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1.
Artigo em Inglês | MEDLINE | ID: mdl-34501846

RESUMO

BACKGROUND: Cervical elongation is commonly associated with pelvic organ prolapse (POP). It was an identified risk for recurrent prolapse after hysteropexy, requiring additional surgeries. The aim of the study is to investigate the risk factors for uterine cervical elongation among women with POP. METHODS: In this single-center retrospective cohort study, women who underwent vaginal total hysterectomy for POP between 2014 and 2016 were collected. The cervical and total uterine lengths were measured by pathologists, while the ratio of cervical length to total uterine length were calculated. The cervical elongation is defined as corpus/cervix ratio ≤ 1.5. RESULTS: A total of 133 patients were enrolled in this study. Among these patients, 43 women had cervical elongation and 90 women had normal length of uterine cervix. We found that age > 65 years old (67.4% vs. 42.2%, p = 0.007), total vaginal length ≥ 9.5 cm (65.1% vs. 45.6%, p = 0.035), uterine weight < 51 gm (72.1% vs. 52.2%, p = 0.03), and Pelvic Organ Prolapse Distress Inventory 6 (POPDI-6) ≥ 12 (30.2% vs. 14.4%, p = 0.032) were associated with the risk of cervical elongation. There were no significant differences on preoperative urodynamic parameters in the two groups. CONCLUSION: The patient age > 65 years old, the total vaginal length of POP-Q system ≥ 9.5 cm, uterine weight < 51 g, and POPDI-6 ≥ 12 are independent risk factors of cervical elongation in women with POP. For women scheduled for pelvic reconstructive hysteropexy, concomitant cervical amputation should be considered.

2.
Sci Rep ; 11(1): 1584, 2021 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-33452330

RESUMO

The study aims to evaluate the effectiveness of local injection of autologous platelet rich plasma (A-PRP) as a treatment for women suffering from stress urinary incontinence (SUI). In a prospective intervention study, twenty consecutive women suffering from SUI were treated with A-PRP injection at anterior vaginal wall where mid-urethra locates. Self-reported questionnaires were used to measure pre-treatment, 1 month and 6 months post-treatment symptom severity. Secondary outcomes of sexual function and treatment effect sorted by age were analyzed with valid statistical methods. A-PRP is effective in relieving SUI symptoms at both 1 month and 6 months post-treatment without significant adverse reactions reported. It seems to have a trend that treatment success rate with cured and improved symptoms was slightly higher in the younger group, although it did not reach statistical significance (P = 0.07). No significant changes in sexual function before and after the treatment were reported by the patients. This pilot study is the first to report A-PRP treatment effect for SUI in women. The result suggested that A-PRP is a considerable treatment option for mild to moderate SUI cases. It also opens up further research opportunities for A-PRP's clinical applications.


Assuntos
Transfusão de Plaquetas , Plasma Rico em Plaquetas/química , Incontinência Urinária por Estresse/terapia , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Índice de Gravidade de Doença , Transplante Autólogo , Resultado do Tratamento , Uretra/patologia , Incontinência Urinária por Estresse/patologia , Urodinâmica , Vagina/patologia
3.
Int J Med Sci ; 18(3): 763-767, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33437211

RESUMO

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is an emerging disease. There has been a rapid increase in cases and deaths since it was identified in Wuhan, China, in early December 2019, with over 4,000,000 cases of COVID-19 including at least 250,000 deaths worldwide as of May 2020. However, limited data about the clinical characteristics of pregnant women with COVID-19 have been reported. Given the maternal physiologic and immune function changes during pregnancy, pregnant women may be at a higher risk of being infected with SARS-CoV-2 and developing more complicated clinical events. Information on severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) may provide insights into the effects of COVID-19's during pregnancy. Even though SARS and MERS have been associated with miscarriage, intrauterine death, fetal growth restriction and high case fatality rates, the clinical course of COVID-19 pneumonia in pregnant women has been reported to be similar to that in non-pregnant women. In addition, pregnant women do not appear to be at a higher risk of catching COVID-19 or suffering from more severe disease than other adults of similar age. Moreover, there is currently no evidence that the virus can be transmitted to the fetus during pregnancy or during childbirth. Babies and young children are also known to only experience mild forms of COVID-19. The aims of this systematic review were to summarize the possible symptoms, treatments, and pregnancy outcomes of women infected with COVID-19 during pregnancy.


Assuntos
COVID-19/epidemiologia , Transmissão Vertical de Doenças Infecciosas , Complicações Infecciosas na Gravidez/epidemiologia , Resultado da Gravidez , SARS-CoV-2/imunologia , Adulto , COVID-19/imunologia , COVID-19/terapia , COVID-19/transmissão , Feminino , Humanos , Recém-Nascido , Exposição Materna , Coronavírus da Síndrome Respiratória do Oriente Médio/imunologia , Gravidez , Complicações Infecciosas na Gravidez/imunologia , Complicações Infecciosas na Gravidez/terapia , Complicações Infecciosas na Gravidez/virologia , Vírus da SARS/imunologia , SARS-CoV-2/isolamento & purificação , Síndrome Respiratória Aguda Grave/epidemiologia , Síndrome Respiratória Aguda Grave/imunologia , Síndrome Respiratória Aguda Grave/virologia , Índice de Gravidade de Doença
4.
Eur J Obstet Gynecol Reprod Biol ; 255: 34-39, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33070088

RESUMO

OBJECTIVE: To identify factors associated with voiding dysfunction after Uphold™ transvaginal mesh (TVM) repair in women with pelvic organ prolapse (POP). STUDY DESIGN: We performed a retrospective analysis of 110 women with symptomatic pelvic organ prolapse (POP), anterior vaginal wall prolapse and/or apical prolapse (stage II to IV) who were scheduled for Uphold™ mesh surgery from September 2015 through December 2016. All subjects underwent urinalyses, UDI-6, IIQ-7, ICI-Q, POPDI-6, and pelvic examinations using the POP quantification (POP-Q) staging system before and after surgeries, with follow-up durations ranging from 24-36 months. RESULTS: A total of 12 (10.9 %) of 110 women reported voiding dysfunction after Uphold™ mesh surgery. Using univariate analysis, there were no differences in body mass index and urodynamic parameters between normal voiding group and dysfunctional voiding group (P > 0.05). However, in patients aged above 71, POPDI-6 score≧13, preoperative concomitant urinary hesitancy, and incomplete emptying were found to be significant predictors of voiding dysfunction following Uphold™ mesh surgeries (P < 0.05). CONCLUSION: In patients aged above 71, POPDI-6 score≧13, preoperative concomitant urinary hesitancy, and incomplete emptying were significant predictors of voiding dysfunction after Uphold™.


Assuntos
Prolapso de Órgão Pélvico , Slings Suburetrais , Prolapso Uterino , Idoso , Feminino , Humanos , Prolapso de Órgão Pélvico/cirurgia , Estudos Retrospectivos , Slings Suburetrais/efeitos adversos , Telas Cirúrgicas/efeitos adversos , Resultado do Tratamento , Vagina
5.
Eur J Obstet Gynecol Reprod Biol ; 247: 198-202, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32146224

RESUMO

OBJECTIVE: To present a comprehensive evaluation of anterior/apical and/or posterior prolapse repair systems with a focus on safety and surgical efficacy. METHODS: Two hundred and twenty women with pelvic organ prolapse (POP) stage II-IV were referred for single-incision transvaginal mesh procedures in a single institution. Pre- and postoperative assessments included pelvic examination, urodynamic studies, and personal interviews about patients' quality of life and urinary symptoms. RESULTS: The anatomical success rate was 92.3 % (203/220), regardless of primary or de-novo POP, at 12-38 month follow-up. The POP quantification parameters, except total vaginal length, improved significantly after surgery (p < 0.05). Complications included bladder injury (one case), mesh exposure (six cases) and urinary retention that required intermittent catheterization (five cases). There were no cases of bowel injury during surgery. The results indicated that 29 % of patients had de-novo stress urinary incontinence and 7.7 % of patients had de-novo POP after surgery. CONCLUSION: The apical vaginal suspension system is a safe and effective procedure, creating good anatomical restoration and significant improvement in quality of life. However, the rate of de-novo POP in the anterior compartment of the vagina (31.8 %) seems high after treatment with apical and posterior prolapse repair systems.


Assuntos
Procedimentos Cirúrgicos em Ginecologia/instrumentação , Prolapso de Órgão Pélvico/cirurgia , Telas Cirúrgicas/estatística & dados numéricos , Idoso , Feminino , Procedimentos Cirúrgicos em Ginecologia/métodos , Procedimentos Cirúrgicos em Ginecologia/estatística & dados numéricos , Humanos , Sintomas do Trato Urinário Inferior/cirurgia , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estudos Retrospectivos
6.
Sci Rep ; 9(1): 17047, 2019 11 19.
Artigo em Inglês | MEDLINE | ID: mdl-31745119

RESUMO

Uphold transvaginal mesh implantation is an option for treating pelvic organ prolapse (POP). This prospective cohort study aims to evaluate the effect of Uphold transvaginal mesh implantation on female sexual function. 205 women with symptomatic POP were recruited and evaluated pre-operatively and re- evaluated six months post-operatively in terms of anatomical restoration, quality of life influenced by urinary incontinence and female sexual function. 30 women eventually completed the assessments and been statistically evaluated. The main outcome focused on sexual function. In our study, we found that Uphold transvaginal mesh surgery could achieve effective anatomical restoration of POP and better sexual function regardless of concomitant sling surgery.


Assuntos
Prolapso de Órgão Pélvico/cirurgia , Qualidade de Vida/psicologia , Comportamento Sexual/psicologia , Disfunções Sexuais Fisiológicas/cirurgia , Incontinência Urinária/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Estudos Prospectivos , Slings Suburetrais , Telas Cirúrgicas , Inquéritos e Questionários , Resultado do Tratamento , Vagina/cirurgia
7.
Top Curr Chem (Cham) ; 377(6): 37, 2019 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-31728771

RESUMO

Over the past decade, the combination of visible light photocatalysis and organocatalysis has made remarkable progress in modern chemical synthesis. In these dual catalysis system, photocatalysts or photosensitizers absorb visible light to induce their photoexcited states which can activate unreactive substrates via electron or energy transfer mechanisms, and organocatalysts are usually employed to regulate the chemical reactivity of the other substrates. By doing so, two reactive species react with each in a selective-especially enantioselective-way, to provide the final products. This article summarizes the recent development of cooperative catalysis by the combination of organocatalysis and photocatalysis in asymmetric organic synthesis. These reactions are classified according to the manner of activation of the organocatalysts. Enamine/iminium catalysts are used to activate unreactive carbonyl molecules. Nucleophilic catalysts including nitrogen heterocycle carbene catalysts and tertiary amine catalysts are employed to reverse the reactivity of electrodeficient substrates including aldehydes and enals. Chiral Brønsted acid catalysts are used to activate substrates by forming key H-bonding complexes between substrates and catalysts.


Assuntos
Aminas/química , Iminas/química , Luz , Aldeídos/química , Alcenos/química , Catálise , Metano/análogos & derivados , Metano/química , Estereoisomerismo
8.
J Org Chem ; 84(11): 6798-6806, 2019 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-31095379

RESUMO

A novel visible-light photoredox-catalyzed phosphinyloxy radical addition/cyclization cascade of arylphosphinic acids or arylphosphonic acid monoesters with alkynes has been developed, which provides an efficient and practical access to various phosphaisocoumarins by using a dual catalytic system containing an acridinium photosensitizer and a cobaloxime proton-reducing catalyst [Co(dmgH)2]PyCl at ambient temperature. This method has advantages of a broad substrate scope, mild condition, as well as no sacrificial oxidant.

9.
Chem Commun (Camb) ; 55(33): 4853-4856, 2019 Apr 18.
Artigo em Inglês | MEDLINE | ID: mdl-30950459

RESUMO

Efficient C-N and C-O coupling reactions of aryl halides with amines and alcohols have been developed by using the strategy of heterogeneous visible light photoredox and nickel dual catalysis. Obviously, the joint use of inexpensive and bench-stable CdS and nickel salts, together with mild reaction conditions, makes these two transformations attractive for the synthetic community. This heterogeneous dual catalysis system also proved to be successful in the ligand-free catalytic hydroxylation of aryl bromide with water as a nucleophile. The practicality of this protocol is further emphasized by the scaled-up reaction and the reusability of heterogeneous photocatalysts.

10.
Angew Chem Int Ed Engl ; 56(32): 9527-9531, 2017 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-28636809

RESUMO

A visible-light-driven radical-mediated strategy for the in situ generation of aza-ortho-quinone methides from 2-vinyl-substituted anilines and alkyl radical precursors is described. This process enables an efficient multicomponent reaction of 2-vinylanilines, halides, and sulfur ylides, and has a wide substrate scope and good functional group tolerance. Treatment of the cycloaddition products with a base leads to densely functionalized indoles in a single-flask operation.

11.
Org Biomol Chem ; 14(23): 5224-8, 2016 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-27215676

RESUMO

A base-catalyzed divergent reaction of 3-ylideneoxindoles with O-Boc hydroxycarbamates has been developed to provide efficient access to various amidoacrylates and spiroaziridine oxindoles with generally high yields, which should be potentially useful in drug discovery.

12.
Nat Commun ; 5: 5500, 2014 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-25413598

RESUMO

Through nearly 50 years of development, sulphur ylides have been established as versatile and powerful reagents for the construction of carbocycles and heterocycles. Despite advances, two important and yet elusive bottlenecks continue to inhibit the advancement of this chemistry: a limited number of reagents with polar groups to react with sulphur ylides, and the wide utilization of chiral auxiliaries or substrates to achieve asymmetric cycloaddition processes in the majority of known reports. Herein, we apply an asymmetric palladium catalysis strategy to the chemistry of sulphur ylides to address these two fundamental problems. We thus achieve an unprecedented decarboxylation-cycloaddition sequence of cyclic allylic esters with sulphur ylides through the enantioselective trapping of Pd-stabilized zwitterionic intermediates by the ylides. As a result, a series of biologically and synthetically important 3-vinyl indolines are rapidly assembled with a high reaction efficiency and stereoselectivity.

13.
J Org Chem ; 79(5): 2296-302, 2014 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-24506322

RESUMO

A [3 + 2] cycloaddition/ring contraction sequence of ylideneoxindoles with in situ-generated 2,2,2-trifluorodiazoethane without the use of any transition-metal catalyst has been developed. The reaction provides efficient access to biologically important and synthetically useful CF3-containing 3,3'-cyclopropyl spirooxindoles in high yield (74-99%) with high diastereoselectivity (>95:5 d.r.).


Assuntos
Compostos Azo/síntese química , Hidrocarbonetos Fluorados/síntese química , Indóis/síntese química , Compostos de Espiro/síntese química , Compostos Azo/química , Catálise , Reação de Cicloadição , Hidrocarbonetos Fluorados/química , Indóis/química , Estrutura Molecular , Compostos de Espiro/química , Estereoisomerismo
14.
Chem Commun (Camb) ; 48(42): 5160-2, 2012 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-22434093

RESUMO

An efficient organocatalytic Michael-aldol cascade reaction for the asymmetric synthesis of spirocyclic oxindole derivatives fused with tetrahydrothiophenes has been developed through a formal [3+2] annulation strategy.


Assuntos
Aldeídos/química , Indóis/química , Compostos de Espiro/química , Catálise , Ciclização , Oxindóis , Estereoisomerismo , Tiofenos/química
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