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Drugs in pregnancy and lactation
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
Major progress has been made in the recent years in investigating fetal disorders. Echography now allows precise diagnosis of congenital malformations (such as digestive, urinary tract or cardiac abnormalities). Diagnosis of abnormal chromosomal pattern is possible with chorion biopsy, amniocentesis or fetal blood sampling [11]. Such procedures have their own complications but their frequency is reduced in experienced hands. The therapeutic decision of whether to carry on pregnancy and to treat fetal diseases or to induce abortion is obviously a matter of individual cases and differences in legislation in various countries. These investigational procedures, particularly the routine use of cord taps, have increased the diagnostic and treatment options for life-threatening fetal disorders.
Basic Physics of Ultrasound
Published in Asim Kurjak, Ultrasound and Infertility, 2020
When speaking about ultrasound intensity in an ultrasound beam, it is not sufficient to simply state the intensity, one must as well state “where” and “when”; i.e., at what position in space and within which interval. Simply stating the intensity applies only to a plane wave in a nonattenuating medium. In echography, one uses pulsed ultrasound and focused beams in attenuating media. After we discuss characteristics of ultrasound beams, we shall turn back to definitions of ultrasound intensities in the beam.
Management of hyphema, repair of iridodialysis, and repair of corneoscleral lacerations
Published in A Peyman MD Gholam, A Meffert MD Stephen, D Conway MD FACS Mandi, Chiasson Trisha, Vitreoretinal Surgical Techniques, 2019
Echography is a user-dependent imaging modality that is less expensive, dynamic, and readily available. It is particularly useful in assessing the posterior segment of traumatized eyes with media opacities (Fig. 47.2). Echography has resolution up to 1 mm and can detect intraocular foreign bodies, lens rupture, retinal detachment, and choroidal hemorrhage. Posterior ruptures can be detected in many cases; however, up to 25% of cases may be missed.2 Echographic clues that increase the likelihood of a posterior rupture include incarcerated vitreous, retinal thickening, irregular scleral contours, decreased scleral reflectivity, and episcleral hemorrhage in the adjacent space.
A mini-review on aplastic anemia, illustrated by a case report on bone marrow hot pockets mimicking sclerotic bone metastases
Published in Acta Clinica Belgica, 2022
Emilie Janssens, Jo Van Dorpe, Vanessa Van Hende, Ine Moors, Philip Vlummens, Ciel De Vriendt
No definitive etiology was found for the patient’s aplastic anemia. An inherited syndrome was unlikely, considering the patient’s age and negative family history. There was no previous exposure to radiation, toxins or cytotoxic drugs. She had no known immune disorders. At diagnosis there were no signs of hemolysis on peripheral blood or venous thrombosis. Fluorescein-labeled proaerolysin (FLAER) test showed insufficient arguments for paroxysmal nocturnal hemoglobinuria (PNH), detecting a PNH clone in only 8% of monocytes and 8% of granulocytes. Flow cytometry found no T-cell large granular lymphocyte leukemia (T-LGL). A routine viral serology was negative. Echography of the abdomen, RX mammography and breast echography were negative. A routine CT thorax was performed to exclude thymoma, underlying neoplasms and opportunistic infections. The latter revealed unexpected sclerotic bone conversions in the dorsal spine, most strikingly at D2, D11 and L2 (Figure 2). Additional whole body SPECT with 99mTc-HDP showed multiple bone lesions in the cervical, thoracic and lumbar spine. A CT guided biopsy of D12 showed no metastatic carcinoma or melanoma, but surprisingly revealed normal trilineage hematopoiesis with well-preserved erythropoiesis (Figure 3).
The effectiveness of micronized progesterone in the complex therapy of ‘thin endometry’ syndrome
Published in Gynecological Endocrinology, 2021
Nagima M. Mamedalieva, Almagul M. Kurmanova, Saltanat B. Baikoshkarova, Saule Issenova, Balzira Bishekova, Gainy Zh. Anartayeva
All patients of the main and comparative groups underwent transvaginal echography on a GEVOLUSONE device (Austria) using a multi-frequency transvaginal transducer with a frequency of 4–10 MHz, with software for the implementation of a triplex scanning mode (gray-scale B-mode in combination of color and pulse Doppler in real time). Dynamic ultrasound examination was performed before and after treatment in phase II (during the ‘window of implantation’). The study began with a transabdominal ultrasound scan (with a filled bladder) to exclude pelvic masses. The study was continued after emptying the bladder: the position of the uterus in the pelvic cavity was determined. Particular attention was paid to the study of the M-echo: thickness, echo structure, and the presence of inclusions. For the normal value of the M-echo was taken: a homogeneous structure, the absence of hypo- or hyperechoic inclusions, the correspondence of its structure to the day of the menstrual cycle, the thickness of the M-echo in the ‘implantation window’ not less than 8 mm. During the examination, in all the applicants of the comparison group, the thickness of the endometrium on the 20–22 day of the menstrual cycle was more than 7 mm. The criterion for ‘thin endometrium’ was the thickness of the endometrium less than 7 mm on the 20–24th day of the menstrual cycle.
Conservative treatment of Achilles tendon partial tear in a futsal player: A case report
Published in Physiotherapy Theory and Practice, 2021
The patient was a 27-year-old male futsal player for 15 years, who felt an acute pain in the right calf after a side cutting movement during a game. The patient left the game immediately after that event. The patient stated that he had not felt any pain or tenderness in the AT before the injury. Immediately after the injury, the patient sought medical assistance, and an echography was performed. The exam showed an AT partial tear of about 50%. The emergency physician suggested that surgical intervention could be necessary. The patient looked for other opinions, and a magnetic resonance image (MRI) (Figure 1) was carried out in order to establish the magnitude of the injury. Two additional physicians suggested that surgery should be performed. Three days after the injury, the patient attended our clinic with the right ankle immobilized. The patient wanted to determine if there was another treatment option. The patient did not want surgery for two reasons: (1) He had known people that did not recover their total function after an AT repair; and (2) He was not confident about the risks inherent in surgical intervention.