Retrospective Analysis of Follow-up and Treatment of Patients With Ectopic Pregnancy and Our 6 Years of Clinical Experience

2020 ◽  
Vol 1 (3) ◽  
pp. 85-91
Author(s):  
Xayala Muradova ◽  
Ece Bahçeci ◽  
Keziban Dogan
Keyword(s):  
Laparoscopic Surgery ◽  
Medical Treatment ◽  
Ectopic Pregnancy ◽  
Success Rate ◽  
Retrospective Analysis ◽  
Treatment Success ◽  
Molar Pregnancy ◽  
Rupture Rate ◽  
Tertiary Center

Objective: In this study, we aimed to make a retrospective analysis of the follow-up and the treatment of the patients who were admitted to our clinic, which is a tertiary center, with the preliminary diagnosis of ectopic pregnancy between 2010-2016 in order to contribute to the data related to ectopic pregnancy in our country.Materials and Methods: We retrospectively evaluated the follow-up and the treatment of 452 patients who were admitted to our clinic with a diagnosis of ectopic pregnancy between 2010-2016. We separated these cases into different groups according to their diagnosis, the way of treatment and results.Results: The study was conducted in …….. Hospital, between 2010-2016 with 452 female cases. We did not visualize any ectopic mass in 12,6% of the cases (n = 57); 85% (n = 385) was tubal; 0.2% (n = 1) was cornual; 1.2% (n = 5) was ovarian, 0.2% (n = 1) was heterotropic; 0.4% (n = 2) was molar pregnancy, and 0.2% (n = 1) was scar pregnancy. Methotrexate(MTX) treatment success rate was 72.7% 17% (n = 77) of the cases used MTX; general rupture rate of the cases were 25,7% (n = 116); rupture rate after MTX treatment was 27.2% (n = 21). In the MTX group the rate of detecting an ectopic mass was significantly higher (p = 0.001; p <0.01). 74.1% (149 cases) of the cases we performed laparoscopy and 25.8% (53 patients) of the cases we performed laparatomy. 86% (173 patients) was performed salpingectomy, 10.9% (18 patients) salpingostomy, and 2.9% ovarian resection.Conclusion: Looking at the data in our clinic, we use follow-up, surgical and medical treatment methods. The success rate of medical treatment was 72.7% and laparoscopic surgery was performed in 74.1% of the cases.

Evaluation of tubal patency using hysterosalpingo-contrast sonography (HyCoSy) following salpingostomy and medical treatment of tubal pregnancy

2021 ◽  
Vol 20 (4) ◽  
pp. 12-16
Author(s):  
Aml El-Shabrawy ◽  
◽  
Ahmed Elsheikh ◽  
Samy Gebreel ◽  
Mohammed Elsokkary ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Ectopic Pregnancy ◽  
Success Rate ◽  
Fallopian Tube ◽  
Tubal Pregnancy ◽  
Tubal Patency ◽  
Group I ◽  
Case Series Study ◽  
Maternity Hospitals ◽  
Significant Difference

Objective. Ectopic pregnancy adversely affects the patency of the fallopian tube and consequently the future pregnancy. There are different options of conservative treatment of tubal pregnancy such as methotrexate and salpingostomy [1]. There is little information on the success rate of maintaining tubal patency after methotrexate and salpingostomy [2]. Therefore, the aim of this study is to evaluate the ipsilateral tubal patency using HyCoSy after treatment of tubal pregnancy with methotrexate therapy versus salpingostomy. Patients and methods. This was a case-series study conducted in Ain Shams and Al-Azhar University Maternity Hospitals to evaluate the ipsilateral tubal patency using hysterosalpingo-contrast sonography (HyC0Sy) following salpingostomy and medical treatment of tubal pregnancy. This study included patients who were admitted to Ain Shams and Al-Azhar University Maternity Hospitals for having tubal pregnancy and were treated either with methotrexate or salpingostomy over a 4-year period between January 2017 and December 2020. The patients seeking fertility were re-evaluated for fallopian tubes patency by hysterosalpingogram 3 months after discharge. The study included 2 groups of women: group I (n = 200): women who were treated with methotrexate, and group II (n = 140): women who underwent salpingostomy. Results. HSG was performed in 200 cases of patients with tubal pregnancy who were treated with methotrexate and 140 cases of patients who underwent salpingostomy. The patency of the ipsilateral tube was 85% after methotrexate treatment and 84.2% after salpingostomy. There was no statistically significant difference between the two groups. Conclusion. The findings suggest similar success rate in maintaining the patency of the fallopian tube with either methotrexate or salpingostomy. Key words: ectopic pregnancy, hysterosalpingography, methotrexate, infertility, salpingostomy

scholarly journals Defibrillation success after subcutaneous implantable cardioverter-defibrillator generator replacement is not affected by impedance increase

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
W Van Der Stuijt ◽  
S Pepplinkhuizen ◽  
ABE Quast ◽  
L Smeding ◽  
LRA Olde Nordkamp ◽  
...  
Keyword(s):  
Ventricular Arrhythmia ◽  
Success Rate ◽  
Implantable Cardioverter Defibrillator ◽  
Retrospective Analysis ◽  
Analysis Data ◽  
Cardioverter Defibrillator ◽  
Replacement Procedure ◽  
Shock Impedance ◽  
Tertiary Center ◽  
Generator Replacement

Abstract Funding Acknowledgements Type of funding sources: None. Background Routine defibrillation testing during implant and replacement of the subcutaneous implantable cardioverter-defibrillator (S-ICD) is recommended per current guidelines. Recently, concerns have been raised about an increase in shock impedance and consequent shock failure during defibrillation testing in S-ICD patients undergoing a generator replacement. Purpose We aim to describe the defibrillation success rate in relation to the shock impedance in patients undergoing S-ICD generator replacement in our large tertiary center. Methods In this retrospective analysis, data from replacement procedures were collected from all patients who underwent an S-ICD generator replacement in our center from June 2014 to December 2020. Defibrillation testing was performed with at least one shock of ≤65J, and a successful shock was defined as terminating the ventricular arrhythmia within 5 seconds after the shock. Results A total of 133 patients underwent an S-ICD generator replacement, 5.8 ± 0.9 years after initial implant. Reasons for replacement were: reaching of elective replacement indicator (n = 119), early battery depletion (n = 9), complaints of generator pocket (n = 3) and device malfunction (n = 2). Defibrillation testing was performed in 111 patients (86.5%) undergoing a replacement procedure. Shock impedance data from both the implant and replacement procedure were available in 101 patients. The median shock impedance of these patients during their replacement procedure was significantly higher than during their implant, 79Ω (IQR 66-94) and 66Ω (IQR 57.5-81) respectively (Z = -5.552, p &lt; 0.001). Despite the higher shock impedance, first shock during defibrillation testing was successful in 105/111 patients (94.6%), with a success rate of 97.3% after two attempts. In the remaining three patients, the ventricular arrhythmia could only be terminated with a 80J shock. This was the case during both their initial implant and their replacement procedure. Shock impedance increase between implant and replacement was not significantly higher in patients with a successful first shock compared to patients with an unsuccessful first shock (Δ+11.1 ± 20.0Ω versus Δ+12.7 ± 27.6Ω, p = 0.86). Conclusion In this large retrospective analysis, we have shown a first shock success rate during S-ICD generator replacement of 94.6%, which is similar to the success rate of defibrillation testing after initial implant. After multiple attempts, defibrillation testing success rate was 100%. Even though the median shock impedance during replacement was significantly higher than during the initial implant, there was no difference in impedance increase in patients with a successful shock compared to patients with an unsuccessful shock. Abstract Figure. Defibrillation success

scholarly journals Medication Event Monitoring System for Infectious Tuberculosis Treatment in Morocco: A Retrospective Cohort Study

2019 ◽  
Vol 16 (3) ◽  
pp. 412 ◽  
Author(s):  
Seup Park ◽  
Ilham Sentissi ◽  
Seung Gil ◽  
Won-Seok Park ◽  
ByungKwon Oh ◽  
...  
Keyword(s):  
Success Rate ◽  
Monitoring System ◽  
Treatment Success ◽  
Treatment Success Rate ◽  
Control Group ◽  
Event Monitoring ◽  
Tb Treatment ◽  
The Mean ◽  
Lost To Follow Up

Non-adherence to tuberculosis (TB) treatment is a barrier to effective TB control. We investigated the effectiveness of a Medication Event Monitoring System (MEMS) as a tailored adherence-promoting intervention in Morocco. We compared patients who received a MEMS (n = 206) with patients who received standard TB care (n = 141) among new active TB patients with sputum smear-positive. The mean total medication days were 141.87 ± 29.5 in the control group and 140.85 ± 17.9 in the MEMS group (p = 0.7147), and the mean age and sex were not different between the two groups (p > 0.05). The treatment success rate was significantly higher in the MEMS group than in the control group (odds ratio (OR): 4.33, 95% confidence interval (CI): 2.13–8.81, p < 0.001), and the lost to follow-up rate was significantly lower in the MEMS group than in the control group (OR: 0.03, 95% CI: 0.05–0.24, p < 0.001) after adjusting for sex, age, and health centers. The mean drug adherence rate in the first month was significantly higher in the MEMS group than in the control group (p = 0.023). MEMS increased TB treatment success rate and decreased the lost to follow-up rate overall for infectious TB patients in a Moroccan rural area.

scholarly journals Review on oral methotrexate in medical management of ectopic pregnancy: a 2 years experience in hospital Shah Alam

2019 ◽  
Vol 8 (8) ◽  
pp. 3229
Author(s):  
Wan Nurul Ezyani Wan Jabarudin ◽  
Normala Mohammad Som ◽  
Afidatul Mardhiah Mohammad Daud ◽  
Nor Dalila Shamsuddin ◽  
Nazian Hanna Yaacob ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Success Rate ◽  
Medical Management ◽  
Secondary Data ◽  
Cross Sectional Study ◽  
Clinical Settings ◽  
Cross Sectional ◽  
Early Presentation ◽  
Oral Methotrexate

Background: The objective of this study is to determine the success rate of oral methotrexate in Hospital Shah Alam for the past 2 years.Methods: This is a cross-sectional study using secondary data obtained from medical record office in Hospital Shah Alam on patients with ectopic pregnancy. A total of 35 patients who fulfilled the criteria for medical management were selected. They were prescribed with oral methotrexate with the dose of 60 mg given in 3 divided doses every 2 hours using the standard tablet of 2.5mg. Follow up was done at day 4, day 7 and till HCG level achieve less than 20 iu/litre.Results: 29 patients were successfully treated with oral methotrexate 60 mg (82.8%). Another 6 patients had to undergo laparoscopic surgery with confirmed leaking, ruptured tubal pregnancy. 4 patients needed second dose of Methotrexate due to rising HCG level and all of them were successfully treated after the second dose. The side effects of oral methotrexate were tolerated well by all patients. There are numbers of predictors for success which are the level of HCG <4000 iu/litre, size of mass <4cm, no abdominal pain during early presentation and decrease of HCG level in between day 4 to day 7 after oral methotrexate.Conclusions: The success rate of oral methotrexate for stable ectopic pregnancy is good making it a suitable option for clinical settings which has no specialised equipment to handle cytotoxic drugs.

Outcomes of Catheter-Directed Thrombolysis in Patients with Acute Arterial Thrombotic Limb Ischemia: A Prospective Interventional Case Series

2021 ◽  
Author(s):  
Javad Salimi ◽  
Ehsan Rahimpour ◽  
Hossein Zabihi Mahmoudabadi ◽  
Pezhman Farshidmehr
Keyword(s):  
Success Rate ◽  
Treatment Success ◽  
Case Series ◽  
Pulmonary Hemorrhage ◽  
Limb Ischemia ◽  
Acute Limb Ischemia ◽  
Technical Success Rate ◽  
Catheter Directed Thrombolysis ◽  
One Year

Introduction: Acute limb ischemia is a critical medical condition that can quickly become a life threat. Therapeutic modalities such as catheter-directed thrombolysis (CDT) have demonstrated various levels of efficacy in previous studies. Objective: This study presents the descriptive findings of a series of cases who presented with acute arterial thrombotic limb ischemia and underwent CDT. Methods: This was a cross-sectional single-hospital-based case series, in which all patients who were diagnosed with acute arterial thrombotic limb ischemia, and consequently underwent CDT during the oneyear study period were included. Detailed baseline characteristics and clinical findings of the studied patients on presentation, after intervention and at one-year follow-up are presented. Results: A total of 21 patients with a mean age of 60.7±15.2 years, including 16 males (76.2%) were included. The initial technical and treatment success rates were 20 (95.2%) and 14 (66.7%), respectively. The amputation-free and the overall survival rates after the one-year follow-up were 15 (71.4%) and 17 (81%), respectively. Four patients (19%) developed complications, two (9.5%) of which were significant (pulmonary hemorrhage and intraventricular hemorrhage). Amputation was performed in 6 (28.6%) cases. Conclusion: In this study, the treatment success rate and the technical success rate were satisfactory.

The effect of ultrasonography in predicting medical treatment success in ectopic pregnancy

2019 ◽  
Vol 1 (1) ◽  
pp. 5-7
Author(s):  
Meric Balikoglu ◽  
Burak Bayraktar ◽  
Mert Mevlüt Akar
Keyword(s):  
Single Dose ◽  
Medical Treatment ◽  
Ectopic Pregnancy ◽  
Adnexal Mass ◽  
Treatment Success ◽  
Dose Methotrexate ◽  
Treatment Prediction ◽  
Significant Difference ◽  
Mass Size ◽  
The Right

Ectopic pregnancy(EP) treatment success in a single dose methotrexate(MTX) regimen is decided by more than 15% β chorionic gonadotropin reduction in the 4th and 7th days after administration of 50mg/m² of medication.  In our study , it was aimed whether the EP mass size less than 40mm detected by ultrasonography and the adnexal side on which it was located had an effect on the success of medical treatment. 82 patients who treated with MTX included in the study were divided into two groups as those with a single dose of methotrexate success and those without (n:67 vs n:15). The groups were compared in terms of age, parity, size of adnexal mass detected on ultrasonography, and the side of ectopic pregnancy. The parity rates and the age of patients were similar in both groups(p = 0.615, p = 0.742). Although the average adnexal mass size was found to be higher in the patient group those single dose MTX treatment was not successful, there was no statistically significant difference(p = 0.098). Ectopic pregnancy was frequently observed on the right side in the group in which the medical treatment was successful(66 % vs 33%). The effect of ectopic pregnancy mass size on medical treatment prediction was investigated in cases with mass size less than 40mm. Ectopic pregnancy mass size, even if it is below 40 mm, may not indicate the medical treatment success.

Laparoscopic versus Open Total Mesorectal Excision: A Nonrandomized Comparative Prospective Trial in a Tertiary Center in Mexico City

2009 ◽  
Vol 75 (1) ◽  
pp. 33-38
Author(s):  
QuintÍN H. GonzÁLez ◽  
Homero A. RodrÍGuez-Zentner ◽  
J. Manuel Moreno-Berber ◽  
Omar Vergara-FernÁNdez ◽  
HÉCtor Tapia-Cid De LeÓN ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Laparoscopic Surgery ◽  
Total Mesorectal Excision ◽  
Laparoscopic Group ◽  
Long Term Results ◽  
Mesorectal Excision ◽  
Randomized Studies ◽  
Tertiary Center

Because definitive long-term results are not yet available, the oncologic safety of laparoscopic surgery in rectal cancer remains controversial. Laparoscopic total mesorectal excision (LTME) for rectal cancer has been proposed to have several short-term advantages in comparison with open total mesorectal excision (OTME). However, few prospective randomized studies have been performed. The main purpose of our study was to evaluate whether relevant differences in safety and efficacy exist after elective LTME for the treatment of rectal cancer compared with OTME in a tertiary referral medical center. This comparative nonrandomized prospective study analyzes data in 56 patients with middle and lower rectal cancer treated with low anterior resection or abdominoperineal resection from November 2005 to November 2007. Follow-up was determined through office charts or direct patient contact. Statistical analysis was performed using χ2 test and Student's t test. Twenty-eight patients underwent LTME and 28 patients were in the OTME group. No conversion was required in the LTME group. Mean operating time was shorter in the laparoscopic group (LTME) (181.3 vs 206.1 min, P < 0.002). Less intraoperative blood loss and fewer postoperative complications were seen in the LTME group. Return of bowel motility was observed earlier after laparoscopic surgery. There was no 30-day mortality and the overall morbidity was 17 per cent in the LTME group versus 32 per cent in the OTME group. The mean number of harvested lymph nodes was greater in the laparoscopic group than in the OTME group (12.1 ± 2 vs 9.3 ± 3). Mean follow-up time was 12 months (range 9-24 months). No local recurrence was found. LTME is a feasible procedure with acceptable postoperative morbidity and low mortality, however it is technically demanding. This series confirms its safety, although oncologic results are at present comparable with the OTME published series with the limitation of a short follow-up period. Further randomized studies are necessary to evaluate long-term clinical outcome.

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