Aim: Evaluation of the predictive ability of serum soluble endoglin (sEng) and placental growth factor (PLGF) levels estimated at the 12 th gestational week (GW) for discrimination of women liable to develop preeclampsia (PE). Materials and Methods: 102 PE women were diagnosed according to the American Society of Hypertension and categorized according to guidelines of American College of Obstetricians and Gynecologists. The severity of PE was judged by the difference between blood pressure (∆BP) measures at time of PE diagnosis and at time of enrolment. Blood samples were obtained at the 12 th GW for ELISA estimation of serum sEng and PLGF. Study outcomes included the predictive ability of these markers for development of PE and the relation between age, body mass index (BMI) and serum levels of studied biomarkers and ΔSBP and ΔDBP. Results: 29 and 73 women developed early-and late-onset PE, respectively and 18 women had severe, while 84 women had mild PE. At time of PE diagnosis, BP measures were increased significantly in PE women in comparison to enrolment measures and to control measures. Serum levels of sEng were significantly higher, while serum PLGF levels were significantly lower in PE women than in controls. Development of PE was positively correlated with serum sEng, while was negatively correlated with serum PLGF levels. Also, there was positive significant correlation between ΔBP and BMI and serum levels of sEng, and negative significant correlation with at enrolment BP and serum levels of PLGF. ROC curve analysis defined ΔSBP and ΔDBP by 33 and 10 mmHg as a cutoff point for diagnosis of PE and defined high serum sEng as the significant sensitive predictor for development of PE at both cutoff points. Conclusion: At 12 th GW, estimated levels of sEng and PLGF could discriminate pregnant women vulnerable for development of PE. Statistical analyses defined high serum sEng levels estimated at the 12 th GW as the significant early predictor for upcoming PE. Maternal obesity and old age are also related to PE severity and must be considered for prediction.
Iatrogenic esophageal traumas are the most common of esophageal perforation, accounting for up to 60% of cases from which endoscopic perforations are about 70%. Despite modern surgical advanced techniques, perforation of the esophagus still represents a true surgical emergency and this condition is associated with a mortality of 20-30%. Early and accurate diagnosis and treatment of esophageal injuries are critical. Indirect signs of esophageal injury can be seen on a posteroanterior and lateral plain chest X-ray. Such signs include pleural effusion, pneumomediastinum, subcutaneous emphysema, hydrothorax, pneumothorax and collapse of the lung. Computer Tomography (CT) of the chest and upper abdomen with oral contrast can also show a leak and confirm the chest X-ray findings. Three approaches are available for the treatment of esophageal perforation: conservative, endotherapy, and surgery. Surgery is mandatory in any part of the esophagus when the perforation is large or when patients do not improve with conservative or endoscopic treatment. We present our case who survived a massive thoracic esophageal tear during endoscopic intragstric balloon insertion. Emergency right thoracotomy was done; we found an inflated gastric balloon perforating the thoracic esophagus and protruding in the right thoracic cavity with a big longitudinal esophageal tear. The tear was primarily repaired with suture of perforation with reinforcement flaps. We conclude that; iatrogenic traumatic injuries of the esophagus is rare but could be life threatening and must be managed by multiple disciplinary teams. Urgent surgical esophageal repair is the treatment of choice in big thoracic esophageal tears. This is the 1st case documented with esophageal rupture due to intragastric balloon insertion.
Background: In vitro fertilization for women with polycystic ovarian syndrome is an essential (PCOS). New methods to improve clinical outcomes are still needed. Objective: this research investigated the effectiveness of PPOS and compared it with the standard PCOS antagonist regimen. Materials and procedures: A total of 76 PCOS women eligible for aided therapy of reproductive technology were recruited in this RCT from February 2020 to May 2021 and put in random two groups (n=38/per group). Since the sixth day of the cycle, the PPOS group has received 20 mg/day orally of Dydrogesterone, while the control group received antagonist treatment. In addition to safety, our results were chemical and clinical pregnancy. Results: oocyte retrieval counts, oocyte metaphase II (MII) and MI have been comparable. There are also comparable numbers of fertilized oocytes and cleaved embryos without any statistical difference in the number of injected oocytes. Lower antagonistic gonadotropin dosage than the PPOS group (2957.8±301.9 vs 3197.4±545.9), with higher stimulation times respectively in the PPOS group than the antagonist. Similar findings across both main outcome groups (OHSS) with no instances of FPPOS and just one case (2.6 percent) of moderate OHSS antagonists. Similar findings also for secondary results (biochemical pregnancy rate , clinical pregnancy rate and miscarriage rate). Conclusion: the established In PCOS patients receiving IVF/ICSI therapy, PPOS is a safe and successful procedure.
Background: Fluid status assessment and management post coronary artery bypass grafting (CABG) is a clinical challenge. The study aimed to establish whether central venous pressure (CVP) and ultrasound measures of respiratory variability of inferior vena cava (IVC) diameter might predict fluid responsiveness in mechanically ventilated patients after CABG. Methods: This comparative study included 200 consecutive adult patients who underwent elective CABG. We recorded the following parameters: heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), central venous pressure (CVP), inferior vena cava maximum (IVCmax), and minimum (IVCmin) diameters, left ventricular ejection fraction (LVEF), and velocity-time integral in the left ventricular outflow tract (VTI-LVOT). Results: The age of the patients ranged from 45 to 71 years, and 147 were males (73.5%). Patients were grouped into fluid responders (n= 135), defined as stroke volume variation (SVV) of 15% or greater following fluid bolus administration, and fluid non-responders (n= 65), defined SVV of less than 15% following fluid bolus administration. There was no statistically significant difference between the groups regarding their CVP, maximum and minimum IVC diameters, inferior vena cava distensibility index (IVC-DI), and other markers of fluid responsiveness (p-value 0.47, 0.34, 0.59, and 0.64, respectively). There was a significant difference in SVV between fluid responders (18.33±2.767) and non-responders (10.95±1.940) (p-value <0.001). Conclusion: Neither CVP nor sonographic measures of IVC diameter respiratory variability provided an accurate method to distinguish between fluid responders and non-responders in the early postoperative period after CABG.
Background: Cardiothoracic surgery is a common cause of acute respiratory failure and is associated with increased morbidity and mortality. We aimed to compare the outcomes of open heart surgery patients treated using oxygen delivery devices with patients who receive NIV as a first-line therapy for hypoxemic respiratory failure. Materials and Methods: 40 patients who developed acute hypoxemic respiratory failure after open heart surgery and admitted to cardiothoracic ICU 20 patients received NIV and 20 patient received oxygen by venture mask. For all patients the following measurements were performed before and after CPAP AND Venture use: CBC, blood urea, serum creatinine body temperature, chest X-ray, Arterial blood gases (arterial pH, sodium bicarbonate, pcO 2 , SpO 2 and PaO 2-to-FiO 2 ratio). Results: Mean PO 2 and SO 2 have increased after using of both venture and Cpap, increase in both PCO 2 and HCO 3 levels after using Venturi mask, CPAP mask was superior to venturi mask in avoiding the need of intubation, decreasing The ICU stay median length and also median length of hospitalization, all were lower in CPAP group than venture group. Also the mortality rate was lower in CPAP group than the venturi group. Conclusion: Using CPAP mask in severe AHRF following open heart surgery can avoid intubation, decreases the levels of tachypnea and arterial hypoxemia, decreases ICU stay, the length of hospitalization and also decreases the mortality rate compared with patients receiving high-concentration oxygen How to cite this paper:
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.