Biomedical subjects

V A Minassian

Publications and source records attributed to V A Minassian.

4 recordsLinked to original sources

PubMed2003

Urinary incontinence as a worldwide problem.

OBJECTIVES: This paper reviews the literature on the prevalence of urinary incontinence (UI) and demonstrates its impact as a worldwide problem. METHODS: A MEDLINE search was performed to review population-based studies in English. Studies were grouped according to demographic variables and type of incontinence. Risk factors, help-seeking behavior, and quality of life measures were analyzed. RESULTS: The median prevalence of female UI was 27.6% (range: 4.8-58.4%) and prevalence of significant incontinence increased with age. The commonest cause of UI was stress (50%), then mixed (32%) and finally urge (14%). Risk factors included parity, obesity, chronic cough, depression, poor health, lower urinary tract symptoms, previous hysterectomy, and stroke. Although quality of life was affected, most patients did not seek help. CONCLUSION: UI is a prevalent cross-cultural condition. Future studies should rely on universally accepted standardized definitions to produce meaningful evidence-based conclusions, as well as project the costs of this global healthcare problem.

Adolescent↗

PubMed2001

Balloon thermoablation in a woman with complex endometrial hyperplasia with atypia. A case report.

BACKGROUND: Endometrial ablation is an alternative to hysterectomy in patients with menorrhagia refractory to medical therapy. The histologic changes in the hyperplastic endometrium secondary to endometrial ablation are not well understood. CASE REPORT: A 44-year-old woman, gravida 4, para 4, had menorrhagia, was at high risk for medical treatment and underwent thermal balloon ablation. The dilatation and curettage specimen at the time of the procedure revealed complex hyperplasia of the endometrium with atypia. Subsequently a hysterectomy was performed, and the pathology specimen showed scarring, fibrosis and focal, weakly proliferative phase endometrium. There was no evidence of hyperplasia or malignancy. CONCLUSION: Endometrial ablation with a thermal balloon seems to have resulted in resolution of endometrial hyperplasia. However, hyperplasia of the endometrium should still be a contraindication to such a procedure because of the inability to accurately assess the endometrium after ablation.

Adult↗

PubMed2000

Longterm central venous access in gynecologic cancer patients.

BACKGROUND: To assess the utility and safety of three different longterm indwelling intravenous catheters in patients with gynecologic malignancies. STUDY DESIGN: A retrospective review was performed of the records of all women with gynecologic malignancies who required longterm venous access catheters and ports between 1990 and 1997. RESULTS: Two hundred sixty-eight women underwent placement of 308 indwelling catheters, of which 305 were available for analysis. Of those, 68 (22%) were Hickman catheters, 162 (53%) were infusaports, and 75 (25%) were Peripheral Access System (PAS) ports. Venous access was obtained percutaneously in 152 (50%) patients and by cutdown in 153 (50%). Prophylactic anticoagulation was used with 96 catheters (31%). Catheter placement was associated with 12 (4%) immediate complications and 87 (29%) delayed complications. The average duration of a catheter in place was 5.6 months for the Hickman, 12.5 months for the infusaport, and 16.0 months for the PAS port (p < 0.001). Bacteremia was more likely to develop in patients with Hickman catheters when compared with those with infusaports and PAS ports (19% versus 6% and 5%, respectively, p = 0.002). Thrombosis was significantly less likely to develop in patients receiving prophylactic anticoagulation (11% versus 4%, p = 0.004). Overall, the complication rate was lower with cutdown versus percutaneous access (p = 0.004). There was no statistically significant difference between the frequency of complications when correlated with the stage of disease, patient age, body mass index, or type of malignancy. CONCLUSIONS: Infusaports and PAS ports were associated with a lower risk of infection and have a longer life than Hickman catheters. The cutdown approach was associated with a lower complication rate. Low-dose prophylactic anticoagulation should be given to all patients with longterm central venous catheters.

Adult↗

PubMed2000

Recurrent sacculation of the pregnant uterus. A case report.

BACKGROUND: Recurrent uterine sacculation is very rare and associated only with pregnancy. It commonly complicates delivery with a retained placenta. CASE: A 24-year-old woman, gravida 4, para 0, with three previous elective abortions, presented in preterm labor at 32 6/7 weeks' gestation. Her second and third abortions were complicated by incomplete evacuation of uterine contents, and uterine sacculation was diagnosed. Preterm delivery and a retained placenta complicated the present pregnancy. At laparotomy, recurrence of uterine sacculation was noted in the left fundal region of a bicornuate uterus. A hysterotomy was performed to remove the placenta from the sacculation. CONCLUSION: In a patient with multiple uterine procedures and retained placenta, uterine sacculation can develop.

Adult↗