Laparotomic myomectomy for a huge cervical myoma in a young nulligravida woman: A case report and review of the literature

Background: A huge cervical myoma (rare) in a young woman is a nightmare of every gynecologist owing to the associated technical challenges in performing a myomectomy. Moreover, the 2014 US Food and Drug Administration prohibited power morcellation during laparoscopic myomectomy due to the inadvertent spread of occult malignancy and an increased risk of iatrogenic parasitic leiomyoma negatively affected the overall rate of a minimally invasive surgery. Case: This report described our experience with a case of a huge anterior cervical myoma (473 gr) in a young nulligravida woman who successfully underwent laparotomic myomectomy. After an initial diagnosis by Magnetic resonance imaging (MRI), we performed preoperative ureteric catheterization. The myoma was enucleated following the footsteps of Victor Bonney, the pioneer of myomectomy, combined with simple additional steps. We did not use preoperative gonadotropin-releasing hormone analog, intraoperative vasopressin injection, or uterine artery ligation. A 6-month follow-up MRI revealed an intact cervical canal in midline position with no evidence of residual fibroid. Conclusion: Based on our experience, the review of the relevant literature, and the US Food and Drug Administration's prohibition of power morcellation during laparoscopic myomectomy, a laparotomic myomectomy for a huge cervical myoma still plays a vital role in fertility preservation. We propose the mnemonic "MUSIC" as a helpful guide for a consistent strategy: M (preoperative MRI), U (prophylactic ureteric catheterization), S (shell out the myoma following Bonney's principles i.e. start-up and stay intracapsular), I (immediate suction to clarify dead space) and C (close the cavity by spiraling stitch). Key words: Cervix, Fibroid, Leiomyoma, Myomectomy.

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CEREBRAL PALSY:A CLINICAL OVERVIEW

JOURNAL OF NEUROLOGY AND NEUROSURGICAL RESEARCH ◽

10.26739/2181-0982-2020-3-12 ◽

2020 ◽

Vol 3 (1) ◽

pp. 54-59

Author(s):

Nargiza Ergasheva ◽

◽

Sardor Anorboev ◽

Gavkhar Kendjaeva ◽

Keyword(s):

Brain Area ◽

Fetal Brain ◽

Clinical History ◽

Screening Tests ◽

Spastic Diplegia ◽

Team Approach ◽

Birth Process ◽

Increased Risk ◽

Spastic Quadriplegia ◽

Magnetic Resonance Imaging Mri

Cerebral palsy (CP) is a disorder characterized by abnormal tone, posture and movement. The incidence of CP is 2–4 per 1,000 live births in the world. Prematurityand low birth weight are important risk factors for CP; however, multiple other factors have been associated with an increased risk for CP, including maternal infections and diseases, and abnormal birth process. In most cases of CP the initial injury to the brain occurs during early fetal brain development, later a brain area that is injured cannot function properly in the future. CP is classified clinically based on the predominant motor syndrome—spastic hemiplegia, spastic diplegia, spastic quadriplegia, ataxic and dyskinetic cerebral palsies. The diagnosis of CPis based on a combination of clinical history, use of standardized neuromotor assessment and findings on magnetic resonance imaging (MRI). If there is a suspicionof genetic or inborn metabolic disorders, screening tests should be provided additionally. Because CP is associated with multiple associated and secondary medical conditions, its management requires a multidisciplinary team approach

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Actionable and incidental neuroradiological findings in twins with neurodevelopmental disorders

Scientific Reports ◽

10.1038/s41598-020-79959-8 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Lynnea Myers ◽

Mai-Lan Ho ◽

Elodie Cauvet ◽

Karl Lundin ◽

Torkel Carlsson ◽

...

Keyword(s):

Neurodevelopmental Disorders ◽

Copy Number Variants ◽

Cross Sectional Study ◽

Autism Spectrum ◽

Molecular Signaling ◽

Mri Findings ◽

Cross Sectional ◽

Increased Risk ◽

Magnetic Resonance Imaging Mri ◽

Morphological Variants

AbstractWhile previous research has investigated neuroradiological findings in autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD), the entire range of neurodevelopmental disorders (NDDs) has not yet been well-studied using magnetic resonance imaging (MRI). Considering the overlap among NDDs and simultaneous development of the brain and face, guided by molecular signaling, we examined the relationship of actionable and incidental (non-actionable) MRI findings and NDD diagnoses together with facial morphological variants and genetic copy number variants (CNVs). A cross-sectional study was conducted with a twin cohort 8–36 years of age (57% monozygotic, 40% dizygotic), including 372 subjects (46% with NDDs; 47% female) imaged by MRI, 280 with data for facial morphological variants, and 183 for CNVs. Fifty-one percent of participants had MRI findings. Males had a statistically significantly higher percentage of MRI findings (57.7%) compared with females (43.8%, p = 0.03). Twin zygosity was not statistically significantly correlated with incidence or severity of specific MRI findings. No statistically significant association was found between MRI findings and any NDD diagnosis or facial morphological variants; however, MRI findings were statistically significantly associated with the number of CNVs (OR 1.20, 95% CI 1.00–1.44, p = 0.05, adjusted OR for sex 1.24, 95% CI 1.03–1.50, p = 0.02). When combining the presence of MRI findings, facial morphological variants, and CNVs, statistically significant relationships were found with ASD and ADHD diagnoses (p = 0.0006 and p = 0.002, respectively). The results of this study demonstrate that the ability to identify NDDs from combined radiology, morphology, and CNV assessments may be possible. Additionally, twins do not appear to be at increased risk for neuroradiological variants.

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Spectrum of Imaging Findings in Rhino-Orbito-Cerebral Mucormycosis (ROCM) in Post COVID Patients - A Pictorial Review with Clinico-Radiological Correlation

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/649 ◽

2021 ◽

Vol 8 (41) ◽

pp. 3584-3590

Author(s):

Devarajan Ellezhutil ◽

Sajeeth Kumar Govindan Keeriyatt ◽

Sunil Kumar Kunhiparambath ◽

John Jimmy Nalappat

Keyword(s):

Early Diagnosis ◽

Virus Disease ◽

Vital Role ◽

Fungal Sinusitis ◽

Mri Findings ◽

Pictorial Review ◽

Radiological Patterns ◽

The Common ◽

Magnetic Resonance Imaging Mri ◽

Very High

BACKGROUND Rhino-orbito-cerebral mucormycosis (ROCM) is a devastating fungal infection with very high rates of mortality. Many patients post corona virus disease (COVID) infection are increasingly being diagnosed with mucormycosis (black fungus). Imaging being central to the early diagnosis of the infection, the study aims to characterize the major radiological patterns of involvement of mucormycosis. Computed tomography (CT) & magnetic resonance imaging (MRI) findings of 10 patients who were subsequently conformed to have mucormycosis were analyzed and 7 major patterns of involvement were detected. Imaging plays a vital role in the early diagnosis of ROCM. Knowledge about the common patterns of spread helps in picking the subtle signs of infection. KEYWORDS Mucormycosis, Post COVID, Fungal Sinusitis, ROCM

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POSSIBLE HEALTH CONSEQUENCES FOR NEWBORNS FROM MOTHERS WHO SUFFERED COVID-19 DURING PREGNANCY

Acta medica Eurasica ◽

10.47026/2413-4864-2021-3-35-47 ◽

2021 ◽

pp. 35-47

Author(s):

Tamara G. Denisova ◽

Adelina I. Sergeeva ◽

Alexandra S. Grigorieva ◽

Enje E. Rechapova ◽

Ivan I. Sergeev ◽

...

Keyword(s):

Pregnant Women ◽

Negative Impact ◽

Close Contact ◽

Relevant Literature ◽

Clinical Manifestations ◽

Future Generation ◽

World Health ◽

Practical Significance ◽

Increased Risk ◽

Coronavirus Infection

According to the WHO statement dated March 11, 2020, the coronavirus infection SARS-CoV-2 has reached the scale of a pandemic and is currently a world health problem. A special group of the population that requires increased attention is pregnant women due to the fact that pneumonia occupies the third place in the structure of indirect causes of maternal mortality. Pregnant women whose immune system has changed appeared to be at an increased risk of infection. Pregnancy is a risk factor for the development of a more severe course of acute respiratory viral diseases and influenza. To date, the issue of intrauterine transmission of coronavirus disease remains completely unexplored, which causes fear among pregnant women for the future generation. Addition of a new coronavirus infection SARS-CoV-2 has a negative impact on pregnancy, childbirth and the postpartum period, the health of newborns, especially in patients with a burdened obstetric history. Pregnancy itself and childbirth do not affect the course of COVID-19, but the infection addition can complicate the course of gestation, causing respiratory distress syndrome, premature birth and spontaneous miscarriages, congenital pneumonia and antenatal death of newborns born from covid-positive mothers. The literature published from December 1, 2019 to July 30, 2021 was searched in several databases, including PubMed, Web of Science, Google Scholar and the WHO COVID-19 database, of which 52 articles were selected for detailed consideration. The relevant literature was searched to understand the issues of infection transmission to newborns from infected mothers and the clinical manifestations of the disease in the former. As a result, it was found that newborns can become infected with SARS-Cov-2 in close contact with infected patients or asymptomatic virus carriers. However, based on the data of modern literature, it is impossible to unequivocally answer the questions posed, more facts are needed to solve the problem. The practical significance of the work is that the results of the study should be used for further studying the consequences of COVID-19 for the health of newborn children.

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Leiomyomatosis Peritonealis Disseminate Following Laparoscopic Myomectomy with Power Morcellation

Journal of Clinical & Experimental Pathology ◽

10.4172/2161-0681.1000329 ◽

2017 ◽

Vol 07 (06) ◽

Author(s):

Yao Sun ◽

Xiaoxiao Lan ◽

Haiyan Shi ◽

Xueqing Wu ◽

Bingjian Lu

Keyword(s):

Laparoscopic Myomectomy ◽

Power Morcellation

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Current and Future Directions of Breast MRI

Journal of Clinical Medicine ◽

10.3390/jcm10235668 ◽

2021 ◽

Vol 10 (23) ◽

pp. 5668

Author(s):

Margaret Houser ◽

David Barreto ◽

Anita Mehta ◽

Rachel F. Brem

Keyword(s):

Breast Cancer ◽

High Risk ◽

Digital Breast Tomosynthesis ◽

Breast Mri ◽

Preoperative Assessment ◽

Average Risk ◽

Dense Breast Tissue ◽

Increased Risk ◽

High Risk Populations ◽

Magnetic Resonance Imaging Mri

Magnetic resonance imaging (MRI) is the most sensitive exam for detecting breast cancer. The American College of Radiology recommends women with 20% or greater lifetime risk of developing breast cancer be screened annually with MRI. However, other high-risk populations would also benefit. Hartmann et al. reported women with atypical hyperplasia have nearly a 30% incidence of breast cancer at 25-year follow-up. Women with dense breast tissue have up to a 4-fold increased risk of breast cancer when compared to average-risk women; their cancers are more likely to be mammographically occult. Because multiple cohorts of women are at high risk for developing breast cancer, there has been a movement to develop an abbreviated MRI (abMRI) protocol to expand the availability of MRI screening. Studies on abMRI effectiveness have been promising, with Weinstein et al. demonstrating a cancer detection rate of 27.4/1000 in women with dense breasts after a negative digital breast tomosynthesis. Breast MRI is also used to evaluate the extent of disease as part of preoperative assessment in women with newly diagnosed breast cancer, and to assess a patient’s response to neoadjuvant chemotherapy. This paper aims to explore the current uses of MRI and propose future indications and directions.

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In-bag manual versus uncontained power morcellation for laparoscopic myomectomy: randomized controlled trial

Fertility and Sterility ◽

10.1016/j.fertnstert.2015.12.133 ◽

2016 ◽

Vol 105 (5) ◽

pp. 1369-1376 ◽

Cited By ~ 28

Author(s):

Roberta Venturella ◽

Morena L. Rocca ◽

Daniela Lico ◽

Nicolò La Ferrera ◽

Roberto Cirillo ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Laparoscopic Myomectomy ◽

Randomized Controlled ◽

Power Morcellation

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Abstract 12954: Impairment of the Compensatory Natriuretic Peptide Response to Myocardial Infarction in the Aged is Associated With Adverse Cardiorenal Repair and Heart Failure

Circulation ◽

10.1161/circ.130.suppl_2.12954 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

S. J Sangaralingham ◽

Tomoko Ichiki ◽

Gerald E Harders ◽

Horng H Chen ◽

John C Burnett

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Natriuretic Peptide ◽

The Elderly ◽

Significant Loss ◽

Coronary Artery Ligation ◽

Artery Ligation ◽

Aged Rat ◽

Clinical Model ◽

Increased Risk

Introduction: The incidence of post-myocardial infarction (MI) heart failure (HF) is increasing in the elderly. Studies have demonstrated that B-type natriuretic peptide (BNP) mediates critical cardiorenal compensatory and protective actions through guanylyl cyclase receptor A and cGMP activation. Such actions include natriuresis, diuresis and suppression of adverse cardiorenal remodelling. Hypothesis: While the mechanism of this increased risk may be multifactorial, we hypothesized that an impairment of the compensatory protective BNP/cGMP axis in both the aged kidney and heart contributes to post-MI HF. Methods: 20 month old Fischer rats were randomized into two groups: Sham-operated (S) and MI(produced by left coronary artery ligation). Cardiorenal structure and function were assessed at 4 weeks and included mean arterial pressure(MAP), LV EF, LV chamber dimension, proteinuria, sodium (Na) excretion and fibrosis by picrosirius red staining. Plasma BNP and cGMP levels were assessed by RIA. Data presented as mean±SE,*P<0.05. Results: LV EF (S:78±2, MI:46±3 %*) was significantly reduced in aged MI rats, despite no difference in LV fibrosis in the remote region and no change in MAP compared to aged sham rats. Post-MI HF was evident and characterized by a significant reduction in Na excretion (S:0.20±0.03, MI:0.13±0.01 mEq/day*) as well as significant increases in LV dilatation (S:7.2±0.1, MI:8.3±0.2 mm*) and cardiac hypertrophy (S:2.78±0.06, MI:3.25±0.16 mg/g*) in aged MI rats. Notably, plasma BNP (S:9±1, MI:11±2 pg/ml) failed to increase and plasma cGMP (S:44±6, MI:27±3 mm*) was significantly reduced in the MI group. Importantly, MI in the aged rat resulted in a significant loss in total renal mass (S:2739±83, MI:2351±68 mg*), consistent with renal atrophy, while no changes in proteinuria or renal fibrosis were observed. Conclusions: Post-MI dysfunction of the protective BNP/cGMP axis in the aged rat was associated with various cardiorenal abnormalities including renal atrophy, which may contribute to the pathophysiology of HF. This pre-clinical model provides new insights into post-MI HF and may be used to examine therapeutic strategies using natriuretic peptides to protect the heart and kidney in the elderly post-MI population.

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Horizontal Cervix as a Novel Sign for Predicting Adhesions on the Posterior Extrauterine Wall in Cases of Placenta Previa

Journal of Clinical Medicine ◽

10.3390/jcm8122141 ◽

2019 ◽

Vol 8 (12) ◽

pp. 2141 ◽

Cited By ~ 3

Author(s):

Shinya Matsuzaki ◽

Aiko Okada ◽

Masayuki Endo ◽

Yoshikazu Nagase ◽

Satoshi Nakagawa ◽

...

Keyword(s):

Placenta Accreta ◽

Placenta Previa ◽

Area Under The Curve ◽

Cervical Canal ◽

Perpendicular Line ◽

Straight Line ◽

Line Passing ◽

Adhesion Rate ◽

Placenta Accreta Spectrum ◽

Magnetic Resonance Imaging Mri

We aimed to identify a magnetic resonance imaging (MRI) feature that can predict posterior extrauterine adhesion (posterior adhesion) antenatally, in patients with placenta previa. We retrospectively reviewed patients with placenta previa who underwent a preoperative MRI examination of placenta accreta spectrum. We categorized the patients into two groups based on whether the cervix was anterior or posterior to a line perpendicular to the anatomical conjugate on the MRI. We projected the perpendicular line toward a straight line through the broad of the back on T2-weighted sagittal MRI images and measured the angle between this line and the line passing through the cervical canal. We analyzed the correlation of the cervical canal angle with the presence of posterior adhesions. Of the 96 patients analyzed, 71 patients had an anteverted cervix and 25 patients had a retroverted cervix. There were 21 posterior adhesions. The adhesion rate was significantly higher in patients with a retroverted cervix than those with an anteverted cervix (8.5% vs. 60%; p = 0.00). The cervical canal angle was ≤10° in 25 patients; of these 17 had adhesions (sensitivity, 81.0%; specificity, 89.3%; area under the curve, 0.887; 95% confidence interval, 0.792–0.981). This finding, labeled “positive horizontal cervix sign,” may be a promising indicator of posterior adhesions in patients with placenta previa.

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