The relationship between pregnancy and multiple sclerosis (MS) was assessed in a clinic-based, prospectively followed, population of 125 patients with a remittent onset of MS who had been followed for a mean (SD) of 10-3 (0-1) years. Thirty three women had a total of 49 pregnancies of which 32 had been full term and 17 terminated. There was a three-fold increase in the relapse rate per year during the first three months following delivery, compared with the baseline period of the same patients [1t62(0*38) vs 0*51(0O08) p = 0.05]. During pregnancy itself, the relapse-rate was not different from baseline. The overall relapse rate of the pregnancy group was lower than that of a control group without pregnancies after MS onset, but similar to that of patients who had children after MS onset, but no pregnancy during follow up. Pregnancy did not lead to increased disability. These results confirm that post partum increase in relapse rate is the main event related to pregnancy in MS and underline the difficulties of undertaking prospective studies in this field. A number of retrospective studies have evaluated the impact of pregnancy on the course of multiple sclerosis (MS).'-"3 Overall they report an increase of the relapse-rate during the post-partum period compared to pregnancy itself or to non-pregnancy periods in the same patients, and a lower relapse-rate during pregnancy itself.81 0 Three studies7 9 12 evaluated disability in relation to pregnancy, but only one of them considered prognostic factors such as duration of MS and age at onset.'2 Prematurely-terminated pregnancies have not been assessed in these studies. The retrospective design of these studies implies obvious limitations as to their conclusions, because recollection biases can alter the number and the temporal location of events, and may lead to false associations. The only prospective study published to date'4 concerns only a small number of patients. We evaluated the effects of all pregnancies on different parameters of the long-term evolution of MS in our clinic-based, prospectively-followed MS population and now report our results in the group of patients with the remittent form of MS. Our objectives were: 1) to describe the course of MS during pregnancies and the post-partum period; and 2) to determine if pregnancies could alter the long-term prognosis of disease in these patients. We compared two groups of patients, with and without pregnancy during follow up, and analysed the relationship between the course of MS and the occurrence of pregnancies in these patients.
Aim: Abdominal textiloma is an uncommon postoperative complication which can result in a fistula with luminal migration in the digestive tract. Surgery has been the mainstay method for textiloma removal; however, removal of retained gauze by upper gastrointestinal endoscopy is possible avoiding reoperation. Case report: We report a case of an abdominal textiloma in a 38-year-old male, which migrated into the stomach and was extracted by upper endoscopy. Conclusion: Endoscopic extraction after a luminal migration of the abdominal textiloma in the digestive tract facilitate its management and could avoid surgery.
Oncocytic carcinomas of the salivary glands are rare. The submandibular gland is a rare location. It is usually associated with a poor prognosis and recurrence after treatment. We report a case of a 52‐year‐old man with a lymph node and brain metastasis recurrence of an oncocytic carcinoma of the submandibular gland.
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