scholarly journals Fibroids and Hysteroscopy: An Overview

2020 ◽  
Author(s):  
Cinta Vidal Mazo
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Economic Cost ◽  
Outpatient Setting ◽  
Health Concern ◽  
Hysteroscopic Myomectomy ◽  
Asymptomatic Patients ◽  
Submucosal Fibroids ◽  
Abdominal Route ◽  
Proper Diagnosis ◽  
Type 3

Submucosal fibroids account for 10% of total fibroids. They significantly impact quality of life causing abnormal uterine bleeding (AUB), reduction in fertility rates/infertility, obstetrics complications and abdominal pain. They are a major public health concern because of economic cost their monitoring and treatment requires. Hysteroscopic myomectomy is the first line minimally invasive and conservative surgical treatment. Treating a fibroid correctly implies knowing its physiopathology: What is a submucosal fibroids and what is its origin, what is the Pseudocapsule?. Proper diagnosis and standardized classification such as the Wamsteker classification are required. What are the limits to perform a hysteroscopic myomectomy? What devices are currently used? What are the requirements for conducting myomectomy procedures in the outpatient setting?. Different forms of surgical approach. Complications and consequences of a myomectomy. What will we do in the future with the management of small submucosal fibroids in asymptomatic patients with future genetic desires and can we resect type 3 fibroids by hysteroscopy avoiding a higher risk surgery by abdominal route?

scholarly journals Prospective selected biomarkers in COVID-19 diagnosis and treatment

2021 ◽  
Author(s):  
Tahani Tabassum ◽  
Ahsab Rahman ◽  
Yusha Araf ◽  
Md A Ullah ◽  
Mohammad J Hosen
Keyword(s):  
Early Diagnosis ◽  
Risk Groups ◽  
Viral Pathogenesis ◽  
Health Concern ◽  
Effective Strategy ◽  
Proper Treatment ◽  
Pulmonary Infections ◽  
Disease Prognosis ◽  
Proper Diagnosis

COVID-19 has become a global health concern, due to the high transmissible nature of its causal agent and lack of proper treatment. Early diagnosis and nonspecific medical supports of the patients appeared to be effective strategy so far to combat the pandemic caused by COVID-19 outbreak. Biomarkers can play pivotal roles in timely and proper diagnosis of COVID-19 patients, as well as for distinguishing them from other pulmonary infections. Besides, biomarkers can help in reducing the rate of mortality and evaluating viral pathogenesis with disease prognosis. This article intends to provide a broader overview of the roles and uses of different biomarkers in the early diagnosis of COVID-19, as well as in the classification of COVID-19 patients into multiple risk groups.

scholarly journals Uterine submucosal leiomyomas: modern diagnosis and miniinvasive surgery

2021 ◽  
Vol 6 (2) ◽  
pp. 88-93
Author(s):  
Oana Denisa Balalau ◽  
◽  
Mihai-George Loghin ◽  
Sabin Vasilache ◽  
Octavian Gabriel Olaru ◽  
...  
Keyword(s):  
Recovery Time ◽  
Uterine Fibroids ◽  
Therapeutic Decision ◽  
Common Complication ◽  
Hysteroscopic Myomectomy ◽  
Abdominal Myomectomy ◽  
Pelvic Tumors ◽  
Submucosal Fibroids ◽  
Miniinvasive Surgery ◽  
Vaginal Myomectomy

Uterine leiomyomatosis is one of the most common benign pelvic tumors diagnosed in women aged 25-44 years. Clinically, it is manifested by vaginal bleeding, pelvic pain, infertility, digestive and urinary symptoms. The diagnosis of uterine fibroids requires careful clinical and paraclinical evaluation. Based on these data, the therapeutic decision is conducted in most cases. The treatment of uterine leiomyomatosis involves several procedures, such as: total abdominal hystectomy, total vaginal hystectomy, abdominal myomectomy, vaginal, laparoscopic or hysteroscopic myomectomy. Hysteroscopic myomectomy is currently the preferred procedure for submucosal fibroids. It has multiple advantages: shorter recovery time, reduced pain related to movements, shorter duration procedure and fewer risks. The procedure has few contraindications. The most common complication is recurrence. The treatment of choice for prolapsed pedunculated submucous leiomyoma is vaginal myomectomy. As described, the procedure has multiple advantages and generally has a low recurrence rate.

scholarly journals Achalasia - two types in the same patient: Case report

2013 ◽  
Vol 141 (11-12) ◽  
pp. 807-809
Author(s):  
Igor Jovanovic ◽  
Dragana Jovanovic ◽  
Milenko Ugljesic ◽  
Nikola Milinic ◽  
Mirjana Cvetkovic ◽  
...  
Keyword(s):  
Case Report ◽  
High Resolution ◽  
Esophageal Achalasia ◽  
Patient Case ◽  
Bolus Transit ◽  
Therapy Approach ◽  
Proper Diagnosis ◽  
Type 3

Introduction. A paper presented a case of esophageal achalasia with both type 2 and type 3 achalasia found in the same patient. Case Outline. High resolution impedance manometry of esophagus was performed. Liquid swallows induced panesophageal pressurization (achalasia type 2), whereas viscous swallows led to compartmentalized pressurization - distal two thirds of esophagus (achalasia type 3). No complete bolus transit was recorded. Patient refused any procedure. Conclusion. The aim of this paper was to show the necessity of performing manometry using both liquid and viscous swallows in GI departments where this approach has not been routinely used in order to establish proper diagnosis since therapy approach is different between type 2 and type 3 achalasia.

Abstract 13197: Characteristics and Outcomes of Patients Presenting With Hypertensive Urgency in the Outpatient Setting

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Krishna Patel ◽  
Laura Young ◽  
Erik H Howell ◽  
Bo Hu ◽  
Shannon J Morrison ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Outpatient Setting ◽  
Uncontrolled Hypertension ◽  
Office Visits ◽  
Hypertensive Urgency ◽  
Admission Rates ◽  
Coronary Syndrome ◽  
Asymptomatic Patients ◽  
Significant Difference ◽  
Hypertensive Urgencies

Background: Hypertensive urgency is a commonly encountered outpatient problem. Prevalence and short term outcomes of this condition are unknown. JNC VII recommends aggressive BP control over several days. However, a small percentage of patients are sent to the emergency department. It is unknown whether hospital management of these patients is better than outpatient BP management. Methods: Retrospective cohort study of all patients presenting to an office in a large health care system from 2008-2013 with SBP ≥180mmHg or DBP ≥ 110mmHg. We excluded pregnant women and patients referred to the hospital for symptoms or treatment of other conditions. Patients were divided into 2 groups: those sent home and those referred to hospital. We recorded baseline demographic and clinical data. Propensity matched outcomes recorded included MACE (acute coronary syndrome, stroke/TIA) uncontrolled hypertension (≥140/90 mmHg) and hospital admissions. Results: Of 2,199,019 office visits, 58,583 (5%) had hypertensive urgency. Mean age was 63±15 yrs, 58% were females, 76% Caucasian, mean BMI was 31±8 kg/m2 and mean SBP and DBP were 182±16 and 96±16 mmHg. Only 426 (0.7%) patients were referred to the ED/hospital. On propensity matched analysis between the patients referred to the hospital and sent home, there was no significant difference in MACE events at 7 days (0% vs. 0.13%, p=1), 30 days (0.25% vs. 0%, p=1) or 6 months (0.5% vs. 0.13%, p=0.26). Compared to patients sent home, patients referred to the hospital had less uncontrolled hypertension at 1 month (81% vs. 88%, p=0.001) but not at 6 months (65% vs 69%, p=0.16). They also had higher 7- and 30-day hospital admission rates (8.5% vs. 4.9%, p=0.01; 11.8% vs 7.6%, p=0.02). Conclusion: Hypertensive urgency occurs commonly, but the rate of MACE in asymptomatic patients is very low. ED visits increased hospitalizations, but did not improve outcomes. Most patients with hypertensive urgencies still had uncontrolled hypertension at 6 months.

scholarly journals Dengue: A Minireview

Viruses ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 829 ◽  
Author(s):  
Harapan Harapan ◽  
Alice Michie ◽  
R. Tedjo Sasmono ◽  
Allison Imrie
Keyword(s):  
Public Health ◽  
Immune Response ◽  
Economic Cost ◽  
Denv Infection ◽  
Diagnostic Methods ◽  
Transmission Dynamics ◽  
Health Concern ◽  
Significant Morbidity ◽  
Public Health Concern ◽  
Dengue Virus Serotypes

Dengue, caused by infection of any of four dengue virus serotypes (DENV-1 to DENV-4), is a mosquito-borne disease of major public health concern associated with significant morbidity, mortality, and economic cost, particularly in developing countries. Dengue incidence has increased 30-fold in the last 50 years and over 50% of the world’s population, in more than 100 countries, live in areas at risk of DENV infection. We reviews DENV biology, epidemiology, transmission dynamics including circulating serotypes and genotypes, the immune response, the pathogenesis of the disease as well as updated diagnostic methods, treatments, vector control and vaccine developments.

scholarly journals Hysteroscopic myomectomy in outpatient setting – 38 months experience

2016 ◽  
Vol 206 ◽  
pp. e23
Author(s):  
Rita Simões Carvalh ◽  
M.J. Morais ◽  
J. Abreu-Silva ◽  
A. Quintas ◽  
E. Pinto ◽  
...  
Keyword(s):  
Outpatient Setting ◽  
Hysteroscopic Myomectomy

scholarly journals Economic burden and prevalence of malaria in companies in Douala, Cameroon

2021 ◽  
Author(s):  
Christian Mbohou Nchetnkou ◽  
Herve Nyabeyeuh Nyabeyeuh ◽  
Calvin Tonga ◽  
Lafortune Kangam ◽  
Loick Pradel Kojom Foko ◽  
...  
Keyword(s):  
Negative Impact ◽  
Demographic Data ◽  
Health Spending ◽  
Economic Cost ◽  
Control Measures ◽  
High Rate ◽  
Health Concern ◽  
Related Absenteeism ◽  
External Management ◽  
The Cost

Abstract Background: Malaria is a public health concern in Africa. At the socio-economic level, it represents a brake on the national growth through an increase of health spending, drop of productivity and high rate of absenteeism at the workplace. Some companies have implemented malaria control measures to improve their performance, but the vast majority are slow to follow this approach. Using the cost-of-illness approach, the objective of this study was to estimate the economic impact of malaria in two companies with 24-hour daily activity based in Douala, Cameroon: an agro-food industry nicknamed "AGRO" and a security company nicknamed "SECU".Method: A retrospective analysis of medical and financial records of these companies was carried out to calculate the economic cost of absenteeism, prophylaxis, Internal Management of Malaria cases (IMM) and External Management of Malaria cases (EMM) to these companies. A malaria screening campaign was carried out also in each company in one day from 8 a.m. to 4 p.m. The clinical, anthropometric and socio-demographic data of the employees were collected before the collection of a drop of blood which was subsequently analyzed under the Cyscope fluorescence microscope (Partec-Sysmex, Münster, RFA). Results: Analysis of retrospective data revealed that the prevalence of symptomatic malaria cases had decreased by 8.9% and 25.1% respectively at AGRO and SECU between 2010 and 2012. Regarding the prospective component, 372 employees of the two companies were included in the study. The prevalence of malaria was 26.83% and 26.44% respectively at AGRO in January 2013 and SECU in February 2013. Malaria-related absenteeism accounted for 5% and 17% of general absenteeism at AGRO and SECU respectively. The cost of an EMM accounted for 19.5% and 40.5% of the monthly income of AGRO and SECU workers respectively. Each year, malaria generates a shortfall of US$ 26,426 and US$ 136,824 respectively to AGRO and SECU. Conclusion: Malaria have a negative impact on companies. However, early detection of suspected cases, campaigns to distribute insecticide-treated mosquito nets, Information, Education and Communication within the company could reduce this impact.

scholarly journals Long-read 16S-seq reveals nasopharynx microbial dysbiosis and enrichment of Mycobacterium and Mycoplasma in COVID-19 patients: A source of co-infection

2021 ◽  
Author(s):  
Punit Prasad ◽  
Soumendu Mahapatra ◽  
Rasmita Mishra ◽  
Krushna Chandra Murmu ◽  
Shifu Aggarwal ◽  
...  
Keyword(s):  
Microbial Diversity ◽  
Respiratory Infections ◽  
Health Concern ◽  
Upper Respiratory Tract ◽  
Opportunistic Pathogens ◽  
Variable Regions ◽  
Microbial Dysbiosis ◽  
Asymptomatic Patients ◽  
Oxford Nanopore ◽  
Long Read

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) is a major global health concern. This virus infects the upper respiratory tract and causes pneumonia-like symptoms. So far, few studies have shown alterations in nasopharyngeal (NP) microbial diversity, enrichment of opportunistic pathogens and their role in co-infections during respiratory infections. Therefore, we hypothesized that microbial diversity changes, with increase in the population of opportunistic pathogens, during SARS-CoV2 infection in the nasopharynx which may be involved in co-infection in COVID-19 patients. Methods The 16S rRNA variable regions, V1-V9, of NP samples of control and COVID-19 (symptomatic and asymptomatic) patients were sequenced using the Oxford Nanopore™ technology. Comprehensive bioinformatics analysis for determining alpha/beta diversities, non-metric multidimensional scaling, correlation studies, canonical correspondence analysis, linear discriminate analysis, and dysbiosis index were used to analyze the control and COVID-19-specific NP microbiomes. Results We observed significant dysbiosis in COVID-19 NP microbiome with increase in abundance of opportunistic pathogens at genus and species levels in asymptomatic/symptomatic patients. The significant abundance of Mycobacteria spp. and Mycoplasma spp. in symptomatic patients suggest their association and role in co-infections in COVID-19 patients. Furthermore, we found strong correlation of enrichment of Mycobacteria and Mycoplasma with the occurrences of chest pain and fever in symptomatic COVID-19 patients. Conclusion This is the first study from India to show the abundance of Mycobacteria and Mycoplasma opportunistic pathogens in non-hospitalized COVID-19 patients and their relationship with symptoms, indicating the possibility of co-infections.

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