scholarly journals ECTOPIC PREGNANCY AND ACUTE APPENDICITIS DURING INTRAUTERIN PREGNANCY AFTER IN VITRO FERTILIZATION

2018 ◽  
Vol 2 (5) ◽  
pp. 169-172
Author(s):  
Наталья Протопопова ◽  
Natalya Protopopova ◽  
Елена Дружинина ◽  
Elena Druzhinina ◽  
Альбина Лабыгина ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Ectopic Pregnancy ◽  
Postoperative Period ◽  
Clinical Symptoms ◽  
Uterine Cavity ◽  
Early Postoperative Period ◽  
Chlamydia Infection ◽  
Surgical Department ◽  
Ultrasound Study

The paper presents a clinical case of the Patient T., 34 years old, who underwent the treatment in the Department of ART of the Regional Perinatal Center for tubal peritoneal infertility for seven years. In the anamnesis: one spontaneous uterine pregnancy, culminating in medical abortion for up to 12 weeks, treatment for chronic salpingo-oophoritis, tu- bectomy on the right side for a progressing ectopic pregnancy. The patient denied the presence of Chlamydia infection in the anamnesis. Studies on sexually transmitted infections before the IVF program were negative. During laparo- scopic tubectomy, no endometriotic foci were found. There were four programs of ART in anamnesis: in 2009, 2012, 2014, 2016. During the fourth ART program in 2016, two embryos were transferred to the uterine cavity, resulting in a uterine pregnancy in combination with an ectopic pregnancy diagnosed in the ultrasound study at 4 to 5 weeks of gestation, in the absence of clinical symptoms. The patient underwent emergency laparoscopic tubectomy on the left, the course of the postoperative period proceeded without complications. Later, in the period of uterine pregnancy of 7–8 weeks, with a clinical picture of acute appendicitis, the woman was hospitalized in the surgical department where she underwent laparoscopic appendectomy. Later the pregnancy proceeded without complications, at 39 weeks the planned cesarean section was performed, a girl weighing 3480 grams, 51 cm long with an Apgar score of 9–10 points was extracted on the operation. The course of the early postoperative period without complications, the patient was discharged with the child on the 4th day.

scholarly journals Experience in the treatment of patients with fusiform aneurysms of cerebral vessels

2020 ◽  
Vol 30 (4) ◽  
pp. 23-30
Author(s):  
D.V. Shchehlov ◽  
Ya.E. Kudelskyi ◽  
O.A. Pastushyn ◽  
O.E. Svyrydiuk ◽  
O.M. Goncharuk
Keyword(s):  
Postoperative Period ◽  
Neurological Deficit ◽  
Clinical Symptoms ◽  
Control Period ◽  
Clinical Manifestations ◽  
Clinical Results ◽  
Early Postoperative Period ◽  
Neurological Symptoms ◽  
Selection Of Patients ◽  
Selection Of

Objective – to analyze there sults of treatment of patients with fusiform aneurysms (FA) depending on localization and type of surgery.Materials and methods. In the period from 2007 to 2019 127 patients with intracranial fusiform cerebral aneurysms underwen treatment in Scientific and Practical Center of Endovascular Neuroradiology of the National Academy of Medical Sciences of Ukraine. 133 fusiform aneurysms were identified. The following neuroimaging methods were used to diagnose FA: magnetic resonance imaging, multispiral computed tomography and cerebral selective angiography according to Seldinger. In this study, patients with fusiform aneurysms are divided according to localization in the FA of the carotid poolsand the FA of the vertebrobasilar basin. Patients with FA of carotid basins were 56 (27 (29 (51.8 %) men and 48.2 %) women). The average age of patients was 45.2 year. 31 (55.3 %) patients were operated. Patients with FA in the vertebrobasilar basin were 71 (43 (60.6 %) men and 28 (39.4 %) women). The average age of patients was 54.5 year. It was operated 48 (67.6 %) patients.Results. It was possible to completely eliminate FA from the bloodstream intraoperative in 16 (51.6 %) patients. In the early postoperative period in this group 5 (16.1 %) patients had a decrease in disease symptoms, in 3 (9.6 %) patients neurological symptoms increased. In other patients the dynamics of neurological manifestations remained unchanged. There were nofatal out comes in either the early or late post operative period. According to the extended Glasgow outcome scale at the time of discharge from the hospital 22 (71 %) patients had > 5 points, 9 (29 %) – 4 points. In the period from 3 to 5 weeks 2 symptomatic thromboses of flow-directingstents were noted, in the form of clinical manifestations of ischemic stroke. In the period from 3 to 6 months 22 (71 %) patients underwent control examination. Angiographically in 19 (86.3 %) revealed a completes hut down of FA from the bloodstream, in 3 (13.7 %) – decrease of volume of FA > 65 %. Clinical symptoms completely regressed in 16 (72.7 %) patients, partially regressed – in 3 (13.7 %), increased – in 2 (13.6 %). In the period from 12 to 18 months 7 (31.8 %) patients underwent control examination. Total FA shut down from the bloodstream was detected in 5 (71.4 %) patients, in 2 (28.6 %) aneurysms decreased by 80 %. Eighteen-month survival was 100 %.It was possible to intraoperatively switch off FA in the vertebrobasilar basin from the bloodstream in 11 (22.9 %) cases. In the early postoperative period a partial regression of neurological symptoms was observed in 7 (14.5 %) patients. In 10 (20.8 %) cases a new or increasing neurological deficit was observed after intracranial stent implantation, which partially regressed against the background of conservative treatment. Four (8.3 %) deaths were recorded in the early postoperative period. The clinical results of 48 patients on the Glasgo woutcome scale at the time of discharge were > 5 points in 27 (56.2 %) patients, 4 points – in 17 (35.4 %) and 1 points – in 4 (8.3 %). In the period from 3 to 6 months 19 (39.5 %) patients underwent control examination. Angiographically in 14 (73.7 %) patients the aneurysm was completely turned off from the blood circulation, in 2 (10.5 %) the decrease in the volume of the aneurysm was > 70 %, in 3 (15.8 %) patients the decrease in the volume of the aneurysm was 47–64 %. Clinical symptoms regressed in 7 (36.8 %) patients, a decrease in neurological deficit was noted in 2 (10.5 %) patients, an increase in neurological deficit in 3 (15.8 %) patients. Three deaths were recorded. In the period from 12 to 18 months, 12 (25 %) patients underwent control examination. Angiographically in 10 (83.3 %) patients FA was excluded totally from the bloodcirculation, in 2 (16.7 %) – the volume of aneurysm was reduced by 80 %. Clinical symptoms regressed in 8 (66.6 %) patients and increased in 1 (8.3 %). During the control period 2 patients died. The 18-month survival rate was 89.5 %, 5 (10.5 %) patients died.Conclusions. Fusiform aneurysms are more common in people of working age, more common in men. A more unfavorable course of the disease occursin patients with symptomatic FA of the vertebrobasilar basin, due to the compression and dysfunction of the brainstem and stem structures. Deconstructive methods for eliminating FA from the bloodstream provide long-termsatis factory treatment results, butrequire careful selection of patients for such in terventions. Endovascular treatment should be considered as the main treatment, asitentails fewer risks for the patient. For aneurysms that cannot be treated with endovascular methods, microsurgical treatments hould be considered. The main forsuccess ful treatment of patients with fusiform aneurysms is th ecareful selection of patients and individual approach to the choice of treatment based on the shape, location and size of the FA.

scholarly journals Cornual Heterotopic Pregnancy after Bilateral Salpingectomy and Uterine Septum Resection Resulting in Term Delivery of a Healthy Infant

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Serkan Oral ◽  
Yaşam Kemal Akpak ◽  
Nilay Karaca ◽  
Ali Babacan ◽  
Kadir Savan
Keyword(s):  
Ectopic Pregnancy ◽  
Transvaginal Ultrasound ◽  
Uterine Cavity ◽  
Heterotopic Pregnancy ◽  
Simultaneous Occurrence ◽  
Free Fluid ◽  
Uterine Septum ◽  
Bilateral Salpingectomy ◽  
Live Fetus

Heterotopic pregnancy is the simultaneous occurrence of two or more implantation sites. A 25-year-old infertile patient with a history of bilateral salpingectomy, uterine septum resection, and left cornual resection was diagnosed with heterotopic pregnancy in her secondin vitrofertilization trial. She attended our clinic when she was 7-week pregnant, complaining initially of severe abdominal pain. Findings associated with peritoneal irritation were positive during the physical examination. Transvaginal ultrasound revealed right cornual ectopic pregnancy with a live fetus in the middle of the uterine cavity. Also free fluid was noted in the pelvis. A diagnosis of heterotopic pregnancy with rupture of the cornual pregnancy was made. She underwent emergency laparoscopy with aspiration of the ruptured ectopic pregnancy, suturing to the entire visible cornual margins, and assurance of good haemostasis. Her recovery was uneventful and she continued receiving care in our obstetric unit. She delivered a healthy newborn by cesarean section at term.

Simultaneous hybrid peripheral re-vascularization: early results

Vascular ◽  
2013 ◽  
Vol 21 (5) ◽  
pp. 279-285 ◽  
Author(s):  
Ismail Yurekli ◽  
Orhan Gokalp ◽  
Tevfik Gunes ◽  
Levent Yilik ◽  
Ali Gurbuz
Keyword(s):  
Peripheral Arterial Disease ◽  
Operating Room ◽  
Postoperative Period ◽  
Clinical Symptoms ◽  
Arterial Disease ◽  
Primary Patency ◽  
Early Postoperative Period ◽  
Graft Occlusion ◽  
Early Results ◽  
Peripheral Arterial

Endovascular and open surgical interventions may be combined in treatment of peripheral arterial disease. In this study, we presented our simultaneous hybrid peripheral interventions under the light of current literature data. Eleven patients who were operated for occlusive peripheral arterial disease without aneurysms between June 2008 and November 2010 at our hybrid operating room were investigated retrospectively. Generally, endovascular intervention was performed initially, and then followed by surgery. After hybrid interventions, control angiograms were held during the same session. None of the patients experienced either stent or graft occlusion during early postoperative period. Primary patency rate was found to be 100% for the postoperative first six months. Ankle-brachial indices (ABI) increased significantly during postoperative period and clinical symptoms were relieved in all patients (mean preoperative ABI: 0.43 ± 0.08, mean postoperative sixth month ABI: 0.87 ± 0.08). Peripheral hybrid interventions may be performed both in separate sessions and also simultaneously by experienced teams if an angiography device is available within the operating room.

scholarly journals Experience of the use of anti-adhesive barrier based on sodium hyaluronate and carboxymethylcellulose in gynecological surgery

2019 ◽  
pp. 149-153
Author(s):  
A. S. Molotkov ◽  
E. N. Popov ◽  
A. O. Ivanova ◽  
E. V. Kazantseva
Keyword(s):  
Postoperative Period ◽  
Abdominal Cavity ◽  
Uterine Fibroids ◽  
Sodium Hyaluronate ◽  
Uterine Cavity ◽  
Early Postoperative Period ◽  
Gynecological Surgery ◽  
Surgical Interventions ◽  
And Control

The article presents our experience in the use of anti-adhesive barrier based on hyaluronic acid and carboxymethylcellulose in gynecological surgery. The study included 63 patients who underwent removal of polyps, uterine fibroids, intrauterine synechiae, removal of ovarian cysts. At the end of operations an anti-adhesive gel was introduced into the uterine cavity and into the abdominal cavity to prevent adhesions. Efficacy and safety were assessed in the early postoperative period and with a further sixmonth follow-up of patients. It is noted that the introduction of the gel does not lead to the development of hyperthermic reactions, and in the postoperative period in patients there is no increase in the level of leukocytes (6.3 ± 0.2 x 109/L before the operation and 5.8 ± 0.5 x 109/L in postoperative period). In 89.7% of patients after surgical interventions, normalization of the menstrual cycle was noted, in 23% of patients with infertility, pregnancy was noted. When carrying out ultrasound of the pelvic organs and control hysteroscopy (in 7 cases), no evidence of the occurrence of adhesions was obtained.

Gynecological diseases in children and adolescents with the acute abdomen syndrome

2021 ◽  
Vol 24 (6) ◽  
pp. 377-382
Author(s):  
I. S. Schneider ◽  
N. A. Tsap
Keyword(s):  
Acute Appendicitis ◽  
Acute Abdomen ◽  
Clinical Symptoms ◽  
Inflammatory Diseases ◽  
Reproductive Function ◽  
Pain Syndrome ◽  
Differential Diagnostics ◽  
Surgical Department ◽  
Gynecological Diseases ◽  
Cause Of Pain

Objective. The differential diagnostics of gynecological diseases with a picture of acute abdomen and acute appendicitis may be challenging and can cause a variety of complications, impaired reproductive function and infertility.Purpose. To assess outcomes after diagnosing and treating girls with the syndrome of “acute abdomen” in whom an acute gynecological pathology was revealed.Material and methods. Case histories of 85 girls with gynecological diseases who were hospitalized to the emergency surgical department of Children City Clinical Hospital No 9 in Yekaterinburg are analyzed. All children were admitted to the emergency department with a picture of “acute abdomen”.Results. All children were operated on laparoscopically, and the cause of their acute abdominal syndrome was clarified. Acute inflammatory diseases of the uterine adnexa prevailed in the structure of causes (59%). In 21% of cases, there was uterine adnexa torsion . The rest of children had apoplexy (11%) and ovarian cysts (9%).Conclusion. The differential diagnostics of acute appendicitis and acute gynecological pathologies is difficult due to various and similar clinical symptoms. Laparoscopy can not only identify the cause of pain syndrome, but also can help to chose a future curative tactics .

ОПЫТ ИССЛЕДОВАНИЯ РАЗЛИЧНЫХ СВОЙСТВ МЕСТНЫХ КРОВООСТАНАВЛИВАЮЩИХ СРЕДСТВ

Innova ◽  
2021 ◽  
Vol 22 (1) ◽  
pp. 20-24
Author(s):  
Вячеслав Александрович Липатов ◽  
Дмитрий Андреевич Северинов ◽  
Елена Леонидовна Пучкова
Keyword(s):  
Postoperative Period ◽  
Personal Experience ◽  
Early Postoperative Period ◽  
Hemostatic Agent ◽  
Present Stage ◽  
Hemostatic Agents ◽  
In Vivo Experiments

Bleeding during surgery or in the early postoperative period remains one of the main problems of surgery, in particular surgery of parenchymal organs. At the present stage, various local hemostatic agents are widely used. To select a specific hemostatic agent in certain operations, it is necessary to have an understanding of the properties of various application hemostatic agents, their effectiveness, features of biodegradation, etc. For this purpose, methods for studying the properties of hemostatic agents in in vitro and in vivo experiments are being developed. Purpose of research. Description of the stages and main methods of research of various properties of spongy hemostatic agents based on the authors ' personal experience.

Sequential Evaluation of Immunoreactivity in Patients with Melanoma Undergoing Surgery and Adjuvant Therapy

1980 ◽  
Vol 66 (1) ◽  
pp. 59-76 ◽  
Author(s):  
Renzo Dionigi ◽  
Lorenzo Dominioni ◽  
Francesco Gnes ◽  
Alberto Bonera ◽  
Ubaldo Prati ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
T Lymphocyte ◽  
Cellular Immunity ◽  
Postoperative Period ◽  
Phagocytic Activity ◽  
Early Postoperative Period ◽  
Factor B ◽  
Total Lymphocyte ◽  
Blastogenic Response

The immunologic profile of 15 patients undergoing surgery and adjuvant chemoimmunotherapy for cutaneous melanoma was studied for a mean period of 18 months. In vivo cellular immunity was assayed by evaluation of delayed hypersensitivity response (DHR) to primary antigen and a panel of recall antigens. In vitro cellular immunity was evaluated by means of total and T-lymphocyte counts in peripheral blood and by the lymphocyte blastogenic response to phytohemagglutinin stimulation. Humoral immunity was assayed by determining the serum levels of IgG, IgA and IgM and of complement components C3c, C4 and Factor B. Phagocytic activity was studied by testing leukocyte chemotaxis, neutrophil phagocytosis and leukocyte random migration. The in vitro parameters were determined preoperatively at diagnosis, 6 times during the first 2 postoperative weeks, and then every month during adjuvant therapy. No correlation was found between DHR and clinico-pathologic stage of tumor, or with subsequent clinical course. Significant depression of total lymphocyte and T-lymphocyte count and blastogenic response of lymphocytes was found at diagnosis. The lymphocyte response to PHA decreased significantly in the early postoperative period but returned to preoperative levels one week after surgery. Periodic fluctuations of lymphocyte blastogenic response and progressive decrease of total lymphocyte counts and T-lymphocyte counts were observed during the 18-month follow-up. No significant alterations of immunoglobulin levels were recorded at diagnosis or during the postoperative period. Complement levels were within normal values preoperatively; in the early postoperative period a transient increase of C3c, C4 and Factor B was recorded, then complement levels progressively decreased. Parameters of phagocytic activity were normal at diagnosis and fluctuated within the normal range throughout the whole period of study.

Magnetic Resonance Imaging Findings and Clinical Outcomes in the Early Postoperative Period after Full Endoscopic Diskectomy for Lumbar Disk Herniation

2021 ◽  
Author(s):  
Tomoya Terai ◽  
Takashi Chikawa ◽  
Tatsuhiko Henmi ◽  
Koichi Sairyo
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Postoperative Period ◽  
Clinical Symptoms ◽  
Early Stage ◽  
Japanese Orthopaedic Association ◽  
Early Postoperative Period ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Postoperative Mri

Abstract Introduction This prospective case-control study aimed to establish the normal spectrum of early magnetic resonance imaging (MRI) findings in patients whose symptoms resolve after full endoscopic diskectomy (FED). We examined the changes in postoperative MRI findings and their relation to early clinical symptoms. Methods In total, 33 patients underwent FED under local anesthesia. Clinical assessments and MRI examinations were performed preoperatively and immediately (within 1 week) and late (at 3 and 12 months) postoperatively. Residual disk bulging after surgery was classified into four grades compared with preoperative MRI findings: none (grade A), <25% (grade B), 25–75% (grade C), and >75% (grade D). Results MRI at postoperative week 1 showed grade B residual disk bulging in 9 patients, grade C residual disk bulging in 8 patients, and grade D residual disk bulging in 16 patients. Improvement was seen at postoperative month 3 (grade A in 18 patients, grade B in 10 patients, and grade C in 5 patients) and at postoperative month 12 (grade A in 29 patients, grade B in 3 patients, and grade C in 1 patient). Visual analog scale scores and the Japanese Orthopaedic Association scores showed significant differences at 1 week, 3 months, and 12 months after surgery. Conclusion Postoperative MRI findings within 1 week of FED showed grade C or D residual disk material in 24 of 33 patients (73%). Clinical symptoms improved in the early postoperative period, even though residual disk bulging was present. Persisting residual bulging in the early stage following surgery may not correlate with clinical symptoms.

scholarly journals Comparative analysis of the results of computerized phonoenterography in patients with acute destructive appendicitis before surgery and in the postoperative period

2017 ◽  
Vol 25 (3) ◽  
pp. 469-475
Author(s):  
K. V. Philippova ◽  
O. V. Zaitsev
Keyword(s):  
Abdominal Pain ◽  
Comparative Analysis ◽  
Acute Appendicitis ◽  
Postoperative Period ◽  
Spectral Power ◽  
Abdominal Cavity ◽  
Pain Syndrome ◽  
Acoustic Signals ◽  
Early Postoperative Period ◽  
Control Group

Using the method of computerized phonoenterography we made an analysis of motor-evacuation function of the gastrointestinal tract in 35 patients with acute destructive appendicitis before surgery and in the postoperative period and in 30 patients without abdominal pain syndrome and concomitant pathology of the organs of the abdominal cavity. The obtained results of computerized phonoenterography different in the group of patients with acute appendicitis before appendectomy in comparison with group of patients without acute abdominal pathology (control group). For patients after appendectomy statistically significant differences with the control group in the vast majority of bands wasn’t obtained. Given the fact that the densities of the spectral power of acoustic signals of the abdominal cavity to assess the motor-evacuation function of the intestine in these groups of patients, we showed a reduction of motor-evacuation function of the intestine in patients with acute destructive appendicitis before surgery in comparison with patients of control group and recover in the postoperative period. Thus, the method of computerized phonoenterography is advisable to apply for the diagnosis of lower motor function of the intestine in patients with acute appendicitis, and in the early postoperative period in patients with acute destructive appendicitis for monitoring recovery of intestinal motility.

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