Acupuncture for Retained Placenta: A Retrospective Case Series

2014 ◽  
Vol 32 (6) ◽  
pp. 506-508 ◽  
Author(s):  
Ivka Djakovic ◽  
Nada Bilic
Keyword(s):  
General Anaesthesia ◽  
Case Series ◽  
Placental Tissue ◽  
Controlled Trials ◽  
Retrospective Case ◽  
Manual Removal ◽  
The Third ◽  
Third Stage ◽  
Life Threatening ◽  
Retained Placental Tissue

Background A placenta is considered to be retained when it remains undelivered 30 or 60 min after the birth of the baby following active or physiological management of the third stage of labour, respectively. It can be life threatening for the mother. Methods We retrospectively examined the influence of acupuncture on the delivery of retained placentas in the third stage of labour in 70 women. In all cases the third stage of labour was actively managed, and acupuncture was provided 30 min after delivery at points KI16 and SP6 for 15 min. Results After acupuncture 77% of placentas separated successfully. In 10% of cases some retained placental tissue was detected and manual removal of the avulsed cotyledon was performed, while in 13% the entire placenta was retained and manual removal of the placenta under general anaesthesia was necessary. Conclusions Acupuncture may help to facilitate placental separation but further controlled trials are needed.

scholarly journals Macrophage Activation Syndrome in Adults: A Retrospective Case Series

2021 ◽  
Vol 9 ◽  
pp. 232470962110264
Author(s):  
Taylor Warmoth ◽  
Malvika Ramesh ◽  
Kenneth Iwuji ◽  
John S. Pixley
Keyword(s):  
Macrophage Activation Syndrome ◽  
Macrophage Activation ◽  
Pediatric Patients ◽  
Inflammatory Diseases ◽  
Systemic Juvenile Idiopathic Arthritis ◽  
Case Series ◽  
Adult Patients ◽  
Retrospective Case ◽  
Life Threatening ◽  
Activation Syndrome

Macrophage activation syndrome (MAS) is a form of hemophagocytic lymphohistocytosis that occurs in patients with a variety of inflammatory rheumatologic conditions. Traditionally, it is noted in pediatric patients with systemic juvenile idiopathic arthritis and systemic lupus erythematous. It is a rapidly progressive and life-threatening syndrome of excess immune activation with an estimated mortality rate of 40% in children. It has become clear recently that MAS occurs in adult patients with underlying rheumatic inflammatory diseases. In this article, we describe 6 adult patients with likely underlying MAS. This case series will outline factors related to diagnosis, pathophysiology, and review present therapeutic strategies.

Are head bandages really required after middle-ear surgery? A systematic review

2015 ◽  
Vol 129 (8) ◽  
pp. 740-743 ◽  
Author(s):  
I Khan ◽  
S Mohamad ◽  
S Ansari ◽  
A Iyer
Keyword(s):  
Systematic Review ◽  
Middle Ear ◽  
Cochlear Implantation ◽  
Randomised Controlled Trials ◽  
Case Series ◽  
Middle Ear Surgery ◽  
Controlled Trials ◽  
Retrospective Case ◽  
Ear Surgery ◽  
Randomised Controlled

AbstractObjective:A systematic review was performed to evaluate the role and effectiveness of head bandages after routine elective middle-ear surgery.Methods:Studies that compared the effectiveness of head bandage use after elective middle-ear surgery (e.g. myringoplasty, mastoidectomy and cochlear implantation) were identified using the following databases: Ovid Medline and Embase, the Ebsco collections, the Cochrane Library, PubMed, and Google Scholar. An initial search identified 71 articles. All titles and abstracts were reviewed. Thirteen relevant articles were inspected in more detail; of these, only five met the inclusion criteria. These included three randomised, controlled trials, one retrospective case series and one literature review.Results:The three randomised, controlled trials (level of evidence 1b) showed no statistically significant differences in post-operative outcomes (in terms of complications) associated with head bandage use in middle-ear surgery. This finding was supported by the retrospective case series involving patients undergoing cochlear implantation.Conclusion:Current available evidence shows no advantage of head bandage use after middle-ear surgery. Head bandages may not be required after routine, uncomplicated middle-ear surgery.

scholarly journals On the history of management of the third stage of labor in Kazan (to the 155th anniversary of the birth of Professor V.S. Gruzdev)

2021 ◽  
Vol 102 (2) ◽  
pp. 249-257
Author(s):  
L A Kozlov
Keyword(s):  
High Efficiency ◽  
Historical Study ◽  
Manual Removal ◽  
The Third ◽  
Obstetrics And Gynaecology ◽  
Third Stage Of Labor ◽  
Third Stage ◽  
Primary Literature ◽  
History Of ◽  
Speed Up

The article aims to show the experience of the Kazan Obstetrics and Gynaecology Clinic named after V.S. Gruzdev for replacing the obstetric operation manual removal of the placenta with other techniques to prevent serious postpartum complications. Research methods the historical study of primary literature sources. Manual removal of the placenta always associated with the risk of infection and developing puerperal sepsis. That is why obstetricians are constantly looking for a replacement for this operation. In 1895, even in the pre-Kazan period of work, professor Gruzdev successfully performed a method of inserting saline into the umbilical vessels to speed-up placental separation in the third stage of labor. While working in Kazan, on his proposal, doctor L.S. Sidorova (1936), and then Professor P.V. Manenkov (1942, 1948, 1955) and doctor M.V. Korotkova (1958) thoroughly studied and implemented the method of Budimilich in the work of the maternity ward of the clinic. This method involves replacing the saline solution with the crude alum solution. The second measure, preventing hemorrhage in the third stage of labor and avoiding manual removal of the placenta, was the successfully testing intravenous pituitrin (oxytocin) injection by Z.N. Yakubova, completed with the defense of her doctoral dissertation (1962). The high efficiency of these methods allowed us to recommend to them for widespread obstetric practice.

scholarly journals Mucormycosis coinfection associated with global COVID-19: a case series from India

2021 ◽  
Vol 7 (5) ◽  
pp. 815
Author(s):  
Deepthi Satish ◽  
Divya Joy ◽  
Anita Ross ◽  
Balasubramanya .
Keyword(s):  
Fungal Infection ◽  
Fungal Infections ◽  
Case Reports ◽  
Case Series ◽  
Retrospective Case ◽  
High Dependency ◽  
Life Threatening ◽  
Immunocompromised Status ◽  
Retrospective Case Study

<p><strong> </strong></p><p class="abstract"><strong>Background: </strong>Mucormycosis is a life-threatening fungal infection that occurs in immunocompromised patients. There has been increasing number of mucormycosis cases during COVID-19 pandemic and also as post COVID-19 sequelae. Our study aimed at scrutinizing a possible coinfection of invasive mycoses and COVID-19 and also its management</p><p class="abstract"><strong>Methods: </strong>We did a retrospective case study of 25 patients presenting as invasive fungal infection from March -December 2020. Majority of patients were immunocompromised, since they presented during the pandemic, all patients were subjected to rapid antigen and RT -PCR testing for COVID-19.</p><p class="abstract"><strong>Results: </strong>11 patients tested COVID-19 positive out of 25. Diagnosis of mucormycosis was based on clinical features, culture, and histopathology from sinus biopsy. COVID-19 positive patients were managed in the high dependency units and COVID-19 wards. Severe COVID-19 positive patients were empirically started on IV Amphotericin based on clinical suspicion of mucormycosis and were taken up for debridement once stable. Negative patients underwent surgical debridement and were started on IV Amphotericin postoperatively.</p><p class="abstract"><strong>Conclusions: </strong>There have been lot of case reports from India showing COVID-19 recovered patients presenting with invasive fungal infections, this could be because of their immunocompromised status and long-term corticosteroid use. In our case series we had three patients with post COVID-19 mucormycosis. There was a surge in COVID-19 positive mucor cases during August and September which also coincided with the maximum peak of cases in India, thereafter, there has been a declining trend. There have been significant challenges in treatment modality and outcome due to the pandemic.</p>

scholarly journals Attenuated androgen discontinuation in patients with hereditary angioedema: a commented case series

2022 ◽  
Vol 18 (1) ◽  
Author(s):  
Marcus Maurer ◽  
Markus Magerl ◽  
Emel Aygören-Pürsün ◽  
Konrad Bork ◽  
Henriette Farkas ◽  
...  
Keyword(s):  
Side Effects ◽  
Hereditary Angioedema ◽  
Treatment Strategies ◽  
Case Series ◽  
Additional Patient ◽  
Type I ◽  
Retrospective Case ◽  
Androgen Withdrawal ◽  
Life Threatening ◽  
Attenuated Androgen

Abstract Background Hereditary angioedema (HAE) is characterized by potentially severe and life-threatening attacks of localized swelling. Prophylactic therapies are available, including attenuated androgens. Efficacy of attenuated androgens has not been assessed in large, randomized, placebo-controlled trials and can be associated with frequent, and sometimes severe, side effects. As better tolerated targeted therapies become available, attenuated androgen withdrawal is increasingly considered by physicians and their patients with HAE. Attenuated androgens withdrawal has not been systematically studied in HAE, although examination of other disorders indicates that attenuated androgen withdrawal may result in mood disturbances and flu-like symptoms. Standardized protocols for attenuated androgen discontinuation that continue to provide control of attacks while limiting potential attenuated androgen withdrawal symptoms are not established as the outcomes of different withdrawal strategies have not been compared. We aim to describe the challenges of attenuated androgen discontinuation in patients with HAE and how these may continue into the post-androgen period. Case presentation We present a retrospective case series of 10 patients with confirmed type I HAE who have discontinued prophylactic treatment with attenuated androgens. The most common reason for attenuated androgen discontinuation was side effects. Attenuated androgens were either immediately withdrawn, tapered and/or overlapped with another treatment. The major challenge of discontinuation was the management of an increased frequency and severity of HAE attacks in some patients. Conclusions Healthcare teams need to undertake careful planning and monitoring after attenuated androgens discontinuation, and modify treatment strategies if HAE control is destabilized with an increased number of attacks. Discontinuation of attenuated androgens is definitively an option in an evolving HAE treatment landscape, and outcomes can be favourable with additional patient support and education.

scholarly journals Oesophageal ulceration in adult patients treated with doxycycline for acne vulgaris

2019 ◽  
Vol 47 (12) ◽  
pp. 6404-6409
Author(s):  
Yan Guo ◽  
Hua-Ming Li ◽  
Chun-Xia Li ◽  
Wei-Qin Zhu ◽  
Yu-Fang Wang ◽  
...  
Keyword(s):  
Acne Vulgaris ◽  
Case Series ◽  
Adult Patients ◽  
Retrospective Case ◽  
Drug Induced ◽  
Endoscopic Findings ◽  
The Third ◽  
Oesophageal Ulceration ◽  
History Of ◽  
Lying Down

Objective To report drug-induced oesophageal ulceration in adult patients treated with doxycycline for acne vulgaris. Methods This retrospective case series included data from adult patients treated with oral doxycycline therapy for acne vulgaris, who had presented with oesophageal ulceration at the Third People’s Hospital of Hangzhou between June 2016 and December 2017, and whose diagnosis was confirmed by gastroscopy. Clinicodemographic data were analysed, including symptom onset, endoscopy results, that were assessed for classic features of oesophageal ulceration. Patients were questioned regarding medication intake. Results A total of 12 patients were included (mean age, 23.50 ± 3.20 years), eight (66.67%) of whom were female. Based on history of medication and endoscopic findings, these patients were diagnosed with doxycycline-induced oesophageal ulceration. Most patients were found to have taken the medication at bedtime, just before lying down, and/or with insufficient water. Conclusion Doxycycline may cause oesophageal irritation when not taken with sufficient water, or taken just before lying down to sleep. Prescribing physicians should be aware of these issues, and instruct patients as to the correct method for intake of doxycycline.

scholarly journals Manual Removal of the Placenta after Vaginal Delivery: An Unsolved Problem in Obstetrics

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Fiona Urner ◽  
Roland Zimmermann ◽  
Alexander Krafft
Keyword(s):  
Maternal Morbidity ◽  
Placenta Previa ◽  
Morbidity And Mortality ◽  
Active Management ◽  
Retained Placenta ◽  
Manual Removal ◽  
The Third ◽  
Third Stage Of Labor ◽  
Third Stage ◽  
Maternal Morbidity And Mortality

The third stage of labor is associated with considerable maternal morbidity and mortality. The major complication is postpartum hemorrhage (PPH), which is the leading cause of maternal morbidity and mortality worldwide. Whereas in the event of PPH due to atony of the uterus there exist numerous treatment guidelines; for the management of retained placenta the general consensus is more difficult to establish. Active management of the third stage of labour is generally accepted as standard of care as already its duration is contributing to the risk of PPH. Despite scant evidence it is commonly advised that if the placenta has not been expelled 30 minutes after delivery, manual removal of the placenta should be carried out under anaesthesia. Pathologic adhesion of the placenta in the low risk situation usually is diagnosed at the time of delivery; therefore a pre- or intrapartum screening opportunity for placenta accreta would be desirable. But diagnosis of abnormalities of placentation other than placenta previa remains a challenge. Nevertheless the use of ultrasound and doppler sonography might be helpful in the third stage of labor. An improvement might be the implementation of standardized operating procedures for retained placenta which could contribute to a reduction of maternal morbidity.

scholarly journals Beware of the Migrating Chest Pain and Widened Mediastinum: Case Series on Aortic Dissection

2002 ◽  
Vol 9 (2) ◽  
pp. 95-101
Author(s):  
CH Chung ◽  
KK Lai
Keyword(s):  
Pericardial Effusion ◽  
Aortic Dissection ◽  
Case Series ◽  
District General Hospital ◽  
X Rays ◽  
Case Review ◽  
Retrospective Case ◽  
Superior Mediastinum ◽  
Presenting Symptoms ◽  
Life Threatening

Objective Aortic dissection is not a rare life-threatening emergency. Undiagnosed and untreated aortic dissection is associated with a high mortality. A review of cases in the hospital may provide a baseline picture to guide clinical decisions. Design Retrospective case review for a period of 3 years and 4 months. Setting District general hospital near the Hong Kong – Shenzhen ‘border’ with 24-hour Accident & Emergency service but without cardiothoracic surgical capability. Population All cases coded as ‘aortic dissection’ in the computerized ‘Clinical Management System’ of the hospital. Main outcome measures Date, sex, age, history of hypertension, presenting symptoms, pulse deficit, chest X-ray findings, pericardial effusion, A&E diagnosis, type of dissection and patient outcome. Results From August 1998 to November 2001, 26 cases of aortic dissection were identified. There were 19 males and 7 females. Age range was 26 to 90 years (mean 65.04 ± SD 15.04, median 66.50, mode 65). In the plain chest X-rays, widened superior mediastinum (>8 cm) was present in 19 patients (73.1%) and pleural effusion in three (11.5%). Pericardial effusion was found in six patients (23.1%). As regard to outcome, 11 were discharged home (42.3%), 14 were transferred to cardiothoracic surgical unit (where two subsequently died) and one died in the hospital. Conclusion The prevalence of aortic dissection may be more common than is generally appreciated by emergency physicians. Owing to its variable clinical presentations mimicking other diseases, the diagnosis of aortic dissection is easily missed. Higher clinical vigilance should be exercised for this potentially deadly condition.

Patellar groove replacement in patellar luxation with severe femoro-patellar osteoarthritis

2015 ◽  
Vol 28 (02) ◽  
pp. 124-130 ◽  
Author(s):  
Z. Dokic ◽  
D. Lorinson ◽  
J. P. Weigel ◽  
A. Vezzoni
Keyword(s):  
Complete Resolution ◽  
Patellar Instability ◽  
Case Series ◽  
Retrospective Case ◽  
Radiographic Images ◽  
Surgical Interventions ◽  
The Third ◽  
Novel Method ◽  
Patellar Stability ◽  
Replacement Prosthesis

SummaryObjective: To report a novel method of treating femoro-patellar instability in association with severe femoro-patellar osteoarthritis, by substituting the femoral trochlear with a patellar groove replacement prosthesis.Study design: Retrospective case series.Methods: Preoperative lameness was scored from 0–4, and radiographic studies including standard positions for patellar luxation were obtained for evidence of malalignment and femoro-patellar osteoarthritis. Cases with or without previous surgeries were included. The size of trochlear implant was determined by transparent templates and confirmed intra-operatively with trials. Radiographic images, together with clinical examinations, were reviewed immediately and at three months postoperatively and at longer term when available.Results: Thirty-five cases of patellar luxation ranging from grades II to IV were included. Eleven of these cases had prior surgical interventions which failed to stabilize the patella. Fourteen dogs required additional surgical procedures in conjunction with patellar groove replacement. Complications occurred in six patients, of which three required revision. Complete resolution of subjectively- assessed lameness was evident in 24/35 cases by the third month and in another seven of 35 patients on the longer term re-evaluations.Clinical significance: Use of a patellar groove replacement prosthesis has the potential to decrease the lameness associated with severe femoro-patellar arthritis, to improve patellar stability, and to correct the alignment of the extensor mechanism.

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