295 DOPPLER SONOGRAPHY OF THE OVARIAN ARTERIES IN SUPEROVULATED CATTLE

2009 ◽  
Vol 21 (1) ◽  
pp. 244 ◽  
Author(s):  
Ä Honnens ◽  
C. Klein ◽  
K.-G. Hadeler ◽  
H. Niemann ◽  
H. Bollwein ◽  
...  
Keyword(s):  
Blood Flow ◽  
Estrous Cycle ◽  
Doppler Sonography ◽  
Color Doppler ◽  
Limiting Factor ◽  
Dominant Follicle ◽  
Intact Group ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Despite considerable progress in the understanding of ovarian follicular growth in cattle, the variable and unpredictable superovulatory response of donor animals is still a limiting factor to the success in the embryo transfer industry. One of the main factors affecting the outcome is the presence or absence of a dominant follicle at the time of gonadotropin treatment. It has been shown that the removal of the dominant follicle using ultrasound-guided aspiration before superovulation increases the number of ova and transferable embryos (Bungartz and Niemann 1994 J. Reprod. Fertil. 101, 581–593). Transrectal color Doppler sonography has been used to evaluate the blood flow in the ovarian artery and to test the ovarian blood flow in relation to ovarian response upon hormonal treatment for superovulation. It has been determined that blood flow parameters (BFV: blood flow volume, PI: pulsatility index) have only limited diagnostic value to predict the outcome of a superovulation treatment (Honnens et al. 2008 doi.org/10.1016/j.anireprosci.2008.05.077). The objective of the present study was to investigate the effect of dominant follicle ablation on the ovarian blood flow during superovulation related to the outcome. At Day 8 of the estrous cycle, the dominant follicle was removed in 16 animals (Group 1). In 12 animals, the dominant follicle was left intact (Group 2). All animals received an eCG (3000 I.U.) injection on Day 10, a PGF2α injection on Day 12 and were inseminated twice starting 48 h later. Ovarian blood flow was determined in all animals by investigating the left and right ovarian arteries on Days 8, 10 and 12 of the estrous cycle and on Day 6 p.i. using a Logiq Book XP (General Electrics, UK) equipped with a 7.5 MHz probe. Doppler analysis was carried out using Pixelflux software (Chameleon Software, Germany). The PI was measured as described recently (Honnens et al. 2008 doi.org/10.1016/j.anireprosci.2008.05.077). On Day 7 p.i., ova/embryos were collected by standard non-surgical uterine flushing and classified according to the IETS guidelines. Similar results were obtained for the PI in group 1 on Day 8 (1.13 ± 0.08) and Day 10 (1.35 ± 0.09). A decrease (P ≤ 0.05) was measured at Day 12 (0.89 ± 0.07) and Day 6 p.i. (0.60 ± 0.06). In group 2, the PI remained constant until Day 12 (Day 8: 1.34 ± 0.11, Day 10: 1.43 ± 0.14, Day 12: 1.44 ± 0.12). At Day 6 p.i., the PI was significantly reduced (0.66 ± 0.09; P ≤ 0.05). Between both groups, a significant difference (P ≤ 0.05) was only detected at Day 12. More ova/embryos and transferable embryos (P ≤ 0.05) were recovered from group 1 (11.3 ± 1.6, 4.7 ± 0.9) compared to group 2 (4.8 ± 1.2, 1.9 ± 0.6). However, no significant relation (P > 0.05, Spearman) between the PI and the number total ova/embryos or the number of transferable embryos could be determined. These results show that removing the dominant follicle increases the number of embryos after superovulation. However, PI in general could not be used to predict the outcome of a superovulatory treatment.

295 SUPEROVULATORY RESPONSE IN COWS FOLLOWING SYNCHRONIZATION OF FOLLICLE WAVE EMERGENCE WITH ESTRADIOL AT DIFFERENT STAGES OF THE ESTROUS CYCLE

2008 ◽  
Vol 20 (1) ◽  
pp. 227
Author(s):  
A. Garcia Guerra ◽  
G. A. Bó ◽  
J. Villarreal ◽  
G. M. Brogliatti
Keyword(s):  
Estrous Cycle ◽  
Buenos Aires ◽  
Animal Health ◽  
Ovarian Response ◽  
Buenos Aires Province ◽  
Transfer Program ◽  
Dominant Follicle ◽  
Follicular Wave ◽  
Significant Difference ◽  
Group 2

Ovarian asynchrony and variability in response to superstimulation remain the most limiting factors in any embryo transfer program (Armstrong D 1993 Theriogenology 39, 7–24). Ovarian response can be increased and less variable if superstimulatory treatment is started at the time of follicular wave emergence (Bö GA et al. 1995 Theriogenology 43, 31–40). A combination of progesterone (P4) and estradiol have been used to synchronize follicular wave for superstimulation. A retrospective analysis was done to compare the ovarian response, superovulatory response and embryo production of cows in Argentina that received progesterone and estradol prior to superstimulation at different stages of the estrous cycle. This research was carried out using different breed of donors (n = 584, 88% Angus) during the last 4 years in Buenos Aires province, Argentina. Heat detection was performed twice a day. At random stages of the estrous cycle, donors received an intravaginal progesterone device (DIB; Syntex, Buenos Aires, Argentina), 2 mg of estradiol benzoate and 50 mg of progesterone (Syntex, Buenos Aires, Argentina) IM on the same day. On day 4 after DIB insertion, superestimulatory treatment was initiated on a decreasing dose regimen of FSH (Pluset; Callier, Spain, or Folltropin, Bioniche Animal Health Inc., Belleville, Ontario, Canada) as IM injections every 12 h over 4 d. On day 6, DIBs were removed, and cows received two doses of 2 mL of cloprostenol 12 h apart. At heat detection, all donors received a dose of 2 mL of GnRH (Dalmarelin; Fatro Von Franken, Buenos Aires, Argentina) by IM injection and were inseminated 12 and 24 h later. Seven days later, embryo collection was performed and ovarian response was evaluated as number of CL + unovulated follicles by transrectal ultrasound using a 7.5-MHz transducer (Pie Medical, Maastricht, the Netherlands). Ova/embryos were evaluated and classified according to the IETS manual. Donors were assigned to receive DIB and estradiol during the following stages of the cycle: group 1: between days 4 and 7 post-estrus (dominant follicle period), group 2: between days 8 and 12 post-estrus (emergence of the second follicular wave), and group 3: between days 13 and 21 post-estrus (dominant follicle of the second wave). Kruskal-Wallis test was used to compare variables among groups, and results are shown in Table 1. Ovarian response as CL + unovulated follicles and number of ovulations were significantly different among groups (P < 0.05). However, there was no significant difference in the number of fertilized ova or transferable embryos. Nevertheless, numeric differences that show that group 2 (started between days 8 and 12 post-estrus) was always superior for all variables. In conclusion, data suggest that estradiol may be more effective in synchronizing follicle wave emergence for superstimulation during the mid-part of the estrous cycle. Table 1. Superovulatory response in cows in which follicle wave emergence was synchronized with estradiol at different stages of the estrous cycle (mean ± SD) Research supported by Centro Genetico Bovino Eolia S.A.

315 USE OF PERIFOLLICULAR BLOOD FLOW TO PREDICT THE DEVELOPMENTAL COMPETENCE OF BOVINE CUMULUS-OOCYTE COMPLEXES COLLECTED DURING REPEATED OVUM PICKUP SESSIONS ONCE OR TWICE WEEKLY

2009 ◽  
Vol 21 (1) ◽  
pp. 254 ◽  
Author(s):  
A. Hanstedt ◽  
K. Höffmann ◽  
Ä Honnens ◽  
H. Bollwein ◽  
C. Wrenzycki
Keyword(s):  
Blood Flow ◽  
Blastocyst Stage ◽  
Developmental Competence ◽  
Small Individual ◽  
Color Flow ◽  
Color Flow Imaging ◽  
Significant Difference ◽  
Developmental Rates ◽  
Group 2 ◽  
Group 1

On average, only 20% of the cumulus–oocyte complexes (COC) develop to the blastocyst stage (Merton et al. 2003 Theriogenology 59, 651–674). An increase in the blood supply to individual follicles appears to be associated with follicular growth rates, whereas a reduction seems to be closely related to follicular atresia (Acosta et al. 2003 Reproduction 125, 759–767). The purpose of this study was to determine whether qualitative perifollicular blood flow changes can be used to predict the developmental competence of COC collected during repeated ovum pickup (OPU) sessions once or twice weekly. Lactating Holstein cows (n = 20) were used as oocyte donors. After dominant follicle removal, OPU was performed twice (group 1, for 3 weeks) or once (group 2, for six weeks) weekly employing a 7.5-MHz transducer (GE 8C-RS) of an ultrasound scanner (GE Logiq Book). Follicle size and Doppler characteristics were recorded by transvaginal ultrasonography just before COC collection using color flow imaging. Owing for technical limitations for measurement of blood flow in small individual follicles, only the presence or absence of blood flow was assessed for each follicle. When a clearly visible blue or red spot (blood flow) was detected in the follicle wall, it was considered as a follicle with detectable blood flow. Follicles with or without detectable blood flow from each individual cow were aspirated separately. After morphological classification of COC, standard protocols for IVP were used for embryo production (Wrenzycki et al. 2001 Biol. Reprod. 65, 323–331). Cleavage and blastocyst rates were recorded at Day 3 and Day 8, respectively. In total, 464 (246 with and 218 without detectable blood flow) and 243 (125 with and 118 without detectable blood flow) follicles ≥3 mm were aspirated in group 1 and group 2, respectively. Morphology of the COC was similar in all groups. Developmental rates for COC stemming from follicles with or without detectable blood flow in group 1 did not show differences for cleavage rates, 54.0% (34/63) and 56.7% (45/81), and for blastocyst rates, 25.4% (16/63) and 22.2% (18/83), respectively. In group 2, the cleavage rates were also similar for COC originating from follicles with and without detectable blood flow, 54.3% (25/46) and 51.5% (34/66). However, developmental rates up to the blastocyst stage did show a significant difference, 23.9% (11/46) and 15.2% (10/66) for COC aspirated from follicles with or without detectable blood flow (P ≤ 0.05). These results show that using COC originating from follicles with detectable perifollicular blood flow collected once weekly may have a higher developmental competence compared to those from follicle without detectable blood flow. Within the detection limits of this study, differences in perifollicular blood flow during repeated OPU sessions once weekly were predictive of oocyte competence. Ruthe Research Farm, Germany, for providing the animals; Masterrind GmbH, Germany, for donation of the semen; and the HW Schaumann Stiftung for financial support.

scholarly journals Feasibility of transabdominal Doppler sonography for studying uterine blood flow characteristics in cycling gilts

2018 ◽  
Vol 46 (03) ◽  
pp. 154-163 ◽  
Author(s):  
Catherine Herlt ◽  
Rosa Stark ◽  
Haukur Sigmarsson ◽  
Johannes Kauffold
Keyword(s):  
Blood Flow ◽  
Estrous Cycle ◽  
Cross Sections ◽  
Doppler Sonography ◽  
Pulse Wave ◽  
Color Doppler ◽  
Flow Characteristics ◽  
Color Doppler Sonography ◽  
Power Pulse ◽  
Uterine Perfusion

Summary Objective: To test for the feasibility of transabdominal Doppler sonography (color, power, pulse wave) to define uterine perfusion characteristics throughout the estrous cycle in gilts. Materials and methods: A total of 15 gilts were synchronized for estrus and scanned in their following spontaneous cycle while being restrained in a purpose-designed mobile crate. To define uterine perfusion characteristics, vessels in between and within uterine cross-sections were imaged and recorded as video sequences to be analyzed by PixelFlux® software for perfused area (Amix), blood flow velocity (vmix) and intensity (Imix) as well as resistance (RIvmix) and pulsatility index (PIvmix). Results: Color Doppler sonography proved to be the only feasible technique, as it was less affected by animal movements than power and pulse wave sonography. As determined by color Doppler sonography, all five parameters determined showed specific patterns through the estrous cycle, i. e. Amix, vmix, Imix were high in proestrus, decreased in estrus and remained low in midestrus and most parts of diestrus; RIvmix and PIvmix with inversely paralleled patterns. Conclusion and clinical relevance: This study has demonstrated that transabdominal color Doppler but not power and pulse wave Doppler sonography is feasible to be performed in crate-restrained gilts for studying uterine perfusion characteristics during the estrous cycle, and that changes of uterine perfusion over the course of the estrous cycle can be clearly followed by color Doppler sonography. Results encourage the use of color Doppler sonography for studying i. e. uterine capacity or uterus related infertility such as for cases of clinically unapparent endometritis.

scholarly journals Contribution of pre-varicocelectomy color Doppler ultrasonography finding to surgery and its correlation with semen parameters

2021 ◽  
Vol 93 (2) ◽  
pp. 227-232
Author(s):  
Caner Ediz ◽  
Muhammed Cihan Temel ◽  
Suna Şahin Ediz ◽  
Serkan Akan ◽  
Serkan Yenigürbüz ◽  
...  
Keyword(s):  
Physical Examination ◽  
Doppler Ultrasonography ◽  
Semen Analysis ◽  
Color Doppler ◽  
Color Doppler Ultrasonography ◽  
Semen Parameters ◽  
Significant Difference ◽  
Group 2 ◽  
Grade 3 ◽  
Group 1

Background: This study aimed to determine the contribution of color Doppler ultrasonography (CDUS) performed before varicocelectomy to the success of surgical treatment and to evaluate the correlation between CDUS findings and semen parameters. Methods: A total of 84 patients diagnosed with grade 3 left varicocele in our clinic between 2016 and 2018 were evaluated. The patients in whom the decision for varicocelectomy was based on only physical examination (PE) findings and abnormal semen analysis (SA) were defined as Group 1, while the patients undergoing varicocelectomy based on PE, CDUS and SA findings were defined as Group 2. The patients diagnosed with varicocele based on PE and CDUS findings who were included in a followup protocol due to normal semen parameters were defined as Group 3. Results: In Group 1, there was a total of 28 patients and the mean number of ligated internal spermatic veins was 4.53 (range, 2-10). In Group 2, there was a total of 30 patients and the number of ligated internal spermatic veins was 3.76 (range, 1-8). No statistically significant difference was found between Group 1 and 2 in terms of the number of internal spermatic veins ligated during varicocelectomy. No statistically significant correlation was found between semen parameters and the number of veins ligated during varicocelectomy in Group 1 and 2 and between semen parameters and CDUS findings group 2 and 3. Conclusions: In patients with primary grade 3 varicocele, diagnosed by physical examination there is no need for additional imaging in primary cases.

Survey of changes in ovarian and uterine artery blood flow and indexes by transvaginal Doppler sonography in POI patients and effect of acupuncture on their fertility

2021 ◽  
Vol 15 (6) ◽  
pp. 2011-2015
Author(s):  
Mohammad Reza Babaei
Keyword(s):  
Blood Flow ◽  
Ovarian Reserve ◽  
Doppler Sonography ◽  
Endometrial Thickness ◽  
Color Doppler ◽  
Resistance Index ◽  
Post Intervention ◽  
Hormone Levels ◽  
Acupuncture Intervention ◽  
Significant Difference

Background: Primary ovarian insufficiency (POI) is a common cause of infertility and usually defined by the triad of amenorrhea, estrogen deficiency, and elevated luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels in women < 40 years of age. The aim of the present study was to investigate the relationship between uterine and ovarian blood flow with acupuncture and fertility ratio in patients of the Firoozgar Hospital Infertility Clinic. Methods: Twenty-nine patients with POI were included in this clinical trial. FSH, LH, estradiol (E2), and anti-Müllerian hormone (AMH) levels were measured. Patients with Turner syndrome were identified and excluded from the study. Selected patients were evaluated using transvaginal color Doppler sonography used to measure ovarian volume, endometrial thickness, flow rates, and uterine and ovarian artery indexes. Patients were treated with acupuncture twice a week for 5 weeks. After the end of treatment, hormonal assays and an ultrasound examination were repeated to check the changes. Results: Indexes of the uterine arteries (Resistance Index, Pulsatility Index) before versus after the intervention were significantly different (P < 0.00) and uterine vascularity increased after treatment in 22 patients (75.8%). LH and FSH hormone levels were significantly decreased after the intervention (P < 0.00), while AMH and E2 levels were significantly increased after treatment (P < 0.00). The post-intervention right ovarian reserve was significantly increased (P = 0.02), whereas there was no significant difference in left ovarian reserve before vs. after treatment (P = 0.39). Spontaneous menstruation was detected after acupuncture in 16 patients. Conclusions: Our study demonstrated changes in vascularity, hormone levels, menopausal symptoms, and menstrual induction in patients after acupuncture intervention. Keywords: POI, acupuncture, arterial indexes.

Effects of adrenalectomy on CCD: evidence for differential response of two cell types

1987 ◽  
Vol 253 (4) ◽  
pp. F742-F752 ◽  
Author(s):  
S. Muto ◽  
G. Giebisch ◽  
S. Sansom
Keyword(s):  
Apical Membrane ◽  
Collecting Duct ◽  
Basolateral Membrane ◽  
Pump Current ◽  
Cell Types ◽  
Cortical Collecting Duct ◽  
Intact Group ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Electrophysiological and chemical methods were used to determine the Na and K transport properties of the isolated cortical collecting duct (CCD) of control and adrenalectomized (ADX) rabbits. Net fluxes of Na (JNa) and K (-JK) in controls were 5.7 and 3.2 pmol . mm-1 . min-1 and in ADX were 1.0 and 0.7 pmol . mm-1 . min-1, respectively, similar to electrically determined rates. In separate experiments, blind impalement of cells from adrenal intact (group 1), ADX (group 2), and ADX rabbits treated with deoxycorticosterone (group 3) allowed identification of two distinct cell types, majority cells (MA) and minority cells (MI). In all groups, MA were distinguished from MI by a relatively high basolateral membrane potential (-Vb), low apical membrane fractional resistance (FRa), and presence of apical and basolateral membrane K conductances. Vb of MA (-82.4 mV) was significantly hyperpolarized in groups 1 and 3 combined, when compared with group 2 (-66.4 mV). However, there was no significant difference between Vb of MI in group 2 (-38.9 mV) and Vb of MI in groups 1 and 3 (-36.2 mV). In MA of group 1 equivalent circuit values of apical membrane Na and K conductances (GNaa, GKa) and maximum pump current (Ipmax) were 0.84 and 6.72 mS/cm2 and 46.7 microA/cm2, respectively. These values in group 2 were significantly lower (0.28 and 1.52 mS/cm2 and 8.7 microA/cm2, respectively). It is concluded that two cell types can be distinguished electrically in the CCD. MA have properties consistent with principal cells and MI have properties consistent with intercalated cells. ADX causes a decrease in GNaa, GKa, and Ipmax of PC that results in proportionate decreases in INaa and IKa.

Clinical Comparison of the Ocular Blood Flow Tonograph and the Goldmann Applanation Tonometer

1998 ◽  
Vol 8 (3) ◽  
pp. 162-166 ◽  
Author(s):  
H. Esgin ◽  
M.L. Alimgil ◽  
S. Erda
Keyword(s):  
Blood Flow ◽  
Ocular Blood Flow ◽  
Mean Value ◽  
Applanation Tonometry ◽  
Goldmann Applanation Tonometry ◽  
Goldmann Applanation Tonometer ◽  
Significant Difference ◽  
Applanation Tonometer ◽  
Group 2 ◽  
Group 1

Purpose To compare the IOP readings of an ocular blood flow (OBF) tonograph (OBF Labs UK Ltd) with Goldmann applanation tonometry. Methods 194 patients were studied. In group 1, the software version 8.2 of the OBF tonograph was used in 214 eyes of 107 patients and in group 2, the 11.2 version of the tonograph was used in 174 eyes of 87 patients. Results We found 63% of the OBF tonograph readings to be within ±2mm Hg of the Goldmann applanation tonometry readings in group 1 and 60% in group 2. In group 1 the correlation coefficient between the readings of the two instruments was 0.71 and 0.82 in group 2. The mean value for the paired differences in group 1 was –1.34±2.75mm Hg overall and –1.04±2.91mm Hg overall in group 2. There was a significant difference between the Goldmann applanation tonometer and OBF tonograph readings in the 8–10mm Hg interval (p<0.001) in group 1, but not in group 2 (p>0.1). Conclusions The 11.2 version of the OBF tonograph is more accurate than the 8.2 version and measures IOP in a manner that corresponds well to the Goldmann applanation tonometer in the 8–10mm Hg and 21–29mm Hg intervals. It corresponds fairly well in the 11–20mm Hg interval.

scholarly journals Ocular Blood Flow Abnormalities and Their Correlation with Body Mass Index in Obese Patients

2021 ◽  
Author(s):  
Melek Tufek ◽  
Mustafa Capraz ◽  
Ahmet Turan Kaya ◽  
Kenan Varol ◽  
Nihat Aydın ◽  
...  
Keyword(s):  
Blood Flow ◽  
Choroidal Thickness ◽  
Ocular Blood Flow ◽  
Control Group ◽  
Choroidal Blood Flow ◽  
Significant Difference ◽  
Retrobulbar Blood Flow ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract PurposeTo evaluate the effects of obesity on ocular blood flow including choroidal thickness and retrobulbar blood flow values in comparison with healthy subjectsMethodsThe 102 eyes of 102 female patients were included in this prospective study.Color Doppler ultrasonography (CDU) was used to evaluate the retrobulber vessels.Choroidal thickness was measured by using the optical coherence tomography (OCT). ResultsThere was a significant difference in IOP values within the groups with the highest values in group 3 and the lowest in group 1.There was also a positive correlation between BMI and IOP. The CT was found to be statistically significantly lower in group 2 and group 3 than in the control group at all measurement points. The choroidal thickness was also statistically significantly lower in group 3 than in group 2 at the subfoveal, nasal 500 µm, and the temporal 500 and 1000 µm measurement points.The mean CRA PSV and EDV values were lower in group 2 and group 3 than in group 1, while group 3 had the lowest mean CRA PSV value among the groups. When compared to group 1, the OA EDV value was lower only in group 3 while the OA PSV value was statistically significantly lower in group 3 than in both group 2 and group 1. There was no significant difference between the groups in terms of RI and PI.ConclusionsObesity can create a predisposition to ocular pathologies both by increasing the IOP and decreasing the retrobulbar and choroidal blood flow.

In-vivo evaluation of the effect of cyanoacrylate on prosthetic vascular graft infection – does cyanoacrylate increase the severity of infection?

VASA ◽  
2020 ◽  
Vol 49 (4) ◽  
pp. 281-284
Author(s):  
Atıf Yolgosteren ◽  
Gencehan Kumtepe ◽  
Melda Payaslioglu ◽  
Cuneyt Ozakin
Keyword(s):  
Vascular Graft ◽  
Graft Infection ◽  
Vascular Graft Infection ◽  
Group 4 ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Prosthetic Vascular Graft Infection ◽  
Group 1

Summary. Background: Prosthetic vascular graft infection (PVGI) is a complication with high mortality. Cyanoacrylate (CA) is an adhesive which has been used in a number of surgical procedures. In this in-vivo study, we aimed to evaluate the relationship between PVGI and CA. Materials and methods: Thirty-two rats were equally divided into four groups. Pouch was formed on back of rats until deep fascia. In group 1, vascular graft with polyethyleneterephthalate (PET) was placed into pouch. In group 2, MRSA strain with a density of 1 ml 0.5 MacFarland was injected into pouch. In group 3, 1 cm 2 vascular graft with PET piece was placed into pouch and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. In group 4, 1 cm 2 vascular graft with PET piece impregnated with N-butyl cyanoacrylate-based adhesive was placed and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. All rats were scarified in 96th hour, culture samples were taken where intervention was performed and were evaluated microbiologically. Bacteria reproducing in each group were numerically evaluated based on colony-forming unit (CFU/ml) and compared by taking their average. Results: MRSA reproduction of 0 CFU/ml in group 1, of 1410 CFU/ml in group 2, of 180 200 CFU/ml in group 3 and of 625 300 CFU/ml in group 4 was present. A statistically significant difference was present between group 1 and group 4 (p < 0.01), between group 2 and group 4 (p < 0.01), between group 3 and group 4 (p < 0.05). In terms of reproduction, no statistically significant difference was found in group 1, group 2, group 3 in themselves. Conclusions: We observed that the rate of infection increased in the cyanoacyrylate group where cyanoacrylate was used. We think that surgeon should be more careful in using CA in vascular surgery.

Tuberculosis of the meninges and central nervous system. Experience of clinical diagnostics in St. Petersburg for 50 years

MedAlliance ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. 14-24
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Medical Errors ◽  
Clinical Diagnostics ◽  
Lethal Outcome ◽  
Significant Difference ◽  
Group 2 ◽  
Allergic Vasculitis ◽  
Tuberculosis Meningitis ◽  
Group 1

The clinic and diagnostics of tuberculosis meningitis (TM) in 926 patients treated in St. Petersburg hospitals in 1965–1994 (group 1) and in 1995–2018 (group 2) is presented. The TM clinic is demonstrated to be determined by the form of tuberculosis and its characteristic generalization nature in the presence of repeated waves of bacteremia and allergic vasculitis of greater or lesser severity. There is clinical peculiarity of TM in primary pulmonary tuberculosis and its early large-focal and late miliar generalization, as well as in hematogenous tuberculosis. In patients of the 1st and 2nd groups the TM clinic shows in some respects a noticeable similarity, in others — a significant difference. Despite the typical symptoms, early diagnosis of TM took place in less than 20% of patients. Clinical examples illustrating the unusual development of TM, contrasting with its usual course, are given. A number of objective and subjective factors contributing to the adverse evolution of TM and its lethal outcome are discussed. These include the peculiarity of modern tuberculosis, especially when associated with HIV infection, as well as medical errors associated with ignorance of the pathogenesis of tuberculosis and failure to comply with the minimum examination for tuberculosis.

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