Outcomes of Research or Clinical Trials Activity Levels Acute Flaccid Paralysis Ageing Anaerobic Threshold Anaesthesia Assistive Technology Brain Cardiorespiratory Cardiovascular Clinical Evaluation Cold Intolerance Complementary Therapies Continence Coping Styles and Strategies Cultural Context Diagnosis and Management Differential Diagnosis Drugs Dysphagia Dysphonia Epidemiology Exercise Falls Fatigue Fractures Gender Differences Immune Response Inflammation Late Effects of Polio Muscle Strength Muscular Atrophy Orthoses Pain Polio Immunisation Post-Polio Motor Unit Psychology Quality of Life Renal Complications Respiratory Complications and Management Restless Legs Syndrome Sleep Analaysis Surgery Vitality Vocational Implications

Title order Author order Journal order Date order
Category: Women's Health

Title: Caesarean Section in Post-polio Patient
Author: de Oliveira AR, Schutz Martinelli E, Lisiane L.
Affiliation: Roth and Roth Anesthesia Clinic, Rio Grande do Sul, Brazil
Hospital Moinhos de Vento, Rio Grande do Sul, Brazil
Hospital Nossa Senhora Conceicao, Rio Grande do Sul, Brazil
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Journal of Clinical Research in Anesthesiology
J Clin Res Anaesthesiol 2018; 1(1):1-2
Publication Year and Month: 2018 01

Abstract: A 26-year-old primigravida patient, ASA I, 39-week gestation, presented with 24 h premature rupture of membranes, without active labor. She had been in anesthetic pre-operative clinic 2 weeks before and had described poliomyelitis with 1 year old and complete recovering in childhood. With 16-year-old, she was submitted to appendicectomy through spinal anesthesia presenting weakness in entire body for approximately 24 h. At physical examination, the only sign was shorter tibial tendon of both legs.
For the cesarean, after volume expansion with cristaloids, the choice was an epidural anesthesia with 15mg of bupivacaine 0.3% (without epinephrine) and morphine 2 mg. “The surgery was initiated after 4min of blockade with T4 sensitive level reached. Hypotension and tachycardia were corrected with metaraminol 1 mg.” After 50 min, the procedure was finished with the same metameric level of anesthesia, but with cardiovascular stability. The entire recovering from anesthesia has occurred after 11h. An elevated consume of analgesics (nonsteroidal inflammatory drugs and opioids) and antiemetics was observed.

Conclusions: Ultimately, the decision to use general or regional anesthesia should be made on an individual patient basis weighing the risks and benefits. This case report describes some of the fewest practical guidelines available about regional anesthesia in post-polio patients with minimal sequelae. The importance of communications about these cases and the anesthetic conduct in this setting needs more debate to
optimize the facilities in another similar case.

Outcome of Research: Effective

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Women's Health

Title: Cesarean delivery under ultrasound-guided spinal anesthesia [corrected] in a parturient with poliomyelitis and Harrington instrumentation.
Author: Costello, JF, Balki, M.
Affiliation: Department of Anesthesia and Pain Management, Mount Sinai Hospital, Ontario, Canada
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Canadian Journal of Anesthesia
Can J Anaesth. 2008 Dec;55(12):889
Publication Year and Month: 2008 12

Abstract: PURPOSE:
To describe the anesthetic implications, and management of a medically complex parturient, who presented for Cesarean delivery (CD). The patient had poliomyelitis complicated with severe kyphoscoliosis, which had been treated with extensive spinal surgery. We used ultrasound guidance to facilitate successful spinal analgesia and anesthesia.

CLINICAL FEATURES:
A 27-yr-old woman, with a history of poliomyelitis and moderate restrictive lung disease secondary to kyphoscoliosis, presented at 38 weeks gestation for elective CD because of cephalopelvic disproportion. The woman had Harrington rods in situ from the level of the second thoracic vertebra, to the level of the fourth lumbar vertebra. Ultrasound guidance enabled one intervertebral space to be visualized (L5-S1), 3 cm from the expected spinal midline, and spinal anesthesia was performed at this interspace without any complications. A healthy infant was delivered, and the mother recovered uneventfully.

CONCLUSIONS:
Spinal anesthesia can be effectively performed in patients with poliomyelitis and severe kyphoscoliosis, that has been treated with extensive Harrington instrumentation. To facilitate regional techniques in such patients, bedside ultrasound may be greatly beneficial in identifying the correct spinal interspace.

Conclusions: This case illustrates several points: first, the benefit of ultrasound in the placement of a spinal block in a patient with abnormal spinal anatomy; second, the choice of anesthetic technique in pregnant patients with poliomyelitits; and third, the management of a pregnant patient with severe kyphoscoliosis, spinal surgery, and restrictive lung disease.

Outcome of Research: Effective

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Women's Health

Title: Menopause and post-polio symptoms as predictors of subjective sleep disturbance in poliomyelitis survivors.
Author: Kalpakjian CZ, Quint EH, Toussaint LL.
Affiliation: Department of Physical Medicine and Rehabilitation, University of Michigan Health System, Ann Arbor, USA
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Climacteric. 2007 Feb;10(1):51-62.
Publication Year and Month: 2007 02

Abstract: OBJECTIVES:
Sleep disturbance in polio survivors is a common complaint, yet little is known about the effects of the interaction of physical disability and menopause on sleep. The purpose of this study was to understand the relative contribution of menopause factors and disability to subjective sleep disturbance.

METHODS:
Participants were 465 women aged 50-65 years who had physical disabilities due to poliomyelitis. Hierarchical regression modeling was used to examine menopause (symptoms, status, hormone replacement use, ovarectomy status) and disability factors (post-polio symptoms) in sleep disturbance.

RESULTS:
In the final model, 19% (frequency) and 17% (severity) of sleep disturbance variance was explained. Psychological symptoms exerted the most influence (for both outcomes) followed by post-polio symptoms, vasomotor symptoms, an interaction of vasomotor and post-polio symptoms and estrogen use. For women with fewer post-polio symptoms, vasomotor symptoms exerted greater influence on sleep disturbance than for women with greater post-polio symptoms.

CONCLUSIONS:
Psychological symptoms had the strongest association with sleep disturbance in these women. Controlling for the influence of various menopause factors, our findings show that vasomotor symptoms were only one of several influences on sleep disturbance.

Conclusions:

Outcome of Research: More research required

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Women's Health

Title: Menopause characteristics of women with physical disabilities from poliomyelitis.
Author: Kalpakjian CZ, Quint EH, Tate DG, Roller S, Toussaint LL.
Affiliation: Department of Physical Medicine and Rehabilitation, University of Michigan Health System, Ann Arbor, USA
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Maturitas. 2007 Feb 20;56(2):161-72.
Publication Year and Month: 2007 02

Abstract: OBJECTIVE:
To describe menopause characteristics of women with physical disabilities from poliomyelitis.

METHODS:
Nine hundred and nine women with a history of poliomyelitis completed a survey on health, physical functioning, emotional well being and menopause.

RESULTS:
The majority of the sample was postmenopausal having had a natural menopause around the average age of 50.3 years; 34.7% of the sample had had hysterectomies. Thirty-nine percent were using some form of hormone replacement therapy (HRT). Menopause symptoms were clustered into psychological, somatic-sensory, somatic-sleep and vasomotor factors. Among never and past HRT users, there were significant differences in menopause factor severity by menopause status. Somatic/sleep symptoms were lowest in never users; past users had significantly higher vasomotor symptoms; desire for sexual activity and painful intercourse did not vary by HRT use. Compared to population estimates, post-polio women had similar rates of hysterectomies overall, but among some age cohorts they had significantly lower rates, contrary to expectations. However, they used HRT at significantly higher rates than expected.

CONCLUSIONS:
This study suggests that basic menopause characteristics of women with polio are generally similar to those of their non-disabled peers. There were few substantial differences in severity of menopause symptoms by HRT use, which is critical in light of the dearth of studies examining its risk-benefit ratio among women with physical disabilities. Until such studies provide some evidence of the specific risks or benefits to women with physical disability, each woman should carefully weigh the known risks and benefits with her physician.

Conclusions:

Outcome of Research: More research required

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Women's Health

Title: Pregnancy following Poliomyelitis
Author: Daw E, Chandler G.
Affiliation: University of Dundee, Scotland
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Postgraduate Medical Journal
Postgrad Med J. 1976; 52:492-496
Publication Year and Month: 1981 08

Abstract: A review of forty-nine pregnancies in thirty-seven patients who had previously suffered from poliomyelitis found that obstetric complications were proportional to the clinical disabilities of the patient. A simple test of unilateral weight-bearing gives a good clue as to whether pelvic asymmetry is present.

Conclusions:

Outcome of Research: Effective

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Women's Health

Title: Pregnancy, delivery and perinatal outcome in female survivors of polio.
Author: Veiby G, Daltveit AK, Gilhus NE.
Affiliation: Department of Clinical Medicine, University of Bergen, Norway
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Journal of the Neurological Sciences
J Neurol Sci. 2007 Jul 15;258(1-2):27-32.
Publication Year and Month: 2007 07

Abstract: OBJECTIVE:
To investigate possible effects on pregnancy, delivery and perinatal outcome in female survivors of polio.

METHODS:
In a cohort design, data from the national population based Medical Birth Registry of Norway (MBRN) were used to compare all 2495 births recorded 1967-1998 by female survivors of polio with all 1.9 mill non-polio deliveries. The results were adjusted for time period, maternal age, and birth order by unconditional logistic regression, with effects presented as adjusted Odds Ratios (OR) with a corresponding 95% Confidence Interval (CI) and p values.

RESULTS:
Female polio survivors had a higher occurrence of pre-eclampsia (3.4% vs. 2.8%, p=0.003, OR=1.4, CI=1.1-1.7), gestational proteinuria (1.3% vs. 0.5%, p<0.001, OR=2.0, CI=1.4-2.8), renal disease prior to pregnancy (1.4% vs. 0.9%, p=0.001, OR=1.8, CI=1.2-2.5), vaginal bleeding (3.8% vs. 2.0%, p<0.001, OR=1.7, CI=1.4-2.1), and urinary tract infection during pregnancy (3.5% vs. 2.4%, p<0.001, OR=1.7, CI=1.4-2.1). Deliveries complicated by obstruction of the birth process were more common in the polio group (6.1% vs. 2.0%, p<0.001, OR=4.8, CI=4.0-5.6), and cesarean section was performed at a higher rate throughout the time period (13.2% vs. 8.3%, p<0.001, OR=2.7, CI=2.4-3.1). Infants of polio mothers had a lower mean birth weight (3383 g vs. 3483 g, p<0.001), and more often had a birth weight below 2500 g (6.9% vs. 5.2%, p=0.001, OR=1.3, CI=1.1-1.5). There was no difference regarding pregnancy length. The risk of perinatal death was increased (2.1% vs. 1.1%, p=0.05, OR=1.3, CI=1.0-1.7).

CONCLUSION:
Pregnancy in female survivors of polio is associated with an increased risk for complications during pregnancy and delivery, as well as an adverse perinatal outcome. Awareness towards risk factors should improve pre-natal care and possibly prevent complications.

Conclusions: Pregnancy in female survivors of polio is associated with an increased risk for complications during pregnancy and delivery, as well as an adverse perinatal outcome. Awareness towards risk factors should improve pre-natal care and possibly prevent complications.

Outcome of Research: Effective

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Women's Health

Title: Successful Use of Succinylcholine for Cesarean Delivery in a Patient with Postpolio Syndrome [letter to the Editor]
Author: Connelly NR, Abbott TC.
Affiliation: Tufts University School of Medicine, Baystate Medical Center, Springfield, Massachusetts.
Journal: Anesthesiology
Citation: Anesthesiology 6 2008, Vol.108, 1151-1152. doi:10.1097/ALN.0b013e318173eb78
Publication Year and Month: 2008 06

Abstract: There have been a few reports over the years using succinylcholine in patients with pathology similar to that seen in PPS. For example, succinylcholine-induced hyperkalemia and circulatory collapse were reported in a patient with acute idiopathic anterior horn cell disease4; the serum potassium during this cardiac arrest was 7.9 mEq/l. Another study of denervated baboons found an increase in intravascular potassium up to 5.5 mEq/l.5 PPS is similar in pathophysiology to the baboon denervation study, and one could assume that hyperkalemia could also be seen in PPS patients. There have been numerous reports of hyperkalemia in patients with neuromuscular disease.4–8 It would have been informative to have had the prepotassium and postpotassium measurements from the patient in the report of Wernet et al. 1 to determine the magnitude and time frame of the increase of serum potassium.
The avoidance of neuraxial anesthesia was also discussed by Wernet et al. Successful neuraxial anesthesia in patients with PPS has been reported without adverse complications.9,10 Many clinicians provide regional anesthesia for labor and delivery in patients with a history of PPS.11
If general anesthesia needs to be induced, the potential hazard of using succinylcholine in patients with PPS has been acknowledged.12 If the need for rapid sequence induction exists in a PPS patient, we believe one should choose a short-acting nondepolarizing muscle relaxant in lieu of succinylcholine; the only caveat would be to consider using a decreased dose because of the increase risk of muscular weakness.13
The mere fact that succinylcholine was used in the current case does not preclude the possible occurrence of severe, acute hyperkalemia in subsequent cases in patients with PPS.

Conclusions: We do not believe that one can conclude from this single case that succinylcholine should be used in patients with PPS.

Outcome of Research: Effective

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


There are currently 7 papers in this category.

Category: Women's Health

Title: Successful Use of Succinylcholine for Cesarean Delivery in a Patient with Postpolio Syndrome [letter to the Editor]
Author: Connelly NR, Abbott TC.
Affiliation: Tufts University School of Medicine, Baystate Medical Center, Springfield, Massachusetts.
Journal: Anesthesiology
Citation: Anesthesiology 6 2008, Vol.108, 1151-1152. doi:10.1097/ALN.0b013e318173eb78
Publication Year and Month: 2008 06

Abstract: There have been a few reports over the years using succinylcholine in patients with pathology similar to that seen in PPS. For example, succinylcholine-induced hyperkalemia and circulatory collapse were reported in a patient with acute idiopathic anterior horn cell disease4; the serum potassium during this cardiac arrest was 7.9 mEq/l. Another study of denervated baboons found an increase in intravascular potassium up to 5.5 mEq/l.5 PPS is similar in pathophysiology to the baboon denervation study, and one could assume that hyperkalemia could also be seen in PPS patients. There have been numerous reports of hyperkalemia in patients with neuromuscular disease.4–8 It would have been informative to have had the prepotassium and postpotassium measurements from the patient in the report of Wernet et al. 1 to determine the magnitude and time frame of the increase of serum potassium.
The avoidance of neuraxial anesthesia was also discussed by Wernet et al. Successful neuraxial anesthesia in patients with PPS has been reported without adverse complications.9,10 Many clinicians provide regional anesthesia for labor and delivery in patients with a history of PPS.11
If general anesthesia needs to be induced, the potential hazard of using succinylcholine in patients with PPS has been acknowledged.12 If the need for rapid sequence induction exists in a PPS patient, we believe one should choose a short-acting nondepolarizing muscle relaxant in lieu of succinylcholine; the only caveat would be to consider using a decreased dose because of the increase risk of muscular weakness.13
The mere fact that succinylcholine was used in the current case does not preclude the possible occurrence of severe, acute hyperkalemia in subsequent cases in patients with PPS.

Conclusions: We do not believe that one can conclude from this single case that succinylcholine should be used in patients with PPS.

Outcome of Research: Effective

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Women's Health

Title: Cesarean delivery under ultrasound-guided spinal anesthesia [corrected] in a parturient with poliomyelitis and Harrington instrumentation.
Author: Costello, JF, Balki, M.
Affiliation: Department of Anesthesia and Pain Management, Mount Sinai Hospital, Ontario, Canada
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Canadian Journal of Anesthesia
Can J Anaesth. 2008 Dec;55(12):889
Publication Year and Month: 2008 12

Abstract: PURPOSE:
To describe the anesthetic implications, and management of a medically complex parturient, who presented for Cesarean delivery (CD). The patient had poliomyelitis complicated with severe kyphoscoliosis, which had been treated with extensive spinal surgery. We used ultrasound guidance to facilitate successful spinal analgesia and anesthesia.

CLINICAL FEATURES:
A 27-yr-old woman, with a history of poliomyelitis and moderate restrictive lung disease secondary to kyphoscoliosis, presented at 38 weeks gestation for elective CD because of cephalopelvic disproportion. The woman had Harrington rods in situ from the level of the second thoracic vertebra, to the level of the fourth lumbar vertebra. Ultrasound guidance enabled one intervertebral space to be visualized (L5-S1), 3 cm from the expected spinal midline, and spinal anesthesia was performed at this interspace without any complications. A healthy infant was delivered, and the mother recovered uneventfully.

CONCLUSIONS:
Spinal anesthesia can be effectively performed in patients with poliomyelitis and severe kyphoscoliosis, that has been treated with extensive Harrington instrumentation. To facilitate regional techniques in such patients, bedside ultrasound may be greatly beneficial in identifying the correct spinal interspace.

Conclusions: This case illustrates several points: first, the benefit of ultrasound in the placement of a spinal block in a patient with abnormal spinal anatomy; second, the choice of anesthetic technique in pregnant patients with poliomyelitits; and third, the management of a pregnant patient with severe kyphoscoliosis, spinal surgery, and restrictive lung disease.

Outcome of Research: Effective

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Women's Health

Title: Pregnancy following Poliomyelitis
Author: Daw E, Chandler G.
Affiliation: University of Dundee, Scotland
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Postgraduate Medical Journal
Postgrad Med J. 1976; 52:492-496
Publication Year and Month: 1981 08

Abstract: A review of forty-nine pregnancies in thirty-seven patients who had previously suffered from poliomyelitis found that obstetric complications were proportional to the clinical disabilities of the patient. A simple test of unilateral weight-bearing gives a good clue as to whether pelvic asymmetry is present.

Conclusions:

Outcome of Research: Effective

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Women's Health

Title: Caesarean Section in Post-polio Patient
Author: de Oliveira AR, Schutz Martinelli E, Lisiane L.
Affiliation: Roth and Roth Anesthesia Clinic, Rio Grande do Sul, Brazil
Hospital Moinhos de Vento, Rio Grande do Sul, Brazil
Hospital Nossa Senhora Conceicao, Rio Grande do Sul, Brazil
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Journal of Clinical Research in Anesthesiology
J Clin Res Anaesthesiol 2018; 1(1):1-2
Publication Year and Month: 2018 01

Abstract: A 26-year-old primigravida patient, ASA I, 39-week gestation, presented with 24 h premature rupture of membranes, without active labor. She had been in anesthetic pre-operative clinic 2 weeks before and had described poliomyelitis with 1 year old and complete recovering in childhood. With 16-year-old, she was submitted to appendicectomy through spinal anesthesia presenting weakness in entire body for approximately 24 h. At physical examination, the only sign was shorter tibial tendon of both legs.
For the cesarean, after volume expansion with cristaloids, the choice was an epidural anesthesia with 15mg of bupivacaine 0.3% (without epinephrine) and morphine 2 mg. “The surgery was initiated after 4min of blockade with T4 sensitive level reached. Hypotension and tachycardia were corrected with metaraminol 1 mg.” After 50 min, the procedure was finished with the same metameric level of anesthesia, but with cardiovascular stability. The entire recovering from anesthesia has occurred after 11h. An elevated consume of analgesics (nonsteroidal inflammatory drugs and opioids) and antiemetics was observed.

Conclusions: Ultimately, the decision to use general or regional anesthesia should be made on an individual patient basis weighing the risks and benefits. This case report describes some of the fewest practical guidelines available about regional anesthesia in post-polio patients with minimal sequelae. The importance of communications about these cases and the anesthetic conduct in this setting needs more debate to
optimize the facilities in another similar case.

Outcome of Research: Effective

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Women's Health

Title: Menopause characteristics of women with physical disabilities from poliomyelitis.
Author: Kalpakjian CZ, Quint EH, Tate DG, Roller S, Toussaint LL.
Affiliation: Department of Physical Medicine and Rehabilitation, University of Michigan Health System, Ann Arbor, USA
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Maturitas. 2007 Feb 20;56(2):161-72.
Publication Year and Month: 2007 02

Abstract: OBJECTIVE:
To describe menopause characteristics of women with physical disabilities from poliomyelitis.

METHODS:
Nine hundred and nine women with a history of poliomyelitis completed a survey on health, physical functioning, emotional well being and menopause.

RESULTS:
The majority of the sample was postmenopausal having had a natural menopause around the average age of 50.3 years; 34.7% of the sample had had hysterectomies. Thirty-nine percent were using some form of hormone replacement therapy (HRT). Menopause symptoms were clustered into psychological, somatic-sensory, somatic-sleep and vasomotor factors. Among never and past HRT users, there were significant differences in menopause factor severity by menopause status. Somatic/sleep symptoms were lowest in never users; past users had significantly higher vasomotor symptoms; desire for sexual activity and painful intercourse did not vary by HRT use. Compared to population estimates, post-polio women had similar rates of hysterectomies overall, but among some age cohorts they had significantly lower rates, contrary to expectations. However, they used HRT at significantly higher rates than expected.

CONCLUSIONS:
This study suggests that basic menopause characteristics of women with polio are generally similar to those of their non-disabled peers. There were few substantial differences in severity of menopause symptoms by HRT use, which is critical in light of the dearth of studies examining its risk-benefit ratio among women with physical disabilities. Until such studies provide some evidence of the specific risks or benefits to women with physical disability, each woman should carefully weigh the known risks and benefits with her physician.

Conclusions:

Outcome of Research: More research required

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Women's Health

Title: Menopause and post-polio symptoms as predictors of subjective sleep disturbance in poliomyelitis survivors.
Author: Kalpakjian CZ, Quint EH, Toussaint LL.
Affiliation: Department of Physical Medicine and Rehabilitation, University of Michigan Health System, Ann Arbor, USA
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Climacteric. 2007 Feb;10(1):51-62.
Publication Year and Month: 2007 02

Abstract: OBJECTIVES:
Sleep disturbance in polio survivors is a common complaint, yet little is known about the effects of the interaction of physical disability and menopause on sleep. The purpose of this study was to understand the relative contribution of menopause factors and disability to subjective sleep disturbance.

METHODS:
Participants were 465 women aged 50-65 years who had physical disabilities due to poliomyelitis. Hierarchical regression modeling was used to examine menopause (symptoms, status, hormone replacement use, ovarectomy status) and disability factors (post-polio symptoms) in sleep disturbance.

RESULTS:
In the final model, 19% (frequency) and 17% (severity) of sleep disturbance variance was explained. Psychological symptoms exerted the most influence (for both outcomes) followed by post-polio symptoms, vasomotor symptoms, an interaction of vasomotor and post-polio symptoms and estrogen use. For women with fewer post-polio symptoms, vasomotor symptoms exerted greater influence on sleep disturbance than for women with greater post-polio symptoms.

CONCLUSIONS:
Psychological symptoms had the strongest association with sleep disturbance in these women. Controlling for the influence of various menopause factors, our findings show that vasomotor symptoms were only one of several influences on sleep disturbance.

Conclusions:

Outcome of Research: More research required

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Women's Health

Title: Pregnancy, delivery and perinatal outcome in female survivors of polio.
Author: Veiby G, Daltveit AK, Gilhus NE.
Affiliation: Department of Clinical Medicine, University of Bergen, Norway
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Journal of the Neurological Sciences
J Neurol Sci. 2007 Jul 15;258(1-2):27-32.
Publication Year and Month: 2007 07

Abstract: OBJECTIVE:
To investigate possible effects on pregnancy, delivery and perinatal outcome in female survivors of polio.

METHODS:
In a cohort design, data from the national population based Medical Birth Registry of Norway (MBRN) were used to compare all 2495 births recorded 1967-1998 by female survivors of polio with all 1.9 mill non-polio deliveries. The results were adjusted for time period, maternal age, and birth order by unconditional logistic regression, with effects presented as adjusted Odds Ratios (OR) with a corresponding 95% Confidence Interval (CI) and p values.

RESULTS:
Female polio survivors had a higher occurrence of pre-eclampsia (3.4% vs. 2.8%, p=0.003, OR=1.4, CI=1.1-1.7), gestational proteinuria (1.3% vs. 0.5%, p<0.001, OR=2.0, CI=1.4-2.8), renal disease prior to pregnancy (1.4% vs. 0.9%, p=0.001, OR=1.8, CI=1.2-2.5), vaginal bleeding (3.8% vs. 2.0%, p<0.001, OR=1.7, CI=1.4-2.1), and urinary tract infection during pregnancy (3.5% vs. 2.4%, p<0.001, OR=1.7, CI=1.4-2.1). Deliveries complicated by obstruction of the birth process were more common in the polio group (6.1% vs. 2.0%, p<0.001, OR=4.8, CI=4.0-5.6), and cesarean section was performed at a higher rate throughout the time period (13.2% vs. 8.3%, p<0.001, OR=2.7, CI=2.4-3.1). Infants of polio mothers had a lower mean birth weight (3383 g vs. 3483 g, p<0.001), and more often had a birth weight below 2500 g (6.9% vs. 5.2%, p=0.001, OR=1.3, CI=1.1-1.5). There was no difference regarding pregnancy length. The risk of perinatal death was increased (2.1% vs. 1.1%, p=0.05, OR=1.3, CI=1.0-1.7).

CONCLUSION:
Pregnancy in female survivors of polio is associated with an increased risk for complications during pregnancy and delivery, as well as an adverse perinatal outcome. Awareness towards risk factors should improve pre-natal care and possibly prevent complications.

Conclusions: Pregnancy in female survivors of polio is associated with an increased risk for complications during pregnancy and delivery, as well as an adverse perinatal outcome. Awareness towards risk factors should improve pre-natal care and possibly prevent complications.

Outcome of Research: Effective

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


There are currently 7 papers in this category.

Category: Women's Health

Title: Successful Use of Succinylcholine for Cesarean Delivery in a Patient with Postpolio Syndrome [letter to the Editor]
Author: Connelly NR, Abbott TC.
Affiliation: Tufts University School of Medicine, Baystate Medical Center, Springfield, Massachusetts.
Journal: Anesthesiology
Citation: Anesthesiology 6 2008, Vol.108, 1151-1152. doi:10.1097/ALN.0b013e318173eb78
Publication Year and Month: 2008 06

Abstract: There have been a few reports over the years using succinylcholine in patients with pathology similar to that seen in PPS. For example, succinylcholine-induced hyperkalemia and circulatory collapse were reported in a patient with acute idiopathic anterior horn cell disease4; the serum potassium during this cardiac arrest was 7.9 mEq/l. Another study of denervated baboons found an increase in intravascular potassium up to 5.5 mEq/l.5 PPS is similar in pathophysiology to the baboon denervation study, and one could assume that hyperkalemia could also be seen in PPS patients. There have been numerous reports of hyperkalemia in patients with neuromuscular disease.4–8 It would have been informative to have had the prepotassium and postpotassium measurements from the patient in the report of Wernet et al. 1 to determine the magnitude and time frame of the increase of serum potassium.
The avoidance of neuraxial anesthesia was also discussed by Wernet et al. Successful neuraxial anesthesia in patients with PPS has been reported without adverse complications.9,10 Many clinicians provide regional anesthesia for labor and delivery in patients with a history of PPS.11
If general anesthesia needs to be induced, the potential hazard of using succinylcholine in patients with PPS has been acknowledged.12 If the need for rapid sequence induction exists in a PPS patient, we believe one should choose a short-acting nondepolarizing muscle relaxant in lieu of succinylcholine; the only caveat would be to consider using a decreased dose because of the increase risk of muscular weakness.13
The mere fact that succinylcholine was used in the current case does not preclude the possible occurrence of severe, acute hyperkalemia in subsequent cases in patients with PPS.

Conclusions: We do not believe that one can conclude from this single case that succinylcholine should be used in patients with PPS.

Outcome of Research: Effective

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Women's Health

Title: Pregnancy following Poliomyelitis
Author: Daw E, Chandler G.
Affiliation: University of Dundee, Scotland
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Postgraduate Medical Journal
Postgrad Med J. 1976; 52:492-496
Publication Year and Month: 1981 08

Abstract: A review of forty-nine pregnancies in thirty-seven patients who had previously suffered from poliomyelitis found that obstetric complications were proportional to the clinical disabilities of the patient. A simple test of unilateral weight-bearing gives a good clue as to whether pelvic asymmetry is present.

Conclusions:

Outcome of Research: Effective

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Women's Health

Title: Caesarean Section in Post-polio Patient
Author: de Oliveira AR, Schutz Martinelli E, Lisiane L.
Affiliation: Roth and Roth Anesthesia Clinic, Rio Grande do Sul, Brazil
Hospital Moinhos de Vento, Rio Grande do Sul, Brazil
Hospital Nossa Senhora Conceicao, Rio Grande do Sul, Brazil
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Journal of Clinical Research in Anesthesiology
J Clin Res Anaesthesiol 2018; 1(1):1-2
Publication Year and Month: 2018 01

Abstract: A 26-year-old primigravida patient, ASA I, 39-week gestation, presented with 24 h premature rupture of membranes, without active labor. She had been in anesthetic pre-operative clinic 2 weeks before and had described poliomyelitis with 1 year old and complete recovering in childhood. With 16-year-old, she was submitted to appendicectomy through spinal anesthesia presenting weakness in entire body for approximately 24 h. At physical examination, the only sign was shorter tibial tendon of both legs.
For the cesarean, after volume expansion with cristaloids, the choice was an epidural anesthesia with 15mg of bupivacaine 0.3% (without epinephrine) and morphine 2 mg. “The surgery was initiated after 4min of blockade with T4 sensitive level reached. Hypotension and tachycardia were corrected with metaraminol 1 mg.” After 50 min, the procedure was finished with the same metameric level of anesthesia, but with cardiovascular stability. The entire recovering from anesthesia has occurred after 11h. An elevated consume of analgesics (nonsteroidal inflammatory drugs and opioids) and antiemetics was observed.

Conclusions: Ultimately, the decision to use general or regional anesthesia should be made on an individual patient basis weighing the risks and benefits. This case report describes some of the fewest practical guidelines available about regional anesthesia in post-polio patients with minimal sequelae. The importance of communications about these cases and the anesthetic conduct in this setting needs more debate to
optimize the facilities in another similar case.

Outcome of Research: Effective

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Women's Health

Title: Cesarean delivery under ultrasound-guided spinal anesthesia [corrected] in a parturient with poliomyelitis and Harrington instrumentation.
Author: Costello, JF, Balki, M.
Affiliation: Department of Anesthesia and Pain Management, Mount Sinai Hospital, Ontario, Canada
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Canadian Journal of Anesthesia
Can J Anaesth. 2008 Dec;55(12):889
Publication Year and Month: 2008 12

Abstract: PURPOSE:
To describe the anesthetic implications, and management of a medically complex parturient, who presented for Cesarean delivery (CD). The patient had poliomyelitis complicated with severe kyphoscoliosis, which had been treated with extensive spinal surgery. We used ultrasound guidance to facilitate successful spinal analgesia and anesthesia.

CLINICAL FEATURES:
A 27-yr-old woman, with a history of poliomyelitis and moderate restrictive lung disease secondary to kyphoscoliosis, presented at 38 weeks gestation for elective CD because of cephalopelvic disproportion. The woman had Harrington rods in situ from the level of the second thoracic vertebra, to the level of the fourth lumbar vertebra. Ultrasound guidance enabled one intervertebral space to be visualized (L5-S1), 3 cm from the expected spinal midline, and spinal anesthesia was performed at this interspace without any complications. A healthy infant was delivered, and the mother recovered uneventfully.

CONCLUSIONS:
Spinal anesthesia can be effectively performed in patients with poliomyelitis and severe kyphoscoliosis, that has been treated with extensive Harrington instrumentation. To facilitate regional techniques in such patients, bedside ultrasound may be greatly beneficial in identifying the correct spinal interspace.

Conclusions: This case illustrates several points: first, the benefit of ultrasound in the placement of a spinal block in a patient with abnormal spinal anatomy; second, the choice of anesthetic technique in pregnant patients with poliomyelitits; and third, the management of a pregnant patient with severe kyphoscoliosis, spinal surgery, and restrictive lung disease.

Outcome of Research: Effective

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Women's Health

Title: Pregnancy, delivery and perinatal outcome in female survivors of polio.
Author: Veiby G, Daltveit AK, Gilhus NE.
Affiliation: Department of Clinical Medicine, University of Bergen, Norway
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Journal of the Neurological Sciences
J Neurol Sci. 2007 Jul 15;258(1-2):27-32.
Publication Year and Month: 2007 07

Abstract: OBJECTIVE:
To investigate possible effects on pregnancy, delivery and perinatal outcome in female survivors of polio.

METHODS:
In a cohort design, data from the national population based Medical Birth Registry of Norway (MBRN) were used to compare all 2495 births recorded 1967-1998 by female survivors of polio with all 1.9 mill non-polio deliveries. The results were adjusted for time period, maternal age, and birth order by unconditional logistic regression, with effects presented as adjusted Odds Ratios (OR) with a corresponding 95% Confidence Interval (CI) and p values.

RESULTS:
Female polio survivors had a higher occurrence of pre-eclampsia (3.4% vs. 2.8%, p=0.003, OR=1.4, CI=1.1-1.7), gestational proteinuria (1.3% vs. 0.5%, p<0.001, OR=2.0, CI=1.4-2.8), renal disease prior to pregnancy (1.4% vs. 0.9%, p=0.001, OR=1.8, CI=1.2-2.5), vaginal bleeding (3.8% vs. 2.0%, p<0.001, OR=1.7, CI=1.4-2.1), and urinary tract infection during pregnancy (3.5% vs. 2.4%, p<0.001, OR=1.7, CI=1.4-2.1). Deliveries complicated by obstruction of the birth process were more common in the polio group (6.1% vs. 2.0%, p<0.001, OR=4.8, CI=4.0-5.6), and cesarean section was performed at a higher rate throughout the time period (13.2% vs. 8.3%, p<0.001, OR=2.7, CI=2.4-3.1). Infants of polio mothers had a lower mean birth weight (3383 g vs. 3483 g, p<0.001), and more often had a birth weight below 2500 g (6.9% vs. 5.2%, p=0.001, OR=1.3, CI=1.1-1.5). There was no difference regarding pregnancy length. The risk of perinatal death was increased (2.1% vs. 1.1%, p=0.05, OR=1.3, CI=1.0-1.7).

CONCLUSION:
Pregnancy in female survivors of polio is associated with an increased risk for complications during pregnancy and delivery, as well as an adverse perinatal outcome. Awareness towards risk factors should improve pre-natal care and possibly prevent complications.

Conclusions: Pregnancy in female survivors of polio is associated with an increased risk for complications during pregnancy and delivery, as well as an adverse perinatal outcome. Awareness towards risk factors should improve pre-natal care and possibly prevent complications.

Outcome of Research: Effective

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Women's Health

Title: Menopause and post-polio symptoms as predictors of subjective sleep disturbance in poliomyelitis survivors.
Author: Kalpakjian CZ, Quint EH, Toussaint LL.
Affiliation: Department of Physical Medicine and Rehabilitation, University of Michigan Health System, Ann Arbor, USA
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Climacteric. 2007 Feb;10(1):51-62.
Publication Year and Month: 2007 02

Abstract: OBJECTIVES:
Sleep disturbance in polio survivors is a common complaint, yet little is known about the effects of the interaction of physical disability and menopause on sleep. The purpose of this study was to understand the relative contribution of menopause factors and disability to subjective sleep disturbance.

METHODS:
Participants were 465 women aged 50-65 years who had physical disabilities due to poliomyelitis. Hierarchical regression modeling was used to examine menopause (symptoms, status, hormone replacement use, ovarectomy status) and disability factors (post-polio symptoms) in sleep disturbance.

RESULTS:
In the final model, 19% (frequency) and 17% (severity) of sleep disturbance variance was explained. Psychological symptoms exerted the most influence (for both outcomes) followed by post-polio symptoms, vasomotor symptoms, an interaction of vasomotor and post-polio symptoms and estrogen use. For women with fewer post-polio symptoms, vasomotor symptoms exerted greater influence on sleep disturbance than for women with greater post-polio symptoms.

CONCLUSIONS:
Psychological symptoms had the strongest association with sleep disturbance in these women. Controlling for the influence of various menopause factors, our findings show that vasomotor symptoms were only one of several influences on sleep disturbance.

Conclusions:

Outcome of Research: More research required

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Women's Health

Title: Menopause characteristics of women with physical disabilities from poliomyelitis.
Author: Kalpakjian CZ, Quint EH, Tate DG, Roller S, Toussaint LL.
Affiliation: Department of Physical Medicine and Rehabilitation, University of Michigan Health System, Ann Arbor, USA
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Maturitas. 2007 Feb 20;56(2):161-72.
Publication Year and Month: 2007 02

Abstract: OBJECTIVE:
To describe menopause characteristics of women with physical disabilities from poliomyelitis.

METHODS:
Nine hundred and nine women with a history of poliomyelitis completed a survey on health, physical functioning, emotional well being and menopause.

RESULTS:
The majority of the sample was postmenopausal having had a natural menopause around the average age of 50.3 years; 34.7% of the sample had had hysterectomies. Thirty-nine percent were using some form of hormone replacement therapy (HRT). Menopause symptoms were clustered into psychological, somatic-sensory, somatic-sleep and vasomotor factors. Among never and past HRT users, there were significant differences in menopause factor severity by menopause status. Somatic/sleep symptoms were lowest in never users; past users had significantly higher vasomotor symptoms; desire for sexual activity and painful intercourse did not vary by HRT use. Compared to population estimates, post-polio women had similar rates of hysterectomies overall, but among some age cohorts they had significantly lower rates, contrary to expectations. However, they used HRT at significantly higher rates than expected.

CONCLUSIONS:
This study suggests that basic menopause characteristics of women with polio are generally similar to those of their non-disabled peers. There were few substantial differences in severity of menopause symptoms by HRT use, which is critical in light of the dearth of studies examining its risk-benefit ratio among women with physical disabilities. Until such studies provide some evidence of the specific risks or benefits to women with physical disability, each woman should carefully weigh the known risks and benefits with her physician.

Conclusions:

Outcome of Research: More research required

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


There are currently 7 papers in this category.

Category: Women's Health

Title: Caesarean Section in Post-polio Patient
Author: de Oliveira AR, Schutz Martinelli E, Lisiane L.
Affiliation: Roth and Roth Anesthesia Clinic, Rio Grande do Sul, Brazil
Hospital Moinhos de Vento, Rio Grande do Sul, Brazil
Hospital Nossa Senhora Conceicao, Rio Grande do Sul, Brazil
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Journal of Clinical Research in Anesthesiology
J Clin Res Anaesthesiol 2018; 1(1):1-2
Publication Year and Month: 2018 01

Abstract: A 26-year-old primigravida patient, ASA I, 39-week gestation, presented with 24 h premature rupture of membranes, without active labor. She had been in anesthetic pre-operative clinic 2 weeks before and had described poliomyelitis with 1 year old and complete recovering in childhood. With 16-year-old, she was submitted to appendicectomy through spinal anesthesia presenting weakness in entire body for approximately 24 h. At physical examination, the only sign was shorter tibial tendon of both legs.
For the cesarean, after volume expansion with cristaloids, the choice was an epidural anesthesia with 15mg of bupivacaine 0.3% (without epinephrine) and morphine 2 mg. “The surgery was initiated after 4min of blockade with T4 sensitive level reached. Hypotension and tachycardia were corrected with metaraminol 1 mg.” After 50 min, the procedure was finished with the same metameric level of anesthesia, but with cardiovascular stability. The entire recovering from anesthesia has occurred after 11h. An elevated consume of analgesics (nonsteroidal inflammatory drugs and opioids) and antiemetics was observed.

Conclusions: Ultimately, the decision to use general or regional anesthesia should be made on an individual patient basis weighing the risks and benefits. This case report describes some of the fewest practical guidelines available about regional anesthesia in post-polio patients with minimal sequelae. The importance of communications about these cases and the anesthetic conduct in this setting needs more debate to
optimize the facilities in another similar case.

Outcome of Research: Effective

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Women's Health

Title: Cesarean delivery under ultrasound-guided spinal anesthesia [corrected] in a parturient with poliomyelitis and Harrington instrumentation.
Author: Costello, JF, Balki, M.
Affiliation: Department of Anesthesia and Pain Management, Mount Sinai Hospital, Ontario, Canada
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Canadian Journal of Anesthesia
Can J Anaesth. 2008 Dec;55(12):889
Publication Year and Month: 2008 12

Abstract: PURPOSE:
To describe the anesthetic implications, and management of a medically complex parturient, who presented for Cesarean delivery (CD). The patient had poliomyelitis complicated with severe kyphoscoliosis, which had been treated with extensive spinal surgery. We used ultrasound guidance to facilitate successful spinal analgesia and anesthesia.

CLINICAL FEATURES:
A 27-yr-old woman, with a history of poliomyelitis and moderate restrictive lung disease secondary to kyphoscoliosis, presented at 38 weeks gestation for elective CD because of cephalopelvic disproportion. The woman had Harrington rods in situ from the level of the second thoracic vertebra, to the level of the fourth lumbar vertebra. Ultrasound guidance enabled one intervertebral space to be visualized (L5-S1), 3 cm from the expected spinal midline, and spinal anesthesia was performed at this interspace without any complications. A healthy infant was delivered, and the mother recovered uneventfully.

CONCLUSIONS:
Spinal anesthesia can be effectively performed in patients with poliomyelitis and severe kyphoscoliosis, that has been treated with extensive Harrington instrumentation. To facilitate regional techniques in such patients, bedside ultrasound may be greatly beneficial in identifying the correct spinal interspace.

Conclusions: This case illustrates several points: first, the benefit of ultrasound in the placement of a spinal block in a patient with abnormal spinal anatomy; second, the choice of anesthetic technique in pregnant patients with poliomyelitits; and third, the management of a pregnant patient with severe kyphoscoliosis, spinal surgery, and restrictive lung disease.

Outcome of Research: Effective

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Women's Health

Title: Successful Use of Succinylcholine for Cesarean Delivery in a Patient with Postpolio Syndrome [letter to the Editor]
Author: Connelly NR, Abbott TC.
Affiliation: Tufts University School of Medicine, Baystate Medical Center, Springfield, Massachusetts.
Journal: Anesthesiology
Citation: Anesthesiology 6 2008, Vol.108, 1151-1152. doi:10.1097/ALN.0b013e318173eb78
Publication Year and Month: 2008 06

Abstract: There have been a few reports over the years using succinylcholine in patients with pathology similar to that seen in PPS. For example, succinylcholine-induced hyperkalemia and circulatory collapse were reported in a patient with acute idiopathic anterior horn cell disease4; the serum potassium during this cardiac arrest was 7.9 mEq/l. Another study of denervated baboons found an increase in intravascular potassium up to 5.5 mEq/l.5 PPS is similar in pathophysiology to the baboon denervation study, and one could assume that hyperkalemia could also be seen in PPS patients. There have been numerous reports of hyperkalemia in patients with neuromuscular disease.4–8 It would have been informative to have had the prepotassium and postpotassium measurements from the patient in the report of Wernet et al. 1 to determine the magnitude and time frame of the increase of serum potassium.
The avoidance of neuraxial anesthesia was also discussed by Wernet et al. Successful neuraxial anesthesia in patients with PPS has been reported without adverse complications.9,10 Many clinicians provide regional anesthesia for labor and delivery in patients with a history of PPS.11
If general anesthesia needs to be induced, the potential hazard of using succinylcholine in patients with PPS has been acknowledged.12 If the need for rapid sequence induction exists in a PPS patient, we believe one should choose a short-acting nondepolarizing muscle relaxant in lieu of succinylcholine; the only caveat would be to consider using a decreased dose because of the increase risk of muscular weakness.13
The mere fact that succinylcholine was used in the current case does not preclude the possible occurrence of severe, acute hyperkalemia in subsequent cases in patients with PPS.

Conclusions: We do not believe that one can conclude from this single case that succinylcholine should be used in patients with PPS.

Outcome of Research: Effective

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Women's Health

Title: Pregnancy, delivery and perinatal outcome in female survivors of polio.
Author: Veiby G, Daltveit AK, Gilhus NE.
Affiliation: Department of Clinical Medicine, University of Bergen, Norway
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Journal of the Neurological Sciences
J Neurol Sci. 2007 Jul 15;258(1-2):27-32.
Publication Year and Month: 2007 07

Abstract: OBJECTIVE:
To investigate possible effects on pregnancy, delivery and perinatal outcome in female survivors of polio.

METHODS:
In a cohort design, data from the national population based Medical Birth Registry of Norway (MBRN) were used to compare all 2495 births recorded 1967-1998 by female survivors of polio with all 1.9 mill non-polio deliveries. The results were adjusted for time period, maternal age, and birth order by unconditional logistic regression, with effects presented as adjusted Odds Ratios (OR) with a corresponding 95% Confidence Interval (CI) and p values.

RESULTS:
Female polio survivors had a higher occurrence of pre-eclampsia (3.4% vs. 2.8%, p=0.003, OR=1.4, CI=1.1-1.7), gestational proteinuria (1.3% vs. 0.5%, p<0.001, OR=2.0, CI=1.4-2.8), renal disease prior to pregnancy (1.4% vs. 0.9%, p=0.001, OR=1.8, CI=1.2-2.5), vaginal bleeding (3.8% vs. 2.0%, p<0.001, OR=1.7, CI=1.4-2.1), and urinary tract infection during pregnancy (3.5% vs. 2.4%, p<0.001, OR=1.7, CI=1.4-2.1). Deliveries complicated by obstruction of the birth process were more common in the polio group (6.1% vs. 2.0%, p<0.001, OR=4.8, CI=4.0-5.6), and cesarean section was performed at a higher rate throughout the time period (13.2% vs. 8.3%, p<0.001, OR=2.7, CI=2.4-3.1). Infants of polio mothers had a lower mean birth weight (3383 g vs. 3483 g, p<0.001), and more often had a birth weight below 2500 g (6.9% vs. 5.2%, p=0.001, OR=1.3, CI=1.1-1.5). There was no difference regarding pregnancy length. The risk of perinatal death was increased (2.1% vs. 1.1%, p=0.05, OR=1.3, CI=1.0-1.7).

CONCLUSION:
Pregnancy in female survivors of polio is associated with an increased risk for complications during pregnancy and delivery, as well as an adverse perinatal outcome. Awareness towards risk factors should improve pre-natal care and possibly prevent complications.

Conclusions: Pregnancy in female survivors of polio is associated with an increased risk for complications during pregnancy and delivery, as well as an adverse perinatal outcome. Awareness towards risk factors should improve pre-natal care and possibly prevent complications.

Outcome of Research: Effective

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Women's Health

Title: Menopause and post-polio symptoms as predictors of subjective sleep disturbance in poliomyelitis survivors.
Author: Kalpakjian CZ, Quint EH, Toussaint LL.
Affiliation: Department of Physical Medicine and Rehabilitation, University of Michigan Health System, Ann Arbor, USA
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Climacteric. 2007 Feb;10(1):51-62.
Publication Year and Month: 2007 02

Abstract: OBJECTIVES:
Sleep disturbance in polio survivors is a common complaint, yet little is known about the effects of the interaction of physical disability and menopause on sleep. The purpose of this study was to understand the relative contribution of menopause factors and disability to subjective sleep disturbance.

METHODS:
Participants were 465 women aged 50-65 years who had physical disabilities due to poliomyelitis. Hierarchical regression modeling was used to examine menopause (symptoms, status, hormone replacement use, ovarectomy status) and disability factors (post-polio symptoms) in sleep disturbance.

RESULTS:
In the final model, 19% (frequency) and 17% (severity) of sleep disturbance variance was explained. Psychological symptoms exerted the most influence (for both outcomes) followed by post-polio symptoms, vasomotor symptoms, an interaction of vasomotor and post-polio symptoms and estrogen use. For women with fewer post-polio symptoms, vasomotor symptoms exerted greater influence on sleep disturbance than for women with greater post-polio symptoms.

CONCLUSIONS:
Psychological symptoms had the strongest association with sleep disturbance in these women. Controlling for the influence of various menopause factors, our findings show that vasomotor symptoms were only one of several influences on sleep disturbance.

Conclusions:

Outcome of Research: More research required

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Women's Health

Title: Menopause characteristics of women with physical disabilities from poliomyelitis.
Author: Kalpakjian CZ, Quint EH, Tate DG, Roller S, Toussaint LL.
Affiliation: Department of Physical Medicine and Rehabilitation, University of Michigan Health System, Ann Arbor, USA
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Maturitas. 2007 Feb 20;56(2):161-72.
Publication Year and Month: 2007 02

Abstract: OBJECTIVE:
To describe menopause characteristics of women with physical disabilities from poliomyelitis.

METHODS:
Nine hundred and nine women with a history of poliomyelitis completed a survey on health, physical functioning, emotional well being and menopause.

RESULTS:
The majority of the sample was postmenopausal having had a natural menopause around the average age of 50.3 years; 34.7% of the sample had had hysterectomies. Thirty-nine percent were using some form of hormone replacement therapy (HRT). Menopause symptoms were clustered into psychological, somatic-sensory, somatic-sleep and vasomotor factors. Among never and past HRT users, there were significant differences in menopause factor severity by menopause status. Somatic/sleep symptoms were lowest in never users; past users had significantly higher vasomotor symptoms; desire for sexual activity and painful intercourse did not vary by HRT use. Compared to population estimates, post-polio women had similar rates of hysterectomies overall, but among some age cohorts they had significantly lower rates, contrary to expectations. However, they used HRT at significantly higher rates than expected.

CONCLUSIONS:
This study suggests that basic menopause characteristics of women with polio are generally similar to those of their non-disabled peers. There were few substantial differences in severity of menopause symptoms by HRT use, which is critical in light of the dearth of studies examining its risk-benefit ratio among women with physical disabilities. Until such studies provide some evidence of the specific risks or benefits to women with physical disability, each woman should carefully weigh the known risks and benefits with her physician.

Conclusions:

Outcome of Research: More research required

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Women's Health

Title: Pregnancy following Poliomyelitis
Author: Daw E, Chandler G.
Affiliation: University of Dundee, Scotland
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Postgraduate Medical Journal
Postgrad Med J. 1976; 52:492-496
Publication Year and Month: 1981 08

Abstract: A review of forty-nine pregnancies in thirty-seven patients who had previously suffered from poliomyelitis found that obstetric complications were proportional to the clinical disabilities of the patient. A simple test of unilateral weight-bearing gives a good clue as to whether pelvic asymmetry is present.

Conclusions:

Outcome of Research: Effective

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


There are currently 7 papers in this category.

Outcomes of Research or Clinical Trials Activity Levels Acute Flaccid Paralysis Ageing Anaerobic Threshold Anaesthesia Assistive Technology Brain Cardiorespiratory Cardiovascular Clinical Evaluation Cold Intolerance Complementary Therapies Continence Coping Styles and Strategies Cultural Context Diagnosis and Management Differential Diagnosis Drugs Dysphagia Dysphonia Epidemiology Exercise Falls Fatigue Fractures Gender Differences Immune Response Inflammation Late Effects of Polio Muscle Strength Muscular Atrophy Orthoses Pain Polio Immunisation Post-Polio Motor Unit Psychology Quality of Life Renal Complications Respiratory Complications and Management Restless Legs Syndrome Sleep Analaysis Surgery Vitality Vocational Implications