-
Stephens Miranda posted an update 6 months ago
l-arginine infused hearts revealed depressed inotropy and chronotropy, weak systolic and diastolic functions with compromised myocardial flow at early 5min of re-perfusion, yet with significantly higher myocardial flow rate by the end of re-perfusion.
Reducing NO availability by l-NAME revealed mild impact on the ischemia re-perfusion induced contractile dysfunction, whereas excess NO worsens cardiac performance at the early re-perfusion period.
Reducing NO availability by l-NAME revealed mild impact on the ischemia re-perfusion induced contractile dysfunction, whereas excess NO worsens cardiac performance at the early re-perfusion period.Post-traumatic hydrocephalus (PTH) following traumatic brain injury (TBI) may develop within or beyond the acute phase of recovery. Recognition and subsequent treatment of this condition leads to improved neurologic outcomes. In this scoping review, we identify statistically significant demographic, clinical, radiographic, and surgical risk factors as well as a predictive time frame for the onset of PTH in order to facilitate timely diagnosis. Two researchers independently performed a scoping review of the PubMed and Cochrane databases for articles relevant to risk factors for PTH. Articles that met inclusion and exclusion criteria underwent qualitative analysis. Twenty-seven articles were reviewed for statistically significant risk factors and a proposed time frame for the onset of PTH. Variables that could serve as proxies for severe brain injuries were identified as risk factors. The most commonly identified risk factors included either very young or old age, intracranial hemorrhage including intraventricular hemorrhage, hygroma, and need for decompressive craniectomy. Although the timeframe for diagnosis of PTH varied widely from within one week to 31.5 months after injury, the first 50 days were more likely. Established risk factors and timeframe for PTH development may assist clinicians in the early diagnosis of PTH after TBI. Increased consistency in diagnostic criterion and reporting of PTH may improve recognition with early treatment of this condition in order to improve outcomes.
To analyse if performing unenhanced CT of the liver aids in the evaluation of metastatic lesions, response assessment or alter the size of the lesions, compared with portal phase alone, in patients with hepatic metastases from breast carcinoma.
One-hundred and fifty-three CT scans of 36 women were included. Scans consisted of unenhanced, arterial and portal delayed phases of the liver. Two readers sorted which phase was best for visualization of metastases, evaluated the number of lesions detected in each phase, selected the best phase for assessment of response in two consecutive scans, and measured one target lesion in all the phases. χ
was used to compare differences among phases and paired
test for measurement differences.
Unenhanced, arterial and portal phases were considered better phases by readers 1/2 in 68/67%, 27/28% and 69/70%, and some lesions were missed in 2%, 11% and 7%, respectively. Sensitivity was significantly better for unenhanced and portal phases compared to arterial phase. Comparison between consecutive scans was considered better in unenhanced (80/79%), followed by portal (70/69%) and arterial phases (31/31%). Maximum diameter of target lesions was 15% greater in unenhanced phase (p < 0.001).
Portal and unenhanced phases of the liver allow better detection and delineation of metastatic hepatic lesions from breast carcinoma. learn more In most cases, unenhanced CT is the best phase to assess response and provides the largest diameter. Therefore, we recommend the use of unenhanced CT in the evaluation of patients with breast carcinoma and suspected or known hepatic metastatic disease.
Portal and unenhanced phases of the liver allow better detection and delineation of metastatic hepatic lesions from breast carcinoma. In most cases, unenhanced CT is the best phase to assess response and provides the largest diameter. Therefore, we recommend the use of unenhanced CT in the evaluation of patients with breast carcinoma and suspected or known hepatic metastatic disease.
Uterine rupture in pregnancy is an obstetric emergency especially in developing countries associated with a significant increase in maternal plus perinatal mortality and morbidity. There is a need to identify the prevalence together with underlining factors which could guide effective intervention. Hence, the study aimed at determining the prevalence of uterine rupture, predisposing factors, management options plus clinical presentation at Secondary Health Facility in Okitipupa, South West Nigeria.
This was a retrospective study of patients with a uterine rupture from January 2009 to December 2012 in the Department of Obstetrics and Gynaecology State Specialist Hospital Okitipupa. The case records of patients in this period were retrieved from the medical health records department and relevant data of sociodemographic characteristics, clinical presentation, management as well as maternal and perinatal outcome were collated using a structured questionnaire. Data were analyzed using Microsoft Excel version 10.
Of the 11,377 deliveries during the study period a total of 52 uterine ruptures were recorded during the same period making an incidence of 0.46% or a ratio of 1219 deliveries. Most of the patients 28 (60.9%) were 20-30 years of age. Uterine rupture was more common amongst multiparous women 36 (78.3%). None was a primigravida. The majority of the patients 34 (73.9%) were nonattendants at the antenatal clinic. The commonest single predisposing factor was the presence of a previous scar being present in 12 (26.1%) of the patients. The most common surgery performed for uterine rupture in the series was repair only 24 (52.2%). There is an absence of uterine rupture in primigravida supports the belief that primigravida is somehow immune to rupture.
Rupture of the gravid uterus is a major contributor to maternal and perinatal mortality in Okitipupa Southwest Nigeria.
Rupture of the gravid uterus is a major contributor to maternal and perinatal mortality in Okitipupa Southwest Nigeria.