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Inflammatory Bowel Disease
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
The manifestations of UC are similar in pregnant and non-pregnant women. The disease course is characterized by periods of remission and relapse. Extension of colonic disease can occur with time. Common symptoms include bloody diarrhea, rectal bleeding, mucous, urgency, tenesmus and abdominal cramping [3, 4]. In severe disease, liquid stool with blood, pus, and fecal matter may be experienced. Generalized symptoms may include anorexia, nausea, vomiting, fever, and weight loss. Acute severe ulcerative colitis (ASUC) is characterized by ≥6 bowel movements per day and at least one systemic sign including tachycardia, fever, anemia, or inflammatory markers [1, 3]. Severe pain and tympany on abdominal exam suggests toxic megacolon, a potentially lethal complication. Signs of peritonitis may suggest perforation. Similar to CD, extraintestinal manifestations are not uncommon (Table 11.2).
Medicine in the Christian West During the First Centuries of the Middle Ages
Published in Arturo Castiglioni, A History of Medicine, 2019
The part that treats of the affections of the respiratory tract is especially interesting because of some observations on the prognosis of consumption. Thus it is maintained that bloody sputum at the beginning of the disease is a good sign. Among the causes of consumption one finds hemoptysis, just as in the older texts; but the treatment recommended emphasizes the necessity of prescribing a generous diet for the patient and a tranquil existence. The differential diagnosis between ascites and tympany is noteworthy: in the first case, percussion gives the sound of a filled bottle; and in the second case, the sound of a drum.
Giovanni Battista Morgagni and eighteenth-century physical examination
Published in Christopher Lawrence, Medical Theory, Surgical Practice, 2018
Morgagni attended to a variety of other bodily noises such as the crepitation of fractured limbs. In one case, by listening to such sounds, Morgagni was able to decide that the bones of a child’s arms had not been fractured or dislocated, but rather the epiphyses had become separated from the main shaft of the bone, owing, he conjectured, to some internal disease.60 He also employed the percussive technique for distinguishing whether there was water or gas in a swollen abdomen. For instance, he diagnosed a case of ascites, which another physician had confused with tympany, by using the following procedure: In the first place if you placed your left hand on the side of the abdomen, you struck the opposite side with small but repeated strokes of the right hand, you perceived the fluctuation of the water striking against the left hand.61
Otosclerosis and stapedotomy: hearing improvement, complications, and analysis of potential prognostic factors in a series of 93 cases
Published in Acta Oto-Laryngologica, 2023
Charlotte Wedel, Niels H. Holm, Frank Mirz, Therese Ovesen
All surgeries were performed under general anaesthesia by one of three ear surgeons trained in the stapedotomy procedure. The small fenestra technique was used, involving Rosen’s incision and elevation of a tympanomeatal flap. The chorda tympany was identified, and a proper view of the facial canal and the stapes footplate was obtained. A 0.5 mm fenestration of the footplate was created using a Lumenis CO2-laser. In two cases, microdrill (Medtronic Xomed Skeeter Drill Ultra-Lite) was used in conjunction with the laser during the stapedotomy. The appropriately sized prosthesis was selected and fitted into the fenestration. The incudo-stapedial joint was separated, and the stapes tendon and the posterior crus of the stapes were severed using a Lumenis CO2 laser. The anterior crus was then divided. The prostheses used were either Fisch Piston, Kurz Titanium Matrix or Kurz Angular Piston (in the case of revision surgery).
Implantability of endaurally insertable active vibratory middle-ear implants – an anatomical study
Published in Acta Oto-Laryngologica, 2019
Katrin Reimann, Sebastian Schraven, Erich Dalhoff, Hans-Peter Zenner, Heinz Arnold
In western countries, epidemiological studies show a prevalence for hearing disorders in 19% of the population [1]. In many cases, an acoustic hearing aid is an option to support hearing in these patients. However, distortion of the acoustic signal in the external auditory canal may cause major problems and discomfort, often leading to low acceptance of hearing aids in these patients. Active vibratory middle-ear implants (AMEIs) that are mechanically coupled to the ossicular chain or the round window (RW) contribute to solve this problem by directly transmitting vibrations into the acoustic system and thereby have the potential to provide higher amplification and better sound fidelity. Nevertheless, despite these beneficial aspects, the implantation technique for most AMEIs still requires extended otosurgical approaches including mastoidectomy and a posterior tympanotomy. This carries relevant operative risks for the patient, e.g. facial nerve palsy or injury of the chorda tympany. From an economical point of view, these surgical procedures are time consuming, enhancing the costs of treatment.
The impact of stapes surgery on osteogenesis imperfecta: a retrospective comparison of operative outcomes with those for patients with otosclerosis
Published in Acta Oto-Laryngologica, 2020
Xiaoyan Ma, Fangyuan Wang, Weidong Shen, Shiming Yang
A total of two ears in the otosclerosis group were revision surgeries. Both of these ears exhibited a hard lateral attic wall. In one ear, the long process of the incus adhered to the tympany, with scar tissue surrounding the stapes piston having resulted in fixation of the prosthesis. Short- and long-term hearing improvements were achieved in both of these ears.