scholarly journals INTERNAL HERNIA FOLLOWING LAPAROSCOPIC ROUX-EN-Y GASTRIC BY-PASS: INDICATIVE FACTORS FOR EARLY REPAIR

2019 ◽  
Vol 56 (2) ◽  
pp. 160-164 ◽  
Author(s):  
Eduardo Pachu Raia dos SANTOS ◽  
Fernando SANTA CRUZ ◽  
Eduarda Araújo HINRICHSEN ◽  
Álvaro Antônio Bandeira FERRAZ ◽  
Josemberg Marins CAMPOS
Keyword(s):  
Internal Hernia ◽  
Early Stage ◽  
Delayed Diagnosis ◽  
Clinical Manifestations ◽  
Major Complication ◽  
Abdominal Distension ◽  
Recurrent Abdominal Pain ◽  
Early Repair ◽  
Gastric By Pass

ABSTRACT BACKGROUND: Internal hernia (IH) following laparoscopic Roux-en-Y gastric bypass (LRYGB) is a major complication that challenges the surgeon due to its non-specific presentation and necessity of early repair. Delayed diagnosis and surgical intervention of IH might lead to increased morbidity of patients and impairments in their quality of life. OBJECTIVE: To evaluate the predictive factors for early diagnosis and surgical repair of IH after LRYGB. METHODS: This study analyzed 38 patients during the postoperative period of LRYGB who presented clinical manifestations suggestive of IH after an average of 24 months following the bariatric procedure. RESULTS: The sample consisted of 10 men and 28 women, with a mean age of 37.5 years and a mean body mass index (BMI) of 39.6 kg/m2 before LRYGB. All patients presented pain, 23 presented abdominal distension, 10 had nausea and 12 were vomiting; three of them had dysphagia, three had diarrhea and one had gastro-esophageal reflux. The patients presented symptoms for an average of 15 days, varying from 3 to 50 days. Seventeen (45.9%) patients were seen once, while the other 20 (54.1%) went to the emergency room twice or more times. Exploratory laparoscopy was performed on all patients, being converted to laparotomy in three cases. Petersen hernia was confirmed in 22 (57.9%). Petersen space was closed in all patients and the IH correction was performed in 20 (52.6%) cases. The herniated loop showed signs of vascular suffering in seven patients, and two (5.3%) had irreversible ischemia, requiring bowel resection. CONCLUSION: The presence of recurrent abdominal pain is one of the main indicators for the diagnosis of IH after LRYGB. Patients operated at an early stage, even with negative imaging tests for this disease, benefited from rapid and simple procedures without major complications.

scholarly journals Oral Manifestations of Celiac Disease and Wheat Allergy: Report of Three Cases and Review of Literature

2018 ◽  
pp. 33-45
Author(s):  
Yadira V. Boza Oreamuno DDS, MSc ◽  
María F. Rugama Flores BSND
Keyword(s):  
Celiac Disease ◽  
Systemic Disease ◽  
Clinical Manifestations ◽  
Abdominal Distension ◽  
Clinical History ◽  
Recurrent Abdominal Pain ◽  
Oral Manifestations ◽  
Wheat Allergy ◽  
Immune Mediated ◽  
History Of

Celiac Disease (CD) is an immune-mediated systemic disease, caused by gluten and related prolamins, in genetically susceptible individuals. It is characterized by gluten-dependent clinical manifestations, CD-specific antibodies, HLA DQ2 or DQ8 haplotypes, and enteropathy. Most patients are asymptomatic or with mild manifestations. It mainly affects the gastrointestinal system causing symptoms and signs such as diarrhea, recurrent abdominal pain and abdominal distension; also extradigestive manifestations. Patients with CD may have oral manifestations that include recurrent aphthous stomatitis (RAS), enamel hypoplasia, atrophic glossitis, among others. The diagnosis of CD is based on clinical history, serology, endoscopy and histology. There are other entities that should be differentiated from CD, such as non-celiac gluten sensitivity and wheat allergy. The aim of this study is to present three patients with a history of RAS and other clinical manifestations associated with the early diagnosis of CD and food allergy.

Ovarian granulosa cell tumors: Experience of National Institute of Oncology in Morocco.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e16527-e16527
Author(s):  
Sakina Sekkate ◽  
Mouna Kairouani ◽  
Badr Serji ◽  
Brahim el Ghissassi ◽  
Hind Mrabti ◽  
...  
Keyword(s):  
Granulosa Cell ◽  
Cox Regression ◽  
Early Stage ◽  
Survival Rates ◽  
Clinical Manifestations ◽  
Stage Iv ◽  
Abdominal Distension ◽  
Adult Form ◽  
Granulosa Cell Tumors

e16527 Background: The granulosa cell tumors are malignancies with a relatively favorable prognosis. They are characterized by prolonged natural history and tendency to late recurrences. The aim of this study is to investigate the epidemiological and pathological characteristics of granulosa cell tumors, and the prognosis factor for recurrences in the national institute of oncology in Rabat in Morocco. Methods: The clinical data of patients with adult granulosa cell tumors of the ovary treated from January 2003 to december 2010 was investigated retrospectively. Data of age, clinical manifestation, imaging, diagnosis, treatment and follow up of the patients were reviewed and analyzed. Histology was obtained in postoperative for all patients. Results: Twenty-seven cases were retrieved. The median age was 53 years. The most common clinical manifestations at diagnosis were: abdominal pain, vaginal bleeding, abdominal distension and hormonal manifestations. The mean tumor size was 14 cm. The majority of patients had stage I (62,96%, n = 17), while (18,51%, n = 5) had stage III, (7,4%, n = 2) had stage IV, and (11,11%, n = 3) of patients had unknown stage.8 patients received adjuvant chemotherapy (4 : bleomycin etoposide, cisplatin (BEP); 1: bleomycin vepeside cisplatin (BVP); 1: endoxan cisplatin; 1: paclitaxel cisplatin; 1: tamoxifene), and 2 patients received chemotherapy for metastatic disease.For a median follow up of 63,44 months, 5 (18,51%) of patients relapsed. The median time to relapse was 41,8 months, (range : 18-62 months).The overall 5-year survival and 9-year survival rates for all stages were 91.3% and 77.3%, respectively. Following univariate Cox regression modeling, the survival depends on stage, it’s better in localized stages (p = 0,05). Conclusions: Granulosa cell tumor of the ovary is an uncommon neoplasm. The adult form progresses slowly and often is diagnosed in an early stage of disease. Surgery is indicated. A prolonged post therapeutic follow-up is necessary because of the risk of recurrences, late and exceptional for the adult form.

scholarly journals A COMPREHENSIVE INFORMATIVE NOTE ON ASCITES

2018 ◽  
Vol 11 (4) ◽  
pp. 154
Author(s):  
Navneet Singh ◽  
Sazal Patyar ◽  
Naveen Chandra Talniya
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Congestive Heart Failure ◽  
Spontaneous Bacterial Peritonitis ◽  
Early Stage ◽  
Abdominal Distension ◽  
Medical Practitioners ◽  
Bacterial Peritonitis ◽  
Loss Of Appetite

 Ascites impairs both the physical and mental dimensions of quality of life in patients. The patients due to unawareness do not report to medical practitioners in the early stage of disease, and also in few cases, medical practitioners due to lack of adequate expertise face difficulty to ensure the early stage detection for causes of ascites, i.e., due to cirrhosis, cancer, congestive heart failure, mycobacterium tuberculosis, or others. Ascites is a symptom of progression of single disease or multiple diseases. Gross collection of fluid in peritoneal cavity may initiate a series of problems such as spontaneous bacterial peritonitis and an increase in abdominal distension and discomfort and hinder the mobility of the patient and dullness and loss of appetite. In the present review, a detail study over the ecology of ascites has been done with emphasizing on diagnosis by history and physical examination, clinical examination, and imagining techniques followed by management of treatment through general guidelines, and various available therapies are covered.

Clinical-anamnestic analysis of the course and treatment of benign and borderline epithelial ovarian tumors

2016 ◽  
pp. 86-93
Author(s):  
M.Yu. Yegorov ◽  
◽  
A.A. Sukhanova ◽  
Keyword(s):  
Varicose Veins ◽  
Clinical Manifestations ◽  
Abnormal Uterine Bleeding ◽  
Abdominal Distension ◽  
Ovarian Tumors ◽  
Lower Limbs ◽  
Benign Tumors ◽  
Age Group ◽  
Venous Disorders ◽  
Serous Tumors

The objective: study the features of gynecological, physical history, diagnosis and treatment of patients with benign epithelial ovarian tumors (BeEOT) and borderline epithelial ovarian tumors (BEOT), determining the frequency of recurrence of ovarian tumors in the postoperative period. Patients and methods. According to a retrospective analysis of case histories of 112 women with epithelial ovarian tumors (EOT) underwent conservative or radical surgical treatment in a hospital, two groups were formed: I group – patients with benign epithelial ovarian tumors (BeEOT), which amounted to 85 (75.9%) women, and group II – patients with borderline epithelial ovarian tumors (BEOT), which amounted to 27 (24.1%) women. It was found that the main complaints of patients with EOT were pain (49.1%), abdominal distension (17%), and abnormal uterine bleeding (12.5%). The highest incidence of BeEOT (31.8%) observed in the age group of 41–50 years, while the peak incidence of BEOT (44.4%) corresponds to the age group of 51–60 years. Results. In BEOT endocrine pathology occurs significantly more frequently (p<0.05) than in BeEOT – 25.9% vs. 9.4%, respectively. Pathology of pancreatic-hepatobiliary system occurs significantly more frequently (p<0.05) in patients with BEOT compared with BeEOT – 81.5% versus 57.6%, respectively. Venous disorders (varicose veins of the pelvic organs, lower limbs, haemorrhoids) observed in BEOT significantly more frequently (p<0.05) than in BeEOT – 18.5% vs. 5.9%, respectively. EOT most often diagnosed in the period from 1 to 6 months after the first clinical manifestations with an average uptake of medical care 4.6±0.57 months. In assessing of peritoneal exudate cytogram the mesothelium cells are significantly more common for BeEOT (p<0.01) than BEOT – 79.4% versus 40.9%, respectively. Cervicitis is more likely significantly to occur in BeEOT (p<0.01) than in BEOT – 29.4% vs. 7.4%, respectively. The most common histological type among the benign tumors of the ovaries are endometriomas, which occurred in 48.2% of all BeEOT cases, and among the borderline tumors – serous tumors, which accounted for 59.3% of all BEOTs. Conclusion. The use of organ sparing surgery in EOT increases the risk of recurrence, especially in the case of endometrial histology or borderline variant of tumor. Key words: benign and borderline epithelial ovarian tumors, clinical-anamnestic analysis, diagnosis, treatment.

scholarly journals Quality of Life among Bangladeshi Youth during the Early Stage of the COVID-19 Pandemic: A Single-site Survey

2021 ◽  
pp. 100157
Author(s):  
Somaresh Kumar Mondal ◽  
Abdul Gaffar Khan ◽  
Md. Mamun Ali ◽  
Mir Kaosar Ahamed ◽  
Kawsar Ahmed
Keyword(s):  
Quality Of Life ◽  
Early Stage ◽  
Single Site ◽  
Site Survey

scholarly journals Fast Multi-Focus Fusion Based on Deep Learning for Early-Stage Embryo Image Enhancement

Sensors ◽  
2021 ◽  
Vol 21 (3) ◽  
pp. 863
Author(s):  
Vidas Raudonis ◽  
Agne Paulauskaite-Taraseviciene ◽  
Kristina Sutiene
Keyword(s):  
Deep Learning ◽  
Image Fusion ◽  
Early Stage ◽  
Image Data ◽  
Cell Detection ◽  
Processing Times ◽  
Fused Image ◽  
Stage Embryo ◽  
Early Stage Embryo

Background: Cell detection and counting is of essential importance in evaluating the quality of early-stage embryo. Full automation of this process remains a challenging task due to different cell size, shape, the presence of incomplete cell boundaries, partially or fully overlapping cells. Moreover, the algorithm to be developed should process a large number of image data of different quality in a reasonable amount of time. Methods: Multi-focus image fusion approach based on deep learning U-Net architecture is proposed in the paper, which allows reducing the amount of data up to 7 times without losing spectral information required for embryo enhancement in the microscopic image. Results: The experiment includes the visual and quantitative analysis by estimating the image similarity metrics and processing times, which is compared to the results achieved by two wellknown techniques—Inverse Laplacian Pyramid Transform and Enhanced Correlation Coefficient Maximization. Conclusion: Comparatively, the image fusion time is substantially improved for different image resolutions, whilst ensuring the high quality of the fused image.

scholarly journals The Prevalence of Sarcopenia and Its Impact on Clinical Outcomes in Lumbar Degenerative Spine Disease—A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (4) ◽  
pp. 773
Author(s):  
Wei-Ting Wu ◽  
Tsung-Min Lee ◽  
Der-Sheng Han ◽  
Ke-Vin Chang
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Clinical Outcomes ◽  
Meta Analysis ◽  
Clinical Manifestations ◽  
Current Evidence ◽  
Degenerative Spine ◽  
Degenerative Spine Disease ◽  
Spine Disease

The association of sarcopenia with poor clinical outcomes has been identified in various medical conditions, although there is a lack of quantitative analysis to validate the influence of sarcopenia on patients with lumbar degenerative spine disease (LDSD) from the available literature. Therefore, this systematic review and meta-analysis aimed to summarize the prevalence of sarcopenia in patients with LDSD and examine its impact on clinical outcomes. The electronic databases (PubMed and Embase) were systematically searched from inception through December 2020 for clinical studies investigating the association of sarcopenia with clinical outcomes in patients with LDSD. A random-effects model meta-analysis was carried out for data synthesis. This meta-analysis included 14 studies, comprising 1953 participants. The overall prevalence of sarcopenia among patients with LDSD was 24.8% (95% confidence interval [CI], 17.3%–34.3%). The relative risk of sarcopenia was not significantly increased in patients with LDSD compared with controls (risk ratio, 1.605; 95% CI, 0.321–8.022). The patients with sarcopenia did not experience an increase in low back and leg pain. However, lower quality of life (SMD, −0.627; 95% CI, −0.844–−0.410) were identified postoperatively. Sarcopenia did not lead to an elevated rate of complications after lumbar surgeries. Sarcopenia accounts for approximately one-quarter of the population with LDSD. The clinical manifestations are less influenced by sarcopenia, whereas sarcopenia is associated with poorer quality of life after lumbar surgeries. The current evidence is still insufficient to support sarcopenia as a predictor of postoperative complications.

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