scholarly journals Scar Tissue after a Cesarean Section—The Management of Different Complications in Pregnant Women

2021 ◽  
Vol 18 (22) ◽  
pp. 11998
Author(s):  
Aleksandra Stupak ◽  
Adrianna Kondracka ◽  
Agnieszka Fronczek ◽  
Anna Kwaśniewska
Keyword(s):  
Cesarean Section ◽  
Holistic Approach ◽  
Scar Tissue ◽  
Anterior Wall ◽  
Gravid Uterus ◽  
Front Wall ◽  
Cesarean Scar Pregnancy ◽  
Tissue Samples ◽  
Definition Of ◽  
Medical University

The definition of a cesarean scar pregnancy (CSP) is the localization of the gestational sac (GS) in the cicatrix tissue, which is created in the front wall of the uterus after a previous cesarean section (CS). The worldwide prevalence of CSP has been growing rapidly. However, there are no general recommendations regarding prophylaxis and treatment of the abnormalities of the anterior wall of the uterus discovered in a non-pregnant myometrium, or how to deal with existing cases of CSP. We present the latest knowledge, a holistic approach to the biology, histology, imaging, and management concerning post-CS scars based on our cases, which were treated in the Department of Pregnancy and Pathology of Pregnancy in the Medical University of Lublin, Poland. In our study, we present images of tissue samples of areas with a cicatrix in the uterus, and ultrasound and MRI images of CSP. We discuss the advances in the biology of the post-CS scar tissue, the prevention techniques used to repair the scar defect (niche) before the pregnancy, and the treatment of different complications of CSP, such as the rupture of the gravid uterus or the dehiscence of the myometrium.

Comparative Study of Ultrasound Signs of Scar Pregnancy in Patients with Cesarean Section and Their Clinical Outcomes

2021 ◽  
Vol 11 (3) ◽  
pp. 886-893
Author(s):  
Shasha Xie ◽  
Wei Dong ◽  
Yeting Liu ◽  
Haixiao Gao
Keyword(s):  
Cesarean Section ◽  
Uterine Cavity ◽  
Clinical Work ◽  
Posterior Wall ◽  
Anterior Wall ◽  
Clinical Value ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
First Choice ◽  
New Type

Caesarean scar pregnancy is the implantation of fertilized eggs in the scar of the previous cesarean section in the lower uterus. It is a serious long-term complication after cesarean section. Ultrasound examination, as the first choice to evaluate cesarean scar pregnancy plays an important role in its diagnosis, treatment and follow-up. This study first tried to propose new ultrasound diagnostic indicators to distinguish cesarean scar pregnancy from non-scar pregnancy of the lower uterine cavity; Logistic regression analysis was used to screen for risk factors related to scar pregnancy bleeding, with a view to providing clinical ultrasound indicators to predict bleeding risk; Secondly, the use of contrast-enhanced ultrasound and three-dimensional ultrasound to observe the scar diverticulum of cesarean section more than six months after the different surgical treatments of scar pregnancy, and to evaluate whether surgical scar repair can improve the scar diverticulum. Finally, using ultrasound to predict the position of the embryonic placenta, the new type of scar pregnancy in cesarean section is divided into three types: anterior wall placenta, anterior wall posterior placenta and posterior wall placental. The three types of CSP have significant differences in the thickness of the muscular layer in the scar of the lower part of the anterior wall of the uterus, the blood flow in the scar of the lower part of the anterior wall of the uterus, the number of days of hospitalization, the treatment method, and the treatment effect, which indicate that the new type is used for the diagnosis of CSP. Treatment and prognosis evaluation have high clinical value, can be used to guide clinical work, and provide a new idea for clinical diagnosis and treatment.

scholarly journals Protocol Deviations: A Holistic Approach from Defining to Reporting

2021 ◽  
Author(s):  
Laura Galuchie ◽  
Catherine Stewart ◽  
Frank Meloni
Keyword(s):  
Holistic Approach ◽  
Rapid Identification ◽  
Study Program ◽  
Protocol Deviation ◽  
Definition Of ◽  
Investigational Agents ◽  
Or Organization ◽  
Study Designs ◽  
Consistent Application

AbstractImproving interpretation of existing guidelines and management of protocol deviation processes could increase process efficiencies and help reduce noise to support rapid identification of important protocol deviations. Towards this end, TransCelerate identified key principles to build upon and clarify the definition of a protocol deviation and developed a holistic approach to protocol deviation management. The approaches are flexible to suit a variety of indications, study designs, and investigational agents while also supporting consistent application within a study, program or organization.

scholarly journals Analysis of risk factors for determining the need for prostate biopsy in patients with negative MRI

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Linghui Liang ◽  
Feng Qi ◽  
Yifei Cheng ◽  
Lei Zhang ◽  
Dongliang Cao ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Detection Efficiency ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Multivariable Logistic Regression Analysis ◽  
Detection Rates ◽  
Prostate Biopsies ◽  
Clinically Significant ◽  
Definition Of ◽  
Medical University

AbstractTo analyze the clinical characteristics of patients with negative biparametric magnetic resonance imaging (bpMRI) who didn’t need prostate biopsies (PBs). A total of 1,012 male patients who underwent PBs in the First Affiliated Hospital of Nanjing Medical University from March 2018 to November 2019, of 225 had prebiopsy negative bpMRI (defined as Prostate Imaging Reporting and Data System (PI-RADS 2.1) score less than 3). The detection efficiency of clinically significant prostate cancer (CSPCa) was assessed according to age, digital rectal examination (DRE), prostate volume (PV) on bpMRI, prostate-specific antigen (PSA) and PSA density (PSAD). The definition of CSPCa for Gleason score > 6. Univariate and multivariable logistic regression analysis were used to identify predictive factors of absent CSPCa on PBs. Moreover, absent CSPCa contained clinically insignificant prostate cancer (CIPCa) and benign result. The detection rates of present prostate cancer (PCa) and CSPCa were 27.11% and 16.44%, respectively. Patients who were diagnosed as CSPCa had an older age (P < 0.001), suspicious DRE (P < 0.001), a smaller PV (P < 0.001), higher PSA value (P = 0.008) and higher PSAD (P < 0.001) compared to the CIPCa group and benign result group. PSAD < 0.15 ng/ml/cm3 (P = 0.004) and suspicious DRE (P < 0.001) were independent predictors of absent CSPCa on BPs. The negative forecast value of bpMRI for BP detection of CSPCa increased with decreasing PSAD, mainly in patients with naive PB (P < 0.001) but not in prior negative PB patients. 25.33% of the men had the combination of negative bpMRI, PSAD < 0.15 ng/ml/cm3 and PB naive, and none had CSPCa on repeat PBs. The incidence of PB was determined, CSPCa was 1.59%, 0% and 16.67% in patients with negative bpMRI and PSAD < 0.15 ng/ml/cm3, patients with negative bpMRI, PSAD < 0.15 ng/ml/cm3 and biopsy naive and patients with negative bpMRI, PSAD < 0.15 ng/ml/cm3 and prior negative PB, separately. We found that a part of patients with negative bpMRI, a younger age, no suspicious DRE and PSAD < 0.15 ng/ml/cm3 may securely avoid PBs. Conversely PB should be considered in patients regardless of negative bpMRI, especially who with a greater age, obviously suspicious DRE, significantly increased PSA value, a significantly small PV on MRI and PSAD > 0.15 ng/ml/cm3.

Separation or Synthesis: A Holistic Approach to Therapeutics

1996 ◽  
Vol 17 (8) ◽  
pp. 279-283
Author(s):  
Kathi J. Kemper
Keyword(s):  
Health Care ◽  
Nurse Practitioners ◽  
Low Cost ◽  
Self Regulation ◽  
Holistic Approach ◽  
Medical Settings ◽  
The Public ◽  
Specialized Health Care ◽  
Definition Of ◽  
Spiritual Healers

Over the past 50 years, health care has grown more complex and specialized. Health-care institutions now are staffed with an array of specialist physicians, social workers, psychologists, therapists, and nutritionists as well as general practitioners and nurses. The types of providers outside of the hospital are even more numerous and diverse: physicians; nurses; nurse practitioners; chiropractors; counselors; acupuncturists; herbalists; spiritual healers; and purveyors of nutritional supplements, aromatherapy, crystals, and more. Intent on distinguishing their "products," providers focus on differences, polarizing into distinct camps such as "mainstream or traditional" versus "alternative or unconventional." Although these dichotomies are simple, they also can mislead. The definition of "alternative" is very dependent on the definition "mainstream"; acupuncture may be an alternative in one setting, but it clearly is traditional within Asian communities. Therapies that once were considered unconventional, such as hypnosis and meditation, have moved into many mainstream medical settings. (See Sugarman article "Hypnosis: Teaching Children Self-regulation" in the January 1996 issue of Pediatrics in Review.) The public wants health care that is low-cost, safe, effective, and personalized. Practitioners of "natural" therapies often are viewed as more humanistic and less technological than busy physicians. According to one study, in 1990, alternative medical therapies were used by nearly one third of Americans.1

Limitations of studying keloid scars using the nude athymic mouse model

2002 ◽  
Vol 10 (2) ◽  
pp. 56-61 ◽  
Author(s):  
Mp Hillmer ◽  
S Salama ◽  
Sm Macleod
Keyword(s):  
Mouse Model ◽  
Scar Tissue ◽  
In Vivo Studies ◽  
Athymic Mice ◽  
Athymic Mouse ◽  
Tissue Samples ◽  
Keloid Scars ◽  
Central Calcification ◽  
Sample Identity

Keloid scars are benign fibroproliferative growths that respond poorly to treatment. This study sought to determine the efficacy of three different glucocorticoids (triamcinolone, methylprednisolone and dexamethasone) in altering human keloid scar tissue implanted in athymic mice. Keloid tissue obtained from three patients (one man and two women) who sought cosmetic removal of their scars was implanted into athymic mice for a duration of 15 or 30 days. The keloid tissue was examined histopathologically and evaluated by a dermatopathologist who was blinded to sample identity and who was using predetermined qualitative scoring criteria. The appearance of central calcification, granulation tissue, foreign body granulomatous reaction and acute inflammatory reaction complicated the comparison of the keloid tissue samples. However, on the basis of observations reported in the present paper, it appears that triamcinolone should remain the treatment of choice for keloid scars. The athymic mouse model that is used for studying keloid scars is the best available approach to in vivo studies; however, limitations identified in this study confound the interpretation of experimental data. Ideally, promising and novel therapies should be investigated clinically.

scholarly journals Study on the method of enucleation of anterior uterine fibroids by transverse incision of the lower uterine segment during cesarean section

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yan Dai ◽  
Li Xia ◽  
Jinxiao Lin ◽  
Rongli Xu ◽  
Wenqiang You
Keyword(s):  
Cesarean Section ◽  
Operation Time ◽  
Anterior Wall ◽  
Control Group ◽  
Study Group ◽  
Transverse Incision ◽  
Postoperative Fever ◽  
Postoperative Changes ◽  
Perioperative Bleeding ◽  
Surgical Data

Abstract Introduction A retrospective study was conducted to investigate the effectiveness and feasibility of fibroid enucleation in the anterior wall of the uterus by transverse uterine incision during cesarean section. Methods The medical history, surgical data, preoperative and postoperative changes in the blood system, and complications of 90 pregnant women who underwent myomectomy of the anterior uterine wall during cesarean section at the second Department of Maternal and Child Health Hospital of Fujian Province were analyzed retrospectively. Results No significant differences were noted in the leiomyoma number, pathological type, preoperative and postoperative hemoglobin level, perioperative bleeding incidence, blood transfusion frequency, postoperative fever incidence, and duration of lochia between the study and control groups. The proportion of large fibroids was slightly higher in the study group than in the control group (p < 0.05), and the operation time and average hospitalization time were slightly longer in the study group than in the control group (p < 0.05). The distribution of type III–V fibroids was slightly more in the study group than in the control group (p < 0.05), and the distribution of type VI fibroids in the study group was less than that in the control group (p < 0.05). Conclusion Fibroid enucleation is safe and effective in the anterior wall of the uterus through the lower uterine transverse incision in cesarean section. It has the potential to reduce the risk of pelvic and intrauterine adhesions in the future.

THE INFLUENCE OF THE SCHOOL OF HEALTH ON THE TREATMENT OF PATIENTS ON THE EXAMPLE OF ARTERIAL HYPERTENSION

2021 ◽  
pp. 43-46
Author(s):  
К.Ю. Досмаганбетова ◽  
А.Б. Исса ◽  
И.Е. Михайлова
Keyword(s):  
Arterial Hypertension ◽  
Medical Care ◽  
Well Being ◽  
Statistical Information ◽  
Emergency Medical Care ◽  
Dynamic Changes ◽  
National Medical ◽  
Definition Of ◽  
Medical University

В статье «Влияние школы здоровья на лечение пациентов на примере артериальной гипертензии», написанной интернами 7го курса НАО «Национального Медицинского Университета им. С.Д. Асфендиярова» Досмаганбетовой К.Е., Иса А.Б под кураторством ассистента кафедры ВОП2 Михайловой И.Е., представлен обзор на школу здоровья, а именно на ее часть, занимающуюся артериальной гипертензией. Собраны статистические сведения об участниках, дано определение термина «школа здоровья» и рассмотрено её влияние на качество лечения пациентов. На основе полученных данных проведен анализ динамических изменений по части грамотности населения в вопросах «управления» артериальной гипертензией, самочувствия пациентов, частоты обращения за «скорой медицинской помощью» и развития осложнений The article "The infiuence of the School of Health on the treatment of patients on the example of Arterial Hypertension", written by interns of the 7th year of the JSC "S.D. Asfendiyarov National Medical University" Dosmaganbetova K.Y., Issa A. B. under the supervision of the assistant of the GPM-2 department Mikhailova I.E., provides an overview of the school of health, namely, its department dealing with arterial hypertension. The article includes statistical information about the participants, definition of the term "school of health", and information about its impact on the quality of treatment. On the basis of the obtained data, the analysis of dynamic changes in the population's literacy in issues of "management" of arterial hypertension, the well-being of patients, the frequency of seeking "emergency medical care" and the development of complications was carried out.

scholarly journals Laparoscopically Assisted Vaginal Hysterectomy for Women With Anterior Wall Adherence After Cesarean Section

2014 ◽  
Vol 18 (3) ◽  
pp. e2014.00315
Author(s):  
Sue Yeon Park ◽  
Jung Hun Lee ◽  
Joong Sub Choi ◽  
Jaeman Bae ◽  
Won Moo Lee ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Vaginal Hysterectomy ◽  
Anterior Wall ◽  
Laparoscopically Assisted Vaginal Hysterectomy

Life Cycle Management and Sharing Economy

2020 ◽  
pp. 152-166
Author(s):  
Roberta Guglielmetti Mugion ◽  
Gabriella Arcese ◽  
Martina Toni ◽  
Luca Silvestri
Keyword(s):  
Life Cycle ◽  
Service Industry ◽  
Sustainability Assessment ◽  
Holistic Approach ◽  
Life Cycle Management ◽  
Sharing Economy ◽  
Management Tool ◽  
Life Cycle Thinking ◽  
Sustainable Value ◽  
Definition Of

The life cycle sustainability assessment based on Life Cycle Thinking is currently considered the most crucial paradigm that includes three kinds of sustainability variables. Life cycle management (LCM) is the most holistic approach in promoting sustainable value creation, embedding the social, economic, and environmental dimensions as a management tool. LCM is mainly applied in the manufacturing and products chain, whereas it is understudied in the service industry. This chapter proposes the development of the LCM general framework and the definition of indicators for the assessment of sustainability in the urban shared mobility. The research framework has been tested in the transportation sector focusing on car sharing context.

Sign in / Sign up

Export Citation Format

Share Document