PubMed Health⌕ Search

Biomedical subjects

M Monga

Publications and source records attributed to M Monga.

At least 37 records · Page 2Linked to original sources
PubMed2000

Pentosanpolysulfate coating of silicone reduces encrustation.

BACKGROUND AND PURPOSE: A significant problem associated with catheterization in the urinary tract is the encrustation of the catheter materials. One approach to reducing encrustation is to alter the surface properties of the catheters. We evaluated the effectiveness of coating with pentosanpolysulfate (PPS), a semisynthetic polysaccharide similar to heparin, in reducing encrustation and the foreign-body inflammatory response to silicone stents in the bladders of male New Zealand White rabbits. MATERIALS AND METHODS: Sixteen rabbits were divided into three groups to receive placement in their bladders of uncoated (N = 7), PPS-coated (N = 7), or sham matrix-processed silicone rings (N = 2) via open cystotomy. After 50 days of maintenance on normal food and water, all rabbits were sacrificed, and the air-dried, unfixed silicone ring surfaces were examined by scanning electron microscopy. Bladders and remaining silicone rings were removed and preserved separately. Silicone rings, cleaned of all encrustation, were stained with toluidene blue to determine the presence or absence of PPS coating on the surface. RESULTS: Histologic examination revealed normal tissue in bladder sections exposed to coated silicone rings and an inflammatory response in sections from bladders having uncoated silicone rings. Coating with PPS was associated with an eightfold reduction in the amount of encrustation of silicone and a marked reduction in the inflammatory response of the bladder wall to the foreign body. CONCLUSIONS: A PPS coating may be useful in reducing the encrustation of long-term indwelling silicone stents or catheters in the human urinary tract.

Animals↗
PubMed2000

Fatigue and work in pregnancy.

Fatigue is a common complaint among women throughout pregnancy and during the postpartum period. It is suggested that there are physical, psychological, and situational factors predisposing a woman to fatigue during pregnancy. Several studies have attempted to correlate levels of fatigue with other variables. While many of these studies have noted an association between stress and fatigue related to work or home environment and the increased risk of antenatal morbidity, the mechanism of these effects is unclear. It is important for health care professionals, family members, and employers to recognize fatigue as a real problem during pregnancy and the potential negative impact of adverse working conditions on pregnancy outcome.

Fatigue↗
PubMed2000

Percutaneous ablation of caliceal diverticulum: long-term followup.

PURPOSE: A caliceal diverticulum is a nonsecretory cavity that serves as a conduit for urinary stasis and its ensuing complications. Indications for intervention and modes of therapy are controversial. We report a series of patients treated with a percutaneous endourological approach to ablation of the diverticular cavity. MATERIALS AND METHODS: A total of 14 patients underwent percutaneous ablation of a caliceal diverticulum for flank pain a mean of 15.5 months in duration. These caliceal diverticula were associated with urinary tract infection in 43% of cases and/or renal calculi in 78%. Mean calculus diameter was 10.2 mm. and mean diverticular diameter was 10.9 mm. An open ended ureteral catheter was placed into the renal pelvis via cystoscopy. Retrograde instillation of radiopaque contrast medium facilitated the localization of a percutaneous renal puncture made directly into the caliceal diverticulum. A flexible tip guide wire was coiled in the diverticulum, and no effort was made to traverse the infundibulum and establish continuity with the remainder of the collecting system. Tract dilation into the caliceal diverticulum was performed, and percutaneous stone fragmentation and extraction were accomplished. The lining of the caliceal diverticulum was electrocauterized using a roller ball electrode. A balloon nephrostomy tube consisting of a Foley catheter with the tip cut off was positioned into the diverticulum. An indwelling ureteral stent was placed and a Foley catheter provided bladder drainage for 48 hours to maintain a low pressure system. The nephrostomy tube was removed after 24 to 48 hours and the ureteral stent was removed after 2 to 4 weeks. RESULTS: Mean operative time was 162 minutes and mean hospital stay was 2.3 days. Obliteration of the diverticular infundibulum and cavity was documented by contrast radiography (excretory urography or retrograde pyelography), and noncontrast and contrast enhanced computerized tomography, respectively, in all 14 patients. No patients have had recurrent symptoms, calculi or urinary tract infection at a mean 38-month followup. CONCLUSIONS: Percutaneous electrocautery ablation of caliceal diverticula without cannulation or dilation of the diverticular infundibulum represents a safe and effective mode of therapy. Careful patient selection and preparation optimize the efficacy of this technique.

Adolescent↗
PubMed1999

Oxytocin-stimulated capacitative calcium entry in human myometrial cells.

OBJECTIVE: Our purpose was to investigate the relative contribution of extracellular calcium recruitment and release of calcium from intracellular stores in an immortalized myometrial cell line derived from a pregnant woman (PHM1-41) and to determine the importance of capacitative calcium entry in the oxytocin-stimulated rise in intracellular free calcium. STUDY DESIGN: The PHM1-41 immortalized myometrial cell line, which retains smooth muscle phenotype, estrogen, and oxytocin receptors and responds to oxytocin with an increase in intracellular free calcium, was used for this study. Intracellular free calcium was measured directly in cells loaded with Fura 2-AM. RESULTS: The oxytocin-stimulated rise in intracellular free calcium decreased in the absence of extracellular calcium or in the presence of phospholipase C inhibitors, suggesting mobilization of calcium from both extracellular and intracellular sources to increase intracellular free calcium. Phospholipase C inhibitors resulted in greater inhibition of the oxytocin-stimulated rise in intracellular free calcium than expected on the basis of experiments performed in the absence of extracellular calcium. This implies interdependence of the intracellular and extracellular pathways for elevation of intracellular free calcium and suggests some capacitative entry of calcium as a consequence of depletion of intracellular stores. The oxytocin-stimulated intracellular free calcium increase resulting from calcium entry was blocked by store depletion by thapsigargin or cyclopiazonic acid, consistent with a capacitative calcium entry mechanism. CONCLUSION: Oxytocin stimulates both capacitative and noncapacitative calcium entry in a pregnant human myometrium cell line.

Calcium↗
PubMed1999

Male infertility and erectile dysfunction in spinal cord injury: a review.

OBJECTIVE: To review the pathophysiology, evaluation, and management of erectile dysfunction and infertility in spinal cord injury (SCI). STUDY SELECTIONS: Studies that covered various treatment options and their contraindications, complications, or side effects, including sildenafil (Viagra), intracavernosal injection therapy, topical medications and a urethral delivery system, a vacuum erection device, and penile prostheses. Other studies covered the effects of SCI on reproduction: spermatogenesis and testicular function, and seminal constituents. In addition, assisted reproductive techniques were compared: external vibratory stimulation, electroejaculation, testicular sperm aspiration, and intracytoplasmic sperm injection. CONCLUSION: Goal-directed therapy is the mainstay of treatment of erectile dysfunction in men with or without SCI. The choice of therapy is often defined more by the needs of the patient's sexual relationship than by his erectile dysfunction. The majority of men with SCI are infertile because of a combination of ejaculatory dysfunction, impaired spermatogenesis, and poor semen quality. Although many technological advances have evolved to overcome ejaculatory dysfunction, the sperm density, motility, and function remain poor. Until these parameters are improved, men with SCI will have to pursue more financially and emotionally taxing procedures. Further studies to elucidate the cellular and molecular mechanisms of diminished sperm quality are needed. Addressing the issues of erectile dysfunction and male infertility may help to preserve the relationship between the patient and his partner.

Erectile Dysfunction↗
PubMed1999

Acute fatty liver in the second trimester.

BACKGROUND: Acute fatty liver of pregnancy is a rare, potentially fatal disease that occurs in the late third trimester or early postpartum period. The case of a woman with acute fatty liver in the second trimester is presented. CASE: A 35-year-old woman, gravida 5, para 4, presented at 22 weeks' gestation with nausea, vomiting, malaise, weight loss, and moderately elevated liver transaminase levels. The differential diagnoses included viral gastroenteritis and cholelithiasis. During the next 12 days, her transaminase levels increased, jaundice developed, her sensorium changed, and coagulopathy appeared. After the patient was transferred to a tertiary care hospital, acute fatty liver of pregnancy was diagnosed. The woman rapidly improved after delivery. CONCLUSION: Although acute fatty liver of pregnancy usually occurs in the late third trimester or early postpartum period, it can occur in the second trimester.

Acute Disease↗
PubMed1999

Prior knowledge of obstetric gestational age and possible bias of Ballard score.

OBJECTIVE: To determine whether prior knowledge of obstetric estimate of gestational age creates a bias in assignment of gestational age by the Ballard assessment score. METHODS: The Ballard assessment score was done on 82 infants weighing less than 2500 g by two examiners, one who had prior knowledge of best obstetric gestational age estimate and the other who was masked to that information. Obstetric gestational age was correlated with masked and unmasked score. Statistical analysis used Spearman rank correlation test, plotting the measurement means against the measurement differences, chi2, Wilcoxon signed-rank test, analysis of variance, and Student t test. Significance was assumed at P < .05. RESULTS: There was high reliability (r = 0.84-0.86) between obstetric gestational age estimates (33.3 +/- 3.0 weeks) and the gestational age derived from masked (34.3 +/- 3.0 weeks) and unmasked (34.0 +/- 3.0 weeks) Ballard scores. The mean difference between unmasked scores and gestational age was 1.38 +/- 1.15 weeks and that between masked scores and obstetric gestational age was 1.40 +/- 1.15 weeks, a nonsignificant difference. There was no significant difference in the number of cases with 100% agreement between masked and unmasked scores and obstetric gestational age or in the number of cases in which the score (masked or unmasked) differed by more than 2 weeks from obstetric gestational age. This study had over 99% power to detect a 1-week difference between the accuracy of masked and unmasked scores. CONCLUSION: Prior knowledge of obstetric gestational age did not bias the Ballard assessment score.

Bias↗
PubMed1999

Medical management of benign prostatic hyperplasia.

The management of benign prostatic hyperplasia has undergone a rapid evolution over the past decade from a surgical emphasis to a medical emphasis. Great strides in the development of alpha-adrenergic blockers, 5 alpha-reductase inhibitors and a variety of phytotherapeutics have fueled this evolution. This article reviews the past, present and future of the medical management of benign prostatic hyperplasia.

Adrenergic alpha-Antagonists↗
PubMed1999

The aging penis: erectile dysfunction.

Over 30 million men and their partners suffer the effects of erectile dysfunction. Erectile dysfunction results in significant psychological, social and physical morbidity; requiring a comprehensive and compassionate approach by the health care provider. The article reviews the epidemiology, pathophysiology and clinical presentation of erectile dysfunction. It provides a comprehensive, outcome-based evaluation of current treatment modalities.

Aging↗
PubMed1999

Metachronous bilateral torsion of the testicular appendices.

BACKGROUND: Torsion of the appendix testis is a common cause of scrotal pain in children and a common cause for surgical exploration of the pediatric scrotum. The first case of metachronous bilateral torsion of the testicular appendices managed by a non-operative approach is reported. METHODS/RESULTS: A case report and a computer-assisted review of the literature are presented. Physical findings of a tender, mobile mass over the anterior surface of the testis characterize the presentation. Doppler findings of normal blood flow to the testes with increased flow to the adjacent appendix testis can be utilized as an adjunct to diagnosis. Ultrasonographic findings of a pedunculated mass with a central hypoechoic area at the superior aspect of the testis support the diagnosis. Accurate non-operative diagnosis of torsion of the appendix testis permits successful conservative management with non-steroidal anti-inflammatory agents. CONCLUSIONS: Improvements in ultrasonographic and Doppler imaging of torsion of the appendix testis have facilitated the diagnosis of this entity and decreased the need for surgical exploration of the scrotum.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1999

Fatigue in pregnancy: a comparative study.

The objective of this study was to use validated scales to determine if fatigue is increased during the first trimester of pregnancy compared to nonpregnant women with similar demographic characteristics. Women between 6 and 12 weeks' gestation were invited to complete a demographics questionnaire and the Numerical Rating Scale for Fatigue (NRS-F), State Trait Anxiety Inventory (STAI), and Beck Depression Index (BDI-II). Nonpregnant women were also invited to participate. Statistical analysis was performed using Mann-Whitney U, Fisher's exact, Spearman correlation, and Monte Carlo tests where appropriate; significance was assumed at p <0.05. Twenty pregnant and 15 nonpregnant patients were enrolled. There was no difference in age, parity, BMI, race, marital status, education, income or hours worked outside the home between pregnant and nonpregnant subjects. Pregnant women reported greater number of hours spent sleeping each day (8 [7-10] vs. 7 [6-9], p = 0.03). There was no significant difference in BDI-II, STAI-S, or STAI-T scores, but pregnant women had significantly higher scores on the NRS-F test (72.5 [20-88] vs. 36 [18-94], p <0.05). Women in the first trimester of pregnancy experience significantly greater fatigue compared to a similar group of nonpregnant women.

Adolescent↗
PubMed1999

Holmium laser lithotripsy of a complicated biliary calculus.

More than 500,000 cholecystectomies are performed annually. Extracorporeal shockwave lithotripsy and endoscopic laser lithotripsy have been used for the management of common bile duct calculi, which complicate 10% of cases. We report the first successful clinical application of the Ho:YAG laser to a complex biliary calculus case.

Aged↗
PubMed1999

Physical conditioning effects on fetal heart rate responses to graded maternal exercise.

PURPOSE: This study examined the effects of advancing gestational age and maternal aerobic conditioning (stationary cycling) on fetal heart rate (FHR) responses to strenuous non-steady-state maternal exercise. METHODS: Subjects chose to participate in either an exercise group (EG) or control group (CG). Fourteen healthy, previously sedentary pregnant women participated in the exercise group, and six pregnant controls remained sedentary. Stationary cycling (heart rate target: 145 beats x min(-1)) was performed 3 d x wk(-1) by the exercised group. Exercise duration was increased from 14 to 25 min x session(-1) during the second trimester and was maintained at 25 min x session(-1) throughout the third trimester. FHR was monitored before, during, and after a progressive submaximal cycle ergometer test (peak heart rate = 170 beats x min(-1)) performed at approximately 27 and 37 wk gestation. RESULTS: Mean FHR increased significantly (P < 0.05) during exercise, followed by a modest suppression and then a delayed rise during the recovery period at both observation times. Fetal bradycardia was not observed in any of the exercise tests. Effects of advancing gestational age included a lower FHR baseline both at rest and in response to maternal exercise and a lower incidence of exercise-induced tachycardia. Maternal physical conditioning did not significantly alter FHR response to maternal exercise. CONCLUSION: Our results support the hypothesis that FHR responses to strenuous exercise are altered by advancing gestational age and a brief progressive exercise test terminated at a maternal heart rate of 170 beats x min(-1) does not induce fetal distress during a healthy pregnancy.

Adult↗
PubMed1999

Mini-percutaneous antegrade endopyelotomy.

Antegrade endopyelotomy is the endourologic treatment of choice for ureteropelvic junction obstruction with a coexisting renal calculus. We report the use of a mini-percutaneous procedure that allows us to perform an antegrade endopyelotomy and stone extraction through a 20F nephrostomy sheath.

Endoscopy↗