Features of early diagnosis and treatment tactics of acute pancreatitis in pregnant women

2018 ◽  
pp. 76-80
Author(s):  
O.V. Golyanovskyi ◽  
◽  
Ya.P. Feleshtynskyi ◽  
T.P. Pavliv ◽  
D.O. Goncharenko ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Treatment Group ◽  
Early Diagnosis ◽  
Pregnant Women ◽  
Early Stage ◽  
Treatment Algorithm ◽  
Complex Treatment ◽  
Traditional Methods ◽  
Surgical Interventions ◽  
Experimental Group

The frequency of acute pancreatitis during pregnancy is from 1: 1000 to 1:10 000 of deliveries. Biliary pancreatitis complicates the pregnancies from 1: 1500 to 1: 3300. The development of complications is associated with difficulty in diagnosis and late determination of diagnosis. The objective: improvement of early diagnosis and complex treatment of acute pancreatitis in pregnant women in order to reduce the complications of the mother and the fetus / newborn. Materials and methods. The analysis of diagnostic results and complex treatment of 123 pregnant women was carried out. The treatment group consisted of 61 pregnant women with acute pancreatitis for the period from 2012–2018, using the developed diagnostic and treatment algorithm and the experimental group included 62 pregnant women, from 2006 to 2012, using traditional methods of treatment and diagnosis. Results. In the treatment group, when applying the diagnostic and treatment algorithm, 100% of patients had acute pancreatitis at an early stage of the disease, which allowed us to obtain the effect of conservative therapy in 27 (44.3%) pregnant women, in 31 (50.8%) cases with the use of delivery and surgical interventions and avoid postoperative lethality, whereas in the experimental group, the effect of conservative treatment was only in 21 (33.9%) cases, and the mortality rate was 1 (1.6%) with pancreonecrosis. In the experimental group in 26 (41.9%) patients, this diagnosis was established only on day 8 ± 2.1 from the onset of the disease. Conclusion. The use of a diagnostic and therapeutic algorithm in comparison with traditional methods can diagnose acute pancreatitis in pregnant women at an early stage, reduce the number of pregnancy complications and maternal mortality. Key words: pregnancy, acute pancreatitis, diagnosis, treatment.

scholarly journals Peculiarities of early diagnosis and tactics of treatment in an acute pancreatitis in pregnant women

2018 ◽  
Vol 85 (6) ◽  
pp. 13-17
Author(s):  
Ya. P. Feleshtynskyi ◽  
О. V. Golyanovskyi ◽  
Т. P. Pavliv
Keyword(s):  
Acute Pancreatitis ◽  
Early Diagnosis ◽  
Pregnant Women ◽  
Comparison Group ◽  
Early Stage ◽  
Treatment Algorithm ◽  
Main Group ◽  
Diagnosis And Treatment ◽  
Treatment Results ◽  
Standard Methods

Objective. Improvement of the treatment results of an acute pancreatitis in pregnant women, using enhanced early diagnosis and tactics of treatment. Маterials and methods. Analysis of the diagnosis and treatment results was conducted in 123 pregnant women, suffering an acute pancreatitis. In the main group (61 pregnant women) the elaborated algorithm of diagnosis and treatment for an acute pancreatitis in the period 2012 - 2018 yrs was applied, while in a comparison group (62 pregnant women) - the standard methods of diagnosis and treatment in an acute pancreatitis for the period of 2006 - 2012 yrs. Results. In the main group in 100% of the patients an acute pancreatitis was revealed on early stage. This have had guaranteed the effect obtaining from the conservative therapy in 27 (44.3%) pregnant women, using miniinvasive surgical interventions - in 31 (50.8%) and to prevent postoperative lethality. In a comparison group in 26 (41.9%) patients an acute pancreatitis diagnosis was established in (8 ± 2.1) days after the disease beginning. In a comparison group the conservative treatment effect was observed in 21 (33.9%) patients only. Two (3.2%) pregnant women died. Conclusion. Application of the diagnostic-treatment algorithm, comparing with standard methods, permits to diagnose an acute pancreatitis in pregnant women on early stage, to reduce the complications and lethality rate.

scholarly journals Microscopic Examination of Urine Samples as the Early Detection of Asymptomatic Urinary Tract Infection in Pregnant Women: A Cross-Sectional Study

2019 ◽  
pp. 208-212
Author(s):  
Yeva Rosana ◽  
Dwiana Ocviyanti ◽  
Rahmah Amran
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Early Diagnosis ◽  
Pregnant Women ◽  
Microscopic Examination ◽  
Urine Culture ◽  
Early Stage ◽  
Urine Samples ◽  
P Value

Abstract Objectives:To investigate the role of microscopic examination of urine sample in supporting early diagnosis of asymptomatic urinary tract infection (UTI) in pregnant women. To compare correspondence between microscopic examination and urine culture result as a gold standard diagnostic modality to support the diagnosis of UTIs and as an evidence-based to start empirical therapy. Methods: Microscopic analysis was conducted in 74 centrifuged and non-centrifuged urine samples from 317 pregnant who came to six healthcare centres in Jakarta, which showed a positive result of nitrite examination.  The results of the microscopic examination of bacteriuria and leukocyturia were compared with a urine culture. Results: Sensitivity of centrifuged bacteriuria was the highest among the other microscopic parameters, which was 74% with the p-value of 0.009. Combination of bacteriuria and leukocyturia≥3/HPF dan≥5/HPF have increased the specificity with the value of 91.5% and 93.6% in non-centrifuged urine. Conclusion: This result showed that the best method of microscopic examination for early diagnosis of asymptomatic urinary tract infection in pregnant women is the detection of bacteriuria in centrifuged urine. Combination of bacteriuriaandleukocyturiatest, as well as leukocyturia≥3/HPF and≥5/HPF,  can be used to rule out the diagnosis of UTI at an early stage. Keywords: asymptomatic urinary tract infection, bacteriuria, leukocyturia,microscopic examination, urine culture.   Abstrak Tujuan: Mengetahui peran pemeriksaan mikroskopis sampel urin dalam mendukung diagnosis dini infeksi saluran kemih asimptomatik (ISK) pada perempuan hamil. Membandingkan kesesuaian antara pemeriksaan mikroskopis dan hasil kultur urin sebagai modalitas diagnostik standar emas untuk mendukung diagnosis ISK dan sebagai dasar bukti untuk memulai terapi empiris. Metode: Penelitian uji mikroskopik dilakukan pada 74 sampel urin disentrifugasi dan tidak sentrifugasi, dari 317 sampel urin perempuan hamil yang berobat ke-enam puskesmas di Jakarta dengan uji nitritpositif. Hasil uji mikroskopik bakteri uria dan leukosit uria dibandingkan dengan hasil kultururin. Hasil: Sensitivitas bakteriuria yang disentrifugasi menunjukan hasil yang paling baik dibandingkan dengan parameter uji mikroskopik lain, yaitu 74% dengan nilai p yang bermakna sebesar 0,009.  Kombinasi bakteri uria dan leukosituria ≥3/LPB dan ≥5/LPB dapat meningkatkan spesifisitas uji dengan nilai 91,5% dan 93,6% pada urin yang  tidak disentrifugasi. Kesimpulan: Hasil menunjukkan bahwa bakteri uria pada urin yang disentrifugasi, merupakan metode yang paling baik untuk membantu diagnosis dini ISK tidak bergejala pada perempuan hamil. Uji kombinasi bakteri uria dan leukosituria, serta uji leukosituria ≥3/LPB dan ≥5/LPB dapat dimanfaatkan untuk membantu secara dini menyingkirkan orang yang tidak mengalami  ISK. Kata kunci: bakteriuria, infeksi saluran kemih tidak bergejala, kultur urin,leukosituria, uji mikroskopik

scholarly journals ENDOSCOPIC HEMOSTASIS IN ULCERATIVE GASTRODUODENAL BLEEDING USING HIGH-FREQUENCY BIOLOGICAL WELDING ELECTROLIGATION

2021 ◽  
Vol 74 (9) ◽  
pp. 2159-2162
Author(s):  
Yaroslav P. Feleshtynskyi ◽  
Sergiy O. Oparin ◽  
Bogdan V. Sorokin ◽  
Margaryta G. Boiarskaia ◽  
Dmytro V. Lutsenko
Keyword(s):  
Treatment Group ◽  
High Frequency ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Early Recurrence ◽  
Endoscopic Hemostasis ◽  
Surgical Interventions ◽  
Plasma Coagulation ◽  
Primary Hemostasis ◽  
Experimental Group

The aim: To increase the efficiency of endoscopic hemostasis in ulcerative gastroduodenal bleeding using high-frequency biological welding electroligation. Materials and methods: The evaluation of endoscopic hemostasis in 160 patients aged 40 to 85 years with ulcerative gastroduodenal bleeding for the period from 2017 to 2020 was carried out. The patients were divided into two groups: the first (treatment) group involved 80 patients who underwent high-frequency biological welding electroligation, the second (experimental) group consisted of 80 patients who underwent monopolar thermal argon plasma coagulation. Results: In the first (treatment) group of patients with ulcerative gastroduodenal bleeding, who underwent endoscopic hemostasis using high-frequency biological welding electroligation, primary hemostasis was achieved in 77 cases (96.25%). In the first group, an early recurrence of bleeding was registered in 3 patients (3.75%). In the second (experimental) group of patients with ulcerative gastroduodenal bleeding, who underwent endoscopic hemostasis using monopolar thermal argon plasma coagulation, primary hemostasis was achieved in 66 cases (82.5%). In the second group, a recurrence of bleeding was observed in 14 patients (17.5%). Conclusions: The use of high-frequency biological welding electroligation for endoscopic hemostasis in ulcerative gastroduodenal bleeding provides a more reliable permanent hemostasis compared to the use of monopolar thermal argon plasma coagulation (77 (96.5%) and 66 (82.5%) cases, respectively). The frequency of bleeding recurrence is reduced to 3.5% and 17.5%, respectively, and the number of surgical interventions for acute bleeding in case of recurrence is decreased to 3 (3.5%) and 7 (8.75%), respectively.

Evaluation of the results of planned open surgical interventions in primary chronic vein disease in pregnant women

2020 ◽  
pp. 51-56
Author(s):  
V.М. Аntonyuk-Kysil ◽  
◽  
І.Y. Dziubanovskyi ◽  
V.М. Yenikeeva ◽  
S.І. Lichner ◽  
...  
Keyword(s):  
Pregnant Woman ◽  
Pregnant Women ◽  
Postoperative Period ◽  
Postpartum Period ◽  
Clinical Manifestations ◽  
Lower Extremities ◽  
Vascular Surgeon ◽  
Surgical Interventions ◽  
Perinatal Center ◽  
Vein Disease

The objective: to evaluate the results of planned open surgical interventions (POSI) in pregnant women with primary symptomatic chronic vein disease (PSCVD). Materials and methods. The study included 457 pregnant women operated on a routine basis with PSCVD. The patients underwent ultrasound duplex angioscanning (USDA) of the veins of the lower extremities, inguinal canals, and iliac veins. The severity of the clinical manifestations of PSCVD was evaluated on a VCSS scale. With the help of the circadian visual-analog scale, the dynamics after the operative pain were studied. The effect of POSI on uterine tone and cardiac function of the fetus was investigated using cardiotocography. When forming the results for POSI, data from USDA, the severity of clinical and cosmetic manifestations of PCVD, the need for active prevention of thrombophlebetic, thromboembolic and hemorrhagic complications, minimization of surgical childbirth were taken into account. The results of treatment were studied in 2 groups of patients. Patients of the first group were treated with conservative therapy, the second group – POSI. Parametric indicators, which were presented as mean and standard error M(SD), were used for statistical data processing of the study, and their reliability was estimated using Student’s t-test. The species was determined to be significant at p<0.05. Results. 495 POSI were performed at 28-38 weeks gestation in an obstetric hospital (perinatal center), by a vascular surgeon from the staff of the center, who was familiarized with the peculiarities of working with this contingent of patients. Surgery was performed under local anesthesia in 346 (75.49%) pregnant women at one extremity, in 111 (24.51%) – at two in one session. According to the results of the study, it was noted that in the first group 33.7% of patients had a positive clinical result due to the reduction of pain syndrome, while 67.5% of patients had an increase and spread of varicose transformation in the area of saphenous and/or non-saphenous veins with spread of pathological venous reflux in the distal direction. 78% of patients had the need to administer prophylactic doses of low molecular weight heparins, both during pregnancy and in postpartum period. Out of 126 pregnant women with pronounced varicose veins of the external genital organs and perineum in 36 (28.6%) deliveries were performed by caesarean section. In 9 (3%) patients there was an acute thrombophlebitis of the subcutaneous veins of the lower extremities, which required 5 pregnant women to undergo urgent surgery when the inflammatory process had spread to the middle and above along the femoral vein of the large subcutaneous vein. Pregnant women of the second group with PSCVD on the basis of obstetric hospital (perinatal center) POSI were performed in the organization, which laid the ideology of the FTS program, strictly individual indications for intervention in the optimal terms of pregnancy, multidisciplinary management of patients, due to this in 93% of operated patients regression of clinical manifestations of the disease was noted, whch contributed to the correct and safe delivery of pregnancy with 100% absence of preterm birth, abnormalities in fetal development, pregnancy course, negative impact on obstetric and somatic condition of the pregnant woman. No hemorrhagic, thrombophlebic, thromboembolic complications were noted. Patients in the postoperative period did not require medical support, as during the period of pregnancy, during delivery and in the postpartum period. There were no indications for surgical delivery. 2.4% of patients experienced complications of post-operative wounds in the form of cheese, which had no effect on pregnancy and was eliminated before delivery. In the postoperative period, if necessary, it was recommended to use elastic compression class garments 1–2. Conclusion. POSI made at PSCVD in optimal terms of pregnancy in a specialized obstetric hospital by a vascular surgeon in strictly individual indications is safe, both for the fetus and the pregnant woman. It is promising to further study the results of POSI in pregnant women with PSCVD to introduce it into the arsenal of treatment of this pathology. Key words: FTS ideology, planned open surgical interventions in pregnant women.

Thyroid Dysfunction in Pregnant Women with Gestational Diabetes Mellitus

2020 ◽  
Vol 16 (8) ◽  
pp. 895-899 ◽  
Author(s):  
Shahin Safian ◽  
Farzaneh Esna-Ashari ◽  
Shiva Borzouei
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Thyroid Dysfunction ◽  
Control Group ◽  
Thyroid Peroxidase ◽  
Free T4 ◽  
Significant Difference ◽  
Experimental Group

Aims: Investigation thyroid dysfunction and autoimmunity in pregnant women with gestational diabetes mellitus. Background: This article was written to evaluate the thyroid function and anti-thyroid peroxidase (anti- TPO) antibodies in pregnant women with gestational diabetes mellitus (GDM). Method: A total of 252 women with GDM and 252 healthy pregnant women were enrolled. Thyroid tests, including TSH, FreeT3, Free T4, and anti-TPO were performed for all women at 24–28 weeks of gestation. Data analysis was then carried out using SPSS ver. 22. Result: There was a significant difference between the experimental group (38.4%) and the control group (14.06%) in terms of the prevalence of subclinical hypothyroidism (p= 0.016). The frequency of anti-TPO was higher in the experimental group than the control group and positive anti-TPO was observed in 18.6% of women with GDM and 10.3% of healthy pregnant women (P= 0.008). Conclusion: Thyroid disorders are observed in pregnant women with GDM more frequently than healthy individuals and it may be thus reasonable to perform thyroid tests routinely.

scholarly journals The Food, Feelings, and Family Study: comparison of the efficacy of traditional methods, social media, and broadcast email to recruit pregnant women to an observational, longitudinal nutrition study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rebecca Smith ◽  
Crystal Alvarez ◽  
Sylvia Crixell ◽  
Michelle A. Lane
Keyword(s):  
Social Media ◽  
Pregnant Women ◽  
Family Study ◽  
Human Subjects ◽  
Recruitment Method ◽  
Traditional Methods ◽  
Chi Square ◽  
Recruitment Methods ◽  
Health Care Intervention ◽  
Time Investment

Abstract Background It is well known that recruitment is a challenging aspect of any study involving human subjects. This challenge is exacerbated when the population sought is reticent to participate in research as is the case with pregnant women and individuals with depression. This paper compares recruitment methods used for the Food, Feelings, and Family Study, an observational, longitudinal pilot study concerning how diet and bisphenol A exposure affect maternal mood and cognitive function during and after pregnancy. Methods Pregnant women were recruited to this study over a period of 15 months using traditional methods, social media including paid and unpaid posts, and emails broadcast to the university community. Contingency analysis using the Pearson’s Chi-square test was used to determine if recruitment method was associated with likelihood of participation. T-tests were used to analyze Facebook advertisement success. ANOVAs and Fisher exact tests were used to determine if recruitment method was related to continuous and categorical demographics, respectively. Results Social media resulted in the largest number of recruits, followed by traditional methods and broadcast email. Women recruited through social media were less likely to participate. In contrast, use of broadcast email resulted in a smaller pool of recruits but these recruits were more likely to be eligible for and complete the study. Most women recruited via social media were the result of unpaid posts to the study’s Facebook page. Paid posts lasting at least 4 days were the most successful. Recruitment method was not associated with participant demographics. Conclusions Social media has the potential to recruit a large pool of potential subjects; however, when studies require a large time investment such as the case here, women recruited through social media are less likely to participate and complete the study than women recruited through other means. Trial registration N/A. This study does not describe a health care intervention.

scholarly journals Contagion Management at the Méditerranée Infection University Hospital Institute

2021 ◽  
Vol 10 (12) ◽  
pp. 2627
Author(s):  
Pierre-Edouard Fournier ◽  
Sophie Edouard ◽  
Nathalie Wurtz ◽  
Justine Raclot ◽  
Marion Bechet ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Early Diagnosis ◽  
Personal Protective Equipment ◽  
Early Stage ◽  
Point Of Care ◽  
University Hospital ◽  
Protective Equipment ◽  
Monitoring Point ◽  
Epidemiological Monitoring ◽  
Wide Range

The Méditerranée Infection University Hospital Institute (IHU) is located in a recent building, which includes experts on a wide range of infectious disease. The IHU strategy is to develop innovative tools, including epidemiological monitoring, point-of-care laboratories, and the ability to mass screen the population. In this study, we review the strategy and guidelines proposed by the IHU and its application to the COVID-19 pandemic and summarise the various challenges it raises. Early diagnosis enables contagious patients to be isolated and treatment to be initiated at an early stage to reduce the microbial load and contagiousness. In the context of the COVID-19 pandemic, we had to deal with a shortage of personal protective equipment and reagents and a massive influx of patients. Between 27 January 2020 and 5 January 2021, 434,925 nasopharyngeal samples were tested for the presence of SARS-CoV-2. Of them, 12,055 patients with COVID-19 were followed up in our out-patient clinic, and 1888 patients were hospitalised in the Institute. By constantly adapting our strategy to the ongoing situation, the IHU has succeeded in expanding and upgrading its equipment and improving circuits and flows to better manage infected patients.

Parathyroid hormone promotes cartilage healing after free reduction of mandibular condylar fractures by upregulating Sox9

2021 ◽  
pp. 153537022110271
Author(s):  
Yuanyuan Jia ◽  
Liuqin Xie ◽  
Zhenglong Tang ◽  
Dongxiang Wang ◽  
Yun Hu ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Internal Fixation ◽  
Early Stage ◽  
Rabbit Model ◽  
Mandibular Condyle ◽  
Fracture Site ◽  
Control Group ◽  
Condylar Cartilage ◽  
Cartilage Healing ◽  
Experimental Group

After high fractures of the mandibular condyle, the insufficient blood supply to the condyle often leads to poor bone and cartilage repair ability and poor clinical outcome. Parathyroid hormone (PTH) can promote the bone formation and mineralization of mandibular fracture, but its effects on cartilage healing after the free reduction and internal fixation of high fractures of the mandibular condyle are unknown. In this study, a rabbit model of free reduction and internal fixation of high fractures of the mandibular condyle was established, and the effects and mechanisms of PTH on condylar cartilage healing were explored. Forty-eight specific-pathogen-free (SPF) grade rabbits were randomly divided into two groups. In the experimental group, PTH was injected subcutaneously at 20 µg/kg (PTH (1–34)) every other day, and in the control group, PTH was replaced with 1 ml saline. The healing cartilages were assessed at postoperative days 7, 14, 21, and 28. Observation of gross specimens, hematoxylin eosin staining and Safranin O/fast green staining found that every-other-day subcutaneous injection of PTH at 20 µg/kg promoted healing of condylar cartilage and subchondral osteogenesis in the fracture site. Immunohistochemistry and polymerase chain reaction showed that PTH significantly upregulated the chondrogenic genes Sox9 and Col2a1 in the cartilage fracture site within 7–21 postoperative days in the experimental group than those in the control group, while it downregulated the cartilage inflammation gene matrix metalloproteinase-13 and chondrocyte terminal differentiation gene ColX. In summary, exogenous PTH can stimulate the formation of cartilage matrix by triggering Sox9 expression at the early stage of cartilage healing, and it provides a potential therapeutic protocol for high fractures of the mandibular condyle.

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