Successful Conservative Management of Second Trimester Spontaneous Abortion Complicated by Clostridial Sepsis.

Clostridium perfringens is responsible for 5% of septic abortions. Emergent hysterectomy is often required for patient survival. This can be devastating to patients desiring future fertility. We report a 15-year-old female patient at 17 weeks and 6 days of gestation with a diagnosis of sepsis on admission. She was managed with broad-spectrum antibiotics followed by immediate evacuation of the retained placenta. Blood and placental cultures confirmed clostridial species. Successful conservative management allowed for a term pregnancy 2 years later, resulting in a healthy newborn. Few reports describe effective conservative management resulting in uterine sparing and good subsequent pregnancy outcomes.

Ovary and Fallopian Tube Displacement in an Adolescent Patient with a History of Omphalocele.

BACKGROUND: Omphalocele is an abnormality in which fetal abdominal organs protrude through the abdominal wall. CASE REPORT: We report the case of a 13-year-old female with a history of omphalocele repair who presented with acute periumbilical pain, nausea, and vomiting. A computed tomography scan showed a para-ovarian cyst and mild dilation of the small bowel. During laparoscopy, the right ovary and fallopian tube were detached from the uterus and located behind the cecum. Despite this displacement, the ovary appeared to have retained functionality with intact blood supply. We hypothesize that surgical repair led to pelvic adhesion that caused torsion and avulsion of the fallopian tube and utero-ovarian ligament that led to the displacement. CONCLUSION: This anatomical change should be considered in surgical patients with a history of omphalocele repair.

Successful Treatment of Recurrent Pyloric Stenosis Using Balloon Dilation.

Infantile hypertrophic pyloric stenosis is a common surgical disease in infants, with an incidence of 2 to 5 cases per 1000 live births. It often presents with nonbilious projectile vomiting after feeding and a mid-epigastric mass in infants between the third and eighth weeks of life. Ramstedt pyloromyotomy remains the gold standard of treatment. Postoperative emesis is common; however, further evaluation for incomplete pyloromyotomy and recurrent pyloric stenosis should be conducted with prolonged, or new-onset postoperative emesis. While repeat pyloromyotomy is the standard of care for infants presenting with incomplete pyloric stenosis, treatment for the rare development of recurrent pyloric stenosis is not clearly outlined. Here, we report a successful balloon dilation procedure in an 8-week-old female with recurrent pyloric stenosis three and a half weeks after the initial laparoscopic pyloromyotomy.

Protecting and Advancing Women's Health and Rights Post-Roe Era Through Policy.

Since federal legalization in 1973, abortion has become a safe and popular option for those who desire to terminate a pregnancy. However, the Supreme Court decision of Dobbs v. Jackson Women's Health Organization in June 2022 clearly outlined a national divide that shifted abortion rights in the hands of state legislatures. This shift in legislative power will unveil major systematic flaws and further exacerbate health inequalities among underserved populations. However, legislatures can mitigate the disruption by addressing current infrastructural gaps that will make a positive lasting impact on women's health. Legislatures should investigate the gaps within the current telehealth guidelines and interstate compact agreements that may lead to a lack of clarity and legality with a shift to state power for abortive services that may prevent abortive service distribution entirely. In addition, Graduate Medical Education Accreditation Councils and state legislatures have the opportunity to blunt the abortion provider shortage that is expected to increase with state power through expansion of family medicine residency programs curriculum and health Advanced Practice Clinicians licensure. Finally, implementation of comprehensive sexual education has shown to promote sexual health and decrease risk factors associated with utilization of abortive service and could be utilized as a preventive measure for future generations. By promptly addressing current infrastructural gaps, legislatures will be on the forefront of the challenges brought by prompt systemic change in the abortion infrastructure.

Dietary effects on the determinants of food choice: Impulsive choice, discrimination, incentive motivation, preference, and liking in male rats.

The current study sought to understand how long-term exposure to diets high in saturated fat and refined sugar affected impulsive choice behavior, discrimination abilities, incentive motivation, food preferences, and liking of fat and sugar in male rats. The results showed that 8 weeks of dietary exposure impaired impulsive choice behavior; rats exposed to diets high in processed fat or sugar were more sensitive to changes in delay, a marker of impulsivity. For the high-fat group, these deficits in impulsive choice may stem from poor time discrimination, as their performance was impaired on a temporal discrimination task. The high-fat group also showed reduced magnitude sensitivity in the impulsive choice task, and they earned fewer rewards during lever press training indicating potentially reduced incentive motivation. The high-fat group also developed a preference for high-fat foods compared to the chow and high-sugar group who both preferred sugar. In contrast, dietary exposure did not alter the liking of fat or sugar as measured by a taste reactivity task. Together, the results suggest that the alterations in impulsive choice, time discrimination, incentive motivation, and food preferences induced by consumption of a high-fat diet could make individuals vulnerable to overeating, and thus obesity.

Diet-induced impulsivity: Effects of a high-fat and a high-sugar diet on impulsive choice in rats.

Impulsive choice is a common charactertistic among individuals with gambling problems, obesity, and substance abuse issues. Impulsive choice has been classified as a trans-disease process, and understanding the etiology of trait impulsivity could help to understand how diseases and disorders related to impulsive choice are manifested. The Western diet is a possible catalyst of impulsive choice as individuals who are obese and who eat diets high in fat and sugar are typically more impulsive. However, such correlational evidence is unable to discern the direction and causal nature of the relationship. The present study sought to determine how diet may directly contribute to impulsive choice. After 8 weeks of dietary exposure (high-fat, high-sugar, chow), the rats were tested on an impulsive choice task, which presented choices between a smaller-sooner reward (SS) and a larger-later reward (LL). Then, the rats were transferred to a chow diet and retested on the impulsive choice task. The high-sugar and high-fat groups made significantly more impulsive choices than the chow group. Both groups became more self-controlled when they were off the diet, but there were some residual effects of the diet on choice behavior. These results suggest that diet, specifically one high in processed fat or sugar, induces impulsive choice. This diet-induced impulsivity could be a precursor to other disorders that are characterized by impulsivity, such as diet-induced obesity, and could offer potential understanding of the trans-disease nature of impulsive choice.