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1.
J Periodontal Res ; 59(1): 74-83, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37909328

RESUMEN

BACKGROUND AND OBJECTIVE: Arterial stiffness, which is a measure of the elasticity of the arteries, is also a risk factor for the development of cardiovascular diseases and its measurement is important for evaluating the atherosclerosis process. The purpose of this cross-sectional study to investigate whether severe periodontitis in short-term type 2 diabetes may be associated with increased cardio-ankle vascular index (CAVI) values specified for subclinical atherosclerosis risk. METHODS: A total of 136 subjects, including 69 subjects with short-term type 2 diabetes (35 with severe periodontitis and 34 with periodontally healthy) and 67 systemically healthy subjects (32 with severe periodontitis and 35 with periodontally healthy) were enrolled to this study. Assessment of all participants included in this study in terms of arterial stiffness was determined by CAVI. Serum fasting plasma glucose (FPG), glycated haemoglobin (HbA1c), triglyceride (TRG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), total cholesterol (TC) and C-reactive protein (CRP) levels were calculated using standard methods. Full mouth periodontal measurements were recorded. Multiple linear regression analysis was performed to evaluate the relationship between periodontal parameters and mean CAVI values of the groups. RESULTS: Mean CAVI levels were significantly higher in diabetic and periodontitis group compared to the other study groups (p < .05). In diabetes and periodontitis group, CAVI was showed positive correlations with CRP (r = .337, p = .048) and HbA1c (r = .442, p = .008). Also, positive significant correlations were found with probing depth (PD) and clinical attachment level (CAL) in the periodontitis groups. Multiple regression analysis revealed that CAL independently predicted CAVI levels in periodontitis groups (ß = .433, p = .019 in diabetes and periodontitis groups and ß = .57, p = .001 in systemically healthy and periodontitis group respectively). CONCLUSION: This is the first study investigating the association between severe periodontitis and CAVI in patients with short-term diabetes. Our findings suggest that severe periodontitis may be an intermediate factor in the pathway between type 2 diabetes and cardiovascular disease by increasing the arterial stiffness.


Asunto(s)
Aterosclerosis , Enfermedades Cardiovasculares , Diabetes Mellitus Tipo 2 , Periodontitis , Rigidez Vascular , Humanos , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/metabolismo , Hemoglobina Glucada , Estudios Transversales , Tobillo/irrigación sanguínea , Enfermedades Cardiovasculares/complicaciones , Periodontitis/complicaciones , Aterosclerosis/complicaciones
2.
J Clin Ultrasound ; 2024 Sep 03.
Artículo en Inglés | MEDLINE | ID: mdl-39225264

RESUMEN

PURPOSE: To investigate whether patients undergoing percutaneous liver mass biopsy (PLMB) can be safely discharged following a two-hour monitoring period. METHODS: A multi-center prospective analysis was conducted for 375 patients (196 males and 179 females), mean age 63 ± 12.45 years (range 37-89) who underwent PLMB between August 2023 and March 2024. Patients were monitored for 24 h, and complications were classified as minor or major. The timing of complications was categorized into three groups: within the first two hours, between the 2nd and 24th hours, and within 1 week after 24 hours. RESULTS: Minor complications occurred in 18.93% (71/375) and major complications in 2.13% (8/375). Most minor complications (80.2%, 57/71) appeared within the first two hours, 12.7% (9/71) between 2 and 24 h, and 7.1% (5/71) after 24 h. All major complications (62.5%, 5/8) except late-onset cases, occurred within the first two hours. No major complications occurred between 2 and 24 h. Late-onset major complications occurred in 37.5% (3/8) after 24 h. CONCLUSION: The two-hour monitoring period did not adversely impact patient management regarding minor complications and is safe for identifying all major complications except for late-onset ones. Extending the post-biopsy recovery period does not significantly improve patient care.

3.
Echocardiography ; 36(5): 1001-1004, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30968436

RESUMEN

Left pulmonary artery sling (LPAS) is a very rare cause of large airway compression. In LPAS, the left pulmonary artery (LPA) arises from the proximal right pulmonary artery, coursing over the right mainstem bronchus, posterior to the trachea and anterior to the esophagus prior to reaching the left hilum. The aberrant course of the LPA results in anatomical obstruction of the right mainstem bronchus, the trachea, or both. Only a few reports present the prenatal features of LPAS. In this report, we present the prenatal diagnosis of a case of LPAS in one of a set of identical twins in which the only feature was that of an abnormal course of the LPA on 3-vessel tracheal view. The cross-sectional view at the level of three vessels which includes both pulmonary artery branches is useful to detect this abnormality. Color and power Doppler may be helpful as well.


Asunto(s)
Ecocardiografía/métodos , Arteria Pulmonar/anomalías , Arteria Pulmonar/diagnóstico por imagen , Ultrasonografía Prenatal/métodos , Adulto , Femenino , Humanos , Lactante , Embarazo , Arteria Pulmonar/embriología , Gemelos
4.
BMC Pregnancy Childbirth ; 17(1): 129, 2017 04 27.
Artículo en Inglés | MEDLINE | ID: mdl-28449642

RESUMEN

BACKGROUND: Placenta percreta is a life-threatening condition that places patients at risk of massive bleeding. It necessitates very complicated surgery and can result in mortality. Caesarean hysterectomy is the accepted procedure worldwide; however, recent studies discussing conservative treatment with segmental resections have been published. Foetal extraction and segmental resection can be performed through the same incision (single uterine incision) or through two different incisions (double uterine incision). In this study, we aimed to evaluate the effectiveness and results of the double incision technique. METHODS: Twenty-two patients with a diagnosis of placenta percreta who underwent conservative surgery were included. Segmental resection was performed via single incision in ten patients and double incision in twelve patients. RESULTS: There was no difference between the patients who underwent segmental resection via single and double incision in terms of age, gravida, number of previous caesarean deliveries, gestational age at delivery, or rate of elective surgeries. The operation time, transfusion requirement, intensive care unit admission, total hospitalization and success of conservative surgery were comparable between the groups. CONCLUSIONS: Based on the outcomes of our study, double uterine incision allows for the safe extraction of the foetus during uterus-preserving surgery in patients with placenta percreta without worsening the results compared to single uterine incision. TRIAL REGISTRATION: NCT02702024 , Date of registration: February 26, 2016, retrospectively registered.


Asunto(s)
Tratamientos Conservadores del Órgano/métodos , Placenta Accreta/cirugía , Herida Quirúrgica , Útero/cirugía , Adulto , Femenino , Humanos , Embarazo , Estudios Retrospectivos , Resultado del Tratamiento , Adulto Joven
5.
Gynecol Endocrinol ; 32(3): 188-92, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-26489983

RESUMEN

The objective of this study was to assess the iodine status of pregnant women in a metropolitan city which was stated as iodine sufficient area after salt iodination program. This multicenter, cross-sectional study was carried out on 3543 pregnant women. Age, gestational weeks, smoking, consumption of iodized salt, dietary salt restriction, history of stillbirth, abortus and congenital malformations were questioned. Spot urine samples were analyzed for urine iodine concentration (UIC). The outcomes were: (a) median UIC in three trimesters of pregnancy and (b) frequency of ID among pregnant women. The median UIC was 73 µg/L. The median UIC was 77 µg/L (1-324), 73 µg/L (1-600) and 70 µg/L (1-1650) in three trimesters of pregnancy, respectively (p: 0.14). UIC <50 µg/L was observed in 36.6% (n: 1295) and UIC<150 µg/L was observed in 90.7% (n: 3214) of pregnant women. Only 1% (n: 34) of the pregnant women had UIC levels higher than 500 µg/L. This study showed that more than 90% of the pregnant women in this iodine-sufficient city are facing some degree of iodine deficiency during their pregnancy. A salt iodization program might be satisfactory for the non-pregnant population, but it seems to be insufficient for the pregnant population.


Asunto(s)
Yodo/orina , Embarazo/orina , Cloruro de Sodio Dietético , Adulto , Estudios Transversales , Femenino , Alimentos Fortificados , Humanos , Turquía , Población Urbana/estadística & datos numéricos , Adulto Joven
6.
Mikrobiyol Bul ; 49(4): 475-83, 2015 Oct.
Artículo en Turco | MEDLINE | ID: mdl-26649405

RESUMEN

Today, the most common cause of bloodstream infections, which led to high mortality, prolonged hospitalization and increased costs are the intravenous catheters. Among the microorganisms associated with catheter infections, staphylococci took the first place and because of their biofilm-forming properties they cause serious problems in treatment and management of the patients. Although the drug of choice in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infection is vancomycin, its effect on the bacterial biofilm is known to be low. Tigecycline, newly used in our country is a well tolerated glycylcycline antibiotic. In this study, we aimed to compare the efficacy of tigecycline and vancomycin in an in vitro MRSA biofilm model. The study consisted of 10 MRSA strains, which were detected as causative agents of catheter-related infections in our hospital. The methicillin resistance of the strains were performed by disk diffusion test with oxacillin (1 µg) disks and the biofilm forming capacity of the strains was evaluated using the Congo red agar method. The silicone disks with created biofilm layer were exposed to tigecycline (2 mg/ml) and vancomycin (2 mg/ml) for 24 hours and for 5 days 4-hours per day in a model of antibiotic lock therapy. The present study showed that, after incubating the silicon discs in antibiotic solution for 24 hours, colony forming unit counts of MRSA decreased from 10(5) cfu/ml to 510 cfu/ml in the tigecycline group and from 105 cfu/ml to 3.800 cfu/ml in the vancomycin group and remained the same in the control (10(5) cfu/ml) group (p< 0.001). In the antibiotic lock therapy model, incubation with antibiotics for 4 hours per day, yielded that the average growth was 1.800 cfu/ml in the tigecycline group and 8.700 cfu/ml in the vancomycin group, which was statistically significant (p< 0.001). No growth was detected in the tigecycline group (0 cfu/ml) while in vancomycin group number of colonies in second, thirth and fourth days were 2.000, 260, 80 cfu/ml, respectively, no growth was seen in the fifth day. From the first day until the fourth day tigecycline was statistically more effective than vancomycin (p< 0.001, p< 0.001, p< 0.001, p= 0.013, according to days respectively). As a result, it was determined that tigecycline showed a higher effect on MRSA biofilm layer created on silicon discs and the results suggested that tigecycline might be a good alternative in the treatment of catheter infections.


Asunto(s)
Antibacterianos/farmacología , Biopelículas/efectos de los fármacos , Staphylococcus aureus Resistente a Meticilina/efectos de los fármacos , Staphylococcus aureus Resistente a Meticilina/fisiología , Minociclina/análogos & derivados , Vancomicina/farmacología , Biopelículas/crecimiento & desarrollo , Infecciones Relacionadas con Catéteres/microbiología , Colorantes , Rojo Congo , Pruebas Antimicrobianas de Difusión por Disco , Humanos , Resistencia a la Meticilina , Minociclina/farmacología , Oxacilina/farmacología , Infecciones Estafilocócicas/microbiología , Tigeciclina
8.
Br J Radiol ; 97(1162): 1683-1689, 2024 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-39120908

RESUMEN

OBJECTIVE: This study aimed to conduct a comparative analysis of procedural efficacy, safety, and patient outcomes between 2 distinct approaches for percutaneous antegrade double-J ureteral stent (DJS) insertion: the first-hand approach and via a nephrostomy route. METHODS: Electronic records of patients undergoing percutaneous antegrade ureteral DJS placement from January 2016 to 2023 were reviewed. Patients were categorized into 2 groups based on stent placement technique: the first-hand group, involving a single-stage approach without prior percutaneous nephrostomy catheter insertion, and the nephrostomy group, where stent placement occurred through a percutaneous nephrostomy tube. Clinical data, including patient demographics, primary diagnoses, procedural details, complication rates, stent placement success, and post-procedural outcomes, were collected and analysed. RESULTS: Both approaches demonstrated high technical success rates (93.1%). However, the nephrostomy route group exhibited a comparatively higher fluoroscopy exposure rate (8.2 min) than the first-hand group (6.8 min). Moreover, the complication risk increased by 3.08 times in patients treated with the nephrostomy method (P = .047). Notably, in cases of urinary malignancies, the preference was for placing DJS via nephrostomy. CONCLUSION: The first-hand approach should be prioritized as the initial choice in suitable cases owing to its reduced fluoroscopy time, lower complication rate, and the single-stage nature of the procedure. ADVANCES IN KNOWLEDGE: With the exception of cases necessitating urgent drainage, such as post-renal acute renal failure and urosepsis, the first-hand method is the primary approach for inserting DJS. This is primarily due to the significantly shorter radiation time and the single-stage nature of the procedure.


Asunto(s)
Nefrostomía Percutánea , Stents , Uréter , Humanos , Femenino , Masculino , Persona de Mediana Edad , Nefrostomía Percutánea/métodos , Estudios Retrospectivos , Anciano , Uréter/cirugía , Adulto , Fluoroscopía , Resultado del Tratamiento , Implantación de Prótesis/métodos , Anciano de 80 o más Años , Complicaciones Posoperatorias
9.
J Infect Dev Ctries ; 18(7): 1026-1031, 2024 Jul 29.
Artículo en Inglés | MEDLINE | ID: mdl-39078780

RESUMEN

INTRODUCTION: This study aimed to investigate the factors influencing the diagnostic yield of microbiologic diagnosis obtained through percutaneous abdominal abscess drainage procedures. We analyzed the influence of diverse clinical, radiological, and pre-procedural factors on the success of microbiologic diagnosis in this context. METHODOLOGY: A retrospective analysis of patients who underwent percutaneous abdominal abscess drainage was performed to assess the factors affecting the diagnostic yield for microbiologic diagnosis. RESULTS: A total of 174 patients undergoing percutaneous abdominal abscess drainage was included. The use of antibiotics during the procedure and the spread of the abscess to other organs significantly increased the likelihood of obtaining a positive culture. Specifically, antibiotic use during the procedure raised the risk by up to 3.30-fold (OR = 3.30, 95% CI 1.48-7.65, p = 0.004), while abscess spread to another organ increased the risk by approximately 1.87-fold (OR = 1.87, 95% CI 0.98-3.61, p = 0.057). Additionally, abscesses containing air and abscesses with an air-fluid level were more common in patients with positive culture results. Other factors, such as gender, age, malignancy prevalence, and surgical history, did not significantly impact culture results. CONCLUSIONS: This study provides valuable insights into the factors affecting the diagnostic yield of microbiologic diagnosis from percutaneous abdominal abscess drainage. The findings underscore the importance of considering patient-specific variables and procedural aspects when planning and executing abscess drainage procedures. Further research can build upon these insights to develop evidence-based guidelines for optimizing the diagnostic yield of percutaneous abdominal abscess drainage procedures.


Asunto(s)
Absceso Abdominal , Drenaje , Humanos , Estudios Retrospectivos , Masculino , Drenaje/métodos , Femenino , Absceso Abdominal/diagnóstico , Absceso Abdominal/microbiología , Persona de Mediana Edad , Anciano , Adulto , Anciano de 80 o más Años , Antibacterianos/uso terapéutico
10.
Cancer Med ; 13(14): e7467, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-39015039

RESUMEN

INTRODUCTION: Peritoneal lesions cannot be definitively distinguished based on clinical and imaging characteristics alone. This study aimed to evaluate the reliability, diagnostic value, and diagnostic yield of ultrasound-guided percutaneous core needle biopsy (PCNB) for peritoneal lesions. METHODS: A retrospective analysis of 129 patients who underwent PCNB for peritoneal lesions was performed to assessed technical completion and diagnostic yield. RESULTS: The results showed that ultrasound-guided PCNB is a safe and reliable diagnostic tool with high diagnostic yield for peritoneal lesions. Technical feasibility and diagnostic yield rates were 100% and 89.9%, respectively. The diagnostic yield was lower for patients with a known history of cancer and a short anteroposterior diameter of the target lesion. CONCLUSIONS: These findings suggest that ultrasound-guided PCNB could be considered as a first-line diagnostic tool for peritoneal lesions, as it offers a minimally invasive and accurate means of obtaining tissue samples for diagnosis.


Asunto(s)
Biopsia Guiada por Imagen , Neoplasias Peritoneales , Humanos , Femenino , Masculino , Persona de Mediana Edad , Anciano , Biopsia con Aguja Gruesa/métodos , Neoplasias Peritoneales/diagnóstico , Neoplasias Peritoneales/diagnóstico por imagen , Neoplasias Peritoneales/patología , Biopsia Guiada por Imagen/métodos , Estudios Retrospectivos , Adulto , Reproducibilidad de los Resultados , Anciano de 80 o más Años , Ultrasonografía Intervencional/métodos , Adulto Joven
11.
Exp Clin Transplant ; 22(8): 613-621, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39254073

RESUMEN

OBJECTIVES: This study investigated whether kidney transplant donors experience increased arterial stiffness compared with the general population and how arterial stiffness changes over time. MATERIALS AND METHODS: Our study included 59 kidney transplant donors and 27 healthy volunteers. All subjects underwent cardio-ankle vascular index measurements. We studied fibroblast growth factor23, klotho, monocyte chemoattractant protein-1, N-terminal pro-B-type natriuretic peptide, indoxyl sulfate, and p-cresyl sulfate levels. RESULTS: Cardio-ankle vascular index level was higher in donors 6 to 11 years after donation (8.02 ± 0.24 m/s) than in donors 2 to 6 years after donation (7.02 ± 0.27 m/s) and healthy volunteers (6.65 ± 0.22 m/s). Cardioankle vascular index level was positively correlated with age (r = 0.382, P < .001) and levels of triglyceride (r = 0.213, P = .049), blood urea nitrogen (r = 0.263, P = .014), creatinine (r = 0.354, P = .001), calcium (r = 0.228, P = .035), indoxyl sulfate (r = 0.219, P = .042), p-cresyl sulfate (r = 0.676, P ≤ .001), and monocyte chemoattractant protein-1 (r = 0.451, P ≤ .001) and negatively correlated with estimated glomerular filtration rate (r = -0.383, P < .001). Multiple linear regression analysis revealed that age (P = .026, B = 0.244), mean arterial blood pressure (P < .001, B = 0.446), blood urea nitrogen (P = .006, B = 0.302), creatinine (P = .032, B = 0.236), estimated glomerular filtration rate (P = .003, B = -0.323), fibroblast growth factor-23 (P = .007, B = 0.294), N-terminal pro-B-type natriuretic peptide (P = .005, B = 0.304), and monocyte chemoattractant protein-1 (P ≤ .001, B = 0.434) independently predicted cardio-ankle vascular index levels. CONCLUSIONS: Even without additional risk factors, kidney donors should be followed closely for arterial stiffness and cardiovascular disease, especially in the long-term (>5 years) after kidney transplant.


Asunto(s)
Biomarcadores , Índice Vascular Cardio-Tobillo , Mediadores de Inflamación , Trasplante de Riñón , Valor Predictivo de las Pruebas , Calcificación Vascular , Rigidez Vascular , Humanos , Masculino , Femenino , Biomarcadores/sangre , Persona de Mediana Edad , Trasplante de Riñón/efectos adversos , Adulto , Estudios de Casos y Controles , Calcificación Vascular/sangre , Calcificación Vascular/fisiopatología , Calcificación Vascular/etiología , Calcificación Vascular/diagnóstico , Factores de Tiempo , Mediadores de Inflamación/sangre , Factores de Riesgo , Factores de Crecimiento de Fibroblastos/sangre , Factor-23 de Crecimiento de Fibroblastos , Quimiocina CCL2/sangre , Uremia/sangre , Uremia/diagnóstico , Uremia/fisiopatología , Indicán/sangre , Resultado del Tratamiento , Donadores Vivos
12.
Saudi Med J ; 45(6): 606-616, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38830660

RESUMEN

OBJECTIVES: To assess the risk variables related to the types of candidemia for each patient, who was admitted into the intensive care unit regardless of the patient with or without complete diagnosis of COVID-19, during the period of March 2019 to December 2022. METHODS: The evaluation comparison of demographic and clinical data of COVID-19 positive and negative patients with candidemia confirmed in blood, 113 cases were assessed. Variables such as gender, age, age of hospitalization, history of hospitalization, concurrently infection, The acute physiology and chronic health evaluation-II scores, comorbidity checking, intubation, central venous catheter use, parenteral nutrition use, steroid use, antibiotic use, lymphopenia, and laboratory variables were evaluated. Candida species distribution, antifungal susceptibility in blood culture were determined. RESULTS: Coronavirus disease-19 was present in 62.8% of cases confirmed candidemia, and these cases were significantly different from COVID-19 negative cases. Significance was found in more intubation, central venous catheter use, parenteral nutrition, and steroid therapy in Group 2. There was no significance with species distribution and associated infection. In total, COVID-19 positive had higher hemoglobin, aspartate aminotransferase, alanine transaminase, and white blood cell levels, which may be associated with the possibility of revealing and controlling candidemia. CONCLUSION: Candida albicans and Candida Parapsilosis (C. parapsilosis) are the species seen in infected COVID-19 patients, while C. parapsilosis and Candida tropicalis are found in non-COVID-19 ones. Risk factors were intubation, parenteral nutrition, central venous catheter, and steroid in the COVID-19 group.


Asunto(s)
COVID-19 , Candida , Candidemia , Unidades de Cuidados Intensivos , Humanos , Candidemia/epidemiología , Factores de Riesgo , Masculino , Femenino , Unidades de Cuidados Intensivos/estadística & datos numéricos , COVID-19/complicaciones , COVID-19/epidemiología , Persona de Mediana Edad , Candida/aislamiento & purificación , Anciano , Adulto , Nutrición Parenteral , Candida albicans/aislamiento & purificación , Antifúngicos/uso terapéutico , SARS-CoV-2 , Candida tropicalis/aislamiento & purificación
13.
Fetal Pediatr Pathol ; 32(5): 341-5, 2013 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-23421545

RESUMEN

Liver tumors seldom occur in the perinatal period. Hepatic hemangiomas are the most common tumors of the liver diagnosed during fetal and neonatal life. The diagnosis can be suspected antenatally by ultrasound and MR scan. The differential diagnosis is often challenging. While small hepatic hemangiomas are usually asymptomatic, large tumors can lead to complications such as high-output congestive heart failure, consumptive thrombocytopenic coagulopathy and hemorrhage after tumor rupture. We describe a case of hepatic hemangioma presenting as a solid abdominal mass with several cystic areas on an obstetric ultrasound and report on the contribition fetal MR imaging to the diagnosis.


Asunto(s)
Hemangioma Cavernoso/diagnóstico , Neoplasias Hepáticas/diagnóstico , Diagnóstico Prenatal/métodos , Adulto , Femenino , Muerte Fetal/etiología , Hemangioma Cavernoso/congénito , Hemangioma Cavernoso/diagnóstico por imagen , Humanos , Hidropesía Fetal/etiología , Neoplasias Hepáticas/congénito , Neoplasias Hepáticas/diagnóstico por imagen , Imagen por Resonancia Magnética , Embarazo , Ultrasonografía Prenatal
14.
J Clin Ultrasound ; 40(9): 598-9, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-21812002

RESUMEN

Aortopulmonary window (APW) is a rare congenital heart malformation. It refers to a connection between the ascending aorta and the pulmonary trunk before bifurcation. We report a case of APW that was detected by prenatal fetal echocardiography. The diagnosis was confirmed postnatally with an additional partial anomalous pulmonary venous connection. Corrective surgery was performed at the age of 1 week. Prenatal diagnosis of APW is important because an operation early after birth is required to prevent congestive heart failure due to high pulmonary blood flow. It is essential to visualize the aortopulmonary septum during fetal echocardiographic examination.


Asunto(s)
Defecto del Tabique Aortopulmonar/diagnóstico por imagen , Enfermedades Fetales/diagnóstico por imagen , Ultrasonografía Prenatal/métodos , Adulto , Aorta/anomalías , Aorta/diagnóstico por imagen , Aorta/cirugía , Defecto del Tabique Aortopulmonar/cirugía , Resultado Fatal , Femenino , Hematoma Subdural , Humanos , Hidrocefalia , Recién Nacido , Masculino , Complicaciones Posoperatorias , Embarazo , Arteria Pulmonar/anomalías , Arteria Pulmonar/diagnóstico por imagen , Arteria Pulmonar/cirugía
15.
J Clin Ultrasound ; 40(9): 590-3, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22362124

RESUMEN

Ductus venosus connecting the portal and embryonic venous circulation into the inferior vena cava has a crucial role in fetal circulation. The absence of ductus venosus is a rare anomaly, in which the umbilical vein connection to the venous system may be extrahepatic, bypassing the liver or intrahepatic via the portal venous system. We report three cases of ductus venosus agenesis with associated anomalies. In two of them the connection was directly to the right atrium, whereas the umbilical vein drained to the left internal iliac artery in the third case.


Asunto(s)
Enfermedades Fetales/diagnóstico por imagen , Ultrasonografía Prenatal/métodos , Venas Umbilicales/anomalías , Venas Umbilicales/diagnóstico por imagen , Vena Cava Inferior/anomalías , Vena Cava Inferior/diagnóstico por imagen , Aborto Eugénico , Adulto , Resultado Fatal , Femenino , Humanos , Recién Nacido , Masculino , Embarazo , Tetralogía de Fallot
16.
Infect Dis Clin Microbiol ; 4(1): 7-17, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38633549

RESUMEN

Objective: Determining the clinical characteristics associated with SARS-COV-2 infection may contribute to reducing mortality in elderly patients, considering the age-related sensitivity and the excess of complications. Our study aimed to evaluate the factors that determine the severity of the disease in elderly patients followed up in our hospital. Materials and Methods: The files of definite or probable COVID-19 patients over 65 years old who were followed up by the infectious diseases clinic of our hospital between March 15 and October 1, 2020, were evaluated retrospectively. Results: A total of 134 patients were included in the study, 52.2% of the patients were male, and the mean age was 75.11±7.15 (min 65-max 94). Multimorbidity was detected in 42.5% of the patients, and the most common comorbidities were hypertension (53.7%) and diabetes mellitus (36.6%). Severe COVID-19 was present in 39.6% of patients. The most common complaints were fatigue (70.9%), cough (59.7%), and shortness of breath (59%). When the patients' computed tomography (CT) images of thorax were evaluated, ground-glass was observed in 94.8% (n=127), infiltration in 42.5% (n=57), and consolidation in 32.8% (n=44). Involvement was bilateral in 93.3% (n=125) of the patients. The most common antiviral treatment used for patients was favipiravir 73.1% (n=98). The average hospitalization period of the patients was 12±6.36 days, the rate of follow-up in the intensive care unit was 20.1% (n=27), and death occurred in 9.7% (n=13) of the patients. In the multivariate analysis, cough and shortness of breath at admission, atelectasis and pleural effusion on thorax CT were found to be significant for severe COVID-19 disease (p<0.05). Conclusion: Providing early medical support to these patients, especially, in the presence of cough and shortness of breath on admission and the presence of pleural effusion and atelectasis on thoracic CT, may help reduce the poor clinical course.

17.
Jpn J Radiol ; 39(12): 1186-1194, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34165683

RESUMEN

PURPOSE: Sometimes, characterization of pleural effusion (PE) can be challenging especially in patients whom invasive procedures/recurrent invasive procedures cannot be performed. The main purpose of the study is to answer this question, Can 18F-FDG-PET/CT contribute to reduction in the number of invasive procedures or patients undergoing to invasive procedures? Results may increase the effectiveness of patient management by facilitating clinical decision-making, especially in patients who cannot undergo invasive/recurrent invasive procedures. METHODS: Sixty-seven patients' 18F-FDG-PET/CT, pleural fluid cytologies (PFCs) and, if any, pleural biopsies were re-assessed. If patient's PFC/biopsy was malignant, effusion was considered as malignant. If two consecutive PFCs were negative in patients without biopsy, effusion was considered as benign. Characterization was based on consensus with baseline/follow-up 18F-FDG-PET/CT and clinical parameters in patients with one negative PFC (n = 6). RESULTS: None of the 18F-FDG-PET/CT parameters could characterize PE alone. However, if PE maximum standardized uptake value (SUVmax) > 1.3 or PE SUVmax/mean standardized uptake value of mediastinal blood pool (MBP SUVmean) > 1.2 was combined with at least one of the following, specificity and positive predictive value (PPV) were 100%, accuracy was around 90%. Diffuse-nodular/nodular pleural thickness, post-obstructive atelectasis, nodule/mass with SUVmax > 2.5 in lung, multiple pulmonary nodules. All 29 patients who had SUVmax > 1.3 together with at least one of the mentioned four parameters diagnosed malignant pleural effusion (MPE). However, sensitivity and negative predictive value (NPV) were still insufficient. CONCLUSION: Patients who have contraindications for invasive diagnostic methods, and meet the aforementioned criteria may be considered as MPE primarily. On the other hand, if PE SUVmax < 1.3 or PE SUVmax/MBP SUVmean < 1.2 with the negativity of the all four parameters mentioned above, it is difficult to say that this can be considered as benign pleural effusion (BPE) according to our results.


Asunto(s)
Nódulos Pulmonares Múltiples , Derrame Pleural , Fluorodesoxiglucosa F18 , Humanos , Recurrencia Local de Neoplasia , Derrame Pleural/diagnóstico por imagen , Tomografía Computarizada por Tomografía de Emisión de Positrones , Radiofármacos
18.
J Obstet Gynaecol Res ; 36(3): 502-5, 2010 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-20598028

RESUMEN

AIM: To study the outcome of cases of incidental adnexal masses detected during cesarean section. METHODS: A total of 126 093 live births and 39 115 cesarean deliveries performed between 2002 and 2008 were retrospectively evaluated and cases with additional adnexal masses and surgical interventions were included in the study. Histopathologic assessment and related outcomes were examined. RESULTS: One hundred and nineteen patients had incidental adnexal masses at the time of cesarean delivery; the incidence of adnexal masses was 1/329. The most common histopathologic diagnoses were mature cystic teratoma (32%) and functional cysts (26%). Six cases (5%) were bilateral. The mean cyst size was 6.4 cm; two of the masses were malignant. CONCLUSION: Incidental masses detected at the time of cesarean section should be extirpated in order to exclude the possibility of malignancy and to avoid additional surgical procedures following cesarean section.


Asunto(s)
Enfermedades de los Anexos/cirugía , Cesárea , Hallazgos Incidentales , Complicaciones Neoplásicas del Embarazo/cirugía , Enfermedades de los Anexos/patología , Femenino , Humanos , Embarazo , Complicaciones Neoplásicas del Embarazo/patología , Estudios Retrospectivos , Resultado del Tratamiento
19.
Arch Gynecol Obstet ; 280(1): 13-8, 2009 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-19034470

RESUMEN

OBJECTIVE: The aim of this study was to determine whether the timing of prophylactic antibiotics at cesarean delivery influences maternal and neonatal infectious morbidity. STUDY DESIGN: This was a prospective, randomized trial. Four hundred patients that underwent elective cesarean section between June and December 2007 formed the study population. Eleven patients were excluded from the study because they needed transfusion during the cesarean section. The population was divided into two groups: Group A, antibiotic prophylaxis was applied to 194 women before skin incision and Group B, antibiotic prophylaxis was applied to 195 women after umbilical cord clamping. The occurrence of endomyometritis/endometritis, wound infection, febrile morbidity, total infectious morbidity, and neonatal complications were compared. RESULTS: There were 389 patients enrolled. No demographic differences were observed between groups. No significant difference was found between the groups for total infectious morbidity [relative risk (RR) 1.39, 95% confidence interval (CI) 0.71-2.69] and endometritis (RR 1.40, 95% CI 0.43-4.51). There was no increase in neonatal sepsis (RR 1.47, 95% CI 0.61-3.53), sepsis workup (RR 1.35, 95% CI 0.75-2.42), need for neonatal intensive care (RR 1.77, 95% CI 0.51-6.16), and intensive care stay period (P = 0.16). CONCLUSIONS: Time of antibiotic prophylaxis application does not change maternal infectious morbidity in cesarean section deliveries. Preoperative prophylaxis application does not affect neonate morbidity rates as stated in literature.


Asunto(s)
Profilaxis Antibiótica , Infecciones Bacterianas/prevención & control , Cesárea , Complicaciones Posoperatorias/prevención & control , Complicaciones Infecciosas del Embarazo/tratamiento farmacológico , Adulto , Profilaxis Antibiótica/métodos , Infecciones Bacterianas/epidemiología , Cefazolina/uso terapéutico , Cesárea/efectos adversos , Esquema de Medicación , Procedimientos Quirúrgicos Electivos , Endometritis/epidemiología , Femenino , Humanos , Recién Nacido , Embarazo
20.
J Clin Ultrasound ; 37(4): 245-8, 2009 May.
Artículo en Inglés | MEDLINE | ID: mdl-19260111

RESUMEN

We describe the abnormal sonographic findings in the brain of a 26-week fetus, which increased the suspicion of isolated lissencephaly. Follow-up ultrasound examination and MRI depicted diffuse cortical agyria, microcephaly, hypotelorism, and proptosis. Cordocentesis showed a normal 46,XY karyotype, and no short arm deletion of chromosome 17 was detectable. Postmortem examination confirmed complete agyria of the whole fetal brain. Early detection of fetal microcephaly and other cranial abnormalities can be a sign of isolated lissencephaly and need to be evaluated carefully with ultrasound and MRI for detection of abnormal cortical development of the fetal brain.


Asunto(s)
Aborto Terapéutico/métodos , Lisencefalia/diagnóstico por imagen , Ultrasonografía Prenatal , Autopsia , Femenino , Edad Gestacional , Humanos , Recién Nacido , Lisencefalia/diagnóstico , Imagen por Resonancia Magnética , Masculino , Embarazo , Diagnóstico Prenatal/métodos , Adulto Joven
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