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المؤلفون: Charlotte Wildblood, Jane Ding, Joe Aquilina, Mary Gbegbaje
المصدر: BMJ case reports. 15(2)
مصطلحات موضوعية: animal structures, Methotrexate, Gestational Sac, Pregnancy, Humans, Female, Pregnancy, Tubal, General Medicine, Fallopian Tubes, Pregnancy, Ectopic
الوصف: Ectopic pregnancy is a pregnancy outside the uterine cavity and is, in majority of cases, a non-viable pregnancy. There are multiple methods of managing patients with ectopic pregnancy including expectant, medical and surgical management. Live tubal ectopic pregnancies, also known as ectopic pregnancies present in the fallopian tube with fetal heartbeat still present, are most commonly treated via surgical route. This case outlines the presentation and an unusual method of management of a patient diagnosed with a live tubal ectopic pregnancy with extensive medical and surgical history.
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المؤلفون: Kamphuis, D., Rosielle, K., van Welie, N., Roest, I., van Dongen, A. J. C. M., Brinkhuis, E. A., Bourdrez, P., Mozes, A., Verhoeve, H. R., van der Ham, D. P., Vrouenraets, F. P. J. M., Risseeuw, J. J., van de Laar, T., Janse, F., den Hartog, J. E., de Hundt, M., Hooker, A. B., Huppelschoten, A. G., Pieterse, Q. D., Bongers, M. Y., Stoker, J., Koks, C. A. M., Lambalk, C. B., Hemingway, A., Li, W., Mol, B. W. J., Dreyer, K., Mijatovic, V.
المساهمون: Radiology and Nuclear Medicine, CCA - Imaging and biomarkers, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Obstetrics and gynaecology, Amsterdam Reproduction & Development (AR&D), ACS - Atherosclerosis & ischemic syndromes
المصدر: Kamphuis, D, Rosielle, K, van Welie, N, Roest, I, van Dongen, A J C M, Brinkhuis, E A, Bourdrez, P, Mozes, A, Verhoeve, H R, van der Ham, D P, Vrouenraets, F P J M, Risseeuw, J J, van de Laar, T, Janse, F, den Hartog, J E, de Hundt, M, Hooker, A B, Huppelschoten, A G, Pieterse, Q D, Bongers, M Y, Stoker, J, Koks, C A M, Lambalk, C B, Hemingway, A, Li, W, Mol, B W J, Dreyer, K & Mijatovic, V 2023, ' The effectiveness of immediate versus delayed tubal flushing with oil-based contrast in women with unexplained infertility (H2Oil-timing study) : study protocol of a randomized controlled trial ', BMC Women's Health, vol. 23, no. 1, 233, pp. 233 . https://doi.org/10.1186/s12905-023-02385-1
BMC Women's health, 23(1):233. BioMed Central
BMC Women's Health, 23(1):233. BioMed Centralمصطلحات موضوعية: Fallopian tubes, HYSTEROSALPINGOGRAPHY, Obstetrics and Gynecology, Tubal flushing, General Medicine, LIPIODOL, Hysterosalpingography (HSG), Oil-based contrast medium, Reproductive Medicine, Fertility work-up, Pregnancy, Randomized controlled trial, Infertility, Live birth, Cost-effectiveness
الوصف: Background In women with unexplained infertility, tubal flushing with oil-based contrast during hysterosalpingography leads to significantly more live births as compared to tubal flushing with water-based contrast during hysterosalpingography. However, it is unknown whether incorporating tubal flushing with oil-based contrast in the initial fertility work-up results to a reduced time to conception leading to live birth when compared to delayed tubal flushing that is performed six months after the initial fertility work-up. We also aim to evaluate the effectiveness of tubal flushing with oil-based contrast during hysterosalpingography versus no tubal flushing in the first six months of the study. Methods This study will be an investigator-initiated, open-label, international, multicenter, randomized controlled trial with a planned economic analysis alongside the study. Infertile women between 18 and 39 years of age, who have an ovulatory cycle, who are at low risk for tubal pathology and have been advised expectant management for at least six months (based on the Hunault prediction score) will be included in this study. Eligible women will be randomly allocated (1:1) to immediate tubal flushing (intervention) versus delayed tubal flushing (control group) by using web-based block randomization stratified per study center. The primary outcome is time to conception leading to live birth with conception within twelve months after randomization. We assess the cumulative conception rate at six and twelve months as two co-primary outcomes. Secondary outcomes include ongoing pregnancy rate, live birth rate, miscarriage rate, ectopic pregnancy rate, number of complications, procedural pain score and cost-effectiveness. To demonstrate or refute a shorter time to pregnancy of three months with a power of 90%, a sample size of 554 women is calculated. Discussion The H2Oil-timing study will provide insight into whether tubal flushing with oil-based contrast during hysterosalpingography should be incorporated in the initial fertility work-up in women with unexplained infertility as a therapeutic procedure. If this multicenter RCT shows that tubal flushing with oil-based contrast incorporated in the initial fertility work-up reduces time to conception and is a cost-effective strategy, the results may lead to adjustments of (inter)national guidelines and change clinical practice. Trial registration number The study was retrospectively registered in International Clinical Trials Registry Platform (Main ID: EUCTR2018-004153-24-NL).
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المصدر: BMJ case reports. 14(10)
مصطلحات موضوعية: Ovarian Neoplasms, medicine.medical_specialty, Abdominal pain, Hernia, medicine.diagnostic_test, Nausea, business.industry, Physical examination, General Medicine, Surgery, Bowel sounds, Ovarian vessels, Abdominal tenderness, medicine, Right Fallopian Tube, Fallopian Tube Neoplasms, Humans, Surgical history, Female, medicine.symptom, business, Fallopian Tubes, Peritoneal Neoplasms
الوصف: A 43-year-old woman presented to the emergency ward with nausea, abdominal pain and failure to pass gas and stool for 3 days. Medical and surgical history was unremarkable. Physical examination showed diffuse abdominal tenderness and reduced bowel sounds. Laboratory tests were normal. A high
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المؤلفون: Poorvi Mathur, Ravi Lohani
المصدر: BMJ case reports. 14(8)
مصطلحات موضوعية: medicine.medical_specialty, Abdominal pain, Constipation, business.industry, Peritonitis, General Medicine, Middle Aged, medicine.disease, Surgery, Abdominal Pain, Bowel obstruction, medicine.anatomical_structure, Intestine, Small, medicine, Right Fallopian Tube, Vomiting, Abdomen, Humans, Female, medicine.symptom, business, Tomography, X-Ray Computed, Fallopian Tubes, Intestinal Obstruction, Fallopian tube
الوصف: A 50-year-old woman was admitted to our emergency surgery department with 1-week history of abdominal pain, distension, vomiting and constipation. On examination, she has a distended abdomen with sluggish bowel sounds, but no clinical signs of peritonitis. Blood tests were normal except for the increased white cell count and erythrocyte sedimentation rate (ESR). CT scan with oral as well as intravenous contrast demonstrated the small bowel obstruction without any insight into the aetiology of the disease. Intraoperatively, the right fallopian tube was found to encircle the terminal ileum. A right salpingo-oophorectomy was performed to release the bowel. This case report describes a rare cause of the small bowel obstruction in female patients.
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المؤلفون: Abigail J. Engwall-Gill, Jennine H. Weller, Simon Rahal, Eric Etchill, Shaun M. Kunisaki, Isam W. Nasr
المصدر: Journal of Pediatric Surgery. 57:994-999
مصطلحات موضوعية: Adolescent, Thoracic Surgery, Video-Assisted, Pneumothorax, General Medicine, Hospitalization, Treatment Outcome, Recurrence, Risk Factors, Chest Tubes, Pediatrics, Perinatology and Child Health, Humans, Surgery, Child, Retrospective Studies
الوصف: The optimal timing of operative management in children with primary spontaneous pneumothorax (PSP) remains controversial. This study sought to determine early risk factors for failure of chest tube nonoperative management during the initial hospitalization in adolescents with PSP.A retrospective review was conducted for children (aged ≤18 years) admitted to a single tertiary care referral center for their first presentation of a PSP managed with at least 48 h of chest tube decompression (CTD) alone. Patient outcomes and early risk factors for operative management were analyzed by multivariate regression.Of the 39 patients who met inclusion criteria, 15 (38.5%) patients failed nonoperative treatment while 24 (61.5%) patients were managed with CTD therapy alone. Progression to thoracoscopic surgery was associated with longer CTD of 8 vs 3 days and hospital length of stay of 9 vs 4 days when compared to nonoperative management (p 0.001, both). Air leak and increase in pneumothorax size at 24 h after CTD were independently associated with progression to surgery (p = 0.007, p = 0.002). Combined, these risk factors were associated with a significant increase in recurrence (OR 6.00, 95% CI 1.11-41.11, p = 0.048). There were no significant differences between PSP management strategies regarding cumulative radiation exposure or 2 year recurrence.Air leak or increasing pneumothorax size within 24 h of CTD are highly correlated with failed nonoperative management during the initial hospitalization in pediatric patients with PSP. This data may be useful in the development of pediatric-specific treatment algorithms to optimally manage these patients.Treatment study, Level III.
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المؤلفون: Alona Emodi-Perlman, Yarden Shreiber-Fridman, Shani Kaminsky-Kurtz, Ilana Eli, Sigalit Blumer
المصدر: Journal of Clinical Medicine; Volume 12; Issue 7; Pages: 2564
مصطلحات موضوعية: sleep bruxism, children, anamnesis, ear tubes, tooth wear, Eustachian tubes, General Medicine
الوصف: Sleep bruxism (SB) is a masticatory muscle activity during sleep, and its clinical manifestation in young children is still unclear. The aim of the present study was to evaluate the role of anamnestic information in predicting possible SB in children aged 4–12 years. In a cross-sectional retrospective exploratory study, the dental files of 521 children were examined with regard to the following anamnestic information: gender, age, medical conditions associated with ear, nose, and throat (ENT), respiratory disorders, use of methylphenidate (Ritalin), oral habits, and bruxing during sleep. A child was defined as presenting possible SB when a positive report was received from parents regarding such behavior (SB positive, No. = 84). There were no age- and/or gender-wise differences between SB-positive children and children whose parents did not report SB behavior (SB negative). SB-positive children suffered more from ENT and respiratory disorders than children without SB. Additionally, the use of pacifiers/finger sucking, as well as snoring, were more common among SB-positive children as compared to their SB-negative counterparts (Chi-square). The variables which were found to significantly increase the odds of possible SB in children were mouth breathing, ENT problems, and use of a pacifier or finger sucking (forward stepwise logistic regression). Clinicians should look for clinical signs of possible SB in children whose anamnesis reveals one or more of these anamnestic signals.
وصف الملف: application/pdf
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المؤلفون: Tadahiro Shoji, Eriko Takatori, Takayuki Nagasawa, Masahiro Kagabu, Tsukasa Baba, Tatsuhiko Shigeto, Yukiko Matsumura, Dai Shimizu, Yukihiro Terada, Manabu Seino, Tsuyoshi Ohta, Satoru Nagase, Shogo Shigeta, Hideki Tokunaga, Muneaki Shimada, Michiko Kaiho-Sakuma, Shigenori Furukawa, Shu Soeda, Takafumi Watanabe, Fumiaki Takahashi, Yoshihito Yokoyama
المصدر: International Journal of Clinical Oncology. 27:1874-1880
مصطلحات موضوعية: Ovarian Neoplasms, Hematology, General Medicine, Progression-Free Survival, Bevacizumab, Oncology, Antineoplastic Combined Chemotherapy Protocols, Humans, Fallopian Tube Neoplasms, Female, Surgery, Neoplasm Recurrence, Local, Peritoneal Neoplasms, Fallopian Tubes, Retrospective Studies, Platinum
الوصف: Outcomes with and without bevacizumab as first-line chemotherapy in Japanese-only ovarian cancer patients have not been reported. In this study, we report a retrospective study conducted at the Tohoku Gynecologic Cancer Unit.The study included 453 patients with stage III/IV ovarian, fallopian tube, and primary peritoneal cancer who received first-line platinum-based chemotherapy. The patients were divided into two groups: bevacizumab (168 patients) and without bevacizumab (285 patients). The primary endpoint was the rate of platinum-resistant recurrence and the secondary endpoints were the antitumor response, progression-free survival, overall survival, and adverse events.The objective response rates for patients with measurable diseases treated with and without bevacizumab were 84.5% and 73.0%, respectively (P = 0.0066). Platinum-resistant recurrence in the groups treated with and without bevacizumab was noted in 31 (18.4%) and 111 (38.6%) patients, respectively (P 0.0001). The median progression-free survival for the bevacizumab and without bevacizumab groups was 23 and 15 months, respectively (P = 0.0002), and the median overall survival was not reached and 49 months, respectively (P = 0.0005). Hypertension of grade 3 or higher was observed in 21 patients (12.5%) in the bevacizumab group (P 0.001), and proteinuria was observed in 18 patients (10.7%) and 1 patient (0.3%) in the bevacizumab and without bevacizumab groups, respectively (P 0.001). Intestinal perforation was observed in only one patient (0.6%) in the bevacizumab group.Combination and maintenance with bevacizumab in primary chemotherapy for advanced ovarian, fallopian tube, and primary peritoneal cancer was effective in reducing platinum-resistant recurrence rates and prolonging progression-free and overall survival.
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المؤلفون: Rachel C, Sisodia, Marcela G, Del Carmen
المصدر: New England Journal of Medicine. 387:727-736
مصطلحات موضوعية: Ovarian Neoplasms, Ovary, Fallopian Tube Neoplasms, Humans, Female, Ovarian Diseases, General Medicine, Fallopian Tube Diseases, Fallopian Tubes, Peritoneal Neoplasms, Pelvis
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المؤلفون: Chieh-Jen Wu, Yuan-Yuarn Liu, Yih-Wen Tarng, Fong-Dee Huang, Yi-Pin Chou, Jung-Fang Chuang
المصدر: Advances in Therapy. 39:3668-3677
مصطلحات موضوعية: Hemothorax, Rib Fractures, Thoracic Surgery, Video-Assisted, Chest Tubes, Drainage, Humans, Pharmacology (medical), Prospective Studies, General Medicine, Length of Stay, Retrospective Studies
الوصف: Large-bore chest tubes are usually applied after thoracic surgery. Recently, small-bore tubes have been increasingly considered owing to the extensive use of video-assisted thoracoscopic surgery (VATS). This study assessed the differences in outcomes between large-bore and small-caliber drainage tubes in patients undergoing surgical stabilization of rib fractures (SSRF) with VATS.Overall, 131 patients undergoing SSRF with VATS were prospectively enrolled, including 65 patients receiving 32-Fr chest tubes (group 1) and 66 patients receiving 14-Fr pigtail catheters (group 2) for postoperative drainage. The clinical characteristics and perioperative outcomes of the patients were compared.All patients underwent SSRF with VATS within 4 days after trauma. After the operation, the mean duration of chest tubes was longer than that of pigtail catheters, with statistical significance (5.08 ± 2.47 vs 3.11 ± 1.31, P = 0.001). Length of stay (LOS) was also longer in group 1 (10.38 ± 2.90 vs 8.18 ± 2.44, P = 0.001). After multivariate logistic regression, the only independent factors between the two groups were duration of postoperative drainage (adjusted odds ratio [AOR] 1.746; 95% confidence interval [CI] 0.171-10.583, P = 0.001) and hospital LOS (AOR 1.272; 95% CI 0.109-4.888, P = 0.027).After reconstruction of the chest wall and lung parenchyma, small-caliber drainage catheters could be easily and safely applied to reduce hospital LOS.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1847687cd9ecbaa835dfd84accd9611b
https://doi.org/10.1007/s12325-022-02182-6 -
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المؤلفون: Yoshito Imamura, Hiroki Watanabe, Yoshinori Hiramatsu, Toshiki Okasaka
المصدر: Asian Cardiovascular and Thoracic Annals. 30:807-812
مصطلحات موضوعية: Pulmonary and Respiratory Medicine, Treatment Outcome, Sutures, Chest Tubes, Suture Techniques, Humans, Surgery, Colloids, General Medicine, Cardiology and Cardiovascular Medicine
الوصف: Objective Ligation is a widely used wound closure method after chest drain removal in thoracic surgery. Knotless suture, which does not require ligation or suture removal, has been developed and is currently used in our institution. This study compared the efficacy of the drain wound closure method between knotless suture and our previous mattress suture. Methods We examined the clinical performance of knotless suture for chest drain wound closure in 117 patients who underwent surgery following this method in our department from October 2020 to April 2021. We compared outcomes with those of mattress suture using 2-0 nylon in 115 patients who underwent thoracic surgery at our institution between October 2018 and April 2019. Hydrocolloid dressing is applied to the drain wound after chest drain removal in a knotless suture. We conducted an analysis of both groups based on the condition of wound closure and drain wound complication. Results Appropriate wound closure was obtained and no patient required a prolonged hospital stay because of incomplete wound closure in both methods. The rate of chest drain wound infection for knotless suture (0.0%, 0/117 patient) was significantly lower than that of mattress suture (5.2%, 6/115 patients) at the outpatient follow-up ( p = 0.01). The rate of delayed drain wound healing was also significantly lower than that of mattress suture (0.9% vs. 7.0%; p = 0.02). Conclusions The results of knotless closure were better than those of conventional mattress suture regarding wound complications. Moreover, knotless suturing requires no suture removal, indicating its usefulness.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::96b599cc5eab7a6d4c34fef27d28f990
https://doi.org/10.1177/02184923221106770
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