Polymorphic Eruption of Pregnancy (PEP) is one of the most common dermatosis related to pregnancy. PEP usually consists of pruritic papules and plaques appearing in the third trimester of pregnancy. It is more common in primigravidae and twin pregnancies. Although not associated with poorer foetal or maternal outcomes, it may be hard for pregnant women to endure. The diagnosis is easy if suspected, though sometimes it may be hard to distinguish from other dermatosis such as atopic eczema of pregnancy, pemphigoid gestationis or dermatitis. Topical treatment with emollients and low-medium potency steroids is usually effective but systemic steroid treatment may be required. PEP is self-limiting and resolves days or weeks after the first appearance or after delivery. In this article, the authors aim to review the literature published from 2000 onwards regarding the subject, either in English or Portuguese.
Incidental appendiceal neuroendocrine tumors (ANETs) occur in 0.2–0.7% of surgical resections for suspected appendicitis (Moris, Tsilimigras, Vagios, Ntanasis-stathopoulos, Karachaliou, Papalampros, et al. Neuroendocrine neoplasms of the appendix: a review of the literature. Anticancer Res [Internet]. 2018; 38 :601–11.). It’s a rare entity, clinically challenging and has controversy surrounding its management. A 69-year-old male presented to our clinic with acute right lower quadrant abdominal pain with less than 24 hours of evolution. The presumed clinical diagnosis was acute appendicitis. It was performed a laparoscopic appendectomy and the histopathologic result of the specimen showed neuroendocrine tumor of the appendix. ANETs are rare and typically diagnosed as incidental histopathologic finds in appendices specimens. However, they are the most common tumors arising from de appendix, between 30% and 80% of the cases (Pape, Niederle, Costa, Gross, Kelestimur, Kianmanesh, et al. ENETS consensus guidelines for neuroendocrine neoplasms of the appendix (excluding goblet cell carcinomas). Neuroendocrinology . 2016; 103 :144–52). Appendectomy may be sufficing for tumors <2 cm and they are associated with good long-term outcomes.
Foramen of Winslow hernias account for 8% of all internal hernias. Their non-specific presentation and often late diagnosis are associated with an estimated mortality of 50%. The use of complementary diagnostic methods facilitates the diagnosis and planning of the therapeutic strategy. Urgent surgery is the appropriate treatment due to the risk of intestinal ischemia, being laparotomy the main form of approach described. Few cases of laparoscopy are referred to in the literature.
Harlequin ichthyosis is the most severe form of autosomal recessive congenital ichthyoses. So far, there are only a few reports of prenatal diagnosis in the literature, as prenatal sonographic features are quite subtle. We report a case of prenatal diagnosis of Harlequin ichthyosis on third‐trimester sonographic examination in a consanguineous couple with no history of the disease and describe its characteristic sonographic features.
RESUMOIntrodução: A incontinência urinária pode afetar até 50% das mulheres em alguma fase das suas vidas, nomeadamente durante a gravidez. Este estudo foi desenhado com a finalidade de identificar e avaliar a prevalência e fatores de risco para incontinência urinária durante o terceiro trimestre da gravidez e três meses após o parto. No total (n = 237), 51,89% das mulheres incluídas no estudo, relataram a ocorrência de incontinência urinária durante a gravidez. A prevalência da incontinência urinária na gravidez, segundo a paridade (primíparas versus multíparas), foi estatisticamente significativa (p = 0,006). No pós-parto (n = 237), 28,69% das mulheres com incontinência urinária tiveram parto vaginal e 5,91% das mulheres foram submetidas a cesariana (p = 0,001). Neste grupo de mulheres com incontinência urinária pós-parto (n = 82), 31,69% apresentaram incontinência urinária de novo e 68,31% das mulheres já apresentavam sintomatologia durante a gravidez (p < 0,001). Discussão: Este estudo demonstra a elevada prevalência da incontinência urinária na gravidez e a respetiva redução no pós-parto. Conclusão:A multiparidade e a ocorrência de incontinência urinária na gravidez surgem como possíveis fatores de risco no aparecimento da incontinência urinária. Palavras-chave: Complicações na Gravidez; Gravidez; Incontinência Urinária; Período Pós-Parto ABSTRACT Introduction:The urinary incontinence can affect up to 50% of women at some stage of their lives, particularly during pregnancy and postpartum. This study was designed in order to identify and assess the prevalence and risk factors for urinary incontinence during the third trimester of pregnancy and three months postpartum. Material and Methods:Observational and cross-sectional study. The population of the study was composed of 268 women who delivered and were admitted to the Centro Hospitalar Tâmega e Sousa in the years 2013 and 2014, and who agreed to participate in this study. Postpartum women were asked to fill out a questionnaire adapted from the International Consultation on Incontinence Questionnaire -Short Form, for urinary incontinence research in the third trimester of pregnancy. Three months after delivery, they were contacted by telephone and asked to answer the same questions about the urinary incontinence postpartum. Results: Of the 268 women interviewed, 31 were excluded from the study, taking into account the defined inclusion and exclusion criteria. In total (n = 237), 51.89% of women included in the study, reported the occurrence of urinary incontinence during pregnancy. The prevalence of urinary incontinence in pregnancy by parity (primiparous versus multiparous) was statistically significant (p = 0.006). At postpartum (n = 237), 28.69% of women with urinary incontinence had vaginal delivery and 5.91% of women underwent cesarean delivery (p = 0.001). In these group of women with postpartum urinary incontinence (n = 82), 31.69% have had urinary incontinence only in the postpartum and 68.31% of women have had symptoms during pregnancy (p < 0.001)....
Objective The present study aims to describe the main characteristics of female couples resorting to a fertility clinic, to understand whether these patients have clear previous plans concerning procreation and how they end up completing their family planning, and to briefly describe the main outcomes of the recepción de ovocitos de pareja (ROPA, in the Spanish acronym: in English, reception of partner's oocytes) method. Methods This is a descriptive retrospective study of the pathway and outcomes of female couples in a fertility clinic during a 2-year period. Results A total of 129 couples were treated. Only one third of the couples had no condition potentially affecting fertility or advanced age. Most couples were decided to undergo artificial insemination or in vitro fertilization and the majority kept their plans, as opposed to 38% of the couples who decided to the ROPA method (lesbian shared in vitro fertilization) who changed plans. Live birth rates per treatment (including frozen embryo transfers) for artificial insemination, 58% for in vitro fertilization, 80% for treatments with donated oocytes or embryos, and 79% for ROPA. Four in five couples achieved live births. Conclusion The present study highlights the importance of a thorough medical workup in same-sex couples resorting to assisted reproduction. Despite the higher-than-expected rates of fertility disorders, the outcomes were good. Most couples end up in a single parented method. Furthermore, the results of the ROPA method are reassuring.
the third trimester when there is marked abdominal distension. Its exact pathophysiology remains unknown [3][4][5]. The main features are an intensely pruritic erythema, affecting the abdominal skin, proximal tights and arms -predominantly the striae; with coalescent papules forming plaques, with no blisters or umbilical involvement (as opposed to Pemphigoid Gestationis -PG) [6][7][8].
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