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Biomedical subjects

A McCausland

Publications and source records attributed to A McCausland.

11 recordsLinked to original sources
PubMed1993

Diagnostic and operative hysteroscopy in the management of persistent postmenopausal bleeding.

OBJECTIVE: To determine the cause and possible treatment of postmenopausal bleeding of 6 months' duration or longer. METHODS: One hundred ten women between the ages of 40-90 years with persistent postmenopausal bleeding were evaluated by diagnostic hysteroscopy and managed by operative hysteroscopy. All had endometrial sampling and/or office hysteroscopy before operative hysteroscopy. RESULTS: A benign organic cause was noted in 95 cases (polyps in 42 and submucous fibroids in 53). Thirteen women had no significant disease and two had an early adenocarcinoma. Resection of the polyps or myomas without ablation was performed in 45 women, and all but one were satisfied with the results of treatment. Resection and ablation with performed in the remaining 50 patients with organic causes, and all but one were satisfied with the results. Twelve of 13 women without organic causes were satisfied with their treatment. The two adenocarcinomas were early lesions, grade 1 without invasion, and were managed by simple hysterectomy. CONCLUSION: Diagnostic and operative hysteroscopy was effective in controlling postmenopausal bleeding of at least 6 months' duration. Almost 90% of the patients had either polyps or submucous fibroids as the primary cause of the bleeding. Resection alone and resection with ablation were equally effective in controlling the bleeding.

Adult↗
PubMed1993

Post-ablation-tubal sterilization syndrome.

OBJECTIVE: To determine the cause of unilateral or bilateral pelvic pain associated with vaginal spotting in women who had previously undergone tubal ligation followed by roller-ball endometrial ablation. METHODS: Women who had undergone previous tubal sterilization followed by rollerball endometrial ablation were evaluated laparoscopically and hysteroscopically when they presented with a symptom complex of intermittent vaginal bleeding associated with severe cramping pain in the lower abdomen. RESULTS: During a 1.5-year observation period, six women with the symptom complex had laparoscopy and hysteroscopy. In all cases, marked endometrial scarring was noted. In every case, the proximal portions of either one or both fallopian tubes were swollen, and two cases had the appearance of an early ectopic pregnancy. In the remaining cases, the fallopian tubes were rubbery and swollen to as much as twice normal size. Symptoms in five of six patients subsided after laparoscopic removal of the oviduct. CONCLUSION: It appears that women who have had a tubal sterilization followed by endometrial ablation are at risk of developing an ectopic-like symptom complex. Salpingectomy appears to be effective in relieving symptoms. Whether this represents a new syndrome or just an unusual association between tubal sterilization and endometrial ablation remains to be seen.

Abdominal Pain↗
PubMed1982

Endosalpingosis ("endosalpingoblastosis") following laparoscopic tubal coagulation as an etiologic factor of ectopic pregnancy.

Recent literature has suggested that the majority of pregnancies following a laparoscopic tubal coagulation failure are ectopic. This is in direct contrast to the failure of other types of tubal ligation procedures which usually result in intrauterine pregnancies. The purpose of this paper is to explain this disparity in hopes of reducing the chance of ectopic pregnancies. A study of pathology is presented and how different portions of the oviduct respond to coagulation injury is reported. It was found that the endosalpinx of the proximal oviduct, which is so frequently injured during laparoscopic coagulation, becomes activated (endosalpingosis or "endosalpingoblastosis") with potential fistula formation. If the coagulation is more distal only fibrosis occurs. This is clinically significant in that if the laparoscopist avoids injury to the proximal isthmic portion of the oviduct, the chance of "endosalpingoblastosis," fistula, and ectopic pregnancy should be reduced, thus improving the outcome of this technique.

Adult↗
PubMed1976

Studies with bluetongue virus in Nigeria.

Using an agar gel diffusion test antibody evidence indicates that bluetongue virus is widely distributed in Nigeria and commonly infects cattle, sheep and goats. In a single dairy herd serological conversions were observed in both wet and dry seasons.

Animals↗
PubMedDate not supplied

The response of adenomyosis to endometrial ablation/resection.

Operative hysteroscopy is a relatively new technique that has significantly improved the diagnosis and therapy of abnormal uterine bleeding. At first, the success of operative hysteroscopy in controlling this bleeding seemed extremely high but, with long-term follow-up, a significant failure rate became evident requiring a repeat hysteroscopic procedure or a hysterectomy. Deep adenomyosis is a major cause of these failures. This paper describes three operative ablation techniques and relates many of their failures to deep adenomyosis. The definition and pathophysiology of adenomyosis are also explored. The possibility of delaying the diagnosis of endometrial cancer under an ablation scar is discussed. Ultimately the depth of adenomyosis seems to correlate with the outcome of endometrial ablation or resection. Patients without or with only minimal endometrial penetration of <2.5 mm (superficial adenomyosis) have good results from the ablation. Patients with deep endometrial penetration of >2.5 mm (deep adenomyosis) usually have persistent problems and should be offered hysterectomy over repeat ablation. Magnetic resonance imaging or ultrasound may be an appropriate pre-operative screening tool to determine the depth of ademomyosis.

Endometrial Neoplasms↗