1/23. Visualization of diaphragmatic fenestration associated with catamenial pneumothorax.Catamenial pneumothorax is a rare entity of unknown etiology characterized by recurrent accumulation of air in the thoracic space during or preceding menstruation. We documented the presence of a diaphragmatic fenestration during thoracoscopy, lending support for hypotheses involving diaphragmatic defects as possible avenues of air collection in the thorax.- - - - - - - - - - ranking = 1keywords = menstruation (Clic here for more details about this article) |
2/23. Recurrent herpetic keratitis induced by laser iridectomy: case report.The mechanism for herpetic keratitis reactivation remains unclear. When observed clinically, the reactivation may be associated with a variety of endogenous and exogenous stimuli, such as strong sunlight, fever, menstruation, and psychiatric disturbances. In experimental studies, most methods of inducing recurrence have involved some degree of corneal trauma, inflammation, neuronal stimulation, or damage to the nerves that innervate the cornea. Although corneal damage after laser iridectomy (LI) is well documented, recurrent herpetic keratitis induced by LI has never been reported. Here we present an unusual case of recurrent herpetic keratitis induced by LI. The location of the bullous keratopathy was strongly correlated to the site of laser iridectomy. Clinical findings as well as the dramatic response to antiviral treatment supported the diagnosis. Although the energy for laser iridectomy is relatively safe for most circumstances, the possibility of inducing herpetic keratitis cannot be ignored. Therefore it is important for clinicians to beware of this potential complication.- - - - - - - - - - ranking = 1keywords = menstruation (Clic here for more details about this article) |
3/23. Current therapy of catamenial pneumothorax.Catamenial pneumothorax, or monthly recurring pneumothorax associated with menstruation, has been reported with increasing frequency in recent years. A representative case illustrates the clinical syndrome, particularly the intraoperative findings. Characteristic of this disorder are a peak incidence in the late twenties or early thirties, recurrent right-sided pneumothoraces occurring at the onset of menstruation, and an association with pelvic endometriosis. Pathologically, there is a consistent pattern of intrathoracic, especially diaphragmatic, foci of ectopic endometrial tissue. There is also a strong association with diaphragmatic fenestrations, though their significance is controversial. Traditional therapy has involved treatment with estrogens, danazol, or thoracotomy with mechanical pleurodesis. These methods have proven, through a large meta-analysis, to be associated with a relatively high rate of recurrence. Subsequent advances in hormonal therapy, along with the development of minimal access surgery, have led to an evolution in management. Despite uncertainty as to the etiology of catamenial pneumothorax, diagnosis of the condition is straightforward and modern treatment is successful in preventing recurrence.- - - - - - - - - - ranking = 2keywords = menstruation (Clic here for more details about this article) |
4/23. complement factor i deficiency associated with recurrent meningitis coinciding with menstruation.BACKGROUND: Complement (C) factor I deficiency is a rare immunodeficiency state frequently associated with recurrent pyogenic infections in early infancy. This deficiency causes a permanent uncontrolled activation of the alternative pathway resulting in massive consumption of C3. PATIENT: A 23-year-old woman with monthly recurrent meningitis episodes, mostly in the perimenstrual period, since August 1999. Previously, at age 16 years, she had meningococcal sepsis, also coinciding with menstruation. OBJECTIVES: To study the patient and her family to elucidate the molecular defects in the pedigree and to evaluate her clinical evolution. RESULTS: We describe clinical, immunological, and treatment follow-up during this period. First, we characterized the existence of a total complement factor i deficiency defined by undetectable levels by enzyme immunosorbent assay. This total deficiency was also found in her sister. Her parents and brother had approximately half of the normal levels. In addition, the patient had very low levels of C3; factor B; and an important reduction of factor H, properdin, C5, C7, and C8 complement components. Additional studies in the patient's sera evidenced high levels of immune complexes containing C1q and immunoglobulin (Ig) G, as well as C3b/factor H, C3b/properdin, C3b/IgG, and properdin/IgG complexes. Treatment with prophylactic antibiotics, antiestrogen medication, plasma infusions, or intravenous immunoglobulin has been unsuccessful in avoiding consecutive meningitis episodes. CONCLUSION: For the first time to our knowledge, these data present an unusual relationship between meningitis episodes and menstruation in factor I immunodeficiency.- - - - - - - - - - ranking = 6keywords = menstruation (Clic here for more details about this article) |
5/23. Nonsurgical treatment of a catamenial pneumothorax with a Gn-RH analogue.Catamenial pneumothorax is a rarely encountered entity characterized by recurrent pneumothorax concurrent with menstruation. Numerous mechanisms have been postulated in the etiology of catamenial pneumothorax and treatment is still controversial. We report a case of a catamenial pneumothorax successfully treated with a Gn-RH analogue supporting the efficacy of this regimen and the endometriosis theory as an underlying cause of the disease.- - - - - - - - - - ranking = 1keywords = menstruation (Clic here for more details about this article) |
6/23. Spinal arteriovenous malformations and subarachnoid haemorrhage.Seventy patients with spinal arteriovenous malformations (AVMs) referred to the author over a 25-year period (1958-82), were equally divided between congenital, intradural and acquired, dural lesions. Amongst the intradural AVMs, were 22 with subarachnoid haemorrhage (SAH), a presenting feature in 18. The clinical findings in these 22 patients are tabulated, the radiological and operative findings indicated, and an account given of the overall outcome. Early operation is recommended, with a good prognosis and prevention of further haemorrhage in most cases. An extended follow-up has been maintained. The influence of menstruation, pregnancy and the puerperium on AVM symptoms is described.- - - - - - - - - - ranking = 1keywords = menstruation (Clic here for more details about this article) |
7/23. Catamenial pneumothorax.Catamenial pneumothorax is defined as spontaneous pneumothorax occurring within 72 hours before or after onset of menstruation. Although catamenial pneumothorax is the most common clinical manifestation of intrathoracic endometriosis, this latter condition is not universally identified in women with catamenial pneumothorax and cannot fully explain the recurrent and cyclical episodes of pneumothorax. Therefore, the etiology of this syndrome is unknown, although many theories have been proposed to explain it. We describe a 37-year-old woman with recurrent episodes of spontaneous right-sided pneumothorax and chest pain that occurred close to her menstrual periods. The patient's condition did not abate after initial surgical exploration with abrasive mechanical pleurodesis or after hormonal suppressive therapy at an institution elsewhere. The patient was referred to our institution for further evaluation. A second surgical inspection of the pleural cavity and diaphragm disclosed the presence of multiple diaphragmatic fenestrations that were closed surgically at that time. Postoperatively, the patient discontinued hormonal suppressive therapy, and menstrual cycles became regular. Six months after surgery, the patient remains asymptomatic with no evidence of recurrence of pneumothorax. This case supports recent reports that diaphragmatic defects are often present in patients with catamenial pneumothorax. Surgical exploration to inspect the diaphragm and to close all Identified defects should be performed in patients who continue to experience pneumothorax despite effective hormonal suppression.- - - - - - - - - - ranking = 1keywords = menstruation (Clic here for more details about this article) |
8/23. A very rare entity: catamenial pneumothorax.Catamenial pneumothorax, a variant of spontaneous pneumothorax occurs exclusively in women of menstrual age. Catamenial pneumothorax is associated with a high rate of recurrence. The etiology and pathogenesis is enigmatic. We describe the case of a 42-year-old woman with right-sided catamenial pneumothorax recurring four times, caused by ectopic endometriosis in the pleural layers which was confirmed histopathologically. Surgical treatment should be accomplished during menstruation for optimal visualization of pleurodiaphragmatic endometriosis.- - - - - - - - - - ranking = 1keywords = menstruation (Clic here for more details about this article) |
9/23. Bronchopulmonary endometriosis: a rare cause of hemoptysis.We have reported a case of hemoptysis caused by pulmonary parenchymal endometriosis which was apparently successfully treated with danazol. Bronchopulmonary endometriosis is a very unusual cause of hemoptysis, and should be suspected on the basis of cyclic hemoptysis with menstruation. danazol is effective therapy, but information regarding optimal dosage and rates of recurrence after completion of therapy is limited at this time.- - - - - - - - - - ranking = 1keywords = menstruation (Clic here for more details about this article) |
10/23. Recurrent hemoperitoneum in women receiving continuous ambulatory peritoneal dialysis.Of 27 women in the reproductive age group receiving continuous ambulatory peritoneal dialysis for more than 3 months, 4 of 7 who menstruated developed recurrent hemoperitoneum. Tubal ligation had been done in 3 of these 4 women. There were 37 episodes of hemoperitoneum; 22 occurred at midcycle and 15 with menstruation. One patient required repeated blood transfusion, but after oral anovulant therapy no further bleeding occurred and no transfusion was required. Two patients needed laparotomy: one for heavy intraperitoneal bleeding originating from a luteal cyst, and the other for severe lower abdominal pain from follicular and luteal cysts. Ultrasound examinations suggested the presence of small ovarian cysts in the two remaining patients. Recurrent midcycle hemoperitoneum in women on continuous ambulatory peritoneal dialysis may be triggered by ovulation and associated ovarian cyst formation. Suppression of ovulation should be considered.- - - - - - - - - - ranking = 1keywords = menstruation (Clic here for more details about this article) |
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