic radiographs were measured, and 90 linear regression models were created. Pearson's correlation analyses confirmed a strong correlation between the errors of conventional radiographic cup anteversion angle measured on AP pelvic radiographs and the magnitude of pelvic tilt (P cup anteversion angle from the influence of pelvic tilt. The current method proposes to measure the pelvic tilt on a lateral radiograph, and to use it as a correction for the radiographic cup anteversion measurement on an AP pelvic radiograph. Thus, both AP and lateral pelvic radiographs are required for the measurement of pelvic posture-integrated cup anteversion. Compared with conventional radiographic cup anteversion, the errors of pelvic posture-integrated radiographic cup anteversion were reduced from 10.03 (SD = 5.13) degrees to 2.53 (SD = 1.33) degrees. Pelvic posture-integrated cup anteversion measurement improves the accuracy of radiographic cup anteversion measurement, which shows the potential of further clarifying the etiology of postoperative instability based on planar radiographs. Copyright © 2017 IPEM. Published by Elsevier Ltd. All rights reserved.

  9. Sexual selection targets cetacean pelvic bones

    Science.gov (United States)

    Dines, J. P.; Otárola-Castillo, E.; Ralph, P.; Alas, J.; Daley, T.; Smith, A. D.; Dean, M. D.

    2014-01-01

    Male genitalia evolve rapidly, probably as a result of sexual selection. Whether this pattern extends to the internal infrastructure that influences genital movements remains unknown. Cetaceans (whales and dolphins) offer a unique opportunity to test this hypothesis: since evolving from land-dwelling ancestors, they lost external hind limbs and evolved a highly reduced pelvis which seems to serve no other function except to anchor muscles that maneuver the penis. Here we create a novel morphometric pipeline to analyze the size and shape evolution of pelvic bones from 130 individuals (29 species) in the context of inferred mating system. We present two main findings: 1) males from species with relatively intense sexual selection (inferred by relative testes size) have evolved relatively large penises and pelvic bones compared to their body size, and 2) pelvic bone shape diverges more quickly in species pairs that have diverged in inferred mating system. Neither pattern was observed in the anterior-most pair of vertebral ribs, which served as a negative control. This study provides evidence that sexual selection can affect internal anatomy that controls male genitalia. These important functions may explain why cetacean pelvic bones have not been lost through evolutionary time. PMID:25186496

  10. Biomimetic implants for pelvic floor repair

    NARCIS (Netherlands)

    Vashaghian, Mahshid; Zaat, Sebastianus A. J.; Smit, Theodoor H.; Roovers, Jan-Paul

    2017-01-01

    Polypropylene implants are used for the reconstructive surgery of urogynaecological disorders like pelvic organ prolapse, but severe complications associated with their use have been reported. There is evidence that surface properties and a difference in mechanical stiffness between the implant and

  11. A Suspected Pelvic Aneurysmal Bone Cyst in Pregnancy

    Directory of Open Access Journals (Sweden)

    Rayan Elkattah

    2013-01-01

    Full Text Available Albeit rare, the majority of identified bone lesions in pregnancy spare the pelvis. Once encountered with a pelvic bone lesion in pregnancy, the obstetrician may face a challenging situation as it is difficult to determine and predict the effects that labor and parturition impart on the pelvic bones. Bone changes and pelvic bone fractures have been well documented during childbirth. The data regarding clinical outcomes and management of pregnancies complicated by pelvic ABCs is scant. Highly suspected to represent an aneurysmal bone cyst, the clinical evaluation of a pelvic lesion in the ilium of a pregnant individual is presented, and modes of delivery in such a scenario are discussed.

  12. [Quality of life in women with pelvic floor dysfunction].

    Science.gov (United States)

    Segedi, Ljiljana Mladenović; Ilić, Katarina Parezanović; Curcić, Aleksandar; Visnjevac, Nemanja

    2011-11-01

    Pelvic floor dysfunction is a frequent problem affecting more than 50% of women in peri- and postmenopause. Considering that ageing and menopause befall in the significant factors causing this issue, as well as the expected longevity of women in the world and in our country, pelvic floor dysfunction prevelence is foreseen to be even higher. The aim of the study was to evaluate impact of the symptoms of pelvic dysfunction on quality of life and examine body image satisfaction in adult women with pelvic organ prolapse presenting to tertiary care clinic for surgical treatment. This prospective case-control study included 50 patients who presented to tertiary care gynecology clinic for surgical treatment and 50 controls with normal pelvic floor support and without urinary incontinence who presented tertiary care gynecology clinic for other reasons. Both, patients and controls, completed two quastionnaires recommended for the evaluation of symptoms (Pelvic floor distress inventory - short forms) and quality of life impact (Pelvic floor impact questionnaire - short form) of pelvic organ prolapse, and Body Image Scale. The patients scored significantly worse on the prolapse, urinary, colorectal scales and overall score of Pelvic floor distress inventory--20 than controls subjects (134.91 vs 78.08; p self-conscious (78% vs 42%; p body. There was a positive correlation between decreased quality of life and body image in women with pelvic dysfunction. Women with pelvic floor dysfunction have decreased quality of life and body image.

  13. Surgical reconstruction of pelvic floor descent: anatomic and functional aspects.

    Science.gov (United States)

    Wagenlehner, F M E; Bschleipfer, T; Liedl, B; Gunnemann, A; Petros, P; Weidner, W

    2010-01-01

    The human pelvic floor is a complex structure and pelvic floor dysfunction is seen frequently in females. This review focuses on the surgical reconstruction of the pelvic floor employing recent findings on functional anatomy. A selective literature research was performed by the authors. Pelvic floor activity is regulated by 3 main muscular forces that are responsible for vaginal tension and suspension of the pelvic floor organs, bladder and rectum. A variety of symptoms can derive from pelvic floor dysfunctions, such as urinary urge and stress incontinence, abnormal bladder emptying, fecal incontinence, obstructive bowel disease syndrome and pelvic pain. These symptoms mainly derive, for different reasons, from laxity in the vagina or its supporting ligaments as a result of altered connective tissue. Pelvic floor reconstruction is nowadays driven by the concept that in case of pelvic floor symptoms, restoration of the anatomy will translate into restoration of the physiology and ultimately improve patients' symptoms. The surgical reconstruction of the anatomy is almost exclusively focused on the restoration of the lax pelvic floor ligaments. Exact preoperative identification of the anatomical lesions is necessary to allow for exact anatomical reconstruction with respect to the muscular forces of the pelvic floor. Copyright 2010 S. Karger AG, Basel.

  14. [Modern aspects of surgical treatment of locally advanced pelvic cancer].

    Science.gov (United States)

    Solovyov, I A; Vasilchenko, M V; Lychev, A B; Ambartsumyan, S V; Alekseev, V V

    2015-09-01

    The aim of investigation is to improve surgical treatment of patients with locally advanced pelvic cancer. The basis of investigation is 186 patients with locally advanced pelvic cancer. The average age of patients is 65.2 ± 5.2 years (from 43.7 to 88.4 years). Among them are 112 women and 74 men. In the period from 2007 to 2015 they were carried out combined (101 patients) and expanded (85 patients) surgical intervention in the department of naval surgery of the Military medical academy after S.M.Kirov. Pelvic evisceration was performed in 63 cases. Both patients were performed isolated vascular hyperthermic chemical pelvic perfusion. Indications for plastic surgery of peritoneum pelvic were: total infralitoral pelvic evisceration (9 patients), dorsal infralitoral pelvic evisceration (11 cases) and expanded abdominoperineal rectum extirpation (34 patients). Plastic surgery with autogenouse tissues was performed to 43 patients, with reticulate explants--to 11 patients. The rate of postoperative complications was 40.2%. The rate of postoperative lethality was 8%. Expanded and combined operations of pelvic at patients with locally advanced cancer without absolute contra-indications can be performed irrespective of age. Plastic surgery of peritoneum pelvic after total and dorsal infralitoral pelvic evisceration and expanded abdominoperineal rectum extirpation indicated in all cases. The easiest method is plastic surgery with greater omentum or peritoneum pelvic. Plastic surgery with reticulate explants is performed when autoplastic is impossible.

  15. Hormonal treatment for endometriosis associated pelvic pain

    Directory of Open Access Journals (Sweden)

    Wu Shun Felix Wong

    2011-01-01

    Full Text Available AbstractBackground: Endometriosis is a common gynecological problem associated with chronic pelvic pain. Objective: To evaluate the effectiveness of current hormonal treatments of endometriosis associated pain.Materials and Methods: Randomized Controlled studies identified from databases of Medline and Cochrane Systemic Review groups were pooled. 7 RCTs were recruited for evaluation in this review. Data from these studies were pooled and meta-analysis was performed in three comparison groups: 1 Progestogen versus GnRHa; 2 Implanon versus Progestogen (injection; 3 Combined oral contraceptive pills versus placebo and progestogen. Response to treatment was measured as a reduction in pain score. Pain improvement was defined as improvement ≥1 at the end of treatment. Results: There was no significant difference between treatment groups of progestogen and GnRHa (RR: 0.036; CI:-0.030-0.102 for relieving endometriosis associated pelvic pain. Long acting progestogen (Implanon and Mirena are not inferior to GnRHa and depot medroxy progesterone acetate (DMPA (RR: 0.006; CI:-0.142-0.162. Combined oral contraceptive pills demonstrated effective treatment of relieving endometriosis associated pelvic pain when compared with placebo groups (RR:0.321CI-0.066-0.707. Progestogen was more effective than combined oral contraceptive pills in controlling dysmenorrhea (RR:-0.160; CI:-0.386-0.066, however, progestogen is associated with more side effects like spotting and bloating than the combined contraceptive pills. Conclusion: Combined oral contraceptive pills (COCP, GnRHa and progestogens are equally effective in relieving endometriosis associated pelvic pain. COCP and progestogens are relatively cheap and more suitable for long-term use as compared to GnRHa. Long-term RCT of medicated contraceptive devices like Mirena and Implanon are required to evaluate their long-term effects on relieving the endometriosis associated pelvic pain

  16. Pelvic floor dyssynergia: efficacy of biofeedback training.

    Science.gov (United States)

    Gadel Hak, Nabil; El-Hemaly, Mohamed; Hamdy, Emad; El-Raouf, Ahmed Abd; Atef, Ehab; Salah, Tarek; El-Hanafy, Ehab; Sultan, Ahmad; Haleem, Magdy; Hamed, Hala

    2011-03-01

    Paradoxical contraction of the pelvic floor during attempts to defaecate is described as pelvic floor dyssynergia (anismus). It is a behavioural disorder (no associated morphological or neurological abnormalities); consequently, biofeedback training has been recommended as a behavioural therapy for such a disorder. The aim of the present study was to evaluate long-term satisfaction of patients diagnosed with pelvic floor dyssynergia after biofeedback. Sixty patients (35 females and 25 males) with a mean age of 30±12years and a 4year duration of constipation were included. Forty-five patients had normal colonic transit and 15 patients had slow colonic transit. History, physical examination and barium enema were done to exclude constipation secondary to organic causes. Colonic and pelvic floor functions (colon-transit time, anorectal manometry, EMG and defaecography) were performed before and after biofeedback treatments. Patients were treated on a weekly basis with an average of (6±2) sessions. At the end of sessions, 55 out of 60 patients (91.6%) reported a subjectively overall improvement. Symptoms of dyschezia were reported less frequently after biofeedback. Age and gender were not predictive factors of outcome. No symptoms at initial assessment were predictive for patient's satisfaction but the only factor of predictive value was the diagnosis of anismus and the motivated patient who wanted to continue the sessions. Biofeedback remains a morbidity free, low-cost and effective outpatient therapy for well-motivated patients complaining of functional constipation and diagnosed as pelvic floor dyssynergia. Copyright © 2011 Arab Journal of Gastroenterology. Published by Elsevier Ltd. All rights reserved.

  17. Protein and genetic diagnosis of limb girdle muscular dystrophy type 2A: The yield and the pitfalls.

    Science.gov (United States)

    Fanin, Marina; Angelini, Corrado

    2015-08-01

    Limb girdle muscular dystrophy type 2A (LGMD2A) is the most frequent form of LGMD worldwide. Comprehensive clinical assessment and laboratory testing is essential for diagnosis of LGMD2A. Muscle immunoblot analysis of calpain-3 is the most useful tool to direct genetic testing, as detection of calpain-3 deficiency has high diagnostic value. However, calpain-3 immunoblot testing lacks sensitivity in about 30% of cases due to gene mutations that inactivate the enzyme. The best diagnostic strategy should be determined on a case-by-case basis, depending on which tissues are available, and which molecular and/or genetic methods are adopted. In this work we survey the current knowledge, advantages, limitations, and pitfalls of protein testing and mutation detection in LGMD2A and provide an update of genetic epidemiology. © 2015 Wiley Periodicals, Inc.

  18. Growth of the pectoral girdle in a sample of juveniles from the kellis 2 cemetery, Dakhleh Oasis, Egypt.

    Science.gov (United States)

    Bleuze, Michele M; Wheeler, Sandra M; Williams, Lana J; Dupras, Tosha L

    2016-09-10

    This study investigates growth patterns in the scapula and clavicle in a cross-sectional juvenile skeletal sample ranging from 20 weeks gestation to 8.5 years of age from the Kellis 2 cemetery, Dakhleh Oasis, Egypt. The primary goal is to quantify growth patterns and growth velocities in the scapula and clavicle to better understand the development of the pectoral girdle. A series of low-order polynomial regression models was used to examine growth curves in clavicle diaphyseal length, scapular height, and scapular width. Incremental growth and relative percent increase were examined among successive age groups as a proxy measure of growth velocity. Scapular body proportions were assessed with the scapular index and compared across age groups using a Kruskal-Wallis test with post-hoc tests. A third-order polynomial best describes growth in clavicle diaphyseal length and scapular height, and a second-order polynomial best describes growth in scapular width. Growth velocity patterns are similar among clavicle diaphyseal length, scapular height, and scapular width particularly from birth until the end of early childhood. Clavicle diaphyseal length decelerates during middle childhood while scapular height and width accelerate during this time. With increasing age, the scapular body proportionately increases more in height than in width. The relatively narrow scapular body characteristic of adult scapulae is first evident during early childhood. Changes in scapular body shape during ontogeny may be a reflection of the greater alterations taking place in the integrated morphology of the pectoral girdle during the biomechanical shift from crawling to bipedalism. Am. J. Hum. Biol. 28:636-645, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  19. Young adults' experiences of living with recessive limb-girdle muscular dystrophy from a salutogenic orientation: an interview study.

    Science.gov (United States)

    Aho, Anna Carin; Hultsjö, Sally; Hjelm, Katarina

    2015-01-01

    To describe young adults' experiences of living with recessive limb-girdle muscular dystrophy (LGMD2) from a salutogenic orientation. A qualitative explorative interview study, including 14 participants aged 20-30 years, was performed focusing on comprehensibility, manageability and meaningfulness in daily life. Content analysis was used for data analysis. Living with LGMD2 not only implies learning to live with the disease and the variations between good and bad periods but also means trying to make sense of a progressive disease that brings uncertainty about future health, by striving to make the best of the situation. Disease progression involves practical and mental struggle, trying to maintain control over one's life despite vanished physical functions that require continual adjustments to the body. Restrictions in a double sense were described, not only due to the disease but also due to poor comprehension of the disease in society. Lack of knowledge about LGMD2 among professionals often results in having to fight for the support needed. In order to manage daily life, it is important to be seen and understood as an individual in contacts with professionals and in society in general, to have informal social support and meaningful activities as well as access to personal assistance if necessary. Recessive limb-girdle muscular dystrophy (LGMD2) is a group of progressive disorders, which manifest in physical and psychological consequences for the individual. According to the salutogenic orientation, people need to find life comprehensible, manageable and meaningful, i.e. to achieve a sense of coherence (SOC), but living with LGMD2 may recurrently challenge the individual's SOC. Through the holistic view of the individual's situation that the salutogenic orientation provides, professionals may support the individual to strengthen SOC and thereby facilitate the movement towards health.

  20. Intra-pelvic pressure changes after pelvic fracture: A cadaveric study quantifying the effect of a pelvic binder and limb bandaging over a bolster.

    Science.gov (United States)

    Morris, Rhys; Loftus, Andrew; Friedmann, Yasmin; Parker, Paul; Pallister, Ian

    2017-04-01

    Unstable pelvic fractures can be life-threatening due to catastrophic haemorrhage. Non-invasive methods of reducing and stabilising these injuries include pelvic binder application and also lower limb bandaging over a knee-flexion bolster. Both of these methods help close the pelvic ring and should tamponade bleeding. This study aimed to quantify the intra-pelvic pressure changes that occurred with 3 different manoeuvres: lower limb bandaging over a bolster; a Trauma Pelvic Orthotic Device (T-POD) pelvic binder, and a combination of both. Following a pilot study with 2 soft embalmed cadavers, a formal study with 6 unembalmed cadavers was performed. For each specimen an unstable pelvic injury was created (OA/OTA 61-C1) by dividing the pelvic ring anteriorly and posteriorly. A 3-4cm manometric water-filled balloon was placed in the retropubic space and connected to a 50ml syringe and water manometer via a 3-way tap. A baseline pressure of 8cmH 2 O (equating to the average central venous pressure) was used for each cadaver. Steady intra-pelvic pressures (more reliably reflecting the pressures achieved following an intervention) were used in the subsequent statistical analysis, using R statistical language and Rstudio. Paired t-test or Wilcoxon's rank sum test were used (depending on the normality of the dataset) to determine the impact of each intervention on the intra-pelvic pressure. The mean steady intra-pelvic pressures were significantly greater than the baseline pressure for each intervention. The binder and limb bandaging over a bolster alone increased the mean steady pelvic pressures significantly to 24 (SE=5) (plower limb bandaging over a bolster and pelvic binder application significantly increased intra-pelvic pressure above the baseline pressure. This was further increased through combining these interventions, which could be useful clinically to augment haemorrhage control in these fractures. Lower-limb bandaging over a bolster, and pelvic binder

  1. Recent Advances in Understanding Pelvic-Floor Tissue of Women With and Without Pelvic Organ Prolapse: Considerations for Physical Therapists.

    Science.gov (United States)

    Saunders, Kimberly

    2017-04-01

    Pelvic organ prolapse is a fairly common condition that imposes significant symptoms, diminished quality of life, social burden, financial expense, and surgical risk on women. As evidence supporting the benefit of pelvic-floor muscle training in nonsurgical management of pelvic organ prolapse grows, physical therapists are becoming a provider of choice interacting with women affected by pelvic organ prolapse. This perspective article will review recent research on tissue characteristics of 3 key components of pelvic organ support: skeletal muscle, ligament, and vaginal wall. This information will be summarized as implications for physical therapists. An improved understanding of pelvic-floor tissue in women with and without pelvic organ prolapse will provide a more comprehensive appreciation of the interaction of multiple systems in the disorder. © 2017 American Physical Therapy Association.

  2. Minimally invasive anterior pelvic internal fixation: An anatomic study comparing Pelvic Bridge to INFIX.

    Science.gov (United States)

    Reichel, Lee M; MacCormick, Lauren M; Dugarte, Anthony J; Rizkala, Amir R; Graves, Sara C; Cole, Peter A

    2018-02-01

    Anterior external fixation for pelvic ring fractures has shown to effectively improve stability and reduce mortality. However, these fixators can be associated with substantial morbidity such as pin tract infection, premature loss of fixation, and decreased quality of life in patients. Recently, two new methods of subcutaneous anterior pelvic internal fixation have been developed; the INFIX and the Pelvic Bridge. These methods have the purported advantages of lower wound complications, less surgical site pain, and improved quality of life. We sought to investigate the measured distances to critical anatomic structures, as well as the qualitative and topographic differences notable during implantation of both devices in the same cadaveric specimen. The Pelvic Bridge and INFIX were implanted in eleven fresh cadavers. Distances were then measured to: the superficial inguinal ring, round ligament, spermatic cord, lateral femoral cutaneous nerve (LFCN), femoral nerve, femoral artery, and femoral vein. Observations regarding implantation and topography were also recorded. The INFIX had greater measured distances from all structures except for the LFCN, in which its proximity placed this structure at risk. Neither device appears to put other critical structures at risk in the supine position. Significant implantation and topographic differences exist between the devices. The INFIX application lacked "safety margins" concerning the LFCN in 10/11 (90.9%) specimens, while Pelvic Bridge placement lacked "safety margins" with regard to the right superficial ring (1/11, 9%) and the right spermatic cord (1/11, 9%). Both the Pelvic Bridge and INFIX lie at safe distances from most critical pelvic structures in the supine position, though INFIX application places the LFCN at risk. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Pelvic Insufficiency Fracture After Pelvic Radiotherapy for Cervical Cancer: Analysis of Risk Factors

    International Nuclear Information System (INIS)

    Oh, Dongryul; Huh, Seung Jae; Nam, Heerim; Park, Won; Han, Youngyih; Lim, Do Hoon; Ahn, Yong Chan; Lee, Jeong Won; Kim, Byoung Gie; Bae, Duk Soo; Lee, Je Ho

    2008-01-01

    Purpose: To investigate the incidence, clinical characteristics, and risk factors of pelvic insufficiency fracture (PIF) after pelvic radiotherapy (RT) in cervical cancer. Methods and Materials: Medical records and imaging studies, including bone scintigraphy, CT, and MRI of 557 patients with cervical cancer who received whole-pelvic RT between January 1998 and August 2005 were reviewed. Results: Eighty-three patients were diagnosed as having PIF after pelvic RT. The 5-year cumulative incidence of PIF was 19.7%. The most commonly involved site was the sacroiliac joint. Pelvic pain developed in 48 patients (57.8%) at diagnosis. Eleven patients (13.3%) needed admission or narcotics because of severe pain, and others had good relief of symptoms with conservative management. In univariate analysis, age ≥55 years (p < 0.001), anteroposterior/posteroanterior parallel opposing technique (p = 0.001), curative treatment (p < 0.001), and radiation dose ≥50.4 Gy (p = 0.005) were the predisposing factors for development of PIF. Concurrent chemotherapy (p = 0.78) was not significant. Multivariate analysis showed that age ≥55 years (p < 0.001), body weight <55 kg (p = 0.02), curative treatment (p = 0.03), and radiation dose ≥50.4 Gy (p = 0.04) were significant predisposing factors for development of PIF. Conclusion: The development of PIF is not rare after pelvic RT. The use of multibeam arrangements to reduce the volume and dose of irradiated pelvic bone can be helpful to minimize the risk of fracture, especially in elderly women with low body weight

  4. A systematic review investigating the effectiveness of Complementary and Alternative Medicine (CAM) for the management of low back and/or pelvic pain (LBPP) in pregnancy.

    Science.gov (United States)

    Close, Ciara; Sinclair, Marlene; Liddle, S Dianne; Madden, Elaine; McCullough, Julie E M; Hughes, Ciara

    2014-08-01

    To evaluate and summarize the current evidence on the effectiveness of complementary and alternative medicine for the management of low back pain and/or pelvic pain in pregnancy. International research demonstrates that 25-30% of women use complementary and alternative medicine to manage low back and pelvic pain in pregnancy without robust evidence demonstrating its effectiveness. A systematic review of randomized controlled trials to determine the effectiveness of complementary and alternative medicine for low back and/or pelvic pain in pregnancy. Cochrane library (1898-2013), PubMed (1996-2013), MEDLINE (1946-2013), AMED (1985-2013), Embase (1974-2013), Cinahl (1937-2013), Index to Thesis (1716-2013) and Ethos (1914-2013). Selected studies were written in English, randomized controlled trials, a group 1 or 2 therapy and reported pain reduction as an outcome measure. Study quality was reviewed using Risk of Bias and evidence strength the Cochrane Grading of Recommendations and Development Evaluation Tool. Eight studies were selected for full review. Two acupuncture studies with low risk of bias showed both clinically important changes and statistically significant results. There was evidence of effectiveness for osteopathy and chiropractic. However, osteopathy and chiropractic studies scored high for risk of bias. Strength of the evidence across studies was very low. There is limited evidence supporting the use of general CAM for managing pregnancy-related low back and/or pelvic pain. However, the restricted availability of high-quality studies, combined with the very low evidence strength, makes it impossible to make evidence-based recommendations for practice. © 2014 John Wiley & Sons Ltd.

  5. [Clinical characteristics and pathophysiology of pelvic pain in women].

    Science.gov (United States)

    Wesselmann, U

    2002-12-01

    Chronic pelvic pain is a common and debilitating problem that can significantly impair the quality of life of a woman. Patients with chronic pelvic pain are usually evaluated and treated by gynecologists, gastroenterologists, urologists, and internists. Although these patients seek medical care because they are looking for help to alleviate their pelvic discomfort and pain, in many cases the only focus is on finding and possibly treating the underlying pelvic disease.However, often the examination and work-up remain unrevealing and no specific cause of the pain can be identified. At this point patients are frequently told, that no etiology for their chronic pain syndrome can be found and that nothing can be done. In these cases it is important to recognize that pain is not only a symptom of pelvic disease, but that the patient is suffering from a chronic pelvic pain syndrome. Knowledge of the clinical characteristics of visceral pain will guide the health care provider in making a diagnosis of chronic pelvic pain and in sorting it out from the lump diagnosis of idiopathic pain. Once the diagnosis of chronic pelvic pain is made, treatment should be directed towards symptomatic pain management.This conceptualization of chronic pelvic pain is very important, because chronic pelvic pain is a treatable condition! Effective treatment modalities are available to lessen the impact of pain and offer reasonable expectations of an improved functional status.

  6. Fraturas do anel pélvico: estudo epidemiológico Pelvic ring fractures: epidemiological study

    Directory of Open Access Journals (Sweden)

    Alceu Gomes Chueire

    2004-03-01

    Full Text Available De fevereiro de 2000 a setembro de 2001, 84 pacientes apresentando fratura do anel pélvico foram avaliados, segundo determinado protocolo aplicado. Houve predomínio do sexo masculino (67%, a maioria dos pacientes eram brancos (86% e a idade média foi de 37 anos. Quanto ao tipo de acidente, os mais freqüentes foram os relacionados ao trânsito (58% - carro, moto e atropelamento - pacientes vítimas de traumas de alta energia. As fraturas foram classificadas de acordo com Tile(13 em estáveis, em 55% (fraturas do tipo A; rotacionalmente instáveis, em 30% (fraturas do tipo B e rotacional e verticalmente instáveis, em 15% (fraturas do tipo C. A fratura mais freqüentemente encontrada foi a dos ramos isquiopúbicos. O tratamento cirúrgico foi realizado em 29% dos pacientes. Houve necessidade de transfusão sangüínea em 20% dos pacientes, utilizando-se uma média de cinco unidades de sangue total; exceto dois pacientes (2,4% com lesão arterial intra pélvica que necessitaram mais de 10 unidades de sangue nas primeiras 48 horas. A mortalidade foi de sete por cento tendo relação significativa com traumas extra pélvicos.From February 2000 to September 2001, 84 patients with pelvic fractures were assessed, using a determined protocol. There were more men (67% than women. Most of the patients were white (86% and the average was 37 years of age. The most frequent accident was reported to have been traffic accidents (58% such as motor vehicle, motorcycle and running over - victims of high-energy injuries. The pelvic ring fractures were classified according to Tile (13 as stable in 55% (type A injury, as rotationally unstable in 30% (type B injury and as unstable in translation in 15% (type C injury. The most frequent lesion affecting the pelvic girdle was the isquiopubic bones fracture (transpubic instability. The overall rate of operative stabilization was 29%. An average of five units of total blood transfusion was required in 20% of the

  7. Pelvic schwannoma in the right parametrium

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    Machairiotis N

    2013-03-01

    Full Text Available Nikolaos Machairiotis,4 Paul Zarogoulidis,3 Aikaterini Stylianaki,1 Eleni Karatrasoglou,4 Georgia Sotiropoulou,4 Alvin Floreskou,4 Eleana Chatzi,4 Athanasia Karamani,4 Georgia Liapi,5 Eleni Papakonstantinou,5 Nikolaos Katsikogiannis,1 Nikolaos Courcoutsakis,2 Christodoulos Machairiotis4 1Surgery Department, 2Radiology Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece; 3Pulmonary Department, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece; 4Obstetric Gynecology Department, 5Pathology Department, Thriasio General Hospital, Athens, Greece Abstract: Neurilemomas are benign usually encapsulated nerve sheath tumors derived from the Schwann cells. These tumors commonly arise from the cranial nerves as acoustic neurinomas but they are extremely rare in the pelvis and the retroperitoneal area (less than 0.5% of reported cases, unless they are combined with von Recklinghausen disease (type 1 neurofibromatosis. We report the case of a 58-year-old female with pelvic schwannoma, 6.5 × 5.5 cm in size, in the right parametrium. This is the first case reported in the literature. Based on the rarity of this tumor and in order to ensure optimum treatment and survival for our patient, we performed laparotomy with total abdominal hysterectomy and en-block tumor excision. A frozen section was taken during the surgery before complete resection of the mass, which was ambiguous. Because of the possibility of malignancy, complete excision of the mass was performed, with pelvic blunt dissection. Histological examination showed a benign neoplasm, originating from the cells of peripheral nerve sheaths; diagnosis was a schwannoma. There were degenerative areas, including cystic degeneration, hemorrhagic infiltrations, ischemic foci with pycnotic cells, and collagen replacement. Pelvic schwannomas are rare neoplasms that can be misdiagnosed. Laparoscopy is a safe

  8. Pelvic fractures following irradiation for endometrial carcinoma

    International Nuclear Information System (INIS)

    Konski, Andre; Sowers, Maryfran

    1996-01-01

    Purpose: To investigate the incidence and etiologic factors of pelvic fractures following radiation therapy for endometrial carcinoma. Methods and Materials: Tumor registry and radiation oncology records of patients treated for endometrial carcinoma at The Toledo Hospital between April 1989, and December 1992, were reviewed. Patients identified as having pelvic fractures without the presence of metastatic disease underwent total body mineral density measurement with dual x-ray densitometry. Results: Two of 75 patients (2.7%) were found to have pelvic fractures an average of 29 months from the completion of postoperative irradiation. One patient, who received preoperative irradiation, was also identified as having developed a fracture of the pelvis and was included in the analysis. All patients were treated prone with 10-15 MV photons in four fields daily. All three fracture patients received 45 Gy external beam radiation therapy. The two postoperative patients each received a single vaginal brachytherapy application delivering 20 Gy to 0.5 cm deep to the vaginal mucosa with a vaginal cylinder containing 30 mgRaeq 137 Cs. The preoperative patient received a single brachytherapy application with tandem and colpostats delivering 20 Gy to point A. Only one of the three fracture patients had the entire pubis included in the field of external beam treatment. One patient was taking nonsteroidal anti-inflammatory medication, one patient thyroid hormone replacement, and one patient was taking both types of medication. Conclusion: The etiology of pelvic fractures after irradiation is multifactorial. A complete medication history should be obtained, and care should be exercised in positioning the radiation fields to avoid inclusion of the entire pubis prior to the initiation of the radiation treatment

  9. Failed pelvic pouch substituted by continent ileostomy.

    Science.gov (United States)

    Wasmuth, H H; Tranø, G; Wibe, A; Endreseth, B H; Rydning, A; Myrvold, H E

    2010-07-01

    The long-term failure rate of ileal pouch-anal anastomosis (IPAA) is 10-15%. When salvage surgery is unsuccessful, most surgeons prefer pouch excision with conventional ileostomy, thus sacrificing 40-50 cm of ileum. Conversion of a pelvic pouch to a continent ileostomy (CI, Kock pouch) is an alternative that preserves both the ileal surface and pouch properties. The aim of the study was to evaluate clinical outcome after the construction of a CI following a failed IPAA. During 1984-2007, 317 patients were operated with IPAA at St Olavs Hospital and evaluated for failure, treatment and outcome. Seven patients with IPAA failure had CI. Four patients with IPAA failure referred from other hospitals underwent conversion to CI and are included in the final analysis. Seven patients had a CI constructed from the transposing pelvic pouch and four had the pelvic pouch removed and a new continent pouch constructed from the distal ileum. Median follow up after conversion to CI was 7 years (0-17 years). Two CI had to be removed due to fistulae. One patient needed a revision of the nipple valve due to pouch loosening. At the end of follow-up, 8 of the 11 patients were fully continent. One patient with Crohn's disease had minor leakage. In patients with pelvic pouch failure, the possibility of conversion to CI should be presented to the patient as an alternative to pouch excision and permanent ileostomy. The advantage is the continence and possibly a better body image. Construction of a CI on a new ileal segment may be considered, but the consequences of additional small bowel loss and risk of malnutrition if the Kock pouch fails should be appraised.

  10. Transvaginal mesh procedures for pelvic organ prolapse.

    Science.gov (United States)

    Walter, Jens-Erik

    2011-02-01

    To provide an update on transvaginal mesh procedures, newly available minimally invasive surgical techniques for pelvic floor repair. The discussion is limited to minimally invasive transvaginal mesh procedures. PubMed and Medline were searched for articles published in English, using the key words "pelvic organ prolapse," transvaginal mesh," and "minimally invasive surgery." Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. Searches were updated on a regular basis, and articles were incorporated in the guideline to May 2010. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The quality of evidence was rated using the criteria described in the Report of the Canadian Task Force on the Preventive Health Care. Recommendations for practice were ranked according to the method described in that report (Table 1). Counselling for the surgical treatment of pelvic organ prolapse should consider all benefits, harms, and costs of the surgical procedure, with particular emphasis on the use of mesh. 1. Patients should be counselled that transvaginal mesh procedures are considered novel techniques for pelvic floor repair that demonstrate high rates of anatomical cure in uncontrolled short-term case series. (II-2B) 2. Patients should be informed of the range of success rates until stronger evidence of superiority is published. (II-2B) 3. Training specific to transvaginal mesh procedures should be undertaken before procedures are performed. (III-C) 4. Patients should undergo thorough preoperative counselling regarding (a) the potential serious adverse sequelae of transvaginal mesh repairs, including mesh exposure, pain, and dyspareunia; and (b) the limited data available

  11. Antenatal depression is associated with pregnancy-related anxiety, partner relations, and wealth in women in Northern Tanzania: a cross-sectional study.

    Science.gov (United States)

    Rwakarema, Mechtilda; Premji, Shahirose S; Nyanza, Elias Charles; Riziki, Ponsiano; Palacios-Derflingher, Luz

    2015-09-02

    Psychosocial health problems, specifically depression during pregnancy, can have negative impact on birth outcomes, postnatal mental health of the mother, and infant health. Antenatal depression is more prevalent among women in low- and middle-income countries than among women in high-income countries. Risk factors for antenatal depression reported in the literature relate to pregnant women in South Asia. Consequently, this study assessed depression in pregnancy and related psychosocial risk factors among select pregnant women residing in Mwanza region, Northern Tanzania. We analysed data from 397 pregnant women recruited from three antenatal clinics for the period June-August 2013 for this cross-sectional study. Women provided data at one time point during their pregnancy by completing the Edinburgh Postnatal Depression Scale and a structured questionnaire assessing psychosocial, demographic, and behavioural risk factors related to antenatal depression. Multiple logistic regression analysis was performed to determine the relationship between risk factors examined and antenatal depression. Overall, 33.8 % (n = 134) of pregnant women had antenatal depression. Pregnancy-related anxiety was associated with antenatal depression (odds ratio (OR) 1.36, 95 % confidence interval (CI) 1.23 to 1.5). Pregnant women with poor relationship with partner and low/moderate socio-economic status had the highest OR for antenatal depression (82.34, 95 % CI 4.47, 1516.60) after adjusting for other covariates. Pregnant women with poor relationship with partner and high socio-economic status had an OR of 13.48 (95 % CI 1.71, 106.31) for antenatal depression. "Reference" pregnant women were those with very good relationship with partner and high socio-economic status. High proportion of self-reported depression among select pregnant women attending antenatal clinics in Mwanza, Tanzania merit integrating depression assessment into existing antenatal care services. Health care providers

  12. Linking women who test HIV-positive in pregnancy-related services to HIV care and treatment services in Kenya: a mixed methods prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Laura Ferguson

    Full Text Available There has been insufficient attention to long-term care and treatment for pregnant women diagnosed with HIV.This prospective cohort study of 100 HIV-positive women recruited within pregnancy-related services in a district hospital in Kenya employed quantitative methods to assess attrition between women testing HIV-positive in pregnancy-related services and accessing long-term HIV care and treatment services. Qualitative methods were used to explore barriers and facilitators to navigating these services. Structured questionnaires were administered to cohort participants at enrolment and 90+ days later. Participants' medical records were monitored prospectively. Semi-structured qualitative interviews were carried out with a sub-set of 19 participants.Only 53/100 (53% women registered at an HIV clinic within 90 days of HIV diagnosis, of whom 27/53 (51% had a CD4 count result in their file. 11/27 (41% women were eligible for immediate antiretroviral therapy (ART; only 6/11 (55% started ART during study follow-up. In multivariable logistic regression analysis, factors associated with registration at the HIV clinic within 90 days of HIV diagnosis were: having cared for someone with HIV (aOR:3.67(95%CI:1.22, 11.09, not having to pay for transport to the hospital (aOR:2.73(95%CI:1.09, 6.84, and having received enough information to decide to have an HIV test (aOR:3.61(95%CI:0.83, 15.71. Qualitative data revealed multiple factors underlying high patient drop-out related to women's social support networks (e.g. partner's attitude to HIV status, interactions with health workers (e.g. being given unclear/incorrect HIV-related information and health services characteristics (e.g. restricted opening hours, long waiting times.HIV testing within pregnancy-related services is an important entry point to HIV care and treatment services, but few women successfully completed the steps needed for assessment of their treatment needs within three months of diagnosis

  13. Abdominal-Pelvic Actinomycosis Mimicking Malignant Neoplasm

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    Teresa Pusiol

    2011-01-01

    Full Text Available Abdominal-pelvic actinomycosis is often mistaken for other conditions, presenting a preoperative diagnostic challenge. In a 46-year-old female, computed tomography showed an abdominal-pelvic retroperitoneal mass extending from the lower pole of the right kidney to the lower pelvis. The patient had a 3-year history of intrauterine device. The mass appeared to involve the ascending colon, cecum, distal ileum, right Fallopian tube and ovary, and ureter anteriorly and the psoas muscle posteriorly. The resection of retroperitoneal mass, distal ileum appendicectomy, right hemicolectomy, and right salpingo-oophorectomy was performed. The postoperative period was uneventful. Penicillin therapy was given for six months without any complication. The retroperitoneal mass measured 4.5 × 3.5 × 3 cm, surrounded adjacent organs and histologically showed inflammatory granulomatous tissue, agglomeration of filaments, and sulfur granules of Actinomyces, with positive reaction with periodic acid Schiff. Right tubo-ovarian abscess was present. Abdominalpelvic actinomycosis should always be considered in patients with a pelvic mass especially in ones using intrauterine device.

  14. Pelvic radiation disease: Updates on treatment options

    Science.gov (United States)

    Frazzoni, Leonardo; La Marca, Marina; Guido, Alessandra; Morganti, Alessio Giuseppe; Bazzoli, Franco; Fuccio, Lorenzo

    2015-01-01

    Pelvic cancers are among the most frequently diagnosed neoplasms and radiotherapy represents one of the main treatment options. The irradiation field usually encompasses healthy intestinal tissue, especially of distal large bowel, thus inducing gastrointestinal (GI) radiation-induced toxicity. Indeed, up to half of radiation-treated patients say that their quality of life is affected by GI symptoms (e.g., rectal bleeding, diarrhoea). The constellation of GI symptoms - from transient to long-term, from mild to very severe - experienced by patients who underwent radiation treatment for a pelvic tumor have been comprised in the definition of pelvic radiation disease (PRD). A correct and evidence-based therapeutic approach of patients experiencing GI radiation-induced toxicity is mandatory. Therapeutic non-surgical strategies for PRD can be summarized in two broad categories, i.e., medical and endoscopic. Of note, most of the studies have investigated the management of radiation-induced rectal bleeding. Patients with clinically significant bleeding (i.e., causing chronic anemia) should firstly be considered for medical management (i.e., sucralfate enemas, metronidazole and hyperbaric oxygen); in case of failure, endoscopic treatment should be implemented. This latter should be considered the first choice in case of acute, transfusion requiring, bleeding. More well-performed, high quality studies should be performed, especially the role of medical treatments should be better investigated as well as the comparative studies between endoscopic and hyperbaric oxygen treatments. PMID:26677440

  15. Tachykinin receptors in the equine pelvic flexure

    International Nuclear Information System (INIS)

    Sonea, I.M.; Wilson, D.V.; Bowker, R.M.; Robinson, N.E.

    1997-01-01

    Tachykinins, of which substance P (SP) is the prototype, are neuropeptides which are widely distributed in the nervous systems. In the equine gut, SP is present in enteric nerves and is a powerful constrictor of enteric muscle; in other species, SP is also known to have potent vasodilatory and pro-inflammatory effects. The specific effects of SP are determined by the subtype of receptor present in the target tissue. There are 3 known subtypes of tachykinin receptors, distinguished by their relative affinities for SP and other tachykinins. The distribution of SP binding sites in the equine pelvic flexure was determined using 125I-Bolton Hunter SP (I-BHSP) autoradiography. Most I-BHSP binding sites were determined to be saturable and specific, therefore presumably representing tachykinin receptors. The greatest degree of I-BHSP binding occurred over very small vessels, and over the muscularis mucosae; I-BHSP binding was also intense over the circular muscle of the muscularis externa and mucosa, and present, although less intense, over the longitudinal muscle of the muscularis externa. Competition of I-BHSP with specific receptor agonists for binding sites in the equine pelvic flexure were used to determine the subtypes of tachykinin receptors present. The neurokinin-1 receptor subtype predominated in the equine pelvic flexure, followed by the neurokinin-3 receptor subtype

  16. Prophylactic ibuprofed administration during pelvic irradiation

    International Nuclear Information System (INIS)

    Stryker, J.A.; Demers, L.M.; Mortel, R.

    1979-01-01

    Thirty-five patients who were to begin pelvic irradiation for malignant disease were randomized to receive ibuprofen 400 mg P.O. q.i.d. during their radiotherapy or standard therapy for radiation-induced gastrointestinal symptoms. Seventeen of 19 patients in the ibuprofen group completed the protocol. There was no significant difference in the daily stool frequency between the ibuprofen and control patients during the 5 to 6 week course of pelvic irradiation; the incidence and severity of diarrhea was the same. There was no significant difference in the incidence of nausea reported by the patients but the severity of nausea was less in the ibuprofen group; none of the 17 patients in the ibuprofen group reported vomiting at any time, whereas, 27% of the patients in the control group reported vomiting. The difference was statistically significant (p < 0.05). The data suggest that prophylactic ibuprofen administration may be beneficial in reducing the severity of nausea and preventing radiation-induced vomiting in patients who receive pelvic irradiation

  17. Patients with Pelvic Floor Muscle Spasm Have a Superior Response to Pelvic Floor Physical Therapy at Specialized Centers.

    Science.gov (United States)

    Polackwich, Alan Scott; Li, Jianbo; Shoskes, Daniel A

    2015-10-01

    Chronic prostatitis/chronic pelvic pain syndrome is a common condition that often requires multimodal therapy. Patients with chronic pelvic pain syndrome have a high incidence of pelvic floor spasm, which can be treated with pelvic floor physical therapy. However, this is a specialized skill. We compared outcomes of pelvic floor physical therapy as part of multimodal therapy in patients with chronic pelvic pain syndrome between those treated at our institution and elsewhere. We identified patients from our chronic pelvic pain syndrome registry with pelvic floor spasm who were seen between 2010 and 2014 for more than 1 visit. Patient phenotype was assessed with the UPOINT system and symptom severity was determined by the National Institutes of Health CPSI. A 6-point decrease in CPSI was used to define patient improvement. A total of 82 patients fit the study criteria. Mean age was 41.6 years (range 19 to 75) and median symptom duration was 24 months (range 3 to 240). Mean CPSI was 26.8 (range 10 to 41), the median number of positive UPOINT domains was 3 (range 1 to 6) and 27 patients (32.9%) were treated locally. At followup 9 patients had refused pelvic floor physical therapy, and 24 and 48 had undergone pelvic floor physical therapy elsewhere and at CCF, respectively. The mean change in CPSI was 1.11 ± 4.1 in patients who refused, -3.46 ± 6.7 in those treated elsewhere and -11.3 ± 7.0 in those treated at CCF (p physical therapy at CCF (OR 4.23, p = 0.002) and symptom duration (OR 0.52, p = 0.03) predicted improvement. Pelvic floor physical therapy can be effective for chronic pelvic pain syndrome in patients with pelvic floor spasm. However, the outcome depends on specialty training and experience of therapists. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  18. Pelvic artery embolization in gynecological bleeding

    International Nuclear Information System (INIS)

    Hausegger, K.A.; Schreyer, H.; Bodhal, H.

    2002-01-01

    The most common reasons for gynecological bleeding are pregnancy-related disorders, fibroids of the uterus, and gynecological malignances. Transarterial embolization is an effective treatment modality for gynecological bleeding regardless of its etiology. Depending on the underlying disease, a different technique of embolization is applied. In postpartal bleeding a temporary effect of embolization is desired, therefore gelatine sponge is used as embolizing agent. In fibroids and malignant tumors the effect should permanent, therefore PVA particles are used. Regardless the etiology, the technical and clinical success of transarterial embolization is at least 90%. In nearly every patient a post-embolization syndrome can be observed, represented by local pain and fever. This post-embolization syndrome usually does not last longer than 3 days. If embolization is performed with meticulous attention to angiographic technique and handling of embolic material, ischemic damage of adjacent organs is rarely observed. Transarterial embolization should be an integrative modality in the treatment of gynecological bleeding. (orig.) [de

  19. [Biomechanical modeling of pelvic organ mobility: towards personalized medicine].

    Science.gov (United States)

    Cosson, Michel; Rubod, Chrystèle; Vallet, Alexandra; Witz, Jean-François; Brieu, Mathias

    2011-11-01

    Female pelvic mobility is crucial for urinary, bowel and sexual function and for vaginal delivery. This mobility is ensured by a complex organ suspension system composed of ligaments, fascia and muscles. Impaired pelvic mobility affects one in three women of all ages and can be incapacitating. Surgical management has a high failure rate, largely owing to poor knowledge of the organ support system, including the barely discernible ligamentous system. We propose a 3D digital model of the pelvic cavity based on MRI images and quantitative tools, designed to locate the pelvic ligaments. We thus obtain a coherent anatomical and functional model which can be used to analyze pelvic pathophysiology. This work represents a first step towards creating a tool for localizing and characterizing the source of pelvic imbalance. We examine possible future applications of this model, in terms of personalized therapy and prevention.

  20. Recognition and Management of Nonrelaxing Pelvic Floor Dysfunction

    Science.gov (United States)

    Faubion, Stephanie S.; Shuster, Lynne T.; Bharucha, Adil E.

    2012-01-01

    Nonrelaxing pelvic floor dysfunction is not widely recognized. Unlike in pelvic floor disorders caused by relaxed muscles (eg, pelvic organ prolapse or urinary incontinence, both of which often are identified readily), women affected by nonrelaxing pelvic floor dysfunction may present with a broad range of nonspecific symptoms. These may include pain and problems with defecation, urination, and sexual function, which require relaxation and coordination of pelvic floor muscles and urinary and anal sphincters. These symptoms may adversely affect quality of life. Focus on the global symptom complex, rather than the individual symptoms, may help the clinician identify the condition. The primary care provider is in a position to intervene early, efficiently, and effectively by (1) recognizing the range of symptoms that might suggest nonrelaxing pelvic floor dysfunction, (2) educating patients, (3) performing selective tests when needed to confirm the diagnosis, and (4) providing early referral for physical therapy. PMID:22305030

  1. Pelvic floor dysfunction, and effects of pregnancy and mode of delivery on pelvic floor

    Directory of Open Access Journals (Sweden)

    Murat Bozkurt

    2014-12-01

    Full Text Available Pelvic floor dysfunction (PFD, although seems to be simple, is a complex process that develops secondary to multifactorial factors. The incidence of PFD is increasing with increasing life expectancy. PFD is a term that refers to a broad range of clinical scenarios, including lower urinary tract excretory and defecation disorders, such as urinary and anal incontinence, overactive bladder, and pelvic organ prolapse, as well as sexual disorders. It is a financial burden on the health care system and disrupts women's quality of life. Strategies applied to decrease PFD are focused on the course of pregnancy, mode and management of delivery, and pelvic exercise methods. Many studies in the literature define traumatic birth, usage of forceps, length of the second stage of delivery, and sphincter damage as modifiable risk factors for PFD. Maternal age, fetal position, and fetal head circumference are nonmodifiable risk factors. Although numerous studies show that vaginal delivery affects pelvic floor structures and their functions in a negative way, there is not enough scientific evidence to recommend elective cesarean delivery in order to prevent development of PFD. PFD is a heterogeneous pathological condition, and the effects of pregnancy, vaginal delivery, cesarean delivery, and possible risk factors of PFD may be different from each other. Observational studies have identified certain obstetrical exposures as risk factors for pelvic floor disorders. These factors often coexist; therefore, the isolated effects of these variables on the pelvic floor are difficult to study. The routine use of episiotomy for many years in order to prevent PFD is not recommended anymore; episiotomy should be used in selected cases, and the mediolateral procedures should be used if needed.

  2. Quality of life in women with pelvic floor dysfunction

    OpenAIRE

    Mladenović-Segedi Ljiljana; Parezanović-Ilić Katarina; Ćurčić Aleksandar; Višnjevac Nemanja

    2011-01-01

    Background/Aim. Pelvic floor dysfunction is a frequent problem affecting more than 50% of women in peri- and postmenopause. Considering that ageing and menopause befall in the significant factors causing this issue, as well as the expected longevity of women in the world and in our country, pelvic floor dysfunction prevelence is foreseen to be even higher. The aim of the study was to evaluate impact of the symptoms of pelvic dysfunction on quality of life and examine body image satisfac...

  3. Assessment of female pelvic pathology by magnetic resonance

    International Nuclear Information System (INIS)

    Gil, M.; Sanchez, A.; Narvaez, J.A.; Valls, C.; Guma, A.; Andia, E.

    1997-01-01

    In recent years, magnetic resonance imaging (MRI) has become the imaging technique of choice for the detection and characterization of pelvic pathology. Its multiplanar capability, excellent soft tissue contrast, use of nonionizing radiations and noninvasive nature make MRI the ideal technique for assessing the female pelvis. The purpose of this study is to describe the normal pelvic anatomy as it appears in MRI and to asses the radiologic features of the different pelvic pathologies. (Author) 21 refs

  4. PELVIC CONGESTION SYNDROME. METHODS OF DIAGNOSIS AND TREATMENT. LITERATURE REVIEW

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    Svetlana Vladimirovna Verezgova

    2014-10-01

    Full Text Available Pelvic pain syndrome is not rare clinical condition without specific symptoms and usually affects multiparous women. Numerous controversies in the management such patients are still present in current publications.Different diagnostic modalities were and are now used to delineate of anatomy and physiology of pelvic venous system. The well-known and recently developed approaches to treat patients with  pelvic congestion syndrome are discussed in present overview of the scientific literature.

  5. Pelvic pain in a young patient: Sclerosing stromal tumor

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    Huriye Ayşe Parlakgümüş

    2013-03-01

    Full Text Available Introduction: Sclerosing stromal tumors are rare, benign sex chord stromal tumors. They are usually unilateral and are seen in second or third decades. The complaint at admission may be menstrual irregularity, pelvic pain, palpable pelvic mass, precocious puberty and postmenopausal bleeding. Because the complaint at admission and radiological findings are not specific to SSTs preoperative diagnosis is challenging. Herein we present the sonographical, intraoperative and histopathological findings of a SST diagnosed during laparoscopy in a patient who admitted with chronic pelvic pain and received pelvic inflammatory disease and endometriosis treatment and differential diagnosis of SSTs with the other ovarian tumors. Case report: 24 years old nulliparous patient first admitted to the gynecology department with the complaint of foul smelling vaginal discharge and pelvic pain. The diagnosis was pelvic inflammatory disease and the patient received antibiotics. The pelvic examination was normal except the mass in the right ovary which had similar echogenity to the ovary. Because of the pelvic pain the mass was assumed to be an endometrioma and the patient was prescribed an oral contraceptive treatment for 3 months. Because of the persistent pelvic pain a diagnostic laparoscopy was performed which revealed a 2 cm, pinkish- white, exophytic lesion originating from the right ovary. Pathological examination reported the mass to be a sclerosing stromal tumor. After the treatment the patient no longer complained of vaginal discharge but pelvic pain still persisted. After the operation the patient no longer complained of pelvic pain. Conclusion: Although SSTs are rare, they should be kept in mind when a young patient admits with menstrual irregularity, pelvic pain and hirsutism, particularly if the pain is refractory to treatment.

  6. Pregnancy-related health information-seeking behaviors among rural pregnant women in India: validating the Wilson model in the Indian context.

    Science.gov (United States)

    Das, Ashavaree; Sarkar, Madhurima

    2014-09-01

    Understanding health information-seeking behaviors and barriers to care and access among pregnant women can potentially moderate the consistent negative associations between poverty, low levels of literacy, and negative maternal and child health outcomes in India. Our seminal study explores health information needs, health information-seeking behaviors, and perceived information support of low-income pregnant women in rural India. Using the Wilson Model of health information-seeking framework, we designed a culturally tailored guided interview to assess information-seeking behaviors and barriers to information seeking among pregnant women. We used a local informant and health care worker to recruit 14 expectant women for two focus group interviews lasting 45 minutes to an hour each. Thirteen other related individuals including husbands, mothers, mothers-in-law, and health care providers were also recruited by hospital counselors for in-depth interviews regarding their pregnant wives/daughters and daughters-in-law. Interviews were transcribed and analyzed by coding the data into thematic categories. The data were coded manually and emerging themes included pregnancy-related knowledge and misconceptions and personal, societal, and structural barriers, as well as risk perceptions and self-efficacy. Lack of access to health care and pregnancy-related health information led participants to rely heavily on information and misconceptions about pregnancy gleaned from elder women, friends, and mothers-in-law and husbands. Doctors and para-medical staff were only consulted during complications. All women faced personal, societal, and structural level barriers, including feelings of shame and embarrassment, fear of repercussion for discussing their pregnancies with their doctors, and inadequate time with their doctors. Lack of access and adequate health care information were of primary concern to pregnant women and their families. Our study can help inform policies and multi

  7. Impact of carbohydrate supply on stem growth, wood and respired CO{sub 2} {delta}{sup 13}C : assessment by experimental girdling

    Energy Technology Data Exchange (ETDEWEB)

    Maunoury-Danger, F. [Paris-Sud Univ., Orsay Cedex (France). Laboratoire Ecologie, Systematique et Evolution; Centre National de la Recherche Scientifique, Orsay CEDEX (France); AgroParisTech, Paris (France); Paul Verlaine-Metz Univ., Metz (France). Laboratoire des Interactions Ecotoxicologie Biodiversite Ecosystemes; Fresneau, C.; Eglin, T.; Berveiller, D.; Francois, C.; Damesin, C. [Paris-Sud Univ., Orsay Cedex (France). Laboratoire Ecologie, Systematique et Evolution; Centre National de la Recherche Scientifique, Orsay CEDEX (France); AgroParisTech, Paris (France); Lelarge-Trouverie, C. [Paris-Sud Univ., Orsay Cedex (France). Inst. de Biotechnologie des Plantes, Plateforme Metabolisme-Metabolome

    2010-07-15

    In trees, carbohydrate storage and remobilization may affect the carbon isotope signals of sugars exported from leaves, tree organic matter and respired carbon dioxide (CO{sub 2}). This study characterized the impact of a change in the carbon (C) source used for stem functioning on the {delta}{sup 13} C of stem organic matter and respired CO{sub 2}. Girdling experiments were carried out on 2-year old oaks that consisted in removing the bark and phloem around the stem so that the sap would cease to flow. The stem was therefore forced to use its own C reserves to maintain metabolic activity. Trees were girdled at 3 different periods, notably just after budburst, during stem growth, and just after cessation of stem radial growth. Stem radial growth and respiration rate were measured throughout the year. Other measured variables included {delta}{sup 13} C of respired CO{sub 2} and contents of starch and water-soluble fraction in stems and leaves. The study showed that girdling stopped growth, even early in the growing season, leading to a decrease in stem CO{sub 2} efflux. The study demonstrated that leaf carbohydrate supply versus reserve use could be an important factor controlling stem growth and {delta}{sup 13} C of both ring and stem CO{sub 2} efflux. 69 refs., 3 tabs., 5 figs.

  8. Pelvic Floor Physical Therapy for Vulvodynia: A Clinician's Guide.

    Science.gov (United States)

    Prendergast, Stephanie A

    2017-09-01

    Vulvar pain affects up to 20% of women at some point in their lives, and most women with vulvar pain have associated pelvic floor impairments. Pelvic floor dysfunction is associated with significant functional limitations in women by causing painful intercourse and urinary, bowel, and sexual dysfunction. A quick screening of the pelvic floor muscles can be performed in the gynecology office and should be used when patients report symptoms of pelvic pain. It is now known the vulvar pain syndromes are heterogeneous in origin; therefore, successful treatment plans are multimodal and include physical therapy. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Pelvic incidence variation among individuals: functional influence versus genetic determinism.

    Science.gov (United States)

    Chen, Hong-Fang; Zhao, Chang-Qing

    2018-03-20

    Pelvic incidence has become one of the most important sagittal parameters in spinal surgery. Despite its great importance, pelvic incidence can vary from 33° to 85° in the normal population. The reasons for this great variability in pelvic incidence remain unexplored. The objective of this article is to present some possible interpretations for the great variability in pelvic incidence under both normal and pathological conditions and to further understand the determinants of pelvic incidence from the perspective of the functional requirements for bipedalism and genetic backgrounds via a literature review. We postulate that both pelvic incidence and pelvic morphology may be genetically predetermined, and a great variability in pelvic incidence may already exist even before birth. This great variability may also serve as a further reminder that the sagittal profile, bipedal locomotion mode, and genetic background of every individual are unique and specific, and clinicians should avoid making universally applying broad generalizations of pelvic incidence. Although PI is an important parameter and there are many theories behind its variability, we still do not have clear mechanistic answers.

  10. Pelvic congestion syndrome masquerading as osteoarthritis of the hip

    Directory of Open Access Journals (Sweden)

    Scott J Dos Santos

    2016-12-01

    Full Text Available Objectives: Pelvic congestion syndrome (PCS is associated with pelvic vein reflux (PVR, occasionally secondary to venous compression. Its symptoms, usually intra-pelvic, are alleviated following the abolition of this reflux by pelvic vein embolisation (PVE. The objective of this report is to present two cases of left hip pain, erroneously diagnosed as osteoarthritis, which disappeared after successful PVE and abolition of PVR. Methods: Two females presented with lower limb varicose veins, and also had a history of left-sided hip pain. Both had previously been investigated for the hip pain and diagnosed as osteoarthritis despite minimal arthritic changes on pelvic X-rays. During investigation for lower limb varicose veins, both showed a pelvic origin for their leg veins and hence underwent transvaginal duplex ultrasound. This revealed PVR, and PVE was planned in both patients. Results: Both patients underwent PVE and reported ‘miraculous’ resolution of left hip pain and also PCS symptoms including pelvic pain, irritable bowel issues and the disappearance of pelvic dragging, with almost immediate disappearance of vulval and vaginal varicosities. One patient also noted reduced clitoral sensitivity. Conclusion: Manifestations of PCS may vary in terms of intra- or extra-pelvic signs. PCS and PVR should be considered in the differential diagnosis of patients with arthritic symptoms in the hip without evident radiographic evidence.

  11. Pelvic belt effects on sacroiliac joint ligaments: a computational approach to understand therapeutic effects of pelvic belts.

    Science.gov (United States)

    Sichting, Freddy; Rossol, Jerome; Soisson, Odette; Klima, Stefan; Milani, Thomas; Hammer, Niels

    2014-01-01

    The sacroiliac joint is a widely described source of low back pain. Therapeutic approaches to relieve pain include the application of pelvic belts. However, the effects of pelvic belts on sacroiliac joint ligaments as potential pain generators are mostly unknown. The aim of our study was to analyze the influence of pelvic belts on ligament load by means of a computer model. Experimental computer study using a finite element method. A computer model of the human pelvis was created, comprising bones, ligaments, and cartilage. Detailed geometries, material properties of ligaments, and in-vivo pressure distribution patterns of a pelvic belt were implemented. The effects of pelvic belts on ligament strain were computed in the double-leg stance. Pelvic belts increase sacroiliac joint motion around the sagittal axis but decrease motion around the transverse axis. With pelvic belt application, most of the strained sacroiliac joint ligaments were relieved, especially the sacrospinous, sacrotuberous, and the interosseous sacroiliac ligaments. Sacroiliac joint motion and ligament strains were minute. These results agree with validation data from other studies. Assigning homogenous and linear material properties and excluding muscle forces are clear simplifications of the complex reality. Pelvic belts alter sacroiliac joint motion and provide partial relief of ligament strain that is subjectively marked, although minimal in absolute terms. These findings confirm theories that besides being mechanical stabilizers, the sacroiliac joint ligaments are likely involved in neuromuscular feedback mechanisms. The results from our computer model help with unraveling the therapeutic mechanisms of pelvic belts.

  12. Morbidity and outcome of pelvic exenteration in locally advanced pelvic malignancies.

    Science.gov (United States)

    Ramamurthy, Rajaraman; Duraipandian, Amudhan

    2012-09-01

    Pelvic exenteration is a technically demanding surgical procedure performed for locally advanced cancers in the pelvis. Aim of the present study was to analyze morbidity, failure pattern and survival after pelvic exenteration during a period of 15 years in a dedicated cancer centre in South India. Retrospective analysis of case records of 50 patients who underwent pelvic exenteration from 1996 to 2011 in the Department of Surgical Oncology, Government Royapettah Hospital Chennai. Forty-six patients were females and 4 were males with a mean age of 48.3 years (range 21-72). Twenty six patients had cervical cancer,14 had rectal cancer, 3 had bladder cancer,2 had endometrial cancer, 2 had vaginal cancer, 1 had uterine sarcoma, 1 had anal cancer and 1 had ovarian cancer. The postoperative morbidity was 50%. 7 patients (14%) developed recurrence of which 5 had local and 2 had distant recurrence. The estimated 5 year overall survival for all patients in our series was 53.5% and for the patients with Ca rectum and Ca cervix was 60.6% and 40.1% respectively. Adjacent organ invasion had a significant impact over survival. Pelvic exenteration provides a curative form of treatment for carefully selected locally advanced cancer in the pelvis and it can be done safely with acceptable complications in centers experienced in multivisceral resections.

  13. Laparoscopic pelvic sling placement facilitates optimum therapeutic radiotherapy delivery in the management of pelvic malignancy.

    LENUS (Irish Health Repository)

    Joyce, M

    2012-02-01

    BACKGROUND: Radiotherapy has a significant role in the management of pelvic malignancies. However, the small intestine represents the main dose limiting organ. Invasive and non-invasive mechanical methods have been described to displace bowel out of the radiation field. We herein report a case series of laparoscopic placement of an absorbable pelvic sling in patients requiring pelvic radiotherapy. METHODS: Six patients were referred to our minimally invasive unit. Four patients required radical radiotherapy for localised prostate cancer, one was scheduled for salvage localised radiotherapy for post-prostatectomy PSA progression and one patient required adjuvant radiotherapy post-cystoprostatectomy for bladder carcinoma. All patients had excessive small intestine within the radiation fields despite the use of non-invasive displacement methods. RESULTS: All patients underwent laparoscopic mesh placement, allowing for an elevation of small bowel from the pelvis. The presence of an ileal conduit or previous surgery did not prevent mesh placement. Post-operative planning radiotherapy CT scans confirmed displacement of the small intestine allowing all patients to receive safely the planned radiotherapy in terms of both volume and radiation schedule. CONCLUSION: Laparoscopic mesh placement represents a safe and efficient procedure in patients requiring high-dose pelvic radiation, presenting with unacceptable small intestine volume in the radiation field. This procedure is also feasible in those that have undergone previous major abdominal surgery.

  14. Assessment of the effect of pelvic floor exercises on pelvic floor muscle strength using ultrasonography in patients with urinary incontinence: a prospective randomized controlled trial

    OpenAIRE

    Tosun, Ozge Celiker; Solmaz, Ulas; Ekin, Atalay; Tosun, Gokhan; Gezer, Cenk; Ergenoglu, Ahmet Mete; Yeniel, Ahmet Ozgur; Mat, Emre; Malkoc, Mehtap; Askar, Niyazi

    2016-01-01

    [Purpose] The aim of this study was to evaluate whether the effect of pelvic floor exercises on pelvic floor muscle strength could be detected via ultrasonography in patients with urinary incontinence. [Subjects and Methods] Of 282 incontinent patients, 116 participated in the study and were randomly divided into a pelvic floor muscle training (n=65) group or control group (n=51). The pelvic floor muscle training group was given pelvic floor exercise training for 12 weeks. Both groups were ev...

  15. Effect of pelvic irradiation of lactose absorption

    International Nuclear Information System (INIS)

    Stryker, J.A.; Mortel, R.; Hepner, G.W.

    1978-01-01

    Twenty-four patients undergoing pelvic irradiation for gynecologic malignancies had 14 C-lactose breath tests performed in the first and fifth weeks of their treatment. The 14 C-lactose breath test was performed by administering 2 μCi of 14 C-lactose by mouth along with 50 g of lactose. Breath samples were collected in ethanolic hyamine 1, 2, and 3 hr later; the radioactivity of the trapped 14 CO 2 was determined by liquid scintillation spectroscopy. In the first week of treatment the percentage of administered 14 C excreted as 14 CO 2 at 1, 2, and 3 hr was 1.7 +- 0.8% (mean +- SD), 4.5 +- 1.6%, and 5.8 +- 1.4%, respectively. In the fifth week of treatment the 1-hr, 2-hr, and 3-hr values were 1.2 +- 0.9%, 3.6 +- 2.0%, and 4.7 +- 1.9%, respectively. The difference between the first week and fifth week test results at 1, 2, and 3 hr was statistically significant (t = 2.64, p 14 C-lactose breath test results in the fifth week and the stool frequency at that time (r = -0.44, p 14 C-lactose breath test results in the fifth week were below normal (<1.2%) had nausea at that time. The data suggest that in some patients, lactose malabsorption as a result of the effect of radiation on small intestinal function may be etiologically related to the symptoms of nausea and diarrhea which occur commonly in patients who are undergoing pelvic irradiation. In addition, the results suggest that lactose-containing foods should be restricted in some patients who are undergoing pelvic irradiation to prevent symptoms resulting from radiation-induced lactose intolerance

  16. Robotic single-site pelvic lymphadenectomy.

    Science.gov (United States)

    Tateo, Saverio; Nozza, Arrigo; Del Pezzo, Chiara; Mereu, Liliana

    2014-09-01

    To examine the feasibility of performing pelvic lymphadenectomy with robotic single site approach. Recent papers described the feasibility of robotic-single site hysterectomy [1-3] for benign and malign pathologies but only with the development of new single site 5mm instruments as the bipolar forceps, robotic single site platform can be safely utilized also for lymphadenectomy. A 65 year-old, multiparous patient with a body mass index of 22.5 and diagnosed with well differentiated adenocarcinoma of the endometrium underwent a robotic single-site peritoneal washing, total hysterectomy, bilateral adnexectomy and pelvic lymphadenectomy. The procedure was performed using the da Vinci Si Surgical System (Intuitive Surgical, Sunnyvale, CA) through a single 2,5 cm umbilical incision, with a multi-channel system and two single site robotic 5mm instruments. A 3-dimensional, HD 8.5mm endoscope and a 5mm accessory instrument were also utilized. Type I lymphonodes dissection for external iliac and obturator regions was performed [4]. Total operative time was 210 min; incision, trocar placement and docking time occurring in 12 min. Total console time was 183 min, estimated blood loss was 50 ml, no intra-operative or post-operative complications occurred. Hospital discharge occurred on post operative day 2 and total number of lymphnodes removed was 33. Difficulties in term of instrument's clashing and awkward motions have been encountered. Robotic single-site pelvic lymphadenectomy using bipolar forceps and monopolar hook is feasible. New developments are needed to improve surgical ergonomics and additional studies should be performed to explore possible benefits of this procedure. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Satellite cell senescence underlies myopathy in a mouse model of limb-girdle muscular dystrophy 2H

    Science.gov (United States)

    Kudryashova, Elena; Kramerova, Irina; Spencer, Melissa J.

    2012-01-01

    Mutations in the E3 ubiquitin ligase tripartite motif-containing 32 (TRIM32) are responsible for the disease limb-girdle muscular dystrophy 2H (LGMD2H). Previously, we generated Trim32 knockout mice (Trim32–/– mice) and showed that they display a myopathic phenotype accompanied by neurogenic features. Here, we used these mice to investigate the muscle-specific defects arising from the absence of TRIM32, which underlie the myopathic phenotype. Using 2 models of induced atrophy, we showed that TRIM32 is dispensable for muscle atrophy. Conversely, TRIM32 was necessary for muscle regrowth after atrophy. Furthermore, TRIM32-deficient primary myoblasts underwent premature senescence and impaired myogenesis due to accumulation of PIAS4, an E3 SUMO ligase and TRIM32 substrate that was previously shown to be associated with senescence. Premature senescence of myoblasts was also observed in vivo in an atrophy/regrowth model. Trim32–/– muscles had substantially fewer activated satellite cells, increased PIAS4 levels, and growth failure compared with wild-type muscles. Moreover, Trim32–/– muscles exhibited features of premature sarcopenia, such as selective type II fast fiber atrophy. These results imply that premature senescence of muscle satellite cells is an underlying pathogenic feature of LGMD2H and reveal what we believe to be a new mechanism of muscular dystrophy associated with reductions in available satellite cells and premature sarcopenia. PMID:22505452

  18. A comparison of the musculoskeletal assessments of the shoulder girdles of professional rugby players and professional soccer players

    Directory of Open Access Journals (Sweden)

    Horsley Ian G

    2012-09-01

    Full Text Available Abstract Objective To identify posture types that exist in professional rugby players, and compare them with a population of non-overhead athletes in order to identify possible relationships towards the potential for shoulder injuries. Design Observational design Setting: Sports Medicine Clinic Participants: Convenience sample Methodology: Static assessment of posture was carried out in standing, active and passive range of glenohumeral motion, and isometric strength was carried out in accordance with previously recorded protocols. Interventions Nil Outcome Measures: Observational classification of posture, active and passive range of glenohumeral joint range of motion, isometric strength of selected muscle groups, selected muscle flexibility and Hawkins and Neer impingement tests. Results There was a significant difference on range of motion between the two groups (0.025–0.000, isometric middle (0.024–0.005, and lower trapezius (0.01–0.001. Conclusion: There were significant differences between strength and flexibility of muscles around the shoulder girdle between professional rugby players and a control group of professional non-overhead athletes.

  19. Quantitative magnetic resonance imaging in limb-girdle muscular dystrophy 2I: a multinational cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Tracey A Willis

    Full Text Available We conducted a prospective multinational study of muscle pathology using magnetic resonance imaging (MRI in patients with limb-girdle muscular dystrophy 2I (LGMD2I. Thirty eight adult ambulant LGMD2I patients (19 male; 19 female with genetically identical mutations (c.826C>A in the fukutin-related protein (FKRP gene were recruited. In each patient, T1-weighted (T1w imaging was assessed by qualitative grading for 15 individual lower limb muscles and quantitative Dixon imaging was analysed on 14 individual lower limb muscles by region of interest analysis. We described the pattern and appearance of muscle pathology and gender differences, not previously reported for LGMD2I. Diffuse fat infiltration of the gastrocnemii muscles was demonstrated in females, whereas in males fat infiltration was more prominent in the medial than the lateral gastrocnemius (p = 0.05. In the anterior thigh of males, in contrast to females, median fat infiltration in the vastus medialis muscle (45.7% exceeded that in the vastus lateralis muscle (11.2% (p<0.005. MRI is non-invasive, objective and does not rely on patient effort compared to clinical and physical measures that are currently employed. We demonstrated (i that the quantitative Dixon technique is an objective quantitative marker of disease and (ii new observations of gender specific patterns of muscle involvement in LGMD2I.

  20. Primary central chondrosarcoma of long bone, limb girdle and trunk: Analysis of 174 cases by numerical scoring on histology.

    Science.gov (United States)

    Konishi, Eiichi; Nakashima, Yasuaki; Mano, Masayuki; Tomita, Yasuhiko; Nagasaki, Ikumitsu; Kubo, Toshikazu; Araki, Nobuhito; Haga, Hironori; Toguchida, Junya; Ueda, Takafumi; Sakuma, Toshiko; Imahori, Masaya; Morii, Eiichi; Yoshikawa, Hideki; Tsukamoto, Yoshitane; Futani, Hiroyuki; Wakasa, Kenichi; Hoshi, Manabu; Hamada, Shinshichi; Takeshita, Hideyuki; Inoue, Takeshi; Aono, Masanari; Kawabata, Kenji; Murata, Hiroaki; Katsura, Kanade; Urata, Yoji; Ueda, Hideki; Yanagisawa, Akio

    2015-09-01

    The aims of this study were: (i) to elucidate clinicopathological characteristics of pcCHS of long bones (L), limb girdles (LG) and trunk (T) in Japan; (ii) to investigate predictive pathological findings for outcome of pcCHS of L, LG and T, objectively; and (iii) to elucidate a discrepancy of grade between biopsy and resected specimens. Clinicopathological profiles of 174 pcCHS (79 male, 95 female), of L, LG, and T were retrieved. For each case, a numerical score was given to 18 pathological findings. The average age was 50.5 years (15-80 years). Frequently involved sites were femur, humerus, pelvis and rib. The 5-year and 10-year disease-specific survival (DSS) rates [follow-up: 1-258 months (average 65.5)] were 87.0% and 80.4%, respectively. By Cox hazards analysis on pathological findings, age, sex and location, histologically higher grade and older age were unfavorable predictors, and calcification was a favorable predictor in DSS. The histological grade of resected specimen was higher than that of biopsy in 37.7% (26/69 cases). In conclusion, higher histological grade and older age were predictors for poor, but calcification was for good prognosis. Because there was a discrepancy in grade between biopsy and resected specimens, comprehensive evaluation is necessary before definitive operation for pcCHS. © 2015 The Authors. Pathology International published by Japanese Society of Pathology and Wiley Publishing Asia Pty Ltd.

  1. Learning Pelvic Examination with Professional Patients

    OpenAIRE

    S Shrestha; B Wijma; K Swahnberg; K Siwe

    2010-01-01

    Performing pelvic examination is a vital skill to learn during gynecological and obstetrical training. It's a difficult maneuver to master as there is very little to see and more to feel and interpret. In addition, learning PE in usual clinical set-up has been found to induce lot of stress and anxiety among both the patients and the students. Students fear of hurting the patients and being judged inept, whereas patients feel embarrassed having to expose their most intimate body parts for lear...

  2. CHRONIC PELVIC PAIN SYNDROME: A PSYCHOPATHOLOGICAL ASPECTS

    Directory of Open Access Journals (Sweden)

    M. N. Kryuchkova

    2017-01-01

    Full Text Available Chronic pelvic pain syndrome (CPPS is a chronic pain disease with high prevalence rates. The etiology and pathogenesis of this problem remains poorly understood. No uniform solitary treatment is known for CPPS. As a result, a multimodal approach is most likely to demonstrate benefit for this disease. An interdisciplinary classification system is commonly used (UPOINT which includes psychosocial domain. Nevertheless, psychosocial and psychopathological influences on CPPS only recently became a research focus. This literature review investigated the association of personality traits, mental disorders with the baseline clinical characteristics of patients with CPPS. We aimed to synthesize the existing data and to identify further research topics.

  3. Conservative treatment of excessive anterior pelvic tilt

    DEFF Research Database (Denmark)

    Brekke, Anders Falk

    of Clinical Research, University of Southern Denmark, Denmark 3Department of Physiotherapy, University College Zealand, Denmark 4Center for Evidence-Based Medicine, Odense University Hospital, Denmark Correspondence Anders Falk Brekke E-mail: afbrekke@health.sdu.dk Mob: +45 7248 2626 Add: Sdr. Boulevard 29......Conservative treatment of excessive anterior pelvic tilt: A systematic review Anders Falk Brekke1,2,3, Søren Overgaard1,2, Asbjørn Hróbjartsson4, Anders Holsgaard-Larsen1,2 1Orthopaedic Research Unit, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital 2Department...

  4. Clinical outcome of ovarian vein embolization in pelvic congestion ...

    African Journals Online (AJOL)

    Introduction: Pelvic congestion syndrome (PCS), is a condition associated with ovarian vein (OV) incompetence among other causes. It is manifested by chronic pelvic pain with associated dyspareunia and dysmenorrhea. The diagnosis of PCS is often overlooked and the management can be difficult. Traditional therapy for ...

  5. Role of pelvic lymphadenectomy in stage 1A endometrial carcinoma ...

    African Journals Online (AJOL)

    Introduction: Endometrial cancer is the commonest gynecological cancer mostly affecting women in the postmenopausal age group. There is a debate regarding the need of pelvic lymphadenectomy in managing stage 1A diagnosed preoperatively, we try to evaluate this need. Objective: To evaluate the role of pelvic ...

  6. Gonad shielding in paediatric pelvic radiography : Disadvantages prevail over benefit

    NARCIS (Netherlands)

    Frantzen, M.J.; Robben, S.; Postma, A.A.; Zoetelief, J.; Wildberger, J.E.; Kemerink, G.J.

    2012-01-01

    Objective To re-evaluate gonad shielding in paediatric pelvic radiography in terms of attainable radiation risk reduction and associated loss of diagnostic information. Methods A study on patient dose and the quality of gonad shielding was performed retrospectively using 500 pelvic radiographs of

  7. Pelvic floor spasm as a cause of voiding dysfunction.

    Science.gov (United States)

    Kuo, Tricia L C; Ng, L G; Chapple, Christopher R

    2015-07-01

    Pelvic floor disorders can present with lower urinary tract symptoms, bowel, sexual dysfunction, and/or pain. Symptoms of pelvic muscle spasm (nonrelaxing pelvic floor or hypertonicity) vary and can be difficult to recognize. This makes diagnosis and management of these disorders challenging. In this article, we review the current evidence on pelvic floor spasm and its association with voiding dysfunction. To distinguish between the different causes of voiding dysfunction, a video urodynamics study and/or electromyography is often required. Conservative measures include patient education, behavioral modifications, lifestyle changes, and pelvic floor rehabilitation/physical therapy. Disease-specific pelvic pain and pain from pelvic floor spasm needs to be differentiated and treated specifically. Trigger point massage and injections relieves pain in some patients. Botulinum toxin A, sacral neuromodulation, and acupuncture has been reported in the management of patients with refractory symptoms. Pelvic floor spasm and associated voiding problems are heterogeneous in their pathogenesis and are therefore often underrecognized and undertreated; it is therefore essential that a therapeutic strategy needs to be personalized to the individual patient's requirements. Therefore, careful evaluation and assessment of individuals using a multidisciplinary team approach including a trained physical therapist/nurse clinician is essential in the management of these patients.

  8. Labor Dystocia as First Presentation of Pelvic Malignancy

    Directory of Open Access Journals (Sweden)

    Dennis van Hamont

    2011-01-01

    Full Text Available The underlying causes of labor dystocia can be various. Lack of expulsive forces or fetal malpresentation are amongst the most common ones. However, pelvic masses are described as well. Here we describe two cases of labor dystocia as first presentation of pelvic malignancy.

  9. Determinants and Management Outcomes of Pelvic Organ Prolapse ...

    African Journals Online (AJOL)

    Conclusion: The incidence of pelvic organ prolapse in this study was 6.5% and the leading determinants of pelvic organ prolapse were multiparity, menopause, chronic increase in IAP and advanced age. Most were lost to follow-up and a lesser proportion was offered conservative management. Early presentation of women ...

  10. Discrepancies in the female pelvic medicine and reconstructive surgeon workforce.

    Science.gov (United States)

    Muffly, Tyler M; Weterings, Robbie; Barber, Mathew D; Steinberg, Adam C

    2015-01-01

    It is unclear whether the current distribution of surgeons practicing female pelvic medicine and reconstructive surgery in the United States is adequate to meet the needs of a growing and aging population. We assessed the geographic distribution of female pelvic surgeons as represented by members of the American Urogynecologic Society (AUGS) throughout the United States at the county, state, and American Congress of Obstetricians and Gynecologists district levels. County-level data from the AUGS, American Congress of Obstetricians and Gynecologists, and the United States Census were analyzed in this observational study. State and national patterns of female pelvic surgeon density were mapped graphically using ArcGIS software and 2010 US Census demographic data. In 2013, the 1058 AUGS practicing physicians represented 0.13% of the total physician workforce. There were 6.7 AUGS members available for every 1 million women and 20 AUGS members for every 1 million postreproductive-aged women in the United States. The density of female pelvic surgeons was highest in metropolitan areas. Overall, 88% of the counties in the United States lacked female pelvic surgeons. Nationwide, there was a mean of 1 AUGS member for every 31 practicing general obstetrician-gynecologists. These findings have implications for training, recruiting, and retaining female pelvic surgeons. The uneven distribution of female pelvic surgeons throughout the United States is likely to worsen as graduating female pelvic medicine and reconstructive surgery fellows continue to cluster in urban areas.

  11. Navicular bone fracture in the pelvic limb in two horses

    International Nuclear Information System (INIS)

    Kaser-Hotz, B.; Ueltschi, G.; Hess, N.

    1991-01-01

    The case history, radiographic and scintigraphic findings of two horses with pelvic limb navicular bone fractures are presented. In both cases the fractures were of traumatic origin. One horse had a bilateral fracture of the navicular bone, distal border, the other horse had a fracture of the proximal articular border in one pelvic limb navicular bone

  12. Acupuncture for chronic pelvic inflammatory disease: A systematic review protocol.

    Science.gov (United States)

    Cheng, Ying; Yuan, Youcai; Jin, Yuhao; Xu, Na; Guo, Taipin

    2018-03-01

    Chronic pelvic inflammation disease (PID) is a difficult-to-treat gynecological disorder with complex etiologies. Acupuncture has been applied widely for treating chronic pelvic inflammation or chronic pelvic pain symptoms in China. The aim of this review is to undertake a systematic review to estimate the effectiveness and safety of acupuncture on chronic PID. A literature search will be conducted electronically with date up to October 2018 in MEDLINE, Cochrane Library, EBASE, and CNKI databases, using combination subject terms of chronic pelvic pain (or chronic pelvic inflammation, and chronic pelvic pain symptoms, etc.) and acupuncture related treatment. Also duplicates will be removed. The primary outcomes consisted of improvement rate and pain relief. Secondary outcomes include the recurrence rate and side effects, such as pneumothorax, bleeding, serious discomfort, subcutaneous nodules, and infection. Systematic reviews and databases will be searched for randomized controlled trials on acupuncture for chronic PID with acupuncture treatment will be included. Cochrane RevMan V5.3.5 risk of bias assessment tool will be implemented for risk of bias evaluation, data synthesis, meta-analyses, and subgroup analysis while condition is met. Mean difference (MD), standard mean difference (SMD), and dichotomous data will be used to present continuous outcomes. This study will generate a comprehensive review of current evidence of acupuncture for chronic pelvic inflammation diseases. The study will provide updated evidence to evaluate the effectiveness and side effects of acupuncture for chronic pelvic inflammation disease. CRD42018087950.

  13. PELVIC AREA ASSESSMENT IN BUNAJI AND RAHAJI COWS ...

    African Journals Online (AJOL)

    Keywords: Fostering calving ease, pelvic area assessment, Bunaji, Rahaji. Abstract. Pelvic area (P.A.) assessment may be used as management tool to reduce the risks associated with dystocia and foster calving ease. Relationship between cow's P.A. and age can aid pre- breeding culling decisions. This study used 100 ...

  14. Motor cortical representation of the pelvic floor muscles.

    Science.gov (United States)

    Schrum, A; Wolff, S; van der Horst, C; Kuhtz-Buschbeck, J P

    2011-07-01

    Pelvic floor muscle training involves rhythmical voluntary contractions of the external urethral sphincter and ancillary pelvic floor muscles. The representation of these muscles in the motor cortex has not been located precisely and unambiguously. We used functional magnetic resonance imaging to determine brain activity during slow and fast pelvic floor contractions. Cerebral responses were recorded in 17 healthy male volunteers, 21 to 47 years old, with normal bladder control. Functional magnetic resonance imaging was performed during metronome paced slow (0.25 Hertz) and fast (0.7 Hertz) contractions of the pelvic floor that mimicked the interruption of voiding. To study the somatotopy of the cortical representations, flexion-extension movements of the right toes were performed as a control task. Functional magnetic resonance imaging during pelvic floor contractions detected activity of the supplementary motor area in the medial wall and of the midcingulate cortex, insula, posterior parietal cortex, putamen, thalamus, cerebellar vermis and upper ventral pons. There were no significant differences in activation between slow and fast contractions. Toe movements involved significantly stronger activity of the paracentral lobule (ie the medial primary motor cortex) than did the pelvic floor contractions. Otherwise the areas active during pelvic floor and leg muscle contractions overlapped considerably. The motor cortical representation of pelvic floor muscles is located mostly in the supplementary motor area. It extends further ventrally and anteriorly than the representation of distal leg muscles. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  15. Comparative histology of mouse, rat, and human pelvic ligaments.

    Science.gov (United States)

    Iwanaga, Ritsuko; Orlicky, David J; Arnett, Jameson; Guess, Marsha K; Hurt, K Joseph; Connell, Kathleen A

    2016-11-01

    The uterosacral (USL) and cardinal ligaments (CL) provide support to the uterus and pelvic organs, and the round ligaments (RL) maintain their position in the pelvis. In women with pelvic organ prolapse (POP), the connective tissue, smooth muscle, vasculature, and innervation of the pelvic support structures are altered. Rodents are commonly used animal models for POP research. However, the pelvic ligaments have not been defined in these animals. In this study, we hypothesized that the gross anatomy and histological composition of pelvic ligaments in rodents and humans are similar. We performed an extensive literature search for anatomical and histological descriptions of the pelvic support ligaments in rodents. We also performed anatomical dissections of the pelvis to define anatomical landmarks in relation to the ligaments. In addition, we identified the histological components of the pelvic ligaments and performed quantitative analysis of the smooth muscle bundles and connective tissue of the USL and RL. The anatomy of the USL, CL, and RL and their anatomical landmarks are similar in mice, rats, and humans. All species contain the same cellular components and have similar histological architecture. However, the cervical portion of the mouse USL and RL contain more smooth muscle and less connective tissue compared with rat and human ligaments. The pelvic support structures of rats and mice are anatomically and histologically similar to those of humans. We propose that both mice and rats are appropriate, cost-effective models for directed studies in POP research.

  16. Survival trends and predictors of mortality in severe pelvic trauma

    DEFF Research Database (Denmark)

    Pohlemann, Tim; Stengel, Dirk; Tosounidis, Georgios

    2011-01-01

    STUDY OBJECTIVE: To determine longitudinal trends in mortality, and the contribution of specific injury characteristics and treatment modalities to the risk of a fatal outcome after severe and complex pelvic trauma. METHODS: We studied 5048 patients with pelvic ring fractures enrolled in the German...... Pelvic Trauma Registry Initiative between 1991 and 1993, 1998 and 2000, and 2004 and 2006. Complete datasets were available for 5014 cases, including 508 complex injuries, defined as unstable fractures with severe peri-pelvic soft tissue and organ laceration. Multivariable mixed-effects logistic...... regression analysis was employed to evaluate the impact of demographic, injury- and treatment-associated variables on all-cause in-hospital mortality. RESULTS: All-cause in-hospital mortality declined from 8% (39/466) in 1991 to 5% (33/638) in 2006. Controlling for age, Injury Severity Score, pelvic vessel...

  17. Small bowel obstruction in percutaneous fixation of traumatic pelvic fractures

    Directory of Open Access Journals (Sweden)

    Roberto Bini

    2013-01-01

    Full Text Available The use of external fixation for the initial treatment of unstable, complex pelvic injuries with hemodynamic instability remains an effective treatment for multiply injured patients. Bowel entrapment within a pelvic fracture is a rarely reported, potentially fatal complication. Here, we report a polytrauma patient with pelvic fractures who developed an intestinal obstruction after an external fixation. At an explorative laparotomy, we found an ileum segment trapped in the sacral fracture. Reported cases of bowel entrapment in pelvic fractures, especially in sacral fractures, are exceedingly rare. The diagnosis is often delayed due to difficulty distinguishing entrapment from the more common adynamic ileus. In conclusion, clinicians and radiologists should be aware of this potentially lethal complication of pelvic fractures treatment. To exclude bowel entrapment, patients with persistent ileus or sepsis should undergo early investigations.

  18. The role of spiral CT in pelvic trauma management

    International Nuclear Information System (INIS)

    Cheung, E.C.F.; Fung, K.K.L.

    1999-01-01

    Rapid and accurate assessment of pelvic injury is critical for good patient management. Plain X-ray is often used as a preliminary evaluation of the injury but this may not give adequate diagnosis of the acetabulum fracture, subtle fracture of the pelvic bone and the associated soft tissue injuries. Nowadays, spiral CT has taken an increasing role in the evaluation of pelvic trauma. It gives a rapid assessment of the bone and soft tissue injuries as compared to conventional CT. Besides, 2-D (multiplanar imaging) and 3-D image reconstruction with multiple angle views, provide the maximum information which facilitates detailed pelvic trauma evaluation. Three cases were used to illustrate the role of spiral CT in pelvic trauma management. Copyright (1999) Blackwell Science Pty Ltd

  19. Ultrasound guided transrectal catheter drainage of pelvic collections.

    Science.gov (United States)

    Thakral, Anuj; Sundareyan, Ramaniwas; Kumar, Sheo; Arora, Divya

    2015-01-01

    The transrectal approach to draining deep-seated pelvic collections may be used to drain The transrectal approach to draining deep-seated pelvic collections may be used to drain intra-abdominal collections not reached by the transabdominal approach. We discuss 6 patients with such pelvic collections treated with transrectal drainage using catheter placement via Seldinger technique. Transrectal drainage helped achieve clinical and radiological resolution of pelvic collections in 6 and 5 of 6 cases, respectively. It simultaneously helped avoid injury to intervening bowel loops and neurovascular structures using real-time visualization of armamentarium used for drainage. Radiation exposure from fluoroscopic/CT guidance was avoided. Morbidity and costs incurred in surgical exploration were reduced using this much less invasive ultrasound guided transrectal catheter drainage of deep-seated pelvic collections.

  20. Pelvic reconstruction with allogeneic bone graft after tumor resection

    Science.gov (United States)

    Wang, Wei; Bi, Wen Zhi; Yang, Jing; Han, Gang; Jia, Jin Peng

    2013-01-01

    OBJECTIVES : Pelvic reconstruction after tumor resection is challenging. METHODS: A retrospective study had been preformed to compare the outcomes among patients who received pelvic reconstructive surgery with allogeneic bone graft after en bloc resection of pelvic tumors and patients who received en bloc resection only. RESULTS: Patients without reconstruction had significantly lower functional scores at 3 months (10 vs. 15, P = 0.001) and 6 months after surgery (18.5 vs. 22, P = 0.0024), a shorter duration of hospitalization (16 day vs. 40 days, P 0.05). CONCLUSIONS : Pelvic reconstruction with allogeneic bone graft after surgical management of pelvic tumors is associated with satisfactory surgical and functional outcomes. Further clinical studies are required to explore how to select the best reconstruction method. Level of Evidence IV, Case Series. PMID:24453659

  1. Turkish adaptation of the pregnancy-related anxiety questionnaire-revised 2: Validity and reliability study in multiparous and primiparous pregnancy.

    Science.gov (United States)

    Aksoy Derya, Yeşim; Timur Taşhan, Sermin; Duman, Mesude; Durgun Ozan, Yeter

    2018-07-01

    The purpose of this study was to create a Turkish version of the Pregnancy-Related Anxiety Questionnaire-Revised 2 (PRAQR2), which was revised for application to multiparous and primiparous pregnancy, and to explore its psychometric characteristics in multiparous and primiparous pregnancy. This study was methodologically designed to assess the reliability and validity of the PRAQ-R2. The study was carried out in the obstetrics clinic of a training and research hospital in Malatya. A total of 616 healthy pregnant women (399 multiparous and 217 primiparous) constituted the sample of the study. The cultural adaptation process of the questionnaire was conducted in three phases: language validity, content validity, and pilot application. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to test the construct validity of the questionnaire. The reliability of the PRAQ-R2 was evaluated with Cronbach's alpha internal consistency coefficient, item-total correlation, test-retest analysis, and parallel forms reliability. The EFA revealed that the PRAQ-R2 consists of 10 items for the multiparous group and 11 for the primiparous group after adding the item ``I am anxious about the delivery because I have never experienced one before.'' The CFA for both groups supported the three-factor questionnaire yielded by the EFA. Good fit index values were obtained in both groups. Cronbach's alpha internal consistency coefficient ranged from 0.81 to 0.93 for the multiparous group and 0.87 to 0.94 for the primiparous group for the complete PRAQ-R2 and each of its subdimensions. In addition, the item-total correlation, test-retest analysis, and parallel forms reliability of the questionnaire were highly correlated. The PRAQ-R2 is a valid and reliable instrument that can be used to evaluate the level of anxiety in Turkish pregnant women irrespective of parity. The use of the PRAQ-R2 in prenatal healthcare services will contribute to the early diagnosis

  2. Long-term effectiveness and costs of a brief self-management intervention in women with pregnancy-related low back pain after delivery

    Directory of Open Access Journals (Sweden)

    Bastiaanssen Janneke M

    2008-05-01

    Full Text Available Abstract Background Pregnancy-related low back pain is considered an important health problem and potentially leads to long-lasting pain and disability. Investigators draw particular attention to biomedical factors but there is growing evidence that psychosocial and social factors might be important. It prompted us to start a large cohort study (n = 7526 during pregnancy until one year after delivery and a nested randomized controlled intervention study in the Netherlands. Methods A randomized controlled trial (n = 126 nested within a cohort study, of brief self-management techniques versus usual care for treatment of women with persisting non-specific pregnancy-related low back pain three weeks after delivery. Women in the intervention group were referred to a participating physiotherapist. Women in the usual care group were free to choose physiotherapy, guidance by a general practitioner or no treatment. Follow up took place at 3 months, 6 months and one year after delivery. Outcomes included change in limitations in activities (RDQ, pain (VAS, severity of main complaints (MC, global feeling of recovery (GPE, impact on participation and autonomy (IPA, pain-related fear (TSK, SF-36, EuroQol and a cost diary. For the outcome measures, series of mixed models were considered. For the outcome variable global perceived effect (GPE a logistic regression analysis is performed. Results Intention-to-treat outcomes showed a statistical significant better estimated regression coefficient RDQ -1.6 {-2.9;-0.5} associated with treatment, as well as better IPA subscale autonomy in self-care -1.0 {-1.9;-0.03} and TSK -2.4 {-3.8;-1.1} but were not clinical relevant over time. Average total costs in the intervention group were much lower than in usual care, primarily due to differences in utilization of sick leave but not statistically significant. Conclusion Brief self-management techniques applied in the first 3 months after delivery may be a more viable first

  3. Urethral sensation following reconstructive pelvic surgery.

    Science.gov (United States)

    Abernethy, M G; Davis, C; Lowenstein, L; Mueller, E R; Brubaker, L; Kenton, K

    2014-11-01

    Most urethral neuromuscular function data focus on efferent rather than afferent innervation. We aimed to determine if changes exist in urethral afferent nerve function before and after reconstructive pelvic surgery (RPS). Secondarily, we compared afferent urethral innervation in women with and without stress urinary incontinence undergoing RPS. Participants underwent current perception threshold (CPT) and urethral anal reflex (UAR) testing prior to surgery and again post-operatively. Wilcoxon signed ranked test and Spearman's correlations were used and all tests were two-sided. p = 0.05 was considered to indicate statistical significance. Urethral CPT thresholds increased significantly after RPS, consistent with decreased urethral afferent function. Pre-operative urethral CPT thresholds at 5 and 250 Hz were lower in SUI women (10 [IQR 5-29], 40 [32-750]) compared with continent women (63 [14-99], 73 [51-109]; p = 0.45, p = 0.020), signifying increased urethral sensation or easier activation of urethral afferents in SUI women. Reconstructive pelvic surgery is associated with a short-term deleterious impact on urethral afferent function, as demonstrated by the higher levels of stimuli required to activate urethral afferent nerves (decreased urethral sensation) immediately after RPS. Women with SUI required lower levels of stimuli to activate urethral afferent nerves prior to RPS, although UAR latencies were similar regardless of concomitant SUI.

  4. Learning Pelvic Examination with Professional Patients

    Directory of Open Access Journals (Sweden)

    S Shrestha

    2010-03-01

    Full Text Available Performing pelvic examination is a vital skill to learn during gynecological and obstetrical training. It's a difficult maneuver to master as there is very little to see and more to feel and interpret. In addition, learning PE in usual clinical set-up has been found to induce lot of stress and anxiety among both the patients and the students. Students fear of hurting the patients and being judged inept, whereas patients feel embarrassed having to expose their most intimate body parts for learning purpose. This hampers effective learning. Learning PE on sedated women before surgery or on mannequins has been practiced as alternative learning models. But, they have been found to miss out on teaching the communication skills, which are as important as the palpation skills. However, there exists another model of learning PE--the professional patients, who are specially trained to act as patients and also guide the students on how to make a proper PE. They provide stress-free environment for the students to learn PE and at the same time, provide immediate feedback on each of their maneuvers. They form a complete learning model and help students to see patients as partner and not just a person seeking help. Keywords: learning model, pelvic examination, stress, students.

  5. Penile Rehabilitation after Pelvic Cancer Surgery

    Directory of Open Access Journals (Sweden)

    Fouad Aoun

    2015-01-01

    Full Text Available Erectile dysfunction is the most common complication after pelvic radical surgery. Rehabilitation programs are increasingly being used in clinical practice but there is no high level of evidence supporting its efficacy. The principle of early penile rehabilitation stems from animal studies showing early histological and molecular changes associated with penile corporal hypoxia after cavernous nerve injury. The concept of early penile rehabilitation was developed in late nineties with a subsequent number of clinical studies supporting early pharmacologic penile rehabilitation. These studies included all available phosphodiesterase type 5 inhibitors, intracavernosal injection and intraurethral use of prostaglandin E1 and to lesser extent vacuum erectile devices. However, these studies are of small number, difficult to interpret, and often with no control group. Furthermore, no studies have proven an in vivo derangement of endothelial or smooth muscle cell metabolism secondary to a prolonged flaccid state. The purpose of the present report is a synthetic overview of the literature in order to analyze the concept and the rationale of rehabilitation program of erectile dysfunction following radical pelvic surgery and the evidence of such programs in clinical practice. Emphasis will be placed on penile rehabilitation programs after radical cystoprostatectomy, radical prostatectomy, and rectal cancer treatment. Future perspectives are also analyzed.

  6. Pelvic floor electrophysiology in spinal cord injury.

    Science.gov (United States)

    Tankisi, H; Pugdahl, K; Rasmussen, M M; Clemmensen, D; Rawashdeh, Y F; Christensen, P; Krogh, K; Fuglsang-Frederiksen, A

    2016-05-01

    The study aimed to investigate sacral peripheral nerve function and continuity of pudendal nerve in patients with chronic spinal cord injury (SCI) using pelvic floor electrophysiological tests. Twelve patients with low cervical or thoracic SCI were prospectively included. Quantitative external anal sphincter (EAS) muscle electromyography (EMG), pudendal nerve terminal motor latency (PNTML) testing, bulbocavernosus reflex (BCR) testing and pudendal short-latency somatosensory-evoked potential (SEP) measurement were performed. In EAS muscle EMG, two patients had abnormal increased spontaneous activity and seven prolonged motor unit potential duration. PNTML was normal in 10 patients. BCR was present with normal latency in 11 patients and with prolonged latency in one. The second component of BCR could be recorded in four patients. SEPs showed absent cortical responses in 11 patients and normal latency in one. Pudendal nerve and sacral lower motor neuron involvement are significantly associated with chronic SCI, most prominently in EAS muscle EMG. The frequent finding of normal PNTML latencies supports earlier concerns on the utility of this test; however, BCR and pudendal SEPs may have clinical relevance. As intact peripheral nerves including pudendal nerve are essential for efficient supportive therapies, pelvic floor electrophysiological testing prior to these interventions is highly recommended. Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  7. Do women with pelvic floor dysfunction referred by gynaecologists and urologists at hospitals complete a pelvic floor muscle training programme?

    DEFF Research Database (Denmark)

    Tibaek, Sigrid; Dehlendorff, Christian

    2013-01-01

    For decades women with pelvic floor dysfunction (PFD) have been referred to pelvic floor muscle training (PFMT), but there is only little information on whether the women complete the programmes and why. The objectives of this study were to investigate to which extent women completed a PFMT...

  8. Pelvic floor muscle training as a persistent nursing intervention: Effect on delivery outcome and pelvic floor myodynamia

    Directory of Open Access Journals (Sweden)

    Xin Wang

    2014-03-01

    Conclusion: Persistent nursing intervention for pregnant/postpartum women helped to shorten the second stage of labour and contributed to the recovery of postpartum pelvic floor myodynamia. The influence of this intervention on the delivery mode, and rates of episiotomy and perineal laceration remains unknown. Medical staff should strengthen health education programmes that involve pelvic floor functional rehabilitation.

  9. Multispecialty retrospective review of the clinical utility of pelvic magnetic resonance imaging in the setting of pelvic pain.

    Science.gov (United States)

    Moore, John R; Pathak, Ram A; Snowden, Caroline; Bolan, Candice W; Young, Paul R; Broderick, Gregory A

    2017-12-01

    Pelvic pain is a common complaint, and management of it is often difficult. We sought to evaluate the utility of magnetic resonance imaging (MRI) in the diagnosis of male pelvic pain. Though MRIs are commonly ordered to evaluate pelvic pain, there are very few studies obtaining the efficacy of pelvic MRI in determining a definitive diagnosis. The primary aim of our study was to evaluate the clinical utility of pelvic MRI for a diagnosis code that included pain. After receiving institutional review board approval, a retrospective study was performed of all pelvic MRIs completed at our institution from January 2, 2010 to December 31, 2014. These were further delineated into ordering providers by specialty and urology-specific International Classification of Diseases, Ninth Revision (ICD-9) code diagnoses (male pelvic pain, prostatitis, groin pain, scrotal pain, testicular pain, and penile pain). Clinical utility was defined as positive if MRI findings resulted in a change in management. Subanalysis was performed on patients with an ICD-9 co-diagnosis of previous oncologic concern. A total of 2,643 pelvic MRIs were ordered at our institution over a 5-year period. Of these, 597 pelvic MRIs (23%) were ordered for a diagnosis code that included pain (hip pain, rectal pain, joint pain, penile pain, scrotal pain, male pelvic pain and orchitis). Total utility for MRIs to find anatomic abnormalities potentially responsible for the present pain was 34% (205/597). When ordered by urologic providers, utility was 23%. Oncologists represented the highest positivity rate at 57%. Chronic pelvic pain is a multispecialty complaint that is difficult to treat. We were surprised to find the large number of both specialists and generalists invested in the management of pelvic pain. The increasing availability of MRI technology makes it a likely candidate to test for a clinically significant anatomic reason for pain. Though MRI is a test with minimal adverse effect and no increased risk

  10. Association between preterm labour and pelvic floor muscle function.

    Science.gov (United States)

    Aran, Turhan; Pekgöz, Ipek; Bozkaya, Hasan; Osmanagaoglu, Mehmet A

    2018-03-23

    We hypothesised that the pressure on the cervix increases with advancing gestation and it may lead to a cervical shortening and cause preterm labour in women with weak pelvic floor muscles. The aim of this prospective study was to measure vaginal resting pressure and pelvic floor muscle strength in the first trimester of pregnancy and to investigate their effects on labour. A study was conducted on the pregnant women with a low risk for preterm birth. The pelvic floor muscle strength and vaginal resting pressure were assessed in 320 pregnant women at their first trimester with a vaginal pressure measurement device. Fifty-two pregnant women were hospitalised for tocolytic therapy because of spontaneous preterm labour. Thirty-two of them (10.2%) had a preterm delivery despite the tocolytic therapy. Both the vaginal resting pressure (p = .009, 95%CI: 0.8; 5.9) and the pelvic floor muscle strength (p = .01, 95%CI: 3.5; 13.1) were significantly lower in the women with a preterm labour. Impact statement What is already known on this subject? The pelvic floor muscles have an essential role in continence and provide support to the pelvic organs. They also have an impact on labour. The pelvic floor muscles should distend to allow the passage of the foetus during labour. The rotation and flexion of the foetal head is due to the pelvic floor resistance. The effect of a vaginal birth on the pelvic floor's function is readily understood. On the other hand, the effect of the pelvic floor muscle function on labour is still controversial. What do the results of this study add? This prospective study showed that there is a negative association between the pelvic floor muscle strength and preterm labour. This is the first clinical study indicating that weak pelvic floor muscles may cause a preterm labour. What are the implications of these findings for clinical practice and/or further research? Pelvic floor physical therapy may be an alternative preventive strategy to reduce

  11. Diagnosis of tumors in the shoulder girdle by means of MRI; Diagnostik von Tumoren des Schulterguertelbereichs in der MRT

    Energy Technology Data Exchange (ETDEWEB)

    Schlecht, I.; Gaffke, G.; Stroszczynski, C.; Felix, R. [Charite Campus Virchow-Klinikum, Berlin (Germany). Strahlenklinik und Poliklinik

    2001-07-01

    The aim of the study was to estimate the value of MRI for evaluation of tumors of the shoulder girdle. We diagnosed respectively 13 patients with lesions in the shoulder region. The imaging has been done with a 'Magnetom SP 63' (Siemens, Erlangen, Germany). The protocol consisted of T1- and T2-based SE-sequences in axial slice orientation, T1-based imaging in coronary respectively in sagittal slice orientation as well as T1-based sequences after application of contrast medium. The evaluation of the tumor expansion within the soft tissue was possible. The exact diagnosis in some individual cases - neurinoma, cyst of the synovia - could be found by MRI. Estimation of the dignity in the case of infiltrative growth was possible in most cases. To assess the exact type of tumor was often difficult. Especially the dignity of the cartilaginous tumors could not be precisely described. (orig.) [German] Ziel der Arbeit war es, den Stellenwert der MRT zur Beurteilung von Raumforderungen im Schulterguertelbereich zu evaluieren. Wir konnten retrospektiv 13 Patienten mit Laesionen in der Schulterregion evaluieren. Die Untersuchungen erfolgten an einem 1,5 T supraleitenden Magneten ('Magnetom SP 63', Firma Siemens, Erlangen Deutschland). Das Untersuchungsprotokoll umfasste T1- und T2-gewichtete SE-Sequenzen in axialer Schnittfuehrung und T1-gewichtete Aufnahmen in schraeg koronarer bzw. schraeg sagittaler Schnittfuehrung sowie T1-gewichtete Sequenzen nach Kontrastmittelgabe. Die Beurteilung der Tumorausdehnung in die Weichteile ist mittels der MRT moeglich. Eine Diagnose ist in Einzelfaellen - Neurinom und Synovialzyste - erst mit der Kernspintomographie sicher zu stellen. Ein infiltratives Wachstum laesst sich in der Regel nachweisen, eine Artdiagnose ist jedoch haeufig nicht moeglich. Die Dignitaet konnte insbesondere bei cartilaginaeren Tumoren nicht eindeutig festgelegt werden. (orig.)

  12. Precise Correction of Disease Mutations in Induced Pluripotent Stem Cells Derived From Patients With Limb Girdle Muscular Dystrophy.

    Science.gov (United States)

    Turan, Soeren; Farruggio, Alfonso P; Srifa, Waracharee; Day, John W; Calos, Michele P

    2016-04-01

    Limb girdle muscular dystrophies types 2B (LGMD2B) and 2D (LGMD2D) are degenerative muscle diseases caused by mutations in the dysferlin and alpha-sarcoglycan genes, respectively. Using patient-derived induced pluripotent stem cells (iPSC), we corrected the dysferlin nonsense mutation c.5713C>T; p.R1905X and the most common alpha-sarcoglycan mutation, missense c.229C>T; p.R77C, by single-stranded oligonucleotide-mediated gene editing, using the CRISPR/Cas9 gene-editing system to enhance the frequency of homology-directed repair. We demonstrated seamless, allele-specific correction at efficiencies of 0.7-1.5%. As an alternative, we also carried out precise gene addition strategies for correction of the LGMD2B iPSC by integration of wild-type dysferlin cDNA into the H11 safe harbor locus on chromosome 22, using dual integrase cassette exchange (DICE) or TALEN-assisted homologous recombination for insertion precise (THRIP). These methods employed TALENs and homologous recombination, and DICE also utilized site-specific recombinases. With DICE and THRIP, we obtained targeting efficiencies after selection of ~20%. We purified iPSC corrected by all methods and verified rescue of appropriate levels of dysferlin and alpha-sarcoglycan protein expression and correct localization, as shown by immunoblot and immunocytochemistry. In summary, we demonstrate for the first time precise correction of LGMD iPSC and validation of expression, opening the possibility of cell therapy utilizing these corrected iPSC.

  13. Natural disease history of mouse models for limb girdle muscular dystrophy types 2D and 2F

    Science.gov (United States)

    Putker, K.; Tanganyika-de Winter, C. L.; Boertje-van der Meulen, J. W.; van Vliet, L.; Overzier, M.; Plomp, J. J.; Aartsma-Rus, A.; van Putten, M.

    2017-01-01

    Limb-girdle muscular dystrophy types 2D and 2F (LGMD 2D and 2F) are autosomal recessive disorders caused by mutations in the alpha- and delta sarcoglycan genes, respectively, leading to severe muscle weakness and degeneration. The cause of the disease has been well characterized and a number of animal models are available for pre-clinical studies to test potential therapeutic interventions. To facilitate transition from drug discovery to clinical trials, standardized procedures and natural disease history data were collected for these mouse models. Implementing the TREAD-NMD standardized operating procedures, we here subjected LGMD2D (SGCA-null), LGMD2F (SGCD-null) and wild type (C57BL/6J) mice to five functional tests from the age of 4 to 32 weeks. To assess whether the functional test regime interfered with disease pathology, sedentary groups were taken along. Muscle physiology testing of tibialis anterior muscle was performed at the age of 34 weeks. Muscle histopathology and gene expression was analysed in skeletal muscles and heart. Muscle histopathology and gene expression was analysed in skeletal muscles and heart. Mice successfully accomplished the functional tests, which did not interfere with disease pathology. Muscle function of SGCA- and SGCD-null mice was impaired and declined over time. Interestingly, female SGCD-null mice outperformed males in the two and four limb hanging tests, which proved the most suitable non-invasive tests to assess muscle function. Muscle physiology testing of tibialis anterior muscle revealed lower specific force and higher susceptibility to eccentric-induced damage in LGMD mice. Analyzing muscle histopathology and gene expression, we identified the diaphragm as the most affected muscle in LGMD strains. Cardiac fibrosis was found in SGCD-null mice, being more severe in males than in females. Our study offers a comprehensive natural history dataset which will be useful to design standardized tests and future pre

  14. Treatment of symptomatic pelvic varices by ovarian vein embolization

    International Nuclear Information System (INIS)

    Capasso, Patrizio; Simons, Christine; Trotteur, Genevieve; Dondelinger, Robert F.; Henroteaux, Denis; Gaspard, Ulysse

    1997-01-01

    Purpose. Pelvic congestion syndrome is a common cause of chronic pelvic pain in women and its association with venous congestion has been described in the literature. We evaluated the potential benefits of lumboovarian vein embolization in the treatment of lower abdominal pain in patients presenting with pelvic varicosities. Methods. Nineteen patients were treated. There were 13 unilateral embolizations, 6 initial bilateral treatments and 5 treated recurrences (a total of 30 procedures). All embolizations were performed with either enbucrilate and/or macrocoils, and there was an average clinical and Doppler duplex follow-up of 15.4 months. Results. The initial technical success rate was 96.7%. There were no immediate or long-term complications. Variable symptomatic relief was observed in 73.7% of cases with complete responses in 57.9%. All 8 patients who had partial or no pain relief complained of dyspareunia. The direct relationship between varices and chronic pelvic pain was difficult to ascertain in a significant number of clinical failures. Conclusion. Transcatheter embolization of lumboovarian varices is a safe technique offering symptomatic relief of pelvic pain in the majority of cases. The presence of dyspareunia seemed to be a poor prognostic factor, indicating that other causes of pelvic pain may coexist with pelvic varicosities

  15. A new tilt on pelvic radiographs: a pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Richards, P.J. [North Staffordshire Royal Infirmary, Department of Radiology, Stoke-on-Trent, Staffordshire (United Kingdom); Pattison, J.M. [University Hospital of North Staffordshire, Department of Radiology, Stoke on Trent (United Kingdom); Belcher, J. [Keele University, Department of Mathematics, Keele, Staffordshire (United Kingdom); DeCann, R.W. [IMECS, Department of Radiology, Market Drayton, Shropshire (United Kingdom); Anderson, Suzanne [University of Melbourne, Department of Radiology, Melbourne (Australia); Wynn-Jones, C. [University Hospital of North Staffordshire, Department of Orthopaedic Surgery, Stoke on Trent (United Kingdom)

    2009-02-15

    The aim of this study was to evaluate pelvic tilt on commonly performed measurements on radiography in primary protrusio acetabuli and developmental dysplasia of the hip. A dry assembled pelvis and spine skeleton was positioned in an isocentric skull unit and films exposed with increasing degrees of angulation of pelvic tilt. The films were then read by two independent readers for seven different measurements used to evaluate the hips and acetabular: acetabular line to ilioischial line, teardrop appearance, intercristal/intertuberous ratio, co-ordinates of femoral head, centre edge angle, acetabular depth/width ratio and acetabular angle. There was so much variation in the protrusio results that no formal recommendation of any standard radiographic test can be given. Only the inter tuberous distance is not effected by pelvic tilt. The acetabular angles for developmental dysplasia of the hip showed the most potential with pelvic tilt below 15 . As pelvic tilt increases, measurements used in protusio become unreliable, and computed tomography/magnetic resonance imaging are probably going to be more accurate as one can directly visualise pelvic intrusion. We recommend a lateral view to assess the degree of pelvic tilt in patients with protrusion to ensure these measurements are valid. (orig.)

  16. Straight leg elevation to rule out pelvic injury.

    Science.gov (United States)

    Bolt, Caroline; O'Keeffe, Francis; Finnegan, Pete; Dickson, Kristofer; Smit, De Villiers; Fitzgerald, Mark C; Mitra, Biswadev

    2018-02-01

    Pelvic x-ray is frequently used as a screening tool during initial assessment of injured patients. However routine use in the awake and alert blunt trauma patient may be questioned due to low yield. We propose a clinical tool that may avoid unnecessary imaging by examining whether the ability to straight leg raise, without pain, can rule out pelvic injury. We conducted a prospective cohort study with the exposure variables of ability to straight leg raise and presence of pain on doing so, and presence of pelvic fracture on x-ray as the primary outcome variable. Of the 328 participants, 35 had pelvic fractures, and of these 32 were either unable to straight leg raise, or had pain on doing so, with a sensitivity of 91.43% (95% CI: 76.94-98.2%) and a negative predictive value of 98.57% (95% CI: 95.88-99.70%). The 3 participants with a pelvic fracture who could straight leg raise with no pain, all had a GCS of less than 15, and therefore, among the sub-group of patients with GCS15, a 100% sensitivity and 100% negative predictive value for straight leg raise with no pain to rule out pelvic fracture was demonstrated. Among awake, alert patients, painless straight leg raise can exclude pelvic fractures and be incorporated into initial examination during reception and resuscitation of injured patients. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  17. FUNCTIONAL DISABILITY, SAGITTAL ALIGNMENT AND PELVIC BALANCE IN LUMBAR SPONDYLOLISTHESIS

    Directory of Open Access Journals (Sweden)

    Luis Muñiz Luna

    2016-03-01

    Full Text Available ABSTRACT Objectives: To demonstrate the recovery of lumbar sagittal pelvic alignment and sagittal pelvic balance after surgical reduction of lumbar spondylolisthesis and establish the benefits of the surgery for reduction and fixation of the lumbar spondylolisthesis with 360o circumferential arthrodesis for 2 surgical approaches by clinical and functional evaluation. Method: Eight patients with lumbar spondylolisthesis treated with surgical reduction and fixation of listhesis and segmental circumferential fusion with two surgical approaches were reviewed. They were evaluated before and after treatment with Oswestry, Visual Analogue for pain and Odom scales, performing radiographic measurement of lumbar sagittal alignment and pelvic sagittal balance with the technique of pelvic radius. Results: Oswestry scales and EVA reported improvement of symptoms after treatment in 8 cases; the Odom scale had six outstanding cases reported. The lumbar sagittal alignment presented a lumbosacral lordosis angle and a lumbopelvic lordosis angle reduced in 4 cases and increased in 4 other cases; pelvic sagittal balance increased the pelvic angle in 4 cases and decreased in 3 cases and the sacral translation of the hip axis to the promontory increased in 6 cases. Conclusion: The surgical procedure evaluated proved to be useful by modifying the lumbar sagittal alignment and the pelvic balance, besides reducing the symptoms, enabling the patient to have mobility and movement and the consequent satisfaction with the surgery.

  18. [Establishement for regional pelvic trauma database in Hunan Province].

    Science.gov (United States)

    Cheng, Liang; Zhu, Yong; Long, Haitao; Yang, Junxiao; Sun, Buhua; Li, Kanghua

    2017-04-28

    To establish a database for pelvic trauma in Hunan Province, and to start the work of multicenter pelvic trauma registry.
 Methods: To establish the database, literatures relevant to pelvic trauma were screened, the experiences from the established trauma database in China and abroad were learned, and the actual situations for pelvic trauma rescue in Hunan Province were considered. The database for pelvic trauma was established based on the PostgreSQL and the advanced programming language Java 1.6.
 Results: The complex procedure for pelvic trauma rescue was described structurally. The contents for the database included general patient information, injurious condition, prehospital rescue, conditions in admission, treatment in hospital, status on discharge, diagnosis, classification, complication, trauma scoring and therapeutic effect. The database can be accessed through the internet by browser/servicer. The functions for the database include patient information management, data export, history query, progress report, video-image management and personal information management.
 Conclusion: The database with whole life cycle pelvic trauma is successfully established for the first time in China. It is scientific, functional, practical, and user-friendly.

  19. Barriers to Pelvic Floor Physical Therapy Regarding Treatment of High-Tone Pelvic Floor Dysfunction.

    Science.gov (United States)

    Zoorob, Dani; Higgins, Margaret; Swan, Kimberly; Cummings, Jennifer; Dominguez, Sarah; Carey, Erin

    Chronic pelvic pain is a prevalent and debilitating condition with a wide range of etiologies. An estimated 30% to 70% of chronic pelvic cases involve musculoskeletal component pain including high-tone pelvic floor dysfunction (HTPFD). Pelvic floor physical therapy has been shown to be a beneficial treatment for HTPFD, yet many patients do not have access to this treatment. The objective of this study was to identify the barriers preventing patients from following through with the first-line management, physical therapy. Participants with a diagnosis of HTPFD (n = 154) were identified from the list of referrals sent from the obstetrics and gynecology department to an affiliated PFPT center. Participants were contacted and asked to complete a phone survey addressing demographics and perceived barriers to care. Responses were collected in REDCap. Univariate and bivariate analyses were performed using a statistical analysis software. Seventy surveys were completed. The top barriers identified by participants were financial constraints (51.4%), perceived lack of utility (37.1%), time constraints (30.0%), and travel issues (18.6%); 84.4% of participants had 1 or more comorbid pain condition. Whereas 51.4% expressed some level of anxiety regarding the PFPT option, only 9.6% of participants did not start treatment because of fear of treatment. The majority of treatment barriers identified were concrete restraints, with insurance noncoverage and time constraints being the top issues. A fair number of participants expressed anxiety about the treatment or felt they received unclear explanations of the treatment. These are areas in which providers can potentially alleviate some barriers to care.

  20. Effect of a Home Based Exercise Program on Postmenopausal Women’s Shoulder Girdle Muscle Strength for Women with Breast Cancer

    Directory of Open Access Journals (Sweden)

    M. Akoochakian

    2014-10-01

    Full Text Available Introduction & Objective: Reducing in muscle strength of the shoulder girdle is a side effect of breast cancer treatment. The aim of this study was to determine the effect of 4 weeks of resistance and mobility training on the shoulder girdle strength of women with breast cancer. Materials & Methods: In this randomized clinical trial study twenty-seven postmenopausal women with breast cancer (mean age, 51±5.96 years, (mean height, 158.08±7.2 cm, (mean weight, 63.08±11.06 kg who underwent surgery, chemotherapy and radiation therapy, were purposefully selected and divided into two groups of intervention and control. Intervention group performed 4 weeks (4 sessions per week of resistance training with flex-band and stretch training at home, but the control group did not participate in any sports or physical program. Muscle strength before and after intervention was measured using a handheld dynamometer. The data were analyzed using ANCOVA. Results: Significant differences were seen between intervention and control groups in shoulder flexion, scapula abduction and upward rotation, shoulder internal rotation, shoulder external rotation, shoulder horizontal adduction and scapula depression and adduction strength, as all strength variables increased after 4 weeks exercise. Conclusion: Since strength plays an important role in ADL performance and shoulder girdle function in breast cancer survivors, it seems that muscle strength improvement following combined home based exercise program can help patients after treatment to easier and faster rehabilitation. (Sci J Hamadan Univ Med Sci 2014; 21 (3: 185-195

  1. Role of laparoscopy in evaluation of chronic pelvic pain

    Directory of Open Access Journals (Sweden)

    Hebbar Shripad

    2005-01-01

    Full Text Available Introduction: Chronic pelvic pain (CPP is a common medical problem affecting women. Too often the physical signs are not specific. This study aims at determining the accuracy of diagnostic laparoscopy over clinical pelvic examination. Settings and Design: A retrospective study of patients who underwent diagnostic laparoscopy for CPP. Materials and Methods: The medical records of 86 women who underwent laparoscopic evaluation for CPP of at least 6-month duration were reviewed for presentation of symptoms, pelvic examination findings at the admission, operative findings and follow up when available. Statistical analysis used: McNemar Chi-square test for frequencies in a 2 x 2 table. Results: The most common presentation was acyclic lower abdominal pain (79.1%, followed by congestive dysmenorrhoea (26.7%. 61.6% of women did not reveal any significant signs on pelvic examination. Pelvic tenderness was elicited in 27.9%. Diagnostic laparoscopy revealed significant pelvic pathology in 58% of those who essentially had normal pervaginal findings. The most common pelvic pathology by laparoscopy was pelvic adhesions (20.9%, followed by pelvic congestion (18.6%. Laparoscopic adhesiolyis achieved pain relief only in one-third of the women. Conclusion: The study revealed very low incidence of endometriosis (4.7%. Overall clinical examination could detect abnormality in only 38% of women, where as laparoscopy could detect significant pathology in 66% of women with CPP. This shows superiority of diagnostic laparoscopy over clinical examination in detection of aetiology in women with CPP (P < 0.001. Adhesiolysis helps only small proportion of women in achieving pain control.

  2. Pharmacokinetics of cephem antibiotics in exudate of pelvic retroperitoneal space after radical hysterectomy and pelvic lymphadenectomy.

    Science.gov (United States)

    Ito, K; Hayasaki, M; Tamaya, T

    1990-01-01

    Many cephalosporin antibiotics have recently been invented and attempts have been made to use them clinically. The choice of which of these drugs should be used has been difficult in gynecology. The efficacies of these drugs depend on their antibacterial spectra, potencies, and concentrations in tissues. This study was designed to investigate the pharmacokinetics of various cephem antibiotics in the exudate of the retroperitoneal space that is formed after radical hysterectomy and pelvic lymphadenectomy. These cephem antibiotics were cefoxitin, cefotiam, cefotetan, cefpiramide, cefminox, cefotaxime, ceftizoxime, cefoperazone, cefmenoxime, cefbuperazone, ceftazidime, cefpimizole, flomoxef, and cefuzonam. The maximum concentrations after administration of a 1-g dose in the exudate of the pelvic retroperitoneal space were 37.9 micrograms/ml with cefminox, 30.3 micrograms/ml with cefpimizole, 21.6 micrograms/ml with flomoxef, 21.5 micrograms/ml with ceftazidime, and 17.6 micrograms/ml with cefbuperazone, which were relatively high. When selecting antibiotics for prophylactic use against infections in the retroperitoneal space after radical hysterectomy and pelvic lymphadenectomy, on the basis of drug transfer, flomoxef, cefminox, cefbuperazone, ceftazidime, and cefpimizole were considered to be the drugs of first choice at a dose of 1 g. PMID:2393276

  3. Pelvic radiotherapy and sexual dysfunction in women

    DEFF Research Database (Denmark)

    Jensen, Pernille Tine; Froeding, Ligita Paskeviciute

    2015-01-01

    focus on late effects and an increasing awareness that patient reported outcomes (PROs) i.e., patient assessment of physical, social, psychological, and sexual functioning provides the most valid information on the effects of cancer treatment. Following cure of cancer allow survivors focus on quality...... of life (QOL) issues; sexual functioning has proved to be one of the most important aspects of concern in long-term survivors. METHODS: An updated literature search in PubMed was performed on pelvic radiotherapy and female sexual functioning/dysfunction. Studies on gynaecological, urological...... and gastrointestinal cancers were included. The focus was on the period from 2010 to 2014, on studies using PROs, on potential randomized controlled trials (RCTs) where female sexual dysfunction (FSD) at least constituted a secondary outcome, and on studies reporting from modern radiotherapy modalities. RESULTS...

  4. Sciatica due to pelvic hematoma: case report

    Directory of Open Access Journals (Sweden)

    Kocaman Umit

    2016-12-01

    Full Text Available Sciatica is defined as pain in the sciatic nerve distribution. The most common reason of sciatica is radiculopathy due to lumbar disc hernia. Other causes can be congenital, acquired, infectious, neoplastic, or inflammatory. The piriformis syndrome is another cause. The pain starts in an insidious manner when the cause of sciatica is an extraspinal tumor. It is intermittent at first but a constant and progressive pain that does not decrease with position or rest gradually develops in all patients. The possibility of an intraabdominal or pelvic mass should always be considered and the relevant tests requested when the cause of the sciatica cannot be explained. We present an 83-year-old male who presented with non-traumatic and non-vascular lumbosacral plexopathy due to a large hematoma in the left adductor muscle following the use of warfarin sodium.

  5. Pelvic aneurysmal bone cyst in a dog

    International Nuclear Information System (INIS)

    Nomura, K.; Sato, K.

    1997-01-01

    A three-year-old male Siberian Husky dog was referred to the Veterinary Teaching Hospital in Osaka Prefecture University with a complaint of difficulty in expelling the stools. By rectal examination, a mass as big as a fist could be detected occupying the cavum pelvis. Radiographically the mass had a thin bony shell bulging from the pubic periosteum. In the shell, radiolucent trabeculation gave the area a ''soap bubble'' appearance. The cut surface of the removed mass showed a honeycomb-like pattern constituted of some small loculate bony cysts. These cysts were separated from each other by a fibrous or bony trabeculae with blood-filled vascular channels or sponge-like structures. From clinical and pathological findings, this mass was diagnosed as a pelvic aneurysmal bone cyst. After surgery, the patient completely recovered without tenesmus

  6. Gorham-Stout disease of the shoulder girdle and cervico-thoracic spine: fatal course in a 65-year-old woman

    International Nuclear Information System (INIS)

    Bode-Lesniewska, B.; Hochstetter, A. von; Exner, G.U.; Hodler, J.

    2002-01-01

    A case of Gorham-Stout disease of the shoulder girdle and cervico-thoracic spine in a 65-year-old woman is described. The patient presented with progressive neurologic symptoms, pain, and deformities of the cervico-thoracic spine as well as of her left shoulder following a traumatic shoulder luxation. Since the patient had a history of uterine carcinoma, the current disease was clinically difficult to differentiate from osteolytic metastases. The results of the clinical, radiological and histopathologic examination leading to the diagnosis of Gorham-Stout disease are described. Neither attempted surgery nor radiotherapy produced clinical improvement and the patient died 1 year after the first clinical evaluation. (orig.)

  7. [Sciatic hernia as a cause of chronic pelvic pain].

    Science.gov (United States)

    De los Ríos, José F; Calle, Gustavo; Castañeda, Juan D; Serna, Eduardo A; Vásquez, Ricardo A; Arango, Adriana M; López, Claudia C

    2013-04-01

    Sciatic hernia constitutes the scarcest group of hernias of pelvic floor; however, they should be considered in the origin of chronic pelvic pain. The proper diagnosis of sciatic hernias has allowed to surgeons treating successfully patients with acute or chronic pelvic pain, with intestinal or ureteral obstruction and with urinary or gluteus sepsis. It has to be considered as differential diagnosis before the finding of a congenital or acquired gluteus mass. Laparoscopist gynecologist should know the existence of this defect, to be familiar with its aspect in laparoscopic view and to know the laparoscopic treatment of this disease.

  8. Primary pelvic hydatic cyst mimicking ovarian carcinoma

    Directory of Open Access Journals (Sweden)

    Faruk Abike

    2011-05-01

    Full Text Available Hydatic cyst is an illness that appears in consequence of the cystic form of small strap-shaped worm Echinococcus granulosis. Frequently, cysts exist in the lungs and liver. Peritoneal involvement is rare, and generally occurs as a result of second inoculation from rupture of a liver-located hydatic cyst. Primary ovarian hydatic cyst is very rare. A 56-year-old female patient was admitted to Emergency Service with the complaint of stomachache and swollen abdomen. From ultrasonographic examination, a right ovarian 52 × 45-mm heterogeneous semi-solid cystic mass and right hydronephrosis were detected. As a result of the tomographic examination, the right ovarian growth was judged to be a 60 × 45-mm lobule contoured, septal, heterogeneously cystic mass (ovarian carcinoma. Depending on these indicators and with the diagnosis of ovarian carcinoma, laparotomy was planned. During the observation, a mass that compressed on the right ureter and dilatation in the right ureter were determined. The mass was approximately 6 cm long and smoothly contoured, including widespread adhesions, and also obliteration of the pouch of Douglas. The mass was excised and total abdominal hysterectomy and bilateral salpingo-oopherectomy performed. After a pathological examination, hydatid cyst was diagnosed. Although pointing at the issue of the distinctive diagnosis of pelvic and peritoneal mass, it should be realized that the existence of primary peritoneal and pelvic involvement of the hydatic cyst is generally a result of the second inoculation, and is also more common in regions in which Echinococcus granulosa is endemic and livestock production is prevalent.

  9. Laparoscopic radical prostatectomy: omitting a pelvic drain

    Directory of Open Access Journals (Sweden)

    David Canes

    2008-03-01

    Full Text Available PURPOSE: Our goal was to assess outcomes of a selective drain placement strategy during laparoscopic radical prostatectomy (LRP with a running urethrovesical anastomosis (RUVA using cystographic imaging in all patients. Materials and Methods: A retrospective chart review was performed for all patients undergoing LRP between January 2003 and December 2004. The anastomosis was performed using a modified van Velthoven technique. A drain was placed at the discretion of the senior surgeon when a urinary leak was demonstrated with bladder irrigation, clinical suspicion for a urinary leak was high, or a complex bladder neck reconstruction was performed. Routine postoperative cystograms were obtained. RESULTS: 208 patients underwent LRP with a RUVA. Data including cystogram was available for 206 patients. The overall rate of cystographic urine leak was 5.8%. A drain was placed in 51 patients. Of these, 8 (15.6% had a postoperative leak on cystogram. Of the 157 undrained patients, urine leak was radiographically visible in 4 (2.5%. The higher leak rate in the drained vs. undrained cohort was statistically significant (p = 0.002. Twenty-four patients underwent pelvic lymph node dissection (8 drained, 16 undrained. Three undrained patients developed lymphoceles, which presented clinically on average 3 weeks postoperatively. There were no urinomas or hematomas in either group. CONCLUSIONS: Routine placement of a pelvic drain after LRP with a RUVA is not necessary, unless the anastomotic integrity is suboptimal intraoperatively. Experienced clinical judgment is essential and accurate in identifying patients at risk for postoperative leakage. When suspicion is low, omitting a drain does not increase morbidity.

  10. Efficacy of pelvic floor muscle training and hypopressive exercises for treating pelvic organ prolapse in women: randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Bruno Teixeira Bernardes

    Full Text Available CONTEXT AND OBJECTIVE: Previous studies have shown that women with pelvic floor dysfunctions present decreased cross-sectional area (CSA of the levator ani muscle. One way to assess the effects of training programs is to measure the CSA of the muscle, using ultrasonography. The aim here was to evaluate the efficacy of pelvic floor muscle training and hypopressive exercises for increasing the CSA of the levator ani muscle in women with pelvic organ prolapse. DESIGN AND SETTING: Prospective randomized controlled trial at the Urogynecology outpatient clinic of Universidade Federal de São Paulo. METHODS: Fifty-eight women with stage II pelvic organ prolapse were divided into three groups for physiotherapy: a pelvic floor muscle training group (GI; a hypopressive exercise group (GII; and a control group (GIII. The patients underwent transperineal ultrasonographic evaluation using a transducer of frequency 4-9 MHz. The (CSA of the levator ani muscle was measured before physiotherapy and after 12 weeks of treatment. RESULTS: The groups were homogeneous regarding age, number of pregnancies, number of vaginal deliveries, body mass index and hormonal status. Statistically significant differences in CSA were found in GI and GII from before to after the treatment (P < 0.001, but not in relation to GIII (P = 0.816. CONCLUSIONS: The CSA of the levator ani muscle increased significantly with physiotherapy among the women with pelvic organ prolapse. Pelvic floor muscle training and hypopressive exercises produced similar improvements in the CSA of the levator ani muscle.

  11. [Continuous improvement of portable domestic pelvic floor neuromuscular electrical stimulation on the pelvic floor function of patients with urinary incontinence].

    Science.gov (United States)

    Sun, Zhijing; Zhu, Lan; Lang, Jinghe; Wang, Wei; Shi, Honghui; Pang, Hongxia; Shi, Xinwen

    2015-12-01

    To evaluate continuous improvement of portable domestic pelvic floor neuromuscular electrical stimulation on the pelvic floor function of patients with stress urinary incontinence after short-term pelvic floor electrophysiological treatment in hospital. Totally 60 women with stress urinary incontinence were recruited for this randomized controlled trial. The control group including a total of 30 patients, only received 4 weeks pelvic floor electrophysiological treatment in the hospital. Family consolidation treatment group (experimental group) including 30 patients, after 4-week treatment in hospital, received 12-week of pelvic floor neuromuscular electrical stimulation using portable electrical stimulator at home under the guidance of doctors. In post-treatment 6 months and 9 months, 1-hour pad test was measured for urine leakage, pelvic floor electrical physiological parameters were assessed, and subjective improvement of symptoms of urinary incontinence were evaluated. All these data were analysed to compare the effect of the two groups. In 9 months after treatment, average change of urine leakage, the control group and experiment group were (75±24)% versus (99±3)%, the difference was statistically significant (Pcontinuous improvement of pelvic floor function.

  12. Is urinary incontinence during and after pregnancy related to family history? A web-based survey among postpartum women (motherfit project).

    Science.gov (United States)

    Albers-Heitner, P; Bekkers, L; Moossdorff, H; Berghmans, B; Verdonk, P

    2016-01-01

    The authors studied whether family history of urinary incontinence (UI) is associated with pre- and postpartum UI. In 2010, Dutch postpartum women at three months were approached to fill in a Web-based questionnaire on UI and risk factors (body mass index, BMI), parity, pelvic organ prolapse, and family history. Results were analyzed with Chi-square and logistic regression analyses. 162 (61%) questionnaires were analyzed, 76 (47%) women reported UI before, during and/or after pregnancy, of which 34% also reported a UI family history. Sixteen (19%) out of 84 women without UI reported UI family history (p = 0.05). BMI was associated with prepartum UI (p = 0.035), but the association disappears when adding family history. Women with unknown UI family history had higher risk for postpartum U. UI family history is associated with UI during pregnancy. More awareness and research is needed whether adding family history questions on UI in prepartum consultations improves timely prevention.

  13. Effects of vitamin A or beta carotene supplementation on pregnancy-related mortality and infant mortality in rural Bangladesh: a cluster randomized trial.

    Science.gov (United States)

    West, Keith P; Christian, Parul; Labrique, Alain B; Rashid, Mahbubur; Shamim, Abu Ahmed; Klemm, Rolf D W; Massie, Allan B; Mehra, Sucheta; Schulze, Kerry J; Ali, Hasmot; Ullah, Barkat; Wu, Lee S F; Katz, Joanne; Banu, Hashina; Akhter, Halida H; Sommer, Alfred

    2011-05-18

    Maternal vitamin A deficiency is a public health concern in the developing world. Its prevention may improve maternal and infant survival. To assess efficacy of maternal vitamin A or beta carotene supplementation in reducing pregnancy-related and infant mortality. Cluster randomized, double-masked, placebo-controlled trial among pregnant women 13 to 45 years of age and their live-born infants to 12 weeks (84 days) postpartum in rural northern Bangladesh between 2001 and 2007. Interventions Five hundred ninety-six community clusters (study sectors) were randomized for pregnant women to receive weekly, from the first trimester through 12 weeks postpartum, 7000 μg of retinol equivalents as retinyl palmitate, 42 mg of all-trans beta carotene, or placebo. Married women (n = 125,257) underwent 5-week surveillance for pregnancy, ascertained by a history of amenorrhea and confirmed by urine test. Blood samples were obtained from participants in 32 sectors (5%) for biochemical studies. All-cause mortality of women related to pregnancy, stillbirth, and infant mortality to 12 weeks (84 days) following pregnancy outcome. Groups were comparable across risk factors. For the mortality outcomes, neither of the supplement group outcomes was significantly different from the placebo group outcomes. The numbers of deaths and all-cause, pregnancy-related mortality rates (per 100,000 pregnancies) were 41 and 206 (95% confidence interval [CI], 140-273) in the placebo group, 47 and 237 (95% CI, 166-309) in the vitamin A group, and 50 and 250 (95% CI, 177-323) in the beta carotene group. Relative risks for mortality in the vitamin A and beta carotene groups were 1.15 (95% CI, 0.75-1.76) and 1.21 (95% CI, 0.81-1.81), respectively. In the placebo, vitamin A, and beta carotene groups the rates of stillbirth and infant mortality were 47.9 (95% CI, 44.3-51.5), 45.6 (95% CI, 42.1-49.2), and 51.8 (95% CI, 48.0-55.6) per 1000 births and 68.1 (95% CI, 63.7-72.5), 65.0 (95% CI, 60.7-69.4), and 69

  14. "Who's afraid?": attitudes of midwives to the use of information and communication technologies (ICTs) for delivery of pregnancy-related health information.

    Science.gov (United States)

    Dalton, J A; Rodger, D L; Wilmore, M; Skuse, A J; Humphreys, S; Flabouris, M; Clifton, V L

    2014-09-01

    Usage rates for information and communication technologies (ICTs) in healthcare have been increasing in recent years, but often lag behind general usage rates for populations as a whole. Research into such differential rates of ICT use across different segments of the population has identified a number of possible causal factors that limit usage. The research investigated midwives' attitudes and experiences of ICT use to identify potential causal factors that encourage or inhibit their usage in antenatal care. Semi-structured interviews, focus groups and short surveys were conducted with midwives who provide antenatal education at an Australian metropolitan hospital. Thematic and statistical analyses were used to interpret the data. Although midwives recognised the potential benefits of using ICTs to deliver pregnancy-related health information many had reservations about their use in everyday work. These reservations centred on lack of training in use of ICTs, the perceived legal risks associated with social media, potential violations of patient privacy, misdiagnosis and misunderstandings between midwife and client. Midwives face a number of barriers to effective use of ICTs in healthcare including material access, skills access, usage access and motivational access. Motivational access appears to be a key concern due to the high perception of risk associated with social media in particular. Reducing the motivational barriers through a range of interventions with midwifery staff may assist in overcoming other barriers to ICT use in antenatal care. Further research is required to determine whether these findings are generalisable to other healthcare contexts. Copyright © 2014 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  15. Awareness and timing of pelvic floor muscle contraction, pelvic exercises and rehabilitation of pelvic floor in lifelong premature ejaculation: 5 years experience

    Directory of Open Access Journals (Sweden)

    Giuseppe La Pera

    2014-06-01

    Full Text Available Objectives: To assess the cure rate of patients with premature ejaculation who underwent a treatment involving: 1 awareness of the pelvic floor muscles 2 learning the timing of execution and maintenance of contraction of the pelvic floor muscles during the sensation of the pre-orgasmic phase 3 pelvic floor rehabilitation (bio feed back, pelvic exercises and electrostimulation. Materials and methods: We recruited 78 patients with lifelong premature ejaculation who completed the training. The patients were informed of the role of the pelvic floor. They were taught to carry out the execution and maintenance of contraction of the pelvic floor muscles during the sensation of the pre-orgasmic phase to control the ejaculatory reflex. In order to improve the awareness, the tone and the endurance of the pelvic floor muscles, patients were treated with the rehabilitation of pelvic floor (RPF consisting mainly in biofeedback, pelvic exercises and in some cases also in electro-stimulation (ES. The training was carried out for a period of about 2-6 months with an average of 2-5 visits per cycle. Results: 54% of patients who completed the training were cured of premature ejaculation and learned over time to be able to postpone the ejaculation reflex. In a subgroup of 26 patients was also measured the IELT which on the average increased from < 2 minutes to >10 minutes. The best results occurred mainly in patients aged less than 35 where the cure rate was 65%. There were no side effects. Conclusions: In this study, approximately half of patients with premature ejaculation were cured after applying the above treatment.This therapy, necessitates a fairly long period of time (2-6 months and a great commitment on the part of the patient, nevertheless it can be a valid and effective treatment for patients with premature ejaculation. This treatment makes the patient independent in that he is not bound to specific times for taking medication. Furthermore there are no

  16. Diagnosis of pelvic wall tumor on multislice CT

    International Nuclear Information System (INIS)

    Zhang Keyun; Deng Lequn; Lei Hongwei

    2011-01-01

    Objective: To evaluate the value of multi-slice CT (MSCT) in diagnosing pelvic wall tumors. Methods: MSCT of 21 cases of pelvic wall tumors including metastasis (10), neurogenic tumor (5), chondrosarcoma (2), chordoma (1), aneurysmal bone cyst (1), giant cell tumor (1), and osteochondroma (1) was retrospectively analyzed. Results: CT appearances of pelvic wall tumors include bony destruction and soft tissue masses. Common features were bone destruction in metastasis, expansion of the neuroforamen in neurogenic tumor, pleomorphic calcification in chondrosarcoma, lower sacral vertebral location of chordoma, iliac crest bone destruction in giant cell tumor, cauliflower-like nodules in osteochondroma. Conclusion: MSCT with three-dimensional volume rendering demonstrates well the tumor shape, size, extent, internal structure and relationship with the surrounding organs to aid diagnosis of pelvic wall tumors. (authors)

  17. Power to the Pelvis: Strengthening Your Pelvic Floor Muscles

    Science.gov (United States)

    ... Bulging Hernia Keeping Your Gut in Check The Power of Your Pancreas Wise Choices Lower Your Risk of Pelvic Floor Issues Maintain a healthy weight. Avoid constipation and straining by getting enough ...

  18. Pelvic orientation and assessment of hip dysplasia in adults

    DEFF Research Database (Denmark)

    Jacobsen, S.; Holm, S.S.; Lund, B.

    2004-01-01

    on the measurements of radiographic indices of hip dysplasia. MATERIAL AND METHODS: We investigated the effect of varying pelvic orientation on radiographic measurements of acetabular dysplasia using a cadaver model. Results from the cadaver study were used to validate the radiographic assessments of acetabular...... radiograph was recorded at each 3 degrees increment. The most widely used radiographic parameters of hip dysplasia were assessed. 2) Critical limits of acceptable rotation and inclination/reclination of pelvises were determined on 4151 standing, standardised pelvic radiographs of the CCHS cohort. RESULTS......BACKGROUND: The study was performed to qualify the source material of 4151 pelvic radiographs for the research into the relationship between unrecognised childhood hip disorders and the development of hip osteoarthrosis, and to investigate the effect of varying degrees of pelvic tilt and rotation...

  19. the anatomy of pelvic corona mortis vessles in black africans

    African Journals Online (AJOL)

    , Moi University, P. O. Box ... This vascular anastomosis is also at risk during ilionguinal approach to the acetabulum (7). A medial approach for pelvic osteotomies for acetabular dysplasia ..... Gray's Anatomy 39th Edition , section 7 abdomen.

  20. Radiation diagnosis of pelvic ring damages in acute injury

    International Nuclear Information System (INIS)

    Dytalov, M.M.

    2000-01-01

    Data on 58 victims with multifocal damages to the pelvic ring were used to examine the diagnostic potentialities of different radiation diagnostic techniques and to compare their resolving power. The later was 65.1, 83.3 and 94.7% in plain and multidimensional X-ray studies, and computed tomography, respectively. Complex of signs is described closed sacral fractures on the plain and oblique pelvic inlet (caudal) radiograms proposed, which could improve the diagnosis of fractures by 8.8 times, and an original orthopedic gauze-plate for the detection and estimation of invisible pelvic bone displacement, and an original procedure for pelvic X-ray study with target load in acute injury. This all can improve the quality of examination of casualties substantially and define indications for different treatments more precise [ru

  1. Surgical Management of Pelvic floor Prolapse in women using Mesh

    African Journals Online (AJOL)

    RAH

    polytetrafluoroethylene) . This article reviews our experience with polypropylene mesh in pelvic floor repair at the. Southern General Hospital Glasgow. The objective was to determine the safety and effectiveness of the prolene mesh in the repair ...

  2. Patterns of pelvic and acetabular injury among Sudanese patients ...

    African Journals Online (AJOL)

    , S Idris. Abstract. Background: Most of major pelvic fractures result from very high energy trauma and require urgent hospital treatment. However more minor, stable fractures may only require a period of rest and analgesia followed by gradual ...

  3. Quality of life in women with pelvic floor dysfunction

    Directory of Open Access Journals (Sweden)

    Mladenović-Segedi Ljiljana

    2011-01-01

    Full Text Available Background/Aim. Pelvic floor dysfunction is a frequent problem affecting more than 50% of women in peri- and postmenopause. Considering that ageing and menopause befall in the significant factors causing this issue, as well as the expected longevity of women in the world and in our country, pelvic floor dysfunction prevelence is foreseen to be even higher. The aim of the study was to evaluate impact of the symptoms of pelvic dysfunction on quality of life and examine body image satisfaction in adult women with pelvic organ prolapse presenting to tertiary care clinic for surgical treatment. Methods. This prospective case-control study included 50 patients who presented to tertiary care gynecology clinic for surgical treatment and 50 controls with normal pelvic floor support and without urinary incontinence who presented tertiary care gynecology clinic for other reasons. Both, patients and controls, completed two quastionnaires recommended for the evaluation of symptoms (Pelvic floor distress inventory - short forms and quality of life impact (Pelvic floor impact questionnaire - short form of pelvic organ prolapse, and Body Image Scale. Results. The patients scored significantly worse on the prolapse, urinary, colorectal scales and overall score of Pelvic floor distress inventory - 20 than controls subjects (134.91 vs 78.08; p < 0.01. The patients also measured significant decrease in condition- specific quality of life (89.23 vs 3.1; p < 0.01. They were more likely to feel self-conscious (78% vs 42%; p < 0.01, less likely to feel physically attractive (78% vs 22%; p < 0.01, more likely to have difficulty looking at themselves naked (70% vs 42%; p < 0.01, less likely to feel sexually attractive (64% vs 32%; p < 0.01, and less likely to feel feminine (56% vs 16%; p < 0.05, than controls. There were no differencies in their feeling of dissatisfaction with appearance when dressed, avoiding people because of appereance and overall dissatisfaction with

  4. Pelvic hydatid cyst with uncommon sciatalgia manifestation: a case report

    Directory of Open Access Journals (Sweden)

    Ghodratolah Maddah

    2013-11-01

    Full Text Available Background: Hydatid disease or echinococcosis is a common parasitic disease of human and bovine, caused by infection with larva of the cestode echinococcus. Liver is the most common organ that is involved in this disease. Pelvic involvement and neurological symptoms, due to mass effect of pelvic involvement, in lower extremities are very uncommon manifestations of the disease.Case presentation: A forty six year old man was referred to clinic of surgery at Ghaem Hospital, Medical University of Mashhad, Iran. The patient complained about weakness and motor impairment in right lower extremity accompanied by numbness and radicular pain over past two months. Physical examination demonstrated muscular atrophy and reduced muscular strength in right lower extremity. Computed tomography and ultrasonographic studies showed a cystic mass in right side of the pelvic cavity with extention to the sciatic notch and another cystic mass in right gluteal region. Surgical operation revealed a cystic mass deep in pelvic cavity with the extention to the right sciatic notch with compression of nerve roots. The cystic mass was contained of daughter cysts which confirmed the diagnosis of hydatid cyst disease. This diagnosis was confirmed by pathologic assessment.Conclusion: Although uncommon, but hydatid disease can involve the pelvic cavity and make a pelvic, usually cystic, mass; that can make compression on nerve roots and so making neurologic symptoms in lower extremities. So in endemic areas for hydatid disease, such as Iran, pelvic hydatid cysts should be considered as a possible differential diagnosis in patients presenting with the sciatic pain and neurological manifestations in whom a pelvic mass has been found too.

  5. Laparoscopic Adhesiolysis and Relief of Chronic Pelvic Pain

    OpenAIRE

    Nezhat, Farr R.; Crystal, Ruth Ann; Nezhat, Ceana H.; Nezhat, Camran R.

    2000-01-01

    Objective: To evaluate the short- and long-term results of laparoscopic enterolysis in patients with chronic pelvic pain following hysterectomy. Methods: Forty-eight patients were evaluated at time intervals from 2 weeks to 5 years after laparoscopic enterolysis. Patients were asked to rate postoperative relief of their pelvic pain as complete/near complete relief (80-100% pain relief), significant relief (50-80% pain relief), or less than 50% or no pain relief. Results: We found that after 2...

  6. Pelvic floor functional disorders in vaginally delivered primiparae

    OpenAIRE

    Antolic, Andrea

    2011-01-01

    In this study we examined pelvic floor functional disorders in primiparae with single pregnancies, cephalic presentation at term at the Charité delivery department before and during pregnancy as well as after vaginal delivery by means of questionnaire in relation to maternal, neonatal and obstetric risk factors. The pathophysiology of pelvic floor disorders is still not statisfyingly resolved. During pregnancy 74% of primiparae knew about the interrelation between delivery and sexual disorde...

  7. Effect of pelvic floor muscle exercises on pulmonary function

    OpenAIRE

    Han, DongWook; Ha, Misook

    2015-01-01

    [Purpose] This study aimed to determine the correlation between pelvic floor muscle strength and pulmonary function. In particular, we examined whether pelvic floor muscle exercises can improve pulmonary function. [Subjects] Thirty female college students aged 19?21 with no history of nervous or musculoskeletal system injury were randomly divided into experimental and control groups. [Methods] For the pulmonary function test, spirometry items included forced vital capacity and maximal volunta...

  8. Sexual function in women with pelvic floor disorders

    OpenAIRE

    Rogers, Rebecca G.

    2013-01-01

    Pelvic floor disorders (PFDs) can impact sexual function. This summary provides an overview of the impact of stress urinary incontinence and pelvic organ prolapse and their treatments on sexual function. In general, interventions that successfully address PFDs will generally improve sexual function as well. However, there are patients whose sexual function will remain unchanged despite treatment, and a small but significant minority who will report worsened sexual function following treatment...

  9. Female Pelvic Vein Embolization: Indications, Techniques, and Outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Lopez, Anthony James, E-mail: consultant@radiologist.co.uk [The Imaging Clinic (United Kingdom)

    2015-08-15

    Until recently, the main indication for pelvic vein embolization (PVE) in women was to treat pelvic venous congestion syndrome (PVC) but increasingly, patients with refluxing pelvic veins associated with leg varicosities are also being treated. A more unusual reason for PVE is to treat pelvic venous malformations, although such lesions may be treated with sclerotherapy alone. Embolotherapy for treating PVC has been performed for many years with several published studies included in this review, whilst an emerging indication for PVE is to treat lower limb varicosities associated with pelvic vein reflux. Neither group, however, has been subjected to an adequate randomized, controlled trial. Consequently, some of the information presented in this review should be considered anecdotal (level III evidence) at this stage, and a satisfactory ‘proof’ of clinical efficacy remains deficient until higher-level evidence is presented. Furthermore, a wide range of techniques not accepted by all are used, and some standardization will be required based on future mandatory prospective studies. Large studies have also clearly shown an unacceptably high recurrence rate of leg varicose veins following venous surgery. Furthermore, minimally or non-invasive imaging is now revealing that there is a refluxing pelvic venous source in a significant percentage of women with de novo leg varicose veins, and many more with recurrent varicosities. Considering that just over half the world’s population is female and a significant number of women not only have pelvic venous reflux, but also have associated leg varicosities, minimally invasive treatment of pelvic venous incompetence will become a common procedure.

  10. Obesity and Pelvic Floor Disorders: A Review of the Literature

    OpenAIRE

    Pomian, Andrzej; Lisik, Wojciech; Kosieradzki, Maciej; Barcz, Ewa

    2016-01-01

    Overweight and obesity are becoming a worldwide health problem associated with numerous co-morbidities. National costs of obesity and pelvic flor disorders have been rising since the 1950s across the world. Obesity is thought to have a very strong effect on pelvic floor disorders, and, considering the high prevalence of both problems worldwide, it is of utmost importance to evaluate the association between these pathologies as well as the impact of obesity on treatment efficacy. This review i...

  11. Female Pelvic Vein Embolization: Indications, Techniques, and Outcomes

    International Nuclear Information System (INIS)

    Lopez, Anthony James

    2015-01-01

    Until recently, the main indication for pelvic vein embolization (PVE) in women was to treat pelvic venous congestion syndrome (PVC) but increasingly, patients with refluxing pelvic veins associated with leg varicosities are also being treated. A more unusual reason for PVE is to treat pelvic venous malformations, although such lesions may be treated with sclerotherapy alone. Embolotherapy for treating PVC has been performed for many years with several published studies included in this review, whilst an emerging indication for PVE is to treat lower limb varicosities associated with pelvic vein reflux. Neither group, however, has been subjected to an adequate randomized, controlled trial. Consequently, some of the information presented in this review should be considered anecdotal (level III evidence) at this stage, and a satisfactory ‘proof’ of clinical efficacy remains deficient until higher-level evidence is presented. Furthermore, a wide range of techniques not accepted by all are used, and some standardization will be required based on future mandatory prospective studies. Large studies have also clearly shown an unacceptably high recurrence rate of leg varicose veins following venous surgery. Furthermore, minimally or non-invasive imaging is now revealing that there is a refluxing pelvic venous source in a significant percentage of women with de novo leg varicose veins, and many more with recurrent varicosities. Considering that just over half the world’s population is female and a significant number of women not only have pelvic venous reflux, but also have associated leg varicosities, minimally invasive treatment of pelvic venous incompetence will become a common procedure

  12. New paradigms in understanding chronic pelvic pain syndrome.

    Science.gov (United States)

    Konkle, Katy S; Clemens, J Quentin

    2011-08-01

    Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common male pain condition that is associated with significant discomfort and disability. Despite significant efforts, there remains no definitive etiology or treatment of the spectrum of pelvic symptoms reported by these patients. The purpose of this review is to summarize important clinical and scientific findings related to CP/CPPS from the previous 2 years, and to evaluate their impact on our understanding of, and approach to, the disease.

  13. Comparison of changes in the mobility of the pelvic floor muscle on during the abdominal drawing-in maneuver, maximal expiration, and pelvic floor muscle maximal contraction

    OpenAIRE

    Jung, Halim; Jung, Sangwoo; Joo, Sunghee; Song, Changho

    2016-01-01

    [Purpose] The purpose of this study was to compare changes in the mobility of the pelvic floor muscle during the abdominal drawing-in maneuver, maximal expiration, and pelvic floor muscle maximal contraction. [Subjects] Thirty healthy adults participated in this study (15 men and 15 women). [Methods] All participants performed a bridge exercise and abdominal curl-up during the abdominal drawing-in maneuver, maximal expiration, and pelvic floor muscle maximal contraction. Pelvic floor mobility...

  14. Myocardial Contractile Dysfunction is Present Without Histopathology in a Mouse Model of Limb-Girdle Muscular Dystrophy-2F and is Prevented after Claudin-5 Virotherapy

    Directory of Open Access Journals (Sweden)

    Nima Milani-Nejad

    2016-12-01

    Full Text Available AbstractMutations in several members of the dystrophin glycoprotein complex lead to skeletal and cardiomyopathies. Cardiac care for these muscular dystrophies consists of management of symptoms with standard heart medications after detection of reduced whole heart function. Recent evidence from both Duchenne muscular dystrophy patients and animal models suggests that myocardial dysfunction is present before myocardial damage or deficiencies in whole heart function, and that treatment prior to heart failure symptoms may be beneficial. To determine whether this same early myocardial dysfunction is present in other muscular dystrophy cardiomyopathies, we conducted a physiological assessment of cardiac function at the tissue level in the δ-sarcoglycan null mouse model (Sgcd-/- of Limb-girdle muscular dystrophy type 2F. Baseline cardiac contractile force measurements using ex vivo intact linear muscle preparations, were severely depressed in these mice without the presence of histopathology. Virotherapy with claudin-5 prevents the onset of cardiomyopathy in another muscular dystrophy model. After virotherapy with claudin-5, the cardiac contractile force deficits in Sgcd-/- mice are no longer significant. These studies suggest that screening Limb-girdle muscular dystrophy patients using methods that detect earlier functional changes may provide a longer therapeutic window for cardiac care.

  15. B4GALNT2 (GALGT2) Gene Therapy Reduces Skeletal Muscle Pathology in the FKRP P448L Mouse Model of Limb Girdle Muscular Dystrophy 2I.

    Science.gov (United States)

    Thomas, Paul J; Xu, Rui; Martin, Paul T

    2016-09-01

    Overexpression of B4GALNT2 (previously GALGT2) inhibits the development of muscle pathology in mouse models of Duchenne muscular dystrophy, congenital muscular dystrophy 1A, and limb girdle muscular dystrophy 2D. In these models, muscle GALGT2 overexpression induces the glycosylation of α dystroglycan with the cytotoxic T cell glycan and increases the overexpression of dystrophin and laminin α2 surrogates known to inhibit disease. Here, we show that GALGT2 gene therapy significantly reduces muscle pathology in FKRP P448Lneo(-) mice, a model for limb girdle muscular dystrophy 2I. rAAVrh74.MCK.GALGT2-treated FKRP P448Lneo(-) muscles showed reduced levels of centrally nucleated myofibers, reduced variance, increased size of myofiber diameters, reduced myofiber immunoglobulin G uptake, and reduced muscle wasting at 3 and 6 months after treatment. GALGT2 overexpression in FKRP P448Lneo(-) muscles did not cause substantial glycosylation of α dystroglycan with the cytotoxic T cell glycan or increased expression of dystrophin and laminin α2 surrogates in mature skeletal myofibers, but it increased the number of embryonic myosin-positive regenerating myofibers. These data demonstrate that GALGT2 overexpression can reduce the extent of muscle pathology in FKRP mutant muscles, but that it may do so via a mechanism that differs from its ability to induce surrogate gene expression. Copyright © 2016 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

  16. Is Bariatric Surgery a Prophylaxis for Pelvic Floor Disorders?

    Science.gov (United States)

    Pomian, Andrzej; Majkusiak, Wojciech; Lisik, Wojciech; Tomasik, Paweł; Horosz, Edyta; Zwierzchowska, Aneta; Kociszewski, Jacek; Barcz, Ewa

    2018-06-01

    Obesity is one of the well-documented risk factors of pelvic floor disorders (PFDs). The PFDs include urinary and fecal incontinence (UI, FI) and pelvic organ prolapse (POP). Surgery-induced weight loss improves different kinds of incontinence as well as POP symptoms. However, there is a lack of evidence how bariatric surgery influences pelvic floor anatomy and function in women without previous PFDs and whether it may be concerned as PFD prophylaxis tool. The present analysis is a prospective, non-randomized case-control study from January 2014 to September 2017. Participants underwent pelvic floor ultrasound examination with bladder neck position estimation at rest, during levator ani tension, and at Valsalva maneuver before surgery and 12-18 months after. Pelvic organ prolapse quantification (POPQ) > 2 stage and PFD complaints were the exclusion criteria. Fifty-nine patients underwent bariatric surgery (57 sleeve gastrectomy and 2 gastric bypass). Mean BMI decreased from 43.8 ± 5.9 to 29 ± 4.6 kg/m 2 after surgery (p betterment of bladder neck position at rest, tension, and Valsalva maneuver in women without PFDs. We postulate that bariatric surgery may be a tool for PFD prevention. It does not improve levator ani function and does not limit bladder neck mobility, which implicates that it has no influence on preexisting pelvic dysfunction.

  17. Pelvic Vein Embolisation in the Management of Varicose Veins

    International Nuclear Information System (INIS)

    Ratnam, Lakshmi A.; Marsh, Petra; Holdstock, Judy M.; Harrison, Charmaine S.; Hussain, Fuad F.; Whiteley, Mark S.; Lopez, Anthony

    2008-01-01

    Pelvic vein incompetence is common in patients with atypical varicose veins, contributing to their recurrence after surgery. Therefore, refluxing pelvic veins should be identified and treated. We present our experience with pelvic vein embolisation in patients presenting with varicose veins. Patients presenting with varicose veins with a duplex-proven contribution from perivulval veins undergo transvaginal duplex sonography (TVUS) to identify refluxing pelvic veins. Those with positive scans undergo embolisation before surgical treatment of their lower limb varicose veins. A total of 218 women (mean age of 46.3 years) were treated. Parity was documented in the first 60 patients, of whom 47 (78.3%) were multiparous, 11 (18.3%) had had one previous pregnancy, and 2 (3.3%) were nulliparous. The left ovarian vein was embolised in 78%, the right internal iliac in 64.7%, the left internal iliac in 56.4%, and the right ovarian vein in 42.2% of patients. At follow-up TVUS, mild reflux only was seen in 16, marked persistent reflux in 6, and new reflux in 3 patients. These 9 women underwent successful repeat embolisation. Two patients experienced pulmonary embolisation of the coils, of whom 1 was asymptomatic and 1 was successfully retrieved; 1 patient had a misplaced coil protruding into the common femoral vein; and 1 patient had perineal thrombophlebitis. The results of our study showed that pelvic venous embolisation by way of a transjugular approach is a safe and effective technique in the treatment of pelvic vein reflux.

  18. Transvaginal versus transabdominal sonography in the evaluation of pelvic pathology

    International Nuclear Information System (INIS)

    Qureshi, I.H.; Ullah, H.; Akram, M.H.; Ashfaq, S.; Nayyar, S.

    2004-01-01

    Objective: To find the accuracy of sonographic information provided by transvaginal sonography (TVS) in pelvic pathology as compared to transabdominal sonography (TAS). Materials and Methods: Hundred patients were included in the study from a total of 212 referred for pelvic sonography. Two radiologists independently performed transabdominal and transvaginal sonography of these patients. An independent observer compared the findings. TVS was graded as superior, equal or inferior to TAS depending on the score assigned by them. Results: TVS was considered superior in 63%, equal in 27% and inferior in 10% of the cases as compared to transabdominal sonography. It was graded inferior to TAS in cases with large pelvic masses and superior in majority of cases of ovarian follicle monitoring, polycystic ovaries, endometrial carcinoma and suspected ectopic pregnancy. Cases in which both techniques were considered equal included patients with no abnormal finding, some pelvic masses and advanced pelvic inflammatory disease. Conclusion: Transvagival sonography is superior to transabdominal sonography in most cases of pelvic pathology. However, TAS should still be the initial sonographic technique for routine evaluation of the female pelvis followed by TVS if indicated. In cases of ovarian follicle monitoring, suspected polycystic ovaries, endometrial pathology and suspected ectopic pregnancy, TVS may be used as the initial sonographic technique and can even replace TAS. (author)

  19. Effect of pelvic floor muscle training compared with watchful waiting in older women with symptomatic mild pelvic organ prolapse : randomised controlled trial in primary care

    NARCIS (Netherlands)

    Wiegersma, Marian; Panman, Chantal M. C. R.; Kollen, Boudewijn J.; Berger, Marjolein Y.; Lisman-Van Leeuwen, Yvonne; Dekker, Janny H.

    2014-01-01

    Objective To compare the effects of pelvic floor muscle training and watchful waiting on pelvic floor symptoms in a primary care population of women aged 55 years and over with symptomatic mild pelvic organ prolapse. Design Randomised controlled trial. Setting Dutch primary care. Participants Women

  20. The 12-month effects of structured lifestyle advice and pelvic floor muscle training for pelvic organ prolapse

    DEFF Research Database (Denmark)

    Due, Ulla; Brostrøm, Søren; Lose, Gunnar

    2016-01-01

    INTRODUCTION: We evaluated the 12-month effects of adding pelvic floor muscle training to a lifestyle advice program in women with symptomatic pelvic organ prolapse stage II-III and the number of women who had sought further treatment. MATERIAL AND METHODS: This study was a 12-month follow up...... of a randomized controlled trial comparing a structured lifestyle advice program alone (lifestyle group) or in combination with pelvic floor muscle training (training and lifestyle group). Both programs consisted of six separate group sessions within 12 weeks. RESULTS: Data were available from 83 (76%) of the 109...... surgery. More severe anterior prolapse and more bladder symptoms at the 3-month follow up were significantly associated with having sought further treatment in both groups. CONCLUSIONS: At 12-month follow up, the effects of adding pelvic floor muscle training to a structured lifestyle advice program were...

  1. Risk factors related to interfractional variation in whole pelvic irradiation for locally advanced pelvic malignancies

    International Nuclear Information System (INIS)

    Yoon, W.S.; Yang, D.S.; Lee, J.A.; Lee, S.; Park, Y.J.; Kim, C.Y.

    2012-01-01

    Purpose: The goal of the present study was to demonstrate risk factors affecting the interfractional variation in whole pelvic irradiation. Patients and methods: Daily image acquisitions of 101 patients with locally advanced pelvic malignancy were undertaken using a kilo-voltage orthogonal on-board imager. The baseline deviation (the shift between the initial treatment and each fraction; Value Base ) and day-to-day variation (the shift between the previous treatment and each fraction; Value DD ) were measured. The standard deviations (SD) along the x- (right-left), y- (cranial-caudal), and z- (anterior-posterior) axes (SD[x], SD[y], and SD[z], respectively), the 3D vector of the SD (SD[3D]), and the mean of 3D shift (mean[3D]) were calculated in each patient. Various clinical factors, lumbar pelvic balance and rotation, and the shift of 5 consecutive fractions from the initial treatment (Value 5Fx ) were investigated as risk factors. Results: The prone set-up showed a larger mean Base [3D] than in the supine position (p =0.063). A body mass index (BMI) ≥ 30 kg/m 2 resulted in the largest mean DD [3D] (p = 0.078) and SD DD [3D] (p = 0.058). All the SD 5Fx along the x-, y-, and z-axes had moderate linear relationships with SD Base and SD DD (p 5Fx [3D] also had a moderate linear relationship with the mean Base [3D], mean DD [3D], SD Base [3D], and SD DD [3D] (p 5Fx had the same significant relationship with SD Base and SD DD (p 2 was associated with the largest SD DD [x] (p = 0.003). Conclusion: Close surveillance through high-quality and frequent image guidance is recommended for patients with extensive variations of the initial five consecutive fractions or obesity. (orig.)

  2. Comprehensive pelvic floor physical therapy program for men with idiopathic chronic pelvic pain syndrome: a prospective study

    OpenAIRE

    Masterson, Thomas A.; Masterson, John M.; Azzinaro, Jessica; Manderson, Lattoya; Swain, Sanjaya; Ramasamy, Ranjith

    2017-01-01

    Background Male chronic pelvic pain syndrome (CPPS) is a heterogeneous constellation of symptoms that causes significant impairment and is often challenging to treat. In this prospective study, we evaluated men with CPPS who underwent comprehensive pelvic floor physical therapy (PFPT) program. We used the previously validated Genitourinary Pain Index (GUPI) to measure outcomes. Methods We included 14 men who underwent physical therapy for idiopathic CPPS from October 2015 to October 2016. Men...

  3. [The Life Impacts and Symptom Distress in Women With Pelvic Organ Prolapse Syndrome Before Pelvic Reconstruction Surgery].

    Science.gov (United States)

    Ko, I-Chen; Lo, Tsia-Shu; Lu, Yu-Ying; Tsao, Lee-Ing

    2017-02-01

    The decision whether or not to undergo pelvic reconstructive surgery is difficult for women suffering from pelvic organ prolapse. However, little research has examined the symptom distress and life impacts that these women face prior to this surgery. Thus, it is crucial that gynecology nurses learn about these life impacts and symptom distresses in order to help these women make the best decisions with regard to surgery. To explore the life impacts and degree of symptom distress in pre-surgery women with pelvic organ prolapse; to explore the relationships between demographic data and the variables of life impact and degree of symptom distress; and to identify the factors that relate to the explainable variance in the life impacts of these women. A cross-sectional and correlational research design was used and a total of 110 women with pelvic organ prolapse who had not yet undergone pelvic reconstruction surgery were recruited in the gynecological clinics of one medical center in Taiwan. Daytime urination frequency was the most prevalent urinary tract symptom noted by the participants; vaginal protrusion was the most prevalent pelvis-related symptom noted; and depression and anxiety were the most prevalent life impacts noted. Moreover, greater lower-urinary-tract symptom distress was associated with greater pelvic-symptom distress. Furthermore, greater lower urinary tract and pelvic symptom distresses were associated with a greater negative impact on life. Education background and pelvis-related symptoms were the explained variances in pre-surgery life impacts. Women with pelvic organ prolapse should pay particular attention to symptoms that include: daytime urinary frequency, vaginal protrusion, and emotional problems including depression and anxiety. Education background and level of symptom distress should be taken into consideration when caring for the life impacts of this vulnerable group of women.

  4. Rehabilitation of the short pelvic floor. II: Treatment of the patient with the short pelvic floor.

    Science.gov (United States)

    FitzGerald, M P; Kotarinos, R

    2003-10-01

    Several urogynecologic syndromes are associated with the clinical finding of a short, painful, tender and weak pelvic floor and a variety of connective tissue abnormalities. Techniques for rehabilitation include the avoidance of perpetuating factors, rehabilitation of extrapelvic musculoskeletal abnormalities, the use of manual techniques and needling to promote resolution of connective tissue problems, closure of any diastasis recti, and transvaginal/transrectal manual release of muscular trigger points and contractures. Therapy can be facilitated by pudendal or epidural nerve block. Patients contribute to their success through home maintenance programs.

  5. A randomized clinical trial comparing pelvic floor muscle training to a Pilates exercise program for improving pelvic muscle strength.

    Science.gov (United States)

    Culligan, Patrick J; Scherer, Janet; Dyer, Keisha; Priestley, Jennifer L; Guingon-White, Geri; Delvecchio, Donna; Vangeli, Margi

    2010-04-01

    The purpose of this study is to determine whether a Pilates exercise program and a pelvic floor muscle-training (PFMT) program could provide similar improvements in pelvic muscle strength. Sixty-two women with little or no pelvic floor dysfunction were randomized to Pilates or PFMT. Each group had 24 biweekly 1-h sessions with either a physical therapist or Pilates instructor. Strength was measured via perineometry (cmH(2)O). Two questionnaires--pelvic floor distress inventory (PFDI-20) and pelvic floor impact questionnaire (PFIQ-7)--were also collected. At baseline, the Pilates and PFMT groups measured 14.9 +/- 12.5 and 12.5 +/- 10.4 cmH(2)O, respectively (p = 0.41). Both the Pilates and PFMT groups got stronger (6.2 +/- 7.5 cmH(2)O, p = 0.0002 and 6.6 +/- 7.4 cmH(2)O, p = 0.0002, respectively), with no difference between groups p = 0.85. PFIQ and PFDI scores improved from baseline but not between groups. Further study is required to determine if Pilates can actually treat pelvic floor dysfunction.

  6. Which pediatric blunt trauma patients do not require pelvic imaging?

    Science.gov (United States)

    Haasz, Maya; Simone, Laura A; Wales, Paul W; Stimec, Jennifer; Stephens, Derek; Beno, Suzanne; Schuh, Suzanne

    2015-11-01

    This study aimed to develop a tool in identifying traumatized children at low risk of pelvic fracture and to determine the sensitivity of this low-risk model for pelvic fractures. We hypothesized that the proportion of children without predictors with pelvic fracture is less than 1%. This is a retrospective trauma registry analysis of previously healthy children 1 year to 17 years old presenting to the pediatric emergency department with blunt trauma. Postulated predictors of pelvic fracture on radiograph or computed tomography included pain/abnormal examination result of the pelvis/hip, femur deformity, hematuria, abdominal pain/tenderness, Glasgow Coma Scale (GCS) score of 13 or lower, and hemodynamic instability. We used multivariable logistic regression to identify independent predictors of fracture. Of 1,121 eligible patients (mean [SD] age, 8.5 [4.6] years), 87 (7.8%) had pelvic fracture. Independent predictors included pain/abnormal examination result of the pelvis/hip (odds ratio [OR], 16.7; 95% confidence interval [CI], 9.6-29.1), hematuria (OR, 6.6; 95% CI, 3.0-14.6), femoral deformity (OR, 5.9; 95% CI, 3.1-11.3), GCS score of 13 or lower (OR, 2.4; 95% CI, 1.3-4.3), and hemodynamic instability (OR, 3.4; 95% CI, 1.7-6.9). One of 590 children (0.2%; 95% CI, 0-0.5%) without predictors had pelvic fractures versus 86 (16.2%) of 531 in those with one or more predictors (OR, 119; 95% CI, 16.6-833). One of 87 children with pelvic fractures had no predictors (1.1%; 95% CI, 0-3%). When assuming a 100% radiography rate, this tool saves 53% pelvic radiographs. Children with multiple blunt trauma without pain/abnormal examination result of the pelvis/hip, femur deformity, hematuria, abdominal pain/tenderness, GCS score of 13 or lower, or hemodynamic instability constitute a low-risk population for pelvic fracture, with less than 0.5% risk rate. This population does not require routine pelvic imaging. Therapeutic study, level IV.

  7. Chronic pelvic pain: Pathogenesis and validated assessment

    Directory of Open Access Journals (Sweden)

    Ali Yosef

    2016-12-01

    Full Text Available Chronic pelvic pain (CPP is a disabling disease that causes distress as the quality of life of CPP patients is vastly diminished. In addition, CPP is a public health crisis and is a burden on healthcare expenditure. In the United States, the annual costs for the diagnosis and treatment of CPP are 2.8 billion US $. Moreover, to the indirect cost resulting from the absence from work and CPP associated family problems add 550 million US $ more making the economic burden more than 3.4 billion US $ (Mathias et al., 1996. Yet, the diagnosis of CPP is usually complicated as there are no gold standard guidelines that clearly define this syndrome. Although we have a limited understanding of its etiology, CPP has been found to be correlated with central sensitization, painful bladder syndrome, irritable bowel syndrome, endometriosis and adhesions. As such, in the evaluation of patients, it is imperative to take a comprehensive patient history. Performing physical examinations and ultrasound imaging is of particular value to elucidate the etiology of pain. As CPP patients are at risk for psychological disorders, psychological assessments are critical to diagnose associated psychological disorders and to take these into account in planning a holistic treatment plan for patients. By such evaluation techniques, we can provide better diagnostic service and patient care to people with CPP.

  8. Transvaginal sonography of acute pelvic inflammatory disease

    International Nuclear Information System (INIS)

    Choi, Jin Soo; Kim, Young Hwa; Shin, Hyung Chul; Han, Gun Soo; Kim, Il Young

    1999-01-01

    To determine the value of transvaginal sonography in evaluating women with acute pelvic inflammatory disease (PID). Transvaginal sonography was performed in 25 patients with clinically suggested PID during recent 36 months. The sonographic findings of fallopian tubes and ovaries were analyzed and correlated with pathological findings of 2 fallopian tubes and 19 ovaries in 16 patients who had operations. The correct diagnosis of acute PID was made in 20/25 (80%) by transvaginal sonography. the abnormal sonographic findings of the fallopian tube include tubal thickening or dilatation with internal echo. The sensitivity, specificity, and accuracy for tubal abnormality were 88%, 96%, and 86% , respectively. Ovarian changes were seen on TVS in 14/19 (73%), which include multiple follicular enlargement in 5, tubo-ovarian complex in 9 (tubo-ovarian adhesion in 3, tubo-ovarian abscess in 6). At surgery, the ovay was not involved in all three women who showed tubo-ovarian adhesion on TVS. Among 6 women who showed tubo-ovarian abscess on TVS, tubo-ovarian abscess was confirmed in 3 and the remaining 3 had ovarian cysts. Trandvaginal sonography, a facilitative and accurate modality, is highly sensitive in detecting the abnormality of the tube and useful in differentiating the tubo-ovarian complex in patients with acute PID.

  9. [Pelvic reconstructions after bone tumor resection].

    Science.gov (United States)

    Anract, Philippe; Biau, David; Babinet, Antoine; Tomeno, Bernard

    2014-02-01

    The three more frequent primitive malignant bone tumour which concerned the iliac bone are chondrosarcoma, following Ewing sarcoma and osteosarcoma. Wide resection remains the most important part of the treatment associated with chemotherapy for osteosarcoma and the Ewing sarcoma. Iliac wing resections and obdurate ring don't required reconstruction. However, acetabular resections and iliac wing resection with disruption of the pelvic ring required reconstruction to provide acceptable functional result. Acetabular reconstruction remains high technical demanding challenge. After isolated acetabular resection or associated to obdurate ring, our usual method of reconstruction is homolateral proximal femoral autograft and total hip prosthesis but it is possible to also used : saddle prosthesis, Mac Minn prosthesis with auto or allograft, modular prosthesis or custom made prosthesis, massive allograft with or without prosthesis and femoro-ilac arthrodesis. After resection of the iliac wing plus acetabulum, reconstruction can be performed by femoro-obturatrice and femora-sacral arthrodesis, homolateral proximal femoral autograft and prosthesis, femoral medialisation, massive allograft and massive allograft. Carcinological results are lesser than resection for distal limb tumor, local recurrence rate range 17 to 45%. Functional results after Iliac wing and obdurate ring are good. However, acetabular reconstruction provide uncertain functional results. The lesser results arrive after hemipelvic or acetabular and iliac wing resection-reconstruction, especially when gluteus muscles were also resected. The most favourable results arrive after isolated acetabular or acetabular plus obturateur ring resection-reconstruction.

  10. A pilot randomized controlled trial comparing the efficacy of exercise, spinal manipulation, and neuro emotional technique for the treatment of pregnancy-related low back pain

    Directory of Open Access Journals (Sweden)

    Peterson Caroline D

    2012-06-01

    Full Text Available Abstract Background This pilot randomized controlled trial evaluated the feasibility of conducting a full scale study and compared the efficacy of exercise, spinal manipulation, and a mind-body therapy called Neuro Emotional Technique for the treatment of pregnancy-related low back pain, a common morbidity of pregnancy. Methods Healthy pregnant women with low back pain of insidious onset were eligible to enroll in the study at any point in their pregnancy. Once enrolled, they remained in the study until they had their babies. Women were randomly allocated into one of three treatment groups using opaque envelopes. The treatment schedule paralleled the prenatal care schedule and women received individualized intervention. Our null hypothesis was that spinal manipulation and Neuro Emotional Technique would perform no better than exercise in enhancing function and decreasing pain. Our primary outcome measure was the Roland Morris Disability Questionnaire and our secondary outcome measure was the Numeric Pain Rating Scale. Intention to treat analysis was conducted. For the primary analysis, regression was conducted to compare groups on the outcome measure scores. In a secondary responder analysis, difference in proportions of participants in attaining 30% and 50% improvement were calculated. Feasibility factors for conducting a future larger trial were also evaluated such as recruitment, compliance to study protocols, cost, and adverse events. Results Fifty-seven participants were randomized into the exercise (n = 22, spinal manipulation (n = 15, and Neuro Emotional Technique (n = 20 treatment arms. At least 50% of participants in each treatment group experienced clinically meaningful improvement in symptoms for the Roland Morris Disability Questionnaire. At least 50% of the exercise and spinal manipulation participants also experienced clinically meaningful improvement for the Numeric Pain Rating Scale. There were no clinically

  11. Direct and indirect costs of surgically treated pelvic fractures.

    Science.gov (United States)

    Aprato, Alessandro; Joeris, Alexander; Tosto, Ferdinando; Kalampoki, Vasiliki; Stucchi, Alessandro; Massè, Alessandro

    2016-03-01

    Pelvic fractures requiring surgical fixation are rare injuries but present a great societal impact in terms of disability, as well as economic resources. In the literature, there is no description of these costs. Main aim of this study is to describe the direct and indirect costs of these fractures. Secondary aims were to test if the type of fracture (pelvic ring injury or acetabular fracture) influences these costs (hospitalization, consultation, medication, physiotherapy sessions, job absenteeism). We performed a retrospective study on patients with surgically treated acetabular fractures or pelvic ring injuries. Medical records were reviewed in terms of demographic data, follow-up, diagnosis (according to Letournel and Tile classifications for acetabular and pelvic fractures, respectively) and type of surgical treatment. Patients were interviewed about hospitalization length, consultations after discharge, medications, physiotherapy sessions and absenteeism. The study comprised 203 patients, with a mean age of 49.1 ± 15.6 years, who had undergone surgery for an acetabular fracture or pelvic ring injury. The median treatment costs were 29.425 Euros per patient. Sixty percent of the total costs were attributed to health-related work absence. Median costs (in Euros) were 2.767 for hospitalization from trauma to definitive surgery, 4.530 for surgery, 3.018 for hospitalization in the surgical unit, 1.693 for hospitalization in the rehabilitation unit, 1.920 for physiotherapy after discharge and 402 for consultations after discharge. Total costs for treating pelvic ring injuries were higher than for acetabular fractures, mainly due to the significant higher costs of pelvic injuries regarding hospitalization from trauma to definitive surgery (p fractures are associated with both high direct costs and substantial productivity loss.

  12. Poor Utility of Gonadal Shielding for Pediatric Pelvic Radiographs.

    Science.gov (United States)

    Lee, Mark C; Lloyd, Jessica; Solomito, Matthew J

    2017-07-01

    Plain pelvic radiographs are commonly used for a variety of pediatric orthopedic disorders. Lead shielding is typically placed over the gonads to minimize radiation exposure to these sensitive tissues. However, misplaced shielding can sabotage efforts to protect patients from excessive radiation exposure either by not covering radiosensitive tissues or by obscuring anatomic areas of interest, prompting repeat radiographic examinations. The goal of this study was to determine the incidence of misplaced shielding for pelvic radiographs obtained for pediatric orthopedic evaluation. Children 8 to 16 years old who had an anteroposterior or frog lateral pelvic radiograph between 2008 and 2014 were included. A total of 3400 patients met the inclusion criteria, and 84 boys and 84 girls were randomly selected for review. For both boys and girls, the percentage of incorrectly positioned or missing shields was calculated. Chi-square testing was used to compare the frequency of missing or incorrectly placed shields between sexes and age groups. Pelvic shields were misplaced in 49% of anteroposterior and 63% of frog lateral radiographs. Shielding was misplaced more frequently for girls than for boys on frog lateral radiographs (76% vs 51%; P<.05). Pelvic bony landmarks were often obscured by pelvic shielding, with a frequency of 7% to 43%, depending on the specific landmark. The femoral head and acetabulum were obscured by shielding in up to 2% of all images. The findings suggest that accepted pelvic shielding protocols are ineffective. Consideration should be given to alternative protocols or abandonment of this practice. [Orthopedics. 2017; 40(4):e623-e627.]. Copyright 2017, SLACK Incorporated.

  13. Muscle function of the pelvic floor in healthy, puerperal women with pelvic floor dysfunction.

    Science.gov (United States)

    Castro-Pardiñas, M A; Torres-Lacomba, M; Navarro-Brazález, B

    2017-05-01

    To understand the function of the pelvic floor muscles (PFM) at different ages in healthy women and in puerperal women with pelvic floor dysfunctions (PFD) and to ascertain whether there are differences among them. A descriptive cross-sectional study was conducted between June 2014 and September 2016 and included 177 women, 70 of whom had no symptoms of PFD, 53 primiparous mothers in late postpartum and 54 with PFD. The function of the PFM was measured through vaginal palpation (quality of the contraction); manometry (force); dynamometer (tone, strength, and response to stretching), and surface electromyography (neuromuscular activity and resistance). The healthy women showed superior values for PFM tone, maximum strength, neuromuscular activity and resistance than the puerperal mothers and the women with PFD (P.05). The muscle function of the healthy women did not vary significantly with age, except in the case of tone, which was lower in the women older than 46 years (P=.004). Age and births decrease the baseline tone of the PFM in healthy women. Therefore, lower strength, resistance and neuromuscular activity appear to be the main difference between the PFM of women with PFD and the PFM of healthy women. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Spine lateral flexion strength development differences between exercises with pelvic stabilization and without pelvic stabilization

    Science.gov (United States)

    Straton, Alexandru; Gidu, Diana Victoria; Micu, Alexandru

    2015-02-01

    Poor lateral flexor muscle strength can be an important source of lumbar/thoracic back pain in women. The purpose of this study was to evaluate pelvic stabilization (PS) and no pelvic stabilization (NoPS) lateral flexion strength exercise training on the development of isolated right and left lateral flexion strength. Isometric torque of the isolated right and left lateral flexion muscles was measured at two positions (0° and 30° opposed angle range of motion) on 42 healthy women before and after 8 weeks of PS and NoPS lateral flexion strength exercise training. Subjects were assigned in three groups, the first (n=14) trained 3 times/week with PS lateral flexion strength exercise, the second (n=14) trained 3 times/week with NoPS lateral flexion strength exercise and the third (control, n=14) did not train. Post training isometric strength values describing PS and NoPS lateral flexion strength improved in greater extent for the PS lateral flexion strength exercise group and in lesser extent for the NoPS lateral flexion strength exercise group, in both angles (pstrength exercises; NoPS lateral flexion strength exercises can be an effective way of training for the spine lateral flexion muscles, if there is no access to PS lateral flexion strength training machines.

  15. Demand dynamic bio-girdling in heart failure: improved efficacy of dynamic cardiomyoplasty by LD contraction during aortic out-flow.

    Science.gov (United States)

    Carraro, U; Rigatelli, G; Rossini, K; Barbiero, M; Rigatelli, G

    2003-03-01

    The value of dynamic cardiomyoplasty has been brought into question by the disappointing results produced by slow contraction-relaxation cycle and possibly degeneration of the latissimus dorsi muscle (LD) secondary to temporary tenotomy and chronic daily electrical stimulation. Objective of our study is to determine whether daily periods of rest introduced by demand stimulation in the continuous contraction protocol produce systolic assistance and improve clinical results. Twelve dynamic cardiomyoplasty patients (mean age 58.2 +/- 5.8 years, M/F=11/1, sinus rhythm/atrial fibrillation=11/1) with dilated myocardiopathy were enrolled in an unrandomized trial of Demand Dynamic Heart Bio-Girdling in a public regional teaching hospital. Periods of LD inactivity, each lasting several hours, were introduced daily on a heart rate-based demand regime. To avoid full transformation of LD, fewer impulses per day were delivered, daily providing the LD with long periods of rest (Demand light stimulation). The contractile properties were measured by transcutaneous non-invasive LD tensiomyogram interrogation (LD tensiomyogram). Bio-Girdle activation was synchronized to heart beat by combining tensiomyogram and echocardiography. Clinical, echocardiographic and hemodynamic records, as well as aortic flow measurements by Doppler aortic flow wire were taken during the follow-up. Mean duration of the demand stimulation follow-up was 40.2+13.8 months. At five years, "Demand stimulation" shows: 1) no operative death; 2) 83% actuarial survival; 3) highly significant 47.4% decrease of the NYHA class (from 3.17 +/- 0.38 to 1.67 +/- 0.77, p=0.0001); 4) 41.6% improvement of LVEF (from 22.6 +/- 4.38 to 32.0 +/- 7.0, p=0.001); 5) 7.5 +/- 3.0% increase in aortic flow velocity peak in assisted vs. unassisted beats, and 6) preservation of LD from slowness (TFF value 33 +/- 7.86 at follow-up versus 15.8 +/- 11.1 Hz just before switching from continuous to demand stimulation, p=0.0001) and muscle

  16. Automated Localization of Multiple Pelvic Bone Structures on MRI.

    Science.gov (United States)

    Onal, Sinan; Lai-Yuen, Susana; Bao, Paul; Weitzenfeld, Alfredo; Hart, Stuart

    2016-01-01

    In this paper, we present a fully automated localization method for multiple pelvic bone structures on magnetic resonance images (MRI). Pelvic bone structures are at present identified manually on MRI to locate reference points for measurement and evaluation of pelvic organ prolapse (POP). Given that this is a time-consuming and subjective procedure, there is a need to localize pelvic bone structures automatically. However, bone structures are not easily differentiable from soft tissue on MRI as their pixel intensities tend to be very similar. In this paper, we present a model that combines support vector machines and nonlinear regression capturing global and local information to automatically identify the bounding boxes of bone structures on MRI. The model identifies the location of the pelvic bone structures by establishing the association between their relative locations and using local information such as texture features. Results show that the proposed method is able to locate the bone structures of interest accurately (dice similarity index >0.75) in 87-91% of the images. This research aims to enable accurate, consistent, and fully automated localization of bone structures on MRI to facilitate and improve the diagnosis of health conditions such as female POP.

  17. The Relationship Between Foot and Pelvic Alignment While Standing

    Directory of Open Access Journals (Sweden)

    Khamis Sam

    2015-06-01

    Full Text Available A normal motion and segmental interrelationship has been determined as a significant factor in normal function. Yet, the relationship between distal segments and pelvic alignment needs further investigation. The aim of this study was to investigate the interrelationship between distal and proximal lower extremity segments while standing and during induced feet hyperpronation. Changes in alignment of the pelvis and lower extremities were measured at a gait laboratory using the VICON 612 computerized motion analysis system. Thirty-five healthy volunteer subjects were recruited. Four randomized repeated-measure standing modes were used: standing directly on the floor and then on three wedges angled at 10°, 15° and 20° to induce bilateral hyperpronation for 20 seconds. A significant (p<0.05 bi-variate relationship was found between the anterior pelvic tilt and thigh internal rotation, in all four standing positions (.41≤r≤.46, in all p<0.014. A combined effect of rotational alignment between segments and the cumulative effect of foot hyperpronation on pelvic tilt revealed that only the shank significantly affected pelvic alignment, acting as a mediator between a foot and a thigh with the thigh having a crude significant effect on the pelvis. When internal rotation of the shank occurs, calcaneal eversion couples with thigh internal rotation and anterior pelvic tilt. It can be concluded that in response to induced hyperpronation, the shank is a pivotal segment in postural adjustment.

  18. Does Attorney Advertising Influence Patient Perceptions of Pelvic Mesh?

    Science.gov (United States)

    Tippett, Elizabeth; King, Jesse; Lucent, Vincent; Ephraim, Sonya; Murphy, Miles; Taff, Eileen

    2018-01-01

    To measure the relative influence of attorney advertising on patient perceptions of pelvic mesh compared with a history of surgery and a first urology visit. A 52-item survey was administered to 170 female patients in 2 urology offices between 2014 and 2016. Multiple survey items were combined to form scales for benefit and risk perceptions of pelvic mesh, perceptions of the advertising, attitudes toward pelvic mesh, and knowledge of pelvic mesh and underlying medical conditions. Data were analyzed using hierarchical linear regression models. Exposure to attorney advertising was quite high; 88% reported seeing a mesh-related attorney advertisement in the last 6 months. Over half of patients reported seeing attorney advertisements more than once per week. A history of prior mesh implant surgery was the strongest predictor of benefit and risk perceptions of pelvic mesh. Exposure to attorney advertising was associated with higher risk perceptions but did not significantly affect perceptions of benefits. Past urologist visits increased perceptions of benefits but had no effect on risk perceptions. Attorney advertising appears to have some influence on risk perceptions, but personal experience and discussions with a urogynecologist or urologist also influence patient perceptions. Implications, limitations, and future research are discussed. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Pelvic Floor Muscle Training: Underutilization in the USA.

    Science.gov (United States)

    Lamin, Eliza; Parrillo, Lisa M; Newman, Diane K; Smith, Ariana L

    2016-02-01

    Pelvic floor disorders are highly prevalent in women of all ages and can greatly impair quality of life. Pelvic floor muscle training (PFMT) is a viable treatment option for several pelvic floor conditions including urinary incontinence and pelvic organ prolapse. PFMT is a program of therapy initiated by an experienced clinician (e.g., women's health or urology nurse practitioner (NP), physical therapist (PT)) that involves exercises for women with stress urinary incontinence (UI) and exercises combined with behavioral or conservative treatments (lifestyle changes, bladder training with urge suppression) for women with urgency or mixed UI. These exercise programs are more comprehensive than simple Kegel exercises. Despite evidence-based research indicating the efficacy and cost-effectiveness for treatment of urinary incontinence, PFMT is not commonly used as a first-line treatment in clinical practice in the USA (Abrams et al., 2012). This article will review PFMT for the treatment of UI and pelvic organ prolapse (POP) and theorize how this conservative therapy can be utilized more effectively in the USA.

  20. Management of Severe Perineal Injuries in Major Pelvic Fractures

    Directory of Open Access Journals (Sweden)

    A Jangjoo

    2009-01-01

    Full Text Available Introduction: Significant perineal injuries and major pelvic fractures resulting from blunt trauma manifest a high-energy injury. Open pelvic fractures (with perineal injury are associated with higher mortality rates of 40 to 60 %. Methods: This study was a review of patients with multiple traumas comprising of major pelvic fracture and severe perineal injuries (Shahid Kamyab hospital in Mashhad from 2002- 2005. A total of 11 patients, with pelvic fracture and perineal injuries (injury to urethra and anal canal were entered in the study. The data was gathered by a checklist and analyzed with SPSS software. Results: The population under study included 11 patients (9 male, 2 female with a mean age of 35years. Cause of trauma in all patients was motor vehicle accidents. All of the patients in the first 6 hours of admission received at least 4 liters of serum ringer lactate and 3 units of packed cells. The mean of packed cell received was 8 units and one patient needed 21 units of packed cells. All of patients were taken to the operating room for diverting colostomy, distal rectal washout, cystostomy and radical debridment and irrigation of devitalized tissue. Good results were achieved in 9 patients and there was one case of mortality and one morbidity (ARF. Conclusion: Open pelvic fractures and perineal injuries are associated with higher mortality rates. Prompt diagnosis and proper treatment (reanimation, colostomy, cystostomy, debridment and irrigation is the key to success.

  1. Management of disorders of the posterior pelvic floor.

    Science.gov (United States)

    Berman, Loren; Aversa, John; Abir, Farshad; Longo, Walter E.

    2005-01-01

    INTRODUCTION: Constipation is a relatively common problem affecting 15 percent of adults in the Western world, and over half of these cases are related to pelvic floor disorders. This article reviews the clinical presentation and diagnostic approach to posterior pelvic floor disorders, including how to image and treat them. METHODS: A Pubmed search using keywords "rectal prolapse," "rectocele," "perineal hernia," and "anismus" was performed, and bibliographies of the revealed articles were cross-referenced to obtain a representative cross-section of the literature, both investigational studies and reviews, that are currently available on posterior pelvic floor disorders. DISCUSSION: Pelvic floor disorders can occur with or without concomitant physical anatomical defects, and there are a number of imaging modalities available to detect such abnormalities in order to decide on the appropriate course of treatment. Depending on the nature of the disorder, operative or non-operative therapy may be indicated. CONCLUSION: Correctly diagnosing pelvic floor disorders can be complex and challenging, and the various imaging modalities as well as clinical history and exam must be considered together in order to arrive at a diagnosis. PMID:16720016

  2. International Continence Society supported pelvic physiotherapy education guideline.

    Science.gov (United States)

    Bakker, Els; Shelly, Beth; Esch, Fetske H; Frawley, Helena; McClurg, Doreen; Meyers, Peter

    2018-02-01

    To provide a guideline of desired knowledge, clinical skills and education levels in Pelvic Physiotherapy (PT). Physiotherapy (PT) involves "using knowledge and skills unique to physiotherapists" and, "is the service only provided by, or under the direction and supervision of a physiotherapist." 1 METHODS: The PT Committee, within the body of the International Continence Society (ICS), collected information regarding existing educational levels for pelvic floor PT. Through face to face and on on-line discussion consensus was reached which was summarized in three progressive educational levels based on knowledge and skills and brought together in a guideline. The guideline was submitted to all physiotherapists and the Educational Committee of the ICS, and after approval, submitted to the Executive Board of the ICS. The guideline lists, in a progressive way, knowledge areas and skills to be achieved by education. It is broad and allows for individual interpretation based on local situations regarding education and healthcare possibilities. It is intended to be dynamic and updated on a regular basis. The proposed Pelvic PT education guideline is a dynamic document that allows course creators to plan topics for continuing course work and to recognize educational level of a therapist in the field of Pelvic PT. This education guideline can be used to set minimum worldwide standards resulting in higher skill levels for local pelvic physiotherapists and thereby better patient care outcome. © 2018 Wiley Periodicals, Inc.

  3. Insufficiency Fractures After Pelvic Radiotherapy in Patients With Prostate Cancer

    International Nuclear Information System (INIS)

    Igdem, Sefik; Alco, Guel; Ercan, Tuelay; Barlan, Metin; Ganiyusufoglu, Kuersat; Unalan, Buelent; Turkan, Sedat; Okkan, Sait

    2010-01-01

    Purpose: To assess the incidence, predisposing factors, and clinical characteristics of insufficiency fractures (IF) in patients with prostate cancer, who received pelvic radiotherapy as part of their definitive treatment. Methods and Materials: The charts of 134 prostate cancer patients, who were treated with pelvic radiotherapy between 1998 and 2007 were retrospectively reviewed. IF was diagnosed by bone scan and/or CT and/or MRI. The cumulative incidence of symptomatic IF was estimated by actuarial methods. Results: Eight patients were identified with symptomatic IF after a median follow-up period of 68 months (range, 12-116 months). The 5-year cumulative incidence of symptomatic IF was 6.8%. All patients presented with lower back pain. Insufficiency fracture developed at a median time of 20 months after the end of radiotherapy and was managed conservatively without any need for hospitalization. Three patients were thought to have metastatic disease because of increased uptake in their bone scans. However, subsequent CT and MR imaging revealed characteristic changes of IF, avoiding any further intervention. No predisposing factors for development of IF could be identified. Conclusions: Pelvic IF is a rare complication of pelvic radiotherapy in prostate cancer. Knowledge of pelvic IF is essential to rule out metastatic disease and prevent unnecessary treatment, especially in a patient cohort with high-risk features for distant spread.

  4. Utilization of Human-Like Pelvic Rotation for Running Robot

    Directory of Open Access Journals (Sweden)

    Takuya eOtani

    2015-07-01

    Full Text Available The spring loaded inverted pendulum (SLIP is used to model human running. It is based on a characteristic feature of human running, in which the linear-spring-like motion of the standing leg is produced by the joint stiffness of the knee and ankle. Although this model is widely used in robotics, it does not include human-like pelvic motion. In this study, we show that the pelvis actually contributes to the increase in jumping force and absorption of landing impact. On the basis of this finding, we propose a new model, SLIP2 (spring loaded inverted pendulum with pelvis, to improve running in humanoid robots. The model is composed of a body mass, a pelvis, and leg springs, and, it can control its springs while running by use of pelvic movement in the frontal plane. To achieve running motions, we developed a running control system that includes a pelvic oscillation controller to attain control over jumping power and a landing placement controller to adjust the running speed. We also developed a new running robot by using the SLIP2 model and performed hopping and running experiments to evaluate the model. The developed robot could accomplish hopping motions only by pelvic movement. The results also established that the difference between the pelvic rotational phase and the oscillation phase of the vertical mass displacement affects the jumping force. In addition, the robot demonstrated the ability to run with a foot placement controller depending on the reference running speed.

  5. Risk factors related to interfractional variation in whole pelvic irradiation for locally advanced pelvic malignancies

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    Yoon, W.S.; Yang, D.S.; Lee, J.A.; Lee, S.; Park, Y.J.; Kim, C.Y. [Korea Univ. Medical Center, Seoul (Korea, Republic of). Dept. of Radiation Oncology

    2012-05-15

    Purpose: The goal of the present study was to demonstrate risk factors affecting the interfractional variation in whole pelvic irradiation. Patients and methods: Daily image acquisitions of 101 patients with locally advanced pelvic malignancy were undertaken using a kilo-voltage orthogonal on-board imager. The baseline deviation (the shift between the initial treatment and each fraction; Value{sub Base}) and day-to-day variation (the shift between the previous treatment and each fraction; Value{sub DD}) were measured. The standard deviations (SD) along the x- (right-left), y- (cranial-caudal), and z- (anterior-posterior) axes (SD[x], SD[y], and SD[z], respectively), the 3D vector of the SD (SD[3D]), and the mean of 3D shift (mean[3D]) were calculated in each patient. Various clinical factors, lumbar pelvic balance and rotation, and the shift of 5 consecutive fractions from the initial treatment (Value{sub 5Fx}) were investigated as risk factors. Results: The prone set-up showed a larger mean{sub Base}[3D] than in the supine position (p =0.063). A body mass index (BMI) {>=} 30 kg/m{sup 2} resulted in the largest mean{sub DD}[3D] (p = 0.078) and SD{sub DD}[3D] (p = 0.058). All the SD{sub 5Fx} along the x-, y-, and z-axes had moderate linear relationships with SD{sub Base} and SD{sub DD} (p < 0.001). The SD{sub 5Fx}[3D] also had a moderate linear relationship with the mean{sub Base}[3D], mean{sub DD}[3D], SD{sub Base}[3D], and SD{sub DD}[3D] (p < 0.001). In multivariate analysis, the SD{sub 5Fx} had the same significant relationship with SD{sub Base} and SD{sub DD} (p < 0.001). A BMI {>=} 30 kg/m{sup 2} was associated with the largest SD{sub DD}[x] (p = 0.003). Conclusion: Close surveillance through high-quality and frequent image guidance is recommended for patients with extensive variations of the initial five consecutive fractions or obesity. (orig.)

  6. Distinguishing benign and malignant pelvic masses : The value of different diagnostic methods in everyday clinical practice

    NARCIS (Netherlands)

    Engelen, Mirjam J. A.; Bongaerts, Alphons H. H.; Sluiter, Wim J.; De Haan, Harm H.; Bogchelman, Dick H.; TenVergert, Els M.; Willemse, Pax H. B.; van der Zee, Ate G. J.

    Objective: To optimize referral to specialized gynaecologists for surgical treatment of ovarian cancer by improving preoperative discrimination between benign and malignant pelvic tumours. Study design: In a prospective multicentre study 143 patients with a pelvic mass were included. At several

  7. Sentinel lymph node imaging guided IMRT for prostate cancer: Individualized pelvic radiation therapy versus RTOG guidelines

    Directory of Open Access Journals (Sweden)

    Chien P. Chen, MD, PhD

    2016-01-01

    Conclusions: SLN-guided pelvic radiation therapy can be used to either treat the most critical nodes only or as an addition to RTOG guided pelvic radiation therapy to ensure that the most important nodes are included.

  8. Introduction to the feature section on functional imaging of the pelvic floor.

    Science.gov (United States)

    Maccioni, Francesca

    2013-10-01

    This is the introduction to the feature section of functional imaging of the pelvic floor, which includes 6 articles, two focused on clinical issues, while four on radiological aspects, mostly on dynamic pelvic floor MRI.

  9. SPECIFIC FEATURES OF THE THEMATIC MATERIAL AND TEXTURE IN THE FANTASY FOR TWO PIANOS BRYUL LUI AMIHALACHIOAIE (AMIHALACHIOAIE’S GIRDLE BY VLAD BURLEA

    Directory of Open Access Journals (Sweden)

    MAMALÂGA MARINA

    2016-06-01

    Full Text Available The article analyzes the fantasy „Bryul lui M. Amihalachioaie” (Amihalachioaie’s Girdle for two pianos composed by Vlad Burlea as the only example of this genre in his creative activity. This work is analyzed from the perspective of genre specificity, determined by the synthesis of the fantasy genre and the monumental miniature, revealing the interaction of variation and improvisation. The author comes to the conclusion that V. Burlea’s creation is characterized by a truthful realization of the language elements of national music, and namely that of the Moldovan dance. The article also considers the form and content of the present work, its intonation-thematic processes and the treatment of the two-piano ensemble that imitates the sound of the dulcimer.

  10. Protein Turnover and Cellular Stress in Mildly and Severely Affected Muscles from Patients with Limb Girdle Muscular Dystrophy Type 2I

    DEFF Research Database (Denmark)

    Hauerslev, Simon; Sveen, Marie-Louise; Vissing, John

    2013-01-01

    Patients with Limb girdle muscular dystrophy type 2I (LGMD2I) are characterized by progressive muscle weakness and wasting primarily in the proximal muscles, while distal muscles often are spared. Our aim was to investigate if wasting could be caused by impaired regeneration in the proximal...... by using the developmental markers embryonic myosin heavy chain (eMHC) and neural cell adhesion molecule (NCAM) and also assessing satellite cell activation status by myogenin positivity. Severe muscle histopathology was occasionally observed in the proximal muscles of patients with LGMD2I whereas distal...... highly increased in severely affected muscles compared to mildly affected muscles. Our results indicate that alterations in the protein turnover and myostatin levels could progressively impair the muscle mass maintenance and/or regeneration resulting in gradual muscular atrophy....

  11. A New Mouse Model of Limb-Girdle Muscular Dystrophy Type 2I Homozygous for the Common L276I Mutation Mimicking the Mild Phenotype in Humans

    DEFF Research Database (Denmark)

    Krag, Thomas O; Vissing, John

    2015-01-01

    Limb-girdle muscular dystrophy type 2I (LGMD2I) is caused by mutations in the Fukutin-related protein (FKRP) gene, leading to inadequate glycosylation of α-dystroglycan, an important protein linking the extracellular matrix to the cytoskeleton. We created a mouse model of the common FKRP L276I...... mutation and a hemizygous FKRP L276I knockout model. We studied histopathology and protein expression in the models at different ages and found that homozygous FKRP L276I mice developed a mild progressive myopathy with increased muscle regeneration and fibrosis starting from 1 year of age. This was likely...... in maintaining proper glycosylation of α-dystroglycan. The mild progression in the homozygous FKRP L276I model resembles that in patients with LGMD2I who are homozygous for the L276I mutation. This animal model could, therefore, be relevant for understanding the pathophysiology of and developing a treatment...

  12. Prediction of pelvic organ prolapse using an artificial neural network.

    Science.gov (United States)

    Robinson, Christopher J; Swift, Steven; Johnson, Donna D; Almeida, Jonas S

    2008-08-01

    The objective of this investigation was to test the ability of a feedforward artificial neural network (ANN) to differentiate patients who have pelvic organ prolapse (POP) from those who retain good pelvic organ support. Following institutional review board approval, patients with POP (n = 87) and controls with good pelvic organ support (n = 368) were identified from the urogynecology research database. Historical and clinical information was extracted from the database. Data analysis included the training of a feedforward ANN, variable selection, and external validation of the model with an independent data set. Twenty variables were used. The median-performing ANN model used a median of 3 (quartile 1:3 to quartile 3:5) variables and achieved an area under the receiver operator curve of 0.90 (external, independent validation set). Ninety percent sensitivity and 83% specificity were obtained in the external validation by ANN classification. Feedforward ANN modeling is applicable to the identification and prediction of POP.

  13. Organising a clinical service for patients with pelvic floor disorders.

    Science.gov (United States)

    Chatoor, Dave; Soligo, Marco; Emmanuel, Anton

    2009-01-01

    The evolution of the multidisciplinary approach to the management of chronic conditions is a reflection of how medicine has evolved from a singular to a plural effort recognising the complex causations and consequences of such disorders. This thinking should not be confined to tertiary centres alone and should be adapted where local expertise is available. Such an approach is especially important in pelvic floor disorders, where the correlation between structure and function is not always straightforward. There is a need to avoid over-investigation by accurate clinical assessment allied to tailored investigation, leading to a step-wise approach to treatment (which may include behavioural, physiotherapy, medical or surgical management). The algorithms here on faecal incontinence, obstetric trauma, pelvic floor prolapse and chronic pelvic pain attempt to provide such a logical approach to patients.

  14. Magnetic resonance imaging in deep pelvic endometriosis: iconographic essay

    International Nuclear Information System (INIS)

    Coutinho Junior, Antonio Carlos; Coutinho, Elisa Pompeu Dias; Lima, Claudio Marcio Amaral de Oliveira; Ribeiro, Erica Barreiros; Aidar, Marisa Nassar; Gasparetto, Emerson Leandro

    2008-01-01

    Endometriosis is characterized by the presence of normal endometrial tissue outside the uterine cavity. In patients with deep pelvic endometriosis, uterosacral ligaments, rectum, rectovaginal septum, vagina or bladder may be involved. Clinical manifestations may be variable, including pelvic pain, dysmenorrhea, dyspareunia, urinary symptoms and infertility. Complete surgical excision is the gold standard for treating this disease, and hence the importance of the preoperative work-up that usually is limited to an evaluation of sonographic and clinical data. Magnetic resonance imaging is of paramount importance in the diagnosis of endometriosis, considering its high accuracy in the identification of lesions intermingled with adhesions, and in the determination of peritoneal lesions extent. The present pictorial review describes the main magnetic resonance imaging findings in deep pelvic endometriosis. (author)

  15. Magnetic resonance imaging in deep pelvic endometriosis: iconographic essay

    Energy Technology Data Exchange (ETDEWEB)

    Coutinho Junior, Antonio Carlos; Coutinho, Elisa Pompeu Dias; Lima, Claudio Marcio Amaral de Oliveira; Ribeiro, Erica Barreiros; Aidar, Marisa Nassar [Clinica de Diagnostico por Imagem (CDPI), Rio de Janeiro, RJ (Brazil); Clinica Multi-Imagem, Rio de Janeiro, RJ (Brazil); E-mail: cmaol@br.inter.net; Gasparetto, Emerson Leandro [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Dept. de Radiologia

    2008-03-15

    Endometriosis is characterized by the presence of normal endometrial tissue outside the uterine cavity. In patients with deep pelvic endometriosis, uterosacral ligaments, rectum, rectovaginal septum, vagina or bladder may be involved. Clinical manifestations may be variable, including pelvic pain, dysmenorrhea, dyspareunia, urinary symptoms and infertility. Complete surgical excision is the gold standard for treating this disease, and hence the importance of the preoperative work-up that usually is limited to an evaluation of sonographic and clinical data. Magnetic resonance imaging is of paramount importance in the diagnosis of endometriosis, considering its high accuracy in the identification of lesions intermingled with adhesions, and in the determination of peritoneal lesions extent. The present pictorial review describes the main magnetic resonance imaging findings in deep pelvic endometriosis. (author)

  16. The Number of Positive Pelvic Lymph Nodes and Multiple Groups of Pelvic Lymph Node Metastasis Influence Prognosis in Stage IA-IIB Cervical Squamous Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Yu Liu

    2015-01-01

    Full Text Available Background: Pelvic lymph node metastasis (LNM is an important prognostic factor in cervical cancer. Cervical squamous cell carcinoma accounts for approximately 75-80% of all cervical cancers. Analyses of the effects of the number of positive lymph nodes (LNs, unilateral versus bilateral pelvic LNM and a single group versus multiple groups of pelvic LNM on survival and recurrence of cervical squamous cell carcinoma are still lacking. The study aimed to analyze the effects of the number of positive pelvic LNs and a single group versus multiple groups of pelvic LNM on survival and recurrence. Methods: We performed a retrospective review of 296 patients diagnosed with Stage IA-IIB cervical squamous cell carcinoma who received extensive/sub-extensive hysterectomy with pelvic lymphadenectomy/pelvic LN sampling at Peking University People′s Hospital from November 2004 to July 2013. Ten clinicopathological variables were evaluated as risk factors for pelvic LNM: Age at diagnosis, gravidity, clinical stage, histological grade, tumor diameter, lymph-vascular space involvement (LVSI, depth of cervical stromal invasion, uterine invasion, parametrial invasion, and neoadjuvant chemotherapy. Results: The incidence of pelvic LNM was 20.27% (60/296 cases. Pelvic LNM (P = 0.00 was significantly correlated with recurrence. Pelvic LNM (P = 0.00, the number of positive pelvic LNs (P = 0.04 and a single group versus multiple groups of pelvic LNM (P = 0.03 had a significant influence on survival. Multivariate analysis revealed that LVSI (P = 0.00, depth of cervical stromal invasion (P = 0.00 and parametrial invasion (P = 0.03 were independently associated with pelvic LNM. Conclusions: Patients with pelvic LNM had a higher recurrence rate and poor survival outcomes. Furthermore, more than 2 positive pelvic LNs and multiple groups of pelvic LNM appeared to identify patients with worse survival outcomes in node-positive IA-IIB cervical squamous cell carcinoma. LVSI

  17. Chronic pelvic pain in women of reproductive and post-reproductive age: a population-based study.

    Science.gov (United States)

    Ayorinde, A A; Bhattacharya, S; Druce, K L; Jones, G T; Macfarlane, G J

    2017-03-01

    Epidemiological studies on chronic pelvic pain (CPP) have focused on women of reproductive age. We aimed to determine the prevalence of chronic pelvic pain (CPP) in adult women and the differences in associated factors among women of reproductive age and older women. In addition, to determine whether distinct subgroups existed among CPP cases. A cross-sectional postal survey was conducted among 5300 randomly selected women aged ≥25 years resident in the Grampian region, UK. Multivariable logistic regression was used to determine pregnancy-related and psychosocial factors associated with CPP. To identify subgroups of CPP cases, we performed cluster analysis using variables of pain severity, psychosocial factors and pain coping strategies. Of 2088 participants, 309 (14.8%) reported CPP. CPP was significantly associated with being of reproductive age (odds ratios (OR) 2.43, 95% CI 1.69-3.48), multiple non-pain somatic symptoms (OR 3.58 95% CI 2.23-5.75), having fatigue (OR mild 1.74 95% CI 1.24-2.44, moderate/severe 1.82, 95% CI 1.25-2.63) and having depression (OR 1.61, 95% CI 1.09-2.38). CPP was less associated with multiple non-pain somatic symptoms in women of reproductive age compared to older women (interaction OR 0.51, 95% CI 0.28-0.92). We identified two clusters of CPP cases; those having little/no psychosocial distress and those having high psychosocial distress. CPP is common in both age groups, though women of reproductive age are more likely to report it. Heightened somatic awareness may be more strongly associated with CPP in older women. There are distinct groups of CPP cases characterized by the absence/presence of psychosocial distress. Heightened somatic awareness may be more strongly associated with CPP in women of post-reproductive years compared to women of reproductive years. Two subgroups of CPP cases can be differentiated by the absence/presence of psychosocial distress suggesting that stratified management approach may be more efficient.

  18. Adult Neandertal clavicles from the El Sidrón site (Asturias, Spain) in the context of Homo pectoral girdle evolution.

    Science.gov (United States)

    Rosas, Antonio; Rodriguez-Perez, Francisco Javier; Bastir, Markus; Estalrrich, Almudena; Huguet, Rosa; García-Tabernero, Antonio; Pastor, Juan Francisco; de la Rasilla, Marco

    2016-06-01

    We undertook a three-dimensional geometric morphometric (3DGM) analysis on 12 new Neandertal clavicle specimens from the El Sidrón site (Spain), dated to 49,000 years ago. The 3DGM methods were applied in a comparative framework in order to improve our understanding of trait polarity in features related to Homo pectoral girdle evolution, using other Neandertals, Homo sapiens, Pan, ATD6-50 (Homo antecessor), and KNM-WT 15000 (Homo ergaster/erectus) in the reference collection. Twenty-nine homologous landmarks were measured for each clavicle. Variation and morphological similarities were assessed through principal component analysis, conducted separately for the complete clavicle and the diaphysis. On average, Neandertal clavicles had significantly larger muscular entheses, double dorsal curvature, clavicle torsion, and cranial orientation of the acromial end than non-Neandertal clavicles; the El Sidrón clavicles fit this pattern. Variation within the samples was large, with extensive overlap between Homo species; only chimpanzee specimens clearly differed from the other specimens in morphometric terms. Taken together, our morphometric analyses are consistent with the following phylogenetic sequence. The primitive condition of the clavicle is manifest in the cranial orientation of both the acromial and sternal ends. The derived condition expressed in the H. sapiens + Neandertal clade is defined by caudal rotation of both the sternal and acromial ends, but with variation in the number of acromia remaining in a certain cranial orientation. Finally, the autapomorphic Neandertal condition is defined by secondarily acquired primitive cranial re-orientation of the acromial end, which varies from individual to individual. These results suggest that the pace of phylogenetic change in the pectoral girdle does not seem to follow that of other postcranial skeletal features. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Evaluation of pelvic ring injuries using SPECT/CT

    Energy Technology Data Exchange (ETDEWEB)

    Scheyerer, Max J. [University Hospital Zurich, Division of Trauma Surgery, Department of Surgery, Zurich (Switzerland); University Medical Center, Centre for Orthopaedic and Trauma Surgery, Cologne (Germany); Huellner, Martin; Pietsch, Carsten [University Hospital Zurich, Division of Nuclear Medicine, Department of Medical Radiology, Zurich (Switzerland); Werner, Clement M.L. [University Hospital Zurich, Division of Trauma Surgery, Department of Surgery, Zurich (Switzerland); Veit-Haibach, Patrick [University Hospital Zurich, Division of Nuclear Medicine, Department of Medical Radiology, Zurich (Switzerland); University Hospital Zurich, Diagnostic and Interventional Radiology, Department of Medical Radiology, Zurich (Switzerland)

    2014-08-12

    The incidence of pelvic fractures is relatively low compared with other fracture locations. The low incidence is in great contrast to the high morbidity and mortality. Particularly in the elderly, with apparently isolated fractures of the pubic rami, these observations are believed to be due to additional occult lesions of the posterior pelvic ring. In these cases diagnosis cannot be established by conventional imaging alone and SPECT/CT is considered as a diagnostic adjunct. The aim of this study was to assess concomitant bony or soft tissue lesions within the pelvic ring in a population of patients with fractures of the anterior elements. In all patients with no obvious lesions of the posterior pelvic ring on X-rays and CT or with suspicious but inconclusive findings on CT an additional SPECT/CT was carried out in a non-acute setting within 3 days of the trauma. In all cases additional lesions within the pelvic ring were found. Most lesions were vertical sacral fractures, followed by transverse fractures, one non-dislocated fracture of the acetabulum on the side of the pubic rami fracture, and one post-traumatic dilatation of the sacroiliac joint with increased tracer uptake. According to our results after SPECT/CT all patients with pubic rami fracture suffered additional lesions, none detectable previously by X-ray or CT, within the pelvic ring. In this context SPECT/CT has proved to be very helpful in the clinical routine to visualize occult fractures and instability within the sacroiliac joint. (orig.)

  20. The value of hyoscine butylbromide in pelvic MRI

    International Nuclear Information System (INIS)

    Johnson, W.; Taylor, M.B.; Carrington, B.M.; Bonington, S.C.; Swindell, R.

    2007-01-01

    Aim: To evaluate the effect of hyoscine butylbromide (HBB) on image quality and lesion and organ visualization in pelvic magnetic resonance imaging (MRI) Materials and methods: A prospective, ethically approved study was undertaken of 47 patients attending for pelvic MRI at a cancer centre. T2-weighted transverse and sagittal sequences were performed before and after intravenous injection of 20 mg HBB. Three radiologists independently scored anonymized image series for overall image quality, visualization of pelvic lesions and visualization of individual pelvic organs. Statistical analysis was performed to assess improvements in radiologists' scores post-HBB administration. Radiologists also assessed pre-HBB administration T1-weighted images for degree of bowel peristalsis to determine whether this could predict improvement in post-HBB T2-weighted image scores. Side effects of HBB were recorded using a patient questionnaire. Results: Radiologists' scores for image quality and lesion visualization were significantly higher on the post-HBB administration T2-weighted series (p < 0.0005). Scores for the visualization of the bladder, rectum, pelvic bowel, prostate, and seminal vesicles (all p < 0.0005), cervix (p = 0.019) and vagina (p = 0.0001) were also significantly higher post-HBB administration. Scores for the degree of peristalsis on T1-weighted images were not related to improvement in image quality or lesion visualization on T2-weighted images post-HBB administration. Side effects of HBB were mild and self-limiting. Conclusion: Intravenous HBB administration improves image quality and lesion visualization in oncological pelvic MRI and is recommended for routine use

  1. Does fibromyalgia influence symptom bother from pelvic organ prolapse?

    Science.gov (United States)

    Adams, Kerrie; Osmundsen, Blake; Gregory, W Thomas

    2014-05-01

    Determine if women with fibromyalgia report increased bother from pelvic organ prolapse compared with women without fibromyalgia. We performed a cross-sectional study of women with symptomatic prolapse on consultation with a private urogynecology practice within a 46-month period. After matching for age, women with a diagnosis of fibromyalgia were compared with a reference group of women without fibromyalgia. Demographic, POPQ examination, medical history, and pelvic floor symptom data (PFDI, PFIQ, and PISQ-12) were collected. Our primary outcome was to compare the mean Pelvic Floor Distress Inventory (PFDI) scores of women with and without fibromyalgia. The prevalence of fibromyalgia in women evaluated for initial urogynecology consultation during the study period was 114 out of 1,113 (7%). Women with fibromyalgia reported significantly higher symptom bother scores related to pelvic organ prolapse, defecatory dysfunction, urinary symptoms, and sexual function: PFDI (p = 0.005), PFIQ (p=0.010), and PISQ (p=0.018). Women with fibromyalgia were found to have a higher BMI (p=0.008) and were more likely to report a history of sexual abuse, OR 3.1 (95 % CI 1.3, 7.9), and have levator myalgia on examination, OR 3.8 (95% CI 1.5, 9.1). In a linear regression analysis, levator myalgia was found to be the significant factor associated with pelvic floor symptom bother. In women with symptomatic prolapse, fibromyalgia is associated with an increased risk of levator myalgia and 50% more symptom bother from pelvic floor disorders.

  2. Training in exercises for pelvic floor muscles of patients with an urinary incontinence after radical prostatectomy

    Directory of Open Access Journals (Sweden)

    P. V. Glybochko

    2014-11-01

    Full Text Available Training of muscles of a pelvic bottom under control of biofeedback is applied at 87 patients with an urinary incontinence after a radical prostatectomy. Biofeedback increases management and control of a pelvic floor. At good ability of management of muscles of a pelvic floor the median of restoration was 4 months. Without opportunity of management of muscles of pelvic floor restoration was 9.4 months.

  3. Training in exercises for pelvic floor muscles of patients with an urinary incontinence after radical prostatectomy

    Directory of Open Access Journals (Sweden)

    P. V. Glybochko

    2013-01-01

    Full Text Available Training of muscles of a pelvic bottom under control of biofeedback is applied at 87 patients with an urinary incontinence after a radical prostatectomy. Biofeedback increases management and control of a pelvic floor. At good ability of management of muscles of a pelvic floor the median of restoration was 4 months. Without opportunity of management of muscles of pelvic floor restoration was 9.4 months.

  4. Ectopic Pelvic Kidney With Urinary Tract Infection Presenting as Lower Abdominal Pain in a Child

    OpenAIRE

    Chung-Ching Lu; You-Lin Tain; Kwok-Wan Yeung; Mao-Meng Tiao

    2011-01-01

    Ectopic pelvic kidney is a rare developmental anomaly. Ectopic pelvic kidney can present without the characteristic symptoms associated with the urinary tract pathology. Ectopic pelvic kidney is usually unknown, and nonspecific vague abdominal comfort maybe the only symptom. Early detection and recognition of an ectopic kidney can prevent long-term complications. We report a 3-year-5-month-old girl with ectopic pelvic kidney who experienced intermittent episodes of lower abdominal pain for ab...

  5. The Pelvic Digit: A Rare Congenital Anomaly as a Cause of Hip Pain

    OpenAIRE

    Moreta-Su?rez, Jes?s; de Ugarte-Sobr?n, Oskar S?ez; S?nchez-Sobrino, Alberto; Mart?nez-De Los Mozos, Jos? Luis

    2012-01-01

    Introduction: The pelvic digit or pelvic rib is an unusual congenital anomaly with a finger or rib like bone formation in soft tissues around normal pelvic skeleton. This is a benign lesion and mostly an Incidental finding on radiographs. Most reported cases are asymptomatic and do not require intervention. We report a case of symptomatic pelvic rib that required surgical excision. Case Report: A 57-year-old man presented with a long history of pain and functional limitation in his right hip....

  6. Optimum pelvic incidence minus lumbar lordosis value can be determined by individual pelvic incidence.

    Science.gov (United States)

    Inami, Satoshi; Moridaira, Hiroshi; Takeuchi, Daisaku; Shiba, Yo; Nohara, Yutaka; Taneichi, Hiroshi

    2016-11-01

    Adult spinal deformity (ASD) classification showing that ideal pelvic incidence minus lumbar lordosis (PI-LL) value is within 10° has been received widely. But no study has focused on the optimum level of PI-LL value that reflects wide variety in PI among patients. This study was conducted to determine the optimum PI-LL value specific to an individual's PI in postoperative ASD patients. 48 postoperative ASD patients were recruited. Spino-pelvic parameters and Oswestry Disability Index (ODI) were measured at the final follow-up. Factors associated with good clinical results were determined by stepwise multiple regression model using the ODI. The patients with ODI under the 75th percentile cutoff were designated into the "good" health related quality of life (HRQOL) group. In this group, the relationship between the PI-LL and PI was assessed by regression analysis. Multiple regression analysis revealed PI-LL as significant parameters associated with ODI. Thirty-six patients with an ODI <22 points (75th percentile cutoff) were categorized into a good HRQOL group, and linear regression models demonstrated the following equation: PI-LL = 0.41PI-11.12 (r = 0.45, P = 0.0059). On the basis of this equation, in the patients with a PI = 50°, the PI-LL is 9°. Whereas in those with a PI = 30°, the optimum PI-LL is calculated to be as low as 1°. In those with a PI = 80°, PI-LL is estimated at 22°. Consequently, an optimum PI-LL is inconsistent in that it depends on the individual PI.

  7. Pelvic fractures-A guide to classification and management

    Energy Technology Data Exchange (ETDEWEB)

    Slater, S.J. [Department of Radiology, Leeds Teaching Hospitals, Leeds (United Kingdom); Radiology Academy, Leeds General Infirmary, Jubilee Wing, Great George St., Leeds LS1 3EX (United Kingdom)], E-mail: s.j.slater@doctors.org.uk; Barron, D.A. [Department of Radiology, Leeds Teaching Hospitals, Leeds (United Kingdom); Musculoskeletal Radiology Dept, Leeds General Infirmary, Jubilee Wing, Great George St, Leeds LS1 3EX (United Kingdom)], E-mail: Dominic.barron@leedsth.nhs.uk

    2010-04-15

    Pelvic fractures are common in polytrauma and continue to pose a difficult management dilemma for even the most experienced clinicians. Due to the high energy mechanisms involved, there are often multiple other injuries and many specialists may be involved. Deriving an effective management strategy relies on early diagnosis and prioritisation of the most immediately life-threatening injuries. Contrary to ATLS advice, CT can be used to facilitate this even in the haemodynamically unstable patient. This article defines the role of CT in pelvic fractures and provides an overview of fracture classification.

  8. Pelvic fractures-A guide to classification and management

    International Nuclear Information System (INIS)

    Slater, S.J.; Barron, D.A.

    2010-01-01

    Pelvic fractures are common in polytrauma and continue to pose a difficult management dilemma for even the most experienced clinicians. Due to the high energy mechanisms involved, there are often multiple other injuries and many specialists may be involved. Deriving an effective management strategy relies on early diagnosis and prioritisation of the most immediately life-threatening injuries. Contrary to ATLS advice, CT can be used to facilitate this even in the haemodynamically unstable patient. This article defines the role of CT in pelvic fractures and provides an overview of fracture classification.

  9. A standard for terminology in chronic pelvic pain syndromes

    DEFF Research Database (Denmark)

    Doggweiler, Regula; Whitmore, Kristene E; Meijlink, Jane M

    2017-01-01

    AIMS: Terms used in the field of chronic pelvic pain (CPP) are poorly defined and often confusing. An International Continence Society (ICS) Standard for Terminology in chronic pelvic pain syndromes (CPPS) has been developed with the aim of improving diagnosis and treatment of patients affected...... domain from 1980 to 2014. Existing ICS Standards for terminology were utilized where appropriate to ensure transparency, accessibility, flexibility, and evolution. Consensus was based on majority agreement. RESULTS: The multidisciplinary CPPS Standard reports updated consensus terminology in nine domains...

  10. Paraganglioma of the urinary bladder with pelvic metastasis

    Directory of Open Access Journals (Sweden)

    Jiun-Hung Geng

    2014-09-01

    Full Text Available A 52-year-old male, diagnosed with paraganglioma of the urinary bladder, underwent transurethral resection of the bladder tumor 10 years ago. He was lost to follow-up after the operation but was recently admitted to our hospital for the treatment of nasopharyngeal cancer. However, refractory hypertension with palpitation was noted and a computed tomography scan revealed a round, well-defined mass at the right pelvic region. Retroperitoneal tumor excision surgery was performed and a subsequent pathological analysis revealed paraganglioma. The diagnosis of paraganglioma of the urinary bladder with pelvic metastasis was confirmed and his blood pressure returned to normal level without medication after the operation.

  11. A prospective study of urinary tract infection during pelvic radiotherapy

    International Nuclear Information System (INIS)

    Bialas, I.; Bessell, E.M.; Sokal, M.

    1989-01-01

    The frequency of urinary tract infection before and during pelvic radiotherapy was studied prospectively in 172 patients who were not catherised and had not had instrumentation for at least 4 weeks prior to radiotherapy. The incidence of urinary tract infection prior to radiotherapy was 17% and a further 17% of patients develped a urinary tract infection during radiotherapy. Mid-stream specimens of urine (MSU) should be examined for infection on a weekly basis during pelvic radiotherapy not only to identify this additional 17% of patients but also to detect those patients who have persistent urinary tract infection in spite of treatment with appropriate antibiotics. (author). 6 refs.; 1 fig.; 4 tabs

  12. Effect of Pelvic Tilt and Rotation on Cup Orientation in Both Supine and Standing Positions.

    Science.gov (United States)

    Yun, Hohyun; Murphy, William S; Ward, Daniel M; Zheng, Guoyan; Hayden, Brett L; Murphy, Stephen B

    2018-05-01

    The purpose of this study is to analyze the effect of pelvic tilt and rotation on radiographic measurement of cup orientation. A total of 68 patients (79 hips) were included in this study. The patients had a computed tomography study and approximately 3 months of postoperative standing anteroposterior pelvic radiographs in both supine and standing positions. We used 2-dimensional (2D)/3-dimensional (3D) matching to measure pelvic tilt and rotation, and cup orientation. There was a wide range of pelvic tilt between individuals in both supine and standing positions. Supine pelvic tilt was different from standing pelvic tilt (P cup anteversion before and after 2D/3D matching in both supine and standing positions (P cup anteversion before and after 2D/3D matching. When all 79 hips were separated into right and left side, pelvic rotation inversely correlated with the pelvic tilt-adjusted difference in anteversion before and after 2D/3D matching of the right side but directly correlated with that of the left side in both supine and standing positions. This study demonstrated that the measurement of cup anteversion on anteroposterior radiographs is significantly affected by both pelvic tilt and pelvic rotation (depending on the side). Improved understanding of pelvic orientation and improved ability to measure pelvic orientation may eventually allow for desired cup positioning to potentially protect against complications associated with malposition of the cup. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Congenital pelvic arteriovenous malformation: uncommon symptoms of lower limb venous hypertension.

    Science.gov (United States)

    Akimaro Kudo, F; Nishibe, T; Miyazaki, K; Flores, J; Yasuda, K

    2001-12-01

    Congenital pelvic arteriovenous malformations (AVMs) are rare and their clinical behavior is quite variable. A case of congenital pelvic AVM manifesting with unusual extrapelvic symptoms of ipsilateral leg pain is described. The causes of symptoms associated with congenital pelvic AVMs are discussed.

  14. Reduction of the posterior pelvic ring by non-invasive stabilisation: a report of two cases.

    Science.gov (United States)

    Qureshi, A; McGee, A; Cooper, J P; Porter, K M

    2005-12-01

    We demonstrate radiological evidence that an external pelvic splint is effective at reducing open book pelvic fractures. Its use in the pre-hospital and emergency department settings should be encouraged in the initial management and resuscitation of patients with pelvic fractures.

  15. Comprehensive pelvic floor physical therapy program for men with idiopathic chronic pelvic pain syndrome: a prospective study.

    Science.gov (United States)

    Masterson, Thomas A; Masterson, John M; Azzinaro, Jessica; Manderson, Lattoya; Swain, Sanjaya; Ramasamy, Ranjith

    2017-10-01

    Male chronic pelvic pain syndrome (CPPS) is a heterogeneous constellation of symptoms that causes significant impairment and is often challenging to treat. In this prospective study, we evaluated men with CPPS who underwent comprehensive pelvic floor physical therapy (PFPT) program. We used the previously validated Genitourinary Pain Index (GUPI) to measure outcomes. We included 14 men who underwent physical therapy for idiopathic CPPS from October 2015 to October 2016. Men with clearly identifiable causes of pelvic pain, such as previous surgery, chronic infection, trauma, prostatitis and epididymitis were excluded. Treatment included: (I) manual therapy (internal and external) of pelvic floor and abdominal musculature to facilitate relaxation of muscles; (II) therapeutic exercises to promote range of motion, improve mobility/flexibility and strengthen weak muscles; (III) biofeedback to facilitate strengthening and relaxation of pelvic floor musculature; (IV) neuromodulation for pelvic floor muscle relaxation and pain relief. GUPI questionnaires were collected at initial evaluation and after the 10th visit. Higher scores reflect worse symptoms. Previous validation of the GUPI calculated a reduction of 7 points to robustly predict being a treatment responder (sensitivity 100%, specificity 76%) and a change in 4 points to predict modest response. Data are presented as medians (ranges). A total of 10 patients completed 10 visits, and the remaining four patients completed between 5 and 9 visits. The median National Institute of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) score at initial evaluation was 30.8 [16-39] and decreased to 22.2 [7-37] at the tenth visit. Five of the 10 patients (50%) in the study had a reduction of greater than 7 points indicating a robust treatment response, and two (20%) had a change of greater than 4 indicating moderate response. Three patients (30%) did not have any meaningful change in NIH-CPSI and the remaining four are in the

  16. Node-positive cervical cancer: impact of pelvic irradiation and patterns of failure

    International Nuclear Information System (INIS)

    Stock, Richard G.; Chen, Alex S. J.; Flickinger, John C.; Kalnicki, Shalom; Seski, Jan

    1995-01-01

    Purpose: The roles of postoperative pelvic and prophylactic paraaortic irradiation in pelvic node positive cervical cancer are currently controversial. A retrospective study was undertaken to examine the effect of pelvic irradiation on pelvic control and survival and to analyze the patterns of recurrence to determine whether indications exist for prophylactic paraaortic irradiation. Methods and Materials: From 1964 to 1991, 143 cases of FIGO Stage I and II cervical cancer undergoing exploratory laparotomy, pelvic lymph node dissection, and radical hysterectomy had positive pelvic lymph nodes. Postoperatively, 108 cases were treated with whole pelvic irradiation while 35 patients were observed. Prophylactic paraaortic irradiation was not given. Results: Patients who received postoperative whole pelvic irradiation compared with those treated with radical hysterectomy alone had a significantly improved pelvic control rate, disease-free survival (DFS), and overall survival. The 5-year actuarial pelvic control rate was 78% vs. 45% (p = <0.0001), respectively. The 5-year actuarial DFS was 65% vs. 41% (p = 0.0004). The 5-year actuarial overall survival was 58% vs. 46% (p 0.02). In multivariate analysis, pelvic irradiation continued to show a positive effect on DFS (p = 0.0001) and overall survival (p = 0.0035). Lymphatic invasion and the total number of positive lymph nodes were the only other independent predictors of overall survival and DFS. The actuarial 5-year pelvic, paraaortic, and distant failure rates were 30%, 10%, and 28%, respectively. An isolated first recurrence in the paraaortic nodes occurred in only three cases. Conclusion: Postoperative pelvic irradiation significantly improves pelvic control, DFS, and overall survival, and should be used in patients with early stage cervical cancer and pathologically proven pelvic nodal metastases. The low incidence of isolated paraaortic nodal failure calls into question the value of routine prophylactic paraaortic

  17. Node-positive cervical cancer: impact of pelvic irradiation and patterns of failure

    Energy Technology Data Exchange (ETDEWEB)

    Stock, Richard G; Chen, Alex S. J.; Flickinger, John C; Kalnicki, Shalom; Seski, Jan

    1995-01-01

    Purpose: The roles of postoperative pelvic and prophylactic paraaortic irradiation in pelvic node positive cervical cancer are currently controversial. A retrospective study was undertaken to examine the effect of pelvic irradiation on pelvic control and survival and to analyze the patterns of recurrence to determine whether indications exist for prophylactic paraaortic irradiation. Methods and Materials: From 1964 to 1991, 143 cases of FIGO Stage I and II cervical cancer undergoing exploratory laparotomy, pelvic lymph node dissection, and radical hysterectomy had positive pelvic lymph nodes. Postoperatively, 108 cases were treated with whole pelvic irradiation while 35 patients were observed. Prophylactic paraaortic irradiation was not given. Results: Patients who received postoperative whole pelvic irradiation compared with those treated with radical hysterectomy alone had a significantly improved pelvic control rate, disease-free survival (DFS), and overall survival. The 5-year actuarial pelvic control rate was 78% vs. 45% (p = <0.0001), respectively. The 5-year actuarial DFS was 65% vs. 41% (p = 0.0004). The 5-year actuarial overall survival was 58% vs. 46% (p 0.02). In multivariate analysis, pelvic irradiation continued to show a positive effect on DFS (p = 0.0001) and overall survival (p = 0.0035). Lymphatic invasion and the total number of positive lymph nodes were the only other independent predictors of overall survival and DFS. The actuarial 5-year pelvic, paraaortic, and distant failure rates were 30%, 10%, and 28%, respectively. An isolated first recurrence in the paraaortic nodes occurred in only three cases. Conclusion: Postoperative pelvic irradiation significantly improves pelvic control, DFS, and overall survival, and should be used in patients with early stage cervical cancer and pathologically proven pelvic nodal metastases. The low incidence of isolated paraaortic nodal failure calls into question the value of routine prophylactic paraaortic

  18. Pregnancy-related mortality in Guatemala, 1993-1996 La mortalidad por causas relacionadas con el embarazo: Guatemala, 1993-1996

    Directory of Open Access Journals (Sweden)

    Edgar Kestler

    2000-01-01

    Full Text Available To select the proper interventions that could prevent maternal mortality, adequate and appropriate maternal mortality data are needed. Nevertheless, the quality and quantity of information and the scope of maternal health- and death-related data are inadequate in many countries, particularly in the developing world. From January 1993 to December 1996 a surveillance program in maternal mortality was developed to conduct surveillance studies in the department of Guatemala, Guatemala. With an active surveillance system, our approach gave a more complete picture of maternal death and produced information on the specific causes of maternal mortality. Using multiple sources of information, we reviewed and analyzed all deaths of women of childbearing age (10 to 49 years. Each death was investigated to determine whether it was pregnancy-related or not. The maternal mortality ratio for the four-year study period was 156.2 deaths per 100 000 live births. Women 35 and older had a higher risk of maternal death than women under that age. Women who were 35-39 years old had a maternal death risk almost three times as high as women aged 20-24. For women who were 40 or older the risk was more than double that of women 20-24 years old. Overall, the two leading causes of maternal mortality were infection and hemorrhage. Vaginal deliveries where there was medical assistance had the highest rate of delivery-related maternal death from general infection. In deliveries attended by nonmedical personnel, delivery-related maternal deaths from hemorrhage were most frequently associated with retained placenta. Developing countries are called on to implement systems that can provide continuous and systematic data collection so that policymakers and health managers have adequate information to design proper interventions to save women's lives.Para poder elegir aquellas intervenciones que podrían prevenir la mortalidad materna, se necesitan datos apropiados y de calidad

  19. Determinants and Management Outcomes of Pelvic Organ Prolapse ...

    African Journals Online (AJOL)

    determine, however, the life time risk of requiring at least one operation to ... are appropriately treated with pelvic floor exercises and/or physical ... improve their quality of life. In Nnewi .... [1,17,19-21] Pregnancy itself, without vaginal birth has.

  20. Medical Treatments for Endometriosis-Associated Pelvic Pain

    Directory of Open Access Journals (Sweden)

    Gabriella Zito

    2014-01-01

    Full Text Available The main sequelae of endometriosis are represented by infertility and chronic pelvic pain. Chronic pelvic pain causes disability and distress with a very high economic impact. In the last decades, an impressive amount of pharmacological agents have been tested for the treatment of endometriosis-associated pelvic pain. However, only a few of these have been introduced into clinical practice. Following the results of the controlled studies available, to date, the first-line treatment for endometriosis associated pain is still represented by oral contraceptives used continuously. Progestins represent an acceptable alternative. In women with rectovaginal lesions or colorectal endometriosis, norethisterone acetate at low dosage should be preferred. GnRH analogues may be used as second-line treatment, but significant side effects should be taken into account. Nonsteroidal anti-inflammatory drugs are widely used, but there is inconclusive evidence for their efficacy in relieving endometriosis-associated pelvic pain. Other agents such as GnRH antagonist, aromatase inhibitors, immunomodulators, selective progesterone receptor modulators, and histone deacetylase inhibitors seem to be very promising, but there is not enough evidence to support their introduction into routine clinical practice. Some other agents, such as peroxisome proliferator activated receptors-γ ligands, antiangiogenic agents, and melatonin have been proven to be efficacious in animal studies, but they have not yet been tested in clinical studies.

  1. Efficient radiologic diagnosis of pelvic and acetabular trauma

    International Nuclear Information System (INIS)

    Kreitner, K.F.; Mildenberger, P.; Thelen, M.; Rommens, P.M.

    2000-01-01

    In spite of the widespread availability of CT scanners, conventional X-ray radiographs remain the basic imaging modality in patients with pelvic and/or acetabular trauma. However, the extent of their use will depend on local utilities (e.g., availability of CT scanners) and on the patient's clinical condition. Regarding the inaccuracy of conventional radiography in the diagnosis of injuries of the dorsal pelvic ring and of the acetabulum, computed tomography represents the most important imaging modality in the clinically stable patient. CT provides an exact staging of the extent of trauma and allows for differentiation of pelvic instabilities. CT clearly demonstrates the severity of acetabular trauma and is superior in the detection of local complicating factors, i.e., impressions fractures and (sub-)luxations of the femoral head as well as free intraarticular fragments. CT findings provide the basis for definite treatment regimens of the injured patient. By extension of the examination, all relevant organs and systems (craniospinal, cardiovascular, gastrointestinal, respiratory, genitourinary) can be imaged during one session. The speed of spiral CT scanners and their diagnostic accuracy will play a major role in the management of, especially, polytraumatized patients. The indication for angiography with the option of therapeutic embolization exists if a pelvic bleeding persists even after reposition and operative fixation of the injury. (orig.) [de

  2. European guideline for the management of pelvic inflammatory disease

    DEFF Research Database (Denmark)

    Ross, J; Judlin, P; Nilas, Lisbeth

    2007-01-01

    Pelvic inflammatory disease (PID) remains one of the most important consequences of sexually transmitted infections (STIs) resulting in severe morbidity and acting as the economic justification for STI screening programmes. Early and appropriate therapy has the potential to significantly reduce t...

  3. Spontaneous occurrence of synergistic bacterial gangrene following external pelvic irradiation

    International Nuclear Information System (INIS)

    Husseinzadeh, N.; Nahhas, W.A.; Manders, E.K.; Whitney, C.W.; Mortel, R.

    1984-01-01

    A case of spontaneous synergistic bacterial gangrene occurring after external pelvic irradiation is presented in a 25-year-old woman with invasive cervical cancer. Treatment consisted of aggressive antibiotic therapy and extensive excision and debridement followed by split-thickness skin grafting. Both recovery and cosmetic results were satisfactory. The pathophysiology, predisposing factors, and treatment modalities are presented

  4. Pelvic organ prolapse in jimma university specialized hospital, southwest ethiopia.

    Science.gov (United States)

    Akmel, Menur; Segni, Hailemariam

    2012-07-01

    Pelvic organ prolapse is the down ward descent of female organs including the bladder, small and large bowel resulting in protrusion of the vagina, uterus or both. It is a disorder exclusive to women and one of the most common indications for gynecologic surgery. This hospital based retrospective descriptive study was conducted to assess the magnitude of pelvic organ prolapse and risk factors for it. All cases of pelvic organ prolapse admitted and treated in Jimma University Specialized Hospital from July 1, 2008 to June 30, 2011 were included. The collected data were analyzed using SPSS computer software version 16.0. Chi-square test was used and was considered to be significant when presidence area. Farmers accounted for 68.2% of the patients and there was a significant association between prolapse and occupation (p creation on risk factors of pelvic organ prolapse and use of contraception to reduce parity is recommended. Health institution delivery should be advocated to minimize the rate of home deliveries and hence of prolonged labor.

  5. Management of pelvic fractures in dog | Sharma | Nigerian ...

    African Journals Online (AJOL)

    Pelvic fractures are common sequelae of major traumatic injury of dogs and cat which, comprise of at least 25% of all fractures in veterinary practice (Piermattei et al., 2006). Fracture of ilium, the most ... We hereby report the successful surgical management of unstable fracture of ilium and ischium of pelvis in a Spitz dog.

  6. Pelvic floor muscle thickness measured by perineal ultrasonography

    DEFF Research Database (Denmark)

    Bernstein, Inge Thomsen; Juul, N; Grønvall, S

    1991-01-01

    Pelvic floor muscle thickness was assessed in nine healthy female physiotherapists by perineal sonography. All measurements were performed as triple-measurements. The aims were to assess the reliability of the measurements and to establish a reference material. The muscle thickness at rest...

  7. Trauma and dissociation in conversion disorder and chronic pelvic pain

    NARCIS (Netherlands)

    Spinhoven, P.; Roelofs, K.; Moene, F.C.; Kuyk, J.; Nijenhuis, E.R.S.; Hoogduin, C.A.L.; Dyck, R. van

    2004-01-01

    Objective: The purpose of this study was to: a) assess the link between sexual and/or physical abuse and dissociation in conversion disorder and chronic pelvic pain patients; and b) assess whether this effect is independent of level of general psychopathology. Method: This report examines data from

  8. Prospective study of nutritional support during pelvic irradiation

    International Nuclear Information System (INIS)

    Kinsella, T.J.; Malcolm, A.W.; Bothe, A. Jr.; Valerio, D.; Blackburn, G.L.

    1981-01-01

    A prospective study of nutritional support during pelvic irradiation was carried out in 32 patients with a primary pelvic malignancy and prior weight loss. Both curative and palliative patients were eligible for the study. Seventeen patients were randomized to receive intravenous hyperalimentation (IVH) and fifteen patients served as controls who were maintained on their regular diet. Patients were stratified by percent body weight loss. Tolerance to therapy was assessed by evaluation of functional status and by using nutritional parameters of body weight change, change in serum protein levels, and response to delayed hypersensitivity skin tests. The curative IVH group tolerated therapy well by both functional and nutritional measurements. All curative IVH patients completed the planned radiation therapy without a treatment break and were fully active following treatment. Patients gained an average of 4.0 kg body weight during irradiation, which was significantly different from the curative control patients. They demonstrated a significant increase in serum transferrin reflecting an improvement in visceral protein. In addition, all showed a positive response to delayed hypersensitivity skin tests at the completion of irradiation. The palliative IVH patients often did poorly because of progression of disease and demonstrated only an elevation of serum transferrin during treatment. The results in the curative IVH group suggest a potential adjunctive role for intravenous hyperalimentation in the malnourished cancer patient undergoing pelvic irradiation. Clearly, further study of nutritional support during pelvic irradiation is needed using curative patients with a single tumor type and significant prior weight loss

  9. Successful Vaginal Delivery in Spite of a Large Pelvic Neurofibroma

    Directory of Open Access Journals (Sweden)

    Hüseyin Levent Keskin

    2010-08-01

    If not otherwise fetally or maternally indicated, initiation of labor and the course of labor should be observed and vaginal delivery should be attempted for the pregnant has a pelvic neurofibroma, before a decision for cesarean section is made.

  10. Stress urinary incontinence: effect of pelvic muscle exercise

    NARCIS (Netherlands)

    Ferguson, K. L.; McKey, P. L.; Bishop, K. R.; Kloen, P.; Verheul, J. B.; Dougherty, M. C.

    1990-01-01

    Twenty women with stress urinary incontinence diagnosed by urodynamic testing participated in a 6-week pelvic muscle exercise program. The aim of the study was to evaluate the effectiveness of the exercise program, with or without an intravaginal balloon, on urinary leakage as determined by a

  11. Incidence of pelvic organ prolapse repair subsequent to hysterectomy

    DEFF Research Database (Denmark)

    Lykke, Rune; Blaakær, Jan; Ottesen, Bent

    2017-01-01

    INTRODUCTION AND HYPOTHESIS: The aim of this study was to compare the incidence of subsequent pelvic organ prolapse (POP) repair in women following radical hysterectomy versus total abdominal hysterectomy. METHODS: From the Danish National Patient Registry, we collected data on all radical...

  12. Gender determination from diagnostic factors on anteroposterior pelvic radiographs

    Directory of Open Access Journals (Sweden)

    Azadeh Memarian

    2017-03-01

    Conclusion: The results of this study revealed that the evaluation of the radiographic images of pelvic bones by assessing the mentioned factors can be useful for sex determination from skeletal remains. However, ethical considerations should also be taken into account while using these factors.

  13. Urinary incontinence after surgery for pelvic organ prolapse

    NARCIS (Netherlands)

    Lensen, E.J.M.; Withagen, M.I.J.; Kluivers, K.B.; Milani, A.L.; Vierhout, M.E.

    2013-01-01

    AIMS: This study focused on the changes in urinary incontinence (UI) rates pre- and postoperatively and identified risk factors which predict the presence of symptoms of urgency urinary incontinence (UUI) or stress urinary incontinence (SUI) after surgery for pelvic organ prolapse (POP) without

  14. Embolization to treat pelvic congestion syndrome and vulval varicose veins.

    NARCIS (Netherlands)

    Vleuten, C.J.M. van der; Kempen, J.A.L. van; Schultze Kool, L.J.

    2012-01-01

    OBJECTIVE: To evaluate the efficacy of embolization for treating the symptoms of pelvic congestion syndrome (PCS). METHODS: Twenty-one women with PCS who were treated with embolization at Radboud University Nijmegen Medical Centre between 2003 and 2008 were sent a questionnaire about their symptoms

  15. Pelvic floor disorders in gynecological malignancies. An overlooked problem?

    Directory of Open Access Journals (Sweden)

    Oana M. Bodean

    2018-04-01

    Full Text Available Cervical, endometrial, ovarian, vulvar, and vaginal cancers affect women of a broad age spectrum. Many of these women are still sexually active when their cancer is diagnosed. Treatment options for gynecological malignancies, such as gynecological surgery, radiation, and chemotherapy, are proven risk factors for pelvic floor dysfunction. The prevalence of urinary incontinence, fecal incontinence, and sexual dysfunction before cancer treatment is still unclear. Hypotheses have been raised in the literature that these manifestations could represent early symptoms of pelvic cancers, but most remain overlooked even in cancer surviving patients. The primary focus of therapy is always cancer eradication, but as oncological and surgical treatment options become more successful, the number of cancer survivors increases. The quality of life of patients with gynecological cancers often remains an underrated subject. Pelvic floor disorders are not consistently reported by patients and are frequently overlooked by many clinicians. In this brief review we discuss the importance of pelvic floor dysfunction in patients with gynecological malignant tumors.

  16. Pelvic pain in endometriosis: painkillers or sport to alleviate symptoms?

    Science.gov (United States)

    Koppan, A; Hamori, J; Vranics, I; Garai, J; Kriszbacher, I; Bodis, J; Rebek-Nagy, G; Koppan, M

    2010-06-01

    To assess potential individual factors influencing quality of life and pain scores of patients suffering from histologically confirmed endometriosis. Study using a questionnaire among patients of reproductive age undergoing laparoscopy with a presumed diagnosis of endometriosis. Details of fertility, previous treatments and quality of life, sexual activity, as well as linear pain scores for several symptoms, were recorded. Details of intraoperative findings were also collected and only those data were used where endometriosis was intraoperatively and histologically proven. A questionnaire before surgery gathered information from women on the following groups of variables: age, marital status, education, reproductive and medical history including previous pregnancies and parity, knowledge of accompanying pelvic disorders, regular sport activity, as well as general quality of life estimates including self-image. Pelvic pain was scored using a visual analogue scale. Data were statistically evaluated. Eighty-one patients complaining about persistent pelvic pain were later intraoperatively and histologically proven to have endometriosis. Thirty-one of them (38.2%) reported regular sport as part of their daily life schedule while 50 of them (61.8%) performed no physical activity at all. Fourteen patients among regular exercisers and 33 patients among those without physical activity reported the effectiveness of painkillers for pelvic pain, corresponding to 45.1% and 66% of these subgroups, respectively (difference statistically significant, ppainkillers might be less effective among endometriosis patients performing regular daily sport activities, and, thus it might impose them to an unnecessary burden of possible side-effects.

  17. A Comparative Study of Endocervical and Pelvic Peritoneal ...

    African Journals Online (AJOL)

    The relationship between the bacterial flora of the endocervix and the pelvic peritoneum in fifty infertile patients undergoing diagnostic laparoscopy and dye test was investigated at the University of Benin Teaching Hospital. The study design was prospective and cross-sectional. The setting was the Department of Obstetrics ...

  18. The future of research in female pelvic medicine.

    Science.gov (United States)

    Chao, Jamie; Chai, Toby C

    2015-02-01

    Female pelvic medicine and reconstructive surgery (FPMRS) was recently recognized as a subspecialty by the American Board of Medical Specialties (ABMS). FPMRS treats female pelvic disorders (FPD) including pelvic organ prolapse (POP), urinary incontinence (UI), fecal incontinence (FI), lower urinary tract symptoms (LUTS), lower urinary tract infections (UTI), pelvic pain, and female sexual dysfunction (FSD). These conditions affect large numbers of individuals, resulting in significant patient, societal, medical, and financial burdens. Given that treatments utilize both medical and surgical approaches, areas of research in FPD necessarily cover a gamut of topics, ranging from mechanistically driven basic science research to randomized controlled trials. While basic science research is slow to impact clinical care, transformational changes in a field occur through basic investigations. On the other hand, clinical research yields incremental changes to clinical care. Basic research intends to change understanding whereas clinical research intends to change practice. However, the best approach is to incorporate both basic and clinical research into a translational program which makes new discoveries and effects positive changes to clinical practice. This review examines current research in FPD, with focus on translational potential, and ponders the future of FPD research. With a goal of improving the care and outcomes in patients with FPD, a strategic collaboration of stakeholders (patients, advocacy groups, physicians, researchers, professional medical associations, legislators, governmental biomedical research agencies, pharmaceutical companies, and medical device companies) is an absolute requirement in order to generate funding needed for FPD translational research.

  19. Clinical functional evaluation of female's pelvic floor: integrative review

    Directory of Open Access Journals (Sweden)

    Ana Carolina Nociti Lopes Fernandes

    2018-06-01

    Full Text Available Abstract Introduction: The effectiveness of pelvic floor muscle training (PFMT depends on the correct prescription of intensity, repetition and endurance of muscle contractions, which are provided by an adequate assessment of pelvic floor muscle. Objective: Verify the techniques, resources and strategies used for clinical functional evaluation of female pelvic floor (PF described in literature. Methods: It’s an integrative review of published studies and books from 2010 until December 2015. Relevant articles with complete description of PF evaluation were found through the use of Scielo, LILACS, PubMed and Medline databases. Results: 34 articles that fulfilled all the criteria were selected. Conclusion: The most used techniques, resources and strategies were: anamnesis, physical examination, measurement of pelvic floor muscle activity using Modified Oxford Scale or perineometry, and use of questionnaires to analyze patient's perspective of their own symptoms. Thus, we could use the parameters obtained in the evaluation to plan an ideal PFMT for each patient, so the physiotherapist would have a good database to analyze the evolution and define the end of therapy.

  20. Ultrasound of the pelvic floor during and after first pregnancy

    NARCIS (Netherlands)

    Veelen, G.A. van

    2015-01-01

    Objective First, to evaluate the reliability of different assessments using three/four-dimensional (3D/4D) transperineal ultrasound in women during and after their first pregnancy. Second, to describe changes in pelvic floor anatomy and function during and after first pregnancy and to provide