RESUMEN
A screening of coronavirus disease 2019 (COVID-19) polymerase chain reaction (PCR) tests using saliva for pregnant women and their partners was performed at all 12 maternity facilities located in Himeji city between May 29 and September 5, 2020. Pregnant women at 37 or more weeks of gestation or who experienced threatened labor and their partners who cared for an infant underwent a saliva PCR test with informed consent. As a result, all of 1475 pregnant women and 1343 partners tested negative for COVID-19 PCR. There were no cases of false positive or false negative PCR tests. This cohort study revealed for the first time that a screening of COVID-19 PCR tests using saliva may be useful to sustain perinatal medical care during the pandemic period in Japan.
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COVID-19/diagnóstico , Complicaciones Infecciosas del Embarazo/diagnóstico , SARS-CoV-2/aislamiento & purificación , Saliva/virología , Estudios de Cohortes , Programas de Detección Diagnóstica , Reacciones Falso Negativas , Reacciones Falso Positivas , Femenino , Humanos , Japón , Masculino , Atención Perinatal , Embarazo , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , EspososRESUMEN
The purpose of this study is to evaluate the diagnostic usefulness of magnetic resonance imaging (MRI) characteristics of endometrial polyps in order to differentiate them from other endometrial lesions. MRI was retrospectively reviewed in 40 patients with pathologically proven endometrial polyps. Special attention was paid to the sizes, shapes, margins, internal structures, signal intensities, and post-contrast enhancement patterns. A central fibrous core, intratumoral cysts, and hemorrhage were seen in 30 (75%), 22 (55%), and 14 (35%) patients, respectively. The predominant signal intensity of the lesions showed iso-to slightly low signal intensity relative to the endometrium on T2-weighted images in 36 (90%), low signal intensity on diffusion-weighted images in 32 (80%), and strong or moderate enhancement on enhanced T1-weighted images in 28 patients (70%), respectively. In 32 (80%) patients, the endometrial polyps showed global or partial early enhancement. On dynamic study, rapid enhancement with a persistent strong enhancement pattern was seen in 17 (42.5%) and a gradually increasing enhancement pattern was seen in 17 patients (42.5%). These MRI features can be helpful to distinguish the endometrial polyps from various other endometrial lesions.
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Neoplasias Endometriales/diagnóstico , Endometrio/patología , Imagen por Resonancia Magnética/métodos , Pólipos/diagnóstico , Adulto , Anciano , Diagnóstico Diferencial , Neoplasias Endometriales/patología , Femenino , Humanos , Persona de Mediana Edad , Pólipos/patología , Estudios RetrospectivosRESUMEN
Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) preserves the life of heart failure patients by providing an adequate oxygen supply and blood flow to vital organs. For patients with severe cardiogenic shock secondary to acute myocardial infarction or acute myocarditis, V-A ECMO is commonly used as the first choice among cardiac circulatory support devices. While V-A ECMO generates circulatory flow using a centrifugal pump, the provision of pulsatile flow is difficult. We previously reported our development of a new circulatory flow assist device (K-beat) for cardiac management with pulsatile flow. To obtain more efficient pulsatile assist flow (diastolic augmentation), an electrocardiogram (ECG)-analyzing device that can detect R waves and T waves increases the assist flow selectively in the diastole phase by controlling (opening and closing) the magnetic valve of the tamper. Here, we describe the first use of the K-beat on a large animal in combination with a clinical device. In addition, the diastolic augmentation effect of the K-beat as a circulatory flow assist device was examined in a pig V-A ECMO model. The K-beat was stopped every 60 minutes for a period of a few minutes, and blood pressure waveforms in the pulsatile and non-pulsatile phases were checked. This experiment showed that stable V-A ECMO could be achieved and that hemodynamics were managed in all animals. The pulsatile flow was provided in synchrony with the ECG in all cases. A diastolic augmentation waveform of femoral arterial pressure was confirmed in the pulsatile phase. K-beat could be useful in patients with severe heart failure.
RESUMEN
PURPOSE: To assess the antitumor efficacy and safety of 2 treatment modalities: intraperitoneal carboplatin combined with intravenous (IV) paclitaxel. PATIENTS AND METHODS: Eligible patients were those with epithelial ovarian carcinoma or primary peritoneal carcinoma stages II to IV who underwent initial surgery and had a residual tumor size of 2 cm or larger. Patients received IV paclitaxel 175 mg/m followed by intraperitoneal carboplatin AUC6. The primary end point was a response. Secondary end points were toxicity, progression-free survival, and overall survival. RESULTS: Twenty-six patients were enrolled, and 24 patients were eligible for assessment. The response rate was 83.3% (95% CI, 62.6%-95.3%; ). The median progression-free survival was 25 months. The median overall survival had not been reached. Incidences of grade (G) 3/4 hematological toxicities were absolute neutrophil count, 96%; hemoglobin, 29%; and thrombocytopenia, 16%. Nonhematological toxicities included G2 liver function, 4%; G3 sensory neuropathy, 8%; and G3 myalgia and arthralgia, 4%. CONCLUSIONS: Intraperitoneal administration of carboplatin combined with IV paclitaxel was well tolerated and showed satisfactory response in the patients with bulky residual tumor. Large-scale phase III trial comparing with IV carboplatin is warranted in this patient population.
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Adenocarcinoma Mucinoso/tratamiento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Cistadenocarcinoma Seroso/tratamiento farmacológico , Neoplasias Endometriales/tratamiento farmacológico , Neoplasias Ováricas/tratamiento farmacológico , Neoplasias Peritoneales/tratamiento farmacológico , Adenocarcinoma Mucinoso/mortalidad , Adenocarcinoma Mucinoso/patología , Carboplatino/administración & dosificación , Cistadenocarcinoma Seroso/mortalidad , Cistadenocarcinoma Seroso/patología , Neoplasias Endometriales/mortalidad , Neoplasias Endometriales/patología , Femenino , Humanos , Infusiones Intravenosas , Infusiones Parenterales , Dosis Máxima Tolerada , Estadificación de Neoplasias , Neoplasias Ováricas/mortalidad , Neoplasias Ováricas/patología , Paclitaxel/administración & dosificación , Neoplasias Peritoneales/mortalidad , Neoplasias Peritoneales/patología , Pronóstico , Tasa de Supervivencia , Resultado del TratamientoRESUMEN
This study was conducted to determine the gestational age-related reference range of the preload index [peak velocity during atrial contraction (A)/peak velocity during ventricular systole (S)] for the inferior vena cava (IVC), the right hepatic vein, the middle hepatic vein and the left hepatic vein. The slope and the intercept of the regression line for each preload index were compared among the 4 veins using analysis of covariance. Doppler measurements were obtained for the 4 veins of 316 normal fetuses at 22-40 weeks of gestation. A and S values were measured from the recorded flow velocity waveform of each vein and the A/S ratio was calculated as the preload index. The regression lines for the preload index of the 4 veins decreased gradually throughout gestation. Analysis of covariance revealed no significant differences in the slopes of the regression lines for the 4 veins. However, the intercepts of the regression lines for all hepatic veins were significantly higher than that of the regression line for the IVC (P<0.0001), with the difference ranging from 0.024 to 0.033. There were no significant differences among the intercepts of the regression lines for different hepatic veins. We concluded that the relationship between the preload index and the duration of gestation was statistically similar for all hepatic veins, and strongly resembled that for the IVC.
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Feto/fisiología , Venas Hepáticas/fisiología , Vena Cava Inferior/fisiología , Velocidad del Flujo Sanguíneo/fisiología , Femenino , Edad Gestacional , Humanos , Embarazo , Valores de Referencia , Ultrasonografía Doppler , Ultrasonografía Prenatal , Vena Cava Superior/fisiologíaRESUMEN
We encountered a case of atypical sclerosing stromal tumor of the ovary (SST) in a middle-aged woman. This 52-year-old woman presented with a 2-year history of abdominal distention. Magnetic resonance imaging (MRI) showed a large mass extending from the pelvis to the epigastrium. T2-weighted MRI showed an island-shaped area of slight hyperintensity. Dynamic MRI demonstrated gradual light enhancement of the area in which T2-weighted imaging showed low intensity. The diagnosis of the tumor proved difficult because neither MRI findings nor the age of getting sick were atypical. We report this case with MRI findings and correlated pathology.