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Diagnostics ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 159
Author(s):  
Maria Paola Bonasoni ◽  
Giuseppina Comitini ◽  
Mariangela Pati ◽  
Giuseppe Russello ◽  
Loredana Vizzini ◽  
...  

Citrobacter koseri is a facultative anaerobic, motile, non-spore-forming Gram-negative bacillus, which belongs to the family of Enterobacteriaceae. Severe infections due to Citrobacter spp. have been reported in the urinary tract, respiratory airways, intra-abdominal organs, skin and soft tissue, eye, bone, bloodstream, and central nervous system. In newborns, C. koseri is a well-known cause of meningitis, cerebral abscesses, brain adhesions, encephalitis, and pneumocephalus. Infection can be acquired through vertical maternal transmission or horizontal hospital settings; however, in many cases, the source is unknown. Preterm premature rupture of membranes (PPROM), caused by C. koseri, has rarely been described. Herein, we describe a case of PPROM at 16 weeks and 3 days of gestation, leading to anhydramnios. The parents opted for legal termination of the pregnancy, as the prognosis was very poor. C. koseri was isolated postmortem from a placental subamniotic swab and parenchymal sample, as well as fetal blood and lung. To the best of our knowledge, this is the first case of early second-trimester PPROM in which C. koseri infection was demonstrated.


2021 ◽  
Vol 50 (3) ◽  
pp. 8-14
Author(s):  
E. K. Ailamazyan ◽  
E. F. Kira ◽  
Yu. V. Tsvelev ◽  
V. F. Bezhenar ◽  
A. A. Bezmenko

On April 19, 1901, at a meeting of the St. Petersburg Obstetric and Gynecological Society, Professor Dmitry Oskarovich Ott for the first time made a report on the method he developed for illuminating the abdominal cavity when performing operations with a vaginal access. He called the proposed method ventroscopy (ventroscopia; Latin venter stomach + Greek skopeo consider). The latter used terms such as celioscopy, abdominoscopy, pelvioscopy, etc. At present, it is customary to call the examination of the abdominal organs using an endoscope inserted through the anterior abdominal wall, the method of laparoscopy, and when the endoscope is introduced through the posterior vaginal fornix - cultoscopy.


Author(s):  
N. V. Mikhailova ◽  
I. I. Petrunko

Aim: Evaluate the relationship of Smoking with fatty liver disease (FLD) of various etiologies.Materials and Methods: Out of1568 residents of the rural therapeutic area agreed to participate in the study of 1123 residents of the rural medical area with negative markers of hepatitis B and / or C. The survey included the collection of anamnesis for smoking and alcohol consumption. An objective, laboratory (complete blood count, biochemical liver function tests) and instrumental examination, including ultrasound examination of the abdominal organs, were carried out.Results: Non-alcoholic fatty liver disease (NAFLD) was detected in 247 (22.0%) people, alcoholic liver disease (ALD) — in 276 (24.6%) (p>0.05). 542 people smoked of the surveyed. Among patients with NAFLD, Smoking was 20.2%, their Smoking experience was 35.1±11.5 years, and the Smoking index was 24.5±10.9. Among patients with ALP, Smoking is higher-93.1% (p<0.05), Smoking experience is less — 29.5±9.8 years (p<0.05), as is the Smoking index of 21.8±7.7 (p<0.05). Among smokers, 56.8% had FLD, 83.8% of them were of alcoholic etiology, and 16.2% were non — alcoholic (p<0.05). Among non-smokers, compared with smokers, FLD was detected less frequently — in 37.2% of people (p<0.05), of which alcohol etiology — in 8.8% (p<0.05), non — alcoholic-in 91.2% (p<0.05).Conclusion: In the rural therapeutic area, 93.1% of ALD sufferers smoke, and 20.2% of NAFLD patients smoke (p<0.05). In patients with NAFLD, the duration of smoking was longer (35.1 ± 11.5) than in patients with ALD — 29.5 ± 9.8 years (p <0.05); the smoking index was 24.5 ± 10.9 and 21.8 ± 7.7 pack-years (p<0.05), respectively. In smokers, FLD was more common (56.8%) than in non-smokers (37.2%) (p<0.05). FLD in smokers was of alcoholic etiology more often (83.8%) than non-alcoholic (16.2%) (p<0.05), in non-smokers non-alcoholic etiology prevailed (91.2%) (p<0.05).


Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2362
Author(s):  
Sinziana Ionescu ◽  
Alin Codrut Nicolescu ◽  
Octavia Luciana Madge ◽  
Marian Marincas ◽  
Madalina Radu ◽  
...  

Tuberculosis (TB) is a public health issue that affects mostly, but not exclusively, developing countries. Abdominal TB is difficult to detect at first, with the incidence ranging from 10% to 30% of individuals with lung TB. Symptoms are non-specific, examinations can be misleading, and biomarkers commonly linked with other diseases can also make appropriate diagnosis difficult. As a background for this literature review, the method used was to look into the main characteristics and features of abdominal tuberculosis that could help with differentiation on the PubMed, Science Direct, and Academic Oxford Journals databases. The results were grouped into three categories: A. general features (the five forms of abdominal tuberculosis: wet and dry peritonitis, lymphadenopathy, lesions at the level of the cavitary organs, lesions at the level of the solid organs), B. different intra-abdominal organs and patterns of involvement (oesophageal, gastro-duodenal, jejunal, ileal, colorectal, hepatosplenic, and pancreatic TB with calcified lymphadenopathy, also with description of extraperitoneal forms), and C. special challenges of the differential diagnosis in abdominal TB (such as diagnostic overlap, the disease in transplant candidates and transplant recipients, and zoonotic TB). The study concluded that, particularly in endemic countries, any disease manifesting with peritonitis, lymphadenopathy, or lesions at the level of the intestines or solid organs should have workups and protocols applied that can confirm/dismiss the suspicion of abdominal tuberculosis.


2021 ◽  
Vol 0 ◽  
pp. 1-7
Author(s):  
Jamil F. Soni ◽  
Najila De M. Sandrin ◽  
Paula R. F. de Oliveira ◽  
Alexandre F. Possamai ◽  
André L. C. Ferreira ◽  
...  

Objectives: The objective of the study was to identify the prevalence of firearm injuries (FI) and bladed weapon injuries (BWIs) in underage people and their respective outcomes. Methods: Using a retrospective observational design, data were recorded on patients who met the inclusion criteria receiving care in a public hospital between June 30, 2015, and June 30, 2018. Results: Ninety-one medical records were found, 76.9% of patients were males and 23.1% were females. Most injuries were caused by firearms (76%) and the remainder by bladed weapons (24%). The majority of patients were 12–18 years old (92.3%), while 7.7% were 6–12 years old. Male participants were the ones who most needed medical care (77%). Male adolescents in the older age group with injury-associated fractures (P = 0.015 and P = 0.032) accounted for the most common association in the sample, demonstrating greater susceptibility to fractures in these groups. Analysis of detailed location proved that BWIs BWIs were the leading cause of injuries to soft abdominal organs (P = 0.011). Conclusion: The occurrence of FI and BWIs in the pediatric population is significant and can imply death and tragic sequelae. Emergency services need to be prepared to provide care to these victims, particularly males and the 12–18 age range, as these are the most affected groups. Further studies should be conducted on this theme to gain a greater and better understanding of the etiology and repercussions of this type of injury in the lives of young patients.


Author(s):  
Izabela Łoń ◽  
Monika Wieliczko ◽  
Jacek Lewandowski ◽  
Jolanta Małyszko

Background: Retroperitoneal fibrosis (RPF) is a rare disease characterized by the presence of inflammatory and fibrous retroperitoneal tissue that often encircles abdominal organs including aorta and ureters. Data on the incidence of this disease are limited. Summary: The disease may be idiopathic or secondary to infections, malignancies, drugs or radiotherapy. Idiopathic form is an immune-mediated entity and a part of the broader spectrum of idiopathic diseases termed chronic periaortitis, characterized by a morphologically similar fibroinflammatory changes in aorta and surrounding tissues. Taking into account the dominant symptoms and clinical charac-teristics of patients with periaortitis, two subtypes of disease could be distinguished. Vascular subtype include patients with non-dilated aorta or with inflammatory abdominal aortic aneu-rysm, both with and without involvement of adjacent structures and with numerous risk factors for atherosclerosis. In renoureteral subtype obstructive uropathy manifesting with hydronephro-sis and acute kidney injury is predominant finding. Due to the variety of symptoms, diagnosis of RPF remains challenging, difficult and often delayed. A series of diagnostic tests should be performed, in order to confirm the diagnosis idiopathic RPF. Laboratory work-up include eval-uation of inflammatory indices and immunological studies. A biopsy and histopathological evaluation may be necessary to confirm diagnosis and differentiate the disease. Computed to-mography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) are the modalities of choice for the diagnosis and follow-up of this disease. Management of ureteral obstruction, hydronephrosis, and aortic aneurysms often requires surgical evaluation and treatment. The pharmacological treatment of RPF has been evaluated in a few randomized trials and is mainly based on observational studies. Steroid therapy remains the gold standard of treatment. Key messages: Nowadays multidisciplinary team approach with clinical and diagnos-tic experience in both primary and secondary RPF as well as two major subtypes should be offered. Centers specialized in rare diseases with collaboration with other units and referral sys-tem yield the best possible outcomes.


Author(s):  
Mohamed Nasor ◽  
Walid Obaid

<span lang="EN-US">In this article a fully automated machine-vision technique for the detection and segmentation of mesenteric cysts in computed tomography (CT) images of the abdominal space is presented. The proposed technique involves clustering, filtering, morphological operations and evaluation processes to detect and segment mesenteric cysts in the abdomen regardless of their texture variation and location with respect to other surrounding abdominal organs. The technique is comprised of various processing phases, which include K-means clustering, iterative Gaussian filtering, and an evaluation of the segmented regions using area-normalized histograms and Euclidean distances. The technique was tested using 65 different abdominal CT scan images. The results showed that the technique was able to detect and segment mesenteric cysts and achieved 99.31%, 98.44%, 99.84%, 98.86% and 99.63% for precision, recall, specificity, dice score coefficient and accuracy respectively as quantitative performance measures which indicate very high segmentation accuracy.</span>


Tomography ◽  
2021 ◽  
Vol 7 (4) ◽  
pp. 815-828
Author(s):  
Daniel Overhoff ◽  
Gregor Jost ◽  
Michael McDermott ◽  
Olaf Weber ◽  
Hubertus Pietsch ◽  
...  

Objectives: To evaluate multiphase low kV computed tomography (CT) imaging of the abdomen with reduced contrast media (CM) dose using different injection protocols. Methods: Two injection protocols were evaluated for use with low kV (80 kV) multiphase abdominal imaging in comparison to the standard procedure acquired at 120 kV (500 mgI/kg; 5 mL/s). This evaluation was conducted in a highly standardized animal study (5 Goettingen minipigs). The low kV protocols consisted of (a) a single-flow (SF) injection with 40% reduced CM dose and injection rate (300 mgI/kg; 3 mL/s) and (b) a DualFlow (DF) injection protocol consisting of 60%/40% contrast to saline ratio administered at 5 mL/s. Dynamic CT was first performed within representative liver regions to determine optimal contrast phases, followed by evaluation of the three protocols in multiphase abdominal CT imaging. The evaluation criteria included contrast enhancement (CE) of abdominal organs and vasculature. Results: The 80 kV DF injection protocol showed similar CE of the abdominal parenchymatous organs and vessels to the 120 kV reference and the 80 kV SF protocol. Hepatic parenchyma showed comparable CT values for all contrast phases. In particular, in the portal venous parenchymal phase, the 80 kV DF protocol demonstrated higher hepatic parenchymal enhancement; however, results were statistically non-significant. Similarly, CE of the kidney, pancreas, and abdominal arterial/venous vessels showed no significant differences between injection protocols. Conclusions: Adapted SF and DF injection protocols with reduced IDR/iodine load offer the potential to calibrate optimal CM doses to the tube voltage in abdominal multiphase low kV CT imaging. The data suggest that the DF approach allows the use of predefined injection protocols and adaption of the contrast to saline ratio to an individualized kV setting and yields the potential for patient-individualized CM adaption.


2021 ◽  
pp. 15-19
Author(s):  
O.K. Sliepov ◽  
N.Y. Zhylka ◽  
V.L. Veselskyi ◽  
N.Y. Skrypchenko ◽  
T.V. Avramenko ◽  
...  

Background. Despite the existence of numerous studies on the optimal delivery mode in gastroschisis (GS), their results remain controversial. Therefore, the presented study is focused on establishing the delivery mode impact on GS anatomy in newborns.Research objective. The study was conducted to determine the impact of the delivery mode on the features of GS anatomy in newborns.Materials and methods. A retrospective analysis of medical records of 135 pregnant women and 135 their newborns with GS born between 1987 and 2020 was conducted. All newborns are divided into 3 groups. Newborns delivered by caesarean section are included in group I (n = 80); children born exclusively naturally are included in groups II (n = 25) and III (n = 30). The following anatomical features of GS in newborns were studied: localization and size of the anterior abdominal wall defect, confluence with the abdominal cavity, the nature and frequency of the eventrated organs.Results. The size of the anterior abdominal wall defect was significantly smaller in children with GS delivered by caesarean section (3.02 ± 0.58 cm; p < 0.01) than in children born naturally (4.17 ± 0.3 cm in group II, 4.7 ± 0.29 cm in group III). The frequency of retroperitoneal organs eventration was significantly less (20.0%; p < 0.01) in caesarean delivery grope than in II and III groups (52% and 63.3%, respectively). There was no significant difference in frequency of other abdominal organs eventration, localization of the anterior abdominal wall defect and confluence with the abdominal cavity. Level of evidence – III. Conclusions. The mode of delivery affects the size of abdominal wall defect and frequency of the abdominal organs eventration in newborns with GS.


Author(s):  
A. Yu. Razumovskiy ◽  
N. V. Kulikova ◽  
V. V. Cholostova ◽  
M. A. Amanova ◽  
A. I. Khavkin

Introduction. Chilaiditi syndrome—hepatodiaphragmatic interposition—is a rare condition in which bowel loops are compressed in the space between the liver and the dome of the diaphragm, which can lead to the development of a wide range of complications. In the available literature data on the clinical manifestations of this condition in children with omphalocele are not described.Materials and methods. The article describes rare clinical cases of patients 1 year 1 month, 2 years 11 month and 12 years old, previously operated on in the neonatal period for omphalocele, in whom, in the long term after surgery, signs of hepatodiaphragmatic interposition persisted, which led to the development of chronic duodenal obstruction.Conclusion: It has been proven that the leading role in restoring the normal topography of the abdominal organs in children with omphalocele is played by the complete mobilization of the liver and the great vessels (IVC) fi xing it, which provide the possibility of its subphrenic localization. Chronic duodenal obstruction in children with a similar pathology has not been previously described. The proposed original method of surgical treatment seems to be pathogenetically justifi ed.


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