Uterine fibroids: a clinical review

Article Abstract:

Fibroid tumors (leiomyomata) found in the smooth muscle layer of the uterus are a major reason for hysterectomy. Although the actual cause is unknown, some women are more prone to the disease. The risk for fibroid tumors is increased in black women (which may relate to increased pelvic infections), women who secrete the hormone estrogen continuously (uninterrupted by pregnancy), and obese women. The risk for fibroid tumors is lowered in women who take birth control pills and in women who smoke. Symptoms include excessive bleeding, pain, and pelvic pressure. Although fibroid tumors can affect fertile and infertile women, fibroid tumors in the uterus may make it difficult for sperm to travel, alter the blood supply to the lining of the uterus, and inhibit embryo implantation. Women with fibroid tumors who achieve pregnancy have higher rates of miscarriage. Some studies have reported fibroid enlargement during pregnancy. The location of the fibroid in relation to the placenta predicts whether premature rupture of the fetal membranes and excessive bleeding during and after delivery will occur. Polypeptide growth factors alone, or in combination with other growth factors, may be involved in the formation of fibroid tissue. Luteinizing hormone-releasing hormone (LHRH) analogues are drugs that mimic the hormones produced in the pituitary gland. Treatment with LHRH analogues initially increase the production of gonadotropin hormone, which in turn increases the level of estrogen produced by the ovaries. Eventually, the hormonal feedback system sends a message to the pituitary-ovarian hormone network to stop producing hormone. In this way, estrogen production is suppressed naturally, thereby shrinking the estrogen-dependent tumors. The drug is administered by nasal spray or implants. The treatment is associated with a few side effects such as hot flashes, mood swings, vaginal dryness, and a small, but significant amount of bone loss (osteoporosis). When therapy is stopped the fibroid tumors return. Other medications currently being investigated are medrogesterone and gestrinone (anti-progesterone and anti-estrogen, respectively). The fibroid tumors can be removed, while preserving the integrity of the uterus, by using a procedure called a myomectomy. This can be performed by surgical resection or laser surgery. Combination hormone therapy may be useful for women who are not good surgical candidates. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Uterine fibroids, Fibromas, Fibroma

---

The clinical presentation of women with human immunodeficiency virus infection

Article Abstract:

A description is presented of 81 women with human immunodeficiency virus (HIV, associated with AIDS) who had been examined in one medical facility in England. Forty-three of the women had apparently acquired HIV through heterosexual contact; 34 by intravenous drug use; and 4 by transfusion of contaminated blood products. Slightly more than half of those who acquired HIV infection heterosexually had been born in Africa. In addition, the 43 heterosexually-infected patients included many women who apparently did not perceive that they were at risk, and had not sought testing, even when they developed symptoms. This suggests that the concept of HIV infection among only ''high risk'' heterosexual people is no longer accurate, and that testing should be made widely available. Research on the factors that promote acceptance of HIV testing indicates that acceptance is highest when no mention is made of risk factors in counseling. Pregnancy may hasten the progress of HIV infection, but data concerning this issue are unclear. Overall, as more women develop HIV infection, medical personnel must be able to accurately diagnose the condition. This is particularly difficult since HIV-infected patients vary widely in their symptoms, which may not be ''typical'' of HIV infection. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diseases, HIV patients, Identification and classification, Heterosexuals

---

A review of 80 endometrial resections for menorrhagia

Article Abstract:

Results are presented from a study of the effectiveness and safety of removing endometrial tissue with the hysteroscopic resectoscope, an instrument that includes a fiberoptic viewing tube and another tube through which surgery can be performed. The current report involves 80 patients with menorrhagia (excessive menstrual bleeding) who underwent the procedure under general anesthesia. The patients compared menstruation before surgery and at 3, 6, 12, and 24 months afterwards. The results at one year showed that 45 (60 percent) of the 75 women had successful outcomes and 9 (12 percent) had some improvement. Failures occurred in 21 cases, of whom 7 had initial good results. Seven complications of the procedure were noted, including uterine perforation (three cases); absorption of glycine, the material used to distend the uterus, (two cases), and hemorrhage (two cases). The success rate improved from 40 percent in the first 20 patients to 75 percent in the last 40. Overall, four women in the series underwent removal of the uterus. Recommendations are presented for successful endometrial resection using the hysteroscopic resectoscope. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Surgery, Endometrium, Menorrhagia, Endoscopic surgery

Similar abstracts:

• Abstracts: The efficacy of inosine pranobex in preventing the acquired immunodeficiency syndrome in patients with human immunodeficiency virus infection
• Abstracts: Drug prophylaxis for human immunodeficiency virus-infected pregnant women: ethical considerations. part 2 Beta-adrenergic receptor blockade in the management of pregnant women with mitral valve stenosis
• Abstracts: Guidelines for safe transportation of children in wheelchairs
• Abstracts: Some historical aspects of toxaemia of pregnancy: a review. Congenital and maternal cytomegalovirus infections in a London population
• Abstracts: Central nervous system magnesium deficiency. Immigrants and health care: mounting problems

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.