scholarly journals Ovarian non-gestational choriocarcinoma: a case report and review of current literature

2021 ◽  
Author(s):  
Ling Han ◽  
Ai Zheng ◽  
Yali Chen
Keyword(s):  
Exploratory Laparotomy ◽  
Young Female ◽  
Therapeutic Effects ◽  
Limited Information ◽  
Gestational Choriocarcinoma ◽  
Mixed Germ Cell Tumor ◽  
Pubmed Database ◽  
Fertility Sparing ◽  
Chinese Girl

Abstract Background: Non-gestational ovarian choriocarcinoma is an extremely rare malignant tumor without established treatment. Because of the rarity of Non-gestational ovarian choriocarcinoma, limited information is available in the literature.Thus, we presented our case and reviewed other cases concerningtheir clinical characteristics, diagnosis, therapeutic effects, and prognoses using the PubMed database.Case presentation: We present a rare case of a patient with Non-gestational ovarian choriocarcinoma with a dysgerminoma. Moreover, we performed a subsequent literature review.An 11-year-old Chinese girl presented with pain persisting for 20 days and a lump in her lower abdomen. Exploratory laparotomy was performed, and postoperative pathological sampling revealed a mixed germ-cell tumor comprising choriocarcinoma and dysgerminoma. Following six cycles of bleomycin, etoposide, and cisplatin, the patient remained recurrence-free after16 months from surgery.Conclusions: The analysis of our and previously reported cases indicated that fertility-sparing surgery combined with postoperative chemotherapy might be beneficial for Non-gestational ovarian choriocarcinoma treatment in adolescent and young female individuals. Longer follow-up periods and further management data are necessary.

BLUNT ABDOMINAL TRAUMA WITH HAEMOPERITONEUM TREATED BY EXPLORATORY LAPAROTOMY VERSUS ONLY ABDOMINAL DRAINAGE: A PROSPECTIVE AND COMPARATIVE STUDY.

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Dhawal Panchal ◽  
Firdaus Dekhaiya ◽  
Harin Tailor
Keyword(s):  
Hospital Stay ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Exploratory Laparotomy ◽  
Blunt Injury ◽  
Abdominal Drainage ◽  
Duration Of Hospital Stay ◽  
Considerable Morbidity ◽  
Injured Patients

In today’s mechanized world, Blunt Abdominal Trauma (BAT) is a common emergency which is associated with considerable morbidity and mortality. More than 75% of abdominal traumas are blunt in nature and liver and spleen are the commonest organs to be injured as a result of BAT. The aim is to analyse and compare two groups of patient of blunt abdominal trauma managed conservatively with drainage and one by exploratory laparotomy. 50 cases of blunt abdominal trauma were taken. The patient were studied  which includes age ,sex, mode of injury, initial vitals on presentation, Mortality in each group, duration of hospital stay, pre interventions and post interventions state and requirements, complications and follow up. It was observed 48% of patients were in between age group ranging from 10 to 30. Overall in terms of sex ratio, males dominated the no. of cases. RTA was most common mode of trauma. Liver and spleen was most common organ to be injured. Patients managed by laparotomy had higher mortality rate, duration of hospital stay was more, and complication were more. Early diagnosis and repeated clinical examination and use of appropriate investigation form the key in managing blunt injury abdomen patients. Keywords:  Blunt Abdominal Trauma, Haemoperitoneum , laparotomy , Abdominal Drainage.

scholarly journals Open Capsulorrhaphy for Recurrent Multidirectional Instability of the Shoulder

2021 ◽  
Vol 1 (3) ◽  
pp. 263502542110071
Author(s):  
Ioanna K. Bolia ◽  
Rebecca Griffith ◽  
Nickolas Fretes ◽  
Frank A. Petrigliano
Keyword(s):  
Shoulder Instability ◽  
Return To Sport ◽  
Young Female ◽  
Subscapularis Tendon ◽  
Shoulder Stabilization ◽  
Ehlers Danlos Syndrome ◽  
Physically Active ◽  
Recurrent Shoulder Instability ◽  
Multidirectional Instability

Background: The management of multidirectional instability (MDI) of the shoulder remains challenging, especially in athletes who participate in sports and may require multiple surgical procedures to achieve shoulder stabilization. Open or arthroscopic procedures can be performed to address shoulder MDI. Indications: Open capsulorrhaphy is preferred in patients with underlying tissue hyperlaxity and who had 1 or more, previously failed, arthroscopic shoulder stabilization procedures. Technique Description: With the patient in the beach-chair position (45°), tissue dissection is performed to the level of subscapularis tendon via the deltopectoral approach. The subscapularis tenotomy is performed in an L-shaped fashion, and the subscapularis tendon is tagged with multiple sutures and mobilized. Careful separation of the subscapularis tendon from the underlying capsular tissue is critical. Capsulotomy is performed, consisting of a vertical limb and an inferior limb that extends to the 5 o’clock position on the humeral neck (right shoulder). After evaluating the integrity of the labrum, the capsule is shifted superiorly and laterally, and repaired using 4 to 5 suture anchors. The redundant capsule is excised, and the subscapularis tendon is repaired in a side-to-side fashion, augmented by transosseous equivalent repair using the capsular sutures. Results: Adequate shoulder stabilization was achieved following open capsulorrhaphy in a young female athlete with tissue hyperlaxity and history of a previously failed arthroscopic soft tissue stabilization surgery of the shoulder. The athlete returned to sport at 6 months postoperatively and did not experience recurrent shoulder instability episodes at midterm follow-up. Discussion/Conclusion: Based on the existing literature, 82% to 97% of patients who underwent open capsulorrhaphy for MDI had no recurrent shoulder instability episodes at midterm follow-up. One study reported 64% return-to-sport rate following open capsulorrhaphy in 15 adolescent athletes with Ehlers-Danlos syndrome, but more research is necessary to better define the indications and outcomes of this procedure in physically active patients.

Maternal age at birth and daughter’s fecundability

2021 ◽  
Author(s):  
Olga Basso ◽  
Sydney K Willis ◽  
Elizabeth E Hatch ◽  
Ellen M Mikkelsen ◽  
Kenneth J Rothman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Maternal Age ◽  
Limited Information ◽  
Loss To Follow Up ◽  
Older Mothers ◽  
Registration Number ◽  
The Usa ◽  
Competing Interest

Abstract STUDY QUESTION Do daughters of older mothers have lower fecundability? SUMMARY ANSWER In this cohort study of North American pregnancy planners, there was virtually no association between maternal age ≥35 years and daughters’ fecundability. WHAT IS KNOWN ALREADY Despite suggestive evidence that daughters of older mothers may have lower fertility, only three retrospective studies have examined the association between maternal age and daughter’s fecundability. STUDY DESIGN, SIZE, DURATION Prospective cohort study of 6689 pregnancy planners enrolled between March 2016 and January 2020. PARTICIPANTS/MATERIALS, SETTING, METHODS Pregnancy Study Online (PRESTO) is an ongoing pre-conception cohort study of pregnancy planners (age, 21-45 years) from the USA and Canada. We estimated fecundability ratios (FR) for maternal age at the participant’s birth using multivariable proportional probabilities regression models. MAIN RESULTS AND THE ROLE OF CHANCE Daughters of mothers ≥30 years were less likely to have previous pregnancies (or pregnancy attempts) or risk factors for infertility, although they were more likely to report that their mother had experienced problems conceiving. The proportion of participants with prior unplanned pregnancies, a birth before age 21, ≥3 cycles of attempt at study entry or no follow-up was greater among daughters of mothers <25 years. Compared with maternal age 25–29 years, FRs (95% CI) for maternal age <20, 20–24, 30–34, and ≥35 were 0.72 (0.61, 0.84), 0.92 (0.85, 1.00), 1.08 (1.00, 1.17), and 1.00 (0.89, 1.12), respectively. LIMITATIONS, REASONS FOR CAUTION Although the examined covariates did not meaningfully affect the associations, we had limited information on the participants’ mother. Differences by maternal age in reproductive history, infertility risk factors and loss to follow-up suggest that selection bias may partly explain our results. WIDER IMPLICATIONS OF THE FINDINGS Our finding that maternal age 35 years or older was not associated with daughter’s fecundability is reassuring, considering the trend towards delayed childbirth. However, having been born to a young mother may be a marker of low fecundability among pregnancy planners. STUDY FUNDING/COMPETING INTEREST(S) PRESTO was funded by NICHD Grants (R21-HD072326 and R01-HD086742) and has received in-kind donations from Swiss Precision Diagnostics, FertilityFriend.com, Kindara.com, and Sandstone Diagnostics. Dr Wise is a fibroid consultant for AbbVie, Inc. TRIAL REGISTRATION NUMBER n/a

Follow-Up Imaging in Patients with Blunt Splenic or Hepatic Injury Managed Nonoperatively

2018 ◽  
Vol 84 (2) ◽  
pp. 208-214 ◽  
Author(s):  
R. Viola Mebert ◽  
Beat SchnÜRiger ◽  
Daniel Candinas ◽  
Tobias Haltmeier
Keyword(s):  
Nonoperative Management ◽  
Imaging Modality ◽  
Ct Scans ◽  
Lower Grade ◽  
Contrast Enhanced Ultrasound ◽  
Promising Alternative ◽  
Contrast Enhanced ◽  
Pubmed Database ◽  
Hepatic Injuries

Nonoperative management of blunt splenic and hepatic injuries has become the standard of care for hemodynamically stable patients. However, nonoperative management may lead to delayed complications and appropriate follow-up is therefore crucial. The aim of this systematic literature review was to assess the role of different imaging modalities in the follow-up assessment of patients with blunt splenic or hepatic injuries using the PubMed database. Eighteen studies were found to be relevant to the topic. A total of 2725 patients were enrolled in the included studies. Both retrospective and prospective studies, but no randomized controlled trials were found. In these studies, CT, ultrasound, and contrast-enhanced ultrasound were discussed. CT was the most commonly used imaging modality. Taking into account all studies included, only one patient underwent intervention due to a complication diagnosed by follow-up CTscan in the absence of clinical signs and symptoms. This equates to a total of 920 CT scans performed to diagnose one clinically nonevident complication that required intervention. Based on the reviewed literature, routine imaging follow-up CT scans may not be indicated in asymptomatic patients with lower grade blunt splenic or hepatic injuries. Contrast-enhanced ultrasound is a promising alternative imaging modality for the follow-up of these patients.

Esthetic Restorative Options for Pulpotomized Primary Molars: A Review of Literature

2011 ◽  
Vol 36 (2) ◽  
pp. 123-126 ◽  
Author(s):  
Marcio Guelmann ◽  
Joseph Shapira ◽  
Daniela Silva ◽  
Anna Fuks
Keyword(s):  
Hybrid Composites ◽  
Primary Molars ◽  
Glass Ionomer ◽  
Limited Information ◽  
Resin Modified Glass Ionomer ◽  
Alternative Materials ◽  
Long Term Follow Up ◽  
Better Than

Objective: The goal of this manuscript was to review the existing literature in regards to esthetic options to restore pulpotomized primary molars. Study design: A pubmed literature search has been performed and all relevant studies were assessed. Results: Two laboratory, 3 restrospective and 4 prospective clinical studies were found, reviewed and analyzed. Conclusions: Based on the limited information available, we concluded that tooth colored and bonded restorations showed promising results as alternative materials to replace stainless steel crowns after pulpotomies in primary molars. Hybrid composites tend to perform better than compomers. Resin modified glass ionomer cements demonstrated excellent marginal seal and retention. More long-term follow up studies are necessary until more definitive recommendations can be made.

Selective Prescribing of Spasmolytics

2000 ◽  
Vol 34 (6) ◽  
pp. 716-720 ◽  
Author(s):  
Kris LL Movig ◽  
Antoine CG Egberts ◽  
Albert W Lenderink ◽  
Hubert GM Leufkens
Keyword(s):  
Clinical Practice ◽  
Initial Therapy ◽  
Daily Clinical Practice ◽  
New Drugs ◽  
Therapeutic Effects ◽  
Policy Makers ◽  
Pharmacy And Therapeutics Committees ◽  
Third Line ◽  
Trial Setting

BACKGROUND: Daily clinical practice often differs largely from the clinical trial setting, so extrapolation of outcomes from trial data, such as safety, effectiveness, and economic outcomes, can be deceptive. Prescribers may intend to treat a selected group of patients with new drugs; this practice could result in significant bias in assessing outcomes of these agents during their use in daily clinical practice. OBJECTIVE: To evaluate what type of patient received tolterodine compared with the spasmolytic drugs previously marketed (oxybutynin, flavoxate, emepronium). DESIGN: An observational, follow-up study. SETTING: Eighteen collaborating community pharmacies. PATIENTS: Aged ≥18 years, noninstitutionalized; initial therapy with tolterodine, oxybutynin, flavoxate, or emepronium. RESULTS: Tolterodine was often used as a second-line and even as a third-line treatment, and was prescribed to a “polluted” population in terms of concomitant psychotropic medication. Tolterodine users were 7.5 times more likely to have received another spasmolytic drug (RR 7.5, 95% CI 4.8 to 11.9). In addition, these patients more frequently used antiparkinsonian drugs (RR 4.1, 95% CI 1.6 to 10.4) as well as antipsychotic drugs (RR 2.9, 95% CI 1.4 to 6.2). There was a small difference in concomitant use of antidepressants and benzodiazepines between patients receiving tolterodine versus those taking other spasmolytic drugs. CONCLUSIONS: Tolterodine is prescribed for a population differing from that receiving previously marketed spasmolytic drugs. Selective prescribing should be recognized when evaluating new drugs in daily clinical practice. Policy makers, such as pharmacy and therapeutics committees, should consider this aspect in their formulary decisions since selective prescribing can lead to unjustified conclusions about a drug's therapeutic effects (e.g., efficacy, safety, cost-effectiveness).

scholarly journals Recovery of new-onset kidney disease in COVID-19 patients discharged from hospital

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nan-Hui Zhang ◽  
Yi-Chun Cheng ◽  
Ran Luo ◽  
Chun-Xiu Zhang ◽  
Shu-Wang Ge ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Kidney Diseases ◽  
Descriptive Statistics ◽  
Limited Information ◽  
High Discharge ◽  
Discharged Patients ◽  
Recovery Group ◽  
Abundant Data ◽  
New Onset

Abstract Background Coronavirus disease 2019 (COVID-19) has emerged as a major global health threat with a great number of deaths worldwide. Despite abundant data on that many COVID-19 patients also displayed kidney disease, there is limited information available about the recovery of kidney disease after discharge. Methods Retrospective and prospective cohort study to patients with new-onset kidney disease during the COVID-19 hospitalization, admitted between January 28 to February 26, 2020. The median follow-up was 4 months after discharge. The follow-up patients were divided into the recovery group and non-recovery group. Descriptive statistics and between-groups comparison were used. Results In total, 143 discharged patients with new-onset kidney disease during the COVID-19 hospitalization were included. Patients had a median age was 64 (IQR, 51–70) years, and 59.4% of patients were men. During 4-months median follow-up, 91% (130 of 143) patients recovered from kidney disease, and 9% (13 of 143) patients haven’t recovered. The median age of patients in the non-recovery group was 72 years, which was significantly higher than the median age of 62 years in the recovery group. Discharge serum creatinine was significantly higher in the non-recovery group than in the recovery group. Conclusions Most of the new-onset kidney diseases during hospitalization of COVID-19 patients recovered 4 months after discharge. We recommend that COVID-19 patients with new-onset kidney disease be followed after discharge to assess kidney recovery, especially elderly patients or patients with high discharge creatinine.

scholarly journals Delayed Perforation of the Large Bowel due to Thermal Injury during Laparoscopic Cholecystectomy

2005 ◽  
Vol 33 (3) ◽  
pp. 360-363 ◽  
Author(s):  
A Polychronidis ◽  
AK Tsaroucha ◽  
AJ Karayiannakis ◽  
S Perente ◽  
E Efstathiou ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Large Bowel ◽  
Thermal Injury ◽  
Clinical Signs ◽  
Exploratory Laparotomy ◽  
Hepatic Flexure ◽  
Temporary Ileostomy ◽  
Delayed Perforation

We report a case of delayed perforation of the large bowel because of thermal injury during a laparoscopic cholecystectomy. A 78-year-old male with symptomatic cholelithiasis underwent a difficult laparoscopic cholecystectomy because of multiple adhesions resulting from two previous cholecystitis episodes. The patient recovered well after surgery and was discharged on post-operative day 2. On postoperative day 10, the patient returned to the hospital with peritonitis. An exploratory laparotomy revealed perforation of the wall of the hepatic flexure of the large bowel, which was centred in a necrotic area 1 cm in diameter. The perforation was sutured and a temporary ileostomy performed, which was closed at a later date. The patient was doing well at a 10-month follow-up review. A delayed rupture of any part of the bowel after laparoscopic surgery can be potentially fatal if not treated during an emergency exploratory laparotomy, even if the clinical signs are not severe.

scholarly journals A rare case of mixed germ cell tumor in a teenage girl: a case report

2017 ◽  
Vol 6 (6) ◽  
pp. 2663
Author(s):  
Faraz S. Vali ◽  
Amit Kyal ◽  
Parul I. Chaudhary ◽  
Sujatha Das ◽  
Aprateem Mukherjee ◽  
...  
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumor ◽  
Embryonal Carcinoma ◽  
Germ Cell Tumors ◽  
Cell Tumor ◽  
Ca 125 ◽  
Gestational Choriocarcinoma ◽  
Mixed Germ Cell Tumor ◽  
Initial Surgery ◽  
Alpha Feto Protein

Germ cell tumors represent only 20% to 25% of all benign and malignant ovarian neoplasms. Mixed germ cell tumors are a rare variety of non–dysgerminomatous germ cell tumors. They contain two or more elements; the most frequent combination being a dysgerminoma and an EST (Endodermal Sinus Tumor). We present a case of malignant mixed germ cell tumor comprising of yolk sac tumor, embryonal carcinoma and choriocarcinoma. A 13-year-old girl presented with a huge 25 x 18 cm mass in abdomen with raised values of CA-125, hCG, AFP (alpha-feto protein) and LDH (lactate dehydrogenase). She underwent laparotomy followed by unilateral salpingoopherectomy and infracolic omentectomy. Histopathology report revealed malignant mixed germ cell tumor comprising predominantly of EST with elements of embryonal carcinoma and non-gestational choriocarcinoma. Following surgery, she was started on adjuvant chemotherapy (Bleomycin, Etoposide and Cisplatin regimen). Mixed germ cell tumor (YST/EST, non-gestational choriocarcinoma and embryonal carcinoma) is a very rare tumor. Careful initial surgery with adequate staging biopsies followed by combination chemotherapy can greatly improve the prognosis of these patients

scholarly journals Olanzapine-high potency antipsychotic drug inducing significant weight gain: A case report

2008 ◽  
Vol 136 (5-6) ◽  
pp. 284-288 ◽  
Author(s):  
Nadja Maric ◽  
Dragana Josifovic-Kostic ◽  
Olivera Vukovic ◽  
Dubravka Britvic ◽  
Miroslava Jasovic-Gasic
Keyword(s):  
Weight Gain ◽  
Psychotic Disorders ◽  
Vascular Diseases ◽  
Initial Response ◽  
Young Female ◽  
The Body ◽  
Average Weight ◽  
Therapeutic Effects ◽  
Significant Weight Gain ◽  
High Level

INTRODUCTION Olanzapine is a second generation antipsychotic (SGA) with a high level of therapeutic effectiveness in schizophrenia and other psychotic disorders. Along with the positive therapeutic effects, an increase of the body weight frequently occurs. According to the literature, the average weight gain is about 6-7 kg during several months of treatment. This could be valued as a moderate weight increase. CASE OUTLINE This article presents a case of a young female with schizophrenia, without clinical improvement with several antipsychotics (clozapine, risperidone, haloperidol) and with the occurrence of significant neurological side effects. The treatment started with olanzapine (baseline) was associated with good initial response (PANSS reduction 20% in the first two weeks) and the improvement was maintained further on (PANSS reduction 50% after 16 weeks). Significant increase (20 kg, 40%) in weight appeared during the following 16 weeks (BMI at baseline 17.9 kg/m2; BMI 16 weeks later 25.1 kg/m2). CONCLUSION High effectiveness of olanzapine in schizophrenia symptoms reduction was accompanied by a significant weight gain. However, this drug leads to impaired glucoregulation, dyslipidaemia etc. It also increases the risk of diabetes and cardio-vascular diseases, i.e. the main causes of mortality in schizophrenia after a suicide. Therefore, clinicians are suggested to focus on possible predictors of weight gain during olanzapine therapy, and act accordingly in order to prevent serious health consequences.

Sign in / Sign up

Export Citation Format

Share Document