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Heterotopic Pregnancy
Published in Botros Rizk, A. Mostafa Borahay, Abdel Maguid Ramzy, Clinical Diagnosis and Management of Gynecologic Emergencies, 2020
Spontaneous heterotopic triplets—a tubal ectopic pregnancy and a twin pregnancy—are rare occurrences [28]. Six cases of spontaneous heterotopic triplets were identified in review. Early surgical intervention is the key to successful treatment of heterotopic triplet pregnancy and allows good neonatal outcome.
Pseudohypoparathyroidism
Published in Pallavi Iyer, Herbert Chen, Thyroid and Parathyroid Disorders in Children, 2020
Ambika P. Ashraf, Todd D. Nebesio
There is currently no specific therapy or medication for heterotopic ossifications. Small ossifications usually do not progress. Ossifications that cause pain and/or irritations may be surgically removed. Regular limb mobilization and physical therapy are necessary when ossifications surround joints.
Emergency Surgery
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
Alastair Brookes, Yiu-Che Chan, Rebecca Fish, Fung Joon Foo, Aisling Hogan, Thomas Konig, Aoife Lowery, Chelliah R Selvasekar, Choon Sheong Seow, Vishal G Shelat, Paul Sutton, Colin Walsh, John Wang, Ting Hway Wong
What is an ectopic pregnancy?A fertilised ovum is implanted outside the uterine cavity.The rate of ectopic pregnancy is 1% of all pregnancies and is higher in IVF pregnancies.Heterotopic pregnancy (the coexistence of an ectopic pregnancy with an intrauterine pregnancy), is very rare (approximately 1 in 30,000 conceptions) but is also more common in IVF pregnancies.
Natural conception resulting in a ruptured heterotopic pregnancy in a multiparous woman
Published in Baylor University Medical Center Proceedings, 2020
Vimal B. Shenoy, C. J. Buckley
In a natural pregnancy, the index of suspicion for heterotopic pregnancy is low, which may mislead the clinician to truncate bedside ultrasound evaluation. The current standard of practice for first-trimester ultrasonography includes evaluation of adnexa and cul-de-sac.3 While the incidence of heterotopic pregnancy is extremely low, the morbidity associated with a missed diagnosis of heterotopic pregnancy is significant.4 Diagnosis of the etiology of abdominal pain in pregnancy can be challenging given concern for effects of radiation coupled with anatomical and functional changes in pregnancy. Heterotopic pregnancy is usually diagnosed with transabdominal or transvaginal ultrasound. However, the diagnosis can be difficult even with use of transvaginal ultrasound.5 In the absence of first trimester ultrasonography, as in this case, the first presenting indication of heterotopic pregnancy can be abdominal pain or vaginal bleeding.
Total hip arthroplasty in the setting of tuberculosis infection of the hip: a systematic analysis of the current evidence
Published in Expert Review of Medical Devices, 2019
Assem A. Sultan, Sarah E. Dalton, Erica Umpierrez, Linsen T. Samuel, Emily Rose, Pierre Tamer, Jacob M. Rabin, Michael A. Mont
Yoon et al. [5] evaluated stability of femoral prostheses in patients treated with immediate cementless THA for active intraarticular tuberculosis with three patients having systemic manifestations as well (two pulmonary, one spine tuberculosis) using the Engh and Bobyn system [21]. All seven patients had stability with radiographic evidence of bone ingrowth into both the socket and femoral stem. They also did not detect heterotopic ossification greater than Grade I according to the Brooker system [22]. Öztürkmen et al. [10] also used the Engh and Bobyn [21] system to confirm the stability of the femoral component in nine patients with active disease who underwent cementless THA. One patient did have grade II heterotopic ossification according to Brooker et al. [22]. Similarly, Sidhu et al. [9] reported one instance of Brooker grade II heterotopic ossification among 23 patients following cemented THA for active disease; this reportedly did not affect joint function. They found no other evidence of implant failure or component loosening. Kim et al. [7] found radiolucent lines less than 1 mm in length in six of 38 patients, as well as un-united osteotomies of the greater trochanter in two patients. One patient had heterotopic ossification that restricted movement, requiring surgery. One patient also required revision arthroplasty for aseptic loosening of femoral and acetabular components.
Longitudinal study of the activities of daily living and quality of life in Japanese patients with fibrodysplasia ossificans progressiva
Published in Disability and Rehabilitation, 2019
Yasuo Nakahara, Hiroshi Kitoh, Yasuharu Nakashima, Junya Toguchida, Nobuhiko Haga
Although FOP is a progressive disease, it is not continuous. It originates as a painful inflammatory swelling brought about by flare-ups, and worsens in stages that are accompanied by decreases in ADL function. Heterotopic ossification typically appears during infancy, usually presenting as a painful soft tissue mass in the posterior regions of the neck and spine (areas that subsequently become foci of ossification). During early childhood, loss in mobility gradually spreads from the trunk to the joints of the upper and lower extremities. The initial site of ossification is frequently the neck, spine, or shoulder girdle. Ossification generally spreads from proximal to distal locations (i.e., from the trunk to the limbs, and from cranial to caudal locations). At least 95% of FOP patients experience functional upper extremity impairment by 15 years of age [15].