expectant treatment
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Author(s):  
Atwa KA ◽  
◽  
Ibrahim ZM ◽  
Elshaer M ◽  
Taha OT ◽  
...  

Objective: To investigate the efficacy of esomeprazole in managing early preeclampsia. Methods: This randomized controlled trial was conducted at the Obstetric/Gynecology department of Suez Canal University Hospital. We included 160 women between 26-31 years of age, with a singleton pregnancy. Eighty women received esomeprazole along with expectant treatment, whereas 80 women received expectant treatment alone. They were followed up from the date of diagnosis up to four weeks after delivery. The gestational age at termination as well as any complications during the follow-up period were documented and compared between both groups. Results: The mean age of the participants was 30.64 ± 1.62. The gestation of women in the intervention group was longer than those within the control group, with a gestational age at termination of 34.53 ± 1.21 versus 32.78 ± 1.60, respectively (P<0.001). Moreover, women in the intervention group had significantly lower incidences of fits (P= 0.005), antepartum hemorrhage (P=0.005), DIC (P=0.032), and IUFD (P<0.001). Conclusions: Esomeprazole is associated with a significant prolongation of gestation in women with early preeclampsia.


2021 ◽  
Author(s):  
Neng Tang ◽  
Xiaolin Dou ◽  
Guodong Liu ◽  
Xing You ◽  
Zhenglin Ou ◽  
...  

Abstract Background: Autoimmune pancreatitis (AIP) is a rare disease, have a dramatic response to steroid therapy, but the relapse rates(RRs) is very high, and the side effects of steroid therapy are inevitable. The aim of this study is to focus on the management of relapse and side effects. Methods: A single-centre, retrospective, cohort study of the type Ⅰ AIP patients admitted to Xiangya Hospital Central South University from September 2008 to September 2019 conducted. Collection and retrospectively analyzed the clinicopathologic data and outcomes of these patients. Results: 82 patients were included, 73.2% were histologically confirmed. 78.0% treated by medications: 62.5% prednisolone, 37.5% prednisolone plus cyclophosphamide. The RRs of the two group have no significant difference (35.0% vs 29.2%, P = 0.630). Increasing the dosage of prednisolone, the effective rate of the prednisolone treatment and prednisolone plus cyclophosphamide treatment relapsed patients were 78.57% and 71.43%, respectively. The side effects were DM in 12.5%; central obesity in 15.6%; hyperlipidemia in 18.8%; gastric ulcer in 6.3%; osteoporosis in 9.4%; bone fracture in 1.6%. For those side effects patients performed low dose prednisolone and expectant treatment have a ideal results. Conclusions: Increasing the dose of prednisolone can effectively treat relapsed patients. Low dose steroid and expectant treatment should be performed when side effects arised.


2021 ◽  
Author(s):  
Neng Tang ◽  
Xiao-lin Dou ◽  
Qun He ◽  
Xue-jun Gong ◽  
Jun Zhou ◽  
...  

Abstract Background: Type Ⅰ autoimmune pancreatitis (AIP) have a dramatic response to steroid therapy, but the relapse rates (RRs) is very high, and the side effects of steroid therapy are inevitable. However, the management of relapse and side effects of steroid therapy have been poorly investigated and no series have been reported previously, so this article focuses on the management of relapse and side effects. Methods: A single-centre, retrospective, cohort study of the type Ⅰ AIP patients admitted to Xiangya Hospital Central South University from September 2008 to September 2019. Collection and retrospectively analyzed the clinicopathologic data and outcomes of type Ⅰ AIP patients. Results: 82 patients with type Ⅰ AIP were included. The ratio of male with female was 2.73: 1 with median age of onset of 52 years old. 73.2% were histologically confirmed, 62.2% were showed other organ involvement (OOI). 78.0% treated by medications: 40 cases (62.5%) prednisolone, 24 cases (37.5%) prednisolone plus cyclophosphamide. The effective rate of prednisolone and prednisolone plus cyclophosphamide was no significant difference (37/40 vs 22/24, P = 0.904). The RRs of prednisolone and prednisolone plus cyclophosphamide after remission have no significant difference (14/40 vs 7/24, P = 0.630). Increasing the dosage of prednisolone, the effective rate of the prednisolone treatment and prednisolone plus cyclophosphamide treatment relapsed patients were 78.57% and 71.43%, respectively. The side effects were diabetes mellitus (DM) in 12.5%; central obesity in 15.6%; hyperlipidemia in 18.8%; gastric ulcer in 6.3%; osteoporosis in 9.4%; bone fracture in 1.6%. For those side effects patients performed low dose prednisolone and expectant treatment have a ideal results. Conclusions: There was no significant difference between prednisolone and prednisolone plus cyclophosphamide in the treatment of type Ⅰ AIP. Increasing the dose of prednisolone can effectively treat relapsed patients. Low dose steroid and expectant treatment should be performed when side effects arised.


2020 ◽  
Vol 8 (2) ◽  
pp. 169-173
Author(s):  
B. Polonsky

The difference of opinion regarding the treatment of miscarriages was the reason for the author to write this article. In science, two currents meet: Brennecke, Heinvicius, Dhrssen, Kleinmacher, Fehling and others. see in the prolonged delay of the fetal egg in the uterine cavity during a miscarriage, not to mention bleeding, a clear danger not only for health (insufficient reverse development), but also for the patient's life, which is why active surgical intervention is recommended. Schroeder, Winckel, Olshausen, Kazan, on the basis of pathological and clinical data, assert completely opposite and believe in full recovery from spontaneous miscarriage, which is why they are limited to expectant treatment.


2020 ◽  
Vol 7 (4) ◽  
pp. 363
Author(s):  
F. Krasnopolskiy

The author reports 3 cases of extrauterine blood tumor; in the first two cases, surgical treatment was used (incision of the tumor through the vagina), in the third - expectant treatment.


2020 ◽  
Vol 6 (12) ◽  
pp. 1239-1241
Author(s):  
A. Zabolotskiy

Passion for laparotomy at different times of ectopic pregnancy is considered by most authors to be mandatory in the first half of pregnancy and the sooner the better; and even some authors are beginning to speak out for expectant treatment, even with internal bleeding as a consequence of such a pregnancy. In view of his enthusiasm for operational assistance in such cases, the author considers it necessary to collect more facts for and against and thus solve the question: when it is necessary to operate and when not. To this end, he reports three cases: two operational and one non-operational.


2020 ◽  
Vol 48 (6) ◽  
pp. 030006052093166
Author(s):  
Qian Zhu ◽  
Jue Ma ◽  
Xiaoya Zhao ◽  
Guiling Liang ◽  
Jing Zhai ◽  
...  

Objective To compare the efficacy of postoperative adjuvant treatment (gonadotropin-releasing hormone agonists [GnRHas] and oral contraceptives [OCs]) and expectant treatment in preventing recurrent dysmenorrhea following conservative laparoscopic surgery for deep infiltrating endometriosis (DIE) with dysmenorrhea. Methods A prospective cohort study was conducted in Shanghai, China. In total, 147 patients with dysmenorrhea who underwent conservative laparoscopic surgery for DIE were enrolled. Following surgery, patients received either postoperative adjuvant therapy (GnRHa or OCs) for 6 months or expectant treatment according to a shared medical decision-making approach. The primary outcome was the postoperative recurrence of dysmenorrhea. The secondary outcomes included reproductive outcomes and drug-induced side effects. Results The generalized estimating equation analysis illustrated that the visual analog scale for dysmenorrhea was significantly higher in the adjuvant treatment group than in the expectant treatment group. Kaplan–Meier analysis and the log-rank test demonstrated that the cumulative recurrence rate was higher in the expectant treatment group than in the adjuvant treatment group, but no difference was noted between the two hormonal treatments. Similar cumulative 24-month clinical pregnancy rates were observed among the three groups. Conclusions Compared with expectant management, postoperative medical treatment more effectively relieved symptoms and prevented the recurrence of dysmenorrhea.


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