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Biomedical subjects

K Teisala

Publications and source records attributed to K Teisala.

At least 37 records · Page 2Linked to original sources
PubMed1989

Urethral closure function after total and subtotal hysterectomy measured by urethrocystometry.

Urethral closure function was measured before and 3 months after operation in 18 patients having hysterectomy and 13 patients having supravaginal uterine amputation performed. Sixteen patients had a symptom of mild stress incontinence before and 11 after the operation. The urethral closure function at rest and under stress was measured by urethrocystometry. No operation-induced changes in urethral closure pressure, functional length, pressure transmission, urethral relaxation or urethral resistance to stress were found after either operation.

Adult↗
PubMed1989

Removal of an intrauterine device and the treatment of acute pelvic inflammatory disease.

The effect of removing intrauterine devices on the resolution of acute pelvic inflammatory disease was retrospectively studied in 186 hospital inpatients. In 105 patients the intrauterine device was left in place and in 81 it was removed on admission. The demographic and clinical findings in the two groups were similar. No differences were found between the two groups in their short-term response to treatment, except that when an intrauterine device was removed the time in hospital was more often prolonged.

Acute Disease↗
PubMed1989

A comparison of ciprofloxacin with doxycycline plus metronidazole in the treatment of acute pelvic inflammatory disease.

We studied the clinical and microbiological response to two treatment regimens in 36 patients with acute pelvic inflammatory disease (PID). All patients were hospitalized and underwent laparoscopy and endometrial biopsy. Cervical, endometrial, tubal and peritoneal cultures for Chlamydia trachomatis, Neisseria gonorrhoeae, genital mycoplasmas, facultative and anaerobic bacteria and Herpes simplex virus were obtained. The patients were randomly assigned to two treatment groups: 16 women received ciprofloxacin 200 mg b.i.d. iv. for two days, followed by oral administration with 750 mg b.i.d. to complete a 14-day course of treatment. Twenty women received the combination of doxycycline and metronidazole according to a similar scheme of administration. The response was evaluated with repeated clinical examinations, monitoring of the erythrocyte sedimentation rate and serum C-reactive protein concentration, and repeated microbial culture from the cervix. Ciprofloxacin treatment was successful in all nine patients with chlamydial or gonococcal PID and in six of seven with nonchlamydial nongonococcal PID. Doxycycline plus metronidazole regimen was successful in five of seven patients with chlamydial or gonococcal PID and in nine of 13 patients with nonchlamydial nongonococcal PID. Thus, the overall success rate was 94% (15 of 16) with ciprofloxacin and 70% (14 of 20) with doxycycline plus metronidazole. Our study suggests that ciprofloxacin is a promising new alternative for the treatment of acute PID.

Acute Disease↗
PubMed1988

Sexual behavior and risk for pelvic inflammatory disease.

Sexual behavior characteristics of 35 patients with pelvic inflammatory disease (PID) and 44 healthy controls was studied prospectively. Patients with PID had sex more often than did controls (P less than 0.001). The mean number of sexual partners or age at first intercourse did not differ significantly between cases and controls. PID patients more often had oral sex than controls (P less than 0.05). These results suggest that sexual behavior characteristics may be important risk factors for PID, and should be prospectively studied in larger populations.

Adult↗
PubMed1987

Endometrial microbial flora of hysterectomy specimens.

Microbiological and histopathological specimens were obtained from three levels (fundal, middle and cervical) of the endometrium immediately after removing the uterus. Hysterectomy indication was menometrorrhagia and uterine fibroids in eight cases and chronic pelvic pain in two cases. All cultures for C. trachomatis, N. gonorrhoeae, M. hominis, U. urealyticum, herpes simplex virus, anaerobic and facultative bacteria were negative. Histopathological examination showed few plasma cells in the endometrium in four cases with the presence of uterine fibroids and in one case with adenomyosis. These results suggest that the endometrial cavity of a nonpregnant uterus is sterile.

Adult↗
PubMed1987

Microbiological and histopathological findings in acute pelvic inflammatory disease.

Upper genital tract infection was investigated in 45 women admitted to hospital for suspected acute pelvic inflammatory disease (PID). Salpingitis was diagnosed by laparoscopy in 30 (67%) women. Histopathological evidence of endometritis was found significantly more often in the 30 women with salpingitis (87%) than in the other 15 women without salpingitis (33%). C. trachomatis or N. gonorrhoeae, or both, were isolated from the upper genital tract in 14 of the 31 women who had both salpingitis and endometritis or endometritis only but in none of the four women who had salpingitis alone and in none of the 10 women who had no evidence of PID. Bacterial vaginosis was associated with histopathological evidence of upper tract infection. Non-chlamydial non-gonococcal organisms were frequently isolated from the upper genital tract. No organisms were isolated from the upper genital tract from 9 of 35 women with laparoscopic or histopathological evidence of PID compared with 7 of 10 women without evidence of PID. C. trachomatis or N. gonorrhoeae in the endometrium was associated with lymphoid follicles comprising transformed lymphocytes, and correlated with the density of plasma cells on biopsy. The microbiological results support the recommendations of broad spectrum antimicrobial therapy for PID.

Acute Disease↗
PubMed1987

Second laparoscopy after treatment of acute pelvic inflammatory disease.

We used second laparoscopy with dye insufflation to evaluate tubal findings in 20 women 15-45 weeks after treatment for acute pelvic inflammatory disease. Eight women had pelvic adhesions, including all six women with adhesions seen at first laparoscopy. However, in five of the six women, adhesions were milder or had disappeared unilaterally. Dye insufflation revealed tubal occlusion in five of eight women with adhesions and one of 12 women without adhesions. Thus, nine women (45%) had pelvic adhesions or tubal occlusion at second laparoscopy. Second laparoscopy is useful to objectively assess posttreatment tubal and peritubal morphology. Larger studies are needed to evaluate the cost-effectiveness of the procedure and the correlation of second laparoscopy findings to future infertility.

Biopsy↗
PubMed1987

Local oestriol treatment improves the structure of elastic fibers in the skin of postmenopausal women.

The effect of local oestriol treatment on the abdominal skin was studied in 14 postmenopausal women. Six control patients received a similar ointment without oestriol. The duration of the treatment in all cases was three weeks. The elastic fibers in the papillary dermis were thickened, better orientated and slightly increased in number in half of these patients but in none of the control patients. The epidermal thickness was slightly increased in four of the patients treated with oestriol. No significant changes were observed in the epidermal cell size, mitotic activity, dermal vascularization or inflammatory infiltrate between the specimens taken before and after the treatment or between the treatment groups.

Administration, Cutaneous↗
PubMed1986

Serum C-reactive protein determination in acute pelvic inflammatory disease.

We have studied the role of serum C-reactive protein determination in the diagnosis of acute pelvic inflammatory disease. Acute-phase serum C-reactive protein concentration reflected the extent and the severity of pelvic inflammatory disease more closely than erythrocyte sedimentation rate or white blood cell count determinations. We recommend that both C-reactive protein concentration and erythrocyte sedimentation rate should be routinely used to augment the clinical diagnosis of pelvic inflammatory disease.

Blood Sedimentation↗
PubMed1986

Treating pelvic inflammatory disease with doxycycline and metronidazole or penicillin and metronidazole.

The best way of treating pelvic inflammatory disease (PID) is not known. The clinical response to two treatment regimens (penicillin plus metronidazole v doxycycline plus metronidazole) was studied in 33 patients with PID confirmed by laparoscopy and endometrial biopsy. The overall failure rate, according to the criteria used in this study was five of 11 (45%) women with chlamydial PID, none of six women with gonococcal PID, all of four women with chlamydial gonococcal PID, and three (25%) of 12 women with non-chlamydial non-gonococcal PID. The failure rate with penicillin plus metronidazole treatment was unacceptably high (53%), and significantly higher than that with doxycycline plus metronidazole (19%) (p = 0.038). In most cases the microbiological and histopathological evaluations identified a probable explanation for the poor response to the treatment regimen used.

Adult↗
PubMed1986

Vasopressin and prolactin as stress hormones.

The effect of electric stimulation of the uterine cervix on vasopressin and prolactin secretions was investigated in 16 patients with uterine myomas and/or hypermenorrhea. One month after hysterectomy a similar stimulation was induced near the fornix of the vagina. Particularly the first test also seemed to be a considerable psychic stress for the patients. The stimulation did not cause any significant changes in plasma vasopressin and prolactin concentrations.

Adult↗
PubMed1986

Operative technique for the repair of posthysterectomy vaginal prolapse.

The operative technique of our own modified sacral colpopexy with a fascial strip for the repair of posthysterectomy vaginal prolapse is described. The complete removal of the enterocele is important. The fascial strip remains extraperitoneal. Only absorbable sutures have been used. Excellent vaginal support was achieved in all cases operated on with the method described. Possible cystocele and rectocele must be corrected separately prior to sacral colpopexy.

Female↗
PubMed1985

Comparison of endometrial biopsy and peritoneal fluid cytologic testing with laparoscopy in the diagnosis of acute pelvic inflammatory disease.

Twenty-seven women with suspected acute pelvic inflammatory disease were studied by laparoscopy and endometrial biopsy. Overall, 67% (18 of 27) of the women had acute salpingitis at laparoscopy, 70% (19 of 27) had plasma cell endometritis, and 67% (10 of 15) had an inflammatory cytologic pattern of the peritoneal fluid. In comparison to laparoscopically detected salpingitis, endometritis detected with biopsy had a sensitivity of 89%, a specificity of 67%, a positive predictive value of 84%, and a false negative rate of 22% in the diagnosis of pelvic inflammatory disease. The corresponding figures for inflammation of the peritoneal fluid were 75%, 67%, 90%, and 25%. This study demonstrates that nonpuerperal endometritis is an entity associated with pelvic inflammatory disease, most likely representing an intermediate stage between cervicitis and salpingitis. Endometrial biopsy as an office procedure is a good alternative to laparoscopy in the diagnosis of acute pelvic inflammatory disease and may in fact detect early cases not yet visible at laparoscopy.

Acute Disease↗
PubMed1985

Haemophilus influenzae causes purulent salpingitis.

We describe two patients with laparoscopically diagnosed, severe acute salpingitis who had nontypable Haemophilus influenzae isolated directly from the fallopian tubes. Nontypable H. influenzae should be recognized as an important genital pathogen.

Adult↗
PubMed1985

Detection of herpes simplex virus in women with acute pelvic inflammatory disease.

Four women are described with acute salpingitis confirmed by laparoscopy who had herpes simplex virus (HSV) isolated from the cervix or the upper genital tract (endometrium, fallopian tube, or cul-de-sac) or both. None of the patients had overt genital herpes, but one had typical HSV cervitis on a cervicovaginal smear stained with Papanicolaou's stain, one had a significant change in level of antibodies to HSV, and one had an endometrial biopsy specimen positive for HSV antigen. There are at least three potential explanations for these findings: chronic viral shedding, viral reactivation caused by acute pelvic inflammatory disease (PID), or that the PID was actually caused by HSV. Further prospective studies are needed to document the role of HSV in causing PID.

Adolescent↗