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Biomedical subjects

K Haadem

Publications and source records attributed to K Haadem.

9 recordsLinked to original sources
PubMed1992

Maximum anal sphincter strength measured by the solid sphere test and anal pressure profiles.

OBJECTIVE: To evaluate two methods of quantifying external anal sphincter function. DESIGN: Open study. SETTING: Helsingborg Hospital, Sweden. SUBJECTS: 73 patients (63 women and 10 men), of whom 25 were incontinent of gas and liquid or solid stool. INTERVENTIONS: Anal pressure profiles and the "solid sphere" test. OUTCOME MEASURE: Correlation between results of tests and presence of incontinence. RESULTS: Continent patients were younger than incontinent ones. The correlation between the maximum force the patient could retain and the maximum anal squeeze pressure was good (r = 0.67, p < 0.001). Younger continent patients (n = 48) and significantly higher pressures than incontinent patients (n = 25), but the range and overlap were wide. The reproducibility of both methods was good. CONCLUSIONS: Although the solid sphere test is easier and quicker to do, anal pressure profiles yield more information that is important in the evaluation of incontinence.

Adult↗
PubMed1991

Estrogen receptors in the external anal sphincter.

Inasmuch as anal competence in women is reduced after the age of 50 years, it may be dependent on effects of estrogens. In this study, samples of the external anal sphincter were analyzed for the presence of estrogen receptors and were found to be present at a median concentration of 5.0 fmol per milligram of protein (range, 1.9 to 13) in women (n = 7), and 1.1 fmol per milligram of protein (range, 0 to 3.2) in men (n = 7). These findings are of interest with regard to the treatment of idiopathic anal incontinence.

Adult↗
PubMed1991

Anal sphincter competence in healthy women: clinical implications of age and other factors.

Normal variation in anal sphincter competence was examined with anal pressure profilometry, using a low compliant recording system and a perfused catheter, in 49 healthy women with a mean age of 51 years (range 20-79). Maximum resting anal pressure and maximum squeeze pressure declined with age (r = -0.61; P less than .001 for both), more rapidly so after menopause. Rectal pressure increased with body mass index (r = 0.60, P less than .001). Closing pressure (ie, the difference between maximum resting anal pressure and rectal pressure), an important determinant of anal continence, was more markedly reduced with age (r = -0.69, P less than .001) than was maximum resting anal pressure. Age-related changes were found for the length of the anal canal (r = -0.36, P less than .05). Parity and anal pressures were unrelated. Women are more frequently affected by anal incontinence than are men. Anal pressure profilometry is a useful diagnostic aid, though age-related changes must be taken into consideration when evaluating the results. The more rapid decline of anal pressures after menopause might imply that anal sphincter tissue is a target for estrogen.

Adult↗
PubMed1990

Anal sphincter function after delivery: a prospective study in women with sphincter rupture and controls.

Twenty-one consecutive women with anal sphincter muscle rupture during delivery (0.79%) and 15 controls were examined. The anal sphincter was immediately repaired in the study group and the function determined with anal profilometry at 3 days and 3 months after delivery, and in ten of the patients after 12 months. Anal sphincter strength was reduced soon after delivery in the controls but regained normal strength within 3 months. In the anal sphincter rupture group, an improvement was found over the first 3 months after delivery, but afterwards no further change occurred. The anal sphincter strength was significantly reduced compared to the control group, both soon after delivery and after 3 months. Their voluntary anal pressure increased from 1.7 kPa immediately after delivery to 3.2 kPa at 3 months in the study group and the corresponding values in the control group were 4.0 and 6.5 kPa, respectively. For the closing pressure, that is the resting pressure minus the rectal pressure, the values in the study group were 4.2 and 6.7 kPa, and in the control group 7.2 and 9.4 kPa, respectively. In the women with anal sphincter rupture, however, a significantly increased frequency of gas incontinence was found.

Adult↗
PubMed1988

Long-term ailments due to anal sphincter rupture caused by delivery--a hidden problem.

Questionnaires concerning ailments were sent postpartum (mean two years) to 62 women with anal sphincter ruptures (ASR), who were compared with a matched control population. The frequency of anal sphincter rupture at the hospital during delivery in the period, 1978-82, was 0.7% (n = 63). Primiparity, instrumental deliveries, abnormal presentation, large babies and oxytocin stimulation were all risk factors. Of 59 women answering the questionnaire 37 (63%) stated that they had had ailments three months postpartum, mainly with pain and involuntary passage of flatus but also with dyspareunia and occasional incontinence of faeces. Long-term symptoms were noted by 28 (48%) of the women, mainly with involuntary passage of flatus but also perineal pain, dyspareunia and occasional incontinence of faeces. Long-term symptoms occurred in 7 (88%) of women with ASR also involving the anal mucosa, but only in 21 (39%) of those with ASR only. Three of the patients subsequently underwent reconstructive surgery, and three complained of psychological problems.

Adult↗
PubMed1987

Anal sphincter function after delivery rupture.

Questionnaires were sent to 63 women with anal sphincter rupture that occurred during vaginal delivery two to seven years earlier. Half of them had significant trouble, such as incontinence for gas, dyspareunia, and pain. We performed anal pressure profilometry in 14 of these women and in ten controls for comparison, and found a significant reduced strength in the external anal sphincters of the studied group. When anal sphincter rupture extended through the rectal mucosa, the internal sphincter strength was also reduced. The persisting signs and symptoms of anal dysfunction indicate that women with anal sphincter rupture need more attention and follow-up.

Adult↗
PubMed1986

Doxorubicin-cisplatin combination chemotherapy for recurrent carcinoma of the cervix.

A total of 31 patients with recurring or metastasizing squamous cell carcinoma of the cervix were treated with doxorubicin and cisplatin. Sixteen patients (Group 1) had previously been treated with external irradiation and two intracavitary radium applications, and 15 patients (Group 2) had been treated with radiotherapy plus chemotherapy with bleomycin plus mitomycin, peplomycin, or melphalan. The overall frequency of response was approximately 16% (five of 31 patients). In Group 1, two of 16 patients had complete remission for 14+ and 28 months, and survival for 36+ and 45+ months. One of 16 patients had partial remission for 8 months, and survival for 16+ months. In Group 2, two of 15 patients achieved partial remission for 16 and 18 months, and survival for 28 and 35 months. No serious side effects were noted in the two groups.

Adult↗