scholarly journals Treatment of Cervical Pregnancy with Ultrasound-Guided Intragestational Injection of Methotrexate: A Case Report

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Angeliki Rouvali ◽  
Panagiotis Vlastarakos ◽  
Sofoklis Stavros ◽  
Maria Giourga ◽  
Kalliopi Pappa ◽  
...  
Keyword(s):  
Main Concern ◽  
Cervical Canal ◽  
Ultrasound Guided ◽  
Conservative Strategy ◽  
Cervical Pregnancy ◽  
The Past ◽  
Life Threatening ◽  
History Of ◽  
Previous Cesarean ◽  
Urine Pregnancy Test

This study is aimed at describing a noninvasive conservative strategy to the treatment of cervical pregnancy and highlighting the success of ultrasound-guided therapeutic techniques. A 43-year-old woman with a history of one previous cesarean section presented in our unit with vaginal spotting and a positive urine pregnancy test. She was diagnosed with a cervical pregnancy, and she was successfully treated conservatively with the administration of intragestational sac methotrexate under ultrasound guidance. Cervical pregnancy is a rare form of ectopic pregnancy that results from conceptus implantation in the cervical canal. The main concern is the associated life-threatening hemorrhage and subsequent need for urgent hysterectomy. The evolution of ultrasound over the past decades has enabled early diagnosis and has shifted the management from a radical surgical approach towards a stepwise conservative therapeutic approach, when possible.

Possible GoLytely-Associated Cardiac Arrest: A Case Report and Literature Review

2019 ◽  
Vol 33 (3) ◽  
pp. 364-367 ◽  
Author(s):  
Yoonsun Mo ◽  
Shiv Gandhi ◽  
Jose Orsini
Keyword(s):  
Cardiac Arrest ◽  
Abdominal Pain ◽  
Sudden Cardiac Arrest ◽  
Lower Abdominal Pain ◽  
The Past ◽  
Life Threatening ◽  
History Of ◽  
Artery Disease ◽  
Possible Cause

Purpose: To report a case of sudden cardiac arrest possibly associated with the administration of GoLytely® (polyethylene glycol 3350 and electrolytes). Summary: A 60-year-old male with a history of hypertension, hyperlipidemia, type 2 diabetes, and coronary artery disease presented to the emergency department with complaints of constipation and lower abdominal pain over the past week, and the inability to urinate over the past day. The patient had received GoLytely as treatment to alleviate symptoms of constipation and abdominal pain. However, several hours after administration of the bowel prep solution, the patient suffered an episode of cardiac arrest. After ruling out other possible etiologies, GoLytely was suspected as a possible cause of cardiac arrest. The patient had suffered an anoxic brain injury and remained intubated and unconscious until he eventually expired, 20 days after the event. Conclusion: Although GoLytely appears to be a safe agent with fewer side effects, clinicians need to be mindful of potential life-threatening adverse events following GoLytely administration and monitor patients closely during and after administration.

A Prospective and Retrospective View of Pediatric Hematology/Oncology

2006 ◽  
Author(s):  
Momcilo Jankovic ◽  
Giuseppe Masera
Keyword(s):  
Health Care Professionals ◽  
Pediatric Hematology ◽  
The Past ◽  
Life Threatening Illness ◽  
Retrospective View ◽  
Simple Question ◽  
Life Threatening ◽  
Working Together ◽  
History Of ◽  
The Moment

How does one help a family whose child has been diagnosed with a life-threatening illness? It is a deceptively simple question with complicated answers. This brief chapter is not meant to be a history of biopsychosocial pediatric oncology, and it does not cover every theme. The explosion of studies on children with cancer over these past decades (Pizzo & Poplack, 2001) renders a retrospective look formidable and subjective. The sole purpose of this retrospective examination into the earliest beginnings is to place into context some of the main themes that have appeared over the past years, so that they can serve as a foundation for our recommendations for future intervention and research in the field. That is our assigned task. Much of the review reflects personal respective experiences beginning in the late 1960s. The chapters that form this volume, written by many of the most experienced psychosocial researchers who have brought the field so far forward over these many years, are the state of the art, tell us where we have been most recently, and tell us in greater detail where we are at the moment. Where does our psychosocial history begin? What have we done these past many years to help the children and their families cope with the illness and its treatment? With due awareness of the subjectivity and inevitable unfairness of our venture, we undertake the task with due apologies for any omissions that may occur in this retrospective review. As we begin to look in some detail at the main themes formed over the past four decades, we place our review into the context of four preambles: a multidisciplinary and international effort; an alliance between physicians and parents; research and service; and a sharing of the research wealth with economically struggling countries. From the earliest years, the effort to care for the child with cancer has been multidisciplinary, multi-institutional, and international, involving a highly cooperative and collaborative effort of physicians, nurses, psychologists, social workers, and allied health care professionals working together across national borders.

scholarly journals Like a Prophet - On Christian Interpretations of a Madonna Video

1996 ◽  
Vol 16 ◽  
pp. 151-174
Author(s):  
Andreas Häger
Keyword(s):  
Popular Music ◽  
Rock Music ◽  
Main Concern ◽  
History Of Christianity ◽  
The Past ◽  
Positive Message ◽  
History Of ◽  
Christian Discourse ◽  
A Current

Throughout the history of Christianity, its relationship to art has been a complicated one, concerning the use of art in worship as well as the views on "secular" art. This article deals with a current example of the latter. More specifically, the article examines some examples of Christian views on popular music. The best-known reactions to pop and rock music' by Christians are likely to be negative ones, probably because these are usually the most loudly declared. But there is also another aspect to the Christian discourse on popular music. Some Christians try to emphasise what is perceived as a positive message in "secular" rock music. This part of the debate is the main concern in this paper.The examples used deal with one of the most controversial pop artists, Madonna, and one of her most discussed works, the video `Like a Prayer'. Madonna Louise Ciccone, born 1958, has been one of the most successful, most imitated and certainly most talked about popular artists of the past decade. She has — at least to a certain degree quite consciously — stirred up controversy with several of her videos. Raised a Catholic, her use of religious themes and images is one aspect that has caught special attention.

Anesthesia for MRI

2018 ◽  
Author(s):  
Trung Du ◽  
Mohamed A. Mahmoud
Keyword(s):  
Anesthetic Techniques ◽  
Resonance Imaging ◽  
Safety Issues ◽  
The Past ◽  
Anesthesia Providers ◽  
Obstructive Sleep ◽  
Life Threatening ◽  
History Of ◽  
Pediatric Sedation ◽  
Magnetic Resonance Imaging Mri

Over the past two decades, recent advances in technological innovation have led to an increased demand for pediatric noninvasive procedures. This clinical demand has resulted in tremendous growth in pediatric sedation in non-operating room anesthesia (NORA) locations. Providing anesthesia in these locations challenges anesthesia providers to gain familiarity with the procedures, tailor an anesthesia plan to the procedure and location, and plan for the management of life-threatening situations in these challenging locations. Anesthesiologists are the final arbiter of whether the child is optimized for the procedure or not in NORA location with potentially limited access to backup help. This chapter explores the current and important safety issues for anesthetic administration in magnetic resonance imaging (MRI) suite, the available anesthetic techniques for MRI anesthesia/sedation and finally discuss some specialty-specific considerations for children with history of obstructive sleep apnea and difficult airway.

scholarly journals The Natural History of “Inhibitors” to Factors VIII and IX in Hemophiliacs

1977 ◽  
Author(s):  
C.E.C. Harris
Keyword(s):  
Factor Viii ◽  
Room Temperature ◽  
Factor Ix ◽  
Standard Dosage ◽  
The Past ◽  
Frequent Administration ◽  
Life Threatening ◽  
History Of ◽  
Viii And Ix

Since 1954 an increasing number of adult hemophiliacs have been followed and “inhibitors” have been found in a minority of patients. A retrospective study was made of 9 factor-VIII and of 9 factor-IX cases who have attended with sufficient regularity for adequate documentation. The presence of this complication was, until recently, suspected because of failure clinically to respond to replacement therapy and confirmed by the original Biggs’ technique in the laboratory. In the past k years, this has been replaced by her method using serial dilutions at room temperature and at 37°C, incubated for 1 hour. In addition, studies have been made of factor recovery and survival following infusions.In no case were immuno-suppressive agents used. There were no deaths. Life-threatening crises were met by conservative measures, including hypothermia, and by the use of porcine factor-VIII. Instances when in vivo survival of infused concentrate was shortened were usually managed successfully by more frequent administration of equal or lesser dosage quantities; it was exceptional in such cases to witness enhancement of “inhibitor” potency as a consequence.In no less than 6 of the 9 patients would it seem that the “inhibitor” has disappeared and full clinical response is now being obtained with standard dosage schedules. The nature of “inhibitors” would not seem to be well understood.

scholarly journals Graves hyperthyroidism in pregnancy: a rare presentation

2019 ◽  
Vol 8 (10) ◽  
pp. 4104
Author(s):  
Priyanka Garg ◽  
Romi Bansal ◽  
Roushali .
Keyword(s):  
Sleep Disturbances ◽  
Fetal Loss ◽  
Rare Presentation ◽  
Fetal Demise ◽  
Present Patient ◽  
Male Baby ◽  
The Past ◽  
Life Threatening ◽  
History Of ◽  
In Pregnancy

Hyperthyroidism in pregnancy is much less common occurring in 0.1-0.2% of women with Grave’s disease being the most common cause accounting for 90% of the cases. It is important to diagnose hyperthyroidism in pregnancy because fetal loss in untreated patients is high and may even be life threatening for the mother. We are presenting a case of 29 years old G3P2L1 who presented to our emergency with amenorrhea of 7 months and history of loose stools for the last 20 days. It was associated with generalized weakness. She also had history of palpitations, weight loss and sleep disturbances. She was a known case of hyperthyroidism for the past 1-2 years and was already taking anti-thyroid drugs. B/L exophthalmos was apparently present. Patient was severly anaemic with haemoglobin of 5.5gms/dl. Ultrasound showed fetal demise at 28weeks. Patient was given 3 units of blood transfusion and was induced with prostaglandins. She delivered a dead male baby weighing 1.2kgs. Her postpartum period was uneventful. Timely diagnosis of graves hyperthyroidism and its optimal treatment throughout pregnancy is vital in reducing maternal, fetal and neonatal complications. 

scholarly journals Silent primary ovarian ectopic pregnancy following ovulation induction: diagnostic dilemma

2021 ◽  
Vol 10 (9) ◽  
pp. 3654
Author(s):  
Kalyani Saidhandapani ◽  
Yashaswi Pandey ◽  
Priya Shaunthini
Keyword(s):  
Ovulation Induction ◽  
Diagnostic Challenge ◽  
Diagnostic Dilemma ◽  
Ovarian Pregnancy ◽  
Threatening Condition ◽  
Reproductive Techniques ◽  
Life Threatening ◽  
History Of ◽  
High Index Of Suspicion ◽  
Urine Pregnancy Test

Early diagnosis of an ovarian pregnancy, of all the diagnoses relating to extrauterine gestations, is perhaps a diagnostic challenge faced by an obstetrician and a radiologist. About 0.5% of extrauterine implantations occur in the ovary. Recent studies have demonstrated infertility and Assisted reproductive techniques (ARTs), multiparity, use of intrauterine devices as risk factors for ovarian ectopic. Knowledge pertaining to ovulation induction and risk of ovarian ectopic is even more scant. In this article, we report a case report of ovarian pregnancy following ovulation induction with letrozole. Patient visited with history of missed menstrual period, mild abdominal pain and a weakly positive urine pregnancy test. Provisional diagnosis of right tubal ectopic was made. Diagnosis of ruptured ovarian ectopic was made on explorative laparoscopy which was later confirmed histopathologically. Patient had normal intra and post-operative course. An ovarian ectopic can present as a life-threatening condition and a high index of suspicion can prevent morbidity as well as mortality. Ovarian pregnancy in a primigravida with ovulation induction without an alarming sign, as in this case, is the rarest entity came across till date.

scholarly journals Kehamilan Pada Jejas Luka Sesar: Diagnosis Yang Akurat Dan Keberhasilan Dalam Tatalaksana Secara Konservatif

2020 ◽  
Vol 4 (1) ◽  
pp. 114-119
Author(s):  
Satrio Budhi Purnomo ◽  
Dovy Djanas
Keyword(s):  
Ectopic Pregnancy ◽  
Conservative Therapy ◽  
Ultrasound Examination ◽  
Transvaginal Ultrasound ◽  
Bladder Wall ◽  
Cervical Canal ◽  
Intrauterine Pregnancy ◽  
Cesarean Scar ◽  
Life Threatening ◽  
History Of

Reported case in a woman aged 30 years, with a history of cesarean scar four years ago, diagnosed with gravid two by one gravid 7-8 weeks with gestation on cesarean scar. The patient had a history of accidental trauma two days prior to the complaint of bleeding from the genitals. Several obstetricians have examined but still obtained different results (intrauterine pregnancy and ectopic pregnancy). An accurate diagnosis is critical to the success of the management of a patient with a pregnancy with this life-threatening cesarean scar. With a precise and accurate transvaginal ultrasound examination, the diagnostic criteria with ultrasound on previous surgical scars have been fulfilled in this patient, including an empty uterus, an empty cervical canal image, growth of a gestational pouch in the anterior lower segment of the uterus, and the absence of myometral image between the bladder wall and the gestational pocket. On B-HCG examination, the result was 58,808.70 mlU / mL. Conservative therapy with metrotrexate (MTX) 50 mg / m2 intramuscularly. After giving metrotrexate (MTX) therapy for four times, the results of B-HCG decreased significantly with 21.530, 12 mlU / mL, 2,949.47 mlU / mL, and 593.61 mlU / mL, respectively. After administration of metrotrexate (MTX) therapy, there was a decrease in the size of the gestational bag. Keywords: Ectopic, Pregnancy, Methotrexate, Cesarean Section

Consultation with the Specialist

1995 ◽  
Vol 16 (2) ◽  
pp. 69-72
Author(s):  
Margaret A. Kenna
Keyword(s):  
Physical Examination ◽  
Pediatric Intensive Care ◽  
Definitive Diagnosis ◽  
Upper Respiratory Infection ◽  
The Past ◽  
Subsequent Discussion ◽  
Life Threatening ◽  
History Of ◽  
Upper Respiratory ◽  
Vocal Nodules

Hoarseness in children is very common and usually self-limiting, but there are several very serious and potentially life-threatening causes of hoarseness that always should be considered. A careful history and physical examination usually can suggest underlying etiologies, with the definitive diagnosis usually made at the time of airway endoscopy. The following case and subsequent discussion attempt to clarify some of these issues. Case Report An 8-year-old boy presented to the emergency room with a 2-week history of increasing hoarseness, accompanied in the past 5 days by some respiratory distress. On physical examination he was alert and cooperative, with a hoarse but understandable voice and moderate inspiratory and expiratory stridor. Further history revealed that 6 weeks earlier he had been admitted to the pediatric intensive care unit with severe asthma that required 8 days of intubation and mechanical ventilation. He had done well after discharge for about 4 weeks, when his symptoms of hoarseness and then stridor developed. Differential Diagnosis The entities causing hoarseness can be divided primarily into congenital, neurogenic, neoplastic, inflammatory, physiologic, and traumatic (Table). The most common overall etiology is laryngitis associated with an upper respiratory infection (URI), which generally is benign and self-limiting. Vocal nodules are the acquired lesions encountered most frequently and usually are not associated with airway compromise.

scholarly journals CHARACTERISTICS OF THE VAGINAL MICROBIOTA, CERVICAL AND UTERINE FLORA IN WOMEN WITH THE PAST HISTORY OF SEXUALLY TRANSMITTED INFECTIONS

2021 ◽  
Vol 74 (4) ◽  
pp. 896-901
Author(s):  
Olena I. Krotik
Keyword(s):  
Chlamydia Trachomatis ◽  
Past History ◽  
Uterine Cavity ◽  
Vaginal Microbiota ◽  
Reproductive Age ◽  
Cervical Canal ◽  
Opportunistic Pathogens ◽  
The Past ◽  
Group I ◽  
History Of

The aim: To identify the characteristics of the vaginal microbiota, cervical and uterine flora in women with the past history of sexually transmitted infections. Materials and methods: A prospective study and the analysis of the vaginal microbiota, cervical and uterine flora were conducted in 96 women of reproductive age with infertility after the past history of STIs, who planned to get pregnant using ART. Together they made up the group I (main group) and the CG included 30 women of reproductive age, who planned pregnancy without a compromised reproductive history. Results: Nonspecific vulvovaginitis (χ2 = 31.6; p <0.001) was diagnosed in 63 (63.6%) patients of the group I, vulvovaginal candidiasis – in 17 (17.7%). Lactobacilli in a vaginal discharge in representatives of the CG and group I – 96.7% and 29.1%, respectively (χ2 = 20.3; p <0.001). Opportunistic pathogens, BV-associated microorganisms and obligate anaerobes in the next titers: 10x5 CFU/ml and higher, CG < 10x3 CFU/ml were found in 68 (70.8%) women of the group I. N. gonorrhoeae was detected in 2 (2.1%) patients of the group I. An intense leukemoid reaction – in 59 (61.5%) women of the group I. The rate of cervical contamination with these pathogens ranged from 10x3 to 10x4 CFU/ml in 35 (36.5%) women of the group I, in 61 (63.5%) – titers of opportunistic pathogens were > 10x4 CFU/ml. Pathogenic bacteria of the cervical canal, represented by obligate anaerobes, was detected in 70 (72.9%) cases, where 11 (11.4%) patients were diagnosed with Chlamydia trachomatis, 2 (2.1%) – N.gonorrhoeae. Chlamydia trachomatis and Mycoplasma genitalium were registered in 11 (11.5%) and 19 (19.8%) cases, respectively, and were not detected in controls. Ureaplasma urealyticum in the cervical canal outnumbered the diagnostic level in women: 17.7% – group I and 6.7% – CG, respectively (χ2 = 7.9; p <0.01). N.gonorrhoeae and Trich. vaginalis were detected in 2.1% and 6.25% of women in the group I, respectively. Persistent urogenital infection – the combination of opportunistic and common pathogens – prevailed in 59 (60.2%). Associations of obligate anaerobes and Chlamydia trachomatis were found in 69 (71.8%) of them, microaerophiles – in 29 (30.2%), the combination of various species of opportunistic pathogens – in 14 (14.6%); the growth of monocultures of opportunistic pathogens, in titers coming to 106-108, was recognized in 19 (19.8%). The growth of monoculture, represented by group B Streptococcus was detected in 8 (8.3%) cases, Enterococcus faecalis – in 12 (12.5%), Mycoplasma genitalium – in 17 (17.7%). The analysis of PCR test results enabled to detect associations of different species of viruses with Myco- and Ureaplasma, Chlamydia in 23 (23.9%) patients of the group I. What should be noted is the predominance of Herpes simplex over CMV infection: 7 (7.3%) and 2 (2.1%), respectively (p <0.05). Conclusions: The predominance of the mixed microbiota, represented by various associations of opportunistic and common pathogens, was identified in infertile women with the past history of STIs as a result of microbial culturing of the samples from the uterine cavity. Chronic inflammation in endometrium is caused by a persistent viral-bacterial infection in the uterine cavity, which differs in the species composition from the microbiota of the lower genital tract.

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