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C.J. Valdera Simbrón A.M. Fernández AlonsoM.A. Fernández Soriano G. Fiol Ruiz 《Progresos de Obstetricia y Ginecología》2011,54(6):320-324
We present the case of a pregnant woman with an 8-week history of amenorrhea and insertion of a gestational sac over a previous cesarean section scar. Methotrexate treatment was unsuccessful and laparotomy was performed. We provide a literature review and update on the incidence, diagnostic methods and current treatment options of this entity. 相似文献
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Esther Pilar García-Santos Virginia Muñoz-Atienza Susana Sánchez-García Alejandro Puerto-Puerto Francisco Javier Ruescas-García María del Carmen Manzanares-Campillo Fernando Martínez-de Paz David Padilla-Valverde Rebeca Vitón-Herrero Lucía González-López Jesús Martín-Fernández 《Progresos de Obstetricia y Ginecología》2014
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A. Perales-Puchalt V.J. DiagoA. Plana A. Perales-Marín 《Clínica e investigación en ginecología y obstetricia》2011,38(2):65
Ectopic cesarean scar pregnancy is a very rare process that has the potential for very severe complications. However, due to the low frequency of this entity, there are no clear protocols for its treatment and many different treatment plans, both medical and surgical, are currently applied.We report the case of a patient with an ectopic pregnancy in a previous cesarean scar, diagnosed by transvaginal ultrasound scan and treated by total abdominal hysterectomy, since the patient did not wish to preserve her fertility. 相似文献
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Imaging techniques are essential in the clinical evaluation of patients with a myocardial infarction. They are of value for both initial assessment of the ischemic injury and for detection of the subgroup of patients at higher risk of developing cardiovascular events during follow-up. Echocardiography remains the technique of choice for the initial evaluation, owing to its bedside capability to determine strong predictors, such as ventricular volumes, global and regional systolic function, and valvular regurgitation. New techniques for evaluating ventricular mechanics, mainly assessment of ventricular deformation, are revealing important aspects of post-infarction ventricular adaptation. The main alternative to echocardiography is cardiac magnetic resonance imaging. This technique is highly accurate for determining ventricular volumes and ventricular function and has the additional advantage of being able to characterize the myocardium and demonstrate changes associated with the ischemic insult such as necrosis/fibrosis, edema, microvascular obstruction, and intramyocardial hemorrhage. These features not only allow detection and quantification of the infarct size, but also reveal additional characteristics of the scar tissue with prognostic value. 相似文献
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Mustafa Candemir Asife ahinarslan Merve Yazol Yusuf Ali
ner Bülent Boyac 《Arquivos brasileiros de cardiologia》2020,114(3):540
BackgroundPathophysiology and prognosis are not clearly determined in patients with the coronary slow flow phenomenon (CSFP). These patients present with various clinical conditions ranging from being asymptomatic to being admitted with sudden cardiac death.ObjectivesWe aimed at assessing the findings of late gadolinium enhancement (LGE) in cardiac magnetic resonance imaging (CMR) as an indicator of myocardial fibrosis. We also aimed at determining the relationship between the presence of myocardial fibrosis and NT-proBNP levels in patients with CSFP in the left anterior descending coronary artery (LAD).MethodsA total of 35 patients were enrolled within an age range of 31-75. The study patients (n=19) had normal epicardial coronary arteries at angiography, but they presented with CSFP in the LAD. The control group patients (n=16) had normal epicardial coronary arteries and TIMI scores at normal levels in angiography. In both groups, the patients were examined with CMR for the presence of myocardial fibrosis. In addition, plasma NT-proBNP levels were measured. A p-value < 0.05 was considered significant.ResultsThe rate of myocardial fibrosis was significantly higher in CMR in the patients with CSFP (p=0.018). A variable amount of myocardial scar tissue was detected at the left ventricular apex in 7 patients and at the inferior and inferolateral regions in 3 patients. There was no difference in the level of NT-proBNP in patients with CSFP. However, the NT-proBNP levels were higher in patients with CSFP, who had scar tissue in CMR (p=0.022).ConclusionsIn conclusion, LGE in CMR showed that ischemic myocardial scarring may exist in patients with CSFP. These results indicate that CSFP may not always be innocent. (Arq Bras Cardiol. 2020; 114(3):540-551) 相似文献
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Begoña Rodríguez Azor José Miguel Ramos Fernández Sonia Sánchiz Cárdenas Ana Cordón Martínez Begoña Carazo Gallego David Moreno-Pérez Antonio Urda Cardona 《Anales de pediatría (Barcelona, Spain : 2003)》2017,86(2):76-80
Introduction
Acute pyelonephritis (APN) is one of the most common causes of serious bacterial infection in infants. Renal scarring is the most prevalent long-term complication.Objectives
To review the incidence of renal scarring within 6 months after an episode of APN in children under 36 months and its relationship with imaging studies, clinical settings, and bacteriology.Method
A retrospective study of previously healthy patients aged one to 36 months, admitted for a first episode of APN, with a minimum follow-up of 6 months. Demographic and clinical variables were collected along with bacteriology, renal and bladder ultrasound scan, voiding cystourethrography, DMSA-scintigraphy, and re-infection events.Results
A total of 125 patients were included in the study, of which 60% were male, the large majority (92%) febrile, and due to E. coli (74.6%). There was a history of prenatal ultrasound scan changes in 15.4%. Ultrasound scan found dilation of the urinary tract in 22.1%. Voiding cystourethrography was performed on 70 patients: 54.3% no abnormalities, 12.8% vesicoureteral reflux (VUR) grade i-iii, and 32.9% iv-v grade VUR. Six patients had iv-v grade VUR with a normal ultrasound scan. Adherence to DMSA-scintigraphy at 6 months was only 61% of that indicated. Renal scarring was found in 44.3% of those in which it was performed (60 cases).Conclusions
Almost half (44%) DMSA-scintigraphy in children aged one to 36 months hospitalised for APN show renal scarring at 6 months, which was found to be associated with the re-infection events and the iv-v grade VUR. There was no relationship between scarring and the bacteriology or the elevations of inflammatory biochemical markers. 相似文献
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