Fallopian tube carcinoma presenting as tubo-ovarian abscess: a report of two cases with literature review

Preoperative diagnosis of fallopian tube carcinoma is difficult, with fewer than 5% being diagnosed preoperatively. We describe tubal carcinoma, presenting as a tubo-ovarian abscess in two 47-year-old women. Both patients presented with abdominal pain, pelvic mass, and fever. Both patients were treated as having a tubo-ovarian abscess but failed to respond to therapy. During surgery a metastatic right tubal carcinoma was found. A definite operation was performed in both patients. Three additional cases of fallopian tube carcinoma, presenting as acute pelvic inflammatory disease, were found while reviewing the English literature. Actually all these three cases presented as tubo-ovarian abscess because of the existence of tender pelvic mass. Carcinoma of the fallopian tube should be considered in the differential diagnosis of tubo-ovarian abscess in those who failed to respond to a previously unreported clinical presentation.     

The influence of pentoxifylline on motility and viability of spermatozoa from normozoospermic semen samples

In order to evaluate the effects of pentoxifylline on sperm motility and longevity, a controlled in-vitro study was conducted on normozoospermic donor semen samples using the Cellsoft automated system for sperm motility analysis. After incubation and selection, pentoxifylline was found to improve the recovery of spermatozoa and to increase their velocity. In the subgroup of progressively motile spermatozoa, curvilinear velocity was also enhanced. It is concluded that pentoxifylline has an effect on the vigour, but not on the pattern, of sperm motion. Pentoxifylline did not improve the motility characteristics of senescent spermatozoa in normozoospermic sperm samples. Sperm survival, as shown by supra-vital staining, and motility longevity both decreased with time after pentoxifylline treatment.     

Perinatal epidemiology in Belgium

Data on the civil registration of all births and deaths recordedin 1987 in Belgium were analysed following WHO rules. The followingstatistics with significant regional variations were recorded:2.5% of teenage pregnancies, 7% of late pregnancies (35 years),6.1% of low birth weights and 5.3% of preterm deliveries. Pretermbirth rates did not improve during the last decade and are higherthan in neighbouring countries. Infant mortality rate is 9.74per 1000. This rate has remained unchanged since the early 1980sbut the relative importance of post-neonatal mortality is increasing.Congenital anomalies account for 26% of all infant deaths followedby the sudden infant death syndrome (17%). Maternal conditionssuch as eclampsia are related to 29% of the infants' deaths.     

MANAGEMENT OF VARICEAL HEMORRHAGE: CURRENT CONCEPTS

Introduction

The treatment of portal hypertension is complex and the the best strategy depends on the underlying disease (cirrhosis vs. schistosomiasis), patient''s clinical condition and time on it is performed (during an acute episode of variceal bleeding or electively, as pre-primary, primary or secondary prophylaxis). With the advent of new pharmacological options and technical development of endoscopy and interventional radiology treatment of portal hypertension has changed in recent decades.

Aim

To review the strategies employed in elective and emergency treatment of variceal bleeding in cirrhotic and schistosomotic patients.

Methods

Survey of publications in PubMed, Embase, Lilacs, SciELO and Cochrane databases through June 2013, using the headings: portal hypertension, esophageal and gastric varices, variceal bleeding, liver cirrhosis, schistosomiasis mansoni, surgical treatment, pharmacological treatment, secondary prophylaxis, primary prophylaxis, pre-primary prophylaxis.

Conclusion

Pre-primary prophylaxis doesn''t have specific treatment strategies; the best recommendation is treatment of the underlying disease. Primary prophylaxis should be performed in cirrhotic patients with beta-blockers or endoscopic variceal ligation. There is controversy regarding the effectiveness of primary prophylaxis in patients with schistosomiasis; when indicated, it is done with beta-blockers or endoscopic therapy in high-risk varices. Treatment of acute variceal bleeding is systematized in the literature, combination of vasoconstrictor drugs and endoscopic therapy, provided significant decline in mortality over the last decades. TIPS and surgical treatment are options as rescue therapy. Secondary prophylaxis plays a fundamental role in the reduction of recurrent bleeding, the best option in cirrhotic patients is the combination of pharmacological therapy with beta-blockers and endoscopic band ligation. TIPS or surgical treatment, are options for controlling rebleeding on failure of secondary prophylaxis. Despite the increasing evidence of the effectiveness of pharmacological and endoscopic treatment in schistosomotic patients, surgical therapy still plays an important role in secondary prophylaxis.     

Prelexical development of unilateral cleft lip and palate babies with reference to presurgical infant orthopaedics: a randomized prospective clinical trial

Presurgical infant orthopaedics (PIO) is widely used to treat children with clefts. However, consensus on the relevance of this treatment is lacking. A prospective clinical trial is under way to investigate the effects of PIO in unilateral cleft lip and palate (UCLP) babies. The prelexical development of two groups of UCLP babies was compared at 12 and 18 months of age; one group received PIO, while the other did not. Analysis of prelexical utterances was performed by means of a perceptually based sensori-motoric classification system. Consonant-like elements were also assessed by means of phonetic analysis of place and manner of articulation. At the age of 12 months the PIO babies showed enhanced use of alveolar articulations. However, the effect of PIO seemed to be transient, because the recordings obtained at 18 months showed similar use of all variables of sound production in the two groups. The longitudinal character of the clinical trial will enable the evaluation of the long-term effects of PIO as the children grow older.     

IN VITRO CHARACTERISTICS OF A FOURTH VENTRICLE EPENDYMOMA MAINTAINED IN ORGAN CULTURE SYSTEMS: LIGHT AND ELECTRON MICROSCOPY OBSERVATIONS

Explants of a well-differentiated fourth ventricle ependymoma were grown on collagen-coated coverslips and in organ culture systems using gelatin sponge foam matrices and Millipore filter platforms. Viable explants were maintained on Millipore filter platforms up to 44 days and on sponge foam matrices up to 86 days. The structure of ependymal rosettes was well maintained throughout the period of study. By electron microscopy, additional features of differentiation were seen after 3 weeks, consisting of an increase in size and complexity of microrosettes, to which large numbers of cellular apical profiles contributed. Cilia with variable internal configurations were present. After 4 weeks there was frequent ependymal differentiation along the surface of the explants at their interface with the supporting matrix. Increased gliofibrillogenesis and glycogen rosettes were also evident after 3 weeks in culture. The explants were intensely positive when tested by immunofluorescence for the antigen of the glial fibrillary acidic protein. After 3 weeks in vitro , dense bands of basement membrane material forming complex intercellular finger-like projections became prominent.