Predictors of Uterine Rupture and Recurrence after Myomectomy
Rooma Sinha, Arnold P. Advincula, Kurian Joseph in FIBROID UTERUS Surgical Challenges in Minimal Access Surgery, 2020
Vascular occlusion. With regard to optimal hemostatic technique in LM, the role of temporary bilateral uterine artery occlusion alone or in combination with utero-ovarian vessel occlusion compared with no vascular occlusion was assessed in 200 patients undergoing an LM. No difference in recurrence rates was found at 30-month follow-up. Furthermore, no statistical difference was noted in anti-Müllerian hormone between the groups preoperatively or at 3, 6, and 12 months postoperatively [44]. A better hemostasis during the myomectomy may allow a more efficient eradication of smaller residual ULs. However, there is currently no convincing biological rationale for reduction in recurrence rate associated with uterine artery occlusion at the index surgery. Sanders et al. analyzed 25 studies involving 2871 patients on uterine artery occlusion at the time of myomectomy and reported to have found a significantly reduced fibroid recurrence rate [45]. However, these results should be interpreted with caution as fibroid recurrence was evaluated as a secondary outcome whereas only a small number of the included studies reported data on recurrence rates and the follow-up time was relatively short. It is noteworthy that there are no data on long-term reproductive implications.
Rheology of Polycythemias T. C. Pearson
Gordon D. O. Lowe in Clinical Blood Rheology, 2019
As far as the arterial circulation is concerned, the site and sex distribution of complications in PPP are different from those found in uncomplicated arteriosclerosis. Barabas and his co-workers6 compared their findings in PPP with those described by Taylor and Calo” in arteriosclerosis. In PPP, men and women are approximately equally affected, but in arteriosclerosis males are at a greater risk. In PPP, cerebrovascular complications occur more frequently than those involving the coronary arteries, while the reverse is true in arteriosclerosis. Cerebrovascular complications occur with a frequency about five times that in the normal population.7 In contrast, the incidence of coronary vessel occlusion appears to be similar.7,12 These findings suggest that the blood changes are in some way responsible for the altered distribution of vascular occlusion.
Thumbprinting Sign
Michael E. Mulligan in Classic Radiologic Signs, 2020
Thumbprinting as a sign of submucosal hemorrhage or edema in colonic vascular occlusion was reported in two articles by Scott Boley and colleagues1 and Solomon Schwartz and co-workers2, in 1963. The first article described the barium enema findings in five patients seen at the Jewish Hospital of Brooklyn and Downstate Medical Center (Figure 1). ‘The roentgenologic finding of importance is pseudotumor formation or ‘thumbprinting’. This appears to be caused by submucosal hemorrhage or by pericolic fat inflammation or both.’1 The second article detailed the course of the radiographic changes in one of the original five patients. They confirmed their impressions of the radiographic findings by conducting animal experiments. ‘Pathologic examination, when marginal indentation or ‘thumbprinting’ was present, revealed two possible explanations: (1) submucosal hemorrhage and (2) inflammatory areas in pericolic fat.’1 Recognizing these ‘pseudotumors’ as a sign of vascular disease is important. The vascular occlusion may only be temporary and the patient’s symptoms may resolve without surgical intervention.
Acute Chest Syndrome in Sickle Cell Disease: Clinical Presentation and Outcomes. The Experience of a Single Thalassemia and Sickle Cell Unit in a University Hospital
Published in Hemoglobin, 2021
Sophia Delicou, Konstantina Aggeli, Konstantinos Magganas, Dimitrios Patsourakos, Aikaterini Xydaki, John Koskinas
Recurring ACS episodes can contribute to the development of interstitial lung disease known as chronic lung sickle disease. For prophylactic therapy both HU [26] and chronic transfusion treatment decrease the risk of severe acute vaso-occlusive episodes and ACS. It is worth noting that 56.2% of patients were receiving chronic HU treatment, which did not prevent the development of ACS. Complex vascular occlusion mechanisms appear to be resistant to HU, although the link between dosage and patient compliance cannot be ignored. A significant number of patients had relapsed in less than 1 year with ACS, which is more common in infancy due to frequent respiratory infections. We assume that the recurrence of acute thoracic syndrome in our own patients is related to the fact that they were all smokers with poor medical compliance.
Dynamic observation on collateral circulation construction of patient with vertebral artery restenosis after stenting: case report
Published in International Journal of Neuroscience, 2021
Yan-Wei Yin, Qian-Qian Sun, Da-Wei Chen, Fa-Guo Zhao, Jin Shi
An extensive collateral circulation plays important role in preserving blood supply to the brain in the event of failure of the primary blood supplying system [4]. Due to sufficient blood supply through collateral circulation, almost 60% of patients tolerate even complete vascular occlusion without infarct development [13, 14]. However, it should be noted that the extent of collateral circulation is highly variable between individuals, which can interpret the variable consequence [15, 16]. For this patient, although there was restenosis at the left vertebral artery after stenting, we speculated this patient was unlikely to develop a severe stroke due to the new collateral flow which fed by external carotid collateral branches and thyrocervical trunk. Moreover, the frequency of loss of consciousness gradually decreased as the collateral circulation improvement.
Retinal findings in glomerulonephritis
Published in Clinical and Experimental Optometry, 2022
Heather G Mack, Deborah J Colville, Phillip Harraka, Judith Anne Savige, Alessandro Invernizzi, Samantha Fraser-Bell
Reported retinal vascular changes include central retinal artery occlusion,80–82 central and branch retinal vein occlusion80,82–85 and retinal vasculitis.73,86–88 In some cases, vascular occlusion is reported in the absence of vasculitis. One proposed mechanism for this is central retinal vein compression by extracapillary granulomatous lesions.85 Limited histopathology studies demonstrate immunoglobulin deposition in retinal and choroidal vessels.89–91 Reported treatments include eculizumab,80,92 which blocks C5 activation; and plasma infusion,84 which provides fresh coagulation factors, immunoglobulins and complement molecules.
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