Clinical-ultrasound and clinical-morphological characteristics of adnexal torsion in girls and adolescents

2021 ◽  
Vol 90 (1) ◽  
pp. 81-87
Author(s):  
I.O. Tuchkina ◽  
S.V. Kiebashvili ◽  
O.V. Piontkovska ◽  
N.V. Romanova

Clinical-ultrasound and clinical-morphological characteristics of adnexal torsion to the improvement of early diagnosis and development of optimal ways of organ-preserving surgical tactics of treatment have been determined. An analysis was carried out of 71 patients with adnexal torsion (group 1– 30 girls of 2–12 years, group 2 – 41 adolescents of 13–17 years). The main clinical signs of adnexal torsion were nonspecific and similar to the well-known clinic of acute abdomen. Ultrasound examination with color doppler mapping (CDM) allowed to suspect adnexal torsion in 44 (62 %) patients. The main echographic features of adnexal torsion were: ovarian enlargement, non-typical location and a change in the structure of ovary, the presence of a free liquid in the cavity of a small pelvis or in the abdominal cavity, «a symptom of springs» (a twisted vascular leg), a decrease or absence of blood flow in CDM. The torsion of intact uterine appendages is installed in 29 patients (twice as often in group 1). In 42 cases were detected the torsion of the uterine appendages, compromised by the presence of tumors and tumor-like formations (twice as often in group 2). In both groups, 36 (50.7 %) organ-preserving and 35 (49.3 %) radical operations were carried out. According to the results of morphological examination of the removed tissues, the following data were obtained: follicular cysts – 15, paratubal cysts – 8, corpus luteum cysts – 8, teratomas – 5, serous cystadenomas – 2, mucinous cystadenoma – 1, paraovarian cysts – 3. Differential diagnosis of adnexal torsion in girls and adolescents should include a thorough collection of anamnestic data, taking into account the features of the clinical course of the disease, the results of a comprehensive examination with an assessment of ultrasound data from CDM, computer and magnetic resonance imaging, which will contribute to the advanced adequate selection of tactics of urgent gynecological intervention. The method of choice for the treatment of adnexal torsion is a minimally invasive surgical intervention – a laparoscopy with organ-preserving operations. Keywords: adnexal torsion, girls, ultrasound and morphological characteristics.

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e022776 ◽  
Author(s):  
Dominique Dos Reis ◽  
Laurie Fraticelli ◽  
Adrien Bassand ◽  
Stéphane Manzo-Silberman ◽  
Nicolas Peschanski ◽  
...  

ObjectivesCardiorenal syndrome (CRS) is the combination of acute heart failure syndrome (AHF) and renal dysfunction (creatinine clearance (CrCl) ≤60 mL/min). Real-life data were used to compare the management and outcome of AHF with and without renal dysfunction.DesignProspective, multicentre.SettingTwenty-six academic, community and regional hospitals in France.Participants507 patients with AHF were assessed in two groups according to renal function: group 1 (patients with CRS (CrCl ≤60 mL/min): n=335) and group 2 (patients with AHF with normal renal function (CrCl >60 mL/min): n=172).ResultsDifferences were observed (group 1 vs group 2) at admission for the incidence of chronic heart failure (56.42% vs 47.67%), use of furosemide (60.9% vs 52.91%), insulin (15.52% vs 9.3%) and amiodarone (14.33% vs 4.65%); additionally, more patients in group 1 carried a defibrillator (4.78% vs 0%), had ≥2 hospitalisations in the last year (15.52% vs 5.81%) and were under the care of a cardiologist (72.24% vs 61.63%). Clinical signs were broadly similar in each group. Brain-type natriuretic peptide (BNP) and BNP prohormone were higher in group 1 than group 2 (1157.5 vs 534 ng/L and 5120 vs 2513 ng/mL), and more patients in group 1 were positive for troponin (58.2% vs 44.19%), had cardiomegaly (51.04% vs 37.21%) and interstitial opacities (60.3% vs 47.67%). The only difference in emergency treatment was the use of nitrates, (higher in group 1 (21.9% vs 12.21%)). In-hospital mortality and the percentage of patients still hospitalised after 30 days were similar between groups, but the median stay was longer in group 1 (8 days vs 6 days).ConclusionsRenal impairment in AHF should not limit the use of loop diuretics and/or vasodilators, but early assessment of pulmonary congestion and close monitoring of the efficacy of conventional therapies is encouraged to allow rapid and appropriate implementation of alternative therapies if necessary.


2018 ◽  
Vol 70 (3) ◽  
pp. 656-660
Author(s):  
R.S. Rezende ◽  
D. Eurides ◽  
C.P. Barbosa ◽  
M.S. Lacerda ◽  
R.L. Sampaio ◽  
...  

ABSTRACT The aim of this study was to evaluate the effectiveness of a GnRH synthetic analog, as an estrous inducer in female dogs when administered during the anestrous phase, and to evaluate the pregnancy rate achieved through natural copulation. For this purpose, ten female dogs of different breeds were used. The subjects received buserelin by intramuscular injections at a dose of 2,1mcg when female dogs weighed up to 10kg (Group 1) and of 4,2mcg when the dogs weighed above 10kg (Group 2). Of the ten subjects, only three presented estrus after a single injection of buserelin: two dogs from Group 1 and one dog from Group 2 on average 7±1.29 days. The remaining seven dogs were given a second dose of buserelin, equal to the first administration. Of these, three belonged to Group 1 and four to Group 2. Four of these dogs exhibited clinical signs of estrus within, on average 9±7.3 days from the second injection. The seven female dogs that did enter estrus were fertilized successfully through natural copulation. The administration of buserelin was effective in inducing estrus in female dogs during the anestrous phase, with a maximum of two administrations.


2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
R I Hodas ◽  
D Opincariu ◽  
N Rat ◽  
I Rodean ◽  
M Chitu ◽  
...  

Abstract Funding Acknowledgements PlaqueImage.- research grant no. 103544/2016, contract number 26/01.09.2016 - Background Previous studies demonstrated that plaque morphology has a crucial role in the development of an acute coronary syndrome (ACS). However, not all vulnerable coronary plaques produce an ACS and the prediction power of various vulnerability features to predict an acute coronary event in a close future, has not been elucidated so far. Objective We aimed to use multi-slice computed tomography angiography (CTA) for assessment of morphological characteristics of culprit lesions producing an ACS in the next several months after CT assessment, in comparison with morphological characteristics of unstable coronary atherosclerotic plaques which did not trigger an ACS. Material and methods We analyzed 40 patients in whom CTA revealed presence of unstable coronary lesions, exhibiting at least one marker of vulnerability: napkin ring sign (NRS), spotty calcium (SC), positive remodeling (PR) or presence of low attenuation plaque (LAP), divided in 2 groups: group 1 - 20 patients who developed an ACS in the next 6 months following CTA examination, and group 2 – 20 patients matched for age, gender and risk factors, who did not present any cardiovascular event 6 month after CTA assessment. Post-processing of multi-slice CTA images was performed in order to assess morphological characteristics and CT-derived markers of atherosclerotic plaque instability. Results Similar mean values of plaque length (17.1 +/- 5.9 mm vs 16.9 +/- 3.4 mm; p = 0.6) and total atheroma volume (188.1 +/- 104.7 mm3vs 186.4 +/- 90.7 mm3; p = 0.8) were obtained for both groups. The mean number of vulnerability markers was 1.6 in group 1 vs 1.2 in group 2 (p = 0.07). However, atherosclerotic lesions in patients from group 1 presented significantly higher values of lipid-rich atheroma (9.8 +/- 10.8 mm3vs 2.6 +/- 1.0 mm3; p = 0.01) and remodeling index (1.14 +/- 0.3 in group 1 vs 0.89 +/- 0.19 in group 2, p = 0.04). At the same time, atheromatous plaques in patients who developed an ACS during the 6-months follow-up showed in a significantly higher proportion LAP (45% in group vs 10% in group 2, p = 0.03) and PR (15%in group 1 versus 5% in group 2, p = 0.04), but not NRS (30% vs 25%, p = ns) or SC (65% vs 40%, p = 0.2). Conclusions Atherosclerotic plaques producing an ACS exhibit a different phenotype than unstable plaques that remain silent. The CTA profile of atheromatous plaques producing an ACS includes the presence of low attenuation, positive remodeling, higher RI and lipid-rich atheroma. Presence of these features in high-risk coronary plaques identifies very high risk patients, who can benefit from adapted therapeutic strategy in order to prevent the development of an ACS.


Vaccines ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 734
Author(s):  
Nadirah Abu Nor ◽  
Mohd Zamri-Saad ◽  
Ina-Salwany Md Yasin ◽  
Annas Salleh ◽  
Farina Mustaffa-Kamal ◽  
...  

Vibrio harveyi causes vibriosis in various commercial marine fish species. The infection leads to significant economic losses for aquaculture farms, and vaccination is an alternative approach for the prevention and control of fish diseases for aquaculture sustainability. This study describes the use of formalin-killed Vibrio harveyi (FKVh) strain Vh1 as a vaccine candidate to stimulate innate and adaptive immunities against vibriosis in a marine red hybrid tilapia model. Tilapia are fast growing; cheap; resistant to diseases; and tolerant to adverse environmental conditions of fresh water, brackish water, and marine water and because of these advantages, marine red hybrid tilapia is a suitable candidate as a model to study fish diseases and vaccinations against vibriosis. A total of 180 healthy red hybrid tilapias were gradually adapted to the marine environment before being divided into two groups, with 90 fish in each group and were kept in triplicate with 30 fish per tank. Group 1 was vaccinated intraperitoneally with 100 µL of FKVh on week 0, and a booster dose was similarly administered on week 2. Group 2 was similarly injected with PBS. Skin mucus, serum, and gut lavage were collected weekly for enzyme-linked immunosorbent assay (ELISA) and a lysozyme activity assay from a total of 30 fish of each group. On week 4, the remaining 60 fish of Groups 1 and 2 were challenged with 108 cfu/fish of live Vibrio harveyi. The clinical signs were monitored while the survival rate was recorded for 48 h post-challenge. Vaccination with FKVh resulted in a significantly (p < 0.05) higher rate of survival (87%) compared to the control (20%). The IgM antibody titer and lysozyme activities of Group 1 were significantly (p < 0.05) higher than the unvaccinated Groups 2 in most weeks throughout the experiment. Therefore, the intraperitoneal exposure of marine red hybrid tilapia to killed V. harveyi enhanced the resistance and antibody response of the fish against vibriosis.


2011 ◽  
Vol 58 (2) ◽  
pp. 57-60 ◽  
Author(s):  
Joao Paulo Steffens ◽  
Márcia Thaís Pochapski ◽  
Fábio André Santos ◽  
Gibson Luiz Pilatti

Abstract The aim of this study was to evaluate the influence of 2 anesthetic agents on patients' postoperative pain perception after periodontal surgery. For this parallel-group, double-blinded, randomized clinical trial, 36 open flap debridement surgeries were performed on patients who presented with periodontal disease with clinical signs of inflammation after nonsurgical treatment on at least 1 quadrant. Patients were allocated to 1 of the following groups: group 1, 2% lidocaine with 1 ∶ 100,000 epinephrine; group 2, 2% mepivacaine with 1 ∶ 100,000 norepinephrine. Pain intensity was assessed using the visual analog scale during the first 8 hours after surgery. All patients received 750-mg acetaminophen tablets, which they were instructed to take as a rescue medication if necessary. The results demonstrated that postoperative pain intensity was statistically lower in group 2 than in group 1 at the 1-, 2-, and 3-hour periods after surgery, although the pain intensity for all groups could be considered mild. In conclusion, patients in both groups reported similar mild pain after periodontal surgery.


2015 ◽  
Vol 21 (1-2) ◽  
Author(s):  
M. Jevcsák ◽  
M. Ördögh ◽  
E. Jámbor-Benczúr

After different pre-culturing period (12, 23 or 34 days) on ½ MS medium with 1 mg l-1 paclobutrazol, 1 mg l-1 N6-benzyladenine and 0.1 mg l-1 1- naphthaleneacetic acid , 3 groups of Narcissus poeticus ssp. radiiflorus bulb scales were kept on the same medium without hormones. The results were evaluated monthly and the final one happened after 7 month. The best results were achieved due to the shortest pre-culturing period (12 days;  Group 1), with 4.9 bulblets and 4.54% hyperhydricity. The result of the second treatment (pre-culturing period of 23 days; Group 2) was not different significantly but the number of bigger bulblet were higher (4.54 bulblets). After the longest pre-culturing period (34 days; Group 3), the number of bulblets was low (3.68) and more hyperhydricity (18.18%) was detected. The highest number of roots (13.91) was observed in this groupvery likely due to the strong after-effect of paclobutrazol.


2019 ◽  
Vol 11 (4) ◽  
pp. 379-386
Author(s):  
Iniobong C.I. UGOCHUKWU ◽  
Sunday I. IDOKO ◽  
Jacinta N. OMEKE ◽  
Chioma I. ANEKE ◽  
Nuhu A. SANI ◽  
...  

Peste des petits ruminants poses a major threat to the development of small ruminant production. The objective of this study was to determine the comparative efficacy of amantadine hydrochloride (HCl), oxytetracycline long acting (LA) and levamisole in West African dwarf (WAD) goats experimentally infected with PPR. In addition to the presence of the characteristic clinical signs, complement ELISA and haem agglutination inhibition (HI) tests were used to confirm PPR infection in the West African dwarf goats, then treatment was instituted in the different groups namely, group 1 which was treated with amantadine HCl orally, oxytetracycline LA intramuscularly (IM) and levamisole per os. Group 2 was treated with oxytetracycline LA IM and levamisole. Group 3 was treated with levamisole while group 4 served as untreated control. The physiological parameters namely rectal temperature, pulse rate and respiratory rates of the different groups were recorded. The mortality rates in the different treatment groups were also recorded. The respiratory rates of the WAD goats increased as the infection progressed, but the increase was not significant (P>0.05). The treatment helped reduce the respiratory rates in the treated WAD. The rectal temperatures of all the animals in the different treatment groups increased only slightly as the infection progressed and was not significant (P>0.05). The percentage mortalities were 0% in Group 1, 25% in the Group 2, 50% in the treated group 3 and highest (75%) in the untreated group respectively. In conclusion, incorporation of specific antiviral agents like amantadine hydrochloride in the treatment regimen with oxytetracycline and levamisole particularly during the early stages of the infection can reduce morbidity and mortality of the disease to the barest minimum.


2021 ◽  
Vol 93 (2) ◽  
pp. 227-232
Author(s):  
Caner Ediz ◽  
Muhammed Cihan Temel ◽  
Suna Şahin Ediz ◽  
Serkan Akan ◽  
Serkan Yenigürbüz ◽  
...  

Background: This study aimed to determine the contribution of color Doppler ultrasonography (CDUS) performed before varicocelectomy to the success of surgical treatment and to evaluate the correlation between CDUS findings and semen parameters. Methods: A total of 84 patients diagnosed with grade 3 left varicocele in our clinic between 2016 and 2018 were evaluated. The patients in whom the decision for varicocelectomy was based on only physical examination (PE) findings and abnormal semen analysis (SA) were defined as Group 1, while the patients undergoing varicocelectomy based on PE, CDUS and SA findings were defined as Group 2. The patients diagnosed with varicocele based on PE and CDUS findings who were included in a followup protocol due to normal semen parameters were defined as Group 3. Results: In Group 1, there was a total of 28 patients and the mean number of ligated internal spermatic veins was 4.53 (range, 2-10). In Group 2, there was a total of 30 patients and the number of ligated internal spermatic veins was 3.76 (range, 1-8). No statistically significant difference was found between Group 1 and 2 in terms of the number of internal spermatic veins ligated during varicocelectomy. No statistically significant correlation was found between semen parameters and the number of veins ligated during varicocelectomy in Group 1 and 2 and between semen parameters and CDUS findings group 2 and 3. Conclusions: In patients with primary grade 3 varicocele, diagnosed by physical examination there is no need for additional imaging in primary cases.


2016 ◽  
Vol 19 (5) ◽  
pp. 383-387 ◽  
Author(s):  
Irina Alexandrovna Khripun ◽  
Sergey Vladislavovich Vorobyev ◽  
Maxim Nikolaevich Morgunov ◽  
Michail Iosifovich Kogan

Type 2 diabetes mellitus (T2DM) increases the risk of cardiovascular disease that is based on endothelial dysfunction (ED). Currently, conventional diagnostic methods are unreliable, especially at early stages of disease.Aims. The aim of this work was to assess endothelial function in men with T2DM without clinical signs of cardiovascular disease.Materials and methods. The study included 100 patients (mean age, 54.3 ± 5.3 years) with a T2DM duration of less than 10 years and without signs of cardiovascular disease. The patients were divided into two groups: group 1 consisted of 60 patients with a T2DM duration of less than five years. Group 2 included 40 men with a history of diabetes between 5 and 10 years. Endothelial function was assessed by the levels of nitric oxide (NO), endothelial NO synthase type 3 (eNOS3), ICAM-1, VCAM-1, E-selectin, P-selectin, resistin and C-reactive protein and the arterial vasoreactivity of the brachial artery (BA) using the D. Celermajer method.Results. Results revealed decreases in levels of both eNOS3 by 2.5 fold (P = 0.0005) and NO by 1.9 fold (P = 0.043) in group 2 patients, compared to those in group 1 patients. When the duration of diabetes was greater than five years, levels of VCAM-1, resistin and C-reactive protein increased by 12.1% (P = 0.048), 62% (P = 0.01) and 45.6%, respectively. Additionally, the time until maximal BA vasodilatation during reactive hyperemia was observed to be higher in group 2 [105 (90; 180) seconds] than those in group 1 [90 (60; 120) seconds].Conclusions. Biochemical and imaging signs of ED begin to appear in the first five years of T2DM, long before clinical manifestations. The earliest symptoms are decreases in eNOS3 and NO levels, increases in VCAM-1 and resistin concentrations and increased time until maximal BA vasodilatation during reactive hyperemia.


2020 ◽  
Vol 10 (4) ◽  
pp. 381-389
Author(s):  
Sergey V. Minaev ◽  
Sergey I. Timofeev ◽  
Alina N. Grigorova ◽  
Oksana V. Vladimirova ◽  
Elena I. Pashneva ◽  
...  

Aim. To assess adhesions of the abdominal cavity in children with varying degrees of connective tissue dysplasia (CTD) severity. Methods. A total of 91 children with average age of 10.6 1.4 years were observed from 2005 to 2019. Composed of 53 boys (58.2%) and 38 girls (41.8%). Patients were divided into two groups: group 1 (69 children without CTD) and group 2 (22 children with CTD). Clinical data and screening cards were used to diagnose DST. All patients underwent an assessment for the clinical course, a macroscopic visual assessment adhesive process severity in the abdominal cavity according to three different scales (Nair, F. Coccolini, N.I. Ayushinova). Immunohistochemistry was performed against collagen I, III, IV type, Laminin 1, angiogenesis factors, transforming growth factor beta (TGF-), and Fibroblast Growth Factor Receptor 1 (FGFR1). A semi-quantitative counting method was used to record the relative number of immunopositive structures. Statistical analysis was carried out by methods of variation statistics using the Chi-square test and MannWhitney U-tests, as well as the Spearman rank correlation method for the reliability of differences between groups. Results. In the adhesive process visualization, the N.I. Ayushinov scale was revealed to be the most informative, showing the average score of 7 0.8 points in group 2 and 14 1.2 in group 1 (rs 0.35; p 0.05). In group 2, the adhesive material showed no (56%) or chaotic fragments (44%) of type I collagen, and the ratio of type I to type III collagen is 2.7: 5.1. In group 1, the ratio of type I to type III collagen is 5.9:1.8. The ratio of collagen IV to type I is 6.5: 2.9. Both groups have a moderate (++) amount of TGF-. TGF- is positive with macrophages. FGFR1 was found in the control group (++++). A positive response was seen in fibroblasts and macrophages (U = 79.00; p = 0.006). Statistically significant analyzes of vascular endothelial growth factor in compared groups (rs = 0.632, p 0.001) had a positive correlation.. Conclusion. Thus, the study showed features of clinical course and morphological changes during the development of adhesions in the abdominal cavity in children with varying degrees of severity of CTD. Data obtained dictate the need for an individual approach in predicting adhesive disease, as well as targeted preventive care.


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