Genital Findings in Sexually Abused, Symptomatic and Asymptomatic, Girls

PEDIATRICS ◽  
1987 ◽  
Vol 79 (5) ◽  
pp. 778-785
Author(s):  
S. Jean Emans ◽  
Elizabeth R. Woods ◽  
Nancy T. Flagg ◽  
Amanda Freeman
Keyword(s):  
Prospective Study ◽  
Sexually Abused ◽  
Asymptomatic Children ◽  
Group 3 ◽  
Group 2 ◽  
A Prospective Study ◽  
Group 1 ◽  
Sexually Abused Girls

Although evaluation of the vulva of sexually abused girls using magnification with a colposcope or pediatric otoscope has become increasingly popular, the incidence of various genital findings in sexually abused and asymptomatic children has not been reported. A prospective study was carried out in which 20 genital findings from three groups of girls (mean age 4.8 ± 2.6 years) were analyzed. The three groups were (1) sexually abused girls (n = 119), (2) normal girls with no genital complaints (n = 127), and (3) girls with other genital complaints (n = 59). Group 1 was more likely than group 2 to have scars on the hymen or posterior forchette (9% v 1%, P = .002), increased friability of the posterior forchette (10% v 1%, P = .001), attenuated hymen (18% v 4%, P = .0003), and synechiae from the hymenal ring to the vagina (8% v 0%, P = .0009). Groups 1 and 3 were remarkably similar with the exception of erythema which was more common in group 3 (34% v 68%, P = .0001). Hymenal diameter was slightly greater in group 1 than 2 but not 3. Although genital findings distinguish some sexually abused girls from asymptomatic girls, many findings also occur in girls with other genital complaints, which suggests that many of these girls have also been molested or that vulvar inflammation may lead to some of these findings.

scholarly journals Impact of Sport Activity and Physical Exercise on Obstetrical and Perineal Outcomes at Delivery: A Prospective Study

2019 ◽  
Vol 36 (S 02) ◽  
pp. S83-S90
Author(s):  
Stefano Uccella ◽  
Paolo Manzoni ◽  
Nicola Marconi ◽  
Carlotta Toscani ◽  
Sara Biasoli ◽  
...  
Keyword(s):  
Physical Activity ◽  
Physical Exercise ◽  
Prospective Study ◽  
Sport Activity ◽  
Demographic Characteristics ◽  
Group 3 ◽  
Group 2 ◽  
A Prospective Study ◽  
Different Levels ◽  
Group 1

Objective This study was aimed to investigate the effects of physical activity on perineal outcomes at delivery according to the different levels and types of maternal physical activity before and during pregnancy. Study Design We prospectively evaluated the obstetrical and perineal outcomes of all consecutive women who delivered at the Del Ponte Hospital, in the period between July 2014 and September 2014. Women were divided into three groups according to the features of physical activity performed before pregnancy: group 1: “very sporty women,” group 2: “moderately sporty women,” and group 3: “inactive women.” A subanalysis of our data was performed based on the specific type of sport activity, on the degree of involvement of perineal muscles during physical activity, and on the continuation/discontinuation of this activity during pregnancy. Results A total of 135, 84, and 85 women were included in group 1, group 2, and group 3, respectively. The demographic characteristics were comparable among all the groups. Sport activity during pregnancy was more frequent in groups 1 and 2 (59.3 and 53.6%, respectively, vs. 29.4% in group 3; p = 0.003). No differences among groups were detected in terms of perineal outcomes. A lower rate of episiotomy/lacerations ≥ 2nd degree was found among women who practiced sports that specifically involved the perineal muscles and who continued this practice during pregnancy. Conclusion Perineal outcomes are not influenced by the intensity of sport activity performed before/during pregnancy. Continuous sports during pregnancy that specifically train the perineal muscles are associated with a lower rate of episiotomy and perineal lacerations ≥ 2nd degree.

Endocardial Fibroelastosis of the Left Ventricle Affects Right Ventricular Performance in Fetuses with Hypoplastic Left Heart Syndrome: A Prospective Study Using M-Mode, PW- and Tissue Doppler Techniques

2017 ◽  
Vol 39 (04) ◽  
pp. 413-421 ◽  
Author(s):  
Oliver Graupner ◽  
Christian Enzensberger ◽  
Larissa Wieg ◽  
Jan Degenhardt ◽  
Aline Wolter ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Prospective Study ◽  
Left Heart ◽  
Endocardial Fibroelastosis ◽  
Hypoplastic Left Heart ◽  
Group 3 ◽  
Group 2 ◽  
A Prospective Study ◽  
Left Heart Syndrome ◽  
Group 1

Abstract Purpose Myocardial function (MF) of the systemic right ventricle (RV) influences the postnatal course of neonates with hypoplastic left heart syndrome (HLHS). Our study examines whether the presence of endocardial fibroelastosis of the left ventricle (LV EFE) influences MF of the RV in HLHS fetuses. Materials and Methods A prospective study was conducted including 10 controls (group 1), 10 HLHS fetuses with (group 2) and 10 without LV EFE (group 3) – all matched for gestational age. M-mode was used to assess tricuspid plane systolic excursion (TAPSE) and the shortening fraction (SF). PW-Doppler-derived and PW-TDI-derived velocities were assessed. E/A, E/e', e'/a' ratios and the myocardial performance index (mpi’) were calculated. Results The examination of MF revealed significantly lower s’ velocities (p < 0.05) and higher values for SF in group 2 compared to group 3. e’/a’ ratio, et’ (ejection time), E wave velocity, E/e’ and SF showed significantly higher values in group 2 compared to group 1. In group 2 a’ velocity increased significantly over gestational age. In group 3 but not in group 2, TAPSE increased during gestation. Conclusion These significant differences in MF between the groups might lend support to the notion of negative ventricular-ventricular interaction in the case of HLHS with LV EFE possibly influencing surgical outcomes.

scholarly journals Management Of Recent Elbow Dislocations: Functional Treatment Versus Immobilization; A Prospective Study About 60 Cases

2017 ◽  
Vol 11 (1) ◽  
pp. 452-459 ◽  
Author(s):  
Ndeye Fatou Coulibaly ◽  
Niane Mouhamadou Moustapha ◽  
Hamadi Hadji Djoumoi ◽  
Sarr Lamine ◽  
Gueye Alioune Badara ◽  
...  
Keyword(s):  
Prospective Study ◽  
Elbow Dislocation ◽  
Early Mobilization ◽  
Functional Results ◽  
Functional Treatment ◽  
Functional Rehabilitation ◽  
Dislocation Reduction ◽  
Group 3 ◽  
Group 2 ◽  
A Prospective Study

Objective: To determine our therapeutic posture trough a comparison of functional treatment results versus immobilization in two different periods. Introduction: For years, the treatment of recent elbow dislocations consisted of reduction and immobilization during 21 days. Given the frequency of stiffness other methods have been tried out. Method: A prospective study was carried out from January 2010 to December 2014. Sixty patients averaging 28.3 years of age underwent elbow dislocation reduction. They were categorized into three separate groups. Patients in the first group had their elbow immobilized for 21 days whereas Group 2 patients were immobilized for 10 days. Group 3 patients were applied a functional treatment followed by a functional rehabilitation. Patients were evaluated according to the Mayo Clinic Elbow Performance Index and the results analyzed with statistical software (SPSS, version 18). Results: During the first month, the functional results of the patients were excellent and good in 19%, 94.7% and 90% respectively for Groups 1, 2 and 3. The pain was intense (10 on the visual analogue scale) in group 3 associated with swelling. At day 90, the results of the patients in Groups 2 and 3 were excellent in 100% of the cases versus 90% for Group 1. At 6 months, all the results were the same. We have not noted any instability, or recurrence or periarticular ossification in our patients. Conclusion: The treatment of stable elbow dislocations remains orthopedic. The risk of instability and pain motivates a short 10-day immobilization period followed by early mobilization.

Platelet Function and Activation in Patients with Immune Thrombocytopenia Treated with Eltrombopag: Comparison with Steroid-Treated and Untreated Patients,

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 3280-3280
Author(s):  
Johanna Haselboeck ◽  
Alexandra Kaider ◽  
Ingrid Pabinger ◽  
Simon Panzer
Keyword(s):  
Platelet Count ◽  
Treatment Group ◽  
Prospective Study ◽  
Platelet Function ◽  
Immune Thrombocytopenia ◽  
Steroid Treatment ◽  
Group 3 ◽  
Group 2 ◽  
Group 1 ◽  
Normally Distributed

Abstract Abstract 3280 Background: Eltrombopag has recently been approved for treatment in immune thrombocytopenia (ITP). Studies on platelet function in eltrombopag-treated patients in comparison to steroid-treated or untreated ITP patients are not available. Objectives: To assess the function of eltrombopag-induced platelets, we compared platelets from eltrombopag-treated patients to those from ITP patients treated with steroids and a group of patients without treatment in a prospective study (ClinicalTrials.gov number NCT00888901). Patients/Methods: We compared platelet function in patients treated with eltrombopag after treatment-induced platelet rise (group 1) to those under steroid treatment (group 2) and ITP patients without treatment (group 3) in a non-randomized prospective study. Platelet function was assessed by adhesion under high shear conditions (surface coverage, SC), P-selectin expression, and formation of platelet-monocyte aggregates (PMA) after treatment induced platelet rise or, in group 3, in patients with ITP without treatment and platelet count between 50–100×109/L at the time of inclusion. Data are given as median [quartiles]. Correlations of the outcome measures are described by the Spearman correlation coefficient. In case of normally distributed data, analysis of variance (ANOVA) and of covariance (ANCOVA) models and in case of non-normally distributed parameters the nonparametric Kruskal-Wallis test were used to compare the groups Results: Eleven patients (female=9) were included in the treatment group with eltrombopag (group 1), thirteen (female=5) in the steroid treatment (group 2) and 6 patients as untreated controls (group 3). None of these patients developed severe bleeding during the study period, none received rescue medication. Four/30 patients were not included in the final analysis, three because they had no treatment induced platelet rise (1 on eltrombopag and 2 on steroids) and 1 because of aspirin medication. Thus, ten patients on eltrombopag, ten patients on steroid treatment and 6 untreated patients were evaluated in the comparative analyses of platelet function. Platelet counts [x109/L] were 48.25 [45.00–59.00] in group 1 after eltrombopag-induced platelet rise, 82.75 [78.50–112.00] in group 2 and 69.25 [65.00–73.00] in group 3. SC was highest in steroid-treated patients (11.25% [8.10–14.00%]) compared to eltrombopag-treated (5.80% [1.80–9.00%]) and untreated (5.03% [3.80–6.20%]) patients and correlated significantly with the platelet count (r=0.72, p<0.0001). There were no differences in P-selectin expression [GeoMFI] (1.15 [0.47–2.77] in group 1, 0.27 [0.10–0.99] in group 2 and 0.59 [0.47–1.44] in group 3; p=0.34) and PMA levels (6.19% [3.91–21.39%] in group 1, 9.73% [1.88–13.29%] in group 2, and 6.56% [4.82–8.43%] in group 3; p=0.93) between the groups. Two patients developed venous thromboses during eltrombopag treatment. No characteristic alteration of platelet function and activation was identified in those 2 patients when compared to the other eltrombopag-treated patients. Conclusions: We proofed a good functional competence of eltrombopag-induced platelets. No substantial hyper-reactivity of eltrombopag-induced platelets in comparison to those of steroid-treated and untreated patients was determined. Disclosures: Pabinger: GlaxoSmithKline: Research Funding, Speakers Bureau. Panzer:GlaxoSmithKline: Speakers Bureau.

Plasma Citrulline as a Biomarker for Early Diagnosis of Necrotizing Enterocolitis in Preterm Infants

2020 ◽  
Author(s):  
Nilima Jawale ◽  
Mallory Prideaux ◽  
Malavika Prasad ◽  
Malki Miller ◽  
Shantanu Rastogi
Keyword(s):  
Necrotizing Enterocolitis ◽  
Clinical Characteristics ◽  
Signs And Symptoms ◽  
Plasma Citrulline ◽  
Key Points ◽  
Group 3 ◽  
Group 2 ◽  
A Prospective Study ◽  
Stage 1 ◽  
Group 1

Objective Citrulline synthesized by healthy enterocytes and decreases with injury. This work aimed to study plasma citrulline concentrations (CITs) as a biomarker to differentiate among infants presenting with early nonspecific signs and symptoms of necrotizing enterocolitis (NEC) with those who will develop NEC. Further to study the correlation between posttreatment CIT with time to full feeds (TTFF) and length of stay (LOS). Study Design This is a prospective study which included infants < 32 weeks gestational age (GA) with 9 infants each in Group 1 (stage 2/3 NEC), Group 2 (with stage 1 NEC-like presentation), and Group 3 (healthy GA-matched infants). CIT was measured in Groups 1 and 2 within 24 hours of presentation and again in Group 1 after treatment. Results The three groups were similar in clinical characteristics. Median CIT (µmol/L) in Group 1 (15.4 [interquartile range, IQR: 7.3–18.0]) was lower than Group 2 (22.2 [IQR: 18.3–27.3], p = 0.02) and Group 3 (24.9 [IQR: 19.8–31.9], p = 0.009). Posttreatment CIT in Group 1 did not correlate with TTFF (r = 0.15; p = 0.69) and LOS (r =  − 0.33; p = 0.38). Conclusion CIT was lower in infants with NEC as compared with healthy controls and those infants with nonspecific signs of NEC. CIT after treatment does not correlate with TTFF and LOS. Key Points

scholarly journals Daflon use for reducing post-tonsillectomy pain and hemorrhage: a prospective study

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Ahmed Shehata El Sayed Saleh ◽  
Hossam Mohamed Kamal Rabie
Keyword(s):  
Prospective Study ◽  
Pain Control ◽  
Safe Procedure ◽  
Bipolar Diathermy ◽  
Secondary Hemorrhage ◽  
Pain Duration ◽  
Group 2 ◽  
A Prospective Study ◽  
Group 1

Abstract Background Tonsillectomy usually was a safe procedure; in adults, the risk of agonizing pain and secondary hemorrhage could be serious. We introduced Daflon as a safe and effective complementary medication in reducing these risks. This prospective study was designed to evaluate the effect of using (Daflon oral medication) on post-tonsillectomy pain and hemorrhage rates. This study was conducted on 60 patients of both sexes, above 21 years, and underwent tonsillectomy using bipolar diathermy. Patients were randomly distributed between 2 groups; each group has 30 patients and with the same post-operative protocol; in group 2, an addition of Daflon 500 mg tablet twice daily for 14 days post-operatively was given. Results In group 2, agonizing pain start day, pain duration, analgesia duration, and need for another type, all were significantly different from group 1, starting day in group 1 (4.3 ± 4.0) and (7.2 ± 1.3) in group 2, pain duration in group 1 (7.3 ± 1.5) and (4.2 ± 1.4) in group 2 and need for more analgesia 80% in group 1 and 50% in group 2. Post-operative hemorrhage was 4 cases (13.3%) in group 1, and 2 cases (7%) in group 2, also severity of post-operative bleeding were less in group 2. Healing membrane detaching time was (12.2 ± 2.2) in group 1 and (9.1 ± 1.9) in group 2. Conclusion The use of Daflon 500 mg tablet after bipolar tonsillectomy added to effectiveness of pain control also could help in reducing bleeding rates and its severity. Overall, its use enhances recovery and improves quality of life.

Outcome after less-invasive decompression of lumbar spinal stenosis: a randomized comparison of unilateral laminotomy, bilateral laminotomy, and laminectomy

2005 ◽  
Vol 3 (2) ◽  
pp. 129-141 ◽  
Author(s):  
Claudius Thomé ◽  
Dimitris Zevgaridis ◽  
Olaf Leheta ◽  
Hansjörg Bäzner ◽  
Christiane Pöckler-Schöniger ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Short Form ◽  
Walking Distance ◽  
Lumbar Stenosis ◽  
Sf 36 ◽  
Group 3 ◽  
Group 2 ◽  
Lumbar Spinal ◽  
A Prospective Study ◽  
Group 1

ObjectRecently, limited decompression procedures have been proposed in the treatment of lumbar stenosis. The authors undertook a prospective study to compare the safety and outcome of unilateral and bilateral laminotomy with laminectomy.MethodsOne hundred twenty consecutive patients with 207 levels of lumbar stenosis without herniated discs or instability were randomized to three treatment groups (bilateral laminotomy [Group 1], unilateral laminotomy [Group 2], and laminectomy [Group 3]). Perioperative parameters and complications were documented. Symptoms and scores, such as visual analog scale (VAS), Roland—Morris Scale, Short Form—36 (SF-36), and patient satisfaction were assessed preoperatively and at 3, 6, and 12 months after surgery.Adequate decompression was achieved in all patients. The overall complication rate was lowest in patients who had undergone bilateral laminotomy (Group 1). The minimum follow up of 12 months was obtained in 94% of patients. Residual pain was lowest in Group 1 (VAS score 2.3 ± 2.4 and 4 ± 1 in Group 3; p < 0.05 and 3.6 ± 2.7 in Group 2; p < 0.05). The Roland—Morris Scale score improved from 17 ± 4.3 before surgery to 8.1 ± 7, 8.5 ± 7.3, and 10.9 ± 7.5 (Groups 1–3, respectively; p < 0.001 compared with preoperative) corresponding to a dramatic increase in walking distance. Examination of SF-36 scores demonstrated marked improvement, most pronounced in Group 1. The number of repeated operations did not differ among groups. Patient satisfaction was significantly superior in Group 1, with 3, 27, and 26% of patients unsatisfied (in Groups 1, 2, and 3, respectively; p < 0.01).ConclusionsBilateral and unilateral laminotomy allowed adequate and safe decompression of lumbar stenosis, resulted in a highly significant reduction of symptoms and disability, and improved health-related quality of life. Outcome after unilateral laminotomy was comparable with that after laminectomy. In most outcome parameters, bilateral laminotomy was associated with a significant benefit and thus constitutes a promising treatment alternative.

Comparative study of aural microflora in healthy cats, allergic cats and cats with systemic disease

2014 ◽  
Vol 16 (12) ◽  
pp. 992-996 ◽  
Author(s):  
Charline Pressanti ◽  
Clémence Drouet ◽  
Marie-Christine Cadiergues
Keyword(s):  
Systemic Disease ◽  
Bacterial Overgrowth ◽  
Clinical Score ◽  
Experimental Unit ◽  
Clinically Normal ◽  
Group 3 ◽  
Group 2 ◽  
A Prospective Study ◽  
Otoscopic Examination ◽  
Group 1

Twenty healthy cats (group 1) with clinically normal ears, 15 cats with systemic disease (group 2) and 15 allergic cats (group 3) were included in a prospective study. The experimental unit was the ear. A clinical score was established for each ear canal after otoscopic examination. Microbial population was assessed on cytological examination of smears performed with the cotton-tipped applicator smear technique. Fungal population was significantly more prominent in allergic cats ( P <0.001) and in diseased cats compared with healthy cats ( P <0.02). Bacterial population was significantly higher in allergic cats than in healthy cats ( P <0.001) and cats suffering from systemic disease ( P <0.001). Bacterial overgrowth was also higher in cats with systemic disease than healthy cats. In cats from group 2, only fungal overgrowth was associated with otitis severity. In group 3, only bacterial overgrowth was associated with otitis severity.

scholarly journals Cord blood albumin as a predictor of neonatal hyperbilirubinemia in healthy neonates

2017 ◽  
Vol 4 (2) ◽  
pp. 503 ◽  
Author(s):  
Gaurav Aiyappa K. C. ◽  
Ashvij Shriyan ◽  
Bharath Raj
Keyword(s):  
At Risk ◽  
Risk Factor ◽  
Prospective Study ◽  
Exchange Transfusion ◽  
Neonatal Jaundice ◽  
Neonatal Hyperbilirubinemia ◽  
Group 2 ◽  
A Prospective Study ◽  
Group 1

Background: Neonatal jaundice or icterus neonatrum has been observed in newborn babies for many centuries. The objective of this study was to determine the correlation between cord albumin levels and development of hyperbilirubinemia in term healthy neonates.Methods: A prospective study was conducted on 165 term healthy neonates. Gender, gestational age, anthropometric measurements were taken into consideration. It was ascertained that there was no other risk factor for hyperbilirubinemia amongst the neonates. The neonates were divided into two groups A and B based on the cord albumin levels of <2.8 gm/dl and >2.8 gm/dl.Results: Of the 165 babies included in the study, 126 babies were under Group 1 and 39 under Group 2. 44 babies (34%) in group 1 and 28 babies (71.7%) in group 2 (p<0.0005) developed clinical icterus of which 16 in group 1 and 19 in group 2 required phototherapy (p<0.05). 1 baby in group required exchange transfusion. The sensitivity and specificity of cord albumin in detecting neonatal hyperbilirubinemia in this study was determined to be 71.8% and 65.1% respectively.Conclusions: Cord albumin levels help to determine and predict the possibility of hyperbilirubinemia among neonates. Hence this can help to identify the at-risk neonates. So, routine determination of cord albumin can be advocated to keep a track on at risk neonates.

Thermal ablation of saphenous veins is feasible and safe in patients older than 75 years: A prospective study (EVTA study)

2014 ◽  
Vol 30 (8) ◽  
pp. 525-532 ◽  
Author(s):  
C Hamel-Desnos ◽  
P Desnos ◽  
F-A Allaert ◽  
P Kern ◽  
Keyword(s):  
Side Effects ◽  
Prospective Study ◽  
Thermal Ablation ◽  
Cardiac Insufficiency ◽  
Control Group ◽  
Saphenous Veins ◽  
Group 2 ◽  
Multicenter Prospective Study ◽  
A Prospective Study ◽  
Group 1

Objectives To investigate the tolerance and safety of thermal ablation (TA), consisting of radiofrequency or endovenous laser (EVLA) of saphenous veins (SV) in elderly (group 1 ≥75 years), compared with a control group (group 2 <75 years). Method An Observational multicenter-prospective study was conducted, under the aegis of the French and Swiss Societies of Phlebology (18 centers). Ninety patients were included in group 1, 617 in group 2 (mean age 80 years and 53 years; 69% women in both groups), representing 863 SV. Mean trunk diameters were similar in both groups (small SV: 6 mm; great SV: 7 mm). In group 1, comorbidities were more frequent, particularly cardiac insufficiency, diabetes, history of thrombosis, and CEAP clinical class was significantly higher. Results EVLA was used in 86% of cases. Settings used were similar in both groups for each technique. Only 6% of TA was performed in an operating room for group 1 (14% group 2). Tumescent local anaesthesia (TLA) alone was used in 91% of cases in group 1 (85% group 2). The mean pain score was only 1.6 for the procedure itself (VASP 0–10; 10 max.) and 1.4 for the 10 days following the procedure. Side effects were few, but rate of paraesthesia was higher when general anaesthesia was used (11.8%) compared with TLA alone (2.2%). At three months, 100% of SV was occluded in group 1 (99.5% group 2), with high satisfaction score (9.3/10). Conclusion TA is safe and effective in elderly; it should be performed strictly under TLA to minimize side effects.

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