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1.
Pan Afr Med J ; 39: 157, 2021.
Artigo em Francês | MEDLINE | ID: mdl-34539954

RESUMO

Herniation of liver segments through defects in the anterior abdominal wall is rare. To our knowledge, only three cases have been described in the literature. This study reports the case of a 84-year-old man presenting to the emergency department with strangulated hernia of the linea alba showing dullness to percussion with protrusion of a sensitive and firm mass. Laboratory test results were normal. Abdominal CT scan showed herniation of liver segment through the linea alba with calculous cholecystitis. The patient underwent retrograde cholecystectomy with subhepatic Redon drain and repair of the herniation by overlapping suture, associated with two subcutaneous vacuum suction Redon drains. The post-operative suite was simple and the patient was discharged on the second post-operative day. Six months after surgery, our patient was healthy. Herniation of liver segments through defects in the anterior abdominal wall is rare. Patients usually show little evidence if clinical signs. Abdominal CT scan is essential to assess the viability of parenchymal liver cells. Patients´ management is studied on a case-by-case basis, it can be surgical or non-surgical. Herniation of liver segments is rare; few cases have been reported in the literature and, in these cases, patients showed little evidence of clinical signs. CT scan is essential to assess the viability of parenchymal liver cells.


Assuntos
Colecistectomia/métodos , Hérnia Abdominal/diagnóstico por imagem , Fígado/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Parede Abdominal/diagnóstico por imagem , Idoso de 80 Anos ou mais , Colecistite/diagnóstico por imagem , Seguimentos , Hérnia Abdominal/cirurgia , Humanos , Fígado/citologia , Fígado/cirurgia , Masculino , Umbigo
2.
Artigo em Alemão | MEDLINE | ID: mdl-34425617

RESUMO

Urachal patency is an umbilical disease in newborn foals. Etiologically, either the closure of the urachus remains absent after birth (persistent urachus) or the urachus was already closed and reopens at a later time (patent urachus). The most common causes of patent urachus are congenital defects, tearing of the navel above the predilection site, trauma, increased intravesical or abdominal pressure and umbilical infections. Patent urachus occurs more frequently in premature or weak and immunocompromised foals. Colts are more often affected than fillies. Typical clinical signs are apparent immediately after birth (persistent urachus) or 7-14 days postpartum (patent urachus). These include either dripping or a stream of urine through umbilicus during micturition as well as a moist umbilical area. The diagnosis is usually unambiguous. Typical laboratory findings are not described for patent urachus. Conservative treatment such as obliteration, cauterization or cryosurgery may be employed in cases lacking an inflammation of the urachus or other umbilical structures and when the urachal lumen measures less than 6 mm. Surgical treatment is indicated in foals with large urachal lumen, an umbilical infection or sepsis as well as when no therapeutic success is attained after a conservative treatment of 5-7 days. In most cases, prognosis is good, however complications such as umbilical inflammation, disseminating infections, and secondary joint diseases may significantly impair prognosis.


Assuntos
Doenças dos Cavalos , Sepse , Cisto do Úraco , Úraco , Animais , Feminino , Doenças dos Cavalos/diagnóstico , Doenças dos Cavalos/terapia , Cavalos , Masculino , Sepse/veterinária , Umbigo , Cisto do Úraco/veterinária
3.
J Perinatol ; 41(10): 2505-2512, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34272469

RESUMO

OBJECTIVE: To determine the incidence of adverse events (AEs) associated with umbilical catheters in the neonatal population. STUDY DESIGN: Systematic review and meta-analysis of observational studies and randomized controlled trials published between 2010 and 2020. RESULTS: In total 14,226 umbilical venous catheters (UVCs) and 4228 umbilical arterial catheters (UACs) were included. Overall, 13.4% of UVCs were associated with an AE (95% CI: 10.1-17.0) or 2.4 per 1000 catheter days (95% CI: 1.8-3.0). UACs had an AE rate of 9% (95% CI: 5.9-12.8) or 0.87 per 1000 catheter days (95% CI: 0.4-1.3). UVC malposition was the most common (41.7% [95% CI: 27.6-56.5]). Local injury from UAC taping was the most common AE in one study. CONCLUSIONS: Umbilical catheters have a high incidence of AEs. Research into accurate methods of tip verification, tip surveillance, and securement is required.


Assuntos
Cateterismo Periférico , Dispositivos de Acesso Vascular , Cateterismo Periférico/efeitos adversos , Cateteres/efeitos adversos , Cateteres de Demora/efeitos adversos , Humanos , Recém-Nascido , Veias Umbilicais , Umbigo
4.
Int J Urol ; 28(10): 1008-1011, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34291508

RESUMO

OBJECTIVE: To report a multicenter experience with the management of urachal abscess treatment in Japan. METHODS: This was a retrospective study of 263 cases of urachal abscess managed at 12 university hospitals in the Kyushu-Okinawa region over a 10-year period. Age, sex, abscess size, clinical symptoms, type of urachal remnants, and treatment were collected and analyzed. RESULTS: The average age was 29.8 ± 18.1 years, with males accounting for approximately two-thirds of the study population. The average abscess size was 1.7 cm (range 0-11 cm). The most common presenting symptom was umbilical secretion (66%), followed by abdominal pain (46%). A total of 127 patients (48.3%) were treated with antibiotics alone, whereas 136 patients (51.7%) received surgical treatment. The surgical approach was laparotomy in 75 patients (61.0%) and laparoscopic surgery in 48 patients (39.0%). Regarding the type of urachal remnant, the urachus sinus (180 patients) accounted for 68.4% of the total. CONCLUSIONS: To our knowledge, this study represents the first report on urachal abscess treatment in Japan. Our data show that the clinical symptoms might vary depending on the type of urachus remnant. It should be noted that gross hematuria, a characteristic symptom of urachal cancer, is rare in patients with urachal abscess.


Assuntos
Abscesso , Úraco , Abscesso/diagnóstico , Abscesso/epidemiologia , Abscesso/terapia , Adolescente , Adulto , Criança , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Umbigo , Úraco/diagnóstico por imagem , Úraco/cirurgia , Adulto Jovem
5.
BMC Surg ; 21(1): 305, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34210315

RESUMO

BACKGROUND: The last procedure performed by the surgeon in laparoscopic surgery is to extract the specimen through the smallest incision possible. This experiment aimed to explore the maximum diameter of specimens that can be extracted through auxiliary incisions of different lengths and shapes by in vitro physical experiments. MATERIALS AND METHODS: We used the abdominal wall with the muscle layer, fixed on a square wooden frame, to simulate the human abdominal wall. Then, specimen extraction ports were made with circular, inverted Y-shaped and straight-line incisions of different sizes and lengths, and specimens of different sizes were made from tissues of different species. These specimens were extracted from different incisions with a force gauge. The tension value (N) was measured, and records were made of the length or diameter of the smallest auxiliary incision through which a given specimen could pass, as well as the largest specimen diameter that could pass through an incision of a given size. This experiment provides us with preliminary experience-based knowledge of how to choose the appropriate auxiliary incision for surgical specimen extraction according to the diameter of the specimen. RESULTS: The maximum diameters of specimens that could be extracted with circular ostomy diameters of 2.4, 2.7 and 3.3 cm were 4.0, 4.5 and 6.0 cm, respectively. Specimens with diameters of 6.0, 8.0 and 10.0 cm could be extracted through inverted Y-shaped incisions with a length around the umbilicus of 1 cm and an extension length of 1.0, 3.0, and 4.0 cm, respectively. Moreover, these same specimens could be extracted through inverted Y-shaped incisions with a length around the umbilicus of 2 cm and extension lengths of 0.0, 1.0 and 2.0 cm. Tough tissue specimens (made from chicken gizzards) with diameters of 1.0, 2.0, 4.0 and 6.0 cm, respectively, could be removed through straight-line incisions measuring 1.0, 2.0, 3.0 and 4.0 cm in length. CONCLUSION: Along with preoperative imaging, surgical planning and trocar position, the shape and length of auxiliary incisions can be used to improve the extraction of specimens via laparoscopic surgery.


Assuntos
Laparoscopia , Ferida Cirúrgica , Humanos , Instrumentos Cirúrgicos , Umbigo
6.
BMJ Case Rep ; 14(7)2021 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-34301696

RESUMO

A term male infant was born to a healthy 24-year-old mother with antenatally diagnosed liver-up, left congenital diaphragmatic hernia (CDH) and gastroschisis. The infant was stabilised in the neonatal intensive care unit and then underwent primary repair of the CDH via left subcostal incision and silo placement for the gastroschisis. Serial silo reductions were started postoperatively and umbilical flap closure for the gastroschisis was performed on day of life 6. The patient was weaned from respiratory support, started on enteral feeds, and discharged home at 1 month of age. He was weaned from supplemental nasogastric feeds by 6 weeks of age and is currently well and thriving at 11 months of age.


Assuntos
Gastrosquise , Hérnias Diafragmáticas Congênitas , Adulto , Nutrição Enteral , Gastrosquise/diagnóstico por imagem , Gastrosquise/cirurgia , Hérnias Diafragmáticas Congênitas/diagnóstico por imagem , Hérnias Diafragmáticas Congênitas/cirurgia , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Resultado do Tratamento , Umbigo , Adulto Jovem
7.
BMJ Case Rep ; 14(7)2021 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-34285034

RESUMO

A 75-year-old woman presented with intermittent abdominal pain and distention for 2 months, followed by purulent discharge from the umbilicus for ten days. She was evaluated and diagnosed to have perforation of the gall bladder leading to formation of an anterior abdominal wall abscess which presented as an umbilical fistula. She underwent laparoscopic cholecystectomy along with lay open of abscess in the falciform ligament and curettage of the umbilical fistula tract. She had an uneventful postoperative recovery.


Assuntos
Colecistectomia Laparoscópica , Fístula , Doenças da Vesícula Biliar , Idoso , Colecistectomia Laparoscópica/efeitos adversos , Feminino , Doenças da Vesícula Biliar/diagnóstico por imagem , Doenças da Vesícula Biliar/etiologia , Doenças da Vesícula Biliar/cirurgia , Humanos , Umbigo
8.
JSLS ; 25(2)2021.
Artigo em Inglês | MEDLINE | ID: mdl-34248340

RESUMO

Background: Minimally invasive surgery is currently a preferred treatment for symptomatic ovarian cyst(s), with single-site techniques, such as transumbilical laparoendoscopic single-site surgery (TU-LESS) and transvaginal laparoendoscopic single-site surgery (TV-LESS), gaining increasing popularity. Although both methods have delivered positive outcomes, there is currently limited literature directly comparing TU-LESS and TV-LESS. Objectives: This study had two primary objectives: (1) to evaluate the safety and feasibility of TV-LESS and TU-LESS for the treatment of ovarian cysts and (2) to compare the surgical and postoperative outcomes of the two procedures. Method: This was a prospective observational clinical analysis of 81 patients with a diagnosis of benign ovarian cyst with indication for TV-LESS or TU-LESS. Surgeries were performed at a tertiary hospital between February 1, 2018 and January 31, 2020. Patients were divided into TV-LESS (n = 40) and TU-LESS groups (n = 40), with one excluded due to severe pelvic adhesive disease. Demographics, operation outcomes, and follow-up details were compared. Results: All 80 patients underwent uncomplicated procedures. The two groups were demographically matched (except age), with no difference in operation time, intra-operative blood loss, hemoglobin loss, and hospitalization costs (P > 0.05). However, TV-LESS patients had significantly faster time to ambulation (P < 0.001), faster time to return of bowel function (P < 0.001), less postoperative pain level (P < 0.001), and shorter length of hospital stay (P < 0.001). The cosmetic scores at 1, 4, and 24 weeks after surgery were also higher for the TV-LESS group. Conclusion: Our preliminary experience suggested that TU-LESS and TV-LESS are both feasible and safe for ovarian cystectomy and salpingo-oophorectomy. However, TV-LESS may provide three main advantages including: (1) fewer postoperative complications (i.e. incisional hernia); (2) less postoperative pain; and (3) improved cosmetic satisfaction.


Assuntos
Laparoscopia/métodos , Cistos Ovarianos/cirurgia , Ovariectomia/métodos , Umbigo/cirurgia , Vagina/cirurgia , Adulto , Perda Sanguínea Cirúrgica/estatística & dados numéricos , Estudos de Viabilidade , Feminino , Humanos , Tempo de Internação , Pessoa de Meia-Idade , Duração da Cirurgia , Complicações Pós-Operatórias/etiologia , Estudos Prospectivos , Resultado do Tratamento
10.
Int J Surg ; 90: 105979, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34077810

RESUMO

BACKGROUND: liver lateral section graft is the most common graft type used for transplantation in children worldwide. Compared to whole liver grafts, a higher rate of biliary complications has been described. Historically, 2 techniques have been described for transection of liver - trans-hilar or trans-umbilical parenchymal transection. Though these techniques allow dividing the biliary system at two distinct positions, the usual surgical strategies do not take advantage of this advantage. MATERIAL AND METHODS: A retrospective study was conducted on 40 candidates who volunteered for donation of their left lateral liver section for transplantation, between October 2017 and April 2019. Preoperative imaging was analyzed to depict the arterial and biliary anatomy of the liver and their variations, with a dedicated attention to the left liver (segments 2, 3 and 4). Anatomy of the biliary system was taken into account for defining the optimal surgical strategy - either through a trans-hilar or a trans-umbilical parenchymal transection. RESULTS: In 26/40 patients, arterial or biliary variations were much relevant for decision-making on the optimal plane of liver division (trans-umbilical (N = 14) and trans-hilar (N = 26)). This resulted in 23 grafts with a single artery and bile duct, 6 grafts with double arteries and a single bile duct, and 9 grafts with double bile ducts and a single artery; only two grafts had complex anatomy. There was no arterial complication and the overall incidence of biliary problems was 14.7%. All grafts are functioning well at a mean follow-up of 19.6 ± 8.5 months. CONCLUSIONS: Anatomical variations are frequent and their knowledge is relevant for procurement of lateral section liver graft. Knowledge of these variation, or -better- preoperative biliary imaging is helpful in guiding parenchymal transection at procurement and preparing optimal liver grafts.


Assuntos
Variação Anatômica , Ductos Biliares/anatomia & histologia , Transplante de Fígado/métodos , Fígado/anatomia & histologia , Obtenção de Tecidos e Órgãos/métodos , Adolescente , Adulto , Artérias/anatomia & histologia , Ductos Biliares/irrigação sanguínea , Criança , Humanos , Fígado/irrigação sanguínea , Transplante de Fígado/efeitos adversos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estudos Retrospectivos , Umbigo
11.
JSLS ; 25(2)2021.
Artigo em Inglês | MEDLINE | ID: mdl-33981136

RESUMO

Background: Both umbilical and epigastric hernias may be associated with rectus muscle divarication. In such cases, isolated repair of combined hernia defects can have high recurrence rates and poorer cosmetic outcomes, thus the repair of both pathologies ought to be favored. The goal of the study below is to provide detailed technical aspects of the endoscopic retro-rectus mesh repair. Methods: We chose a group of 16 patients who underwent the repair of ventral hernias associated with both primary and incisional rectus diastasis, using the extended-view of a totally extraperitoneal Rives-Stoppa repair (eRives) technique. All defects were < 6 cm in width. Our outcome measures perioperative complications and early recurrences. Results: The approach used in our study has led to zero cases of perioperative complications and only one early recurrence. Conclusions: We believe that the e-Rives repair is the optimal approach for ventral hernias associated with diastasis recti. This technique additionally produces favorable cosmetic outcomes that granted our results a well-deserved recognition in the medical literature.


Assuntos
Hérnia Ventral/cirurgia , Adulto , Idoso , Endoscopia , Feminino , Herniorrafia/métodos , Humanos , Laparoscopia , Masculino , Pessoa de Meia-Idade , Recidiva , Telas Cirúrgicas , Umbigo/cirurgia
14.
Anticancer Res ; 41(4): 2197-2201, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33813434

RESUMO

BACKGROUND/AIM: To evaluate complications and risk factors associated with transumbilical incision as an organ removal site in laparoscopic pancreatectomy (LP). PATIENTS AND METHODS: In total, 52 patients who underwent LP between 2009 and 2017 were included in this study. The development of superficial surgical site infection (SSI) and transumbilical port-site incisional hernia was recorded. RESULTS: None of the patients had SSI. However, three (5.77%) presented with transumbilical incisional hernia. No variables were significantly associated with the risk of transumbilical incisional hernia. CONCLUSION: No evident risk factors correlated with hernia formation. Hence, incisional hernia might have occurred at a certain probability. In some cases, it was caused by technical problems. However, the use of transumbilical incision as an organ removal site was feasible, and a new incision for organ removal alone was not required.


Assuntos
Laparoscopia/métodos , Pâncreas/patologia , Pancreatectomia/métodos , Pancreatopatias/cirurgia , Umbigo/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Bases de Dados Factuais , Feminino , Humanos , Hérnia Incisional/diagnóstico , Hérnia Incisional/epidemiologia , Hérnia Incisional/etiologia , Japão/epidemiologia , Laparoscopia/efeitos adversos , Laparoscopia/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Pâncreas/cirurgia , Pancreatectomia/efeitos adversos , Pancreatectomia/estatística & dados numéricos , Pancreatopatias/epidemiologia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Fatores de Risco , Manejo de Espécimes/efeitos adversos , Manejo de Espécimes/métodos , Infecção da Ferida Cirúrgica/diagnóstico , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/etiologia , Umbigo/patologia , Adulto Jovem
15.
Ann Chir Plast Esthet ; 66(3): 261-267, 2021 Jun.
Artigo em Francês | MEDLINE | ID: mdl-33715869

RESUMO

Dermatofibrosarcoma is the most common cutaneous sarcoma. Its surgical management is a technical challenge due to the high amount of substance loss. We explain a new technique of abdominal wall reconstruction by a reverse abdominoplasty with umbilical transposition. This new surgical technique allowed, in one time, the excision and the abdominal wall reconstruction. Functional and esthetic results are really satisfactory.


Assuntos
Parede Abdominal , Abdominoplastia , Histiocitoma Fibroso Benigno , Neoplasias Cutâneas , Parede Abdominal/cirurgia , Estética , Humanos , Neoplasias Cutâneas/cirurgia , Umbigo/cirurgia
16.
Intern Med ; 60(18): 3059, 2021 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-33776011
17.
Surg Radiol Anat ; 43(9): 1461-1466, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33743034

RESUMO

PURPOSE: Pyramidalis is a lower anterior abdominal wall muscle that is considered vestigial and shows variations in prevalence and size. It's been utilized as an anatomical landmark and harvested for use in various surgical procedures. Despite knowledge of its clinical importance, data on the prevalence of pyramidalis remain absent from the Kenyan population with few studies globally reporting on its pubo-umbilical index. We therefore aimed to determine the prevalence and relative lengths (pubo-umbilical index) of pyramidalis muscle in a sample Kenyan population. MATERIALS AND METHODS: Fifty-two cadavers (41 males, 11 females) from the Department of Human Anatomy, University of Nairobi were used. Prevalence and length of the muscle (l) were established, and the distance between pubic symphysis and umbilicus (L) measured and used to calculate pubo-umbilical index (l/L ×100%). Independent and paired T tests were done, using SPSS® version 22. A p value of ≤ 0.05 was considered statistically significant at a 95% confidence interval. RESULTS: Pyramidalis was present in 84% (44) of cadavers; 83% (43) bilaterally, 2% (1) unilaterally, and 85.4% (35) in males, 81.8% (9) in females. Mean length in males and females was 71.8 ± 35 mm and 63.5 ± 37.5 mm, respectively. Mean pubo-umbilical index was 38% ± 18 (39 % ± 18 males, 35% ± 19 females). No statistically significant difference was found. CONCLUSION: Pyramidalis is a highly prevalent muscle in the Kenyan population and, hence, could be exploited for its clinical and surgical utilities. The muscle terminates largely within the 2nd quarter (25-50%) of the infra-umbilical linea alba measured from pubic symphysis. Its pubo-umbilical index would be useful to surgeons making midline infra-umbilical incisions and performing procedures involving the muscle.


Assuntos
Músculos Abdominais/anatomia & histologia , Variação Anatômica , Umbigo/anatomia & histologia , Cadáver , Feminino , Humanos , Quênia , Masculino
18.
J Laparoendosc Adv Surg Tech A ; 31(4): 497-504, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33651634

RESUMO

Purpose: We are presenting a very minimally invasive technique for laparoscopic appendectomy (needlescopic appendectomy [NAP]) in children and adolescents using suture grasper device, epidural needle, and homemade isolated long diathermy probe without any conventional laparoscopic instruments. Patients and Methods: NAP was attempted in 48 patients with uncomplicated acute appendicitis at Al-Azhar, Tanta University Hospitals and other allied hospitals during the period from May 2017 to November 2018. The study included patients with acute appendicitis and patients scheduled for interval appendectomy. Exclusion criteria were patients with concealed appendix, patients with appendicular abscess or appendicular mass, patients with acute appendicitis complicated with generalized peritonitis, and patients unfit for laparoscopy. The appendix was brought outside through the umbilical port and the operation was completed extracorporeally. In cases of appendicitis with tethered cecum, the whole procedure was completed intracorporeally. Results: Forty-eight patients with acute uncomplicated appendicitis were treated by NAP. They were 36 males and 12 females with a mean age of 9 ± 3.7 years (range = 4-15 years). Two cases with concealed appendix and one case with appendicular mass were diagnosed during initial laparoscopy and excluded from the study. Thirty-two cases (71.11%) were completed intracorporeally and 13 cases (28.89%) were completed by extracorporeal NAP. The mean operative time was 33.29 ± 3.95 minutes (range = 27-40 minutes) for intracorporeal NAP and 20.9 ± 7.01 minutes (range = 14-40 minutes) for extracorporeal NAP. Degrees of cosmetic satisfaction of the patients and parents were excellent in 93.33% (N = 42/45 patients), and very good in 6.67% (N = 3/45 patients) of patients. Conclusion: NAP using needles only is a new technique that is very minimally invasive, very cheap, safe, reproducible, and easy to be done with outstanding cosmetic results.


Assuntos
Apendicectomia/métodos , Apendicite/cirurgia , Apêndice/cirurgia , Laparoscopia/métodos , Agulhas , Duração da Cirurgia , Umbigo/cirurgia , Abscesso/cirurgia , Doença Aguda , Adolescente , Criança , Pré-Escolar , Diatermia , Feminino , Força da Mão , Hospitais Universitários , Humanos , Hipertermia Induzida , Masculino , Microcirurgia , Satisfação do Paciente , Peritonite/cirurgia , Instrumentos Cirúrgicos
19.
Zhen Ci Yan Jiu ; 46(2): 158-63, 2021 Feb 25.
Artigo em Chinês | MEDLINE | ID: mdl-33788438

RESUMO

OBJECTIVE: To assess the therapeutic effect of acupuncture of eight acupoints around the umbilicus in improving the metabolic level and reproductive function in endomorph polycystic ovary syndrome (PCOS) infertile patients. METHODS: Retrospective analysis was performed on 96 cases of endomorph type PCOS infertility patients who were admitted to the clinic of the Reproductive Center of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from October 2015 to June 2018. Among them, fifty-six cases of the acupuncture group received treatment with acupuncture stimulation of eight acupoints (Shuifen ï¼»CV9ï¼½, Yinjiao ï¼»CV7ï¼½, Tianshu ï¼»ST25ï¼½, Wailing ï¼»ST26ï¼½, Huaroumen ï¼»ST24ï¼½, etc.) around the umbilicus, and 40 cases of the control group were treated by oral administration of Letrozole. Acupuncture was performed once every other day, and Letrozole (2.5 mg/day) given once daily for 5 days, if no pregnancy got, the treatment procedure was repeated once again next menstruation cycle, continuously for 3 months. The pregnancy outcomes including the pregnancy rate, persistent pregnancy rate, ovulation rate and the first trimester abortion rate, and the levels of fat-related factors including body mass index (BMI), waist-to-hip ratio (WHR), homeostasis model of insulin resistance (HOMA-IR=fasting insulin x fasting blood glucose /22.5), leptin(LEP) and adiponectin(APN) of the two groups were compared. The ovulation rate (number of effective ovulation cycles/ number of observation cycles) x 100%, the first trimester abortion rate (number of spontaneous abortion within 12 weeks÷pregnancy cases) X100% were calculated. The fasting blood samples were taken for assaying serum LEP and APN contents using ELISA, blood glucose level using hexokinase assay, and serum insulin by using chemiluminescent microparticle immunoassay, separately. RESULTS: After the treatment, the pregnancy rate and the level of APN were significantly higher (P<0.05), and the BMI, WHR, HOMA-IR and LEP levels were all obviously lower in the acupuncture group than in the control group (P<0.05). There were no significant differences between the two groups in the persistent pregnancy rate, abortion rate and ovulation rate (P>0.05). CONCLUSION: Acupuncture at the eight points around the umbilicus can raise the pregnancy rate in obese type PCOS patients, which may be related to its effects in up-regulating serum APN and lowering BMI, WHR, HOMA-IR, and serum LEP levels.


Assuntos
Terapia por Acupuntura , Infertilidade , Resistência à Insulina , Síndrome do Ovário Policístico , Pontos de Acupuntura , Feminino , Humanos , Síndrome do Ovário Policístico/terapia , Gravidez , Resultado da Gravidez , Estudos Retrospectivos , Somatotipos , Umbigo
20.
Pediatrics ; 147(4)2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33771917

RESUMO

Umbilical cord nonseverance (UCNS) is the practice of leaving the umbilical cord attached to the placenta after delivery. Limited case reports exist revealing adverse outcomes of UCNS. We report a case of neonatal omphalitis associated with Escherichia coli bacteremia and urinary tract infection after UCNS.


Assuntos
Bacteriemia/microbiologia , Infecções por Escherichia coli/complicações , Cordão Umbilical , Umbigo/microbiologia , Infecções Urinárias/microbiologia , Escherichia coli , Humanos , Recém-Nascido , Masculino
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