BACKGROUND Nearly-complete labial adhesions diagnosed with repetitive cystitis in postmenopausal women:A case report CASE SUMMARY The case of an 83-year-old woman who presented with dysuria,urination disorders,recurre...BACKGROUND Nearly-complete labial adhesions diagnosed with repetitive cystitis in postmenopausal women:A case report CASE SUMMARY The case of an 83-year-old woman who presented with dysuria,urination disorders,recurrent cystitis,and bacteriuria and was admitted to a private hospital after 1 mo of antibiotic treatment without improvement of her symptoms.Upon examination,labial adhesions were observed with nearly-complete labial fusion with a pinpoint opening.Bacteriuria was detected in urine analysis,and the urine culture test was positive for Escherichia coli.Therefore,a parenteral antibiotic(Fosfomycin)and topical estrogen cream were administered.However,since the adhesion did not separate after 2 wk of treatment,surgical correction was performed.First,adhesiolysis was conducted with a blunt instrument.Then,hysteroscopy and cystoscopy were performed.Hysteroscopic findings showed no abnormalities of the endometrium and endocervix,and the cystoscopic results were also normal.Finally,labiaplasty was completed to prevent adhesion recurrence.One month after the surgery,the discomfort while urinating was eliminated and the adhesion did not recur.CONCLUSION Labial adhesions in postmenopausal women cannot be successfully treated with estrogen creams,and surgical treatment should be considered.展开更多
A 62 years old, post-menopausal female was admitted to the Internal Medicine Ward due to dyspnoea, cough and sputum of at least 2 months. Shortness of breath, cough and hypoxaemia persisted and the patient was submitt...A 62 years old, post-menopausal female was admitted to the Internal Medicine Ward due to dyspnoea, cough and sputum of at least 2 months. Shortness of breath, cough and hypoxaemia persisted and the patient was submitted to a pulmonary angiogram ct which revealed numerous thin-walled air cysts affecting upper and medial zones of both lungs, typical images of pulmonary lymphangioleiomyomatosis. After discharge to Internal Medicine Consultation Service with Metilprednisolone, the patient was no longer hypoxaemic and remained asymptomatic, even after withdrawal of oral corticosteroid to inhalatory formulation. Further surveillance in short time was scheduled in order to implement rapid imunossupressive treatment when necessary.展开更多
Given the relevance of vitamin D in calcium metabolism homeostatic control, as well as its role as differentiation and cell proliferation modulator, it is important to study its circulating level in patients considere...Given the relevance of vitamin D in calcium metabolism homeostatic control, as well as its role as differentiation and cell proliferation modulator, it is important to study its circulating level in patients considered at risk, in order to develop prevention strategies. We studied 77 postmenopausal women with no history of osteoactive drug therapy, corticosteroid intake or diseases that could alter bone metabolism, attending the Menopause Center at the Hospital Provincial del Centenario, Rosario, Argentina. A medical history was taken, and a food consumption frequency questionnaire was applied in order to estimate daily calcium intake. To assess daily physical exercise, work and sports activities were investigated. Serum parathyroid hormone (PTH) and 25(OH)D were measured, and a hip DXA scan was performed in every patient. An inappropriate level of 25(OH)D was observed in 86.3% of patients. The 25(OH)D average value was found within the insufficiency range (<30 ng/ml) whereas PTH average concentration fell within the normal range, and bone mineral density average value was found within the osteopenic category. A statistically significant negative logarithmic association was observed between serum PTH level and vitamin D status (p = 0.01). Mean 25(OH)D concentration among patients who had reported fractures was significantly lower than the corresponding to women who had not suffered this type of event. Patients with vitamin D deficiency had significantly wider mean Cobb angle;higher sum of wedge angles of T4 - T12 vertebral bodies mean values, and higher uncompromised vertebrae wedge angle values than non-deficient women. This study shows high hypovitaminosis D occurrence among these postmenopausal women.展开更多
Background: Nowadays, a substantial number of women spend more than one-third of their lives in the postmenopausal period. It is characterized by a marked decrease in the production of estrogen, which leads to urogeni...Background: Nowadays, a substantial number of women spend more than one-third of their lives in the postmenopausal period. It is characterized by a marked decrease in the production of estrogen, which leads to urogenital atrophy. The symptoms stemming from vulvovaginal atrophy and the lower urinary tract are currently referred to as the Genitourinary Syndrome of Menopause (GSM), which can have a negative impact on the quality of life (QoL). Estrogen replacement is the ideal treatment for GSM, and vaginal administration is the most recommended. Objective: To assess the impact of the use of topical vaginal estriol on the quality of life (QoL) of postmenopausal women with lower urinary tract symptoms (LUTS). Methods: This is an interventional, prospective study, performed in 49 women at the Antonio Pedro Hospital, at the Universidade Federal Fluminense, in Niterói, Brazil, from August 2014 to April 2015. It included postmenopausal women with lower urinary tract symptoms who were not using any estrogen hormone therapy, and it excluded those with contraindications for the use of estriol. A specific questionnaire on QoL and urinary tract symptoms, the King’s Health Questionnaire (KHQ), which identifies LUTS and assesses to what extent those symptoms interfere with QoL, has been used as a research tool. Results: The average age was 62.24 years. Urinary urgency and urge incontinence were reported by 91.8% of women. The average scores of the domains of the KHQ decreased in the domains General Health Perception (before: 46.42 ± 21.65;after: 40.81 ± 22.64), Incontinence Impact (before: 74.82 ± 27.66;after: 41.49 ± 30.83), Role Limitations (before: 43.20 ± 32.80;after: 21.09 ± 24.71), Physical Limitations (before: 38.09 ± 32.09;after: 14.62 ± 24.20), Social Limitations (before: 30.38 ± 28.75;after: 12.62 ± 19.85), Emotions (before: 43.31 ± 32.96;after: 20.18 ± 26.41), Sleep/Energy (before: 41.48 ± 37.74;after: 15.98 ± 23.31) and Severity Measures (before: 48.02 ± 24.68;after: 22.31 ± 20.25). All the differences were statistically significant (p-value ≤ 0.05). Conclusion: In the group of postmenopausal women with lower urinary tract symptoms included in the study, the use of topical vaginal estriol led to a decrease in the frequency of each symptom and the average scores in all domains of the KHQ, suggesting a positive effect on women’s QoL.展开更多
Objective:To investigate the effects of Bushen Jiangu decoction (kidney invigorating and bone invigorating decoction) on sex hormones and cytokines in women with postmenopausal osteoporosis (PMOP).Methods:From Februar...Objective:To investigate the effects of Bushen Jiangu decoction (kidney invigorating and bone invigorating decoction) on sex hormones and cytokines in women with postmenopausal osteoporosis (PMOP).Methods:From February 2014 to May 2016, 98 PMOP patients were selected as the research objects, randomly divided into observation group and control group (n=49). Two groups were given oral alendronate 70 mg/ times, 1 time/week, Caltrate D 1 tablets, 2 times/d. The observation group was given Bushen Jiangu decoction, daily 1 agent. The treatment period was 6 months. The fasting peripheral venous blood was collected before and after treatment and analyzed by automated chemiluminescence immunoassay analyzer for determination of serum estradiol (E2), follicle stimulating hormone (FSH) and luteinizing hormone (LH), prolactin (PRL), testosterone (T) and type I collagen carboxy terminal peptide (CTX), type I precollagen (PINP);using radioimmunoassay method of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-alpha), insulin-like growth factor (IGF-1).Results:The E2 and T levels of the observation group after treatment were significantly increased compared with before treatment (P<0.05). The IL-6 and TNF-alpha of the observation group after treatment were lower than before treatment, while IGF-1 increased than that before treatment, significantly better than the control group (P<0.05);The CTX, P of NP of the observation group after treatment was significantly lower than the control group during the same period (P<0.05).Conclusions:The combination of Bushen Jiangu decoction combined with sodium hyaluronate can effectively improve the level of sex hormones in patients with PMOP, regulate the level of IL-6, TNF-alpha and IGF-1, inhibit the formation of osteoclasts and bone resorption, and improve the treatment effect of osteoporosis.展开更多
文摘BACKGROUND Nearly-complete labial adhesions diagnosed with repetitive cystitis in postmenopausal women:A case report CASE SUMMARY The case of an 83-year-old woman who presented with dysuria,urination disorders,recurrent cystitis,and bacteriuria and was admitted to a private hospital after 1 mo of antibiotic treatment without improvement of her symptoms.Upon examination,labial adhesions were observed with nearly-complete labial fusion with a pinpoint opening.Bacteriuria was detected in urine analysis,and the urine culture test was positive for Escherichia coli.Therefore,a parenteral antibiotic(Fosfomycin)and topical estrogen cream were administered.However,since the adhesion did not separate after 2 wk of treatment,surgical correction was performed.First,adhesiolysis was conducted with a blunt instrument.Then,hysteroscopy and cystoscopy were performed.Hysteroscopic findings showed no abnormalities of the endometrium and endocervix,and the cystoscopic results were also normal.Finally,labiaplasty was completed to prevent adhesion recurrence.One month after the surgery,the discomfort while urinating was eliminated and the adhesion did not recur.CONCLUSION Labial adhesions in postmenopausal women cannot be successfully treated with estrogen creams,and surgical treatment should be considered.
文摘A 62 years old, post-menopausal female was admitted to the Internal Medicine Ward due to dyspnoea, cough and sputum of at least 2 months. Shortness of breath, cough and hypoxaemia persisted and the patient was submitted to a pulmonary angiogram ct which revealed numerous thin-walled air cysts affecting upper and medial zones of both lungs, typical images of pulmonary lymphangioleiomyomatosis. After discharge to Internal Medicine Consultation Service with Metilprednisolone, the patient was no longer hypoxaemic and remained asymptomatic, even after withdrawal of oral corticosteroid to inhalatory formulation. Further surveillance in short time was scheduled in order to implement rapid imunossupressive treatment when necessary.
文摘Given the relevance of vitamin D in calcium metabolism homeostatic control, as well as its role as differentiation and cell proliferation modulator, it is important to study its circulating level in patients considered at risk, in order to develop prevention strategies. We studied 77 postmenopausal women with no history of osteoactive drug therapy, corticosteroid intake or diseases that could alter bone metabolism, attending the Menopause Center at the Hospital Provincial del Centenario, Rosario, Argentina. A medical history was taken, and a food consumption frequency questionnaire was applied in order to estimate daily calcium intake. To assess daily physical exercise, work and sports activities were investigated. Serum parathyroid hormone (PTH) and 25(OH)D were measured, and a hip DXA scan was performed in every patient. An inappropriate level of 25(OH)D was observed in 86.3% of patients. The 25(OH)D average value was found within the insufficiency range (<30 ng/ml) whereas PTH average concentration fell within the normal range, and bone mineral density average value was found within the osteopenic category. A statistically significant negative logarithmic association was observed between serum PTH level and vitamin D status (p = 0.01). Mean 25(OH)D concentration among patients who had reported fractures was significantly lower than the corresponding to women who had not suffered this type of event. Patients with vitamin D deficiency had significantly wider mean Cobb angle;higher sum of wedge angles of T4 - T12 vertebral bodies mean values, and higher uncompromised vertebrae wedge angle values than non-deficient women. This study shows high hypovitaminosis D occurrence among these postmenopausal women.
文摘Background: Nowadays, a substantial number of women spend more than one-third of their lives in the postmenopausal period. It is characterized by a marked decrease in the production of estrogen, which leads to urogenital atrophy. The symptoms stemming from vulvovaginal atrophy and the lower urinary tract are currently referred to as the Genitourinary Syndrome of Menopause (GSM), which can have a negative impact on the quality of life (QoL). Estrogen replacement is the ideal treatment for GSM, and vaginal administration is the most recommended. Objective: To assess the impact of the use of topical vaginal estriol on the quality of life (QoL) of postmenopausal women with lower urinary tract symptoms (LUTS). Methods: This is an interventional, prospective study, performed in 49 women at the Antonio Pedro Hospital, at the Universidade Federal Fluminense, in Niterói, Brazil, from August 2014 to April 2015. It included postmenopausal women with lower urinary tract symptoms who were not using any estrogen hormone therapy, and it excluded those with contraindications for the use of estriol. A specific questionnaire on QoL and urinary tract symptoms, the King’s Health Questionnaire (KHQ), which identifies LUTS and assesses to what extent those symptoms interfere with QoL, has been used as a research tool. Results: The average age was 62.24 years. Urinary urgency and urge incontinence were reported by 91.8% of women. The average scores of the domains of the KHQ decreased in the domains General Health Perception (before: 46.42 ± 21.65;after: 40.81 ± 22.64), Incontinence Impact (before: 74.82 ± 27.66;after: 41.49 ± 30.83), Role Limitations (before: 43.20 ± 32.80;after: 21.09 ± 24.71), Physical Limitations (before: 38.09 ± 32.09;after: 14.62 ± 24.20), Social Limitations (before: 30.38 ± 28.75;after: 12.62 ± 19.85), Emotions (before: 43.31 ± 32.96;after: 20.18 ± 26.41), Sleep/Energy (before: 41.48 ± 37.74;after: 15.98 ± 23.31) and Severity Measures (before: 48.02 ± 24.68;after: 22.31 ± 20.25). All the differences were statistically significant (p-value ≤ 0.05). Conclusion: In the group of postmenopausal women with lower urinary tract symptoms included in the study, the use of topical vaginal estriol led to a decrease in the frequency of each symptom and the average scores in all domains of the KHQ, suggesting a positive effect on women’s QoL.
文摘Objective:To investigate the effects of Bushen Jiangu decoction (kidney invigorating and bone invigorating decoction) on sex hormones and cytokines in women with postmenopausal osteoporosis (PMOP).Methods:From February 2014 to May 2016, 98 PMOP patients were selected as the research objects, randomly divided into observation group and control group (n=49). Two groups were given oral alendronate 70 mg/ times, 1 time/week, Caltrate D 1 tablets, 2 times/d. The observation group was given Bushen Jiangu decoction, daily 1 agent. The treatment period was 6 months. The fasting peripheral venous blood was collected before and after treatment and analyzed by automated chemiluminescence immunoassay analyzer for determination of serum estradiol (E2), follicle stimulating hormone (FSH) and luteinizing hormone (LH), prolactin (PRL), testosterone (T) and type I collagen carboxy terminal peptide (CTX), type I precollagen (PINP);using radioimmunoassay method of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-alpha), insulin-like growth factor (IGF-1).Results:The E2 and T levels of the observation group after treatment were significantly increased compared with before treatment (P<0.05). The IL-6 and TNF-alpha of the observation group after treatment were lower than before treatment, while IGF-1 increased than that before treatment, significantly better than the control group (P<0.05);The CTX, P of NP of the observation group after treatment was significantly lower than the control group during the same period (P<0.05).Conclusions:The combination of Bushen Jiangu decoction combined with sodium hyaluronate can effectively improve the level of sex hormones in patients with PMOP, regulate the level of IL-6, TNF-alpha and IGF-1, inhibit the formation of osteoclasts and bone resorption, and improve the treatment effect of osteoporosis.
