China
Africa
Explore chapters and articles related to this topic
Trial Of Labor After Cesarean
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Uterine dehiscence: Disruption of the uterine muscle with intact serosa [7]. It can include asymptomatic opening if the uterine scar is from a prior surgery, without protrusion of fetus/fetal organs outside the uterus.
Adenomyomectomy
Published in Rooma Sinha, Arnold P. Advincula, Kurian Joseph, FIBROID UTERUS Surgical Challenges in Minimal Access Surgery, 2020
Anshumala Shukla Kulkarni, Fouzia Hayat
This procedure involves asymmetric dissection of the uterus longitudinally, using a round-type loop electrode and a high-frequency cutter, followed by retracting the uterine fundus upward using a silk suture and then cutting the uterine adenomyoma into slices. From the incision, the myometrium is dissected diagonally as if hollowing out the uterine cavity. It is followed by a transverse incision to open the uterine cavity. As the index finger is inserted into the uterine cavity, the adenomyosis lesion is excised to more than 5 mm of the inner myometrium. The lesion is then excised to more than 5 mm of the serosal myometrium on the left uterine side. Afterward, the uterine cavity is sutured and closed, followed by uterine reconstruction, and the left side covers the right side. The serosa is continuously sutured using the same suture to rejoin the uterus. To date, 1349 patients have undergone this technique. Postoperative spontaneous uterine rupture was seen in five cases in this series [12].
The patient with acute renal problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
The bladder is a hollow, muscular bag, located behind the symphysis pubis and in front of the rectum. In females, it rests on the anterior vagina and in front of the uterus, whereas, in males, it is situated above the prostate gland. The wall of the bladder is made up of three different layers: The tunica mucosa: this has folds, called rugae, in it and they allow the bladder to distend, while acting as a reservoir for urine before it is excreted from the body.The tunica muscularis: this consists of three layers of meshed smooth muscle. In this area, a network of muscle fibres cross over one another in different directions and these are known collectively as the detrusor muscle.The tunica serosa or adventitia: this outer layer moistens the tissues and lubricates surfaces so that, when the bladder is full, it does not compress other organs.
Advances in multi-modality imaging for constrictive pericarditis and pericardial inflammation: role of imaging-guided therapy
Published in Expert Review of Cardiovascular Therapy, 2023
Tahir S Kafil, Tom Kai Ming Wang, Ankit Agrawal, Muhammad Majid, Alveena B Syed, Erika Hutt, Ben Alencherry, Joshua A Cohen, Sachin Kumar, Agam Bansal, Brian P Griffin, Allan L Klein
The pericardium is the fluid-filled, fibro-serous double-walled sac that encloses the heart and great vessels as they emerge from the pericardium. It is made up of visceral pericardium or inner serosal layer and parietal pericardium or outer fibrosa layer [9,10]. It anchors the heart in the anteromedial thorax and has copiousness of fibrous tissue in the fibrosa layer and a thin layer of mesothelial cells in the serosa layer [9,10]. There is 10–50 mL of serous fluid in between two layers which permits smooth cardiac motion [9,10]. The two layers (visceral and parietal layer) that are elastic and can stretch easily at low stress [3]. With inspiration, there is a decrease in intrathoracic pressure causing more venous blood to return to the right atrium and ventricle, causing the right ventricle to increase in size. The pericardium adjusts accordingly around the right ventricle, thus the enlarging right ventricle does not impinge on the adjacent left ventricle [3].
Methotrexate induced peritonitis: diagnosis per exclusionem
Published in Journal of Obstetrics and Gynaecology, 2021
Raphaël Rienstra, Eva A.S. Koster, Catharina C.A.H. Janssen
Two cases of peritonitis have been described with a similar presentation of severe recurrent abdominal pain during methotrexate therapy for persistent trophoblastic disease. In these cases, the abdominal pain started during the second course, no other cause was found and symptoms resolved spontaneously after stopping methotrexate (Sharma et al. 1999; Zimmermann et al. 2012). Sharma et al. (1999) also described other serosal complications, such as pleuritis, pneumonitis, and pericarditis. Eulgem et al. (2000) described a local peritonitis with a benign pattern from a superficial lesion of the small bowel, possibly after diagnostic laparoscopy. They concluded that methotrexate, by inducing immunosuppression, may have aggravated an abdominal infection. However, Sachdev et al. (2006) described a severe case of sclerosing encapsulating peritonitis, eight weeks after short pulse methotrexate for molar pregnancy. The symptoms followed a more chronic course of recurrent abdominal pain and weight loss. Laparotomy revealed adhesions, severe peritoneal fibrosis and ‘cocooning’ of the small bowel. Ureyen et al. (2013) described a case of peritonitis as a complication due to methotrexate, but secondary related to a former pelvic abscess. It was remarkable that, in contrast to our case, laboratory results showed normal CRP, although it was not clearly described when antibiotic treatment was started.
Deciphering the absorption profile and interaction of multi-components of Zhi-Zi-Da-Huang decoction based on in vitro–in silico–in vivo integrated strategy
Published in Xenobiotica, 2019
Qing Hu, Xixi Li, Qingshui Shi, Gongjun Yang, Fang Feng
Ex vivo everted gut sac experiment has been used extensively in the study of drug absorption, in which the absorption process in vivo could be mimicked by the transport from mucosal side to serosal side (Alam et al., 2012). As shown in Figure 4, in both positive and negative ion modes, 104 constituents were detected altogether in the serosal fluid (sac contents) of ZZDHD group. These compounds were all identified in the mucosal side and were deemed as good orally absorbable ingredients. Whereas the other 13 compounds that existed in the database of ZZDHD chemical component but could not transport into the serosal side were defined as non-absorbable (see Table 1). To some extent, their poor absorption characteristic might attribute to complex chemical structure, strong polarity or poor lipophilicity. For example, based on the above analysis, aloe-emodin (peak 101) was found in the serosal fluid, whereas its glycoside aloe-emodin 1-O-glucoside was not detected. This was in accordance with the fact that the transport of combined anthraquinones across the intestinal mucosa was much more difficult than that of free anthraquinones due to bigger molecular size and more polarity (Yan et al., 2015). Besides, interactions and metabolisms in the intestine or extremely low content may also cause these components to be undetectable in the serosal side solution.